BACKGROUND: Masseter muscle hypertrophy manifests itself as enlargement of masseter muscle. It can be associated with square shaped lower face, pain, dental attrition, maxillary and mandibular bone resorption, and accelerated aging process of the lower face. OBJECTIVE: Is to assess efficacy and safety of botulinum toxin type A in contouring the masseter and its impact on quality of life, the aging process of the lower face, and it's role in full face rejuvenation. METHODS: A PubMed search was conducted for articles on masseter treatment with botulinum toxin type A, masseter muscle hypertrophy, and aging process of the lower face. Key studies are reviewed and findings are summarized. RESULTS: Botulinum toxin type A can be injected in the lower posterior aspect of the masseter muscle. Treatment decreases muscle bulk and reshapes the lower face. Furthermore, patient quality of life measures, including pain and symptoms of grinding and clenching are improved. Treatment can decrease shear stress on maxillary and mandibular bones and can possibly prevent tooth loss and progressive bone resorption of the lower face. Adverse effects are minimal and short lasting. CONCLUSION: Botulinum toxin type A is a safe and effective treatment of masseter hypertrophy. The treatment results in improvement of functionality, cosmesis and restoring facial harmony. Financial Disclosure: This manuscript received no financial support. Sabrina G. Fabi is an investigator and consultant for Allergan, Merz, Galderma, and Revance. Corresponding author: Rawaa M. Almukhtar, MD, MPH, Louisiana State University, Department of Dermatology, 1542 Tulane Ave., Ste. 639 , New Orleans, LA 70112, Email: ralmuk@lsuhsc.edu ©2018American Society of Plastic Surgeons
https://ift.tt/2Ee721D
Τετάρτη 10 Οκτωβρίου 2018
Tissue Expander Complications Do Not Preclude A Second Successful Implant Based Breast Reconstruction
Background: Implant based breast reconstruction is the most common method of breast reconstruction in the United States but the outcomes of subsequent implant based reconstruction after a tissue expander (TE) complication are rarely studied. The purpose of this study is to determine the long term incidence of implant loss in patents with a previous TE complication. Methods: This is a retrospective review of the long term outcomes of all patients with TE complications at a large academic medical center from 2003-2013. Patients with subsequent TE or implant complications were compared to those with no further complications to assess risk factors for additional complications, or reconstructive failure. Results: One hundred sixty-two women were included in this study. The mean follow up was 8.3 ± 3.1 years. Forty-eight women (30%) went on to have a second TE or implant placed. They did not differ from women who went on to autologous reconstruction or no further reconstruction. Of these, 34 women (71%) had no further complications, and 38 women (79%) had a successful implant based reconstruction at final follow-up. There were no patient or surgical factors significantly associated with a second complication or implant loss. Conclusions: Following TE complications, it is reasonable to offer women a second attempt at tissue expansion and implant placement. This study demonstrates that long term success rates are high and there are no definitive patient or surgical factors that preclude a second attempt at implant based breast reconstruction. Financial Disclosure Statement: Dr. Myckatyn receives grant funding, consultant, and advisory board fees from Allergan, investigator-initiated grant funding and consultant fees from LifeCell, investigator-initiated grant funding and consultant fees from RTI, and advisory board fees from Viveve. No other authors report any disclosures. No funds were received to conduct this study. Presented at: Not Applicable Corresponding Author: Terence M. Myckatyn, MD, 1020 North Mason Road, Suite #110, Creve Coeur, MO 63141 ©2018American Society of Plastic Surgeons
https://ift.tt/2RE5vVj
https://ift.tt/2RE5vVj
Effect of the endogenous vascular endothelial growth factor on flap surgical delay in a rat flap model
Background: Experimental evidence suggests that endogenous vascular endothelial growth factor (VEGF) may play a major role in the surgical delay phenomenon. The purpose of this study was to investigate the effect of the endogenous vascular endothelial growth factor on flap surgical delay. Methods: A total of 82 adult male Sprague-Dawley rats with an average weight of 330g were used for these experiments. These experiments were then conducted in two parts. In part 1, thirty-two rats were used to assess the effectiveness of VEGF inhibitor through western blot assay and ELISA. In part 2, fifty rats were used to investigate the effect of VEGF on flap surgical delay via arteriography, histology analysis, and flap viability. Results: The VEGF protein inhibition ratio reached the maximum (approximately 91.6%) on the 5 to 7 days. The number of transverse arteries and the number of vessels > 0.1mm in diameter on the 3-day delay duration and the 6-day delay duration were significantly greater than those of the normal group. The number of transverse arteries and the number of vessels > 0.1mm in diameter on the 6-day inhibition duration were not significantly changed compared with the normal group. Microvascular density on the 6-day delay duration obviously increased whereas the 6-day inhibition duration was not significantly changed in comparison to the normal group. Conclusions: Endogenous VEGF is an initiating factor of the surgical delay effect by controlling choke vessel dilation and neovascularization within the choke zones. Conflict of interest: None Source of fund: This work is supported by the National Natural Science Foundation of China (NO.81472062). Corresponding Authors:* Xu Gong, E-mail: 13944099151@163.com, Tel.: +86 13944099151, Address: Department of Hand Surgery, The First Hospital of Jilin University, No.71, Xinmin Street, Changchun, Jilin Province, 130021, China. ©2018American Society of Plastic Surgeons
https://ift.tt/2EaV60x
https://ift.tt/2EaV60x
Evaluation of prepectoral implant placement and complete coverage with TiLoop® Bra mesh for breast reconstruction: a prospective study on long-term and patient reported BREAST-Q outcomes.
Background: Breast reconstruction is rapidly evolving, owing to the changing face of cancer surgery and the growing acceptance of acellular dermal matrices (ADM) and synthetic meshes. Although some early reports showed encouraging results after prepectoral breast reconstruction, there is a paucity of data on long term outcomes. Methods: Between January 2012 and March 2015, 179 patients undergoing mastectomy were enrolled at our institution. Patients underwent mastectomy and immediate prepectoral breast reconstruction with the definitive implant entirely wrapped in a titanium-coated polypropylene mesh (TiLoop®). BREAST-Q questionnaire was administered prior to surgery and after 2 years. Capsular contracture was evaluated by Baker scale. Oncological, surgical and aesthetic outcomes along with the changes in BREAST-Q score were analyzed over time. Results: Patients were followed up for an average of 38.5 months. A total of 250 mastectomies were performed. Locoregional recurrence rate was 2.1 %. Complications requiring a reoperation were recorded in 6 patients (2.4%) and implant removal was necessary in 3 cases (1.2%), followed by reconstruction with submuscular expanders. Grade IV capsular contracture was detected in 5 breasts (2%), while 212 breasts were evaluated as grade I (84.8%), 28 breasts as grade II (11.2%) and 5 breast as grade III (2%). Patients reported significant high rates in the BREAST-Q overall satisfaction with outcome (73.8), overall satisfaction with breasts (72.5), psychosocial well-being (77.7) and sexual well-being (57.9), scoring a significant increase in these domains from the preoperative to the postoperative period (p
https://ift.tt/2RERjv7
https://ift.tt/2RERjv7
“Three-Dimensional Topography of the Emerging Point of the Ophthalmic Artery.”
Background: During periorbital noninvasive and surgical procedures there is the risk of iatrogenic injury to the emerging point of the ophthalmic artery. This study aimed to determine the three-dimensional location of the emerging point of the ophthalmic artery and to provide clinicians with anatomic information that would help them to avoid associated complications. Methods: Seventeen hemifaces of the emerging point of the ophthalmic artery from 10 Korean and 7 Thai cadavers were dissected and scanned by a three-dimensional scanner. The emerging points of the ophthalmic artery of 30 healthy Korean volunteers were also detected using an ultrasound imaging system. Results: The transverse distance from the medial canthus to the emerging of the ophthalmic artery was 3.8±1.0 mm medially, while the vertical distance was 14.0±2.9 mm superiorly. The transverse distance from the midline was 16.5±1.7 mm to the emerging point of the ophthalmic artery and 20.0±2.0 mm to the medial canthus. The measured depth from the skin surface to the emerging point of the ophthalmic artery was 4.8±1.7 mm in three-dimensional scanning and 4.5±1.1 mm in ultrasound detection. The vertical distance from the inferior margin of the superior orbital rim to the emerging point of the ophthalmic artery was 5.3±1.4 mm. Conclusions: These data inform clinicians about the anatomic three-dimensional location of the emerging point of the ophthalmic artery, which will help them to avoid iatrogenic injury when they are performing periorbital clinical procedures. Lists of Authors and their participation: * None of the authors have financial or private relationships with commercial, academic, or political organizations or people that could have improperly influenced this research. All cadaveric objects in this study were legally donated to Yonsei Medical Center and Chulalongkorn University. Financial Disclosure Statement: None of the authors has received any financial support for this study. The institutional ethics committee approved the study, and the volunteers provided written informed consents after the study had been fully explained to them (IRB No. 2-2017-0023). Correspondence to: Name: Hee-Jin Kim, Address: Room 601, Division in Anatomy & Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Telephone: +82-2-2228-3067; Fax: +82-2-393-8076 E-mail: hjk776@yuhs.ac ©2018American Society of Plastic Surgeons
https://ift.tt/2EdruzJ
https://ift.tt/2EdruzJ
Overaugmentation to compensate for postextraction ridge atrophy using a putty-type porcine bone substitute material with recombinant bone morphogenetic protein-2: 4 weeks of healing in a canine model
Abstract
Objectives
The aims of the present study were (i) to determine the short-term effects of putty-type porcine bone substitute material (PB) with recombinant bone morphogenetic protein-2 (rhBMP-2) for alveolar ridge preservation (ARP) and (ii) evaluate the early healing of labial overaugmentation.
Materials and methods
Two groups were randomly assigned to the extraction sockets in mandibular incisors of eight dogs: labial overaugmentation with (i) PB (control) or (ii) rhBMP-2-loaded PB (BMP). Microcomputed tomography (micro-CT), and histologic and histomorphometric analyses were performed after 4 weeks.
Results
Micro-CT revealed that some of the overaugmented PB was dispersed in both groups. The new bone volume was significantly larger in the BMP group than in the control group (18.4 ± 3.3 vs. 15.5 ± 3.0 mm3, mean ± SD, P < 0.05). Labial bone resorption was generally found histologically. No signs of mineralization were observed in the overaugmented area despite significantly increased ridge width, as compared to the adjacent tooth area. The area of new bone formation was larger in the BMP group than in the control group overall (23.7 ± 18.8 vs. 18.3 ± 21.2 mm2) and in three parts (apical, middle, and coronal), although the difference was statistically significant only in the coronal part (7.7 ± 7.9 vs. 4.6 ± 6.4 mm2, P < 0.05).
Conclusions
The addition of rhBMP-2 enhanced ossification in the coronal part of the extraction socket relative to using PB alone. Overaugmentation increased the ridge dimension with no evidence of ossification in situ at 4 weeks.
Clinical relevance
In early healing following ARP, rhBMP-2 enhances bone formation within the socket, but ossification in the overaugmented area needs to be studied further.
https://ift.tt/2PtcTB8
Effect of NaF, AmF, KF gels and NaF toothpaste combined with a saliva substitute on dentin lesions in vitro
Abstract
Objective
The aim of the present in vitro study was to evaluate the remineralizing effects of NaF, AmF, KF gels and NaF toothpaste in combination with a potentially demineralizing saliva substitute (Glandosane; pH = 5.1) being widely used in Germany.
Methods
In each of 120 dentin specimens, three artificial lesions were created. One lesion was covered for analysis of pre-demineralization (ΔZB). Treatments during pH cycling (3 × 1 h demineralization/day [pH = 5.0] and 3 × 3 h Glandosane/day; 12 h 100%humidity) were as follows: no treatment (NT), application (5 min,2×/day) of 12.500 ppm F− [pH = 6.04] (NaF-gel1), 12.500 ppm F− [pH = 7.34] (NaF-gel2), 12.500 ppm F− [pH = 5.82] (AmF-gel), 1450 ppm F− [pH = 7.35] (KF-gel), and 5000 ppm F− [pH = 8.14]; (NaF-TP) for 7 days (E1). Subsequently, from each specimen, one lesion was covered, while the remaining lesion was cycled for another 7 days (E2). Differences in integrated mineral loss (ΔΔZE1/ΔΔZE2) were calculated between values before and after pH cycling.
Results
Mean (95%CI) ΔZB was 3851 (3762;3939) vol% × μm. Except for NaF-gel2 and NaF-TP, specimens of all other groups further demineralized. Only NaF-gel2 induced a significant gain in mineral content (p ≤ 0.004; paired t test). Significant differences in the change of mineral loss were found between NT and all fluoride groups for both ΔΔZE1 and for ΔΔZE2 (p < 0.05, Bonferroni post hoc test). However, only NaF-gel2 and NaF-TP induced remineralization.
Conclusion
Under the in vitro conditions chosen, all fluoride agents could significantly hamper the adverse effects of a demineralizing saliva substitute.
Clinical significance
In combination with a demineralizing saliva substitute, slight mineral gain was only observed for neutral NaF-gel2 and 5000 ppm F− toothpaste.
https://ift.tt/2Nzdf7B
Bone-anchored maxillary protraction in patients with unilateral complete cleft lip and palate and Class III malocclusion
Abstract
Objective
This prospective controlled study evaluated the effect of bone-anchored maxillary protraction therapy in cleft children with Class III malocclusion using CBCT-derived 3D surface models.
Materials and subjects
Eighteen cleft patients between 10 and 12 years old were included. Intermaxillary elastics were worn after the placement of four zygoma bone plates for 18 months. Uniquely, three age-matched untreated groups including both cleft subjects and non-cleft subjects with Class III malocclusion served as controls. Profile photos and CBCT scans for each patient were taken before (T0) and 18 months after the protraction (T1). 3D measurements were made on CBCT surface models from the treatment group using tomographic color mapping method. Cephalometric measurements were made on lateral cephalogram reconstructed from the CBCT scans and were compared with those obtained from the control groups.
Results
Two thirds of the treatment subjects showed improved lip projection towards more convex facial profile. The most significant skeletal changes on 3D surface models were observed at the zygomatic regions (mean 1.5-mm forward, downward, and outward displacement) and at the maxillary complex (mean 1.5-mm forward displacement). Compared with the control groups, the treatment subjects showed significant increase in the SNA and ANB angles, increased Wits appraisal, a more forward movement of point A and overjet improvement (p < 0.05).
Conclusions
BAMP in cleft patients gives a significant forward displacement of the zygomaxillairy complex in favor of the Class III treatment.
Clinical relevance
This treatment method shows clearly favorable outcome in cleft patients after 1.5 years of BAMP.
https://ift.tt/2QFWVDQ
Can subunit specific phenotypes guide surveillance imaging decisions in asymptomatic SDH mutation carriers?
Clinical Endocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2OiwlUL
Influence of the emollient on emulsions containing lamellar liquid crystals: from molecular organization towards applicative properties
International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.
https://ift.tt/2CC9ai8
Changes in neurosteroidogenesis during demyelination and remyelination in cuprizone treated mice
Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2RzWIUh
Comprehensive mapping of human body skin hydration: A pilot study
Skin Research and Technology, EarlyView.
https://ift.tt/2yxLxTa
Twenty classic signs in oral and maxillofacial radiology
Abstract
Teachers of radiology often employ the use of classic signs to help learners identify the typical appearance of various pathologies. This article is a compendium of simply-described classic signs in oral and maxillofacial radiology, including their use in differential diagnoses.
https://ift.tt/2ytXEAS
Effect of arch wire size on orthodontic reverse closing loop and retraction force in canine tooth distalization
Abstract
Aim
The purpose of this study is to compare the effects of different wire size reverse closing loop and retraction forces in canine tooth distalization using the finite element analysis method.
Materials and methods
Maxillary alveolar bone, maxillary first molar, second premolar and canine teeth were constructed in three dimensions along with their periodontal ligaments and standard edgewise brackets of 0.022 inch and stainless-steel reverse closing loop of 0.016 × 0.022 inch and 0.019 × 0.025 inch were designed. Force of 0.98 N and 1.96 N were applied to the arch wire from the posterior region of the molar tooth in the distal direction for activating the reverse closing loop. The stress distribution and displacement of the maxillary canine tooth were performed using the three-dimensional finite element analysis method.
Results
The maximum deformation on the canine tooth was higher in the x‑, y‑, and z‑axes in both arch wires with 1.96 N force activation. Moreover, 1.96 N caused more stress on the canine tooth in both arch wires compared to the application of 0.98 N. In terms of von Mises stress distribution on alveolar bones, the amount of stress was higher during the application of 1.96 N than the application of 0.98 N.
Conclusion
The finite element method is a reliable instrument which allows the effects of biomechanics applied in orthodontics to be evaluated. The finite element analysis method precisely predicted the mechanical effects of reverse closing loop of different wire sizes and different retraction forces.
https://ift.tt/2IMQi01
Effect of arch wire size on orthodontic reverse closing loop and retraction force in canine tooth distalization
Abstract
Aim
The purpose of this study is to compare the effects of different wire size reverse closing loop and retraction forces in canine tooth distalization using the finite element analysis method.
Materials and methods
Maxillary alveolar bone, maxillary first molar, second premolar and canine teeth were constructed in three dimensions along with their periodontal ligaments and standard edgewise brackets of 0.022 inch and stainless-steel reverse closing loop of 0.016 × 0.022 inch and 0.019 × 0.025 inch were designed. Force of 0.98 N and 1.96 N were applied to the arch wire from the posterior region of the molar tooth in the distal direction for activating the reverse closing loop. The stress distribution and displacement of the maxillary canine tooth were performed using the three-dimensional finite element analysis method.
Results
The maximum deformation on the canine tooth was higher in the x‑, y‑, and z‑axes in both arch wires with 1.96 N force activation. Moreover, 1.96 N caused more stress on the canine tooth in both arch wires compared to the application of 0.98 N. In terms of von Mises stress distribution on alveolar bones, the amount of stress was higher during the application of 1.96 N than the application of 0.98 N.
Conclusion
The finite element method is a reliable instrument which allows the effects of biomechanics applied in orthodontics to be evaluated. The finite element analysis method precisely predicted the mechanical effects of reverse closing loop of different wire sizes and different retraction forces.
https://ift.tt/2IMQi01
A ‘Nobel’ Look at Metabolism
Publication date: Available online 9 October 2018
Source: Trends in Endocrinology & Metabolism
Author(s): Jianhua Xiong
Metabolism has recently been in the spotlight because of technical advances in metabolite measurement; however, it is not a new topic in the Nobel Prize's history. Emerging evidence suggests that metabolism is more complex than was previously believed. Retrospective analysis of the Nobel Prize-winning metabolic discoveries may inspire future studies.
https://ift.tt/2RG7Y1m
Quantitative analysis of the coupling coefficients between energy flow, value flow, and material flow in a Chinese lead-acid battery system
Abstract
To reveal the historic characteristics of the material flow, energy flow and value flow in a lead-acid battery (LAB) system, a framework for the coupling relationship among the three flows was established based on material flow analysis and the characteristics of the energy and value flows. The coupling coefficients between energy and material (CCEM) and value and material (CCVM) were also defined. The investigation used by China as a case to study changes in stages and the historic evolution. The results show that the CCEM for lead in LABs was highest in the usage stage, approximately 5–16 times greater than in the other stages. The CCEM for production was almost twice as high for primary lead as for secondary lead, and the CCEM was lowest for the fabrication and product manufacture stage. The CCVM for lead in LABs was 2.5–6 times higher than for other types of lead. The CCVM was lower for scrap lead than for lead ore, and the CCVM was approximately 1.7 times higher for refined lead than for scrap and refined lead. For lead trade, CCVM was correlated with domestic and overseas markets. From 1990 to 2014, the CCEM for each stage was in decline, whereas the opposite was the case for CCVM. The influencing factors were analyzed in terms of resources, the environment, and markets. Increasing the circulation rate of scrap lead is an effective way to rapidly save resources, reduce lead pollution, and promote a circular economy. The limitations and potential value of the study are also highlighted, and future research is outlined.
https://ift.tt/2CCeJNu
A Prospective Trial Evaluating the Safety of a Shortened Infusion of Ramucirumab in Patients with Gastrointestinal Cancer
AbstractLessons Learned. A shortened infusion of ramucirumab (from 60 to 20 minutes) was safe and feasible without infusion‐related reactions.Twenty‐minute infusions of ramucirumab can be an option for patients with no infusion‐related reactions during the first 60‐minute treatment.Background.Ramucirumab is usually administered over 60 minutes, during which it is unlikely to cause infusion‐related reactions (IRRs). This prospective study evaluated the safety of a shortened infusion of ramucirumab.Methods.Patients who received their first dose of ramucirumab in a 60‐minute infusion without developing IRRs were eligible and received their second ramucirumab dose for 20 minutes. The primary study endpoint was incidence of IRR during the first short‐term infusion, and the secondary endpoints were incidence of IRR at any time and adverse events other than IRR.Results.Of the 40 patients enrolled (median age, 68.5 years), 20 (55%) were male, 27 (67.5%) had stage IV gastric cancer, 25 (62.5%) received ramucirumab in combination with taxane‐based chemotherapy, and 24 (60%) received only a single administration of ramucirumab prior to their enrollment. Notably, no IRR was observed during the first short‐term infusion (IRR rate, 0%; 95% confidence interval [CI], 0%–0.72%). Among the 149 short‐term infusions performed, there were no instances of IRRs or unexpected adverse events related to the treatment (Table 1).Conclusion.For patients without development of IRRs upon the first ramucirumab administration, shortening infusion time (from 60 to 20 minutes) is safe and feasible.
https://ift.tt/2IOHPcI
Magnetic Resonance Imaging‐Based Screening for Asymptomatic Brain Tumors: A Review
AbstractBrain tumors comprise 2% of all cancers but are disproportionately responsible for cancer‐related deaths. The 5‐year survival rate of glioblastoma, the most common form of malignant brain tumor, is only 4.7%, and the overall 5‐year survival rate for any brain tumor is 34.4%. In light of the generally poor clinical outcomes associated with these malignancies, there has been interest in the concept of brain tumor screening through magnetic resonance imaging. Here, we will provide a general overview of the screening principles and brain tumor epidemiology, then highlight the major studies examining brain tumor prevalence in asymptomatic populations in order to assess the potential benefits and drawbacks of screening for brain tumors.Implications for Practice.Magnetic resonance imaging (MRI) screening in healthy asymptomatic adults can detect both early gliomas and other benign central nervous system abnormalities. Further research is needed to determine whether MRI will improve overall morbidity and mortality for the screened populations and make screening a worthwhile endeavor.
https://ift.tt/2pLnIDB
Effect of Collagenase ointment versus Mebo ointment on healing of full‐thickness burns in mice by removing of necrotic tissue
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2RFz0pt
Usefulness of OLGA and OLGIM system not only for intestinal type but also for diffuse type of gastric cancer, and no interaction among the gastric cancer risk factors
Helicobacter, EarlyView.
https://ift.tt/2A34C1B
Demethylated Drug in the Treatment of Nasopharyngeal Carcinoma
Condition: Nasopharyngeal Carcinoma
Intervention: Drug: Demethylated drug decitabine
Sponsors: Wei Jiang; Guilin Hospital of Traditional Chinese Medicine
Recruiting
https://ift.tt/2yxK7bg
Intervention: Drug: Demethylated drug decitabine
Sponsors: Wei Jiang; Guilin Hospital of Traditional Chinese Medicine
Recruiting
https://ift.tt/2yxK7bg
Androgens in Women: Hormone modulating therapies for skin disease (Part II)
Publication date: Available online 10 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Sarah Azarchi, Amanda Bienenfeld, Kristen Lo Sicco, Shari Marchbein, Jerry Shapiro, Arielle R. Nagler
Abstract
Androgen-mediated cutaneous disorders (AMCDs) in women including acne, hirsutism, and female pattern hair loss (FPHL) can be treated with hormone-modulating therapies. In the second part of this Continuing Medical Education series, we discuss the hormone-modulating therapies available to dermatologists for the treatment of AMCDs including combined oral contraceptives, spironolactone, finasteride, dutasteride, and flutamide. Available hormone-modulating treatments utilized for each AMCDs are reviewed, along with mechanisms of androgen modulation, safety profile, contraindications, monitoring parameters, and evidence of efficacy. Medications discussed include ones that are FDA-approved for certain AMCDs as well as some that are used off-label. Despite the ubiquity of hormone-modulating therapies used for AMCDs, this review highlights the need for more rigorous studies to evaluate these therapies for acne, hirsutism, and FPHL.
https://ift.tt/2PsaqqI
Androgens in Women: Androgen mediated skin disease and patient evaluation (Part I)
Publication date: Available online 10 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Amanda Bienenfeld, Sarah Azarchi, Kristen Lo Sicco, Shari Marchbein, Jerry Shapiro, Arielle R. Nagler
Abstract
Androgens are produced throughout the body in steroid-producing organs, such as the adrenal glands and ovaries, as well as in other tissues, like the skin. Several androgens are found normally in women, including dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S), testosterone, dihydrotestosterone (DHT), and androstenedione. These androgens are essential in the development of several common cutaneous conditions in women, including acne, hirsutism, and female pattern hair loss (FPHL) – androgen mediated cutaneous disorders (AMCDs). However, the role of androgens in the pathophysiology of these diseases is complicated and incompletely understood. In the first article in this Continuing Medical Education series, we discuss the role of the skin in androgen production as well as the impact of androgens on the skin in women. Specifically, we review the necessary, but insufficient role that androgens play in the development of acne, hirsutism, and FPHL in women. Dermatologists face the challenge of differentiating physiologic from pathologic presentations of AMCDs in women. There are currently no dermatology guidelines outlining the indications for endocrinologic evaluation in women presenting with acne, hirsutism, and/or FPHL. We review available evidence regarding when to consider an endocrinologic work-up in women presenting with AMCDs, including the appropriate type and timing of testing.
https://ift.tt/2ychtgx
Localisation of DBS Electrodes Post-Implantation, to CT or MRI? Which Is the Best Option?
Stereotact Funct Neurosurg
https://ift.tt/2ysrTbf
Is calcitonin gene-related peptide a modulator of menopausal vasomotor symptoms?
Abstract
Purpose
Calcitonin gene-related peptide (CGRP) is a neuropeptide widely distributed in the central and peripheral nervous systems, which is known as a potent vasodilator. Postmenopausal women who experience hot flushes have high levels of plasma CGRP, suggesting its involvement in menopausal vasomotor symptoms.
Methods
In this review, we describe the biochemical aspects of CGRP and its effects associated with deficiencies of sexual hormones on skin temperature, vasodilatation, and sweating as well as the possible peripheral and central mechanisms involved in these events.
Results
Several studies have shown that the effects of CGRP on increasing skin temperature and inducing vasodilatation are potentiated by a deficiency of sex hormones, a common condition of postmenopausal women. Additionally, the medial preoptic area of the hypothalamus, involved in thermoregulation, contains over 25-fold more CGRP-immunoreactive cells in female rodents compared with male rodents, reinforcing the role of female sex hormones on the action of CGRP. Some studies suggest that ovarian hormone deficiency decreases circulating endogenous CGRP, inducing an upregulation of CGRP receptors. Consequently, the high CGRP receptor density, especially in blood vessels, amplifies the stimulatory effects of this neuropeptide to raise skin temperature in postmenopausal women during hot flushes.
Conclusions
The duration of the perception of each hot flush in a woman is brief, while local reddening after intradermal administration of α-CGRP persists for 1 to 6 h. This contrast remains unclear.
https://ift.tt/2NxFO5p
Is calcitonin gene-related peptide a modulator of menopausal vasomotor symptoms?
Abstract
Purpose
Calcitonin gene-related peptide (CGRP) is a neuropeptide widely distributed in the central and peripheral nervous systems, which is known as a potent vasodilator. Postmenopausal women who experience hot flushes have high levels of plasma CGRP, suggesting its involvement in menopausal vasomotor symptoms.
Methods
In this review, we describe the biochemical aspects of CGRP and its effects associated with deficiencies of sexual hormones on skin temperature, vasodilatation, and sweating as well as the possible peripheral and central mechanisms involved in these events.
Results
Several studies have shown that the effects of CGRP on increasing skin temperature and inducing vasodilatation are potentiated by a deficiency of sex hormones, a common condition of postmenopausal women. Additionally, the medial preoptic area of the hypothalamus, involved in thermoregulation, contains over 25-fold more CGRP-immunoreactive cells in female rodents compared with male rodents, reinforcing the role of female sex hormones on the action of CGRP. Some studies suggest that ovarian hormone deficiency decreases circulating endogenous CGRP, inducing an upregulation of CGRP receptors. Consequently, the high CGRP receptor density, especially in blood vessels, amplifies the stimulatory effects of this neuropeptide to raise skin temperature in postmenopausal women during hot flushes.
Conclusions
The duration of the perception of each hot flush in a woman is brief, while local reddening after intradermal administration of α-CGRP persists for 1 to 6 h. This contrast remains unclear.
https://ift.tt/2NxFO5p
Sodium-fluoride PET-CT for the non-invasive evaluation of coronary plaques in symptomatic patients with coronary artery disease: a cross-correlation study with intravascular ultrasound
Abstract
Objectives
The aim of this study was to evaluate the 18F-sodium fluoride (18F-NaF) coronary uptake compared to coronary intravascular ultrasound (IVUS) in patients with symptomatic coronary artery disease.
Background
18F-NaF PET enables the assessment of vascular osteogenesis by interaction with surface hydroxyapatite, while IVUS enables both identification and quantification of intra-plaque components.
Methods
Forty-four patients with symptomatic coronary artery disease were included in this prospective controlled trial, 32 of them (30 patients with unstable angina and 2 patients with stable angina), representing the final study cohort, got additional IVUS. All patients underwent cardiac 18F-NaF PET/CT and IVUS within 2 days. 18F-NaF maximum tissue-to-blood ratios (TBRmax) were calculated for 69 coronary plaques and correlated with IVUS plaque classification.
Results
Significantly increased 18F-NaF uptake ratios were observed in fibrocalcific lesions (meanTBRmax = 1.42 ± 0.28), thin-cap atheroma with spotty calcifications (meanTBRmax = 1.32 ± 0.23), and thick-cap mixed atheroma (meanTBRmax = 1.28 ± 0.38), while fibrotic plaques showed no increased uptake (meanTBRmax = 0.96 ± 0.18). The 18F-NaF uptake ratio was consistently higher in atherosclerotic lesions with severe calcification (meanTBRmax = 1.34 ± 0.22). The regional 18F-NaF uptake was most likely localized in the border region of intensive calcification. Coronary lesions with positive 18F-NaF uptake showed some increased high-risk anatomical features on IVUS in comparison to 18F-NaF negative plaques. It included a significant severe plaque burden (70.1 ± 13.8 vs. 61.0 ± 13.8, p = 0.01) and positive remodeling index (1.03 ± 0.08 vs. 0.99 ± 0.07, p = 0.05), as well as a higher percentage of necrotic tissue (37.6 ± 13.3 vs. 29.3 ± 15.7, p = 0.02) in positive 18F-NaF lesions.
Conclusions
18F-NaF coronary uptake may provide a molecular insight for the characterization of coronary atherosclerotic lesions. Specific regional uptake is needed to be determined by histology.
https://ift.tt/2NyDnzF
68 Ga-PSMA PET/CT in patients with recurrent prostate cancer after radical treatment: prospective results in 314 patients
Abstract
Purpose
We studied the usefulness of 68Ga-prostate-specific membrane antigen (PSMA) PET/CT for detecting relapse in a prospective series of patients with biochemical recurrence (BCR) of prostate cancer (PCa) after radical treatment.
Methods
Patients with BCR of PCa after radical surgery and/or radiotherapy with or without androgen-deprivation therapy were included in the study. 68Ga-PSMA PET/CT scans performed from the top of the head to the mid-thigh 60 min after intravenous injection of 150 ± 50 MBq of 68Ga-PSMA were interpreted by two nuclear medicine physicians. The results were correlated with prostate-specific antigen (PSA) levels at the time of the scan (PSApet), PSA doubling time, Gleason score, tumour stage, postsurgery tumour residue, time from primary therapy to BCR, and patient age. When available, 68Ga-PSMA PET/CT scans were compared with negative 18F-choline PET/CT scans routinely performed up to 1 month previously.
Results
From November 2015 to October 2017, 314 PCa patients with BCR were evaluated. Their median age was 70 years (range 44–92 years) and their median PSApet was 0.83 ng/ml (range 0.003–80.0 ng/ml). 68Ga-PSMA PET/CT was positive (one or more suspected PCa lesions detected) in 197 patients (62.7%). Lesions limited to the pelvis, i.e. the prostate/prostate bed and/or pelvic lymph nodes (LNs), were detected in 117 patients (59.4%). At least one distant lesion (LNs, bone, other organs, separately or combined with local lesions) was detected in 80 patients (40.6%). PSApet was higher in PET-positive than in PET-negative patients (P < 0.0001). Of 88 patients negative on choline PET/CT scans, 59 (67%) were positive on 68Ga-PSMA PET/CT.
Conclusion
We confirmed the value of 68Ga-PSMA PET/CT in restaging PCa patients with BCR, highlighting its superior performance and safety compared with choline PET/CT. Higher PSApet was associated with a higher relapse detection rate.
https://ift.tt/2ONS5r3
Correction to: PET imaging of EGFR expression using an 18 F-labeled RNA aptamer
The original version of this article contained a mistake in the first paragraph of "Cell uptake and internalization of 18F-FB-ME07" section. The text "The specific activity was 7.4–14.8 kBq/nmol" should have been "The specific activity was 7.4–14.8 Mbq/nmol".
https://ift.tt/2NAYb9A
Correction to: Regulation of human brown adipose tissue by adenosine and A 2A receptors – studies with [ 15 O]H 2 O and [ 11 C]TMSX PET/CT
The original version of this article contained a mistake in the first sentence of the Results section of the Abstract.
https://ift.tt/2NAY5Pg
Can integrated 18F-FDG PET/MR replace sentinel lymph node resection in malignant melanoma?
Abstract
Purpose
To compare the sensitivity and specificity of 18F-fluordesoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), 18F-FDG PET/magnetic resonance (18F-FDG PET/MR) and 18F-FDG PET/MR including diffusion weighted imaging (DWI) in the detection of sentinel lymph node metastases in patients suffering from malignant melanoma.
Material & Methods
Fifty-two patients with malignant melanoma (female: n = 30, male: n = 22, mean age 50.5 ± 16.0 years, mean tumor thickness 2.28 ± 1.97 mm) who underwent 18F-FDG PET/CT and subsequent PET/MR & DWI for distant metastasis staging were included in this retrospective study. After hybrid imaging, lymphoscintigraphy including single photon emission computed tomography/CT (SPECT/CT) was performed to identify the sentinel lymph node prior to sentinel lymph node biopsy (SLNB). In a total of 87 sentinel lymph nodes in 64 lymph node basins visible on SPECT/CT, 17 lymph node metastases were detected by histopathology. In separate sessions PET/CT, PET/MR, and PET/MR & DWI were assessed for sentinel lymph node metastases by two independent readers. Discrepant results were resolved in a consensus reading. Sensitivities, specificities, positive predictive values and negative predictive values were calculated with histopathology following SPECT/CT guided SLNB as a reference standard.
Results
Compared with histopathology, lymph nodes were true positive in three cases, true negative in 65 cases, false positive in three cases and false negative in 14 cases in PET/CT. PET/MR was true positive in four cases, true negative in 63 cases, false positive in two cases and false negative in 13 cases. Hence, we observed a sensitivity, specificity, positive predictive value and negative predictive value of 17.7, 95.6, 50.0 and 82.3% for PET/CT and 23.5, 96.9, 66.7 and 82.3% for PET/MR. In DWI, 56 sentinel lymph node basins could be analyzed. Here, the additional analysis of DWI led to two additional false positive findings, while the number of true positive findings could not be increased.
Conclusion
In conclusion, integrated 18F-FDG PET/MR does not reliably differentiate N-positive from N-negative melanoma patients. Additional DWI does not increase the sensitivity of 18F-FDG PET/MR. Hence, sentinel lymph node biopsy cannot be replaced by 18F-FDG-PE/MR or 18F-FDG-PET/CT.
https://ift.tt/2ONr9aP
Feasibility of dynamic stress 201 Tl/rest 99m Tc-tetrofosmin single photon emission computed tomography for quantification of myocardial perfusion reserve in patients with stable coronary artery disease
Abstract
Purpose
We evaluated the feasibility of dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT imaging using a cardiac camera equipped with cadmium-zinc-telluride detectors for the quantification of myocardial perfusion reserve (MPR).
Methods
Subjects with stable known or suspected coronary artery disease (CAD) who had undergone or were scheduled to undergo fractional flow reserve (FFR) measurement were prospectively enrolled. Dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT imaging was performed using a dedicated multiple pinhole SPECT camera with cadmium-zinc-telluride detectors. MPR was derived using Corridor4DM software.
Results
A total of 34 subjects were enrolled (25 men and 9 women; mean age 60.4 years). FFR was measured in 65 coronary arteries with intermediate lesions. The average global MPR was 2.58 ± 1.03. Global MPR was associated with the extent of CAD (P = 0.028) and global summed stress score (r = −0.60, P < 0.001). Regional MPR showed a significant correlation with diameter stenosis (r = −0.57, P < 0.001), minimum lumen diameter (r = 0.50, P < 0.001), summed stress score (r = −0.52, P < 0.001) and FFR (r = 0.52, P < 0.001). The area under the receiver operating characteristic curve of MPR for the diagnosis of functionally significant stenosis (FFR ≤0.8) was 0.79 (P < 0.001). The sensitivity and specificity of regional MPR were 67% and 83%, respectively, using a cut-off value of 2.0.
Conclusion
Dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT imaging and quantification of MPR is feasible in patients with stable CAD. The preliminary results of this study in a small number of patients require confirmation in a larger cohort to determine their implications for bolstering the role of SPECT imaging in the diagnosis and risk prediction of CAD.
https://ift.tt/2NAXsoS
Prognostic value of posttreatment 18 F-FDG PET/CT and predictors of metabolic response to therapy in patients with locally advanced cervical cancer treated with concomitant chemoradiation therapy: an analysis of intensity- and volume-based PET parameters
Abstract
Purpose
To investigate the prognostic value of posttreatment 18F-FDG PET/CT in patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation therapy (CCRT). The secondary aim was to assess the possible role of intensity-based and volume-based PET parameters including SUVmax, SUVmean, MTV and TLG, and clinical parameters including age, pathology, FIGO stage and nodal involvement as factors predicting response to treatment.
Methods
This retrospective study included 82 patients affected by LACC treated with CCRT. All patients underwent 18F-FDG PET/CT both before and after treatment. The posttreatment PET/CT scans were used to classify patients as complete metabolic responders (CMR) or non-complete metabolic responders (N-CMR) according to the EORTC criteria. Kaplan-Meier analysis was used to evaluate differences in overall survival (OS) between the CMR and N-CMR groups. Student's t test, Pearson's chi-squared test and logistic regression were used to investigate the possible value of PET and clinical parameters as predictors of metabolic response to therapy.
Results
KaplanMeier analysis showed a highly significant difference in OS between the CMR and N-CMR groups (log-rank test p < 0.0001). Significant independent predictors of response to therapy were MTV (p = 0.019, odds ratio = 1.015, 95% CI = 1.002–1.028, Nagelkerke R2 = 0.110), TLG (p = 0.045, odds ratio = 1.001, 95% CI = 1.000–1.002, Nagelkerke R2 = 0.081) and nodal involvement (p = 0.088, odds ratio = 2.361, 95% CI = 0.879–6.343, Nagelkerke R2 = 0.051).
Conclusion
18F-FDG PET/CT-based response assessment using the EORTC criteria reliably predicts OS in LACC patients treated with CCRT. In our cohort of patients, pretreatment MTV and TLG and nodal involvement were predictors of response to therapy. MTV was the best predictor of response. However, its additional risk value seems to be low (MTV odds ratio = 1.015).
https://ift.tt/2OQhOiD
Differences in the subgingival microbial population of chronic periodontitis in subjects with and without type 2 diabetes mellitus—a systematic review
Abstract
Objectives
The purpose of this systematic review was to evaluate the available evidence in the literature in regard to the subgingival microbial population of chronic periodontitis in subjects with type 2 diabetes mellitus (T2DM+PD) compared to non-diabetic subjects (NDM+PD).
Materials and methods
A literature search was conducted at Ovid MEDLINE and EMBASE database from 1980 to 2016, supplemented by hand searching as needed. Studies presenting with at least one of the primary outcomes (presence of any subgingival microorganisms, proportion and/or the amount of any subgingival plaque bacteria in T2DM+PD versus NDM+PD) were included. Screening, data extraction and quality assessment were conducted independently and in duplicate.
Results
From 611 citations, 19 full-text papers were screened and 11 articles were included for critical appraisal by both reviewers. Some evidence of a difference in the microbial profile between chronic PD subjects with and without T2DM was identified. The strength of evidence is strongest in Tannerella forthysia (T .forsythia) which was reported to be less frequent in the diabetic (T2DM+PD) group in five of the studies, followed by a weaker strength of evidence for other periodontal pathogens such as Porphyromonas gingivalis (P. gingivalis) and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), which were also found less frequent in the diabetic (T2DM+PD) group .
Conclusion
Only few studies have compared T2DM+PD with NDM+PD. It is therefore strongly recommended that further studies which include four distinct groups of participants (NDM+PD, T2DM+PD, NDM+NPD, T2DM+NPD) instead of using intra-subject comparisons between healthy and diseased sites of the same subjects.
Clinical relevance
Differences in bacterial populations of T2DM+PD in comparison to NDM+PD subjects may indicate the need of different protocols for the treatment of the diabetic patients with periodontal disease.
https://ift.tt/2A2DRdS
Self-assembled three-dimensional double network graphene oxide/polyacrylic acid hybrid aerogel for removal of Cu 2+ from aqueous solution
Abstract
Three-dimensional (3D) double network graphene oxide/polyacrylic acid (GO/PAA) hybrid aerogels were fabricated under mild conditions from the mixture of GO and acrylic acid (AA) monomers using a one-pot in situ solution polymerization process which included the polymerization of AA and the self-assembly of functional GO sheets. The PAA chains served as not only binder to assemble GO sheets into 3D framework but also modifier to provide more active functional groups. The adsorbents based on such material exhibited superior adsorption performance towards Cu2+ ions in aqueous media due to rich mesopores, high specific surface area, and abundant active sites. This work brings a new vision for assembling 3D porous graphene-based nanomaterials as adsorbents in environmental protection.
https://ift.tt/2A33hYO
Scholar : These new articles for Environmental Claims Journal are available online
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Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 33-34
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Bed and suspended sediment-associated rare earth element concentrations and fluxes in a polluted Brazilian river system
Abstract
Rare earth elements (REEs) have been recently recognized as emergent pollutants in rivers. However, data regarding REE fluxes in association with either bed or suspended are scarce. To address this knowledge gap, we determined the concentrations and fluxes of La, Ce, Pr, Nd, Sm, Eu, Gd, Yb, Lu, Dy, Er, Ho, Tb, and Tm in bed and suspended sediment samples of a representative polluted Brazilian River. Sediment-associated data on REEs were placed in the context of corresponding background concentrations in soils under natural conditions along the Ipojuca watershed. Light rare earth elements (LREEs) comprised more than 94% of the total REEs associated with bed and suspended sediments. Suspended sediments accounted for more than 95% of the total REE flux. The Ce and Nd fluxes of about 7 t year−1 underscore the importance of including REEs in future estimations of global suspended sediment-associated element fluxes. In contrast, bedload often transported less than 0.0007 t year−1 of each REE. The main sources of pollution in the Ipojuca River are anthropogenic, likely due to domestic effluent and waste water from industrial and agricultural operations—major causes of sediment-associated Gd transport in polluted streams.
https://ift.tt/2E8P4xd
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