Αρχειοθήκη ιστολογίου

Τρίτη 23 Οκτωβρίου 2018

APRT deficiency: the need for early diagnosis

Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive disorder which leads to accumulation of poorly soluble 2,8-dihydroxyadenine in kidneys resulting in nephrolithiasis as well as chronic kidney disease from crystal nephropathy. This report describes a 55-year-old previously fit man who presented with shortness of breath and the investigative pathway that eventually led to a diagnosis of APRT deficiency. Early diagnosis has aided in timely institution of allopurinol, thereby improving his renal function and possibility of weaning off renal replacement therapy. Genetic testing has enabled early identification of other family members at risk and prevention of renal failure by commencing xanthine oxidoreductase (XOR) inhibitors. The issues surrounding kidney donation by a member of this family are also discussed. This case represents the importance of awareness and recognition of the signs and symptoms of this rare condition, complications of which can be easily prevented by early institution of XOR inhibitor therapy.



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Congenital hypoplasia of depressor anguli oris muscle (CHDAOM): an uncommon cause of asymmetric crying facies in childhood

Description 

A 2-year-old developmentally normal girl presented to us with a history of deviation of angle of mouth to right only during crying, persisting from neonatal period. She was born at term by normal vaginal delivery to a primigravida mother with a birth weight of 2.2 kg and smooth perinatal transition. Parents noticed asymmetry of face from neonatal period visible only during crying, which disappeared when she was consoled, without any drooling, regurgitation of feeds or poor sucking. There is no history suggestive of any other neurological or systemic abnormality in index case or in family.

Local examination revealed thinning of lower lip near left angle of mouth on palpation. There was no facial asymmetry while the child was calm (figure 1A), however, on crying there was deviation of the angle of mouth downwards and towards right side (figure 1B). There was no evidence of hypoplasia...



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Brazilian experience with atopy patch tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis

The aim of this study was to evaluate the positivity rates of atopy patch tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis in patients with respiratory diseases such as ast...

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A paediatric case of cutaneous larva migrans acquired in the UK

Clinical and Experimental Dermatology, EarlyView.


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Sturz bei der Gartenarbeit mit asymptomatischer penetrierender Halsverletzung

Laryngo-Rhino-Otol
DOI: 10.1055/a-0756-9714



© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text



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Aerobe Belastung bei Mundatmung verändert die Wahrnehmungsschwelle für H2S nicht

10-1055-a-0753-0367-1.jpg

Laryngo-Rhino-Otol
DOI: 10.1055/a-0753-0367

Hintergrund Während aerober körperlicher Belastung verschlechterte sich in einer früheren Studie bei Nasenatmung die Wahrnehmungsschwelle für H2S. Die Ursache blieb offen. Es soll in dieser Studie geprüft werden, wie sich die Wahrnehmungsschwelle bei alleiniger Mundatmung verändert. Material und Methoden Während einer Ruhephase einer aeroben Belastung und nachfolgender Erholungsphase wurden unterschiedliche H2S-Konzentrationen mittels eines Fluss-Olfaktometers im staircase Verfahren inspirationssynchron intranasal appliziert. Die fehlende Nasenatmung wurde online und offline objektiviert. Es wurden die Reaktionszeiten bestimmt. Parallel sind verschiedene Vitalparameter gemessen worden. Ergebnisse Die passiven Wahrnehmungsschwellen zwischen den Belastungs- und der Erholungsphasen differierten nicht. In der Ruhephase war die H2S Schwelle am höchsten. Die Reaktionszeiten waren in den drei Versuchsphasen nicht different. Schlussfolgerung Eine etwa halbstündige aerobe Belastung veränderte die passive Riechschwelle für H2S bei Mundatmung im Vergleich zur nachfolgenden Erholungsphase nicht. Die hohe Riechschwelle in der Ruhephase wird mit anfänglichen Anpassungsschwierigkeiten an die Versuchsbedingungen erklärt.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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



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Dear Dr. Dermatoethicist: Erection Ethics



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Surgical Pearl: Reverse Beveling to Improve Wound Edge Apposition



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The Cost of an Itch: A Nationally Representative Retrospective Cohort Study of Pruritus-Associated Healthcare Expenditure in the United States



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Association between atopic dermatitis, depression and suicidal ideation: A systematic review and meta-analysis

This meta-analysis found that atopic dermatitis was associated with increased odds of clinical depression, depressive symptoms, anti-depressant use, suicidality and parental depression. Presence of depression and suicidality should be incorporated into clinical decision-making of atopic dermatitis patients.

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Treatment of primary non-metastatic melanoma at high-volume academic facilities is associated with improved long-term patient survival

Volume-outcome relationships in cancer care have motivated calls for regionalization of care. We demonstrate that high-volume academic facilities achieve improved outcomes for melanoma patients. Increased utilization of those aspects of these centers that increase patient survival, whether by regionalization of care or dissemination of these practices, may improve patient outcomes.

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High-Throughput Sequencing of the T-cell receptor beta chain gene distinguishes two subgroups of cutaneous T-cell lymphoma



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Nonproteinogenic deep mutational scanning of linear and cyclic peptides [Chemistry]

High-resolution structure–activity analysis of polypeptides requires amino acid structures that are not present in the universal genetic code. Examination of peptide and protein interactions with this resolution has been limited by the need to individually synthesize and test peptides containing nonproteinogenic amino acids. We describe a method to scan entire...

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Protein shape modulates crowding effects [Chemistry]

Protein−protein interactions are usually studied in dilute buffered solutions with macromolecule concentrations of <10 g/L. In cells, however, the macromolecule concentration can exceed 300 g/L, resulting in nonspecific interactions between macromolecules. These interactions can be divided into hard-core steric repulsions and "soft" chemical interactions. Here, we test a hypothesis from...

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Bottom trawl fishing footprints on the world’s continental shelves [Sustainability Science]

Bottom trawlers land around 19 million tons of fish and invertebrates annually, almost one-quarter of wild marine landings. The extent of bottom trawling footprint (seabed area trawled at least once in a specified region and time period) is often contested but poorly described. We quantify footprints using high-resolution satellite vessel...

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Long noncoding RNA GM12371 acts as a transcriptional regulator of synapse function [Neuroscience]

Despite the growing evidence suggesting that long noncoding RNAs (lncRNAs) are critical regulators of several biological processes, their functions in the nervous system remain elusive. We have identified an lncRNA, GM12371, in hippocampal neurons that is enriched in the nucleus and necessary for synaptic communication, synapse density, synapse morphology, and...

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Randomly distributed embedding making short-term high-dimensional data predictable [Applied Mathematics]

Future state prediction for nonlinear dynamical systems is a challenging task, particularly when only a few time series samples for high-dimensional variables are available from real-world systems. In this work, we propose a model-free framework, named randomly distributed embedding (RDE), to achieve accurate future state prediction based on short-term high-dimensional...

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Interplay between coronavirus, a cytoplasmic RNA virus, and nonsense-mediated mRNA decay pathway [Microbiology]

Coronaviruses (CoVs), including severe acute respiratory syndrome CoV and Middle East respiratory syndrome CoV, are enveloped RNA viruses that carry a large positive-sense single-stranded RNA genome and cause a variety of diseases in humans and domestic animals. Very little is known about the host pathways that regulate the stability of...

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Faults and associated karst collapse suggest conduits for fluid flow that influence hydraulic fracturing-induced seismicity [Environmental Sciences]

During December 2011, a swarm of moderate-magnitude earthquakes was induced by hydraulic fracturing (HF) near Cardston, Alberta. Despite seismological associations linking these two processes, the hydrological and tectonic mechanisms involved remain unclear. In this study, we interpret a 3D reflection-seismic survey to delve into the geological factors related to these...

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Cbln2 and Cbln4 are expressed in distinct medial habenula-interpeduncular projections and contribute to different behavioral outputs [Neuroscience]

Cerebellins are important neurexin ligands that remain incompletely understood. Two critical questions in particular remain unanswered: do different cerebellins perform distinct functions, and do these functions act in the initial establishment of synapses or in rendering nascent synapses capable of normal synaptic transmission? Here we show that in mice, Cbln2...

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Distinct facial expressions represent pain and pleasure across cultures [Psychological and Cognitive Sciences]

Real-world studies show that the facial expressions produced during pain and orgasm—two different and intense affective experiences—are virtually indistinguishable. However, this finding is counterintuitive, because facial expressions are widely considered to be a powerful tool for social interaction. Consequently, debate continues as to whether the facial expressions of these extreme...

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Histone methylation regulator PTIP is required to maintain normal and leukemic bone marrow niches [Medical Sciences]

The bone is essential for locomotion, calcium storage, and harboring the hematopoietic stem cells (HSCs) that supply the body with mature blood cells throughout life. HSCs reside at the interface of the bone and bone marrow (BM), where active bone remodeling takes place. Although the cellular components of the BM...

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The structural basis for cancer drug interactions with the catalytic and allosteric sites of SAMHD1 [Biochemistry]

SAMHD1 is a deoxynucleoside triphosphate triphosphohydrolase (dNTPase) that depletes cellular dNTPs in noncycling cells to promote genome stability and to inhibit retroviral and herpes viral replication. In addition to being substrates, cellular nucleotides also allosterically regulate SAMHD1 activity. Recently, it was shown that high expression levels of SAMHD1 are also...

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Activity-dependent bulk endocytosis proteome reveals a key presynaptic role for the monomeric GTPase Rab11 [Neuroscience]

Activity-dependent bulk endocytosis (ADBE) is the dominant mode of synaptic vesicle endocytosis during high-frequency stimulation, suggesting it should play key roles in neurotransmission during periods of intense neuronal activity. However, efforts in elucidating the physiological role of ADBE have been hampered by the lack of identified molecules which are unique...

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Molecular mechanism of activation of the immunoregulatory amidase NAAA [Biochemistry]

Palmitoylethanolamide is a bioactive lipid that strongly alleviates pain and inflammation in animal models and in humans. Its signaling activity is terminated through degradation by N-acylethanolamine acid amidase (NAAA), a cysteine hydrolase expressed at high levels in immune cells. Pharmacological inhibitors of NAAA activity exert profound analgesic and antiinflammatory effects...

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DSCAM promotes self-avoidance in the developing mouse retina by masking the functions of cadherin superfamily members [Neuroscience]

During neural development, self-avoidance ensures that a neuron's processes arborize to evenly fill a particular spatial domain. At the individual cell level, self-avoidance is promoted by genes encoding cell-surface molecules capable of generating thousands of diverse isoforms, such as Dscam1 (Down syndrome cell adhesion molecule 1) in Drosophila. Isoform choice...

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Meiosis-specific recombinase Dmc1 is a potent inhibitor of the Srs2 antirecombinase [Biochemistry]

Cross-over recombination products are a hallmark of meiosis because they are necessary for accurate chromosome segregation and they also allow for increased genetic diversity during sexual reproduction. However, cross-overs can also cause gross chromosomal rearrangements and are therefore normally down-regulated during mitotic growth. The mechanisms that enhance cross-over product formation...

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Translating biased signaling in the ghrelin receptor system into differential in vivo functions [Pharmacology]

Biased signaling has been suggested as a means of selectively modulating a limited fraction of the signaling pathways for G-protein–coupled receptor family members. Hence, biased ligands may allow modulation of only the desired physiological functions and not elicit undesired effects associated with pharmacological treatments. The ghrelin receptor is a highly...

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Entropic contribution to enhanced thermal stability in the thermostable P450 CYP119 [Biophysics and Computational Biology]

The enhanced thermostability of thermophilic proteins with respect to their mesophilic counterparts is often attributed to the enthalpy effect, arising from strong interactions between protein residues. Intuitively, these strong interresidue interactions will rigidify the biomolecules. However, the present work utilizing neutron scattering and solution NMR spectroscopy measurements demonstrates a contrary...

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iNOS promotes CD24+CD133+ liver cancer stem cell phenotype through a TACE/ADAM17-dependent Notch signaling pathway [Medical Sciences]

The inducible nitric oxide synthase (iNOS) is associated with more aggressive solid tumors, including hepatocellular carcinoma (HCC). Notch signaling in cancer stem cells promotes cancer progression and requires Notch cleavage by ADAM (a disintegrin and metalloprotease) proteases. We hypothesized that iNOS/NO promotes Notch1 activation through TACE/ADAM17 activation in liver cancer...

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Swi5-Sfr1 stimulates Rad51 recombinase filament assembly by modulating Rad51 dissociation [Biophysics and Computational Biology]

Eukaryotic Rad51 protein is essential for homologous-recombination repair of DNA double-strand breaks. Rad51 recombinases first assemble onto single-stranded DNA to form a nucleoprotein filament, required for function in homology pairing and strand exchange. This filament assembly is the first regulation step in homologous recombination. Rad51 nucleation is kinetically slow, and...

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MmpL8MAB controls Mycobacterium abscessus virulence and production of a previously unknown glycolipid family [Microbiology]

Mycobacterium abscessus is a peculiar rapid-growing Mycobacterium (RGM) capable of surviving within eukaryotic cells thanks to an arsenal of virulence genes also found in slow-growing mycobacteria (SGM), such as Mycobacterium tuberculosis. A screen based on the intracellular survival in amoebae and macrophages (MΦ) of an M. abscessus transposon mutant library...

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Perspectives on Dexmedetomidine Use for Neurosurgical Patients

The α2-adrenergic receptor agonist dexmedetomidine has sedative, anxiolytic, analgesic, and sympatholytic effects. The potential advantages of neuroprotection, minimal impact on neuronal function, stable hemodynamics, opioid and anesthesia sparing effects, and minimal respiratory depression during awake procedures render it an effective anesthetic adjuvant in various neurosurgical settings. However, both the benefits and drawbacks of the use dexmedetomidine in neuroanesthesia should be considered. This narrative review will summarize the applications of dexmedetomidine in various neurosurgical settings, highlighting evidence regarding both its common and controversial uses. Supported by Beijing Municipal Administration of Hospitals' Youth Program (QML20160503) and by the National Natural Science Foundation of China (Grant No.1701038). The authors have no funding or conflicts of interest to disclose. Address correspondence to: Adrian W. Gelb, MB, ChB, Department of Anesthesia & Perioperative Care, University of California San Francisco, 500 Parnassus Ave., MUE 408, San Francisco, CA 94143 (e-mail: adrian.gelb@ucsf.edu). Received March 27, 2018 Accepted September 6, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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How To Prevent the Flu | Tips to Keep Your Family Healthy

It's that time of the year. Flu season is upon us! We are already seeing influenza cases in some St. Louis clinics. Flu season comes around regularly each fall. Unfortunately, some years it is worse than the others. The Centers for Disease Control and Prevention (CDC) reports that each year about 20,000 children younger than five years of age are hospitalized from flu complications like pneumonia.

I get a lot of questions every year about the flu vaccine. Last year, two Air Force physicians lost their four-year-old son to complications of the flu on Christmas Eve. The child was scheduled to receive a flu shot but unfortunately, ended up with the flu before his appointment. He was previously healthy and was one of the 183 children who died from flu last year. The strain that struck the U.S. last year was considered severe and peaked in early February.

Influenza (flu) is an infection of the nose, throat, and lungs caused by the influenza virus.  Most influenza cases are seen from October through May, though it can occur anytime during the year. The virus spreads mainly by droplets made when infected people sneeze, cough or talk. Droplets that enter the mouth or nose of a healthy person, can cause the infection. You can also get the infection by touching a contaminated surface and then touching your own mouth or nose.

How do you know if your child is coming down with the flu? Oh, You'll Know. The sniffles set in and the throat becomes sore. Your child gets body aches and headaches and their temperature starts rising. Your child can also experience nausea, vomiting, and/or diarrhea.

I look at tackling flu as three main areas of work- prevention, supportive care (rest, fluids and fever management) and recognizing complications promptly.

Preventative Measures

The best preventative measures include receiving vaccinations and practicing healthy habits to prevent the spread of germs.

About The Flu Vaccine

The Flu vaccine is recommended every year. For the 2018-19 flu season, the Advisory Committee on Immunization Practices (ACIP) recommends an annual influenza vaccination for everyone six months and older with any licensed, age-appropriate flu vaccine (IIV, RIV4 or LAIV4) with no preference expressed for anyone vaccine over another.

The flu shot is an inactivated vaccine (containing the dead virus) that is given with a needle, normally in the arm. The 2018-19 seasonal flu vaccine will protect against the three influenza viruses that research indicates will be most common during the upcoming season, including the H1N1 Influenza A and two other influenza virus strains – H3N2 Influenza A virus and influenza B virus. The American Academy of Pediatrics recommends the injectable form of the vaccine as a first choice but supports the use of nasal spray or live attenuated influenza vaccine for the 2018-19 flu season. The nasal spray vaccine may be used for children who would not otherwise receive the flu shot, as long as they are two years of age or older and healthy without an underlying medical condition.

It's important that young children, children with chronic illnesses, and caregivers of such children get vaccinated. Since babies less than six months of age are too young to receive the vaccine, their caregivers should get vaccinated to help prevent infection in these babies. Pregnant women should receive the vaccine because some have studies shown that vaccines provide some protection for the baby inside the mother and for a few months after birth. Getting the vaccine as soon as it is available provides protection if the flu season comes early.

The Importance of Sleep After Receiving a Vaccination

In an interesting study published a few years ago, people who slept fewer than six hours on average per night were far less likely to mount antibody responses to vaccination and were far more likely to be unprotected by the vaccine than people who slept more than seven hours on average. Now, that's another good reason to maintain a healthy sleep routine! Not only does it keep your immune system healthy but also helps mount a good immune response to vaccines.

Preventing the Spread of Germs

Encourage your child to wash his hands several times during the day, especially after using the bathroom, playing outside, visiting crowded places like the mall, and before eating. Washing hands with soap and water and scrubbing well for about 20 seconds will help protect against many germs. An alcohol-based hand sanitizer is a good option if soap and water are unavailable.

It is best to avoid people who are sick and to keep the sick person in a separate room, away from others in the household. Teach children to minimize the spread of the virus by coughing into their elbow or the sleeve. Promptly throw away the tissues and disposable items used by the sick person. Clean surfaces like bathroom and kitchen counters, bedside tables, etc. with a household disinfectant. Clean and wash linens and eating utensils used by the sick person before reusing. Teach your kids to avoid touching the eyes, nose, and mouth since germs spread this way.

Providing Supportive Care

The flu vaccine offers variable protection: in spite of vaccination, you can still get the flu by those strains of the flu virus that was not included in the vaccine. If your child has the flu, keep your them home from school or daycare and give them plenty of rest, fluids, and fever medications such as acetaminophen. Many schools and daycares require a child be fever-free (without a fever-reducing medicine) for at least 24 hours before they can return.  Since influenza is a viral infection, antibiotics are not necessary for uncomplicated influenza cases.

Recognizing the Complications

This is one of the most important pieces of taking care of your sick child. Common complications of the flu include dehydration and bacterial superinfections such as ear infections and pneumonia. Seek immediate medical attention if your child has any of these symptoms – trouble breathing, persistent vomiting and dehydration, acts lethargic (not waking up easily or interacting normally), irritability (especially important in infants), has flu with other chronic illnesses (such as asthma, diabetes, heart, or lung disease), or any other signs of worsening. Trust your parental instincts!

When the flu strikes, it's important to give the body enough rest and time to heal. Assist the immune system in fighting off the infection by adhering to the simple tips mentioned above. It's important to keep your child's doctor informed about how your child is feeling. Also, make sure that you, as a parent, relax and take good care of yourself. Sleepless nights staying up with your sick kid, cleaning, and tending to your little ones can be exhausting. For more information about influenza, visit www.cdc.gov/flu or www.flu.gov or https://www.stlouischildrens.org/conditions-treatments/flu.

The post How To Prevent the Flu | Tips to Keep Your Family Healthy appeared first on ChildrensMD.



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Androgen-dependent immune modulation in parasitic infection

Abstract

Parasitic infections modulate the immune system of the host, resulting in either immune tolerance or the induction of pro-inflammatory defense mechanisms against the pathogen. In both cases, sex hormones are involved in the regulation of the immune response, as they are present in the systemic circulation and can act on a wide variety of cell types, including immune cells. Men and women have a different milieu of sex hormones, and these hormones play a role in determining immune responses to parasitic infections. Men, who have higher plasma levels of androgens than women, are generally more susceptible to parasitic infections. Many immune cells express the androgen receptor (AR), and the immunologic functions of these cells can be modulated by androgens. In this review, we will highlight the immune cell types that are sensitive to male steroid hormones and describe their roles during three parasitic diseases, amebiasis, leishmaniasis, and helminthiasis.



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Methodology to Evaluate Dripper Sensitivity to Clogging due to Solid Particles: An Assessment

Emitter clogging is a major problem in microirrigation systems, which may result from the isolated or combined effects of physical, chemical, and biological agents. Clogging caused by suspended solid particles is the most common plugging form of emitters. Water quality and emitter geometry are key aspects in clogging processes. Any suitable test procedure to assess the sensitivity of drippers to clogging should take into account the predominant factors that influence clogging and must reproduce the field conditions. This research set out to assess the performance and suitability of a laboratory clogging test procedure in order to validate a methodology and to provide scientific results that may support the standardization of a clogging test method. The evaluated methodology has been used by the IRSTEA laboratory since 1974 (Platform of Research and experiment on Science and Technology for Irrigation - PReSTI, formerly LERMI) and its contents are currently being discussed by the ISO TC23/SC18 committee. The aim is to define a standardized testing protocol to evaluate the sensitivity of emitters to clogging due to solid particles. Replications analyzing the clogging resistance of four models of emitting pipes were carried out in a laboratory. The clogging test procedure enabled an accurate assessment of the combinations of concentration and size of particles that caused clogging in each model of dripper. However, a significant variability in degree of clogging was identified when the results of replications for each model of dripper were compared. Several requirements, concerns, and improvements related to the clogging test protocol were discussed.

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Using World RePORT to Measure How Much HPV-related Research is Being Funded Throughout the World

World RePORT, an open-access and interactive database of international research projects, grants, and collaborations dedicated to improving health, compiles data submitted by the U.S. National Institutes of Health (NIH), the UK's medical research council (MRC), the European Commission (EC), the Canadian Institutes of Health Research (CIHR), the Bill and Melinda Gates Foundation, and the Wellcome Trust. We use this database to determine where research on HPV is taking place.



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Halloween Safety Tips for Your Family

Halloween is a fun and exciting time for the whole family. As ghouls and goblins fill the night, trick-or-treaters fill the streets. However, it's important to keep your family's safety in mind as you travel from house to house on Halloween night. Dr. Jamie Kondis offers the best Halloween safety tips for your family.

The post Halloween Safety Tips for Your Family appeared first on ChildrensMD.



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Lésions auto-provoquées dans un contexte d’hidradénite suppurée : un cas de pathomimicrie

Publication date: Available online 22 October 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Marzouki-Zerouali, A. Schoeffler, A.-L. Liegeon, P. Le Vaou, F. Truchetet

Résumé
Introduction

Les troubles factices constituent un domaine complexe de la pathologie. Si le diagnostic est souvent évoqué, il est difficile à poser et la thérapeutique est délicate. La pathomimie cutanée est une expression somatique cutanée d'un désordre psychiatrique souvent grave, provoquée dans un état de conscience claire par le malade lui-même sur son revêtement cutanéomuqueux mais dont la motivation est inconsciente, sans recherche de bénéfices secondaires ; elle se distingue donc de la simulation. Les pathomimicries représentent une entité particulière proche de la pathomimie : il s'agit de l'induction de poussées d'une maladie connue déclenchées par l'exposition volontaire à l'agent responsable. Nous rapportons un cas de pathomimicrie dans un contexte d'hidradénite suppurée.

Observation

Une adolescente ayant pour antécédents principaux une obésité de grade 2 et un épisode d'abcès pubien était vue en consultation pour des lésions axillaires. Elle arrivait dans un état d'incurie, méfiante, agressive et refusait de se déshabiller. Après mise en confiance, l'examen clinique montrait de larges ulcérations à distance des plis sur les zones axillaires, à contours géographiques et à fond propre et bourgeonnant, associées à des lésions typiques d'hidradénite suppurée de grade 2 (Hurley), avec des pertuis purulents et des cicatrices en corde des plis inguinaux. Une hospitalisation était proposée et l'évolution était favorable sous antibiothérapie par doxycycline et soins locaux par pansements alginates et hydrocellulaires. L'avis psychiatrique concluait à une faille narcissique ancienne à type de dysmorphophobie probablement réactionnelle à un harcèlement scolaire récurrent depuis l'enfance. Sous couvert d'une relation de confiance difficilement établie, la patiente reconnaissait la manipulation de ses lésions. Devant les données anamnestiques, cliniques, la négativité du bilan paraclinique, le diagnostic de pathomimicrie était retenu.

Discussion

Plusieurs cas de pathomimicrie de dermatoses (auto-entretien d'un ulcère de cause connue, contact avec un allergène identifié dans l'eczéma ou reprise d'un médicament incriminé dans une toxidermie) ou de maladies systémiques (injections d'insuline chez un patient diabétique) ont été rapportés. Ce cas est le premier décrit, à notre connaissance, de pathomimicrie dans le cadre d'une hidradénite suppurée. Sur le plan thérapeutique, le suivi doit être multidisciplinaire. Il faut éviter l'affrontement avec le patient et ne pas forcer son aveu, ce qui risquerait d'induire une décompensation psychiatrique grave. Une attitude rassurante permet le recours au psychiatre une fois la confiance durablement établie. Le dermatologue a donc une place primordiale dans la prise en charge de ces patients.

Summary
Background

Factitious disorders constitute a complex pathology for the dermatologist. Although a diagnosis is often indicated, it is difficult to confirm and treatment is complicated. Dermatitis artefacta is the somatic expression of an often serious psychiatric disorder consciously created by patients on their own cutaneous-mucosal surfaces but the motivation is unconscious and no secondary benefits are sought (in contrast to simulation). Pathomimicry represent a specific entity: the provocation of outbreaks of a known disease, triggered by voluntary exposure to a causative agent. Herein we report on a case of pathomimicry in a context of hidradenitis suppurativa.

Patients and methods

A teenage girl whose main previous medical history consisted of grade-2 obesity and an episode of pubic abscess was seen at our clinic for axillary lesions. She presented in a state of negligence, was suspicious and aggressive, and refused to undress. After gaining her trust, clinical examination revealed prominent ulcerations (each with a granulated base) at a distance from the folds in the axillary areas, as well as typical hidradenitis lesions of Hurley Grade 2 with purulent openings and rope-like scars from the inguinal folds. Hospitalization was recommended and a positive outcome was achieved under antibiotic therapy with doxycycline, topical alginate and hydrocellular dressings. A psychiatric evaluation concluded that the patient was presenting dysmorphophobic narcissistic weakness, probably in reaction to recurrent harassment at school since childhood. Once she developed trust with us, which was difficult to establish, the patient admitted to having caused the lesions herself. Given the history and clinical data, as well as the negative laboratory tests, a diagnosis of pathomimicry was made.

Discussion

Several cases of dermatological pathomimicry (sustainment by the patient of an ulcer with a known cause, contact with an allergen found in eczema, or renewed use of a medication implicated in toxiderma) or systemic disease (insulin injection in a diabetic patient) have been reported. To the best of our knowledge, this is the first description of pathomimicry associated with hidradenitis suppurativa. Regarding therapy, aftercare should be multidisciplinary. Confessions should not be forced and confrontations, which risk serious psychiatric collapse, should be avoided. A reassuring attitude enables psychiatry to be applied once trust has been sustainably established, hence the crucial role of the dermatologist.



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Sinking Skin Flap Syndrome: Phenomenon of Neurological Deterioration after Decompressive Craniectomy

Sinking skin flap syndrome is rare phenomenon that occurs in patients with large craniectomies. Alteration in normal anatomy and pathophysiology can result in wide variety of symptoms including altered mental status, hemodynamic instability, and dysautonomias. Management is largely conservative. We here present a case of a patient with large craniectomy who was admitted to our hospital with pneumonia. Later on, he developed worsening mental status and CT head revealed sinking skin flap with significant midline shift. This is a very rare case of neurological deterioration after craniectomies, commonly known as sinking skin flap syndrome. To our knowledge, only few cases have been reported so far.

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DNA repair in trinucleotide repeat ataxias

Yau, WY; O'Connor, E; Sullivan, R; Akijian, L; Wood, NW; (2018) DNA repair in trinucleotide repeat ataxias. The FEBS Journal , 285 (19) pp. 3669-3682. 10.1111/febs.14644 . Green open access

https://ift.tt/2R9rthQ

EU extraterritorial obligations with respect to trade with occupied territories: Reflections after the case of Front Polisario before EU courts

Ryngaert, C.; Fransen, R.; (2018) EU extraterritorial obligations with respect to trade with occupied territories: Reflections after the case of Front Polisario before EU courts. Europe and the World: A law review , 2 (7) pp. 1-20. 10.14324/111.444.ewlj.2018.07 . Green open access

https://ift.tt/2q4FRfG

Body mass index is negatively associated with telomere length: a collaborative cross-sectional meta-analysis of 87 observational studies

Gielen, M; Hageman, GJ; Antoniou, EE; Nordfjall, K; Mangino, M; Balasubramanyam, M; de Meyer, T; ... Zeegers, MP; + view all Gielen, M; Hageman, GJ; Antoniou, EE; Nordfjall, K; Mangino, M; Balasubramanyam, M; de Meyer, T; Hendricks, AE; Giltay, EJ; Hunt, SC; Nettleton, JA; Salpea, KD; Diaz, VA; Farzaneh-Far, R; Atzmon, G; Harris, SE; Hou, L; Gilley, D; Hovatta, I; Kark, JD; Nassar, H; Kurz, DJ; Mather, KA; Willeit, P; Zheng, Y-L; Pavanello, S; Demerath, EW; Rode, L; Bunout, D; Steptoe, A; Boardman, L; Marti, A; Needham, B; Zheng, W; Ramsey-Goldman, R; Pellatt, AJ; Kaprio, J; Hofmann, JN; Gieger, C; Paolisso, G; Hjelmborg, JBH; Mirabello, L; Seeman, T; Wong, J; van der Harst, P; Broer, L; Kronenberg, F; Kollerits, B; Strandberg, T; Eisenberg, DTA; Duggan, C; Verhoeven, JE; Schaakxs, R; Zannolli, R; dos Reis, RMR; Charchar, FJ; Tomaszewski, M; Mons, U; Demuth, I; Molli, AEI; Cheng, G; Krasnienkov, D; D'Antono, B; Kasielski, M; McDonnell, BJ; Ebstein, RP; Sundquist, K; Pare, G; Chong, M; Zeegers, MP; - view fewer (2018) Body mass index is negatively associated with telomere length: a collaborative cross-sectional meta-analysis of 87 observational studies. The American Journal of Clinical Nutrition , 108 (3) pp. 453-475. 10.1093/ajcn/nqy107 .

https://ift.tt/2R4Af0m

Extraterritoriality and public procurement regulation in the context of global supply chains’ governance

Corvaglia, M.A.; Li, K.; (2018) Extraterritoriality and public procurement regulation in the context of global supply chains' governance. Europe and the World: A law review , 2 (6) pp. 1-16. 10.14324/111.444.ewlj.2018.06 . Green open access

https://ift.tt/2q6vTKJ

Tailoring cells for clinical needs: Meeting report from the Advanced Therapy in Healthcare symposium (October 28–29 2017, Doha, Qatar)

Deola, S; Guerrouahen, BS; Sidahmed, H; Al-Mohannadi, A; Elnaggar, M; Elsadig, R; Abdelalim, EM; ... Cugno, C; + view all Deola, S; Guerrouahen, BS; Sidahmed, H; Al-Mohannadi, A; Elnaggar, M; Elsadig, R; Abdelalim, EM; Petrovski, G; Gadina, M; Thrasher, A; Wels, WS; Hunger, SP; Wang, E; Marincola, FM; ATH Consortium, ; Maccalli, C; Cugno, C; - view fewer (2018) Tailoring cells for clinical needs: Meeting report from the Advanced Therapy in Healthcare symposium (October 28–29 2017, Doha, Qatar). Journal of Translational Medicine , 16 p. 276. 10.1186/s12967-018-1652-y . Green open access

https://ift.tt/2R6oS8j

Mapping inclusion of a child with autism in a mainstream kindergarten: how can we move towards more inclusive practices?

Olsen, K; Croydon, A; Olson, M; Jacobsen, KH; Pellicano, E; (2018) Mapping inclusion of a child with autism in a mainstream kindergarten: how can we move towards more inclusive practices? International Journal of Inclusive Education 10.1080/13603116.2018.1441914 . (In press).

https://ift.tt/2q4lm2J

Conversion therapies and access to transition related healthcare in transgender people: a narrative systematic review

Wright, T; Candy, B; King, M; (2018) Conversion therapies and access to transition related healthcare in transgender people: a narrative systematic review. BMJ Open (In press).

https://ift.tt/2R4zLr4

Neurological effects of GBA mutations

Mullin, S; Hughes, D; Mehta, A; Schapira, AHV; (2018) Neurological effects of GBA mutations. European Journal of Neurology 10.1111/ene.13837 . (In press).

https://ift.tt/2q6ybcI

Retinopathy Associated with Biallelic Mutations in PYGM (McArdle Disease)

Mahroo, OA; Khan, KN; Wright, G; Ockrim, Z; Scalco, RS; Robson, AG; Tufail, A; ... Webster, AR; + view all Mahroo, OA; Khan, KN; Wright, G; Ockrim, Z; Scalco, RS; Robson, AG; Tufail, A; Michaelides, M; Quinlivan, R; Webster, AR; - view fewer (2018) Retinopathy Associated with Biallelic Mutations in PYGM (McArdle Disease). Ophthalmology 10.1016/j.ophtha.2018.09.013 . (In press). Green open access

https://ift.tt/2R8zm71

Theory and practice of state intervention: Italy, South Korea and stages of economic development

Cardinale, R; (2018) Theory and practice of state intervention: Italy, South Korea and stages of economic development. Structural Change and Economic Dynamics 10.1016/j.strueco.2018.09.004 . (In press).

https://ift.tt/2q5Vofl

Multi-component frailty assessment tools for older people with functional mental illness: A systematic review

Sutton, JL; Gould, RL; Coulson, MC; Ward, EV; Butler, AM; Smith, M; Lavelle, G; ... Howard, RJ; + view all Sutton, JL; Gould, RL; Coulson, MC; Ward, EV; Butler, AM; Smith, M; Lavelle, G; Rosa, A; Langridge, M; Howard, RJ; - view fewer (2019) Multi-component frailty assessment tools for older people with functional mental illness: A systematic review. Journal of the American Geriatrics Society (In press).

https://ift.tt/2R7fn8M

GaSb and GaSb/AlSb Superlattice Buffer Layers for High-Quality Photodiodes Grown on Commercial GaAs and Si Substrates

Gutierrez, M; Lloret, F; Jurczak, P; Wu, J; Liu, HY; Araujo, D; (2018) GaSb and GaSb/AlSb Superlattice Buffer Layers for High-Quality Photodiodes Grown on Commercial GaAs and Si Substrates. Journal of Electronic Materials , 47 (9) pp. 5083-5086. 10.1007/s11664-018-6388-1 .

https://ift.tt/2q6Ps5C

The extraterritorial human rights obligations of the EU in its external trade and investment policies

Berkes, A.; (2018) The extraterritorial human rights obligations of the EU in its external trade and investment policies. Europe and the World:A law review , 2 (5) pp. 1-21. 10.14324/111.444.ewlj.2018.05. . Green open access

https://ift.tt/2R7WQt2

Undersampled Pulse Width Modulation for Optical Camera Communications

Luo, P; Jiang, T; Haigh, PA; Ghassemlooya, Z; Zvanovec, S; (2018) Undersampled Pulse Width Modulation for Optical Camera Communications. In: Proceedings of the 2018 IEEE International Conference on Communications Workshops (ICC Workshops). IEEE: Kansas City, MO, USA. Green open access

https://ift.tt/2q8ysvU

Territorial extension and case law of the Court of Justice: Good administration and access to justice in procurement as a case study

Sanchez-Graells, A.; (2018) Territorial extension and case law of the Court of Justice: Good administration and access to justice in procurement as a case study. Europe and the World:A law review , 2 (4) pp. 1-18. 10.14324/111.444.ewlj.2018.04 . Green open access

https://ift.tt/2R7fd1a

Increase in Extracellular Hydration Status After Initiating Peritoneal Dialysis Electively

Panorchan, K; Davenport, A; (2017) Increase in Extracellular Hydration Status After Initiating Peritoneal Dialysis Electively. Peritoneal Dialysis International , 37 (3) pp. 338-340. 10.3747/pdi.2016.00213 . Green open access

https://ift.tt/2q4Okzs

Class size, grouping practices and classroom management

Blatchford, P; Russell, A; (2018) Class size, grouping practices and classroom management. International Journal of Educational Research 10.1016/j.ijer.2018.09.004 . (In press).

https://ift.tt/2R9wqXH

Demonstration of reduced complexity multi-band CAP modulation using xia-pulses in visible light communications

Haigh, PA; Darwazeh, I; (2018) Demonstration of reduced complexity multi-band CAP modulation using xia-pulses in visible light communications. In: Proceedings of the 2018 Optical Fiber Communication Conference. (pp. M2K.5-M2K.5). OSA Publishing: San Diego, CA, USA.

https://ift.tt/2q8yhAK

Extraterritoriality of EU law and human rights after Lisbon: The case of trade and public procurement

Velluti, S.; Tzevelekos, V.; (2018) Extraterritoriality of EU law and human rights after Lisbon: The case of trade and public procurement. Europe and the World: A law review , 2 (1) pp. 1-9. 10.14324/111.444.ewlj.2018.02. . Green open access

https://ift.tt/2R9w6br

Research and practice in history education in England: a perspective from London

Chapman, AJ; (2017) Research and practice in history education in England: a perspective from London. The Journal of Social Studies Education , 6 pp. 13-41.

https://ift.tt/2q8ybsS

Adjuvant De-Escalated Radiation + Adjuvant Nivolumab for Intermediate-High Risk P16+ Oropharynx Cancer

Conditions:   Carcinoma, Squamous Cell of Head and Neck;   Oropharynx Squamous Cell Carcinoma
Interventions:   Drug: Nivolumab Injection;   Radiation: Radiotherapy (RT)
Sponsors:   Robert Ferris;   Bristol-Myers Squibb
Not yet recruiting

https://ift.tt/2z0kzUn

Hyaluronic acid gel based on CPM® technology with and without lidocaine: Is there a difference?

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2D1BZ7P

Effects of isotretinoin on the hair cycle

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2PU7oMl

Autologous pure platelet‐rich plasma injections for facial skin rejuvenation: Biometric instrumental evaluations and patient‐reported outcomes to support antiaging effects

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2D2qJYX

Histologic pattern of invasion and epithelial-mesenchymal phenotype predict prognosis in squamous carcinoma of the head and neck

Publication date: December 2018

Source: Oral Oncology, Volume 87

Author(s): Gregory T. Wolf, William Winter, Emily Bellile, Ariane Nguyen, C.R. Donnelly, Jonathan B. McHugh, Dafydd Thomas, Lahin Amlani, Laura Rozek, Yu L. Lei, the Head and Neck SPORE Program

Abstract
Introduction

Disruption of E-cadherin function and increased expression of vimentin and the transcriptional oncogene, SOX2, are thought to characterize epithelial to mesenchymal transition (EMT) in HNSCC that contributes to invasive and metastatic behavior. To determine if such changes relate to prognosis or host immune response, expression of these markers and correlations with clinical characteristics, histologic worst pattern of invasion (WPOI) and tumor infiltrating lymphocytes (TIL) and survival were assessed.

Methods

Immunohistologic expression of markers was determined in tissue microarrays from 274 previously untreated HNSCC patients. Expression was correlated with levels of TILs in microcores and WPOI in biopsy specimens. Correlations were assessed by Kruskal-Wallis testing and Spearman correlation coefficients where appropriate. Overall and relapse-free survival were analyzed with Cox proportional hazards models. Median follow up was 60.0 months.

Results

Loss of E-cadherin expression was significantly associated with low or absent SOX2 expression (R = 0.433, p < 0.0001). SOX2 expression and low grade WPOI were significantly associated with favorable overall (OS) and relapse free (RFS) survival in multivariable analysis. E-cadherin expression did not correlate with TILs, however WPOI score correlated indirectly with CD4, CD8, and FoxP3 levels. When grouped by primary treatment, lower grades (1, 2) of WPOI predicted improved RFS and OS in patients treated with primary surgery but not for patients treated with chemoradiation.

Conclusion

The findings suggest that SOX2 expression and WPOI are significant prognostic factors and that WPOI correlates with decreased T cell infiltration. The combination of markers and TILs might be useful in selecting patients for primary surgery.



https://ift.tt/2PQknyu

Treatment outcomes of squamous cell carcinoma of the oral cavity in young adults

Publication date: December 2018

Source: Oral Oncology, Volume 87

Author(s): Mauricio E. Gamez, Ryan Kraus, Michael L. Hinni, Eric J. Moore, Daniel J. Ma, Stephen J. Ko, Jean Claude M. Rwigema, Lisa A. McGee, Michele Y. Halyard, Matthew R. Buras, Robert L. Foote, Samir H. Patel

Abstract
Objectives

The natural history of squamous cell carcinoma (SCC) of the oral cavity (OC) in young adults is unknown. We sought to provide an updated report on treatment outcomes of patients with OC SCC who were 40 years or younger.

Materials and methods

We performed a retrospective analysis of 124 consecutive patients with primary OC SCC treated at Mayo Clinic (1980–2014). Patient and tumor characteristics and treatment approach were abstracted from patient charts.

Results

Median patient age was 35 years (range, 19–40 years). The most common primary site was oral tongue (107 patients; 86.3%). Most patients (101; 81.5%) underwent wide local excision. Surgery alone was curative in 77 patients (62.1%); 47 (37.9%) received radiotherapy, and 26 (21%) received chemotherapy. Five-year overall survival (OS) was 78.1%; 10-year OS was 76.9%. Five-year disease-free survival (DFS) was 66.6%; 5-year local control was 87.6%; and 5-year locoregional control was 78.5%. On multivariable analysis, factors associated with worse OS and DFS were higher pathologic T stage (P = .008), lymph node positivity (P < .001), and disease recurrence (P < .001).

Conclusion

Young adults with primary OC SCC may be treated with a similar treatment approach as older adults.



https://ift.tt/2D3RVGy

Assessment of the long-term safety of mepolizumab and durability of clinical response in patients with severe eosinophilic asthma

Publication date: Available online 23 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Sumita Khatri, Wendy Moore, Peter G. Gibson, Richard Leigh, Arnaud Bourdin, Jorge Maspero, Manuel Barros, Roland Buhl, Peter Howarth, Frank C. Albers, Eric S. Bradford, Martyn Gilson, Robert G. Price, Steven W. Yancey, Hector Ortega

Abstract
Background

Mepolizumab has demonstrated favorable safety and efficacy profiles in placebo-controlled trials ≤12 months' duration; however, long-term data are lacking.

Objective

To evaluate the long-term safety and efficacy of mepolizumab in patients with severe eosinophilic asthma (SEA).

Methods

COLUMBA (NCT01691859) was an open-label extension study in patients with SEA previously enrolled in DREAM (NCT01000506). Patients received 100mg subcutaneous mepolizumab every 4 weeks plus standard of care, until a protocol-defined stopping criterion was met. Safety endpoints included frequency of adverse events (AEs), serious AEs (SAEs), and AEs of special interest. Efficacy endpoints included annualized exacerbation rate, changes from baseline in Asthma Control Questionnaire (ACQ)-5 score, and blood eosinophil counts. Immunogenicity was also assessed.

Results

Overall, 347 patients were enrolled for an average of 3.5yrs (maximum: 4.5yrs; total exposure: 1201 patient-years). On-treatment AEs were reported in 94% of patients (exposure-adjusted rate: 3688 events/1000 patient-years). The most frequently reported on-treatment AEs were respiratory tract infection, headache, bronchitis, and asthma worsening. Seventy-nine (23%) patients experienced ≥1 on-treatment SAE; there were 6 deaths, none assessed as related to mepolizumab. For patients with ≥156 weeks enrollment, the exacerbation rate was 0.74 events/year (Weeks 0–156), a 56% reduction from the off-treatment period between DREAM and COLUMBA. For all patients, at the first post-baseline assessment, the mean ACQ-5 score was reduced by 0.47 points and blood eosinophil counts by 78%, with similar improvements maintained throughout the study. The immunogenicity profile (8% anti-drug antibodies) was consistent with previous studies.

Conclusion

These data support the long-term safety and efficacy of mepolizumab in patients with SEA.

Clinical Implications

Following long-term use in patients with severe eosinophilic asthma, mepolizumab maintains clinical effectiveness and continues to demonstrate a favorable safety profile, with no evidence of inducing neutralizing antibodies.

Graphical abstract

Graphical abstract for this article



https://ift.tt/2CAuCDl

Advances in Atopic Dermatitis in 2017

Publication date: Available online 22 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Katie Kennedy, Jennifer Heimall, Jonathan M. Spergel

Synopsis

This review encompasses relevant scientific and clinical advances in atopic dermatitis published in 2017. These include articles from the Journal as well as other prominent publications that have contributed to the emerging field of the microenvironment of the skin and molecular patterns guiding biologic treatment strategies. The most commonly questioned and explored themes of the year included the impact of the microbiome on atopic dermatitis development as well as cell signaling and severity of symptoms. Topics also included the description of patient specific molecular endotypes within the larger atopic dermatitis population. All of these factors will create potential opportunities to guide personalized therapy with the broadening array of topical and systemic interventions currently available, as well as provide new insights to guide development of novel, molecularly targeted therapeutics. With recent FDA approval of the first wave of new, targeted therapies for atopic dermatitis (AD), additional information exploring the safety profiles and long-term effects of these medications was also at the forefront of 2017.



https://ift.tt/2AmHQSn

Elevated IgE M1 prime transcripts in nasal tissues in patients with nasal polyps and asthma

Publication date: Available online 22 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Heleen Scheerens, Ashley Smith, Olga Li, Lee Honigberg, Jeffrey M. Harris, Gabriele Holtappels, Claus Bachert



https://ift.tt/2CxTcES

Lingual cavernous hemangioma in a Nepalese boy—‘A Difficult Associate!!!’

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Abstract
Hemangiomas are benign tumors comprising of ectatic blood vessels. Although common in the head and neck region, those occurring within the oral cavity and tongue are exceedingly rare. We report a 5-year-old boy with a swelling over the anterior third of tongue post failed conservative therapy eventually treated with surgical excision and confirmed histologically as a cavernous hemangioma probably first of its kind reported from Nepal.

https://ift.tt/2EEljoh

Pheno4J: a gene to phenotype graph database

Mughal, S; Moghul, I; Yu, J; Clark, T; Gregory, DS; Pontikos, N; (2017) Pheno4J: a gene to phenotype graph database. Bioinformatics , 33 (20) pp. 3317-3319. 10.1093/bioinformatics/btx397 . Green open access

https://ift.tt/2q4pn7i

At the Crossroads of Sustainability: The Natural Recompositioning of Architecture

Eufrasia, M.; (2018) At the Crossroads of Sustainability: The Natural Recompositioning of Architecture. Architecture_MPS , 14 (2) pp. 1-21. 10.14324/111.444.amps.2018v14i2.001 . Green open access

https://ift.tt/2R6eMUM

A direct glia-to-neuron natural transdifferentiation ensures nimble sensory-motor coordination of male mating behaviour

Molina-García, L; Cook, SJ; Kim, B; Bonnington, R; Sammut, M; O'Shea, J; Elliott, D; ... Poole, RJ; + view all Molina-García, L; Cook, SJ; Kim, B; Bonnington, R; Sammut, M; O'Shea, J; Elliott, D; Hall, DH; Emmons, SW; Barrios, MA; Poole, RJ; - view fewer (2018) A direct glia-to-neuron natural transdifferentiation ensures nimble sensory-motor coordination of male mating behaviour. BioRxiv Green open access

https://ift.tt/2q895ua

Environmental Effect of Bus Priority Measures Applied on a Road Network in Santiago, Chile

Karekla, X; Fernandez, R; Tyler, N; (2018) Environmental Effect of Bus Priority Measures Applied on a Road Network in Santiago, Chile. Transportation Research Record: Journal of the Transportation Research Board 10.1177/0361198118784134 . (In press). Green open access

https://ift.tt/2R6eBc4

Explaining the content of impact assessment in the United Kingdom: Learning across time, sectors, and departments

Fritsch, O; Kamkhaji, JC; Radaelli, CM; (2017) Explaining the content of impact assessment in the United Kingdom: Learning across time, sectors, and departments. Regulation & Governance , 11 (4) pp. 325-342. 10.1111/rego.12129 . Green open access

https://ift.tt/2q88QiK

Maintaining balance on a moving bus: The importance of three-peak steps whilst climbing stairs

Karekla, X; Tyler, N; (2018) Maintaining balance on a moving bus: The importance of three-peak steps whilst climbing stairs. Transportation Research Part A: Policy and Practice , 116 pp. 339-349. 10.1016/j.tra.2018.06.020 .

https://ift.tt/2R6eays

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Abubakar, I; Lalvani, A; Southern, J; Sitch, A; Jackson, C; Onyimadu, O; Lipman, M; ... Drobniewski, F; + view all Abubakar, I; Lalvani, A; Southern, J; Sitch, A; Jackson, C; Onyimadu, O; Lipman, M; Deeks, JJ; Griffiths, C; Bothamley, G; Kon, OM; Hayward, A; Lord, J; Drobniewski, F; - view fewer (2018) Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study. Health Technology Assessment , 22 (56) 10.3310/hta22560 . Green open access

https://ift.tt/2q88HvI

Maintaining balance on a moving bus: The importance of three-peak steps whilst walking on the lower-deck

Karekla, X; Tyler, N; (2018) Maintaining balance on a moving bus: The importance of three-peak steps whilst walking on the lower-deck. Transportation Research Part A: Policy and Practice , 116 pp. 484-496. 10.1016/j.tra.2018.06.022 .

https://ift.tt/2R3roMk

Student Choice in Higher Education—Reducing or Reproducing Social Inequalities?

Callender, C; Dougherty, K; (2018) Student Choice in Higher Education—Reducing or Reproducing Social Inequalities? Social Sciences , 7 (10) , Article 189. 10.3390/socsci7100189 . Green open access

https://ift.tt/2q8Ccxu

The direct interconnection of the UK and Nordic power market – Impact on social welfare and renewable energy integration

Zakeri, B; Price, J; Zeyringer, M; Keppo, I; Mathiesen, BV; Syri, S; (2018) The direct interconnection of the UK and Nordic power market – Impact on social welfare and renewable energy integration. Energy , 162 pp. 1193-1204. 10.1016/j.energy.2018.08.019 . (In press).

https://ift.tt/2R6dVn2

Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents

Pasvol, TJ; Foster, C; Fidler, S; (2018) Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents. Current Opinion in HIV and AIDS , 13 (3) pp. 281-287. 10.1097/COH.0000000000000455 .

https://ift.tt/2q8l6Qo

Failed microvascular decompression for trigeminal neuralgia: options for long-term pain relief from a historical cohort

Jafree, DJ; Zakrzewska, JM; (2018) Failed microvascular decompression for trigeminal neuralgia: options for long-term pain relief from a historical cohort. British Journal of Neurosurgery 10.1080/02688697.2018.1538484 . (In press).

https://ift.tt/2R6dLMs

Reducing non-collision injuries aboard buses: Passenger balance whilst walking on the lower deck

Karekla, X; Tyler, N; (2018) Reducing non-collision injuries aboard buses: Passenger balance whilst walking on the lower deck. Safety Science , 105 pp. 128-133. 10.1016/j.ssci.2018.01.021 .

https://ift.tt/2q88qZI

A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule

Panovska-Griffiths, J; Crowe, S; Pagel, C; Shin, T; Grove, P; Utley, M; (2018) A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule. Vaccine , 36 (35) pp. 5340-5347. 10.1016/j.vaccine.2018.05.083 .

https://ift.tt/2R6QOcg

Optical comb for generation of a continuously tunable coherent THz signal from 122.5 GHz to > 2.7 THz

Ponnampalam, L; Fice, M; Shams, H; Renaud, C; Seeds, A; (2018) Optical comb for generation of a continuously tunable coherent THz signal from 122.5 GHz to > 2.7 THz. Optics Letters , 43 (11) pp. 2507-2510. 10.1364/OL.43.002507 .

https://ift.tt/2q9nGoZ

JAMA Otolaryngology-Head & Neck Surgery.

JAMA Otolaryngology-Head & Neck Surgery.

JAMA Otolaryngol Head Neck Surg. 2018 Oct 01;144(10):861

Authors:

PMID: 30347055 [PubMed - in process]



https://ift.tt/2EEs6OX

Timely Adjuvant Postoperative Radiotherapy: Racing to a PORT in the Storm.

Timely Adjuvant Postoperative Radiotherapy: Racing to a PORT in the Storm.

JAMA Otolaryngol Head Neck Surg. 2018 Oct 18;:

Authors: Teng MS, Gupta V

PMID: 30347023 [PubMed - as supplied by publisher]



https://ift.tt/2OHEEK0

Association of Facility Volume With Positive Margin Rate in the Surgical Treatment of Head and Neck Cancer.

Association of Facility Volume With Positive Margin Rate in the Surgical Treatment of Head and Neck Cancer.

JAMA Otolaryngol Head Neck Surg. 2018 Oct 18;:

Authors: Nocon CC, Ajmani GS, Bhayani MK

Abstract
Importance: The achievement of complete tumor resection with tumor-free margins is one of the main principles of oncologic surgery for head and neck squamous cell carcinoma (HNSCC). The negative prognostic influence of a positive margin (PM) across all head and neck subsites has been well established. National guidelines recommend the use of adjuvant chemoradiation therapy (CRT) in the setting of PM.
Objective: To determine the incidence of PM in HNSCC across multiple subsites, as well as the factors associated with its occurrence.
Design, Setting, and Participants: This retrospective cohort study used the National Cancer Database to identify patients diagnosed with HNSCC between 2010 and 2014 and who underwent surgical resection (n = 28 840).
Main Outcomes and Measures: Predictors of PM rate and likelihood to receive adjuvant CRT.
Results: Among the 28 840 patients included in this study, 19 727 (68.4 %) were men, and the average age was 62.4 years (range, 40 to ≥90 years). In univariable analysis, a lower PM rate was associated with higher facility volume (26.3% for the lowest volume quartile, 16.5% for the middle 2 quartiles, and 10.8% for the highest volume quartile) and treatment at academic vs nonacademic facilities (14.0% vs 22.7%). In multivariate analysis, those treated at higher-volume facilities remained significantly less likely to have PM (adjusted odds ratio, 0.85; 95% CI, 0.83-0.88). The trend of decreasing PM rate with increasing facility volume was observed in both academic (aOR, 0.88 per 10-case volume increase [95% CI, 0.85-0.91]) and nonacademic (aOR, 0.73 per 10-case volume increase [95% CI, 0.68-0.80]) facilities. There was no association between facility volume and patient likelihood of receiving adjuvant CRT in the setting of PM (compared with CCPs: aOR, 0.98 per 10-case volume increase [95% CI, 0.84-1.14] for CCCPs; and aOR, 1.24 [95% CI, 0.99-1.55] for INCPs).
Conclusions and Relevance: These findings suggest that high-volume facilities are associated with lower rates of PM in the surgical treatment of HNSCC in both academic and nonacademic settings. Facility volume for head and neck oncologic surgeries may be considered a benchmark for quality of care.

PMID: 30347018 [PubMed - as supplied by publisher]



https://ift.tt/2EEs5dR

Association of Care Processes With Timely, Equitable Postoperative Radiotherapy in Patients With Surgically Treated Head and Neck Squamous Cell Carcinoma.

Association of Care Processes With Timely, Equitable Postoperative Radiotherapy in Patients With Surgically Treated Head and Neck Squamous Cell Carcinoma.

JAMA Otolaryngol Head Neck Surg. 2018 Oct 18;:

Authors: Janz TA, Kim J, Hill EG, Sterba K, Warren G, Sharma AK, Day TA, Hughes-Halbert C, Graboyes EM

Abstract
Importance: Delays in initiation of postoperative radiotherapy (PORT) after surgery for head and neck squamous cell carcinoma (HNSCC) are common, predominantly affect racial minorities, and are associated with decreased survival. Details regarding the care processes that contribute to timely, equitable PORT remain unknown.
Objective: To determine care processes associated with timely, equitable PORT.
Design, Setting, and Participants: This retrospective cohort study included patients 18 years or older undergoing surgery for HNSCC at the Medical University of South Carolina (MUSC), Charleston, followed by PORT (at MUSC or elsewhere) with or without chemotherapy from January 1, 2014, through December 31, 2016. Data were analyzed from September 15, 2017, through June 28, 2018.
Main Outcomes and Measures: The main outcome measure was the proportion of timely, guideline-adherent initiation of PORT (≤6 weeks postoperatively). Secondary outcome measures included care processes associated with timely PORT. The association between process variables with timely PORT was explored using multivariable logistic regression analysis. Effect modification of the association between receipt of care processes and timely PORT by race was explored using interaction effects.
Results: A total of 197 patients were included in the analysis; they were predominantly white (157 [79.7%]) and male (136 [69.0%]) with a mean age of 59 years (range, 28-89 years). Overall, 89 patients (45.2%) experienced a delay initiating PORT. African American patients had a 13.5% absolute increase in the rate of delayed PORT relative to white patients (21 of 37 [56.8%] vs 68 of 157 [43.3%]). The adjusted multivariable regression showed that the following care processes were associated with timely PORT: preoperative radiotherapy consultation (odds ratio [OR], 8.94; 95% CI, 1.64-65.53), PORT at MUSC (OR, 6.21; 95% CI, 1.85-24.75), pathology report within 7 postoperative days (OR, 4.14; 95% CI, 1.21-15.86), time from surgery to PORT referral of no longer than 10 days (OR, 12.14; 95% CI, 3.14-63.00), time from PORT referral to consultation of no longer than 10 days (OR, 10.76; 95% CI, 3.01-49.70), and time from PORT consultation to its start of no longer than 21 days (OR, 4.80; 95% CI 1.41-18.44). Analysis of interactions revealed no statistically significant differences between African American and white patients in receipt of key processes associated with timely PORT.
Conclusions and Relevance: Specific care processes are associated with guideline-adherent initiation of PORT. Novel strategies appear to be needed to ensure that these processes are performed for all patients with HNSCC, thereby facilitating timely, equitable PORT.

PMID: 30347012 [PubMed - as supplied by publisher]



https://ift.tt/2OEYYM9

The fragility of statistically significant results in otolaryngology randomized trials

Publication date: Available online 22 October 2018

Source: American Journal of Otolaryngology

Author(s): Mason Skinner, Daniel Tritz, Clayton Farahani, Andrew Ross, Tom Hamilton, Matt Vassar

Abstract
Objectives

The American Academy of Otolaryngology–Head and Neck Surgery regards randomized controlled trials as class A evidence. A novel method to determine the robustness of outcomes in trials is the fragility index. This index represents the number of patients whose status would have to change from a non-event to an event to make a statistically significant result non-significant.

Methods

Investigators included otolaryngology journals listed in the top 10 of one or both of Google Scholar Metrics and Clarivate Analytics' Journal rankings. For inclusion, a randomized controlled trial needed to report a one-to-one random assignment of participants to condition, contain two parallel arms or have used a two-by-two factorial design, and report at least one statistically significant dichotomous outcome.

Results

Sixty-nine trials met inclusion criteria. The median fragility index was three events (interquartile range 1–7.5). Median sample size was 72 (interquartile range 50–102.5). Modest correlations were observed between fragility index and total sample size (r = 0.27) and fragility index and event rate (r = 0.46). Investigators found no correlation between fragility index and impact factor or Science Citation Index. In 39% (27/69) of trials, the number lost to follow-up was equal to or greater than the fragility index.

Conclusion

A median fragility index of 3 indicates that three people, on average, are needed to alter the outcomes in otolaryngology trials. This indicates that the results of two-group randomized controlled trials reporting binary endpoints published in otolaryngology journals may frequently be fragile.



https://ift.tt/2yXzkaL

Resveratrol Represses Tumor Necrosis Factor α/c-Jun N-terminal Kinase Signaling via Autophagy in Human Dental Pulp Stem Cells

Publication date: Available online 22 October 2018

Source: Archives of Oral Biology

Author(s): Feng-Ming Wang, Zhiai Hu, Xiaohua Liu, Jian Q. Feng, Robert. A. Augsburger, James L. Gutmann, Gerald N. Glickman

Abstract
Objectives

To study the effects of polyphenol resveratrol on TNFα-induced inflammatory signaling as well as the underlying mechanism in human dental pulp stem cells (DPSCs).

Materials and Methods

Human DPSCs were cultured and treated by TNFα in the presence or absence of resveratrol. NF-κB and mitogen-activated protein kinase (MAPK) signaling pathways were analyzed by Western blotting and immunofluorescence staining. Interleukin 6 (IL6) and interleukin 8 (IL8) mRNA levels were analyzed by reverse transcription polymerase chain reaction. For the mechanistic study, autophagy was examined and further manipulated by gene silencing of Atg5 using siRNAs. Statistical analysis was performed by Student's t- test, and values of p < 0.05 were considered significant.

Results

Upon TNFα treatments, neither degradation of IκBα nor the phosphorylation and nuclear translocation of p65 NF-κB were inhibited by resveratrol at different concentrations. In contrast, resveratrol dramatically inhibited TNFα-induced phosphorylation of c-Jun N-terminal kinase (JNK) MAPK. Furthermore, resveratrol activated autophagy, as evidenced by the accumulated autophagic puncta formed by lipid bound LC3B in resveratrol-treated cells. Intriguingly, both resveratrol and JNK inhibitor SP600125 suppressed TNFα-induced IL6 and IL8 mRNA expression (P < 0.05). Silencing autophagy gene Atg5 led to the hyper-activation of JNK and augmented TNFα-induced IL6 and IL8 mRNA expression (P < 0.05).

Conclusions

The results suggest that resveratrol suppresses TNFα-induced inflammatory cytokines expressed by DPSCs through regulating the inhibitory autophagy-JNK signaling cascade. Resveratrol might be beneficial to ameliorate pulpal damage during the acute phase of inflammation in vital pulp therapy.



https://ift.tt/2ScoKpd

Poorly differentiated plasmacytoid squamous cell carcinoma: Case report of a rare malignancy

Publication date: Available online 23 October 2018

Source: American Journal of Otolaryngology

Author(s): Gabrielle Rieth, Arminé Kocharyan, Akina Tamaki, Jason Thuener, Freedom Johnson

Abstract

Plasmacytoid squamous cell carcinoma is an especially aggressive variant of squamous cell carcinoma that has previously been described in the literature as a variant of oral cancers and most extensively, in vulvular [3], transitional cell, and urothelial carcinomas [2,13,15–20]. In this case report, we present a 36-year-old man with 6 to 8 weeks of a progressively enlarging mass over the lateral third of his clavicle, acromion process, and deltoid. The mass was resected, and the supraclavicular defect was reconstructed using an anterolateral thigh free flap. Final pathology determined the specimen was an invasive poorly differentiated squamous cell carcinoma with spindle cell and plasmacytoid features of cutaneous origin. Plasmacytoid squamous cell carcinomas have previously been described in the oral cavity, but in no other subsite of the head and neck. This article describes the patient's case and provides a literature review of the available reports related to plasmacytoid variant of squamous cell carcinoma.



https://ift.tt/2SeEjwH

Andrologie bei onkologischen Erkrankungen

Zusammenfassung

In der dermatoonkologischen Behandlung findet sich eine Vielzahl gonadotoxischer Interventionen. Insbesondere alkylierende und hormonell aktive Substanzen sowie gonadale Bestrahlungen sind bekannt für eine fertilitätseinschränkende Wirkung beim Mann. Die zertifizierten Hautkrebszentren in Deutschland haben deshalb seit 2017 die Auflage zur Umsetzung von Beratungen zum Fertilitätserhalt. Gestützt wird dies durch die S2k-Leitlinie zur Fertilitätserhaltung bei onkologischen Therapien. Da die verschiedenen Interventionen von den dermatoonkologischen Leitlinien stadienabhängig empfohlen werden, befürworten die Autoren mindestens die Frage „Ist Kinderwunsch ein Thema für Sie?", wenn Patienten ein entsprechendes Stadium erreichen. Die Fertilitätsprotektion des Mannes über eine Kryokonservierung von Ejakulat oder Hodenmaterial ist dann eine einfache und sichere Möglichkeit. Das Verfahren ist standardisiert und häufig verfügbar. Zudem bietet sich über das neue Projekt Androprotect jetzt die Möglichkeit zur Kryokonservierung von Hodenmaterial präpubertärer männlicher Kinder und Säuglinge. Treten unter Therapie Zeichen eines Hypogonadismus auf, kann in Abwägung der Testosteronwirkungen eine Behandlung erwogen werden, wichtig ist, hier die anabolen und immunmodulierenden Effekte zu beachten.



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Analysis of the role of thyroidectomy and thymectomy in the surgical treatment of secondary hyperparathyroidism

Publication date: Available online 22 October 2018

Source: American Journal of Otolaryngology

Author(s): Mateus R. Soares, Graziela V. Cavalcanti, Ricardo Iwakura, Leandro J. Lucca, Elen A. Romão, Luiz C. Conti de Freitas

Abstract
Purpose

Parathyroidectomy can be subtotal or total with an autograft for the treatment of renal hyperparathyroidism. In both cases, it may be extended with bilateral thymectomy and total or partial thyroidectomy. Thymectomy may be recommended in combination with parathyroidectomy in order to prevent mediastinal recurrence. Also, the occurrence of thyroid disease observed in patients with hyperparathyroidism is poorly understood and the incidence of cancer is controversial. The aim of the present study was to report the experience of a single center in the surgical treatment of renal hyperparathyroidism and to analyse the role of thyroid and thymus surgery in association with parathyroidectomy.

Materials and methods

We analysed parathyroid surgery data, considering patient demographics, such as age and gender, and surgical procedure data, such as type of hyperparathyroidism, associated thyroid or thymus surgery, surgical duration and mediastinal recurrence. Histopathological results of thyroid and thymus samples were also analysed.

Results

Medical records of 109 patients who underwent parathyroidectomy for secondary hyperparathyroidism were reviewed. On average, thymectomy did not have impact on time of parathyroidectomy (p = 0.62) even when thyroidectomy was included (p = 0.91). Intrathymic parathyroids were detected in 7.5% of the thymuses removed and papillary carcinoma was detected in 20,8% of thyroid tissue samples. Two patients showed recurrence of supernumerary intrathymic parathyroids and a single case of mediastinitis was observed.

Conclusions

Parathyroidectomy with thymectomy and/or thyroidectomy has an important role in the treatment of renal hyperparathyroidism since thyroid cancer can frequently occur and require surgery. Thymectomy should be considered to avoid recurrence and a risky re-operation.



https://ift.tt/2S9qDml

SLAM family receptors in natural killer cells – Mediators of adhesion, activation and inhibition via cis and trans interactions

Publication date: Available online 22 October 2018

Source: Clinical Immunology

Author(s): Maren Claus, Doris Urlaub, Frank Fasbender, Carsten Watzl

Abstract

SLAM family receptors are important for the fine-tuning of immune reactions. Their expression is restricted to cells of hematopoietic origin and most SLAM family receptors are their own ligand. Here we review how these receptors are involved in regulating the functions of Natural Killer (NK) cells. We discuss that promoting cellular adhesion may be a main function of SLAM family receptors in NK cells. The homophilic interactions of SLAM family receptors can not only occur in trans between different cells, but also in cis on the surface of the same cell. This cis interaction additionally modulates the function of the receptors and subsequently affects the activities of NK cells. Finally, SLAM-family receptors can also mediate inhibitory signals under certain conditions. These inhibitory signals can contribute to the functional maturation of NK cells during NK cell education. Therefore, SLAM family receptors are critically involved in many aspects of NK cell functionality.



https://ift.tt/2RbP5T1

Imbalance of two main circulating dendritic cell subsets in patients with myasthenia gravis

Publication date: Available online 22 October 2018

Source: Clinical Immunology

Author(s): Pei Chen, Yingkai Li, Hao Huang, Yan Li, Zhenguang Chen, Xiaoxi Liu, Li Qiu, Changyi Ou, Zhidong Huang, Zhongqiang Lin, Hao Ran, Weibin Liu

Abstract

Although it is well documented that circulating dendritic cells (DCs) have specialized features in many kinds of physiological and pathological condition of human, there is still lack reports about the features of DCs in the peripheral blood of myasthenia gravis (MG) patients. We aimed to investigate the quantitative and component features of DCs and their implication in MG. We collected peripheral blood from different kinds of MG patients and recorded their clinical characteristics. Using flow cytometry, we distinguished circulating DC subsets [plasmacytoid DCs (pDCs) and myeloid DCs (mDCs)] and enumerated their densities in peripheral blood. Absolute numbers of circulating pDCs were significantly decreased in naïve MG patients compared with healthy controls, resulting in a markedly lower ratio of pDCs/mDCs (percentage). Thus, there was an imbalance in the proportions of different circulating DC subsets. We did not find clustered pDCs in the hyperplastic thymus of MG patients. The clinical status of MG patients was improved after drug treatment, together with an increased ratio of pDCs/mDCs. In a longitudinal follow-up, we observed that circulating mDCs were significantly reduced after 1 month of therapy with a steroid and immunosuppressant, resulting in recovery of the pDC/mDC ratio. The ratio of circulating DC subsets might reflect the balance between the autoimmune response and immune tolerance of a patient, and ratio changes during treatment could be a promising marker to predict the efficacy of a specific drug used for MG patients.



https://ift.tt/2q8044i

Assessment of balance skills and falling risk in children with congenital bilateral profound sensorineural hearing loss

Publication date: Available online 23 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Emre Soylemez, Suha Ertugrul, Erkan Doğan

Abstract
Objective

To evaluate the balance skills and falling risk in children with a congenital bilateral profound sensorineural hearing loss (CBPSNHL)

Methods

25 children with CBPSNHL and healthy 25 children with similar age and gender were included in the study. The flamingo balance test, the tandem stance test, and the one-leg standing test were performed to assess the patients' static balance skills. The pediatric balance scale (PBS) was used to evaluate the dynamic balance. Visual analog scale (VAS) was applied to the patients assess the frequency of falls.

Results

The flamingo balance test, the tandem stance test, and the one-leg standing test in the children with CBPSNHL were all significantly worse than the control group. Although the scores of PBS in patients with CBPSNHL were significantly lower than the control group (p <0.001), the results of both groups were consistent with a low risk of falls. There was no significant difference between the VAS scores indicating the frequency of falls among the groups (p = 0.552).

Conclusion

Static and dynamic balance skills of the children with CBPSNHL are significantly impaired compared to their healthy peers. Children with CBPSNHL also have a lower risk of falling just like their healthy peers and there is no significant difference between their falling frequencies. Balance skills of children with CBPSNHL can be assessed quickly and effectively on a hard floor (eyes closed), with a tandem standing test or a one-leg standing test.



https://ift.tt/2EDRUdX

In response to Letter to the Editor entitled “Cortical mastoidectomy with posterior atticotomy as surgical treatment in cases of acute mastoiditis in children”

Publication date: Available online 23 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Józef Mierzwiński, Karolina Haber, Justyna Tyra, Maria Drela, Anna Sinkiewicz, Michael David Puricelli



https://ift.tt/2PjM2uo

Cortical mastoidectomy with posterior atticotomy as surgical treatment in cases of acute mastoiditis in children

Publication date: Available online 22 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Rafal Zielinski



https://ift.tt/2EFMr6o

Hazardous Noise Exposure From Noisy Toys May Increase After Purchase and Removal From Packaging: A Call for Advocacy

Publication date: Available online 22 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Noel Jabbour, Heather M. Weinreich, James Owusu, Marta Lehn, Bevan Yueh, Samuel Levine

Abstract
Objective

Previous studies identified hazardous noise levels from packaged toys. Sound levels may increase when packaging is removed and therefore, complicate the ability to accurately assess noise levels before purchase. The goal of this study was to evaluate how packaging affects the decibel (dB) level of toys by:

Methods

Thirty-five toys were selected from the 2009-2011 Sight and Hearing Association (SHA) based on availability for purchase. Toys' speakers were categorized as Exposed, Partially Exposed, or Covered, based on its packaging. The dB level of each toy was tested at 0 cm and 25 cm from the speaker using a handheld digital sound meter in a standard audiometric booth. T tests and ANOVA were performed to assess mean change in sound level before and after packaging removal.

Results

Significant dB increases were noted after packaging was removed (mean change 11.9 dB at 0 cm; and 2.5 dB at 25 cm, p<0.001). Sixty-four percentage of Covered toys (n=14) had dB greater than 85 dB when packaged and this increased to 100% when unpackaged.

Conclusion

Many manufactured toys have hazardous sound levels. Caregivers and healthcare providers should be aware that toys tested in the store may actually be louder when brought home and removed from their packaging. Limits on and disclosure of dB level of toys should be considered nationally.



https://ift.tt/2PfK0vC

Prevalence of Bifid Uvula in Primary School Children

Publication date: Available online 22 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Pranvera Feka, Jacqueline Banon, Igor Leuchter, Giorgio C. La Scala

Abstract
Background

A bifid uvula is an anatomic variation that can be predictive of sub-mucous cleft palate, which may cause velopharyngeal insufficiency (VPI). Bifid uvula prevalence in the literature ranges from 0.18% to 10.3%, depending on the population studied. The aim of this study is to determine the prevalence of bifid uvula in the Geneva's school children population.

Methods

A cross-sectional study was conducted in Geneva's primary school children, from September 2014 to June 2015. An examination of the uvula was performed by dentists working for the Scholastic Dental Service, after a specific training in diagnosing bifid uvulas. The dentists recorded their findings on a standardized form.

Results

The total number of school children in Geneva in the school year 2014-2015 was 30,375. 23,961 children had their uvula examined, representing 79% of the total population of school children. Among them, a hundred school children had a cleft uvula. One schoolgirl had no uvula. The prevalence of bifid uvula is 0.42%. Sex ratio (M/F) is 0.96.

Discussion

This large study, the second in literature for number of patients examined, identified a prevalence of bifid uvula of 0.42%. This result is in agreement with previous studies.



https://ift.tt/2EFOiIw

Oral peanut immunotherapy ‐ How much is too much? How much is enough?

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


https://ift.tt/2CAcRUH

Delayed granulomatous reaction and cutaneous fistula induced by retained electrodes from a cardiac pacemaker in a child

Pediatric Dermatology, EarlyView.


https://ift.tt/2PdLRkw

Cover Image

Head &Neck, Volume 40, Issue 10, Page C1-C1, October 2018.


https://ift.tt/2CB73KG

Issue Information

Head &Neck, Volume 40, Issue 10, Page 2117-2120, October 2018.


https://ift.tt/2AnNjIQ

Network meta‐analyses of systemic treatments for psoriasis: a critical appraisal

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


https://ift.tt/2An72Zc

Combined THC and CBD to treat pain in epidermolysis bullosa: a report of three cases

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


https://ift.tt/2POE6yp

Tetracycline, nicotinamide, and lesionally administered clobetasol as a therapeutic option to prednisone in patients with bullous pemphigoid: a comparative, retrospective analysis of 106 patients with long‐term follow‐up

International Journal of Dermatology, EarlyView.


https://ift.tt/2CA3qVh

Clinical and molecular evaluation of therapy with the use of cyclosporine A in patients with psoriasis vulgaris

International Journal of Dermatology, EarlyView.


https://ift.tt/2AnmdSg

Pyridoxine dependent epilepsy: Is late onset a predictor for favorable outcome?

de Rooy, RLP; Halbertsma, FJ; Struijs, EA; van Spronsen, FJ; Lunsing, RJ; Schippers, HM; van Hasselt, PM; ... Bok, LA; + view all de Rooy, RLP; Halbertsma, FJ; Struijs, EA; van Spronsen, FJ; Lunsing, RJ; Schippers, HM; van Hasselt, PM; Plecko, B; Wohlrab, G; Whalen, S; Benoist, JF; Valence, S; Mills, PB; Bok, LA; - view fewer (2018) Pyridoxine dependent epilepsy: Is late onset a predictor for favorable outcome? European Journal of Paediatric Neurology , 22 (4) pp. 662-666. 10.1016/j.ejpn.2018.03.009 .

https://ift.tt/2ytCJyo

PomBase 2018: user-driven reimplementation of the fission yeast database provides rapid and intuitive access to diverse, interconnected information

Lock, A; Rutherford, K; Harris, MA; Hayles, J; Oliver, SG; Bähler, J; Wood, V; (2018) PomBase 2018: user-driven reimplementation of the fission yeast database provides rapid and intuitive access to diverse, interconnected information. Nucleic Acids Research 10.1093/nar/gky961 . (In press). Green open access

https://ift.tt/2JdrLBs

Are smokers who are regularly exposed to e-cigarette use by others more or less motivated to stop or to make a quit attempt? A cross-sectional and longitudinal survey

Jackson, S; Beard, EV; Michie, S; Shahab, L; Raupach, T; West, R; Brown, J; (2018) Are smokers who are regularly exposed to e-cigarette use by others more or less motivated to stop or to make a quit attempt? A cross-sectional and longitudinal survey. BMC Medicine (In press).

https://ift.tt/2ywNQqr

An emerging viral pathogen truncates population age structure in a European amphibian and may reduce population viability

Campbell, LJ; Garner, TWJ; Tessa, G; Scheele, BC; Griffiths, AGF; Wilfert, L; Harrison, XA; (2019) An emerging viral pathogen truncates population age structure in a European amphibian and may reduce population viability. PeerJ (In press).

https://ift.tt/2JcmsSK

Universality Without Uniformity: A Culturally Inclusive Approach to Sensitive Responsiveness in Infant Caregiving

Mesman, J; Minter, T; Angnged, A; Cissé, IAH; Salali, GD; Migliano, AB; (2018) Universality Without Uniformity: A Culturally Inclusive Approach to Sensitive Responsiveness in Infant Caregiving. Child Development , 89 (3) pp. 837-850. 10.1111/cdev.12795 . Green open access

https://ift.tt/2yuE6Nl

Oral Health Disparities in Children: A Canary in the Coalmine?

Watt, RG; Mathur, MR; Aida, J; Bönecker, M; Venturelli, R; Gansky, SA; (2018) Oral Health Disparities in Children: A Canary in the Coalmine? Pediatric Clinics of North America , 65 (5) pp. 965-979. 10.1016/j.pcl.2018.05.006 .

https://ift.tt/2JboVgh

The development of a tool to assess beliefs about mythical causes of cancer: the Cancer Awareness Measure Mythical Causes Scale

Smith, S; Beard, EV; McGowan, J; Fox, E; Cook, C; Pal, R; Waller, J; Smith, S; Beard, EV; McGowan, J; Fox, E; Cook, C; Pal, R; Waller, J; Shahab, L; - view fewer (2018) The development of a tool to assess beliefs about mythical causes of cancer: the Cancer Awareness Measure Mythical Causes Scale. BMJ Open (In press).

https://ift.tt/2yuyQcO

Design of metalloproteins and novel protein folds using variational autoencoders

Greener, JG; Moffat, L; Jones, D; (2018) Design of metalloproteins and novel protein folds using variational autoencoders. Scientific Reports (In press).

https://ift.tt/2JboUZL

Multidisciplinary Rectal Cancer Care in the United States: Lessons Learned from the United Kingdom Multidisciplinary Team Model and Future Perspectives

Keller, DS; Wexner, SD; Chand, M; (2018) Multidisciplinary Rectal Cancer Care in the United States: Lessons Learned from the United Kingdom Multidisciplinary Team Model and Future Perspectives. Diseases of the Colon and Rectum , 61 (7) pp. 753-754. 10.1097/DCR.0000000000001107 .

https://ift.tt/2yq3hkj

The Future of Rectal Cancer Surgery: A Narrative Review of an International Symposium

de Lacy, FB; Chadi, SA; Berho, M; Heald, RJ; Khan, J; Moran, B; Panis, Y; ... Chand, M; + view all de Lacy, FB; Chadi, SA; Berho, M; Heald, RJ; Khan, J; Moran, B; Panis, Y; Perez, R; Tekkis, P; Mortensen, NJ; Lacy, AM; Wexner, SD; Chand, M; - view fewer (2018) The Future of Rectal Cancer Surgery: A Narrative Review of an International Symposium. Surgical Innovation , 25 (5) pp. 525-535. 10.1177/1553350618781227 . Green open access

https://ift.tt/2Japas5

STAC3 variants cause a congenital myopathy with distinctive dysmorphic features and malignant hyperthermia susceptibility

Zaharieva, IT; Sarkozy, A; Munot, P; Manzur, A; O'Grady, G; Rendu, J; Malfatti, E; ... Muntoni, F; + view all Zaharieva, IT; Sarkozy, A; Munot, P; Manzur, A; O'Grady, G; Rendu, J; Malfatti, E; Amthor, H; Servais, L; Urtizberea, JA; Neto, OA; Zanoteli, E; Donkervoort, S; Taylor, J; Dixon, J; Poke, G; Foley, AR; Holmes, C; Williams, G; Holder, M; Yum, S; Medne, L; Quijano-Roy, S; Romero, NB; Fauré, J; Feng, L; Bastaki, L; Davis, MR; Phadke, R; Sewry, CA; Bönnemann, CG; Jungbluth, H; Bachmann, C; Treves, S; Muntoni, F; - view fewer (2018) STAC3 variants cause a congenital myopathy with distinctive dysmorphic features and malignant hyperthermia susceptibility. Human Mutattion 10.1002/humu.23635 . (In press).

https://ift.tt/2yseAZm

Mixed binary‐continuous copula regression models with application to adverse birth outcomes

Klein, N; Kneib, T; Marra, G; Radice, R; Rokicki, S; McGovern, ME; (2018) Mixed binary‐continuous copula regression models with application to adverse birth outcomes. Statistics in Medicine 10.1002/sim.7985 . (In press).

https://ift.tt/2JfGZWI

Copula selection models for non‐Gaussian outcomes that are missing not at random

Gomes, M; Radice, R; Brenes, JC; Marra, G; (2018) Copula selection models for non‐Gaussian outcomes that are missing not at random. Statistics in Medicine 10.1002/sim.7988 . (In press).

https://ift.tt/2yt9L1V

Automated vehicles: exploring possible consequences of government (non)intervention for congestion and accessibility

Cohen, T; Cavoli, C; (2018) Automated vehicles: exploring possible consequences of government (non)intervention for congestion and accessibility. Transport Reviews 10.1080/01441647.2018.1524401 . (In press).

https://ift.tt/2Jbx9oA

Epilepsy surgery near or in eloquent cortex in children—Practice patterns and recommendations for minimizing and reporting deficits

Jayakar, P; Jayakar, A; Libenson, M; Arzimanoglou, A; Rydenhag, B; Cross, JH; Bhatia, S; ... Gaillard, WD; + view all Jayakar, P; Jayakar, A; Libenson, M; Arzimanoglou, A; Rydenhag, B; Cross, JH; Bhatia, S; Tassi, L; Lachhwani, D; Gaillard, WD; - view fewer (2018) Epilepsy surgery near or in eloquent cortex in children—Practice patterns and recommendations for minimizing and reporting deficits. Epilepsia , 59 (8) pp. 1484-1491. 10.1111/epi.14510 .

https://ift.tt/2yvkR6h

The Trajectory Towards a Seasonally Ice-Free Arctic Ocean

Notz, D; Stroeve, J; (2018) The Trajectory Towards a Seasonally Ice-Free Arctic Ocean. Current Climate Change Reports 10.1007/s40641-018-0113-2 . (In press). Green open access

https://ift.tt/2Jbx984

Bleeding and splenectomy in Wiskott-Aldrich syndrome: A single-centre experience

Rivers, E; Worth, A; Thrasher, AJ; Burns, SO; (2018) Bleeding and splenectomy in Wiskott-Aldrich syndrome: A single-centre experience. [Letter]. The Journal of Allergy and Clinical Immunology: In Practice 10.1016/j.jaip.2018.07.009 . (In press).

https://ift.tt/2yvd88B

The Unfolded State of the C-Terminal Domain of L9 Expands at Low but Not at Elevated Temperatures

Stenzoski, NE; Luang, B; Holehouse, AS; Raleigh, DP; (2018) The Unfolded State of the C-Terminal Domain of L9 Expands at Low but Not at Elevated Temperatures. Biophysical Journal , 115 (4) pp. 655-663. 10.1016/j.bpj.2018.07.013 .

https://ift.tt/2Jcr9Mr

An evaluation of a safety improvement intervention in care homes in England: a participatory qualitative study

Marshall, M; Pfeifer, N; de Silva, D; Wei, L; Anderson, J; Cruickshank, L; Attreed-James, K; Marshall, M; Pfeifer, N; de Silva, D; Wei, L; Anderson, J; Cruickshank, L; Attreed-James, K; Shand, J; - view fewer (2018) An evaluation of a safety improvement intervention in care homes in England: a participatory qualitative study. Journal of the Royal Society of Medicine 10.1177/0141076818803457 . (In press). Green open access

https://ift.tt/2yq394j

Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues

Parola, M; Pinzani, M; (2018) Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues. Molecular Aspects of Medicine 10.1016/j.mam.2018.09.002 . (In press).

https://ift.tt/2JaTx1x