Voice outcome after unilateral ELS type III or bilateral type II resections for T1‐T2 glottic carcinoma: Results after 1 year

Abstract

Background

Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification.

Methods

Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self‐assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure.

Results

The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5.

Conclusion

Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self‐reported voice impairment.

http://bit.ly/2QU2kXF

Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

Abstract

Background

Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non‐aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior.

Methods

Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004‐2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC.

Results

Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28‐1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82‐0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86‐0.92 and aOR = 0.81, 95% CI: 0.79‐0.84) and higher odds of LNM and ETE than whites (P < .001).

Conclusions

Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

http://bit.ly/2VXaItc

Transoral robotic excision of laryngocele: Surgical considerations

Abstract

Background

Transoral robotic surgery (TORS) has emerged as a novel, safe, and feasible procedure for the resection of malignant supraglottic laryngeal cancers. The purpose of this study was to demonstrate the surgical technique with extension of the use of TORS to excise a laryngeal cyst.

Results

Laryngeal cyst resection, along with its tract, was accomplished with preservation of both false and true vocal cords. There was no perioperative or early postoperative complications. The patient was extubated immediately after surgery. Oral diet was initiated within 24 hours. No tracheostomy was required. A video demonstration of the surgical technique is included on Head & Neck's website.

Conclusion

TORS is a safe and feasible procedure for excision of selected laryngeal cysts.

http://bit.ly/2QTMVqo

Actigraphy‐measured nocturnal wrist movements and assessment of sleep quality in patients with bullous pemphigoid: a pilot case–control study

Summary

Background

Bullous pemphigoid (BP) is a distressing autoimmune bullous disease strongly associated with severe pruritus; however, data concerning pruritus in BP are still scarce. No clinical research evaluating the effect of BP on sleep quality has been conducted.

Aim

To evaluate the intensity of pruritus measured by nocturnal wrist movements (NWMs) and the sleep quality in patients with BP using actigraphy in comparison with nonpruritic healthy controls (HCs) with subsequent correlations with an itch visual analogue scale (VAS) as a subjective measure, disease severity [Bullous Pemphigoid Disease Area Index (BPDAI), urticaria/erythema, erosions/blisters] and serum total IgE level.

Methods

In total, 31 patients with newly diagnosed BP (mean ± SD age 75.4 ± 12.3 years) and 40 nonpruritic HCs (age 73.5 ± 11.7 years) were recruited. All participants wore a sleep monitor (ActiSleep+) on the dominant wrist.

Results

For patients with BP, median VAS score was 5.5 and median BPDAI was 43 (urticaria/erythema BPDAI was 16, erosions/blisters BPDAI was 29). Scratching, defined as bouts of NWMs, was significantly (P < 0.001) more intensive in patients with BP than in controls. Characteristic of BP was that scratching bouts corresponded with the slowest wrist movements. There were no correlations with VAS, BPDAI or total IgE level. Compared with HCs, patients with BP presented significant (P < 0.001) sleep disturbances, as determined by sleep efficiency, waking after sleep onset and average duration of awakening, and these were strongly correlated with urticaria/erythema BPDAI.

Conclusion

Nocturnal wrist movements measured by actigraphy are more intensive in patients with BP than in nonpruritic HCs, and characteristically slow movements. Actigraphy method showed very low sleep quality in patients with BP, thus severity of BP has a negative impact on sleep.

http://bit.ly/2Ru9ZBn

Association of interleukin‐6 gene promoter polymorphism with acne vulgaris and its severity

Summary

Background

Acne vulgaris (AV) is an inflammatory disorder with a possible genetic background. Different cytokines and mediators are involved in its pathogenesis.

Aim

Our aim was to investigate the interleukin (IL)‐6 572 polymorphism in patients with AV and its relation to patient sex and acne severity.

Methods

In total, 30 patients with acne and 20 healthy controls (HCs) were enrolled. The Global Acne Grading System was used to assess acne severity. The IL‐6 572 gene promoter polymorphism was assessed using the PCR–restriction fragment length polymorphism method.

Results

There was a significantly higher association of IL‐6 572 variants genotypes in patients with acne (93%) compared with the HC group (45%) (P < 0.001), with a higher incidence of the IL‐6 572 CC polymorphism in patients with acne. A significant difference (P < 0.001) between C and G alleles in patients vs. HCs was detected. There were no significant associations between the IL‐6 572 variant genotypes and either patient sex or AV severity.

Conclusion

IL‐6 gene promoter polymorphism might have a role in AV susceptibility but it is not related to AV severity.

http://bit.ly/2CoI7Ek

January is Thyroid Awareness Month

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The post January is Thyroid Awareness Month appeared first on American Thyroid Association.

http://bit.ly/2FuRzdj

A case of erythrodermic psoriasis successfully treated with ixekizumab

Abstract

Erythrodermic psoriasis (EP) is the most severe form of psoriasis, resulting in significant morbidity and mortality. International guidelines on EP treatment are lacking, with most of the biologic drugs being used basing on case reports or small case series. Ixekizumab, a fully human anti‐interleukin (IL)‐17A monoclonal antibody, is approved for moderate to severe plaque psoriasis while its use in EP is off label. However, two studies conducted on 8 Japanese EP patients have showed ixekizumab as an efficacious and well tolerated therapy up to 24 and 52 weeks, respectively. To date, no case reports on Caucasian patients have been described. We report the case of a 66‐year‐old Caucasian female with EP successfully treated with ixekizumab, reaching PASI 100 after only 6 weeks of therapy and still maintaining this response at week 24. Our case report suggest ixekizumab as a highly efficacious treatment in EP, presenting also a very rapid action which leads to complete resolution of the disease after 6 weeks. Further studies are warrant to confirm our data, with controlled trials specifically dedicated to EP being strictly needed in order to verify the role and efficacy of the new biologics in EP.

This article is protected by copyright. All rights reserved.

http://bit.ly/2AZQO8n

A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


http://bit.ly/2FwTtdp

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


http://bit.ly/2FHNYIh

SELF-ASSESSMENT

No abstract available

http://bit.ly/2TVC551

Parabens

Parabens have been widely used as preservatives in the cosmetics, food, and pharmaceutical industries for more than 70 years. Monitoring for paraben allergy closely followed with studies reporting paraben testing in standard screening fashion as early as 1940. The frequency of sensitivity to this widely used biocide has remained low and remarkably stable for many decades despite extensive use and progressive expansion of utilization worldwide. The authors select paraben mix as the (non)allergen of the year. Paraben reactions are quite uncommon and generally relevant. Parabens remain one of the least allergenic preservatives available. The unsubstantiated public perception of paraben safety has led to its replacement in many products with preservatives having far greater allergenic potential. This report reviews the well-established safety of parabens from an allergologic standpoint.

http://bit.ly/2Df1cuc

Airborne Contact Dermatitis Caused by Essential Oils in a Child

No abstract available

http://bit.ly/2TWc6e0

Paraben Toxicology

Parabens now being formally declared as the American Contact Dermatitis Society (non)allergen of the year, the allergologic concerns regarding parabens raised during the past century are no longer a significant issue. The more recent toxicological concerns regarding parabens are more imposing, stemming from the gravity of the noncutaneous adverse health effects for which they have been scrutinized for the past 20 years. These include endocrine activity, carcinogenesis, infertility, spermatogenesis, adipogenesis, perinatal exposure impact, and nonallergologic cutaneous, psychologic, and ecologic effects. To assert that parabens are safe for use as currently used in the cosmetics, food, and pharmaceutical industries, all toxicological end points must be addressed. We seek to achieve perspective through this exercise: perspective for the professional assessing systemic risk of parabens by all routes of exposure. The data reviewed in this article strive to provide a balanced perspective for the consumer hopefully to allay concerns regarding the safety of parabens and facilitate an informed decision-making process. Based on currently available scientific information, claims that parabens are involved in the genesis or propagation of these controversial and important health problems are premature. Haste to remove parabens from consumer products could result in their substitution with alternative, less proven, and potentially unsafe alternatives, especially given the compelling data supporting the lack of significant dermal toxicity of this important group of preservatives.

http://bit.ly/2Deap6b

A Subtle Historical Clue Unlocks a Contact Puzzle

No abstract available

http://bit.ly/2U0NT6r

Systemic Treatments for Allergic Contact Dermatitis

Allergic contact dermatitis is a common disease within the family of delayed-type hypersensitivity reactions. In more severe cases of allergic contact dermatitis, topical steroids may prove insufficient, and systemic therapeutic agents are often used. Even when systemic therapies such as cyclosporine lead to improvement, withdrawal of these agents is challenging and can lead to undesirable morbidities. Currently, there are no systemic treatments indicated for the treatment of widespread recalcitrant contact dermatitis. This review discusses the targets of in-use off-label systemic medications and potential therapeutics in the pipeline.

http://bit.ly/2Df1Mbm

Allergic Reaction to Red Cosmetic Lip Tattoo Treated With Hydroxychloroquine

No abstract available

http://bit.ly/2TOngRQ

Atopic Dermatitis and Hospitalization for Mental Health Disorders in the United States

Little is known about mental health (MH) emergencies in atopic dermatitis (AD) and their financial burden. We sought to determine hospitalization rates and costs of MH disorders in AD patients. We analyzed data from the Nationwide Inpatient Sample from 2002 to 2012, containing a representative 20% sample of US hospitalizations. Overall, 835 AD (1.36%) and 2,434,703 non-AD (0.75%) patients had a primary admission for an MH disorder. Atopic dermatitis patients admitted for MH disorders were more likely to be younger, Asian, of black race, and in a higher income quartile and have an increasing number of chronic conditions. In multivariable logistic regression models adjusting for demographics, AD was associated with a primary admission for MH disorders in adults, including mood disorders, schizophrenia, and developmental disorders. Atopic dermatitis was not associated with a primary admission for an MH disorder in children. There were an estimated US $183,821,629 excess costs of care annually for MH disorders in inpatients with versus without AD. In conclusion, AD was associated with higher odds of hospitalization for all MH disorders and substantial excess costs of inpatient care.

http://bit.ly/2Df1Ho4

Formaldehyde in Hypoallergenic Household Gloves

No abstract available

http://bit.ly/2TVC3tV

Atopy and Sensitization to Allergens Known to Cause Systemic Contact Dermatitis

Background Atopic dermatitis (AD) associated with respiratory atopy may represent a form of systemic contact dermatitis (SCD), whereby AD flares after ingestion or inhalation of allergens. Objective The aim of the study was to compare the prevalence of positive patch tests to allergens known to cause SCD in AD patients with and without respiratory atopy. Methods This is a retrospective study of patients with AD patch tested to 23 allergens known to cause SCD. Positive patch tests were compared between AD patients with and without respiratory atopy, stratified by age and wet or dry work occupation. Conclusions Children and adolescents, but not adults, with AD and respiratory atopy were more likely than age-matched AD patients without respiratory atopy to have positive patch tests to these allergens (odds ratio, 2.33; 95% confidence interval, 1.13–4.79). Moreover, AD patients with respiratory atopy and engaging in wet work, but not dry work, occupations were more likely than AD patients without respiratory atopy to have positive patch tests to allergens known to cause SCD (odds ratio, 1.47; 95% confidence interval, 1.05–2.06). Thus, respiratory atopy and wet work are associated with sensitization to allergens known to cause SCD in patients with AD, and patch testing may be valuable in identifying systemic triggers of dermatitis in these patients.

http://bit.ly/2DdQqEu

Everlasting Liquid Lipstick: Reminder to Patch Test Personal Products

No abstract available

http://bit.ly/2TUsZFP

Formaldehyde Release From Personal Care Products: Chromotropic Acid Method Analysis

Background Preservatives such as formaldehyde and formaldehyde releasers (F/FRs) are found in personal care products. Studies from Europe and Israel have indicated that products with undeclared F/FRs on product labels may have detectable levels of formaldehyde. Objective The aim of the study was to determine the presence of formaldehyde in samples of US personal care products. Methods Fifty-four baby and adult products were tested with the chromotropic acid method. A blinded investigator graded the color change as mild, moderate, or strong. Results All 8 products declaring F/FRs resulted in a deep purple color change, indicating a strong reaction. Of the 46 products with undeclared F/FRs, 4 (8.6%) were found to release formaldehyde. All 4 resulted in a light purple color change, indicating a mild reaction. Conclusions Overall, 4 of 54 products (7.4%) had label information, which did not match chromotropic acid method testing results. Clinicians and formaldehyde-allergic individuals should be aware of the limitations of product ingredient labeling in managing allergic contact dermatitis to formaldehyde.

http://bit.ly/2De6Z3b

Pediatric Cases Involving Chemical Burns to Garlic Used to Treat Warts

No abstract available

http://bit.ly/2TW1sUx

“Fresh Breath” on Toothpaste: Peppermint as Cause of Cheilitis

No abstract available

http://bit.ly/2DbULIg

Interleukin-4 Inhibition in Recalcitrant Dermatitis

No abstract available

http://bit.ly/2TUaqkZ

Melanoma prognosis in the United States: Identifying barriers for improved care

Mortality-to-incidence ratio approximates melanoma survival and can help identify survival disparities. States with increased melanoma incidence and dermatologist density had better melanoma survival. States with more active physicians and more Non-Hispanic whites had worse melanoma survival. Efforts to improve survival should occur locally, as local differences explain most survival variations.

http://bit.ly/2FBr4SJ

Metabolic Health in Severely Obese Subjects: A Descriptive Study

Metabolic Syndrome and Related Disorders, Ahead of Print.


http://bit.ly/2TY7LXP

Flexural Hyperpigmentation With Reticulation in an Adolescent Girl

An adolescent girl with polycystic ovarian syndrome presented with hyperpigmented skin lesions on her neck, upper limbs, and trunk, which had begun 6 months previously as recurrent pruritic erythematous papules that subsided leaving brownish-bluish black hyperpigmentation. What is your diagnosis?

http://bit.ly/2sy49Qg

Systemic Amyloidosis

This case report describes a patient with systemic amyloidosis.

http://bit.ly/2Mf4dxz

Trends in Oral Antibiotic Prescription in Dermatology, 2008 to 2016

This repeated cross-sectional analysis of antibiotic prescribing by dermatologists characterizes the use of antibiotics in dermatology, including changes over time, from 2008 to 2016.

http://bit.ly/2swFls6

Sex and Ethnic Diversity of US Medical Students and Their Exposure to Dermatology Programs

This study characterizes sex and racial/ethnic discrepancies in exposure to dermatology among US medical students.

http://bit.ly/2MiMS76

A Case of Pansclerotic Morphea Treated With Tocilizumab

This case report describes a patient with pansclerotic morphea treated with tocilizumab.

http://bit.ly/2sE7b5X

Updating Dermatologists’ Prescribing Habits for Antibiotics

http://bit.ly/2MiMZj2

Assessment of the Association Between Major Depressive Disorder and Alopecia Areata

This cohort study of over 6 million patients uses data from The Health Improvement Network in the United Kingdom to assess the bidirectional association between major depressive disorder and alopecia areata.

http://bit.ly/2sxMeJL

Cutaneous Suture Spacing During Linear Wound Closures and the Effect on Wound Cosmesis

This randomized clinical trial uses a split-wound/split-scar model to compare the outcomes and wound cosmesis achieved with running cutaneous sutures spaced 2 vs 5 mm apart.

http://bit.ly/2MgOuOk

Τhe minimum fascia–tumor distance (MFTD) criterion is more feasible for benign tumors than for malignant tumors for the localization of parotid tumors. For benign parotid tumors, US is enough to guide operations.

The Diagnostic Performance of Ultrasonography and Computed Tomography in Differentiating Superficial from Deep Lobe Parotid Tumors

Ping‐Chia Cheng  Chih‐Ming Chang  Chun‐Chieh Huang  Wu‐Chia Lo  Tsung‐Wei Huang  Po‐Wen Cheng Li‐Jen Liao

First published: 12 January 2019 https://doi.org/10.1111/coa.13289

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/coa.13289

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Abstract

Objectives

To validate and compare ultrasound (US) versus computed tomography (CT) criteria in the localization of superficial/deep lobe tumors of the parotid gland.

Design and Setting

This was a retrospective study of diagnostic tests performed from January 2008 to June 2017.

Participants

We included adult patients who were referred for a neck ultrasonography examination due to parotid tumors, and who subsequently underwent parotid surgery.

Main outcome measures

We assessed the location of parotid tumors, comparing the minimum fascia–tumor distance (MFTD) criterion on an US with eight CT criteria. We analyzed receiver operating characteristic (ROC) curves of the MFTD for malignant, benign, and all parotid tumors, and compared the accuracy, sensitivity, and specificity of the optimal MFTD with those of CT anatomical criteria.

Results

A total of 166 parotid tumors were included. The mean (SD) MFTD in superficial lobe tumors was significantly shorter than that of deep lobe tumors (1.2 [0.7] vs 2.8 [1.9] mm, effect size: 1.84; 95% CI, 1.27 to 2.41). The areas under the ROC curve were 0.63 for malignant tumors and 0.88 for benign tumors. The optimal MFTD cut point was 2.4 mm for the 154 benign parotid tumors and the accuracy, sensitivity, and specificity were 90%, 80% and 91%, respectively. For the 136 benign parotid tumors that underwent CT examination, three criteria had an accuracy of over 90% (FNline, tMasseter and Conn's arc), but the sensitivities were all below 50%.

Conclusions

MFTD is more feasible for benign tumors than for malignant tumors for the localization of parotid tumors. For benign parotid tumors, US is enough to guide operations.

Diagnostic Error, the Internet, and Collaboration in Global Health

In high-income countries, 5% of adults suffer from diagnostic error each year in the outpatient setting. Of these, over half of these errors have "the potential for severe harm." This is thought to be an underestimate in high-income countries, and the rate of diagnostic errors in low income countries may be much higher.^[1] In the United States, "Postmortem examination research spanning decades has shown that diagnostic errors contribute to approximately 10 percent of patient deaths, and medical record reviews suggest that they account for 6 to 17 percent of adverse events in hospitals."^[2]

In the case report, "Empirical treatment of tuberculosis: TB or not TB?" Webb et al describe a 38 year-old woman in India who presented with cough, and malaise. CT of her chest revealed findings suggestive of interstitial TB. Despite being sputum negative, she was treated empirically for TB due to its high prevalence and the possibility of sputum negative TB (as high as 50% of all newly diagnosed TB annually). She slowly developed greater malaise, jaundice and abdominal pain. Her husband was unable to work as he frequently presented her to medical care for diagnosis. Finally, a community health worker uploaded the patient's care records (de-identified and with patient consent) to an open access database to stimulate discussion among clinicians and increase the number of her care team. The patient traveled to a hospital that one of the clinicians staffed in order to undergo an in-person examination, where she was diagnosed with drug-induced liver injury and improved with supportive care.

Access to medical care remains a problem in much of the world. Poorly-qualified practitioners are particularly an issue in rural areas. Delays in diagnosis and incorrect diagnosis can lead to substantial patient harm. Some of the techniques for improving diagnosis have included facilitating more effective teamwork, enhancing health care professional education, and ensuring that health information technology supports patients and healthcare professionals in the diagnostic process. The internet has a substantial role to play in the future, especially in difficult to access or underserved areas. This case report introduced a new "collaborative initiative headed by Dr. Rakesh Biswas… to encourage discourse among his medical colleagues regarding challenging cases they may face."^[3] Another promising project is the app "Human Diagnosis Project," which allows providers to enhance diagnostic capabilities and collaborate around the world on difficult cases.^[4] Access to the internet and a way to protect patient identity would be substantial barriers to further development of this technology, as would the language barriers inherent in any system used in multiple states and countries. However this technology could be promising to break down barriers to health care for the underserved, and seems to fit well with currently in place community health workers.

BMJ Case Reports invites authors to submit global health case reports that describe the need for accurate and timely diagnosis. These cases could focus on:

• Deleterious effects of delayed or missed diagnoses
• Interventions which overcome the barriers to diagnosis
• Ways in which current tools are adapted to difficult situations to ensure safe, timely care

Manuscripts may be submitted by students, physicians, nurses and allied health professionals to BMJ Case Reports at www.bmjcasereports.com. For more information, review our guidance on how to write a global health case report and look through our online collection

To read more about difficult diagnoses, specifically TB, at BMJ Case Reports please review:

• Extrapulmonary tuberculosis: a debilitating and often neglected public health problem
• Multidrug-resistant tuberculosis in rural China: lack of public awareness, unaffordable costs and poor clinical management
• Delays in diagnosis and treatment of extrapulmonary tuberculosis in Guatemala

To read more about diagnostic error and tools to overcome, please review:

^[1]Diagnostic  Errors: Technical  Series on Safer Primary  Care. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO

^[2] National Academies of Sciences, Engineering, and Medicine. Improving diagnosis in health care. National Academies Press; 2016 Jan 29.

^[3]Debashish A. Evidence-based care: 38 year old woman suffering from TB with Jaundice seeking medical experts help, 2017. http://bit.ly/2MdJ0UI. (accessed 11 Jan 2019).

^[4] Human Diagnosis Project [Internet]. https://www.humandx.org/ Accessed on 11 Jan 2019.

The post Diagnostic Error, the Internet, and Collaboration in Global Health appeared first on BMJ Case Reports blog.

http://bit.ly/2suA6t5

Contemporary treatment patterns and outcomes of salivary gland carcinoma: a National Cancer Database review

Abstract

Purpose

Salivary gland carcinomas (SGC) are rare malignancies and data regarding treatment outcomes stratified by histologic subtype are currently limited. This study aims to examine current, national treatment patterns and overall survival (OS) of patients with the major histologic subtypes of salivary gland carcinoma.

Subjects and methods

A review was performed of the National Cancer Database (NCDB) of patients with confirmed diagnoses of mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma, or carcinoma ex pleomorphic receiving curative treatment between 2004 and 2014. Univariate and multivariate regression modeling were performed to identify risk factors significantly associated with overall survival (OS). Adjusted survival analyses stratified by treatment and staging were performed with the primary outcome of overall survival (OS) and were further stratified based on histologic subtype.

Results

The final analysis included 7342 patients [3547 men (48.3%) and 3795 women (51.7%); mean age 58.3 years (range 18–90 years)]. Mucoepidermoid carcinoma was the most common histology encountered [n = 2669 (36.4%)]. Unadjusted and adjusted analysis demonstrated improved survival with surgery and radiation therapy (RT) for adenoid cystic (HR = 0.69; p = 0.029), adenocarcinoma (HR = 0.61; p < 0.001), high-grade mucoepidermoid carcinoma (HR = 0.70; p = 0.026), and carcinoma ex pleomorphic (HR = 0.64; p = 0.028), while surgery with chemoradiation therapy (CRT) was associated with worse OS regardless of histologic subtype. The impact of advanced stage on survival varied amongst the histologic subtypes but portended the worst prognosis for patients with adenocarcinoma and carcinoma ex pleomorphic.

Conclusions

The results of this NCDB review demonstrate unique treatment patterns and survival outcomes for SGC based on major histologic subtype.

http://bit.ly/2AQ3s9C

Identity, belonging and solidarity in the Russian-speaking queer diaspora in Berlin

Mole, RCM; (2019) Identity, belonging and solidarity in the Russian-speaking queer diaspora in Berlin. In: Mole, RCM, (ed.) Soviet and Post-Soviet Sexualities. Rouledge: Abingdon. (In press).

http://bit.ly/2HcK5gE

Relative frequencies of alloantigen-specific helper CD4 T cells and B cells determine mode of antibody-mediated allograft rejection.

Alsughayyir, .; Chhabra, .; Qureshi, .; Mallik, .; Ali, .; Gamper, .; Moseley, .; ... Pettigrew, GJ; + view all Alsughayyir, .; Chhabra, .; Qureshi, .; Mallik, .; Ali, .; Gamper, .; Moseley, .; Peacock, .; Kosmoliaptsis, .; Goddard, .; Linterman, .; Motallebzadeh, R; Pettigrew, GJ; - view fewer (2019) Relative frequencies of alloantigen-specific helper CD4 T cells and B cells determine mode of antibody-mediated allograft rejection. Frontiers in Immunology 10.3389/fimmu.2018.03039 . (In press).

http://bit.ly/2RPDooU

Blockchain Competition – Gaining Competitive Advantage in the Digital Economy: Competition Law Implications

Lianos, I; (2019) Blockchain Competition – Gaining Competitive Advantage in the Digital Economy: Competition Law Implications. In: Hacker, P and Lianos, I and Dimitropoulos, G and Eich, S, (eds.) Regulating Blockchain: Techno-Social and Legal Challenges. Oxford University Press: Oxford, UK. (In press).

http://bit.ly/2Hbqy02

Sustained Release of Cx43 Antisense Oligodeoxynucleotides from Coated Collagen Scaffolds Promotes Wound Healing

Gilmartin, DJ; Soon, A; Thrasivoulou, C; Phillips, ARJ; Jayasinghe, SN; Becker, DL; (2016) Sustained Release of Cx43 Antisense Oligodeoxynucleotides from Coated Collagen Scaffolds Promotes Wound Healing. Advanced Healthcare Materials , 5 (14) pp. 1786-1799. 10.1002/adhm.201600175 . Green open access

http://bit.ly/2RO2MeS

Cortical reorganisation in the primary sensorimotor cortex following hand loss

Kikkert, S; Root, V; Makin, TR; (2019) Cortical reorganisation in the primary sensorimotor cortex following hand loss. In: The Oxford Handbook of Cortical Plasticity. Oxford University Press: Oxford, UK. (In press).

http://bit.ly/2Hg6NEI

Dialectical behavioural therapy skills for employment

Feigenbaum, JD; (2018) Dialectical behavioural therapy skills for employment. In: Swales, M, (ed.) The Oxford Handbook of Dialectical Behaviour Therapy. Oxford University Press: Oxford, UK.

http://bit.ly/2RUWwBO

The History of Higher Education in Modern Europe

Carpentier, V; (2019) The History of Higher Education in Modern Europe. In: Rury, John L. and Tamura, Eileen H., (eds.) The Oxford Handbook of The History of Education. Oxford University Press: Oxford, UK. (In press).

http://bit.ly/2Hg6BW0

An empirical formulation for predicting welding-induced biaxial compressive residual stresses on steel stiffened plate structures and its application to thermal plate buckling prevention

Yi, MS; Hyun, CM; Paik, JK; (2018) An empirical formulation for predicting welding-induced biaxial compressive residual stresses on steel stiffened plate structures and its application to thermal plate buckling prevention. Ships and Offshore Structures 10.1080/17445302.2018.1552343 . (In press).

http://bit.ly/2RSJRPV

Day Hospital versus Intensive Outpatient Mentalization-Based Treatment for borderline personality disorder: A multicentre randomized clinical trial

Smits, ML; Feenstra, DJ; Eeren, HV; Bales, DL; Laurenssen, EMP; Blankers, M; Soons, MBJ; ... Luyten, PJ; + view all Smits, ML; Feenstra, DJ; Eeren, HV; Bales, DL; Laurenssen, EMP; Blankers, M; Soons, MBJ; Dekker, JJM; Lucas, Z; Verheul, R; Luyten, PJ; - view fewer (2019) Day Hospital versus Intensive Outpatient Mentalization-Based Treatment for borderline personality disorder: A multicentre randomized clinical trial. British Journal of Psychiatry (In press).

http://bit.ly/2Hh2aKF

Energy-Materials Nexus for a Low Carbon Energy System

de Selliers, D; Spataru, C; (2018) Energy-Materials Nexus for a Low Carbon Energy System. Presented at: 3rd AIEE Energy Symposium Current and Future Challenges on Energy Security, Milan, Italy. Green open access

http://bit.ly/2RM3md1

ALS/FTD-associated FUS activates GSK-3 to disrupt the VAPB-PTPIP51 interaction and ER-mitochondria associations

Stoica, R; Paillusson, S; Gomez-Suaga, P; Mitchell, JC; Lau, DHW; Gray, EH; Sancho, RM; ... Miller, CCJ; + view all Stoica, R; Paillusson, S; Gomez-Suaga, P; Mitchell, JC; Lau, DHW; Gray, EH; Sancho, RM; Vizcay-Barrena, G; De Vos, KJ; Shaw, CE; Hanger, DP; Noble, W; Miller, CCJ; - view fewer (2016) ALS/FTD-associated FUS activates GSK-3 to disrupt the VAPB-PTPIP51 interaction and ER-mitochondria associations. EMBO reports , 17 (9) pp. 1326-1342. 10.15252/embr.201541726 . Green open access

http://bit.ly/2Hg70b0

The European citizen science landscape – a snapshot

Hecker, S.; Garbe, L.; Bonn, A.; (2018) The European citizen science landscape – a snapshot. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z. and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (pp. 190-200). UCL Press: London. Green open access

http://bit.ly/2RSwgYO

Citizen science on the Chinese mainland

Li, Ch.; (2018) Citizen science on the Chinese mainland. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z. and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (pp. 185-189). UCL Press: London. Green open access

http://bit.ly/2Hg502z

Slow natal dispersal across a homogeneous landscape suggest the use of mixed movement behaviours during dispersal in the Darwin’s frog

Valenzuela-Sánchez, A; Cayuela, H; Schmidt, BR; Cunningham, AA; Soto-Azat, C; (2019) Slow natal dispersal across a homogeneous landscape suggest the use of mixed movement behaviours during dispersal in the Darwin's frog. Animal Behaviour (In press).

http://bit.ly/2RSwjUu

Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life

Van Assche, L; Van de Ven, L; Vandenbulcke, M; Luyten, PJ; (2020) Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life. Aging and Mental Health (In press).

http://bit.ly/2Hi4EIw

Creative collaboration in citizen science and the evolution of ThinkCamps

Gold, M.; Ochu, E.; (2018) Creative collaboration in citizen science and the evolution of ThinkCamps. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z. and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (pp. 146-167). UCL Press: London. Green open access

http://bit.ly/2RPJrtH

Citizen engagement and collective intelligence for participatory digital social innovation

Novak, J.; Becker, M.; Grey, F.; Mondardini, R.; (2018) Citizen engagement and collective intelligence for participatory digital social innovation. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (pp. 124-145). UCL Press: London. Green open access

http://bit.ly/2Holwh4

Association of bone mineral density and fat fraction with magnetic susceptibility in inflamed trabecular bone

Bray, TJP; Karsa, A; Bainbridge, A; Sakai, N; Punwani, S; Hall-Craggs, MA; Shmueli, K; (2019) Association of bone mineral density and fat fraction with magnetic susceptibility in inflamed trabecular bone. Magnetic Resonance in Medicine 10.1002/mrm.27634 . (In press). Green open access

http://bit.ly/2RPOtGr

Author Correction: Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases

Iglesias, AI; Mishra, A; Vitart, V; Bykhovskaya, Y; Höhn, R; Springelkamp, H; Cuellar-Partida, G; ... MacGregor, S; + view all Iglesias, AI; Mishra, A; Vitart, V; Bykhovskaya, Y; Höhn, R; Springelkamp, H; Cuellar-Partida, G; Gharahkhani, P; Bailey, JNC; Willoughby, CE; Li, X; Yazar, S; Nag, A; Khawaja, AP; Polašek, O; Siscovick, D; Mitchell, P; Tham, YC; Haines, JL; Kearns, LS; Hayward, C; Shi, Y; van Leeuwen, EM; Taylor, KD; Blue Mountains Eye Study - GWAS group, .; Bonnemaijer, P; Rotter, JI; Martin, NG; Zeller, T; Mills, RA; Souzeau, E; Staffieri, SE; Jonas, JB; Schmidtmann, I; Boutin, T; Kang, JH; Lucas, SEM; Wong, TY; Beutel, ME; Wilson, JF; Wellcome Trust Case Control Consortium 2 (WTCCC2), .; NEIGHBORHOOD consortium, .; Uitterlinden, AG; Vithana, EN; Foster, PJ; Hysi, PG; Hewitt, AW; Khor, CC; Pasquale, LR; Montgomery, GW; Klaver, CCW; Aung, T; Pfeiffer, N; Mackey, DA; Hammond, CJ; Cheng, C-Y; Craig, JE; Rabinowitz, YS; Wiggs, JL; Burdon, KP; van Duijn, CM; MacGregor, S; - view fewer (2019) Author Correction: Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases. [Corrigendum]. Nature Communications , 10 , Article 155. 10.1038/s41467-018-07819-1 . Green open access

http://bit.ly/2Holk1k

The value of indigenous and local knowledge as citizen science

Danielsen, F.; Burgess, N.D.; Coronado, I.; Enghoff, M.; Holt, S.; Jensen, P.M.; Poulsen, M.K.; Danielsen, F.; Burgess, N.D.; Coronado, I.; Enghoff, M.; Holt, S.; Jensen, P.M.; Poulsen, M.K.; Rueda, R.M.; - view fewer (2018) The value of indigenous and local knowledge as citizen science. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z. and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (pp. 110-123). UCL Press: London. Green open access

http://bit.ly/2RPOhHd

Dizziness at a Canadian tertiary care hospital: a cost-of-illness study

Abstract

Background

In the Canadian health care system, determining overall costs associated with a particular diagnostic subgroup of patients, in this case dizzy patients, is the first step in the process of determining where costs could be saved without compromising patient care. This study is the first Canadian study that evaluates these costs at a tertiary care hospital and will allow for the extrapolation of cost data for other similar academic health science centers, regional health initiatives, and provincial healthcare planning structures.

Methods

We conducted a retrospective cohort study of patients of any age presenting to The Ottawa Hospital (TOH), a tertiary care hospital, between January 1st, 2009 and December 31st^, 2014 with a main diagnosis of dizziness or dizziness-related disease.

De-identified patient information was acquired through TOH Data Warehouse and included a patient's sex, age, arrival and departure dates, Elixhauser co-morbidity score, location of presentation (emergency department or admitted inpatient) presenting complaint, final diagnosis code, any procedure codes linked to their care, and the direct and indirect hospital costs linked with any admission.

We derived the mean hospital costs and 95% confidence interval for each diagnosis. We obtained the number of patients who were diagnosed with dizziness within Ontario in year 2015–16 from Canadian Institute for Health Information (CIHI). A simple frequency multiplication was performed to estimate the total cost burden for Ontario based on the cost estimate for the same year obtained from TOH. Cost data were presented in 2017 Canadian dollars.

Results

The average total hospital cost per patient with dizziness for the entire cohort is $450 (SD = $1334), with ED only patients costing $359 (SD = $214). The total estimated hospital cost burden of dizziness in Ontario is $31,202,000 (95% CI $29,559,000 – 32,844,000).

Conclusions

The estimated annual costs of emergency department ambulatory and inpatient dizziness in Ontario was calculated to be approximately 31 million dollars per year. This is the first step in identifying potential areas for cost savings to aid local and provincial policy-makers in allocation of health care spending.

http://bit.ly/2SWl2jp

A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer

Abstract

Background

Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity.

Methods

Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m² at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE.

On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment.

For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables.

Results

Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically (p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz.

Conclusions

Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes.

Trial registration

ClinicalTrials.gov, NTC02281006, Registered 3 November 2014.

http://bit.ly/2AOiBrU

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Background

Chronic rhinosinusitis (CRS) patients who fail medical management have few treatment options other than endoscopic sinus surgery (ESS). A novel biodegradable mometasone furoate drug delivery system (LYR‐210) providing continuous topical steroid therapy to sinonasal mucosa over 24 weeks was developed to treat unoperated CRS patients who have failed medical management prior to ESS. LYR‐210 was designed to slowly expand in the middle meatus, ensuring efficient drug delivery as mucosal swelling reduces.

Methods

A prospective, multicenter, open‐label study was conducted in 20 CRS subjects who were determined to be candidates for ESS. Under endoscopic guidance and topical anesthesia, LYR‐210 was placed in both middle meatuses. The primary endpoint was product‐related serious adverse events (SAEs) at 4 weeks. Additional assessments included plasma drug concentration, morning serum cortisol levels, intraocular pressures (IOPs), and Sino‐Nasal Outcome Test (SNOT‐22) scores.

Results

LYR‐210 was successfully placed bilaterally in 20 subjects (12 without nasal polyps and 8 with polyps) in an office setting. There were no product‐related SAEs through 24 weeks, at which point 86% of LYR‐210 depots were still retained in the middle meatus. Serum cortisol, IOP, and plasma drug concentrations supported systemic safety at all time points tested. Subjects experienced significant reductions in their SNOT‐22 scores as early as week 1, and this reduction persisted through week 24 (p < 0.01). Significant symptom improvement was achieved in the SNOT‐22 rhinologic, extranasal rhinologic, ear‐facial, psychological, and sleep dysfunction subdomains at 24 weeks (p < 0.05).

Conclusion

LYR‐210 is safe and well‐tolerated in ESS‐naive CRS patients and leads to sustained symptom improvement in patients.

http://bit.ly/2ANaYlE

Adenoid cystic carcinoma of the sinonasal tract: a review of the national cancer database

Background

Sinonasal adenoid cystic carcinoma (SNACC) is a rare malignancy with a propensity for distant metastasis. In this study we describe the incidence and determinants of survival among patients with SNACC between the years 2004 and 2012 using the National Cancer Database (NCDB).

Methods

This was a retrospective, population‐based cohort study performed at a tertiary academic medical center. All participants were diagnosed with SNACC between 2004 and 2012 within the NCDB. The main outcome was overall survival (OS).

Results

A total of 793 patients were identified. The cohort was composed of 46.9% males. Mean age at diagnosis was 59.6 years. The maxillary sinus was the most common primary site (49.7%). Nodal disease was seen in 3.6% of the patients, whereas 3.7% had distant metastases. Stage IV disease was seen in 49.1% of cases. In total, 77.4% of patients underwent surgery, 68.2% received radiation therapy, and 16.4% had chemotherapy. Median OS was 78.5 months; OS at 1, 2, and 5 years was 91%, 83%, and 61%, respectively. On multivariate analysis, advanced age (p = 0.001), frontal sinus primary site (p < 0.001), positive margins (p < 0.001), Charlson comorbidity index >0 (p = 0.01), residing in an urban setting (p = 0.04), poorly differentiated or undifferentiated tumor grade (p = 0.003), and advanced tumor stage (p = 0.01) were associated with worse OS, whereas surgery (p < 0.001), but not radiation therapy (p = 0.52) or chemotherapy (p = 0.57), predicted improved OS.

Conclusion

Predictors of survival in SNACC include age, comorbidity status, grade, and stage. Surgery is associated with improved survival and remains the mainstay of therapy, whereas the roles of radiation therapy and chemotherapy require future investigation.

http://bit.ly/2SZmCko

Torus mandibularis affects the severity and position‐dependent sleep apnea in non‐obese patients

Abstract

Objective

Various anatomical structures of upper airway and physical differences are known to be risk factors for obstructive sleep apnea (OSA). Torus mandibularis is a structure that can appear on the inside of the mandible. Therefore, it is possible for tori to influence airway volume by occupying the space for tongue, and cause sleep apnea. The purpose of this study is to investigate the effect of torus mandibularis on the severity of OSA as one of the craniofacial risk factors.

Design

Retrospective case‐control study.

Setting

University‐based tertiary medical center.

Participants

Adult patients over 19‐years‐old who visited out‐patient clinics with complaints of sleep‐disordered breathing symptoms between January 2010 and December 2017 were investigated.

Main outcome measures

The presence of torus mandibularis in oral cavity was confirmed by physical examination or CT image. We analyzed demographic findings including age, sex, medical history, previous operation history, physical findings of upper airway, and result of polysomnography. To evaluate the effect of torus mandibularis on OSA, polysomnography data of the two groups according to presence or absence of torus mandibularis were compared and analyzed.

Results

232 OSA patients with BMI less than 25 were divided into two groups, according to either the presence or absence of torus mandibularis. We analyzed 138 patients of control group and 94 of torus mandibularis group. AHI was 18.8 ± 14.9 in control group and 25.1 ± 18.4 in torus mandibularis group (p=0.006). RDI was 23.1 ± 14.7 in control group and 27.9 ± 18.4 in torus mandibularis group (p=0.035). Supine AHI showed 26.6 ± 20.3 in control group and 32.5 ± 22.6 in torus mandibularis group (p=0.039). Patients with torus mandibularis had a trend of increase in proportion according to the severity of sleep apnea, such as AHI (p=0.007) or RDI (p=0.034).

Conclusions

We newly found that the presence of torus mandibularis affects not only severity of OSA and also position dependent OSA. These results support the necessity of torus mandibularis evaluation in OSA patients, and further study is also required to investigate its consequence in the surgical outcome.

This article is protected by copyright. All rights reserved.

http://bit.ly/2MghDcs

Our Experience with a Novel CSF Leak Repair Material in 14 Patients Following Anterior Skull Base Surgery

Abstract

Hemopatch (HE) advanced hemostatic pad composed of collagen and a synthetic, protein‐reactive monomer which polymerises on contact with protein containing body fluids such as blood and CSF to seal tissues.

HE is readily available which shortens the operating time, and may be manipulated intra‐nasally to reconstruct defects of the anterior skull base.

Reconstruction using HE reduces the morbidity compared with traditional facia lata graft harvesting techniques.

Length of stay and operative times might be decreased due to lower morbidity from donor site complications.

This article is protected by copyright. All rights reserved.

http://bit.ly/2stVL4j

Burden of treatment: Reported outcomes in a head and neck cancer survivorship clinic

Objective

With the intensification and utilization of multimodal treatment, acute toxicities have increased; however, the frequency of treatment sequelae in long‐term head and neck cancer (HNC) survivors are poorly described. The purpose of this analysis was to determine the prevalence and predictors of patient‐reported late and long‐term treatment‐related sequelae in HNC survivors.

Methods

We performed a cross‐sectional analysis of patient‐reported outcomes from 228 survivors attending a multidisciplinary HNC survivorship clinic. The primary outcomes comprised quality of life (QOL), symptoms of anxiety and depression, and swallowing dysfunction.

Results

Male gender, tumor sites in the oropharynx and larynx, longer time since treatment, and treatment with surgery alone were associated with higher physical QOL (P < .05). Male gender, longer time since treatment, and treatment with surgery alone were associated with higher social‐emotional QOL (P < .05). A reduction in anxiety symptoms and a higher QOL were related to longer time since treatment; however, a reduction in swallowing dysfunction symptoms was only related to longer time since treatment until approximately 6 years. After 6 years, survivors reported worse swallowing dysfunction (P < .05). One hundred thirty‐two survivors (56%) reported at least three treatment‐related effects that impacted their daily life. Finally, advanced stage disease at diagnosis (stage III–IV) was also associated with severe swallowing dysfunction (P = .004).

Conclusion

These data indicate the remarkable prevalence of treatment‐related effects in HNC survivors. These results highlight the need for de‐intensification of therapies, where appropriate, and for a better understanding of pathophysiology and new approaches to mitigating treatment effects.

Level of Evidence

4. Laryngoscope, 2019

http://bit.ly/2AKmmP5

Hospitalization of high and low inpatient service users before and after enrollment into Assertive Community Treatment teams: a naturalistic observational study

Clausen, H; Landheim, A; Odden, S; Benth, JS; Heiervang, KS; Stuen, HK; Killaspy, H; Clausen, H; Landheim, A; Odden, S; Benth, JS; Heiervang, KS; Stuen, HK; Killaspy, H; Ruud, T; - view fewer (2016) Hospitalization of high and low inpatient service users before and after enrollment into Assertive Community Treatment teams: a naturalistic observational study. International Journal of Mental Health Systems , 10 (14) 10.1186/s13033-016-0052-z . Green open access

http://bit.ly/2AN49AO

Clinical practice recommendations for the diagnosis and management of X-linked hypophosphatemia

Haffner, D; Emma, F; Eastwood, D; Biosse Duplan, M; Bacchetta, J; Schnabel, D; Wicart, P; ... Linglart, A; + view all Haffner, D; Emma, F; Eastwood, D; Biosse Duplan, M; Bacchetta, J; Schnabel, D; Wicart, P; Bockenhauer, D; Santos, F; Levtchenko, E; Harvengt, P; Kirchhoff, M; Di Rocco, F; Chaussain, C; Brandi, ML; Savendahl, L; Briot, K; Kamenicky, P; Rejnmark, L; Linglart, A; - view fewer (2019) Clinical practice recommendations for the diagnosis and management of X-linked hypophosphatemia. Nature Reviews Nephrology (In press).

http://bit.ly/2SYXVEH

Prognosis and Neuropathologic Correlation of Clinical Subtypes of Parkinson Disease

De Pablo Fernandez, E; Lees, A; Holton, J; Warner, T; (2019) Prognosis and Neuropathologic Correlation of Clinical Subtypes of Parkinson Disease. JAMA Neurology 10.1001/jamaneurol.2018.4377 . (In press).

http://bit.ly/2AL8p3y

Critical residues involved in tau binding to fyn: implications for tau phosphorylation in Alzheimer's disease

Lau, DHW; Hogseth, M; Phillips, EC; O'Neill, MJ; Pooler, AM; Noble, W; Hanger, DP; (2016) Critical residues involved in tau binding to fyn: implications for tau phosphorylation in Alzheimer's disease. Acta Neuropathologica Communications , 4 (49) 10.1186/s40478-016-0317-4 . Green open access

http://bit.ly/2SVYgbq

Come il mondo ha cambiato i social media

Miller, D; Costa, E; Haynes, N; McDonald, T; Nicolescu, R; Sinanan, J; Juliano, S; ... Wang, X; + view all Miller, D; Costa, E; Haynes, N; McDonald, T; Nicolescu, R; Sinanan, J; Juliano, S; Venkatraman, S; Wang, X; - view fewer (2019) Come il mondo ha cambiato i social media (Gabriella D'Agostino, Vincenzo Matera, Trans.). UCL Press: London, UK. Green open access

http://bit.ly/2ANwxm0

Current and novel biomarkers in anti-neutrophil cytoplasm-associated vasculitis

Draibe, JB; Fulladosa, X; Cruzado, JM; Torras, J; Salama, AD; (2016) Current and novel biomarkers in anti-neutrophil cytoplasm-associated vasculitis. Clinical Kidney Journal , 9 (4) pp. 547-551. 10.1093/ckj/sfw056 . Green open access

http://bit.ly/2SVXP0M

Long-term Survival and Risk Analysis in 136 Consecutive Patients With Type B Aortic Dissection Presenting to a Single Centre Over an 11 Year Period

Clough, RE; Barillà, D; Delsart, P; Ledieu, G; Spear, R; Crichton, S; Mounier Vehier, C; ... Haulon, S; + view all Clough, RE; Barillà, D; Delsart, P; Ledieu, G; Spear, R; Crichton, S; Mounier Vehier, C; Peacock, J; Sobocinski, J; Haulon, S; - view fewer (2019) Long-term Survival and Risk Analysis in 136 Consecutive Patients With Type B Aortic Dissection Presenting to a Single Centre Over an 11 Year Period. European Journal of Vascular and Endovascular Surgery 10.1016/j.ejvs.2018.08.042 . (In press).

http://bit.ly/2AIpQ4T

Effects of both preemption and entrenchment in the retreat from verb overgeneralization errors: four reanalyses, an extended replication, and a meta-analytic synthesis

Ambridge, B; Barak, L; Wonnacott, E; Bannard, C; Sala, G; (2018) Effects of both preemption and entrenchment in the retreat from verb overgeneralization errors: four reanalyses, an extended replication, and a meta-analytic synthesis. Collabra: Psychology , 4 (1) , Article 23. 10.1525/collabra.133 . Green open access

http://bit.ly/2SYbtAi

Green and blue spaces and physical functioning in older adults: Longitudinal analyses of the Whitehall II study

de Keijzer, C; Tonne, C; Sabia, S; Basagana, X; Valentin, A; Singh-Manoux, A; Maria Anto, J; ... Dadvand, P; + view all de Keijzer, C; Tonne, C; Sabia, S; Basagana, X; Valentin, A; Singh-Manoux, A; Maria Anto, J; Alonso, J; Nieuwenhuijsen, MJ; Sunyer, J; Dadvand, P; - view fewer (2019) Green and blue spaces and physical functioning in older adults: Longitudinal analyses of the Whitehall II study. Environment International , 122 pp. 346-356. 10.1016/j.envint.2018.11.046 . Green open access

http://bit.ly/2ANwqXC

Cohesion, citizenship and coherence: schools’ responses to the British values policy

Vincent, C; (2019) Cohesion, citizenship and coherence: schools' responses to the British values policy. British Journal of Sociology of Education 10.1080/01425692.2018.1496011 . (In press).

http://bit.ly/2SZdSe4

Hadronic energy resolution of a combined high granularity scintillator calorimeter system

Repond, J; Xia, L; Apostolakis, AJ; Folger, G; Ivantchenko, V; Ribon, A; Uzhinskiy, V; ... Zeitnitz, C; + view all Repond, J; Xia, L; Apostolakis, AJ; Folger, G; Ivantchenko, V; Ribon, A; Uzhinskiy, V; Boumediene, D; Francais, V; Blazey, GC; Dyshkant, A; Francis, K; Zutshi, V; Bach, O; Brianne, E; Ebrahimi, A; Gadow, K; Goettlicher, P; Hartbrich, O; Krivan, F; Kruger, K; Kvasnicka, J; Lu, S; Neubueser, C; Provenza, A; Reinecke, M; Sefkow, F; Schuwalow, S; Sudo, Y; Tran, HL; Buhmann, P; Garutti, E; Laurien, S; Lomidze, D; Matysek, M; Kaplan, A; Schultz-Coulon, H-C; Wilson, GW; Jeans, D; Kawagoe, K; Sekiya, I; Suehara, T; Yamashiro, H; Yoshioka, T; Wing, M; Kotera, K; Nishiyama, M; Sakuma, T; Takeshita, T; Tozuka, S; Tubokawa, T; Uozumi, S; Calvo Alamillo, E; Fouz, MC; Marin, J; Navarrete, J; Puerta Pelayo, J; Verdugo, A; Chadeeva, M; Danilov, M; Drutskoy, A; Popova, E; Rusinov, V; Tarkovsky, E; Emberger, L; Gabriel, M; Graf, C; Israeli, Y; van der Kolk, N; Simon, F; Szalay, M; Windel, H; Bilokin, S; Bonis, J; Poschl, R; Irles, A; Thiebault, A; Richard, F; Zerwas, D; Anduze, M; Balagura, V; Becheva, E; Boudry, V; Brient, J-C; Cornat, R; Edy, E; Frotin, M; Gastaldi, F; Li, B; Magniette, F; Nanni, J; Rubio-Roy, M; Shpak, K; Tran, TH; Videau, H; Yu, D; Cvach, J; Janata, M; Kovalcuk, M; Polak, I; Smolik, J; Vrba, V; Zalesak, J; Zuklin, J; Chang, S; Khan, A; Kim, DH; Kong, DJ; Oh, YD; Elkhalii, A; Goetze, M; Zeitnitz, C; - view fewer (2018) Hadronic energy resolution of a combined high granularity scintillator calorimeter system. Journal of Instrumentation , 13 , Article P12022. 10.1088/1748-0221/13/12/P12022 . Green open access

http://bit.ly/2AP3X3U

Outcome of non-surgical re-treatment

Ng, Y-L; Gulabivala, K; (2011) Outcome of non-surgical re-treatment. Endodontic Topics , 18 (1) pp. 3-30. 10.1111/j.1601-1546.2011.00260.x . Green open access

http://bit.ly/2SVXuLy

The Explanatory Role of Basic Psychological Need Experiences in the Relation between Dependency, Self-criticism and Psychopathology in Adolescence

Vandenkerckhove, B; Brenning, K; Vansteenkiste, M; Luyten, PJ; Soenens, B; (2019) The Explanatory Role of Basic Psychological Need Experiences in the Relation between Dependency, Self-criticism and Psychopathology in Adolescence. Journal of Psychopathology and Behavioral Assessment (In press). Green open access

http://bit.ly/2AQmLjk

Seizures as an early symptom of autosomal dominant Alzheimer's disease

Vöglein, J; Noachtar, S; McDade, E; Quaid, KA; Salloway, S; Ghetti, B; Noble, J; ... Dominantly Inherited Alzheimer Network, .; + view all Vöglein, J; Noachtar, S; McDade, E; Quaid, KA; Salloway, S; Ghetti, B; Noble, J; Berman, S; Chhatwal, J; Mori, H; Fox, N; Allegri, R; Masters, CL; Buckles, V; Ringman, JM; Rossor, M; Schofield, PR; Sperling, R; Jucker, M; Laske, C; Paumier, K; Morris, JC; Bateman, RJ; Levin, J; Danek, A; Dominantly Inherited Alzheimer Network, .; - view fewer (2019) Seizures as an early symptom of autosomal dominant Alzheimer's disease. Neurobiology of Aging , 76 pp. 18-23. 10.1016/j.neurobiolaging.2018.11.022 .

http://bit.ly/2SVXpre

Hierarchical quantum classifiers

Grant, E; Benedetti, M; Cao, S; Hallam, A; Lockhart, J; Stojevic, V; Green, AG; Grant, E; Benedetti, M; Cao, S; Hallam, A; Lockhart, J; Stojevic, V; Green, AG; Severini, S; - view fewer (2018) Hierarchical quantum classifiers. npj Quantum Information , 4 , Article 65. 10.1038/s41534-018-0116-9 . Green open access

http://bit.ly/2AN46F8

Inhibition of gamma-Secretase Leads to an Increase in Presenilin-1

Sogorb-Esteve, A; Garcia-Ayllon, M-S; Llansola, M; Felipo, V; Blennow, K; Saez-Valero, J; (2018) Inhibition of gamma-Secretase Leads to an Increase in Presenilin-1. Molecular Neurobiology , 55 (6) pp. 5047-5058. 10.1007/s12035-017-0705-1 . Green open access

http://bit.ly/2SVXiMk

Intracoronary ethanol ablation of ventricular premature contractions in patients with preserved left ventricular function

McLellan, AJA; Bhuva, A; Sporton, S; Knight, C; O'Mahony, C; Dhinoja, MB; (2016) Intracoronary ethanol ablation of ventricular premature contractions in patients with preserved left ventricular function. Indian Pacing and Electrophysiology Journal , 16 (5) pp. 165-168. 10.1016/j.ipej.2016.10.014 . Green open access

http://bit.ly/2AR4LFp

Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids

Prendecki, M; Tanna, A; Salama, AD; Tam, FWK; Caims, T; Taube, D; Cook, HT; ... Pusey, CD; + view all Prendecki, M; Tanna, A; Salama, AD; Tam, FWK; Caims, T; Taube, D; Cook, HT; Ashby, D; Duncan, ND; Pusey, CD; - view fewer (2017) Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids. Clinical Kidney Journal , 10 (2) pp. 233-239. 10.1093/ckj/sfw116 . Green open access

http://bit.ly/2SVWXcw

The developmental relations between spatial cognition and mathematics in primary school children

Gilligan, KA; Hodgkiss, A; Thomas, MSC; Farran, EK; (2019) The developmental relations between spatial cognition and mathematics in primary school children. Developmental Science , Article e12786. 10.1111/desc.12786 . (In press).

http://bit.ly/2AQqRHZ

Foreword

Moedas, C.; (2018) Foreword. In: Hecker, S. and Haklay, M. and Bowser, A. and Makuch, Z. and Vogel, J. and Bonn, A., (eds.) Citizen Science - Innovation in Open Science, Society and Policy. (v-vi). UCL Press: London. Green open access

http://bit.ly/2SVWx5W

The Tralokinumab Story: Nothing is ever simple

Publication date: Available online 16 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Andrea J. Apter

http://bit.ly/2Fv5hg7

Clinical Snippets

http://bit.ly/2HifCxM

Issue Information

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Dissecting alterations in human CD8+ T cells with aging by high-dimensional single cell mass cytometry

Publication date: Available online 16 January 2019

Source: Clinical Immunology

Author(s): Min Sun Shin, Kristina Yim, Kevin Moon, Hong-Jai Park, Subhasis Mohanty, Joseph W. Kim, Ruth R. Montgomery, Albert C. Shaw, Smita Krishnaswamy, Insoo Kang

Abstract

We investigated the effect of aging on the multi-dimensional characteristics and heterogeneity of human peripheral CD8⁺ T cells defined by the expression of a set of molecules at the single cell level using the recently developed mass cytometry or Cytometry by Time-Of-Flight (CyTOF) and computational algorithms. CD8⁺ T cells of young and older adults had differential expression of molecules, especially those related to cell activation and migration, permitting the clustering of young and older adults through an unbiased approach. The changes in the expression of individual molecules were collectively reflected in the altered high-dimensional profiles of CD8⁺ T cells in older adults as visualized by the dimensionality reduction analysis tools principal component analysis (PCA) and t-distributed stochastic neighbor embedding (t-SNE). A combination of PhenoGraph clustering and t-SNE analysis revealed heterogeneous subsets of CD8⁺ T cells that altered with aging. Furthermore, intermolecular quantitative relationships in CD8⁺ T cells appeared to change with age as determined by the computational algorithm conditional-Density Resampled Estimate of Mutual Information (DREMI). The results of our study showed that heterogeneity, multidimensional characteristics, and intermolecular quantitative relationships in human CD8⁺ T cells altered with age, distinctively clustering young and older adults through an unbiased approach.

http://bit.ly/2QTqL7A

Separating Acute Rheumatic Fever from Nonrheumatic Streptococcal Myocarditis

Introduction. Streptococcal pharyngitis has been historically complicated with systemic involvement manifesting as acute rheumatic fever, which is a serious condition that can lead to permanent damage to heart valves. A recent association between streptococcal pharyngitis and nonrheumatic heart disease is emerging in literature. We present a case of nonrheumatic streptococcal myocarditis diagnosed using cardiac MRI. Case Presentation. A 25-year-old male, presented with complaints of sore throat, nonproductive cough, fever, pleuritic chest pain, and progressive dyspnea for four days. The patient had elevated troponins at presentation of 0.47 (ng/L) that peaked at 4.0 (ng/L). ECG showed sinus rhythm and ST elevations in leads V2, V3, V4, and V5. NT-Pro-BNP was 1740. Transthoracic echocardiogram (TTE) showed reduced ejection fraction (EF) of 37% and global hypokinesis. The rapid strep test was positive for group A streptococcus and C-reactive protein was elevated at 161. Cardiac MRI demonstrated an EF of 53% and edema in the anterior wall without delayed gadolinium enhancement. Cardiac catheterization showed normal coronaries. Discussion. According to modified Jones criteria, the patient did not meet the full major or minor criteria to be diagnosed with acute rheumatic fever. The course of the nonrheumatic myocarditis is favorable and includes a full recovery of cardiac function, no involvement of cardiac valves, or long-term use of antibiotics. Conclusion. It is crucial to make a separate distinction between acute rheumatic fever and nonrheumatic myocarditis because this will have huge implications on management and long-term use of antibiotics. Cardiac imaging modalities can aid in distinction between the two disease entities.

http://bit.ly/2Fvrjzt

Leukocytoclastic vasculitis with purpura and renal failure induced by the anti-epidermal growth factor receptor antibody panitumumab: a case report

Panitumumab is the first human combinatorial antibody for the treatment of metastatic colorectal carcinoma. Dermatologic toxicity of all grades occurs in more than 90% of patients. However, there are few repor...

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Vergleich von piezoelektrisch assistierter und konventioneller Osteotomie bei der Rhinoplastik

Zusammenfassung

Hintergrund

Bei der Rhinoplasik werden postoperative periorbitale Ödeme und Ekchymosen v. a. durch die konventionelle nasale Osteotomie mit Hammer und Meißel verursacht. Möglicherweise führt die Piezochirurgie zu einem verbesserten frühpostoperativen Verlauf durch Schonung des Weichgewebes. Ziel dieser Arbeit war eine systematische Übersicht über Methoden und Ergebnisse von Studien zum Vergleich einer konventionellen mit einer piezoelektrischen Osteotomie.

Methoden

Es erfolgte eine systematische Literaturrecherche in den elektronischen Datenbanken PubMed/MEDLINE und Google Scholar. Bei der primären Selektion wurden alle Studien über den Vergleich konventioneller und piezoelektrischer Osteotomie hinsichtlich postoperativer periorbitaler Ödeme und/oder Ekchymosen erfasst. Die sekundäre Selektion umfasste nur Publikationen mit einer Kontrollgruppe.

Ergebnisse

Die primäre Selektion ergab 15 thematisch relevante Publikationen mit deutlicher Zunahme an jährlichen Veröffentlichungen zwischen 2007 und 2017. Es wurden 6 Studien mit Kontrollgruppen sekundär selektiert, die qualitativ und methodisch sehr heterogen waren. Die Ergebnisse von 5 der 6 Studien wiesen auf einen deutlichen Vorteil der Piezotechnik im Vergleich zur konventionellen Osteotomie hin. Nur in einer Studie wurde kein signifikanter Unterschied bezüglich des untersuchten Ergebnisses festgestellt.

Schlussfolgerung

Nach piezoelektrischer Osteotomie fand sich eine geringere Neigung zu postoperativer Ödembildung und Ekchymose als bei konventioneller Osteotomietechnik. Derzeit sollten die Ergebnisse als Trend interpretiert werden. Eine abschließende Empfehlung zur Überlegenheit einer Methode kann erst bei Vorliegen von mehr Studien mit größeren Patientenzahlen erfolgen.

http://bit.ly/2FCH5b5

Perioperative Dextrose Infusion and Postoperative Nausea and Vomiting: A Meta-analysis of Randomized Trials

BACKGROUND: Perioperative IV dextrose infusions have been investigated for their potential to reduce the risk of postoperative nausea and vomiting. In this meta-analysis, we investigated the use of an intraoperative or postoperative infusion of dextrose for the prevention of postoperative nausea and vomiting. METHODS: Our group searched PubMed, Embase, Cochrane library, and Google Scholar for relevant randomized controlled trials examining the use of perioperative IV dextrose for prevention of postoperative nausea and vomiting. The primary outcome was the incidence of postoperative nausea and vomiting (both in the postanesthesia care unit and within the first 24 h of surgery). Secondary outcomes included postoperative antiemetic administration and serum glucose level. RESULTS: Our search yielded a total of 10 randomized controlled trials (n = 987 patients) comparing the use of a perioperative dextrose infusion (n = 465) to control (n = 522). Perioperative dextrose infusion was not associated with a significant reduction in postoperative nausea and vomiting in the postanesthesia care unit (risk ratio = 0.91, 95% CI, 0.73–1.15; P = .44) or within the first 24 h (risk ratio = 0.76, 95% CI, 0.55–1.04; P = .09) of surgery. Although the use of dextrose was associated with a significant reduction in antiemetic administration within the first 24 h (risk ratio = 0.55, 95% CI, 0.45–0.69; P

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Impact of Preoperative Erythropoietin on Allogeneic Blood Transfusions in Surgical Patients: Results From a Systematic Review and Meta-analysis

BACKGROUND: Erythropoietic-stimulating agents such as erythropoietin have been used as part of patient blood management programs to reduce or even avoid the use of allogeneic blood transfusions. We review the literature to evaluate the effect of preoperative erythropoietin use on the risk of exposure to perioperative allogeneic blood transfusions. METHODS: The study involved a systematic review and meta-analysis of randomized controlled trials evaluating the use of preoperative erythropoietin. The primary outcome was the reported incidence of allogeneic red blood cell transfusions during inpatient hospitalizations. Secondary outcomes included phase-specific allogeneic red blood cell transfusions (ie, intraoperative, postoperative), intraoperative estimated blood loss, perioperative hemoglobin levels, length of stay, and thromboembolic events. RESULTS: A total of 32 randomized controlled trials (n = 4750 patients) were included, comparing preoperative erythropoietin (n = 2482 patients) to placebo (n = 2268 patients). Preoperative erythropoietin is associated with a significant decrease in incidence of allogeneic blood transfusions among all patients (n = 28 studies; risk ratio, 0.59; 95% CI, 0.47–0.73; P

http://bit.ly/2QQJOQf

Pain Management for Ambulatory Arthroscopic Anterior Cruciate Ligament Reconstruction: Evidence-Based Recommendations From the Society for Ambulatory Anesthesia

Ambulatory arthroscopic anterior cruciate ligament reconstruction is associated with moderate pain, even when nonopioid oral analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs are used. Regional analgesia can supplement nonopioid oral analgesics and reduce postoperative opioid requirements, but the choice of regional analgesia technique for anterior cruciate ligament reconstruction remains controversial. Femoral nerve block, adductor canal block, and local instillation analgesia have all been proposed and are supported by some evidence from randomized controlled trials. Consequently, regional analgesia practice in patients undergoing anterior cruciate ligament reconstruction remains mixed. Published systematic reviews were used to identify the regional analgesia modality that would provide a balance between analgesic efficacy and associated potential risks in the setting of nonopioid multimodal analgesic strategies. Based on the evidence available, local instillation analgesia provides the best balance of analgesic efficacy and associated risks (strong recommendation, moderate level of evidence) when used as a component of multimodal analgesic technique in the first 24 hours after outpatient arthroscopic anterior cruciate ligament reconstruction. In the absence of local instillation analgesia, clinicians might use adductor canal block or femoral nerve block (weak recommendation, weak level of evidence). These recommendations have been endorsed by the Society of Ambulatory Anesthesia and approved by its board of directors. Accepted for publication November 05, 2018. Funding: No external funding was provided from any source. No funding was received from the Society for Ambulatory Anesthesia. Conflicts of Interest: See Disclosures at the end of the article. Reprints will not be available from the authors. Address correspondence to Girish P. Joshi, MBBS, MD, FFARCSI, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390. Address e-mail to girish.joshi@utsouthwestern.edu. © 2019 International Anesthesia Research Society

http://bit.ly/2VYHiuL

Essentials of Anesthesia for Neurotrauma, 1st ed

No abstract available

http://bit.ly/2QSElYS

In Response

No abstract available

http://bit.ly/2VYHc6n

Changes in International Normalized Ratio After Plasma Transfusion in Clinical Settings

No abstract available

http://bit.ly/2QMP8E9

Systematic Review and Meta-analysis: Sometimes Bigger Is Indeed Better

Clinicians encounter an ever increasing and frequently overwhelming amount of information, even in a narrow scope or area of interest. Given this enormous amount of scientific information published every year, systematic reviews and meta-analyses have become indispensable methods for the evaluation of medical treatments and the delivery of evidence-based best practice. The present basic statistical tutorial thus focuses on the fundamentals of a systematic review and meta-analysis, against the backdrop of practicing evidence-based medicine. Even if properly performed, a single study is no more than tentative evidence, which needs to be confirmed by additional, independent research. A systematic review summarizes the existing, published research on a particular topic, in a well-described, methodical, rigorous, and reproducible (hence "systematic") manner. A systematic review typically includes a greater range of patients than any single study, thus strengthening the external validity or generalizability of its findings and the utility to the clinician seeking to practice evidence-based medicine. A systematic review often forms the basis for a concomitant meta-analysis, in which the results from the identified series of separate studies are aggregated and statistical pooling is performed. This allows for a single best estimate of the effect or association. A conjoint systematic review and meta-analysis can provide an estimate of therapeutic efficacy, prognosis, or diagnostic test accuracy. By aggregating and pooling the data derived from a systemic review, a well-done meta-analysis essentially increases the precision and the certainty of the statistical inference. The resulting single best estimate of effect or association facilitates clinical decision making and practicing evidence-based medicine. A well-designed systematic review and meta-analysis can provide valuable information for researchers, policymakers, and clinicians. However, there are many critical caveats in performing and interpreting them, and thus, like the individual research studies on which they are based, there are many ways in which meta-analyses can yield misleading information. Creators, reviewers, and consumers alike of systematic reviews and meta-analyses would thus be well-served to observe and mitigate their associated caveats and potential pitfalls. Accepted for publication December 10, 2018. Funding: None. The author declares no conflicts of interest. Reprints will not be available from the author. Address correspondence to Thomas R. Vetter, MD, MPH, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Health Discovery Bldg, Room 6.812, 1701 Trinity St, Austin, TX 78712. Address e-mail to thomas.vetter@austin.utexas.edu. © 2019 International Anesthesia Research Society

http://bit.ly/2VWo60U

Continuous Noninvasive Arterial Pressure Monitoring in Obese Patients During Bariatric Surgery: An Evaluation of the Vascular Unloading Technique (Clearsight system)

BACKGROUND: Continuous monitoring of arterial pressure is important in severely obese patients who are at particular risk for cardiovascular complications. Innovative technologies for continuous noninvasive arterial pressure monitoring are now available. In this study, we compared noninvasive arterial pressure measurements using the vascular unloading technique (Clearsight system; Edwards Lifesciences Corp, Irvine, CA) with invasive arterial pressure measurements (radial arterial catheter) in severely obese patients during laparoscopic bariatric surgery. METHODS: In 35 severely obese patients (median body mass index, 47 kg/m2), we simultaneously recorded noninvasive and invasive arterial pressure measurements over a period of 45 minutes. We compared noninvasive (test method) and invasive (reference method) arterial pressure measurements (sampling rate 1 Hz = 1/s) using Bland-Altman analysis (accounting for multiple measurements per subject), 4-quadrant plot/concordance analysis (2-minute interval, 5 mm Hg exclusion zone), and error grid analysis (calculating the proportions of measurements in risk zones A–E with A indicating no risk, B low risk, C moderate risk, D significant risk, and E dangerous risk for the patient due to the risk of wrong clinical interventions because of measurement errors). RESULTS: We observed a mean of the differences (±SD, 95% limits of agreement) between the noninvasively and invasively assessed arterial pressure values of 1.1 mm Hg (±7.4 mm Hg, −13.5 to 15.6 mm Hg) for mean arterial pressure (MAP), 6.8 mm Hg (±10.3 mm Hg, −14.4 to 27.9 mm Hg) for systolic arterial pressure, and 0.8 mm Hg (±6.9 mm Hg, −12.9 to 14.4 mm Hg) for diastolic arterial pressure. The 4-quadrant plot concordance rate (ie, the proportion of arterial pressure measurement pairs showing concordant changes to all changes) was 93% (CI, 89%–96%) for MAP, 93% (CI, 89%–97%) for systolic arterial pressure, and 88% (CI, 84%–92%) for diastolic arterial pressure. Error grid analysis showed that the proportions of measurements in risk zones A–E were 89.5%, 10.0%, 0.5%, 0%, and 0% for MAP and 93.7%, 6.0%, 0.3%, 0%, and 0% for systolic arterial pressure, respectively. CONCLUSIONS: During laparoscopic bariatric surgery, the accuracy and precision of the vascular unloading technique (Clearsight system) was good for MAP and diastolic arterial pressure, but only moderate for systolic arterial pressure according to Bland-Altman analysis. The system showed good trending capabilities. In the error grid analysis, >99% of vascular unloading technique–derived arterial pressure measurements were categorized in no- or low-risk zones. Accepted for publication October 18, 2018. Sebastian A. Haas, MD, and Daniel A. Reuter, MD, are currently affiliated with the Department of Anesthesiology and Intensive Care Medicine, University Medical Center Rostock, Rostock, Germany. Funding: Edwards Lifesciences Corp (Irvine, CA) provided the technical equipment for the study. Edwards Lifesciences was not involved in the collection of the data, drafting of the manuscript, or the decision to submit the manuscript for publication. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Dorothea E. Rogge, MD, Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. Address e-mail to d.rogge@uke.de. © 2019 International Anesthesia Research Society

http://bit.ly/2QSwScz

Intraoperative Hyperoxia Does Not Reduce Postoperative Pain: Subanalysis of an Alternating Cohort Trial

BACKGROUND: Postoperative pain is common and promotes opioid use. Surgical wounds are hypoxic because normal perfusion is impaired. Local wound ischemia and acidosis promote incisional pain. Some evidence suggests that improving oxygen supply to surgical wounds might reduce pain. We therefore tested the hypothesis that supplemental (80% inspired) intraoperative oxygen reduces postoperative pain and opioid consumption. METHODS: We conducted a post hoc analysis of a large, single-center alternating cohort trial allocating surgical patients having general anesthesia for colorectal surgery to either 30% or 80% intraoperative oxygen concentration in 2-week blocks for a total of 39 months. Irrespective of allocation, patients were given sufficient oxygen to maintain saturation ≥95%. Patients who had regional anesthesia or nerve blocks were excluded. The primary outcome was pain and opioid consumption during the initial 2 postoperative hours, analyzed jointly. The secondary outcome was pain and opioid consumption over the subsequent 24 postoperative hours. Subgroup analyses of the primary outcome were conducted for open versus laparoscopic procedures and for patients with versus without chronic pain. RESULTS: A total of 4702 cases were eligible for analysis: 2415 were assigned to 80% oxygen and 2287 to 30% oxygen. The groups were well balanced on potential confounding factors. Average pain scores and opioid consumption were similar between the groups (mean difference in pain scores, −0.01 [97.5% CI, −0.16 to 0.14; P = .45], median difference in opioid consumption, 0.0 [97.5% CI, 0 to 0] mg morphine equivalents; P = .82). There were also no significant differences in the secondary outcome or subgroup analyses. CONCLUSIONS: Supplemental intraoperative oxygen does not reduce acute postoperative pain or reduce opioid consumption. Accepted for publication November 26, 2018. Funding: This work received internal funding. None of the authors has a personal financial interest in this analysis. B.C. is a recipient of a Fellowship Grant from the American Physicians Fellowship for Medicine in Israel. 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 (http://bit.ly/KegmMq). Trial registration: ClinicalTrials.gov number NCT01777568. Reprints will not be available from the authors. Address correspondence to Alparslan Turan, MD, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave, P77, Cleveland, OH 44195. Address e-mail to TuranA@ccf.org. © 2019 International Anesthesia Research Society

http://bit.ly/2VUR40W

Quantile Regression and Its Applications: A Primer for Anesthesiologists

Multivariable regression analysis is a powerful statistical tool in biomedical research with numerous applications. While linear regression can be used to model the expected value (ie, mean) of a continuous outcome given the covariates in the model, quantile regression can be used to compare the entire distribution of a continuous response or a specific quantile of the response between groups. The advantage of the quantile regression methodology is that it allows for understanding relationships between variables outside of the conditional mean of the response; it is useful for understanding an outcome at its various quantiles and comparing groups or levels of an exposure on those quantiles. We present quantile regression in a 3-step approach: determining that quantile regression is desired, fitting the quantile regression model, and interpreting the model results. We then apply our quantile regression analysis approach using 2 illustrative examples from the 2015 American College of Surgeons National Surgical Quality Improvement Program Pediatric database, and 1 example utilizing data on duration of sensory block in rats. Accepted for publication December 12, 2018. Funding: None. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://bit.ly/KegmMq). Reprints will not be available from the authors. Address correspondence to Steven J. Staffa, MS, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115. Address e-mail to steven.staffa@childrens.harvard.edu. © 2019 International Anesthesia Research Society

http://bit.ly/2QRIeNJ

Innovation in Education Research: Creation of an Education Research Core

Within academic medical centers, there is increasing interest among physicians to pursue education as a promotion pathway. Many medical schools and universities offer professional development opportunities for these individuals such as workshops and certificate and advanced degree programs. However, there exists a need for a more personalized support for clinician-educators to be successful in educational scholarship in the health care setting. In 2017, a departmental level educational research community was established within Anesthesiology and Critical Care Medicine at Johns Hopkins University to support faculty, staff, and trainees in creating, completing, and publishing educational scholarship. The research infrastructure includes administrative and institutional review board submission assistance, internal grant support, database management, statistical analysis, and consultation with professional educators. Also, integral to the education core is monthly education lab meetings that allow an opportunity for education researchers to present work in progress, conceive new projects, discuss relevant literature, and cultivate and sustain a community of educational scholars. This innovation in education demonstrates feasibility at a departmental level to successfully support educational research. We have initiated education meetings with a cohort of core education faculty who are interested in an educational promotion track. We present several metrics that can be used to evaluate the effectiveness of the programs similar to this innovation. Accepted for publication November 1, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Deborah A. Schwengel, MD, MEHP, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, 1800 Orleans St, Suite 6349H, Baltimore, MD. Address e-mail to Dschwen1@jhmi.edu. © 2019 International Anesthesia Research Society

http://bit.ly/2VUiLHo

Vasopressor Infusion During Prone Spine Surgery and Acute Renal Injury: A Retrospective Cohort Analysis

BACKGROUND: Hypotension is associated with acute kidney injury, but vasopressors used to treat hypotension may also compromise renal function. We therefore tested the hypothesis that vasopressor infusion during complex spine surgery is not associated with impaired renal function. METHODS: In this retrospective cohort analysis, we considered adults who had complex spine surgery between January 2005 and September 2014 at the Cleveland Clinic Main Campus. Our primary outcome was postoperative estimated glomerular filtration rate. Secondarily, we evaluated renal function using Acute Kidney Injury Network criteria. We obtained data for 1814 surgeries, including 689 patients (38%) who were given intraoperative vasopressors infusion for ≥30 minutes and 1125 patients (62%) who were not. Five hundred forty patients with and 540 patients without vasopressor infusions were well matched across 32 potential confounding variables. RESULTS: In matched patients, vasopressor infusions lasted an average of 173 ± 100 minutes (SD) and were given a median dose (1st quintile, 3rd quintile) of 3.4-mg (1.5, 6.7 mg) phenylephrine equivalents. Mean arterial pressure and the amounts of hypotension were similar in each matched group. The postoperative difference in mean estimated glomerular filtration rate in patients with and without vasopressor infusions was only 0.8 mL/min/1.73 m2 (95% CI, −0.6 to 2.2 mL/min/1.73 m2) (P = .28). Intraoperative vasopressor infusion was also not associated with increased odds of augmented acute kidney injury stage. CONCLUSIONS: Clinicians should not avoid typical perioperative doses of vasopressors for fear of promoting kidney injury. Tolerating hypotension to avoid vasopressor use would probably be a poor strategy. Accepted for publication November 13, 2018. Funding: Institutional. 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 (http://bit.ly/KegmMq). Reprints will not be available from the authors. Address correspondence to Daniel I. Sessler, MD, Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Ave, P77, Cleveland, OH 44195. Address e-mail to DS@OR.org. © 2019 International Anesthesia Research Society

http://bit.ly/2QSEhIC

Little adaptive potential of a threatened passerine

de Villemereuil, P; Rutschmann, A; Lee, KD; Ewen, JG; Brekke, P; Santure, AW; (2019) Little adaptive potential of a threatened passerine. [Dataset]. UCL (Institute of Zoology) Green open access

http://bit.ly/2MbqEnp

Transitions between frailty states among community-dwelling older people: A systematic review and meta-analysis

Kojima, G; Taniguchi, Y; Iliffe, S; Jivraj, S; Walters, K; (2019) Transitions between frailty states among community-dwelling older people: A systematic review and meta-analysis. [Review]. Ageing Research Reviews (In press).

http://bit.ly/2sx8jb7

Predicted Benign and Synonymous Variants in CYP11A1 Cause Primary Adrenal Insufficiency Through Missplicing

Maharaj, A; Buonocore, F; Meimaridou, E; Ruiz-Babot, G; Guasti, L; Peng, H-M; Capper, CP; ... Metherell, LA; + view all Maharaj, A; Buonocore, F; Meimaridou, E; Ruiz-Babot, G; Guasti, L; Peng, H-M; Capper, CP; Burgos-Tirado, N; Prasad, R; Hughes, CR; Maudhoo, A; Crowne, E; Cheetham, TD; Brain, CE; Suntharalingham, JP; Striglioni, N; Yuksel, B; Gurbuz, F; Gupta, S; Lindsay, R; Couch, R; Spoudeas, HA; Guran, T; Johnson, S; Fowler, DJ; Conwell, LS; McInerney-Leo, AM; Drui, D; Cariou, B; Lopez-Siguero, JP; Harris, M; Duncan, EL; Hindmarsh, PC; Auchus, RJ; Donaldson, MD; Achermann, JC; Metherell, LA; - view fewer (2019) Predicted Benign and Synonymous Variants in CYP11A1 Cause Primary Adrenal Insufficiency Through Missplicing. Journal of the Endocrine Society , 3 (1) pp. 201-221. 10.1210/js.2018-00130 . Green open access

http://bit.ly/2MdQWoT

Unresolved trauma and reorganization in mothers: Attachment and neuroscience perspectives

Iyengar, U; Rajhans, P; Kim, S; Fonagy, P; Strathearn, L; (2019) Unresolved trauma and reorganization in mothers: Attachment and neuroscience perspectives. Frontiers in Psychology 10.3389/fpsyg.2019.00110 . (In press).

http://bit.ly/2swWwJS

Characterization of The Brazilian ARSACS Phenotype: Clinical, Ophthalmological, Neuroimaging, and Genetic Features of Fourteen Cases

Rezende Filho, F; Pedroso, JL; Sallum, JM; Kok, F; Franca, M; Vasconcellos, I; Marques, W; ... Barsottini, O; + view all Rezende Filho, F; Pedroso, JL; Sallum, JM; Kok, F; Franca, M; Vasconcellos, I; Marques, W; Lourenco, C; Giunti, P; Barsottini, O; - view fewer (2018) Characterization of The Brazilian ARSACS Phenotype: Clinical, Ophthalmological, Neuroimaging, and Genetic Features of Fourteen Cases. In: (Proceedings) 70th Annual Meeting of the American-Academy-of-Neurology (AAN). LIPPINCOTT WILLIAMS & WILKINS (In press).

http://bit.ly/2MczxwU

I don't feel like I'm in an abusive relationship”: women's naming of their partner's abusive behaviours and how this may be affected by institutional definitions

Rivas, CA; (2010) I don't feel like I'm in an abusive relationship": women's naming of their partner's abusive behaviours and how this may be affected by institutional definitions. Psychology of Women Quarterly Review , 12 (2) pp. 2-10. Green open access

http://bit.ly/2srKFwR

Comparison of MRI Activity Scoring Systems and Features for the Terminal Ileum in Patients With Crohn Disease

Puylaert, CAJ; Nolthenius, CJT; Tielbeek, JAW; Makanyanga, JC; Rodriguez-Justo, M; Brosens, LAA; Nio, CY; ... Stoker, J; + view all Puylaert, CAJ; Nolthenius, CJT; Tielbeek, JAW; Makanyanga, JC; Rodriguez-Justo, M; Brosens, LAA; Nio, CY; Pendsé, DA; Ponsioen, CY; Vos, FM; Taylor, SA; Stoker, J; - view fewer (2018) Comparison of MRI Activity Scoring Systems and Features for the Terminal Ileum in Patients With Crohn Disease. American Journal of Roentgenology (AJR) , 2018 W1-W7. 10.2214/AJR.18.19876 . (In press).

http://bit.ly/2Mfne2K

Power as Active Self: From Acquisition to the Expression and Use of Power

Guinote, A; Chen, S; (2018) Power as Active Self: From Acquisition to the Expression and Use of Power. In: Deaux, K and Snyder, M, (eds.) The Oxford Handbook of Personality and Social Psychology. (pp. 645-671). Oxford University Press: Oxford, UK.

http://bit.ly/2swCAHj

Jurisdiction and State Responsibility

Trapp, KN; (2019) Jurisdiction and State Responsibility. In: Allen, S and Fitzmaurice, M and Guntrip, E and Costeelloe, D and Gragl, P, (eds.) Oxford Handbook of Jurisdiction in International Law. Oxford University Press: Oxford, UK. (In press).

http://bit.ly/2Mfn7nQ

P53 and mTOR signalling determine fitness selection through cell competition during early mouse embryonic development

Bowling, S; Di Gregorio, A; Sancho, M; Pozzi, S; Aarts, M; Signore, M; Schneider, MD; ... Rodriguez, TA; + view all Bowling, S; Di Gregorio, A; Sancho, M; Pozzi, S; Aarts, M; Signore, M; Schneider, MD; Barbera, JPM; Gil, J; Rodriguez, TA; - view fewer (2018) P53 and mTOR signalling determine fitness selection through cell competition during early mouse embryonic development. Nature Communications , 9 , Article 1763. 10.1038/s41467-018-04167-y . Green open access

http://bit.ly/2sx8inz

Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics

Finkel, RS; Mercuri, E; Meyer, OH; Simonds, AK; Schroth, MK; Graham, RJ; Kirschner, J; ... Sejersen, T; + view all Finkel, RS; Mercuri, E; Meyer, OH; Simonds, AK; Schroth, MK; Graham, RJ; Kirschner, J; Iannaccone, ST; Crawford, TO; Woods, S; Muntoni, F; Wirth, B; Montes, J; Main, M; Mazzone, ES; Vitale, M; Snyder, B; Quijano-Roy, S; Bertini, E; Davis, RH; Qian, Y; Sejersen, T; - view fewer (2018) Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscular Disorders , 28 (3) pp. 197-207. 10.1016/j.nmd.2017.11.004 . Green open access

http://bit.ly/2MczxNq

fMRI reveals neural activity overlap between adult and infant pain

Goksan, S; Hartley, C; Emery, F; Cockrill, N; Poorun, R; Moultrie, F; Rogers, R; ... Slater, R; + view all Goksan, S; Hartley, C; Emery, F; Cockrill, N; Poorun, R; Moultrie, F; Rogers, R; Campbell, J; Sanders, M; Adams, E; Clare, S; Jenkinson, M; Tracey, I; Slater, R; - view fewer (2015) fMRI reveals neural activity overlap between adult and infant pain. eLife , 2015 (4) , Article e06356. 10.7554/eLife.06356.001 . Green open access

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Reprint of: Important imaging considerations in the pre-operative assessment of rectal cancer

Chand, M; Brown, G; (2018) Reprint of: Important imaging considerations in the pre-operative assessment of rectal cancer. Seminars in Colon and Rectal Surgery , 29 (4) pp. 199-205. 10.1053/j.scrs.2018.11.008 .

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