Journal of the American Academy of Dermatology: Original article Comorbidities in alopecia areata: A systematic review and meta-analysis

Publication date: Available online 18 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Solam Lee, Hanil Lee, Chung Hyeok Lee, Won-Soo Lee

Abstract

Background

Alopecia areata (AA) may be associated with various systemic diseases according to several studies.

Objective

To identify prevalent and incident diseases in AA patients and quantify their prevalence and odds and hazard ratio compared with those in non-AA controls.

Methods

A systematic review of the studies published before February 28, 2018 was performed using MEDLINE, Embase, Web of Science and Cochrane Library databases. Observational studies on prevalent or incident diseases in AA patients were included, whereas studies limited to pediatrics or providing only laboratory results or continuous data were excluded. Inverse variance method with random-effects model was used for meta-analyses.

Results

Eighty-seven studies were analyzed. Atopic diseases, metabolic syndrome, Helicobacter pylori infection, lupus erythematosus, iron deficiency anemia, thyroid diseases, psychiatric diseases, vitamin D deficiency, and audiologic and ophthalmic abnormalities were more prevalent in AA patients. AA patients had a higher risk of developing autoimmune diseases.

Limitations

Some diseases were investigated by an insufficient number of studies to be meta-analyzed. Meta-analysis on incident diseases was not performed owing to the limited availability on cohort studies.

Conclusion

AA is associated with various systemic and psychiatric diseases. Physicians are encouraged to evaluate and manage potential comorbid conditions to achieve better outcomes.

https://ift.tt/2O1awoN

Long-term sheltering mustaches reduce incidence of lower lip actinic keratosis

Publication date: Available online 18 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Deede Y. Liu, Muhammad I. Gul, Jo Wick, Anand N. Rajpara, Prescilia Isedeh, Ting Wang, Daniel J. Aires

https://ift.tt/2NsFvJD

Reduction in the colonization of Staphylococcus aureus on the skin surface under calcium-/magnesium-depleted conditions.

Related Articles

Reduction in the colonization of Staphylococcus aureus on the skin surface under calcium-/magnesium-depleted conditions.

Lett Appl Microbiol. 2018 Jun 20;:

Authors: Amagai Y, Makita Y, Takai M, Muko R, Matsuda H, Tanaka A

Abstract
Excessive expansion of Staphylococcus aureus is associated with several skin diseases, including atopic dermatitis (AD). Recently, we have demonstrated that washing skins with ultra-pure soft water containing little bivalent metal ions improved skin conditions of atopic subjects. In this study, we investigated the roles of calcium or magnesium on the proliferation of S. aureus both in vitro and in vivo. Depletion of calcium and magnesium in the culture medium significantly suppressed the expansion of S. aureus growth. When S. aureus, diluted with water containing calcium/magnesium at the concentration of medium-hard water (83·0 mg l-1 as CaCO3 ) or the one that contains little calcium/magnesium, was applied onto the tape-stripped skin of Hos:HR-1 mice, growth of S. aureus in water without those minerals on the skin was suppressed. These results suggest that depletion of both calcium and magnesium abrogate the proliferation of S. aureus not only in the culture system but also on the skin surface of mice. Since colonization of S. aureus on the skin is well-known to exacerbate AD symptoms, usage of ultra-pure soft water containing less calcium and magnesium may improve the skin condition through the suppression of S. aureus growth on the skin of patients with skin problems.

PMID: 30015352 [PubMed - as supplied by publisher]

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Mast Cells Stimulated with Peptidoglycan from Staphylococcus aureus Augment the Development of Th1 Cells.

Related Articles

Mast Cells Stimulated with Peptidoglycan from Staphylococcus aureus Augment the Development of Th1 Cells.

J Pharm Pharm Sci. 2018;21(1):296-304

Authors: Matsui K, Kanai S, Ikuta M, Horikawa S

Abstract
BACKGROUND: The skin of patients with atopic dermatitis (AD) is superficially colonized by Staphylococcus aureus. We have previously found that percutaneous permeation of peptidoglycan (PEG) from S. aureus increases the number of mast cells in the dermis, as seen in skin lesions of AD patients. The purpose of the present study was to clarify the influence of PEG on T helper type 1 (Th1)/ T helper type 2 (Th2) cell development mediated by mast cells.
METHODS: Mast cells were induced by long-term culture of murine spleen cells in medium supplemented with tumor necrosis factor (TNF)- a. Ovalbumin (OVA) peptide-pulsed mast cells were incubated with naïve Th cells in the presence or absence of PEG. Five days later, Th cells in the culture were stimulated with phorbol 12-myristate 13-acetate (PMA) and ionomycin, and Th1/Th2 cytokine production was investigated by enzyme-linked immunosorbent assay.
RESULTS: It was confirmed that the mast cells we obtained had surface expression of I-Ad, worked as antigen-presenting cells, and induced Th1 cell and Th2 cell development. The stimulation of mast cells with PEG enhanced the development of Th1 cells but not that of Th2 cells. The increase of Th1 cell development stimulated by PEG was associated with an increase in the expression of Notch ligand Delta 1 in the mast cells. Furthermore, treatment of mast cells with the macrolide antibiotic josamycin suppressed Th1 cell development and this was correlated with a reduction of both Delta 1 expression and interleukin (IL)-12 production in mast cells.
CONCLUSIONS: Colonization of S. aureus on the lesioned skin of AD patients contributes to not only an increase in the number of mast cells but also Th1 cell development mediated by mast cells in the dermis and subsequent induction of chronic inflammation, which is characterized by up-regulation of the Th1 cytokine, interferon (IFN)- g. Therefore, application of josamycin to the lesional skin of AD patients may provide relief from chronic inflammation mediated by mast cells.

PMID: 30012242 [PubMed - in process]

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Cosmetics, Vol. 5, Pages 45: A Novel Stilbene-Like Compound That Reduces Melanin through Inhibiting Melanocyte Differentiation and Proliferation without Inhibiting Tyrosinase

Cosmetics, Vol. 5, Pages 45: A Novel Stilbene-Like Compound That Reduces Melanin through Inhibiting Melanocyte Differentiation and Proliferation without Inhibiting Tyrosinase

Cosmetics doi: 10.3390/cosmetics5030045

Authors: Kristy Martinson Noah Stueven Aaron Monte Cheng-chen Huang

Cosmetic practices that use skin-lightening agents to obtain desired skin tones or treat pigment abnormalities have been popular worldwide. However, the molecular and cellular mechanisms of these agents are still largely unknown. Here we identified a family of compounds, with the lead compound named A11, that exhibited strong pigment reduction in developing zebrafish embryos. The pigment inhibition lasted for several days and is effective both before and after melanogenesis. By comparison with several known skin-lightening compounds, A11 appeared to be more potent and caused slower pigment recovery after withdrawal. A11, however, did not inhibit tyrosinase or cause apoptosis in melanocytes. We further found that A11 suppressed proliferation in melanocytes and reduced the number of differentiated melanocytes by activating MAPK (mitogen-activated protein kinase) and Akt. Finally, A11 also caused melanin reduction in mammalian melanocytes. Together, A11 might be a potent skin-lightening agent with novel mechanisms.

https://ift.tt/2zTFVGY

Site-specific investigation and spatial modeling of canopy drip effect on element concentrations in moss

Abstract

In this study, the canopy drip effect on the exposure of forests to atmospheric deposition of potentially toxic metals and nitrogen (N) and element accumulation was investigated. Thereby, the respective element concentrations of metals and N in moss specimens were investigated by example of North-Western Germany. To this end, on the one hand, the concentrations of Al, As, Cd, Cr, Cu, Fe, Hg, Pb, Ni, Sb, V, Zn, and N in mosses sampled under, outside, and at the edge of forest canopies were examined for statistical significant differences. On the other hand, vegetation structures parameterizing the canopy drip effect were quantified by use of information collected, in addition to the element data, at each moss sampling site. The statistical relations between ratios of vegetation parameters and ratios of element concentrations were modeled by regression analysis, and the respective element concentration in moss was geostatistically estimated and mapped for unsampled locations throughout Germany. This article tackles regression models with R² > 0.5 (Cu, Hg, Pb, Sb, and N) to adapt the element concentrations measured at the 400 sites of the European Moss Survey (EMS) to three different features of hypothetical vegetation structures. To this end, the continuum of vegetation structures were represented as follows: open land (meadows) described by a leaf area index (LAI) value of 2.96 and under canopy sites in coniferous forests represented by a LAI value of 11. The arithmetic mean of LAI values at 400 EMS sites throughout Germany amounts to 5.1. The element concentrations for these target LAIs representing three site categories were calculated and mapped. Then, these LAI-dependent element concentration maps were compared with the maps depicting the spatial patterns of "pure" element concentrations. Spatial differences were evaluated and supposed to be of great value for the validation of atmospheric deposition modeling.

https://ift.tt/2Luhdyc

Spatial and temporal variations in the geochemistry of shallow groundwater contaminated with nitrate at a residential site

Abstract

The concentrations of nitrate (NO₃⁻), major ions, and dissolved inorganic carbon (DIC) and the stable carbon isotopes of DIC (δ¹³C_DIC) in shallow groundwater below a 45 × 60 m residential property was investigated over a period of 38 months. Our aim was to identify the processes which control the spatial and temporal distribution of NO₃⁻ in the shallow groundwater and assess water-rock interactions linked to denitrification. Groundwater sampled quarterly from eight locations showed an average NO₃⁻ concentration of 36.8 mg/L and a range between 0.1 and 214.9 mg/L compared to the US EPA maximum contaminant level of 10 mg/L. Heterogeneity in nitrate distribution was from residential application of N-based fertilizers offsite and from onsite application on flower beds and for lawn care. The temporal behavior of nitrate at all eight groundwater locations was markedly different and independent of seasonal hydrologic variations. Nitrate attenuation was spatially controlled by heterogeneous denitrification and rain dilution near roof drains. Groundwater locations with active denitrification were characterized by higher DIC concentrations and lower δ¹³C_DIC from organic carbon mineralization and by higher ionic concentrations from weathering of aquifer minerals. The variation in the relative standard deviations (RSD) of the measured parameters over space (RSD-s) and time (RSD-t) was highest for NO₃⁻ associated with variable spatiotemporal input and lowest for pH, pCO₂, and δ¹³C_DIC indirectly controlled by denitrification. Denitrification induced mineral weathering products such as DIC, Ca²⁺, Mg²⁺, and HCO₃⁻ showed medium to high RSD-s and RSD-t. The RSD-s and RSD-t were positively correlated (R² = 0.85) with the RSD-s showing approximately twofold higher magnitude than RSD-t due to greater variability between monitoring wells locations than variability at each groundwater location over time. Nitrate contamination and denitrification represent important long-term driver of aquifer weathering and changes in groundwater geochemistry below residential communities.

https://ift.tt/2NZodVr

Microscale dispersion behaviors of dust particles during coal cutting at large-height mining face

Abstract

In order to ensure safe production and occupational health at a large-mining-height fully mechanized mining face in a coal mine, the present study firstly establishes an airflow-dust coupled model based on gas/solid two-phase flow equations and combines numerical simulation and field measurement for analyzing the dispersion pattern of dust particles with various sizes for different coal cutter locations. Results show that, due to the existence of drums, airflow deviates from the original direction and enters the footway. Driven by the airflow, dust particles enter the footway at different locations depending on coal cutter locations. The coal-cutting location (denoted as P_rl) and the location where dust particles enter the footway (denoted as P_dt) are correlated as follows: P_dt(P_rl) = − 0.0007P_rl² + 1.0343P_rl − 3.3536. When P_rl < 55 m, dust particles produced by the rear drum during coal cutting enter the footway earlier than those produced by the front drum, leading to the first and second dust concentration peaks in respiratory zones of footway. Dust suppression effects are assessed in these regions based on the first and second dust concentration peaks. Due to the superposition of the concentration fields associated with dust particles 2.5, 7, and 20 μm in diameter, dust concentration 25 m down the leeward side of the coal cutter can reach 1440 mg/m³. The concentration of dust particles with a diameter of 40 μm drops steadily and approaches 0 at the return corner. The dust particles 80 μm in diameter are fully settled within 22 m down the leeward side of the coal cutter. A comparison with the field measurement indicates that the present simulation results are highly accurate.

Graphical abstract

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Campbell de Morgan Spots (Cherry Angiomas) Show Endothelial Proliferation

Abstract: Campbell de Morgan spots (also known as adult hemangiomas, cherry angiomas, or senile angiomas) show clinical and histopathological features that make them distinct. Despite this, they are not included as benign vascular tumors in the current classification by the International Society for Vascular Anomalies (ISSVA). In the current study, we investigated the proliferation rate (Ki67) of the endothelia of 23 cases of Campbell de Morgan spots, as well as the immunoexpression of Wilms tumor protein 1 (WT1) by these vascular anomalies. The youngest patient was 24 years old (range: 24–80; mean: 52.61). Ten patients were women (43.48%). All cases showed intense cytoplasmic expression of WT1 by the endothelia in 80%–100% of the endothelial cells. Ki67 demonstrated proliferation by the endothelia of all vascular lesions. A mean of 1077.6 nuclei were evaluated per case. Eight cases showed a very low proliferation (less than 0.5% of the nuclei). In the other 15 cases, the proliferation ranged from 0.59% to 3.59% (mean: 1.89%). Correspondence: Angel Fernandez-Flores, MD, PhD, Department of Cellular Pathology, Servicio de Anatomía Patologica, Hospital El Bierzo, Medicos sin Fronteras 7, 24411, Ponferrada, Spain (e-mail: dermatopathonline@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Indeterminate Cell Histiocytosis and Mycosis Fungoides. A Hitherto Unreported Association

No abstract available

https://ift.tt/2msZR9U

Uncommon Histopathological Variants of Malignant Melanoma: Part 1

Abstract: Despite new horizons opened by recent advances in molecular pathology, histological evaluation still remains the diagnostic gold standard regarding cutaneous melanocytic neoplasms. Several histological variants of melanoma have been described, and their knowledge is crucial for accurate diagnosis and classification of cases with unusual clinicopathological features. Uncommon histological variants of melanoma have been described based on a broad constellation of features, including architectural pattern, stromal alterations, cytological attributes, and other morphological properties. This review is aimed at providing an extensive discussion of unusual but distinctive histopathological variants of melanoma. Correspondence: Lorenzo Cerroni, MD, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Austria (e-mail: lorenzo.cerroni@medunigraz.at). All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Do Patterns of Reconstruction Choices After Mohs Surgery Vary by Specialty? A Pilot Study of Mohs Surgeons and Facial Plastic Surgeons

BACKGROUND Differences in approach to repair a specified defect after Mohs micrographic surgery (MMS) between specialties have not been previously examined. OBJECTIVE To assess the difference in frequency of which reconstruction repairs are selected after MMS, among Mohs surgeons and facial plastic surgeons (FPS), and evaluate whether the level of satisfaction with the final repair outcome differed between specialties. MATERIALS AND METHODS The study was approved by the Saint Louis University Institutional Review Board. A link to the survey was distributed to members of American College of Mohs Surgery (ACMS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), between January and May 2016. RESULTS The reconstructive procedure selected most often ("top choice") was not significantly different between Mohs surgeons and FPS for the majority of the images. There was no material difference in how dermatologists and FPS rate the aesthetic outcome of the 3 presented closure types, with the exception of one closure type—nose with graft. CONCLUSION Mohs surgeons were found to more likely cluster around a single preference for their reconstruction technique compared with FPS, in which a higher percentage of surgeons also selected other options. Address correspondence and reprint requests to: Ian A. Maher, MD, 1755 S. Grand Avenue, 2nd Floor, St. Louis, MO 63104, or e-mail: maheria@slu.edu 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 Web site (https://ift.tt/2bw6lgr). The authors have indicated no significant interest with commercial supporters. A.O. Kurta and D. Sarhaddi contributed equally to the project and are co-first authors. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Injectable Platelet-, Leukocyte-, and Fibrin-Rich Plasma (iL-PRF) in the Management of Androgenetic Alopecia

BACKGROUND The role of enriched autologous plasmas in androgenetic alopecia (AGA) management is emerging in recent literature. OBJECTIVE In this prospective study, the authors aimed to confirm that the induction of a minor local trauma immediately followed by injections of an enriched plasma made of a strongly concentrated platelet fraction, a robust white cell presence, concentrated fibrinogen, and other plasma proteins (injectable leukocyte platelet-rich fibrin [iL-PRF]) could be able to produce positive clinical results in patients with AGA. MATERIALS AND METHODS A 2-injection regimen was instituted, with a 3-month interval between the 2 interventions. A treatment group (TG) and a control group (CG) were instituted. Macrophotographs were taken at baseline and after 6 months, and rated by 5-people expert panel (blinded to this assignment) using the 15-point scale proposed by Jaeschke to evaluate the clinical change. RESULTS Overall, TG showed better scores compared with the CG in all 5 classes of global physician assessment at baseline, all age groups, and in both sexes, and such differences always reached statistical significance. A greater severity at baseline showed a larger improvement after treatment in the TG. CONCLUSION This study provides preliminary evidence that the biological composition of the iL-PRF is of crucial importance in ensuring a good degree of clinical efficacy in patients with AGA. Address correspondence and reprint requests to: Andrea Paradisi, MD, Dermatology Unit, "Cristo Re" General Hospital, Via delle Calasanziane 25, 00168 Rome, Italy, or e-mail: aparad78@gmail.com This work has been supported in part by the "Progetto Ricerca Corrente—2016" of the Italian Ministry of Health. The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience

BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. Address correspondence and reprint requests to: Galina Balakirski, MD, Department of Dermatology and Allergology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany, or e-mail: galina.balakirski@ukbonn.de The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Unique Tumor Heterogeneity Within a Single Locally Advanced Basal Cell Carcinoma Resulting in Partial Response Despite Continuous Vismodegib Treatment

No abstract available

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Emerging Nonsurgical Therapies for Locally Advanced and Metastatic Nonmelanoma Skin Cancer

BACKGROUND Locally advanced and metastatic nonmelanoma skin cancer (NMSC) not amenable to surgical resection requires a different approach to therapy. OBJECTIVE To review the efficacy and adverse effects of emerging treatment options for locally advanced and metastatic NMSC. MATERIALS AND METHODS A comprehensive search on PubMed was conducted to identify relevant literature investigating the role of program cell death 1 (PD-1) inhibitor, cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor, epidermal growth factor receptor (EGFR) inhibitor, and Hedgehog pathway inhibitors in the treatment of NMSC. RESULTS PD-1 inhibitor and CTLA-4 inhibitor have shown promising efficacy with tolerable side-effect profiles in the treatment of NMSC, although the number of cases reported is limited. Currently, 3 larger-scale clinical trials are investigating PD-1 inhibitor therapy for NMSC. Similarly, EGFR inhibitor demonstrated marginal success in unresectable cutaneous squamous cell carcinomas. Hedgehog pathway inhibitors were approved by the US FDA for treatment of locally advanced and metastatic basal cell carcinomas and have shown favorable efficacy. Common adverse effects included muscle spasm, alopecia, and dysgeusia. CONCLUSION Systemic therapies including PD-1 inhibitors and CTLA-4 inhibitors have demonstrated early promising results for difficult-to-treat NMSC. Future studies are necessary to optimize treatment outcome. Address correspondence and reprint requests to: Michael R. Migden, MD, Departments of Dermatology and Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 1452, Houston, TX 77030, or e-mail: mrmigden@mdanderson.org M.R. Migden has participated on advisory boards and received honoraria from Genentech, Inc.,; Novartis Pharmaceuticals Corporation; Eli Lilly and Company; and Sun Pharmaceutical Industries. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Bone tissue reaction, setting time, solubility, and pH of root repair materials

Abstract

Objectives

This study aims to compare the bone tissue reaction, setting time, solubility, and pH of NeoMTA Plus, Biodentine (BD), and MTA Angelus (MTA-A).

Materials and methods

Initial and final setting times (n = 7) and solubility up to 7 days (n = 11) were evaluated in accordance with ASTM C266–15 and ANSI/ADA Specification No. 57, respectively. pH (n = 10) was measured up to 28 days. Bone tissue reactions in 48 rats' femur were histologically analyzed after 7, 30, and 90 days. ANOVA and Tukey's tests compared setting time, solubility, and pH data; bone reactions data were compared by Kruskal-Wallis and Dunn's tests.

Results

NeoMTA Plus had longer initial and final setting times than MTA-A and BD (P < 0.05). At 7 days, BD showed the highest solubility, similar to NeoMTA Plus (P > 0.05) and different from MTA-A (P < 0.05). NeoMTA Plus had a progressive mass loss over time; at 7 days, it was significantly different from the initial mass (P < 0.05). BD showed higher pH in the periods assessed when compared to the other materials (P < 0.05). Bone tissue repair had no differences between groups in each experimental period (P > 0.05). All groups presented no difference from 30 to 90 days (P > 0.05) and had better bone repair at 90 days than at 7 days (P < 0.05).

Conclusions

NeoMTA Plus, BD, and MTA-A showed satisfactory setting time, high mass loss, alkaline pH, and allowed bone repair.

Clinical relevance

Calcium silicate-based cements are indicated for multiple clinical situations. NeoMTA Plus and BD showed satisfactory physical-chemical and biological properties, being considered as alternatives to MTA-A, as root repair materials for clinical use.

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Effects of non-thermal atmospheric plasma treatment on dentin wetting and surface free energy for application of universal adhesives

Abstract

Objectives

The study aims to evaluate the effects of non-thermal atmospheric plasma (NTAP) treatments on dentin wetting and surface free energy (SFE) and compare the effects of NTAP treatment, etch-and-rinse, and self-etch protocols for application of universal adhesives.

Materials and methods

Mid-coronal dentin of intact third molars was used to measure contact angles of distilled water, ethylene-glycol, and diiodomethane and calculate SFE following different NTAP preset treatments (feeding gas consisting of pure He, He + 1% O₂, He + 1.5% O₂), power input (1 or 3 W), and tip-to-surface distance (2, 4, or 8 mm). Contact angles of reference liquids and SFE of dentin following He + 1.5% O₂ at 3-W and 4-mm treatment was compared to phosphoric acid etching. Contact angles of Single Bond Universal (SBU; 3M ESPE) and Clearfil Universal Bond (CUB; Kuraray Noritake) were measured following NTAP, etch-and-rinse, and self-etch protocols.

Results

NTAP significantly reduced contact angles of reference liquids and increased dentin SFE compared to untreated dentin (p < 0.05). O₂ intensified the effect of He NTAP (p < 0.05). NTAP and phosphoric acid increased dentin polarity and Lewis base surface characteristics. Phosphoric acid increased contact angles of adhesives compared to the self-etch protocol (p < 0.05). NTAP resulted in lower adhesive contact angles than phosphoric acid, the difference being statistically significant for CUB (p < 0.05). Compared to the self-etch protocol, NTAP slightly reduced CUB contact angle but not that of SBU (p > 0.05).

Conclusions

He NTAP with and without O₂ increased dentin wetting and SFE, surpassing the effect of phosphoric acid and lowering adhesive contact angles. NTAP produced no apparent micro-morphological changes on dentin surface comparable to acid etching.

Clinical significance

NTAP treatment of dentin prior to adhesive application increases dentin wetting and surface free energy facilitating better adhesive distribution on dentin surface compared to phosphoric acid etching and similar to the "self-etch" application protocol.

https://ift.tt/2uv5ER0

Hair mercury concentrations in the spotted seal ( Phoca largha ) pups from the Sea of Japan

Abstract

This publication presents the results of a study of the total mercury (THg) concentration in the fetal hair (lanugo) of the young spotted seals inhabiting the Peter the Great Bay, Sea of Japan. We analyzed samples from pups that were collected in 2014–2017 at the seal breeding grounds. The concentration of total mercury was determined by atomic absorption spectrometry. The concentration of THg ranged from 1.52 to 6.68 μg/g dry weight. Mercury concentration in the lanugo exceeds that found in the environment (bottom sediments, sea water) and in other animals inhabiting the Bay. At the same time, the level was generally lower than that found in young seals of most other pinniped species (Steller sea lion Eumetopias jubatus, Northern fur seal Callorhinus ursinus, Harbor seal Phoca vitulina richardsi, Northern elephant seal Mirounga angustirostris, California sea lion Zalophus californianus) from the North Pacific.

https://ift.tt/2zRoKpm

Efficacy & Safety of OPN-375 Adults With Bilateral Nasal Polyps Using Nasoendoscopic Video

Condition:   Bilateral Nasal Polyposis
Intervention:   Drug: OPN-375
Sponsor:   Optinose US Inc.
Recruiting

https://ift.tt/2zO4vZR

A Phase 1b Dose Escalation/Expansion Study of Abexinostat in Combination With Pembrolizumab in Patients With Advanced Solid Tumor Malignancies

Conditions:   Stage III Cutaneous Melanoma;   Stage IV Cutaneous Melanoma;   Locally Advanced Melanoma;   Locally Advanced Solid Neoplasm;   Metastatic Head and Neck Squamous Cell Carcinoma;   Metastatic Malignant Solid Neoplasm;   Metastatic Melanoma;   Metastatic Urothelial Carcinoma;   Non-Small Cell Lung Carcinoma;   Stage IB Lung Cancer AJCC v7;   Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8;   Stage III Lung Cancer AJCC v8;   Stage III Ureter Cancer AJCC v8;   Stage IIIA Lung Cancer AJCC v8;   Stage IIIB Lung Cancer AJCC v8;   Stage IIIC Lung Cancer AJCC v8;   Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8;   Stage IV Lung Cancer AJCC v8;   Stage IV Ureter Cancer AJCC v8;   Stage IVA Lung Cancer AJCC v8;   Stage IVB Lung Cancer AJCC v8
Interventions:   Drug: Abexinostat;   Biological: Pembrolizumab
Sponsors:   Rahul Aggarwal;   Xynomic Pharmaceuticals, Inc.
Not yet recruiting

https://ift.tt/2mswQLL

Papuloerythroderma of Ofuji successfully treated with methotrexate

Dermatologic Therapy, EarlyView.


https://ift.tt/2uLplD7

Hyaluronic acid filler for skin rejuvenation: The role of diet on outcomes. A pilot study

Dermatologic Therapy, EarlyView.


https://ift.tt/2LhqLQ5

Scholar : These new articles for International Journal of Performance Arts and Digital Media are available online

The online platform for Taylor & Francis Online content New for International Journal of Performance Arts and Digital Media and online now on Taylor & Francis Online: Original Articles Seeing and feeling in VR: bodily perception in the gaps between layered realities Lisa May Thomas & David R. Glowacki Pages: 1-24 | DOI: 10.1080/14794713.2018.1499387 RISE UP and join us at the American Alliance for Theatre & Education National Conference this summer – August 1-5 in Minneapolis! 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.

Experimental Study of Build Orientation in Direct Metal Laser Sintering of 17-4PH Stainless Steel

3D Printing and Additive Manufacturing, Ahead of Print.


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Editorial Board

Publication date: August 2018

Source: Journal of Autoimmunity, Volume 92

Author(s):

https://ift.tt/2zZHbZh

Scholar : These new articles for Activities, Adaptation & Aging are available online

The online platform for Taylor & Francis Online content New for Activities, Adaptation & Aging and online now on Taylor & Francis Online: Original Articles The impact of "The Art of Happiness" class on community dwelling older adults: a positive psychology intervention Katie E. Greenawalt, Elizabeth Orsega-Smith, Jennie L. Turner, Steve Goodwin & Erica J. Rathie Pages: 1-15 | DOI: 10.1080/01924788.2018.1493898 FREE ACCESS: Health Care for Women International: Research on Women's Health in Africa: Issues, Challenges & Opportunities 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.

A phase I pharmacokinetic and pharmacodynamic study of GTI-2040 in combination with gemcitabine in patients with solid tumors

Abstract

Purpose

GTI-2040 is a novel antisense oligonucleotide inhibitor of the R2 subunit of ribonucleotide reductase. This phase I study assessed safety and maximum tolerated dose (MTD) of GTI-2040 in combination with weekly gemcitabine in patients with advanced solid tumors.

Methods

GTI-2040 was given as a 14-day continuous intravenous infusion, while gemcitabine was administered on days 1, 8, and 15. This combination was repeated every 4 weeks and study followed a modified 3 + 3 Fibonacci schema. Incidence, severity of adverse events, pharmacokinetics (PK), and pharmacodynamics (PD) was assessed. Responses were assessed using RECIST criteria version 1.0 with CT scans performed after every other cycle.

Results

A total of 16 patients received at least one dose of GTI-2040/gemcitabine and were included in the safety analysis. The MTD of this regimen is 100 mg/m²/day of GTI-2040 over 14 days combined with 400 mg/m²/day of gemcitabine administered weekly on days 1, 8, and 15. The dose-limiting toxicities (DLTs) included grade 3 fatigue and thrombocytopenia with hematemesis (both at 100/600 mg/m²/day). The most common adverse events were grade 1/2 fatigue, nausea, vomiting, diarrhea, and anorexia. There was no evidence of alteration in gemcitabine PKs. PD modulation of R2mRNA expression in peripheral blood mononuclear cells was observed. No objective tumor response was observed although stable disease was seen in 25% patients.

Conclusions

The combination of GTI-2040 and gemcitabine has an acceptable safety profile in a heavily pre-treated patient population with advanced solid tumors. No clear signal of anti-tumor activity was observed; however, several patients had prolonged stable disease.

https://ift.tt/2mqAvcX

Scholar : African Journal of Aquatic Science, Volume 43, Issue 2, June 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content African Journal of Aquatic Science, Volume 43, Issue 2, June 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Research Papers Evidence for diet partitioning among three coexisting native freshwater fishes in South Africa's Cape Fold Ecoregion JM Shelton, MS Bird & SM Marr Pages: 89-100 | DOI: 10.2989/16085914.2018.1470490 Reproductive strategies of smooth-head catfish Clarias liocephalus (Boulenger, 1898), in the Rwizi-Rufuha wetland system, south-western Uganda J Yatuha, J Rutaisire, L Chapman, J Kang'ombe & D Sikawa Pages: 101-109 | DOI: 10.2989/16085914.2018.1470082 Can the presence of curved forms of the diatom Aulacoseira ambigua in the Nile (Egypt) and Vaal (South Africa) Rivers be ascribed to similar water quality conditions? S Janse van Vuuren, AA Saber, A Swanepoel & M Cantonati Pages: 111-122 | DOI: 10.2989/16085914.2018.1455575 Cyanotoxins in small artificial dams in Kenya utilised for cage fish farming – a threat to local people? MN Kaggwa, N Straubinger-Gansberger & M Schagerl Pages: 123-129 | DOI: 10.2989/16085914.2018.1470084 Biodiversity and ecology of epilithic diatoms in the Agnéby River, Ivory Coast KR N'Guessan, BRD Aboua, J Tison-Rosebery, A Ouattara & EP Kouamelan Pages: 131-140 | DOI: 10.2989/16085914.2018.1470083 Evaluation of satellite retrievals of water quality parameters for Lake Victoria in East Africa A Gidudu, R Mugo, L Letaru, J Wanjohi, R Nakibule, E Adams, A Flores, B Page & W Okello Pages: 141-151 | DOI: 10.2989/16085914.2018.1446899 Suppression of the aquatic weed Hydrilla verticillata (L.f.) Royle (Hydrocharitaceae) by a leaf-cutting moth Parapoynx diminutalis Snellen (Lepidoptera: Crambidae) in Jozini Dam, South Africa A Bownes Pages: 153-162 | DOI: 10.2989/16085914.2018.1462758 Effect of drift sampler exposure time and net mesh size on invertebrate drift density in the Njoro River, Kenya PW Mureithi, JG Mbaka, CM M'Erimba & JM Mathooko Pages: 163-168 | DOI: 10.2989/16085914.2018.1465394 Short Note Trophic state and nutrient limitation in Lake Baringo, Kenya EO Okech, N Kitaka, SO Oduor & D Verschuren Pages: 169-173 | DOI: 10.2989/16085914.2018.1462139 First records of Atyoida serrata (CS Bate, 1888) from South Africa (Crustacea: Caridea: Atyidae) M Coke Pages: 175-177 | DOI: 10.2989/16085914.2018.1474084 A mass mortality of fishes caused by receding water levels in the vegetated littoral zone of the West Kleinemonde Estuary, South Africa AK Whitfield & PD Cowley Pages: 179-186 | DOI: 10.2989/16085914.2018.1466685 Record of Blue tilapia Oreochromis aureus (Steindachner, 1864) in the Eerste River catchment, Western Cape province, South Africa SM Marr, G Gouws, S Avlijas, D Khosa, ND Impson, M van der Westhuizen & OLF Weyl Pages: 187-193 | DOI: 10.2989/16085914.2018.1455576 Studies on the biology of Nile tilapia (Oreochromis niloticus) in Lake Victoria, Kenya: in light of intense fishing pressure E Yongo, N Outa, K Kito & Y Matsushita Pages: 195-198 | DOI: 10.2989/16085914.2018.1455574 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. 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 : These new articles for Norwegian Archaeological Review are available online

The online platform for Taylor & Francis Online content New for Norwegian Archaeological Review and online now on Taylor & Francis Online: Book Reviews The Oxford Handbook of The Prehistoric Arctic Eirik Haug Røe Pages: 1-3 | DOI: 10.1080/00293652.2018.1497084 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.

Novel frontiers in detecting cancer metastasis

Abstract

Cancer microenvironment is the critical battle ground between the cancer cells and host response. Thus, more emphasis is directed to study the relationship between cancer cells and the stromal cells. Multiplex microscopy is an emerging technique in which multiple cell populations within the cancer microenvironment may be stained so that spatial relationship between cancer cells and, in particular, the immune cells may be studied during different stages of cancer development. Recent discovery of mutational burden and neoantigens in cancer has opened new landscapes in the interaction of host immune cells and cancer neoantigens. The emerging role of miRNAs may become an added dimension to study cancer beyond traditional pathway of DNA directed RNA being associated with the malignant behavior of cancer. Circulating tumor cells, cancer markers and ctDNA can be used as markers for circulating cancer cells in the blood. Further studies are needed to validate if liquid biopsy of cancer may become a routine clinical tool to screen cancer or follow patients for recurrence or responses to treatment.

https://ift.tt/2NX3Qs5

Accuracy assessment of a potential clinical use of navigation-guided intra-operative liver metastasis brachytherapy—a planning study

Abstract

For patients with inoperable liver metastases, intra-operative liver high dose-rate brachytherapy (HDR-BT) is a promising technology enabling delivery of a high radiation dose to the tumor, while sparing healthy tissue. Liver brachytherapy has been described in the literature as safe and effective for the treatment of primary or secondary hepatic malignancies. It is preferred over other ablative techniques for lesions that are either larger than 4 cm or located in close proximity to large vessels or the common bile duct. In contrast to external beam radiation techniques, organ movements do not affect the size of the irradiated volume in intra-operative HDR-BT and new technical solutions exist to support image guidance for intra-operative HDR-BT. We have retrospectively analyzed anonymized CT datasets of 5 patients who underwent open liver surgery (resection and/or ablation) in order to test whether the accuracy of a new image-guidance method specifically adapted for intra-operative HDR-BT is high enough to use it in similar situations and whether patients could potentially benefit from navigation-guided intra-operative needle placement for liver HDR-BT.

https://ift.tt/2Jzdu0j

Scholar : Astropolitics, Volume 16, Issue 2, May-August 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Astropolitics, Volume 16, Issue 2, May-August 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Articles Treating Outer Space Like a Place: A Case for Rejecting Other Domain Analogies Elizabeth Mendenhall Pages: 97-118 | DOI: 10.1080/14777622.2018.1484650 Counterspace Operations and Nascent Space Powers Zaeem Shabbir & Ali Sarosh Pages: 119-140 | DOI: 10.1080/14777622.2018.1486792 Space Traffic Management at the National and International Levels Gerie W. Palanca Pages: 141-156 | DOI: 10.1080/14777622.2018.1484651 Fighting a War in Space: The Case for a Space Innovation Force Michael Nayak Pages: 157-173 | DOI: 10.1080/14777622.2018.1486173 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.

Large-Volume Infusions into the Brain: A Comparative Study of Catheter Designs

Background/Aims: "Whole-brain" infusions have emerged as a potential need with the promise of disease-modifying therapies for neurodegenerative diseases. In addition, several current clinical trials in brain cancer utilize direct delivery of drugs that are required to fill large volumes. Such requirements may not be well served by conventional single port catheters with their "point source" of delivery. Our aim is to examine infusions into large volumes of heterogeneous tissue, aiming for uniformity of distribution. Methods: A porous catheter (porous brain infusion catheter, PBIC), designed by Twin Star TDS LLC, for brain infusions was developed for this study and compared with another convection-enhanced delivery catheter (SmartFlow^TM NGS-NC-03 from MRI Interventions, a step end-port catheter, SEPC) in current use in clinical trials. The studies were in vivo in porcine brain. A total of 8 pigs were used: the size of the pig brain limited the porous length to 15 mm. The placements of the tips of the two catheters were chosen to be the same (at the respective brain hemispheres). Results: The PBIC and SEPC both performed comparably and well, with the PBIC having some advantage in effecting larger distributions: p ∼ 0.045, with 5 infusions from each. Conclusions: Given the performance of the PBIC, it would be highly appropriate to use the device for therapeutic infusions in human clinical trials to assess its capability for large-volume infusions.
Stereotact Funct Neurosurg

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Patient-Reported Outcome Measures for Pediatric Psoriasis: A Systematic Review and Critical Appraisal from International Dermatology Outcome Measures (IDEOM)

Childhood onset psoriasis has a profound impact on the development and quality of life of pediatric patients. Consequently, validated patient-reported outcome measures (PROMs) for pediatric psoriasis are vital to patient care. We sought to critically appraise the literature on the measurement properties of PROMs used in the pediatric psoriasis population. We performed a 2-stage systematic literature synthesis in MEDLINE (1950–2017) and EMBASE (1947–2017) to identify PROMs and studies evaluating their measurement properties. Analysis of studies followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology to inform a best evidence synthesis. From 1,128 articles, we identified 29 PROMs. Subsequently, we identified 8 studies evaluating the measurement properties of 7 instruments. Among these instruments, the Simplified Psoriasis Index (SPI) achieved a positive rating for criterion validity, the Dutch version of the Children's Dermatology Life Quality Index (CDLQI) achieved a positive rating for hypothesis testing, and the Swedish version of the CDLQI achieved a negative rating for hypothesis testing. All other assessed measurement properties received indeterminate or unknown ratings due to flaws in study design. PROMs are paramount to the management of pediatric psoriasis. This synthesis emphasizes the critical need for additional studies to further describe the measurement properties of PROMs used in pediatric psoriasis and identify validated, standardized measures for use in clinical practice and research.
Dermatology

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Comparison of a novel clinical score to estimate the risk of REsidual neuromuscular block Prediction Score and the last train-of-four count documented in the electronic anaesthesia record: A retrospective cohort study of electronic data on file

BACKGROUND Residual neuromuscular block (rNMB) after surgery is not difficult to identify if proper neuromuscular monitoring is used, but many clinicians do not use quantitative neuromuscular monitoring. OBJECTIVE The aim of this study was to develop a REsidual neuromuscular block Prediction Score (REPS) to predict postoperative rNMB and compare the predictive accuracy of the prediction score with train-of-four count (TOFC) measurement at the end of a surgical case. DESIGN Retrospective cohort study of data on file. DATA SOURCE Electronic patient data and peri-operative data on vital signs, administered medications, and train-of-four ratio (TOFR) obtained in the postoperative recovery rooms [postanaesthesia care unit (PACU)] at Massachusetts General Hospital in Boston, Massachusetts, USA. PATIENTS Quantitative TOFR measurements obtained on admission to the PACU were available from 2144 adult noncardiac surgical patients. MAIN OUTCOME MEASURE Presence of rNMB at PACU admission, defined as a TOFR of less than 0.9. RESULTS In the score development cohort (n=2144), rNMB occurred in 432 cases (20.2%). Ten independent predictors for residual paralysis were identified and used for the score development. The final model included: hepatic failure, neurological disease, high-neostigmine dose, metastatic tumour, female sex, short time between neuromuscular blocking agent administration and extubation, aminosteroidal neuromuscular blocking agent, BMI more than 35, absence of nurse anaesthetist and having an experienced surgeon. The model discrimination by C statistics was 0.63, 95% confidence interval (0.60 to 0.66), and risk categories derived from the REPS had a higher accuracy than the last documented intra-operative TOFC for predicting rNMB (net reclassification improvement score 0.26, standard error 0.03, P 

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Near-infrared spectroscopy in vegetables and humans: An observational study

BACKGROUND Cerebral near-infrared spectroscopy (NIRS) of tissue oxygen saturation is claimed to be a surrogate marker for global cerebral perfusion. Increasingly, NIRS target-based therapy has been used during cardiac surgery in the hope of decreasing the incidence of adverse neurological outcome. OBJECTIVES We report NIRS values for some common vegetables and faculty at a world-class medical institution. DESIGN Observational nonblinded study. SETTING Single tertiary care institution and local urban vegetable market. PARTICIPANTS Five yams (Dioscorea cayenensis), five courgettes (Cucurbita pepo) and five butternut squashes (Cucurbita moschata) were studied. Five cardiothoracic surgeons and anaesthesiologists were the control group. INTERVENTIONS None. MAIN OUTCOME MEASURES NIRS value of each species. RESULTS Mean NIRS value for the control group was 71% [95% confidence interval (CI) 68 to 74] and was similar to that of the yellow squashes [75% (95% CI 74 to 76)]. These values were significantly greater than the NIRS measurements of both the butternut squash and yam [63% (95% CI 62 to 64) and 64% (95% CI 63 to 65), respectively, P 

https://ift.tt/2JD1Guk

Combination of paromomycin plus human anti-TNF-α antibodies to control the local inflammatory response in BALB/ mice with cutaneous leishmaniasis lesions

Publication date: Available online 17 July 2018

Source: Journal of Dermatological Science

Author(s): Juana Schwartz, Esther Moreno, Alba Calvo, Laura Blanco, Celia Fernández-Rubio, Carmen Sanmartín, Paul Nguewa, Juan M. Irache, Esther Larrea, Socorro Espuelas

Abstract

Background

Cutaneous leishmaniasis (CL) skin lesions are the result of a deregulated immune response, which is unable to eliminate Leishmania parasites. The control of both, parasites and host immune response, is critical to prevent tissue destruction. The skin ulceration has been correlated with high TNF-α level.

Objective

Because human anti-TNF-α antibodies (Ab) have been successfully assayed in several mice inflammatory diseases, we hypothesized that their anti-inflammatory effect could optimize the healing of CL lesions achieved after topical application of paromomycin (PM), the current chemotherapy against CL.

Methods and results

We first compared the in vitro efficacy of PM and Ab alone and the drug given in combination with Ab to assess if the Ab could interfere with PM leishmanicidal activity in L. major-infected bone marrow-derived macrophages. The combination therapy had similar antileishmanial activity to the drug alone and showed no influence on NO production, which allows macrophage-mediated parasite killing. Next, we demonstrated in an in vivo model of Imiquimod®-induced inflammation that topical Ab and PM inhibit the infiltration of inflammatory cells in the skin. In the efficacy studies in L. major-infected BALB/c mice, PM combined with Ab led to a sharp infection reduction and showed a stronger anti-inflammatory activity than PM alone. This was confirmed by the down-regulation of TNF-α, IL-1β, iNOS, IL-17, and CCL3 as well as by a decrease of the neutrophilic infiltrate during infection upon treatment with the Ab.

Conclusions

In terms of parasite elimination and inflammation reduction, topical application of Ab in combination with PM was more effective than the drug alone.

https://ift.tt/2NnxdCA

Investigation of zero TE MR in preoperative planning in dentistry

Publication date: Available online 17 July 2018

Source: Magnetic Resonance Imaging

Author(s): Yu Kang, Cong Hua, Bing Wu, Zhenyu Zhou, Yongwei Xu, Peng Wu, Haifeng Wang, Nan Hong

Abstract

Preoperative planning in dentistry relies on imaging to assess the separation between the teeth and mandibular canal. Cone beam CT(CBCT) shows inferior contrast of the mandible canal and features radiation. In this work, the use of zero TE (zTE) imaging as an alternative to CBCT imaging for preoperative planning in dentistry is investigated. Twenty-two patients (11 males, 11 females, age 26–65) were enrolled in this prospective study. The performance of zTE imaging was assessed using CBCT as a gold standard in preoperative planning for tooth extraction (qualitative classification) and implanting (quantitative dimensional measurement). Zero TE imaging showed clear delineation of teeth and mandible, and showed better depiction of the mandible canal as compared to CBCT. In assessing the spatial relationship between the third molar and the mandibular canal, identical results were obtained from two readers based on zTE and CBCT images; in spatial measurements related to the second premolar, high intraclass coefficient was obtained in all the performed measurements between zTE and CBCT (0.782 to 0.921) and between reviewers (0.812 to 0.958). The results of Bland Altman analysis also indicated low level of bias (max −1.8%) and disagreements (max −15.1% to 11.3%) between the results of zTE and CBCT. Zero TE imaging may be a potential imaging tool in preoperative planning in dentistry when CBCT is undesirable.

https://ift.tt/2uLGBYW

Changes in periapical status, quality of root fillings and estimated endodontic treatment need in a similar urban German population 20 years later

Abstract

Objectives

The study aimed at assessing, as primary objective, the periapical status and quality of root fillings, and, as secondary objective, the endodontic treatment need of a German urban population in a cross-sectional study 20 years after the first one.

Materials and methods

Clinical and radiographic data of 353 patients were evaluated. Descriptive and regression analyses were performed and the endodontic treatment need was calculated. Results were compared with data from the year 1993.

Results

A total of 9269 teeth were examined (26.2 teeth per patient; 1993, 24.4), of which 337 teeth were root filled (3.6%; 1993, 2.7%). Prevalence of apical periodontitis in root-filled teeth was 34% (1993, 61%). Quality of root fillings was adequate in 117 cases (35%; 1993, 14%). Minimum endodontic treatment need was estimated with 1.6% (1993, 2.3%), including teeth with clinical symptoms. Considering symptomless teeth with apical periodontitis and poor quality of root filling, the treatment need was 2.9% (1993, 3.7%). Regression analysis identified quality of root filling as a significant factor for periapical health (p = 0.01, odds ratio 3.4×, 95% CI 1.9–6.3×), likewise the type of instrumentation. Teeth treated with rotary files had a significantly better outcome (p = 0.02, odds ratio 2.0×, 95% CI 1.1–3.7×).

Conclusions

Quality of root fillings and the periapical status have improved over the last 20 years in Germany. However, there is still a need for an increase in quality of root canal treatment.

https://ift.tt/2LsT1MC

RECOTOX, a French initiative in ecotoxicology-toxicology to monitor, understand and mitigate the ecotoxicological impacts of pollutants in socioagroecosystems

Abstract

RECOTOX is a cross-cutting initiative promoting an integrated research to respond to the challenges of monitoring, understanding, and mitigating environmental and health impacts of pesticides in agroecosystems. The added value of RECOTOX is to develop a common culture around spatial ecotoxicology including the whole chain of pressure-exposure-impact, while strengthening an integrated network of in natura specifically equipped sites. In particular, it promotes transversal approaches at relevant socioecological system scales, to capitalize knowledge, expertise, and ongoing research in ecotoxicology and, to a lesser extent, environmental toxicology. Thus, it will open existing research infrastructures in environmental sciences to research programs in ecotoxicology of pesticides.

https://ift.tt/2uQKZ9p

“Anatomic Basis of the Gastroepiploic Vascularized Lymph Node Transfer: A Radiographic Evaluation Using Computed Tomography Angiography (CTA)”

PURPOSE: The omentum, nourished by the gastroepiploic vessels, has gained popularity as an option for vascularized lymph node transfer (VLNT). The anatomy of the gastroepiploic vessels, omentum, and lymph nodes (LN) has not been investigated. The purpose of this study is to describe the right gastroepiploic artery (GEA) and related structures by using computed tomography angiography (CTA). MATERIALS AND METHODS: A retrospective analysis was conducted on 34 patients who received CTA. Statistical models were applied to identify right GEA and LN anatomical characteristics. RESULTS: The right GEA was identified in 33 of 34 patients. It was found to have a diameter of 2.49mm at its origin (SD 0.66). The gastroduodenal artery length prior to right GEA takeoff was 3.09cm (SD 1.31). Twenty-five patients had lymph nodes in the right GEA lymphosome. There were 2.7 LNs identified per patient (SD 2.12). The distance from the right GEA origin to the most proximal LN was 3.99cm (SD 2.21). The distance from the GEA origin to the third LN was 9.12cm (SD 5.06). Each LN was within 7.00mm (SD 6.2) of the right GEA. CONCLUSIONS: When using the right GEA donor site for VLNT, the plastic surgeon should anticipate using a pedicle length of 4cm, a total flap length of 9cm with 3cm of surrounding tissue in order to obtain at least 3 lymph nodes for transfer. CTA is an effective imaging modality that can be used for patient-specific surgical navigation prior to vascularized lymph node transfer. Financial Disclosure Statement: Ketan Patel is a consultant for Novadaq Corp and receives textbook royalties from Elsevier Corp. All other authors have no disclosures. Corresponding Author: Ketan M. Patel, M.D., Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, ketan.patel@med.usc.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2mnApTo

Comparison of Pediatric Intercalary Allograft Reconstructions With and Without a Free Vascularized Fibula

Introduction: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combing the allograft with a vascularized fibula graft (FVFG) has been described; however there is a paucity of data comparing the outcome of these reconstructions. Material and Methods: 29 pediatric patients (15 males, 14 females) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. The most common diagnosis was osteosarcoma (n=18). Patients were reconstructed with an allograft alone (n=11) or supplemented with a FVFG (n=18). Results: The mean time to union of the allograft was 11 months, with 10 patients requiring additional bone grafting. There was no difference in the need for an additional bone graft (OR 0.87, P=1.0) between patients with a FVFG and those without. The allograft was revised in 3 patients due to fracture (n=2) and fracture and infection (n=1). In all these patients the allograft was not supplemented with a FVFG (P

https://ift.tt/2uKfAVZ

Correlation between Quantity of Transferred Lymph Nodes and Outcome in Vascularized Submental Lymph Node Flap Transfer for Lower Limb Lymphedema

Background: Vascularized lymph node transfer (VLNT) has shown promising results in the treatment of lower limb lymphedema, but little is known about the number of lymph nodes needed for the transfer to achieve optimal results. This study investigated the correlation between number of transferred lymph nodes in submental VLNT and outcomes regarding limb circumference reduction and cellulitis incidence. Methods: Thirty-five patients who had received submental VLNT to an ankle for lower limb lymphedema, post-gynecological cancer treatment, were included in the study. Limb circumference was determined via tape measurement pre- and postoperatively and was used to calculate the circumferential difference. Ultrasonography was performed postoperatively to determine the number of lymph nodes within the transferred flap. Patients were divided into groups A-C depending on the number of transferred lymph nodes: 1-2 (n=10), 3-4 (n=14) and 5-8 (n=11), respectively. Results: The mean age was 60.0 ± 9.2 years. All flaps survived. The mean improvement of circumferential difference for the whole cohort was 19.8 ± 9.2 %. Groups B and C both had significantly higher improvements in the circumferential difference than group A (p=0.04 and p=0.02, respectively), but when compared to each other, the difference was non-significant. All groups had significant reductions in cellulitis incidence postoperatively. Conclusions: Submental VLNT for lower limb lymphedema reduced the incidence of cellulitis, regardless of the number of transferred lymph nodes. The transfer of 3 or more lymph nodes provided significantly better outcome regarding limb circumference reduction than the transfer of 2 or fewer lymph nodes. FINANCIAL DISCLOSURE STATEMENT: The authors have nothing to disclose. No funding was received for this article. AUTHOR CONTRIBUTIONS: JG and MHC were responsible for the study idea, design and follow-through. JG, SYC and WHC were responsible for data collection. All authors were involved in the interpretation of results. JG and MHC were responsible for statistical analysis. All authors were involved in critical review and approval of the final result. IRB NUMBER: 101-3481B ACKNOWLEDGMENTS: The authors would like to thank Miffy Chia-yu Lin, M. Sc., for her assistance in the preparation of tables and figures for this manuscript. CORRESPONDING AUTHOR: Ming-Huei Cheng, MD, MBA, FACS, Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Center of Tissue Engineering, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No. 5 Fu-Hsing Street, Kweishan, Taoyuan 333, Taiwan , Telephone: +886 3 281200 ext. 2172, Fax: +886 3 3972681, E-mail: minghueicheng@gmail.com, minghuei@adm.cgmh.org.tw ©2018American Society of Plastic Surgeons

https://ift.tt/2mnNprU

Nonvisualization of Sentinel Lymph Nodes by Lymphoscintigraphy in Primary Cutaneous Melanoma – Incidence, Risk Factors, and a Review of Management Options

PURPOSE: Lymphoscintigraphy (LS) is often obtained prior to sentinel lymph node biopsy (SLNB), especially in areas likely to have multiple or aberrant drainage patterns. This study aims to determine the incidence and characteristics of melanoma patients with a negative LS and to review the management options and surgical recommendations. METHODS: This is a retrospective study of patients with primary cutaneous melanoma who underwent SLNB between 2005 and 2016. Patients with nonvisualized lymph nodes on preoperative LS were compared in a 1:4 ratio with a randomly selected unmatched cohort drawn from all melanoma patients who underwent preoperative LS within the time period of the study. Demographic, clinical and outcome data were compared between these groups. RESULTS: A negative LS was seen in 2.3% of all cases (25 in 1073). In both univariate and multivariate analyses, predictive patient and tumor-specific factors for negative LS included older age and head and neck location. Patients with a non-visualized SLN had significantly worse overall survival compared with patients who had a visualized SLN, but there was no difference in melanoma-specific survival. In 16 of the 25 cases (64%), at least one SLN was found intraoperatively despite the negative LS. CONCLUSION: Older patients with head and neck melanomas are more likely to experience nodal nonvisualization on LS. In patients who have nodal nonvisualization, the surgeon should attempt SLNB at the time of excision of the primary lesion since a SLN can still be found in a majority of cases, and it offers prognostic information. CONFLICTS OF INTEREST AND SOURCE OF FUNDING: None of the authors have a financial interest in or a commercial association with any of the products, devices, or drugs mentioned in this manuscript. There was no source of funding for this manuscript. CORRESPONDING AUTHOR: Dr. Deepak Narayan, Yale University School of Medicine, Section of Plastic Surgery, 330 Cedar Street, P.O. Box 208041, New Haven, CT, 06520-8041, United States. Phone number: (203) 785-2570, Fax number: (203) 785-5714, deepak.narayan@yale.edu ©2018American Society of Plastic Surgeons

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Influence of Repaired Cleft Lip and Palate on Layperson Perception following Orthognathic Surgery

Background: Facial scarring and disharmony due to clefting is associated with psychosocial stress which may be improved by orthognathic surgery. The authors examine how a history of clefting influences change in layperson perception of a patient following orthognathic surgery. Methods: 1000 laypeople were recruited through Mechanical Turk to evaluate patient photographs pre- and post-orthognathic surgery. Nineteen patients – 5 with unilateral and 4 with bilateral clefting – were included. Respondents assessed 6 personality traits, 6 emotional expressions, and likelihood of 7 interpersonal experiences on a scale from 1-7. Results: Using Mann-Whitney U and independent samples t-tests, changes in all aspects of social perception post-procedure differed significantly between cleft vs. non-cleft cohorts (p

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“Incidents of Mandibular Distraction Osteogenesis for Hemifacial Microsomia.”

Background: This article mainly focused on the safety and unexpected incidents of mandibular distraction osteogenesis in treating patients with hemifacial microsomia. Methods: Records of 71 patients with hemifacial microsomia treated by mandibular distraction osteogenesis from February 2010 to March 2015 were examined in this retrospective study. The modified mandibular osteotomy was conducted under the assistance of three-dimensional (3D) reconstruction, computer-aided design and rapid prototyping technique. Distraction was conducted 4-7 days postoperatively at a frequency of 1 mm/d; moreover, the distractor was kept in place for 4 to 13 months after the first operation before it was removed. The scope of distraction ranged from 20 to 40 mm. All incidents encountered during and following the mandibular distraction process were documented in the medical records of patients. The patients were followed up for an average of 34.4 months after the second-stage operation. Results: The overall rate of incidents was 36.6%. Of them, minor incidents, which could be resolved with or without noninvasive therapy, were observed in 18.3% of all procedures in this series. Meanwhile, the rate of moderate incidents necessitating invasive therapy was reported to be 12.7%, while that of major incidents that could not be resolved with invasive therapy was 5.6%. Conclusions: Mandibular distraction osteogenesis is a widely used procedure for treating patients with hemifacial microsomia. It is extremely important to be fully aware of variety of incidents occurring during and following the surgical procedure to minimize the incidence of such incidents. Financial Disclosure Statement: All authors has no financial conflict to disclose. The study was funder by Special Fund for Scientific Research in the Public Interest from National Health and Family Planning Commission of the People's Republic of China (No. 201502016), and 2015 Major Project of School/Institution of Plastic Surgery Hospital, Chinese Academic of Medical Sciences (No.Z2015008). Corresponding author: Zhiyong Shi, MD, Department of maxillofacial surgery, Plastic Surgery Hospital (Institude), Chinese Academy of Medical Sciences, Peking Union Medical College; No.33 Badachu Road, Shijingshan District, Beijing, 100144, China. zhangzy1011@163.com ©2018American Society of Plastic Surgeons

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“Interposition Vein Grafting in Head and Neck Free Flap Reconstruction”

Background: Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery due to concerns for elevated risk of flap loss. Methods: We conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss were analyzed using univariate and multivariate models. Results: A total of 3240 free flaps were performed. Vein grafts were used in 241 flaps (7.4%). The free flap compromise rate was 14.5% with vein grafts and 3.4% without vein grafts (p

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