Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Παρασκευή 12 Φεβρουαρίου 2016
Reduced thermal threshold in patients with Temporomandibular Disorders
Summary
Background
Many studies have demonstrated the presence of somatosensory modulation changes at different sites in patients with temporomandibular disorders (TMDs) using different modalities. However, the neck area, a well-know condition related to TMD, remains unexplored.
Objective
To assess the thermal pain threshold in patients with TMD and controls at cephalic and extra-cephalic areas, including the neck.
Methods
Twenty female patients with TMDs diagnosed by the Research Diagnostic Criteria for TMD (RDC/TMD) and twenty age-matched controls underwent a first interview about neck pain and disability (NDI questionnaire). A blinded evaluator assessed the thermal pain threshold for cold (CPT) and heat (HPT) stimuli in accordance with an ascending method of limits of the Quantitative Sensory Testing at the following sites: periorbital, masseter, cervical posterior and ventral forearm. The groups were compared using a t-test with α = 5%.
Results
Patients with TMDs reported pain at higher temperature for cold stimuli in all sites (P < 0·05) and at lower temperature for heat stimuli in the right periorbital site (P < 0·05) than controls. Pain and disability due tothis symptom were reported more often in the TMD group (P < 0·05).
Conclusion
Patients with TMD have pain modulation changes in the neck area as well, especially for cold stimuli, associated with higher disability and a higher report of neck pain than controls. These findings reinforce the evidence regarding the relationship between TMDs and neck pain.
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Lanthanide-based luminescent biolabelling
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC00922K, Feature Article
DOI: 10.1039/C6CC00922K, Feature Article
mohamadou Sy, Aline Nonat, Niko Hildebrandt, L. J. Charbonniere
Luminescent lanthanide complexes display unrivalled spectroscopic properties, which place them in a special category in the luminescent toolbox. Their long-lived line-like emission spectra are the cornerstones of numerous analytical applications...
The content of this RSS Feed (c) The Royal Society of Chemistry
Luminescent lanthanide complexes display unrivalled spectroscopic properties, which place them in a special category in the luminescent toolbox. Their long-lived line-like emission spectra are the cornerstones of numerous analytical applications...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Dynamic Encapsulation and Activation of Carbonic Anhydrase in Multivalent Dynameric Host Matrixes
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC00796A, Communication
DOI: 10.1039/C6CC00796A, Communication
Yan Zhang, Yves-Marie Legrand, Petit Eddy, Claudiu Supuran, Mihail Barboiu
A straight-forward Carbonic Anhydrase activation strategy via dynamic encapsulation has been achieved by direct addition of multivalent amide dynamers into the enzyme reaction solutions.
The content of this RSS Feed (c) The Royal Society of Chemistry
A straight-forward Carbonic Anhydrase activation strategy via dynamic encapsulation has been achieved by direct addition of multivalent amide dynamers into the enzyme reaction solutions.
The content of this RSS Feed (c) The Royal Society of Chemistry
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Sequential process in brain-derived neurotrophic factor-induced functional periodontal tissue regeneration
We recently demonstrated that brain-derived neurotrophic factor (BDNF) promotes periodontal tissue regeneration. The purpose of this study was to establish an essential component of a rational approach for the clinical application of BDNF in periodontal regenerative therapy. Here, we assessed the sequence of early events in BDNF-induced periodontal tissue regeneration, especially from the aspect of cementum regeneration. Brain-derived neurotrophic factor was applied into experimental periodontal defects in Beagle dogs. The localization of cells positive for neurotrophic tyrosine kinase, receptor, type 2, proliferating cell nuclear antigen, osteopontin, integrin αVβ3, and integrin α2β1 was evaluated by immunohistochemistry. The effects of BDNF on adhesion of cultured human periodontal ligament cells was examined by an in vitro study. The results suggest that BDNF could induce rapid cementum regeneration by stimulating adhesion, proliferation, and differentiation of periodontal ligament cells in the early regenerative phase, resulting in enhancement of periodontal tissue regeneration.
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Design of 3D artificial leaves with spatially separated active sites for H2 and O2 generation and their application in water splitting
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC00116E, Communication
DOI: 10.1039/C6CC00116E, Communication
Haiyan Li, Jian Han, Na Guo, Hongwen Yu
This is an Accepted Manuscript, which has been through the RSC Publishing peer review process and has been accepted for publication. Accepted manuscripts are published online shortly after acceptance. This version of the article will be replaced by the fully edited, formatted and proof read Advance Article as soon as this is available.
The content of this RSS Feed (c) The Royal Society of Chemistry
This is an Accepted Manuscript, which has been through the RSC Publishing peer review process and has been accepted for publication. Accepted manuscripts are published online shortly after acceptance. This version of the article will be replaced by the fully edited, formatted and proof read Advance Article as soon as this is available.
The content of this RSS Feed (c) The Royal Society of Chemistry
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Perceived Stress, Coping, and Cortisol Reactivity in Daily Life: A Study of Adolescents during the First Year of College
Source:Biological Psychology
Author(s): Michael R. Sladek, Leah D. Doane, Linda J. Luecken, Nancy Eisenberg
Adolescents change how they cope with stress across different situations, but also differ from one another in their general capacity to cope. The current study examined whether cortisol reactivity to perceived daily stress varies with both situational (within-person) and individual (between-person) differences in coping. First-year college students (N=63;Mage=18.85) provided 15 stress-coping diaries and 15 corresponding saliva samples across 3 weekdays. Results from hierarchical linear growth models revealed that perceiving greater stress than usual in the last hour was significantly associated with elevations in cortisol (relative to diurnal patterning) only during situations characterized by greater than usual diary-reported engagement coping. Regarding individual differences, perceiving greater stress than usual was significantly associated with elevations in cortisol only for adolescents below average on trait measures of engagement coping or belief in their ability to handle stress. Findings indicate that cortisol reactivity to daily stress varies with both situational variation and individual differences in coping.
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Maurizio Battino and Hojjat Adeli being named a Thomson Reuters Highly Cited Researcher
IOS Press congratulates Maurizio Battino, Editor-in-Chief of Journal of Berry Research and Mediterranean Journal of Nutrition and Metabolism, and Hojjat Adeli, founder and Editor-in-Chief of Integrated Computer-Aided Engineering, on being recognized as a 2015 Thomson Reuters Highly Cited Researcher.
Thomson Reuters carefully analyzed citation data over an 11-year period using Thomson Reuters Web of ScienceTM and InCitesTM to identify some of the best and brightest scientific minds of our time.
Maurizio Battino and Hojjat Adeli were selected due to the number of citations their work has received from their fellow researchers and their contributions have been identified as being among the most valuable and significant in the field of Agricultural Sciences.
List containing Maurizio Battino's publications.
List containing Hojjat Adeli's publications.
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Research discovers neuroprotective protein in blood is biomarker of Alzheimer’s disease
A new discovery by Tel Aviv University, Technion (Rambam Medical Center), and Harvard University researchers takes the medical community a leap forward in the process of effectively screening and diagnosing Alzheimer's disease. The new study, published in the Journal of Alzheimer's Disease, proposes a new biomarker for cognitive aging and Alzheimer's disease: activity-dependent neuroprotective protein (ADNP), the levels of which can be easily monitored in routine blood tests. The study also found that ADNP levels tested in the blood correlate with higher IQ in healthy older adults.
The research was led by Prof. Illana Gozes, the incumbent of the Lily and Avraham Gildor Chair for the Investigation of Growth Factors and former director of the Adams Super Center for Brain Studies at TAU's Sackler Faculty of Medicine and a member of TAU's Sagol School of Neuroscience, conducted by TAU PhD student Anna Malishkevich and spearheaded by Dr. Gad Marshall, Dr. Aaron Schultz, and Prof. Reisa Sperling of Harvard University, and Prof. Judith Aharon-Peretz of Rambam Medical Center – The Technion Institute of Technology.
A step to early intervention
Significant increases in ADNP RNA levels were observed in patients ranging from mild cognitive impairment (MCI) to Alzheimer's dementia. ADNP levels tested in plasma and serum samples, as well as white blood cell RNA levels, distinguished among cognitively normal elderly, MCI, and Alzheimer's dementia participants.
For the purpose of the cross-sectional study, the investigators analyzed blood samples taken from 42 healthy adults, MCI patients, and Alzheimer's disease patients at Rambam Medical Center in Israel. After comparing the ADNP expression in the blood samples, the researchers prepared plasma samples and once again compared the protein levels.
"This study has provided the basis to detect this biomarker in routine, non-invasive blood tests, and it is known that early intervention is invaluable to Alzheimer's patients," said Prof. Gozes. "We are now planning to take these preliminary findings forward into clinical trials — to create a pre-Alzheimer's test that will help to tailor potential preventative treatments."
Builds on original research
This new research is based on Prof. Gozes' earlier investigation of neuronal plasticity and nerve cell protection at the molecular, cellular, and system level, and her discovery of novel families of proteins, including ADNP, associated with cross-communication among neural nerve cells and their support cells.
Prof. Gozes focused on the potential utility of blood ADNP levels as an Alzheimer's biomarker. "The more ADNP RNA found in the blood cells, the fewer aggregates found in the brain of elderly cognitively normal individuals," said Prof. Gozes. "Interestingly, we also found that the more ADNP in the serum, the higher the person's IQ level."
These findings are corroborated by a separate study by an independent group that found that the ADNP protein is present in lesser quantities in serum samples from select mild Alzheimer's disease patients. However, in Prof. Gozes' studies, which approach advanced Alzheimer's disease patients, the ADNP mRNA levels in white blood cells dramatically rose above the levels measured in cognitively normal individuals. This finding suggests that dramatically increased ADNP mRNA blood levels in Alzheimer's patients may be either insufficient or damaging.
"We have found a clear connection between ADNP levels in the blood and amyloid plaques in the brain," said Prof. Gozes. "Our study is the first to assess ADNP in elderly individuals at risk for Alzheimer's disease, and its results open the door for further validation in larger, more informative studies."
The researchers are currently exploring larger clinical trials to better determine the ability of ADNP to predict cognitive decline and disease progression.
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Changes over lactation in breast milk serum proteins involved in the maturation of immune and digestive system of the infant
Publication date: Available online 12 February 2016
Source:Journal of Proteomics
Author(s): Lina Zhang, Marita de Waard, Hester Verheijen, Sjef Boeren, Jos A. Hageman, Toon van Hooijdonk, Jacques Vervoort, Johannes B. van Goudoever, Kasper Hettinga
To objective of this study was to better understand the biological functions of breast milk proteins in relation to the growth and development of infants over the first six months of life. Breast milk samples from four individual women collected at seven time points in the first six months after delivery were analyzed by filter aided sample preparation and dimethyl labeling combined with liquid chromatography tandem mass spectrometry. A total of 247 and 200 milk serum proteins were identified and quantified, respectively. The milk serum proteome showed a high similarity (80% overlap) on the qualitative level between women and over lactation. The quantitative changes in milk serum proteins were mainly caused by three groups of proteins, enzymes, and transport and immunity proteins. Of these 21 significantly changed proteins, 30% were transport proteins, such as serum albumin and fatty acid binding protein, which are both involved in transporting nutrients to the infant. The decrease of the enzyme bile salt-activated lipase as well as the immunity proteins immunoglobulins and lactoferrin coincide with the gradual maturation of the digestive and immune system of infants. The human milk serum proteome didn't differ qualitatively but it did quantitatively, both between mothers and as lactation advanced. The changes of the breast milk serum proteome over lactation corresponded with the development of the digestive and immune system of infants.Biological significanceBreast milk proteins provide nutrition, but also contribute to healthy development of infants. Despite the previously reported large number of identified breast milk proteins and their changes over lactation, less is known on the changes of these proteins in individual mothers. This study is the first to determine the qualitative and quantitative changes of milk proteome over lactation between individual mothers. The results indicate that the differences in the milk proteome between individual mothers are more related to the quantitative level than qualitative level. The correlation between the changes of milk proteins and the gradual maturation of the gastrointestinal tract and immune system in infants, contributes to a better understanding of the biological functions of human milk proteins for the growth and development of infants.
Graphical abstract
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Toxicovenomics and antivenom profiling of the Eastern green mamba snake (Dendroaspis angusticeps)
Publication date: Available online 12 February 2016
Source:Journal of Proteomics
Author(s): Line P. Lauridsen, Andreas H. Laustsen, Bruno Lomonte, José María Gutiérrez
A toxicovenomic study was performed on the venom of the green mamba, Dendroaspis angusticeps. Forty-two different proteins were identified in the venom of D. angusticeps, in addition to the nucleoside adenosine. The most abundant proteins belong to the three-finger toxin (3FTx) (69.2%) and the Kunitz-type proteinase inhibitor (16.3%) families. Several sub-subfamilies of the 3FTxs were identified, such as Orphan Group XI (Toxin F-VIII), acetylcholinesterase inhibitors (fasciculins), and aminergic toxins (muscarinic toxins, synergistic-like toxins, and adrenergic toxins). Remarkably, no α-neurotoxins were identified. Proteins of the Kunitz-type proteinase inhibitor family include dendrotoxins. Toxicological screening revealed a lack of lethal activity in all RP-HPLC fractions, except one, at the doses tested. Thus, the overall toxicity depends on the synergistic action of various types of proteins, such as dendrotoxins, fasciculins, and probably other synergistically-acting toxins. Polyspecific antivenoms manufactured in South Africa and India were effective in the neutralization of venom-induced lethality. These antivenoms also showed a pattern of broad immunorecognition of the different HPLC fractions by ELISA and immunoprecipitated the crude venom by gel immunodiffusion. The synergistic mechanism of toxicity constitutes a challenge for the development of effective recombinant antibodies, as it requires the identification of the most relevant synergistic toxins.Biological significanceEnvenomings by elapid snakes of the genus Dendroaspis, collectively known as mambas, represent a serious medical problem in sub-Saharan Africa. The development of novel antivenoms and of recombinant neutralizing antibodies demands the identification of the most relevant toxins in these venoms. In this study, a bottom-up approach was followed for the study of the proteome of the venom of the Eastern green mamba, D. angusticeps. Forty-two different proteins were identified, among which the three-finger toxin (3FTx) family, characteristic of elapid venoms, was the most abundant, followed by the Kunitz-type proteinase inhibitor family. In addition, several other protein families were present in the venom, together with the nucleoside adenosine. No α-neurotoxins were identified within the family of 3FTxs in the venom of D. angusticeps, in contrast to the venom of Dendroaspis polylepis, in which α-neurotoxins are largely responsible for the toxicity. With one exception, HPLC fractions from D. angusticeps venom did not kill mice at the doses tested. This underscores that the toxicity of the whole venom is due to the synergistic action of various components, such as fasciculins and dendrotoxins, and probably other synergistically-acting toxins. Thus, the venoms of these closely related species (D. angusticeps and D. polylepis) seem to have different mechanisms to subdue their prey, which may be related to different prey preferences, as D. angusticeps is predominantly arboreal, whereas D. polylepis lives mostly in open bush country and feeds mainly on mammals. It is therefore likely that the predominant clinical manifestations of human envenomings by these species also differ, although in both cases neurotoxic manifestations predominate. Polyspecific antivenoms manufactured in South Africa and India were effective in the neutralization of venom-induced lethality in mice and showed a pattern of broad immunorecognition of the various venom fractions. It is necessary to identify the toxins responsible for the synergistic mode of toxicity in this venom, since they are the targets for the development of recombinant antibodies for the treatment of envenomings.
Graphical abstract
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In sickness and in health: classmates are highly motivated to provide in-hospital support during childhood cancer therapy
Abstract
Objectives
Extended hospitalization for school-aged cancer patients increases their risk of social marginalization. School-aged children mature through peer-interaction, but healthcare providers fail to incorporate this in rehabilitation efforts. The RESPECT study offers classmates to cancer patients to become ambassadors during hospital stays. This study explores classmate decision-making patterns about ambassadorship.
Methods
An open-ended question was prospectively and consecutively provided to classmates (N = 221) (and parents) of 10 children diagnosed with cancer in 2014 and enrolled in the RESPECT study. Statements were analysed using thematic content analysis.
Results
Of 221 classmates, 140 responded (63%). Of these, 81 applied for ambassadorship (median 8/patient), 58 declined, one was undecided. Nine forms were incomplete; leaving 131 in total that revealed 303 statements for analysis. Five major themes emerged: existing friendship (132/303 statements), personal resources (academic, emotional and social) (107/303), attitudes towards the ambassadorship (34/303), hospital environment (18/303) and logistics (12/303). Of the classmates with pre-existing friendships, 77% applied for ambassadorship and 80% with a surplus of personal resources applied. These were predominant predictors for ambassadorship application. Classmate motives were condensed into four archetypes: pre-existing friendship with a surplus of resources (100% applied), non-friend classmates with a surplus of resources (63% applied), pre-existing friendship with limited resources (22% applied) and non-friend classmates with limited resources (0% applied).
Conclusion
Classmates are highly motivated to support patients during serious illness, irrespective of pre-existing friendships. Ambassadors offer a novel in-hospital approach to promote rehabilitation in children with severe/chronic diseases. Results need validation in other settings. Copyright © 2016 John Wiley & Sons, Ltd.
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A pilot trial of brief group cognitive-behavioral treatment for insomnia in an adult cancer survivorship program
Abstract
Background
Cognitive-behavioral therapy for insomnia (CBT-Insomnia) is effective, yet rarely available for cancer survivors. This is unfortunate because survivors are at elevated risk for insomnia, which is associated with significant health consequences in this already at-risk population. Barriers to delivering CBT-Insomnia in oncology settings include a lack of trained providers, distance to cancer centers, and treatment duration.
Purpose
To address insomnia treatment barriers, we adapted standard CBT-Insomnia treatment and evaluated a pilot group-based approach for feasibility and efficacy in an adult cancer survivorship program.
Methods
Thirty-eight cancer survivors (mean age = 52.2 years) enrolled in our three-session program delivered over 1 month. They were primarily diagnosed with breast cancer (58.6%) and were an average of 6.0 years post-diagnosis and 3.6 years post-treatment. Participants completed sleep logs throughout the study and measures of sleep at baseline and week 4.
Results
Participants reported experiencing insomnia symptoms an average of 2.4 years, with 89.7% indicating that the cancer experience had caused/exacerbated symptoms. Significant pre/post-intervention group improvements in sleep efficiency (77.3% to 88.5%), sleep quality, and insomnia symptoms were reported (all ps < .01). Less than 1 in 3 had discussed insomnia symptoms with their oncology providers in the prior year.
Conclusions
Pilot data indicate that a brief, group-based CBT-Insomnia intervention in a survivorship setting is both feasible and efficacious. There is a need to increase awareness about insomnia and its treatment among both cancer survivors and oncology providers. If validated in future studies, this novel approach can improve cancer survivors' access to much needed insomnia treatment. Copyright © 2016 John Wiley & Sons, Ltd.
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Models of financing research: public funding mechanisms for universities in Flanders
This paper gives an overview of the models of financing research at universities in Flanders, Belgium. The Flemish government installed parallel mechanisms to distribute financial means for scientific research at the universities: research is supported via the allocation of block grants to the universities based on specific interuniversity allocation keys on the one hand and via project-based funding allocated on competitive basis by public funding agencies on the other hand. The composition of the allocation key of both the Special Research Fund and the Industrial Research Fund and the impact of the research performance-based parameters of these allocation keys on the research policy of universities and on the peer-reviewed assessment of the quality of research proposals submitted to the Fund for Scientific Research – Flanders, one of the Flemish public funding agencies, are discussed.
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Thermal properties of methyl ester-containing poly(2-oxazoline)s
This paper describes the synthesis and thermal properties in solution and bulk of poly(2-alkyl-oxazoline)s (PAOx) containing a methyl ester side chain. Homopolymers of 2-methoxycarbonylethyl-2-oxazoline (MestOx) and 2-methoxycarbonylpropyl-2-oxazoline (C3MestOx), as well as copolymers with 2-ethyl-2-oxazoline (EtOx) and 2-n-propyl-2-oxazoline (nPropOx), with systematic variations in composition were prepared. The investigation of the solution properties of these polymers revealed that the cloud point temperatures (T(CP)s) could be tuned in between 24 degrees C and 108 degrees C by variation of the PAOx composition. To the best of our knowledge, the T(CP)s of PMestOx and PC3MestOx are reported for the first time and they closely resemble the T(CP)s of PEtOx and PnPropOx, respectively, indicating similar hydrophilicity of the methyl ester and alkyl side chains. Furthermore, the thermal transitions and thermal stability of these polymers were investigated by DSC and TGA measurements, respectively, revealing amorphous polymers with glass transition temperatures between -1 degrees C and 54 degrees C that are thermally stable up to >300 degrees C.
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Treatment outcomes with hypofractionated high-dose radiation therapy for prostate cancer
Publication date: May–June 2016
Source:Reports of Practical Oncology & Radiotherapy, Volume 21, Issue 3
Author(s): Gustavo Arruda Viani, Bruno Tiago Rossi, Elton Suguikawa, Gisele Zuliani, Eduardo Jose Stefano
AimTo report the treatment results of a retrospective cohort of prostate cancer patients treated with Hypo-RT with a high equivalent biological effective dose (BED).BackgroundHypofractionated radiotherapy (Hypo-RT) has gained popularity and interest in the treatment of prostate cancer. However, there are few experiences with adequate follow-up reporting treatment results using high equivalent dose with Hypo-RT.Materials and methodsWe assigned 149 men with low-, intermediate- and high-risk prostate cancer to receive Hypo-RT with a total dose of 69Gy/23 fractions. Late gastrointestinal (GI) and genitourinary (GU) toxicity were prospectively evaluated according to modified RTOG criteria. Biochemical no evidence of disease (bNED) was defined as the nadir prostate-specific antigen level plus 2ng/mL.ResultsThe median follow-up was 53 months. For the entire cohort, the 5-year bNED rate was 94.6%, and for low-, intermediate- and high-risk patients the 5-year bNED was 100%, 96.4%, and 86% (p=0.007), respectively. The 5-year overall survival rate was 92%. Only 1 patient died from the disease at 48 months after treatment, giving a 5-year cancer-specific survival of 98%. The worst grade ≥2 rate GI and GU toxicity was 13.4% and 14%, respectively. No grade >3 toxicity was observed. The presence of grade ≥2 GI and GU toxicity at the last follow-up was only 1.3% and 3%, respectively.ConclusionsHypo-RT (69Gy/23 fractions) with a high equivalent BED produces excellent rates of biochemical control for low, intermediate and high-risk prostate cancer. The long term GU and GI toxicity rates were considered low and acceptable.
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Cost-effective geocoding with exterior orientation for airborne and terrestrial archaeological photography: possibilities and limitations
Taking a photograph is often considered to be an indispensable procedural step in many archaeological fields (e.g. excavating), whereas some sub-disciplines (e.g. aerial archaeology) often consider photographs to be the prime data source. Whether they were acquired on the ground or from the air, digital cameras save with each photograph the exact date and time of acquisition and additionally enable to store the camera's geographical location in specific metadata fields. This location is typically obtained from GNSS (Global Navigation Satellite System) receivers, either operating in continuous mode to record the path of the camera platform, or the position is observed for each exposure individually. Although such positional information has huge advantages in archiving the imagery, this approach has several limits as it does not record the complete exterior orientation of the camera. More specifically, the essential roll, pitch and yaw camera angles are missing, thus the viewing direction and the camera rotation around it. Besides enabling to define the exact portion of the scene that was photographed (essential for proper archiving), these parameters can also aid the subsequent orthophoto production workflows and even guide photo acquisition. This paper proposes a cost-effective hard- and software solution (camera position: 2.5 m and orientation in static conditions: maximally 2°, both at 1σ) to record all indispensable exterior orientation parameters during image acquisition. After the introduction of the utilized hardware components, the software that allows recording and estimating these parameters as well as embedding them into the image metadata is introduced. Afterwards, the obtainable accuracy in both static (i.e. terrestrial) and dynamic (i.e. airborne) conditions are calculated and assessed. Finally, the good use of this solution for different archaeological purposes will be detailed and commented where needed, while an outlook on future developments finalizes this article.
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Fulminant zygomycosis of graft liver following liver transplantation
A 44-year-old man with hepatitis B virus (HBV)-related cirrhosis underwent living donor liver transplantation at our institute. Induction of immunosuppression was achieved with basiliximab, due to deranged renal function, and maintained with prednisolone, tacrolimus and mycophenolate mofetil. The intraoperative and immediate postoperative periods were fairly uneventful. A duplex scan, taken during the third week post-transplantation due to sudden rise in liver enzymes, revealed multifocal hypoechoic lesions in the graft liver with normal Doppler parameters. Multidetecor computed tomography (MDCT) showed multiple hypodense vessel-sparing lesions in the graft liver. Cultures from the aspirate grew filamentous fungi identified as Basidiobolus ranarum species. Despite multiple broad spectrum antifungal infusions including liposomal amphotericin, itraconazole, caspofungin and posaconazole, serial sonography showed the hepatic lesions increasing in size, and involving segments V, VI and VII. The patient developed severe liver dysfunction ultimately progressing to sepsis, multiorgan dysfunction and death.
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Inflammatory fibroid polyp (Vanek's tumour): my worst nightmare in the emergency department
A middle-aged woman presented in shock with bleeding per rectum for 2 days without any significant past medical or surgical illness. Abdominal sonography, oesophagogastroduodenoscopy and sigmoidocolonoscopy were unremarkable. Despite 6 units of blood transfusion, 3000 mL of plasma expanders and ionotropes, the arterial pressure gradually decreased. We had no choice but to undergo life-threatening yet possibly life saving laparotomy. We found a 1x1 cm ileal bleeding mucosal polyp about 20 cm away from the ileocaecal junction. We resected and anastomosed end to end. Perioperatively, the patient was transfused with another 4 units of blood product. Immunohistopathology revealed a large number of CD34 positive spindle cells and eosinophils with extensive thick-walled capillaries compatible with inflammatory fibroid polyp. This case of Vanek's tumour is reported for its atypical site, which presented as massive obscure gastrointestinal haemorrhage without any prior warning signs.
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Sigmoid vaginoplasty in testicular feminising syndrome: surgical technique, outcome and review of the literature
Vaginal agenesis occurs in approximately 1:5000 live female births. It results from failure of the sinovaginal bulbs to develop and form the vaginal plate. Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is the most common cause of vaginal absence followed by complete or partial androgen insensitivity syndrome. Treatment of these patients encompasses a spectrum from simple non-operative dilation to the more complicated surgical creation of a neovagina. We present a case of a patient with testicular feminising syndrome who was reared as a female and underwent bilateral gonadal excision and sigmoid vaginoplasty.
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Dasatinib improves insulin sensitivity and affects lipid metabolism in a patient with chronic myeloid leukaemia
A 65-year-old woman had been visiting our department for the treatment of type-2 diabetes mellitus since December 2012. Her glycated haemoglobin levels were well controlled (5.8% (40 mmol/mol)) by metformin (500 mg). In July 2014, her white cell count increased suddenly to 33 530 cells/μL and she was diagnosed with Ph+ chronic myeloid leukaemia. She was started on dasatinib (100 mg), which immediately normalised plasma levels of WCC. Dasatinib improved the glycaemic index to <6.0% and also improved plasma levels of triglycerides (TGs) and high-density lipoprotein-cholesterol (HDL-c). Levels of low-density lipoprotein-cholesterol were increased but remained within the normal range. The TG:HDL-c ratio and Quantitative Insulin Sensitivity Check Index rapidly improved. Followed by an improvement in insulin sensitivity, plasma levels of adiponectin and leptin were increased. This case study suggests that dasatinib might have positive as well as negative effects on the metabolism of glucose and lipids.
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Ectopic pregnancy in an undescended fallopian tube: a diagnostic challenge
Uterine malformations are the most frequent anomalies of the Müllerian ducts, but undescended ovaries and fallopian tubes are very rare congenital defects. Pregnancy in these misplaced organs may occur, frequently posing a diagnostic challenge. A case of a ruptured ectopic pregnancy in an undescended fallopian tube associated with other genital malformations is presented. This case provides evidence for the recognised phenomenon of peritoneal gametes or embryo transmigration.
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An overview of burning mouth syndrome for the dermatologist
Summary
Burning mouth syndrome is characterized by an idiopathic burning pain affecting the oral mucosa, with no clinically apparent changes. It can present to a variety of health professionals including dermatologists. This article summarizes the important aspects of the condition, including theories of pathogenesis, diagnosis and management.
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Vemurafenib-induced hyperkeratosis of the areola treated with topical adapelene
Summary
We present a rare condition, hyperkeratosis of the areola, induced by vemurafenib. Only a few papers have described an association of BRAF inhibitors with hyperkeratosis of the areola and/or nipple. Vemurafenib is a selective BRAF inhibitor used in patients with unresectable or metastatic melanoma who are positive for the V600 mutation. This drug has been associated with numerous cutaneous side effects, both benign and malignant. We report a male patient with vemurafenib-induced hyperkeratosis of the areola managed successfully with a topical retinoid, and describe for the first time a treatment for this side effect.
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Optoelectronic plethysmography to evaluate the effect of posture on breathing kinematics in spinal cord injury: A cross sectional study
European Journal of Physical and Rehabilitation Medicine
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Prescriptions of antidepressants and anxiolytics in survivors of out-of-hospital cardiac arrest - a nationwide register-based follow-up study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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The CG balloon is an innovative condom balloon tamponade for the management of postpartum hemorrhage in low-resource settings
International Journal of Gynecology & Obstetrics
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