Pitfalls in anaphylaxis

Purpose of review Anaphylaxis is an acute medical emergency characterized by sudden presentation of life-threatening respiratory and cardiovascular symptoms. Rapid diagnosis of anaphylaxis is crucial to implement an appropriate treatment and management plan. However, mistakes in the diagnosis of anaphylaxis may occur because of the limited time during which the diagnosis must be made, the stressful environment of the emergency room, the often aspecific or incomplete clinical features of early anaphylaxis and the lack of useful laboratory markers. Recent findings Several disorders may mimick anaphylaxis and cause wrong or delayed diagnosis increasing chances of fatal outcomes. In addition, certain clinical situations, like general anesthesia, may complicate detection of early signs of anaphylaxis. Drugs like beta-blockers, angiotensin converting enzyme-inhibitors, antihistamines or steroids may hide or blunt initial clinical manifestations of anaphylaxis. Summary A careful evaluation of clinical signs in all organs is mandatory to quickly establish and confirm a diagnosis of anaphylaxis. Alternative diagnosis should be considered, particularly in the case of unresponsive patients. Avoiding pitfalls in anaphylaxis diagnosis will help to establish rapidly effective treatments and would further reduce the rate of fatal events. Correspondence to Massimo Triggiani, MD, PhD, Division of Allergy and Clinical Immunology University of Salerno, Via S. Allende Baronissi, Fisciano, Salerno, Italy. Tel: +39 089 965056; fax: +39 089 965056; e-mail: mtriggiani@unisa.it Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Methodological empiricism and the choice of measurement models in social sciences

Abstract

Realism is generally assumed as the correct position with regards to psychological research and the measurement of psychological attributes in psychometrics. Borsboom et al. (Psychological Review, 110(2), 203–219 2003), for instance, argued that the choice of a reflective measurement model necessarily implies a commitment to the existence of psychological constructs as well as a commitment to the belief that empirical testing of measurement models can justify their correspondence with real causal structures. Hood (Erkenntnis, 78(4):739–761 2013) deemphasized Borsboom et al.'s position and argued that the choice of a reflective measurement model does not necessarily require ontological commitments, though, in his view, it does necessitate a commitment to minimal epistemic realism. Although these arguments are formulated with regard to psychological research, they can actually be generalized to other disciplines in social sciences that use similar methodologies and statistical techniques. In Hood's opinion, empiricism does not suffice to provide an adequate account of the choice of reflective measurement models given that this choice requires an appeal to causal explanations. In this paper, we argue against Hood and answer this challenge, providing epistemic foundations for social science research that do not appeal to realism.

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Intrathoracic scapular dislocation following lung cancer resection

Abstract

A 64-year-old man underwent right upper lobectomy combined resection with third-fifth rib for lung cancer and reconstruction of chest wall using Dual Mesh. Six days after surgery, he experienced acute severe pain in the right shoulder. The purulent drainage through the drainage tube was also found. Chest CT showed that the inferior angle of the scapula protruded into the right intrathoracic cavity. We performed a removal of Mesh. Although we did not want to use synthetic materials because of infection, we performed titanium plate fifth rib fixation to avoid the recurrent dislocation of the scapula. After the redo surgery, continuous lavages with physiologic saline of the thoracic cavity was also performed. Patient is now doing well without recurrences of cancer, infection and scapular dislocation, 14 months after the redo surgery.

https://ift.tt/2uSoIIa

Concomittant fibrous dysplasia with aneurysmal bone cyst formation within the skull, humerus and rib

Abstract

Polyostotic fibrous dysplasia (FD) is a rare pathology characterized by the abnormal and gradual replacement of normal bone (calcium hydroxylapatite of osteoid matrix) with fibrous connective tissue. Aneurysmal bone cyst (ABC) is a tumor-like benign lesion with blood-filled cavities that can affect virtually any bone in the body. We report on a 20-year-old male presenting with an extremely rare pathology of FD with ABC formation of the skull, fourth rib and humerus. Our case report represents a novel literary addition to rare FD with ABC pathologies. Optimal diagnosis of this rare pathology can be achieved by a full body evaluation for clinical and radiographic FD with or without ABC, and optimal treatment for this rare pathology is the maximum surgical excision of the tumor and/or soft tissue.

https://ift.tt/2LmMFld

Case report: irreducible medial subtalar dislocation with incarcerated anterior talar head fracture in a young patient

Abstract

Subtalar dislocations are rare injuries that typically occur from high-energy injuries. All subtalar dislocations should be attempted to be closed reduced, however, ~32% are irreducible requiring open reduction. We present an irreducible medial subtalar dislocation following a motor vehicle accident with no associated fractures demonstrated on radiograph. However, open reduction revealed an incarcerated anterior talar head fracture that was reduced and stabilized with retrograde K-wires.

https://ift.tt/2JG9Wtt

Food protein-induced eosinophilic enteritis with intestinal stricture in a neonate: a case report and review of the literature

Abstract

The case of a 21-day-old boy with eosinophilic enteritis with intestinal stricture due to a food protein-induced allergy is reported herein. For the first 4 days of life, he was both breast-fed and formula-fed, after which he was exclusively breast-fed. At the age of 24 days, he underwent laparotomy to investigate the possibility of intestinal obstruction for bilious vomiting, and an ileal stricture was detected and resected. Pathologic analysis showed the presence of eosinophil accumulation in the lesions presented more than 20 eosinophils per high-power field and the eosinophils were oriented towards the epithelium and diffusely distributed throughout the tissue, but the margins of resection showed a few infiltration of eosinophiles. Allergen-specific lymphocyte stimulation testing showed a markedly increased lymphocyte response to lactoferrin. He was finally diagnosed as eosinophilic enteritis with intestinal stricture due to a food protein-induced allergy. The patient remained asymptomatic during a follow-up period of 12 months.

https://ift.tt/2LxrPQh

Total arch replacement as treatment for repeated cerebral infarctions due to unstable plaque simultaneously in the innominate artery and left subclavian artery: a case report

Abstract

We report a case of total arch replacement in a patient who suffered repeated cerebral infarctions due to unstable plaque simultaneously in the innominate and left subclavian arteries.

https://ift.tt/2JI35Q9

Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada

An analysis of the scope of practice of recent Otolaryngology – Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency program...

https://ift.tt/2Lt657K

Absence of host NF-κB p50 induces murine glioblastoma tumor regression, increases survival, and decreases T-cell induction of tumor-associated macrophage M2 polarization

Abstract

High-grade gliomas harbor abundant myeloid cells that suppress anti-tumor immunity and support tumor growth. Targeting transcription factors, such as NF-κB p50, that mediate suppressive myeloid M2 polarization may prove therapeutic. GL261-Luc glioblastoma cells were inoculated into wild-type and p50^−/− mice, followed by analysis of tumor growth, survival, tumor myeloid cells, and T cells. The absence of host p50 slows tumor growth and enables regression in 30% of recipients, leading to prolonged survival. Tumors developing in p50^−/− mice possess a greater concentration of tumor-infiltrating myeloid cells (TIMs) than those in wild-type mice. TIMs are predominantly F4/80^hi macrophages which, along with tumor-associated microglia, express increased pro-inflammatory M1 and reduced immune-suppressive M2 markers. In p50^−/− mice, total tumor CD4 T cells are threefold more abundant, whereas CD8 T-cell numbers are unchanged, and both produce increased IFNγ and Granzyme B. Naïve splenic p50^−/− CD8 T cells manifest increased activation, whereas naïve p50^−/− and WT CD4 T cells show similar Th1, Th2, and Th17 polarization. Antibody targeting CD4, but not CD8, fully obviates the p50^−/− survival advantage. Combined CD4 and CD8 T-cell depletion reverses myeloid M2 polarization in wild-type hosts, without affecting myeloid M1 polarization in p50^−/− hosts. Finally, gliomas grow similarly in p50(f/f) and p50(f/f);Lysozyme-Cre mice, the latter having reduced p50 specifically in myeloid cells and tumor microglia. Thus, high-grade glioma T cells play a key role in directing M2 polarization of tumor myeloid cells, and reducing NF-κB p50 in both tumor myeloid cells and T cells may contribute to glioma therapy.

https://ift.tt/2O7Vmyb

Recurring acute urticaria and abdominal pain: Consider a diagnosis of alpha-galactose anaphylaxis

Publication date: Available online 20 July 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): A. Deschamps Huvier, F. Tetart, O. Bauvin, J. Martinet, P. Joly

Summary

Background

Food urticaria is common and generally benign, and it may be of viral or idiopathic aetiology. A food origin of the allergy is frequently sought but rarely found. Mammalian meat anaphylaxis, or alpha-galactose (α-gal) anaphylaxis, is a rare and recently discovered entity.

Patients and methods

Herein, we report a case of alpha-galactose (α-gal) anaphylaxis in a 60-year-old woman presenting four episodes of acute urticaria with signs of anaphylaxis occurring a few hours after meals containing mammalian meat (beef meat, pork meat and offal). The diagnosis was confirmed by a positive gelatine prick-test and the presence of α-gal IgE.

Discussion

In the event of acute urticaria associated with systemic symptoms, in particular gastrointestinal signs, allergy to α-galactose should be considered.

Résumé

Introduction

L'urticaire aiguë est fréquente et le plus souvent bénigne, d'étiologie virale ou idiopathique. Une origine allergique alimentaire est souvent cherchée et rarement trouvée. L'allergie aux viandes de mammifères, ou allergie à l'alpha-galactose (α-gal), est une entité rare de découverte récente.

Observation

Nous rapportons une observation d'allergie à l'α-galactose chez une femme de 60 ans ayant présenté quatre épisodes d'urticaire aiguë avec signes d'anaphylaxie apparus à distance des repas, après l'ingestion de viande de mammifères (viande de bœuf, viande et abats de porc). Le diagnostic a été confirmé par la positivité du prick-test à la gélatine et la présence d'IgE α-gal.

Discussion

Devant une urticaire aiguë associée à des symptômes systémiques, notamment signes digestifs, il faut savoir évoquer une allergie à l'α-galactose.

https://ift.tt/2NtVPtx

Th17 activation by dendritic cells stimulated with gamma-irradiated Streptococcus pneumoniae

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Hyun Young Kim, Sun Kyung Kim, Ho Seong Seo, Soyoung Jeong, Ki Bum Ahn, Cheol-Heui Yun, Seung Hyun Han

Abstract

Dendritic cells (DCs) play an important role in antigen presentation, which is an essential step for the induction of antigen-specific adaptive immunity. Inactivated bacterial whole cell vaccines have been widely used to prevent many bacterial infections because they elicit good immunogenicity due to the presence of various antigens and are relatively inexpensive and easy to manufacture. Recently, gamma-irradiated whole cells of nonencapsulated Streptococcus pneumoniae were developed as a broad-spectrum and serotype-independent multivalent vaccine. In the present study, we generated gamma-irradiated S. pneumoniae (r-SP) and investigated its capacity to stimulate mouse bone marrow-derived DCs (BM-DCs) in comparison with heat-inactivated and formalin-inactivated S. pneumoniae (h-SP and f-SP, respectively). r-SP showed an attenuated binding and internalization level to BM-DCs when compared to h-SP or f-SP. r-SP weakly induced the expression of CD80, CD83, CD86, MHC class I, and PD-L2 compared with h-SP or f-SP. Furthermore, r-SP less potently induced IL-6, TNF-α, and IL-23 expression than h-SP or f-SP but more potently induced IL-1β expression than h-SP or f-SP in BM-DCs. Since Th17-mediated immune responses are known to be important for the protection against pneumococcal infections, r-SP-primed DCs were co-cultured with splenocytes or splenic CD4⁺ T cells. Interestingly, r-SP-sensitized BM-DCs markedly induced IL-17A⁺ CD4⁺ T cells whereas h-SP- or f-SP-sensitized BM-DCs weakly induced them. Collectively, these results suggest that r-SP could be an effective pneumococcal vaccine candidate eliciting Th17-mediated immune responses by stimulation of DCs.

https://ift.tt/2JGrWUp

Harare children’s hospital airway symposium and pentafrica conference 2018

Publication date: Available online 20 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Clemence Chidziva, Titus Dzongodza, Cameline Nyamarebvu, Shazia Peer, Christopher Prescott, Naboth Matinhira, Peter J. Koltai

https://ift.tt/2NuuOGe

Urinary polycyclic aromatic hydrocarbons and allergic sensitization in a nationwide study of children and adults in the U.S.

Publication date: Available online 20 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Franziska Rosser, Yueh-Ying Han, Erick Forno, Juan C. Celedón

https://ift.tt/2Lo1uDT

Case 22-2018: A 64-Year-Old Man with Progressive Leg Weakness, Recurrent Falls, and Anemia

Presentation of Case. Dr. Molly E. Wolf (Medicine): A 64-year-old man was admitted to this hospital because of progressive leg weakness, recurrent falls, and anemia. The patient had been in his usual state of health until 8 months before this admission, when fatigue on exertion and subjective leg…

https://ift.tt/2mwo67a

Case 21-2018: A 61-Year-Old Man with Grandiosity, Impulsivity, and Decreased Sleep

Presentation of Case. Dr. Samuel J. Boas (Psychiatry): A 61-year-old man was brought to the emergency department of this hospital by his family because of concerns about grandiosity, impulsivity, decreased sleep, and increased alcohol use. The patient had a history of alcohol-use disorder; he had…

https://ift.tt/2uuSrXi

CD4 T cell loss and Th2 and Th17 bias are associated with the severity of severe fever with thrombocytopenia syndrome (SFTS)

Publication date: Available online 20 July 2018

Source: Clinical Immunology

Author(s): Meng-Meng Li, Wen-Jing Zhang, Xiu-Fang Weng, Ming-Yue Li, Jia Liu, Yan Xiong, Shu-E Xiong, Cong-Cong Zou, Hua Wang, Meng-ji Lu, Dong-Liang Yang, Cheng Peng, Xin Zheng

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease caused by a novel bunyavirus with high mortality. Immune suppression is thought to be crucial in disease progression. However, data on immune responses during SFTS are scarce. This study aimed to evaluate the changes in CD4 T-cell subsets throughout the entirety of infection and analyse their relationships with disease severity in SFTS patients. In parallel with CD4 T-cell depletion, decreased Th1, Th2 and Treg numbers, but comparable Th17-cell numbers, were observed in deceased patients compared with those in surviving patients. Additionally, increased Th2 and Th17-cell percentages in the residual CD4 T-cell population led to aberrant Th2/Th1 and Th17/Treg ratios, which were positively correlated with disease severity. Collectively, our data indicated that CD4 T-cell deficiency, Th2 and Th17 bias were closely correlated with the severity of SFTS, indicating therapeutic potential of early immune interventions to ameliorate disease severity.

https://ift.tt/2NxiLIb

Socioeconomics of Atopic Dermatitis-Can We Afford New Treatments?

To get a grasp of the socioeconomics of atopic dermatitis (AD), we need to understand its prevalence in the population, its burden, co-morbidities, and costs, both direct and indirect. Only then can we extrapolate whether it makes sense for society to cover new, more costly treatments in the management of this condition. AD affects a large percentage of the pediatric and adult population in the United States. 1 Generally, this chronic inflammatory condition of the skin has no mortality, which has to weigh into assessing the socioeconomics of this disorder.

https://ift.tt/2Nu47Bw

Atopic dermatitis in US adults - epidemiology, association with marital status and atopy

Atopic Dermatitis (AD) prevalence and risk factors in the US-population are not fully elucidated. A study from the 2010 National Health Interview Survey (NHIS) found that 10.2% of US adults reported having "dermatitis, eczema, or any other red, inflamed skin rash"1 in the past 12 months, likely overestimating AD prevalence by including other rashes. Further, 3.2% reported having rash with asthma and/or hay fever1, likely underestimating AD prevalence by excluding intrinsic AD or those with remote history of atopic disease.

https://ift.tt/2O6Jf4y

Differences in egg and milk food challenge outcomes based on tolerance to the baked form

Previous studies suggest inclusion of baked egg and milk in the diet of egg or cow's milk (CM) allergic children may positively impact native tolerance. Differences in native food reactivity based on historical baked tolerance, however, is not fully understood. Objective: To assess differences in native egg and CM oral food challenge (OFC) outcomes based on presenting history of tolerance and exposure to these foods in the baked form.

https://ift.tt/2NtATmn

Characterization of the mature form of a β-defensin-like peptide, Hoa-D1, in the lobster Homarus americanus

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Giap H. Vu, Daniel Do, Cindy D. Rivera, Patsy S. Dickinson, Andrew E. Christie, Elizabeth A. Stemmler

Abstract

We report on the characterization of the native form of an American lobster, Homarus americanus, β-defensin-like putative antimicrobial peptide, H. americanus defensin 1 (Hoa-D1), sequenced employing top-down and bottom-up peptidomic strategies using a sensitive, chip-based nanoLC-QTOF-MS/MS instrument. The sequence of Hoa-D1 was determined by mass spectrometry; it was found to contain three disulfide bonds and an amidated C-terminus. The sequence was further validated by searching publicly-accessible H. americanus expressed sequence tag (EST) and transcriptome shotgun assembly (TSA) datasets. Hoa-D1, SYVRScSSNGGDcVYRcYGNIINGAcSGSRVccRSGGGYamide (with c representing a cysteine participating in a disulfide bond), was shown to be related to β-defensin-like peptides previously reported from Panulirus japonicas and Panulirus argus. We found Hoa-D1 in H. americanus hemolymph, hemocytes, the supraoesophageal ganglion (brain), eyestalk ganglia, and pericardial organ extracts, as well as in the plasma of some hemolymph samples. Using discontinuous density gradient separations, we fractionatated hemocytes and localized Hoa-D1 to hemocyte sub-populations. While Hoa-D1 was detected in semigranulocytes and granulocytes using conventional proteomic strategies for analysis, the direct analysis of cell lysates exposed evidence of Hoa-D1 processing, including truncation of the C-terminal tyrosine residue, in the granulocytes, but not semigranulocytes. These measurements demonstrate the insights regarding post-translational modifications and peptide processing that can be revealed through the MS analysis of intact peptides. The identification of Hoa-D1 as a widely-distributed peptide in the lobster suggests the possibility that it may be pleiotropic, with functions in addition to its proposed role as an antimicrobial molecule in the innate immune system.

https://ift.tt/2zXiv3f

TGF-β activity in cow milk and fermented milk products: An in vitro bioassay with oral fibroblasts

Publication date: November 2018

Source: Archives of Oral Biology, Volume 95

Author(s): Layla Panahipour, Alexandra Stähli, Nadja Haiden, Reinhard Gruber

Abstract

Objective

Milk is a rich source of transforming growth factor (TGF)-β which supports intestinal mucosal homeostasis of infants. Milk may also have beneficial effects on the integrity of the oral cavity, its being part of the gastrointestinal tract. However, it is unclear if milk and fermented milk products provoke a TGF-β response in oral cells.

Material and Methods

Human gingival fibroblasts were exposed to pasteurized cow milk, yoghurt, sour milk, buttermilk and whey, followed by a reverse transcriptase polymerase chain reaction of the TGF-β target genes interleukin11 (IL11), proteoglycan4 (PRG4), and NADPH oxidase 4 (NOX4). Immunoassays were performed for IL11 and TGF-β in cell culture supernatant and milk products, respectively. Signaling was investigated with the TGF-β receptor type I kinase inhibitor SB431542.

Results

We report here that pasteurized cow milk and the aqueous fractions of yoghurt, sour milk, buttermilk and whey enhanced the expression of IL11, NOX4 and PRG4 in gingival fibroblasts. Moreover, IL11 protein levels in the respective supernatant were significantly increased. Cow milk, yoghurt, sour milk and buttermilk contain approximately 1–2 ng TGF-β1, whereas active TGF-β1 is hardly detectable in whey. SB431542 reduced the response of gingival fibroblasts to pasteurized cow milk and fermented milk products based on IL11 release into the supernatant.

Conclusions

These results demonstrate that gingival fibroblasts respond to pasteurized cow milk and to fermented milk products with an increased expression of TGF-β target genes.

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The effect of intratympanic steroid injection frequency in idiopathic sudden sensorineural hearing loss

Publication date: Available online 20 July 2018

Source: American Journal of Otolaryngology

Author(s): Eric M. Sugihara, Michel A. Evans, Miles Neumann, Seilesh C. Babu

Abstract

Purpose

To evaluate the effect of intratympanic steroid injection frequency on hearing outcomes for patients with idiopathic sudden sensorineural hearing loss.

Materials and methods

A retrospective chart review was performed from 2007 to 2015 at a neurotology tertiary referral center. Adults who met academy criteria for idiopathic sudden sensorineural hearing loss within two months of onset and negative imaging were grouped based on injection frequency. Injection schedules were every 1–4 (group 1), 5–10 (group 2), or 11–30 (group 3) days. All patients had at least two injections with Dexamethasone 10 mg/ml. All patients had pre- and post-injection audiograms.

Results

Seventy patients met inclusion criteria (group 1, n = 21; group 2, n = 29; group 3, n = 20). There was no significant difference between group demographics or baseline audiometric data. Mean gains were significant and similar between groups for pure tone average (group 1 = −23.6 ± 22.0 dB; group 2 = −19.7 ± 18.4 dB; group 3 = −24.9 ± 24.7 dB; p = 0.67) and word recognition score (group 1 = +26.3 ± 34.8%; group 2 = +23.3 ± 29.9%; group 3 = +33.4 ± 28.9%; p = 0.53).

Conclusions

Frequency of intratympanic steroid injections does not significantly affect hearing outcomes. Following injection therapy, hearing outcomes improved regardless of prior or concomitant oral steroid regimen. Earlier time to initiating injections yielded a higher rate of hearing improvement. Long term hearing outcomes >6 months did not show significant additional improvement.

https://ift.tt/2NtY6EW

Topical micronutrients in atopic dermatitis—An evidence‐based review

Dermatologic Therapy, EarlyView.


https://ift.tt/2NuFrJg

Highly‐focused ultrasound in non‐invasive body contouring: Long‐term follow‐up in Korean patients

Dermatologic Therapy, EarlyView.


https://ift.tt/2O6nkui

The 13th International Pan Arab League of Dermatology Conference Held Jointly with the Ninth Dermopolitan Congress Jordan at the Dead Sea, Jordan

Dermatologic Therapy, EarlyView.


https://ift.tt/2NuFm8q

Oral Isotretinoin for the treatment of Aripiprazol‐induced acneiform rash

Dermatologic Therapy, EarlyView.


https://ift.tt/2O3xBao

PDT and BF‐200 ALA: The therapy option for the treatment of Poikiloderma of Civatte

Dermatologic Therapy, EarlyView.


https://ift.tt/2NuFchk

10th International Conference of Jordanian Society of Dermatology, Venereology, Dermatosurgery & Laser, Amman, Kingdom of Jordan

Dermatologic Therapy, EarlyView.


https://ift.tt/2O6EgRx

Intralesional 5‐fluorouracil to treat extensive molluscum contagiosum in an immunocompromised patient: A novel therapeutic modality

Dermatologic Therapy, EarlyView.


https://ift.tt/2L9D2qE

Scoring the tumor-stroma ratio in colon cancer: procedure and recommendations

Abstract

The tumor-stroma ratio (TSR) has been reported as a strong, independent prognostic parameter in colon cancer as well as in other epithelial cancer types, and may be implemented to routine pathology diagnostics. The TSR is an easy technique, based on routine hematoxylin and eosin stained histological sections, estimating the amount of stroma present in the primary tumor. It links tumors with high stromal content to poor prognosis. The analysis time is less than 2 min with a low inter-observer variation. Scoring of the TSR has been validated in a number of independent international studies. In this manuscript, we provide a detailed technical description of estimating the TSR in colon cancer, including examples, pitfalls, and recommendations.

https://ift.tt/2uRCx9w

Ein neu entwickeltes Biofeedbackprogramm zum Gesichtsmuskeltraining für Patienten mit Fazialisparese

Zusammenfassung

Hintergrund

Patienten mit einer Fazialisparese sind in ihrer Lebensqualität deutlich eingeschränkt. Ist kein irreversibler Nervenschaden erkennbar, wird zunächst neben einer medikamentösen Therapie mit Kortison ein intensives Training der Gesichtsmuskulatur empfohlen. Dazu haben die Autoren einen digitalen Biofeedbackspiegel mit Bewegungsverstärkung entwickelt, um das vegetative Nervensystem indirekt zu beeinflussen.

Fragestellung

Ziel dieser Arbeit war es, die Zuverlässigkeit des Biofeedbackprogramms im Vergleich zur klinischen Einteilung nach House-Brackmann zu evaluieren.

Methoden

Das Biofeedbacksystem ähnelt einem Spiegel und nutzt den Vorteil der Steigerung der körperlichen Selbstkontrolle. Es spiegelt nicht nur das Bild des Patienten wider, sondern potenziert die Bewegung durch Videoverarbeitung und eine Lupenfunktion. Die Gesichtsbewegungen des Patienten werden gefilmt und in Echtzeit verstärkt. Kleinste Bewegungen können sichtbar gemacht und gemessen werden, sodass der Patient ein direktes Feedback über Nervenregenerationen erhält. Dies kann die Motivation zum täglichen Gesichtsmuskeltraining steigern und die Compliance verbessern.

Ergebnisse

Die Einschränkung der Lebensqualität wurde mithilfe der Fragebögen Facial Clinimetric Evaluation Scale (FaCE) und Facial Disability Index (FDI) evaluiert und objektiviert und belegte, dass die Selbstwahrnehmung der Patienten mit einer schlechten Lebensqualität assoziiert war.

Schlussfolgerung

In der vorliegenden Studie zeigte die Messung der Gesichtsbewegungen eine gute Übereinstimmung mit der klinischen Einteilung nach House-Brackmann. Das Biofeedbacksystem ist eine zuverlässige Unterstützung im Rahmen der Regenerationsphase bei Patienten mit Fazialisparese.

https://ift.tt/2muWi39

Mechanics of antigen extraction in the B cell synapse

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Katelyn M. Spillane, Pavel Tolar

Abstract

B cell encounter with antigen displayed on antigen-presenting cells leads to B cell immune synapse formation, internalisation of the antigen, and stimulation of antibody responses. The sensitivity with which B cells detect antigen, and the quality and quantity of antigen that B cells acquire, depend upon mechanical properties of the immune synapse including interfacial tension, the strength of intermolecular bonds, and the compliance of the molecules and membranes that participate in antigen presentation. In this review, we discuss our current understanding of how these various physical parameters influence B cell antigen extraction in the immune synapse and how a more comprehensive understanding of B cell mechanics may promote the development of new approaches to stimulate the production of desired antibodies.

https://ift.tt/2Loi4ng

CD11c + MHCII lo GM-CSF-bone marrow-derived dendritic cells act as antigen donor cells and as antigen presenting cells in neoepitope-elicited tumor immunity against a mouse fibrosarcoma

Abstract

Dendritic cells play a critical role in initiating T-cell responses. In spite of this recognition, they have not been used widely as adjuvants, nor is the mechanism of their adjuvanticity fully understood. Here, using a mutated neoepitope of a mouse fibrosarcoma as the antigen, and tumor rejection as the end point, we show that dendritic cells but not macrophages possess superior adjuvanticity. Several types of dendritic cells, such as bone marrow-derived dendritic cells (GM-CSF cultured or FLT3-ligand induced) or monocyte-derived ones, are powerful adjuvants, although GM-CSF-cultured cells show the highest activity. Among these, the CD11c⁺ MHCII^lo sub-set, distinguishable by a distinct transcriptional profile including a higher expression of heat shock protein receptors CD91 and LOX1, mannose receptors and TLRs, is significantly superior to the CD11c⁺ MHCII^hi sub-set. Finally, dendritic cells exert their adjuvanticity by acting as both antigen donor cells (i.e., antigen reservoirs) as well as antigen presenting cells.

https://ift.tt/2zVunD7

Combination and QCD analysis of charm and beauty production cross-section measurements in deep inelastic ep scattering at HERA

Abramowicz, H; Abt, I; Adamczyk, L; Adamus, M; Aggarwal, R; Andreev, V; Antonelli, S; ... Zomer, F; + view all Abramowicz, H; Abt, I; Adamczyk, L; Adamus, M; Aggarwal, R; Andreev, V; Antonelli, S; Aushev, V; Baghdasaryan, A; Begzsuren, K; Behnke, O; Behrens, U; Belousov, A; Bertolin, A; Bloch, I; Bolz, A; Boudry, V; Brandt, G; Brisson, V; Britzger, D; Brock, I; Brook, NH; Brugnera, R; Bruni, A; Buniatyan, A; Bussey, PJ; Bylinkin, A; Bystritskaya, L; Caldwell, A; Campbell, AJ; Cantun Avila, KB; Capua, M; Catterall, CD; Cerny, K; Chekelian, V; Chwastowski, J; Ciborowski, J; Ciesielski, R; Contreras, JG; Cooper-Sarkar, AM; Corradi, M; Cvach, J; Dainton, JB; Daum, K; Dementiev, RK; Devenish, RCE; Diaconu, C; Dobre, M; Dusini, S; Eckerlin, G; Egli, S; Elsen, E; Favart, L; Fedotov, A; Feltesse, J; Fleischer, M; Fomenko, A; Foster, B; Gallo, E; Garfagnini, A; Gayler, J; Geiser, A; Gizhko, A; Gladilin, LK; Goerlich, L; Gogitidze, N; Golubkov, YA; Gouzevitch, M; Grab, C; Grebenyuk, A; Greenshaw, T; Grindhammer, G; Grzelak, G; Gwenlan, C; Haidt, D; Henderson, RCW; Hladky, J; Hlushchenko, O; Hochman, D; Hoffmann, D; Horisberger, R; Hreus, T; Huber, F; Ibrahim, ZA; Iga, Y; Jacquet, M; Janssen, X; Jomhari, NZ; Jung, AW; Jung, H; Kadenko, I; Kananov, S; Kapichine, M; Karshon, U; Katzy, J; Kaur, P; Kiesling, C; Kisielewska, D; Klanner, R; Klein, M; Klein, U; Kleinwort, C; Kogler, R; Korzhavina, IA; Kostka, P; Kotanski, A; Kovalchuk, N; Kowalski, H; Kretzschmar, J; Kruecker, D; Krueger, K; Krupa, B; Kuprash, O; Kuze, M; Landon, MPJ; Lange, W; Laycock, P; Lebedev, A; Levchenko, BB; Levonian, S; Levy, A; Libov, V; Lipka, K; Lisovyi, M; List, B; List, J; Lobodzinski, B; Loehr, B; Lohrmann, E; Longhin, A; Lukina, OY; Makarenko, I; Malinovski, E; Malka, J; Martyn, H-U; Masciocchi, S; Maxfield, SJ; Mehta, A; Meyer, AB; Meyer, H; Meyer, J; Mikocki, S; Idris, FM; Nasir, NM; Morozov, A; Muller, K; Myronenko, V; Nagano, K; Nam, JD; Naumann, T; Newman, PR; Nicassio, M; Niebuhr, C; Nowak, G; Olsson, JE; Onderwaater, J; Onishchuk, Y; Ozerov, D; Pascaud, C; Patel, GD; Paul, E; Perez, E; Perlanski, W; Petrukhin, A; Picuric, I; Pirumov, H; Pitzl, D; Pokrovskiy, NS; Polifka, R; Polini, A; Przybycien, M; Radescu, V; Raicevic, N; Ravdandorj, T; Reimer, P; Rizvi, E; Robmann, P; Roosen, R; Rostovtsev, A; Rotaru, M; Ruspa, M; Salek, D; Sankey, DPC; Sauter, M; Sauvan, E; Saxon, DH; Schioppa, M; Schmitt, S; Schneekloth, U; Schoeffel, L; Schoening, A; Schoerner-Sadenius, T; Sefkow, F; Selyuzhenkov, I; Shcheglova, LM; Shushkevich, S; Shyrma, Y; Skillicorn, IO; Slominski, W; Solano, A; Soloviev, Y; Sopicki, P; South, D; Spaskov, V; Specka, A; Stanco, L; Steder, M; Stefaniuk, N; Stella, B; Stern, A; Stopa, P; Straumann, U; Surrow, B; Sykora, T; Sztuk-Dambietz, J; Tassi, E; Thompson, PD; Tokushuku, K; Tomaszewska, J; Traynor, D; Truol, P; Tsakov, I; Tseepeldorj, B; Tsurugai, T; Turcato, M; Turkot, O; Tymieniecka, T; Valkarova, A; Vallee, C; Van Mechelen, P; Vazdik, Y; Verbytskyi, A; Abdullah, WATW; Wegener, D; Wichmann, K; Wing, M; Wuensch, E; Yamada, S; Yamazaki, Y; Zacek, J; Zarnecki, AF; Zawiejski, L; Zenaiev, O; Zhang, Z; Zhautykov, BO; Zlebcik, R; Zohrabyan, H; Zomer, F; - view fewer (2018) Combination and QCD analysis of charm and beauty production cross-section measurements in deep inelastic ep scattering at HERA. The European Physical Journal C , 78 (6) , Article 473. 10.1140/epjc/s10052-018-5848-3 . Green open access

https://ift.tt/2mufVYZ

Variants in genes encoding small GTPases and association with epithelial ovarian cancer susceptibility

Earp, M; Tyrer, JP; Winham, SJ; Lin, H-Y; Chornokur, G; Dennis, J; Aben, KKH; ... Phelan, CM; + view all Earp, M; Tyrer, JP; Winham, SJ; Lin, H-Y; Chornokur, G; Dennis, J; Aben, KKH; Anton-Culver, H; Antonenkova, N; Bandera, EV; Bean, YT; Beckmann, MW; Bjorge, L; Bogdanova, N; Brinton, LA; Brooks-Wilson, A; Bruinsma, F; Bunker, CH; Butzow, R; Campbell, IG; Carty, K; Chang-Claude, J; Cook, LS; Cramer, DW; Cunningham, JM; Cybulski, C; Dansonka-Mieszkowska, A; Despierre, E; Doherty, JA; Dörk, T; du Bois, A; Dürst, M; Easton, DF; Eccles, DM; Edwards, RP; Ekici, AB; Fasching, PA; Fridley, BL; Gentry-Maharaj, A; Giles, GG; Glasspool, R; Goodman, MT; Gronwald, J; Harter, P; Hein, A; Heitz, F; Hildebrandt, MAT; Hillemanns, P; Hogdall, CK; Høgdall, E; Hosono, S; Iversen, ES; Jakubowska, A; Jensen, A; Ji, B-T; Jung, AY; Karlan, BY; Kellar, M; Kiemeney, LA; Kiong Lim, B; Kjaer, SK; Krakstad, C; Kupryjanczyk, J; Lambrechts, D; Lambrechts, S; Le, ND; Lele, S; Lester, J; Levine, DA; Li, Z; Liang, D; Lissowska, J; Lu, K; Lubinski, J; Lundvall, L; Massuger, LFAG; Matsuo, K; McGuire, V; McLaughlin, JR; McNeish, I; Menon, U; Milne, RL; Modugno, F; Moysich, KB; Ness, RB; Nevanlinna, H; Odunsi, K; Olson, SH; Orlow, I; Orsulic, S; Paul, J; Pejovic, T; Pelttari, LM; Permuth, JB; Pike, MC; Poole, EM; Rosen, B; Rossing, MA; Rothstein, JH; Runnebaum, IB; Rzepecka, IK; Schernhammer, E; Schwaab, I; Shu, X-O; Shvetsov, YB; Siddiqui, N; Sieh, W; Song, H; Southey, MC; Spiewankiewicz, B; Sucheston-Campbell, L; Tangen, IL; Teo, S-H; Terry, KL; Thompson, PJ; Thomsen, L; Tworoger, SS; van Altena, AM; Vergote, I; Vestrheim Thomsen, LC; Vierkant, RA; Walsh, CS; Wang-Gohrke, S; Wentzensen, N; Whittemore, AS; Wicklund, KG; Wilkens, LR; Woo, Y-L; Wu, AH; Wu, X; Xiang, Y-B; Yang, H; Zheng, W; Ziogas, A; Lee, AW; Pearce, CL; Berchuck, A; Schildkraut, JM; Ramus, SJ; Monteiro, ANA; Narod, SA; Sellers, TA; Gayther, SA; Kelemen, LE; Chenevix-Trench, G; Risch, HA; Pharoah, PDP; Goode, EL; Phelan, CM; - view fewer (2018) Variants in genes encoding small GTPases and association with epithelial ovarian cancer susceptibility. PLoS One , 13 (7) , Article e0197561. 10.1371/journal.pone.0197561 . Green open access

https://ift.tt/2mtMXbE

Antennal Protein Profile in Honeybees: Caste and Task Matter More Than Age

Iovinella, I; Cappa, F; Cini, A; Petrocelli, I; Cervo, R; Turillazzi, S; Dani, FR; (2018) Antennal Protein Profile in Honeybees: Caste and Task Matter More Than Age. Frontiers in Physiology , 9 , Article 748. 10.3389/fphys.2018.00748 . Green open access

https://ift.tt/2zXyQVU

Adalimumab in Active and Inactive, Non-Infectious Uveitis: Global Results from the VISUAL I and VISUAL II Trials

Goto, H; Zako, M; Namba, K; Hashida, N; Kaburaki, T; Miyazaki, M; Sonoda, K-H; ... Ohno, S; + view all Goto, H; Zako, M; Namba, K; Hashida, N; Kaburaki, T; Miyazaki, M; Sonoda, K-H; Abe, T; Mizuki, N; Kamoi, K; Brézin, AP; Dick, AD; Jaffe, GJ; Nguyen, QD; Inomata, N; Kwatra, NV; Camez, A; Song, AP; Kron, M; Tari, S; Ohno, S; - view fewer (2018) Adalimumab in Active and Inactive, Non-Infectious Uveitis: Global Results from the VISUAL I and VISUAL II Trials. Ocular Immunology and Inflammation 10.1080/09273948.2018.1491605 . (In press).

https://ift.tt/2mxwQd6

Sex differences in frontal lobe connectivity in adults with autism spectrum conditions

Zeestraten, EA; Gudbrandsen, MC; Daly, E; de Schotten, MT; Catani, M; Dell'Acqua, F; Lai, M-C; ... Craig, MC; + view all Zeestraten, EA; Gudbrandsen, MC; Daly, E; de Schotten, MT; Catani, M; Dell'Acqua, F; Lai, M-C; Ruigrok, ANV; Lombardo, MV; Chakrabarti, B; Baron-Cohen, S; Ecker, C; MRC AIMS Consortium, ; Murphy, DGM; Craig, MC; - view fewer (2017) Sex differences in frontal lobe connectivity in adults with autism spectrum conditions. Transl Psychiatry , 7 (4) , Article e1090. 10.1038/tp.2017.9 . Green open access

https://ift.tt/2zUyNu1

Influence of vegetation physiognomy, elevation and fire frequency on medium and large mammals in two protected areas of the Espinhaco Range

de Pinho, FF; Ferreira, GB; Paglia, AP; (2017) Influence of vegetation physiognomy, elevation and fire frequency on medium and large mammals in two protected areas of the Espinhaco Range. Zoologia , 34 , Article ee11921. 10.3897/zoologia.34.e11921 . Green open access

https://ift.tt/2mw0hwb

Gynaecologists' and general surgeons' preference for the features of integrated theatres: a discrete choice experiment

Holland, TK; Morris, S; Cutner, A; (2018) Gynaecologists' and general surgeons' preference for the features of integrated theatres: a discrete choice experiment. BMC Women's Health , 18 , Article 112. 10.1186/s12905-018-0576-2 . Green open access

https://ift.tt/2A5rKPh

Feeding ecology and spraint deposition sites of the Neotropical otter (Lontra longicaudis) at Cavernas do Peruaçu National Park, Brazil

De Pinho, FF; Ferreira, GB; Barata, IM; (2018) Feeding ecology and spraint deposition sites of the Neotropical otter (Lontra longicaudis) at Cavernas do Peruaçu National Park, Brazil. IUCN/SCC Otter Specialist Group Bulletin , 35 (1) pp. 11-21.

https://ift.tt/2mufSwh

All disease begins in the gut: Influence of gastrointestinal disorders and surgery on oral drug performance

Hatton, GB; Madla, CM; Rabbie, SC; Basit, AW; (2018) All disease begins in the gut: Influence of gastrointestinal disorders and surgery on oral drug performance. International Journal of Pharmaceutics , 548 (1) pp. 408-422. 10.1016/j.ijpharm.2018.06.054 .

https://ift.tt/2mxw9Rj

Amphibian species composition and priorities for regional conservation at the Espinhaço mosaic, Southeastern Brazil

Barata, IM; Correia, CM; Ferreira, GB; (2016) Amphibian species composition and priorities for regional conservation at the Espinhaço mosaic, Southeastern Brazil. Herpetological Conservation and Biology , 11 (2) pp. 293-303.

https://ift.tt/2uY3VDd

Cross-cultural adaptation and psychometric evaluation of the Sinhala version of Lawton Instrumental Activities of Daily Living Scale

Siriwardhana, DD; Walters, K; Rait, G; Bazo-Alvarez, JC; Weerasinghe, MC; (2018) Cross-cultural adaptation and psychometric evaluation of the Sinhala version of Lawton Instrumental Activities of Daily Living Scale. PLoS One , 13 (6) , Article e0199820. 10.1371/journal.pone.0199820 . Green open access

https://ift.tt/2msUwiW

Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre

Lane, T; Pinney, JH; Gilbertson, JA; Hutt, DF; Rowczenio, DM; Mahmood, S; Sachchithanantham, S; ... Lachmann, HJ; + view all Lane, T; Pinney, JH; Gilbertson, JA; Hutt, DF; Rowczenio, DM; Mahmood, S; Sachchithanantham, S; Fontana, M; Youngstein, T; Quarta, CC; Wechalekar, AD; Gillmore, JD; Hawkins, PN; Lachmann, HJ; - view fewer (2017) Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre. Amyloid: The Journal of Protein Folding Disorders , 24 (3) pp. 162-166. 10.1080/13506129.2017.1342235 . Green open access

https://ift.tt/2mxwLWQ

Breaking wave impact on a floating body with air bubble effect

Sun, S; Wu, G; Xu, G; (2018) Breaking wave impact on a floating body with air bubble effect. Journal of Fluids and Structures , 82 pp. 16-34. 10.1016/j.jfluidstructs.2018.06.016 .

https://ift.tt/2zXyizk

Motion of a floating body in a harbour by domain decomposition method

Shi, YY; Li, ZF; Wu, GX; (2018) Motion of a floating body in a harbour by domain decomposition method. Applied Ocean Research , 78 pp. 223-240. 10.1016/j.apor.2018.06.015 .

https://ift.tt/2muGRb7

Regional and national trends in attention-deficit/hyperactivity disorder (ADHD) medication use: a multinational study in North America, Europe, Asia and Australia

Raman, SR; Man, KKC; Bahmanyar, S; Berard, A; Bilder, S; Boukhris, T; Bushnell, G; ... Wong, ICK; + view all Raman, SR; Man, KKC; Bahmanyar, S; Berard, A; Bilder, S; Boukhris, T; Bushnell, G; Crystal, S; Furu, K; Yang, Y-HK; Karlstad, O; Kieler, H; Kubota, K; Lai, EC-C; Martikainen, JE; Maura, G; Moore, N; Montero, D; Nakamura, H; Neumann, A; Pate, V; Pottegård, A; Pratt, NL; Roughead, EE; Saint-Gerons, DM; Stürmer, T; Su, CC; Zoega, H; Sturkenbroom, MCJM; Chan, EW; Coghill, D; Ip, P; Wong, ICK; - view fewer (2018) Regional and national trends in attention-deficit/hyperactivity disorder (ADHD) medication use: a multinational study in North America, Europe, Asia and Australia. The Lancet Psychiatry (In press).

https://ift.tt/2zWHBiT

Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study

Fancourt, DE; Perkins, R; (2018) Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study. BMJ Open , 8 (7) , Article e021251. 10.1136/bmjopen-2017-021251 . Green open access

https://ift.tt/2mxwKlK

First ever record of a black-coloured maned wolf

Braga Ferreira, G; Barros, C; Costa, A; Dias, T; Oliveira, M; (2017) First ever record of a black-coloured maned wolf. Canid Biology & Conservation , 20 (10) pp. 42-45.

https://ift.tt/2uR9rav

Low-Level EMF Stimulation for Paroxysmal Atrial Fibrillation

Conditions:   Atrial Fibrillation;   Catheter Ablation;   Autonomic Imbalance
Interventions:   Device: Low-level Pulsed EMF;   Device: Sham Stimulation
Sponsor:   Daniel Sohinki
Not yet recruiting

https://ift.tt/2msMpD0

Study to Evaluate Safety & Tolerability of AGI-134 in Solid Tumour

Conditions:   Superficial, Palpable, Unresectable/Metastatic Solid Tumour;   Metastatic Colorectal Cancer;   Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: AGI-134;   Drug: AGI-134 + Pembrolizumab
Sponsor:   Agalimmune Ltd.
Not yet recruiting

https://ift.tt/2uPn61K

A Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of AZD8233 in Healthy Male Subjects With Increased Elevated LDL-C Levels.

Condition:   Hypercholesterolemia
Intervention:   Drug: AZD8233
Sponsors:   AstraZeneca;   Parexel
Not yet recruiting

https://ift.tt/2mvStdR

Atopic dermatitis in US adults - epidemiology, association with marital status and atopy

Publication date: Available online 20 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Tammy Hua, Jonathan I. Silverberg

https://ift.tt/2JEoqtI

The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan

Trenouth, L; Colbourn, T; Fenn, B; Pietzsch, S; Myatt, M; Puett, C; (2018) The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan. Health Policy and Planning , 33 (6) pp. 743-754. 10.1093/heapol/czy045 . Green open access

https://ift.tt/2zXbCz4

Review of 'Learning as Development: Rethinking International Education in a Changing World'

Golding, J; (2019) Review of 'Learning as Development: Rethinking International Education in a Changing World'. London Review of Education (In press). Green open access

https://ift.tt/2uxBP27

Physical activity referral to cardiac rehabilitation, leisure centre or telephone-delivered consultations in post-surgical people with breast cancer: a mixed methods process evaluation

Hubbard, G; Campbell, A; Fisher, A; Harvie, M; Maltinsky, W; Mullen, R; Banks, E; ... Ozakinci, G; + view all Hubbard, G; Campbell, A; Fisher, A; Harvie, M; Maltinsky, W; Mullen, R; Banks, E; Gracey, J; Gorely, T; Munro, J; Ozakinci, G; - view fewer (2018) Physical activity referral to cardiac rehabilitation, leisure centre or telephone-delivered consultations in post-surgical people with breast cancer: a mixed methods process evaluation. Pilot Feasibility Stud , 4 , Article 108. 10.1186/s40814-018-0297-1 . Green open access

https://ift.tt/2zUwqHl

An absolute sodium abundance for a cloud-free 'hot Saturn' exoplanet

Nikolov, N; Sing, DK; Fortney, JJ; Goyal, JM; Drummond, B; Evans, TM; Gibson, NP; ... Spake, JJ; + view all Nikolov, N; Sing, DK; Fortney, JJ; Goyal, JM; Drummond, B; Evans, TM; Gibson, NP; De Mooij, EJW; Rustamkulov, Z; Wakeford, HR; Smalley, B; Burgasser, AJ; Hellier, C; Helling, C; Mayne, NJ; Madhusudhan, N; Kataria, T; Baines, J; Carter, AL; Ballester, GE; Barstow, JK; McCleery, J; Spake, JJ; - view fewer (2018) An absolute sodium abundance for a cloud-free 'hot Saturn' exoplanet. Nature , 557 (7706) pp. 526-529. 10.1038/s41586-018-0101-7 .

https://ift.tt/2uxBFYz

Mathematics education in the spotlight: its purpose and some implications

Golding, J; (2018) Mathematics education in the spotlight: its purpose and some implications. London Review of Education (In press). Green open access

https://ift.tt/2zX8enY

60 GHz Transmission Link using Uni-Travelling Carrier Photodiodes at the Transmitter and the Receiver

Mohammad, AW; Shams, H; Liu, C; Graham, C; Natrella, M; Seeds, AJ; Renaud, CC; (2018) 60 GHz Transmission Link using Uni-Travelling Carrier Photodiodes at the Transmitter and the Receiver. Journal of Lightwave Technology 10.1109/JLT.2018.2849938 . (In press). Green open access

https://ift.tt/2uxBwEv

A crowd route choice evacuation model in large indoor building spaces

Wu, Y; Kang, J; Wang, C; (2018) A crowd route choice evacuation model in large indoor building spaces. Frontiers of Architectural Research , 7 (2) pp. 135-150. 10.1016/j.foar.2018.03.003 . Green open access

https://ift.tt/2A1KRtw

A Common Glaucoma-risk Variant of SIX6 Alters Retinal Nerve Fiber Layer and Optic Disc Measures in a European Population: The EPIC-Norfolk Eye Study

Khawaja, AP; Chan, MPY; Yip, JLY; Broadway, DC; Garway-Heath, DF; Viswanathan, AC; Luben, R; ... Foster, PJ; + view all Khawaja, AP; Chan, MPY; Yip, JLY; Broadway, DC; Garway-Heath, DF; Viswanathan, AC; Luben, R; Hayat, S; Hauser, MA; Wareham, NJ; Khaw, K-T; Fortune, B; Allingham, RR; Foster, PJ; - view fewer (2018) A Common Glaucoma-risk Variant of SIX6 Alters Retinal Nerve Fiber Layer and Optic Disc Measures in a European Population: The EPIC-Norfolk Eye Study. Journal of Glaucoma 10.1097/IJG.0000000000001026 . (In press).

https://ift.tt/2uDsCFr

The impact of Teach First on pupil attainment at age 16

Allen, R; Allnutt, J; (2017) The impact of Teach First on pupil attainment at age 16. British Educational Research Journal , 43 (4) pp. 627-646. 10.1002/berj.3288 .

https://ift.tt/2zWBlaX

Towards better integration of ecology in palaeoecology: from proxies to indicators, from inference to understanding

Davidson, TA; Bennion, H; Reid, M; Sayer, CD; Whitmore, TJ; (2018) Towards better integration of ecology in palaeoecology: from proxies to indicators, from inference to understanding. Journal of Paleolimnology , 60 (2) pp. 109-116. 10.1007/s10933-018-0032-1 . (In press).

https://ift.tt/2uBcy7j

Early Holocene human presence in Madagascar evidenced by exploitation of avian megafauna

Hansford, J; Wright, PC; Rasoamiaramanana, A; Pérez, VR; Godfrey, LR; Errickson, D; Thompson, T; Hansford, J; Wright, PC; Rasoamiaramanana, A; Pérez, VR; Godfrey, LR; Errickson, D; Thompson, T; Turvey, ST; - view fewer (2018) Early Holocene human presence in Madagascar evidenced by exploitation of avian megafauna. Science Advances (In press).

https://ift.tt/2LCAaP2

A tour of contemporary color vision research

Conway, BR; Eskew, RT; Martin, PR; Stockman, A; (2018) A tour of contemporary color vision research. Vision Research 10.1016/j.visres.2018.06.009 . (In press).

https://ift.tt/2uBcvIF

Longitudinal associations between psychotic experiences and disordered eating behaviours in adolescence: a UK population-based study

Solmi, F; Melamed, D; Lewis, G; Kirkbride, JB; (2018) Longitudinal associations between psychotic experiences and disordered eating behaviours in adolescence: a UK population-based study. The Lancet Child and Adolescent Health , 2 (8) pp. 591-599. 10.1016/S2352-4642(18)30180-9 . (In press). Green open access

https://ift.tt/2LwFvHD

Shopping and Scheming, and the Rule in Gibbs

Mokal, R; (2017) Shopping and Scheming, and the Rule in Gibbs. South Square Digest pp. 58-63.

https://ift.tt/2uDTO6S

Company Law: Chapter 14

Lowry, JP; (2018) Company Law: Chapter 14. [Book]. (10th edition ed.). OUP (Oxford University Press): Oxford, UK. (In press). Green open access

https://ift.tt/2LzgRpZ

Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada

Abstract

Background

An analysis of the scope of practice of recent Otolaryngology – Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates.

Methods

Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded.

Results

There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as 'otology' (42%), 'general otolaryngology' (35%), 'rhinology' (17%) and 'head and neck' (4%). The most common procedure codes were categorized as 'general otolaryngology' (45%), 'otology' (23%), 'head and neck' (13%) and 'rhinology' (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon.

Conclusion

This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. The findings demonstrated a prominent representation of 'otology', 'general' and 'rhinology' based consultation diagnoses and procedures. The data derived from the study needs to be considered as residency curricula are modified to satisfy competency-based requirements.

https://ift.tt/2uCq6zd

Optic Neuritis Possibly Induced by Anti-PD-L1 Antibody Treatment in a Patient with Non-Small Cell Lung Carcinoma

Background: Recent immune therapy with checkpoint inhibitors (CPIs) has demonstrated remarkable antitumor effects on specific tumors, such as malignant lymphoma and non-small cell lung carcinoma. By contrast, CPIs cause an imbalance in the immune system, triggering a wide range of immunological side effects termed immune-related adverse effects (irAEs). Here, we report a rare case of optic neuritis and hypopituitarism during anti-programmed death-ligand 1 (PD-L1) antibody treatment. Case Presentation: A patient with non-small cell lung carcinoma received anti-PD-L1 antibody treatment every 3 weeks; however, the patient started experiencing headaches, general fatigue, anorexia, and diarrhea approximately 1 year after the initiation of the treatment. Moreover, sudden visual loss of the right eye occurred 1 week after the interruption of the anti-PD-L1 antibody treatment. MRI findings showed gadolinium enhancement in the left optic nerve, but no enlargement of the pituitary gland and stalk. Laboratory data showed decreased serum adrenocorticotropic hormone (ACTH), cortisol, and free T₄ levels, and a hormone tolerance test indicated hypopituitarism, hypothyroidism, and hypoadrenocorticism. The central scotoma caused by optic neuritis completely disappeared immediately after a course of steroid pulse therapy, and no recurrence occurred up to 2 years after initiation of the steroid pulse therapy while replacement therapy for hypothyroidism and hypoadrenocorticism was continued. Conclusions: The patient presented with optic neuritis and hypopituitarism, possibly due to irAEs of the anti-PD-L1 antibody treatment. Steroid pulse therapy was effective for optic neuritis, suggesting underlying immunological mechanisms. Neurological complications including optic neuritis should be considered when examining patients with cancer undergoing CPI treatment.
Case Rep Ophthalmol 2018;9:348–356

https://ift.tt/2muLfaf

The 10 fundamental principles of lay resuscitation: Recommendations by the German Resuscitation Council

No abstract available

https://ift.tt/2Lrmx8w

Drug Now in Clinical Trials for Parkinson’s Strengthens Heart Contractions in Animals

A drug currently in clinical trials for treating symptoms of Parkinson's disease may someday have value for treating heart failure, according to results of early animal studies by Johns Hopkins Medicine researchers.

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Protective effects of SIRT6 against lipopolysaccharide (LPS) are mediated by deacetylation of Ku70

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Lin Zhang, Li Bai, Qihui Ren, Guohui Sun, Yajing Si

Abstract

Progression of pulpitis is facilitated by the immune system's response to bacteria, enhancing the production of inflammatory regulators. Bacterial lipopolysaccharide (LPS) is the major structural component of the outer wall of all Gram-negative bacteria and a potent activator of the immune system. Apoptosis is believed to play an important role in the inflammatory process of pulpitis. SIRT6 is a member of class III of histone deacetylases (HDACs), also called sirtuins (SIRTs). The role of SIRT6 in apoptosis in pulpitis is unknown. In this study, we found that the expression of SIRT6 in human dental pulp cells (hDPCs) was down-regulated by treatment with LPS. MTT and LDH assays revealed that overexpression of SIRT6 in hDPCs attenuated cell death induced by LPS. Consistently, our results demonstrated that SIRT6 was able to protect hDPCs from apoptosis. We found that SIRT6 could interact with Ku70, an important apoptosis regulator, by the immunoprecipitation (IP) experiment. SIRT6 physically binds to Ku70. Overexpression of SIRT6 reduced acetylation of Ku70 and promoted interaction of Ku70 with the proapoptotic protein Bax. These studies underscore an essential role of SIRT6 in the survival of hDPCs in stress situations.

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HMBOX1 in hepatocytes attenuates LPS/D-GalN-induced liver injury by inhibiting macrophage infiltration and activation

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Hengli Zhao, Qiuju Han, Nan Lu, Dongqing Xu, Zhigang Tian, Jian Zhang

Abstract

The HMBOX1 (Homeobox Containing 1) gene was first isolated from the human pancreatic cDNA libraries and is widely expressed in many tissues. Previously, we detected high expression of HMBOX1 in the liver, but its function was unclear. In this study, hepatocyte-specific HMBOX1 knockout mice (Hm^△hep mice) were generated and used to characterize the function of HMBOX1 in the LPS/D-GalN-induced acute liver failure model. HMBOX1-knockout exhibits exacerbated liver injury induced by LPS/D-GalN, accompanied with high levels of inflammatory cytokines both in the liver and in circulation. Further investigation demonstrated that HMBOX1 negatively regulates NF-κB signal transduction. Therefore, HMBOX1-knockout in hepatocytes promotes CCL2 expression through the activation of NF-κB signaling, which enhanced the infiltration of macrophages into the liver. In addition, the decrease of HMBOX1 in hepatocytes promotes the activation of macrophages, upregulating CD80 and MHCⅡ, as well as inflammatory factors TNF-α and IL-6. Importantly, overexpression of HMBOX1 rescued liver injury in Hm^△hep mice. These findings indicate that HMBOX1 in hepatocytes acts as a key immunosuppressive factor for inflammation and plays a critical protective role in LPS/D-GalN-induced liver injury.

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Polymorphisms in the DAD1 and OXA1L genes are associated with asthma and atopy in a South American population

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Anaque de Oliveira Pires, Gerson de Almeida Queiroz, Milca de Jesus Silva, Raimon Rios da Silva, Hugo Bernardino Ferreira da Silva, Norma Vilany Queiroz Carneiro, Héllen Freitas Fonseca, Maria Borges Rabelo de Santana, Regina Santos Nascimento, Neuza Maria Alcântara-Neves, Gustavo Nunes de Oliveira Costa, Ryan dos Santos Costa, Maurício L. Barreto, Camila Alexandrina Figueiredo

Abstract

Atopic asthma, which is characterized by the chronic inflammation and morbidity of airways, is a disease of great complexity, and multiple genetic and environmental factors are involved in its etiology. In the first genome-wide association study (GWAS) conducted in Brazil for asthma, a positive association was found between atopic asthma and a variant (rs1999071), which is located between the DAD1 and OXA1L genes, although neither gene has previously been reported to be associated with asthma or allergies. The DAD1 gene is involved in the regulation of programmed cell death, and OXA1L is involved in biogenesis and mitochondrial oxidative phosphorylation. This study aimed to evaluate how polymorphisms in DAD1 and OXA1L are associated with asthma and markers of atopy in individuals from the Salvador cohort of the SCAALA (Social Change Asthma and Allergy in Latin America) program. The DNA of 1220 individuals was genotyped using the Illumina 2.5 Human Omni Bead chip. Logistic regression analyses were performed with PLINK 1.9 software to verify the association between DAD1 and OXA1L polymorphisms and asthma and atopic markers, adjusted for sex, age, helminth infections and ancestry markers, using an additive model. The DAD1 and OXA1L genes were associated with some of the evaluated phenotypes, such as asthma, skin prick test (SPT), specific IgE for aeroallergens, and Th1/Th2-type cytokine production. Using qPCR, as well as in silico gene expression analysis, we have demonstrated that some of the polymorphisms in both genes are able to affect their respective gene expression levels. In addition, DAD1 was over-expressed in asthmatic patients when compared with controls. Thus, our findings demonstrate that variants in both the DAD1 and OXA1L genes may affect atopy and asthma in a Latin American population with a high prevalence of asthma.

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Regenerative Medicine 3.TX: What Can We Learn About Organ Regeneration From Organ Replacement

No abstract available

https://ift.tt/2LBCs1f

A clinical decision support system can help facilitate living kidney donor assessments

No abstract available

https://ift.tt/2LalnPt

Deep Profiling of the CD8+ T cell Compartment identifies Activated cell subsets and Multifunctional Responses Associated with Control of Cytomegalovirus Viremia

Background Human cytomegalovirus (HCMV) is a common opportunistic pathogen in transplant recipients. Patterns of viremia and reactivation are influenced by the host immune response, including CD8+ T cells. However, the cellular deficits or phenotypic differences that account for differential outcomes during HCMV viremia are incompletely understood. Methods PBMCs were collected from 20 transplant recipients (10 viremia controllers and 10 noncontrollers) at onset of HCMV viremia and 4-weeks post. We utilized mass cytometry to perform in-depth characterization of cell-surface and intracellular CD8+ T cell markers and to compare frequencies of these cells between groups. Results Deep profiling identified 2 TCM subsets at onset and 5 TEMRA subsets at 4 weeks that were associated with control of HCMV viremia, in addition to 6 TEMRA subsets at onset and 4 weeks associated with relapsing or remitting HCMV viremia. In general, CD8+ T cell clusters associated with poorly controlled HCMV viremia lacked markers of activation or terminal differentiation including CD38, CD69, CD25, CD57 and HLA-DR. We also measured the production of 8 HCMV-specific effector molecules (TNFα, IFNγ, IL2, granzyme B, perforin, MIP1β, IL10 and CD107a) in CD8+ T cells. Viremia controllers had greater diversity of HCMV-specific multi-functional responses at both time points, including significantly higher frequencies of HCMV-specific TNFα+IFNγ+ CD8+ T cells at onset. These multifunctional cells had a phenotype consistent with activated TEM/TEMRA cells. Conclusions Uncontrolled CMV viremia is associated with specific clusters of memory T cell subsets and lower frequencies of HCMV-specific multifunctional CD8+ T cells. *Indicates joint senior authorship. Corresponding Author: Atul Humar MD MSc FRCPC, PMB 11-175, 585 University Avenue, Toronto, Canada M5G 2N2; tel: (416) 340-4241; fax (416) 340-4043; email: atul.humar@uhn.ca AUTHORSHIP PAGE Authors: Victor H. Ferreira – victor.ferreira@uhnresearch.ca Deepali Kumar – deepali.kumar@uhn.ca Atul Humar – atul.humar@uhn.ca Author Contributions: V.H.F. - participated in performance of the research, data analysis, and writing of the paper. D.K. – participated in research design, data interpretation, data collection, and writing of the paper. A.H. – participated in research design, data interpretation, data collection, and writing of the paper. Disclosure: A.H. has received a research grant from Roche and Qiagen, consulting fees from Astellas and Chimerix. D.K. has received research grants from Roche, Qiagen and Oxford Immunotec and consulting fees from Qiagen and Oxford Immunotec. Funding: This study was funded by the Canadian National Transplant Research Program (CNTRP). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Development of a clinical decision support system for living kidney donor assessment based on national guidelines

Background Live donor nephrectomy is an operation that places the donor at risk of complications without the possibility of medical benefit. Rigorous donor selection and assessment is therefore essential to ensure minimisation of risk and for this reason robust national guidelines exist. Previous studies have demonstrated poor adherence to donor guidelines. Methods We developed a clinical decision support system (CDSS), based upon national living donor guidelines, to facilitate the identification of contraindications, additional investigations, special considerations and the decision as to nephrectomy side in potential living donors. The CDSS was then tested with patient data from 45 potential kidney donors. Results The CDSS comprises 17 core tasks completed by either patient or nurse, and 17 optional tasks that are triggered by certain patient demographics or conditions. Decision rules were able to identify contraindications, additional investigations, special considerations and predicted operation side in our patient cohort. 17/45 patients went on to donate a kidney, of whom 7 had major contraindications defined in the national guidelines, many of which were not identified by the clinical team. Only 43% of additional investigations recommended by national guidelines were completed, with the most frequently missed investigations being oral glucose tolerance testing and routine cancer screening. Conclusions We have demonstrated the feasibility of turning a complex set of national guidelines into an easy-to-use machine-readable CDSS. Comparison with real-world decisions suggests that use of this CDSS may improve compliance with guidelines and informed consent tailored to individual patient risks. Corresponding Author, Mr Simon R Knight, Senior Clinical Lecturer and Honorary Consultant Transplant Surgeon, Oxford Transplant Centre, Nuffield Department of Surgical Sciences, Churchill Hospital, Old Road, Oxford OX3 7LE. Tel: +44 1865 227 131, Mob: +44 7909 921 103. E-mail: simon.knight@nds.ox.ac.uk Authorship All authors made a significant contribution to the content of this manuscript, as per ICMJE recommendations. SRK conceived the study idea, participated in study design, provided clinical input to the decision support system (CDSS), coded the CDSS, entered and analysed patient data and wrote the manuscript. KNC participated in study design, coded the clinical decision support system and reviewed the manuscript. MS participated in study design, developed the openclinical.net platform, advised on the technical development of the clinical decision support system, provided the tools required for data analysis and reviewed the manuscript. NH provided clinical input to the content of the clinical decision support system and reviewed the manuscript JPH participated in study design, provided clinical input to the content of the clinical decision support system and reviewed the manuscript JF developed the openclinical.net concept, participated in study design, advised on the technical development of the clinical decision support system and reviewed the manuscript. Disclosures JF is a shareholder and Chief Scientific Officer of Deontics Ltd., a commercial company that makes use of the technologies described in this paper. He is also a cofounder of OpenClinical CIC. MS is a cofounder of both Deontics Ltd and OpenClinical CIC. KNC is a Medical AI advisor for OpenClinical CIC. SK, JH and NH have no conflicts of interest in relation to this work. Funding This work did not receive funding from any external sources. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Rethinking Regenerative Medicine From a Transplant Perspective (and Vice Versa)

No field in health sciences has more interest than organ transplantation in fostering progress in regenerative medicine (RM) because the future of no other field more than the future of organ transplantation will be forged by progress occurring in RM. In fact, the most urgent needs of modern transplant medicine - namely, more organs to satisfy the skyrocketing demand and immunosuppression-free transplantation -, cannot be met in full with current technologies and are at risk of remaining elusive goals. Instead, in the past few decades, groundbreaking progress in RM is suggesting a different approach to the problem. New, RM-inspired technologies among which decellularization, 3D printing and interspecies blastocyst complementation, promise organoids manufactured from patients' own cells and bear potential to render the use of currently used allografts obsolete. Transplantation, a field that has traditionally been immunology-based, is therefore destined to become a RM-based discipline. However, the contours of RM remain unclear, mainly due to the lack of a universally accepted definition, the lack of clarity of its potential modalities of application and the unjustified and misleading hype that often follows the reports of clinical application of RM technologies. All this generates excessive and unmet expectations and an erroneous perception of what RM really is and can offer. In this manuscript, we will (i) discuss these aspects of RM and transplant medicine, (ii) propose a definition of RM, and (iii) illustrate the state of the art of the most promising RM-based technologies of transplant interest. Disclosure: authors have no conflicts of interest to disclose Authorship Giuseppe Orlando conceived the work and the design of the manuscript, was responsible for its undertaking and completion, wrote the introduction, the paragraph on decellularization technology and the conclusions and approved the final draft Sean Murphy participated to the design of the manuscript, wrote the part on 3D printing and approved the final draft Benedetta Bussolati participated to the design of the manuscript, wrote the part on stem cells, regeneration and blastocyst complementation, and approved the final draft Marc Clancy participated to the design of the manuscript, wrote the part on ischemia-reperfusion and approved the final draft Paolo Cravedi wrote the part on the regenerative immunology. and approved the final draft Giovanni Migliaccio wrote the part on product development and translation, and approved the final draft Patricia Murray participated to the design of the manuscript, wrote the part on stem cells, regeneration and blastocyst complementation, and approved the final draft Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Production of a mouse monoclonal IgM antibody that targets the carbohydrate Thomsen-nouveau cancer antigen resulting in in vivo and in vitro tumor killing

Abstract

The construction of a tumor-associated carbohydrate antigen-zwitterionic polysaccharide conjugate, Thomsen-nouveau-polysaccharide A1 (Tn-PS A1, where Tn = d-GalpNAc), has led to the development of a carbohydrate binding monoclonal antibody named Kt-IgM-8. Kt-IgM-8 was produced via hybridoma from Tn-PS A1 hyperimmunized Jackson Laboratory C57BL/6 mice, splenocytes and the murine myeloma cell line Sp2/0Ag14 with subsequent cloning on methyl cellulose semi-solid media. This in-house generated monoclonal antibody negates binding influenced from peptides, proteins, and lipids and preferentially binds monovalent Tn antigen as noted by ELISA, FACS, and glycan array technologies. Kt-IgM-8 demonstrated in vitro and in vivo tumor killing against the Michigan Cancer Foundation breast cell line 7 (MCF-7). In vitro tumor killing was observed using an LDH assay that measured antibody-induced complement-dependent cytotoxicity and these results were validated in an in vivo passive immunotherapy approach using an MCF-7 cell line-derived xenograft model. Kt-IgM-8 is effective in killing tumor cells at 30% cytotoxicity, and furthermore, it demonstrated approximately 40% reduction in tumor growth in the MCF-7 model.

https://ift.tt/2uCgGnj

Small bowel perforation due to an adhesion ruptured by peritoneal insufflation

Abstract

Background:Despite the widespread use of laparoscopic cholecystectomy, technical complications unique to the laparoscopic approach may lead to significant postoperative morbidity and mortality. Case report: We report the first published case of small bowel fistula due to peritoneal insufflation that broke a thin string adhesion between the peritoneal wall and a jejunal segment, which lead to a focal perforation in a 75-year-old woman. Leakage of enteric fluid through the umbilical scar indicated this adverse event during the early postoperative period. The patient was immediately and successfully treated with a suture of the intestinal lesion. Conclusion: Peritoneal insufflation induced for laparoscopic procedures may break abdominal adhesions and lead to organs and vascular injuries, including small bowel perforation.

https://ift.tt/2JDcA38

Small bowel obstruction SBO after TAPP repair caused by a self-anchoring barbed suture device for peritoneal closure: case report

Abstract

A 50-year-old man underwent laparoscopic hernia repair for a groin hernia, presenting acute abdominal pain and bowel obstruction syndrome 1 day post surgery. Diagnostic laparoscopy was performed at postoperative the day after the hernioplasty and a volvulus was found. The residual end of the barbed V-LOC adopted in the peritoneal closure was incidentally hooked to the mesentery and caused a small bowel obstruction as a volvulus. The redundant V-LOC strand was released and cut superficial to the peritoneum. A detorsion of volvulus was preformed. Neither bowel ischemia nor significant bowel injury was noted. The following day he was discharged without complication. The residual 'free' barbel suture in the peritoneal cavity invited adhesion formations and subsequently the Bowel obstruction.

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Acute oesophageal necrosis: a rare but potentially fatal association of cocaine use

Acute oesophageal necrosis (AON), also known as 'black oesophagus', is a rare condition characterised by the necrosis of the oesophagus usually involving the distal part. It has been associated with various conditions, and the pathogenesis is thought to involve hypovolaemia combined with decreased function of oesophageal protective mucosal barriers and may be compounded by the effect of gastric secretions on oesophageal mucosa. The hallmark of this condition is characteristic circumferential black discolouration of the distal oesophagus that may extend proximally. We present a case of a man who presented with haematemesis associated with cocaine abuse. Oesophagogastroduodenoscopy confirmed black oesophagus. The patient was managed with intravenous fluids, packed red blood cell transfusions, proton pump inhibitors and sucralfate suspension; however, he failed to recover. We have also reviewed the previous reported cases of AON in association with cocaine use.

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Presentation of papillary fibroelastoma of the aortic valve with atypical symptoms

Papillary fibroelastomas are rare benign tumours arising from the cardiac endothelium. The rationale behind the treatment of fibroelastomas is to eliminate the risk of embolic events and the associated morbidity and mortality. These tumours present predominantly in males during the seventh decade of life and most commonly affect the aortic valve. We report a case of aortic valve papillary fibroelastoma with an atypical clinical presentation, treated with valve-sparing surgical excision. Our case highlights the management of this rare but serious condition and emphasises the need to develop clear guidelines regarding the treatment of asymptomatic patients with a papillary fibroelastoma.

https://ift.tt/2zV03Zg

Unusual cause of sinusitis and cough

Description

A 60-year-old woman with chronic lymphocytic leukaemia (CLL) previously treated with ofatumumab was referred for evaluation of worsening productive cough, sinus pain and nasal congestion. She had received multiple courses of antibiotics, antifungals and steroids with partial symptomatic improvement. CT of the chest demonstrated bilateral bronchial wall thickening and bronchial dilatation associated with patchy opacities (figure 1A). An open lung biopsy revealed a dense monotonous lymphocytic infiltrate in a bronchiolocentric distribution sparing the lung parenchyma with associated vague non-caseating granulomatous inflammation and focal areas of organising pneumonia. These findings suggested pulmonary involvement by CLL (figure 1B, C). Nasal and paranasal sinus biopsies were also consistent with CLL. She was started on salvage therapy with ibrutinib. Sinus, nasal and pulmonary symptoms resolved completely after 4 months without the need for additional antibacterial or antifungal medication. Repeat imaging showed resolution of opacities (figure 1D). The...

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Trans-scleral explantation of posteriorly dislocated IOL-CTR complex in a case of anterior megalophthalmos with an unusually thin cornea

Anterior megalophthalmos and keratoglobus are characterised by corneal thinning and deep anterior chamber. They are clinically distinguished on the basis of normal to slightly decreased corneal thickness with a large corneal diameter (>13 mm) in case of anterior megalophthalmos, and marked limbus-to-limbus corneal thinning with globular protrusion in keratoglobus. To achieve and maintain a centred and stable intraocular lens (IOL) position in the bag is often difficult in cases of anterior megalophthalmos due to a too large diameter of the capsular bag and ciliary ring. We report a case of a 40-year-old man with features of anterior megalophthalmos with extremely thin cornea. He had spontaneous posterior dislocation of IOL and capsular tension ring (CTR) within the bag after initial successful cataract surgery. The dislocated complex could neither have been repositioned with scleral fixation due to large diameter of ciliary ring nor could it have been explanted through a clear corneal incision due to associated very thin cornea. We performed pars plana vitrectomy and separated the IOL-CTR complex inside the eye and explanted them separately through the sclerotomy, as is done for removal of intraocular foreign body. This avoided incision on the thin cornea. We conclude that this method can be very useful in a similar clinical situation but is complex enough to justify its use in routine cases.

https://ift.tt/2zVljhj

Paracaval pseudolipoma mimicking intracaval mass lesion and thrombus

Description 

A 53-year-old man presented with moderate dull non-radiating right upper quadrant pain for the past 1 month. There were no exacerbating or relieving factors or associated symptoms. His medical history was positive for hepatocellular carcinoma for which segmentectomy was performed 6 months ago. On physical examination, he was vitally stable and all systemic examinations were unremarkable. Contrast-enhanced abdominal CT scan showed an enhancing lesion at the surgical bed, representing recurrence of hepatocellular carcinoma (figure 1 and 2). There was also an apparently intracaval fat-density lesion in the suprahepatic part (figure 1 and 2). However, on detailed inspection, particularly on sagittal images (figure 3), its extracaval location became evident, and it was diagnosed as a paracaval pseudolipoma.

Figure 1

Contrast-enhanced CT scan axial section showing fat density compressing the inferior vena cava (IVC) representing paracaval pseudolipoma, mimicking...

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Total electrical alternans in a patient with malignant pericardial tamponade

We present a case of a 59-year-old man with acute abdominal pain and progressive shortness of breath. A focused assessment with sonography for trauma scan showed free fluid in the hepatorenal recess and in the recto-uterine recess. Later, due to clinical deterioration and the differential possibility of a pulmonary embolism or aortic dissection, a CT scan was performed which revealed large pericardial effusion. This, together with a dilated vena cava inferior and portal system, raised the suspicion of cardiac tamponade. The diagnosis was confirmed by transthoracic echocardiography (TTE). In retrospect, the ECG at admission showed a sinus tachycardia, low-voltage QRS complexes and a total electrical alternans corresponding with the swinging heart seen on TTE. An electrical alternans on ECG is an important diagnostic clue but is often missed, causing an unnecessary delay to proper diagnostic and therapeutic measures.

https://ift.tt/2zU87t5

Pneumatosis intestinalis in an adult patient with antral stenosis and midgut malrotation

Pneumatosisintestinalis (PI) is a radiological finding with about 0.03% incidence and incompletely understood pathogenesis. We report a case of PI with a rare presentation of pneumoperitoneum that underwent diagnostic surgery and finally diagnosed by midgut malrotation and antral stenosis. A 40-year-old man with 1-year history of dyspepsia and vomiting which was aggravated by 20 kg underweight since 3 months ago, despite medications was presented. His imaging examinations showed partial antral obstruction besides pneumoperitoneum and gas collection in the small intestine wall, which were in favour of PI. Samplings of the small intestine during laparotomy reported simple serosal cysts. Persistence of his symptoms forced him to recourse to another hospital and their new imaging revealed Ladds' band in addition to mentioned findings in previous studies; he underwent subtotal gastrectomy plus Ladds' band division by Braun gastrojejunostomy. PI could be a presentation of antral stenosis and midgut malrotation. PI with pneumoperitoneum needs surgical interventions. Considering that most of the midgut malrotation cases are diagnosed in the first year of life and it is very rare in adults, it may bethat these new findings are due to adhesion band formation after the first surgery in this case.

https://ift.tt/2mtad9T

Traumatic abdominal wall hernia secondary to seatbelt injury: a case successfully managed by delayed surgical mesh repair and complicated by intervening pregnancy

Traumatic abdominal wall hernia (TAWH) is a rare type of hernia occurring secondary to blunt trauma. We report a case of seatbelt-associated TAWH in a 20-year-old woman who was presented to hospital via ambulance following a road traffic collision with a distended abdomen, peritonitis and free gas, with an associated TAWH identified on CT imaging. The patient underwent delayed surgical repair of her hernia using biological mesh, without recurrence, with a clinical course complicated by pregnancy. We use this report to demonstrate late repair as a safe and effective option for management of TAWH in pregnancy, with active surveillance and a multidisciplinary approach by the obstetric, plastic surgery and trauma teams.

https://ift.tt/2uNIkxa

Genetic testing for a patient with suspected familial hypercholesterolaemia

Familial hypercholesterolaemia (FH) is a genetic condition that results in elevated low-density lipoprotein (LDL) cholesterol (LDL-C) levels with consequent increased risk for premature cardiovascular disease events. Although it is considered an autosomal-dominant genetic condition, the underlying genetic causes of FH can be complex. Currently most guidelines rely on clinical criteria to diagnose FH. But this approach has some pitfalls. We present a patient who was not formally diagnosed with FH using commonly used and well-accepted clinical criteria but via genetic testing was found to have a mutation for this disorder. This case brings to fore the challenges clinicians face in diagnosing and managing such unusual cases optimally. Through this case report, we hope to stimulate a debate among clinicians as well as other stakeholders regarding the need to develop more efficient ways of selecting patients for genetic testing in response to elevated LDL levels.

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Concurrent emphysematous pyelonephritis and emphysematous cholecystitis due to community-acquired ESBL E. coli

Description  

A 62-year-old man with a history of hypertension and poorly controlled type II diabetes mellitus presented to his primary care physician with a 5-day history of chills, decreased urinary output and haematuria. Urinalysis was consistent with urinary tract infection and the patient was prescribed ciprofloxacin. He did not take the antibiotics as instructed and subsequently had to come to Emergency Room due to worsening of his condition as well as new complaints of increased thirst, dark urine and lower back pain. He also admitted that for the previous 3 days he had not been taken insulin due to his illness. On examination, he was an obese man in no distress, fully alert and oriented. The temperature was 97^oF, the blood pressure 125/58 mm Hg, the pulse 112 beats/min, the respiratory rate 16 breaths/min and the oxygen saturation 93% on ambient air. Abnormal findings included scleral icterus, mild jaundice, tachycardia, right...

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Sealing capacity of the ventricular muscle band after iatrogenic left ventricular perforation during transcatheter aortic valve implantation

Left ventricular (LV) perforation accompanied by acute cardiac tamponade is a rare but one of the most feared complication during transcatheter aortic valve implantation. Few cases with the need of emergent surgical repair are described in literature. Handling of this uncommon but possible life-threatening event requires well-considered action by the implanting team and is associated with substantially increased intrahospital mortality. We present a unique case of LV perforation management with percutaneous pericardiocentesis only. As a possible underlying physiological mechanism, we identified the movement of the ventricular muscle band which possibly sealed the perforation side due to transverse and circumferential muscle contractions.

https://ift.tt/2mxHyAA

Lemierres syndrome and 2016 American College of Physician guidelines for pharyngitis: no to empiric coverage for bacterial pharyngitis. While no role for routine Fusobacterium PCR, keep suspicion for this pathogen

An 18-year-old woman presented to clinic with acute pharyngitis with 4/4 Centor criteria. Rapid streptococcal antigen test was negative. The patient, who was allergic to penicillin, was prescribed azithromycin. Ultimately, after 5 days and without any corticosteroids, she presented to the emergency department with 10/10 chest pain and was admitted to the intensive care unit. CT showed nodular lung disease and blood cultures on admission grew Fusobacterium, likely Fusobacterium nucleatum. She sustained two cardiac arrests, three tube thoracostomies, acute kidney injury requiring dialysis and ventilatory failure requiring tracheostomy. After 16 days in hospital and 18 days in long-term acute care, the patient was discharged home. It is unclear how much of this could have been prevented by prescribing an antimicrobial that had activity against Fusobacterium. When severe pharyngitis occurs, Fusobacterium needs to be considered as an underlying cause. In vitro macrolides have marginal activity against most anaerobes, such as this pathogen, and should be avoided.

https://ift.tt/2zU7UWP

Correction: Splenic myoid angioendothelioma mimicking metastatic disease in an 8-year-old with Stage IV Wilms tumour

Shah AA, Luca DC, Kane TD, et al. Splenic myoid angioendothelioma mimicking metastatic disease in an 8-year-old with Stage IV Wilms' tumour. BMJ Case Rep 2018. doi: 10.1136/bcr-2018-224550.

The correct full name of the second author is Dragos C Luca.

https://ift.tt/2mtaedX

Loco-regional treatments on the liver transplant waiting list: unmasking hepatocellular carcinoma (HCC) biology

Benmassaoud, A; Tsochatzis, EA; (2018) Loco-regional treatments on the liver transplant waiting list: unmasking hepatocellular carcinoma (HCC) biology. [Editorial comment]. Hepatobiliary Surgery and Nutrition , 7 (3) pp. 199-201. 10.21037/hbsn.2018.02.03 .

https://ift.tt/2LbRVIS

How effective is community physical activity promotion in areas of deprivation for inactive adults with cardiovascular disease risk and/or mental health concerns? Study protocol for a pragmatic observational evaluation of the 'Active Herts' physical activity programme

Howlett, N; Jones, A; Bain, L; Chater, A; (2017) How effective is community physical activity promotion in areas of deprivation for inactive adults with cardiovascular disease risk and/or mental health concerns? Study protocol for a pragmatic observational evaluation of the 'Active Herts' physical activity programme. BMJ Open , 7 (11) , Article e017783. 10.1136/bmjopen-2017-017783 . Green open access

https://ift.tt/2L9JptT

Investigating Clear Speech Adaptations in Spontaneous Speech Produced in Communicative Settings

Tuomainen, OT; Hazan, V; (2018) Investigating Clear Speech Adaptations in Spontaneous Speech Produced in Communicative Settings. In: Gósy, M and Gráczi, TE, (eds.) Challenges in analysis and processing of spontaneous speech. (pp. pp. 9-25). Research Institute for Linguistics of the Hungarian Academy of Sciences: Budapest, Hungary.

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Optimisation of Medical Management of Chronic Rhinosinusitis

Abstract

Purpose of Review

Chronic rhinosinusitis (CRS) is a common condition and can have a significant impact on quality of life for affected patients. The aetiology is poorly understood leading to the use of a variety of medical treatments to manage the condition, some with little evidence to suggest any benefit.

Recent Findings

Over the last 3 years, research has been carried out investigating alternatives and alterations to many of the current treatment options for CRS. Of these, alternative delivery methods for intranasal corticosteroids and immunomodulation with monoclonal antibodies show the most promise to improve medical treatment of CRS.

Summary

CRS can be a difficult to manage condition with multiple treatment options available; however, many of these have a poor evidence base to support their use. When medical management fails, patients can be subjected to debilitating symptoms and repeated endoscopic sinus operations. New treatments which prevent this cycle could revolutionise current management.

https://ift.tt/2LpeusY

Osteoradionecrosis

Abstract

Purpose of Review

The purpose of this review is to explain the history, clinical presentation, staging, and treatment options available for osteoradionecrosis in order to aid surgeons and clinicians alike in the diagnosis and treatment of the disease.

Recent Findings

There has been a recent proposal by Delanian et al. as to an alternate mechanism of pathogenesis. As outlined by this theory, there are novel pharmacologic modalities that have shown promising early success in the treatment of osteoradionecrosis. There remains limited primary research on this topic.

Summary

Osteoradionecrosis remains a capricious disease process. There remains no standardized treatment protocol or universal staging system. There is an evolving role for hyperbaric oxygen, as well as treatments with pentoxifylline, tocopherol, and clodronate therapies. Aggressive surgical extirpation of devitalized tissue combined with microvascular tissue transfers continues to be the gold standard for treatment of advanced disease.

https://ift.tt/2uPlfKq

Longitudinal associations of social cognition and substance use in childhood and early adolescence: findings from the Avon Longitudinal Study of Parents and Children

Fluharty, ME; Heron, J; Munafò, MR; (2018) Longitudinal associations of social cognition and substance use in childhood and early adolescence: findings from the Avon Longitudinal Study of Parents and Children. European Child & Adolescent Psychiatry , 27 (6) pp. 739-752. 10.1007/s00787-017-1068-x . Green open access

https://ift.tt/2LC6CkA

Advances in the slow freezing cryopreservation of microencapsulated cells

Gurruchaga, H; Saenz del Burgo, L; Hernandez, RM; Orive, G; Selden, C; Fuller, B; Ciriza, J; Gurruchaga, H; Saenz del Burgo, L; Hernandez, RM; Orive, G; Selden, C; Fuller, B; Ciriza, J; Pedraz, JL; - view fewer (2018) Advances in the slow freezing cryopreservation of microencapsulated cells. Journal of Controlled Release , 281 pp. 119-138. 10.1016/j.jconrel.2018.05.016 .

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Noninvasive options for 'wearing-off' in Parkinson's disease: a clinical consensus from a panel of UK Parkinson's disease specialists

Fackrell, R; Carroll, CB; Grosset, DG; Mohamed, B; Reddy, P; Parry, M; Chaudhuri, KR; Fackrell, R; Carroll, CB; Grosset, DG; Mohamed, B; Reddy, P; Parry, M; Chaudhuri, KR; Foltynie, T; - view fewer (2018) Noninvasive options for 'wearing-off' in Parkinson's disease: a clinical consensus from a panel of UK Parkinson's disease specialists. Neurodegenerative Disease Management 10.2217/nmt-2018-0020 . Green open access

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X-ray phase-contrast imaging with engineered porous materials over 50 keV

Wang, H; Cai, B; Pankhurst, MJ; Zhou, T; Kashyap, Y; Atwood, R; Le Gall, N; ... Sawhney, K; + view all Wang, H; Cai, B; Pankhurst, MJ; Zhou, T; Kashyap, Y; Atwood, R; Le Gall, N; Lee, P; Drakopoulos, M; Sawhney, K; - view fewer (2018) X-ray phase-contrast imaging with engineered porous materials over 50 keV. Journal of Synchrotron Radiation , 25 (4) pp. 1182-1188. 10.1107/S1600577518005623 . Green open access

https://ift.tt/2LbRDlg

Icons and Idols in Dante and Petrarch

Rushworth, J; (2017) Icons and Idols in Dante and Petrarch. Romance Studies , 35 (2) pp. 73-84. 10.1080/02639904.2017.1341197 .

https://ift.tt/2LClAYc

Developing a core outcome set for fistulising perianal Crohn's disease

Sahnan, K; Tozer, PJ; Adegbola, SO; Lee, MJ; Heywood, N; McNair, AGK; Hind, D; ... ENiGMA collaborators, ; + view all Sahnan, K; Tozer, PJ; Adegbola, SO; Lee, MJ; Heywood, N; McNair, AGK; Hind, D; Yassin, N; Lobo, AJ; Brown, SR; Sebastian, S; Phillips, RKS; Lung, PFC; Faiz, OD; Crook, K; Blackwell, S; Verjee, A; Hart, AL; Fearnhead, NS; ENiGMA collaborators, ; - view fewer (2018) Developing a core outcome set for fistulising perianal Crohn's disease. Gut 10.1136/gutjnl-2017-315503 . (In press). Green open access

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The Effect of Short Pulse Width Settings on the Therapeutic Window in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's disease

Dayal, V; Grover, T; Limousin, P; Akram, H; Cappon, D; Candelario, J; Salazar, M; ... Foltynie, T; + view all Dayal, V; Grover, T; Limousin, P; Akram, H; Cappon, D; Candelario, J; Salazar, M; Tripoliti, E; Zrinzo, L; Hyam, J; Jahanshahi, M; Hariz, M; Foltynie, T; - view fewer (2018) The Effect of Short Pulse Width Settings on the Therapeutic Window in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's disease. Journal of Parkinson's Disease , 8 (2) pp. 273-279. 10.3233/JPD-171272 . Green open access

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A-type K(+) channels impede supralinear summation of clustered glutamatergic inputs in layer 3 neocortical pyramidal neurons

Biro, AA; Bremaud, A; Falck, J; Ruiz, AJ; (2018) A-type K(+) channels impede supralinear summation of clustered glutamatergic inputs in layer 3 neocortical pyramidal neurons. Neuropharmacology 10.1016/j.neuropharm.2018.07.005 . (In press). Green open access

https://ift.tt/2LcYvio

The New Urban Crisis: how are cities are increasing inequality, deepening segregation, and failing the middle-class – and what we can do about it

Rowe, JMJ; Ahmed, S; Harris, A; Smith, O; (2018) The New Urban Crisis: how are cities are increasing inequality, deepening segregation, and failing the middle-class – and what we can do about it. [Review]. Planning Perspectives 10.1080/02665433.2018.1492072 . (In press).

https://ift.tt/2JDMj4A

What Effects Might Exenatide have on Non-Motor Symptoms in Parkinson's Disease: A Post Hoc Analysis

Athauda, D; Maclagan, K; Budnik, N; Zampedri, L; Hibbert, S; Skene, SS; Chowdhury, K; ... Foltynie, T; + view all Athauda, D; Maclagan, K; Budnik, N; Zampedri, L; Hibbert, S; Skene, SS; Chowdhury, K; Aviles-Olmos, I; Limousin, P; Foltynie, T; - view fewer (2018) What Effects Might Exenatide have on Non-Motor Symptoms in Parkinson's Disease: A Post Hoc Analysis. Journal of Parkinson's Disease , 8 (2) pp. 247-258. 10.3233/JPD-181329 . Green open access

https://ift.tt/2L84B3E

Standardised Neuropsychological Assessment for the Selection of Patients Undergoing DBS for Parkinson's Disease

Foley, JA; Foltynie, T; Limousin, P; Cipolotti, L; (2018) Standardised Neuropsychological Assessment for the Selection of Patients Undergoing DBS for Parkinson's Disease. Parkinson's Disease , 2018 , Article 4328371. 10.1155/2018/4328371 . Green open access

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Toxicity associated with tuberculosis chemotherapy in the REMoxTB study

Tweed, CD; Crook, AM; Amukoye, EI; Dawson, R; Diacon, AH; Hanekom, M; McHugh, TD; ... Gillespie, SH; + view all Tweed, CD; Crook, AM; Amukoye, EI; Dawson, R; Diacon, AH; Hanekom, M; McHugh, TD; Mendel, CM; Meredith, SK; Murphy, ME; Murthy, SE; Nunn, AJ; Phillips, PPJ; Singh, KP; Spigelman, M; Wills, GH; Gillespie, SH; - view fewer (2018) Toxicity associated with tuberculosis chemotherapy in the REMoxTB study. BMC Infectious Diseases , 18 , Article 317. 10.1186/s12879-018-3230-6 . Green open access

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Impact of attributed audit on procedural performance in cardiac electrophysiology catheter laboratory

Sawhney, V; Volkova, E; Shaukat, M; Khan, F; Segal, O; Ahsan, S; Chow, A; ... Schilling, RJ; + view all Sawhney, V; Volkova, E; Shaukat, M; Khan, F; Segal, O; Ahsan, S; Chow, A; Ezzat, V; Finlay, M; Lambiase, P; Lowe, M; Dhinoja, M; Sporton, S; Earley, MJ; Hunter, RJ; Schilling, RJ; - view fewer (2018) Impact of attributed audit on procedural performance in cardiac electrophysiology catheter laboratory. Journal of Interventional Cardiac Electrophysiology 10.1007/s10840-018-0383-6 . (In press).

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Care workers, the unacknowledged persons in person-centred care: A secondary qualitative analysis of UK care home staff interviews

Kadri, A; Rapaport, P; Livingston, G; Cooper, C; Robertson, S; Higgs, P; (2018) Care workers, the unacknowledged persons in person-centred care: A secondary qualitative analysis of UK care home staff interviews. PLoS One , 13 (7) , Article e0200031. 10.1371/journal.pone.0200031 . Green open access

https://ift.tt/2L84i90

European Multicentre Tics in Children Studies (EMTICS): protocol for two cohort studies to assess risk factors for tic onset and exacerbation in children and adolescents

Schrag, A; Martino, D; Apter, A; Ball, J; Bartolini, E; Benaroya-Milshtein, N; Buttiglione, M; ... EMTICS Collaborative Group, ; + view all Schrag, A; Martino, D; Apter, A; Ball, J; Bartolini, E; Benaroya-Milshtein, N; Buttiglione, M; Cardona, F; Creti, R; Efstratiou, A; Gariup, M; Georgitsi, M; Hedderly, T; Heyman, I; Margarit, I; Mir, P; Moll, N; Morer, A; Müller, N; Müller-Vahl, K; Münchau, A; Orefici, G; Plessen, KJ; Porcelli, C; Paschou, P; Rizzo, R; Roessner, V; Schwarz, MJ; Steinberg, T; Tagwerker Gloor, F; Tarnok, Z; Walitza, S; Dietrich, A; Hoekstra, PJ; EMTICS Collaborative Group, ; - view fewer (2018) European Multicentre Tics in Children Studies (EMTICS): protocol for two cohort studies to assess risk factors for tic onset and exacerbation in children and adolescents. European Child and Adolescent Psychiatry 10.1007/s00787-018-1190-4 . (In press). Green open access

https://ift.tt/2JEyaV3

Propensity score matched comparison of subcutaneous and transvenous implantable cardioverter-defibrillator therapy in the SIMPLE and EFFORTLESS studies

Brouwer, TF; Knops, RE; Kutyifa, V; Barr, C; Mondésert, B; Boersma, LVA; Lambiase, PD; ... Healey, JS; + view all Brouwer, TF; Knops, RE; Kutyifa, V; Barr, C; Mondésert, B; Boersma, LVA; Lambiase, PD; Wold, N; Jones, PW; Healey, JS; - view fewer (2018) Propensity score matched comparison of subcutaneous and transvenous implantable cardioverter-defibrillator therapy in the SIMPLE and EFFORTLESS studies. Europace 10.1093/europace/euy083 . (In press).

https://ift.tt/2L6w19Y

Pre-clinical pharmacology and mechanism of action of SG3199, the pyrrolobenzodiazepine (PBD) dimer warhead component of antibody-drug conjugate (ADC) payload tesirine

Hartley, JA; Flynn, MJ; Bingham, JP; Corbett, S; Reinert, H; Tiberghien, A; Masterson, LA; ... Howard, PW; + view all Hartley, JA; Flynn, MJ; Bingham, JP; Corbett, S; Reinert, H; Tiberghien, A; Masterson, LA; Antonow, D; Adams, L; Chowdhury, S; Williams, DG; Mao, S; Harper, J; Havenith, CEG; Zammarchi, F; Chivers, S; van Berkel, PH; Howard, PW; - view fewer (2018) Pre-clinical pharmacology and mechanism of action of SG3199, the pyrrolobenzodiazepine (PBD) dimer warhead component of antibody-drug conjugate (ADC) payload tesirine. Scientific Reports , 8 , Article 10479. 10.1038/s41598-018-28533-4 . Green open access

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Desafíos para un nuevo director

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Cirugía endoscópica nasal en el tratamiento de papiloma invertido: A propósito de 18 casos

RESUMEN Introducción El papiloma invertido nasosinusal es un tumor benigno con tendencia a la recidiva, y con riesgo de malignización. El tratamiento habitual es la extirpación quirúrgica. Objetivo Describir y analizar las características clínicas, epidemiológicas, y resultados del tratamiento quirúrgico por vía endoscópica. Material y método Estudio retrospectivo, descriptivo, incluyendo pacientes con papiloma invertido nasosinusal sometidos a extirpación quirúrgica endoscópica entre los años 2012 y 2016. Se analizaron variables epidemiológicas, clínicas, complicaciones quirúrgicas, recurrencias y transformación maligna. El grado de extensión se evaluó con tomografia computarizada según la clasificación de Krouse. Resultados La serie está constituida por 18 pacientes, con una edad promedio de 57,4 años. La clínica se caracterizó por obstrucción nasal unilateral 72,2% (13/18 pacientes), rinorrea 33,3% (6/18 pacientes), hiposmia 27,8% (5/18 pacientes) y epistaxis 27,8% (5/18 pacientes). Según la clasificación de Krouse, las lesiones iniciales se describen como estadio T1 en 7/18, T2 en 5/18, T3 en 5/18 y T4 en 1/18 pacientes. En el período de seguimiento, se observa recurrencia en 4 pacientes en un período promedio de seguimiento de 5,6 meses, y un caso de transformación maligna. No hubo complicaciones quirúrgicas, excepto un caso de epífora por obstrucción de la vía nasolagrimal. Conclusiones El abordaje endoscópico fue efectivo para el tratamiento de papilomas invertidos nasosinusales.

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ABSTRACT Introduction Sinonasal inverted papillomas are benign tumors with a tendency to recur and a potential for malignant transformation. Surgical resection is the treatment of choice. Aim To describe and analyze the clinical characteristics, epidemiology, and surgical results from an endoscopic endonasal approach. Material and method Retrospective and descriptive study of all patients who underwent endoscopic sinus surgery for the treatment of a sinonasal inverted papilloma between the years 2012 and 2016. Variables analyzed include demographics, signs and symptoms, surgical complications, recurrence rate and malignant transformation. Tumor extension was evaluated with the Krouse staging system on computed tomography imaging. Results This series includes 18 patients, with a mean age of 57.4 years. Clinically, patients presented with unilateral nasal obstruction 72.2% (13/18 patients), followed by rhinorrhea 33.3% (6/18 patients), hyposmia 27.8% (5/18 patients) and epistaxis 27.8% (5/18 patients). Based on the Krouse staging system, 7/18 were T1, 5/18 were T2, 5/18 were T3 and 1/18 was T4 on initial evaluation. On follow-up, 4 patients presented with a recurrence at a mean period of 5.6 months, and one patient exhibited malignant transformation. No surgical complications were observed except for one case of epyphora as a consequence of nasolacrimal obstruction. Conclusions The endoscopic approach was effective for the treatment of sinonasal inverted papillomas.

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