Medicine by Sfakianakis Alexandros: 01/19/19

Σάββατο 19 Ιανουαρίου 2019

The Impact of Immunodeficiency on NK Cell Maturation and Function

Abstract

Purpose of Review

Natural killer cells are innate lymphoid cells (ILCs) that play critical roles in human host defense and are especially useful in combating viral pathogens and malignancy.

Recent Findings

The NK cell deficiency (NKD) is particularly underscored in patients with a congenital immunodeficiency in which NK cell development or function is affected. The classical NK cell deficiency (cNKD) is a result of absent or a profound decrease in the number of circulating NK cells. In contrast, functional NKD (fNKD) is characterized by abnormal NK cell function but with normal number of NK cells. The combined immune deficiencies with significant impact on NK cells are not considered classical or functional NK cell deficiencies. In these disorders, the impairment of NK cells represents an important aspect of the overall immunodeficiency. In turn, this leads to improved insights on the NK cell development and function.

Summary

Here, we detail the NK cell biology based upon recent natural killer cell defects described in combined immune deficiencies.

http://bit.ly/2T6b0ME

Direct to Consumer Telemedicine

Abstract

Purpose of Review

Telemedicine uses technology to connect patients and data with providers at a distance. Direct to consumer telemedicine is a rapidly growing segment of the industry.

Recent Findings

The telehealth market has skyrocketed in recent years, making it a multi-billion dollar industry. Direct to consumer telehealth, dominated by the for-profit private sector, is the most popular form.

Summary

Direct to consumer telemedicine is a subset of telehealth that shows promise in increasing access to and engagement in medical care. Quality assurance, reimbursement, and regulatory oversight are important factors in assuring appropriate widespread adoption.

http://bit.ly/2AS1sOg

Low-Income Children with Neonatal Hypothyroidism Are at Increased Risk for Intellectual Disability

Clinical Thyroidology, Volume 31, Issue 1, Page 14-16, January 2019.

http://bit.ly/2sAVAEo

How Can Levothyroxine Overuse Be Reduced?

Clinical Thyroidology, Volume 31, Issue 1, Page 5-7, January 2019.

http://bit.ly/2Mlx0ke

An Increased Relative but Small Absolute Risk of Leukemia Can Be Attributed to I-131 Ablation

Clinical Thyroidology, Volume 31, Issue 1, Page 30-32, January 2019.

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New miRNA-Based Classifier Test Uses FNA Cytology to Evaluate Cytologically Indeterminate Thyroid Nodules

Clinical Thyroidology, Volume 31, Issue 1, Page 23-26, January 2019.

http://bit.ly/2MoRQ28

Fear of Recurrence Affects Health-Related Quality of Life in Thyroid Cancer Patients

Clinical Thyroidology, Volume 31, Issue 1, Page 27-29, January 2019.

http://bit.ly/2sB9DtN

Clinical Validation of ThyroSeq V3 Shows High Sensitivity and Specificity

Clinical Thyroidology, Volume 31, Issue 1, Page 20-22, January 2019.

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A Mild Risk of Neonatal Hyperthyroidism Follows Preconception Radioactive Iodine Treatment for Graves’ Disease

Clinical Thyroidology, Volume 31, Issue 1, Page 11-13, January 2019.

http://bit.ly/2sKl2Yt

More Hürthle-Cell Aspirations Will Be Identified as Benign by the New Afirma GSC Test

Clinical Thyroidology, Volume 31, Issue 1, Page 17-19, January 2019.

http://bit.ly/2MmKaNz

Dyslipidemia Is Common in Patients with Hypothyroidism Despite Correction of Abnormal TSH: A Systematic Review and Meta-Analysis

Clinical Thyroidology, Volume 31, Issue 1, Page 8-10, January 2019.

http://bit.ly/2sB3ein

The Difficult to Access “Right-To-Try” U.S. Health Care Law

Clinical Thyroidology, Volume 31, Issue 1, Page 33-36, January 2019.

http://bit.ly/2MoJ5VS

Greetings From the New Editor of Clinical Thyroidology

Clinical Thyroidology, Volume 31, Issue 1, Page 4-4, January 2019.

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A Systematic Review of Radiofrequency Treatment of the Ankle for the Management of Chronic Foot and Ankle Pain

Abstract

Background

Chronic pain of the lower extremity remains challenging to manage. Radiofrequency treatment applies heat to nerve fibers with the goal of mitigating chronic pain conditions. The clinical efficacy has not yet been adequately established for pathologies of the ankle and foot. In this review paper, we report the use and efficacy of radiofrequency treatment applied to foot and ankle pain.

Recent Findings

PubMed and the Cochrane Controlled Trials Register were searched (final search 30 March 2018) using the MeSH terms "radiofrequency ablation," "neurolysis," "radiofrequency therapy," "pain syndrome," "analgesia," "plantar heel pain," "plantar fascitis," and "chronic pain" in the English literature. Of the 23 papers screened, 18 were further investigated for relevance. Our final search methodology yielded 15 studies that investigated the use of radiofrequency treatment at the ankle. Of these 15 studies, there were three randomized control trials, four prospective studies, three retrospective studies, and five case reports. The quality of selected publications was assessed using the Cochrane risk of bias instrument.

Summary

The evidence from our studies suggests that radiofrequency treatment can be used safely for the management foot and ankle pain. The technique (continuous vs pulsatile), temperature, location of treatment, and duration of administration need more thorough evaluation. Randomized control trials are needed to establish the efficacy and safety profile of radiofrequency ablation and its long-term benefits in patients with chronic pain of the foot and ankle.

Conclusion

http://bit.ly/2MldDro

Adherence to Behavioral Therapy for Migraine: Knowledge to Date, Mechanisms for Assessing Adherence, and Methods for Improving Adherence

Abstract

Purpose of Review

In other disease states, adherence to behavioral therapies has gained attention, with a greater amount of studies discussing, defining, and optimizing adherence. For example, a meta-analysis formally discussed adherence in 25 studies of CBT for 11 different disorders, with only 6 of the 25 omitting addressing or defining adherence. Many studies have discussed the use of text messages, graph-based adherence rates, and email/telephone reminders to improve adherence. This paper examined the available literature regarding adherence to behavioral therapy for migraine as well as adherence to similar therapies in other disease states. The goal of this research is to apply lessons learned from adherence to behavioral therapy for other diseases in better understanding how we can improve adherence to behavioral therapy for migraine.

Recent Findings

Treatment for migraine typically includes both pharmacologic and non-pharmacologic therapies, including progressive muscle relaxation (PMR), cognitive behavioral therapy (CBT), and biofeedback. Behavioral therapies have been shown to significantly reduce headache frequency and intensity, but high attrition rates and suboptimal adherence can undermine their efficacy. Traditionally, adherence to behavioral therapy has been defined by self-report, including paper headache diaries and assignments. In person attendance has also been employed as a method of defining and monitoring adherence. With the advent of personal electronics, measurements of adherence have shifted to include electronic-based methods such as computer-based programs and mobile-based therapies. Furthermore, some studies have taken advantage of electronic methods such as email reminders, push notifications, and other mobile-based reminders to optimize adherence. The JITA-I, a novel method of engaging individual patient adherence, has also been suggested as a possible method to improve adherence by tailoring engagement with a mobile health app-based on patient input. These novel methods may be utilized in behavioral therapy for migraine for further optimizing adherence.

Summary

Few intervention studies to date have addressed the optimal ways to impact adherence to migraine behavioral therapy. Further research is required regarding adherence with behavioral therapies, specifically via mobile health interventions to better understand how to define and improve adherence via this novel forum. Once we are able to understand optimal methods of tracking adherence, we will be better equipped to understand the role of adherence in shaping outcomes for behavioral therapy in migraine.

http://bit.ly/2szdOGz

The Status of Pain Research in Academia and how We Are Doing in the United States

http://bit.ly/2MoRPv6

Imaging of Carotid Dissection

Abstract

Purpose of Review

Here, we describe the four primary imaging modalities for identification of carotid artery dissection, advantages, limitations, and clinical considerations. In addition, imaging characteristics of carotid dissection associated with each modality will be described.

Recent Findings

Recent advances in etiopathogenesis describe the genetic factors implicated in cervical artery dissection. MRI/MRA (magnetic resonance angiography) with fat suppression is regarded as the best initial screening test to detect dissection. Advances in magnetic resonance imaging for the diagnosis of dissection include the use of susceptibility-weighted imaging (SWI) for the detection of intramural hematoma and multisection motion-sensitized driven equilibrium (MSDE), which causes phase dispersion of blood spin using a magnetic field to suppress blood flow signal and obtain 3D T1- or T2*-weighted images. Digital subtraction angiography (DSA) remains the gold standard for identifying and characterizing carotid artery dissections.

Summary

Carotid artery dissection is the result of a tear in the intimal layer of the carotid artery. This leads to a "double lumen" sign comprised of the true vessel lumen and the false lumen created by the tear. The most common presentation of carotid artery dissection is cranial and/or cervical pain ipsilateral to the dissection. However, severe neurological sequelae such as embolic ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage can also result from carotid artery dissection. Carotid artery dissection can be identified by a variety of different imaging modalities including computed tomographic angiography (CTA), MRI, carotid duplex imaging (CDI), and digital subtraction angiography (DSA).

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Different Types of Maculopathy in Eyes after a High-Voltage Electrical Shock Injury

Background: We report a case of different types of maculopathy in eyes after a high-voltage electrical shock injury. Case Report: A 43-year-old male suffered high-voltage electrical injury through his left arm. He underwent cataract surgery in both eyes 3 months after the injury, but there was no vision improvement. Ocular examination, including spectral domain optical coherence tomography, revealed diffuse retinal atrophy in the left eye which did not change until the final visit. In the right eye, an impending macular hole was observed but regressed spontaneously 9 months after the injury, and the visual acuity improved to 20/32 at the final visit. Conclusion: Two different types of maculopathy can occur in each eye after high-voltage electrical shock injury, and this might be due to asymmetric pathogenesis of the eyes according to the proximity to the route of electrical current.
Case Rep Ophthalmol 2019;10:19–23

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The Difficulty of Diagnosing Invasive Aspergillosis Initially Manifesting as Optic Neuropathy

Background: Invasive aspergillosis is often fatal. Here, we report a patient with invasive aspergillosis primarily involving the optic nerve diagnosed on autopsy. Case Presentation: A 77-year-old female with underlying diabetes mellitus, hyperlipidemia, and hypertension presented with disc swelling of the left eye. Although mini-pulse steroid therapy improved visual acuity (VA) of the left eye, it abruptly decreased to no light perception within a month, followed by a decrease in VA of the right eye to 0.5. At referral, VA was 0.3 in the right eye, and there was no light perception in the left eye. Results: Fundus examination revealed optic disc swelling of both eyes. Goldmann perimetry showed irregular visual field defects, whereas magnetic resonance imaging (MRI), general, and cerebrospinal fluid (CSF) examinations revealed no distinct abnormalities. We suspected anterior ischemic optic neuropathy and invasive optic neuropathy. As with the left eye, steroid pulse therapy temporarily improved VA of the right eye and then decreased to 0.2. Additional anticoagulant therapy did not improve VA. Concurrent to therapy, the patient became febrile with depressed consciousness. Repeat MRI identified suspected midbrain infarction, and CSF examination indicated cerebral meningitis. In spite of administering transfusions and antibiotics, she died on hospital day 40. Autopsy revealed large amounts of Aspergillus hyphae mainly localized in the dura mater of the optic nerve and destruction of the cerebral artery wall, suggesting an etiology of subarachnoid hemorrhage. Conclusions: When examining refractory and persistent disc swelling, we should rule out fungal infections of the optic nerve.
Case Rep Ophthalmol 2019;10:11–18

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Tonsillectomy plus steroid pulse therapy is the most effective treatment in adult patients with C-Grade I IgA nephropathy, and the weight of the extracted palatine tonsils and Yamamoto scale have no significant correlation with the effects of this treatment

Publication date: Available online 18 January 2019

Source: Auris Nasus Larynx

Author(s): Norio Kondo, Takahito Moriyama, Mayako Tachikawa, Erika Tomita, Ai Hattori, Yukie Yamamura, Manabu Nonaka

Abstract

Objective

We studied patients who underwent tonsillectomy plus steroid pulse therapy (TSP) for immunoglobulin A nephropathy (IgAN), in order to investigate the clinical factors associated with a positive response to this treatment.

Methods

We analyzed 118 IgAN patients who underwent TSP. We collected patients' data retrospectively, including age, sex, blood pressure, onset of IgAN, pathological findings of a renal biopsy, serum concentration of creatinine, estimated glomerular filtration rate, serum concentration of protein, urinary protein, hematuria, past history of tonsillitis, the Yamamoto scale, the weight and pathological findings of the extracted palatine tonsils, and the presence or absence of anti-platelet drugs and renin-angiotensin system inhibitors (RAS-I) usage. This study included participants who were over 18 years of age, had undergone tonsillectomy within three months of steroid pulse therapy administered thrice, in whom renal biopsy was performed within a year before treatment, and with follow-up period of over 3 years. Clinical remission (CR) of urinary abnormalities was defined as remission of both proteinuria and hematuria: three consecutive negative results over a 6-month period, with a urinary sediment red blood cell count of <5/HPF, and a proteinuria qualitative reaction of (−) to (±).

Results

The CR rate of all cases was 56.8% and statistical significance was observed with respect to the C-Grade (P = 0.0003, P = 0.028) using both univariate and multivariate analysis. The CR rate of C-Grade І (73.4%) patients was significantly higher than that of C-Grade II patients (39.0%; P = 0.0004) and C-Grade III patients (30.8%; P = 0.003). We analyzed clinical factors in each C-Grade patient. No statistical significance was observed with respect to any of the factors using univariate analysis in C-Grade I patients. The weight of the extracted palatine tonsils and Yamamoto scale showed no statistical significance in every analysis. Fibrosis or hyalinization of the stroma of the palatine tonsils showed statistical significance (P = 0.026) only in the univariate analysis of C-Grade III patients. However, the patient number of C-Grade III was small.

Conclusion

Our results indicate that TSP is mostly effective in patients with of C-Grade I IgAN and that the C-Grade reflects the clinical indication for TSP. The weight of the extracted palatine tonsils and Yamamoto scale did not show obvious correlations with the clinical effect of TSP.

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Production, purification, and evaluation of quail immunoglobulin Y against Salmonella typhimurium and Salmonella enteritidis

Publication date: March 2019

Source: Molecular Immunology, Volume 107

Author(s): Atefeh Esmailnejad, Bahman Abdi-Hachesoo, Elhamsadat Hosseini Nasab, Maryam Shakoori

Abstract

Salmonella species have been the major foodborne problems in food production systems, with Salmonella enterica serovars typhimurium (S. typhimurium) and enteritidis (S. enteritidis) being among the more common isolates. The oral administration of chicken egg yolk specific antibodies (IgYs) has been established as an efficient alternative for treatment and prevention of gastrointestinal pathogens including Salmonella. The present study was aimed to investigate the possible production of specific IgYs against Salmonella typhimurium and Salmonella enteritidis in quail egg yolks. Salmonella spp.-free female Japanese quails (Coturnix coturnix japonica) were intramuscularly immunized with formalin or heat-inactivated Salmonella immunogens (1.0 × 10⁹ CFU/mL) emulsified with Freund adjuvants. Egg yolk IgYs were purified using ammonium sulfate precipitation method. Anti-Salmonella IgYs titer and specificity were determined using enzyme-linked immunosorbent assay (ELISA) and western blot analysis. Salmonella specific IgYs detected in the immunized quails were significantly higher than those of the control group, which confirmed the immunization procedure. Specific IgYs against S. typhimurium and S. enteritidis were identified in both groups immunized with heat or formalin-inactivated immunogens. However, formalin-inactivated immunogens induced relatively higher immune responses over the heat-inactivated ones. Quail anti-Salmonella IgYs showed a high specificity to their corresponding immunogens, with moderate cross-reactivity to other members of Enterobacteriaceae family. Quail can be regarded as a valuable and inexpensive source for producing large-scale of specific antibodies that can be used for immunodiagnostic and immunotherapeutic purposes.

http://bit.ly/2RVIoZf

Role of interleukin-17 in acute myocardial infarction

Publication date: March 2019

Source: Molecular Immunology, Volume 107

Author(s): Mónica Daniela Mora-Ruíz, Francisco Blanco-Favela, Adriana Karina Chávez Rueda, María Victoria Legorreta-Haquet, Luis Chávez-Sánchez

Abstract

Acute myocardial infarction (AMI) is a leading cause of death worldwide. Myocardial necrosis generates damage signals and triggers an intense inflammatory response. Many cytokines that contribute to repair tissue can also cause adverse left ventricular remodeling and heart failure. Several studies have revealed that interleukin-17 (IL-17) is a cytokine with a potential role in AMI. IL-17 plays an important role in the immune response and affects the production of different inflammatory mediators in several types of cells, involved in the damage or scar process in myocardial tissue. In this review, we will discuss the current knowledge of the role of IL-17 in AMI and the effect of IL-17 in different cells, such as cardiomyocytes, smooth muscle cells and immune system cells, in AMI pathogenesis.

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Adverse events need for hospitalization and systemic immunosuppression in very elderly patients (over 80 years) treated with ipilimumab for metastatic melanoma

Abstract

Background

Checkpoint inhibitors are first-line therapies in melanoma, but safety in older adults has not yet been assessed. Ipilimumab improves survival, but immunologic-related adverse events (AEs) can be threatening, and its use in elderly people raises questions.

Aim

To assess safety in a cohort of very elderly patients treated with ipilimumab.

Methods

All patients over 80 years treated with ipilimumab for melanoma were retrospectively included. AE occurrence, management, and outcome, as well as response rate at week 16 and overall survival were recorded, and compared to data for a group of younger patients treated in our institution during the same period.

Results

In the elderly group, 23 patients were included with a median age of 82 years [80–90]. AEs amounting to 23 occurred in 15 patients (65%) with 5 grade 3 (22%) and 1 grade 5 (opportunistic infection) AEs. Corticosteroids were required for five (22%) patients, additive immunosuppressive therapy for two, hospitalization for four, and definitive interruption of ipilimumab for three. Median overall survival was 14 months. In the younger group, 29 patients were included with a median age of 58 years. AEs occurred in 15/29 (52%) with 4 grade 3 (19%) and 1 grade 4 (7%). Median OS was 17 months.

Conclusion

Serious AEs occurred in 80 + adults at the same rate as observed in our younger patients and as previously reported in younger populations. Ipilimumab can be an option in elderly patients, as patients may benefit from therapy and safety seems to be manageable.

http://bit.ly/2Taeiyg

The effect of everolimus and low-dose cyclophosphamide on immune cell subsets in patients with metastatic renal cell carcinoma: results from a phase I clinical trial

Abstract

For the treatment of metastatic renal cell cancer several strategies are used among which the mTOR inhibitor everolimus. As mTOR plays an important role in the immune system, e.g., by controlling the expression of the transcription factor FoxP3 thereby regulating regulatory T cells (Tregs), it plays a key role in the balance between tolerance and inflammation. Previous reports showed stimulatory effects of mTOR inhibition on the expansion of Tregs, an effect that can be considered detrimental in terms of cancer control. Since metronomic cyclophosphamide (CTX) was shown to selectively deplete Tregs, a phase 1 clinical trial was conducted to comprehensively investigate the immune-modulating effects of several dosages and schedules of CTX in combination with the standard dose of everolimus, with the explicit aim to achieve selective Treg depletion. Our data show that 50 mg of CTX once daily and continuously administered, in combination with the standard dose of 10 mg everolimus once daily, not only results in depletion of Tregs, but also leads to a reduction in MDSC, a sustained level of the CD8⁺ T-cell population accompanied by an increased effector to suppressor ratio, and reversal of negative effects on three peripheral blood DC subsets. These positive effects on the immune response may contribute to improved survival, and therefore this combination therapy is further evaluated in a phase II clinical trial.

http://bit.ly/2QUmxN5

Strong antigen-specific T-cell immunity induced by a recombinant human TERT measles virus vaccine and amplified by a DNA/viral vector prime boost in IFNAR/CD46 mice

Abstract

Cancer immunotherapy is seeing an increasing focus on vaccination with tumor-associated antigens (TAAs). Human telomerase (hTERT) is a TAA expressed by most tumors to overcome telomere shortening. Tolerance to hTERT can be easily broken both naturally and experimentally and hTERT DNA vaccine candidates have been introduced in clinical trials. DNA prime/boost strategies have been widely developed to immunize efficiently against infectious diseases. We explored the use of a recombinant measles virus (MV) hTERT vector to boost DNA priming as recombinant live attenuated measles virus has an impressive safety and efficacy record. Here, we show that a MV-TERT vector can rapidly and strongly boost DNA hTERT priming in MV susceptible IFNAR/CD46 mouse models. The cellular immune responses were Th1 polarized. No humoral responses were elicited. The 4 kb hTERT transgene did not impact MV replication or induction of cell-mediated responses. These findings validate the MV-TERT vector to boost cell-mediated responses following DNA priming in humans.

http://bit.ly/2RU1ezP

STAT3 inhibition specifically in human monocytes and macrophages by CD163-targeted corosolic acid-containing liposomes

Abstract

Tumor-associated macrophages (TAMs) are of major importance in cancer-related immune suppression, and tumor infiltration by CD163^pos TAMs is associated with poor outcome in most human cancers. Therefore, therapeutic strategies for reprogramming TAMs from a tumor-supporting (M2-like) phenotype towards a tumoricidal (M1-like) phenotype are of great interest. Activation of the transcription factor STAT3 within the tumor microenvironment is associated with worse prognosis, and STAT3 activation promotes the immunosuppressive phenotype of TAMs. Therefore, we aimed to develop a drug for inhibition of STAT3 specifically within human TAMs by targeting the endocytic CD163 scavenger receptor, which is highly expressed on TAMs. Here, we report the first data on a CD163-targeted STAT3-inhibitory drug consisting of corosolic acid (CA) packaged within long-circulating liposomes (LCLs), which are CD163-targeted by modification with monoclonal anti-CD163 antibodies (αCD163)—CA-LCL-αCD163. We show, that activation of STAT3 (by phosphorylation) was inhibited by CA-LCL-αCD163 specifically within CD163^pos cells, with minor effect on CD163^neg cells. Furthermore, CA-LCL-αCD163 inhibited STAT3-regulated gene expression of IL-10, and increased expression of TNFα, thus indicating a pro-inflammatory effect of the drug on human macrophages. This M1-like reprogramming at the mRNA level was confirmed by significantly elevated levels of pro-inflammatory cytokines (IFNγ, IL-12, TNFα, IL-2) in the culture medium. Since liposomes are attractive vehicles for novel anti-cancer drugs, and since direct TAM-targeting may decrease adverse effects of systemic inhibition of STAT3, the present results encourage future investigation of CA-LCL-αCD163 in the in vivo setting.

http://bit.ly/2RKg6ki

First in Houston to Offer a New Treatment for Obtructive Sleep Apnea

UT Physicians is now offering an alternative therapy for obstructive sleep apnea (OSA) when traditional approaches fail. The first six...

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Head and Neck Surgical Oncology: How Do We Make the Experience Better for the Patient?

By asking cancer patients what they want, physicians in the Head and Neck Surgical Oncology Program at Memorial Hermann and...

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On a Mission: Dr. Yuksel Returns to Nicaragua

Pediatric otolaryngologist Sancak Yuksel, MD joined a team of otolaryngologists, nurses, audiologists, and speech pathologists supported by Oklahoma-based Mayflower Medical Outreach...

http://bit.ly/2ATqkFk

Radioguided Surgery of Non-palpable Neck Lymph Node in Lymphoma Patients

Abstract

Lymphomas have frequent relapses; early diagnosis is important to treat and improve outcomes. Clinical exam and imaging are useful but confirmation with biopsy is always required. Minimally exploratory surgery is a tool to take good samples with precision and safety. Evaluate the use of ROLL technique to track non-palpable lesions on the neck which were suspicious of recurrence in lymphoma patients. A retrospective review of the patients with high probability of lymphoma relapse who were biopsied using ROLL technique. Suspicious lesions on the neck where identified on the follow up of five lymphoma patients. Roll technique was used successfully to guide the biopsy. There were no complications. Relapse was confirmed in two patients; the other three was reactive follicular hyperplasia. Management was redirected on relapsing patients. ROLL technique proved to be a simple, safe and effective method to detect and biopsy non- palpable lesions on the neck of patients with suspicious relapsing lymphoma.

http://bit.ly/2R1fN0a

Spontaneous Resolution of Fourth Branchial Fistula Following Thyroid Surgery: Case Report

Abstract

Fourth branchial pouch anomalies represent one of the rarest types of all branchial apparatus anomalies. They appear in the first lifedecade in a form of recurrent left-sided neck masses which demands surgical treatment. Accidental finding, appearance later in life and spontaneous resolving are really rare. We present a case of a 43-year-old man with accidental finding of asymptomatic fourth pouch cyst and fistula following follicular thyroid cancer surgery. The day after the surgery, suction bottle was filled with little white crumbs and the wound started to suppurate. Barium swallow revealed the presence of a fistulous canal that arose from the left pyriform sinus. Meanwhile, the pathologist confirmed the presence of a lateral neck cyst within this thyroid lobe. The patient was operated on but fistulous canal was not visualized. In the meantime, wound discharge ceased spontaneously. At 1-year follow up, the patient was still well and free from any symptoms. These anomalies may manifest not only in childhood but may stay asymptomatic for a long time. It seems that the fistula can resolve spontaneously and that conservative approach is an alternative to multiple surgical procedures.

http://bit.ly/2DjX8ZQ

CNPAS: A Differential to Choanal Atresia

Abstract

A case of 7 day old male child, born at 36 weeks, presented with feeding difficulties, hypothermia and failure to thrive. After clinical examination to rule out any gross congenital anomalies, CT scan was done which was suggestive of pyriform aperture stenosis. It was surgically dilated and stented successfully.

http://bit.ly/2Mjur1U

“Sinus Headache”: Diagnosis and Dilemma?? An Analytical and Prospective Study

Abstract

To evaluate the type, location, severity of headache and their relation to various nasal and sinus related pathological conditions. All the patients presenting with acute and chronic sinus and nasal infections along with headache were included in the study. The diagnostic confirmation was done with clinical along with radiological and endoscopic evaluation. Various parameters categorized accordingly. Chronic rhinosinusitis/chronic recurrent rhinosinusitis are the most common nasal condition seen in oto-rhino-laryngology OPD which has enormous economic burden and significant morbidity on general population. The headache is the commonest associated symptom which is needed to be given attention. The location, variation, pattern of the headache can guide us towards the correct diagnosis.

http://bit.ly/2RCF8Cv

Reconstruction of Orbital Suprastructure Maxillectomy Defects by Temporalis Myofascial Flap

Abstract

Oncological surgery being radical is often mutilating in form and function especially in the maxillary/orbit region reconstruction of maxillo-orbit defects are challenging due to the complex three dimensional anatomy. Free flaps are de-rigueur but a technical resource with constraints. The temporalis myofascial flap (TMFF) is a locally available, safe and reliable flap which can be used for the reconstruction of various orbital and supramaxillary facial defects. To study the use of the temporalis myofascial flap in the reconstruction of various orbital and supramaxillary facial defects. Temporalis myofascial flap was harvested and successfully used in reconstruction of three patients who had undergone orbital exenteration with or without suprastructural maxillectomy. There was no morbidity related to flap loss. Temporalis flap (TMFF) can be considered as a first line reconstructive option for limited resection of upper maxilla with palatal preservation. Its proximity to the oral cavity, palate and mid third face and the technical ease makes the TMFF valuable for reconstruction. The techniques and outcomes of TMFF are discussed.

http://bit.ly/2sz246Z

Ewing’s Sarcoma of the Sinonasal Tract: A Report of Two Challenging Cases

Abstract

Ewing's sarcoma (ES) is a malignant small round cell tumor that belongs to the primitive neuroectodermal tumor class. ES generally arises in the long bones of the extremities (skeletal form) and less frequently in the soft tissue of the trunk and extremities (extra-skeletal form). Sinonasal localization of ES is an extremely rare event. About 80% of the patients are less than 20 years old with the highest incidence in the second decade of life. The combination of histopathological examination and ancillary methods (such as immunohistochemistry and molecular genetics) is extremely important to establish the diagnosis of ES. The most effective treatment plan for ES includes a multidisciplinary approach with surgery, radiotherapy and chemotherapy. This is a report of two challenging cases of sinonasal ES in two different age groups. The first case is a 13-years old female patient who presented with right nasal obstruction, anosmia, intermittent epistaxis and hearing loss. The second case is a 24-years old male patient who presented with a history of right nasal obstruction, right eye pain and periorbital edema. We present these cases due to the rarity of the disease and the difficulty of diagnosis.

http://bit.ly/2ARXrcJ

Symptom-based patient-reported outcomes in adults with eosinophilic esophagitis: value for treatment monitoring and randomized controlled trial design

Purpose of review In adults with eosinophilic esophagitis (EoE), a chronic, inflammatory immune-mediated condition of the esophagus, both inflammation and fibrosis are likely associated with symptom generation. Therefore, assessing symptom-based patient-reported outcomes (PROs), defined by US Food and Drug Administration as 'any report of the status of a patient's health condition that comes directly from the patients, without interpretation of the patient's response by a clinician or anyone else', is important in the context of trials and observational studies of emerging therapies. Recent findings For purposes of treatment monitoring, lack of symptoms does not predict the absence of biologic inflammation; hence, endoscopy with esophageal biopsies should be performed to check for residual inflammation. Lack of inflammation does not predict lack of symptoms, and the presence of subepithelial fibrosis cannot be excluded. No published instrument currently measures the frequency of dysphagia described all possible ways, strategies of living with this symptom and various pain types. In randomized controlled trials, in which symptom response was detected using validated PRO measures, only modest decreases in symptom scores were observed. Summary Accessing full EoE symptom spectrum and optimizing PRO measures remains a challenge that should be tackled to reliably assess response to existing and emerging therapies. Correspondence to Ekaterina Safroneeva, PhD, Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland. E-mail: ekaterina.safroneeva@ispm.unibe.ch Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Diagnosis of occupational hypersensitivity pneumonitis

Purpose of review To discuss the diagnostic methods currently used in the study of patients with hypersensitivity pneumonitis, with special emphasis on the most recent contributions published in the medical literature regarding the diagnosis of occupational hypersensitivity pneumonitis (OHP). This review presents an update of the use of these diagnostic tests, a controversial issue among experts. Recent findings In spite of the multiple attempts at systematization and the publication of expert consensus statements, standardizing and diagnostic methods and criteria remain particularly difficult. As a result, centers tend to rely on their own experience and establish diagnosis by consensus among their multidisciplinary teams. Though recommendable in many ways, this method presents significant limitations. Summary Diagnosis of OHP should be made with a thorough clinical history of the symptoms and clinical signs as well as a meticulous review, if possible by an expert, of possible exposures in the working environment; a meticulous physical examination; high-resolution computed tomography of the thorax; serum determination of specific immunoglobuline Gs; bronchoalveolar lavage and possibly cryobiopsy; fungal culture; and, when appropriate, a specific inhalation challenge test with the suspected antigen. Correspondence to Ferran Morell, MD, PhD, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain. Tel: +34 932746157; fax: +34 932746083; e-mail: fmorell@vhebron.net Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2W4pFtO

Management of acute loss of asthma control: yellow zone strategies

Purpose of review Asthma exacerbations are associated with a significant burden to both the individual patient and to the healthcare system. Patients often step-up home therapies in response to increased asthma symptoms, and the asthma action plan was created to empower patients to self-manage their asthma care. The yellow (intermediate) zone of the asthma action plan is frequently poorly defined, and current Expert Panel Report 3 guideline recommendations are not effective for all patients. This article reviews the evidence behind various recommended yellow zone intervention strategies. Recent findings There are many potential methods of delivering yellow zone therapy, and recent studies have assessed preventive efficacy of a scheduled increase in controller medication(s), reliever medication(s), or a symptom-driven combination of both. The literature suggests that, in certain asthma subpopulations, some methods may be more efficacious than others. Summary Multiple yellow zone approaches may be beneficial, and the yellow zone is not a 'one size fits all' narrative. Correspondence to Brooke I. Polk, MD, Division of Allergy, Immunology, and Pulmonary Medicine, St. Louis Children's Hospital, Washington University in St. Louis School of Medicine, 1 Children's Place, Campus Box 8116, St. Louis, MO 63110, USA. Tel: +1 314 454 2694; fax: +1 314 454 2694; e-mail: bpolk@wustl.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2R0AGIz

Precision medicine in childhood asthma

Purpose of review Childhood asthma is a heterogeneous disease and many children have uncontrolled disease. Therefore an individualized approach is needed to improve asthma outcomes in children. Precision medicine using clinical characteristics, biomarkers, and the rapidly involving field of genomics and pharmacogenomics aims to achieve asthma control and reduce future risks with less side-effects in individual children with asthma. Recent findings It is not yet possible to select treatment options on clinical characteristics. Novel monoclonal antibodies are efficacious in patients with severe, eosinophilic asthma. Reduced lung function growth and early decline is a prevalent finding in children with persistent asthma. Pharmacogenetic studies have identified children at risk for cortisol suppression when using inhaled corticosteroids. Summary Clinical characteristics and simple biomarkers like eosinophils, IgE, and the fraction of exhaled nitric oxide may be used in clinical practice for a basic precision medicine approach, deciding which children will have the best chance to respond to inhaled corticosteroids and to the biologicals omalizumab and mepolizumab. Further application of pharmacogenomics and breathomics needs additional studies before they can be applied as tools for precision medicine in individual children with asthma. Correspondence to Mariëlle W. Pijnenburg, MD, PhD, Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC – Sophia, University Medical Center Rotterdam, PO Box 2060, 3000 CB Rotterdam, The Netherlands. Tel: +31 107036263; e-mail: m.pijnenburg@erasmusmc.nl Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2W4pAX2

Eine seltene Ursache der peripheren Fazialisparese

Laryngo-Rhino-Otol
DOI: 10.1055/a-0821-5850

Article in Thieme eJournals:
Table of contents | Full text

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Radioguided Surgery of Non-palpable Neck Lymph Node in Lymphoma Patients

Abstract

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Frequency characteristics and speech recognition in cartilage conduction

Cartilage conduction (CC) is a new transduction form, and hearing devices that utilize CC present a new option for patients with aural atresia. However, in occluded ears, low-tone sounds are transmitted very effectively, resulting in excessive low-tone sound emphasis and speech recognition reduction. This study aimed to clarify low-tone speech recognition for CC in occluded ears, and determine if excessive low-tone sound emphasis decreases maximum speech recognition scores.

http://bit.ly/2U0GzHG

A novel approach to outpatient clinic management

Abstract

I read with great interest the study by Khoury et al¹ in the BJD on the safety of patient‐initiated care consultations (PICC) for psoriasis patients, though has wider implications for all patients with chronic conditions. There are over 15 million people in England with chronic conditions, accounting for 64% of outpatient appointments, and with future trends suggesting a further increase.

http://bit.ly/2MjWaj0

Anti‐TNF‐associated cutaneous leishmaniasis: a single‐institution experience

Abstract

Leishmaniasis is an infection by protozoa Leishmania, vector‐transmitted by sandflies. There are three major forms: cutaneous (CL), mucocutaneous and visceral (VL). It is endemic on the European Mediterranean basin, where mostly Leishmania infantum produces CL. Over the last decade, cases in patients undergoing tumor necrosis factor (TNF) inhibitor (anti‐TNF) have been reported. This could result from increasingly widespread anti‐TNF use coupled with a rising global incidence¹. Notably, 80% of all reported cases are related to residence or travel to European Mediterranean countries, particularly Spain.

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A re‐introduction of environmental mite allergen control strategies for asthma treatment and the debate on their effectiveness

Abstract

Asthma affects three hundred million people worldwide. The effectiveness of house dust mite allergen control for asthma treatment is debatable. One aspect that has been little discussed in existing meta‐analyses is the possible role of environmental strategies. Here, we re‐introduce the previously defined strategies for mite allergen control and discuss their importance to the debate on clinical effectiveness. The strategy of concurrent bedroom interventions is related to the combined use of a priori defined interventions, while the strategy of exposure‐based control relates to the treatment of relevant textiles after assessing exposure. The air purification strategy aims to purify the human breathing zone of airborne allergens. In Western European patient practice, the use of these strategies differs. A post hoc study of the dominant Cochrane review by Gøtzsche and Johansen (Cochrane Database of Systematic Reviews, 2008, Art. No: CD001187) appears to indicate that a majority of the underlying trials reported on the strategy of concurrent bedroom interventions, which were mainly executed in a minimal manner. Some trials have reported on the air purification strategy and may potentially alter the debate on effectiveness. No trial has reported on the strategy of exposure‐based control. We therefore hypothesize that the absence of evidence for the effectiveness of mite allergen control for asthma treatment applies to the strategy of concurrent bedroom interventions. The evidence‐based effectiveness of the exposure‐based control strategy appears to be undetermined. The results of our post hoc re‐analysis urge that future meta‐analyses of mite allergen control should a priori define the environmental strategy under study. Future trials of mite allergen control are warranted to test the exposure‐based strategy as well as the sparsely tested strategy of air purification.

http://bit.ly/2ASB5b5

Skin lesions, differential diagnosis and practical approach to potential survivors of torture

Abstract

As the international refugee crisis has reached new proportions,¹ survivors of torture increasingly present to treating physicians with an array of acute or chronic skin lesions. Physicians should be aware of common presentations and likely differential diagnoses in order to avoid mislabeling or underrecognizing torture. Survivors of torture also frequently suffer from psychological sequelae, such as post‐ traumatic stress disorder, and appropriate referrals are essential in order to improve recovery trajectory. Skin sequelae are the most common physical findings of torture. Not all skin lesions seen in tortured survivors are due to perpetrator inflicted injuries, and many dermatological conditions can mimic lesions typical of torture, as can scars as a result of folk remedies or cultural practices specific to geographical regions. Medical documentation of torture includes injury and lesion description. While forensic dermatology and other forensic specialties use an injury description taxonomy, and the standard dermatologic taxonomy uses an anatomic description, they are complementary sciences for lesions inflicted by torture. This results in an opportunity for learning across disciplines in order to improve evidence documentation for survivors of torture. This article describes features of common skin lesions consistent with torture, including their clinical appearances, differential diagnoses, patterns of injury and appropriate clinical descriptions.

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DNA copy number imbalances in primary cutaneous lymphomas (PCL)

Abstract

Background

Cutaneous lymphomas (CL) represent a clinically defined group of extran‐ odal non‐Hodgkin lymphomas harbouring heterogeneous and incompletely delineated molecular aberrations. Over the past decades, molecular stud‐ ies have identified several chromosomal aberrations, but the interpreta‐ tion of individual genomic studies can be challenging.

Objective

With a comprehensive meta‐analysis, we aim to delineate genomic alter‐ ations for different types of CL and propose a more accurate classifica‐ tion in line with their various pathogenicity.

Methods

We searched PubMed and ISI Web of Knowledge for publications from 1996 to 2016 reporting the investigation of CL for genome‐wide copy number alterations, by means of comparative genomic hybridisation tech‐ niques and whole genome and exome sequencing. We then extracted and re‐mapped the available copy number variation (CNV) data from these publications with the same pipeline and performed clustering and visuali‐ sation to aggregate samples of similar CNV profiles.

Results

For 449 samples from 22 publications, copy number variation data was accessible for sample based meta‐analysis. Our findings illustrate struc‐ tural and numerical chromosomal imbalance patterns. Most frequent CNAs were linked to oncogenes or tumour suppressor genes with important roles in the course of the disease.

Conclusion

Summary profiles for genomic imbalances, generated from case‐specific data, identified complex genomic imbalances, which could discriminate between different subtypes of CL and promise a more accurate classifi‐ cation. The collected data presented in this study are publicly available through the "Progenetix" online repository.

http://bit.ly/2DmzeNh

Accuracy of a TaqMan‐based real‐time polymerase chain reaction combined to a Novy‐MacNeal‐Nicolle medium culture for the diagnosis of American tegumentary leishmaniasis

Abstract

Dear editor, tests used for the diagnosis of tegumentary leishmaniasis (TL) have variable accuracy and in classic parasitological methods, sensitivity tends to vary according to examiner‐dependent factors¹. In vitro culture is a highly specific method but its sensitivity is limited^1,2. Real‐time PCR (qPCR) is considered a very efficient technique and it adds quantitative results to clinical analyses^3‐5. We aimed to test the accuracy of the combination of a Novy‐MacNeal‐Nicolle (NNN) medium culture and TaqMan‐based qPCR analysis for the diagnosis of TL.

http://bit.ly/2TX7qUY

Replicative senescence of human dermal fibroblasts affects structural and functional aspects of the golgi apparatus

Abstract

It is well recognized that the world population is aging rapidly. Therefore, it is important to understand aging processes at the cellular and molecular levels to predict the onset of age‐related diseases and prevent them. Recent research has focused on the identification of aging biomarkers, including those associated with the properties of the Golgi apparatus. In this context, Golgi‐mediated glycosylation of proteins has been well characterized. Additionally, other studies show that the secretion of many compounds, including pro‐inflammatory cytokines and extracellular matrix degrading enzymes, is modified during aging, resulting in physical and functional skin degradation. Since the Golgi apparatus is a central organelle of the secretory pathway, we investigated its structural organization in senescent primary human dermal fibroblasts using confocal and electron microscopy. In addition, we monitored the expression of Golgi‐related genes in the same cells. Our data showed a marked alteration in the Golgi morphology during replicative senescence. In contrast to its small and compact structure in non‐senescent cells, the Golgi apparatus exhibited a large and expanded morphology in senescent fibroblasts. Our data also demonstrated that the expression of many genes related to Golgi structural integrity and function was significantly modified in senescent cells, suggesting a relationship between Golgi apparatus function and aging.

http://bit.ly/2SYHUyQ

A critical analysis of the prognostic performance of the 8th edition American Joint Committee on Cancer staging for metastatic cutaneous squamous cell carcinoma of the head and neck

Abstract

Background

The 8th edition AJCC staging of cutaneous squamous cell carcinoma of the head and neck (cSCCHN) incorporated extranodal extension (ENE) for the first time. This study compared the prognostic performance of the 7th and 8th edition staging for cSCCHN with nodal metastases.

Methods

Retrospective analysis of 96 patients with metastatic cSCCHN, comparing the ability of staging systems to predict disease‐specific and overall survival (OS) using the proportion of variation explained and Harrell's C‐index.

Results

In AJCC8, the N classification was upstaged in 77% of patients due to the presence of ENE and 88% of patients were classified as TNM stage IV. AJCC8 was inferior to AJCC7 in predicting disease‐specific survival for both N and TNM stages, and OS by TNM stage.

Conclusions

The majority of patients with metastatic cSCCHN have ENE and are classified as TNM stage IV based on the 8th edition staging, resulting in poor prognostic performance.

http://bit.ly/2szpIQD

Impact of tumor‐associated macrophages and BRAFV600E mutation on clinical outcomes in patients with various thyroid cancers

Abstract

Background

Tumor‐associated macrophages (TAMs) play a role in thyroid cancer tumor progression and metastasis. This study aimed to investigate the association of TAM density and cluster of differentiation 68 (CD68) expression with thyroid tumors as a prognostic marker and the relationship of these factors with BRAF^V600E mutations.

Methods

This study included 275 thyroid specimen tissues, including benign and malignant lesions. We compared the clinicopathological features according to thyroid tumor types and evaluated the presence of CD68 expression and BRAF^V600E mutations.

Results

CD68 positive expression increased with aggressiveness of thyroid tumor histologic grades (P < 0.001). In patients with poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC), CD68 positivity was associated with aggressive adverse clinical outcomes such as extrathyroidal extension, cervical lymph node metastases, and distant metastases (P < 0.05).

Conclusions

CD68 positivity was more frequent in advanced and aggressive thyroid cancer types such as PDTC/ATC.

http://bit.ly/2MizKi5

Bilateral vs ipsilateral adjuvant radiotherapy in patients with cancer of unknown primary of the head and neck: An analysis of the clinical outcome and radiation‐induced side effects

Abstract

Background

The purpose of this study was to analyze and compare ipsilateral and bilateral adjuvant radiotherapy in patients with cancer of unknown primary (CUP) of the head and neck.

Methods

Overall survival, recurrence‐free survival, and radiation‐induced side effects were assessed in 76 patients with CUP who underwent ipsilateral (n = 29) or bilateral (n = 47) radiotherapy.

Results

At a median follow‐up of 41 months, the 5‐year overall survival and recurrence‐free rate were 67.9% and 71.5%, respectively. No statistically significant difference between ipsilateral and bilateral radiotherapy could be found regarding 5‐year overall survival, recurrence‐free survival, occurrence of a primary tumor, and distant metastasis. The analysis of radiation‐induced acute side effects showed a significant benefit of ipsilateral radiotherapy.

Conclusion

As the main parameters of the study regarding the outcome and radiation‐induced side effects showed no advantages of bilateral radiotherapy, the strategy of ipsilateral radiotherapy can be recommended for the adjuvant treatment of CUP patients.

http://bit.ly/2szpHfx

Issue Information

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Cover Image

The cover image, by David H. Yeh et al., is based on the Original Article Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap, DOI: 10.1002/hed.25342.

http://bit.ly/2sAB0UJ

Competence of final year otolaryngology residents with the bedside head impulse test

The bedside head impulse test (bHIT) is a clinical method of assessing the vestibulo-ocular reflex (VOR). It is a critical component of the bedside assessment of dizzy patients, and can help differentiate acut...

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CNPAS: A Differential to Choanal Atresia

Abstract

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Reconstruction of Orbital Suprastructure Maxillectomy Defects by Temporalis Myofascial Flap

Abstract

http://bit.ly/2sz246Z

Spontaneous Resolution of Fourth Branchial Fistula Following Thyroid Surgery: Case Report

Abstract

http://bit.ly/2DjX8ZQ

A Case of Pityriasis Lichenoides et Varioliformis Acuta Pemphigoides Successfully Treated with Methotrexate and Corticosteroids

Abstract

Pityriasis lichenoides et varioliformis acuta(PLEVA) pemphigoides is an uncommon skin disease, which is characterized by the appearance of blistering skin lesions in patients with PLEVA. We present a 3‐year‐old boy, who was diagnosed PLEVA pemphigoides. Combined treatment of oral methotrexate and corticosteroids was more effective than corticosteroids alone on this patient.

http://bit.ly/2FCHBXb

Impressive response of CD30‐negative, treatment‐refractory mycosis fungoides to brentuximab vedotin

Abstract

Brentuximab vedotin is a CD30‐antibody/drug conjugate which has demonstrated excellent response in treating CD30‐positive mycosis fungoides (MF) and anaplastic large cell lymphoma (ALCL). In this report, we present a patient with CD30‐negative MF refractory to multiple other lines of therapy who demonstrated a dramatic response to brentuximab. This paradoxical response may be due to inadequate detection of CD30 expression by immunohistochemical techniques. From this case we see that even in the setting of apparent CD30 negativity, brentuximab may be a viable treatment option for patients who require bridging to stem cell transplant or seek successful palliation. This case highlights the point that rigid inclusion criteria for MF trials without use of more sensitive techniques to confirm lack of CD30 expression may inappropriate.

http://bit.ly/2FJ9DQ9

Acitretin Combined with NB‐UVB in the Treatment of Cutaneous CD30‐positive Anaplastic Large Cell Lymphoma

Abstract

Cutaneous CD30⁺ lymphoproliferative disorders represent a spectrum of skin lymphatic reticular proliferative diseases, including lymphomatoid papulosis (LYP), primary cutaneous anaplastic large cell lymphoma (PC‐ALCL), and borderline lesions between them. Although they all express CD30 as a phenotypic marker and share overlapping immunophenotypic features, they differ in clinical manifestations, pathological features, treatment, and prognosis. LYP is a kind of benign disease characterized by recurrent papules and nodules and may spontaneously regress. PC‐ALCL presents with solitary tumor or local grouped nodules characterized by large T‐cells and may completely or partially resolve in fewer than half of cases. We reported a case of patient with clinical manifestation and pathologic features consistent with LYP in its early stages, which later turned into PC‐ALCL. This patient was treated with acitretin combined with NB‐UVB and had an obvious response.

http://bit.ly/2FCHyKZ

Rapid remission of Stevens‐Johnson syndrome by combination therapy using etanercept and intravenous immunoglobulin and a review of the literature

Abstract

SJS/TEN are spectrum of rare, acute and life‐threatening delayed‐type drug hypersensitivity reactions that are associated with high mortality rates. However, no therapeutic standard has been proposed for SJS/TEN. Here, we report a case of a patient diagnosed with Stevens‐Johnson syndrome whose disease progression was halted by a single dose of etanercept and was treated successfully. In addition, we reviewed the literature reporting patients with SJS/TEN treated with similar regimens.

http://bit.ly/2FPr2a7

“Intramatricial Platelet Rich Plasma Therapy: A Novel Treatment Modality in Refractory Nail Disorders”

Abstract

Background

Platelet rich plasma (PRP) is essentially an increased concentration of autologous platelets (growth factors) suspended in small amount of plasma. These factors have a proliferative and regenerative effect on a number of tissues in body and have been extensively used in dermatology, surgery, orthopedics and dentistry.

Case report

Two patients, one with nail lichen striatus and second with idiopathic trachyonychia were treated with intramatriceal injections of platelet rich plasma. 0.1ml of the plasma solution was injected into the matrix of the involved nails at 3 weekly intervals. Follow up was done at each sitting and thereafter at 16 and 20 weeks. Assessment was done both photographically and by dermoscopy. Case 1 showed marked improvement within 3 weeks and case 2 showed improvement within 6 weeks. No relapses were seen at 16weeks and 20 weeks of follow up.

Conclusion

Intramatricial PRP is a safe and effective therapeutic modality in nail lichen striatus and idiopathic trachyonychia refractory to other treatment options. Further studies with larger sample size and controls are required to validate the results.

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Successful treatment of porocarcinoma with maxacalcitol and imiquimod

http://bit.ly/2FKURIG

Omalizumab as an alternative therapeutic tool in the treatment of Bullous Pemphigoid: a case report

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Scalp basal cell carcinoma: a different entity?

Abstract

Basal cell carcinoma is the most frequent malignant neoplasm in white‐skinned individuals. It develops in different body areas, including in the scalp, which is a unique anatomical region due to the high number of pilosebaceous follicles; the scalp is protected from UV exposure, a main risk factor for basal cell carcinoma development. Moreover, scalp basal cell carcinoma has been described as more aggressive and difficult to treat than other forms of basal cell carcinoma. In this study, we reviewed the clinical and pathological characteristics, risk factors, genetics, and treatment options for scalp basal cell carcinoma to better understand this special type of cancer. Even though it is not yet clear whether scalp basal cell carcinomas represent a different entity, it seems important to give them special attention due to their potential aggressiveness, invasion capacities, tendency to relapse, and treatment difficulties.

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“Change over time in the treatment of pemphigus vulgaris between 2004 and 2016 in Iran”: A multiple cross‐sectional study

http://bit.ly/2FEPvQb

Kaposi varicelliform eruption induced by methotrexate in an adult atopic dermatitis patient

http://bit.ly/2FHVti6

Quality assurance in head and neck cancer surgery: where are we, and where are we going?

Purpose of review The scope of this review is to summarize current efforts in quality assurance for head and neck cancer surgery. National and international initiatives are summarized and progress in terms of identification of process indicators and outcome indicators delineated. Recent findings Massive efforts have been made in order to improve quality of head and neck cancer surgery. New guidelines for quality assurance of head and neck cancer surgery in clinical trials have recently been proposed by EORTC. Summary Quality assurance programs can be tested within the clearly defined environment of prospective clinical trials. If positive, such programs could be rolled out within national healthcare systems, if feasible. Testing quality programs in clinical trials could be a versatile tool to help head neck cancer patients benefit from such initiatives on a global level. Correspondence to Christian Simon, MD, Service d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne (UNIL), Rue du Bugnon 21, 1011 Lausanne, Switzerland. Tel: +41 21 314 11 11; fax: +41 21 314 27 06; e-mail: Christian.Simon@chuv.ch Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2TYm6mU

Radiation-induced papillary thyroid cancer: is it a distinct clinical entity?

Purpose of review To present the current status of knowledge regarding radiation-induced papillary thyroid cancer (RIPTC), defining its epidemiologic, pathologic, and clinical characteristics, with ensuing possible therapeutic and prognostic consequences. Recent findings Cumulative evidence shows that RIPTC resembles sporadic papillary thyroid cancer (PTC) of comparable age, both in terms of clinical-pathological features and prognosis. Therefore, more aggressive treatment does not seem to be required when managing RIPTC as its prognosis is comparable to that of never-irradiated patients. Summary Radiation exposure in childhood is a well-documented risk factor for development of PTC. Therefore, increased exposure to medical or environmental radiation may be in part responsible, along with increased screening, of the recent burgeoning incidence of PTC. A specific morphological and molecular portrait of RIPTC is unlikely to exist. The more aggressive histologic and clinical features initially reported in radiation-induced cases are consistent with the expectations in nonradiation-related PTC of a comparable age. Aggressive histology, nodal, and distant metastases correlate with early age at onset rather than with radiation exposure. Although relapses are frequent in children, long-term cancer-specific mortality is approximately 1%, lower than that observed for adults and comparable between irradiated and nonirradiated cohorts. RIPTC does not require more aggressive surgery or more adjuvant treatments, as prognosis is as good as that of sporadic PTC when matched for stage and treatment received. Correspondence to Lorenzo Bresciani, MD, Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, 20133 Milan, Italy. Tel: +390223902793; fax: +390223902760; e-mail: lorenzo.bresciani@istitutotumori.mi.it Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2DlH3CQ

Management of the marginal mandibular nerve during and after neck dissection

Purpose of review Marginal mandibular nerve palsy (MMNP) is often an understated complication after neck dissection. This article reviews literature regarding anatomic landmarks that help define marginal mandibular nerve (MMN) during neck dissection, oncologic safety of surgical maneuvers, implications of MMNP, and reconstructive options. Recent findings A thorough knowledge of anatomy of the nerve can aid in its preservation. Course, branching pattern and communications of MMN are extremely variable. The Hayes Martin method classically described to preserve the nerve may not be oncologically safe in patients with prefacial nodal involvement. MMNP significantly affects quality of life after neck dissection. Cause, timing, and degree of neural damage play an important role in determining diagnostic and therapeutic options to correct the deformity resulting from MMNP. Owing to treatment-related factors, functionality of local structures may be compromised, which limits available reconstructive options for the surgeon. This should favor a shift of management option toward more conservative procedures in patients treated for head and neck cancer. Summary When oncologically safe, the MMN must always be preserved. The patient perceived deformity resulting from MMNP is significantly higher than clinician-detected rate. In select patients who are affected by significant smile asymmetry, multiple dynamic and static corrective procedures can be offered. Correspondence to Deepak Balasubramanian, MCh, Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India 682041. Tel: +91 8089089887; e-mail: dr.deepak.b@gmail.com Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

http://bit.ly/2U11Pgp

Correlation between systemic inflammatory response and quality of life in patients with chronic rhinosinusitis

Background

Local sinonasal inflammation resulting from altered T‐cell immune signaling is a contributor to the pathogenesis of chronic rhinosinusitis (CRS). CRS patients experience negative impacts on quality of life (QOL) and suffer from comorbidities linked to systemic inflammation. However, systemic inflammatory profiling to evaluate the association between systemic inflammation and QOL in CRS has not been performed. Our objectives were to compare local and systemic inflammatory gene expression in patients with CRS to determine if systemic markers of inflammation associate with disease severity and disease‐specific QOL.

Methods

A prospective observational study was conducted comparing 16 patients with CRS to 10 controls. Inflammatory gene expression in the anterior ethmoid tissues and peripheral blood of patients was measured using multiplex gene expression analysis and correlated to disease severity (computed tomography and nasal endoscopy) and disease‐specific QOL (22‐item Sino‐Nasal Outcome Test [SNOT‐22] and Rhinosinusitis Disability Index) using linear regression analyses.

Results

Patients with CRS showed significant increases in the expression of ctla4 and jak1 in sinonasal tissue and blood (p < 0.05), whereas the gene expression of hla‐dqa1, hla‐dqb1, and dusp4 was significantly decreased in patients with CRS compared to controls (p < 0.05). Soluble and local ctla4 and jak1 showed a significant positive correlation with clinical markers of disease severity and disease‐specific QOL (p < 0.05).

Conclusion

Local and systemic gene expression involved in T‐cell immune signaling was found to be significantly altered in the blood and sinonasal tissues of patients with CRS compared to controls and significantly correlated to disease severity and QOL in patients with CRS.

http://bit.ly/2AThfMR

Herbal dry extract BNO 1011 improves clinical and mucociliary parameters in a rabbit model of chronic rhinosinusitis

Background

Enhancing chloride (Cl^–) secretion in sinus epithelia represents a novel therapeutic approach to chronic rhinosinusitis (CRS). Herbal dry extract BNO 1011 enhances mucociliary clearance (MCC) via upregulation of Cl^– secretion in sinonasal cultures in vitro and murine epithelium in vivo. The objective of this study is to evaluate whether the BNO 1011 improves MCC and clinical parameters in a rabbit model of CRS.

Methods

After the development of CRS in 30 New Zealand white rabbits, animals were randomly assigned to receive oral placebo (n = 10), BNO 1011 (low dose [LD], 25 mg/kg/daily) (n = 10), or BNO1011 (high dose [HD], 125 mg/kg/daily) (n = 10) for 4 weeks. Outcomes included sinus opacification (Kerschner's rabbit sinus CT grade), maxillary epithelial Cl⁻ secretion (sinus potential difference [PD] assay), airway surface liquid (ASL) depth using micro‐optical coherence tomography (μOCT), and submucosal gland density (SMD) on histopathology. Outcome parameters were analyzed by 2 blinded investigators.

Results

BNO 1011 significantly cleared sinus opacification (HD = 1.21 ± 0.63, LD = 1.26 ± 0.37,) compared to placebo (4.02 ± 0.92) (p = 0.009). BNO 1011 resulted in markedly greater mean sinus PD polarization (HD = –12.23 ± 1.4 mV, LD = –12.0 ± 3.0 mV) when compared to rabbits treated with placebo (–4.1 ± 1.1 mV) (p = 0.03). ASL depth was significantly improved when treated with HD (4.08 ± 0.06 μm) and LD (4.05 ± 0.06 μm) compared to placebo (3.5 ± 0.05 μm) (post hoc analysis, p < 0.0001). Histologically, epithelial thickness (HD = 10.0 ± 0.7 μm; LD = 13.7 ± 0.9 μm; placebo = 21.1 ± 2.3 μm; p < 0.005), subepithelial thickness (HD = 63.1 ± 6.6 μm; LD = 103.2 ± 6.7 μm; placebo = 113.3 ± 6.0 μm; p < 0.001), and SMD (HD = 22.2 ± 2.9%; LD = 31.8 ± 1.1%; placebo = 43.8 ± 1.7%; p < 0.0001) were noticeably better with the HD.

Conclusion

Herbal dry extract BNO 1011 improves radiographic, histologic, and MCC parameters in a rabbit model of CRS.

http://bit.ly/2T2F6Rj

Outcomes and imaging findings of respiratory epithelial adenomatoid hamartoma: a systematic review

Background

Respiratory epithelial adenomatoid hamartoma (REAH) is a recently classified histopathologic diagnosis often identified incidentally following endoscopic sinus surgery (ESS) for presumed chronic rhinosinusitis. Limited data exist defining preoperative imaging features and surgical outcomes. The purpose of this study is to examine characteristic imaging findings of REAH and postoperative olfactory and recurrence outcomes.

Methods

A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines on articles published from 1995 to present. PubMed, EMBASE, and Ovid MEDLINE databases were queried for studies pertinent to imaging findings of REAH and surgical outcomes. Quality of articles was assessed using the Methodological Index for Non‐Randomized Studies (MINORS).

Results

A total of 294 articles were identified, with 15 meeting inclusion criteria. Seven articles assessed both imaging findings and surgical outcomes. Three articles focused exclusively on imaging, whereas 5 examined surgical outcomes. Olfactory cleft (OC) widening greater than 10 mm on computed tomography (CT) was characteristic of REAH. A total of 441 patients with REAH were included; 221 patients (50.1%) had concurrent nasal polyposis, whereas 154 patients (34.9%) had isolated REAH. Surgical intervention ranged from simple excision to complete ESS. Sixty‐five percent (65%) of patients reported improved olfaction; 4.1% of patients recurred with follow‐up ranging from 4 months to 5 years.

Conclusion

A widened OC may suggest the presence of REAH. This disease process has been identified in patients with nasal polyposis or encountered as an isolated lesion. Targeted surgery may result in improved olfaction and a low likelihood of recurrence, though long‐term prospective studies are necessary.

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Deadly amoeba infections from nasal and sinus irrigation: how should we discuss with our patients?

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Long‐term olfaction outcomes in transnasal endoscopic skull‐base surgery: a prospective cohort study comparing electrocautery and cold knife upper septal limb incision techniques

Background

Olfactory nerve fibers are at risk of injury during transnasal endoscopic skull‐base approaches. Olfactory outcomes for various techniques have not been thoroughly investigated. This study aims to report long‐term olfactory outcomes when a cold knife upper septal limb incision technique is used compared to monopolar cautery.

Methods

A prospective cohort study was performed at a tertiary referral center. Adult patients undergoing endoscopic approaches with septal incisions were randomized to cold knife or monopolar cautery groups. Patient demographics, clinical history, surgical data, and outcomes were collected. Preoperative, 3‐month, and 12‐month postoperative scores on the University of Pennsylvania Smell Inventory Test (UPSIT) and 22‐item Sino‐Nasal Outcome Test (SNOT‐22) were measured. Fisher's exact tests were performed for categorical variables and t tests were performed for continuous variables.

Results

Twenty‐two (22) patients (10 cold knife, 12 cautery) were enrolled between March 2016 and August 2017. The average age ± standard deviation was 50.2 ± 14.0 years (p = 0.59), 54% (p = 0.69) were female, and the primary pathology was pituitary adenoma (73%, p = 1.00). Preoperative, 3‐month, and 12‐month postoperative UPSIT scores were similar between the cold knife and cautery groups (32.8 vs 32.4, p = 0.80; 33.1 vs 33.0, p = 0.96; 33.6 vs 33.3, p = 0.84). On the "sense of smell/taste" question of the SNOT‐22, there was also no difference at all time points (p > 0.22).

Conclusion

There was no significant change in patient UPSIT scores 1 year after transnasal skull‐base approaches, and no short‐term or long‐term differences between cold knife and cautery upper septal limb incision techniques. Our study supports an individualized approach based on surgeon preference.

http://bit.ly/2ASfZcA

Subepidermal calcified nodule on the periungual finger successfully treated with ablative carbon dioxide laser

Abstract

Subepidermal calcified nodules are lesions that primarily affect children and are most commonly located on the head. The current standard of treatment for these is surgical excision. However, surgical excision is not always possible and may not be cosmetically favorable. We describe the use of a CO₂ laser as a successful treatment for a subepidermal calcified nodule of the finger.

http://bit.ly/2Hlp0kk

Novel tretinoin 0.05% lotion for the once‐daily treatment of moderate‐to‐severe acne vulgaris in a preadolescent population

Abstract

Background

Acne vulgaris (acne) is a common skin condition in children and adolescents. Efficacy of tretinoin is well documented in studies that included pediatric patients (12‐18 years of age). With acne routinely presenting in younger patients, data are needed in this important group. Lotion formulations are commonly used across dermatology and are well liked by patients.

Objective

To evaluate the safety and efficacy of a novel once‐daily tretinoin 0.05% lotion in preadolescent subjects (≤ 13 years) with moderate‐to‐severe acne.

Methods

Post hoc analysis of two multicenter, randomized, double‐blind, vehicle‐controlled phase 3 studies in moderate‐to‐severe acne. Preadolescent subjects (N = 154) randomized (1:1) to receive tretinoin 0.05% lotion or vehicle, once daily for 12 weeks. Efficacy assessments included changes in baseline inflammatory/noninflammatory lesions and treatment success (at least 2‐grade reduction in Evaluator's Global Severity Score [EGSS] and clear/almost clear). Safety, adverse events (AEs), and cutaneous tolerability evaluated throughout.

Results

At Week 12, mean percent reduction in inflammatory and noninflammatory lesion counts were 49.5% and 44.0% compared with 31.4% and 18.8% with vehicle (both P = 0.001). Treatment success was achieved by 23.7% of subjects by Week 12, compared with 7.2% (P = 0.009). The majority of AEs were mild and transient: most frequently were application site pain (5.6%) and application site dryness (2.8%). Local cutaneous safety and tolerability assessments were generally mild‐to‐moderate and improved by Week 12.

Conclusions

Tretinoin 0.05% lotion was significantly more effective than vehicle in achieving treatment success and reducing inflammatory and noninflammatory lesions in preadolescent acne. It was well tolerated, with all treatment‐related AEs deemed mild or moderate.

http://bit.ly/2RV18rB

The microbiome in preadolescent acne: Assessment and prospective analysis of the influence of benzoyl peroxide

Abstract

Background/Objectives

The pathogenesis of preadolescent acne has not been well studied, and it is uncertain if Cutibacterium acnes is a predominant organism in the microbiome in this age group. The aim of this study was to analyze the microbiome of preadolescent females and to assess whether benzoyl peroxide impacts the microbiome.

Methods

The study enrolled girls, aged 7‐12 years, with evidence of at least six acne lesions who had not been previously treated. Participants' skin surface of forehead, cheeks, nose, chin, left retroauricular crease, and extruded contents of a comedonal lesion were sampled at baseline. Participants used benzoyl peroxide 4% wash for 6‐8 weeks and returned for skin surface sampling and extraction collection. Microbiome analysis was performed using 16S ribosomal RNA gene amplicon sequencing on all swab and lesional extraction samples.

Results

Fifty‐one participants were enrolled with a median IGA score of 2 (mild). Changes in microbiome diversity were associated with increasing age and number of acne lesions (P = 0.001). C. acnes had higher abundances on forehead and nose, as opposed to cheeks and chin (P = 0.009). Bacterial diversity (alpha diversity) of the skin microbiome was comparable between preadolescent at baseline and after treatment with benzoyl peroxide.

Conclusion

This is the first large assessment characterizing female acne microbiome in early and late preadolescence. Results show that preadolescent acne can vary in its microbial profile, reflecting surrounding changes associated with the onset of puberty. Although benzoyl peroxide use was associated with decreased acne counts, its effect on microbial diversity was not demonstrated in our study.

http://bit.ly/2HjCsoP

Bacterial biofilm is associated with higher levels of regulatory T‐cells in unaffected hidradenitis suppurativa skin

Abstract

Background

The role of bacterial biofilm in hidradenitis suppurativa (HS) is highly debated. Less biofilm is found in clinically unaffected axillary perilesional skin of HS patients compared with healthy controls.

Objective

To study the correlation between biofilm and the phenotypical characterization of the pre‐clinical inflammatory infiltrate.

Materials And Methods

An exploratory comparative study of punch biopsies from unaffected axillary HS skin compared to similarly biopsies from healthy controls underwent standard staining procedures for CD4, CD8, CD25, FoxP3 and IL17. Standard‐sized inflammatory histological hotspots were identified manually. Slides were scanned into Leica Biosystems' Digital Image Hub. Number of stained cells per slide and hotspot were found using an algorithm.

Results

12.5% of HS had biofilm compared to 85% of controls. For full slides, HS patients had more CD4+ cells than controls; HS patients with biofilm had higher CD4+ cell number than controls with or without biofilm and HS patients without biofilm. For hotspots, HS patients with biofilm had higher number of CD4+FoxP3+ cells than HS patients without biofilm and controls with biofilm.

Conclusion

The association between biofilm and the number of regulatory T‐cells in HS patients supports the concept of dysbiosis as a factor in the pre‐clinical HS lesions.

http://bit.ly/2W52240

Delayed hemolysis, elevated liver enzymes, low platelet count syndrome in succession of switches of preventive anticoagulant treatment in a 41-year-old patient with a history of recurrent assisted implantation failures: a case report

For the past decades the mean age of primiparae in Western societies is constantly increasing. At the same time, there is a growing demand for assisted reproductive technologies such as in vitro fertilization and...

http://bit.ly/2Mku9aZ

Thymoma‐associated graft‐versus‐host‐like disease treated with high‐dose i.v. immunoglobulin

http://bit.ly/2HtCJFU

Relationship between rosacea and dietary factors: A multicenter retrospective case–control survey

Abstract

Although patients with rosacea often consult dermatologists for dietary factors that might be related to their skin disorders, few studies have been conducted to research the relationship between rosacea and dietary factors. The purpose of this study was to evaluate the potential relationship between rosacea and diet among the large Chinese population with rosacea, which would provide dietary guidelines for patients with rosacea. A multicenter case–control study was conducted. The feeding frequency 2 years before the occurrence of rosacea was collected by standardized questionnaires. Multiple logistic regression analysis was used to calculate risks related to the diet. One thousand three hundred and forty‐seven patients with rosacea and 1290 controls were enrolled in our study. We found that high‐frequency intake of fatty food and tea presented a positive correlation with rosacea, while high‐frequency dairy product intake showed significant negative correlation with rosacea. Sweet food, coffee and spicy food appeared to be independent of any subset of rosacea in our study. However, high‐frequency dairy product intake showed a borderline beneficial effect on rosacea severity. We further analyzed the correlation between diet and the subtype of rosacea. We found that high‐frequency fatty intake was associated with erythematotelangiectatic rosacea (ETR) and phymatous rosacea, while high‐frequency tea intake was only associated with ETR. In addition, high‐frequency dairy product intake showed negative correlations with ETR and papulopustular rosacea. Rosacea is associated with some dietary factors, and our study is valuable in establishing dietary guidelines to prevent and improve rosacea.

http://bit.ly/2RUMtwD

Prikazi: Marc Abélès, Thinking beyond the State, Cornell University Press, Ithaca, 2017

Tomicic, A; (2018) Prikazi: Marc Abélès, Thinking beyond the State, Cornell University Press, Ithaca, 2017. [Review]. Etnološka tribina: Godišnjak Hrvatskog etnološkog društva , 48 (41) pp. 329-331. Green open access

http://bit.ly/2U3bpQe

People Should Be Allowed to Do What They Like”: Autistic Adults’ Views and Experiences of Stimming

Kapp, SK; Steward, R; Crane, LM; Elliott, D; Elphick, C; Pellicano, E; Russell, G; (2019) People Should Be Allowed to Do What They Like": Autistic Adults' Views and Experiences of Stimming. Autism (In press).

http://bit.ly/2DkuVCb

Growth mechanisms for InAs/GaAs QDs with and without Bi surfactants

Chen, XY; Gu, Y; Ma, YJ; Chen, SM; Tang, MC; Zhang, YY; Yu, XZ; ... Zhang, YG; + view all Chen, XY; Gu, Y; Ma, YJ; Chen, SM; Tang, MC; Zhang, YY; Yu, XZ; Wang, P; Zhang, J; Wu, J; Liu, HY; Zhang, YG; - view fewer (2019) Growth mechanisms for InAs/GaAs QDs with and without Bi surfactants. Materials Research Express , 6 (1) 10.1088/2053-1591/aae85d .

http://bit.ly/2U2RvVq

III-V quantum-dot lasers monolithically grown on silicon

Liao, M; Chen, S; Park, J-S; Seeds, A; Liu, H; (2018) III-V quantum-dot lasers monolithically grown on silicon. Semiconductor Science and Technology , 33 (12) 10.1088/1361-6641/aae6a5 .

http://bit.ly/2DlDUD5

Computational Studies of Nanographene Systems: Extended Discotics, Covalently Linked "Supermolecules," and Functionalized Supramolecular Assemblies

Ziogos, OG; Konstantinopoulos, S; Tsetseris, L; Theodorou, DN; (2018) Computational Studies of Nanographene Systems: Extended Discotics, Covalently Linked "Supermolecules," and Functionalized Supramolecular Assemblies. Journal of Physical Chemistry C , 122 (32) pp. 18715-18731. 10.1021/acs.jpcc.8b04576 .

http://bit.ly/2U2Rvoo

Reduction of Propionic Acid over a Pd-Promoted ReOx/SiO2 Catalyst Probed by X-ray Absorption Spectroscopy and Transient Kinetic Analysis

Kammert, JD; Xie, J; Godfrey, IJ; Unocic, RR; Stayitski, E; Attenkofer, K; Sankar, G; Kammert, JD; Xie, J; Godfrey, IJ; Unocic, RR; Stayitski, E; Attenkofer, K; Sankar, G; Davis, RJ; - view fewer (2018) Reduction of Propionic Acid over a Pd-Promoted ReOx/SiO2 Catalyst Probed by X-ray Absorption Spectroscopy and Transient Kinetic Analysis. ACS Sustainable Chemistry and Engineering , 6 (9) pp. 12353-12366. 10.1021/acssuschemeng.8b02820 .

http://bit.ly/2DlHqgM

An Energy-Efficient 1.2V 4-Channel Wireless CMOS Potentiostat for Amperometric Biosensors

Valente, V; Schormans, M; Demosthenous, A; (2018) An Energy-Efficient 1.2V 4-Channel Wireless CMOS Potentiostat for Amperometric Biosensors. In: 2018 IEEE International Symposium on Circuits and Systems (ISCAS). IEEE Green open access

http://bit.ly/2TZbUKY

Image of Flesh/Flesh of the Image: the Flayed Figure in Henri de Mondeville’s Chirurgia

Rozenberg, LSZ; (2019) Image of Flesh/Flesh of the Image: the Flayed Figure in Henri de Mondeville's Chirurgia. Object , 20 (20) pp. 82-100. 10.14324/111.2396-9008.037 . Green open access

http://bit.ly/2DkgFZT

Influence of dopant metal ions on the formation of cordierite using combined SAXS/WAXS and EXAFS/WAXS techniques

Sankar, G; Dent, AJ; Dobson, B; Bras, W; (2016) Influence of dopant metal ions on the formation of cordierite using combined SAXS/WAXS and EXAFS/WAXS techniques. Journal of Non-Crystalline Solids , 451 pp. 16-22. 10.1016/j.jnoncrysol.2016.07.030 . Green open access

http://bit.ly/2TYBZK7

LRP10 in alpha-synucleinopathies

Guerreiro, R; Orme, T; Neto, JL; Bras, J; International DLB Genetics Consortium, .; (2018) LRP10 in alpha-synucleinopathies. Lancet Neurology , 17 (12) pp. 1032-1033. 10.1016/S1474-4422(18)30399-5 .

http://bit.ly/2DmojmR

The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions

Wu, J; Hasselgren, C; Zettergren, A; Zetterberg, H; Blennow, K; Skoog, I; Halleröd, B; (2019) The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions. Aging and Mental Health 10.1080/13607863.2018.1531368 . Green open access

http://bit.ly/2TZBOy4

Cognitive Impairment and Depression-Cause, Consequence, or Coincidence?

Halahakoon, DC; Lewis, G; Roiser, JP; (2019) Cognitive Impairment and Depression-Cause, Consequence, or Coincidence? JAMA Psychiatry 10.1001/jamapsychiatry.2018.3631 . (In press).

http://bit.ly/2DkgyNX

Molecular Simulations of Nanographene Systems

Ziogos, OG; Theodorou, DN; (2018) Molecular Simulations of Nanographene Systems. In: Zaspalis, Vassilis and Paras, Spiros and Assimopoulou, Andreana and Chatzidoukas, Christos and Tsivintzelis, Ioannis, (eds.) Materials Today Proceedings. (pp. pp. 27446-27452). Elsevier: Thessaloniki, Greece.

http://bit.ly/2TZncin

Charmaine Nelson, Slavery, Geography and Empire in Nineteenth-Century Marine Landscapes of Montreal and Jamaica, London, 2016

Birkeli, Helene; (2019) Charmaine Nelson, Slavery, Geography and Empire in Nineteenth-Century Marine Landscapes of Montreal and Jamaica, London, 2016. [Review]. Object , 20 (20) pp. 101-103. Green open access

http://bit.ly/2DkYmUv

Dynamical model selection near the quantum-classical boundary

Ralph, JF; Toros, M; Maskell, S; Jacobs, K; Rashid, M; Setter, AJ; Ulbricht, H; (2018) Dynamical model selection near the quantum-classical boundary. Physical Review A , 98 (1) 10.1103/PhysRevA.98.010102 . Green open access

http://bit.ly/2U3blzY

On the closure problem of the effective stress in the Eulerian-Eulerian and mixture modeling approaches for the simulation of liquid-particle suspensions

Jamshidi, R; Mazzei, L; Angeli, P; (2019) On the closure problem of the effective stress in the Eulerian-Eulerian and mixture modeling approaches for the simulation of liquid-particle suspensions. Physics of Fluids , 31 (1) , Article 013302. 10.1063/1.5081677 . Green open access

http://bit.ly/2DkgqxX

Detection of anisotropic particles in levitated optomechanics

Toros, M; Rashid, M; Ulbricht, H; (2018) Detection of anisotropic particles in levitated optomechanics. Physical Review A , 98 (5) 10.1103/PhysRevA.98.053803 . Green open access

http://bit.ly/2TYexww

Football pollution: An investigation of spatial and temporal patterns of crime in and around stadia in England

Kurland, J; Tilley, N; Johnson, SD; (2017) Football pollution: An investigation of spatial and temporal patterns of crime in and around stadia in England. Security Journal , 31 (3) pp. 665-684. 10.1057/s41284-017-0123-0 . Green open access

http://bit.ly/2DlA3WA

Mutations in Chromatin Modifier and Ephrin Signaling Genes in Vein of Galen Malformation

Duran, D; Zeng, X; Jin, SC; Choi, J; Nelson-Williams, C; Yatsula, B; Gaillard, J; ... Kahle, KT; + view all Duran, D; Zeng, X; Jin, SC; Choi, J; Nelson-Williams, C; Yatsula, B; Gaillard, J; Furey, CG; Lu, Q; Timberlake, AT; Dong, W; Sorscher, MA; Loring, E; Klein, J; Allocco, A; Hunt, A; Conine, S; Karimy, JK; Youngblood, MW; Zhang, J; DiLuna, ML; Matouk, CC; Mane, S; Tikhonova, IR; Castaldi, C; López-Giráldez, F; Knight, J; Haider, S; Soban, M; Alper, SL; Komiyama, M; Ducruet, AF; Zabramski, JM; Dardik, A; Walcott, BP; Stapleton, CJ; Aagaard-Kienitz, B; Rodesch, G; Jackson, E; Smith, ER; Orbach, DB; Berenstein, A; Bilguvar, K; Vikkula, M; Gunel, M; Lifton, RP; Kahle, KT; - view fewer (2019) Mutations in Chromatin Modifier and Ephrin Signaling Genes in Vein of Galen Malformation. Neuron , 101 10.1016/j.neuron.2018.11.041 .

http://bit.ly/2U3yp1s

“Sinus Headache”: Diagnosis and Dilemma?? An Analytical and Prospective Study

Abstract

http://bit.ly/2RCF8Cv

Multiple skin nodules in a newborn

http://bit.ly/2Cw6wrw

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Σάββατο 19 Ιανουαρίου 2019

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