Αρχειοθήκη ιστολογίου

Τετάρτη 28 Νοεμβρίου 2018

Does the Current American Society of Anesthesiologists Physical Status Classification Represent the Chronic Disease Burden in Children Undergoing General Anesthesia?

No abstract available

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Pain Management: A Problem-Based Learning Approach

No abstract available

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Handbook of Sepsis

No abstract available

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A Comparison of Spinal Anesthesia Versus Monitored Anesthesia Care With Local Anesthesia in Minimally Invasive Fetal Surgery

BACKGROUND: Minimally invasive fetal surgery is commonly performed to treat twin-to-twin transfusion syndrome with selective fetoscopic laser photocoagulation and twin-reversed arterial perfusion sequence using radiofrequency ablation. Although an increasing number of centers worldwide are performing these procedures, anesthetic management varies. Both neuraxial anesthesia and monitored anesthesia care with local anesthesia are used at different institutions. We sought to determine the efficacy and outcomes of these 2 anesthetic techniques for fetal procedures at our institution. METHODS: All patients undergoing minimally invasive fetal surgery for twin-to-twin transfusion syndrome or twin-reversed arterial perfusion sequence over a 6-year time period (2011–2016) were reviewed. Patients receiving monitored anesthesia care with local anesthesia were compared with those receiving spinal anesthesia in both selective fetoscopic laser photocoagulation and radiofrequency ablation fetal procedures. The primary outcome examined between the monitored anesthesia care and spinal anesthesia groups was the difference in conversion to general anesthesia using a noninferiority design with a noninferiority margin of 5%. Secondary outcome measures included use of vasopressors, procedure times, intraoperative fluids administered, maternal complications, and unexpected fetal demise within 24 hours of surgery. RESULTS: The difference in failure rate between monitored anesthesia care and spinal was −0.5% (95% CI, −4.8% to 3.7%). Patients receiving monitored anesthesia care plus local anesthesia were significantly less likely to need vasopressors, had a shorter presurgical operating room time, and received less fluid (P

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Speaker Gender Representation at the American Society of Anesthesiology Annual Meeting: 2011–2016

The American Society of Anesthesiologists (ASA) Annual Meeting is the primary venue for anesthesiologists to present research, share innovations, and build networks. Herein, we describe gender representation for physician speakers at the Annual Meeting relative to the specialty overall. Details of ASA Annual Meeting presentations for individuals and panels were abstracted from the ASA archives for 2011–2016. Observed speaker gender composition was compared to expected composition based on the gender distribution of members of the ASA. There were 5167 speaker slots across 2025 presentations and panels. Of the speaker slots, 3874 were assigned to men and 1293 to women. Speaker slot gender composition was relatively consistent between 2011 and 2016 (annual percentage 22.3%–27.7% women, trend test P = .062). ASA membership composition of women increased slightly over the study period (24%–28%). The overall observed number of women in speaker slots over the study period did not differ significantly from what would be expected based on the ASA membership composition (25.0% observed vs 25.9% expected; P = .153). However, the percentage of single speakers who were women was significantly less than would be expected based on the ASA gender distribution (20.2% observed vs 25.9% expected; P

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The Impact of Postoperative Intensive Care Unit Admission on Postoperative Hospital Length of Stay and Costs: A Prespecified Propensity-Matched Cohort Study

BACKGROUND: In this prespecified cohort study, we investigated the influence of postoperative admission to the intensive care unit versus surgical ward on health care utilization among patients undergoing intermediate-risk surgery. METHODS: Of adult surgical patients who underwent general anesthesia without an absolute indication for postoperative intensive care unit admission, 3530 patients admitted postoperatively to an intensive care unit were matched to 3530 patients admitted postoperatively to a surgical ward using a propensity score based on 23 important preoperative and intraoperative predictor variables. Postoperative hospital length of stay and hospital costs were defined as primary and secondary end points, respectively. RESULTS: Among patients with low propensity for postoperative intensive care unit admission, initial triage to an intensive care unit was associated with increased postoperative length of stay (incidence rate ratio, 1.69 [95% CI, 1.59–1.79]; P

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General Anesthesia Alters the Diversity and Composition of the Intestinal Microbiota in Mice

Dysbiosis of the intestinal microbiota has been shown to result in altered immune responses and increased susceptibility to infection; as such, the state of the intestinal microbiome may have profound implications in the perioperative setting. In this first-in-class study, we used 16s ribosomal RNA sequencing and analysis in a mouse model of general anesthesia to investigate the effects of volatile anesthetics on the diversity and composition of the intestinal microbiome. After 4-hour exposure to isoflurane, we observed a decrease in bacterial diversity. Taxonomic alterations included depletion of several commensal bacteria including Clostridiales. These data identify volatile anesthetics as potential contributors to microbial dysbiosis in the postoperative patient. Accepted for publication October 17, 2018. Funding:This work was supported by grants from the National Institutes of Health (R01 GM120519-01). The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Cyrus D. Mintz, MD, PhD, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Ross Bldg 370, Baltimore, MD 21205. Address e-mail to Cmintz2@jhmi.edu. © 2018 International Anesthesia Research Society

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Remote Surveillance Technologies: Realizing the Aim of Right Patient, Right Data, Right Time

The convergence of multiple recent developments in health care information technology and monitoring devices has made possible the creation of remote patient surveillance systems that increase the timeliness and quality of patient care. More convenient, less invasive monitoring devices, including patches, wearables, and biosensors, now allow for continuous physiological data to be gleaned from patients in a variety of care settings across the perioperative experience. These data can be bound into a single data repository, creating so-called data lakes. The high volume and diversity of data in these repositories must be processed into standard formats that can be queried in real time. These data can then be used by sophisticated prediction algorithms currently under development, enabling the early recognition of patterns of clinical deterioration otherwise undetectable to humans. Improved predictions can reduce alarm fatigue. In addition, data are now automatically queriable on a real-time basis such that they can be fed back to clinicians in a time frame that allows for meaningful intervention. These advancements are key components of successful remote surveillance systems. Anesthesiologists have the opportunity to be at the forefront of remote surveillance in the care they provide in the operating room, postanesthesia care unit, and intensive care unit, while also expanding their scope to include high-risk preoperative and postoperative patients on the general care wards. These systems hold the promise of enabling anesthesiologists to detect and intervene upon changes in the clinical status of the patient before adverse events have occurred. Importantly, however, significant barriers still exist to the effective deployment of these technologies and their study in impacting patient outcomes. Studies demonstrating the impact of remote surveillance on patient outcomes are limited. Critical to the impact of the technology are strategies of implementation, including who should receive and respond to alerts and how they should respond. Moreover, the lack of cost-effectiveness data and the uncertainty of whether clinical activities surrounding these technologies will be financially reimbursed remain significant challenges to future scale and sustainability. This narrative review will discuss the evolving technical components of remote surveillance systems, the clinical use cases relevant to the anesthesiologist's practice, the existing evidence for their impact on patients, the barriers that exist to their effective implementation and study, and important considerations regarding sustainability and cost-effectiveness. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Accepted for publication October 18, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Jeanine P. Wiener-Kronish, MD, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, GRB 4–444, Boston, MA 02114. Address e-mail to jwiener-kronish@partners.org. © 2018 International Anesthesia Research Society

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Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

Abstract

Background

Pharyngocutaneous fistula is a major wound complication of total laryngectomy. Surgical sealants may be used to increase the strength and/or integrity of surgical repairs. The purpose of this study was to present our evaluation of the feasibility and utility of the application of sealant to the pharyngeal repair with the aim of reducing pharyngocutaneous fistula incidence.

Methods

This was a prospective single‐blind randomized controlled study; patients undergoing primary total laryngectomy for advanced carcinoma of the larynx were randomized into control and treatment (albumin‐polyaldehyde sealant applied to pharyngeal repair) groups. Relevant patient, disease, and management‐related factors were recorded.

Results

Forty‐five patients were included (23 controls and 22 who received treatments). No difference in the incidence of pharyngocutaneous fistula was observed between the 2 groups. No treatment‐related complications occurred.

Conclusion

Feasibility of application of an albumin‐polyaldehyde surgical sealant to the pharyngeal repair was demonstrated, however, a pharyngocutaneous fistula‐preventative effect was not observed. Larger animal and clinical studies are encouraged to clarify this finding.



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Posterior Reversible Encephalopathy Syndrome due to Hypomagnesemia: A Case Report and Literature Review

Background. Hypomagnesemia can cause various unspecific neurological complications, which can lead to diagnostic confusion. One of these complications is the posterior reversible encephalopathy syndrome (PRES), which is extremely uncommon and has been reported only twice in the English-language literature. Case presentation. We report the case of a 60-year-old man who presented with PRES involving only the cerebellar hemispheres and associated with hypomagnesemia. After excluding all the other possible etiologies of PRES, we started magnesium replacement therapy, which led to a remarkable but fluctuating clinical and chemical improvement. A full recovery with no need for further supplementation was achieved only after discontinuation of a proton pump inhibitor. Conclusions. This case highlights the role of magnesium in the pathophysiology of PRES; thereby, underlying hypomagnesemia should be considered in every PRES case with unclear etiology.

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Pallister–Hall syndrome with orofacial narrowing and tethered cord: a case report

Pallister–Hall syndrome is a rare, autosomal dominant, genetic disorder characterized by different congenital abnormalities: hypothalamic hamartoblastoma, bifid or shortened epiglottis, polydactyly, renal anom...

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Der p 1‐specific regulatory T cell response during house dust mite allergen immunotherapy

Abstract

Background

Allergen‐specific immunotherapy (AIT) is the only available treatment for allergic diseases that can induce specific immune tolerance to allergens. The key mechanisms involved in this process include changes in allergen‐specific regulatory T (Treg) cells.

Methods

We studied 25 allergic rhinitis patients undergoing subcutaneous house dust mite‐specific immunotherapy. Peripheral blood mononuclear cells were studied before, after 10 weeks, 30 weeks and 3 years of AIT. Der p 1‐specific T regulatory cell responses was investigated by characterization of Der p 1‐MHC‐class II tetramer‐positive cells and correlated with nasal symptom score.

Results

Twelve of 25 AIT patients matched with their MHC‐class II expression to the Der p 1 peptide‐MHC‐class II tetramers. A significant increase in the numbers of Der p 1‐specific FOXP3+Helios+CD25+CD127 Treg cells after 30 weeks was observed, which slightly decreased after 3 years of AIT. In contrast, Der p 1‐specific immunoglobulin‐like transcript 3 (ILT3)+CD25+ Treg cells decreased substantially from baseline after 3 years of AIT. ILT3+ Treg cells displayed compromised suppressive function and low FOXP3 expression. In addition, Der p 1‐specific IL‐10 and IL‐22 responses have increased after 30 weeks, but only IL‐10+ Der p 1‐specific Treg cells remained present at high frequency after 3 years of AIT. Increased number of FOXP3+Helios+, IL‐10+ and decreased ILT3+ Treg cell responses correlated with improved allergic symptoms.

Conclusion

The results indicate that AIT involves upregulation of the activated allergen‐specific Treg cells and downregulation of dysfunctional allergen‐specific Treg cells subset. Correction of dysregulated Treg cells responses during AIT is associated with improved clinical response.

This article is protected by copyright. All rights reserved.



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Eine seltene Ursache der asymptomatischen Arteria carotis interna Dissektion

Laryngo-Rhino-Otol
DOI: 10.1055/a-0798-3615



© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text



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Cutaneous extranodal natural killer/T-cell lymphoma: Clinical implications of whole blood Epstein-Barr virus DNA



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A Four-Year Retrospective Assessment of Post-Operative Complications in Immunosuppressed Patients Following Mohs Micrographic Surgery

Solid organ transplant and immunosuppressive medications confer higher risk of complications like infection and dehiscence due to larger defect size, complex repair, and impaired healing. Dermatologists should take into account the higher risk of complications when counseling and managing immunosuppressed solid organ transplant recipients undergoing Mohs surgery.

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Alopecia Areata and Poliosis: A Retrospective Analysis of 258 Cases



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A Cross-Sectional Survey and Analysis of Dermatology Foundation Career Development Award Recipients

The DF's CDA Program has had a major favorable impact on the academic workforce and supported innovations that have led to improved patient care. Each dollar of CDA funding through 2015 (i.e., $36.2 M) can be linked to over $10 and $12 in grant support through 2015 and 2017, respectively.

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Clindamycin versus clindamycin plus rifampicin in Hidradenitis Suppurativa treatment: clinical and ultrasound observations

The aim of the study was to assess and compare the clinical efficacy of clindamycin versus clindamycin plus rifampicin in HS patients, after 8 weeks of treatment, according to Hidradenitis Suppurativa Clinical Response measure. Study results suggest that clindamycin in mono-therapy may be a useful and safety alternative to the combination of clindamycin and rifampicin regardless of the clinical stage of HS.

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Response to tofacitinib therapy of eyebrows and eyelashes in alopecia areata



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Human Oncoviruses: Mucocutaneous Manifestations, Pathogenesis, Therapeutics, and Prevention (Part II: Hepatitis Viruses, Human T-cell Leukemia Viruses, Herpesviruses, and Epstein-Barr Virus)

In 1964, the first human oncovirus, Epstein-Barr virus (EBV), was identified in Burkitt lymphoma cells. Since then, six other human oncoviruses have been identified: human papillomavirus (HPV), Merkel cell polyomavirus (MCPyV), hepatitis B and C viruses (HBV and HCV), human T-cell lymphotropic virus-1 (HTLV-1), and human herpesvirus-8 (HHV-8). These viruses are causally linked to 12% of all cancers, many of which have mucocutaneous manifestations. Additionally, oncoviruses are associated with many benign mucocutaneous diseases.

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Human Oncoviruses: Mucocutaneous Manifestations, Pathogenesis, Therapeutics, and Prevention (Part I: Papillomaviruses and Merkel cell polyomavirus)

In 1964, the first human oncovirus, Epstein-Barr virus (EBV), was identified in Burkitt lymphoma cells. Since then, six other human oncoviruses have been identified: human papillomavirus (HPV), Merkel cell polyomavirus (MCPyV), hepatitis B and C viruses (HBV and HCV), human T-cell lymphotropic virus-1 (HTLV-1), and human herpesvirus-8 (HHV-8). These viruses are causally linked to 12% of all cancers, many of which have mucocutaneous manifestations. Additionally, oncoviruses are associated with multiple benign mucocutaneous diseases.

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Psoriasis and Hidradenitis Suppurativa: A Large-scale Population-based Study

How does this article integrate into what was already known This large-scale study reveals a significant association between psoriasis and hidradenitis suppurativa, and supports previous case reports and small studies. How does it change practice? That is, what does the article mean to the practice of dermatology and what should you do as a result of having read this article? What should change in the way you practice Awareness of this association is valuable to physicians treating patients with psoriasis, and systemic therapies confirmed as effective for both conditions may be preferred in patients with dual diagnosis.

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Impaired eating‐related quality of life in chronic rhinosinusitis

Background

Despite the tremendous burden of smell and taste dysfunction in patients with chronic rhinosinusitis (CRS), objective measures of smell and taste fail to fully account for eating‐related disruptions in CRS patient quality of life (QOL). In this study we sought to investigate the driving force behind impaired eating‐related QOL in CRS patients.

Methods

Adult CRS patients were prospectively enrolled and answered a series of surveys relating to smell, taste, overall sinus‐specific QOL, and depression. Patients with both smell‐related and taste‐related eating complaints were considered to have impaired eating‐related QOL. Clinical demographics, objective chemosensory scores, and endoscopy scores were collected.

Results

Seventy patients were enrolled and 23% showed impaired eating‐related QOL. In multivariable analyses, patients with aspirin‐exacerbated respiratory disease (AERD) showed 10.7 times higher odds of impaired eating‐related QOL (odds ratio [OR] 10.72; 95% confidence interval [CI], 1.09 to 105.09; p = 0.042); meanwhile, for every 1‐point increase in depression scores, the odds of impaired eating‐related QOL increased by 1.3 (OR 1.31; 95% CI, 1.10 to 1.57; p = 0.003). For every 1‐point decrease in orthonasal olfactory threshold, the odds of impaired eating‐related QOL increased by 1.9 times (OR 1.85; 95% CI, 1.14 to 3.00; p = 0.013). Symptom scores, polyp status, endoscopic scores, and other olfactory measures did not remain significant after adjusting for other variables in forward‐selection multivariable modeling.

Conclusion

Disruptions in eating‐related QOL cannot be fully explained by objective smell or taste testing alone. We identified AERD and depression as independent risk factors for greater odds of impaired eating‐related QOL in CRS. Improved orthonasal threshold scores were independently associated with better eating‐related QOL.



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From stem cells protection to skin microbiota balance: Orobanche rapum extract, a new natural strategy

Summary

Background

Healthy skin is a delicate balance between skin renewal and microbiota homeostasis, and its imbalance promotes premature aging and dermatological disorders. Skin stem cells are key actors in this process but their sensitivity to aging and external stressors such as UV reduces the skin renewal power. The skin microbiota has been recently described as active in the healthy skin, and its imbalance could trigger some disorders.

Aims

We hypothesized that reactivation of stem cells and maintenance of microbiota could be a disruptive strategy for younger and healthier skin. We thus developed a new plant extract that restores the entire skin renewal process by sequential activation from stem cells stimulation to microbiota protection.

Methods

We studied stem cells comportment in the presence of Orobanche rapum extract by survivin immunocytochemistry and caspases 3 and 9 dosages. We also analyzed epidermal differentiation markers by immunohistochemistry and lipids organization by GC/MS At the clinical level, we investigated the impact of O. rapum extract on microbiota and on skin aspect.

Results

We demonstrated an active protection of skin stem cells through the maintenance of their clone‐forming capacity and resistance to UV through the overexpression of survivin coupled to caspases inhibition. Furthermore, we showed the restoration of epidermal differentiation markers and ceramide biosynthesis favorable to orthorhombic organization. Clinical studies, including microbiota analysis, showed an active skin surface renewal coupled with microbiota protection.

Conclusion

We evidenced that our active ingredient is able to stimulate skin rejuvenation while protecting the cutaneous microbiota, creating healthier skin and thereby beauty.



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SDHx gene detection and clinical Phenotypic analysis of multiple paraganglioma in the head and neck

Objectives

The goal of this study was to detect and explore the mechanisms of the succinate dehydrogenase (SDH) complex subunit‐related gene mutations in cases of multiple paraganglioma (PGL) in the head and neck.

Methods

In Beijing Tongren Hospital (Capital Medical University, Beijing, People's Republic of China) between January 2013 and February 2017, 23 cases of head and neck multiple PGL were evaluated by genetic sequencing. From these cases, four hereditary families and 10 cases with sporadic occurrences were found. Gene mutations, including SDHD, SDHB, SDHC, SDHAF2, VHL and RET in germ cells and somatic cells, were detected by gene capture and high throughput sequencing.

Results

In family 1, 12 instances of SDHD gene mutation were detected, eight of which manifested as bilateral carotid body tumor (CBT) with one bilateral malignant CBT. In family 2, three cases of SDHD mutation were found with one case of bilateral CBT and two cases of unilateral CBT. In family 3, two cases of SDHD gene mutation were found, both characterized by vagus PGL and pheochromocytoma. Of the 10 patients with sporadic manifestations, five cases of SDHD gene mutation and one case of RET gene mutation were detected. Two novel gene mutations, c.387_393del7 mutation of SDHD gene and c.3247A>G mutation of RET gene, were also detected.

Conclusion

In patients with multiple PGL in the head and neck, these are accompanied by a genetic mutation of the germ cell. In this case study, this mutation was most commonly a mutation of the SDHD gene.

Level of Evidence

4. Laryngoscope, 2018



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When to replace legacy cochlear implants for technological upgrades: Indications and outcomes

Objective

To determine indications, surgical efficacy, and audiologic outcomes of replacing Advanced Bionics Clarion C1.2 internal devices (Advanced Bionics, LLC, Valencia, CA) as a means of technology upgrade.

Study Design

Retrospective review, case series.

Methods

Ten patients were initially implanted as a child (mean age = 3.87 years) and underwent cochlear implant reimplantation (CIR) with current Advanced Bionics internal device as a young adult (mean duration of implant use = 15.66 years). Demographic data and pre‐ and post‐CIR speech perception scores were collected.

Results

Technology upgrade was the primary (9) or secondary (1) motivation for CIR. No surgical complications were noted, and full insertion was obtained in nine cases. Intraoperative impedance levels and neural response imaging measures were within normal limits for eight patients. At most recent post‐CIR follow‐up evaluation, all patients (100%) performed within or better than the 95% confidence interval of their pre‐CIR word and sentence recognition scores; and 55.6%, 50.0%, and 50.0% of patients performed above the 95% confidence interval of their pre‐CIR scores for the CNC words, sentences in quiet, and sentences in noise, respectively.

Conclusion

Post‐CIR audiological benefit was stable or improved compared to pre‐CIR results in all categories by 3 months after reactivation. Given these results, patients who are unable to use the most current external processors due to incompatibility with a legacy internal device could consider reimplanation to optimize their overall performance with a cochlear implant.

Level of Evidence

4. Laryngoscope, 2018



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Vocal motor control and central auditory impairments in unilateral vocal fold paralysis

Objectives

To evaluate differences in vocal motor control and central auditory processing between treated unilateral vocal fold paralysis (UVFP) and healthy control cohorts.

Study Design

Cross‐sectional.

Methods

Ten UVFP study patients treated by type I thyroplasty with stable voices were compared to 12 control subjects for vocal motor control using a pitch perturbation response task and central auditory processing performance using a battery of complex sound intelligibility assays that included adverse temporal and noise conditions. Standard clinical evaluations of voice production and peripheral audiometric sensitivity were performed.

Results

Vocal motor control was impaired in treated UVFP. The UVFP cohort exhibited a 32.5% reduction in the instantaneous, subconscious compensatory response to pitch feedback perturbation in the interval between 150 ms and 550 ms following onset (P < 0.0001, linear mixed effects model). This impairment cannot simply be ascribed to vocal motor capacity insufficiency in the UVFP cohort because both cohorts demonstrated comparable functional capacity to perform the vocal motor task. The UVFP cohort also showed greater propensity for central auditory processing impairment (P < 0.05), notably for temporal compression and added noise challenges.

Conclusion

Combined central vocal motor control and auditory processing impairments in treated UVFP highlight reciprocal interdependency of sensory and motor systems. This pilot study suggests that peripheral motor impairment of the larynx can degrade central auditory processing, which in turn may contribute to vocal motor control impairment. A more complete restoration communicative function in UVFP will require deeper understanding of sensory, motor, and sensorimotor aspects of the human communication loop.

Level of Evidence

3b Laryngoscope, 2018



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Correlating laryngoscopic appearance of laryngeal lesions with histopathology

Objectives/Hypothesis

Meticulous scrutiny of laryngeal lesions with laryngoscopes and microscopes often identify angiogenic activity, one of the hallmarks of neoplastic and preneoplastic lesions. The aim of this study was to determine if there is an association between laryngoscopic appearance and histopathology of laryngeal lesions based on operative biopsies.

Study Design

Retrospective case‐control study.

Methods

One hundred forty‐four laryngeal biopsies from 92 patients between 2015 and 2017 met inclusion criteria. Cases were patients who had biopsy‐proven laryngeal dysplasia or malignancy. Controls were patients who had benign laryngeal pathology. All of the laryngeal lesions had either keratosis or vascular stippling, an indication of angiogenic activity. Medical records, videostroboscopies and operative findings of these patients were reviewed. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of laryngeal lesions and presence or absence of dysplasia and invasive carcinoma.

Results

Fifty percent of the 144 laryngeal lesions were classified either as dysplastic or malignant by histopathology. Vascular stippling was present in 31% of all laryngeal lesions. On logistic regression, vascular stippling was significantly associated with dysplastic and malignant lesions (P = .0018). Overall sensitivity and specificity of vascular stippling and the presence of dysplasia and malignancy were 51% and 89%, respectively.

Conclusions

Laryngoscopic and microscopic appearance of vascular stippling could inform clinicians on diagnostic sampling of suspicious laryngeal lesions that reduces delay in diagnosis. The low sensitivity of vascular stippling underlies the importance of maintaining high clinical suspicion and proceeding to the operating theater for adequate tissue sampling.

Level of Evidence

3 Laryngoscope, 2018



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Infections of the Ears, Nose, Throat, and Sinuses. Edited by Marlene L. Durand and Daniel G. Deschler . Heidelberg, Germany: Springer; 2018; 404 pp. $199.00



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Primär kutane Lymphome – eine Fallserie von 163 Patienten

Zusammenfassung

Hintergrund

Neben einem breiten, klinisch vielgestaltigen Spektrum bekannter primär kutaner Lymphome, für die eine Inzidenz von 1–3:100.000 angegeben wird, werden jedes Jahr weitere Entitäten präzisiert und definiert. Ziel ist die Darstellung einer Fallserie aus dem klinischen Alltag.

Methodik

Innerhalb eines Zeitraumes von 6 Jahren und 2 Monaten wurden Patienten mit kutanen Lymphomen in der Klinik für Dermatologie und Venerologie am Universitätsklinikum Freiburg registriert. Die Mycosis fungoides (MF) mit ihren Varianten, Sézary-Syndrome (SS), CD30+-lymphoproliferative Erkrankungen, Einzelfälle seltener kutaner Lymphome und Subkollektive der B‑Zell-Lymphome sind erfasst. Die große Anzahl der MF-Fälle erlaubte zusätzlich auch die quantitative Analyse der angewendeten Therapien.

Ergebnisse

Die Auswertung von 163 primär kutanen Lymphomen mit jährlich 16 bis 25 Neudiagnosen ergab 111 Fälle mit einer MF einschließlich 9 besonderer MF-Varianten (68,1 %), 15 primär kutane CD30+-lymphoproliferative Erkrankungen (9,2 %), dominierend mit 10 Fällen einer lymphomatoiden Papulose (LyP) neben 5 primär kutanen anaplastisch großzelligen Lymphomen (PCALCL), 6 SS (3,68 %) und 24 kutane B‑Zell-Lymphome (14,72 %). Drei Fälle seltener Varianten primär kutaner T/NK(natürliche Killerzellen)-Zell-Lymphome werden gesondert ausgeführt. Es waren 82 % der MF-Fälle im Stadium IA/IB. Für die Stadien I–III wurden therapeutisch in einem absteigenden Ranking Glukokortikoide und diverse UV-Therapien, Bexaroten, Interferon-α, Methotrexat und extrakorporale Photopherese eingesetzt.

Schlussfolgerungen

Lymphomdiagnosen gehören in ein weites differenzialdiagnostisches Spektrum. Die hier dargestellte Registrierung stellt häufige Befunde dar und zeigt seltene Varianten. Man diagnostiziert nur, was man kennt. Dementsprechend können Fallsammlungen, zu denen wir ermutigen möchten, zur Aufarbeitung und Spezifizierung von Entitäten beitragen.



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Panorama Dermatologische Praxis



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Warum Andrologie in der Dermatologie

Zusammenfassung

Die Andrologie entwickelte sich vor mehr als 100 Jahren, um der Gynäkologie eine spezifische Männermedizin v. a. in der Reproduktionsmedizin an die Seite zu stellen. Die ersten Impulse zur klinischen und wissenschaftlichen Entwicklung des Faches gingen in Deutschland von Dermatologen aus. Die Dermatologie darf daher als Mutterdisziplin der Andrologie angesehen werden. Im Jahr 2003 wurde der Sichtbarkeit der Andrologie im medizinischen Fächerkanon durch die Einführung einer Zusatzbezeichnung für Dermatologen, Endokrinologen und Urologen Rechnung getragen, da auch die beiden anderen medizinischen Disziplinen sich mehr und mehr mit andrologischen Fragestellungen beschäftigten. Heute sind die Urologen sowohl unter den Mitgliedern der Gesellschaft für Andrologie als auch unter den Ärzten mit der Zusatzbezeichnung in der Mehrheit. In der Dermatologie gibt es neben den reproduktionsmedizinischen Fragestellungen viele weitere Topics, die den Einschluss der Andrologie lohnen. Deshalb wird die Einbindung dieses Faches nicht nur aus historischen Gründen gepflegt. Die Andrologie ist eine lebendige Subdisziplin in der Dermatologie, und junge Dermatologen sollten zur Beschäftigung mit ihr motiviert sein.



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Linear lipoatrophy following intra‐articular triamcinolone acetonide injection mimicking linear scleroderma

Abstract

A 12‐year‐old female with oligoarticular juvenile inflammatory arthritis developed an atrophic linear plaque involving the left medial forearm and proximal arm 7 months after intra‐articular triamcinolone injection for arthritis. The plaque spontaneously resolved without treatment over approximately one year. It is important to recognize this rare complication of intra‐articular steroid injection in order to avoid potential misdiagnosis as linear scleroderma and subsequent immunosuppressive treatment.



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An unexpected cause of bilateral periorbital oedema



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Assesment of Transient Palmoplantar Keratoderma With Bullous Pemphigoid

This case series study of 6 patients describes the clinical and immunologic characteristics of bullous pemphigoid associated with transient palmoplantar keratoderma.

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Erythematous Papule on the Glans Penis

A 60-year-old man with a history of IgA kappa multiple myeloma was referred for evaluation of an indolent, erythematous papule on his glans penis of 2 weeks' duration; he denied sexual risk behavior and reported no recent changes in medication. What is your diagnosis?

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Nationwide Incidence of Metastatic Cutaneous Squamous Cell Carcinoma in England

This population-based study assesses the national incidence of cutaneous and metastatic cutaneous squamous cell carcinoma in England from 2013 through 2015.

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Creating a Partnership Between Dermatologists and Geriatricians

To the Editor We read with great interest and enthusiasm the recent Viewpoint by Linos et al about the need to create a coherent framework to address geriatric dermatologic issues. We agree that older adults are a rapidly expanding and vulnerable segment of the population who require special attention by dermatologists.

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Creating a Partnership Between Dermatologists and Geriatricians—Reply

In Reply We thank Drs Mundluru and Lee for their thoughtful response to our Viewpoint titled "Geriatric Dermatology—A Framework for Caring for Older Patients With Skin Disease." We agree that we need to create practical collaborations that simultaneously support increased knowledge of dermatology in the field of geriatrics while also broadening the knowledge and application of geriatrics in the field of dermatology. We share a common goal—to improve the care of older adults with skin disease. Collaboration is essential. We support the proposed approach to improving the content of dermatology in geriatrics fellowships.

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Patch Testing and Allergen-Specific Inhibition in a Patient Taking Dupilumab

This case report describes changes in repeated patch test results in a patient receiving dupilumab therapy.

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Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks

This study compares the accuracy of a convolutional neural network–based classifier with that of physicians with different levels of experience at classifying dermoscopic and close-up images of nonpigmented lesions.

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Utility of Naltrexone Treatment for Chronic Inflammatory Dermatologic Conditions

This systematic review examines the literature on low- and high-dose naltrexone to summarize evidence about the drug's potential use in treatment of chronic inflammatory conditions of the skin.

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The Difficult Secondary Tracheoesophageal Puncture: A Technique for Safe Insertion

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Background/Aims: The tracheoesophageal prothesis (TEP) has become the primary modality for laryngeal communication after total laryngectomy due to high success rates, minimal morbidity, and more natural pulmonary driven speech. Fibrosis, kyphosis, and post-radiation contracture may preclude TEP placement through rigid esophagoscopy, and certain patients may not tolerate an in-office awake procedure. For such patients, a technique for flexible esophageal stenting and TEP placement is necessary. Methods: We performed a retrospective review of 3 patients who underwent TEP placement through endotracheal-tube esophageal stenting at the Massachusetts Eye and Ear Infirmary. Results: All 3 patients underwent laryngectomy after prior chemoradiotherapy for laryngeal cancer with resulting neck contracture and fibrosis preventing rigid esophagoscopy. All patients underwent successful TEP placement through endotracheal stenting without complication and developed excellent tracheoesophageal speech. Specific technical details are highlighted. Conclusions: In patients with anatomical constraints preventing traditional TEP placement through rigid esophagoscopy, fiberoptic guidance through an endotracheal tube stent provides a safe and efficient approach for TEP placement.
ORL 2019;81:10–15

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Proceeding report of the Second Symposium on Hidradenitis Suppurativa Advances (SHSA) 2017

Abstract

The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA, and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This was the second annual meeting of the SHSA with experts from different disciplines arriving from North America, Europe and Australia, in a joint aim to discuss most recent innovations, practical challenges and potential solutions to issues related in the management and care of Hidradenitis Suppurativa patients. The last session involved clinicians, patients and their families in an effort to educate them more about the disease.

This article is protected by copyright. All rights reserved.



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Aktuelle Therapiekonzepte bei Kopf-Hals-Karzinomen



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Implantierbare Hörsysteme



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Subglottic acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia (ALL) is one of the the most common malignancies of childhood and can occasionally present as acute airway obstruction. We present the unusual case of a 1-year-old boy who was referred to our Paediatric Otolaryngology (ENT) clinic with a recurrent history of croup. This is the first reported case of localised ALL presenting as a subglottic mass in a paediatric patient. It highlights the need to have a broader differential diagnosis in children presenting with 'recurrent croup' including extramedullary presentation of leukaemia and to have a low threshold for performing endoscopy in such cases.



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Metformin-associated lactic acidosis precipitated by liraglutide use: adverse effects of aggressive antihyperglycaemic therapy

Older patients with type 2 diabetes are prone to developing adverse events with aggressive antihyperglycaemic therapy. Metformin-associated lactic acidosis (MALA) is one such rare, life-threatening adverse drug effect. We report the case of a 70-year-old man with a glycated haemoglobin of 7.9% who was on a stable, maximally tolerated dose of metformin for managing his type 2 diabetes. He was initiated on liraglutide injections with hopes to achieve better glycaemic control, but developed unrelenting nausea and vomiting during the third week of treatment. He presented to the hospital with these symptoms and was noted to have severe MALA. He sustained an in-hospital cardiac arrest requiring emergent resuscitation along with vasopressor and mechanical ventilator support. He underwent continuous venovenous haemodiafiltration to remove metformin and correct the acidosis, following which he stabilised and supportive therapy was weaned off. He was discharged from the hospital on insulin therapy with incomplete renal recovery.



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Corynebacterium striatum prosthetic valve endocarditis with severe aortic regurgitation successfully treated with transcatheter aortic valve replacement

We describe the case of a 69-year-old man with a history of bioprosthetic aortic valve replacement who presented with Corynebacterium striatum prosthetic valve endocarditis (PVE) complicated by severe aortic insufficiency with refractory cardiogenic shock despite antibiotic therapy. He was considered a prohibitive-risk surgical candidate due to co-morbid conditions and off-label valve-in-valve transcatheter aortic valve replacement (TAVR) was performed after detailed multidisciplinary evaluation. He recovered well without recurrent infection following completion of antibiotics and transthoracic echocardiogram at 12 months showed a normal functioning prosthetic valve. To our knowledge, this is the first reported case of native or PVE treated with TAVR.



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Tardy ulnar nerve palsy following a neglected childhood lateral epicondyle fracture non-union and resultant cubitus valgus deformity



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Insertion of a Dumon Y-stent via a permanent tracheostoma without using a rigid bronchoscope

A 63-year-old man who had received a permanent tracheostoma after oesophageal cancer surgery developed fistulas in the left and right main bronchi and suffered repeated aspiration pneumonia. Placing an indwelling Dumon Y-stent using a rigid bronchoscope is an option to treat fistula and stenosis at the tracheal bifurcation, but in some cases, it may be difficult to use a rigid bronchoscope in patients with a permanent tracheostoma. In this study, we report placing a Dumon Y-stent in a patient with a permanent tracheostoma using a specially modified stent and forceps instead of a rigid bronchoscope.



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Spontaneous intestinal perforation in a preterm neonate



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Superior sinus venosus atrial septal defect with anomalous pulmonary venous drainage



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Foot drop post varicella zoster virus

Leg pain and weakness can often be seen in a musculoskeletal physiotherapy outpatient setting. While the differential diagnoses for neuropathic pain and weakness is often spine related, this unusual cause for polyradiculopathy is less commonly seen. Shingles is not something routinely seen in a physiotherapy department but is usually associated with skin eruptions and pain but less so with motor loss. The purpose of this case report is to therefore raise awareness that this presentation can occur and should not be mistaken for spinal radiculopathy.



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Dandy-Walker variant with precocious puberty: a rare association

Precocious puberty is characterised by premature appearance of secondary sexual characteristics before the age of 7 years in girls and 9 years in boys. Dandy-Walker malformation comprises a spectrum of intracranial malformations of the posterior fossa. We present a case of a 7-year-old male child who has presented with features of central precocious puberty and on further evaluation has been found to have Dandy-Walker variant and secondary hypothyroidism. The following case report describes this association which is extremely rare and has never been described in literature.



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Hiding in plain sight: a brain lesion in a patient with a history of colon and breast cancer

We present a case of a 76-year-old woman who was admitted to our hospital with a low Glasgow Coma Scale score. She had a medical history of breast and colon cancer. The CT scan showed possible diagnosis of brain metastasis. However, the MRI scan showed this to be a completely different diagnosis.



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Does ocular inflammation play a role in xeroderma pigmentosum with endothelial dysfunction: an immunological study

We report a case of xeroderma pigmentosum (XP) with endothelial dysfunction where the analysis of tears revealed elevated levels of proinflammatory cytokines, even in the absence of active inflammation and neovascularisation of the ocular surface. Although the role of ultraviolet (UV) radiation-induced inflammation in the occurrence of ocular manifestations of XP is known, little is published on the molecular mechanisms and there are no reports quantifying the presence of inflammatory cytokines in the tears of patients with ocular involvement of XP. Tear analysis demonstrated an increase in inflammatory cytokines and chemokines, especially interleukin-8 (2.38 ng/µg), tumour necrosis factor alpha (0.87 ng/µg) and granulocyte monocyte colony stimulating factor (0.44 ng/µg) as compared with the control eye. Effective management of the underlying UV-induced inflammation and promoting DNA repair may play a vital role in managing ocular manifestations and its sequelae in patients of XP.



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Laundry detergents and detergent residue after rinse directly disrupt tight junction barrier integrity in human bronchial epithelial cells

Publication date: Available online 27 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Ming Wang, Ge Tan, Andrzej Eljaszewicz, Yifan Meng, Paulina Wawrzyniak, Swati Acharya, Can Altunbulakli, Patrick Westermann, Anita Dreher, Liying Yan, Chengshuo Wang, Mubeccel Akdis, Luo Zhang, Kari C. Nadeau, Cezmi A. Akdis

Abstract
Background

Defects in epithelial barrier have recently been associated with asthma and other allergies. The influence of laundry detergents on human bronchial epithelial cells (HBECs) and their barrier function remain unknown.

Objective

We investigated the effects of laundry detergents on cytotoxicity, barrier function, transcriptome and epigenome in HBECs.

Methods

Air-liquid interface cultures of primary HBECs from healthy control subjects, asthma and chronic obstructive pulmonary disease patients were exposed to laundry detergents and detergent residue after rinse. The cytotoxicity and epithelial barrier function were evaluated. RNA sequencing, assay for transposase accessible chromatin with high-throughput sequencing and DNA methylation arrays were used for checking transcriptome and epigenome.

Results

Laundry detergents and rinse residue showed dose dependent toxic effect to HBECs with irregular cell shape and leakage of lactate dehydrogenase after 24h exposure. A disrupted epithelial barrier function was found with decreased transepithelial electric resistance, increased paracellular flux and stratified tight junction immunostaining in HBECs exposed to laundry detergent at 1:25,000 dilutions or rinse residue at further 1:10 dilutions. RNA sequencing analysis showed that lipid metabolism, apoptosis progress and epithelial-derived alarmins related genes were up-regulated, while cell adhesion related genes were down-regulated by laundry detergent at 1:50,000 dilutions after 24h exposure without substantially affecting chromatin accessibility and DNA methylation.

Conclusion

Our data demonstrate that laundry detergents even at a very high dilution and rinse residue show significant cell toxic and directly disruptive effects on the tight junction barrier integrity of HBECs without affecting the epigenome and tight junction genes expression.



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Early B cell developmental impairment with progressive B cell deficiency in NFKB2 mutated CVID disease without autoimmunity

Publication date: Available online 28 November 2018

Source: Clinical Immunology

Author(s): Vassilios Lougaris, Daniele Moratto, Manuela Baronio, Tiziana Lorenzini, Stefano Rossi, Luisa Gazzurelli, Maria Pia Bondioni, Alessandro Plebani

Abstract

This study provides evidence for a novel role for NFKB2 in human B cell development in the bone marrow and in the periphery, leading to progressive peripheral B cell deficiency not always combined with autoimmune phenomena, broadening thus the clinical spectrum of NFKB2 mutated CVID disease and implying an essential role for NFKB2 in early human B cell development.



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The role and clinical significance of programmed cell death- ligand 1 expressed on CD19+B-cells and subsets in systemic lupus erythematosus

Publication date: Available online 28 November 2018

Source: Clinical Immunology

Author(s): Xiao-Yun Jia, Qing-qing Zhu, Yuan-Yuan Wang, Yang Lu, Zhi-Jun Li, Bai-Qing Li, Jie Tang, Hong-Tao Wang, Chuan-Wang Song, Chang-Hao Xie, Lin-Jie Chen

Abstract
Background

Programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1)-targeted therapies have enhanced T-cell response and demonstrated efficacy in the treatment of multiple cancers. However, the role and clinical significance of PD-L1 expression on CD19+ B-cells and their subsets, with particular reference to systemic lupus erythematosus (SLE), have not yet been studied in detail.

Objective

The present study aimed to investigate PD-L1 expression on CD19+ B-cells and their subsets, in addition to exploring its possible role in Tfh-cell activation and B-cell differentiation in SLE.

Methods

Frequencies of CD19+ B-cells, their subsets, PD-L1 and Tfh cells in the peripheral blood of SLE patients and healthy controls (HCs) were determined using cytometry. The clinical data of SLE patients were recorded in detail, and the correlation between their laboratory parameters, clinical parameters and disease activity indices was statistically analyzed. CD19+PD-L1+B-cells and CD19+PD-L1 B-cells were sorted and cultured with a stimulant, following which the supernatants were collected for immunoglobulin G and anti-double stranded DNA detection via enzyme-linked immunosorbent assay.

Results

In SLE patients, CD19+B-cells and partial subgroups were enriched in peripheral blood. Also, the observed increase in the frequency of CD19+PD-L1+B-cells was significantly associated with a higher disease activity index. An in vitro culture test demonstrated that the amounts of anti-dsDNA and immunoglobulin G secreted by the CD19+PD-L1+B-cells of SLE patients and HCs were vastly different. In addition, a strong correlation existed between the frequencies of CD19+PD-L1+B-cells and defined Tfh cells of SLE patients.

Conclusion

This study demonstrated that the expression of CD19+PD-L1+B-cells in the peripheral blood of SLE patients was abnormal, and that disease-related laboratory parameters and clinical indicators were correlated. CD19+PD-L1+B-cells were enriched and played a critical role in activating the pathogenic T-cell and B-cell responses in patients with SLE.



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STRUCTURAL CLASSIFICATION SYSTEM FOR LOAD BEARING MASONRY SCHOOL BUILDINGS

Adhikari, RK; D'Ayala, DF; Ferreira, CF; Cortez, FR; (2018) STRUCTURAL CLASSIFICATION SYSTEM FOR LOAD BEARING MASONRY SCHOOL BUILDINGS. In: (Proceedings) 16th European Conference on Earthquake Engineering (16ECEE). European Association of Earthquake Engineering (EAEE) (In press). Green open access

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New Neuronal Subtypes With a "Pre-Pancreatic" Signature in the Sea Urchin Stongylocentrotus purpuratus

Perillo, M; Paganos, P; Mattiello, T; Cocurullo, M; Oliveri, P; Arnone, M; (2018) New Neuronal Subtypes With a "Pre-Pancreatic" Signature in the Sea Urchin Stongylocentrotus purpuratus. Frontiers in Endocrinology , 9 , Article 650. 10.3389/fendo.2018.00650 . Green open access

https://ift.tt/2FJ95vq

A New Hierarchical Redundancy Eliminated Tree Augmented Naive Bayes Classifier for Coping with Gene Ontology-based Features

Wan, C; Freitas,, AA; (2016) A New Hierarchical Redundancy Eliminated Tree Augmented Naive Bayes Classifier for Coping with Gene Ontology-based Features. In: Proceedings of the 33rd International Conference on International Conference on Machine Learning 2017. JMLR: New York, USA. Green open access

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Kawasaki disease: a prospective population survey in the UK and Ireland from 2013 to 2015

Tulloh, RMR; Mayon-White, R; Harnden, A; Ramanan, AV; Tizard, EJ; Shingadia, D; Michie, CA; ... Brogan, PA; + view all Tulloh, RMR; Mayon-White, R; Harnden, A; Ramanan, AV; Tizard, EJ; Shingadia, D; Michie, CA; Lynn, RM; Levin, M; Franklin, OD; Craggs, P; Davidson, S; Stirzaker, R; Danson, M; Brogan, PA; - view fewer (2018) Kawasaki disease: a prospective population survey in the UK and Ireland from 2013 to 2015. Archives of Disease in Childhood 10.1136/archdischild-2018-315087 . (In press). Green open access

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Patient-reported outcomes from a randomized phase II study of the deferasirox film-coated tablet in patients with transfusion-dependent anemias

Taher, AT; Origa, R; Perrotta, S; Kouraklis, A; Ruffo, GB; Kattamis, A; Goh, A-S; ... Porter, JB; + view all Taher, AT; Origa, R; Perrotta, S; Kouraklis, A; Ruffo, GB; Kattamis, A; Goh, A-S; Huang, V; Zia, A; Herranz, RM; Porter, JB; - view fewer (2018) Patient-reported outcomes from a randomized phase II study of the deferasirox film-coated tablet in patients with transfusion-dependent anemias. Health and Quality of Life Outcomes , 16 , Article 216. 10.1186/s12955-018-1041-5 . Green open access

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Development of a 3D Collagen Model for the In Vitro Evaluation of Magnetic-assisted Osteogenesis

Huang, J; (2018) Development of a 3D Collagen Model for the In Vitro Evaluation of Magnetic-assisted Osteogenesis. Scientific Reports , 8 , Article 16270. 10.1038/s41598-018-33455-2 . Green open access

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Developmental links between speech perception in noise, singing, and cortical processing of music in children with cochlear implants

Faulkner, A; Torppa, R; Kujala, T; Huotilainen, M; Lipsanen, J; (2018) Developmental links between speech perception in noise, singing, and cortical processing of music in children with cochlear implants. Music Perception , 36 (2) pp. 156-174. 10.1525/MP.2018.36.2.156 . Green open access

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Associations of Y chromosomal haplogroups with cardiometabolic risk factors and subclinical vascular measures in males during childhood and adolescence

O'Keeffe, LM; Howe, LD; Fraser, A; Hughes, AD; Wade, KH; Anderson, EL; Lawlor, DA; ... Stergiakouli, E; + view all O'Keeffe, LM; Howe, LD; Fraser, A; Hughes, AD; Wade, KH; Anderson, EL; Lawlor, DA; Erzurumluoglu, AM; Davey-Smith, G; Rodriguez, S; Stergiakouli, E; - view fewer (2018) Associations of Y chromosomal haplogroups with cardiometabolic risk factors and subclinical vascular measures in males during childhood and adolescence. Atherosclerosis , 274 pp. 94-103. 10.1016/j.atherosclerosis.2018.04.027 . Green open access

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New evidence of predation on humans by cookiecutter sharks in Kauai, Hawaii

Ribéreau-Gayon, A; Carter, DO; Regan, S; (2018) New evidence of predation on humans by cookiecutter sharks in Kauai, Hawaii. International Journal of Legal Medicine , 132 (5) pp. 1381-1387. 10.1007/s00414-018-1786-8 . Green open access

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Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review

Flynn, S; Vereenooghe, L; Hastings, RP; Adams, D; Cooper, S-A; Gore, N; Hatton, C; ... Waite, J; + view all Flynn, S; Vereenooghe, L; Hastings, RP; Adams, D; Cooper, S-A; Gore, N; Hatton, C; Hood, K; Jahoda, A; Langdon, PE; McNamara, R; Oliver, C; Roy, A; Totsika, V; Waite, J; - view fewer (2017) Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review. [Review]. Clinical Psychology Review , 57 pp. 32-44. 10.1016/j.cpr.2017.08.006 .

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ALPS: the Arbitrary Linear Plasma Solver

Verscharen, D; Klein, KG; Chandran, BDG; Stevens, ML; Salem, CS; Bale, SD; (2018) ALPS: the Arbitrary Linear Plasma Solver. Journal of Plasma Physics , 84 (4) , Article 905840403. 10.1017/S0022377818000739 . Green open access

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Automatic Cone Photoreceptor Localisation in Healthy and Stargardt Afflicted Retinas Using Deep Learning

Davidson, B; Kalitzeos, A; Carroll, J; Dubra, A; Ourselin, S; Michaelides, M; Bergeles, C; (2018) Automatic Cone Photoreceptor Localisation in Healthy and Stargardt Afflicted Retinas Using Deep Learning. Scientific Reports , 8 , Article 7911. 10.1038/s41598-018-26350-3 . Green open access

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Spatial distribution of multiple sclerosis lesions in the cervical spinal cord

Eden, D; Gros, C; Badji, A; ........, ; Ciccarelli, O; (2019) Spatial distribution of multiple sclerosis lesions in the cervical spinal cord. Brain (In press).

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Adversarial Sets for Regularising Neural Link Predictors

Minervini, P; Demeester, T; Rocktäschel, T; Riedel, S; (2017) Adversarial Sets for Regularising Neural Link Predictors. In: Elidan, Gal and Kersting, Kristian and Ihler, Alexander, (eds.) Proceedings of the 33rd Conference on Uncertainty in Artificial Intelligence (UAI 2017). Curran Associates Inc: Red Hook, NY, USA.

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The Factor Structure of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in Thirteen Distinct Populations

Halamová, J; Kanovský, M; Gilbert, P; Troop, NA; Zuroff, DC; Hermanto, N; Petrocchi, N; ... Kupeli, N; + view all Halamová, J; Kanovský, M; Gilbert, P; Troop, NA; Zuroff, DC; Hermanto, N; Petrocchi, N; Sommers-Spijkerman, M; Kirby, JN; Shahar, B; Krieger, T; Matos, M; Asano, K; Yu, FY; Basran, J; Kupeli, N; - view fewer (2018) The Factor Structure of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in Thirteen Distinct Populations. Journal of Psychopathology and Behavioral Assessment , 40 (4) pp. 736-751. 10.1007/s10862-018-9686-2 . Green open access

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A mindfulness parent well-being course: evaluation of outcomes for parents of children with autism and related disabilities recruited through special schools

Jones, L; Gold, E; Totsika, V; Hastings, RP; Jones, M; Griffiths, A; Silverton, S; (2018) A mindfulness parent well-being course: evaluation of outcomes for parents of children with autism and related disabilities recruited through special schools. European Journal of Special Needs Education , 33 (1) pp. 16-30. 10.1080/08856257.2017.1297571 . Green open access

https://ift.tt/2FLRDq4

Altered transcription of glutamatergic and glycinergic receptors in spinal cord dorsal horn following spinal cord transection is minimally affected by passive exercise of the hindlimbs

Chopek, JW; MacDonell, CW; Shepard, PC; Gardiner, KR; Gardiner, PF; (2018) Altered transcription of glutamatergic and glycinergic receptors in spinal cord dorsal horn following spinal cord transection is minimally affected by passive exercise of the hindlimbs. European Journal of Neuroscience , 47 (4) pp. 277-283. 10.1111/ejn.13823 .

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Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest

Moseby-Knappe, M; Mattsson, N; Nielsen, N; Zetterberg, H; Blennow, K; Dankiewicz, J; Dragancea, I; ... Cronberg, T; + view all Moseby-Knappe, M; Mattsson, N; Nielsen, N; Zetterberg, H; Blennow, K; Dankiewicz, J; Dragancea, I; Friberg, H; Lilja, G; Insel, PS; Rylander, C; Westhall, E; Kjaergaard, J; Wise, MP; Hassager, C; Kuiper, MA; Stammet, P; Wanscher, MCJ; Wetterslev, J; Erlinge, D; Horn, J; Pellis, T; Cronberg, T; - view fewer (2018) Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest. JAMA Neurology 10.1001/jamaneurol.2018.3223 . (In press).

https://ift.tt/2FLPtGW

Prediction of electronic couplings for molecular charge transfer using optimally tuned range-separated hybrid functionals

Manna, D; Blumberger, J; Martin, JML; Kronik, L; (2018) Prediction of electronic couplings for molecular charge transfer using optimally tuned range-separated hybrid functionals. Molecular Physics , 116 (19-20) pp. 2497-2505. 10.1080/00268976.2018.1489084 .

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MAGNET: A Dynamic Resource Management Architecture

Kostkova, Patricie; (1999) MAGNET: A Dynamic Resource Management Architecture. Doctoral thesis (Ph.D), City University, London, UK. Green open access

https://ift.tt/2FL9NIl

Magnolol attenuates the inflammation and enhances phagocytosis through the activation of MAPK, NF-κB signal pathways in vitro and in vivo

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Hongce Chen, Wuyu Fu, Hongyuan Chen, Siyuan You, Xiawan Liu, Yujiao Yang, Yao Wei, Jun Huang, Wen Rui

Abstract

Magnolol is a natural extract and the main bioactive component from Chinese medicine-Magnolia. We speculate that it's functional action might be associated with the anti-inflammatory effects of magnolol. Herein, the main purpose was to elucidate the phagocytic immune function and anti-inflammatory activities associated. The toxicity of magnolol on U937 and LO-2 cells was assayed by MTT, flow cytometry and laser scanning confocal microscope was utilized to detect the phagocytosis effect on U937 cells, C57BL/6 mice and the follow-up hematoxylin-eosin staining methods were used to evaluate its bioactivity in vivo. The results showed that magnolol had dose dependent effects on enhancement of phagocytosis ability and significantly inhibited the NO production at the concentration range from10 to 40 μM. Furthermore, Magnolol significantly reduced the gene expression and protein release of IL-1β and TNF-α. However, the p-ERK1/2 in MAPK signaling pathway was not significantly affected by magnolol, whereas p-JNK and p-P38 were down-regulated. Magnolol also inhibited the expression of p-IκBα and p-P65 of NF-κB signaling pathways. The loss of body weight and the shorter length of colon were significantly improved in DSS-treated colitis C57BL/6 mice after the administration of magnolol. The cytokines of pro-inflammatory factors TNF-α, IL-6 and IL-1β attenuated significantly in a concentration dependent manner. The histopathological manifestations of 5–20 mg/kg after the treatment magnolol were markedly improved in the DSS-treated mice. These findings showed that magnolol exerted an anti-inflammatory effect through immunoregulatory phagocytosis, MAPK and NF-κB signaling pathways. Our results provide experimental evidence and theory basis for research on anti-inflammatory effects for magnolol as a potentially anti-inflammatory drug candidate.

Graphical abstract

Graphical abstract for this article



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E. coli induced larger neutrophils in the peritoneal cavity of mice with severe septic peritonitis

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Yilan Song, Guang Yang, Zhiqin Li, Peiyan Zhao, Lei Yang, Cuiyun Cui, Shiyu Xing, Liying Wang, Yongli Yu

Abstract

Neutrophils, classified as professional phagocytes, are crucial in killing bacteria and preventing inflammation. When studying the roles of neutrophils in the development of the septic peritonitis induced by E. coli, we noticed some of the larger cells existed among peritoneal lavage fluid cells (PLCs). Besides the large size, their nuclei are segmented and flat, and squeezed to the marginal zone of the inner membrane. The cells, therefore, were designated as E. coli induced larger neutrophils (e-Neus). Further studies showed that, the e-Neus were ly6G positive, indicating the e-Neus were a type of neutrophils. The enlarged cell size and marginal nucleus of the e-Neus were caused by engulfing abundant of E. coli, marking the active participation of the e-Neus in clearance of E. coli. Functionally, the e-Neus generated reactive oxygen species (ROS) and IL-10. Furthermore, the occurrence and accumulation of the e-Neus were closely correlated with the severity of septic peritonitis and mortality of the mice. Overall, the e-Neus presented here may enrich the understandings on neutrophil transitions in response to various insults, and could be used to evaluate the severity of septic peritonitis induced by E. coli.



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Toll like receptor induces Ig synthesis in Catla catla by activating MAPK and NF-κB signalling

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Bhakti Patel, Rajanya Banerjee, Madhubanti Basu, Saswati S. Lenka, Mahismita Paichha, Mrinal Samanta, Surajit Das

Abstract

The molecular crosstalk of proximal innate immune receptor signaling mediated by Toll-like receptors (TLRs) is crucial in generating an adaptive immune response. The extracellular-signal regulated kinases (ERK) participate in propagating intracellular signals initiated by stimulated TLRs to transcription factors eliciting cytokine release. Although ERK signaling has been extensively studied in mammalian counterparts, very little is known about its existence in carps and its role in augmentation of immunoglobulin (Ig) synthesis. Therefore, to gain insights into the efficacy of MAP kinase cascade in orchestrating fish antigen receptor generation, Catla catla fingerlings were induced with various TLR agonists or pathogen associated molecular patterns (PAMPs). Analysis of upstream signaling events revealed that PAMPs stimulated the tissues leading to a significant upregulation (P < 0.001, One-way ANOVA) of different TLRs (TLR2, TLR3, TLR4 and TLR5) followed by activation of MyD88 dependent and independent pathway. Activation of ERK and NF-κB mediated cytokine production consequently triggered the enhanced expression of IgZ and IgM as was evident by qRT-PCR analysis, flow cytometry, immunoblotting and ELISA. Pretreatment with ERK inhibitor (UO126) antagonized PAMPs mediated TLR stimulation, leading to sequential downregulation of MyD88/NF-κB/cytokines via interrupting ERK/NF-κB signaling axis. Together these results demonstrate that TLR stimulation triggers IgZ and IgM production via activation of ERK and NF-κB in C. catla indicating that NF-κB mediated cytokine production and ERK1/2 signaling is not only functional in fish, but may be crucial for generation of Ig repertoire in lower vertebrates.

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Graphical abstract for this article



https://ift.tt/2rbuPWk

Unveiling the regulation of NKT17 cell differentiation and function

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Ageliki Tsagaratou

Abstract

Invariant natural killer T cells (iNKTs) are distinct from conventional T cells. iNKT cells express a semi-invariant T cell receptor (TCR) that can specifically recognize lipid antigens presented by CD1d, an MHC class I-like antigen-presenting molecule. Currently, iNKT cells are distinguished in three functionally distinct subsets. Each subset is defined by lineage-specifying factors: T-bet shapes the fate of NKT1 subset that mainly secretes IFNγ, Gata3 specifies the NKT2 subset that produces robustly IL-4 whereas RORγt seals the differentiation of NKT17 subset that secretes IL-17. In the present review, the focus is placed on the regulation of NKT17 specification and their function.



https://ift.tt/2FNqX8t

Palmatine attenuated dextran sulfate sodium (DSS)-induced colitis via promoting mitophagy-mediated NLRP3 inflammasome inactivation

Publication date: January 2019

Source: Molecular Immunology, Volume 105

Author(s): Chu-Tian Mai, Mei-Mei Wu, Chun-Li Wang, Zi-Ren Su, Yuan-Yuan Cheng, Xiao-Jun Zhang

Abstract

Activation of NLRP3 inflammasomes is crucial in the pathological process of Ulcerative colitis (UC), which could be negatively regulated by PINK1/Parkin-driven mitophagy. Palmatine is a herb derived isoquinoline alkaloid with potent anti-inflammatory and anti-bacteria activities. In present study, we evaluated the effect of palmatine on dextran sulfate sodium (DSS)-induced mice colitis and examined whether its effect is exerted by promoting mitophagy-mediated NLRP3 inflammasome inactivation. The result showed that palmatine (40, 100 mg/kg) significantly prevented bodyweight loss and colonic shortening in DSS mice, and reduced the disease activity index and histopathologic score. The levels of MPO, IL-1β, TNF-α and the number of F4/80+ cells in colon of DSS mice were remarkably decreased by palmatine. Moreover, palmatine suppressed NLRP3 inflammasomes activation, but enhanced the expression of the mitophagy-related proteins involving LC3, PINK1 and Parkin in colonic tissue of DSS mice. These effects was consistent with the in vitro data revealing that palmatine inhibited the activation of NLRP3 inflammasomes, while promoted the expression and mitochondrial recruitment of PINK1 and Parkin in THP-1 cell differentiated macrophages. Furthermore, the effect of palmatine on THP-1 cells was neutralized by a mitophagy inhibitor Cyclosporin A (CsA) and PINK1-siRNA. In parallel, CsA significantly attenuated the therapeutic effect of palmatine in DSS mice, illustrating that the anti-colitis effect of palmatine is closely related to mitophagy. Taken together, the current results demonstrated that palmatine protected mice against DSS-induced colitis by facilitating PINK1/Parkin-driven mitophagy and thus inactivating NLRP3 inflammasomes in macrophage.

Graphical abstract

Graphical abstract for this article



https://ift.tt/2r8C3ux

Editorial board

Publication date: December 2018

Source: Annales de Dermatologie et de Vénéréologie, Volume 145, Issue 12

Author(s):



https://ift.tt/2E2hRmw

Change in endolymphatic hydrops 2 years after endolymphatic sac surgery evaluated by MRI

Publication date: Available online 27 November 2018

Source: Auris Nasus Larynx

Author(s): Kayoko Higashi-Shingai, Takao Imai, Tomoko Okumura, Atsuhiko Uno, Tadashi Kitahara, Arata Horii, Yumi Ohta, Yasuhiro Osaki, Takashi Sato, Suzuyo Okazaki, Takefumi Kamakura, Yasumitsu Takimoto, Yoshiyuki Ozono, Yoshiyuki Watanabe, Ryusuke Imai, Yukiko Hanada, Kazuya Ohata, Ryohei Oya, Hidenori Inohara

Abstract
Objective

This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (−SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière's disease (MD).

Methods

Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings.

Results

In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the −SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level.

Conclusion

The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks.



https://ift.tt/2RiDMIV

‘Unexpected item in the bagging area’: Anomaly Detection in X-ray Security Images

Griffin, LD; Caldwell, M; Andrews, J; Bohler, H; (2019) 'Unexpected item in the bagging area': Anomaly Detection in X-ray Security Images. IEEE Transactions on Information Forensics and Security 10.1109/TIFS.2018.2881700 . Green open access

https://ift.tt/2TSAY7i

New literacy challenge for the twenty-first century: genetic knowledge is poor even among well educated

Chapman, R; Likhanov, M; Selita, F; Zakharov, I; Smith-Woolley, E; Kovas, Y; (2018) New literacy challenge for the twenty-first century: genetic knowledge is poor even among well educated. Journal of Community Genetics 10.1007/s12687-018-0363-7 . (In press). Green open access

https://ift.tt/2AshCNi

Peri-meatal PeIN and urethral SCC: a case report

Doiron, PR; Menage, HP; Freeman, A; Muneer, A; Bunker, CB; (2017) Peri-meatal PeIN and urethral SCC: a case report. Journal of the European Academy of Dermatology and Venereology , 31 (9) E409-E410. 10.1111/jdv.14207 . Green open access

https://ift.tt/2TS7qGP

Change in non-alcoholic beverage sales following a 10-pence levy on sugar-sweetened beverages within a national chain of restaurants in the UK: interrupted time series analysis of a natural experiment

Cornelsen, L; Mytton, OT; Adams, J; Gasparrini, A; Iskander, D; Knai, C; Petticrew, M; ... Cummins, S; + view all Cornelsen, L; Mytton, OT; Adams, J; Gasparrini, A; Iskander, D; Knai, C; Petticrew, M; Scott, C; Smith, R; Thompson, C; White, M; Cummins, S; - view fewer (2017) Change in non-alcoholic beverage sales following a 10-pence levy on sugar-sweetened beverages within a national chain of restaurants in the UK: interrupted time series analysis of a natural experiment. Journal of Epidemiology & Community Health , 71 (11) pp. 1107-1112. 10.1136/jech-2017-209947 . Green open access

https://ift.tt/2Awl8WT

TANGOS: The Agile Numerical Galaxy Organization System

Pontzen, A; Tremmel, M; (2018) TANGOS: The Agile Numerical Galaxy Organization System. The Astrophysical Journal Supplement Series , 237 (2) 10.3847/1538-4365/aac832 . Green open access

https://ift.tt/2TSYvF6

Interpretable Fully Convolutional Classification of Intrapapillary Capillary Loops for Real-Time Detection of Early Squamous Neoplasia

Garcéa-Peraza-Herrera, LC; Everson, M; Li, W; Luengo, I; Berger, L; Ahmad, O; Lovat, LB; ... Ourselin, S; + view all Garcéa-Peraza-Herrera, LC; Everson, M; Li, W; Luengo, I; Berger, L; Ahmad, O; Lovat, LB; Wang, H-P; Wang, W-L; Haidry, RJ; Stoyanov, D; Vercauteren, T; Ourselin, S; - view fewer (2018) Interpretable Fully Convolutional Classification of Intrapapillary Capillary Loops for Real-Time Detection of Early Squamous Neoplasia. CoRR , Article arXiv:1805.00632. Green open access

https://ift.tt/2AuJ7pn

Theoretical study of ArH+ dissociative recombination and electron-impact vibrational excitation

Abdoulanziz, A; Colboc, F; Little, DA; Moulane, Y; Mezei, JZ; Roueff, E; Tennyson, J; ... Laporta, V; + view all Abdoulanziz, A; Colboc, F; Little, DA; Moulane, Y; Mezei, JZ; Roueff, E; Tennyson, J; Schneider, IF; Laporta, V; - view fewer (2018) Theoretical study of ArH+ dissociative recombination and electron-impact vibrational excitation. Monthly Notices of the Royal Astronomical Society , 479 (2) pp. 2415-2420. 10.1093/mnras/sty1549 . Green open access

https://ift.tt/2TN93W6

Oxytocin Enhances Social Recognition by Modulating Cortical Control of Early Olfactory Processing

Oettl, L-L; Ravi, N; Schneider, M; Scheller, MF; Schneider, P; Mitre, M; da Silva Gouveia, M; ... Kelsch, W; + view all Oettl, L-L; Ravi, N; Schneider, M; Scheller, MF; Schneider, P; Mitre, M; da Silva Gouveia, M; Froemke, RC; Chao, MV; Young, WS; Meyer-Lindenberg, A; Grinevich, V; Shusterman, R; Kelsch, W; - view fewer (2016) Oxytocin Enhances Social Recognition by Modulating Cortical Control of Early Olfactory Processing. Neuron , 90 (3) pp. 609-621. 10.1016/j.neuron.2016.03.033 . Green open access

https://ift.tt/2AsgAko

The ExoMol atlas of molecular opacities

Tennyson, J; Yurchenko, SN; (2018) The ExoMol atlas of molecular opacities. Atoms , 6 (2) , Article 26. 10.3390/atoms6020026 . Green open access

https://ift.tt/2TTOyqJ

Mode i interlaminar fracture toughness of carbon nanotube web-modified polymer composites

Chitwan, R; Nistal, A; Falzon, BG; Hawkins, SC; (2017) Mode i interlaminar fracture toughness of carbon nanotube web-modified polymer composites. In: Proceedings of the 21st International Conference on Composites Materials (ICCM-21). (pp. p. 4133). ICCM: Xi'an, China. Green open access

https://ift.tt/2AyNDn4

The terrestrial laser scanning revolution in forest ecology

Danson, FM; Disney, MI; Gaulton, R; Schaaf, C; Strahler, A; (2018) The terrestrial laser scanning revolution in forest ecology. Interface Focus , 8 (2) , Article 20180001. 10.1098/rsfs.2018.0001 .

https://ift.tt/2TRtam9

Phantom limb sensations in the ear of a patient with a brachial plexus lesion

Pazzaglia, M; Galli, G; Lucci, G; Scivoletto, G; Molinari, M; Haggard, P; (2018) Phantom limb sensations in the ear of a patient with a brachial plexus lesion. Cortex 10.1016/j.cortex.2018.08.020 . (In press).

https://ift.tt/2At0SFx

POLG-related disorders and their neurological manifestations

Rahman, S; Copeland, WC; (2018) POLG-related disorders and their neurological manifestations. [Review]. Nature Reviews Neurology (2018) 10.1038/s41582-018-0101-0 . (In press).

https://ift.tt/2TSADl2

Changing interpretations of emotional expressions in working memory with aging

Mok, RM; Hajonides van der Meulen, JE; Holmes, EA; Nobre, AC; (2017) Changing interpretations of emotional expressions in working memory with aging. PsyArXiv Preprints Green open access

https://ift.tt/2AranVQ

A literature synthesis of personalised technology-enhanced learning: what works and why

Fizgerald, E; Jones, A; Kucirkova, N; Scanlon, E; (2018) A literature synthesis of personalised technology-enhanced learning: what works and why. Research in Learning Technology , 26 (2018) , Article 2095. 10.25304/rlt.v26.2095 . Green open access

https://ift.tt/2TQnPLO

Risk factors for community-acquired Escherichia coli bacteraemia: a systematic review protocol

Aryee, A; Härmälä, S; Shallcross, L; Hayward, A; (2018) Risk factors for community-acquired Escherichia coli bacteraemia: a systematic review protocol. Wellcome Open Research , 3 (117) 10.12688/wellcomeopenres.14804.1 . Green open access

https://ift.tt/2AzWzbw

Measurement of iron status in chronic kidney disease

Hayes, W; (2018) Measurement of iron status in chronic kidney disease. Pediatric Nephrology 10.1007/s00467-018-3955-x . (In press). Green open access

https://ift.tt/2TN8JXo

Long-term outcomes of supraventricular tachycardia ablation in congenital heart disease: single centre uk experience

Sawhney, V; McLellan, A; Perera, D; Izquierdo, D; Babra, D; Schilling, R; Lambiase, P; ... Ezzat, V; + view all Sawhney, V; McLellan, A; Perera, D; Izquierdo, D; Babra, D; Schilling, R; Lambiase, P; Lowe, M; Ezzat, V; - view fewer (2017) Long-term outcomes of supraventricular tachycardia ablation in congenital heart disease: single centre uk experience. Presented at: Annual Conference of the British-Cardiovascular-Society (BCS) 2017, Manchester, UK. Green open access

https://ift.tt/2At4ac1

Trem2 promotes anti-inflammatory responses in microglia and is suppressed under pro-inflammatory conditions

Liu, W; Taso, O; Wang, R; Garcia-Reitboeck, P; Andrews, WD; Piers, TM; Pocock, JM; ... Salih, D; + view all Liu, W; Taso, O; Wang, R; Garcia-Reitboeck, P; Andrews, WD; Piers, TM; Pocock, JM; Cummings, DM; Hardy, J; Edwards, FA; Salih, D; - view fewer (2018) Trem2 promotes anti-inflammatory responses in microglia and is suppressed under pro-inflammatory conditions. bioRxiv

https://ift.tt/2TVtIHs

Can the choice of building performance simulation tool significantly alter the level of predicted indoor overheating risk in London flats?

Petrou, G; Mavrogianni, A; Symonds, P; Mylona, A; Virk, G; Raslan, R; Davies, M; (2018) Can the choice of building performance simulation tool significantly alter the level of predicted indoor overheating risk in London flats? In: Choudhary, Rudhi, (ed.) Proceedings of the 4th Building Simulation and Optimization Conference, 11-12 September 2018, Cambridge, UK (BSO 2018). IBPSA England: Cambridge, UK.

https://ift.tt/2AtdkFx

Patterns of distant metastasis in head and neck cancer at presentation: Implications for initial evaluation

Publication date: January 2019

Source: Oral Oncology, Volume 88

Author(s): Jeffrey C Liu, Mihir Bhayani, Kristine Kuchta, Thomas Galloway, Christopher Fundakowski

Abstract
Importance

Evaluation of distant metastasis (DM) is part of every new cancer evaluation. Understanding DM presentation patterns may impact the imaging workup of Head and Neck Squamous Cell Carcinoma (HNSCC).

Objective

Examine the frequency and location of DM at presentation in HNSCC. We hypothesize that DM are rare, and the lung is the most common site for DM. Secondary evaluation includes identifying patient and tumor factors predictive of DM, and the implications for selection of workup imaging.

Design

Data from the National Cancer Data Base (NCDB) from 2010 to 2015 were analyzed. Subsites evaluated included oral cavity, oropharynx, larynx, hypopharynx, and nasopharynx. Sites of distant metastasis were evaluated in available cases and analyzed.

Setting

Population based database study.

Results

151,730 cases were available for analysis. Nasopharynx had the highest percentage of M1 disease (9.1%) followed by hypopharynx (7.3%). Excluding the nasopharynx (NP), 3.1% of cases were reported as M1. Advanced T-stage, positive N-stage, and N3 status were all predictors of M1 status on univariate and multivariate analysis for all subsites (P < 0.05). Where site of metastasis was available, most (53.1%) DM cases presented with at least lung involvement. In nasopharynx cancers, only 32.8% of DM included the lung.

Conclusions and relevance

Distant metastasis in HNSCC are rare events. PET/CT offers many advantages, but for routine distant metastasis evaluation in HNSCC, CT scan of the chest may be more cost-effective.



https://ift.tt/2PW9nDL

Comparative study of epidermal growth factor and observation only on human subacute tympanic membrane perforation

Publication date: Available online 27 November 2018

Source: American Journal of Otolaryngology

Author(s): Zheng-Cai Lou, Yihan Dong, Zi-Han Lou

Abstract
Objective

To compare the effects of epidermal growth factor (EGF) and observation only on human subacute tympanic membrane perforation (TMP).

Methods

A total of 44 patients with traumatic TMPs >2 months after trauma were divided into an observation group (n = 18) and EGF group (n = 26). Patients in the EGF group underwent direct application of EGF without stripping of the perforation edge. All patients were followed up for at least 6 months. The TMP closure rate, closure time, and hearing gain were evaluated.

Results

At 6 months, 25 of 26 (96.2%) perforations achieved complete closure with a mean closure time of 9.1 ± 3.9 days (range, 3–14 days) in the EGF group. However, only 11 of 18 (61.1%) perforations achieved complete closure in the observation group, with a mean closure time of 20.6 ± 10.7 days (range = 9–71 days). The patients in the EGF-treated group had significantly improved closure rates (P = 0.026) and a reduced closure time (P < 0.01) compared to those in the observation group. The difference in mean hearing improvement between the two groups was not statistically significant (P = 0.86).

Conclusions

Topical application of EGF improved the closure rate and shortened the closure time of human subacute TMPs compared with spontaneous healing, the stripping of the perforation edge was unnecessary. This treatment is simple and convenient and should be recommended pre-myringoplasty.



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Recurrent Desmoid Tumor of the Neck: A Case Report of a Benign Disease with Aggressive Behavior

We present a case of a desmoid tumor recurrence in a patient with a history of a resected desmoid tumor of the right neck area with free surgical margins six months earlier. The neoplasm was found to invade the parapharyngeal space, and wide excision was performed including most of the sternocleidomastoid muscle (SCM), the thrombosed internal jugular vein (IJV), and the infiltrated spinal accessory nerve (SAN). The histopathologic findings displayed free microscopic margins, with close margins at the site of the parapharyngeal space extension. After 3 months, there was no sign of tumor recurrence. After 6 months, local tumor recurrence was identified on clinical examination and imaging. The decision of the Oncology Board was further treatment with radiotherapy (RT). Response to treatment was satisfactory, and the patient was on close follow-up for twelve months. Desmoid tumors are very rare benign neoplasms of mesenchymal origin with negligible mortality but high morbidity, due to their high recurrence rates, local tissue infiltration, and unpredictable disease course and response to treatment. No universally acceptable treatment protocols have been introduced to date. Appropriate patient counseling and close follow-up are warranted in all cases.

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IgE-mediated allergic responses associated to Ailanthus altissima pollen using an animal model

Publication date: Available online 28 November 2018

Source: Allergologia et Immunopathologia

Author(s): F. Mousavi, G.A. Kardar, Z. Pourpak

Abstract
Background

Murine models have been widely used in the study of allergy as sensitized mice can produce IgE and/or IgG1in response after the injection of an antigen/adjuvant combination. Ailanthus altissima pollen (AAP) has been recently reported as an emerging aeroallergen in Iran. So far, several AAP candidate allergens by the screening of allergen-specific IgE in the sera from AAP sensitized patients in Iran.

Objective

The aim of the present study was to detect and compare the allergens eliciting an IgE response in a mouse model, and in human, using pollen extract of A. altissima and an immunoproteomics based approach.

Methods

The pollen proteins were extracted in phosphate-buffered saline (PBS). Thirty male BALB/c mice were randomly divided into two groups of AP extract sensitized and sham that respectively received AAP PBS extract and a PBS control by intraperitoneal injections at regular intervals. The optimized AAP protein extracts were analyzed using 2D-gel electrophoresis and were subsequently confronted to pooled sera of sensitized mice.

Results

Two-D gel electrophoresis of AAP extract allowed the separation of 125 protein spots distributed in a wide range of pI and molecular masses. Two-DE immunoblotting using pooled sera of sensitized mice led to the detection of 14 IgE reactive spots with molecular masses ranging from 12 to 40–42 kDa.

Conclusion

The results do not correlate with our previous analyses using human AAP-sensitized sera. These findings reflect some differences in the sIgE reactivity to allergenic proteins in animal models.



https://ift.tt/2r9sJXl

The efficiency of the symptom-based score in infants diagnosed with cow's milk protein and hen's egg allergy

Publication date: Available online 27 November 2018

Source: Allergologia et Immunopathologia

Author(s): Seda Sirin Kose, G. Atakul, S. Asilsoy, N. Uzuner, O. Anal, O. Karaman

Abstract
Introduction and objectives

Symptom-based score (SBS) quantifies the number and severity of suspected cow's milk-related symptoms. In this study, we aimed to evaluate the efficiency of SBS in patients diagnosed with cow's milk protein (CMPA) and hen's egg allergy (HEA).

Materials and methods

A single-center study was conducted between June 2015 and August 2017. Infants who were diagnosed with CMPA and HEA or both were enrolled in the study. SBS was applied at baseline and at one month during an elimination diet.

Results

One hundred and twelve patients were enrolled in the study. Of these, 56 (50%) were female. Forty-nine (43.8%) patients were diagnosed with CMPA, 39 (34.8%) patients were diagnosed with HEA and 24 (21.4%) patients were diagnosed with cow's milk protein and hen's egg allergy (CMPHEA).

In the analysis of SBS, median Bristol scale and initial total symptom-based scores were significantly lower in the HEA group than others (p = 0.002; p = 0.025). After the elimination diet, mean SBS decrease in the CMPHEA group (11.3 ± 4.7) was found to be higher than CMPA (8.8 ± 3.7) and HEA (8.0 ± 4.0) groups (p = 0.009). In 41 (83.7%) patients with CMPA, 33 (84.6%) patients with HEA and 21 (87.5%) patients with CMPHEA, a ≥50% decrease in SBS was observed after the elimination diet.

Conclusion

We may conclude that the present study suggests that SBS can be useful in monitoring the response to elimination diet in infants diagnosed with cow's milk protein and hen's egg allergy.



https://ift.tt/2FL5c9h

ALS-associated missense and nonsense TBK1 mutations can both cause loss of kinase function

de Majo, M; Topp, SD; Smith, BN; Nishimura, AL; Chen, H-J; Gkazi, AS; Miller, J; ... Shaw, CE; + view all de Majo, M; Topp, SD; Smith, BN; Nishimura, AL; Chen, H-J; Gkazi, AS; Miller, J; Wong, CH; Vance, C; Baas, F; ten Asbroek, ALMA; Kenna, KP; Ticozzi, N; Garcia Redondo, A; Esteban-Pérez, J; Tiloca, C; Verde, F; Duga, S; Morrison, KE; Shaw, PJ; Kirby, J; Turner, MR; Talbot, K; Hardiman, O; Glass, JD; de Belleroche, J; Gellera, C; Ratti, A; Al-Chalabi, A; Brown, RH; Silani, V; Landers, JE; Shaw, CE; - view fewer (2018) ALS-associated missense and nonsense TBK1 mutations can both cause loss of kinase function. Neurobiology of Aging , 71 266.e1-266.e10. 10.1016/j.neurobiolaging.2018.06.015 . Green open access

https://ift.tt/2P6OjVP

Intron retention and nuclear loss of SFPQ are molecular hallmarks of ALS

Luisier, R; Tyzack, GE; Hall, CE; Mitchell, JS; Devine, H; Taha, DM; Malik, B; ... Patani, R; + view all Luisier, R; Tyzack, GE; Hall, CE; Mitchell, JS; Devine, H; Taha, DM; Malik, B; Meyer, I; Greensmith, L; Newcombe, J; Ule, J; Luscombe, NM; Patani, R; - view fewer (2018) Intron retention and nuclear loss of SFPQ are molecular hallmarks of ALS. Nature Communications , 9 , Article 2010 (2018). 10.1038/s41467-018-04373-8 . Green open access

https://ift.tt/2zDMcEf

SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer

Robles-Zurita, J; Boyd, KA; Briggs, AH; Iveson, T; Kerr, RS; Saunders, MP; Cassidy, J; ... Paul, J; + view all Robles-Zurita, J; Boyd, KA; Briggs, AH; Iveson, T; Kerr, RS; Saunders, MP; Cassidy, J; Hollander, NH; Tabernero, J; Segelov, E; Glimelius, B; Harkin, A; Allan, K; McQueen, J; Pearson, S; Waterston, A; Medley, L; Wilson, C; Ellis, R; Essapen, S; Dhadda, AS; Hughes, R; Falk, S; Raouf, S; Rees, C; Olesen, RK; Propper, D; Bridgewater, J; Azzabi, A; Farrugia, D; Webb, A; Cunningham, D; Hickish, T; Weaver, A; Gollins, S; Wasan, HS; Paul, J; - view fewer (2018) SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer. British Journal of Cancer 10.1038/s41416-018-0319-z . (In press). Green open access

https://ift.tt/2P7sNjC

Moderate to high levels of pre-treatment HIV drug resistance in KwaZulu-Natal Province, South Africa

Chimukangara, B; Kharsany, AB; Lessells, RJ; Naidoo, K; Rhee, S-Y; Manasa, J; Gräf, T; ... de Oliveira, T; + view all Chimukangara, B; Kharsany, AB; Lessells, RJ; Naidoo, K; Rhee, S-Y; Manasa, J; Gräf, T; Lewis, L; Cawood, C; Khanyile, D; Diallo, K; Ayalew, KA; Shafer, R; Hunt, G; Pillay, D; Abdool, SK; de Oliveira, T; - view fewer (2018) Moderate to high levels of pre-treatment HIV drug resistance in KwaZulu-Natal Province, South Africa. AIDS Research and Human Retroviruses 10.1089/AID.2018.0202 . (In press).

https://ift.tt/2zxtIoF

Phenotype, penetrance, and treatment of 133 cytotoxic T-lymphocyte antigen 4-insufficient subjects

Schwab, C; Gabrysch, A; Olbrich, P; Patiño, V; Warnatz, K; Wolff, D; Hoshino, A; ... Grimbacher, B; + view all Schwab, C; Gabrysch, A; Olbrich, P; Patiño, V; Warnatz, K; Wolff, D; Hoshino, A; Kobayashi, M; Imai, K; Takagi, M; Dybedal, I; Haddock, JA; Sansom, DM; Lucena, JM; Seidl, M; Schmitt-Graeff, A; Reiser, V; Emmerich, F; Frede, N; Bulashevska, A; Salzer, U; Schubert, D; Hayakawa, S; Okada, S; Kanariou, M; Kucuk, ZY; Chapdelaine, H; Petruzelkova, L; Sumnik, Z; Sediva, A; Slatter, M; Arkwright, PD; Cant, A; Lorenz, H-M; Giese, T; Lougaris, V; Plebani, A; Price, C; Sullivan, KE; Moutschen, M; Litzman, J; Freiberger, T; van de Veerdonk, FL; Recher, M; Albert, MH; Hauck, F; Seneviratne, S; Pachlopnik Schmid, J; Kolios, A; Unglik, G; Klemann, C; Speckmann, C; Ehl, S; Leichtner, A; Blumberg, R; Franke, A; Snapper, S; Zeissig, S; Cunningham-Rundles, C; Giulino-Roth, L; Elemento, O; Dückers, G; Niehues, T; Fronkova, E; Kanderová, V; Platt, CD; Chou, J; Chatila, TA; Geha, R; McDermott, E; Bunn, S; Kurzai, M; Schulz, A; Alsina, L; Casals, F; Deyà-Martinez, A; Hambleton, S; Kanegane, H; Taskén, K; Neth, O; Grimbacher, B; - view fewer (2018) Phenotype, penetrance, and treatment of 133 cytotoxic T-lymphocyte antigen 4-insufficient subjects. Journal of Allergy and Clinical Immunology 10.1016/j.jaci.2018.02.055 . (In press). Green open access

https://ift.tt/2P6O9xH

The effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokers

Hindocha, C; Freeman, TP; Grabski, M; Crudgington, H; Davies, AC; Stroud, JB; Das, RK; ... Curran, HV; + view all Hindocha, C; Freeman, TP; Grabski, M; Crudgington, H; Davies, AC; Stroud, JB; Das, RK; Lawn, W; Morgan, CJA; Curran, HV; - view fewer (2018) The effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokers. Scientific Reports , 8 , Article 7568 (2018). 10.1038/s41598-018-25846-2 . Green open access

https://ift.tt/2zul36l

Prevalence, course and psychosis-predictive value of negative symptoms in 22q11.2 deletion syndrome

Schneider, M; Armando, M; Schultze-Lutter, F; Pontillo, M; Vicari, S; Debbané, M; Eliez, S; (2018) Prevalence, course and psychosis-predictive value of negative symptoms in 22q11.2 deletion syndrome. Schizophrenia Research 10.1016/j.schres.2018.10.014 . (In press).

https://ift.tt/2P6O3Gl

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