Halitosis: Helicobacter pylori or oral factors

Abstract

Introduction

Halitosis is a common complaint among people which has various socioeconomic effects. The prevalence of halitosis includes a variety of 22% up to 50% in different societies. According to studies, there have been reports of remarkable improvements in halitosis after Helicobacter pylori eradication treatment. In studies on the relationship between H. Pylori and halitosis, the role of oral factors as the most important cause of halitosis has been neglected. This study was conducted with the aim of investigating the effect of oral factors on halitosis in patients with H. Pylori.

Materials and Methods

A total of 100 dyspeptic patients who had H. pylori‐positive serologic test were examined by an organoleptic method for the presence of halitosis. DMFT index was used in order to record the dental status. Oral hygiene was evaluated using the simplified oral hygiene index (OHI‐S).

Results

The mean DMFT index was 9.09 ± 3.97. The score of simplified oral hygiene index was 1.79 ± 0.949. There was a direct and significant relationship between halitosis with DMFT, OHI‐S (P < 0.01). There was no significant relationship between halitosis and coated tongue (P > 0.01).

Conclusions

According to the results of this study, there is a relation between oral factors and halitosis in patients with positive H. pylori test. Due to the lower level of all these indices in patients with halitosis, we cannot attribute halitosis in patients with H. pylori infection to the presence of this microorganism with certainty.

https://ift.tt/2QNRDa0

Relative potency of proton‐pump inhibitors, Helicobacter pylori therapy cure rates, and meaning of double‐dose PPI

Abstract

Background

Helicobacter pylori treatment recommendations often recommend use of double‐dose PPI or greater. This is confusing because PPIs very markedly in relative potency such that a double dose of one may not even be equivalent to the single dose of another.

Objective

To relate the concept of double‐dose to specific amounts of the different PPIs

Methods

We used data standardizing PPI potency in terms of the duration of intragastric pH >4/24 hours (pH4‐time) to rank PPIs. Relative potency varies from 4.5 mg omeprazole equivalents (20 mg pantoprazole) to 72 mg omeprazole equivalents (40 mg rabeprazole).

Results

We defined PPI dosing for H. pylori therapy as low dose (eg, approximately 20 mg omeprazole equivalents, b.i.d.), high or double dose as approximately 40 mg omeprazole equivalents, b.i.d.) and high dose as approximately 60 mg omeprazole equivalents, b.i.d.). For example, standard double dose PPI would thus be 40 mg of omeprazole, 20 mg of esomeprazole or rabeprazole, 45 mg of lansoprazole, or 120 mg of pantoprazole each given b.i.d.

Conclusions

Simply doubling the dose of any PPI achieves markedly different effects on pH4‐time. However, PPIs can be used interchangeably and cost effectively based on their omeprazole equivalency.

https://ift.tt/2PtuXiK

Evaluation of gastric microbiome and metagenomic function in patients with intestinal metaplasia using 16S rRNA gene sequencing

Abstract

Background

Despite recent advances in studies on the gastric microbiome, the role of the non‐Helicobacter pylori gastric microbiome in gastric carcinogenesis remains unclear. We evaluated the characteristics of the gastric microbiome and metagenomic functions in patients with IM.

Methods

Participants were classified into six groups according to disease status (chronic superficial gastritis [CSG], intestinal metaplasia [IM], and cancer) and H. pylori‐ infection status (H. pylori‐positive and H. pylori‐negative). The gastric microbiome was analyzed in mucosal tissues at the gastric antrum by 16S rRNA gene sequencing. Moreover, we assessed the metagenome including the type IV secretion system (T4SS) gene, as T4SS proteins are essential for transferring CagA from H. pylori- into the human gastric epithelium.

Results

Among the 138 included patients, 48, 9, 23, 14, 12, and 32 were classified into the H. pylori‐negative CSG, H. pylori‐negative IM, H. pylori‐negative cancer, H. pylori‐positive CSG, H. pylori‐positive IM, and H. pylori‐positive cancer groups, respectively. Cyanobacteria were predominant in the H. pylori‐negative CSG group compared to in the H. pylori‐negative IM and H. pylori‐negative cancer groups (H. pylori‐negative CSG vs H. pylori‐negative IM vs H. pylori‐negative cancer: 14.0% vs 4.2% vs 0.04%, P < 0.001). In contrast, Rhizobiales were commonly observed in the H. pylori‐negative IM group (H. pylori‐negative CSG vs H. pylori‐negative IM vs H. pylori‐negative cancer: 1.9% vs 15.4% vs 2.8%, P < 0.001). The relative abundance of Rhizobiales increased as H. pylori‐infected stomachs progressed from gastritis to IM. In the H. pylori‐negative IM group, genes encoding T4SS were prevalent among the metagenome. Additionally, after H. pylori- eradication therapy, the gastric microbiome was similar to the microbiome observed after spontaneous clearance of H. pylori-.

Conclusions

The relative abundance of Rhizobiales was higher in patients with H. pylori‐negative IM than in those with H. pylori‐negative CSG or cancer. Additionally, T4SS genes were highly observed in the metagenome of patients with IM. Highly abundant T4SS proteins in these patients may promote gastric carcinogenesis.

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Review of antimicrobial peptides with anti‐Helicobacter pylori activity

Abstract

Background

The emergence of antibiotic‐resistant Helicobacter pylori strains in recent years has increased the need for finding an alternative in the post‐antibiotic era. One of the fields being considered for this purpose is antimicrobial peptides. The aim of this review was to provide an obvious scheme from the studied anti‐H. pylori peptides and to investigate their common features.

Method

First, all of the antimicrobial peptides with their anti‐H. pylori effects have been proved up to September 2018 were selected and their information including structure, mechanism of action, and function was reviewed. To achieve this, three databases of PubMed, Scopus, and Web of science were used.

Results

A total of 9 groups containing 22 antimicrobial peptides were found with demonstrated anti‐H. pylori effects. The nine groups included pexiganan, tilapia piscidins, epinecidin‐1, cathelicidins, defensins, bicarinalin, odorranain‐HP, PGLa‐AM1, and bacteriocins. Most of the antimicrobial peptides, not all, had common features such as the ability to kill antibiotic‐resistant strains, having α‐helical structure, being cationic, with high positive charge and isoelectric point.

Conclusion

Antimicrobial peptides with anti‐H. pylori effects have the potential to replace the antibiotics, especially in the post‐antibiotic era, if a rapid and low‐cost production method would be found.

https://ift.tt/2PyAvIQ

Helicobacter pylori infection and prevalence of stroke

Abstract

Background

Helicobacter pylori causes peptic ulcer disease; however, conflicting evidence exists regarding its role in extragastric conditions. We aimed to examine associations of H pylori infection and peptic ulcer disease with stroke.

Methods

A cross‐sectional study was undertaken using data of 147 936 individuals aged 25‐95 years who underwent the urea breath test during 2002‐2012, based on the computerized database of the second largest health maintenance organization in Israel. Logistic regression models were fitted to control for potential confounders.

Results

Overall, 1397 (0.9%) patients had stroke and 76 965 (52.0%) had a H pylori positive test. The likelihood of prevalent stroke increased in relation to H pylori infection: adjusted odds ratio (aOR) 1.16 (95% confidence intervals [CI]: 1.04‐1.29), gastric ulcer: aOR 1.50 (95% CI: 1.18‐1.91), and duodenal ulcer: aOR 1.25 (95% CI: 1.07‐1.46).

Conclusions

The results support the premise that stroke may be associated with a history of H pylori infection.

https://ift.tt/2QKi68j

Prevalence of Helicobacter pylori infection among junior high school students in Grudziadz, Poland

Abstract

Background

The purpose of the study was to assess the prevalence of Helicobacter pylori infection among the junior high school students in city Grudziądz, Poland.

Materials and methods

A prospective cross‐sectional study among second junior high school students was conducted from September 2008 to June 2015 during seven consecutive school years. The studied group was 3241 students 13‐17 years old. The ¹³C‐urea breath test (UBT) was administered to all participants for current H. pylori infection. Clinical, sociodemographic, and hygienic risk factors for H. pylori positivity were analyzed in children with positive and negative UBT.

Results

Urea breath test was performed and results were obtained for 3067 of 3241 children, including 723 children (23.6%) with positive result (group 1) and 2344 children (76.4%) with negative result (group 2). The prevalence of H. pylori infection was not different in subsequent seven school years (P = 0.06) and depending on the gender (P = 0.57). In group 1 the cough and in group 2 the epigastric discomfort occurred more frequent (P = 0.04 and P = 0.002, respectively). In multivariate analysis, factors positively associated with prevalence of H. pylori were age >16 years (OR = 2.556; 95%CI 1.293‐5.025), living in old town district (OR = 1.374; 95%CI 1.097‐1.723), consumption of raw vegetables (OR 1.305; 95%CI 1.038‐1.642) or unboiled water (OR = 1.444; 95%CI 1.138‐1.832) and using collective catering facilities (OR 1.338; 95%CI 1.039‐1.724). Having a cat was protective against H. pylori (OR 0.78; 95%CI 0.614‐0.991).

Conclusions

Over the past 10 years, the prevalence of H. pylori infection in Polish adolescents has decreased. H. pylori infection remains problem closely associated with socioeconomic and sanitary conditions. Our results are important to develop prevention strategies for H. pylori‐related diseases.

https://ift.tt/2PxuJan

Lupus erythematous mimicking mycosis fungoides: CD123+ plasmacytoid dendritic cells as a useful diagnostic clue

Mycosis fungoides (MF) is a primary cutaneous lymphoma, characterized by a clonal proliferation of T cell helper memory cells in the skin [1]. Various benign conditions, such as chronic inflammatory dermatoses, may mimic MF, either clinically or histologically. Distinguishing MF from dermatologic conditions mimicking MF may be challenging. Clinicopathological correlation is fundamental to support the diagnosis, which is essential to ensure proper treatment and to provide an accurate prognosis [2].

This article is protected by copyright. All rights reserved.

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Neutrophilic Figurate Erythema of Infancy: A Diagnostic Challenge

Neutrophilic figurate erythema of infancy (NFEI) is a rare variant of annular erythema of infancy. It is characterized by annular erythematous plaques, occasionally with a polycyclic configuration. The main challenge is to differentiate this rare entity from other figurate erythemas associated with serious diseases such as neonatal lupus erythematosus. We present the case of a 9‐month‐old female admitted with a skin rash of unclear etiology. The rash started on her face at the age of 3 months and gradually spread to her extremities. She had no constitutional symptoms, and her health and development were otherwise unremarkable since birth. This persistent skin eruption consisted of many ill‐defined erythematous papules and annular plaques. Histologic examination revealed perivascular neutrophils and eosinophils with abundant nuclear dust without signs of vasculitis. NFEI is a diagnostic enigma both clinically and histologically. Absence of an underlying cause, dermal neutrophilic infiltrate with leukocytoclasis, and lack of vascular damage are the keys to diagnosis.

This article is protected by copyright. All rights reserved.

https://ift.tt/2qMLhMy

High Concordance of BRAF Mutational Status in Matched Primary and Metastatic Melanoma

Background

Techniques for the accurate identification of activating mutations of BRAF in metastatic melanoma are of great clinical importance, due to the availability of targeted therapies for these tumours. There is uncertainty regarding the frequency with which BRAF status differs between primary and metastatic sites.

Methods

Between 2011 and 2016, 219 melanoma cases underwent BRAF testing in our institution. In 53 of these, paired primary and metastatic specimens were available for PCR and immunohistochemical evaluation.

Results

52 out of 53 cases (98%) showed concordant BRAF status between primary and metastatic site by IHC. In one case, a metastasis and its matched primary were positive by IHC but the metastasis was negative on PCR. On further investigation, PCR was positive in the primary and repeat PCR in the metastasis was positive, following macrodissection.

Conclusions

Our results suggest that discordance of BRAF mutational status between primaries and metastases is a rare occurrence. In one case, immunohistochemistry provided strong evidence that initial PCR testing had provided a false negative result due to low tumour volume. Thus, in cases where tissue is is difficult to obtain from a metastasis or unavailble, the primary tumour can be used with confidence.

This article is protected by copyright. All rights reserved.

https://ift.tt/2FrGY3L

Increased Expression of GARP in Papillary Thyroid Carcinoma

Abstract

Regulatory T cells (Tregs) are immunosuppressive immune cells that play an important role in tumor development. Suppression of Treg function is considered to be an effective strategy for cancer therapy. Glycoprotein A repetitions predominant (GARP) has been found on the surface of activated Tregs. GARP has been recently observed in only a few solid tumors including breast, colon, lung cancers, and melanoma. However, its function in cancers remains unknown. Here, we investigated the expression of GARP in human papillary thyroid carcinoma (PTC) and its prognostic significance. In this study, immunohistochemistry was performed to examine the expression of GARP and Foxp3 in 19 human PTC tissues (including 10 cases with and 9 cases without lymph node metastasis) and 20 benign thyroid diseases (including 10 cases with nodular goiter and 10 cases with adenoma). Compared with benign thyroid diseases, we found a significant increase in the expression of GARP in PTC. Increased GARP expression in PTC was positively correlated with increased expression of Foxp3, which is very important for development of Tregs. But, there is no significant association of elevated expression of GARP with lymph node metastasis in PTC. Our results indicate that GARP is implicated in the development of PTC and might be a potential novel target for anticancer therapy. In addition, our findings further support the existence of a positive-feedback loop between GARP and Foxp3.

https://ift.tt/2FC1nDl

Spectroscopy Used as a Tool to Evaluate Hair Damage and Protection

Abstract

Objective

Methods that can be used to analyze hair damage and to support a claim of hair protection are important for the cosmetic industry. There are many approaches available, but they are usually laborious and expensive. The researchers propose a simple fluorescence method that is based upon the emissive properties of damaged hair.

Methods

Hair fluorescence was observed when using both fluorimetry and microscopic procedures. The method was developed by comparing native hair with hair that was damaged by UVA and visible light.

Results

Spectroscopic properties (absorption and emission) of hair in the visible range are presented. The changes in the emissive properties of hair during irradiation were characterized and they were correlated with photobleaching, which is due to the generation of singlet oxygen. Emissions were also obtained in the hair shafts that had been previously treated with chamomile extract and this treatment was able to avoid hair bleaching.

Conclusion

The emissive properties of hair in the visible range can be used as a tool for the evaluation of hair damage and protection. This method can be useful as a tool in order to claim substantiation.

This article is protected by copyright. All rights reserved.

https://ift.tt/2QKlhwT

Photo Protection against Visible Light Induced Pigmentation

Abstract

Objective

This paper presents in vivo an in vitro studies demonstrating the induction of pigmentation in human skin by visible light which can be blocked by using formulation containing the correct amount of yellow iron oxide (YIO).

Methods

An in vitro absorption method was developed to determine the protection provided by a test formulation containing 4.5% YIO using an IPD UVA‐VIS action spectrum. Following the development of the in vitro method and in vivo study with 10 normal healthy volunteers with Fitzpatrick skin phototypes IV to VI was conducted to verify if the predictive model.

Results

The in vitro model for visible light protection provided a protection factor of 2.5 using the in vitro absorption spectrum of 4.5% of YIO with a very similar result from the in vivo study with a protection factor of 3.0. Multiple daily exposures of visible light have shown increase in skin pigmentation and the application of YIO provide less development of pigmentation when compared to unprotected skin.

Conclusion

In vitro testing of the absorbance of the pigmented formulation using a proposed action spectrum for immediate pigment darkening (IPD) response in the visible light range supports the in vivo protection observations for persistent pigment darkening (PPD) and can be used as predictor for skin pigmentation induced by visible light.

This article is protected by copyright. All rights reserved.

https://ift.tt/2PAyego

Intralesional triamcinolone alone or in combination with botulinium toxin A is ineffective for the treatment of formed keloid scar: A double blind controlled pilot study

Cutaneous injury can ignite excessive fibroproliferative growth that results in keloid formation. Keloids are associated with significant morbidity related to disfigurement and/or symptoms (e.g. pain, pruritus). First‐line treatment of formed keloids involves topical or intralesional steroids. Recurrent or resistant keloids are managed by surgical excision or cryotherapy, followed by steroidal application or adjuvant irradiation. While adjuvant irradiation appears to be most efficacious, alternative therapeutic options are needed for patients without access to radiation centers. Botulinum Toxin A (BTA) appears to have similar inhibitory effects to irradiation on the cell cycle via downregulation of pathogenic cytokines. Herein, we conducted a study to compare the efficacy of intralesional triamcinolone used alone, or in combination with BTA, in the treatment of formed keloid scars. 20 patients with a cumulative of 40 keloids completed the study. There was no significant difference between treatment arms with respect to height vascularization, pliability and pigmentation scores. The addition of BTA resulted in significant symptomatic improvement of pain and pruritus as compared to intralesional triamcinolone alone (P<0.001). Irradiation is only effective when administered in the adjuvant setting where inhibitory effects on cell cycle and migration are optimized. Future studies with intralesional triamcinolone and BTA should be performed adjuvantly.

This article is protected by copyright. All rights reserved.

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Injectable profiloplasty: Forehead, nose, lips, and chin filler treatment

Summary

Introduction

We propose a medical filler treatment algorithm of the profile which includes forehead, nose, and chin and to evaluate profilometric results and complications.

Materials and Methods

83 case reviews of associated liquid forehead, nose, and chin plasty performed consecutively from 2014 to 2016. We monitored the horizontal and vertical sagittal stability into two age group: <40 y.o. and >40 y.o. using profilometric Arnett analysis measurements on the F, Gb, Na, Nd, Nt, Sn, ULA, LLA, B, Pg, and Gn soft‐tissue points.

Results

The results at both 3 and 6 months were consistent with the normal ranges indicated by Arnett, with a 0.8 mm maximum of defect/excess. Forehead treatment was performed in 51 (61.4%) patient. Patients >40 y.o. always needed a global correction of the forehead profile. We performed nasal treatment in 83 (100%) patient, acute nasolabial angles was the more frequent nasal defect. The lips were injected in 59 patients (71.1) more frequently >40 y.o. In 83 (100%) patients we perform a chin augmentation. The average advancement of the chin was 3 mm.

Conclusions

The correction of the projection of the forehead, of the profile and shape of the nose, of the lips and chin as well as an overall improvement in face aesthetics and harmony gives a good solution in patients avoiding the need for a surgical intervention, scars and cost of general anesthesia, thus providing the optimum in patient satisfaction.

https://ift.tt/2K7ozYC

Intradermal injection of Fluorouracil versus triamcinolone in localized vitiligo treatment

Summary

Background

Vitiligo is an autoimmune disease with a prevalence of 1.22% in Egypt. Intralesional steroids use in localized vitiligo treatment still a matter of debate. Fluorouracil was tried in vitiligo treatment after lesion dermabrasion, ablative laser, or micro‐needling. The study aimed to compare the efficacy of intradermal fluorouracil and triamcinolone acetonide without any adjuvant therapy in localized vitiligo treatment.

Patients and methods

Sixty patients with localized non‐segmental stable vitiligo were assigned randomly and equally into groups. Patients subjected to intradermal injection of either fluorouracil (50 mg/mL), triamcinolone acetonide (3 mg/mL) or an equal mixture of both drugs. All patients had four treatment sessions every 2 weeks were followed up for 6 months.

Results

Intradermal fluorouracil showed the best overall improvement (median 52.27, IQR 36.25‐68.18) when compared with triamcinolone (median 13.86, IQR 3.83‐33.32) and the drug mixture (median 17.15, IQR 7.48‐41.67). During follow‐up, the vitiliginous patches continued to repigment for 6 months in fluorouracil and the drug mixture groups. The improvement stopped 1 month after the last session in the triamcinolone group.

Conclusion

The intradermal fluorouracil injection is an effective treatment of localized vitiligo. The intradermal steroid has a short‐acting therapeutic effect, but the mixture of drugs added no therapeutic effect.

https://ift.tt/2B8BFls

Relevance of peripheral cholinesterase activity on postoperative delirium in adult surgical patients (CESARO): A prospective observational cohort study

BACKGROUND The cholinergic system is considered to play a key role in the development of postoperative delirium (POD), which is a common complication after surgery. OBJECTIVES To determine whether peri-operative acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are associated with the development of POD in in-hospital surgical patients, and raise hypotheses on cholinergic regulatory mechanisms in POD. DESIGN A prospective multicentre observational study by the Peripheral Cholinesterase-activity on Neurocognitive Dysfunctions in Surgical Patients (CESARO) study group. SETTING Nine German hospitals. PATIENTS Patients of at least 18 years of age scheduled for inpatient elective surgery for a variety of surgical procedures. A total of 650 patients (mean age 61.5 years, 52.8% male) were included. METHODS Clinical variables, and peripheral AChE and BuChE activities, were assessed throughout the peri-operative period using bedside point-of-care measurements (one pre-operative and two postoperative measurements). POD screening was conducted postoperatively for at least 24 h and up to the third postoperative day using a validated screening tool (nursing delirium screening scale). RESULTS In all, 179 patients (27.5%) developed POD within the early postoperative phase. There was a lower BuChE activity in patients with delirium compared with patients without delirium pre-operatively (Cohen's r = 0.07, P = 0.091), on postoperative day 1 (Cohen's r = 0.12, P = 0.003) and on postoperative day 2 (Cohen's r = 0.12, P = 0.002). In contrast, there was a significantly higher AChE activity in patients with delirium compared with patients without delirium pre-operatively (Cohen's r = 0.10, P = 0.012), on postoperative day 1 (Cohen's r = 0.11, P = 0.004) and on postoperative day 2 (Cohen's r = 0.13, P = 0.002). After adjusting for covariates in multiple logistic regression, a significant association between both BuChE and AChE activities and POD was not found. However, in the multivariable analysis using the Generalized Estimating Equation, cholinesterase activities showed that a decrease of BuChE activity by 100 U L−1 increased the risk of a delirium by approximately 2.1% (95% CI 1.6 to 2.8%) and for each 1 U g−1 of haemoglobin increase in AChE activity, there was a 1.4% (95% CI 0.6 to 2.2%) increased risk of POD. CONCLUSION Peri-operative peripheral cholinesterase activities may be related to the development of POD, but the clinical implications remain unclear. Further studies, in homogeneous patient groups with a strict protocol for measurement time points, are needed to investigate the relationship between cholinesterase activities and POD. TRIAL REGISTRATION www.clinicaltrials.gov. Identifier NCT01964274. Correspondence to Claudia D. Spies, Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, D-13353 Berlin, Germany Tel: +49 30 450 551001; e-mail: claudia.spies@charite.de 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/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2DqPXj5

Goal-directed therapy during transthoracic oesophageal resection does not improve outcome: Randomised controlled trial

BACKGROUND Goal-directed therapy (GDT) is expected to be of highest benefit in high-risk surgery. Therefore, GDT is recommended during oesophageal resection, which carries a high risk of postoperative complications. OBJECTIVES The aim of this study was to confirm the hypothesis that GDT during oesophageal resection improves outcome compared with standard care. DESIGN A randomised controlled study. SETTING Two Swedish university hospitals, between October 2011 and October 2015. PATIENTS Sixty-four patients scheduled for elective transthoracic oesophageal resection were randomised. Exclusion criteria included colonic interposition and significant aortic or mitral valve insufficiency. INTERVENTION A three-step GDT protocol included stroke volume optimisation using colloid boluses as assessed by pulse-contour analysis, dobutamine infusion if cardiac index was below 2.5 l min−1 m−2 and norepinephrine infusion if mean arterial blood pressure was below 65 mmHg. MAIN OUTCOME MEASURE The incidence of complications per patient at 5 and 30 days postoperatively as assessed using a predefined list. RESULTS Fifty-nine patients were available for analysis. Patients in the intervention group received more colloid fluid (2190 ± 875 vs. 1596 ± 759 ml, P 

https://ift.tt/2DnkMF2

Development of a prediction model for postoperative pneumonia: A multicentre prospective observational study

BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 °C; leucocyte count more than 12 000 μl−1. RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P 

https://ift.tt/2Q1PTN2

Ultrasound-guided vs. palpation-guided techniques for radial arterial catheterisation in infants: A randomised controlled trial

BACKGROUND The usefulness of ultrasound-guided techniques for radial arterial catheterisation has been well identified; however, its usefulness has not been completely evaluated in infants under 12 months of age, who are generally considered the most difficult group for arterial catheterisation. OBJECTIVE We evaluated whether ultrasound guidance would improve success rates and reduce the number of attempts at radial arterial catheterisation in infants. DESIGN A randomised, controlled and patient-blinded study. SETTING Single-centre trial, study period from June 2016 to February 2017. PATIENTS Seventy-four infants undergoing elective cardiac surgery. INTERVENTION Patients were allocated randomly into either ultrasound-guided group (group US) or palpation-guided group (group P) (each n=37) according to the technique applied for radial arterial catheterisation. All arterial catheterisations were performed by one of two experienced anaesthesiologists based on group assignment and were recorded on video. MAIN OUTCOME MEASURES The primary endpoint was the first-pass success. The number of attempts and total duration of the procedure until successful catheterisation were also analysed. RESULTS The first-pass success rate was significantly higher in the group US than in the group P (68 vs. 38%, P = 0.019). In addition, fewer attempts were needed for successful catheterisation in the group US than in the group P (median 1 [IQR 1 to 2] vs. 2 [1 to 4], P = 0.023). However, the median [IQR] procedural time (s) until successful catheterisation in the two groups was not significantly different (102 [49 to 394] vs. 218 [73 to 600], P = 0.054). CONCLUSION The current study demonstrated that the ultrasound-guided technique for radial arterial catheterisation in infants effectively improved first-pass success rate and also reduced the number of attempts required. TRIAL REGISTRATION ClinicalTrials.gov NCT02795468. Correspondence to Jong-Hwan Lee, MD, PhD, Associate Professor, Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea Tel: +82 2 3410 1928; fax: +82 2 3410 0361; e-mail: jonghwanlee75@gmail.com © 2018 European Society of Anaesthesiology

https://ift.tt/2DngSvR

Familial frontal fibrosing alopecia: A cross‐sectional study of 20 cases from nine families

Abstract

Background/Objectives

Frontal fibrosing alopecia (FFA) is a scarring alopecia whose prevalence is increasing. The pathogenesis of this disease is not well known. Genetic, environmental, hormonal and autoimmunity related factors have been considered; however, only a few cases of familial frontal fibrosing alopecia have been reported.

Material and methods

A cross‐sectional study was performed at University Hospital in Granada (Spain). Twenty patients with frontal fibrosing alopecia belonging to nine different families were included, and clinical and dermoscopic features were analysed.

Results

Overall, 90% of the patients studied were women (mean age 61.4 years). About 50% of the patients had grade II frontal fibrosing alopecia at the time of diagnosis, whilst 35% had grades III or V. Mean recession was 2.83 cm in the frontal area and 1.99 cm in the temporo‐parietal area. Daughters presented a shorter recession area and earlier debut of the disease than mothers. Androgenetic alopecia was found in only two patients (10%). The dermoscopic signs most commonly found were perifollicular erythema (85%), hyperkeratosis (85%), and absence of vellus hair in the hairline (78.9%).

Conclusion

This study adds to the growing evidence that there is a genetic component to frontal fibrosing alopecia. The clinical pattern of frontal fibrosing alopecia was not different from that found in non‐familial cases, but the debut of the disease in daughters of mothers with frontal fibrosing alopecia may be earlier.

https://ift.tt/2qN9e6z

Commentary to accompany: The Cervicofacial lift under Pure local anaesthesia diminishes the incidence of postoperative haematoma

The authors present a large series (1500) of their standard cervico-facial lift (including liposuction of the neck and re-tensioning of the SMAS) carried out under local anaesthesia alone and have demonstrated only onset of an early bleeding event in 0.6% of the cases.

https://ift.tt/2qMgJL3

Minimal Invasive Laparoscopic Harvest of the Greater Omental Flap for Fournier's Gangrene Scrotal Reconstruction.

Aggressive surgical debridement is often warranted for patients with Fournier's gangrene, which result in extensive defects.[1] Many methods have been described for the coverage of these kind of defects including free and pedicled myocutaneous, fasciofucaneous, and also the greater omental flap (GOF).[2,3] The aim of this letter is to present for the first time, the laparoscopic harvest of GOF for complete scrotal reconstruction in a patient with Fournier's gangrene.

https://ift.tt/2FoHXkW

The emerging role of lncRNAs in the regulation of cancer stem cells

Abstract

Background

Tumors contain a functional subpopulation of cells that exhibit stem cell properties. These cells, named cancer stem cells (CSCs), play significant roles in the initiation and progression of cancer. Long non-coding RNAs (lncRNAs) can act at the transcriptional, posttranscriptional and translational level. As such, they may be involved in various biological processes such as DNA damage repair, inflammation, metabolism, cell survival, cell signaling, cell growth and differentiation. Accumulating evidence indicates that lncRNAs are key regulators of the CSC subpopulation, thereby contributing to cancer progression. The aim of this review is to overview current knowledge about the functional role and the mechanisms of action of lncRNAs in the initiation, maintenance and regulation of CSCs derived from different neoplasms. These lncRNAs include CTCF7, ROR, DILC, HOTAIR, H19, HOTTIP, ATB, HIF2PUT, SOX2OT, MALAT-1, CUDR, Lnc34a, Linc00617, DYNC2H1–4, PVT1, SOX4 and ARSR Uc.283-plus. Furthermore, we will illustrate how lncRNAs may regulate asymmetric CSC division and contribute to self-renewal, drug resistance and EMT, thus affecting the metastasis and recurrence of different cancers. In addition, we will highlight the implications of targeting lncRNAs to improve the efficacy of conventional drug therapies and to hamper CSC survival and proliferation.

Conclusions

lncRNAs are valuable tools in the search for new targets to selectively eliminate CSCs and improve clinical outcomes. LncRNAs may serve as excellent therapeutic targets because they are stable, easily detectable and expressed in tissue-specific contexts.

https://ift.tt/2NJf3za

Epigenetic markers in basal cell carcinoma: universal themes in oncogenesis and tumor stratification? - a short report

Abstract

Background

Advanced basal cell carcinomas (BCCs) suffer from a scarcity of effective treatment options. Previously, we found that the targetable histone methyltransferase EZH2 was upregulated in aggressive BCC subtypes, suggesting that epigenetics may play a role in BCC progression. The purpose of this study was to determine whether EZH2-associated proteins and marks may be employed for the stratification of BCC histologic subtypes.

Methods

Sixty-two specimens (from 61 patients), representing more or less aggressive BCC histologic subtypes and matching non-malignant epidermal cells, were included in this study. Immunohistochemistry of H3K27me3, 5hmC, NSD2, MOF and JARID1B was performed to assess their putative associations with BCC histologic subtypes, as well as with EZH2 and Ki67 expression levels.

Results

We found that H3K27me3 and 5hmC upregulation was positively correlated with the occurrence of a less aggressive BCC histology. The modifications were also positively correlated with each other. Interestingly, we found that they were negatively correlated with the expression of EZH2, a marker for an aggressive BCC histology. The levels of NSD2, MOF, H3K27me3 and 5hmC were found to be universally upregulated in BCCs versus non-malignant epidermal cells.

Conclusions

Our data reveal an EZH2-associated epigenetic marker profile that correlates with histologic signs of BCC aggressiveness. Our findings may have diagnostic and therapeutic implications, and indicate that epigenetic markers may be shared even with relatively less aggressive tumor types, thereby suggesting universal themes.

https://ift.tt/2N6jEfb

Emerging ways to treat breast cancer: will promises be met?

Abstract

Background

Breast cancer (BC) is the most common cancer among women and it is responsible for more than 40,000 deaths in the United States and more than 500,000 deaths worldwide each year. In previous decades, the development of improved screening, diagnosis and treatment methods has led to decreases in BC mortality rates. More recently, novel targeted therapeutic options, such as the use of monoclonal antibodies and small molecule inhibitors that target specific cancer cell-related components, have been developed. These components include ErbB family members (HER1, HER2, HER3 and HER4), Ras/MAPK pathway components (Ras, Raf, MEK and ERK), VEGF family members (VEGFA, VEGFB, VEGFC, VEGF and PGF), apoptosis and cell cycle regulators (BAK, BAX, BCL-2, BCL-X, MCL-1 and BCL-W, p53 and PI3K/Akt/mTOR pathway components) and DNA repair pathway components such as BRCA1. In addition, long noncoding RNA inhibitor-, microRNA inhibitor/mimic- and immunotherapy-based approaches are being developed for the treatment of BC. Finally, a novel powerful technique called CRISPR-Cas9-based gene editing is emerging as a precise tool for the targeted treatment of cancer, including BC.

Conclusions

Potential new strategies that are designed to specifically target BC are presented. Several clinical trials using these strategies are already in progress and have shown promising results, but inherent limitations such as off-target effects and low delivery efficiencies still have to be resolved. By improving the clinical efficacy of current therapies and exploring new ones, it is anticipated that novel ways to overcome BC may become attainable.

https://ift.tt/2Ij21mC

In silico screening for ERα down modulators identifies thioridazine as an anti-proliferative agent in primary, 4OH-tamoxifen-resistant and Y537S ERα-expressing breast cancer cells

Abstract

Purpose

Most breast cancers (BCs) express estrogen receptor α (ERα) and are treated with the endocrine therapy (ET) drugs 4OH-tamoxifen (Tam) and fulvestrant (ICI 182,780; ICI). Unfortunately, a high fraction of ET treated women relapses and becomes resistant to ET. Therefore, additional anti-BC drugs are needed. Recently, we proposed that the identification of novel anti-BC drugs can be achieved using modulation of the intracellular ERα content in BC cells as a pharmacological target. Here, we searched for Food and Drug Administration (FDA)-approved drugs that potentially modify the ERα content in BC cells.

Methods

We screened in silico more than 60,000 compounds to identify FDA-approved drugs with a gene signature similar to that of ICI. We identified mitoxantrone and thioridazine and tested them in primary, Tam-resistant and genome-edited Y537S ERα-expressing BC cells.

Results

We found that mitoxantrone and thioridazine induced ERα downmodulation and prevented MCF-7 BC cell proliferation. Interestingly, while mitoxantrone was found to be toxic for normal breast epithelial cells, thioridazine showed a preferential activity towards BC cells. Thioridazine also reduced the ERα content and prevented cell proliferation in primary, Tam-resistant and genome-edited Y537S ERα expressing BC cells.

Conclusions

We suggest that modulation of the intracellular ERα concentration in BC cells can be exploited in in silico screens to identify anti-BC drugs and uncover a re-purposing opportunity for thioridazine in the treatment of primary and metastatic ET resistant BCs.

https://ift.tt/2NgqD4r

Anti-tumor effect of CDK inhibitors on CDKN2A -defective squamous cell lung cancer cells

Abstract

Background

Squamous cell lung cancer (SqCLC) is a distinct histologic subtype of non-small cell lung cancer (NSCLC). Although the discovery of driver mutations and their targeted drugs has remarkably improved the treatment outcomes for lung adenocarcinoma, currently no such molecular target is clinically available for SqCLC. The CDKN2A locus at 9p21 encodes two alternatively spliced proteins, p16^INK4a (p16) and p14^ARF (p14), which function as cell cycle inhibitors. The Cancer Genome Atlas (TCGA) project revealed that CDKN2A is inactivated in 72% of SqCLC cases. In addition, it was found that CDKN2A mutations are significantly more common in SqCLC than in adenocarcinoma. Down-regulation of p16 and p14 by CDKN2A gene inactivation leads to activation of cyclin-dependent kinases (CDKs), thereby permitting constitutive phosphorylation of Rb and subsequent cell cycle progression. Here, we hypothesized that CDK inhibition may serve as an attractive strategy for the treatment of CDKN2A-defective SqCLC.

Methods

We investigated whether the CDK inhibitors flavopiridol and dinaciclib may exhibit antitumor activity in CDKN2A-defective SqCLC cells compared to control cells. The cytotoxic effect of the CDK inhibitors was evaluated using cell viability assays, and the induction of apoptosis was assessed using TUNEL assays and Western blot analyses. Finally, anti-tumor effects of the CDK inhibitors on xenografted cells were investigated in vivo.

Results

We found that flavopiridol and dinaciclib induced cytotoxicity by enhancing apoptosis in CDKN2A-defective SqCLC cells, and that epithelial to mesenchymal transition (EMT) decreased and autophagy increased during this process. In addition, we found that autophagy had a cytoprotective role.

Conclusion

Our data suggest a potential role of CDK inhibitors in managing CDKN2A-defective SqCLC.

https://ift.tt/2NhEeZu

CXCL12 expression is a bona fide predictor of recurrence in lung neuroendocrine tumours; a multicentric study with emphasis on atypical carcinoids - a short report

Abstract

Purpose

Neuroendocrine tumors of the lung (LNETs) encompass a heterogeneous group of lesions, including tumors with no or low metastatic potential, such as typical (TCs) and atypical (ACs) carcinoids, and highly aggressive neuroendocrine carcinomas. To date, only a few biomarkers with prognostic impact have been identified in LNETs. Previous experimental studies have suggested that the cytokine CXCL12 might have a role in stratifying the outcome of lung cancer as well as LNET patients. However, the reliability of immunohistochemical (IHC) tissue expression of CXCL12 in evaluating the prognosis of resected LNETs is currently not known.

Methods

Here, we subjected a cohort of 112 resected LNETs specifically enriched for ACs to IHC for CXCL12 and Ki67 using routine procedures. The clinical value of CXCL12 was assessed by applying the Cox proportional-hazards model to overall and disease-free survival rates.

Results

We found that CXCL12 was expressed in 8.3 to 38% of LNETs, depending on the different diagnostic categories. Upon survival analysis, when considering the whole cohort, we found that CXCL12-positive cases exhibited shorter disease-free survival rates compared to CXCL12-negative cases. Among ACs, tumors overexpressing CXCL12 showed significantly shorter disease-free survival rates. Finally, we found that the Ki67 index in ACs was higher in the CXCL12-positive cases.

Conclusion

CXCL12 immunohistochemistry may serve as a potentially useful tool to better stratify LNETs, and more specifically ACs, in clinical practice.

https://ift.tt/2Q15REx

Association of Resistance to Immune Checkpoint Inhibitors in Metastatic Colorectal Cancer With Misdiagnosis of Status

This cohort study investigates possible mechanisms underlying primary resistance to immune checkpoint inhibitors of metastatic colorectal cancers displaying microsatellite instability or mismatch repair deficiency.

https://ift.tt/2qLVF7o

Hemifacial Hyperhidrosis in a Patient With an Apical Non–Small Cell Lung Cancer

This case report describes an unusual case of hyperhidrosis associated with apical lung cancer with sympathetic nerve involvement.

https://ift.tt/2FmDteP

Competing Risks for a Diagnosis of Invasive Breast Cancer—Reply

In Reply Syn expresses concern that our analysis of the long-term accuracy of breast cancer risk assessment in a cohort of women who underwent breast cancer screening could be inadequate because some women could have undergone risk-reducing surgery or preventive therapy. Although we do not have data to directly assess this issue, we believe that our findings are robust; this is an average-risk cohort, and very few women are likely to have received these interventions. This view is supported by 4 observations.

https://ift.tt/2qNybyE

Detecting a Survival Benefit to Dose Escalation

To the Editor We commend Michalski et al for reporting the anticipated results of RTOG 0126, and in particular, for reporting the incidences of both all-cause and cause-specific mortality. Surprisingly, many trials do not report this vital information. The incidence of prostate cancer mortality was unexpectedly low in their trial, possibly owing to improvement in salvage therapies and changes in the patient population. We are concerned that the proposed effect size (hazard ratio, 0.77) on overall survival (OS) was, in retrospect, mathematically infeasible, and therefore the true power of this study to detect an OS benefit with dose escalation is much lower than 90%.

https://ift.tt/2FnESSj

Detecting a Survival Benefit to Dose Escalation—Reply

In Reply We thank Dr Zakeri and colleagues for their interest in the NRG/RTOG 0126 trial. After design, how a clinical trial plays out depends on accurate projections of several key parameters. As mentioned by Zakeri et al and described in the report, the overall survival (OS) was much better than anticipated, owing largely to better-than-expected prostate cancer prognosis. This result, in turn, has major bearing on the hazard ratio (HR) for the composite end point of OS. Indeed, the benefit on OS is bounded, and a simplified way to conceptualize this, similar to the argument by Zakeri et al, is that the HR of the composite outcome is a weighted average of effects on constituent end points:

https://ift.tt/2qLKL1v

Competing Risk for a Diagnosis of Invasive Breast Cancer

To the Editor In their recent article in JAMA Oncology, Brentnall et al reported on long-term results from a praiseworthy cohort study that observed women who completed a breast cancer risk assessment until the diagnosis of invasive breast cancer or censoring. Women were censored at death, diagnosis of ductal carcinoma in situ, when they reached 75 years of age, or at the end of study follow-up.

https://ift.tt/2Fmwi6g

Surgery vs Radiotherapy in the Management of Gleason Score 9-10 Prostate Cancer and the Risk of Mortality

This cohort study investigates whether treatment of Gleason score 9-10 prostate cancer with radical prostatectomy, adjuvant external beam radiotherapy, and androgen deprivation therapy (termed MaxRP) vs external beam radiotherapy, brachytherapy, and androgen deprivation therapy (termed MaxRT) was associated with prostate cancer–specific mortality and all-cause mortality risk.

https://ift.tt/2qPuKaY

Social Media and Gender Equity in Oncology

This article illustrates how social media can create new communities within medicine and, in particular, advance gender equity in oncology.

https://ift.tt/2FxV4Ai

The Italian Registry of GH Treatment: electronic Clinical Report Form (e-CRF) and web-based platform for the national database of GH prescriptions

Abstract

Background

In Italy, the utilization and the reimbursement of Growth Hormone (rGH) therapy by the National Health System (Servizio Sanitario Nazionale) are regulated by the "Note #39" included in the "Notes for the use of drugs" by the Italian Medicines Agency (AIFA), which are published in the Official Gazette, thus having the force of law. The "Note #39" establishes the diagnosis for which the reimbursement is granted and confirms the assignment of the national health surveillance on the use of GH therapy to the Italian National Institute of Health, requesting its computerization.

Aim

The aim of this work was to realize a dedicated electronic Clinical Report Form based on the mandatory data requested by the Note #39 and allowing the online reporting of the rGH prescriptions by the regional accredited centers.

Results and Conclusions

This interface is at the base of the national database of the Italian Registry of GH Treatment, which allows obtaining and managing correct and complete data to provide public health surveillance on GH therapy, both at national and local levels, necessary for policymakers decisions. In addition, this national database could be a useful instrument for improving knowledge about aspects of this treatment still under discussion.

https://ift.tt/2Pzvpfy

Scholar : These new articles for Journal of Dance Education are available online

The online platform for Taylor & Francis Online content New for Journal of Dance Education and online now on Taylor & Francis Online: Student Readings Extraordinary Dancing Requires Extraordinary (Motor) Learning Rebecca Lynn Gose MFA Pages: 1-7 | DOI: 10.1080/15290824.2017.1383611 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Insulin resistance linked to subtle myocardial dysfunction in normotensive Turner syndrome young patients without structural heart diseases

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2RXIFqY

Insulin resistance in children with familial hyperlipidemia

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2DFpChU

Early higher dosage of alglucosidase alpha in classic Pompe disease

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2RTk0nf

Do parents of children with metabolic diseases benefit from the Triple P – Positive Parenting Program? A pilot study

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2DJIRaa

Baseline characteristics of gender dysphoric youth

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2RWDbg5

Arterial stiffness as a measure of cardiovascular risk in obese adolescents and adolescents with diabetes type 1

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2DJIPPA

Scholar : The Aging Male, Volume 21, Issue 4, December 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content The Aging Male, Volume 21, Issue 4, December 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Article Association between hand-grip strength and erectile dysfunction in older men Ho Seok Chung, Min-Ho Shin & Kwangsung Park Pages: 225-230 | DOI: 10.1080/13685538.2017.1412423 Integrative transcriptome analysis identifies genes and pathways associated with enzalutamide resistance of prostate cancer Subo Qian, Jia Xia, Hailong Liu, Yu Zhang, Lin Zhang & Yongjiang Yu Pages: 231-237 | DOI: 10.1080/13685538.2018.1424129 Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia Mustafa Erkoc, Alper Otunctemur, Huseyin Besiroglu & Fatih Altunrende Pages: 238-242 | DOI: 10.1080/13685538.2018.1433654 Should information about sexual health be included in education directed toward men with cardiovascular diseases? Dariusz Kałka, Romuald Zdrojowy, Krzysztof Womperski, Jana Gebala, Ryszard Smoliński, Alicja Dulanowska, Karolina Stolarczyk, Jakub Dulanowski, Witold Pilecki & Lesław Rusiecki Pages: 243-250 | DOI: 10.1080/13685538.2018.1439911 Review Article Bioactive compounds of the Mediterranean diet and prostate cancer Olga López-Guarnido, Noelia Urquiza-Salvat, Maria Saiz, David Lozano-Paniagua, Lourdes Rodrigo, Manrique Pascual-Geler, Jose Antonio Lorente, Maria Jesus Alvarez-Cubero & Ana Rivas Pages: 251-260 | DOI: 10.1080/13685538.2018.1430129 Lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction: from physiology to clinical aspects Aldo E. Calogero, Giovanni Burgio, Rosita A. Condorelli, Rossella Cannarella & Sandro La Vignera Pages: 261-271 | DOI: 10.1080/13685538.2018.1430758 Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction Aldo E. Calogero, Giovanni Burgio, Rosita A. Condorelli, Rossella Cannarella & Sandro La Vignera Pages: 272-280 | DOI: 10.1080/13685538.2018.1432586 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Adsorptive removal of As(V) by crawfish shell biochar: batch and column tests

Abstract

As a toxic and metalloid substance, excess arsenic (As) can cause serious harm to the environment and public health. In this work, crayfish shell biochar (CFS450) and modified biochar (MCFS450) were prepared to remove As(V) from aqueous solutions under various conditions. Compared to CFS450, MCFS450 had a higher specific surface area, better pore structure, and higher As(V) adsorption capacity. Based on the Langmuir model, its maximum As(V) adsorption capacity was 17.2 mg/g. The biochar had a large number of surface functional groups such as C-O, O-H, and -OH. After modification, a certain mass of ZnO nanoparticles existed on MCFS450, which increased positive charge on the surface and promoted the adsorption of As(V). As the temperature rose, the adsorption capacity increased, suggesting the adsorption was endothermic. Under low PH conditions, the adsorption effect was better. When Cl⁻, HCO₃⁻, SO₄²⁻, and PO₄³⁻ respectively existed, the adsorption capacity decreased, indicating that As(V) competed with other anions. The column adsorption experiments showed that Thomas, Yoon-Nelson, and Adams-Bohart models can be expressed as a unified model (EXY model). The EXY model can be used for the design of biochar-based filter for As(V) removal, providing a theoretical basis for practical production applications.

Graphical abstract

Experimental setup and results of column adsorption.

https://ift.tt/2PXMA9O

Effect of lead on plant availability of phosphorus and potassium in a vegetable–soil system

Abstract

Two typical red soils were sequentially cultivated with celery (Apium graveolens L.) and Chinese cabbage (Brassica chinensis L.) in a greenhouse to determine the effect of lead (Pb) on plant availability of phosphorus (P) and potassium (K) in the soils. The concentrations of available P as estimated by the 0.05 mol L⁻¹ HCl-0.025 mol L⁻¹ (1/2 H₂SO₄) extraction and available K estimated by the NH₄OAc extraction method in the crop-free soils were not affected by Pb treatment. Plant P concentrations in the above-ground part of celery and Chinese cabbage exposed to Pb were either lower or showed no significant difference to the control.

https://ift.tt/2DlY7sQ

A theoretical method for the high-sensitivity fluorescence detection of PAEs through double-substitution modification

Abstract

A highly sensitive method for the detection of phthalate acid ester (PAE) derivatives by fluorescence spectroscopy based on a double-substitution modification is reported. The fluorescence intensities of 18 PAE derivatives and the template PAEs after docking with the protein bovine serum albumin (BSA) are compared; the fluorescence intensities of the PAE derivatives increase significantly (28.20 to 110.00 times) with high sensitivities, but the functionalities (stability and insulation) are not affected. The persistence, mobility, and toxicity of the PAE derivatives are reduced by varying degrees, and their amounts of bioaccumulation are not significantly changed, indicating that the derivatives are more environmentally friendly. Within the wavelength range 240–420 nm in the fluorescence spectrum, there is no interference between the PAE derivatives and polycyclic aromatic hydrocarbons (PAHs), and the derivatives can be detected with good precision. Based on the analysis of fluorescence characteristics using a 2D quantitative structure-activity relationship (QSAR) model, the occupied orbital energies and Mulliken charge numbers are the main factors that influence the spectral characteristics of the PAE derivatives.

https://ift.tt/2Q6XJ8x

Polystyrene microplastics did not affect body growth and swimming activity in Xenopus laevis tadpoles

Abstract

A growing number of studies have highlighted the contamination and the effects towards organisms of diverse microplastics (μPs) in the marine environment. Surprisingly, although the main sources of μPs for marine environments are inland surface waters, the information on the occurrence and the effects of μPs in freshwater ecosystems is still scant. Thus, the aim of the present work is to investigate the ingestion and possible adverse effects due to the exposure to polystyrene μPs (PSμPs; Ø = 3 μm) on tadpoles of the Amphibian Xenopus laevis. Larvae at the developmental stage 36, prior to mouth opening, were exposed under semi-static conditions to 0.125, 1.25, and 12.5 μg mL⁻¹ of PSμPs, and allowed to develop until stage 46. At the end of the exposure, the digestive tract and the gills from exposed and control tadpoles were microscopically examined, as well as changes in body growth and swimming activity. PSμPs were observed in tadpoles' digestive tract, but not in the gills, from each tested concentration. However, neither body growth nor swimming activity were affected by PSμPs exposure. Our results demonstrated that PSμPs can be ingested by tadpoles, but they did not alter X. laevis development and swimming behavior at least during early-life stages, also at high, unrealistic concentrations.

https://ift.tt/2DnEznO

Carbon fiber paper@MgO films: in situ fabrication and high-performance removal capacity for phosphate anions

Abstract

Porous magnesium oxide (MgO) films on carbon fiber paper (CF) have been successfully fabricated in a hydrothermal route at different calcination temperatures. The CF@MgO samples (CF@MgO-300, -400, and -500) show different morphologies with the increasing surface area from 3 for CF to 27 m² g⁻¹ for CF@MgO-400. Among the four investigated samples, the CF@MgO-400 exhibits the highest phosphate removal ability (~ 1230 mg g⁻¹) with promising applications for the large-scale utilization at low cost.

https://ift.tt/2PVPGeB

Adsorption-desorption of hydrophilic contaminants rhodamine B with/without Cd 2+ on a coastal soil: implications for mariculture and seafood safety

Abstract

An experimental study on adsorption and desorption behaviors of rhodamine B (RhB) with/without cadmium ion (Cd²⁺) on a coastal soil was carried out in the face of the scarce studies on its environmental behaviors, especially its combined pollution with metal ions. The implications on mariculture and seafood safety, rarely concerned either, were also analyzed for providing a new insight between azo dyes and them. It showed that the adsorption of RhB on the tested soil was affected by Cd²⁺ and could be better fitted by the Freundlich model and dominantly identified as chemical adsorption according to the threshold of ΔG⁰ (40 kJ/mol). There is a positive hysteresis on the desorption of RhB, which was generally strengthened with the increasing concentration of RhB but generally weakened in the presence of Cd²⁺. The azo dyes including RhB and heavy metals such as Cd, as the major class of typical pollutants in coastal environment, are closely related to the mariculture and seafood safety. In the consideration of three aspects including potential pollutants for the mariculture, potential risks for seafood safety, and potential relationships between dyes and mariculture and seafood safety, their implications were further clarified.

https://ift.tt/2DmDc8Y

Semi-analytical solutions for two-dimensional convection–diffusion–reactive equations based on homotopy analysis method

Abstract

Convention applied to describe contaminant transport in landfills and groundwater systems is typically characterized by simplified geometries and boundary conditions. As a result, they neglect the more general boundary conditions encountered in the real world, including convection and diffusion of contaminants (e.g., landfill leachate) associated with fluid transportation in the lateral direction. Here, we present semi-analytical solutions that can be used to describe and estimate the contaminants' fate in two-dimensional space. This is achieved by applying the homotopy analysis method (HAM) to create a different order deformation equation series, the sum of which is the solution of the two-dimensional target problem. To ensure the accuracy of the semi-analytical solution, elements of the equation series have been defined and adapted to satisfy the partial differential equation of the discussed problem. Similarly, the convergence of the HAM solution has been achieved by adopting proper convergent control parameters, ensuring the convergence of each element of the deformation equation series. This guarantees that the sum of the equation series is convergent. HAM has been applied to three cases with more general and smooth initial conditions. Good agreement between HAM solutions and numerical solutions from the literature demonstrates the capacity of HAM.

https://ift.tt/2PWFy5k

In vitro evaluation of genomic damage induced by glyphosate on human lymphocytes

Abstract

Glyphosate is an important broad-spectrum herbicide used in agriculture and residential areas for weed and vegetation control, respectively. In our study, we analyzed the in vitro clastogenic and/or aneugenic effects of glyphosate by chromosomal aberrations and micronuclei assays. Human lymphocytes were exposed to five glyphosate concentrations: 0.500, 0.100, 0.050, 0.025, and 0.0125 μg/mL, where 0.500 μg/mL represents the established acceptable daily intake value, and the other concentrations were tested in order to establish the genotoxicity threshold for this compound. We observed that chromosomal aberration (CA) and micronuclei (MNi) frequencies significantly increased at all tested concentrations, with exception of 0.0125 μg/mL. Vice versa, no effect has been observed on the frequencies of nuclear buds and nucleoplasmic bridges, with the only exception of 0.500 μg/mL of glyphosate that was found to increase in a significant manner the frequency of nucleoplasmic bridges. Finally, the cytokinesis-block proliferation index and the mitotic index were not significantly reduced, indicating that glyphosate does not produce effects on the proliferation/mitotic index at the tested concentrations.

https://ift.tt/2DlXSOs

Decolorization and reusing of PET depolymerization waste liquid by electrochemical method with magnetic nanoelectrodes

Abstract

This work is aimed at electrochemical decolorization of real waste liquid which obtained in the PET depolymerization process. Firstly, PET fabrics were glycolysized by utilizing excess ethylene glycol (EG). Then, the glycolysis product was mixed with water and purified through repeated crystallization to get bis(2-hydroxyethyl) terephthalate (BHET) crystal. At last, the waste liquid of the depolymerization process was electrochemical decolorized by utilizing chitosan/Fe₃O₄ nanoparticles as the dispersed electrodes under a DC voltage. The UV-Vis absorptions at 338, 531, and 635 nm which were due to the dyes in the waste liquid decreased with the electrolysis time. In contrast, slight change of absorption of EG (at 322 nm) indicated that EG was not destroyed in the electrolytic process. The variation of color removal efficiency with dosage of chitosan/Fe₃O₄ nanoparticles, applied voltage, concentration of electrolyte, pH and electrolytic time were investigated. The max color removal efficiency was 87.24%. PET fabrics were depolymerized by using the decolorized waste liquid or mixture of decolorized waste liquid and EG (1:1 v/v), and the yields of BHET were 72.3% and 76.6%, respectively. The products were BHET without dyes which were confirmed by DSC and FTIR spectroscopy.

Graphical abstract

https://ift.tt/2PVPtYR

Effect of Cervical Collar on the Optic Nerve Sheath Diameter in Minor Head Trauma

Condition:   Head Trauma
Intervention:   Diagnostic Test: ultrasonography
Sponsor:   Marmara University
Recruiting

https://ift.tt/2RYrWUx

Quantitative HPV Genotyping in Screening of Anal Intraepithelial Neoplasia in HIV-positive Patients

Condition:   Human Immunodeficiency Virus
Intervention:   Diagnostic Test: HPV genotyping
Sponsors:   Universitaire Ziekenhuizen Leuven;   Belgian Scientific Institute of Public Health
Recruiting

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Scholar : Africa Review, Volume 11, Issue 1, January 2019 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Africa Review, Volume 11, Issue 1, January 2019 is now available online on Taylor & Francis Online. This new issue contains the following articles: Articles Whose perception matters? An analysis of the social construction of Ghana Police Service and the implementation of the Single Spine Pay Policy Antwi Boasiako Pages: 1-16 | DOI: 10.1080/09744053.2018.1538676 Renewable energy and power: a review of the power sector reform and renewable energy law and policy nexus in Ghana Nana Asare Obeng-Darko Pages: 17-33 | DOI: 10.1080/09744053.2018.1538677 Energy sector of Cameroon Lea Laouan Marius & Ndjinang Alex Joel Pages: 34-45 | DOI: 10.1080/09744053.2018.1538678 The political (in) dependence of the judiciary in Cameroon: fact or fiction? Gerard Emmanuel Kamdem Kamga Pages: 46-62 | DOI: 10.1080/09744053.2018.1538679 Assessment of university students' level of financial literacy: the voices of the National University of Development Studies education students Malimpho Elsie Seotsanyana Pages: 63-76 | DOI: 10.1080/09744053.2018.1538680 Contemporary local governance and indigenous institutions: the case of the Sidaama, Southern Ethiopia Tsegaye Tuke Kia Pages: 77-94 | DOI: 10.1080/09744053.2018.1538681 Book Reviews Gender and mobility in Africa- borders, bodies and boundaries Suraiya Tabassum Pages: 95-97 | DOI: 10.1080/09744053.2018.1538683 Gender, violence, refugees Anupama Sharan Pages: 97-100 | DOI: 10.1080/09744053.2018.1538682 Contemporary issues in African society: historical analysis and perspective Khalid Ansari Pages: 100-102 | DOI: 10.1080/09744053.2018.1538684 Living the city in Africa: processes of invention and intervention (Schweizerische Afrikastudien - Etudes Africaines Suisses Book 10) Safia Mahdi Pages: 102-105 | DOI: 10.1080/09744053.2018.1485259 Do you have original research that relates to present-day Japan and its recent historical development? Contemporary Japan welcomes your submissions. To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Scholar : Advances in the History of Rhetoric, Volume 21, Issue 3, 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Advances in the History of Rhetoric, Volume 21, Issue 3, 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Articles The Impulse to Rhetoric in India: Rhetorical and Deliberative Practices and Their Relation to the Histories of Rhetoric and Democracy Keith Lloyd Pages: 223-246 | DOI: 10.1080/15362426.2018.1526544 The Pluralistic Style and the Demands of Intercultural Rhetoric: Swami Vivekananda at the World's Parliament of Religions Scott R. Stroud Pages: 247-270 | DOI: 10.1080/15362426.2018.1526545 Bloody Rhetoric and Civic Unrest: Rhetorical Aims of Human Blood Splashing in the 2010 Thai Political Revolt Chanon Adsanatham Pages: 271-292 | DOI: 10.1080/15362426.2018.1526546 African-American Rhetorical Education and Epistolary Relations at the Holley School (1868–1917) Pamela VanHaitsma Pages: 293-313 | DOI: 10.1080/15362426.2018.1526547 Book Review Forum: Darrel Wanzer-Serrano, The New York Young Lords and the Struggle for Liberation Book Review Editor's Note Heather Hayes Pages: 314-314 | DOI: 10.1080/15362426.2018.1526548 Darrel Wanzer-Serrano's The New York Young Lords and the Struggle for Liberation: Theoretical Contributions Kent A. Ono Pages: 315-319 | DOI: 10.1080/15362426.2018.1526549 Advancing a Decolonial Rhetoric Lisa Flores Pages: 320-322 | DOI: 10.1080/15362426.2018.1526550 Building and Being a Community Control Vincent N. Pham Pages: 323-325 | DOI: 10.1080/15362426.2018.1531666 Book Review Forum: Author Response Decolonial Rhetoric and a Future Yet-to-Become: A Loving Response Darrel Wanzer-Serrano Pages: 326-330 | DOI: 10.1080/15362426.2018.1526551 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer

Abstract

Background and purpose

To evaluate the effect of changes in bladder volume during high-dose intensity-modulated-radiotherapy (IMRT) of prostate cancer on acute genitourinary (GU) toxicity and prospectively evaluate a simple biofeedback technique for reproducible bladder filling with the aim of reducing acute GU toxicity.

Methods

One hundred ninety-three patients were trained via a biofeedback mechanism to maintain a partially filled bladder with a reproducible volume of 200–300 cc at planning CT and subsequently at each fraction of radiotherapy. We prospectively analyzed whether and to what extent the patients' ability to maintain a certain bladder filling influenced the degree of acute GU toxicity and whether cut-off values could be differentiated.

Results

We demonstrated that the ability to reach a reproducible bladder volume above a threshold volume of 180 cc and maintain that volume via biofeedback throughout treatment predicts for a decrease in acute GU toxicity during curative high-dose IMRT of the prostate. Patients who were not able to reach a partial bladder filling to that cut-off value and were not able to maintain a partially filled bladder throughout treatment had a significantly higher risk of developing ≥grade 2 GU acute toxicity.

Conclusion

Our results support the hypothesis that a biofeedback training for the patient is an easy-to-apply, useful, and cost-effective tool for reducing acute GU toxicity in high-dose IMRT of the prostate. Patients who are not able to reach and maintain a certain bladder volume during planning and treatment—two independent risk factors—might need special consideration.

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Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism

Summary

Context

Data on longitudinal changes of computed tomography (CT)‐determined visceral fat area (VFA), skeletal muscle area (SMA), and skeletal muscle radiodensity (SMD) after adrenalectomy are limited in patients with hypercortisolism.

Objective

To examine the association of severity of cortisol excess and improvement of CT‐based muscle and fat parameters after adrenalectomy.

Design

Retrospective observational cohort study.

Patients

One‐hundred‐thirty‐four patients with overt Cushing's syndrome (CS; n=39), mild autonomous cortisol excess (MACE; n=57), or nonfunctioning adrenal tumor (NFAT; n=38) at a tertiary endocrinology institution between 2006 and 2017 were included.

Measurements

Changes in CT‐determined VFA, visceral‐to‐subcutaneous fat ratio (VSR), SMA, skeletal muscle index (SMI), and SMD measured at the third lumbar vertebra (L3)

Results

At baseline, CS patients had higher VFA, lower SMA, SMI, and SMD values, compared to NFAT or MACE patients. Compared to NFAT, significant decreases in VFA and increases in SMA, SMI, and SMD was observed in CS 1 year after adrenalectomy. In MACE, adjusted mean changes of SMD but not VFA, SMA, or SMI differ significantly compared to NFAT (+8.9% vs. ‐3.4%, P=0.032). In a multivariate linear regression model, the increase by 1 μg/dL of post‐dexamethasone serum cortisol at baseline was independently associated with greater reduction of VFA (‐3.95%), VSR (‐3.07%), and increase in SMD (+0.92%, P<0.05 for all) after adrenalectomy.

Conclusions

The severity of cortisol excess was associated with greater improvement of L3 VFA, VSR, and SMD 1 year after adrenalectomy. These CT‐based markers may allow more objective assessment of treatment benefit at earlier stage.

This article is protected by copyright. All rights reserved.

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