Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood

Abstract

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients' satisfaction of 595-nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked-randomized, split-faced 595-nm PDL (fluence 8 J/cm³ pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was −1.828 on the treated side and 0.103 on the non-treated side of the face, P-value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients' satisfaction on the laser-treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment.

http://ift.tt/2qaomwi

Hypersensitivity reactions in patients receiving hemodialysis

Publication date: Available online 26 April 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Lavjay Butani, Gianfranco Calogiuri
ObjectiveTo describe hypersensitivity reactions in patients receiving maintenance hemodialysis.Data SourcesPubMed search of articles published during the past 30 years with an emphasis on publications in the past decade.Study SelectionsCase reports and review articles describing hypersensitivity reactions in the context of hemodialysis.ResultsPharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis. These include iron, erythropoietin, and heparin, which can cause anaphylactic or pseudoallergic reactions, and topical antibiotics and anesthetics, which lead to delayed-type hypersensitivity reactions. Many hypersensitivity reactions are triggered by complement activation and increased bradykinin resulting from contact system activation, especially in the context of angiotensin-converting enzyme inhibitor use. Several alternative pharmacologic preparations and dialyzer membranes are available, such that once an etiology for the reaction is established, recurrences can be prevented without affecting the quality of care provided to patients.ConclusionAlthough hypersensitivity reactions are uncommon in patients receiving hemodialysis, they can be life-threatening. Moreover, considering the large prevalence of the end-stage renal disease population, the implications of such reactions are enormous. Most reactions are pseudoallergic and not mediated by immunoglobulin E. The multiplicity of potential exposures and the complexity of the environment to which patients on dialysis are exposed make it challenging to identify the precise cause of these reactions. Great diligence is needed to investigate hypersensitivity reactions to avoid recurrence in this high-risk population.



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Higher fractional exhaled nitric oxide and Der p 1 exposure in children with asthma living in tropical environments

Publication date: Available online 26 April 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Miguel J. Lanz, Mirna M. Gonzalez, Benjamin J. Efaw, Ronald J. Harbeck




http://ift.tt/2p6cNEW

Lupus miliaris disseminatus faciei: A resistant case with response to cyclosporine

Abstract

Lupus miliaris disseminatus faciei (LMDF) is a chronic, inflammatory dermatosis of unknown etiology, characterized by multiple, monomorphic, symmetrical, reddish-brown papules over forehead, cheeks, and eyelids. Histopathology shows perifollicular epitheloid cell granuloma. Though numerous therapies, ranging from cyclines, macrolides, dapsone tranilast, isotretinoin, steroids, and tacrolimus have been tried, the results are inconsistent, except with systemic steroids. One approach is to administer therapies based on the histological findings and the corresponding mode of action of drugs, thus antibiotics and dapsone are effective in the early inflammatory stage while clofazamine can be used in the granulomatous stage of the disease. A case of LMDF, recalcitrant to multiple systemic therapies, who responded dramatically to cyclosporine (50 mg twice daily), which probably was due to the specific effect on T_H1 cell response which mediates cell mediated immunity responsible for granulomatous changes on histology has been reported. This case highlights that LMDF is an independent granulomatous entity (not a variant of rosacea or tuberculosis).

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Announcement

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Periodontitis and risk of psoriasis: another comorbidity

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Better data on psoriasis and psyche: but do they really reach the clinician?

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Forthcoming Events

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Issue Information

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Increased filaggrin expression in oral lichenoid lesions: is this cause or effect?

http://ift.tt/2qh6hsR

Influence of surface modified dental implant abutments on connective tissue attachment: A systematic review

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Mónica Blázquez-Hinarejos, Raúl Ayuso-Montero, Enric Jané-Salas, José López-López
ObjectiveDetermine whether surface modified prosthetic abutments for dental implants influence connective tissue attachment to the implant-abutment system.DesignA systematic review was conducted using the MEDLINE-PubMed database, with two independent reviewers filtering the titles and abstracts. Two reviewers assessed all potentially relevant articles. An assessment was carried out on the level of evidence of the research according to the guidelines of the Oxford Centre for Evidence-Based Medicine (OCEBM).ResultsAfter an initial search, 109 potentially relevant articles were found. After reading the titles and abstracts, 99 articles were excluded because the surface treatment was limited to the implant and not to the abutment, or because different materials were analysed instead of surface treatments; 28 were also duplicate articles. An additional 6 research studies were included that were of interest and were found by reading the references of the included articles. The studies included are: 7 in vitro studies, 5 experimental studies in animals, 2 clinical trials in humans and 2 clinical cases.ConclusionSurface modification for prosthetic abutments on dental implants can achieve connective tissue attachment to the abutment; however, more studies should be conducted in humans to obtain more and better evidence of these results.



http://ift.tt/2qa4F7J

Stimulation of human gingival fibroblasts viability and growth by roots treated with high intensity lasers, photodynamic therapy and citric acid

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Paula Stephania Brandão Hage Karam, Rafael Ferreira, Rodrigo Cardoso Oliveira, Sebastião Luiz Aguiar Greghi, Maria Lúcia Rubo de Rezende, Adriana Campos Passanezi Sant'Ana, Mariana Schutzer Ragghianti Zangrando, Carla Andreotti Damante
ObjectiveThe aim of this study was to compare the effect of root biomodification by lasers, citric acid and antimicrobial photodynamic therapy (aPDT) on viability and proliferation of human gingival fibroblasts (FGH).DesignGroups were divided in control (CC – only cells), and root fragments treated by: scaling and root planing (positice control – SC), Er:YAG (ER–60mJ,10pps,10Hz,10s,2940nm), Nd:YAG (ND–0.5W,15Hz,10s,1640nm), antimicrobial photodynamic therapy (PDT–InGaAIP,30mW,45J/cm²,30s,660nm,toluidine blue O), citric acid plus tetracycline (CA). Fibroblasts (6th passage, 2×10³) were cultivated in a 24-h conditioned medium by the treated root fragments. Cell viability was measured by MTT test at 24, 48, 72 and 96h. In a second experiment, FGH cells (10⁴) were cultivated on root fragments which received the same treatments. After 24, 48, 72h the number of cells was counted in SEM pictures. In addition, chemical elements were analyzed by energy dispersive spectroscopy (EDS). Data was analyzed by two-way ANOVA (first experiment), repeated measures ANOVA (second experiment) and ANOVA (EDS experiment) tests complemented by Tukey's test (p<0.05).ResultsND, PDT and CA promoted higher cell viability (p<0.05). ND and ER groups presented higher number of cells on root surfaces (p<0.05). ER group presented higher calcium and CA group a higher carbon percentages (p<0.05).ConclusionsAll treatments but scaling and root planing stimulated fibroblast viability while Er:YAG and Nd:YAG treated root surfaces presented higher number of cells.



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Dermoscopy enhances insight into correct diagnosis

http://ift.tt/2p64KYM

Dermoscopy pathology correlation in melanoma

Abstract

Dermoscopy is a widely used technique whose role in the clinical (and preoperative) diagnosis of melanocytic and non-melanocytic skin lesions has been well established in recent years. The aim of this paper is to clarify the correlations between the "local" dermoscopic findings in melanoma and the underlying histology, in order to help clinicians in routine practice.

http://ift.tt/2oLbxUh

Issue Information

http://ift.tt/2p5XAUl

Dermoscopic evaluation of melanonychia

Abstract

The prevalence of melanonychia is approximately 1%, and it is a common symptom encountered in daily practise. However, it may also be the first symptom of melanoma of the nail apparatus. Evaluation of adult melanonychia with clinical information and clinical images is sometimes difficult for clinicians. Dermoscopic observation provides important information based on the algorithm method. Melanonychia in children requires a different approach, because dermoscopic features observed in adult nail apparatus melanoma are generally observed in benign pediatric cases.

http://ift.tt/2p5UbVs

Dermoscopy–pathology relationship in seborrheic keratosis

Abstract

Making a definitive diagnosis of seborrheic keratosis (SK) can be challenging for the naked eye due to its wide variation in clinical features. Fortunately, however, most cases of SK exhibit the typical dermoscopic findings of fissures and ridges, hairpin vessels with white halo, comedo-like openings, and milia-like cysts, all of which are helpful to distinguish SK from melanoma, melanocytic nevus, squamous cell carcinoma, basal cell carcinoma (BCC) and other skin tumors. Histopathologically, these dermoscopic characteristics correspond to papillomatous surface of the epidermis, enlarged capillaries of the dermal papillae, pseudohorn cysts in the epidermis opened to the surface of the lesion and intraepidermal cysts, respectively. Clinicians should bear in mind that the clonal type of SK dermoscopically mimics melanoma and BCC by the presence of globule-like structures, while regressing SK exhibits a granular pattern that is similar to the peppering found in melanoma. Furthermore, milia-like cysts alone are insufficient for a conclusive diagnosis of SK because melanoma in rare cases displays cysts along with other SK-like dermoscopic findings.

http://ift.tt/2oLcD2r

Review of vasculature visualized on dermoscopy

Abstract

Dermoscopy is a useful tool for finding and screening skin tumors, especially skin cancers. It is well known that it is useful to diagnose pigmented tumors, such as melanocytic lesions. In recent years, after the publication of a revised two-step algorithm in 2010, dermoscopy gradually has been used to diagnose non-pigmented or non-melanocytic lesions based on their vascular structures. Some skin lesions have specific vascular structures that aid in diagnosis. In this review, I discuss the various patterns of the vascular structures and their distribution, focusing on their clinical importance and usefulness in daily medical treatment.

http://ift.tt/2oKYlPk

Issue Information

http://ift.tt/2p5VOm0

Abundance of the benign melanocytic universe: Dermoscopic–histopathological correlation in nevi

Abstract

The broad universe of "melanocytic nevi" includes a variety of different subtypes, which can be classified either due to their morphology, epidemiology, genetic alterations or risk for developing melanoma. Regarding morphology, on the one hand macroscopic/clinical and on the other hand histopathological appearance were used to subdivide in the past, often resulting in confusion and poor interobserver agreement, while nowadays dermoscopy presents the clinician's precious bridge between naked-eye examination and histopathological diagnostics, allowing prediction of the lesions' histopathology, follow up and monitoring over time without need of excision. The non-invasive dermoscopic examination relies on the assessment of colors, patterns and the distribution of both within a cutaneous lesion. Until today, the correspondence of certain dermoscopic colors and patterns to certain histopathological correlates has been reported for a huge amount of different cutaneous lesions. Moreover, the correspondence of certain dermoscopic features to certain body sites, age groups and pigmentary traits, but also to specific genetic alterations in lesions, has been broadly investigated. Dermoscopy has led us to a new understanding of melanocytic nevi's biology and evolution and, last but not least, to a new classification system, which we want to present herein.

http://ift.tt/2oLd6kU

Candida albicans-induced pustular lesions in mice

http://ift.tt/2p60ati

Estimating melanin location in the pigmented skin lesions by hue–saturation–lightness color space values of dermoscopic images

Abstract

The depth of melanin in the skin can be estimated roughly by observation of the color exhibited on dermoscopy. Currently, there are no objective methods to estimate it. The aim of the present study was to clarify the relationship between the depth of melanin in the skin and the color variation exhibited, and to objectively estimate the 3-D location of melanin in the pigmented skin lesions from dermoscopic images. Representative colors in dermoscopic images of acral compound nevus, Spitz nevus and blue nevus were evaluated by the subjectively perceived color on dermoscopy and objective values in hue–saturation–lightness color space values. Brown colors due to small quantities of superficial melanin in the skin had high saturation and low lightness values, whereas black colors due to large quantities of superficial melanin had low saturation and low lightness values. On the other hand, colors due to melanin in the dermis were perceived as blue–gray on dermoscopy, but extracted colors showed gray–brown hue and intermediate saturation and high lightness values. In all cases, extracted representative colors of pigmented skin lesions had similar hue values within the red–orange range. Objective estimation of the 3-D location of melanin in the pigmented skin lesions is possible by the saturation and lightness values of the colors extracted from dermoscopic images. Subjectively perceived colors of melanin, especially in the dermis, can be modified by the surrounding environment effect and blue color perception.

http://ift.tt/2oKYiTE

Serum vitamin D level is related to disease severity in pediatric alopecia areata

Summary

Background

Alopecia areata (AA) is the most common cause of inflammatory hair loss. AA is considered an autoimmune disease and occurs with various autoimmune disorders. Recent studies have revealed connection between autoimmune diseases and vitamin D deficiency.

Objectives

In this study, we investigated vitamin D status in AA and its relationship with disease severity, number of patches, and disease duration.

Methods

This study included 20 pediatric patients with AA and 34 pediatric healthy controls. The serum vitamin D levels were evaluated.

Results

The mean serum 25(OH)D concentration of patients was 15.47±7.66 ng/mL and of control group was 11.09±10.53 ng/mL. There was no statistically significant difference between two groups (P: .084). Vitamin D concentration had significantly and negatively correlated with SALT score (P<.001 and r: −.831), number of patch (P<.001 and r: −.989), and disease duration (P<.001 and r: −.997).

Conclusion

Vitamin D deficiency is not the only etiologic factor in AA pathogenesis, but in the presence of other etiological factors, this deficiency can aggravate AA severity, and thus, vitamin D supplementation may be beneficial in treatment of pediatric AA.

http://ift.tt/2oygfcZ

The Upper Paleolithic man from Markina Gora: Morphology vs. genetics?

Abstract

The latest results of anthropological studies of bone remains from the earliest Upper Paleolithic burial discovered on Russian territory, the Markina Gora site (Kostenki 14), are described. Multivariate statistical methods and parallel studies of the buried skull structure and dentition established that their morphological characteristics undoubtedly belonged to the Caucasian complex. In combination with paleogenetic data, the findings contradict the earlier hypothesis of the southern origin of the Kostenki 14 individual and its similarity to the population of the Australo-Melanesian region.

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Variable polyrhythmicity of processes in nature and society

Abstract

The authors discuss possible causes of the variable polyrhythmicity of processes in nature and society, particularly in geophysics. It may be caused by desynchronization or resynchronization of processes that manifest themselves as a result of a shock impact on the geological environment, for example, in the form of an earthquake. Medical parameters are considered for which de- and resynchronization of rhythmic processes in the human organism are known, as well as geophysical processes, including underground noise of tidal origin and the seismicity of the Moon.

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Lasers in modern clinical practice

Abstract

Many new developments in laser medical equipment, as well as laser diagnostic technologies and treatment, are based on the results of basic research conducted at the Prokhorov Institute of General Physics, RAS. The introduction of these results into the clinical practice of Russian health care and their use in ophthalmology, neurosurgery, urology, cosmetology, dermatology, photodynamic therapy, autofluorescence and photodynamic diagnostics, and minimally invasive diagnostics of exhaled air are considered.

http://ift.tt/2q8kyIU

Molecular and biotechnological methods of creating genetic resources for vegetable crops

Abstract

The results obtained by the research team of the All-Russia Research Institute of Selection and Seed Breeding for Vegetable Crops are presented. Specific examples demonstrate the efficacy of methods and technologies that create genetic resources for vegetable crops: the cytogenetic GISH and FISH methods, the doubled haploid technology in the culture of unpollinated ovules, and molecular marking used as a specific and varietal identifier of vegetable crops and for the study and identification of genes responsible for agronomic characters. The results of regular phytosanitary monitoring are considered separately: identifying the composition of pathogenic species not recorded previously in vegetable crops in individual regions and throughout the country in general and developing the scientific basis for the evaluation and selection of vegetable crops with a highly effective antioxidant system to design socially and economically important functional food products.

http://ift.tt/2oyAPK3

Sanctions and import substitution as exemplified by the experience of Iran and China

Abstract

The problem of the effectiveness of external sanctions as an instrument of pressure on three states that have adhered to but have abandoned the course of self-reliance is considered. The constructive base of this study is the idea of a conservative project that finds its imperative in reindustrialization. It is shown that the experience of new Russia has yielded the worst results, while China has demonstrated the best outcomes. Iran falls in between.

http://ift.tt/2q8gjgm

Genetic methods of creating new varieties of garden plants

Abstract

The efficiency of targeted breeding of new varieties of fruit and berry crops and grapevines with characters that meet modern cultivation technologies and consumer demand depends on the inclusion of donors and sources with prominent agronomic characters in hybridization. This paper emphasizes the importance of studying, preserving, and replenishing genetic collections to accelerate and increase breeding effectiveness and the high significance of donors and sources with identified genes responsible for the presence of characters in new genotypes. The results of improving the assortment of fruit and berry crops to reach a new level of fruit and berry production are shown.

http://ift.tt/2q8d1tN

Joint interview of Martin Mos, Chief Operating Officer (COO) Springer Nature, and Аlexander Shustorovich, President of Pleiades Publishing

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Basic science as a crucial element in the modern system of national security

Abstract

The role of basic science in qualitative improvement of the national defense potential is considered. The exceptional strategic importance of the results obtained during basic research for military security and the necessity to expand their practical application for these purposes are shown. The authors propose to increase the efficiency of the organizational mechanism of control of defense-oriented basic research and discuss possible consequences of the reorganization of the Russian Academy of Sciences in terms of Russia's defense potential.

http://ift.tt/2q8k9WX

Genetic resources of plants, animals, and microorganisms as the basis for basic agricultural research

Abstract

The significance of the genetic resources of plants, animals, poultry, and useful and harmful microorganisms can hardly be overestimated. Living organisms, carrying a specific set of genes of their own, guarantee life on the Earth. In Russia, the genetic resources of grains, fodder, fruit, and vegetable crops; cattle; sheep; horses; and poultry have been collected for many hundred years due to monastery lands, estates of progressive landowners, exchange of animals between governorates, and imports of cattle and horses. Gradually, the best samples were concentrated in scientific organizations and experimental enterprises and were used to obtain high indicators of productivity.

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Ensuring the safety of genetically engineered and modified organisms for food production

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The creation of high-yield animal and poultry breeds and crosses

Abstract

As a result of recent basic research by teams of research institutions of the Federal Agency for Scientific Organizations (FASO Russia) in coordination with institutes of the Russian Ministry of Agriculture, the Russian Academy of Sciences, and regional pedigree enterprises, new breeding forms in cattle raising, hog farming, sheep farming, horse breeding, fishery, and poultry farming have been created and assimilated. Traditional breeds that ensure import substitution of genetic resources of animals necessary to intensify meat and dairy production have been improved. In recent decades, more than 40 new and improved breeding forms of animals have been created, providing for about two-thirds of the total gain of livestock products per year.

http://ift.tt/2oyqiyk

Metagenomic technologies of detecting genetic resources of microorganisms

Abstract

Although metagenomics is a relatively new scientific trend, it has managed to become popular in many countries, including Russia, over its 20-year history. This division of molecular genetics studies ecosystem- extracted nucleic acids (DNA and RNA), which contain full information about the microbial community of a habitat. Owing to metagenomic methods, soil microbiology has undertaken to study not only known cultivated types of microorganisms but also noncultivated forms, the biological properties of which can be suggested exclusively from the genetic information coded in their DNA. It turns out that such "phantom" types constitute the overwhelming majority within soil microbial communities; to all appearances, they actively participate in ensuring soil fertility, and, hence, in the opinion of the authors of this paper, study of them is topical for both basic research and agricultural practice. The development of metagenomic technologies will help understand biological phenomena determined by close plant–microbe interactions, such as increasing the productivity of agricultural crops and protecting them against phytopathogens. However, the introduction of new methods has always presented difficulties; in metagenomics, they are associated with the acquisition, storage, and bioinformational analysis of a huge array of genetic information.

http://ift.tt/2q8kuZG

The military–strategic and humanitarian significance of the defense of Leningrad

Abstract

The authors of this article respond to V.A. Nekhamkin's call to answer the counterfactual challenge of the past related to the question of surrendering Leningrad in the course of the Great Patriotic War. Refuting numerous pseudoscientific investigations of revisionists of the history of that war, the authors show the misanthropic essence of the Third Reich's plans with respect to the Soviet Union in general and Leningrad in particular and, using the logic of alternative history, analyze, first, possible actions of the military–political leadership of Nazi Germany in a situation similar to the blockade of Leningrad and, second, possible military consequences of the loss of the city on the Neva River. From the point of view of military science and humanitarian considerations, it is proved that the actions of the Soviet command in defending Leningrad were not only right but also that no alternative existed.

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Molecular–genetic and immunobiochemical markers in assessing the health of agricultural animals

http://ift.tt/2q8wRVx

Breeding new varieties and hybrids of agricultural plants

Abstract

The author attracts attention to the mobilization, investigation, and use of genetic resources of cultivated plants to create state-of-the-art adaptive stress-resistant varieties and hybrids of various (grain, legume, oil-bearing, fruit, vegetable, feed, and medicinal) crops. It is emphasized that constant replenishing of the plant genetic pool and the rational use of plants in breeding are the basis for the country's food security. Priority tasks in research on genetic resources are outlined.

http://ift.tt/2oyCVd5

History and current status of reserve management and study in Russia

Abstract

A brief history of reserve management and study in Russia is presented; the background of modern ideas of reserves that established various approaches to the formation of a network of specially protected natural territories is analyzed. The author holds to the classical ideas of reserves, which were formulated by domestic scientists V.V. Dokuchaev, I.P. Borodin, G.A. Kozhevnikov, and V.P. and A.P. Semenov-Tyan-Shanskii, and insists on the necessity to retain their status as "inviolable territories of virgin nature taken under protection for ever and ever." This article is dedicated to the Year of Specially Protected Natural Territories of Russia (2017), announced by a decree of the Russian President. The author calls for a moratorium on the withdrawal of conservation territories for economic and recreational and tourist purposes.

http://ift.tt/2q8aEqy

Status and prospects of marker-assisted and genomic plant breeding

Abstract

State-of-the-art approaches to obtaining new plant varieties based on the potential of traditional breeding and the use of modern methods and achievements in genetics and genomics are considered. The opportunities and advantages of marker-assisted and genomic selection, as well as the importance of developing advanced methods in phenomics and genome editing, are discussed.

http://ift.tt/2oyqgXe

A counterfactual challenge of the past: Ways of negotiation

Abstract

The question about the influence of unrealized options of the past on the present is considered. In this context, the notion counterfactual challenge of the past is formulated. By the example of two stably reproduced alternative scenarios (the surrender of Leningrad in the years of the Great Patriotic War and the autonomous existence of "the Island of Crimea" in 1920–1970), the author shows the necessity to respond to such challenges using scientific assessments and public consultation on the propriety of one scenario or another. Long-term negative consequences of ignoring such challenges and methods to neutralize them are shown.

http://ift.tt/2q8nTb1

Directed conversion of protein modules of plant and animal foods

Abstract

Activity within the food and manufacturing industries is based on factors that affect the state of the food market and improve the quality of life. A subject of inquiry for scientists who work in this sphere is systems of transforming plant and animal raw materials into foods. In the course of production, the nutrition and energy value of foods, their safety for humans and the environment, and consumer properties are controlled. The success of studies is determined by the multidisciplinary approach, perfectly interfacing different scientific trends—medicine, biology, physics, chemistry, agriculture, etc.

http://ift.tt/2oyCT4X

Unilateral Fungal Sphenoiditis Presenting with Diplopia and Ptosis

http://ift.tt/2pi2QTp

Efficacy of TRT Using Noise Presentation from Mobile Phone

Abstract

The purpose of tinnitus retraining therapy (TRT) is to induce habituation, first of the reaction to the tinnitus signal, and subsequently to habituate the perception of tinnitus itself. Habituation of sound is achieved through sound treatment which involves the use of low-level broadband noise mainly through noise maskers. Noise maskers are costly hence there is a need to find an alternate source of noise like MP3 and mobile phones. The goal of present study was to find out whether persons with tinnitus may be successfully treated with TRT using sound treatment from the noise presented through mobile phones. Total 30 male adult patients with tinnitus were enrolled for TRT. TRT comprised of two activities i.e. directive counseling and sound treatment. The most efficient noise stimulus was tape recorded by presenting the noise in the sound field using speakers and was recorded using a digital tape recorder. The recorded noise was saved to the mobile phone of the person with tinnitus and was asked to play it using hands-free at the level which was just audible for the duration of 3–4 hours per day. The Tinnitus interview forms were used to measure: (1) Percentage awareness of tinnitus, (2) Percentage of the time it caused distress and (3) Number of life factors affected. After 6 months these measurements were repeated and an improvement score of 40% was taken as criteria for the significant success of TRT. Out of 30 patients, 25 could continue coming for follow up sessions. Out of these 25 patients, 17 patients (68%) showed significant improvement. The sound treatment may be provided with the help mobile phones, which is a cheaper substitute for costly noise maskers.

http://ift.tt/2p4hjDQ

Hypersensitivity reactions in patients receiving hemodialysis

To describe hypersensitivity reactions in patients receiving maintenance hemodialysis.

http://ift.tt/2oxZZsg

Higher fractional exhaled nitric oxide and Der p 1 exposure in children with asthma living in tropical environments

The interaction between environmental exposure and airway inflammation in pediatric asthma is multifactorial, but a specific clinical association exists.1,2 We attempted to study allergens common to our patient population who live in 2 distinctly different indoor environments and their effect on markers of airway inflammation. Our primary objective was to evaluate specific allergen sensitivities and exposures that would affect clinical airway inflammatory markers.3,4 Skin test results and levels of indoor allergens of dust mites, cat, dog, and cockroach were examined and compared with respiratory markers, fractional exhaled nitric oxide (FeNO) and spirometry, and systemic atopic markers, serum eosinophils, and total IgE.

http://ift.tt/2q81CtQ

Akzeptanz emotionssensitiver Trainingssysteme von Patienten mit Fazialisparese und deren Angehöriger

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-100764

Neue telemedizinische Technologien können Versorgungsprobleme lösen, die durch den demografischen Wandel erwartet werden. Die vorliegende Studie untersuchte deshalb die Akzeptanz emotionssensitiver Trainingssysteme für Menschen mit Fazialisparese. Es wurden N=76 Patienten mit Fazialisparese und N=44 Angehörige mit Fragebögen befragt (Technikakzeptanz, Technikaffinität, körperliche und psychische Lebensqualität (SF36), Depressivität (PHQ9), soziale Ängste (LSAS) und Funktionsstörungen einzelner Gesichtsregionen (FACE, nur Patienten)). Selbsterstellte Items erfassten die Einstellung hinsichtlich des erwarteten therapeutischen Nutzens, Datenschutz, und Mensch-Trainingssystem-Interface. Patienten- und Angehörigengruppe wurden im Hinblick auf die Mittelwerte der Fragebogenskalen verglichen. Prädiktoren der Akzeptanz der Patienten wurden mit einem Strukturgleichungsmodell untersucht. Patienten und deren Angehörige beurteilten Nutzen, Datenschutz und Gestaltung des Interfaces durchgängig positiv. Es gab keine signifikanten Unterschiede zwischen Patienten und Angehörigen. Der stärkste Prädiktor für die Technikakzeptanz der Patienten war die Technikkompetenz. Des Weiteren war die Akzeptanz umso größer, je depressiver die Patienten und je eingeschränkter ihre Mimik war. Emotionssensitive Trainingssysteme scheinen aus Sicht der Befragten eine sinnvolle therapeutische Option darzustellen. Insbesondere Patienten mit starken Beeinträchtigungen würden solche Technologien akzeptieren. Bei der Entwicklung solcher Systeme sollte auf eine einfache Bedienbarkeit geachtet werden. New technologies in telemedicine may be able to solve impeding supply gaps which are associated with demographic change in Germany. This study evaluated the acceptance of emotion-sensitive training systems for individuals with facial palsy. 76 patients with facial-paralysis and 44 of their relatives where surveyed for technology acceptance and affinity, mental and physical health-related quality of life (HrQoL), depression (PHQ9), social anxiety (LSAS) and dysfunction of facial expression (FACE, patients only). Additional items assessed the patients̓ attitudes regarding therapeutic benefit, data protection and design of human-machine-interfaces. We compared patients and their relatives with univariate tests. Predictors of the patients' technology acceptance were analysed using a Structural Equation Model. Patients and their relatives reported positive attitudes towards therapeutic benefit, data protection and design of the interfaces. No significant differences between both groups were found. The strongest predictor of patients̓ technology acceptance was their technical competence. Furthermore, patients with more severe impairment of facial expression and higher depression scores rated significantly higher acceptance. Emotion-sensitive training systems for patients with facial palsy seem to be a useful therapeutic option if the patients̓ attitudes are considered. Especially patients with severe impairment would accept telemedicine technologies. One focus of the development of such systems should be easy handling of human-machine-interfaces.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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

http://ift.tt/2q7OHb9

How to treat a patulous Eustachian tube

We would like to comment on the manuscript entitled "Endoscopic autologous cartilage injection for the patulous Eustachian tube" by Oh et al. [1]. This is an interesting study and excellent work. Although a patulous Eustachian tube (ET) is not usually seen in otorhinolaryngology clinics, it may cause aural fullness and autophony of the voice or breath sounds, negatively affecting the patient's quality of life. The relief of these symptoms is important. Although many scholars have proposed treatment methods, no ideal method has been developed due to the small sample size, short follow-up, and complications seen in the various studies.

http://ift.tt/2qge75X

Teaching and practice patterns of lateral osteotomies for rhinoplasty

Publication date: Available online 26 April 2017
Source:American Journal of Otolaryngology
Author(s): Jenny X. Chen, Elliott D. Kozin, Matthew M. Dedmon, Linda N. Lee
PurposeLateral osteotomies are important during rhinoplasty and represent a challenging technique that otolaryngology and plastic surgery trainees must learn. The approaches for osteotomies are difficult to teach as they are accomplished through tactile feedback. Trends in teaching and practice patterns of lateral osteotomies are poorly described in the literature, and this study aims to fill this knowledge gap.Materials and methodsMembers of the American Academy of Facial Plastic and Reconstructive Surgery were surveyed to characterize surgeon preferences for intranasal versus percutaneous lateral osteotomies and understand how techniques are taught.ResultsAmong surgeons who completed the survey (n=172), 87% reported that they "always" or "mostly" use intranasal lateral osteotomies whereas only 8% "always" or "mostly" use percutaneous approaches. There is no significant trend towards changing osteotomy techniques when teaching trainees. Only 15% of respondents allow trainees to perform lateral osteotomies in more than half of operations.ConclusionsMost facial plastic surgeons prefer to use intranasal lateral osteotomies. However, many do not allow trainees to perform this critical step during rhinoplasty. This study has implications for both patient care and surgical education.



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Skull base osteomyelitis secondary to malignant otitis externa mimicking advanced nasopharyngeal cancer: MR imaging features at initial presentation

Publication date: Available online 26 April 2017
Source:American Journal of Otolaryngology
Author(s): J.P.N. Goh, A. Karandikar, S.C. Loke, T.Y. Tan
PurposeSkull base osteomyelitis (SBOM) is an inflammatory process which often arises from malignant otitis externa (MOE); the diffuse skull base and adjacent soft tissue involvement may be mistaken at initial imaging for advanced nasopharyngeal carcinoma (NPC), especially if there is no prior knowledge of MOE, direct spread from the sphenoid sinus or in atypical presentations of MOE. This study aims to evaluate imaging features on MR that may differentiate SBOM from NPC.Materials and MethodsThe MR examinations of 26 patients diagnosed with SBOM between January 1996 and January 2013 were retrospectively reviewed. Comparison was also made with the MR images of 22 consecutive patients with newly diagnosed advanced T3 and T4 NPC between July 2011 and August 2012. Imaging features in both conditions were compared, including the presence of a nasopharyngeal bulge, nasopharyngeal mucosal irregularity, lateral extension, architectural distortion (or lack thereof), increased T2 signal and enhancement patterns.ResultsThe most prevalent findings in SBOM were lateral extension, increased T2 signal in adjacent soft tissues, lack of architectural distortion and enhancement greater than or equal to mucosa. The combination of these 4 findings was found to best differentiate SBOM from advanced NPC, and found to be statistically significant (p<0.001).ConclusionWe suggest that the combination of lateral extension, increased T2 signal, lack of architectural distortion and enhancement greater than or equal to mucosa is helpful in differentiating SBOM from advanced NPC.



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Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit

Publication date: Available online 25 April 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Daniel Peñaranda, Juan Manuel Garcia, Maria Leonor Aparicio, Felipe Montes, Clemencia Barón, Roberto C. Jiménez, Augusto Peñaranda
IntroductionThe bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision.ObjectiveTo assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids.MethodsThis was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0=none; Grade 1=erythema; Grade 2=erythema and discharge; Grade 3=granulation tissue; and Grade 4=inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit.ResultsA total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p=0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications.ConclusionDespite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of patients with bone-anchored hearing aids.



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Functional Interplay Between the Putative Measures of Rostral and Caudal Efferent Regulation of Speech Perception in Noise

Abstract

Efferent modulation has been demonstrated to be very important for speech perception, especially in the presence of noise. We examined the functional relationship between two efferent systems: the rostral and caudal efferent pathways and their individual influences on speech perception in noise. Earlier studies have shown that these two efferent mechanisms were correlated with speech perception in noise. However, previously, these mechanisms were studied in isolation, and their functional relationship with each other was not investigated. We used a correlational design to study the relationship if any, between these two mechanisms in young and old normal hearing individuals. We recorded context-dependent brainstem encoding as an index of rostral efferent function and contralateral suppression of otoacoustic emissions as an index of caudal efferent function in groups with good and poor speech perception in noise. These efferent mechanisms were analysed for their relationship with each other and with speech perception in noise. We found that the two efferent mechanisms did not show any functional relationship. Interestingly, both the efferent mechanisms correlated with speech perception in noise and they even emerged as significant predictors. Based on the data, we posit that the two efferent mechanisms function relatively independently but with a common goal of fine-tuning the afferent input and refining auditory perception in degraded listening conditions.

http://ift.tt/2qfEetN

Functional Interplay Between the Putative Measures of Rostral and Caudal Efferent Regulation of Speech Perception in Noise

Abstract

Efferent modulation has been demonstrated to be very important for speech perception, especially in the presence of noise. We examined the functional relationship between two efferent systems: the rostral and caudal efferent pathways and their individual influences on speech perception in noise. Earlier studies have shown that these two efferent mechanisms were correlated with speech perception in noise. However, previously, these mechanisms were studied in isolation, and their functional relationship with each other was not investigated. We used a correlational design to study the relationship if any, between these two mechanisms in young and old normal hearing individuals. We recorded context-dependent brainstem encoding as an index of rostral efferent function and contralateral suppression of otoacoustic emissions as an index of caudal efferent function in groups with good and poor speech perception in noise. These efferent mechanisms were analysed for their relationship with each other and with speech perception in noise. We found that the two efferent mechanisms did not show any functional relationship. Interestingly, both the efferent mechanisms correlated with speech perception in noise and they even emerged as significant predictors. Based on the data, we posit that the two efferent mechanisms function relatively independently but with a common goal of fine-tuning the afferent input and refining auditory perception in degraded listening conditions.

http://ift.tt/2qfEetN

Chronic Opioid Use Following Surgery for Oral Cavity Cancer

This cohort study assesses the prevalence of chronic opioid use in patients undergoing surgery for oral cavity cancer and evaluates possible associated clinical factors.

http://ift.tt/2p4w5L0

Margin Distance and Local Recurrence Rate in Oral Cancer Surgery

This cohort study of patients with surgically treated oral cavity squamous cell carcinoma evaluates the association between risk of local recurrence and different sizes, in 1-mm increments, of cancer-free surgical margins.

http://ift.tt/2oJYl1V

Maintenance Treatment of Apatinib in Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Carcinoma
Intervention:   Drug: Apatinib mesylate tablet
Sponsors:   Guilin Medical University, China;   Wuzhou Red Cross Hospital;   Guangxi Naxishan Hospital;   National Hospital of Guangxi Zhuang Autonomous Region
Recruiting - verified April 2017

http://ift.tt/2qfhx8U

Study to Evaluate Immunological Response to PD-1 Inhibition in Squamous Cell Carcinoma of the Head and Neck (SCCHN)

Condition:   Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: [18F]F-AraG PET Scan, baseline + post anti-PD-1 therapy.;   Drug: [18F]F-AraG PET Scan, baseline + post anti-PD-1 therapy.
Sponsors:   CellSight Tehnologies, Inc.;   Stanford University
Not yet recruiting - verified April 2017

http://ift.tt/2pmfwdV

Oligo-metastases NPC Patients Received Radiation for Primary Tumors and Treatments for Metastatic Lesions

Conditions:   Nasopharyngeal Cancer;   Neoplasm Metastasis
Intervention:   Radiation: radical radiotherapy
Sponsor:   Zhejiang Cancer Hospital
Recruiting - verified April 2017

http://ift.tt/2qfgdTp

Occupational Dermatitis Associated With Pyemotes ventricosus

This case series examines 18 employees of a company that produced herbal medicines who experienced unusual pruritic dermatitis.

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Annular Flaccid Pustules on the Trunk

This case examines a woman in her 50s who presented with itching skin lesions.

http://ift.tt/2q8deQe

Sweet’s-Like Infiltrate After Talimogene Laherparepvec Melanoma Treatment

This case report describes complete response of advanced melanoma treated with talimogene laherparepvec and subsequent Sweet's-like infiltrate

http://ift.tt/2pj82Xf

Errors in Figure Panel Labels

In the case report titled "BRAF V600E mutation in involuting nevus in a patient treated with vemurafenib," published online March 1, 2017, The Figure panel labels for panels C and D were incorrect. Each should read "Nevus specimen after complete excision." This article was corrected online.

http://ift.tt/2q8zmtP

Suggestions for Increasing Diversity in Clinical Trials

To the Editor The article by Charrow et al discusses the gap in proportional racial representation in clinical trials. We applaud the authors for bringing this topic to the forefront. One shortcoming of the article, however, is that it does not discuss measures for correcting this gap. Therefore, the purpose of this letter is to provide suggestions derived from clinical trial literature to improve minority participation.

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Enhancing the Relevance of Skin Self-examination for Latinos

This study solicits information from Hispanic focus groups to enhance the relevance of skin self-examination in the Latino community.

http://ift.tt/2q86Mst

Connective Tissue Nevi in Tuberous Sclerosis Complex

This analysis of patient medical records and skin photography describes the clinical characteristics of connective tissue nevi on the trunk and extremities of patients with tuberous sclerosis complex.

http://ift.tt/2pj1o3b

Noninvasive 2-Gene Molecular Assay for Cutaneous Melanoma

This multiple-reader–multiple-case study examines the utility of a noninvasive pigmented lesion assay for LINC/PRAME expression in decisions by dermatologists to biopsy a series of suspicious skin lesions.

http://ift.tt/2q8wz3Q

Birth decade affects the sensitization pattern and asthma-risk in Finnish adult population

Abstract

Background

We have previously shown that sensitizations to several types of allergens distinguishes subjects with and without adult-onset asthma in Finland. The aim was to analyze how age affects sensitization and asthma-risk.

Methods

We used previous population-based case-control data (N=523) from Finnish adult asthma patients with one or two matched controls. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. Allergic sensitization was determined by skin prick test (SPT) to 17 aeroallergens. Information on demographics was obtained by a questionnaire.

Results

Sensitization to more than one allergen type and the number of positive SPT reactions associated with younger age and asthma. Atopic subjects aged 65 or over were characterized by sensitization to only 1-2 allergens, with very few animal danders and without an association with asthma.

Conclusions

Multiple sensitizations and animal dander sensitization are more common among Finnish asthmatic adults aged under 56 than among older asthmatics. Cohort studies are needed to understand timing of host-environmental interactions behind this.

This article is protected by copyright. All rights reserved.

http://ift.tt/2piS2o5

Changing use and attitudes towards teledermatology in the UK over 10 years: results of the 2016 National Survey

Abstract

Dermatology has been described as a speciality in crisis in the UK, with a shortfall of 250 dermatologists nationally combined with steadily increasing referrals and skin cancer incidence¹. This has fuelled interest in teledermatology (TD). TD utilises telecommunication technology at a distance to exchange medical information. Most commonly this is via store and forward techniques, which involve transmission of patient images and information to a teledermatologist to enable consultation not in real-time.

This article is protected by copyright. All rights reserved.

http://ift.tt/2q837uQ

Paradoxical psoriasiform reactions to anti-TNFα drugs in hidradenitis suppurativa

Abstract

Paradoxical psoriasiform reactions to anti-tumor necrosis factor α (TNFα) agents occur with an incidence of 0.3 to 5.6% in patients with inflammatory bowel diseases and rheumatic diseases¹. Various clinical features have been described while histopathological findings often show lichenoid infiltrate, spongiosis associated with a psoriasiform pattern and a "type I interferon (IFN) signature " in immunohistochemistry²

This article is protected by copyright. All rights reserved.

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Alitretinoin therapy for palmoplantar pustulosis

Abstract

We read with interest the RCT by Reich et al., and we found that the conclusion given: "this study provided no evidence to support further exploration of alitretinoin in the treatment of severe palmoplantar pustulosis (PPP)" should be carefully interpreted.¹ The authors found no significant difference in the percentage change in PPPASI between the alitretinoin (45.2% ±32.8 of improvement) and placebo (44.6%, ±45.9), 95% CI rate difference -31% to 32%.¹

This article is protected by copyright. All rights reserved.

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Transitions in middlebrow writing, 1880–1930

http://ift.tt/2piJRbn

Leaving the beaten track: the EU regulation on conflict minerals

http://ift.tt/2pizVOY

The effect of boiler conditions on the thermolysis of film forming amine

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Separation of organics and salts with ion-exchange membranes: effect of matrix and organics

Separation of organics and salts with ion-exchange membranes: effect of matrix and organics Ion-exchange membranes (IEM) are expected to be a good candidate to achieve a selective separation between organics and salts, since they are less prone to fouling because of the lack of pressure during operation. This is useful for the application of IEM in the treatment of complex streams by electrodialysis and reverse electrodiaysis for example, especially when wastewater and seawater are used. However, although fouling of IEM has received attention in literature, the transport mechanics of organics is not well understood yet. In a previous study, we showed that the presence of NaCl greatly influences the transport of organics and that this transport seems to be mainly diffusion driven in the presence of salts [1], indicating that operational parameters such as the applied potential have little influence on the transport, but rather matrix and membrane properties will have an effect. This study focusses on the effect of different salt types (NaCl, MgCl2, Na2SO4) and the direction of the transport of the organics relative to the transport of the salts. Both trace organic contaminants (TOrC) and organic acids (OA) are used as a model for organics. Results Three different hypotheses were tested in this research; (1) transport of organics is different in the presence of multivalent salt ions versus monovalent ones, (2) the transport direction of the organics with respect to the salt is important and (3) organics transport is mainly diffusion driven. The tests with multivalent salt ions clearly show that the transport of negatively charged organics is higher in the presence of Na2SO4 and the transport of positively charged organics is higher in the presence of MgCl2 when compared to NaCl. This can be explained by the lower diffusion coefficient of both SO42- and Mg2+ compared to Cl- and Na+ respectively. When salts and organics are dosed in different compartments, Donnan dialysis plays a significant role in diffusion, causing an increase in the organics transport. This was observed both in experiments with and without an external driving force, further confirming the diffusive nature of the organics transport. This was further endorsed by the experiments with OA, where no difference in transport rate can be observed between experiments with and without external driving force. Furthermore, experiments with OA in the absence of salts show a significantly higher transport rate, both with and without a constant current density. This study confirms the diffusive nature of organics transport in the presence of salts. Ongoing research focusses on the influence of membrane characteristics on the transport behaviour of organics, with the ultimate goal of developing tailor-made membranes for the selective separation between organics and salts. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 685579 References [1] Vanoppen, M., Bakelants, A.F. a M., Gaublomme, D., Schoutteten, K.V.K.M., Bussche, J. Vanden, Vanhaecke, L. et al. (2015) Properties Governing the Transport of Trace Organic Contaminants through Ion-Exchange Membranes. Environmental Science & Technology, 49, 489–97.

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In this issue

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The effect of optokinetic stimulation on perceptual and postural symptoms in visual vestibular mismatch patients

Background : Vestibular patients occasionally report aggravation or triggering of their symptoms by visual stimuli, which is called visual vestibular mismatch (VVM). These patients therefore experience discomfort, disorientation, dizziness and postural unsteadiness. Objective : Firstly, we aimed to get a better insight in the underlying mechanism of VVM by examining perceptual and postural symptoms. Secondly, we wanted to investigate whether roll-motion is a necessary trait to evoke these symptoms or whether a complex but stationary visual pattern equally provokes them. Methods : Nine VVM patients and healthy matched control group were examined by exposing both groups to a stationary stimulus as well as an optokinetic stimulus rotating around the nasooccipital axis for a prolonged period of time. Subjective visual vertical (SVV) measurements, posturography and relevant questionnaires were assessed. Results : No significant differences between both groups were found for SVV measurements. Patients always swayed more and reported more symptoms than healthy controls. Prolonged exposure to roll-motion caused in patients and controls an increase in postural sway and symptoms. However, only VVM patients reported significantly more symptoms after prolonged exposure to the optokinetic stimulus compared to scores after exposure to a stationary stimulus. Conclusions : VVM patients differ from healthy controls in postural and subjective symptoms and motion is a crucial factor in provoking these symptoms. A possible explanation could be a central visual-vestibular integration deficit, which has implications for diagnostics and clinical rehabilitation purposes. Future research should focus on the underlying central mechanism of VVM and the effectiveness of optokinetic stimulation in resolving it.

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The effect of optokinetic stimulation on perceptual and postural symptoms in visual vestibular mismatch patients

http://ift.tt/2q5Yuii

Bilingualism, Multilingualism, Globalization, and Superdiversity: Toward Sociolinguistic Repertoire

http://ift.tt/2q5JWiA

EMBalance data repository modeling and clinical application

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Ocular vestibular evoked myogenic potentials (oVEMPs): evaluation of three different electrode positions using a minishaker

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Association between vestibular findings and the motor performance in hearing impaired children

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Vestibular and motor performance in children with uni- and bilateral cochlear implant

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Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport: A Descriptive Study of MRI-Confirmed Reinjuries

http://ift.tt/2plDeqx

Enteritis with pneumatosis intestinalis following rotavirus immunisation in an infant with short bowel syndrome

Rotavirus vaccines now form part of the national immunisation schedule in many countries. Contraindications to its use are few but do not currently include infants with short bowel syndrome (SBS). We present a nearly 3-month-old boy with SBS who developed enteritis with pneumatosis intestinalis following administration of the Rotarix vaccine.

http://ift.tt/2plxeOJ

Paracentral acute middle maculopathy: precursor to macular thinning in sickle cell retinopathy

We present a case of paracentral acute middle maculopathy (PAMM) in a patient with sickle cell disease (SCD). Though gradual capillary loss may contribute to pathophysiology of sickle cell retinopathy as well, our case suggests that PAMM may be the precursor lesion to macular thinning commonly observed in patients with SCD. In addition, fluorescein angiography may be unable to detect these acute vascular events occurring at the deep capillary plexus.

http://ift.tt/2oMh3qs

Scheitern / Failure

Young, CSR; (2007) Scheitern / Failure. [Catalogue]. (1 vols). Bibliothek der Provinz: Austria.

http://ift.tt/2p3Ol7g

The Relationship of Bilingualism Compared to Monolingualism to the Risk of Cognitive Decline or Dementia: A Systematic Review and Meta-Analysis

Mukadam, N; Sommerlad, A; Livingston, G; (2017) The Relationship of Bilingualism Compared to Monolingualism to the Risk of Cognitive Decline or Dementia: A Systematic Review and Meta-Analysis. Journal of Alzheimer's Disease 10.3233/JAD-170131 . (In press). Green open access

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Global Feminisms

Young, CSR; (2007) Global Feminisms. [Group exhibition]. Brooklyn Museum, Brooklyn, New York. 23 March 2007 - 01 July 2007.

http://ift.tt/2p40xEM

Nano-sized Co/Co(OH)(2) core-shell structure synthesized in molten salt as electrode materials for supercapacitors

Wang, X; Xu, R; Wang, R; Wang, H; Brett, DJL; Pollet, BG; Ji, S; (2017) Nano-sized Co/Co(OH)(2) core-shell structure synthesized in molten salt as electrode materials for supercapacitors. Ionics , 23 (3) pp. 725-730. 10.1007/s11581-016-1829-4 .

http://ift.tt/2oJvhb3

Consideration

Young, CSR; (2007) Consideration. [Solo exhibition]. Midway Contemporary Art, Minneapolis. 10 March 2007 - 05 May 2007.

http://ift.tt/2oJs3Ed

Feedforward. The Angel of History

Young, CSR; (2009) Feedforward. The Angel of History. [Group exhibition]. LABoral Centro de Arte y Creación Industrial, Gijón, Spain. 22 October 2009 - 05 April 2010.

http://ift.tt/2p46fqp

Does a child's language ability affect the correspondence between parent and teacher ratings of ADHD symptoms?

Gooch, D; Maydew, H; Sears, C; Norbury, CF; (2017) Does a child's language ability affect the correspondence between parent and teacher ratings of ADHD symptoms? BMC Psychiatry , 17 , Article 129. 10.1186/s12888-017-1300-8 . Green open access

http://ift.tt/2p4hMWx

The World as Stage (Die Welt als Bühne)

Young, CSR; (2009) The World as Stage (Die Welt als Bühne). [Group exhibition]. Neue Berliner Kunstverein (NBK), Berlin. 21 November 2009 - 10 January 2010.

http://ift.tt/2p45cGI

Grey and white matter abnormalities in treated HIV-disease and their relationship to cognitive function

Underwood, J; Cole, JH; Caan, M; De Francesco, D; Leech, R; van Zoest, RA; Su, T; Underwood, J; Cole, JH; Caan, M; De Francesco, D; Leech, R; van Zoest, RA; Su, T; Geurtsen, GJ; Schmand, BA; Portegies, P; Prins, M; Wit, FWNM; Sabin, CA; Majoie, C; Reiss, P; Winston, A; Sharp, DJ; Co-morBidity in Relation to Aids (COBRA) Collaboration, .; - view fewer (2017) Grey and white matter abnormalities in treated HIV-disease and their relationship to cognitive function. Clinical Infectious Diseases 10.1093/cid/cix301 . (In press).

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Zebrafish sleep: from geneZZZ to neuronZZZ

Barlow, IL; Rihel, J; (2017) Zebrafish sleep: from geneZZZ to neuronZZZ. Current Opinion in Neurobiology , 44 pp. 65-71. 10.1016/j.conb.2017.02.009 .

http://ift.tt/2oJqFS7

Ours: Democracy in the Age of Branding

Young, CSR; (2008) Ours: Democracy in the Age of Branding. [Group exhibition]. New School, New York. 16 October 2008 - 09 February 2009.

http://ift.tt/2p4bR3J

Erratum to: Convexity subarachnoid haemorrhage has a high risk of intracerebral haemorrhage in suspected cerebral amyloid angiopathy

Wilson, D; Hostettler, IC; Ambler, G; Banerjee, G; Jäger, HR; Werring, DJ; (2017) Erratum to: Convexity subarachnoid haemorrhage has a high risk of intracerebral haemorrhage in suspected cerebral amyloid angiopathy. Journal of Neurology , 264 (4) p. 674. 10.1007/s00415-017-8428-9 .

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Securitisation, Alterity and the State: Human (In)Security on an Amazonian Frontier

Brightman, MA; Grotti, V; (2014) Securitisation, Alterity and the State: Human (In)Security on an Amazonian Frontier. Regions and Cohesion , 4 (3) pp. 17-38. 10.3167/reco.2014.040302 . Green open access

http://ift.tt/2p4aGBD

Stock Zero: The 2nd Moscow Biennial of Contemporary Art, curated by Nicolas Bourriaud

Young, CSR; (2007) Stock Zero: The 2nd Moscow Biennial of Contemporary Art, curated by Nicolas Bourriaud. [Group exhibition]. Moscow Federation Tower, Moscow. 02 March 2007 - 01 April 2007.

http://ift.tt/2oJut5S

Jump into Cold Water

Young, CSR; (2006) Jump into Cold Water. [Group exhibition]. Shedhalle, Zurich. 03 June 2006 - 30 July 2006.

http://ift.tt/2p4279L

Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium

Berendsen, AAM; Kang, JH; van de Rest, O; Jankovic, N; Kampman, E; Kiefte-de Jong, JC; Franco, OH; Berendsen, AAM; Kang, JH; van de Rest, O; Jankovic, N; Kampman, E; Kiefte-de Jong, JC; Franco, OH; Ikram, MA; Pikhart, H; Nilsson, LM; Brenner, H; Boffetta, P; Rafnsson, SB; Gustafson, D; Kyrozis, A; Trichopoulou, A; Feskens, EJM; Grodstein, F; de Groot, LCPGM; - view fewer (2017) Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium. Dementia and Geriatric Cognitive Disorders , 43 (3-4) pp. 215-227. 10.1159/000464269 . Green open access

http://ift.tt/2oJBSC1

Sequential therapy of anti-Nogo-A antibody treatment and treadmill training leads to cumulative improvements after spinal cord injury in rats

Chen, K; Marsh, BC; Cowan, M; Al'Joboori, YD; Gigout, S; Smith, CC; Messenger, N; Chen, K; Marsh, BC; Cowan, M; Al'Joboori, YD; Gigout, S; Smith, CC; Messenger, N; Gamper, N; Schwab, ME; Ichiyama, RM; - view fewer (2017) Sequential therapy of anti-Nogo-A antibody treatment and treadmill training leads to cumulative improvements after spinal cord injury in rats. Experimental Neurology , 292 pp. 135-144. 10.1016/j.expneurol.2017.03.012 .

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How to Improve the World: 60 Years of British Art

Young, CSR; Newman, M; (2006) How to Improve the World: 60 Years of British Art. [Catalogue]. Hayward Gallery Publishing: London.

http://ift.tt/2oJuoPC

Hey Hey Glossolalia: Exhibiting the Voice

Young, CSR; (2008) Hey Hey Glossolalia: Exhibiting the Voice. [Group exhibition]. Various venues in New York City. May 2008 - June 2008.

http://ift.tt/2p40BV2

Hey Hey Glossolalia (BEFORE) and (AFTER)

Young, CSR; Beasley, M; Pendleton, A; Gillick, L; (2010) Hey Hey Glossolalia (BEFORE) and (AFTER). [Book]. Creative Time: New York.

http://ift.tt/2oJuoiA

Re “International survey on skin patch test procedures, attitudes and interpretation” L.K. Tanno et al., WAOJ (2016) 9:8

A previous survey on the practice of diagnostic patch testing among representatives of member societies of the World Allergy Organization (WAO) has, in some countries, not addressed those stakeholders actually...

http://ift.tt/2q5wNWE

Johns Hopkins Supporting Innovation With New Innovation Hub

The Johns Hopkins University announced today the opening of its state-of-the-art innovation hub, FastForward 1812. The 23,000-square-foot space near Johns Hopkins' flagship hospital and schools of medicine, public health and nursing provides Baltimore's burgeoning innovation ecosystem and area startups sought-after office, co-working and wet lab space to accommodate a variety of startups.

http://ift.tt/2ow5lnU

Clearing Out Old Cells Could Extend Joint Health, Stop Osteoarthritis

In a preclinical study in mice and human cells, researchers report that selectively removing old or 'senescent' cells from joints could stop and even reverse the progression of osteoarthritis.

http://ift.tt/2oLOIki

Teaching Real Apologies to Your Children with Dr. Dehra Harris

 

On this episode of MomDocs, Dr. Dehra Harris is back to discuss teaching real apologies to your children. As your children get older, the eye rolls and attitudes are common. After an argument, have a cool down period and wait until everyone is calm even if it takes a few days. It's important to focus on the behavior instead of the child.

The post Teaching Real Apologies to Your Children with Dr. Dehra Harris appeared first on ChildrensMD.

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The efficacy of serratus anterior plane block in analgesia for thoracotomy: a retrospective study

Abstract

Purpose

A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain.

Methods

A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20). The Visual Analogue Scale (VAS) was used for pain evaluation at the 1st, 2nd, 4th, 6th, 8th, 12th and 24th postoperative hours and morphine consumption was evaluated at the 6th, 12th and 24th postoperative hours. Secondary outcomes were additional analgesic requirement, side effects, the Ramsay Sedation Scale (RSS) scores, block onset time and block level.

Results

The VAS scores and the amount of morphine consumed at the 6th, 12th and 24th hours were found to be significantly lower in Group S than in Group M (P < 0.001). No statistically significant difference was found in the rate of side effects, including nausea, vomiting, pruritus, respiratory depression, bradycardia and hypotension, and RSS outcomes between the groups.

Conclusion

Our study suggests that SAPB is an effective adjuvant treatment option for thoracotomy analgesia.

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“Spike” in acute asthma exacerbations during enterovirus D68 epidemic in Japan: A nation-wide survey

Publication date: Available online 25 April 2017
Source:Allergology International
Author(s): Seigo Korematsu, Kengo Nagashima, Yasunori Sato, Mizuho Nagao, Shunji Hasegawa, Haruna Nakamura, Shiro Sugiura, Katsushi Miura, Kenji Okada, Takao Fujisawa
BackgroundIn September 2015, Japan experienced an unusual increase in acute asthma hospitalizations of children that coincided with an enterovirus D68 (EV-D68) epidemic. The objective of this study is to investigate whether EV-D68 had a causal relationship with the spike in asthma hospitalizations.MethodsA nation-wide retrospective survey of asthma hospitalizations of children was performed for the period from January 2010 through October 2015. The Japanese Society of Pediatric Allergy and Clinical Immunology asked its affiliated hospitals to report monthly numbers of hospitalizations, ICU admissions and mechanical ventilations due to acute asthma exacerbation. The data were retrieved from medical databases using predefined search criteria: diagnosis of asthma or asthmatic bronchitis, admission, and age <20 years. Monthly numbers of EV-D68 detection were also obtained from the Infectious Disease Surveillance Center of Japan. A Granger causality test was used to analyze the association of EV-D68 detections for asthma exacerbation.ResultsA total of 157 hospitals reported 87,189 asthma hospitalizations, including 477 ICU admissions and 1193 mechanical ventilations, during the survey period of 5 years and 10 months. The numbers of these events increased drastically in September 2015. The Granger causality test verified the association between EV-D68 and asthma hospitalizations/mechanical ventilations. The most-affected age group was 3–6 years old.ConclusionsThe spike in pediatric asthma hospitalizations in Japan in September 2015 was found to be associated with the EV-D68 epidemic. Respiratory pathogens can cause "epidemics" of asthma exacerbation. Coordinated surveillance of infectious diseases and asthma may be beneficial for prevention and better control of both illnesses.



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Funeral invitations, elegies, and the ephemeral cultures of mourning

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Ten lessons from ten years PPP experience in Belgium

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Gamified music improvisation with BilliArT: a multimodal installation with balls

This paper presents the concept and the realisation of an interactive multimedia installation, called BilliArT, together with an explorative user study conducted on the data gathered during a public exhibition of the installation. The study concerns functional properties of the installation (e.g. usability, design quality) and subjective qualities of the sonic and visual feedback of the installation. The installation consists in a collaborative environment based on the carambole billiards game, which allows the users to engage in a user-driven machine-based jazz-inspired music improvisation, augmented with visual feedback. The installation is designed to promote the interaction among the users and the billiard game, stimulating the motivation to engage in the game by balancing predictable and unpredictable output, and reinforcing the feeling of reward, irrespective of their level of musical training. BilliArT introduces a new framework for expressive interaction related to the concepts of motivation and reward. The exploratory study proved the ability of the installation to activate the users' sense of aesthetic reward, leading to a more active and satisfactory engagement in the game. Future studies may exploit these results to the advantage of the world of the arts, as well as of studies in human-computer interaction, interface design, and cultural heritage preservation.

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Framing the 'child at risk' in social work reports: truth-telling or storytelling?

Summary: In the field of child welfare and protection, the notion of the 'child at risk' implies a central ground and legitimation for intervention yet is extremely ambiguous, since it can be constructed in radically different ways in practice. This construction process might involve challenges to professional assessment and intervention, since dealing with this complex notion is about more than tools, (risk) management and protocols. We focus on the practice of writing reports as an exemplary practice in which social workers exercise their power while assessing and constructing the child as 'at risk'. Two approaches of social workers in interpreting the complexity of situations where children are potentially at risk are considered: truth-telling and storytelling. We report on a qualitative study conducted with 152 social work students in which we explore how they construct reports. Findings: In our analysis, we identify three major issues in the construction of the "child at risk" when social work students approach report writing as an open-ended and reflexive practice of storytelling: recognisability, comprehensibility and stigmatisation. Applications: The normative judgment processes in social work are complex, determined by the analysis of situations in which the child may potentially be constructed as being at risk. Dealing with this complexity therefore requires reflexivity of social workers regarding their perceptions and interpretations at stake in practice. We argue that normative judgment in risk assessment should be an essential area for exploration in social work education.

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Impact of par-baking and storage conditions on the quality of par-baked and fully baked bread

Par-baking (PB) contributes to the extension of the microbiological and technological shelf-life of food products. The impact of processing conditions on the quality of PB bread, either when PB or fully baked (FB), was investigated. Processing conditions included PB time (8 and 13 min), temperature (150, 175 and 200 °C), amount of steam (200 and 600 mL) and storage temperature (ambient and frozen temperature) before fully baking. Volume, weight, crust color, crust thickness and crumb/crust texture of PB and FB breads were evaluated. PB temperature showed the most significant overall effect on bread quality. Influence of PB time was expressed in the weight of the FB bread, not in the weight of the PB bread. The storage temperature of the PB breads had the most significant influence on the texture characteristics of the FB breads. Surprisingly, PB and FB bread volume was not affected by PB time, steam and storage temperature.

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The documentary surreal : film and painting in Luciano Emmer’s 'La Leggenda di Sant’Orsola' (1948) and Henri Storck’s 'Le Monde de Paul Delvaux' (1946)

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Auditory brainstem response latency in noise as a marker of cochlear synaptopathy

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Contribution of near-and suprathreshold hearing deficits to speech recognition

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Synergetic and redundant information flow detected by unnormalized Granger causality: application to resting state fMRI

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A comparative study of seven human cochlear filter models

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On the Interplay Between Cochlear Gain Loss and Temporal Envelope Coding Deficits

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Individual differences in hearing-impaired data: Stats, troubles, and approaches

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Isolating cochlear synaptopathy in people with impaired audiograms: An auditory brainstem and envelope-following response modeling study

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The two functions of the reticular lamina

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Otoacoustic Emissions (Part I) and central auditory effects: A moderated discussion

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Click-evoked otoacoustic emissions for the assessment of auditory filter tuning at supra-threshold levels

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Individual differences reveal correlates of hidden hearing deficits

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Relating the variability of tone-burst otoacoustic emission and auditory brainstem response latencies to the underlying cochlear mechanics

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Functional modeling of the human auditory brainstem response to broadband stimulation

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How do the medial olivocochlear efferents influence the biomechanics of the outer hair cells and thereby the cochlear amplifier? Simulation results

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Primary aortojejunal fistula: a rare cause for massive upper gastrointestinal bleeding

A 68-year-old man presented to the emergency department with haematemesis and shock. Upper endoscopy and selective angiography could not identify the source of bleeding. He underwent selective embolisation of the gastroduodenal artery. The patient then had a period of about 24 hours with relative haemodynamic stability before having another episode of massive upper gastrointestinal bleed. A second attempt to embolise the common hepatic artery and distal coeliac axis was unsuccessful. Hence, he was urgently taken to the operating room for exploratory laparotomy. The source of bleeding could not be identified in the operating room. The patient went into cardiac arrest and expired. Autopsy revealed a fistula between proximal jejunum and a previously unknown abdominal aortic aneurysm (AAA). We present an entity that has only been described a few times in the literature while highlighting the importance of having a broad differential with upper gastrointestinal bleeding, especially when the source is not clearly evident.

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Revisiting propafenone toxicity

Propafenone is a Vaughan Williams class 1c antiarrhythmic medication widely used for treatment of arrhythmias. Although the long-term safety of propafenone use has not been established, it is commonly used for treatment of atrial fibrillation in patients with no structural heart disease. Propafenone is well known as pill-in-the-pocket treatment for its effect in terminating paroxysmal episodes of atrial fibrillation. Herein, we discuss an unusual adverse reaction to propafenone in a patient who presented with symptomatic bradycardia and hypotension. The aim of this article is to increase physician awareness for propafenone toxicity and its management, with a focused literature review on propafenone pharmacotherapy.

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Unusual cause for testicular swelling in a child

Myeloid sarcoma is a rare solid tumour composed of primitive precursors of granulocytic series of white blood cells involving extramedullary anatomic site. Here we report the case of a 10-month-old with testicular swelling, who was finally diagnosed with granulocytic sarcoma. This case demonstrates that Granulocytic sarcoma should be considered as a part of the differential diagnosis for testicular swelling in spite of having normal peripheral counts and absence of hepatosplenomegaly.

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Haemophagocytic lymphohistiocytosis as a consequence of untreated B-cell chronic lymphocytic leukaemia

Haemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening syndrome characterised by defective cytotoxic function and hypercytokinaemia leading to macrophage expansion and haemophagocytosis. Patients often present with unexplained fevers, hepatosplenomegaly and pancytopenia, with elevation in serum ferritin and triglyceride. Acquired forms are triggered by infection, malignancy or rheumatological disorders. HLH in the setting of chronic lymphocytic leukaemia is rarely reported, however, and is usually associated with infection or as a consequence of chemotherapy. We present a case of HLH in a 64-year-old Caucasian woman with the only identified trigger being her hitherto untreated CLL.

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Alveolar soft part sarcoma presenting with back pain

Description

A 35-year-old man was referred to the Sarcoma service with a 2-year history of worsening back pain, left-sided radicular pain and a mass on CT scan. In the 6 months following the onset of the back pain, he developed progressive numbness and paraesthesia in the L2 dermatome. This was worse on standing. On clinical examination, power was unaffected but somewhat limited by pain. No 'red flag' symptoms were present (table 1). The CT scan demonstrated a large retroperitoneal mass on the left with invasion into the L2 vertebra (figure 1 and 2) and bilateral pulmonary metastases. USS-guided biopsy revealed high grade alveolar soft part sarcoma. He was started on palliative radiotherapy (30 Gy and 10 fractions) and given six cycles of doxorubicin and ifosfamide. Imaging at 8 months postdiagnosis has indicated stable disease.

Table 1

'Red flag' symptoms of back pain4...

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Severe chronic diarrhoea secondary to primary lymph node gastrinoma

The existence of primary lymph node (LN) gastrinoma is questionable and controversial. In fact, the presence of gastrinoma in such uncommon site raises the possibility of metastasis from another occult primary site. An extensive evaluation and careful follow-up is always warranted. A female aged 48 years presented with chronic abdominal pain and watery diarrhoea. Her serum gastrin and chromogranin were elevated, and an underlying gastrinoma was suspected. Further evaluation with an octreotide scan, an endoscopic ultrasound and a secretin stimulation test confirmed the diagnosis. Further evaluation for multiple endocrine neoplasia-1 syndrome was negative. She underwent a surgical enucleation near the head of the pancreas. No other lesions were found after careful exploration of the gastrinoma triangle. Histology showed a LN with a neuroendocrine tumour that tested positively with gastrin and chromogranin stains. Her symptoms resolved postoperatively, her serum gastrin normalised and a repeated octreotide scan was negative.

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Secondary parkinsonism in a patient of psychogenic polydipsia

A 44-year-old man presented with history of slurring of speech, slowness in activities, abnormal posturing of the upper limbs and drooling of saliva from the mouth. He had a 5-yearlong history of compulsive water drinking, consuming 12–15 L of water every day. He was earlier evaluated for the same and found to have low serum sodium (126 mEq/L). Presently, he was admitted at a primary care facility with fever and altered sensorium. He was found to have serum sodium of 94 mEq/L. His sensorium improved with hypertonic saline infusion; however, after a lucid interval of 48 hours, he developed florid extrapyramidal symptoms. Contrast-enhanced MRI brain revealed bilaterally symmetric T2-weighted fluid-attenuated inversion recovery hyperintensity in caudate and lentiform nuclei. A diagnosis of extrapontine myelinolysis with secondary parkinsonism was made. He improved significantly with levodopa therapy.

Psychogenic polydipsia is an important cause of hyponatraemia. Overzealous correction of hyponatraemia can be counterproductive.

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Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Childhood tuberculosis (TB) is a significant global health burden. There are more than 1 million new cases of childhood TB annually. Despite this, many national TB control programs largely focus on identification and treatment of smear positive adults. Early case detection is essential if childhood TB is to be controlled and eradicated.

Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes. Younger children who go undiagnosed for long periods are at risk of developing severe pulmonary and extrapulmonary disease, such as meningitis. Additionally, advanced childhood TB is a common respiratory cause of death in TB-endemic areas. Undoubtedly, delayed diagnosis contributes significantly to TB-related morbidity and mortality.

Diagnostic delay may be divided into patient delay, the duration between development of symptoms and presentation to healthcare provider, and healthcare provider delay, the duration between presentation and initiation of appropriate treatment.

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Spontaneous ruptured iliac artery aneurysm causing acute secondary AV fistula

A 73-year-old woman presented with a 6-hour history of sudden onset lower abdominal pain. Her comorbidities included chronic obstructive pulmonary disease and hypertension. She was under surveillance for a known thoracoabdominal aneurysm. On presentation, she was hypotensive with a systolic blood pressure of 50 mm Hg and a pulse of 60 beats per minute. On examination, she had a pulsatile mass with bruit in her right lower abdomen. Pedal pulses were palpable in both feet. Blood gas analysis revealed a metabolic acidosis with a pH of 7.21 and a lactate of 7.1. Haemoglobin remained stable between 90–100 g/dL. Her other routine blood tests were unremarkable, and blood cultures were negative. Imaging showed a ruptured right common iliac artery aneurysm into the right common iliac vein with secondary arteriovenous fistula communication. Surgical intervention was discussed with the patient but due to her frailty, it was deemed not in the patient's best interests.

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Eculizumab in a child with atypical haemolytic uraemic syndrome and haemophagocytic lymphohistiocytosis triggered by cytomegalovirus infection

We present the case of a 21-month-old girl with two rare and life-threatening conditions, atypical haemolytic uraemic syndrome (aHUS) and haemophagocytic lymphohistiocytosis (HLH), triggered by a cytomegalovirus (CMV) infection. Soon after admission, the girl became anuric and required continuous venovenous haemodiafiltration.

Initial treatments included methylprednisolone, fibrinogen and plasma infusion (for HLH), plasmapheresis (for thrombotic microangiopathy), immunoglobulins (for inflammation), ganciclovir (for CMV infection) and the antibiotic cefotaxime. On day 5, eculizumab (600 mg) was given for aHUS, with rapid improvement in haematological and nephrological parameters. Despite a subsequent isolated episode of right heart thrombosis that resolved with heparin treatment, the patient showed a favourable response to eculizumab (300 mg/15 days), with improved renal function, normal haematological values, and no treatment complications. In conclusion, eculizumab effectively treated aHUS in this case despite a comorbid immunological disease.

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Cystic artery pseudoaneurysm following acute necrotising pancreatitis

Cystic artery pseudoaneurysm is a rare pathology. Of the 20 cases reported so far, chronic cholecystitis and iatrogenic biliary injury form the majority of causes. Currently, there is no published report of such pseudoaneurysms caused secondary to pancreatitis, hence the management in such a scenario is unclear. We hereby present the first such report of cystic artery pseudoaneurysm occurring as a sequel of acute necrotising pancreatitis. A 33-year-old man who recovered from a recent attack of acute pancreatitis was readmitted for melena and fever. Computed tomography of abdomen revealed blood in the gall bladder with pericholecystic blush and resolving pancreatic necrosis. Percutaneous transarterial embolisation of the cystic artery was done. This stabilised the patient but persistent sepsis and clinical deterioration warranted a surgical exploration and cholecystostomy. Hence, transarterial embolisation followed by surgery in selected cases can be an ideal management protocol.

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Complicated acute cerebellitis with obstructive hydrocephalus and tonsillar herniation in a child

Acute cerebellitis (AC) is a rare inflammatory syndrome presenting as cerebellar dysfunction, seen more frequently in children. AC can have a variable course with features of cerebellar dysfunction, raised intracranial pressure and neurological deficits, and can sometimes even be potentially fatal due to complications such as obstructive hydrocephalus and brainstem compression, warranting surgical intervention. We report a case of a 12-year-old boy who presented with raised intracranial pressure and ataxia. Imaging with CT and MRI showed AC with obstructive hydrocephalus and tonsillar herniation. He was managed with medications for raised intracranial pressure and with ventriculoperitoneal shunt, and he recovered completely over a period of 2 weeks. Imaging has an important role in the diagnosis of AC and in differentiating it from acute cerebellar ataxia, which has a more benign course. It is crucial to diagnose and promptly manage the rarely occurring but life-threatening complications of AC.

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Pure form of Ackermanns tumour of the tongue in a young female patient

Description

A 28-year-old female presented to our outpatient department with a painless, well-circumscribed keratotic, exophytic lesion with broad base over the left lateral aspect of the tongue (figure 1). The lesion had a rough, shaggy, papillomatous surface with sharp finger-like surface projections with no surrounding induration (figure 2). She did not have any habits relevant to history. A biopsy performed at a different centre earlier to her visit here suggested of verrucous hyperplasia. Taking into consideration the history of lesion progression and the gross appearance of the lesion, a strong suspicion of verrucous carcinoma (VC) was made. A wide local excision of the lesion with 1-cm margin was done (figure 3). The histopathology showed a verrucoid lesion lined by hyperkeratotic, acanthotic and focally inflamed stratified squamous epithelium with papillomatosis and broad and fused rete with cells showing mild anisonucleosis, overlying fibrocollagenous stroma with dense...

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Scheduling the Australian Football League

Generating a schedule for a professional sports league is an extremely demanding task. Good schedules have many benefits for the league, such as higher attendance and TV viewership, lower costs, and increased fairness. The Australian Football League is particularly interesting because of an unusual competition format integrating a single round robin tournament with additional games. Furthermore, several teams have multiple home venues and some venues are shared by multiple teams. This paper presents a 3-phase process to schedule the Australian Football League. The resulting solution outperforms the official schedule with respect to minimizing and balancing travel distance and breaks, while satisfying more requirements.

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SALT WEATHERING OF SANDSTONE DURING DRYING: EFFECT OF PRIMARY AND SECONDARY CRYSTALLISATION

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First steps to computer-aided decision-making in repair mortar recipes: Working on three fronts

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Marketingcommunicatie

Marketingcommunicatie geeft een volledig overzicht van de fundamenten, technieken en toepassingen van marketingcommunicatie in een Europese context. Het boek bevat hoofdstukken over alle elementen van de communicatiemix, zoals adverteren, public relations, sponsoring, verkoopacties, direct marketing, winkelcommunicatie, vakbeurzen, persoonlijke verkoop en internet. Het boek beschrijft eveneens hoe bedrijven omgaan met aspecten als branding, internet en cross-culturele marketingcommunicatie.

http://ift.tt/2p3Mb7H

The effectiveness of facial exercises for facial rejuvenation: a systematic review

Background: Although aesthetic correction of facial aging had long been the exclusive domain of plastic surgeons and dermatologists, alternative nonmedical approaches to facial rejuvenation are becoming more popular, such as facial acupuncture, facial acupressure, and facial exercises. However, the effectiveness of these alternative approaches is still a topic of debate. Objectives: The authors review the evidence of the effectiveness of facial exercises for facial rejuvenation. Methods: A literature search was performed in Medline, Web of Science, Science Direct, SciELO, and LILACS databases for the terms facial rejuvenation, facial exercises, facial massage, face building, face yoga, (oro)facial (a)esthetics, (a)esthetic logopedics, and (a)esthetic speech therapy. Nine reports were identified from the search and were subject to further assessment. Results: Although positive outcomes were achieved in all 9 studies, none of the studies used a control group and randomization process. They were single case reports, small case series, or studies with a single-group pretest-posttest design. Moreover, the effectiveness assessments in most of the studies were purely subjective, carried out by the authors and/or the patients themselves, without blinding. Conclusions: The evidence to date is insufficient to determine whether facial exercises are effective for facial rejuvenation. Evidence from large randomized controlled trials will be needed before conclusions can be drawn.

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A theoretical lens for revealing the complexity of chronic care

The increasing prevalence of co-occurring multiple chronic conditions in an aging population has influenced the debate on complexity in chronic care and nowadays provides an impetus to the reform of numerous health systems. This article presents a theoretical lens for understanding the complexity of chronic care based on research and debate conducted in the context of multiple quality improvement programs over the last five years in Belgium and The Netherlands. We consider four major components of complexity in chronic care against a background of complex adaptive systems: (1) case (patient) complexity; (2) care complexity; (3) quality assessment complexity; and (4) health systems complexity. Each of these components represents a range of elements that contribute to the picture of complexity in chronic care. We emphasize that planning for chronic care requires equal attention to the complexity of all four components. It also requires multifaceted interventions and implementation strategies that target improvements in multiple outcomes related to the structural, process, and outcome components of care. Further empirical research is needed to assess the validity of our complexity framework in the health-care environment.

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A review of non-cultured epidermal cellular grafting in vitiligo

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Protein-blotting from SDS-polyacrylamide gels on glass-fiber sheets coated with quaternized ammonium polybases

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Effect of phagocytosed fat and casein on the intraphagosomal pH in bovine polymorphonuclear leukocytes

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Milk and plasma glucocorticoid alterations after injections of hydrocortisone and ACTH

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Effect of fat and casein on intracellular killing of Staphylococcus aureus by milk leukocytes

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Plasma corticosteroid, circulating leukocyte and milk somatic cell responses to Escherichia coli endotoxin induced mastitis

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Nursing duration and suckling intensity: effects on plasma corticosterone, circulating leukocytes, and mammary nucleic acids

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Relationship among nursing frequency, lactation pituitary prolactin, and adrenocorticotropic hormone content in rats

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Belgium’s legal periodicals as vectors of translation policy: How Flemish legal journals contributed to the development of a Dutch legal language

Belgium's national history has been characterized by linguistic issues. As soon as Belgium gained independence in 1830, French was promoted as the nation's first and most important language, despite the fact that a large majority of its people spoke Flemish. Constitutionally, the choice of which language to use was free, but the legal world easily adopted French. Flemish was only able to loosen the yoke of French during the final quarter of the nineteenth century, after a few sensational court cases. Jurists played a primordial role in the use of Flemish as a full-fledged legal professional language and one of their instruments were legal periodicals. Editors and authors used their position to offer colleagues translations of legal terminology, and gave guidelines as to how Flemish could and should be used in the Flanders court rooms (in Wallonia, French was used exclusively). This article examines the works that promoted the idea of Flemish as a professional legal language and the methods that were seen as the best way to reach the goal of a unilingual legal world in Flanders

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Ice crystallization in porous building materials: assessing damage using real-time 3D monitoring

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Atypical employment in the European aviation sector

Labour Law and Social Progress: Holding the Line or Shifting the Boundaries? is a collection of incisive essays that focus on the emerging global paradigm shift in labour and employment relations. For forty years the international watchword has been deregulation of labour law and of social security. Now, however, the rise in unemployment and lack of employment security, the dizzying inequality gulf, and the environmental disasters and mass migrations caused by this deregulation are generating an impetus that defines social justice no longer merely in terms of the equitable distribution of resources but also – and often primarily – in terms of the just recognition of persons. This book recognizes that the growing interdependence among people demands that labour rights are understood as an aspect of human rights, and thus envisaged at international level. This volume of BCLR is based on a selection of papers presented at the 21st World Congress of the International Society for Labour and Social Security Law in Cape Town in 2015.

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Vinderhoute, een ruraal dienstencentrum (1795-1975)

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THE MACQUENOISE SANDSTONE: A suitable Lochkovian raw material for ancient millstones: quarries, properties, manufacture and distribution (Belgium-France)

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The last glacial inception in continental northwestern Europe: characterization and timing of the Late Eemian Aridity Pulse (LEAP) recorded in multiple Belgian speleothems.

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Online reconfigurable routing method for handling link failures in NoC-based MPSoCs

As silicon features approach the atomic scale, the Networks-on-Chip (NoCs) are becoming more susceptible to faults. Resiliency to device failures is, therefore, a key objective in the design of the Systems-on-Chip (SoCs). This paper seeks to address reliability by presenting a routing algorithm for 2D mesh NoCs. Using the proposed method which is designed based on the Abacus Turn Model (AbTM), the healthy paths can be dynamically configured according to the location of faults and congestion in the network. As a result, not only the functionality of the network is maintained in the vicinity of faults, but also a high performance communication can be provided. The presented technique is an adaptive, distributed, deadlock-free, and congestion-aware routing method which does not require routing tables or virtual channels. The experimental results demonstrate the reliability of NoC against multiple link failures with a small hardware overhead penalty.

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On how X-ray (micro) computed tomography on turbidites can help us unravel paleoflow successions, directions and dynamics

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De bortstelling en insolventie

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Writing otorhinolaryngology head & neck surgery operative reports

Publication date: Available online 4 April 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): O. Laccourreye, F. Rubin, A. Villeneuve, P. Bonfils
Only about ten articles devoted to operative reports have been published in the medical literature, but this document is essential, both medically and legally, to ensure optimal management of operated patients. In this technical note, based on published studies on this subject, the authors describe the key features of operating reports after otorhinolaryngology head & neck surgery and emphasize the need to write this document during the minutes after the end of the operation, the importance of standardization and its teaching role during surgical training.



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Endoscopic endonasal excision of nasal chondromesenchymal hamartoma with intracranial extension

Publication date: Available online 4 April 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): M. Nakaya, S. Yoshihara, A. Yoshitomi, S. Baba
IntroductionNasal chondromesenchymal hamartoma (NCMH) is an extremely rare benign hamartoma of the sinonasal tract, predominantly involving infants and young children.MethodsWe report the case of a 3-year-old boy of NCMH with extension to anterior skull base.ResultsThe tumor was completely resected piece by piece via an endonasal endoscopic approach. There is no recurrence 3 years after operation.ConclusionsWe reported the case of NCMH extending to skull base was successfully resected by endonasal endoscopic approach.



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Consideration

Young, CSR; (2005) Consideration. [Solo exhibition]. Paula Cooper Gallery, New York. 16 November 2005 - 20 November 2005.

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Body: New Art from the UK

Young, CSR; Coupland, D; Ledwith, C; Grenville, B; (2005) Body: New Art from the UK. [Catalogue]. British Council: London.

http://ift.tt/2ovpWsi

Causal Inference via Algebraic Geometry: Feasibility Tests for Functional Causal Structures with Two Binary Observed Variables

Lee, CM; Spekkens, RW; (2017) Causal Inference via Algebraic Geometry: Feasibility Tests for Functional Causal Structures with Two Binary Observed Variables. Journal of Causal Inference , Article 20160013. 10.1515/jci-2016-0013 .

http://ift.tt/2q4JctZ

Zoology: War of the Worms

Telford, MJ; Copley, RR; (2016) Zoology: War of the Worms. Current Biology , 26 (8) R335-R337. 10.1016/j.cub.2016.03.015 . Green open access

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Clinical failure is more common in young children with acute otitis media who receive a short course of antibiotics compared with standard duration

Venekamp, RP; Schilder, AGM; (2017) Clinical failure is more common in young children with acute otitis media who receive a short course of antibiotics compared with standard duration. Evidence-Based Medicine 10.1136/ebmed-2017-110697 . (In press). Green open access

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Frank-Thomas Ott, Die zweite Philippica als Flugschrift in der späten Republik, Berlin – Boston (De Gruyter), 2013

Manuwald, G; (2016) Frank-Thomas Ott, Die zweite Philippica als Flugschrift in der späten Republik, Berlin – Boston (De Gruyter), 2013. Klio , 98 (2) pp. 773-777. 10.1515/klio-2016-0077 .

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Otorhinolaryngologic manifestations of Hartsfield syndrome: Case series and review of literature

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Jeremie D. Oliver, Deanna C. Menapace, Shelagh A. Cofer
Diagnosis of Hartsfield syndrome includes recognition of three distinct clinical anomalies: holoprosencephaly, ectrodactyly, and bilateral cleft-lip and palate syndrome. A family including three male siblings all affected by Hartsfield syndrome presented to our institution for care. An autosomal dominant variant in Fibroblast Growth Factor Receptor 1 (FGFR1) was identified. This report focuses on otorhinolaryngologic manifestationsof Hartsfield syndrome, previously undescribed, including midline defects of holoprosencephaly, bilateral cleft-lip and palate, retrognathia, gastroesophageal reflux disease, external ear anomalies, eustachian tube dysfunction, and midface abnormalities, in addition to multidisciplinary, long-term management strategies. Multidisciplinary management is imperative in the care of these children with modification of approach based on their medical complexity.



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Quality and readability of websites for patient information on tonsillectomy and sleep apnea

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Ethan Chi, Noel Jabbour, Nicole Leigh Aaronson
ObjectivesTonsillectomy is a common treatment for obstructive sleep apnea (OSA). The Internet allows patients direct access to medical information. Since information on the Internet is largely unregulated, quality and readability are variable. This study evaluates the quality and readability of the most likely visited websites presenting information on sleep apnea and tonsillectomy.MethodsThe three most popular search engines (Google, Bing, Yahoo) were queried with the phrase "sleep apnea AND tonsillectomy." The DISCERN instrument was used to assess quality of information. Readability was evaluated using the Flesch-Kincaid Reading Grade Level (FKGL) and Flesch Reading Ease Score (FRES).ResultsOut of the maximum of 80, the average DISCERN quality score for the websites was 55.1 (SD- 12.3, Median- 60.5). The mean score for FRES was 42.3 (SD- 15.9, Median- 45.5), which falls in the range defined as difficult. No website was above the optimal score of 65. The mean score for the FKGL was US grade-level of 10.7 (SD- 1.6, Median- 11.6). Only 4(27%) websites were in the optimal range of 6–8. There was very weak correlation between FRES and DISCERN (r = 0.07) and FKGL and DISCERN (r = 0.21).ConclusionsTonsillectomy is one of the most common surgeries in the US. However, the internet information readily available to patients varies in quality. Additionally, much of the information is above the recommended grade level for comprehension by the public. By being aware of what information patients are reading online, physicians can better explain treatments and address misunderstandings. Physicians may consider using similar methods to test the readability for their own resources for patient education.



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