Correction to: Passive blood anaphylaxis: subcutaneous immunoglobulins are a cause of ongoing passive anaphylactic reaction

Upon publication of the original article [1], the authors reported the following funding information was omitted: Publication supported by Wroclaw Centre of Biotechnology, programme The Leading National Resear...

https://ift.tt/2CuXbmj

A rare case of large pyosalpinx in an elderly patient with well-controlled type 2 diabetes mellitus: a case report

Pyosalpinx, which is one of the pelvic inflammatory diseases, is usually observed in young women; it is rarely found in older women. Possible causative agents are thought to be Chlamydia trachomatis and Neisseria...

https://ift.tt/2BZkqnl

Phytochemical screening and antityrosinase activity of carvacrol, thymoquinone, and four essential oils of Lebanese plants

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2yetzoG

Natural regulatory plasma cells

Simon Fillatreau

https://ift.tt/2OHWjAm

To treat or not to treat: The minimally symptomatic EoE patient

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder in which a mixed inflammatory cell infiltrate leads to symptoms of esophageal dysfunction. While great strides have been made to understand the pathophysiology and natural history of eosinophilic esophagitis over the last 30 years, there still does not exist an FDA-approved therapy.

https://ift.tt/2yjdVsg

Multidisciplinary Tracheostomy Care

There have been reports of successful quality-improvement initiatives surrounding tracheostomy care for more than a decade, but widespread adoption of best practices has not been universal. Five key drivers have been found to improve the quality of care for tracheostomy patients: multidisciplinary synchronous ward rounds, standardization of care protocols, appropriate interdisciplinary education and staff allocation, patient and family involvement, and use of data to drive improvement. The Global Tracheostomy Collaborative is a quality-improvement collaborative dedicated to improving the care of tracheostomy patients worldwide through communication, dissemination, and implementation of proven strategies based on these 5 key drivers.

https://ift.tt/2QCkjT5

Rethinking Morbidity and Mortality Conference

This article will discuss the importance of an effective morbidity and mortality (M&M) conference toward supporting a proactive and preventative approach to patient safety and quality improvement (PSQI). Key characteristics will be discussed that enhance this process for being a mechanism for driving positive PSQI culture change that permeates the department. The focus of this article will be on how to approach the structure and process of this conference for maximal benefit.

https://ift.tt/2OH9YHO

Publicly Available Databases in Otolaryngology Quality Improvement

The historical context for quality improvement is provided. Important differences are described between the two overarching types of databases: clinical registries and administrative databases. The pros and cons of each are provided as are examples of their utilization in otolaryngology–head and neck surgery.

https://ift.tt/2Qx9yRJ

Management of Flaccid Facial Paralysis of Less Than Two Years’ Duration

Flaccid facial paralysis results in disfiguring facial changes. The treatment of flaccid facial paralysis is complex and treatment approaches should be determined based on duration and the causes of paralysis, status and accessibility of the affected facial nerve, medical comorbidities, and patient-specific goals. Although primary nerve repair is the preferred treatment strategy when possible, nerve substitution procedures are the mainstay of treatment for patients with flaccid facial paralysis of less than 2 years duration.

https://ift.tt/2ODIgvS

Medical Management of Acute Facial Paralysis

Acute facial paralysis (FP) describes acute onset of partial or complete weakness of the facial muscles innervated by the facial nerve. Acute FP occurs within a few hours to days. The differential diagnosis is broad; however, the most common cause is viral-associated Bell Palsy. A comprehensive history and physical examination are essential in arriving at a diagnosis. Medical treatment for acute FP depends on the specific diagnosis; however, corticosteroids and antiviral medications are the cornerstone of therapy. Lack of recovery after 4 months should prompt further diagnostic workup.

https://ift.tt/2QxKD0h

Delivering Otolaryngologic Care Safely and Successfully

In 2000, when the Institute of Medicine published To Err Is Human,1 the focus of the patient safety movement was on convincing both providers and patients that we had a safety problem. Currently, most people understand that patient safety is a real issue. Unfortunately, there are still an estimated 251,000 deaths2 and over 1,000,000 nonfatal injuries3 from medical errors annually in the United States. The focus now is on how to implement the best practices that we know exist. An additional challenge is creating a culture around safety, with leadership engagement.

https://ift.tt/2OH9QYQ

The use of topical rapamycin in the treatment of superficial lymphatic malformations

Rapamycin can be useful in the treatment of vascular malformations, but the value of its topical application to superficial lymphatic malformations has not been established .Topical rapamycin improves the clinical appearance of superficial lymphatic malformations and alleviates associated symptoms. 


https://ift.tt/2pEJZTA

Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments

Acne is one of the most common diseases worldwide and affects approximately 50 million individuals in the United States. Oral antibiotics are the most common systemic agent prescribed for the treatment of acne. However, their use may be associated with a variety of adverse outcomes including bacterial resistance and disruption of the microbiome. As a result, multiple treatment guidelines call for limiting the use of oral antibiotics in the treatment of acne, although actual prescribing often does not follow these guidelines.

https://ift.tt/2Pg2ys6

Surgical Pearl: Achieving Eversion Utilizing Topical Tissue Adhesive

https://ift.tt/2pDiklX

Predictors of mucosal melanoma survival in a population-based setting

This population-based study underscores that extracutaneous melanomas are rare and aggressive neoplasms. Poorer survival in patients with mucosal melanoma was observed in relation to stage and anatomic site, but not tumor thickness (i.e., Breslow depth) or patient race/ethnicity. Due to the poor prognosis for all stages of mucosal melanoma, dermatologists should consider incorporating examination of the oropharynx and genitalia in the full body skin exam.

https://ift.tt/2PeVdcB

Dipeptidyl-peptidase IV inhibitor-associated bullous pemphigoid: A systematic review and meta-analysis

https://ift.tt/2pB4ala

Relative efficacy of systemic treatments for atopic dermatitis

Systemic treatments are common for severe atopic dermatitis and biologic medications represent recent advances in the field. Dupilumab and cyclosporine are both effective at improving clinical severity of atopic dermatitis, as are newer biologic medications lebrikizumab and tralokinumab. Long term efficacy and safety results are needed for biologic medications.

https://ift.tt/2Pf2Rnc

Comparative Clinicopathological Analysis of Cutaneous Peripheral T-cell lymphoma, Not Otherwise Specified, According to Primary Tumor Site

https://ift.tt/2pBZYBx

Future considerations for clinical dermatology in the setting of 21st century American policy reform: corporatization and the rise of private equity in dermatology

Within the last two decades, for-profit financial groups have become increasingly involved in health care. Outlier dermatology practices with high volumes of well-reimbursed procedures are attractive to consolidation backed by private equity. With fewer choices for independent or group private practice, junior dermatologists are increasingly seeking employment without ownership in private equity-backed corporate groups, whose primary fiscal responsibility lies with investors. Medicare's response to corporatization and consolidation has already changed the practice of dermatopathology.

https://ift.tt/2PekJhX

Co-occurrence of infantile hemangiomas and other birthmarks

https://ift.tt/2pDnkGZ

Analysis of cutaneous Merkel Cell Carcinoma outcomes after different surgical interventions

Despite current recommendation of 1-2 cm excision margin for merkel cell carcinoma, we compared different surgical option for better outcome. We did not recommend local destruction and confirmed superior survival with excision margin of more than 2 cm in patients younger than 60 years having T1/T2 tumors or adjuvant radiotherapy.

https://ift.tt/2pzTyTI

To treat or not to treat: The minimally symptomatic EoE patient

Publication date: Available online 5 October 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Amanda Muir, Hillary Moore, Jonathan Spergel

https://ift.tt/2PfBOrI

Lupin: An Emerging Food Allergen in the United States

Publication date: Available online 4 October 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Theresa A. Bingemann, Carah B. Santos, Anne F. Russell, Aikaterini Anagnostou

https://ift.tt/2y3NhUT

Sensitization Profiles to Hazelnut Allergens across the United States of America

Publication date: Available online 4 October 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Andre Valcour, Jonas Lidholm, Magnus P. Borres, Robert G. Hamilton

https://ift.tt/2QxlEKx

Level of competence of primary and secondary school teachers in the management of anaphylaxis

Publication date: Available online 4 October 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Silvia F Cantariño, Silvia Novío

https://ift.tt/2zUjj77

Ultrasound-guided quadratus lumborum block in pediatrics: trans-muscular versus intra-muscular approach

Abstract

Purpose

Quadratus lumborum (QL) block has four approaches. However, there is difference between the four approaches regarding efficacy, safety and adverse effects. The primary objective of this study is to compare the analgesic effect between trans-muscular and intra-muscular approaches of the QL block in pediatric patients for elective lower abdominal surgery.

Methods

54 patients aged between 1 and 6 years were enrolled. Patients of both genders were selected. The patients were randomly classified into two groups: Group TQL includes patients (27 patients) in whom bilateral QL block was performed using trans-muscular approach, and Group IQL (27 patients), which underwent bilateral QL block using an intra-muscular approach. The primary outcome measure was the number of patients who require rescue analgesia in the first 24 h. The secondary outcome measures were FLACC score, heart rate, non-invasive blood pressure at 2, 4, 6, 12, and 24 h postoperatively, and postoperative complications (e.g., quadriceps muscle weakness, local hematoma).

Results

In the first 24 h after surgery, 13 patients in the IQL group (48.1%) required rescue analgesia, whereas only five patients in the TQL group (18.5%) required rescue analgesia. The FLACC score was lower in the TQL group than the IQL group at all time intervals up to 24 h postoperatively. In the TQL group, eight patients (29.6%) developed quadriceps weakness; whereas, only one patient (3.7%) in the IQL group developed quadriceps weakness.

Conclusion

TQL is better than IQL in the analgesic efficacy following the pediatric lower laparotomy.

https://ift.tt/2pzwioS

Atopic dermatitis in cats and dogs: a difficult disease for animals and owners

The purpose of this review article is to give an overview of atopic dermatitis in companion animals and of recent developments including knowledge on immunological background, novel treatment options and diffi...

https://ift.tt/2RtcJew

Fall Allergy Relief For Your Child

Enjoying the cool air during fall is refreshing after the heat of the summer months. Unfortunately, many kids struggle with fall allergies after spending time outdoors.  Dr. Katherine Rivera discusses the best ways to help keep your child's allergies in check this fall.

The post Fall Allergy Relief For Your Child appeared first on ChildrensMD.

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CAIX and pax-8 Commonly Immunoreactive in Endolymphatic Sac Tumors: A Clinicopathologic Study of 26 Cases with Differential Considerations for Metastatic Renal Cell Carcinoma in von Hippel-Lindau Patients

Abstract

Endolymphatic sac tumors (ELSTs) are rare, slowly growing temporal bone neoplasms which show a high association with von Hippel-Lindau (VHL) syndrome. The immunohistochemistry evaluation of these papillary-cystic neoplasms frequently raises the differential diagnosis with renal cell carcinoma, among other metastatic neoplasms, whether in VHL patients or not. A cohort of 26 patients with ELSTs were evaluated for histologic features, immunohistochemistry findings, and association with VHL. Standard immunohistochemistry evaluation was performed. Sixteen females and 10 males ranging in age from 10 to 69 years (mean 44; VHL mean: 32) at initial presentation, comprised the cohort of patients. Most (86%) experienced hearing changes or inner ear symptoms (vertigo, dizziness), with an average duration of symptoms for 39 months (range 2–240 months). The tumors were an average of 2.9 cm (range 0.4–8 cm), with 14 left, 11 right sided and one bilateral tumor. Nine patients had documented VHL, with 3 patients having a concurrent or subsequent clear cell renal cell carcinoma. Patients were followed an average of 6.2 years (available in 24 patients): 19 alive without disease, 7.5 years; 2 dead without disease, 1.2 years; and 3 alive with disease, 3.1 years. The neoplastic cells show the following immunohistochemistry findings: AE1/AE3, EMA, CK7, CAIX, GLUT1, VEGF: 100% of cases tested were positive; pax-8: 85% of cases positive; CD10 and RCC: 0% of cases reactive. Based on this cohort of 26 patients with ELST, 9 of whom had VHL, the strong pax-8 and CAIX should be used in conjunction with negative CD10 and RCC to help exclude a metastatic renal cell carcinoma. As CAIX is an enzyme overexpressed in hypoxia and hypoxia inducible factor is what VHL protein regulates, this is an expected, although previously unreported finding. Whether part of VHL or not, VHL mutations may be a somatic rather than germline finding in the tumors, a possible further explanation for the CAIX reaction.

https://ift.tt/2yiefaH

Paediatric auditory brainstem implantation: The South Asian experience

Publication date: Available online 4 October 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): S. Raghunandhan, K. Madhav, A. Senthilvadivu, K. Natarajan, M. Kameswaran

Abstract

Introduction

Paediatric Auditory Brainstem Implantation (ABI) is indicated for children with congenital cochlear aplasia, absent/hypoplastic vestibulocochlear nerve, for whom cochlear implantation is not possible. Knowledge of the anatomical landmarks and variants in anatomy of the brainstem is vital for ABI surgery.

Method

Study was done at Auditory implant centre in Madras ENT research foundation, which includes 24 children who had undergone ABI surgery and are being followed up for 1 year, post operatively. Aims were to study the anatomical variants and the outcomes of ABI implantation. To determine if different anatomical variants effect placement of ABI electrode. To assess the patient outcomes by Categories of auditory Performance (CAP) scores and Speech Intelligibility Ratings (SIR) scores.

Results

All the candidates showed gradual improvement in audiological and verbal outcomes after the ABI. The mean CAP and SIR scores after 6 months of AVHT were 2.07 and 1.37 respectively. After 1 year of auditory verbal rehabilitation therapy CAP was 3.42 and SIR was 2.33. Flocculus of the cerebellum can be of different grades. Though, there was difficulty in insertion of the electrode in subjects with anatomical variants, the outcomes were comparable with other subjects.

Conclusion

ABI surgery involves frequent anatomical variations surrounding the lateral recess which makes the positioning of the auditory prosthesis difficult. Variants during the surgery can make the placement of ABI electrodes difficult, but promising results were seen all the implantees.

https://ift.tt/2QxdH8l

Strategy for facial nerve management during surgical removal of benign jugular foramen tumors: Outcomes and indications

Publication date: Available online 4 October 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J.-Q. Chen, H.-Y. Tan, Z.-Y. Wang, W.-D. Zhu, Y.-C. Chai, H. Jia, H. Wu

Abstract

Objective

Classical surgical management of jugular foramen (JF) tumors usually requires facial nerve rerouting which results in permanent facial palsy in most patients. The purpose of the article is to study the outcomes of different rerouting techniques, and to discuss their indications.

Material and methods

We retrospectively reviewed 98 patients with JF tumors operated at our center between January 2008 and December 2016 using different surgical approaches with the following procedures for facial nerve management: total anterior rerouting (TR), partial anterior rerouting (PR), and fallopian bridge (FB) technique. The data for facial nerve management, surgical outcome and postoperative facial nerve function were collected from the medical records.

Results

In the study, there were 48 males and 50 females. Of them, 61 (62.2%) were jugular paragangliomas, 22 (22.4%) schwannomas, and 15 (15.3%) meningiomas. Total tumor removal was achieved in 95 (96.9%) patients, while near-total removal was achieved in 3 (3.1%) paragangliomas. TR was applied in 31 (31.6%) patients with PR in 26 (26.5%) patients, and FB in 41 (41.8%) patients. The mean follow-up duration was 39.4 ± 22.6 months, and 2 recurrences of paragangliomas were observed. Seventy-five patients (76.5%) had good facial function (HB I-II) at 1 year after surgery, the patients who received a TR approach presented significantly less HB I-II FN function (48.4%) than those with PR (82.6%, P < 0.05) or those with FB technique (95.1%, P < 0.001). 21 patients (21.4%) presented new-onset lower cranial nerve dysfunction of which 13 recovered at 1 year after surgery.

Conclusion

Facial nerve management in JF tumors should be tailored individually. No-rerouting methods, such as the fallopian bridge technique, bring significantly better results in terms of facial nerve function, which might be performed first during surgery; its indication is based mainly on the tumor type and extent.

https://ift.tt/2zT9oyK

CAIX and pax-8 Commonly Immunoreactive in Endolymphatic Sac Tumors: A Clinicopathologic Study of 26 Cases with Differential Considerations for Metastatic Renal Cell Carcinoma in von Hippel-Lindau Patients

Abstract

Endolymphatic sac tumors (ELSTs) are rare, slowly growing temporal bone neoplasms which show a high association with von Hippel-Lindau (VHL) syndrome. The immunohistochemistry evaluation of these papillary-cystic neoplasms frequently raises the differential diagnosis with renal cell carcinoma, among other metastatic neoplasms, whether in VHL patients or not. A cohort of 26 patients with ELSTs were evaluated for histologic features, immunohistochemistry findings, and association with VHL. Standard immunohistochemistry evaluation was performed. Sixteen females and 10 males ranging in age from 10 to 69 years (mean 44; VHL mean: 32) at initial presentation, comprised the cohort of patients. Most (86%) experienced hearing changes or inner ear symptoms (vertigo, dizziness), with an average duration of symptoms for 39 months (range 2–240 months). The tumors were an average of 2.9 cm (range 0.4–8 cm), with 14 left, 11 right sided and one bilateral tumor. Nine patients had documented VHL, with 3 patients having a concurrent or subsequent clear cell renal cell carcinoma. Patients were followed an average of 6.2 years (available in 24 patients): 19 alive without disease, 7.5 years; 2 dead without disease, 1.2 years; and 3 alive with disease, 3.1 years. The neoplastic cells show the following immunohistochemistry findings: AE1/AE3, EMA, CK7, CAIX, GLUT1, VEGF: 100% of cases tested were positive; pax-8: 85% of cases positive; CD10 and RCC: 0% of cases reactive. Based on this cohort of 26 patients with ELST, 9 of whom had VHL, the strong pax-8 and CAIX should be used in conjunction with negative CD10 and RCC to help exclude a metastatic renal cell carcinoma. As CAIX is an enzyme overexpressed in hypoxia and hypoxia inducible factor is what VHL protein regulates, this is an expected, although previously unreported finding. Whether part of VHL or not, VHL mutations may be a somatic rather than germline finding in the tumors, a possible further explanation for the CAIX reaction.

https://ift.tt/2yiefaH

Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography

Hannan, S; Faulkner, M; Aristovich, K; Avery, J; Walker, M; Holder, D; (2018) Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography. NeuroImage: Clinical , 20 pp. 674-684. 10.1016/j.nicl.2018.09.004 . Green open access

https://ift.tt/2zTn1hc

Prompt and non-prompt J/ ψ elliptic flow in Pb+Pb collisions at √sNN=5.02 Tev with the ATLAS detector

Aaboud, M; Aad, G; Abbott, B; Abdinov, O; Abeloos, B; Abhayasinghe, DK; Abidi, SH; ... Araujo Pereira, R; + view all Aaboud, M; Aad, G; Abbott, B; Abdinov, O; Abeloos, B; Abhayasinghe, DK; Abidi, SH; AbouZeid, OS; Abraham, NL; Abramowicz, H; Abreu, H; Abulaiti, Y; Acharya, BS; Adachi, S; Adamczyk, L; Adelman, J; Adersberger, M; Adiguzel, A; Adye, T; Affolder, AA; Afik, Y; Agheorghiesei, C; Aguilar-Saavedra, JA; Ahmadov, F; Aielli, G; Akatsuka, S; Åkesson, TPA; Akilli, E; Akimov, AV; Alberghi, GL; Albert, J; Albicocco, P; Alconada Verzini, MJ; Alderweireldt, S; Aleksa, M; Aleksandrov, IN; Alexa, C; Alexopoulos, T; Alhroob, M; Ali, B; Alimonti, G; Alison, J; Alkire, SP; Allaire, C; Allbrooke, BMM; Allen, BW; Allport, PP; Aloisio, A; Alonso, A; Alonso, F; Alpigiani, C; Alshehri, AA; Alstaty, MI; Alvarez Gonzalez, B; Álvarez Piqueras, D; Alviggi, MG; Amadio, BT; Amaral Coutinho, Y; Ambroz, L; Amelung, C; Amidei, D; Amor Dos Santos, SP; Amoroso, S; Amrouche, CS; Anastopoulos, C; Ancu, LS; Andari, N; Andeen, T; Anders, CF; Anders, JK; Anderson, KJ; Andreazza, A; Andrei, V; Anelli, CR; Angelidakis, S; Angelozzi, I; Angerami, A; Anisenkov, AV; Annovi, A; Antel, C; Anthony, MT; Antonelli, M; Antrim, DJA; Anulli, F; Aoki, M; Aparisi Pozo, JA; Aperio Bella, L; Arabidze, G; Araque, JP; Araujo Ferraz, V; Araujo Pereira, R; - view fewer (2018) Prompt and non-prompt J/ ψ elliptic flow in Pb+Pb collisions at √sNN=5.02 Tev with the ATLAS detector. European Physical Journal C , 78 (9) 10.1140/epjc/s10052-018-6243-9 . Green open access

https://ift.tt/2QuFQg9

Encontros cartografados: reflexões sobre encontros entre meninos e educadores de rua

Sauma, JF; (2006) Encontros cartografados: reflexões sobre encontros entre meninos e educadores de rua. Cadernos de Campo , 15 (14-15) pp. 41-63. 10.11606/issn.2316-9133.v15i14-15p41-63 .

https://ift.tt/2zT7qOS

Recent Advances in Macrocyclic Fluorescent Probes for Ion Sensing

Wong, JK-H; Todd, MH; Rutledge, PJ; (2017) Recent Advances in Macrocyclic Fluorescent Probes for Ion Sensing. Molecules , 22 (2) 10.3390/molecules22020200 . Green open access

https://ift.tt/2QuQp2U

Search for Higgs bosons produced via vector-boson fusion and decaying into bottom quark pairs in root s=13 TeV pp collisions with the ATLAS detector

Aaboud, M; Aad, G; Abbott, B; Abdinov, O; Abeloos, B; Abhayasinghe, DK; Abidi, SH; ... Zwalinski, L; + view all Aaboud, M; Aad, G; Abbott, B; Abdinov, O; Abeloos, B; Abhayasinghe, DK; Abidi, SH; AbouZeid, OS; Abraham, NL; Abramowicz, H; Abreu, H; Abulaiti, Y; Acharya, BS; Adachi, S; Adamczyk, L; Adelman, J; Adersberger, M; Adiguzel, A; Adye, T; Affolder, AA; Afik, Y; Agheorghiesei, C; Aguilar-Saavedra, JA; Ahmadov, F; Aielli, G; Akatsuka, S; Akesson, TPA; Akilli, E; Akimov, A; Alberghi, GL; Albert, J; Albicocco, P; Verzini, MJA; Aldenveireldt, S; Aleksa, M; Aleksandrov, IN; Alexa, C; Alexopoulos, T; Alhroob, M; Ali, B; Alimonti, G; Alison, J; Allcire, SP; Allaire, C; Allbrooke, BMM; Allen, BW; Allport, PP; Aloisio, A; Alonso, A; Alonso, F; Alpigiani, C; Alshehri, AA; Alstaty, M; Gonzalez, BA; Piqueras, DA; Alviggi, MG; Amadio, BT; Coutinho, YA; Ambroz, L; Amelung, C; Amidel, D; Dos Santos, SPA; Amoroso, S; Amrouche, CS; Anastopoulos, C; Ancu, LS; Andari, N; Andeen, T; Anders, CF; Anders, JK; Anderson, KJ; Andreazza, A; Andrei, V; Anelli, CR; Angelidakis, S; Angelozzi, I; Angerami, A; Anisenkov, A; Annovi, A; Antel, C; Anthony, MT; Antonelli, M; Antrim, DJA; Anulli, F; Aoki, M; Pozo, JAA; Bella, LA; Arabidze, G; Araque, JP; Ferraz, VA; Pereira, RA; Arce, ATH; Arde, RE; Arduh, FA; Arguin, J-F; Argyropoulos, S; Armbruster, AJ; Armitage, LJ; Armstrong, A; Arnaez, O; Arnold, H; Arratia, M; Arslan, O; Artamonov, A; Artoni, G; Artz, S; Asai, S; Asbah, N; Ashkenazi, A; Asimakapoulou, EM; Asquith, L; Assamagan, K; Astalos, R; Atkin, RJ; Atkinson, M; Atlay, NB; Augesten, K; Avolio, G; Avramidou, R; Ayoub, MK; Azuelos, G; Bass, AE; Baca, MJ; Bachacou, H; Bachas, K; Backes, M; Bagnaia, P; Bahmani, M; Bahrasemani, H; Bailey, AJ; Baines, JT; Bajic, M; Bakalis, C; Baker, OK; Bakker, PJ; Bakshi Gupta, D; Baldin, EM; Balek, P; Balli, F; Balunas, WK; Balz, J; Banas, E; Bandyopadhyay, A; Banerjee, S; Bannoura, AAE; Barak, L; Barbe, WM; Barberio, EL; Barberis, D; Barbero, M; Bariilari, T; Barisits, M-S; Barkeloo, J; Barklow, T; Barlow, N; Barnea, R; Barnes, SL; Barnett, BM; Barnett, RM; Barnovska-Blenessy, Z; Baroncelli, A; Barone, G; Barr, AJ; Navarro, LB; Barreiro, F; da Costa, JBG; Bartoldus, R; Barton, AE; Bartos, P; Basalaev, A; Bassalat, A; Bates, RL; Batista, SJ; Batlamous, S; Batley, JR; Battaglia, M; Bauce, M; Bauer, F; Bauer, KT; Bawa, HS; Beacham, JB; Beattie, MD; Beau, T; Beauchemin, PH; Bechtle, P; Beck, NC; Beck, HP; Becker, K; Becker, M; Becot, C; Beddall, A; Beddall, AJ; Bednyakov, VA; Bedognetti, M; Bee, CP; Beermann, TA; Begalli, M; Begel, M; Behera, A; Behr, JK; Bell, AS; Bella, G; Bellagamba, L; Bellerive, A; Bellomo, M; Bellos, P; Belotskiy, K; Belyaev, NL; Benary, O; Benchekroun, D; Bender, M; Benekos, N; Benhammou, Y; Noccioli, EB; Benitez, J; Benjamin, DP; Benoit, M; Bensinger, JR; Bentvelsen, S; Beresford, L; Beretta, M; Berge, D; Kuutmann, EB; Berger, N; Bergsten, LJ; Beringer, J; Berlendis, S; Bernard, NR; Bernardi, G; Bernius, C; Bernlochner, FU; Berry, T; Berta, P; Bertella, C; Berta, G; Bertram, IA; Besjes, GJ; Bylund, OB; Bessner, M; Besson, N; Bethani, A; Bethke, S; Betti, A; Bevan, AJ; Beyer, J; Bianchi, RMB; Biebel, O; Biedermann, D; Bielski, R; Bierwagen, K; Biesuz, N; Biglietti, M; Billoud, TR; Bindi, M; Bingul, A; Bini, C; Biondi, S; Birman, M; Bisanz, T; Biswal, JP; Bittrich, C; Bjergaard, DM; Black, JE; Black, KM; Blazek, T; Bloch, I; Blocker, C; Blue, A; Blumenschein, U; Blunier, ; Bobbink, GJ; Bobrovnikov, VS; Bocchetta, SS; Bocci, A; Bogavac, D; Bogdanchikov, AG; Bohm, C; Boisvert, V; Bokan, P; Bold, T; Boerner, D; Boldyrev, AS; Bolz, AE; Bomben, M; Bona, M; Bonilla, JS; Boonekamp, M; Borisov, A; Borissov, G; Bortfeldt, J; Bortoletto, D; Bortlotto, V; Boscherini, D; Bosman, M; Sola, JDB; Bouaouda, K; Boudreau, J; Bouhova-Thacker, E; Boumediene, D; Bourdarios, C; Boutle, SK; Boveia, A; Boyd, J; Boyko, IR; Bozson, AJ; Bracinik, J; Brahimi, N; Brandt, A; Brandt, G; Brandt, O; Braren, F; Bratzler, U; Brau, B; Brau, JE; Madden, WDB; Brendlinger, K; Brennan, AJ; Brenner, L; Brenner, R; Bressler, S; Brickwedde, B; 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Wolters, H; Wong, VWS; Woods, NL; Worm, SD; Wosiek, BK; Wozniak, KW; Wraight, K; Wu, M; Wu, SL; Wu, X; Wu, Y; Wyatt, TR; Wynne, BM; Xella, S; Xi, Z; Xia, L; Xu, D; Xu, H; Xu, L; Xu, T; Xu, W; Yabsley, B; Yacoob, S; Yajima, K; Yallup, DP; Yamaguchi, D; Yamaguchi, Y; Yamamoto, A; Yamanaka, T; Yamane, F; Yamatani, M; Yamazaki, T; Yamazaki, Y; Yan, Z; Yang, HJ; Yang, HT; Yang, S; Yang, Y; Yang, Z; Yao, W-M; Yap, YC; Yasu, Y; Yatsenko, E; Ye, J; Ye, S; Yeletskikh, I; Yigitbasi, E; Yildirim, E; Yorita, K; Yoshihara, K; Young, CJS; Young, C; Yu, J; Yue, X; Yuen, SPY; Zabinski, B; Zacharis, G; Zaffaroni, E; Zaidan, R; Zaitsev, AM; Zakharchuk, N; Zalieckas, J; Zambito, S; Zanzi, D; Zaripovas, DR; Zeissner, S; Zeitnitz, C; Zemaityte, G; Zeng, JC; Zeng, Q; Zenis, T; Zenin, O; Zerwas, D; Zgubic, M; Zhang, DF; Zhang, D; Zhang, F; Zhang, G; Zhang, H; Zhang, J; Zhang, L; Zhang, M; Zhang, P; Zhang, R; Zhang, X; Zhang, Y; Zhang, Z; Zhao, X; Zhao, Y; Zhao, Z; Zhemchugov, A; Zhou, B; Zhou, C; Zhou, L; Zhou, MS; Zhou, M; Zhou, N; Zhou, Y; Zhu, CG; Zhu, HL; Zhu, H; Zhu, J; Zhu, Y; Zhuang, X; Zhukov, K; Zhulanov, V; Zibell, A; Zieminska, D; Zimine, N; Zimmermann, S; Zinonos, Z; Zinser, M; Ziolkowski, M; Zivkovic, L; Zobernig, G; Zoccoli, A; Zoch, K; Zorbas, TG; Zou, R; Zur Nedden, M; Zwalinski, L; - view fewer (2018) Search for Higgs bosons produced via vector-boson fusion and decaying into bottom quark pairs in root s=13 TeV pp collisions with the ATLAS detector. Physical Review D , 98 , Article 052003. 10.1103/PhysRevD.98.052003 . Green open access

https://ift.tt/2zToRP2

Exploring the effects of ad schemes on the performance cost of mobile phones

Sarro, F; Gao, C; Zeng, J; Lyu, MR; King, I; (2018) Exploring the effects of ad schemes on the performance cost of mobile phones. In: Li, L and Meng, G and Klein, J and Malek, S, (eds.) A-Mobile 2018: Proceedings of the 1st International Workshop on Advances in Mobile App Analysis. (pp. pp. 13-18). Association for Computing Machinery (ACM): New York, NY, USA. Green open access

https://ift.tt/2QqPHUm

CAIX and pax-8 Commonly Immunoreactive in Endolymphatic Sac Tumors: A Clinicopathologic Study of 26 Cases with Differential Considerations for Metastatic Renal Cell Carcinoma in von Hippel-Lindau Patients

Abstract

Endolymphatic sac tumors (ELSTs) are rare, slowly growing temporal bone neoplasms which show a high association with von Hippel-Lindau (VHL) syndrome. The immunohistochemistry evaluation of these papillary-cystic neoplasms frequently raises the differential diagnosis with renal cell carcinoma, among other metastatic neoplasms, whether in VHL patients or not. A cohort of 26 patients with ELSTs were evaluated for histologic features, immunohistochemistry findings, and association with VHL. Standard immunohistochemistry evaluation was performed. Sixteen females and 10 males ranging in age from 10 to 69 years (mean 44; VHL mean: 32) at initial presentation, comprised the cohort of patients. Most (86%) experienced hearing changes or inner ear symptoms (vertigo, dizziness), with an average duration of symptoms for 39 months (range 2–240 months). The tumors were an average of 2.9 cm (range 0.4–8 cm), with 14 left, 11 right sided and one bilateral tumor. Nine patients had documented VHL, with 3 patients having a concurrent or subsequent clear cell renal cell carcinoma. Patients were followed an average of 6.2 years (available in 24 patients): 19 alive without disease, 7.5 years; 2 dead without disease, 1.2 years; and 3 alive with disease, 3.1 years. The neoplastic cells show the following immunohistochemistry findings: AE1/AE3, EMA, CK7, CAIX, GLUT1, VEGF: 100% of cases tested were positive; pax-8: 85% of cases positive; CD10 and RCC: 0% of cases reactive. Based on this cohort of 26 patients with ELST, 9 of whom had VHL, the strong pax-8 and CAIX should be used in conjunction with negative CD10 and RCC to help exclude a metastatic renal cell carcinoma. As CAIX is an enzyme overexpressed in hypoxia and hypoxia inducible factor is what VHL protein regulates, this is an expected, although previously unreported finding. Whether part of VHL or not, VHL mutations may be a somatic rather than germline finding in the tumors, a possible further explanation for the CAIX reaction.

https://ift.tt/2yiefaH

Reproducibility of Molecular Phenotypes after Long-Term Differentiation to Human iPSC-Derived Neurons: A Multi-Site Omics Study

Volpato, V; Smith, J; Sandor, C; Ried, JS; Baud, A; Handel, A; Newey, SE; ... Lakics, V; + view all Volpato, V; Smith, J; Sandor, C; Ried, JS; Baud, A; Handel, A; Newey, SE; Wessely, F; Attar, M; Whiteley, E; Chintawar, S; Verheyen, A; Barta, T; Lako, M; Armstrong, L; Muschet, C; Artati, A; Cusulin, C; Christensen, K; Patsch, C; Sharma, E; Nicod, J; Brownjohn, P; Stubbs, V; Heywood, WE; Gissen, P; De Filippis, R; Janssen, K; Reinhardt, P; Adamski, J; Royaux, I; Peeters, PJ; Terstappen, GC; Graf, M; Livesey, FJ; Akerman, CJ; Mills, K; Bowden, R; Nicholson, G; Webber, C; Cader, MZ; Lakics, V; - view fewer (2018) Reproducibility of Molecular Phenotypes after Long-Term Differentiation to Human iPSC-Derived Neurons: A Multi-Site Omics Study. Stem Cell Reports 10.1016/j.stemcr.2018.08.013 . (In press). Green open access

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Entrosar-se, uma reflexão etnográfica afroindígena

Sauma, J; (2014) Entrosar-se, uma reflexão etnográfica afroindígena. Cadernos de Campo , 23 (23) p. 257. 10.11606/issn.2316-9133.v23i23p257-270 .

https://ift.tt/2QqPHDQ

The functions of imitative behaviour in humans

Farmer, H; Ciaunica, A; Hamilton, AFDC; (2018) The functions of imitative behaviour in humans. Mind & Language , 33 (4) pp. 378-396. 10.1111/mila.12189 . Green open access

https://ift.tt/2zToCDC

Where actual is not factual: Times Square in the era of Post-Truth Politics

Fatah gen. Schieck, A; Ergin, E; (2018) Where actual is not factual: Times Square in the era of Post-Truth Politics. In: (Proceedings) Media Architecture Biennale Conference. ACM (In press).

https://ift.tt/2QrykTg

Similar Representations of Emotions Across Faces and Voices

Kuhn, LK; Wydell, T; Lavan, N; McGettigan, C; Garrido, L; (2017) Similar Representations of Emotions Across Faces and Voices. Emotion , 17 (6) pp. 912-937. 10.1037/emo0000282 . Green open access

https://ift.tt/2zTZpsZ

Linear Programming as a Baseline for Software Effort Estimation

Sarro, F; Petrozziello, A; (2018) Linear Programming as a Baseline for Software Effort Estimation. ACM Transactions on Software Engineering and Methodology , 27 (3) , Article 12. 10.1145/3234940 . Green open access

https://ift.tt/2Qryeem

Alterations in the metabolic and cardiorespiratory response to exercise in Huntington's Disease

Steventon, JJ; Collett, J; Furby, H; Hamana, K; Foster, C; O'Callaghan, P; Dennis, A; ... Dawes, H; + view all Steventon, JJ; Collett, J; Furby, H; Hamana, K; Foster, C; O'Callaghan, P; Dennis, A; Armstrong, R; Németh, AH; Rosser, AE; Murphy, K; Quinn, L; Busse, M; Dawes, H; - view fewer (2018) Alterations in the metabolic and cardiorespiratory response to exercise in Huntington's Disease. Parkinsonism & Related Disorders , 54 pp. 56-61. 10.1016/j.parkreldis.2018.04.014 .

https://ift.tt/2zSLymw

Customer Rating Reactions Can Be Predicted Purely Using App Features

Sarro, F; Harman, M; Jia, Y; Zhang, Y; (2018) Customer Rating Reactions Can Be Predicted Purely Using App Features. In: Proceedings of the IEEE 26th International Requirements Engineering Conference :RE 18. IEEE: Banff, Alberta, Canada. (In press).

https://ift.tt/2Qxafup

Neurocognitive bases of emotion regulation development in adolescence

Ahmed, SP; Bittencourt-Hewitt, A; Sebastian, CL; (2015) Neurocognitive bases of emotion regulation development in adolescence. Developmental Cognitive Neuroscience , 15 pp. 11-25. 10.1016/j.dcn.2015.07.006 . Green open access

https://ift.tt/2zT7nTc

Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials

Harrison, A; Fernandez de la Cruz, L; Enander, J; Radua, J; Mataix-Cols, D; (2016) Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review , 48 pp. 43-51. 10.1016/j.cpr.2016.05.007 . Green open access

https://ift.tt/2QrxNAK

Young-Onset Multiple System Atrophy: Clinical and Pathological Features

Batla, A; De Pablo-Fernandez, E; Erro, R; Reich, M; Calandra-Buonaura, G; Barbosa, P; Balint, B; ... Bhatia, KP; + view all Batla, A; De Pablo-Fernandez, E; Erro, R; Reich, M; Calandra-Buonaura, G; Barbosa, P; Balint, B; Ling, H; Islam, S; Cortelli, P; Volkmann, J; Quinn, N; Holton, JL; Warner, TT; Bhatia, KP; - view fewer (2018) Young-Onset Multiple System Atrophy: Clinical and Pathological Features. Movement Disorders , 33 (7) pp. 1099-1107. 10.1002/mds.27450 .

https://ift.tt/2zSLjb6

Evaluation of Sterilisation Techniques for Regenerative Medicine Scaffolds Fabricated with Polyurethane Nonbiodegradable and Bioabsorbable Nanocomposite Materials

Kalaskar, D; (2018) Evaluation of Sterilisation Techniques for Regenerative Medicine Scaffolds Fabricated with Polyurethane Nonbiodegradable and Bioabsorbable Nanocomposite Materials. International Journal of Biomaterials , 2018 (6565783) 10.1155/2018/6565783 . Green open access

https://ift.tt/2QuPqja

Marsh’s Mirror

Sella, A; (2017) Marsh's Mirror. Chemistry World Green open access

https://ift.tt/2zU1Rzy

Self-Fulfilling Liquidity Dry-Ups

Malherbe, F; (2014) Self-Fulfilling Liquidity Dry-Ups. The Journal of Finance , 69 (2) pp. 947-970. 10.1111/jofi.12063 .

https://ift.tt/2Qy9HEK

Three dimensional evaluation of soft tissue after orthognathic surgery

Abstract

Background

To evaluate the nasolabial soft tissue change three-dimensionally after orthognathic surgery, using a structured light scanner.

Methods

Thirty-two malocclusion patients, who underwent orthognathic surgery, were evaluated. CBCT and 3D facial scans were obtained before surgery and 3 months after surgery. The 3D changes in the 26 landmarks, and the relative ratio of the soft tissue movement to the bony movement, were evaluated.

Results

In the Le Fort I advancement patients, the nasal tip moved 17% forward, compared to the maxillary bony movement, but the nasal prominence decreased 15%. The alar width increased 4 mm after the advancement, and the width decreased 4.7 mm after Le Fort I setback. The relative ratio of the soft tissue movement to the bony movement after bilateral sagittal split osteotomy was about 66% at the Li point in the anteroposterior direction, and it was 21% in the Le Fort I advancement and 14% in Le Fort I setback at the Ls point.

Conclusion

Alar cinch suturing may not be sufficient to overcome the effect of the maxilla advancement compressing the nasal complex. Alar width widening was prevented in Le Fort I setback. However, it is uncertain that the alar cinch suturing was solely responsible. The soft tissue around the mandible tends to accompany the bony movement more than the maxillary area. In addition, structured light scanning system proved to be a useful tool to evaluate the nasolabial soft tissue.

https://ift.tt/2BY6fyT

Bite injuries caused by transcranial electrical stimulation motor-evoked potentials’ monitoring: incidence, associated factors, and clinical course

Abstract

Purpose

The incidence of bite injuries associated with transcranial electrical stimulation motor-evoked potentials monitoring reportedly ranges from 0.13 to 0.19%. However, in clinical practice, bite injuries appear to occur more frequently than previously reported. Our aim was to identify the incidence of and perioperative risk factors associated with bite injuries caused by transcranial electrical stimulation motor-evoked potential monitoring.

Methods

Patients who underwent elective surgery with transcranial electrical stimulation motor-evoked potential monitoring at a single tertiary hospital in Japan between June 2017 and December 2017 were included in this study. All patients were assessed by oral surgeons preoperatively and postoperatively. The associated factors with bite injuries were explored by the univariate analysis.

Results

12 of 186 patients experienced 13 bite injuries, including three lip, six oral mucosa, and four tongue injuries. No patient required suture repair. 11 of 12 patients had uneventful postoperative courses and were cured within 12 postoperative days. One patient with a tongue ulcer and a hematoma had difficulty in oral intake and persistent dysgeusia. Patient severe movement during transcranial electrical stimulation motor-evoked potential monitoring was associated with bite injuries (p = 0.03).

Conclusions

The incidence of bite injuries assessed by oral surgeons was 6.5% in patients with transcranial electrical stimulation motor-evoked potential monitoring, and the patients with severe movement during the monitoring tended to incur bite injuries. In rare cases, transcranial electrical stimulation motor-evoked potential monitoring may cause difficulty in oral intake and dysgeusia.

https://ift.tt/2QwltPU

Thoracic spinal cord injury without radiologic abnormality in a pediatric patient case report

Abstract

Spinal Cord Injury Without Radiologic Abnormality (SCIWORA) accounts for up to 19% of spinal cord related lesions in pediatric population, mostly comprising the cervical spine. A 2-year-old patient is presented, who suffered a motor-vehicle accident. After being admitted, neither X-Ray nor spinal TC scan showed any structural abnormalities. Neurological examination showed complete sensory and motor loss under T7 as well as bladder and bowel dysfunction. Magnetic resonance imaging (MRI) showed spinal cord lesion extending from T7 to T10. The patient was treated with external immobilization and physical therapy. Thoracic SCIWORA is an uncommon diagnosis that should be considered in pediatric patients who suffer spinal trauma. Spinal cord MRI has proven to be the most accurate modality for diagnosis.

https://ift.tt/2y1iKH9

Ectopic jejunal pancreas with pancreatitis mistaken for a post-transplant lymphoproliferative disease in an immunosuppressed kidney transplant patient

Abstract

An ectopic pancreas, also known as pancreatic rest or heterotopic pancreas, consists of pancreatic tissue found in a location with no continuity with the anatomic pancreas. This lesion can occasionally cause gastrointestinal obstruction, ulceration or become inflamed and cause ectopic pancreatitis. We present the case of a 29-year-old immunocompromised female patient due to a previous kidney transplant. She presented with nausea and vague abdominal discomfort and was admitted for investigation and treatment of an acute kidney injury. A small bowel mass of unknown etiology was incidentally found on abdominal computed tomography imaging. Due to the high suspicion of a post-transplant lymphoproliferative disease, a surgical exploration took place and revealed the presence of a pancreatic rest with chronic pancreatitis. Ectopic pancreas diagnosis is challenging and surgical exploration is warranted when a neoplastic process is suspected.

https://ift.tt/2PcacDT

Adenocarcinoma arising in a colonic interposition after esophagectomy for benign stricture and review of the literature

Abstract

Colon interposition in oesophageal replacement after oesophagectomy for benign strictures is associated with significant perioperative complications that carry high morbidity and mortality. Long-term sequelae such as further strictures and colonic redundancy are frequent. Adenocarcinoma in the colonic graft is rare. A 70-year-old female presented to our clinic with symptoms of dysphagia. When she was 51 years, she underwent left colonic oesophageal interposition for an oesophageal stricture caused by caustic ingestion. Studies revealed colonic adenocarcinoma in interposed colonic graft, with latero-cervical lymph nodes. She was proposed to neoadjuvant chemotherapy. Although long-term risk analysis is lacking, it's not unreasonable to propose endoscopic screening according to general colonic cancer guidelines in patients with colonic interposition in oesophageal replacement after oesophagectomy.

https://ift.tt/2y2UnZX

A Case series of candy cane limb syndrome after laparoscopic Roux-en-Y gastric bypass

Abstract

Candy cane syndrome is a rare complication reported in bariatric patients following Roux-en-Y gastric bypass. It occurs when there is an excessive length of roux limb proximal to gastrojejunostomy, creating the possibility for food particles to lodge and remain in the blind redundant limb. Patients present with non-specific symptoms such as abdominal pain associated with nausea and vomiting. Most remain undiagnosed as the disease process is poorly described. We report three cases of candy cane syndrome treated successfully at our institution.

https://ift.tt/2PeE5Dw

Aortic valve reconstruction with autologous pericardium in a patient with osteogenesis imperfecta

Abstract

Cardiac valve surgery for patients with osteogenesis imperfecta is associated with a high incidence of complications such as perioperative bleeding and valve detachment. In this report, we present a patient who was diagnosed with osteogenesis imperfecta and severe aortic insufficiency and also discussed treatment options.

https://ift.tt/2y0WcGO

Renal clear cell carcinoma metastasis to submandibular gland: case report and review of the literature

Abstract

Metastases from renal clear cell carcinoma (RCCC) to the head and neck (HN) region are rare, representing 8–14% of all RCCC metastases, with the thyroid gland being the most common site of RCCC metastasis in the HN. Metastatic tumors that are located in the salivary glands have a prevalence of 5%, while the submandibular gland is only involved in 1% of the cases. We present the case of a 74-year-old female patient with metastasis to the submandibular gland, 11 years after radical nephrectomy for a RCCC.

https://ift.tt/2P8Jzj7

Ascaris lumbricoides and its almost deadly complication

Abstract

Parasitic infections are still a burden in developing countries. The lack of sanitation and hygiene measures can result in an increase in morbidity and mortality due to parasitic infections. Surgery may be needed to treat serious complications caused by some of these parasites. Ascaris lumbricoides is one of the most common parasites and although infections are usually mild, severe complications, although rare, still exist. We present a case of a patient from the Ecuadorean Amazon region with limited access to drinking water. She presented to the emergency room with abdominal pain and a mass in the abdomen. After surgery, a mass with a perforation due to Ascaris was discovered. After discharge and due to lack of follow up and self-care, she became infected again, this time making her prognosis more complex and her clinical presentation more difficult. However, after proper clinical and surgical management, patient fully recovered.

https://ift.tt/2y0Dyif

Continuing Medical Education Calendar

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2OHPyOY

Information for Readers

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2NpT9g1

Editorial Board

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2OFZj00

Table of Contents

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2NoLOxm

Brief Overview of This Month's JACI

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2OyPAJ9

Cover 1

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2NoLKh6

Correction

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s):

https://ift.tt/2OIPgY6

GM-CSF therapy in human caspase recruitment domain–containing protein 9 deficiency

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Rebecca A. Drummond, Fatema Tuz Zahra, Mukil Natarajan, Muthulekha Swamydas, Amy P. Hsu, L. Joseph Wheat, Christina Gavino, Donald C. Vinh, Steven M. Holland, Constantinos M. Mikelis, Michail S. Lionakis

https://ift.tt/2NpTOhv

Nuclear factor (erythroid-derived 2)-like-2 pathway modulates substance P–induced human mast cell activation and degranulation in the hair follicle

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Laura Jadkauskaite, Rajia Bahri, Nilofer Farjo, Bessam Farjo, Gail Jenkins, Ranjit Bhogal, Iain Haslam, Silvia Bulfone-Paus, Ralf Paus

https://ift.tt/2OFZdWc

Evolution of IgE responses to multiple allergen components throughout childhood

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Rebecca Howard, Danielle Belgrave, Panagiotis Papastamoulis, Angela Simpson, Magnus Rattray, Adnan Custovic

Background

There is a paucity of information about longitudinal patterns of IgE responses to allergenic proteins (components) from multiple sources.

Objectives

This study sought to investigate temporal patterns of component-specific IgE responses from infancy to adolescence, and their relationship with allergic diseases.

Methods

In a population-based birth cohort, we measured IgE to 112 components at 6 follow-ups during childhood. We used a Bayesian method to discover cross-sectional sensitization patterns and their longitudinal trajectories, and we related these patterns to asthma and rhinitis in adolescence.

Results

We identified 1 sensitization cluster at age 1, 3 at age 3, 4 at ages 5 and 8, 5 at age 11, and 6 at age 16 years. "Broad" cluster was the only cluster present at every follow-up, comprising components from multiple sources. "Dust mite" cluster formed at age 3 years and remained unchanged to adolescence. At age 3 years, a single-component "Grass" cluster emerged, which at age 5 years absorbed additional grass components and Fel d 1 to form the "Grass/cat" cluster. Two new clusters formed at age 11 years: "Cat" cluster and "PR-10/profilin" (which divided at age 16 years into "PR-10" and "Profilin"). The strongest contemporaneous associate of asthma at age 16 years was sensitization to dust mite cluster (odds ratio: 2.6; 95% CI: 1.2-6.1; P < .05), but the strongest early life predictor of subsequent asthma was sensitization to grass/cat cluster (odds ratio: 3.5; 95% CI: 1.6-7.4; P < .01).

Conclusions

We describe the architecture of the evolution of IgE responses to multiple allergen components throughout childhood, which may facilitate development of better diagnostic and prognostic biomarkers for allergic diseases.

https://ift.tt/2NpTL5j

PD-1 blocks lytic granule polarization with concomitant impairment of integrin outside-in signaling in the natural killer cell immunological synapse

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Yu Huang, Zhiying Chen, Joon Hee Jang, Mirza S. Baig, Grant Bertolet, Casey Schroeder, Shengjian Huang, Qian Hu, Yong Zhao, Dorothy E. Lewis, Lidong Qin, Michael Xi Zhu, Dongfang Liu

Background

The inhibitory receptor programmed cell death protein 1 (PD-1) is upregulated on a variety of immune cells, including natural killer (NK) cells, during chronic viral infection and tumorigenesis. Blockade of PD-1 or its ligands produces durable clinical responses with tolerable side effects in patients with a broad spectrum of cancers. However, the underlying molecular mechanisms of how PD-1 regulates NK cell function remain poorly characterized.

Objective

We sought to determine the effect of PD-1 signaling on NK cells.

Methods

PD-1 was overexpressed in CD16-KHYG-1 (a human NK cell line with both antibody-dependent cellular cytotoxicity through CD16 and natural cytotoxicity through NKG2D) cells and stimulated by exposing the cells to NK-sensitive target cells expressing programmed death ligand 1 (PD-L1).

Results

PD-1 engagement by PD-L1 specifically blocked NK cell–mediated cytotoxicity without interfering with the conjugation between NK cells and target cells. Further examination showed that PD-1 signaling blocked lytic granule polarization in NK cells, which was accompanied by failure of integrin-linked kinase, a key molecule in the integrin outside-in signaling pathway, to accumulate in the immunological synapse after NK–target cell conjugation.

Conclusion

Our results suggest that NK cell cytotoxicity is inhibited by PD-1 engagement, which blocks lytic granule polarization to the NK cell immunological synapse with concomitant impairment of integrin outside-in signaling. This study provides novel mechanistic insights into how PD-1 inhibition disrupts NK cell function.

Graphical abstract

https://ift.tt/2OFZatu

ORAI1 mutations abolishing store-operated Ca2+ entry cause anhidrotic ectodermal dysplasia with immunodeficiency

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Jayson Lian, Mario Cuk, Sascha Kahlfuss, Lina Kozhaya, Martin Vaeth, Frédéric Rieux-Laucat, Capucine Picard, Melina J. Benson, Antonia Jakovcevic, Karmen Bilic, Iva Martinac, Peter Stathopulos, Imre Kacskovics, Thomas Vraetz, Carsten Speckmann, Stephan Ehl, Thomas Issekutz, Derya Unutmaz, Stefan Feske

Background

Store-operated Ca²⁺ entry (SOCE) through Ca²⁺ release–activated Ca²⁺ channels is an essential signaling pathway in many cell types. Ca²⁺ release–activated Ca²⁺ channels are formed by ORAI1, ORAI2, and ORAI3 proteins and activated by stromal interaction molecule (STIM) 1 and STIM2. Mutations in the ORAI1 and STIM1 genes that abolish SOCE cause a combined immunodeficiency (CID) syndrome that is accompanied by autoimmunity and nonimmunologic symptoms.

Objective

We performed molecular and immunologic analysis of patients with CID, anhidrosis, and ectodermal dysplasia of unknown etiology.

Methods

We performed DNA sequencing of the ORAI1 gene, modeling of mutations on ORAI1 crystal structure, analysis of ORAI1 mRNA and protein expression, SOCE measurements, immunologic analysis of peripheral blood lymphocyte populations by using flow cytometry, and histologic and ultrastructural analysis of patient tissues.

Results

We identified 3 novel autosomal recessive mutations in ORAI1 in unrelated kindreds with CID, autoimmunity, ectodermal dysplasia with anhidrosis, and muscular dysplasia. The patients were homozygous for p.V181SfsX8, p.L194P, and p.G98R mutations in the ORAI1 gene that suppressed ORAI1 protein expression and SOCE in the patients' lymphocytes and fibroblasts. In addition to impaired T-cell cytokine production, ORAI1 mutations were associated with strongly reduced numbers of invariant natural killer T and regulatory T (Treg) cells and altered composition of γδ T-cell and natural killer cell subsets.

Conclusion

ORAI1 null mutations are associated with reduced numbers of invariant natural killer T and Treg cells that likely contribute to the patients' immunodeficiency and autoimmunity. ORAI1-deficient patients have dental enamel defects and anhidrosis, representing a new form of anhidrotic ectodermal dysplasia with immunodeficiency that is distinct from previously reported patients with anhidrotic ectodermal dysplasia with immunodeficiency caused by mutations in the nuclear factor κB signaling pathway (IKBKG and NFKBIA).

Graphical abstract

https://ift.tt/2NpTKhL

Loss-of-function nuclear factor κB subunit 1 (NFKB1) variants are the most common monogenic cause of common variable immunodeficiency in Europeans

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Paul Tuijnenburg, Hana Lango Allen, Siobhan O. Burns, Daniel Greene, Machiel H. Jansen, Emily Staples, Jonathan Stephens, Keren J. Carss, Daniele Biasci, Helen Baxendale, Moira Thomas, Anita Chandra, Sorena Kiani-Alikhan, Hilary J. Longhurst, Suranjith L. Seneviratne, Eric Oksenhendler, Ilenia Simeoni, Godelieve J. de Bree, Anton T.J. Tool, Ester M.M. van Leeuwen

Background

The genetic cause of primary immunodeficiency disease (PID) carries prognostic information.

Objective

We conducted a whole-genome sequencing study assessing a large proportion of the NIHR BioResource–Rare Diseases cohort.

Methods

In the predominantly European study population of principally sporadic unrelated PID cases (n = 846), a novel Bayesian method identified nuclear factor κB subunit 1 (NFKB1) as one of the genes most strongly associated with PID, and the association was explained by 16 novel heterozygous truncating, missense, and gene deletion variants. This accounted for 4% of common variable immunodeficiency (CVID) cases (n = 390) in the cohort. Amino acid substitutions predicted to be pathogenic were assessed by means of analysis of structural protein data. Immunophenotyping, immunoblotting, and ex vivo stimulation of lymphocytes determined the functional effects of these variants. Detailed clinical and pedigree information was collected for genotype-phenotype cosegregation analyses.

Results

Both sporadic and familial cases demonstrated evidence of the noninfective complications of CVID, including massive lymphadenopathy (24%), unexplained splenomegaly (48%), and autoimmune disease (48%), features prior studies correlated with worse clinical prognosis. Although partial penetrance of clinical symptoms was noted in certain pedigrees, all carriers have a deficiency in B-lymphocyte differentiation. Detailed assessment of B-lymphocyte numbers, phenotype, and function identifies the presence of an increased CD21^low B-cell population. Combined with identification of the disease-causing variant, this distinguishes between healthy subjects, asymptomatic carriers, and clinically affected cases.

Conclusion

We show that heterozygous loss-of-function variants in NFKB1 are the most common known monogenic cause of CVID, which results in a temporally progressive defect in the formation of immunoglobulin-producing B cells.

Graphical abstract

https://ift.tt/2OFZ8So

Autonomous role of Wiskott-Aldrich syndrome platelet deficiency in inducing autoimmunity and inflammation

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Lucia Sereni, Maria Carmina Castiello, Francesco Marangoni, Achille Anselmo, Dario di Silvestre, Sara Motta, Elena Draghici, Stefano Mantero, Adrian J. Thrasher, Silvia Giliani, Alessandro Aiuti, Pierluigi Mauri, Luigi D. Notarangelo, Marita Bosticardo, Anna Villa

Background

Wiskott-Aldrich syndrome (WAS) is an X-linked immunodeficiency characterized by eczema, infections, and susceptibility to autoimmunity and malignancies. Thrombocytopenia is a constant finding, but its pathogenesis remains elusive.

Objective

To dissect the basis of the WAS platelet defect, we used a novel conditional mouse model (CoWas) lacking Wiskott-Aldrich syndrome protein (WASp) only in the megakaryocytic lineage in the presence of a normal immunologic environment, and in parallel we analyzed samples obtained from patients with WAS.

Methods

Phenotypic and functional characterization of megakaryocytes and platelets in mutant CoWas mice and patients with WAS with and without autoantibodies was performed. Platelet antigen expression was examined through a protein expression profile and cluster proteomic interaction network. Platelet immunogenicity was tested by using ELISAs and B-cell and platelet cocultures.

Results

CoWas mice showed increased megakaryocyte numbers and normal thrombopoiesis in vitro, but WASp-deficient platelets had short lifespan and high expression of activation markers. Proteomic analysis identified signatures compatible with defects in cytoskeletal reorganization and metabolism yet surprisingly increased antigen-processing capabilities. In addition, WASp-deficient platelets expressed high levels of surface and soluble CD40 ligand and were capable of inducing B-cell activation in vitro. WASp-deficient platelets were highly immunostimulatory in mice and triggered the generation of antibodies specific for WASp-deficient platelets, even in the context of a normal immune system. Patients with WAS also showed platelet hyperactivation and increased plasma soluble CD40 ligand levels correlating with the presence of autoantibodies.

Conclusion

Overall, these findings suggest that intrinsic defects in WASp-deficient platelets decrease their lifespan and dysregulate immune responses, corroborating the role of platelets as modulators of inflammation and immunity.

Graphical abstract

https://ift.tt/2NpdfXU

CCL19-producing fibroblastic stromal cells restrain lung carcinoma growth by promoting local antitumor T-cell responses

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Hung-Wei Cheng, Lucas Onder, Jovana Cupovic, Maximilian Boesch, Mario Novkovic, Natalia Pikor, Ignazio Tarantino, Regulo Rodriguez, Tino Schneider, Wolfram Jochum, Martin Brutsche, Burkhard Ludewig

Background

A particular characteristic of non–small cell lung cancer is the composition of the tumor microenvironment with a very high proportion of fibroblastic stromal cells (FSCs).

Objective

Lapses in our basic knowledge of fibroblast phenotype and function in the tumor microenvironment make it difficult to define whether FSC subsets exist that exhibit either tumor-promoting or tumor-suppressive properties.

Methods

We used gene expression profiling of lung versus tumor FSCs from patients with non–small cell lung cancer. Moreover, CCL19-expressing FSCs were studied in transgenic mouse models by using a lung cancer metastasis model.

Results

CCL19 mRNA expression in human tumor FSCs correlates with immune cell infiltration and intratumoral accumulation of CD8⁺ T cells. Mechanistic dissection in murine lung carcinoma models revealed that CCL19-expressing FSCs form perivascular niches to promote accumulation of CD8⁺ T cells in the tumor. Targeted ablation of CCL19-expressing tumor FSCs reduced immune cell recruitment and resulted in unleashed tumor growth.

Conclusion

These data suggest that a distinct population of CCL19-producing FSCs fosters the development of an immune-stimulating intratumoral niche for immune cells to control cancer growth.

Graphical abstract

https://ift.tt/2OIQd2Y

A Jagged 1–Notch 4 molecular switch mediates airway inflammation induced by ultrafine particles

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Mingcan Xia, Hani Harb, Arian Saffari, Constantinos Sioutas, Talal A. Chatila

Background

Exposure to traffic-related particulate matter promotes asthma and allergic diseases. However, the precise cellular and molecular mechanisms by which particulate matter exposure acts to mediate these effects remain unclear.

Objective

We sought to elucidate the cellular targets and signaling pathways critical for augmentation of allergic airway inflammation induced by ambient ultrafine particles (UFP).

Methods

We used in vitro cell-culture assays with lung-derived antigen-presenting cells and allergen-specific T cells and in vivo mouse models of allergic airway inflammation with myeloid lineage-specific gene deletions, cellular reconstitution approaches, and antibody inhibition studies.

Results

We identified lung alveolar macrophages (AM) as the key cellular target of UFP in promoting airway inflammation. Aryl hydrocarbon receptor–dependent induction of Jagged 1 (Jag1) expression in AM was necessary and sufficient for augmentation of allergic airway inflammation by UFP. UFP promoted T_H2 and T_H17 cell differentiation of allergen-specific T cells in a Jag1- and Notch 4–dependent manner. Treatment of mice with an anti–Notch 4 antibody abrogated exacerbation of allergic airway inflammation induced by UFP.

Conclusion

UFP exacerbate allergic airway inflammation by promoting a Jag1-Notch 4–dependent interaction between AM and allergen-specific T cells, leading to augmented T_H cell differentiation.

Graphical abstract

https://ift.tt/2NniRlf

Pathogenic TH17 inflammation is sustained in the lungs by conventional dendritic cells and Toll-like receptor 4 signaling

Publication date: October 2018

Source: Journal of Allergy and Clinical Immunology, Volume 142, Issue 4

Author(s): Karim H. Shalaby, Miranda R. Lyons-Cohen, Gregory S. Whitehead, Seddon Y. Thomas, Immo Prinz, Hideki Nakano, Donald N. Cook

Background

Mechanisms that elicit mucosal T_H17 cell responses have been described, yet how these cells are sustained in chronically inflamed tissues remains unclear.

Objective

We sought to understand whether maintenance of lung T_H17 inflammation requires environmental agents in addition to antigen and to identify the lung antigen-presenting cell (APC) types that sustain the self-renewal of T_H17 cells.

Methods

Animals were exposed repeatedly to aspiration of ovalbumin alone or together with environmental adjuvants, including common house dust extract (HDE), to test their role in maintaining lung inflammation. Alternatively, antigen-specific effector/memory T_H17 cells, generated in culture with CD4⁺ T cells from Il17a fate-mapping mice, were adoptively transferred to assess their persistence in genetically modified animals lacking distinct lung APC subsets or cell-specific Toll-like receptor (TLR) 4 signaling. T_H17 cells were also cocultured with lung APC subsets to determine which of these could revive their expansion and activation.

Results

T_H17 cells and the consequent neutrophilic inflammation were poorly sustained by inhaled antigen alone but were augmented by inhalation of antigen together with HDE. This was associated with weight loss and changes in lung physiology consistent with interstitial lung disease. The effect of HDE required TLR4 signaling predominantly in lung hematopoietic cells, including CD11c⁺ cells. CD103⁺ and CD11b⁺ conventional dendritic cells interacted directly with T_H17 cells in situ and revived the clonal expansion of T_H17 cells both ex vivo and in vivo, whereas lung macrophages and B cells could not.

Conclusion

T_H17-dependent inflammation in the lungs can be sustained by persistent TLR4-mediated activation of lung conventional dendritic cells.

https://ift.tt/2OEE135