Prostaglandin D2 Levels Regulate CD103+ Conventional Dendritic Cell Activation in Neonates During Respiratory Viral Infection

Viral Immunology, Ahead of Print.


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Three-dimensional force analysis of surgical manipulations at the long process of the incus

Abstract

Purpose

Surgical manipulation with application of inappropriate force may damage middle ear structures leading to hearing loss. This work analyzes the forces applied in simulated otosurgical exercises in a laboratory set-up by measuring the spatial components of applied forces with objective assessment criteria. With these criteria, the individual force characteristics applied by the surgeon can be quantified and an objective feedback can be given about their surgical maneuvers.

Methods

A natural size model of the human incus was mounted on a load cell to measure the spatial forces in all three directions during different manipulation tasks performed under the microscope by ten surgeons from our department having different levels of experience in otosurgery. The motions of the incus model and the instrument tip were recorded simultaneously with a video camera.

Results

Independent of surgical experience, a three-dimensional force pattern could be detected with components transverse to the desired force directions. The measured forces applied by trainees showed larger variations in magnitude, in spatial distribution and in temporal course than those applied by experienced surgeons. A better repeatability of identical tasks, constancy of force patterns and low peak force values could be seen in the group of experienced surgeons.

Conclusions

The laboratory system presented in this study using simultaneous video and 3-D force registration allows the objective assessment of surgical manipulations, e.g., at the long process of the incus. Training with video and force feedback provides information about surgical techniques and skill development of surgeons and has the potential to shorten the learning curve and to diminish intra-operative risks to patients.

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A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Abstract

Carotid Body Paraganglioma (CBPGL), is a type of neuroendocrine tumor that should be managed promptly due to their malignant potential and locally aggressive nature making resection at a later stage difficult. The objective of this case report is to explore the benefit of coil embolization and describe the surgical techniques employed in successful resection of a huge CBPGL.

https://ift.tt/2PO0B9X

A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Abstract

Carotid Body Paraganglioma (CBPGL), is a type of neuroendocrine tumor that should be managed promptly due to their malignant potential and locally aggressive nature making resection at a later stage difficult. The objective of this case report is to explore the benefit of coil embolization and describe the surgical techniques employed in successful resection of a huge CBPGL.

https://ift.tt/2PO0B9X

Paralytic Lagophthalmos: Comprehensive Approach to Management

Abstract

Purpose of Review

Facial paralysis can lead to lagophthalmos, loss of corneal protection, and devastating ocular consequences like corneal ulcers or even blindness. The purpose of this review is to discuss the importance of comprehensive and early eye care.

Recent Findings

Treatment of paralytic lagophthalmos should be individualized to each patient's situation; depending on the severity of the problem and the prognosis for recovery, treatment modalities are broad and include lubrication, selective chemodenervation, filler injection, fat augmentation, and surgical procedures like canthopexy and tarsorrhaphy.

Summary

This paper serves to highlight the importance of treating paralytic lagophthalmos and provides an overview of the optimal management algorithm of the compromised periocular complex to help improve function and quality of life. Prospective studies and long-term comparisons of surgical techniques for repair of paralytic lagophthalmos will help improve our understanding of this complex problem and perhaps introduce novel treatment strategies.

https://ift.tt/2Peir6F

Meilensteine der Schilddrüsenchirurgie

Laryngo-Rhino-Otol 2018; 97: 762-771
DOI: 10.1055/a-0664-8953

In der hier vorgelegten Darstellung der Entwicklung der Schilddrüsenchirurgie hin zu einer sicheren Chirurgie, die auf dem aktuellen chirurgischen und medizinhistorischen Forschungsstand und der verfügbaren einschlägigen Literatur basiert, wird die Entwicklungskontinuität hin zu den minimalinvasiven Operationsverfahren, die den dank der historischen Entwicklung erreichten hohen Sicherheitsstandards mindestens genügen müssen, erstmals im medizingeschichtlichen Kontext interpretiert. Das zunehmende Verständnis der Erkrankungen der Schilddrüse und der perioperativen Folgen und Komplikationen, die zu neuen medizinischen und therapeutischen Erkenntnissen führten, wird somit erstmals auch in diesem Kontext interpretiert.Zur Verbesserung des Patientenkomforts im Hinblick auf die Operationswunde und spätere Narbenbildung werden seit Beginn des 21. Jahrhunderts immer wieder neue minimalinvasive Operationsmethoden beschrieben, die sich durch die Zugangsmodalitäten und -wege unterscheiden. Zukünftige Weiterentwicklungen der operativen Zugangswege und Methoden müssen dem heutigen hohen Stand der chirurgischen und nuklearmedizinischen Therapie und ihren Qualitäts- und Sicherheitsstandards mindestens genügen.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Unterkieferprotrusionsschiene bei obstruktivem Schlafapnoesyndrom getestet

Laryngo-Rhino-Otol 2018; 97: 752-753
DOI: 10.1055/a-0677-5541

Marco Pitarch R et al. Effectiveness of a mandibular advancement device in obstructive sleep apnea patients: a prospective clinical trial. Eur Arch Otorhinolaryngol 2018; 275: 1903–1911 In einer prospektiven Studie wurde die Effektivität einer Unterkieferprotrusionsschiene (mandibular advancement device, MAD) bei Patienten mit obstruktivem Schlafapnoesyndrom getestet. Evaluiert wurden dabei verschiedene Merkmale der Patienten und der MAD als Prädiktoren des Behandlungsergebnisses.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 812-813
DOI: 10.1055/a-0652-6802

© Georg Thieme Verlag KG Stuttgart · New York

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Fixationsoptionen des Receivers/Stimulators bei Cochlea-Implantation begutachtet

Laryngo-Rhino-Otol 2018; 97: 753-754
DOI: 10.1055/a-0651-4028

Pamuk AE et al. The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate. J Laryngol Otol 2018; 11:1–6 Zur Prävention einer Migration des Receivers/Stimulators bei der Cochlea-Implantation ist seine Einbettung entscheidend. Türkische Ärzte der Klinik für Hals-, Nasen- und Ohrenheilkunde der Universität von Istanbul verglichen zwei Techniken der Einbettung.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Schwieriger magnetresonanztomografischer Nachweis eines Hämangioms des N. facialis – Ein Fallbericht

Laryngo-Rhino-Otol 2018; 97: 793-795
DOI: 10.1055/a-0747-6990

© Georg Thieme Verlag KG Stuttgart · New York

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Oropharynx-Karzinom-CT: prognostische Bedeutung der extranodalen Ausbreitung

Laryngo-Rhino-Otol 2018; 97: 754-755
DOI: 10.1055/a-0677-5308

Patel MR et al. Radiographic Imaging Does Not Reliably Predict Macroscopic Extranodal Extension in Human Papilloma Virus-Associated Oropharyngeal Cancer. ORL 2018; 80: 85–95 Amerikanische Radiologen und Fachärzte für Otorhinolaryngologie evaluierten bei Patienten mit Oropharynx-Plattenepithelkarzinomen (OPSCC) die Genauigkeit der präoperativen kontrastmittelverstärkten Computertomographie (CECT), um die extranodale Ausdehnung (ENE) (> 2 mm) zu prognostizieren.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Reinke-Ödem

Laryngo-Rhino-Otol 2018; 97: 760-761
DOI: 10.1055/a-0652-6769

© Georg Thieme Verlag KG Stuttgart · New York

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Funktionell-ästhetische Rhinochirurgie unter besonderer Berücksichtigung physiologischer Aspekte

Laryngo-Rhino-Otol 2018; 97: 756-756
DOI: 10.1055/a-0719-7383

© Georg Thieme Verlag KG Stuttgart · New York

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Stimm- und Kehlkopfveränderungen im Alter (Presbyphonie und Presbylarynx)

Laryngo-Rhino-Otol 2018; 97: 772-776
DOI: 10.1055/a-0652-6758

Etwa 20 % der über 60-Jährigen weisen eine Altersstimmstörung (Presbyphonie) auf, die oftmals von Presbyakusis (Altersschwerhörigkeit), Presbyphagie (Schluckstörungen im Alter), Presbyvertigo (Altersschwindel) und/oder Presbyopie (Alterssichtigkeit) begleitet wird.Presbyphonie betrifft die Singstimme häufiger, früher und deutlicher als die Sprechstimme. Aber nicht nur Qualität und Belastbarkeit von Sing- und Sprechstimme werden beeinträchtigt, auch der Atemantrieb wird durch die eingeschränkte Lungenfunktion schwächer. Durch das Absenken des Kehlkopfes verändern sich bei Senioren zudem die Resonanzverhältnisse im Ansatzrohr, und das Aspirationsrisiko steigt.Die stimmlichen Einbußen beruhen auf morphologischen Altersveränderungen des Kehlkopfes (Prebylarynx), die sowohl das ektolaryngeale Kehlkopfskelett als auch die endolaryngealen Weichteile (insbesondere die Stimmlippen) betreffen.Der Vokalismuskel atrophiert und wird hypoton, was zu einer spindelförmig-ovalären Glottisschlussinsuffizienz mit Luftverlust bei Phonation führt. Die Schleimhäute trocknen aus im Sinne einer Laryngitis sicca.Bei der Stimmrehabilitation im Alter müssen allgemeine und speziell auf die Stimme bezogene Behandlungsoptionen unterschieden werden: Zu den allgemeinen Therapieansätzen gehört die Mitbehandlung internistischer und neurologischer Grunderkrankungen (z. B. Reflux, neurodegenerative oder zerebrovaskuläre Erkrankungen) – auch Nebenwirkungen von Medikamenten müssen beachtet werden. Ein gesunder Lebensstil ohne Noxen begünstigt den Funktionserhalt von Phonations- und Atemorganen. Stimmtherapeutisch kommen sowohl Tonisierungsübungen zur Verbesserung des phonatorischen Glottisschlusses als auch detonisierende Entspannungsübungen zum Abbau supraglottischer hyperfunktioneller Pressmechanismen in Betracht. In Einzelfällen mit großem Glottisspalt bei Phonation kann eine phonochirurgische Stimmlippenaugmentation den Glottisschluss verbessern und somit die Stimme kräftigen. Stimmhygienische Maßnahmen (z. B. regelmäßiges Befeuchten der Atemwege) ergänzen das Stimmtraining.Singen im Alter hat sowohl psychosozial (Steigerung des Wohlbefindens und der sozialen Teilhabe) als auch immunologisch (Anstieg des IgA im Speichel) positive Effekte.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Nachruf Prof. Dr. med. Joachim Heermann

Laryngo-Rhino-Otol 2018; 97: 758-759
DOI: 10.1055/a-0734-4304

Am 20.07.2018 ist Herr Prof. Dr. med. Joachim Heermann nach langer Krankheit im Kreise seiner großen Familie in Essen verstorben. Mit Joachim Heermann verliert die HNO-Gesellschaft eine außergewöhnliche Persönlichkeit, einen Pionier der Mikrochirurgie des Ohres und der Nase und einen menschlichen innovativen Geist.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Aus der Gutachtenpraxis: Die Bedeutung der Bulbusvolumometrie für die Begutachtung von Riechstörungen

Laryngo-Rhino-Otol 2018; 97: 796-798
DOI: 10.1055/a-0652-6791

© Georg Thieme Verlag KG Stuttgart · New York

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Fehlbildungschirurgie von Nase und Lippe

Laryngo-Rhino-Otol 2018; 97: 814-816
DOI: 10.1055/a-0652-6846

© Georg Thieme Verlag KG Stuttgart · New York

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 748-749
DOI: 10.1055/a-0652-6736

© Georg Thieme Verlag KG Stuttgart · New York

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Immunology of the Ancestral Differences in Eosinophilic Esophagitis

Eosinophilic Esophagitis (EoE) is an allergen driven disease characterized by eosinophilic inflammation in the esophagus1. Like other atopic disorders such as atopic dermatitis (AD), food allergy (FA), allergic rhinitis (AR), and asthma, EoE has complex etiology with genetic predisposition and environmental factors playing a major role in disease development2. The genetic predisposition has been suggested as an important factor by familial and twin studies. Additionally, numerous genetic risk loci have been now described linked to EoE risk confirming that inheritability is associated with genetic predisposition3.

https://ift.tt/2QsQtka

Review of 400 Consecutive Oral Food Challenges to Almond

Diagnosis of almond allergy is complicated by a high rate of false positive test results. Accurate diagnosis of almond allergy is critical as almond is a source of nutrition and milk products for children with other food allergies.

https://ift.tt/2PfQw69

Unraveling the enigma: elucidating the relationship between the physicochemical properties of aluminium-based adjuvants and their immunological mechanisms of action

Aluminium salts are by far the most commonly used adjuvants in vaccines. There are only two aluminium salts which are used in clinically-approved vaccines, Alhydrogel® and AdjuPhos®, while the novel aluminium adj...

https://ift.tt/2JOeijN

Are egg white face masks good for your skin?

Many people use egg white face masks as a way to boost the health of both oily and dry skin. However, there is little to no evidence to support the suggested benefits of these masks. We take a closer look at these alleged benefits and explain how to make an egg white face mask.

https://ift.tt/2DqQkuv

Modified Ramped Position for Endotracheal Intubation of Obese Patients

Conditions:   Obesity;   Anesthesia
Interventions:   Other: Modified ramped position;   Other: Ramped position
Sponsor:   Cairo University
Not yet recruiting

https://ift.tt/2JK2oHD

Panitumumab-IRDye800 and 89Zr-Panitumumab in Identifying Metastatic Lymph Nodes in Patients With Squamous Cell Head and Neck Cancer

Condition:   Cutaneous Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: Panitumumab-IRDye800;   Drug: Zirconium Zr-89 Panitumumab;   Device: Pinpoint IR IR9000 flourescence imaging system (FIS);   Device: SPY-PHI IR9000 flourescence imaging system (FIS);   Device: Explorer Air camera;   Device: PDE-NEO II camera;   Device: FIS-00 fluorescence imaging system (FIS);   Device: Da Vinci Firefly Imaging System;   Device: IGP-ELVIS-v4 Macroscopic Specimen Imager;   Device: Vevo 3100 LAZR-X;   Device: Pearl Triology Imaging System;   Device: Odyssey CLx Imaging System;   Device: Leica fluorescence microscope
Sponsors:   Stanford University;   National Institutes of Health (NIH);   National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2ASTV2h

Disseminated Vegetating Plaques and Pustules

A teenaged male in Kenya presented with painful vegetating, bleeding plaques and pustules on his face, scalp, trunk, and extremities. He continued to develop new lesions despite prescribed daily medications. He was HIV negative. What is your diagnosis?

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Staging Systems to Predict Metastatic Cutaneous Squamous Cell Carcinoma

Disease staging systems play 2 critical roles in oncology. In the first instance, these systems summarize the extent of a patient's cancer at the time of diagnosis and disease progression, by including information on the tumor characteristics at the primary site (eg, location, size, histologic features, etc) as well as locoregional (lymph node involvement) and distant metastatic state. Second, clinicians use these systems to evaluate treatment options, assess prognosis, and plan their patients' care. Ideally, staging systems should have strong prognostic value so that clinicians can inform patients, with a reasonable degree of certainty, about the course of their disease and eligibility for adjuvant and therapeutic interventions.

https://ift.tt/2PMVHdl

Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin

This randomized clinical trial investigates whether platelet-rich plasma injection improves the visual appearance, including texture and color, of photodamaged facial skin in adults with bilateral cheek rhytids of Glogau class II or greater.

https://ift.tt/2D8IYLl

Effectiveness of Tacrolimus Swish-and-Spit Treatment in Patients With Geographic Tongue

This study evaluates the effectiveness of a twice daily tacrolimus swish-and-spit treatment regimen for geographic tongue.

https://ift.tt/2PIA5ih

Incomplete Data in Cutaneous Squamous Cell Carcinoma Staging System Analysis—Reply

In Reply On behalf of our coauthors, we thank Jambusaria-Pahlajani and colleagues for their interest in and comments to our study and appreciate the opportunity to respond to their concerns.

https://ift.tt/2D7wCTI

Incomplete Data in Cutaneous Squamous Cell Carcinoma Staging System Analysis

To the Editor We read with interest the article by Roscher et al on validation of 4 staging systems for cutaneous squamous cell carcinoma published in the April issue of JAMA Dermatology. We believe that such a population-based case-control comparison of staging systems is highly valuable in helping to refine subsequent staging. However, we have some concerns with the report's analysis and conclusions.

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Notice of Retraction and Replacement

This is a notice of the retraction and replacement for an article by Roscher et al. to correct errors detected throughout the text.

https://ift.tt/2DbT4uK

Cutaneous Sensitization to Peanut in Children With Atopic Dermatitis

This Viewpoint discusses recent findings associating atopic dermatitis in infants with increased sensitization to peanut protein and how those findings are informing new guidelines and efforts to prevent peanut allergy.

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Perspektiven für die Praxis

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The nature of the human T cell response to the cancer antigen 5T4 is determined by the balance of regulatory and inflammatory T cells of the same antigen-specificity: implications for vaccine design

Abstract

The oncofoetal antigen 5T4 is a promising T cell target in the context of colorectal cancer, as demonstrated by a recent clinical study where 5T4-specific T cell responses, induced by vaccination or cyclophosphamide, were associated with a significantly prolonged survival of patients with metastatic disease. Whilst Th1-type (IFN-γ⁺) responses specific to 5T4, and other oncofoetal antigens, are often readily detectable in early stage CRC patients and healthy donors, their activity is suppressed as the cancer progresses by CD4⁺CD25^hiFoxp3⁺ regulatory T cells (Treg) which contribute to the immunosuppressive environment conducive to tumour growth. This study mapped the fine specificity of Th1 and Treg cell responses to the 5T4 protein. Surprisingly, both immunogenic peptides and those recognised by Tregs clustered in the same HLA-DR transcending epitope-rich hotspots within the 5T4 protein. Similarly, regions of low Th1-cell immunogenicity also did not contain peptides capable of stimulating Tregs, further supporting the notion that Treg and Th1 cells recognise the same peptides. Understanding the rules which govern the balance of Th1 and Treg cells responding to a given peptide specificity is, therefore, of fundamental importance to designing strategies for manipulating the balance in favour of Th1 cells, and thus the most effective anti-cancer T cell responses.

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Adding dextran to local anesthetic enhances analgesia

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BRAF mutation testing in melanoma: results from a German observational multicenter study

Abstract

Quality control of BRAF mutation testing methods used in routine practice is crucial for optimal treatment selection. In this prospective study, we assessed the impact of patient/sample characteristics on BRAF mutation testing results in patients with melanoma, during clinical practice. Data were collected on routine testing practices and documented mutation status in patients with melanoma stages IIIB, IIIC, or IV across 28 diagnostic pathology centers in Germany. Patient/sample data collected included: patient age, location of primary melanoma and metastases, origin of sample, melanoma subtype, and quality of tissue. Statistical influence of patient/sample characteristics on BRAF mutation rate was assessed using multiple logistic regression analyses and statistical models developed to predict the probability of BRAF mutations for individual patient cohorts. Data/samples from 642 patients with melanoma were analyzed. BRAF mutations were documented in 241/642 patients (37.5%). The primary statistical model to predict BRAF mutation rates included: age (continuous), origin of sample, method of mutation analysis, and quality of tissue. Analyses of post hoc collected data identified major deviations between documented mutation rates included in this study vs. routinely recorded mutation rates for three centers. When samples from these centers were excluded, the influence of testing method was no longer statistically significant. The final model included patient age, origin of sample (including metastasis location), and quality of tissue. Once validated in an independent population, this type of model could allow pathology centers to compare the performance of their testing methods with what would be expected based on patient, tumor, and sample characteristics.

https://ift.tt/2F8ws0S

Les Annales de dermatologie ont 150 ans !

Publication date: Available online 7 November 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): B. Cribier

https://ift.tt/2OsgEpi

Programme des Posters

Publication date: Available online 6 November 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s):

https://ift.tt/2yVC1dK

Before the common learning, before the Inns of Court: common opinion in the fourteenth century

Williams, IS; (2019) Before the common learning, before the Inns of Court: common opinion in the fourteenth century. In: Jones, N and Ibbetson, D and Ramsay, N, (eds.) English legal history and its sources: essays in honour of Sir John Baker. Cambridge University Press: Cambridge. (In press).

https://ift.tt/2RHu7vr

Aortic Pulse wave velocity is greater in peritoneal dialysis patients with lower dual energy X-ray absorptiometry (DXA) femoral neck bone mineral density

Tangvoraphonkchai, K; Davenport, A; (2019) Aortic Pulse wave velocity is greater in peritoneal dialysis patients with lower dual energy X-ray absorptiometry (DXA) femoral neck bone mineral density. Journal of Nephrology (In press).

https://ift.tt/2yXFfx7

Psychedelics and the science of self-experience

Nour, MM; Carhart-Harris, RL; (2017) Psychedelics and the science of self-experience. The British Journal of Psychiatry , 210 (3) pp. 177-179. 10.1192/bjp.bp.116.194738 .

https://ift.tt/2RJcxY3

Waking Up: Searching for Spirituality without Religion. Sam Harris. Bantam Press, 2014, £20, hb, 245 pp. ISBN: 9780593074015

Nour, MM; (2017) Waking Up: Searching for Spirituality without Religion. Sam Harris. Bantam Press, 2014, £20, hb, 245 pp. ISBN: 9780593074015. [Review]. BJPsych Bulletin , 41 (1) pp. 62-63. 10.1192/pb.bp.115.053090 . Green open access

https://ift.tt/2ySdBle

Phase-sensitive terahertz imaging using room-temperature near-field nanodetectors

Giordano, MC; Viti, L; Mitrofanov, O; Vitiello, MS; (2018) Phase-sensitive terahertz imaging using room-temperature near-field nanodetectors. Optica , 5 (5) pp. 651-657. 10.1364/OPTICA.5.000651 . Green open access

https://ift.tt/2RFGnwj

Brief Report: Innate lymphoid cells and T-cells contribute to the IL-17A signature detected in the synovial fluid of patients with Juvenile Idiopathic Arthritis

Rosser, EC; Lom, H; Bending, D; Duurland, CL; Bajaj-Elliott, M; Wedderburn, LR; (2018) Brief Report: Innate lymphoid cells and T-cells contribute to the IL-17A signature detected in the synovial fluid of patients with Juvenile Idiopathic Arthritis. Arthritis and Rheumatology 10.1002/art.40731 . (In press). Green open access

https://ift.tt/2yWv0Jq

Dynamics and thermodynamics of Ibuprofen conformational isomerism at the crystal/solution interface

Marinova, V; Wood, GPF; Marziano, I; Salvalaglio, M; (2018) Dynamics and thermodynamics of Ibuprofen conformational isomerism at the crystal/solution interface. Journal of Chemical Theory and Computation 10.1021/acs.jctc.8b00702 . (In press).

https://ift.tt/2RF9LTt

Challenges of Inequality to Democracy

Bellamy, RP; Merkel, W; Bhargava, R; Bidadanure, J; Christiano, T; Felt, U; Hay, C; ... Verloo, M; + view all Bellamy, RP; Merkel, W; Bhargava, R; Bidadanure, J; Christiano, T; Felt, U; Hay, C; Lamboy, L; Pogrebinschi, T; Smith, G; Talshir, G; Urbinati, N; Verloo, M; - view fewer (2018) Challenges of Inequality to Democracy. In: IPSP, , (ed.) Rethinking Society for the 21st Century: Report of the International Panel on Social Progress: Volume 2: Political Regulation, Governance, and Societal Transformations. (pp. 563-596). Cambridge University Press: Cambridge, UK. Green open access

https://ift.tt/2yVoOBA

Formation of methane clathrate hydrates at elevated pressures and in the presence of nanoparticles

Skipper, N; Taylor, D; Cox, S; Michaelides, A; Youngs, T; Soper, A; Totton, T; ... Arjmandi, M; + view all Skipper, N; Taylor, D; Cox, S; Michaelides, A; Youngs, T; Soper, A; Totton, T; Chapman, R; Hodges, M; Arjmandi, M; - view fewer (2018) Formation of methane clathrate hydrates at elevated pressures and in the presence of nanoparticles. Journal of the American Chemical Society , 140 (9) pp. 3277-3284. 10.1021/jacs.7b12050 . Green open access

https://ift.tt/2RFFXpJ

Utilitarianism

Schofield, P; (2019) Utilitarianism. In: Breckman, W and Gordon, P, (eds.) The Cambridge History of Modern European Thought. Cambridge University Press: Cambridge, UK. (In press).

https://ift.tt/2yWuYBi

Heteropolymerization of α-1-antitrypsin mutants in cell models mimicking heterozygosity

Laffranchi, M; Berardelli, R; Ronzoni, R; Lomas, DA; Fra, A; (2018) Heteropolymerization of α-1-antitrypsin mutants in cell models mimicking heterozygosity. Human Molecular Genetics , 27 (10) pp. 1785-1793. 10.1093/hmg/ddy090 .

https://ift.tt/2RBmdnc

Heterozygous carriage of the alpha1-antitrypsin Pi*Z variant increases the risk to develop liver cirrhosis

Strnad, P; Buch, S; Hamesch, K; Fischer, J; Rosendahl, J; Schmelz, R; Brueckner, S; ... Trautwein, C; + view all Strnad, P; Buch, S; Hamesch, K; Fischer, J; Rosendahl, J; Schmelz, R; Brueckner, S; Brosch, M; Heimes, CV; Woditsch, V; Scholten, D; Nischalke, HD; Janciauskiene, S; Mandorfer, M; Trauner, M; Way, MJ; McQuillin, A; Reichert, MC; Krawczyk, M; Casper, M; Lammert, F; Braun, F; von Schönfels, W; Hinz, S; Burmeister, G; Hellerbrand, C; Teufe, A; Feldman, A; Schattenberg, JM; Bantel, H; Pathil, A; Demir, M; Kluwe, J; Boettler, T; Ridinger, M; Wodarz, N; Soyka, M; Rietschel, M; Kiefer, F; Weber, T; Marhenke, S; Vogel, A; Hinrichsen, H; Canbay, A; Schlattjan, M; Sosnowsky, K; Sarrazin, C; von Felden, J; Geier, A; Deltenre, P; Sipos, B; Schafmayer, C; Nothnagel, M; Aigner, E; Datz, C; Stickel, F; Morgan, MY; Hampe, J; Berg, T; Trautwein, C; - view fewer (2018) Heterozygous carriage of the alpha1-antitrypsin Pi*Z variant increases the risk to develop liver cirrhosis. Gut 10.1136/gutjnl-2018-316228 . Green open access

https://ift.tt/2yUDEbl

Long-term effect of cataract phacoemulsification on the inflammation control and clinical outcome in uveitis patients

Sharief, L; Lightman, S; Baltinas, J; Tomkins-Netzer, O; (2018) Long-term effect of cataract phacoemulsification on the inflammation control and clinical outcome in uveitis patients. Clinical and Experimental Ophthalmology 10.1111/ceo.13369 . (In press).

https://ift.tt/2RJs0Y5

Patient awareness of orthodontic mobile phone apps

Sharif, MO; Siddiqui, N; Hodges, S; (2019) Patient awareness of orthodontic mobile phone apps. Journal of Orthodontics (In press).

https://ift.tt/2yXEx2V

Common and Rare Variants Genetic Association Analysis of Cigarettes per Day Among Ever-Smokers in Chronic Obstructive Pulmonary Disease Cases and Controls

Lutz, SM; Frederiksen, B; Begum, F; McDonald, M-L; Cho, MH; Hobbs, B; Parker, MM; ... Hokanson, JE; + view all Lutz, SM; Frederiksen, B; Begum, F; McDonald, M-L; Cho, MH; Hobbs, B; Parker, MM; DeMeo, DL; Hersh, CP; Eringher, M; Young, K; Jiang, L; Foreman, MG; Kinney, GL; Make, BJ; Lomas, DA; Bakke, P; Gulsvik, A; Crapo, JD; Silverman, EK; Beaty, TH; Hokanson, JE; - view fewer (2018) Common and Rare Variants Genetic Association Analysis of Cigarettes per Day Among Ever-Smokers in Chronic Obstructive Pulmonary Disease Cases and Controls. Nicotine & Tobacco Research 10.1093/ntr/nty095 . (In press).

https://ift.tt/2RHtPol

Orthodontic retention: A clinical guide for the GDP

Sharif, MO; Aslam, A; (2019) Orthodontic retention: A clinical guide for the GDP. Dental Update (In press).

https://ift.tt/2yXEmEN

Women and Constitution-Making in Post-Communist Romania

Brodeala, E; Suteu, S; (2019) Women and Constitution-Making in Post-Communist Romania. In: Rubio-Marín, R and Irving, H, (eds.) Women As Constitution-Makers: Case Studies From The New Democratic Era. Cambridge University Press (In press).

https://ift.tt/2RJrYiV

Optimization Based Partitioning Selection for Improved Contaminant Detection Performance

Kyriacou, A; Timotheou, S; Reppa, V; Boem, F; Panayiotou, C; Polycarpou, MM; Parisini, T; (2019) Optimization Based Partitioning Selection for Improved Contaminant Detection Performance. In: Proceedings of the The 57th IEEE Conference on Decision and Control (CDC) 2018. IEEE: Miami Beach, FL, USA. (In press).

https://ift.tt/2yXEdRL

Clinical Outcome of Retinal Vasculitis and Predictors for Prognosis of Ischemic Retinal Vasculitis

Sharief, L; Lightman, S; Blum-Hareuveni, T; Bar, A; Tomkins-Netzer, O; (2017) Clinical Outcome of Retinal Vasculitis and Predictors for Prognosis of Ischemic Retinal Vasculitis. American Journal of Ophthalmology , 177 pp. 206-212. 10.1016/j.ajo.2017.02.028 . Green open access

https://ift.tt/2RH5Eq2

Relationships between peritoneal protein clearance and parameters of fluid status agree with clinical observations in other diseases, that venous congestion increases microvascular protein escape

Krediet, RT; Yoowannakul, S; Harris, LS; Davenport, A; (2019) Relationships between peritoneal protein clearance and parameters of fluid status agree with clinical observations in other diseases, that venous congestion increases microvascular protein escape. Peritoneal Dialysis International (In press).

https://ift.tt/2yXE0Ot

Next-Generation Robotic Head and Neck Surgery

Following the inception of transoral robotic surgery (TORS) in 2005, the field of robotic head and neck surgery has undergone refinement and innovation. Optimizing patient outcome, preserving function, and limiting morbidity are the key drivers. The next leap forward is another generation of flexible robotic surgical systems. Several such systems are under clinical and preclinical evaluation. A new single-port (Sp) robotic surgical architecture is now available integrating three fully articulating instruments and a flexible three-dimensional high-definition camera delivered through a 25-mm cannula. Preclinical feasibility studies of the Sp in human cadaver and porcine models suggest improved application compared to existing platforms for oropharyngeal and nasopharyngeal resection. With 3-handed manipulation of tissue, traction and countertraction may be used to deliver a more precise surgical dissection of head and neck anatomy than is currently possible. The single-port design permits greater access and maneuverability for the bedside surgical assistant. An alternative currently available in clinical use includes the Flex® system using a robotic camera and manually controlled endoscopic instruments. The Cambridge Medical Robotics Versius system is undergoing preclinical evaluation for TORS and may offer a novel modular approach. All of these systems allow the head and neck surgeon to reach further beyond the upper aerodigestive tract with greater agility and precision, expanding the boundaries of minimal access head and neck surgery.
ORL 2018;80:213–219

https://ift.tt/2SNiDrH

Editorial Board/Aims & Scope

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s):

https://ift.tt/2PMGedf

Apoptosis of tumor-infiltrating T lymphocytes: a new immune checkpoint mechanism

Abstract

Immunotherapy based on checkpoint inhibitors is providing substantial clinical benefit, but only to a minority of cancer patients. The current priority is to understand why the majority of patients fail to respond. Besides T-cell dysfunction, T-cell apoptosis was reported in several recent studies as a relevant mechanism of tumoral immune resistance. Several death receptors (Fas, DR3, DR4, DR5, TNFR1) can trigger apoptosis when activated by their respective ligands. In this review, we discuss the immunomodulatory role of the main death receptors and how these are shaping the tumor microenvironment, with a focus on Fas and its ligand. Fas-mediated apoptosis of T cells has long been known as a mechanism allowing the contraction of T-cell responses to prevent immunopathology, a phenomenon known as activation-induced cell death, which is triggered by induction of Fas ligand (FasL) expression on T cells themselves and qualifies as an immune checkpoint mechanism. Recent evidence indicates that other cells in the tumor microenvironment can express FasL and trigger apoptosis of tumor-infiltrating lymphocytes (TIL), including endothelial cells and myeloid-derived suppressor cells. The resulting disappearance of TIL prevents anti-tumor immunity and may in fact contribute to the absence of TIL that is typical of "cold" tumors that fail to respond to immunotherapy. Interfering with the Fas–FasL pathway in the tumor microenvironment has the potential to increase the efficacy of cancer immunotherapy.

https://ift.tt/2yX5d41

Application of indocyanine green in the parathyroid detection and protection: Report of 3 cases

Publication date: Available online 7 November 2018

Source: American Journal of Otolaryngology

Author(s): Jinrui Fan, Hao Jin, Jun Yang, Kun Liao, Zhuocheng He, Min Cui

Abstract

Background

It was thought that identifying the parathyroid gland during surgery was difficult for surgeons. It may be critical to locate the parathyroid for surgeons during thyroidectomy or parathyroidectomy due to the significant function of the parathyroid in calcium balance. According to recent reports, intrinsic fluorescence of the parathyroid has been found. There is some evidence to suggest that new equipment can detect the intrinsic fluorescence via imaging technology. In this case reports, a newly-invented intraoperative fluorescence imaging system and indocyanine green dye were applied to detect the parathyroid gland and evaluate the vascularization of parathyroid.

Case presentation

From July 1st to August 8st, 2018, 3 patients underwent total thyroidectomy in Zhuhai People's Hospital. The 3 subjects were recruited into our research. Indocyanine green angiography was performed on all the three participants. By ICG angiography, parathyroid glands were identified and protected. In the 3 patients, postoperative PTH levels were in the normal range. No one of them developed transient hypoparathyroidism.

Conclusions

This study has identified that the fluorescence imaging system applied with indocyanine green is a safe, easy and effective method to protect the parathyroid and predict postoperative parathyroidism.

https://ift.tt/2OwHvk7

Expression of T‐cell immunoglobulin and immunoreceptor tyrosine‐based inhibitory motif domain on CD4+ T cells in patients with atopic dermatitis

Abstract

The T‐cell immunoglobulin and immunoreceptor tyrosine‐based inhibitory motif domain (TIGIT) is a co‐inhibitory receptor mainly expressed on T cells. Although TIGIT plays an important role in various autoimmune diseases, its role in atopic dermatitis (AD) remains unclear. In this study, we examined the expression levels of TIGIT and their association with clinical features in patients with AD. TIGIT expression on CD4⁺ T cells, central memory T cells, effector memory T cells and regulatory T cells was determined by flow cytometry. CD4⁺ T cells exhibited enhanced TIGIT expression in patients with AD compared with healthy individuals. In particular, effector memory T cells and regulatory T cells, but not central memory T cells, exhibited higher TIGIT expression in patients with AD than in healthy individuals. The frequency of TIGIT⁺ cells among CD4⁺ T cells was significantly increased in patients with mild AD compared with healthy individuals, while decreased in patients with severe AD. Consistently, the frequency of TIGIT⁺ cells among CD4⁺ T cells was negatively correlated with both serum thymus and activation‐regulated chemokine levels and immunoglobulin E levels in patients with AD. Furthermore, TIGIT expression on CD4⁺ T cells inhibited cell proliferation in patients with AD. These results suggest that TIGIT expression on CD4⁺ T cells in patients with AD may be increased to suppress chronic cutaneous inflammation. Moreover, TIGIT expression may be impaired in a subset of patients with AD, leading to a deterioration of skin inflammation. Our study may provide new insight into a TIGIT pathway‐based therapeutic approach for AD.

https://ift.tt/2PMyvMh

Interleukin-4/interleukin-13 versus interleukin-5: a comparison of molecular targets in biologic therapy for the treatment of severe asthma

Purpose of review Asthma is a chronic, inflammatory disorder of the airways caused by a complex interplay of various biologic mechanisms. Several monoclonal antibody therapies targeting interleukin (IL)-4/IL-13 and IL-5 cytokine pathways have been developed for the treatment of severe eosinophilic asthma. As individuals can display biomarkers and clinical features characteristic of several asthma phenotypes, selection of anoptimal biologic can be difficult. Recent findings Dupilumab, a monoclonal antibody that binds to the α subunit of the IL-4 receptor (IL-4Rα) and has been approved for the treatment of adults with severe atopic dermatitis, has been shown in recent phase 3 trials to also have significant clinical benefits in the asthmatic population irrespective of baseline eosinophil counts. Summary As monoclonal antibodies targeting either IL-4 or IL-13 cytokines individually have failed to demonstrate significant clinical benefits, biologics that target cytokine receptors may be more efficacious compared to those that target cytokines. Furthermore, inhibition of the IL-4/IL-13 signaling cascades may disrupt a broader Th2 inflammatory response compared to a more selective impairment of eosinophil proliferation and activity via blockage of the IL-5 pathway. Future research with independently funded, head-to-head trials of approved biologics is needed to elucidate a favorable therapeutic option. Correspondence to Julia W. Tripple, MD, Allergy and Immunology Division, University of Texas Medical Branch, Galveston, TX 77555, USA. E-mail: jgwoodar@utmb.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2PJkejl

Strategies to reduce corticosteroid-related adverse events in asthma

Purpose of review Severe asthmatics, despite the chronic use of high inhaled corticosteroids (ICS) doses and frequent intake of systemic corticosteroids, remains clinically and/or functionally uncontrolled. These patients are also often affected by rhinitis or chronic rhinosinusitis requiring frequent use of intranasal corticosteroids. Therefore, severe asthmatics are exposed to an overload of corticosteroids that is frequently associated with relevant and costly adverse events. This clinical problem and the strategies to overcome it are here summarized. Recent findings Different therapeutic options may help in reducing the corticosteroid load in asthmatics, ranging from allergy immunotherapy (nonsuitable for severe uncontrolled patients), immunosuppressant agents like methotrexate or cyclosporine, novel biologic drugs (mainly anti-IgE, anti-IL5 and anti-IL4-receptor-alpha), and aspirin desensitization (for patients with anti-inflammatory drugs exacerbated respiratory disease). Summary The evidence of even serious corticosteroid-related adverse events associated with consistent health-care costs, should prompt the entire scientific community and health regulatory authorities to promote actions to increase the use of well tolerated and effective strategies to reduce the corticosteroid need in asthmatics; the most promising option seems to be the add-on use of biologic agents. Correspondence to Professor Enrico Heffler, Personalized Medicine, Asthma and Allergy Unit, Istituto Clinico Humanitas, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano MI, Italy. Tel: +39 282247013; fax: +39 282246484; e-mail: enrico.heffler@hunimed.eu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2Dbg4KL

Distributed Fault Detection for Interconnected Large-Scale Systems: a Scalable Plug & Play Approach

Boem, F; Carli, R; Farina, M; Ferrari-Trecate, G; Parisini, T; (2018) Distributed Fault Detection for Interconnected Large-Scale Systems: a Scalable Plug & Play Approach. IEEE Transactions on Control of Network Systems 10.1109/TCNS.2018.2878500 . (In press). Green open access

https://ift.tt/2OxFh3M

Crossing Disciplines in Planning: A Renewable Energy Case Study

Lee, M; Lock, S; Natarajan, L; Rydin, Y; (2018) Crossing Disciplines in Planning: A Renewable Energy Case Study. In: Pedersen, O, (ed.) Perspectives on Environmental Law Scholarship. (pp. 79-95). Cambridge university press: Cambridge, UK.

https://ift.tt/2yUFmK8

Ultimate strength of initially deflected plate under longitudinal compression: Part I = An advanced empirical formulation

Kim, DK; Poh, BY; Lee, JR; Paik, J; (2018) Ultimate strength of initially deflected plate under longitudinal compression: Part I = An advanced empirical formulation. Structural Engineering and Mechanics , 68 (2) pp. 247-259. 10.12989/sem.2018.68.2.247 .

https://ift.tt/2OplVhn

Heritability of Gray Matter Structural Covariation and Tool Use Skills in Chimpanzees (Pan troglodytes): A Source-Based Morphometry and Quantitative Genetic Analysis

Hopkins, WD; Latzman, RD; Mareno, MC; Schapiro, SJ; Gómez-Robles, A; Sherwood, CC; (2018) Heritability of Gray Matter Structural Covariation and Tool Use Skills in Chimpanzees (Pan troglodytes): A Source-Based Morphometry and Quantitative Genetic Analysis. Cereb Cortex , Article bhy250. 10.1093/cercor/bhy250 . (In press).

https://ift.tt/2yZBMhA

Postmortem microfocus computed tomography for early gestation fetuses: a validation study against conventional autopsy

Hutchinson, JC; Kang, X; Shelmerdine, SC; Segers, V; Lombardi, CM; Cannie, MM; Sebire, NJ; ... Arthurs, OJ; + view all Hutchinson, JC; Kang, X; Shelmerdine, SC; Segers, V; Lombardi, CM; Cannie, MM; Sebire, NJ; Jani, JC; Arthurs, OJ; - view fewer (2018) Postmortem microfocus computed tomography for early gestation fetuses: a validation study against conventional autopsy. American Journal of Obstetrics and Gynecology , 218 (4) 10.1016/j.ajog.2018.01.040 .

https://ift.tt/2OplOlX

RISK ESTIMATORS FOR CHOOSING REGULARIZATION PARAMETERS IN ILL-POSED PROBLEMS - PROPERTIES AND LIMITATIONS

Lucka, F; Proksch, T; Brune, C; Bissantz, N; Burger, M; Dette, H; Wubbeeling, F; (2018) RISK ESTIMATORS FOR CHOOSING REGULARIZATION PARAMETERS IN ILL-POSED PROBLEMS - PROPERTIES AND LIMITATIONS. Inverse Problems and Imaging , 12 (5) pp. 1121-1155. 10.3934/ipi.2018047 .

https://ift.tt/2yXchOa

Loss of function desmoplakin I and II mutations underlie dominant arrhythmogenic cardiomyopathy with a hair and skin phenotype

Maruthappu, T; Posafalvi, A; Castelletti, S; Delaney, PJ; Syrris, P; O'Toole, EA; Green, KJ; ... Kelsell, DP; + view all Maruthappu, T; Posafalvi, A; Castelletti, S; Delaney, PJ; Syrris, P; O'Toole, EA; Green, KJ; Elliott, PM; Lambiase, PD; Tinker, A; McKenna, WJ; Kelsell, DP; - view fewer (2018) Loss of function desmoplakin I and II mutations underlie dominant arrhythmogenic cardiomyopathy with a hair and skin phenotype. British Journal of Dermatology 10.1111/bjd.17388 . (In press).

https://ift.tt/2Ow6JyO

Future-proofing the Cenozoic macroperforate planktonic foraminifera phylogeny of Aze & others (2011)

Fordham, BG; Aze, T; Haller, C; Zehady, AK; Pearson, PN; Ogg, JG; Wade, BS; (2018) Future-proofing the Cenozoic macroperforate planktonic foraminifera phylogeny of Aze & others (2011). PLoS One , 13 (10) , Article e0204625. 10.1371/journal.pone.0204625 . Green open access

https://ift.tt/2yZuJWh

Extending the Minority Stress Model to Understand Mental Health Problems Experienced by the Autistic Population

Botha, M; Frost, DM; (2018) Extending the Minority Stress Model to Understand Mental Health Problems Experienced by the Autistic Population. Society and Mental Health 10.1177/2156869318804297 . (In press). Green open access

https://ift.tt/2OwuWFt

In situ strain tuning of the metal-insulator-transition of Ca2RuO4 in angle-resolved photoemission experiments

Riccò, S; Kim, M; Tamai, A; McKeown Walker, S; Bruno, FY; Cucchi, I; Cappelli, E; ... Baumberger, F; + view all Riccò, S; Kim, M; Tamai, A; McKeown Walker, S; Bruno, FY; Cucchi, I; Cappelli, E; Besnard, C; Kim, TK; Dudin, P; Hoesch, M; Gutmann, MJ; Georges, A; Perry, RS; Baumberger, F; - view fewer (2018) In situ strain tuning of the metal-insulator-transition of Ca2RuO4 in angle-resolved photoemission experiments. Nature Communications , 9 , Article 4535. 10.1038/s41467-018-06945-0 . Green open access

https://ift.tt/2yVtffR

Insights gained on the great recession’s effects

Bynner, J; Elder, GH; Heinz, WR; Schoon, I; (2017) Insights gained on the great recession's effects. In: Schoon, I and Bynner, J, (eds.) Young People's Development and the Great Recession: Uncertain Transitions and Precarious Futures. (pp. 447-478). Cambridge University Press: Cambridge, UK. Green open access

https://ift.tt/2OxFdRA

Financial and economic education on the English curriculum and PSHE: new hope or another false dawn?

Brant, JW; (2018) Financial and economic education on the English curriculum and PSHE: new hope or another false dawn? Teaching Business and Economics (In press).

https://ift.tt/2yVCiNU

Towards understanding the influence of subject knowledge in the practice of 'expert' geography teachers

Brooks, Clare; (2007) Towards understanding the influence of subject knowledge in the practice of 'expert' geography teachers. Doctoral thesis (Ph.D), Institute of Education, University of London. Green open access

https://ift.tt/2OuMBgM

Amplitude Modulation May Be Confused with Infrasound

Marquardt, T; Jurado, C; (2018) Amplitude Modulation May Be Confused with Infrasound. Acta Acustica united with Acustica , 104 (5) pp. 825-829. 10.3813/AAA.919232 . Green open access

https://ift.tt/2yRBl9d

The Untapped Potential of the Gaming Community: Narrative Review

Goodman, W; McFerran, E; Purves, R; Redpath, I; Beeken, RJ; (2018) The Untapped Potential of the Gaming Community: Narrative Review. [Review]. JMIR Serious Games , 6 (3) , Article e10161. 10.2196/10161 . Green open access

https://ift.tt/2OuZszm

Carbon and carbon isotope mass balance in the Neoproterozoic Earth system

Shields, GA; (2018) Carbon and carbon isotope mass balance in the Neoproterozoic Earth system. Emerging Topics in Life Sciences , 2 (2) pp. 257-265. 10.1042/ETLS20170170 .

https://ift.tt/2yZuIBH

Impact of modern cattle feeding practices onmilk fatty acid stable carbon isotope compositions emphasise the need for caution in selecting reference animal tissues and products for archaeological investigations

Roffet-Salque, M; Lee, MRF; Timpson, A; Evershed, RP; (2017) Impact of modern cattle feeding practices onmilk fatty acid stable carbon isotope compositions emphasise the need for caution in selecting reference animal tissues and products for archaeological investigations. Archaeological and Anthropological Sciences , 9 (7) pp. 1343-1348. 10.1007/s12520-016-0357-5 . Green open access

https://ift.tt/2OuZs2k

Recurring obscuration in NGC 3783

Kaastra, J. S., ; Mehdipour, M; Behar, E., ; Bianchi, S., ; Branduardi Raymont, G., ; et al., ; (2018) Recurring obscuration in NGC 3783. Astronomy and Astrophysics 10.1051/0004-6361/201832629 . (In press). Green open access

https://ift.tt/2yXqNpb

Endothelial cells release cardioprotective exosomes that may contribute to ischaemic preconditioning

Davidson, SM; Riquelme, JA; Zheng, Y; Vicencio, JM; Lavandero, S; Yellon, DM; (2018) Endothelial cells release cardioprotective exosomes that may contribute to ischaemic preconditioning. Scientific Reports , 8 , Article 15885. 10.1038/s41598-018-34357-z . Green open access

https://ift.tt/2OvNbL1

National Movements against Nation States: Bohemia and Lombardy between the Habsburg Empire, the German Confederation and Piedmont

Körner, A; (2018) National Movements against Nation States: Bohemia and Lombardy between the Habsburg Empire, the German Confederation and Piedmont. In: Moggach, D and Stedman Jones, G, (eds.) The 1848 Revolutions and European Political Thought. (pp. 345-382). Cambridge University Press: Cambridge, UK. Green open access

https://ift.tt/2yRVf3O

“Normal‐appearing” scalp areas are also affected in lichen planopilaris and frontal fibrosing alopecia: an observational histopathologic study of 40 patients

Abstract

Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocyte‐mediated scarring alopecias which clinically affect primarily the anterior and mid scalp. However, unaffected scalp areas have not yet been investigated in a systemic manner. In this study we assessed histopathologic changes in affected and unaffected scalp in both diseases and healthy control subjects and compared these findings with clinical signs and scalp symptoms. We have demonstrated that "normal‐appearing" scalp that is devoid of clinical lesions of LPP and FFA showed lymphocytic perifollicular inflammation around the isthmus/infundibulum areas in 65% of biopsy specimens, perifollicular fibrosis in 15% and mucin deposits in 7.5% of the cases. None of these findings were found in control samples. No direct correlation was found between the degree of histopathological inflammation, scalp symptoms and clinical lesions in the corresponding affected scalp areas. This preliminary study suggests that both diseases may be more generalized processes which affect the scalp and therefore, need systemic or total scalp therapy.

This article is protected by copyright. All rights reserved.

https://ift.tt/2RGIBf0

Interleukin-4/interleukin-13 versus interleukin-5: a comparison of molecular targets in biologic therapy for the treatment of severe asthma

Purpose of review Asthma is a chronic, inflammatory disorder of the airways caused by a complex interplay of various biologic mechanisms. Several monoclonal antibody therapies targeting interleukin (IL)-4/IL-13 and IL-5 cytokine pathways have been developed for the treatment of severe eosinophilic asthma. As individuals can display biomarkers and clinical features characteristic of several asthma phenotypes, selection of anoptimal biologic can be difficult. Recent findings Dupilumab, a monoclonal antibody that binds to the α subunit of the IL-4 receptor (IL-4Rα) and has been approved for the treatment of adults with severe atopic dermatitis, has been shown in recent phase 3 trials to also have significant clinical benefits in the asthmatic population irrespective of baseline eosinophil counts. Summary As monoclonal antibodies targeting either IL-4 or IL-13 cytokines individually have failed to demonstrate significant clinical benefits, biologics that target cytokine receptors may be more efficacious compared to those that target cytokines. Furthermore, inhibition of the IL-4/IL-13 signaling cascades may disrupt a broader Th2 inflammatory response compared to a more selective impairment of eosinophil proliferation and activity via blockage of the IL-5 pathway. Future research with independently funded, head-to-head trials of approved biologics is needed to elucidate a favorable therapeutic option. Correspondence to Julia W. Tripple, MD, Allergy and Immunology Division, University of Texas Medical Branch, Galveston, TX 77555, USA. E-mail: jgwoodar@utmb.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2PJkejl

Strategies to reduce corticosteroid-related adverse events in asthma

Purpose of review Severe asthmatics, despite the chronic use of high inhaled corticosteroids (ICS) doses and frequent intake of systemic corticosteroids, remains clinically and/or functionally uncontrolled. These patients are also often affected by rhinitis or chronic rhinosinusitis requiring frequent use of intranasal corticosteroids. Therefore, severe asthmatics are exposed to an overload of corticosteroids that is frequently associated with relevant and costly adverse events. This clinical problem and the strategies to overcome it are here summarized. Recent findings Different therapeutic options may help in reducing the corticosteroid load in asthmatics, ranging from allergy immunotherapy (nonsuitable for severe uncontrolled patients), immunosuppressant agents like methotrexate or cyclosporine, novel biologic drugs (mainly anti-IgE, anti-IL5 and anti-IL4-receptor-alpha), and aspirin desensitization (for patients with anti-inflammatory drugs exacerbated respiratory disease). Summary The evidence of even serious corticosteroid-related adverse events associated with consistent health-care costs, should prompt the entire scientific community and health regulatory authorities to promote actions to increase the use of well tolerated and effective strategies to reduce the corticosteroid need in asthmatics; the most promising option seems to be the add-on use of biologic agents. Correspondence to Professor Enrico Heffler, Personalized Medicine, Asthma and Allergy Unit, Istituto Clinico Humanitas, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano MI, Italy. Tel: +39 282247013; fax: +39 282246484; e-mail: enrico.heffler@hunimed.eu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2Dbg4KL

Active vaccination against Interleukin‐5 as long‐term treatment for insect bite hypersensitivity in horses

Abstract

Background

Insect‐bite hypersensitivity (IBH) in horses is a chronic allergic dermatitis caused by insect bites. Horses suffer from pruritic skin lesions, caused by type‐I/type‐IV allergic reactions accompanied by prominent eosinophil infiltration into the skin. Interleukin‐5 (IL‐5) is the key cytokine for eosinophils and we have previously shown that targeting IL‐5 by vaccination reduces disease symptoms in horses.

Objective

Here we analyzed the potential for long‐term therapy by assessing a second follow‐up year of the previously published study.

Methods

The vaccine consisted of equine IL‐5 (eIL‐5) covalently linked to a cucumber mosaic virus‐like particle (VLP) containing a universal T cell epitope (CuMV_TT) using a semi‐cross over design to follow vaccinated horses during a second treatment season. Thirty Icelandic horses were immunized with 300 μg of eIL‐5‐CuMV_TT without adjuvant.

Results

The vaccine was well tolerated and did not reveal any safety concerns throughout the study. Upon vaccination all horses developed reversible anti‐eIL‐5 auto‐antibody titers. The mean course of eosinophil levels was reduced compared to placebo treatment leading to significant reduction of clinical lesion scores. Horses in their second vaccination year showed a more pronounced improvement of disease symptoms when compared to first treatment year, most likely due to more stable antibody titers induced by a single booster injection. Hence, responses could be maintained over two seasons and the horses remained protected against disease symptoms.

Conclusion

Yearly vaccination against IL‐5 may be a long‐term solution for the treatment of IBH and other eosinophil‐mediated diseases in horses and other species including humans.

This article is protected by copyright. All rights reserved.

https://ift.tt/2RH23bz

Funktionelle Rehabilitation schwerer laryngopharyngealer Verletzungen nach Suizidversuch durch Erhängen

Zusammenfassung

Hintergrund

Die Mortalitätsrate nach einem Suizidversuch durch Erhängen beträgt etwa 70 %. Die häufigste Todesursache ist hierbei eine zerebrale Hypoxie, aber auch schwere Verletzungen des oberen Aerodigestivtrakts werden selten überlebt. Die klinisch erhobenen Befunde von Patienten, die lebend das Krankenhaus erreichen, können trotz schwerer Verletzungen gering sein. Es ist daher entscheidend, zügig eine multidisziplinäre Diagnostik und Therapie einzuleiten, welche gefolgt ist von einer psychiatrischen Behandlung und der funktionellen Rehabilitation.

Fallbeschreibung und Ergebnisse

Anhand zweier Fälle von Patienten mit einer schweren Verletzung des oberen Aerodigestivtrakts nach suizidalem Erhängen wird die primäre Versorgung sowie die funktionelle Rehabilitation dargestellt. Die anschließende Kanülenversorgung und Schlucktherapie bis zur vollständigen Erholung werden beschrieben. Darüber hinaus wird ein Algorithmus für die Behandlung solcher Fälle vorgeschlagen, der nicht nur die primäre interdisziplinäre Diagnostik und Therapie, sondern auch die funktionelle Rehabilitation und die psychiatrische Behandlung berücksichtigt.

Schlussfolgerung

Minimale Symptome oder äußere Befunde nach Suizidversuchen durch Erhängen schließen schwere Verletzungen des oberen Aerodigestivtrakts nicht aus. Nach der chirurgischen Rekonstruktion sind ein angepasstes Kanülenmanagement sowie eine frühe und intensive Schlucktherapie, begleitet von der psychiatrischen Behandlung, für eine rasche Rehabilitation der Stimme, Luftwege und Schluckfunktion unerlässlich.

https://ift.tt/2DrKklq

Anteriomediale Maxillektomie zur Verbesserung der Nasenatmung

Zusammenfassung

Das Ziel der klassischen chirurgischen Korrektur bei Nasenatmungsbehinderung besteht darin, durch eine Operation an Nasenscheidewand und unteren Nasenmuscheln den physiologischen Spaltraum in der Nase harmonisch zu erweitern. Hierbei sollen der Durchflusscharakter erhalten bleiben und die Schleimhaut geschont werden, um die respiratorische Funktion der Nase nicht zu gefährden. Die vorliegende Arbeit stellt ein seit wenigen Jahren schrittweise entwickeltes operatives Vorgehen vor, bei dem verschiedene operative Teilschritte entsprechend der individuellen anatomischen Situation und der zugrunde liegenden Schleimhauterkrankung durchgeführt werden. Die anteriomediale partielle Maxillektomie steht im Mittelpunkt.

https://ift.tt/2RDfwkH

Hyperresponsiveness to interferon gamma exposure as a response mechanism to anti-PD-1 therapy in microsatellite instability colorectal cancer

Abstract

Colorectal cancer (CRC) with high-level microsatellite instability (MSI-H) tends to be associated with a better response to programmed death receptor-1 (PD-1) blockade than does microsatellite stable CRC. However, emerging evidence makes the use of programmed death ligand-1 (PD-L1) as a biomarker problematic. Here, we sought to characterize the interactions between PD-L1 expression and the response to PD-1 blockade therapy in BALB/c mice with a subcutaneous tumor challenge. We further focused on interferon gamma (IFNγ)-induced PD-L1 expression in an in vitro setting to evaluate the responsiveness to IFNγ exposure and the specific signaling of PD-1 in HCT116 and SW480 cell lines. In this study, enhanced PD-L1 expression increased survival in CT26 cells, and PD-1 blockade increased the CTL profile and apoptotic cells in mice with CRC. Our in vitro findings showed that PD-L1 expression was significantly upregulated by a low-dose IFNγ treatment, and the MSI-H cell line might exhibit hyperresponsiveness to IFNγ exposure partly through the JAK–STAT pathway. These results suggest that intrinsic PD-L1 in cooperation with extrinsic IFNγ exposure in CRC may be more responsive to anti-PD-1 therapy, mainly through the CTL profile in the tumor microenvironment.

https://ift.tt/2PMCCIa

Instrumental evaluation sensitively detects subclinical skin changes by the epidermal growth factor receptor inhibitors and risk factors for severe acneiform eruption

Abstract

Epidermal growth factor receptor inhibitors (EGFRI), EGFR tyrosine kinase inhibitors (TKI) and anti‐EGFR antibodies commonly develop skin toxicities including acneiform eruption (AfE). However, precise skin changes and risk factors for severe AfE are still unclear. The objective of the current study was elucidation of the useful parameters for early and sensitive detection of the skin changes by EGFRI. Transepidermal water loss (TEWL), skin surface hydration, skin surface lipid levels and erythema/melanin index were serially measured for 2 weeks in 19 EGFR‐TKI afatinib/erlotinib‐treated patients and for 8 weeks in 20 anti‐EGFR antibody cetuximab‐treated patients. The TEWL levels of the cheek in the patients who developed AfE of grade 2 and more (AfE ≥ Gr2) were already elevated at 7 days after the initiation of afatinib/erlotinib therapy compared with those before therapy as well as in patients with grade 1 or less (AfE ≤ Gr1). In patients treated with cetuximab, the skin surface hydration on the cheek in AfE ≥ Gr2 patients significantly decreased compared with that of AfE ≤ Gr1 patients at the 2nd and 6th week. Baseline skin surface lipid levels and erythema index on the cheek of patients with AfE ≥ Gr2 were significantly higher than those with AfE ≤ Gr1. The small sample size of the present study, especially for logistic regression analysis, is a limitation. In conclusion, instrumental evaluation declared rapid inflammatory changes of the skin by EGFRI and elucidated oily skin as a risk for severe AfE.

https://ift.tt/2F5f4dl

Improvement of nail lesions in a patient with psoriatic arthritis by switching the treatment from an anti‐interleukin‐17A antibody to an anti‐tumor necrosis factor‐α antibody

https://ift.tt/2qyx468

Pathological complete response after neoadjuvant pembrolizumab and radiation

https://ift.tt/2FbAjub

Tuberculous coxitis with trochanteric bursitis manifesting a year after immigration to Germany: a case report

Osteoarticular tuberculosis is rare in Germany. In particular, trochanteric bursitis is an extremely rare manifestation of osteoarticular tuberculosis. We describe a case of tuberculous coxitis with trochanter...

https://ift.tt/2Pd8Cpw

A Radical Approach to Ebola: Saving Humans and Other Animals

Edwards, SJL; Norell, CH; Illari, P; Clarke, B; Neuhaus, CP; (2018) A Radical Approach to Ebola: Saving Humans and Other Animals. The American Journal of Bioethics , 18 (10) pp. 35-42. 10.1080/15265161.2018.1513584 . Green open access

https://ift.tt/2yVhDtk

Mastication and Oral Motor Function in McArdle Disease: Patient Reported Complaints

Kouwenberg, CV; Voermans, NC; Quinlivan, R; van den Engel-Hoek, L; (2018) Mastication and Oral Motor Function in McArdle Disease: Patient Reported Complaints. Journal of Neuromuscular Diseases , 5 (3) pp. 353-357. 10.3233/JND-180320 . Green open access

https://ift.tt/2Oxah42

Quantifying Waddington's epigenetic landscape: a comparison of single-cell potency measures.

Shi, J; Teschendorff, AE; Chen, W; Chen, L; Li, T; (2018) Quantifying Waddington's epigenetic landscape: a comparison of single-cell potency measures. Briefings in Bioinformatics , Article 093. 10.1093/bib/bby093 . Green open access

https://ift.tt/2yX077H

Abiraterone Alone or in Combination With Enzalutamide in Metastatic Castration-Resistant Prostate Cancer With Rising Prostate-Specific Antigen During Enzalutamide Treatment

Attard, G; Borre, M; Gurney, H; Loriot, Y; Andresen-Daniil, C; Kalleda, R; Trinh, P; Attard, G; Borre, M; Gurney, H; Loriot, Y; Andresen-Daniil, C; Kalleda, R; Trinh, P; Taplin, M-E; - view fewer (2018) Abiraterone Alone or in Combination With Enzalutamide in Metastatic Castration-Resistant Prostate Cancer With Rising Prostate-Specific Antigen During Enzalutamide Treatment. Journal of Clinical Oncology , 36 (25) pp. 2639-2646. 10.1200/JCO.2018.77.9827 . Green open access

https://ift.tt/2Oxg6hM

Using principal component analysis to describe the midfacial deformities in patients with craniofacial microsomia

Maas, BDPJ; Pluijmers, BI; Knoops, PGM; Ruff, C; Koudstaal, MJ; Dunaway, D; (2018) Using principal component analysis to describe the midfacial deformities in patients with craniofacial microsomia. Journal of Cranio-Maxillofacial Surgery 10.1016/j.jcms.2018.09.019 . (In press).

https://ift.tt/2yVhtSK

Focus on paediatrics 2018

Kanthimathinathan, HK; Peters, MJ; (2018) Focus on paediatrics 2018. Intensive Care Medicine 10.1007/s00134-018-5421-4 . (In press).

https://ift.tt/2OvJipk

Gene editing and gene regulation with CRISPR

Harrison, P; Hart, S; (2018) Gene editing and gene regulation with CRISPR. Experimental Physiology , 103 (4) pp. 437-438. 10.1113/EP086864 .

https://ift.tt/2yVhjuC

Medical conferences: Value for money?

Swash, M; Lees, AJ; (2018) Medical conferences: Value for money? Journal of Neurology, Neurosurgery and Psychiatry 10.1136/jnnp-2018-319248 . (In press). Green open access

https://ift.tt/2Otd6mN

Long-term efficacy, tolerability and overall survival in patients with platinum-sensitive, recurrent high-grade serous ovarian cancer treated with maintenance olaparib capsules following response to chemotherapy

Friedlander, M; Matulonis, U; Gourley, C; du Bois, A; Vergote, I; Rustin, G; Scott, C; ... Ledermann, J; + view all Friedlander, M; Matulonis, U; Gourley, C; du Bois, A; Vergote, I; Rustin, G; Scott, C; Meier, W; Shapira-Frommer, R; Safra, T; Matei, D; Shirinkin, V; Selle, F; Fielding, A; Lowe, ES; McMurtry, EL; Spencer, S; Rowe, P; Mann, H; Parry, D; Ledermann, J; - view fewer (2018) Long-term efficacy, tolerability and overall survival in patients with platinum-sensitive, recurrent high-grade serous ovarian cancer treated with maintenance olaparib capsules following response to chemotherapy. British Journal of Cancer , 119 pp. 1075-1085. 10.1038/s41416-018-0271-y . Green open access

https://ift.tt/2yX8GzH

Open-System Orchestration as a Relational Source of Sensing Capabilities: Evidence from a Venture Association

Giudici, A; Reinmoeller, P; Ravasi, D; (2018) Open-System Orchestration as a Relational Source of Sensing Capabilities: Evidence from a Venture Association. Academy of Management Journal , 61 (4) pp. 1369-1402. 10.5465/amj.2015.0573 .

https://ift.tt/2Ovq5Ej

Candidate biomarkers of PARP inhibitor sensitivity in ovarian cancer beyond the BRCA genes

Hodgson, DR; Dougherty, BA; Lai, Z; Fielding, A; Grinsted, L; Spencer, S; O'Connor, MJ; ... Barrett, JC; + view all Hodgson, DR; Dougherty, BA; Lai, Z; Fielding, A; Grinsted, L; Spencer, S; O'Connor, MJ; Ho, TW; Robertson, JD; Lanchbury, JS; Timms, KM; Gutin, A; Orr, M; Jones, H; Gilks, B; Womack, C; Gourley, C; Ledermann, J; Barrett, JC; - view fewer (2018) Candidate biomarkers of PARP inhibitor sensitivity in ovarian cancer beyond the BRCA genes. British Journal of Cancer 10.1038/s41416-018-0274-8 . (In press). Green open access

https://ift.tt/2yWm5aZ

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson's disease: a pilot randomised controlled trial (PD COMM pilot)

Sackley, CM; Smith, CH; Rick, CE; Brady, MC; Ives, N; Patel, S; Woolley, R; ... PD COMM Pilot Collaborative Group, ; + view all Sackley, CM; Smith, CH; Rick, CE; Brady, MC; Ives, N; Patel, S; Woolley, R; Dowling, F; Patel, R; Roberts, H; Jowett, S; Wheatley, K; Kelly, D; Sands, G; Clarke, CE; PD COMM Pilot Collaborative Group, ; - view fewer (2018) Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson's disease: a pilot randomised controlled trial (PD COMM pilot). Pilot and Feasibility Studies , 4 (30) 10.1186/s40814-017-0222-z . Green open access

https://ift.tt/2Otd3aB

Challenges in administrative data linkage for research

Harron, K; Dibben, C; Boyd, J; Hjern, A; Azimaee, M; Barreto, ML; Goldstein, H; (2017) Challenges in administrative data linkage for research. Big Data & Society , 4 (2) pp. 1-12. 10.1177/2053951717745678 . Green open access

https://ift.tt/2yRBpFS

Deep Learning Parkinson's from Smartphone Data

Stamate, C; Magoulas, GD; Kueppers, S; Nomikou, E; Daskalopoulos, I; Luchini, MU; Moussouri, T; Stamate, C; Magoulas, GD; Kueppers, S; Nomikou, E; Daskalopoulos, I; Luchini, MU; Moussouri, T; Roussos, G; - view fewer (2017) Deep Learning Parkinson's from Smartphone Data. In: (Proceedings) IEEE International Conference on Pervasive Computing and Communications (PerCom). IEEE Green open access

https://ift.tt/2Ovq4jJ

Fibrinogen does not relate to cardiovascular or muscle manifestations in COPD: cross-sectional data from the ERICA study

Mohan, D; Forman, JR; Allinder, M; McEniery, CM; Bolton, CE; Cockcroft, JR; MacNee, W; ... Polkey, MI; + view all Mohan, D; Forman, JR; Allinder, M; McEniery, CM; Bolton, CE; Cockcroft, JR; MacNee, W; Fuld, J; Marchong, M; Gale, NS; Fisk, M; Nagarajan, S; Cheriyan, J; Lomas, DA; Calverley, PMA; Miller, BE; Tal-Singer, R; Wilkinson, IB; Polkey, MI; - view fewer (2018) Fibrinogen does not relate to cardiovascular or muscle manifestations in COPD: cross-sectional data from the ERICA study. [Rapid communication]. Thorax 10.1136/thoraxjnl-2018-211556 . (In press). Green open access

https://ift.tt/2yY70Wv

A Link Between Local Enrichment and Scalar Diversity

Sun, C; Tian, Y; Breheny, RET; (2018) A Link Between Local Enrichment and Scalar Diversity. Frontiers in Psychology , 9 , Article 2092. 10.3389/fpsyg.2018.02092 . Green open access

https://ift.tt/2OueMwf

Author Correction: α1-Antitrypsin deficiency

Greene, CM; Marciniak, SJ; Teckman, J; Ferrarotti, I; Brantly, ML; Lomas, DA; Stoller, JK; Greene, CM; Marciniak, SJ; Teckman, J; Ferrarotti, I; Brantly, ML; Lomas, DA; Stoller, JK; McElvaney, NG; - view fewer (2018) Author Correction: α1-Antitrypsin deficiency. [Corrigendum]. Nature Reviews Disease Primers , 4 , Article 40. 10.1038/s41572-018-0043-2 .

https://ift.tt/2yRBoSk

Comparing the effectiveness of hyperspectral imaging and Raman spectroscopy: a case study on Armenian manuscripts

Maybury, IJ; Howell, D; Terras, M; Viles, H; (2018) Comparing the effectiveness of hyperspectral imaging and Raman spectroscopy: a case study on Armenian manuscripts. Heritage Science , 6 , Article 42. 10.1186/s40494-018-0206-1 . Green open access

https://ift.tt/2OurICo

Equity against the odds: Three stories of island prisons, education and hope

Unterhalter, ES; (2018) Equity against the odds: Three stories of island prisons, education and hope. In: Carney, S and Schweisfurth, M, (eds.) Equity in and through education. Changing contexts, consequences and contestations. (pp. 13-27). Brill | Sense: Leinden/Boston.

https://ift.tt/2yY6Qyn

Being Ritual in Mesolithic Britain and Ireland: Identifying Ritual Behaviour Within an Ephemeral Material Record

Blinkhorn, E; Little, A; (2018) Being Ritual in Mesolithic Britain and Ireland: Identifying Ritual Behaviour Within an Ephemeral Material Record. Journal of World Prehistory , 31 (3) pp. 403-420. 10.1007/s10963-018-9120-4 . Green open access

https://ift.tt/2OvGiJC

Perioperative Considerations and Positioning for Neurosurgical Procedures: A Clinical Guide

No abstract available

https://ift.tt/2ST88mE

Serum Concentrations of Lidocaine During Bariatric Surgery

Lidocaine has been shown to be clinically beneficial during bariatric surgery. However, information about lidocaine serum concentrations in this setting is scarce. This prospective clinical trial included 42 obese patients undergoing laparoscopic bariatric surgery. They received lidocaine based on adjusted body weight. Administration began with a 1.5 mg·kg−1 bolus of intravenous lidocaine followed by a continuous infusion of 2 mg·kg−1·hour−1. After skin closure, administration was decreased to 1 mg·kg−1·hour−1 until discharge from the recovery room. No serum concentrations of lidocaine were outside the usual accepted range (1.5–5 µg·mL−1). Accepted for publication October 3, 2018. Funding: None. 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). Clinical trial number: NCT02525016. https://ift.tt/2ST81HK. Reprints will not be available from the authors. Address correspondence to Jean-François Carabalona, MD, Département d'Anesthésie Réanimation, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, 5 place d'Arsonval, 69003, Lyon, France. Address e-mail to jeffcarabalona@gmail.com. © 2018 International Anesthesia Research Society

https://ift.tt/2JOzwOE

Comparison of Invasive and Noninvasive Blood Pressure Measurements for Assessing Signal Complexity and Surgical Risk in Cardiac Surgical Patients

BACKGROUND: Continuous arterial blood pressure (ABP) is typically recorded by placement of an intraarterial catheter. Recently, noninvasive ABP monitors have been shown to be comparable in accuracy to invasive measurements. In a previous study, we showed that the fluctuations in beat-to-beat ABP measurements were not random variations but had a complex dynamical structure, and that ABP dynamical complexity was inversely associated with surgical risk estimated using the Society of Thoracic Surgeons (STS) index. Dynamical complexity is a mathematical construct that reflects the capacity of a physiological system to adapt to stimuli. The objectives of present study were to: (1) determine whether noninvasive beat-to-beat ABP measurements also exhibit a complex temporal structure; (2) compare the complexity of noninvasive versus invasive ABP time series; and (3) quantify the relationship between the complexity of noninvasive ABP time series and the STS risk scores. METHODS: Fifteen adult patients undergoing coronary artery bypass graft, valve, or combined coronary artery bypass graft/valve surgery ;were enrolled in this observational study. Preoperative ABP waveforms were simultaneously recorded for ≥15 minutes using a radial artery catheter (invasive) and a continuous noninvasive arterial pressure monitor. Beat-to-beat systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) time series were extracted from the continuous waveforms. Complexity was assessed using the multiscale entropy method. The Wilcoxon signed-rank test was used to compare the mean ranks of indices derived from invasive versus noninvasive ABP time series. Spearman correlation coefficients were used to quantify the relationship between invasive and noninvasive indices. Linear regression analysis was used to quantify the association between each of the complexity indices and the STS risk scores. RESULTS: Beat-to-beat fluctuations in noninvasive ABP measurements were not random but complex; however, their degree of complexity was lower than that of fluctuations in invasively obtained ABP signals (SBP: 7.05 vs 8.66, P

https://ift.tt/2SSaXUX

In Response

No abstract available

https://ift.tt/2JMubqX

Drug Diversion in the Anesthesia Profession: How Can Anesthesia Patient Safety Foundation Help Everyone Be Safe? Report of a Meeting Sponsored by the Anesthesia Patient Safety Foundation

No abstract available

https://ift.tt/2ST7Ufi

23rd Nantes Actualités Transplantation: “Genomics and Immunogenetics of Kidney and Inflammatory Diseases – Lessons for Transplantation”

No abstract available

https://ift.tt/2QpjX26

A Randomized Controlled Trial of Naloxone for Optimization of Hypoxemia in Lung Donors after Brain Death

Background Persistent hypoxemia is the principal reason lungs from otherwise eligible BD organ donors are not transplanted. Experimental models and retrospective studies have suggested that naloxone attenuates neurogenic pulmonary edema and reverses hypoxemia after brain death. We undertook a multi-site randomized placebo-controlled trial to evaluate whether naloxone is able to improve oxygenation in BD donors with hypoxemia. Methods BD organ donors at four OPOs were randomized in a blinded manner to naloxone 8-mg or saline placebo if lung were being considered for allocation but exhibited hypoxemia (PFR below 300 mm Hg). The primary outcome was change in PFR from baseline to final ABG. Secondary outcomes included early improvement in PFR and proportion of lungs transplanted. Results A total of 199 lung-eligible BD donors were randomized to naloxone (n=98) or placebo (n=101). Groups were comparable at baseline. Both groups exhibited similar improvements in oxygenation (median improvement in PFR of 81 with naloxone vs. 80 with saline, p=0.68) with 37 (39%) vs. 38 (40%) exhibiting reversal of hypoxemia. There was no difference in the rate of lungs transplanted (19% in both groups, p=0.97) although it was significantly higher in those with reversal of hypoxemia (32/69 vs. 2/111, p

https://ift.tt/2PeXGHW

The Continued Need for Clinical Trials in Deceased Organ Donor Management

No abstract available

https://ift.tt/2QpxnLP

Liver Transplantation for Nonalcoholic Steatohepatitis: New Evidence of a Profound Increase Across Age Cohorts

No abstract available

https://ift.tt/2Pfptbd

Rapidly Growing Conjunctival Squamous Cell Carcinoma Following Corneal Transplantation in a Patient with Xeroderma Pigmentosum

No abstract available

https://ift.tt/2PcN2Bs

Safety and efficacy of PCSK9 inhibitor treatment in heart transplant patients

No abstract available

https://ift.tt/2QpjFIy

Effect of case volume on mortality after pediatric liver transplantation in Korea

Background The purpose of this study was to evaluate whether institutional case volume affects clinical outcomes after pediatric liver transplantation. Methods: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 521 pediatric liver transplantations were performed at 22 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >10, 1-10, and 10 pediatric liver transplantations/year) had better outcomes after pediatric liver transplantation, including in-hospital mortality and long-term mortality, compared to centers with lower case volume (≤10 liver transplantations/year). Hannah Lee and Eun Jin Jang equally contributed to this work and are co-first authors. Corresponding author: Ho Geol Ryu, M.D. Ph.D. Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea, Tel: +82-2-2072-2065, Fax: +82-2-747-5639, E-mail: hogeol@gmail.com Authorship H.G.R., E.J.J. and H.L. designed the study. H.L., E.J.J. and H.G.R wrote the article. E.J.J., G.H.K. and D.H.K. analyzed the data. S.Y., H.S.R., C.W.J. and S.Y.O. participated in the performance of the research. C.W.J. and H.S.R. collected the data. N.J.Y. and S.Y.O. provided feedback and suggestions. Funding None. Conflicts of Interest None declared. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2PeWx2V

“Chylous Ascites: Complication of laparoscopic donor nephrectomy. Case Report and review of literature.”

Background Chylous ascites (CA) is an extremely rare complication after laparoscopic donor nephrectomy (LDN). It can increase the hospital stay, morbidity in postoperative period and thus negating the benefits of laparoscopic surgery. Most of the cases were managed conservatively, but surgical intervention may be occasionally required. This report describes importance of accurate localization of the leaking chyle duct and its repair by endosuturing in a renal donor not responding to conservative treatment. Methods A comprehensive review of literature regarding this rare complication after LDN was performed with Pubmed/Medline and Google Scholar using "chyle, complications, laparoscopic donor nephrectomy" as keywords. The demographic profile and management of patients is discussed in detail. The various surgical modalities used to manage these patients are described. Results Fifty-four cases of Chyle leak/ascites have been reported after LDN in literature till date. Around 77% donors with CA could be successfully managed conservatively with dietary measures and total parentral nutrition. Surgical intervention was required in nearly 23% donors ranging from clip application, use of argon coagulation, endosuturing with application of glue after 36.1±19.07 days of failed conservative treatment. Donors with massive ascites or requiring frequent large volume paracentesis on conservative treatment are likely to require surgical therapy. The present case was successfully managed with laparoscopic endosuturing and has no recurrence at 6 month follow-up. Conclusions Chylous ascites is a rare complication after donor nephrectomy in experienced centers. While conservative management remains the first line of treatment, early surgical treatment shall be undertaken in cases of massive ascites. Corresponding Author: Sarbpreet Singh, Assistant Professor, Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Sector -12, Pin code: 160012, Chandigarh, India. Email: drsarbpreetsingh@yahoo.com Authorship Page Authors: Abhinav Seth, Ashish Sharma, Deepesh Benjamin Kenwar, Sarbpreet Singh, Abhinav Seth, M.S. General Surgery, Senior Resident, Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Sector-12, Pin Code: 160012, Chandigarh, India. Email: drabhinavseth@gmail.com Contribution: Participated in research design, writing of paper and data analysis. Ashish Sharma, M.S. General Surgery, Professor and Head, Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Sector-12, Pin Code: 160012, Chandigarh, India. Email: ashish_chd@hotmail.com Contribution: Participated in research design. Deepesh Benjamine Kenwar, Additional Professor, Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Sector-12, Pin Code: 160012, Chandigarh, India. Email: deepesh.doc@gmail.com Contribution: Participated in the performance of the research Sarbpreet Singh (Corresponding author), Assistant Professor, Department of Renal Transplant Surgery, Postgraduate Institute of Medical Education and Research, Sector-12, Pin Code: 160012, Chandigarh, India. Email: drsarbpreet@yahoo.com Contribution: Participated in research design, writing of paper and data analysis Disclosure: The authors declare no conflict of interests. Funding: The authors did not receive any funding for this manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2QpGkol