Transcutaneous Recording During Intraoperative Neuromonitoring in Thyroid Surgery

Thyroid, Ahead of Print.


https://ift.tt/2MuGhJY

Immune tumor board: integral part in the multidisciplinary management of cancer patients treated with cancer immunotherapy

Abstract

Recent progress in the understanding of immune responses to cancer and how tumor cells evade immune control have led to the successful introduction of cancer immunotherapy, in particular immune checkpoint inhibitors (ICI). Treatment of cancer patients with immunotherapy such as ICIs has led to new challenges, including starting and stopping rules for immunotherapy, the management of immune-related adverse events, and logistic issues for the production of cellular therapies and viral delivery vectors. These challenges are not disease- or organ-specific and several potential biomarkers to predict response to ICI are under investigation. We installed an interdisciplinary discussion platform for managing patient-specific challenges associated with cancer immunotherapy in our institution. Here, we describe an immune tumor board for the management of cancer patients treated with immunotherapy and provide an outlook on how such a platform could be potentially used in the future to discuss rational and personalized combination therapies, and how to improve the management of side effects occurring under immunotherapy.

https://ift.tt/2PzHXzH

Traumatic tibia shaft fractures caused by the impact of a golf ball: two case reports

As golf becomes increasingly popular, the number of injuries while playing golf also increases. We experienced two cases of traumatic tibia shaft fractures caused by the impact of a golf ball.

https://ift.tt/2P1CVuU

Being Mesolithic in Life and Death

Abstract

Fifty years ago, approaches to Mesolithic identity were limited to ideas of 'Man the Hunter' and 'Woman the Gatherer', while evidence of non-normative practice was ascribed to 'shamans' and to 'ritual', and that was that. As post-processual critiques have touched Mesolithic studies, however, this has changed. In the first decade of the 21st century a strong body of work on Mesolithic identity in life, as well as death, has enabled us to think beyond modern Western categories to interpret identity in the Mesolithic. These studies have addressed the nature of personhood and relational identities, the body, and the relationship between human and other-than-human persons. Our paper reviews these changing approaches, offering a series of case studies from a range of different sites that illustrate how identity is formed and transformed through engagements with landscapes, materials, and both living and dead persons. These are then developed to advocate an assemblage approach to identity in the Mesolithic.

https://ift.tt/2Lr5oI7

FDA OKs New Prophylactic Drug for Rare Hereditary Angioedema

Lanadelumab (Takhzyro) is the first monoclonal antibody to help prevent attacks of hereditary angioedema in patients age 12 years and older.
FDA Approvals

https://ift.tt/2LpEP61

In this issue

https://ift.tt/2P8G1gL

5 tips to provide safe and effective ventilation

Assign someone to monitor the patient's airway visually and with capnography using these five tips

https://ift.tt/2LodaT7

Management of Long-Standing Flaccid Facial Palsy: Midface/Smile

Masseter and temporalis muscle transfer is an effective technique for restoring facial symmetry and commissure excursion in flaccid facial paralysis. Adherence to the principles and biomechanics of muscle transfer is essential for achieving optimal results. Muscle transfer has the advantage of being single staged with fast recovery of function. It is particularly useful in patients with low life expectancy or multiple comorbidities where a more complex, multiple stage procedure may be detrimental.

https://ift.tt/2wcDCdz

A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns

Abstract

Introduction

Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns.

Methods

Searches of Embase (2005–2016) and abstracts from selected meetings (2014–2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity.

Results

Published literature partially supports clinical guidelines, with emollients and topical medications being the most investigated. There were disproportionately more publications for topical calcineurin inhibitors (TCI) compared with topical corticosteroids (TCS); however, the search interval may have biased the results toward treatments approved near the beginning of the time frame. In contrast, publications documenting clinical practice patterns reflect greater use of emollients and TCS (over TCI), as well as systemic corticosteroids. Data is relatively limited for long-term and combination treatment, treatment of severe AD, and patients younger than 2 years of age, and completely lacking for systemic corticosteroids.

Conclusion

This scoping review demonstrates that available medical literature largely supports published guidelines for topical therapy; however, clinical practice patterns are less aligned. There is a lack of data for older, more frequently used generic treatments, including oral antihistamines, oral antibiotics, and systemic corticosteroids. Overall, literature is lacking for long-term treatment, treatment for patients younger than 2 years of age, and for systemic treatment for severe disease.

Funding

Regeneron Pharmaceuticals Inc.

https://ift.tt/2MvXVwJ

Treatment of Grade II and III Actinic Keratosis Lesions with a Film-Forming Medical Device Containing Sunscreen/Piroxicam 0.8% and a Retinoic Acid/Glycolic Gel: A Pilot Trial

Abstract

Introduction

Lesion and field-targeted treatments of actinic keratosis (AK) are commonly indicated for grade I and II type lesions. Grade III lesions are in general more difficult to treat. A film-forming medical device containing piroxicam 0.8% and sunscreen (SPF 50+) (PS) has been shown to be effective in the treatment of grade I and II AK lesions. Topical and oral retinoids have been utilized in AK and non-melanoma skin cancers. Topical glycolic acid promotes keratolysis and stimulates collagen synthesis for repair and skin rejuvenation and could be useful in AK treatment strategies. A gel containing retinoid acid (0.02%) and glycolic acid (4%) (RC) is commercially available. The objective of the study was to evaluate the efficacy and local tolerability of a combined treatment approach with PS and RC in subjects with multiple grade II and III AK lesions.

Methods

Twenty-two subjects (16 males and 6 females; mean age 68 years) with more than five AK lesions were enrolled after obtaining their informed consent in a 3-month trial. PS cream was applied twice daily every day and RC gel was applied twice daily for 2 consecutive days every week. The primary endpoint was the evolution of the AK mean number from baseline to the end of the trial. Secondary endpoints were the thickness of the target lesion (expressed in mm³) and the erythema score (hemoglobin content), evaluated using a standardized computer-based image acquisition analysis system (Anthera 3D).

Results

At baseline, the mean (SD) lesion number was 7.7 (3) for grade II and 1.4 (1) for grade III AK. At the end of the study, a significant (P = 0.001) reduction was observed for both grade II (− 81%; from 7.7 to 1.5) and grade III (− 22%) lesions. Six grade III lesions out of 31 (20%), presented at baseline, completely disappeared at month 3. For grade III lesions, a significant mean thickness reduction of 51% was observed at month 3. The erythema score (all lesions) was reduced by 70%. Four patients out of 22 (18%) were completely free of AK lesions at month 3. No severe side effects were reported.

Conclusion

In this exploratory trial, a combined treatment with a cream containing piroxicam and sunscreen and a retinoic/glycolic gel was associated with a substantial reduction of both grade II and III AK lesions with good local tolerability.

Funding

Cantabria Labs Difa Cooper.

https://ift.tt/2P2RhLg

Basal Cell Carcinoma: A Patient and Physician’s Experience

Abstract

In this article, the first coauthor, a patient with a basal cell carcinoma on her upper lip, discusses her experience with Mohs micrographic surgery for the treatment of the skin cancer. The second coauthor, who is the patient's physician (a dermatologist who shares her last name but is not a relative), diagnosed her skin cancer and referred her for Mohs surgery. The third coauthor, who is the patient's son and not only a dermatologist, but also a dermatopathologist and a Mohs surgeon (and also shares her last name), summarizes the presentation and treatment of the basal cell carcinoma.

https://ift.tt/2MxBNlU

Squamous Cell Carcinomas in Two Cases of Nail Lichen Planus: Is There a Real Association?

Abstract

Lichen planus (LP) is a chronic inflammatory disease that affects the skin and oral mucosa. Although its etiology is unknown, its potential for cancerization has been confirmed. We herein report the cases of a brother and sister, both with a 15-year history of nail lichen planus of the fingers and toes, who developed squamous cell carcinomas of the nail bed and matrix. This article shows the potential for malignant transformation in lichen planus disease and highlights the importance of periodic clinical follow-up.

https://ift.tt/2LnwcJi

Building a Citizen Pscientist: Advancing Patient-Centered Psoriasis Research by Empowering Patients as Contributors and Analysts

Abstract

Introduction

To design and implement a novel cloud-based digital platform that allows psoriatic patients and researchers to engage in the research process.

Methods

Citizen Pscientist (CP) was created by the National Psoriasis Foundation (NPF) to support and educate the global psoriatic disease community, where patients and researchers have the ability to analyze data. Psoriatic patients were invited to enroll in CP and contribute health data to a cloud database by responding to a 59-question online survey. They were then invited to perform their own analyses of the data using built-in visualization tools allowing for the creation of "discovery charts." These charts were posted on the CP website allowing for further discussion.

Results

As of May 2017, 3534 patients have enrolled in CP and have collectively contributed over 200,000 data points on their health status. Patients posted 70 discovery charts, generating 209 discussion comments.

Conclusion

With the growing influence of the internet and technology in society, medical research can be enhanced by crowdsourcing and online patient portals. Patient discovery charts focused on the topics of psoriatic disease demographics, clinical features, environmental triggers, and quality of life. Patients noted that the CP platform adds to their well-being and allows them to express what research questions matter most to them in a direct and quantifiable way. The implementation of CP is a successful and novel method of allowing patients to engage in research. Thus, CP is an important tool to promote patient-centered psoriatic disease research.

https://ift.tt/2PCgugS

Untersuchung zur Inanspruchnahme einer HNO-Klinik im ländlichen Bereich: Elektive Patienten

Zusammenfassung

Hintergrund

Die ambulante medizinische Versorgung wird in Deutschland überwiegend von niedergelassenen Fachärzten für Allgemeinmedizin und anderer Fachrichtungen gewährleistet. Nur unter speziellen Auflagen stehen die Krankenhausambulanzen für Fälle auf Facharztüberweisung zur spezielleren Abklärung bzw. zur Behandlung und in definierten Ausnahmefällen wie nach § 116b zur Verfügung. Ziel der Untersuchung war die Evaluation der ambulanten elektiven Patienten.

Material und Methoden

Es handelt sich um eine prospektive Untersuchung über den Zeitraum eines Jahres. Es wurden bei allen elektiven, ambulanten Patienten neben den persönlichen bzw. medizinischen Daten Vorstellungszeitpunkt, -grund und Sinnhaftigkeit der Inanspruchnahme erfasst.

Ergebnisse

Insgesamt konnten 6463 Fälle in die Untersuchung einbezogen werden. Die junge und betagtere Patientengruppe war quantitativ stärker repräsentiert im Vergleich zu den Notfallpatienten. Unter Berücksichtigung des definierten Scores war die überwiegende Mehrheit der Vorstellungen (87 %) medizinisch sinnvoll, was positiv mit der Distanz des Anfahrtswegs der Patienten korrelierte.

Diskussion

Die Analyse unterstreicht, dass das duale fachärztliche Versorgungsprinzip in Deutschland zu einer medizinisch vernünftigen Inanspruchnahme der vorhandenen Ressourcen beiträgt, was für die Notfallpatienten mit freier Wahl der Anlaufstelle nicht zutrifft.

https://ift.tt/2wqGa7r

The Role of the Primary Sensory Cortices in Early Language Processing

Papanicolaou, AC; Kilintari, M; Rezaie, R; Narayana, S; Babajani-Feremi, A; (2017) The Role of the Primary Sensory Cortices in Early Language Processing. Journal of Cognitive Neuroscience , 29 (10) pp. 1755-1765. 10.1162/jocn_a_01147 . Green open access

https://ift.tt/2LrKSai

Childhood fat and lean mass: differing relations to vascular structure and function at age 8-9-years

Sletner, L; Mahon, P; Crozier, S; Inskip, H; Godfrey, K; Chiesa, S; Bhowruth, D; ... Hanson, M; + view all Sletner, L; Mahon, P; Crozier, S; Inskip, H; Godfrey, K; Chiesa, S; Bhowruth, D; Charakida, M; Deanfield, J; Cooper, C; Hanson, M; - view fewer (2018) Childhood fat and lean mass: differing relations to vascular structure and function at age 8-9-years. Arteriosclerosis, Thrombosis, and Vascular Biology (In press).

https://ift.tt/2wcsq0F

Randomized Study of Early Continuous Positive Airways Pressure in Acute Respiratory Failure in Children With Impaired Immunity (SCARF) ISRCTN82853500

Peters, MJ; Agbeko, R; Davis, P; Klein, N; Zenasi, Z; Jones, A; Mackerness, C; ... SCARF study investigators and the Pediatric Intensive Care Socie, ; + view all Peters, MJ; Agbeko, R; Davis, P; Klein, N; Zenasi, Z; Jones, A; Mackerness, C; George, S; Veys, P; Ray, S; Mouncey, PR; Harrison, DA; Rowan, K; SCARF study investigators and the Pediatric Intensive Care Socie, ; - view fewer (2018) Randomized Study of Early Continuous Positive Airways Pressure in Acute Respiratory Failure in Children With Impaired Immunity (SCARF) ISRCTN82853500. Pediatric Critical Care Medicine 10.1097/PCC.0000000000001683 . (In press).

https://ift.tt/2LoPWMx

The role of intelligence in decision-making in early adolescence

Flouri, E; Moulton, V; Ploubidis, GB; (2018) The role of intelligence in decision-making in early adolescence. British Journal of Developmental Psychology 10.1111/bjdp.12261 . (In press). Green open access

https://ift.tt/2wa2jY7

Evaluation of mutant huntingtin and neurofilament proteins as potential markers in Huntington’s disease

Byrne, LM; Brogueira Rodrigues, F; Johnson, E; Wijeratne, P; De Vita, E; Alexander, D; Palermo, G; ... Wild, E; + view all Byrne, LM; Brogueira Rodrigues, F; Johnson, E; Wijeratne, P; De Vita, E; Alexander, D; Palermo, G; Czech, C; Schobel, S; Scahill, R; Heslegrave, A; Zetterberg, H; Wild, E; - view fewer (2018) Evaluation of mutant huntingtin and neurofilament proteins as potential markers in Huntington's disease. Science Translational Medicine (In press).

https://ift.tt/2LmLsGo

A cuckoo in the nest? Powerful Knowledge in English History Education Discourse

Smith, J; Jackson, DA; (2017) A cuckoo in the nest? Powerful Knowledge in English History Education Discourse. European Journal of Curriculum Studies , 4 (2) pp. 633-643.

https://ift.tt/2wcQcJS

Optimisation of the simulation of advanced control strategies for adaptive building skins

Borkowski, E; Donato, M; Zemella, G; Rovas, D; Raslan, R; (2018) Optimisation of the simulation of advanced control strategies for adaptive building skins. In: (Proceedings) BSO 18, Building Simulation and Optimization 2018, Fourth IBPSA - England Conference, 11-12 September 2018, Cambridge, UK. IBPSA - England (In press). Green open access

https://ift.tt/2LoHLQo

Optical injection locking for carrier phase recovery and regeneration

Slavík, R; Liu, Z; Richardson, DJ; (2017) Optical injection locking for carrier phase recovery and regeneration. In: (Proceedings) 2017 Optical Fiber Communications Conference and Exhibition (OFC). IEEE Green open access

https://ift.tt/2wa2h2r

Laser generated ultrasound sources using carbon-polymer nanocomposites for high frequency metrology

Rajagopal, S; Sainsbury, T; Treeby, BE; Cox, BT; (2018) Laser generated ultrasound sources using carbon-polymer nanocomposites for high frequency metrology. The Journal of the Acoustical Society of America , 144 (2) pp. 584-597. 10.1121/1.5048413 .

https://ift.tt/2LmQfYl

Nicotine preloading for smoking cessation: the Preloading RCT

Aveyard, P; Lindson, N; Tearne, S; Adams, R; Ahmed, K; Alekna, R; Banting, M; ... Pokhrel, S; + view all Aveyard, P; Lindson, N; Tearne, S; Adams, R; Ahmed, K; Alekna, R; Banting, M; Healy, M; Khan, S; Rai, G; Wood, C; Anderson, EC; Ataya-Williams, A; Attwood, A; Easey, K; Fluharty, M; Freuler, T; Hurse, M; Khouja, J; Lacey, L; Munafò, M; Lycett, D; McEwen, A; Coleman, T; Dickinson, A; Lewis, S; Orton, S; Perdue, J; Randall, C; Anderson, R; Bisal, N; Hajek, P; Homsey, C; McRobbie, HJ; Myers-Smith, K; Phillips, A; Przulj, D; Li, J; Coyle, D; Coyle, K; Pokhrel, S; - view fewer (2018) Nicotine preloading for smoking cessation: the Preloading RCT. Health Technology Assessment , 22 (41) pp. 1-84. 10.3310/hta22410 . Green open access

https://ift.tt/2wa2eDN

448-Gb/s PAM4 transmission over 300-km SMF-28 without dispersion compensation fiber

Liu, Z; Xu, T; Saavedra, G; Bayvel, P; (2018) 448-Gb/s PAM4 transmission over 300-km SMF-28 without dispersion compensation fiber. In: (Proceedings) Optical Fiber Communication Conference 2018. OSA Publishing (The Optical Society)

https://ift.tt/2LoPtKh

The Dark Energy Survey and operations: Years 4 and 5

Diehl, HT; Neilsen, E; Gruendl, RA; Abbott, TMC; Allam, S; Alvarez, O; Annis, J; ... Secco, LF; + view all Diehl, HT; Neilsen, E; Gruendl, RA; Abbott, TMC; Allam, S; Alvarez, O; Annis, J; Balbinot, E; Bhargava, S; Bechtol, K; Bernstein, GM; Bhatawdekar, R; Bocquet, S; Brout, D; Capasso, R; Cawthon, R; Chang, C; Cook, E; Conselice, CJ; Cruz, J; D Andrea, C; Da Costa, L; Das, R; DePoy, DL; Drlica-Wagner, A; Elliott, A; Everett, SW; Frieman, J; Fausti Neto, A; Ferté, A; Friswell, I; Furnell, KE; Gelman, L; Gerdes, DW; Gill, MSS; Goldstein, DA; Gruen, D; Gulledge, DJ; Hamilton, S; Hollowood, D; Honscheid, K; James, DJ; Johnson, MD; Johnson, MWG; Kent, S; Kessler, R; Khullar, G; Kovacs, E; Kremin, A; Kron, R; Kuropatkin, N; Lasker, J; Lathrop, A; Li, TS; Manera, M; March, M; Marshall, JL; Medford, M; Menanteau, F; Mohammed, I; Monroy, MR; Moraes, B; Morganson, EP; Muir, J; Murphy, M; Nord, B; Pace, AB; Palmese, A; Park, Y; Paz-Chinchón, F; Pereira, MES; Petravick, D; Plazas, AA; Poh, J; Prochaska, T; Reil, K; Romer, AK; Roodman, A; Sako, M; Sauseda, M; Scolnic, D; Secco, LF; - view fewer (2018) The Dark Energy Survey and operations: Years 4 and 5. In: Proceedings of SPIE. (pp. 107040D). SPIE: Austin, TX, USA. Green open access

https://ift.tt/2whHvOL

Effect of model complexity on fiber activation estimates in a wearable neuromodulator for migraine

Salkim, E; Shiraz, A; Demosthenous, A; (2017) Effect of model complexity on fiber activation estimates in a wearable neuromodulator for migraine. In: (Proceedings) 2017 IEEE Biomedical Circuits and Systems Conference (BioCAS). IEEE Green open access

https://ift.tt/2LpxN1d

Optimization for Maximizing Sum Secrecy Rate in SWIPT-enabled NOMA Systems

Tang, J; Dai, T; Cui, M; Zhang, X; Shojaeifard, A; Wong, KK; Li, Z; (2018) Optimization for Maximizing Sum Secrecy Rate in SWIPT-enabled NOMA Systems. IEEE Access 10.1109/ACCESS.2018.2859935 . (In press). Green open access

https://ift.tt/2w9kQUH

Clear speech adaptations in spontaneous speech produced by young and older adults

Hazan, VL; Tuomainen, O; Kim, J; Davis, C; Sheffield, B; Brungart, D; (2019) Clear speech adaptations in spontaneous speech produced by young and older adults. Journal of the Acoustical Society of America (In press).

https://ift.tt/2LpxCD5

Personalized treatment in the epilepsies: challenges and opportunities

Balestrini, S; Sisodiya, SM; (2018) Personalized treatment in the epilepsies: challenges and opportunities. Expert Review of Precision Medicine and Drug Development , 3 (4) pp. 237-247. 10.1080/23808993.2018.1486189 .

https://ift.tt/2w9qyFO

Neuropathy following spinal nerve injury shares features with the irritable nociceptor phenotype: a back-translational study of oxcarbazepine

Patel, R; Kucharczyk, M; Montagut-Bordas, C; Lockwood, S; Dickenson, AH; (2018) Neuropathy following spinal nerve injury shares features with the irritable nociceptor phenotype: a back-translational study of oxcarbazepine. European Journal of Pain 10.1002/ejp.1300 . (In press).

https://ift.tt/2LpxovJ

Model selection for univariable fractional polynomials

Royston, P; (2017) Model selection for univariable fractional polynomials. The Stata Journal , 17 (3) pp. 619-629.

https://ift.tt/2whHudF

Three distinct genomic subtypes of head and neck squamous cell carcinoma associated with clinical outcomes

Publication date: October 2018

Source: Oral Oncology, Volume 85

Author(s): Dong Jin Lee, Young-Gyu Eun, Young Soo Rho, Eui Hyun Kim, Sun Young Yim, Sang Hee Kang, Bo Hwa Sohn, Gee Hwan Kwon, Ju-Seog Lee

Abstract

Objectives

Heterogeneity of head and neck squamous cell carcinomas (HNSCCs) results in unpredictable outcomes for patients with similar stages of cancer. Beyond the role of human papilloma virus (HPV), no validated molecular marker of HNSCCs has been established. Thus, clinically relevant molecular subtypes are needed to optimize HNSCC therapy. The purpose of this study was to identify subtypes of HNSCC that have distinct biological characteristics associated with clinical outcomes and to characterize genomic alterations that best reflect the biological and clinical characteristics of each subtype.

Materials and methods

We analyzed gene expression profiling data from pan-SCC tissues including cervical SCC, esophageal SCC, lung SCC, and HNSCC (n = 1346) to assess the similarities and differences among SCCs and to identify molecular subtypes of HNSCC associated with prognosis. Subtype-specific gene expression signatures were identified and used to construct predictive models. The association of the subtypes with prognosis was validated in two independent cohorts of patients.

Results

Pan-SCC analysis identified three novel subtypes of HNSCC. Subtype 1 had the best prognosis and was similar to cervical SCC, whereas subtype 3 had the worst prognosis and was similar to lung SCC. Subtype 2 had a moderate prognosis. The 600-gene signature associated with the three subtypes significantly predicted prognosis in two independent validation cohorts. These three subtypes also were associated with potential benefit of immunotherapy.

Conclusion

We identified three clinically relevant HNSCC molecular subtypes. Independent prospective studies to assess the clinical utility of the subtypes and associated gene signature are warranted.

https://ift.tt/2w9XP3M

Trial of Ibrutinib Combined With Nivolumab or Cetuximab to Treat Recurrent/Metastatic HNSCC

Conditions:   Head and Neck Cancer;   Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: Ibrutinib 560mg PO daily;   Drug: Ibrutinib 560mg PO daily (Imbruvica);   Drug: Cetuximab;   Drug: Nivolumab
Sponsors:   University of California, San Diego;   Pharmacyclics LLC.
Not yet recruiting

https://ift.tt/2P3Ac3N

Study of the Feasibility of Radiofrequency Ablation of Benign Thyroid Nodules

Condition:   Benign Thyroid Nodules
Intervention:   Procedure: Radiofrequency ablation
Sponsor:   University Hospital, Toulouse
Not yet recruiting

https://ift.tt/2MsTWB8

Oxygen Enhanced MRI Measurement in Head and Neck Cancer: Validation and Efficacy of Response.

Condition:   Head and Neck Cancer
Intervention:   Diagnostic Test: MRI scan
Sponsors:   Sally Falk;   University of Manchester
Not yet recruiting

https://ift.tt/2P5sqqr

The Comparison of Single and Multi-incision MIE for Esophageal Cancer

Condition:   Esophageal Cancer
Intervention:   Procedure: Minimally invasive esophagectomy
Sponsor:   National Taiwan University Hospital
Recruiting

https://ift.tt/2MsztMV

Venous Thromboembolism and Bleeding Risk in Patients With Esophageal Cancer: a Retrospective Study

Conditions:   Venous Thromboembolism;   Esophagus Cancer;   Bleeding;   Chemotherapy Effect
Intervention:   Other: Venous thromboembolic event, arterial thromboembolic event, bleeding events
Sponsor:   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Recruiting

https://ift.tt/2OY8HbY

Prospective Pilot Study of Multi-actor Tolerance Evaluation Using the VIRARE Device (VIrtual Reality Assisted Rehabilitation) in Visually Impaired Patients

Condition:   Visual Impairment
Intervention:   Device: Virtual reality tests
Sponsor:   Centre Hospitalier Universitaire de Nīmes
Not yet recruiting

https://ift.tt/2MtRpXm

Study of Autologous Tumor Infiltrating Lymphocytes in Patients With Solid Tumors

Conditions:   Metastatic Melanoma;   Squamous Cell Carcinoma of the Head and Neck;   Non-small Cell Lung Cancer
Interventions:   Biological: Lifileucel;   Biological: LN-145;   Drug: Pembrolizumab
Sponsor:   Iovance Biotherapeutics, Inc.
Not yet recruiting

https://ift.tt/2P06pco

Dental fluorosis and a polymorphism in the COL1A2 gene in Mexican children

Publication date: Available online 23 August 2018

Source: Archives of Oral Biology

Author(s): Lizet Jarquín-Yañez, Jorge Alejandro Alegría-Torres, Claudia G. Castillo, José de Jesús Mejía-Saavedra

Abstract

Objective

To determine the allelic and genotypic frequencies of rs 412777 polymorphism in the Collagen type I alpha 2 chain (COL1A2) gene and the association with the severity of dental fluorosis in children between 6 and 12 years old in the State of San Luis Potosi, Mexico.

Design

A cross-sectional study was designed; participants were 230 children from two rural communities of San Luis Potosí. Fluoride in drinking water and urine samples was quantified using a potentiometric method with a selective ion electrode. Dental fluorosis was diagnosed using the Thylstrup-Fejerskov index while the identification of the polymorphism was made by allelic discrimination, using allele-specific probes by real-time Polymerase chain reaction (PCR). Statistical analysis was carried out with Student's t-test and Chi-square and Odds Ratio (OR). A confidence interval of 95% and a value of p < 0.05 were considered.

Results

The concentration of fluoride in drinking water was 2.36 ± 0.02 mg/L in Ojo Caliente and 4.56 ± 0.07 mg/L in La Reforma, the concentration of fluoride in urine was 2.05 ± 0.62 mg/L and 2.99 ± 0.99 mg/L respectively. The prevalence of dental fluorosis was 100% and the frequency of alleles was 67% wild-type and 33% mutant allelic, alleles were found in Hardy-Weinberg equilibrium (X² = 0.33, p = 0.89). The association between the degree of dental fluorosis and the evaluated polymorphism was statistically significant (OR = 7.10, 95% CI = 3.96-12.70, p < 0.05).

Conclusions

An association of rs 412777 polymorphism in the COL1A2 gene with dental fluorosis was found. Therefore, genetic variants represent a relevant risk factor to develop dental fluorosis, as it was proven in this study conducted in Mexican children.

https://ift.tt/2o8r02U

Orbita

https://ift.tt/2wmrXbp

Immediate anaphylaxis due to beef intestine following tick bites

Publication date: Available online 23 August 2018

Source: Allergology International

Author(s): Michimasa Fujiwara, Tooru Araki

https://ift.tt/2MyEG5W

Central suppressant therapies in unexplained chronic cough patients whose sputum cultures yielded Bjerkandera adusta

Publication date: Available online 23 August 2018

Source: Allergology International

Author(s): Haruhiko Ogawa, Kazuya Tone, Masaki Fujimura, Koichi Makimura

https://ift.tt/2P5im0D

Defective TLR9-driven STAT3 activation in B cells of patients with CVID

Publication date: Available online 23 August 2018

Source: Clinical Immunology

Author(s): Arturo Borzutzky, Ingrid Rauter, Ari Fried, Rima Rachid, Douglas R. McDonald, Lennart Hammarstrom, Bodo Grimbacher, Roshini S. Abraham, Raif S. Geha

Abstract

B cell activation by Toll-like receptor 9 (TLR9) ligands is dependent on STAT3 and is important for optimal antibody responses to microbial antigens. B cells from patients with common variable immune deficiency (CVID) have impaired proliferation and differentiation in response to the TLR9 ligand CpG, despite normal levels of TLR9 expression. We demonstrate that CpG-driven STAT3 phosphorylation, but not activation of NFκB and p38, is selectively impaired in B cells from CVID patients. These results suggest that defective STAT3 activation contributes to the defective TLR9 and antibody response of B cells in CVID.

https://ift.tt/2BIdDjn

Recombinant chemotaxis inhibitory protein of Staphylococcus aureus (CHIPS) protects against LPS-induced lung injury in mice

Publication date: Available online 23 August 2018

Source: Clinical Immunology

Author(s): Youssif M. Ali, Abeer M. Abd El-Aziz, Maha Mabrook, Ahmed A. Shabaan, Robert B. Sim, Ramadan Hassan

Abstract

Acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS) are clinical conditions caused by trauma, lung infection or sepsis. ALI/ARDS is associated with massive recruitment of neutrophils into the lung with release of reactive oxygen species and excessive inflammatory response that damage alveolar tissue. Here we report the successful use of a potent chemotaxis inhibitory protein (rCHIPS) derived from Staphylococcus aureus in reducing the severity of ALI/ARDS. Treatment with rCHIPS reduces pulmonary inflammation and permeability in mice after intranasal administration of lipopolysaccharide (LPS). rCHIPS treatment significantly reduces lung myeloperoxidase (MPO) activity, pro-inflammatory cytokines, broncho-alveolar lavage fluid (BALF) protein content as well as histopathological changes. In addition, treatment with rCHIPS significantly diminishes neutrophils and leukocytes recruitment into lung tissue after LPS administration and hence protects mice from reactive oxygen species mediated lung injury. Our finding reveals potential therapeutic benefits of using rCHIPS for the treatment of ALI/ARDS.

https://ift.tt/2o6SAxm

Human cystatin SN is an endogenous protease inhibitor that prevents allergic rhinitis

Publication date: Available online 23 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Ayumi Fukuoka, Kazufumi Matsushita, Taiyo Morikawa, Takumi Adachi, Koubun Yasuda, Hiroshi Kiyonari, Shigeharu Fujieda, Tomohiro Yoshimoto

Background

Protease allergens disrupt epithelial barriers to exert their allergenicity. Cystatin SN (encoded by CST1) is an endogenous cysteine protease inhibitor upregulated in nasal epithelia in patients with allergic rhinitis (AR).

Objective

We sought to investigate the protective effect of human cystatin SN on AR symptoms using pollen-induced AR mouse models.

Methods

We performed an in vitro protease activity assay to evaluate the effect of recombinant human cystatin SN (rhCystatin SN) on Japanese cedar (JC) or ragweed proteases. A human nasal epithelial cell line, RPMI 2650, was used to examine tight junction (TJ) disruption in vitro. Mice were sensitized and nasally challenged with JC or ragweed pollens with or without rhCystatin SN to examine the effect of rhCystatin SN on AR symptoms and the epithelial barrier in vivo. Because mice lack CST1, we generated transgenic (Tg) mice expressing human CST1 under control of its genomic control region (hCST1-Tg mice) to examine the role of cystatin SN in physiologically expressed conditions.

Results

rhCystatin SN inhibited JC but not ragweed protease activities and prevented JC-induced but not ragweed-induced TJ disruption in vitro. Exogenous administration of rhCystatin SN ameliorated JC-induced but not ragweed-induced sneezing and nasal TJ disruption in vivo. Furthermore, hCST1-Tg mice showed decreased JC-induced but not ragweed-induced sneezing symptoms and nasal TJ disruption compared with wild-type mice.

Conclusion

Human cystatin SN suppresses AR symptoms through inhibiting allergen protease activities and protecting the nasal TJ barrier in an allergen-specific manner. We propose that upregulation of nasal endogenous protease inhibitors, including cystatin SN, is a novel therapeutic strategy for protease allergen–induced AR.

https://ift.tt/2BHgUzs

Impaired cytolytic activity of asthma-associated natural killer cells is linked to dysregulated transcriptional program in energy metabolism

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Haisi Wu, Jiacheng Bi, Gaohui Wu, Chaoyue Zheng, Zhen Lu, Lulu Cui, Xiaochun Wan

Abstract

Natural killer (NK) cells are a cytotoxic subset of the innate lymphoid cells, playing essential roles in host defense against tumors and infections, which, however, are usually functionally compromised in chronic diseases. Atopic diseases, such as allergic asthma, characterized by type 2 immune responses, are usually associated with chronic inflammations. Whether asthma -associated immune environment affects the cytolytic function of NK cells has not been elucidated. Here, YTS, a human NK cell line, was exposed to serum from healthy donors or asthma patients for analysis of its cytolytic function. We found that, serum from asthma patients reduced the cytolytic activity of YTS cells against Raji human B lymphoblasts, in comparison with normal serum. The impairment of cytolytic activity of these YTS cells was accompanied with decreased degranulation potentials, weakened conjugation formation with Raji cells, and premature termination of ERK phosphorylation upon stimulation. Meanwhile, apoptosis or cell death of YTS cells was not increased after exposure to serum from asthma patients. Importantly, such impairment of cytolytic activity of asthma -associated YTS NK cells was accompanied with aberrantly enriched genes involved in oxidative phosphorylation. Taken together, these results demonstrate that the serum of asthma patients directly suppresses the cytolytic function of NK cells, possibly through dysregulation of energy metabolism in NK cells.

https://ift.tt/2BKvvdG

Selection of immunodominant epitopes during antigen processing is hierarchical

Publication date: Available online 24 August 2018

Source: Molecular Immunology

Author(s): Scheherazade Sadegh-Nasseri, AeRyon Kim

Abstract

MHC II proteins present processed antigens to CD4 + T cells through a complex set of events and players that include chaperons and accessory molecules. Antigen processing machinery is optimized for the selection of the best fitting peptides, called 'immunodominant epitopes', in the MHC II groove to which, specific CD4 + T cells respond and differentiate into memory T cells. However, due to the complexity of antigen processing, understanding the parameters that lead to immunodominance has proved difficult. Moreover, immunodominance of epitopes vary, depending on multiple factors that include; simultaneous processing of multiple proteins, involvement of multiple alleles of MHC II that can bind to the same antigen, or competition among several suitable epitopes on a single protein antigen. The current dogma assumes that once an antigenic determinant is selected under a specific condition, it would emerge immunodominant wherever it is placed. Here we will discuss some established parameters that contribute to immunodominance as well as some new findings, which demonstrate that slight changes to antigen structure can cause a complete shift in epitope selection during antigen processing and distort the natural immunodominant epitope.

Graphical abstract

https://ift.tt/2o5P1Yr

Paroxysmal 1:1 narrow complex tachycardia: What is the mechanism?

Garcia, JV; Daw, HL; Behar, JM; Lambiase, PD; (2018) Paroxysmal 1:1 narrow complex tachycardia: What is the mechanism? HeartRhythm Case Reports 10.1016/j.hrcr.2018.06.005 . (In press). Green open access

https://ift.tt/2Nf5gNL

Part III: Minimum Quality Threshold in Pre-Clinical Sepsis Studies (MQTiPSS) for Fluid Resuscitation and Antimicrobial Therapy Endpoints

Hellman, J; Bahrami, S; Boros, M; Chaudry, I; Fritsch, G; Gozdzik, W; Inoue, S; ... Huber-Lang, M; + view all Hellman, J; Bahrami, S; Boros, M; Chaudry, I; Fritsch, G; Gozdzik, W; Inoue, S; Radermacher, P; Singer, M; Osuchowski, MF; Huber-Lang, M; - view fewer (2018) Part III: Minimum Quality Threshold in Pre-Clinical Sepsis Studies (MQTiPSS) for Fluid Resuscitation and Antimicrobial Therapy Endpoints. Shock 10.1097/SHK.0000000000001209 . (In press).

https://ift.tt/2MMDone

Pathological correlates of white matter hyperintensities in a case of progranulin mutation associated frontotemporal dementia

Woollacott, IOC; Bocchetta, M; Sudre, CH; Ridha, BH; Strand, C; Courtney, R; Ourselin, S; ... Rohrer, JD; + view all Woollacott, IOC; Bocchetta, M; Sudre, CH; Ridha, BH; Strand, C; Courtney, R; Ourselin, S; Cardoso, MJ; Warren, JD; Rossor, MN; Revesz, T; Fox, NC; Holton, JL; Lashley, T; Rohrer, JD; - view fewer (2018) Pathological correlates of white matter hyperintensities in a case of progranulin mutation associated frontotemporal dementia. Neurocase 10.1080/13554794.2018.1506039 . (In press). Green open access

https://ift.tt/2NcXzHH

Perceived causes of prescribing errors by physicians: A qualitative study

Al-Fageh, B; Aljadhey, H; Mahmoud, MA; Al-Fadel, N; Hassali, MA; Franklin, BD; (2018) Perceived causes of prescribing errors by physicians: A qualitative study. Tropical Journal of Pharmaceutical Research , 17 (7) pp. 1415-1422. 10.4314/tjpr.v17i7.27 . Green open access

https://ift.tt/2MT0nNy

The importance of surface reflectance anisotropy for cloud and NO2 retrievals from GOME-2 and OMI

Lorente, A; Folkert Boersma, K; Stammes, P; Gijsbert Tilstra, L; Richter, A; Yu, H; Kharbouche, S; Lorente, A; Folkert Boersma, K; Stammes, P; Gijsbert Tilstra, L; Richter, A; Yu, H; Kharbouche, S; Muller, JP; - view fewer (2018) The importance of surface reflectance anisotropy for cloud and NO2 retrievals from GOME-2 and OMI. Atmospheric Measurement Techniques , 11 (7) pp. 4509-4529. 10.5194/amt-11-4509-2018 . Green open access

https://ift.tt/2Nfr5Nh

Initial findings of Shortwave Infrared Otoscopy in a Pediatric Population

Publication date: Available online 23 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Tulio A. Valdez, Jessica A. Carr, Katherine R. Kavanagh, Marissa Schwartz, Danielle Blake, Oliver Bruns, Moungi Bawendi

Abstract

Objective

To evaluate the feasibility of Shortwave infrared (SWIR) otoscopy in a pediatric population and establish differences with visible otoscopy

Methods

Pediatric patients 3 years of age and older seen in the otolaryngology clinic with an audiogram and tympanogram obtained within a week of the visit were recruited for video otoscopy using visible light otoscopy and SWIR otoscopy. Videos were rated by two otolaryngologists based on ability to identify the promontory, ability to identify the ossicular chain and presence or absence of middle ear fluid.

Results

A total of 74 video recordings of ears were obtained in 20 patients. We obtained interpretable images in 63/74 (85.1%) ears. There was no statistical significance between ability to perform SWIR otoscopy versus white light video otoscopy as indicated by a p-value of 0.376.

There was high inter-rater agreement for identification of both the promontory and the ossicular chain with Kappa values of 0.81 and 0.92 respectively. There was statistical significance between SWIR otoscopy and visible otoscopy in the ability to image the promontory (p =0.012) and the ossicular chain (p=0.010). Increased contrast of middle ear fluid was seen in SWIR otoscopy when compared to visible otoscopy.

Conclusion

SWIR otoscopy is feasible in a pediatric population and could offer some advantages over visible light otoscopy such as better visualization of the middle ear structures through the tympanic membrane and increased contrast for middle ear effusions.

https://ift.tt/2w9lK3o

Epistaxis health disparities in the United States pediatric population

Publication date: Available online 23 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Lindsay Yang, Kevin Hur, Jeffrey Koempel, Elisabeth H. Ference

Abstract

Objective

Despite epistaxis occurring in up to 60% of the population, few studies have investigated health status disparities in the pediatric epistaxis population. The aim of this study was to evaluate sociodemographic risk factors associated with epistaxis visits for pediatric patients.

Methods

Data were extracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey Outpatient Department from 2001-2010. Outpatient visits of children less than 18 years who received a primary, secondary, or tertiary diagnosis of epistaxis (ICD-9CM code 784.7X) were included. Bivariate and stepwise multivariate regressions were conducted to develop a final model for epistaxis visits described by sociodemographics.

Results

Epistaxis visits accounted for 5 ± 0.6 million visits in children less than 18 years. 51% and 33% of children presenting with epistaxis had private insurance and Medicaid, respectively (p=0.001). 69% of epistaxis visits were evaluated at a pediatric clinic, 18% at an ENT/surgery clinic, and 13% at a general/family medicine clinic (p<0.0001). After multivariate adjustment, epistaxis visits were associated with older age (p=0.006). Black children were more likely to present with epistaxis (95% CI 1.3-4.1, p=0.005) compared to white children. Allergic rhinitis, present in 11% of epistaxis visits, was a significant comorbidity associated with visits (95%CI 1.3-4.6, p=0.008). Patients were also more likely to present to an ENT/surgery clinic (95% CI 4.5-16.5, p<0.0001) compared to a general/family medicine clinic.

Conclusions

Epistaxis visits by children are associated with age, race, and specialty. Targeted interventions to help reduce this common presentation should be developed.

https://ift.tt/2LoW3jY

The effects of nasal decongestion on obstructive sleep apnoea

Publication date: Available online 23 August 2018

Source: American Journal of Otolaryngology

Author(s): Yunsong An, Yanru Li, Dan Kang, S.K. Sharama-adhikari, Wen Xu, Yunchuan Li, Demin Han

Abstract

Background

Many studies have indicated associations between impaired nasal breathing and sleep disorders. However, the precise nature of the relationship between nasal patency and sleep remains unclear.

Purpose

We analysed the effects of nasal patency on sleep architecture and breath in nasal obstruction-predominant obstructive sleep apnoea (NO-OSA) patients by applying nasal decongestant.

Material and methods

A randomized, placebo-controlled double-blind crossover study was performed in OSA patients with chronic nasal obstruction and without obvious pharyngeal narrowing. All OSA patients (confirmed by polysomnography) were recruited and completed 2 overnight studies (randomly applying oxymetazoline or placebo). Data collected after oxymetazoline or placebo treatments were compared. The ClinicalTrials.gov identifier is NCT03506178.

Results

Compared with placebo, oxymetazoline resulted in significant increase in rapid eye movement sleep (p = 0.027) and reduction of stage 1 sleep (p = 0.004), as well as arousal index (p = 0.002). Moreover, great improvements in apnoea/hypopnea index (AHI) were observed (p < 0.001); AHI in the supine position was significantly reduced (p = 0.001). Oxygen saturation during sleep was increased significantly [mean oxygen saturation (p = 0.005) and lowest oxygen saturation (p = 0.024)]. Oxygen desaturation index was significantly reduced (p < 0.001).

Conclusions

Improving nasal patency by decongestant could improve sleep quality, AHI, and oxygen saturation level during sleep.

https://ift.tt/2Ln44pR

Neue Ergebnisse zur Immuntherapie hämatologischer Neoplasien

https://ift.tt/2wqL6ZO

Changes in airway inflammation and remodeling in swimmers after quitting sport competition

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2MtbDAG

Tetrahydrocurcumin, a major metabolite of curcumin, ameliorates allergic airway inflammation by attenuating Th2 responses and suppressing the IL4Ra‐Jak1‐STAT6 and Jagged1/Jagged2 ‐Notch1/Notch2 pathways in asthmatic mice

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2o3McHc

Nachruf auf Herrn Prof. Dr. med. Dr. h.c. mult. Otto Braun-Falco

https://ift.tt/2PzzpJ2

Transcutaneous Baha Attract system: long‐term outcomes of the French multicenter study

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LnurMj

Facial nerve decompression

Purpose of review Facial nerve paralysis is a debilitating condition. Bell's palsy and temporal bone trauma are common causes of acute facial palsy, with recurrent idiopathic paralysis and Melkersson–Rosenthal syndrome accounting for a smaller subset of cases. Properly selected patients may benefit from facial nerve decompression. This article will review the relevant literature on facial nerve decompression. Recent findings The middle cranial fossa approach provides access to the primary site of lesion in Bell's palsy while preserving hearing. Patients with complete facial paralysis secondary to Bell's palsy or temporal bone trauma, more than 90% degeneration on electroneurography testing, and absent voluntary electromyography within 14 days of onset may benefit from facial nerve decompression. Facial nerve decompression may prevent future occurrences of recurrent forms of facial nerve paralysis. The return of facial nerve function following decompression will occur over weeks to months. Summary Appropriately selected patients with facial paralysis secondary to Bell's palsy or temporal bone trauma may benefit from facial nerve decompression. Patients should be counseled regarding the risks of decompression and that the return of maximal facial nerve function may be delayed up to 12 months. Correspondence to Marlan R. Hansen, MD, Departments of Otolaryngology – Head and Neck Surgery and Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. Tel: +1 319 353 7151; fax: +1 319 356 3967; e-mail: marlan-hansen@uiowa.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2MKPmh2

Treatments of uremic pruritus: A systematic review

Dermatologic Therapy, EarlyView.


https://ift.tt/2LqXQFg

Dermatological manifestations in cardiofaciocutaneous syndrome: A prospective multicentric study of 45 mutation‐positive patients

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2BIaUXh

Sleep disturbance in psoriasis: a case‐controlled study

British Journal of Dermatology, EarlyView.


https://ift.tt/2o4umE3

Association between gait and cognition in an elderly population based sample

Valkanova, V; Esser, P; Demnitz, N; Sexton, CE; Zsoldos, E; Mahmood, A; Griffanti, L; ... Ebmeier, KP; + view all Valkanova, V; Esser, P; Demnitz, N; Sexton, CE; Zsoldos, E; Mahmood, A; Griffanti, L; Kivimäki, M; Singh-Manoux, A; Dawes, H; Ebmeier, KP; - view fewer (2018) Association between gait and cognition in an elderly population based sample. Gait and Posture , 65 pp. 240-245. 10.1016/j.gaitpost.2018.07.178 . Green open access

https://ift.tt/2Lkfqe1

The Impact of Tissue Storage Conditions on Rat Olfactory Ensheathing Cell Yield and the Future Clinical Implications.

Liadi, M; Collins, A; Li, Y; Li, D; (2018) The Impact of Tissue Storage Conditions on Rat Olfactory Ensheathing Cell Yield and the Future Clinical Implications. Cell Transplant 10.1177/0963689718787762 . (In press). Green open access

https://ift.tt/2w8WOZQ

Dental caries and anthropometric measures in a sample of 5- to 9-year-old children in Dhaka, Bangladesh.

Mishu, MP; Tsakos, G; Heilmann, A; Watt, RG; (2018) Dental caries and anthropometric measures in a sample of 5- to 9-year-old children in Dhaka, Bangladesh. Community Dent Oral Epidemiol 10.1111/cdoe.12412 . (In press).

https://ift.tt/2Lm1GQ0

Closed-loop integration of planning, scheduling and multi-parametric nonlinear control

Charitopoulos, VM; Papageorgiou, LG; Dua, V; (2018) Closed-loop integration of planning, scheduling and multi-parametric nonlinear control. Computers and Chemical Engineering 10.1016/j.compchemeng.2018.06.021 . (In press). Green open access

https://ift.tt/2waMsbV

Big Data and Geospatial Analysis

Lansley, G; De Smith, M; Goodchild, M; Longley, P; (2018) Big Data and Geospatial Analysis. In: De Smith, M and Goodchild, M and Longley, P, (eds.) Geospatial Analysis: A comprehensive guide to principles, techniques and software tools. (pp. 547-570). The Winchelsea Press: Edinburgh. Green open access

https://ift.tt/2Lkfn1P

Spin-Pumping-Induced Inverse Spin Hall Effect in Nb/Ni80Fe20 Bilayers and its Strong Decay Across the Superconducting Transition Temperature

Jeon, K-R; Ciccarelli, C; Kurebayashi, H; Wunderlich, J; Cohen, LF; Komori, S; Robinson, JWA; Jeon, K-R; Ciccarelli, C; Kurebayashi, H; Wunderlich, J; Cohen, LF; Komori, S; Robinson, JWA; Blamire, MG; - view fewer (2018) Spin-Pumping-Induced Inverse Spin Hall Effect in Nb/Ni80Fe20 Bilayers and its Strong Decay Across the Superconducting Transition Temperature. Physical Review Applied , 10 (1) , Article 014029. 10.1103/PhysRevApplied.10.014029 . Green open access

https://ift.tt/2w917o1

A cross-sectional survey of awareness of human papillomavirus-associated oropharyngeal cancers among general practitioners in the UK

Lechner, M; Vassie, C; Kavasogullari, C; Jones, O; Howard, J; Masterson, L; Fenton, T; ... Gilson, R; + view all Lechner, M; Vassie, C; Kavasogullari, C; Jones, O; Howard, J; Masterson, L; Fenton, T; Yarbrough, W; Waller, J; Gilson, R; - view fewer (2018) A cross-sectional survey of awareness of human papillomavirus-associated oropharyngeal cancers among general practitioners in the UK. BMJ Open , 8 (7) , Article e023339. 10.1136/bmjopen-2018-023339 . Green open access

https://ift.tt/2LnY8wS

Apoptosis, A Double-Edge Sword!

Rossello, X; Yellon, DM; (2017) Apoptosis, A Double-Edge Sword! JACC: Basic to Translational Science , 2 (4) p. 498. 10.1016/j.jacbts.2017.07.008 . Green open access

https://ift.tt/2waMhxh

Asymptotic theory of quasiperiodically driven quantum systems

Cubero, D; Renzoni, F; (2018) Asymptotic theory of quasiperiodically driven quantum systems. Physical Review E , 97 (6) , Article 062139. 10.1103/PhysRevE.97.062139 . Green open access

https://ift.tt/2LpsPSd

The VAR2CSA malaria protein efficiently retrieves circulating tumor cells in an EpCAM-independent manner

Agerbæk, MØ; Bang-Christensen, SR; Yang, M-H; Clausen, TM; Pereira, MA; Sharma, S; Ditlev, SB; ... Salanti, A; + view all Agerbæk, MØ; Bang-Christensen, SR; Yang, M-H; Clausen, TM; Pereira, MA; Sharma, S; Ditlev, SB; Nielsen, MA; Choudhary, S; Gustavsson, T; Sorensen, PH; Meyer, T; Propper, D; Shamash, J; Theander, TG; Aicher, A; Daugaard, M; Heeschen, C; Salanti, A; - view fewer (2018) The VAR2CSA malaria protein efficiently retrieves circulating tumor cells in an EpCAM-independent manner. Nature Communications , 9 (1) , Article 3279. 10.1038/s41467-018-05793-2 . Green open access

https://ift.tt/2wbgfkF

Feedback and Feedforward Mechanisms for Generating Occupant Datasets for UK School Stock Simulation Modelling

Grassie, DA; Korolija, I; Mumovic, D; Ruyssevelt, P; (2018) Feedback and Feedforward Mechanisms for Generating Occupant Datasets for UK School Stock Simulation Modelling. In: (Proceedings) Building Simulation and Optimization Conference 2018. IBPSA - England (In press). Green open access

https://ift.tt/2LhGwCJ

Progression from isolated growth hormone deficiency to combined pituitary hormone deficiency

Cerbone, M; Dattani, MT; (2017) Progression from isolated growth hormone deficiency to combined pituitary hormone deficiency. Growth Hormone and IGF Research , 37 pp. 19-25. 10.1016/j.ghir.2017.10.005 .

https://ift.tt/2w8whf2

Randomised double-blind placebo-controlled 1 trial of vorapaxar for HIV associated inflammation and coagulopathy - the ADVICE study

Pett, S; Kent, SJ; Hough, S; Kelleher, AD; LAW, MG; Hutchinson, J; Catalfamo, M; ... Emery, S; + view all Pett, S; Kent, SJ; Hough, S; Kelleher, AD; LAW, MG; Hutchinson, J; Catalfamo, M; Bockel, DV; Lane, C; Baker, JV; Emery, S; - view fewer (2018) Randomised double-blind placebo-controlled 1 trial of vorapaxar for HIV associated inflammation and coagulopathy - the ADVICE study. The Lancet HIV (In press).

https://ift.tt/2LoqqqK

Association between bullous pemphigoid and psoriasis: Systematic review and meta‐analysis of case‐control studies

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2wksXwR

In Response

No abstract available

https://ift.tt/2PxffPY

Intrinsic Plan B Airway for Patients Undergoing Bronchial Thermoplasty

No abstract available

https://ift.tt/2wnipx7

Anesthesia in High-Risk Patients, 1st ed

No abstract available

https://ift.tt/2PAkUVt

71st World Health Assembly, Geneva, Switzerland 2018

No abstract available

https://ift.tt/2wndgVK

Oxygen Reserve Index: Validation of a New Variable

BACKGROUND: Pulse oximetry–derived oxygen saturation is typically >97% in normoxia and hyperoxia, limiting its clinical use. The new Oxygen Reserve Index (ORi), a relative indicator of the partial pressure of oxygen dissolved in arterial blood (PaO2) in the range of 100–200 mm Hg, may allow additional monitoring of oxygen status. METHODS: In this prospective validation intervention study, 20 healthy volunteers were breathing standardized oxygen concentrations ranging from mild hypoxia (fraction of inspired oxygen = 0.14) to hyperoxia (fraction of inspired oxygen = 1.0) via a tight-fitting face mask. ORi was measured noninvasively by multiwavelength pulse co-oximetry using 2 finger sensors. These ORi values (unitless scale, 0.00–1.00) were compared with measured PaO2 values. Repeated-measurements correlation analysis was performed to assess the ORi/PaO2 relationship. ORi trending ability was assessed using a 4-quadrant plot. The area under the receiver operating characteristics curve was calculated to assess the prediction of hypoxia (low-ranged PaO2,

https://ift.tt/2PDH0qe

Dexmedetomidine Pharmacokinetics and a New Dosing Paradigm in Infants Supported With Cardiopulmonary Bypass

BACKGROUND: Dexmedetomidine is increasingly used off-label in infants and children with cardiac disease during cardiopulmonary bypass (CPB) and in the postoperative period. Despite its frequent use, optimal dosing of dexmedetomidine in the setting of CPB has not been identified but is expected to differ from dosing in those not supported with CPB. This study had the following aims: (1) characterize the effect of CPB on dexmedetomidine clearance (CL) and volume of distribution (V) in infants and young children; (2) characterize tolerance and sedation in patients receiving dexmedetomidine; and (3) identify preliminary dosing recommendations for infants and children undergoing CPB. We hypothesized that CL would decrease, and V would increase during CPB compared to pre- or post-CPB states. METHODS: Open-label, single-center, opportunistic pharmacokinetics (PK) and safety study of dexmedetomidine in patients ≤36 months of age administered dexmedetomidine per standard of care via continuous infusion. We analyzed dexmedetomidine PK data using standard nonlinear mixed effects modeling with NONMEM software. We compared model-estimated PK parameters to those from historical patients receiving dexmedetomidine before anesthesia for urologic, lower abdominal, or plastic surgery; after low-risk cardiac or craniofacial surgery; or during bronchoscopy or nuclear magnetic resonance imaging. We investigated the influence of CPB-related factors on PK estimates and used the final model to simulate dosing recommendations, targeting a plasma concentration previously associated with safety and efficacy (0.6 ng/mL). We used the Wilcoxon rank sum test to evaluate differences in dexmedetomidine exposure between infants with hypotension or bradycardia and those who did not develop these adverse events. RESULTS: We collected 213 dexmedetomidine plasma samples from 18 patients. Patients had a median (range) age of 3.3 months (0.1–34.0 months) and underwent CPB for 161 minutes (63–394 minutes). We estimated a CL of 13.4 L/h/70 kg (95% confidence interval, 2.6–24.2 L/h/70 kg) during CPB, compared to 42.1 L/h/70 kg (95% confidence interval, 38.7–45.8 L/h/70 kg) in the historical patients. No specific CPB-related factor had a statistically significant effect on PK. A loading dose of 0.7 µg/kg over 10 minutes before CPB, followed by maintenance infusions through CPB of 0.2 or 0.25 µg/kg/h in infants with postmenstrual ages of 42 or 92 weeks, respectively, maintained targeted concentrations. We identified no association between dexmedetomidine exposure and selected adverse events (P = .13). CONCLUSIONS: CPB is associated with lower CL during CPB in infants and young children compared to those not undergoing CPB. Further study should more closely investigate CPB-related factors that may influence CL. Accepted for publication June 27, 2018. Funding: K.O.Z. is funded by grant KL2TR001115-03 from the Duke Clinical and Translational Science Awards and K23 grant HD091398 from the National Institutes of Health (NIH). H.W. received salary support from grant K23HD0785891 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) for completion of this project. M.L. receives support from the US government for work in neonatal clinical pharmacology, clinical trials, and cohort studies including Food and Drug Administration (FDA) R01 FD005101, Prinicipal Investigator (PI) M.L.; National Heart, Lung and Blood Institute (NHLBI) R34 HL124038, PI M.L.; the NIH Office of the Director, Environmental Influences on Child Health Outcomes (ECHO) Coordinating Center U2C OD023375, PI P.B.S., Duke University School of Medicine; the NICHD Pediatric Trials Network Government Contract HHSN267200700051C, PI Daniel Benjamin Jr, Duke University School of Medicine; and as the satellite site PI for the NICHD Neonatal Research Network NICHD U10 HD040492, PI C. Michael Cotten, Duke University School of Medicine. R.G.G. receives salary support for research from the NIH training grants (5T32HD043029-13), NIH awards (HHSN 275201000003I, HHSN 272201300017I), and from the FDA (HHSF223201610082C). P.B.S. receives salary support for research from the NIH (NIH-1R21HD080606-01ª1) and the National Center for Advancing Translational Sciences of the NIH (UL1TR001117), the NICHD (HHSN275201000003I), and the FDA (1R18-FD005292-01). C.P.H. receives salary support for research from the National Center for Advancing Translational Sciences of the NIH (UL1TR001117) and the US government for his work in pediatric and neonatal clinical pharmacology (Government Contract HHSN267200700051C, PI: Daniel Benjamin Jr under the Best Pharmaceuticals for Children Act). M.C.-W. receives support for research from the NIH (1R01-HD076676-01A1), the National Institute of Allergy and Infectious Disease (HHSN272201500006I and HHSN272201300017I), the NICHD (HHSN275201000003I), the Biomedical Advanced Research and Development Authority (HHSO100201300009C), and industry for drug development in adults and children (https://ift.tt/2PAHZY8). K.M.W. receives support from the Pediatric Critical Care and Trauma Scientist Development Program (5K12HD047349) and the NICHD (1K23HD075891) for his work in pediatric clinical pharmacology. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Kanecia O. Zimmerman, MD, MPH, Department of Pediatrics, Duke University School of Medicine, Box 3850, Durham, NC 27710. Address e-mail to Kanecia.obie@dm.duke.edu. © 2018 International Anesthesia Research Society

https://ift.tt/2wo5w5B

When Laryngeal Masks Fail

No abstract available

https://ift.tt/2wnRvFd

Process Optimization and Digital Quality Improvement to Enhance Timely Initiation of Epidural Infusions and Postoperative Pain Control

BACKGROUND: Although intraoperative epidural analgesia improves postoperative pain control, a recent quality improvement project demonstrated that only 59% of epidural infusions are started in the operating room before patient arrival in the postanesthesia care unit. We evaluated the combined effect of process and digital quality improvement efforts on provider compliance with starting continuous epidural infusions during surgery. METHODS: In October 2014, we instituted 2 process improvement initiatives: (1) an electronic order queue to assist the operating room pharmacy with infusate preparation; and (2) a designated workspace for the storage of equipment related to epidural catheter placement and drug infusion delivery. In addition, we implemented a digital quality improvement initiative, an Anesthesia Information Management System–mediated clinical decision support, to prompt anesthesia providers to start and document epidural infusions in pertinent patients. We assessed anesthesia provider compliance with epidural infusion initiation in the operating room and postoperative pain-related outcomes before (PRE: October 1, 2012 to September 31, 2014) and after (POST: January 1, 2015 to December 31, 2016) implementation of the quality improvement initiatives. RESULTS: Compliance with starting intraoperative epidural infusions was 59% in the PRE group and 85% in the POST group. After adjustment for confounders and preintervention time trends, segmented regression analysis demonstrated a statistically significant increase in compliance with the intervention in the POST phase (odds ratio, 2.78; 95% confidence interval, 1.73–4.49; P

https://ift.tt/2PxLPBj

Update on Perioperative Acute Kidney Injury

Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a reduction of the urine output and/or an increase of serum creatinine. Novel biomarkers may detect kidney damage in the absence of a change in function and can also predict the development of AKI. Several specific considerations for AKI risk are important in surgical patients. The surgery, especially major and emergency procedures in critically ill patients, may cause AKI. In addition, certain comorbidities, such as chronic kidney disease and chronic heart failure, are important risk factors for AKI. Diuretics, contrast agents, and nephrotoxic drugs are commonly used in the perioperative period and may result in a significant amount of in-hospital AKI. Before and during surgery, anesthetists are supposed to optimize the patient, including preventing and treating a hypovolemia and correcting an anemia. Intraoperative episodes of hypotension have to be avoided because even short periods of hypotension are associated with an increased risk of AKI. During the intraoperative period, urine output might be reduced in the absence of kidney injury or the presence of kidney injury with or without fluid responsiveness. Therefore, fluids should be used carefully to avoid hypovolemia and hypervolemia. The Kidney Disease: Improving Global Outcomes guidelines suggest implementing preventive strategies in high-risk patients, which include optimization of hemodynamics, restoration of the circulating volume, institution of functional hemodynamic monitoring, and avoidance of nephrotoxic agents and hyperglycemia. Two recently published studies found that implementing this bundle in high-risk patients reduced the occurrence of AKI in the perioperative period. In addition, the application of remote ischemic preconditioning has been studied to potentially reduce the incidence of perioperative AKI. This review discusses the epidemiology and pathophysiology of surgery-associated AKI, highlights the importance of intraoperative oliguria, and emphasizes potential preventive strategies. Accepted for publication July 17, 2018. Funding: A.Z. received lecture fees from Baxter, Astute Medical, Fresenius, Braun, and Ratiopharm and unrestricted research grants from Fresenius, German Research Foundation, Astellas, and Astute Medical. J.L.K. reports receiving consulting fees from Astute Medical, Sphingotec, and Pfizer and research funds from Astute Medical, Bioporto, Nxstage, Satellite Healthcare, and the National Institutes of Health. J.A.K. reports consulting fees and grant support from Astute Medical. E.A.J.H. received a travel grant from AM Pharma, a speaker's fee from Astute Medical, and a research grant from Bellco. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Alexander Zarbock, MD, Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Bldg A1, 48149 Münster, Germany. Address email to zarbock@uni-muenster.de. © 2018 International Anesthesia Research Society

https://ift.tt/2wnRnpd

Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Amisulpride as Treatment of Established Postoperative Nausea and Vomiting in Patients Who Have Had No Prior Prophylaxis

BACKGROUND: Postoperative nausea and vomiting (PONV) occurs commonly in surgical patients despite widespread prophylactic antiemetic use. Rescue options are currently limited. 5HT3 antagonists are most frequently used for prophylaxis, but if they fail, additional doses are not effective as rescue medication. Intravenous (IV) amisulpride, a well-studied D2/D3 antagonist, has been shown in trials to prevent PONV. This study was designed to determine if amisulpride could be used to treat established PONV in patients at low-to-moderate risk of PONV who had not received any prior prophylaxis. METHODS: Men and women aged over 18 years were permitted to enroll if they were to undergo general inhalational anesthesia, expected to last at least 1 hour, for an outpatient or inpatient surgical procedure. Patients who then suffered PONV were randomized equally to 1 of 3 single-dose IV regimens: placebo or 5 or 10 mg amisulpride. The primary end point was complete response, defined as no emesis in the period 30 minutes to 24 hours after study drug treatment and no use of rescue medication in the entire 24-hour period. RESULTS: One thousand nine hundred eighty-eight patients were enrolled preoperatively, of whom 560 were randomized to a treatment arm. Complete response occurred in 39 of 181 patients (21.5%) in the placebo group compared to 60 of 191 patients (31.4%; P = .016) and 59 of 188 patients (31.4%; P = .016) in the amisulpride 5 and 10 mg groups, respectively. The adverse event profile of amisulpride at either dose was similar to placebo. CONCLUSIONS: IV amisulpride at 5 and 10 mg was safe and efficacious in the treatment of established PONV in surgical patients undergoing general anesthesia with no prior PONV prophylaxis. Accepted for publication July 3, 2018. Funding: This work was supported by Acacia Pharma Ltd, Cambridge, United Kingdom. Conflicts of Interest: See Disclosures at the end of the article. Clinical trial registry number: ClinicalTrials.gov NCT2449291. Reprints will not be available from the authors. Address correspondence to Keith A. Candiotti, MD, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Jackson Memorial Hospital, (C-302), 1611 NW 12th Ave, Miami, FL 33136. Address e-mail to kcandiotti@miami.edu. © 2018 International Anesthesia Research Society

https://ift.tt/2wlNCR1

In Response

No abstract available

https://ift.tt/2PxLAWV

Anesthesia

No abstract available

https://ift.tt/2PxmtmZ

Postoperative Care in Thoracic Surgery: What’s New

No abstract available

https://ift.tt/2wkr2IF

Anesthesiologists’ Overconfidence in Their Perceived Knowledge of Neuromuscular Monitoring and Its Relevance to All Aspects of Medical Practice: An International Survey

BACKGROUND: In patients who receive a nondepolarizing neuromuscular blocking drug (NMBD) during anesthesia, undetected postoperative residual neuromuscular block is a common occurrence that carries a risk of potentially serious adverse events, particularly postoperative pulmonary complications. There is abundant evidence that residual block can be prevented when real-time (quantitative) neuromuscular monitoring with measurement of the train-of-four ratio is used to guide NMBD administration and reversal. Nevertheless, a significant percentage of anesthesiologists fail to use quantitative devices or even conventional peripheral nerve stimulators routinely. Our hypothesis was that a contributing factor to the nonutilization of neuromuscular monitoring was anesthesiologists' overconfidence in their knowledge and ability to manage the use of NMBDs without such guidance. METHODS: We conducted an Internet-based multilingual survey among anesthesiologists worldwide. We asked respondents to answer 9 true/false questions related to the use of neuromuscular blocking drugs. Participants were also asked to rate their confidence in the accuracy of each of their answers on a scale of 50% (pure guess) to 100% (certain of answer). RESULTS: Two thousand five hundred sixty persons accessed the website; of these, 1629 anesthesiologists from 80 countries completed the 9-question survey. The respondents correctly answered only 57% of the questions. In contrast, the mean confidence exhibited by the respondents was 84%, which was significantly greater than their accuracy. Of the 1629 respondents, 1496 (92%) were overconfident. CONCLUSIONS: The anesthesiologists surveyed expressed overconfidence in their knowledge and ability to manage the use of NMBDs. This overconfidence may be partially responsible for the failure to adopt routine perioperative neuromuscular monitoring. When clinicians are highly confident in their knowledge about a procedure, they are less likely to modify their clinical practice or seek further guidance on its use. Accepted for publication July 3, 2018. A. F. Kopman is now retired. Funding: S.J.B. has received research funding from Merck & Co, Inc (Kenilworth, NJ) (funds to Mayo Clinic). Conflicts of Interest: See Disclosures at the end of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). M. Naguib and S. J. Brull contributed equally to this work and share first authorship. Reprints will not be available from the authors. Address correspondence to Mohamed Naguib, MD, MSc, FCARCSI, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave, NE6-306, Cleveland, OH 44195. Address e-mail to naguibm@ccf.org. © 2018 International Anesthesia Research Society

https://ift.tt/2PAGiKi