Ιατρικά Άρθρα: 09/05/18

Background: There is clinical and experimental evidence that botulinum toxin applied to the healthy side of patients with facial paralysis positively affects functional recovery of the paralyzed side. We created an experimental model to study the effects of botulinum toxin injection in the gastrocnemius muscle contralateral to the side of tibial nerve lesion/repair in rats. Methods: Fifty rats were allocated into five groups: I: control; II: tibial nerve section; III: tibial nerve section, immediate neurorrhaphy; IV: tibial nerve section, immediate neurorrhaphy and botulinum toxin injected into the contralateral gastrocnemius muscle; V: botulinum toxin injected into the gastrocnemius muscle, no surgery. Assessment tools included a walking track, electromyography, gastrocnemius muscle weight measurement, and histological analysis of the nerve. Results: Paralysis in group V was transient, with function returning to normal at 8 weeks. At 12 weeks, group V had lower latency levels. At week 12, group IV showed higher functional outcomes and amplitude levels than group III, and lower muscle atrophy on the side injected with botulinum toxin than group V. Conclusions: Transient paralysis of the contralateral gastrocnemius muscle by abobotulinumtoxinA improved functional recovery in rats that underwent section and repair of the tibial nerve. Presented at: American Society for Peripheral Nerve Annual Meeting (ASPN) 2017 in Waikoloa, Hawaii. Financial Disclosure Statement: The authors have no financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding author: Alessandra Grassi Salles, Rua Joaquim Floriano, 466, cj. 2102, São Paulo 04534-002, Brazil. Tel/Fax: 55-11-3078-1009, E-mail: agsalles30@gmail.com ©2018American Society of Plastic Surgeons

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Clockwise and Counterclockwise Le Fort I Movements Influence Nasolabial Morphology Differently

Introduction: Le Fort I maxillary advancements are reported to affect nasal proportions. However, there is a no significant data on the three-dimensional nasal changes that occur with differential lateral plane adjustment (clockwise (CW) and counterclockwise (CCW) movements) during Le Fort I maxillary advancements. The purpose of this study was to analyze and compare nasolabial soft tissue changes after Le Fort I CW and CCW repositioning. Methods: Single-piece Le Fort I advancements were included in this morphometric study. A retrospective study of patients split into CW and CCW groups was performed. Pre- and postoperative 3D photographs (VECTRA, Canfield, Fairfield, NJ) were analyzed. Nasolabial anthropometric measurements were recorded (Mirror). Two observers verified the landmarks. Statistical analysis involved paired t test to compare pre- and postoperative nasolabial measurements. Results: Twenty-four patients were evaluated (12 per group), with 22 distinct nasolabial relationships measured. CCW showed a statistically significant increase in alar width (3.6mm, P

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Neural Perforasomes of the Upper Extremity

Background: In the setting of the rapid advancement of integumentary vascular knowledge, we hypothesized that the extrinsic blood supply to the major peripheral nerves of the upper extremity could be categorized into discrete neural "perforasomes". Methods: Total limb perfusion of the arterial system was performed with gelatin-red lead oxide in cadaveric upper limbs. The perforating vessels to the radial, median and ulnar nerves were identified, confirmed with fluoroscopy and dissected. Distances to major anatomic landmarks of the upper extremity were measured. Additional cadaveric limbs' nerves were dissected and source arteries were selectively cannulated and injected to assess specific contribution to extrinsic nerve perfusion. The perfusion of each nerve was then calculated among all specimens. Results: The radial, median and ulnar nerve perforators were mapped. The corresponding neural perforasomes were mapped. The distal portions of the superficial radial nerve (SRN) and the posterior interosseous nerve (PIN) demonstrated a lack of staining. Similarly, at the carpal tunnel and at the proximal 25% of the median nerve (corresponding to the pronator teres), the nerve lacked vascular staining. At Guyon's canal and the flexor carpi ulnaris (FCU) the ulnar nerve demonstrated a lack of vascular staining. Conclusions: Peripheral nerves can be divided into neural perforasomes with limited overlap. The extrinsic perfusion of peripheral nerves is highly segmental. Absent staining within the nerves correspond to common sites of compression: carpal tunnel and pronator teres for the median nerve, supinator for the PIN, and Guyon's canal and the FCU for the ulnar nerve. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. This research was supported by the American Foundation for Surgery of the Hand. This research was supported by the Piedmont Orthopaedic Foundation. This research has not been presented at any meetings. All named authors hereby declare that they have no conflicts of interest to disclose. This study is deemed exempt by the Duke University Institutional Review Board, Pro00075741. This research is supported by the Piedmont Orthopaedic Foundation. This research is supported by the American Foundation for Surgery of the Hand. Corresponding author: Steven Koehler, MD, Department of Orthopaedic Surgery, SUNY Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY 11203, Email: steven.koehler@downstate.edu ©2018American Society of Plastic Surgeons

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Effects of Extracorporeal Shock Wave Therapyon Distraction Osteogenesis in Rat Mandible

Background: Distraction osteogenesis (DO) has widespread clinical use in the treatment of congenital and acquired craniofacial deformities. Nonetheless, during the prolonged consolidation period, the newly regenerated bone carries the risk of complications. One of the proposed methods to enhance bone healing and shorten the consolidation period is extracorporeal shock wave therapy (ESWT). In the field of orthopedics, ESWT has been shown to induce neovascularization and promote tissue regeneration. We investigated whether ESWT can accelerate bony consolidation and regeneration in distraction osteogenesis of the rat mandible and at which stage of DO it should be applied. Methods: 24 male Sprague Dawley rats were subjected to DO of the right mandible (latency period, 3 days; distraction period, 10 days, 0.5 mm/day). Experimental groups: group I (control) no ESWT: group II received ESWT (0.18 mJ/mm2) at the latency period; group III received ESWT (0.18 mJ/mm2) at the consolidation period. Explants were removed for evaluation following four weeks of consolidation. Results: Histological evaluation showed well developed cortical cortex and a higher degree of bone formation and mature bone in group III; µCT showed significantly increased bone mineral density, bone volume fraction and trabecular thickness; immunohistochemistry demonstrated significantly increased expression of Bone Morphogenetic Protein-2, Vascular Endothelial Growth Factor and PCNA. Conclusions: ESWT application at the consolidation period during DO in the rat mandible enhances bone formation, osteogenic and angiogenic growth factors, improves bone mechanical properties and accelerates bone mineralization. Financial Disclosure Statement: he authors declare that they have no conflict of interest. No funding was received for this article. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding author: Jiriys George Ginini, DMD, Rambam Health Care Campus, 8 Ha'Aliyah Street, Haifa 35254, Israel, Phone: +972-503330896, Fax: +972-7772557, Email: jiriysginini@technion.ac.il ©2018American Society of Plastic Surgeons

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“Non-invasive flap preconditioning by foam-mediated external suction improves the survival of fascio-cutaneous axial-pattern flaps in a type-2 diabetic murine model”

Background: Advances in reconstructive surgery are leading to an increased number of flaps at risk for ischemic necrosis, either due to intrinsic (e.g., larger flap size) or extrinsic (e.g., diabetes) factors. Yet, methods to pre-operatively improve flap vascularity and limit post-operative ischemia are lacking. Non-invasive suction, using either a macro-deformational silicone-cup interface (External Volume Expansion, EVE) or a micro-deformational polyurethane-foam interface (F-EVE), has shown to induce angiogenesis in tissues. We investigated whether, by increasing the vascular density of flaps, the pre-operative use of EVE/F-EVE (preconditioning) improves flap survival in an obesity-induced diabetic animal model. Methods: Db/Db mice underwent either mechanical stimulation with suction for 5 days using either EVE, or F-EVE, or received no stimulation (n = 8 per group). Five days after the last stimulation, a critical-sized, axial-pattern, fascio-cutaneous flap was raised in all animals. Post-operatively, flap survival was monitored with digital imaging for 10 days. Following this period, flaps were harvested to assess tissue survival, angiogenesis, and inflammation, utilizing histology and PCR. Results: F-EVE preconditioning significantly increased the viable flap area (+28%), the viable flap volume (+27%), the flap capillary density (+36%), in comparison to controls; VEGF was also upregulated (>300%). In contrast, EVE resulted in severe inflammatory response and increased flap necrosis. Conclusions: F-EVE improves flap survival in obese diabetic mice. This procedure may allow for improved clinical rates of flap survival in high-risk patients. Acknowledgments, conflict of interest and role of funding sources disclosure statement: Authors are thankful to KCI, Inc. for providing the pumps and the foam-shaped Interface used in this study. Dr. Orgill serves as a consultant and has received sponsored research grants from KCI to Brigham and Women's Hospital. Authors declare no actual or potential conflict of interest: in addition, they disclose no commercial or financial associations, personal or other relationships with other people or organizations that could inappropriately influence the reported manuscript or create a conflict of interest with the information presented. This study was funded by a research grant from the Gillian Reny Stepping Strong Foundation to Brigham and Women's Hospital. Ethics: The displayed study was carried out with respect to high ethical standards. All the studies have been approved, when required, by the appropriate ethics committee and have, therefore, been performed in accordance and in compliance with the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments. Meetings at which the paper has been presented: None. Corresponding author: Giorgio Giatsidis (* corresponding author), Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital - Harvard Medical School, 75 Francis St., Boston MA 02115, T: 617-525-7837, F: 617-730-2855, E: ggiatsidis@bwh.harvard.edu ©2018American Society of Plastic Surgeons

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Pretibial Lymphoplasmacytic Plaque in Children: Case Report and Review of the Literature

Abstract: An 8-year-old girl presented with a persistent 5 × 2-cm violaceous doughy plaque on the left lower leg. Histologic examination revealed hyperkeratosis, variable but mild epidermal hyperplasia, and vacuolar interface changes with melanin pigment incontinence confined to the papillary dermis. A diagnosis of pretibial lymphoplasmacytic plaque in children was made. This report outlines the clinical characteristics of this entity and a review of other cases reported in the literature. Correspondence: David N. Adam, MD, FRCPC, DABD, 95 Bayly Street West Suite G -02, Ajax, ON L1S 7K8, Canada (e-mail: dnadam@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Acquired Dermal Melanocytosis Associated With Diffuse Systemic Sclerosis in a White Patient

Abstract: We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70–positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding. Correspondence: Lidia Ossorio-García, MD, Department of Dermatology, Hospital Universitario Puerta del Mar, Ana de Viya Av, 21 Cadiz, Andalusia 11009, Spain (e-mail: lidia.osga@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Reflectance Confocal Microscopy Can Help the Dermatopathologist in the Diagnosis of Challenging Skin Lesions

Abstract: Despite the successful assignment of Current Procedural Terminology codes, there are barriers to incorporating in vivo reflectance confocal microscopy (RCM) into daily practice. Importantly, the dermatopathologist can play a key role in interpreting RCM images and can use these images to correlate with histopathology. Herein, we describe, using a case series, how RCM can be incorporated into the dermatopothalogist's practice. We also summarize the criteria for RCM diagnosis of common neoplasms. Correspondence: Jane M. Grant-Kels, MD, UCONN Dermatology Department, 21 South Road, Farmington, CT 06032 (e-mail: grant@uchc.edu). H. Rabinovitz and M. Oliviero have received honoraria in the past from Caliber, the company that produces RCM. J.M. Grant-Kels and H. Rabinovitz have also received equipment in the past from Caliber. There were no payments for conducting or publicizing this study. The remaining authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Hypopigmented Interface T-Cell Dyscrasia and Hypopigmented Mycosis Fungoides: A Comparative Study

Abstract: Hypopigmented interface T-cell dyscrasia (HITCD) is a distinct form of lymphoid dyscrasia that may progress to hypopigmented mycosis fungoides (HMF). We compared both diseases as regards their CD4/CD8 phenotype and expression of granzyme B and tumor necrosis factor-alpha (TNF-α) and how these are affected by narrow-band UVB (nb-UVB). The study included 11 patients with HITCD and 9 patients with HMF. They received nb-UVB thrice weekly until complete repigmentation or a maximum of 48 sessions. Pretreatment and posttreatment biopsies were stained using anti CD4, CD8, TNF-α, and granzyme B monoclonal antibodies. Epidermal lymphocytes were CD8 predominant in 54.5% and 66.7% of HITCD and HMF cases, respectively, whereas dermal lymphocytes were CD4 predominant in 63.6% and 66.7%, respectively. Significantly, more dermal infiltrate was encountered in HMF (P = 0.041). In both diseases, granzyme B was only expressed in the dermis, whereas TNF-α was expressed both in the epidermis and dermis. No difference existed as regards the number of sessions needed to achieve repigmentation or cumulative nb-UVB dose reached at end of study. (P > 0.05). Narrow-band UVB significantly reduced only the epidermal lymphocytes in both diseases (P ≤ 0.05) with their complete disappearance in 8 (72.7%) HITCD and 6 (66.7%) HMF cases. In both diseases, nb-UVB did not affect granzyme B or TNF-α expression (P > 0.05). In conclusion, both diseases share the same phenotype, with HITCD being a milder form of T-cell dysfunction. In both diseases, epidermal lymphocytes are mainly CD8+-exhausted cells lacking cytotoxicity, whereas dermal cells are mostly reactive cells exerting antitumor cytotoxicity. Tumor necrosis factor-alpha mediates hypopigmentation in both diseases and prevents disease progression. Repigmentation after nb-UVB in both diseases occurs before and independently from disappearance of the dermal infiltrate. Correspondence: Mona R. E. Abdel-Halim, MD, Dip Dermpath (ICDP-UEMS), Dermatology Department, Cairo University, Kasr Al Aini Street, Cairo 11562, Egypt (e-mail: abdelhalimmona@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Refractory Hand Dermatitis With Massive Thumb Enlargement

No abstract available

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Alveolar Soft-Part Sarcoma of the Tongue

Abstract: Alveolar soft-part sarcoma is a rare neoplasm of unknown histogenesis that accounts for less than 1% of all soft-tissue sarcomas. The tumor is highly vascularized with small vascular spaces separating nests of cells, and from cytogenetic point of view, is characterized by chromosome rearrangement der(17)t(X:17)(p11:q25) that results in the ASPL-TFE3 translocation. It can occur at any age, but it is most common between 15 and 35 years of age. The prognosis is poor, despite the relatively slow growth of the tumor. We present here an atypical case of alveolar soft-part sarcoma in which the age of the patient, the location, and the histopathologic characteristics of the lesion represented a diagnostic challenge. Correspondence: Luis Requena, MD, Department of Dermatology, Fundación Jiménez Díaz, Avenida Reyes Católicos 2, 28040 Madrid, Spain (e-mail: lrequena@fjd.es). V. Alegría-Landa and V. Lora have contributed equally in the performance of this article. The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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An acral papulovesicular eruption

Clinical and Experimental Dermatology, EarlyView.

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An unusual case of melanocytic matricoma in a young pregnant woman

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2NQmi55

Updated Guidelines on Complex Regional Pain Syndrome in Adults

A multidisciplinary team representing 28 professional bodies has updated the guidelines for the management of Complex regional Pain Syndrome (CRPS), published by the Royal College of Physicians of England (RCP) 2018. The author represented the British Association of Plastic, Reconstructive and Aesthetic Surgeons in this process and is an author of the guidelines. This article summarises the updated guidelines and highlights aspects relevant to Plastic and Reconstructive Surgery.

https://ift.tt/2Q5o7wp

Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study

This study aimed to investigate the versatility of septocutaneous thoracodorsal artery perforator flaps in various areas in the body and the running pattern of septocutaneous perforators.

https://ift.tt/2M0YwBK

Determining Post-Operative Outcomes After Cleft Palate Repair: A Systematic Review and Meta Analysis

A lack of high level evidence exists on the outcomes of different cleft palate repair techniques. A critical appreciation for the complication rates of common repair techniques is paramount to optimize cleft palate care.

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Comments on “Long-term outcome of patients with or without osseointegrated implants after resection of mandibular ameloblastoma and reconstruction with vascularized bone graft: Functional assessment and quality of life”

Dear editor:

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Stress-related hormones in association with periodontal condition in adolescents—results of the epidemiologic LIFE Child study

Abstract

Objectives

The aim of this study was to investigate the associations between blood levels of stress-related hormones and early signs of periodontal disease in children and adolescents.

Materials and methods

Within the LIFE (Leipzig research center for civilization diseases) Child study, 498 adolescents (10 to 18 years) were included. Early signs of periodontal inflammation were measured by probing depth (PD) at six index teeth (16, 11, 26, 36, 31, 46). Blood levels of stress-related hormones (cortisol, dehydroepiandosterone-sulfate [DHEA-S]) and, additionally interleukine-6 (IL-6) were measured. Socioeconomic status, oral hygiene, orthodontic appliances, and nutritional status, recorded by body-mass-index-standard-deviation-score (BMI-SDS), were considered as confounding factors. Additionally, in 98 participants, an oral chairside active matrix metalloproteinase-8 (aMMP-8) test was performed. Statistical tests are the Mann-Whitney U tests, chi-squared tests and multivariate logistic regression model.

Results

IL-6, BMI-SDS as well as positive aMMP-8 test result were significantly associated with maximum PD > 3 mm (p < 0.05). However, no statistically significant associations between stress-related hormones (cortisol and DHEA-S) and presence of maximum PD > 3 mm were found (p > 0.05). Higher DHEA-S and BMI were associated with positive aMMP-8 result, even after adjusting for age and gender (p = 0.027, p_adj = 0.026).

Conclusion

The results reveal no associations between PD and stress-related hormones cortisol and DHEA-S. aMMP-8 test result might be associated with DHEA-S level. Nutritional status seems to influence periodontal disease in adolescents.

Clinical relevance

DHEA-S and BMI-SDS show associations with early signs of periodontal disease in adolescents aged 10 to 18 years. This association should be confirmed by the investigation of high-risk groups.

https://ift.tt/2NRMwUM

Selenium application alters soil cadmium bioavailability and reduces its accumulation in rice grown in Cd-contaminated soil

Abstract

Selenium (Se) alleviates cadmium (Cd) accumulation in several plants. Nevertheless, it is still unclear why it has such effect. Thus, this study aimed to investigate the effects of Se on soil Cd bioavailability, and Cd accumulation in flooded rice plants, and to determine the mechanisms underlying these effects. Concentration of Cd and Se in different rice tissues was determined along Cd and Se concentrations in the soil solution and soil Cd fractions. Results showed that exogenous selenite and selenate treatments significantly increased rice grain Se by 4.25- and 2.39-fold and decreased Cd by 36.5% and 25.3% relative to control treatment, respectively. The addition of Se to Cd-contaminated soil significantly decreased total Cd concentration in the soil solution by 11.2–13.0%, increased soil pH by 0.06–0.32 units, and enhanced soil Cd immobilization in relation to control. Exogenous Se also reduced diethylenetriaminepentaacetic acid-Cd, exchangeable, and residual Cd but increased the levels of Cd bound to carbonate and iron and manganese oxides. Thus, amending Cd-contaminated soil with Se may help decrease Cd content as well as increase Se levels in rice grain, as Se may mitigate Cd accumulation in rice plants by increasing soil pH, reducing Cd bioavailability, and inhibiting Cd translocation from roots to shoots.

https://ift.tt/2CntiFh

A review on removal of siloxanes from biogas: with a special focus on volatile methylsiloxanes

Abstract

The occurrence of siloxanes is a major barrier to use of biogas as renewable energy source, and removal of siloxanes from biogas before combustion is needed. The siloxane can be transformed into silicon dioxide (SiO₂) through the combustion process in engine, which will be deposited on the spark plug, cylinder, and impeller to form the silica layer, causing the wear and damage of the engine parts, and shorten the life of the engine and affect the utilization efficiency of the biogas. This paper reviewed some methods and technologies for siloxanes removal from biogas. There are three commercial available technologies to remove siloxanes: adsorption, absorption, and cryocondensation. Other newer technologies with better prospects for development also have made a research progress, including membrane, catalysts, biotrickling filters. This work introduces the source and characterization of siloxanes in biogas, reviews the scientific progress of siloxanes removal, and discusses the development direction and further research of removal siloxanes.

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Estimation of formaldehyde occupational exposure limit based on genetic damage in some Iranian exposed workers using benchmark dose method

Abstract

The present study evaluated an occupational exposure level for formaldehyde employing benchmark dose (BMD) approach. Dose–response relationship was determined by utilizing cumulative occupational exposure dose and DNA damage. Based on this goal, outcome of comet assay for some Iranian exposed people in occupational exposure individuals was used. In order to assess formaldehyde exposure, 53 occupationally exposed individuals selected from four melamine tableware workshops and 34 unexposed subjects as a control group were examined. The occupational exposure dose was carried out according to the NIOSH-3500 method, and the DNA damage was obtained by employing comet assay in peripheral blood cells. EPA Benchmark Dose Software was employed for calculating BMD and BMDL. Cumulative exposure dose of formaldehyde was between of 2.4 and 1972 mg. According to the findings of the current study, the induction of DNA damage in the exposed persons was increased tail length and tail moment (p < 0.001), when compared to controls. Finally, an acceptable dose–response relationship was obtained in three-category information between formaldehyde cumulative exposure doses and genetic toxicity. BMDL was 0.034 mg/m³ (0.028 ppm), corresponding to genetic damage of peripheral blood cells. It can be concluded that the occupational permissible limit in Iranian people could be at levels lower than OSHA standards.

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Evaluation of (–)-borneol derivatives against the Zika vector, Aedes aegypti and a non-target species, Artemia sp.

Abstract

Zika, dengue, and chikungunya are vector-borne diseases of pronounced concern transmitted by the mosquito Aedes aegypti Linn. (Diptera: Culicidae). The most important method to avoid outbreaks is to control mosquito spreading by the employment of insecticides and larvicides. Failure to control mosquito dispersal is mostly accounted to Ae. aegypti resistance to currently available larvicides and insecticides, encouraging the development of novel pesticides. In addition, the excessive use of larvicides poses serious threats to human health and the environment. Evaluation of natural products as larvicides in an attempt to overcome this situation is often found in the literature because products originated from nature are considered less toxic to non-target species and more eco-friendly. (–)-Borneol is a bicyclic monoterpene present in essential oils with moderate larvicidal activity. On account of these facts, it was of our interest to synthesize (–)-borneol ester derivatives aiming to study its structure-activity relationships against Ae. aegypti larvae. With the goal to estimate toxicity to a non-target species, evaluation of the lethal concentration 50% (LC₅₀) on Artemia sp. (Artemiidae) and calculation of selectivity towards Ae. aegypti were carried out. The most potent derivative, (–)-Bornyl chloroacetate, exhibited the highest suitability index, demonstrating lower environmental toxicity than other borneol ester derivatives. A parabolic relationship between (–)-borneol esters larvicidal activity and partition coefficient (Log P) was achieved and a correlation equation obtained, validating the importance of lipophilicity to the larvicidal activity of these compounds.

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Commentary on Making a Case for the Use of Platelet-Rich Plasma in Cicatricial Alopecia

No abstract available

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Laser Ablation of the Recipient Area With Platelet-Rich Plasma–Enriched Epidermal Suspension Transplant in Vitiligo Surgery: A Pilot Study

BACKGROUND Noncultured epidermal cell suspension transplantation is a very popular surgical modality for treating vitiligo. However, the procedure can be modified to improve results. OBJECTIVE To study the extent of repigmentation with noncultured trypsinized fragmented epidermal suspension using platelet-rich plasma (PRP) as a suspending agent and pixel erbium yttrium aluminium garnet laser for ablation of recipient area in patients with stable vitiligo. MATERIALS AND METHODS Autologous noncultured tiny epidermal fragments suspended in PRP were grafted on superficially pixel erbium YAG laser-ablated vitiligo lesions in 10 patients. The repigmentation was evaluated over a period of 6 months using a digital image analysis system. RESULTS Repigmentation was observed as early as 2 weeks after the treatment. Of 20 lesions, 12 (60%) showed excellent response; of which 10 lesions (50%) showed complete repigmentation in 8 weeks only. There were no milia or keloid formation, donor-site scarring, stuck on appearance at recipient site or infection. CONCLUSION This study indicates that PRP-enriched epidermal suspension transplant (LA-PEEST) has the potential to improve the rate of healing and repigmentation in vitiligo patches. Further investigations and larger controlled trials are required to establish this technique as a rapid surgical method to restore pigmentation. Address correspondence and reprint requests to: Suruchi Garg, MD, Department of Dermatology, Aesthetic Surgery, and Intervention Dermatology, Aura Skin Institute, S.C.O. 44-45, First Floor, Madhya Marg, Sector 9-D, Chandigarh 160009, India, or e-mail: gargsuruchi01@gmail.com 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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Botulinum Toxin for Depression: More Than Skin Deep

No abstract available

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Neurological and Ophthalmological Manifestations of Varicella Zoster Virus

Background: Approximately 1 million new cases of herpes zoster (HZ) occur in the United States annually, including 10%–20% with herpes zoster ophthalmicus (HZO). Postherpetic neuralgia, a debilitating pain syndrome occurs in 30% HZ, whereas 50% HZO develop ophthalmic complications. Diplopia from cranial nerve palsy occurs in less than 30% HZO, whereas optic neuropathy is seen in less than 1% HZO. We reviewed recent developments in the diagnosis, treatment, and prevention of HZ as well as neurological and ophthalmological complications of relevance to the neuro-ophthalmologist. Evidence Acquisition: We searched the English language literature on Pubmed and Google scholar for articles relevant to the various sections of this review. Results: Antiviral treatment should be initiated within 48–72 hours of onset of HZ and HZO to decrease pain and reduce complications. We recommend neuroimaging in all patients with neuro-ophthalmic manifestations such as diplopia and acute vision loss. Diagnostic confirmation using polymerase chain reaction and serology on paired serum and cerebrospinal fluid samples should be obtained in those with neurological signs and symptoms or abnormal imaging. Patients with neurological and/or retinal varicella zoster virus (VZV) infection should be treated promptly with intravenous acyclovir. Patients with isolated optic neuropathy or cranial nerve palsy can be managed with oral antivirals. The prognosis for visual recovery is good for patients with isolated optic neuropathy and excellent for patients with isolated ocular motor cranial nerve palsy. Conclusions: HZ produces a spectrum of potentially blinding and life-threatening complications that adversely affect quality of life and increase health care costs. Individuals at risk for HZ, such as the elderly and immunocompromised, should be encouraged to receive the highly effective VZV vaccine to prevent HZ and its complications. Address correspondence to Sachin Kedar, MD, Nebraska Medical Center, Omaha, NE 68198-8435; E-mail: sachin.kedar@unmc.edu S. Kedar, reports being a coinventor for the Advanced Pupil Simulator licensed by EON Reality Inc. J. R. Berger, grants from Biogen, during the conduct of the study; personal fees from Amgen, personal fees from Astra-Zeneca, personal fees from Janssen, personal fees from Millennium/Takeda, personal fees from Novartis, personal fees from Biogen, personal fees from Roche, personal fees from Genentech, personal fees from Genzyme/Sanofi, personal fees from Inhibikase, personal fees from Forward Pharma, personal fees from Johnson and Johnson, personal fees from Pfizer, and personal fees from Eisai, outside the submitted work. The remaining author reports no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

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Deep vs. moderate neuromuscular blockade during laparoscopic surgery: A systematic review and meta-analysis

BACKGROUND Previous studies have reported that deep neuromuscular block (posttetanic-count 1 to 2 twitches) improves surgical conditions during laparoscopy compared with moderate block (train-of-four count: 1 to 2 twitches). However, comparisons of surgical conditions were made using different scales and assessment intervals with variable results. OBJECTIVE To explore the heterogeneity of previous comparisons between deep and moderate neuromuscular block. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched from inception to October 2017. ELIGIBILITY CRITERIA Our meta-analysis included RCTs comparing the effects of deep with moderate neuromuscular block on surgical field conditions during laparoscopic surgery. The frequency of excellent or good operating conditions on a surgical rating scale was compared. Heterogeneity was assessed by subgroup analyses. RESULTS Eleven RCTs involving 844 patients were included. On the surgical rating scale, the frequency of excellent or good operating conditions was higher with deep block compared with a moderate block (odds ratio 2.83, 95% confidence interval 1.34 to 5.99, P = 0.007, I2 = 59%). We analysed surgical rating according to the number of assessments made. There was a significant difference in surgical rating with multiple assessments, but no difference when the assessment was made on only one occasion. A significant difference in rating was noted with variable abdominal pressures; there was no significant difference with the same fixed abdominal pressure. Trial sequential analysis demonstrated that the cumulative z-curve crossed the O′Brien–Fleming significance boundary. However, required information size was not achieved. CONCLUSION Deep block was associated with excellent or good surgical rating more frequently than moderate block. However, this finding was not consistent on subgroup analyses based on frequencies of assessment of surgical conditions and abdominal pressure. Further studies are required to address the heterogeneity and power shortage demonstrated by the trial sequential analysis. Correspondence to Won Ho Kim, MD, PhD, Department of Anesthesiology and Pain Medicine, Institute of the Research of the Perioperative Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea Tel: +82 2 2072 2462; fax: +82 2 747 5639; e-mail: wonhokim.ane@gmail.com 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

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The role of ADAMTS4 and ADAMTS9 in cardiovascular disease in premature ovarian insufficiency and idiopathic hypogonadotropic hypogonadism

Abstract

Purpose

We aimed to determine the relation of a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS4), and a disintegrin and metalloproteinase with thrombospondin motifs-9 (ADAMTS9) with cardiovascular disease (CVD) risk, in ovarian dysfunction patients with premature ovarian insufficiency (POI), and idiopathic hypogonadotropic hypogonadism (IHH).

Methods

43 IHH and 44 POI patients were enrolled to this case–control study. Serum hormonal parameters, lipid profiles, ADAMTS4 and ADAMTS9 levels were measured. Lipid accumulation product (LAP) index, visceral adiposity index (VAI), and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. The patients with at least two out of the four following criteria were accepted to have increased CVD risk; waist-to-hip ratio (WHR) ≥ 0.8, waist circumference (WC) ≥ 79 cm, triglycerides (TG) ≥ 150 mg/dL, high-density lipoprotein cholesterol (HDL-C) < 50 mg/dL. Serum ADAMTS4 and ADAMTS9 levels were measured by enzyme-linked immunosorbent assay (ELISA).

Results

ADAMTS4 and ADAMTS9 levels were significantly higher in the IHH group than the POI group (p = 0.002, and p = 0.013, respectively). IHH group had significantly higher levels of insulin, HOMA-IR index, and LAP index (p = 0.006, p = 0.005, and p = 0.013, respectively). The mean age of patients in the IHH group (23.60 ± 5.64 years) was significantly lower than the POI group (31.05 ± 6.03 years), (p < 0.001). Odds ratios (OR) were 1.236 (95% CI 1.055–1.447) and 1.002 (95% CI 1.000–1.004) for LAP index and ADAMTS4, respectively, in the IHH group. These two parameters found to have high predictivity for CVD risk in the IHH group (p = 0.009 and p = 0.028, respectively).

Conclusion

The lower levels of ADAMTS4 in the POI group, when compared with the IHH patients pointed out that even limited hormone secretion and ovulation in the POI group, may have protective effect on cardiovascular system. The higher levels of ADAMTS4 and LAP index in the IHH group demonstrated the increased risk of these patients for CVD.

https://ift.tt/2oHDfnp

Die Radiotherapie des Pleuramesothelioms – Klinische Praxisleitlinie der American Society of Clinical Oncology

https://ift.tt/2NPp76q

Radical Resection of Single-hole Inflatable Mediastinal Mirror Synchronization With Laparoscopic Esophageal Carcinoma

Condition: Esophagus Cancer
Intervention: Procedure: Single-hole inflatable mediastinal mirror
Sponsor: Qingdong Cao
Recruiting

https://ift.tt/2wKSb8s

Voice Outcomes Following Thyroidectomy

Conditions: Thyroid Cancer; Thyroid Nodule
Intervention: Other: No intervention: observational only
Sponsor: University of Virginia
Not yet recruiting

https://ift.tt/2Cl9HW3

Magnetic biochar-based manganese oxide composite for enhanced fluoroquinolone antibiotic removal from water

Abstract

Magnetic biochar-based manganese oxide composite (MMB) and raw biochar (BC) were synthesized via pyrolysis at a temperature of 500 °C under anoxic conditions of potato stems and leaves, characterized, and successfully used for the removal of norfloxacin (NOR), ciprofloxacin (CIP), and enrofloxacin (ENR) as representative compounds of fluoroquinolone antibiotics (FQs). Characterization results suggested that Fe₃O₄ and MnO_x are the dominant crystals in MMB. MMB possessed large surface area and pore volume than BC. Batch adsorption experiments showed that the maximum adsorption abilities of MMB for norfloxacin (NOR), ciprofloxacin (CIP), and enrofloxacin (ENR) were 6.94, 8.37, and 7.19 mg g⁻¹. In comparison to BC, the adsorption abilities of MMB increased 1.2, 1.5, and 1.6 times for NOR, CIP, and ENR, respectively. The pseudo-second-order kinetic model and the Langmuir model correlated satisfactorily to the experimental data. Thermodynamic studies revealed that the adsorption processes were spontaneous and endothermic. The adsorption capacity of MMB decreased with increasing solution pH (between 3.0 and 10.0) and increasing ionic strength (0.001–0.1). The MMB with high FQ removal efficiency, easy separation, and desirable regeneration ability may have promising environmental applications for the removal of fluoroquinolone antibiotics from water environment.

https://ift.tt/2PCrGsU

The effect of cellulose production waste and municipal sewage sludge on biomass and heavy metal uptake by a plant mixture

Abstract

Environmental management of cellulose production waste and municipal sewage sludge appears to be substantiated due to various physicochemical properties of these wastes. The aim of the conducted research was to determine the effect of cellulose production waste and sewage sludge on yielding and heavy metal uptake by a plant mixture. The research was conducted under field experiment conditions, determining the fertilizer value of these wastes in the environmental aspect. The research was carried out in the years 2013–2016. Species composition of the plant mixture was adjusted to habitat conditions. It was established that, as compared with the cellulose production waste, the municipal sewage sludge used in the experiment had a higher content of macroelements. The content of heavy metals in the studied waste did not exceed the limits that condition their use in agriculture and reclamation. Applying only the cellulose production waste did not significantly decrease the yield of the plants. Municipal sewage sludge showed the highest yield-forming effect. Mixing the above-mentioned wastes and their application to soil had a significant effect on the increase in the plant mixture yield. The waste applied to soil also increased the content of Cr, Cd, Pb, Cu, and Zn in the plant mix. The level of heavy metal content in the plant mix did not exclude this biomass from being used for fodder or reclamation purposes. The cellulose production waste and municipal sewage sludge increased the heavy metal uptake by the plant mixture. The plant biomass extracted heavy metals from the sewage sludge more intensively than from the cellulose production waste. Among the analyzed heavy metals, the highest phytoremediation was recorded for Ni (30%), followed by Cd (20%), Cr (15%), Pb (10%), and the lowest for Cu (9%) and Zn (8%). Application of the cellulose production waste and sewage sludge to soil also increased the content of the studied heavy metals in soil. However, it did not cause deterioration of soil quality standards. Heterogeneity in the chemical composition of the wastes confirms that each batch intended to be used for environmental management should be subjected to chemical control.

https://ift.tt/2MLieXn

Physiological characterization of common bean ( Phaseolus vulgaris L.) under abiotic stresses for breeding purposes

Abstract

In the Brazilian wet and dry seasons, common beans (Phaseolus vulgaris L.) are grown under rainfed conditions with unexpected episodes of drought and high temperatures. The objective of this study was to evaluate the physiological mechanisms associated with drought adaptation traits in landraces and line/cultivars of beans from the Andean and Mesoamerican gene pools. Twenty-five genotypes, contrasting in terms of drought tolerance, were evaluated in a phenotyping platform under irrigated and rainfed conditions. Agronomic and physiological parameters such as grain yield, shoot structures, gas exchange, water potential, and osmotic adjustment were evaluated. The stress intensity was estimated to be 0.57, and the grain yield reduction ranged from 22 to 89%. Seven accessions, representative of the Andean and Mesoamerican germplasm (CF 200012, CF 240056, CF 250002, CF 900004, CNF 4497, CNF 7382, and SEA 5), presented superior performance in grain yield with and without stresses. The physiological responses under abiotic stresses were highly variable among the genotypes, and two Mesoamerican accessions (CF 200012 and SEA 5) showed more favorable adaptive responses. As the main secondary physiological traits, gas exchange and osmotic adjustment should be evaluated together with the grain yield to increase the selection efficiency of abiotic stresses-tolerant common bean lines.

https://ift.tt/2NONwcj

Highly efficient treatment of real benzene dye intermediate wastewater by simple limestone and lime neutralization-coagulation with improved Fenton oxidation

Abstract

Multistage Fenton oxidation is a favored method for the treatment of benzene dye intermediate (BDI) wastewater, but the pH adjustments required after each stage of the Fenton process with a simple way is still a challenge. Limestone pretreatment and lime neutralization-coagulation were used to solve the problem in multistage Fenton process. First, we determined the optimal conditions of Fenton oxidation using the Box-Behnken response surface method. Limestone pretreatment before the multistage Fenton process allowed for simultaneous pH adjustment and 14.15% COD removal. Most notably, the lime cream neutralization-coagulation process effectively adjusted the pH after each stage of the Fenton process. The optimum CaO particle size, lime mass fraction, mixing time, and stirring speed were determined by orthogonal tests. COD removal (89.23%) was obtained when lime cream neutralization-coagulation was applied to the three-staged Fenton process, while only 58.57% COD removal was obtained by the unadjusted single-staged Fenton process. The COD and wastewater color were reduced from 10,600 mg/L and 12,200 multiples to 495 mg/L and 20 multiples, respectively, using the adjusted process. This improved method provides a promising cost-effective way to efficiently treat real BDI wastewater.

https://ift.tt/2MLi6qR

Effect of distillery spentwash fertigation on crop growth, yield, and accumulation of potentially toxic elements in rice

Abstract

The safe disposal of industrial effluents always remained a challenging process because of their high level of nutrients, toxic elements, and salts. A pot experiment was conducted to investigate the effects of various concentrations (5%, 10%, 15%, and 20%) of sugar industry effluent spentwash (SW) fertigated with tab water (TW), on soil properties, crop growth, physiological parameters, yield components, and accumulation of potentially toxic elements (PTEs) in rice (Oryza sativa L.) grains and straw. The results showed that soil physico-chemical properties were modified with rise in SW concentration. Application of 5% SW significantly enhanced the plant growth, and yield components. Photosynthesis rate, transpiration rate, and stomatal conductance were significantly higher under 5% SW concentration in comparison with control. However, SW concentrations of > 5% showed inhibitory effects for all growth, physiological, and yield components. Accumulation of PTEs showed increasing trend with rise in SW concentration. However, under 5% SW concentration, all the PTEs in rice grain and straw were within the permissible limits (PLs) recommended by FAO/WHO and no health hazards were detected by health risk assessment. Based on the study results, 5% SW fertigation with TW can be applied as fertilizer for enhancing the growth and productivity of rice.

Graphical abstract

https://ift.tt/2NONhxV

The mTOR-inhibitor Sirolimus decreases the cyclosporine-induced expression of the oncogene ATF3 in human keratinocytes

Publication date: Available online 5 September 2018

Source: Journal of Dermatological Science

Author(s): Katrin Schaper-Gerhardt, Antje Walter, Christina Schmitz-Rode, Imke Satzger, Ralf Gutzmer

Abstract

Background

Due to their immunosuppressive therapy, organ transplant recipients (OTRs) exhibit a high incidence for the development of cutaneous squamous cell carcinoma (cSCC). Randomized studies of kidney-transplanted patients indicate a significant lower susceptibility for cSCC among patients receiving the mTOR-inhibitor Sirolimus, compared to patients without mTOR-regimen. The exact mechanism, how mTOR inhibition affects keratinocyte carcinogenesis remains unclear.

Objective

Our aim was to investigate the impact of Sirolimus on the expression level of the oncogene ATF3, which is involved in the development and progression of cSCC.

Methods

We incubated human keratinocytes, cSSC cell lines and 3D skin equivalents with Sirolimus, exposed the cells to calcineurin inhibitors (CNI) and UVA-radiation and measured the expression level of ATF3 by real-time PCR and western blot.

Results

We show that Sirolimus downregulates the expression of ATF3 induced by cyclosporine or cyclosporine plus UV-radiation in keratinocytes. In line with this we demonstrate a decrease in ATF3 expression, by incubating 3D skin equivalents with Sirolimus prior to cyclosporine and UV-light. However, Sirolimus has no significant impact on the ATF3 expression levels of cyclosporine stimulated cSCC cell lines.

Conclusion

Taken together, our study demonstrates that Sirolimus downregulates the CNI or UV-induced ATF3 expression in human keratinocytes, which could be a potential molecular mechanism how Sirolimus reduces cSCC in OTRs. The lack of ATF3 suppression by Sirolimus in cSCC cell lines fits to observations from clinical studies which demonstrated a clinical benefit from the switch to an mTOR-regimen in patients with low tumor burden in early stage of disease.

https://ift.tt/2oJF3Mo

Efficient segmentation and correction model for brain MR images with level set framework based on basis functions

Publication date: Available online 5 September 2018

Source: Magnetic Resonance Imaging

Author(s): Yunyun Yang, Sichun Ruan, Boying Wu

Abstract

With the wide application of MR images to detect disease in human's brain deeply, the shortcomings of the technology are necessarily waiting to be solved. For example, MR images always show serious intensity inhomogeneity called the bias field, which may prevent to deduce exact analysis of images. To eliminate the distraction, many methods are proposed. Though experimental results already have stood for the advantages of those methods, there are still lots of problems that cannot be neglected, such as bad segmentation, wrong correction and over-correction which has not attracted much attention yet. Among all those methods, the multiplicative intrinsic component optimization (MICO) model influenced us more. Based on the MICO model and split Bregman method, in this paper, we put forward a new model to segment and correct bias field moderately and simultaneously for MR images. Then, we applied our model to a large quantity of MR images, and gained lots of expected results. For a better observation, we compared our model with the MICO model in both segmentation and bias correction results, it can be seen from the experimental results that our model has performed well for the challenging intensity inhomogeneity problems. Many good characteristics like accuracy, efficiency and robustness also have been exhibited in numerical results and comparisons with the MICO model.

https://ift.tt/2PCG6cM

ADC-histogram analysis in head and neck squamous cell carcinoma. Associations with different histopathological features including expression of EGFR, VEGF, HIF-1α, Her 2 and p53. A preliminary study

Publication date: Available online 4 September 2018

Source: Magnetic Resonance Imaging

Author(s): Hans Jonas Meyer, Leonard Leifels, Gordian Hamerla, Anne Kathrin Höhn, Alexey Surov

Abstract

Objective

Apparent diffusion coefficient (ADC) values derived from Diffusion-weighted images are able to reflect tumor microstructure, such as cellularity, extracellular matrix or proliferation potential. This present study sought to correlate prognostic relevant histopathologic parameters with ADC values derived from a whole lesion measurement in head and neck squamous cell carcinoma (HNSCC).

Materials and methods

Thirty-four patients with histological proven primary HNSCC were prospectively acquired. Histogram analysis was derived from ADC maps. In all cases, expression of Hif1-alpha, VEGF, EGFR, p53, p16, Her 2 were analyzed.

Results

In the overall patient sample, ADCmax correlated with p53 expression (p = −0.446, p = 0.009) and ADCmode correlated with Her2-expression (p = −0.354, p = 0.047). In the p16 positive group there were several correlations. P25, P90 and entropy correlated with Hif1-alpha (p = −0.423, p = 0.05, p = −0.494, p = 0.019, p = 0.479, p = 0.024, respectively). Kurtosis correlated with P53 expression (p = −0.466, p = 0.029).

For p16 negative carcinomas the following associations could be identified. Mode correlated with VEGF-expression (p = −0.657, p = 0.039). ADCmax, P75, P90, and Std correlated with p53-expression (p = −0.827, p = 0.002, p = −0.736, p = 0.01, p = −0.836, p = 0.001 and p = −0.70, p = 0.016, respectively). There were no statistically significant differences of ADC histogram parameters between p16 positive and p16 negative carcinomas.

Conclusion

ADC histogram values can reflect different histopathological features in HNSCC. Associations between ADC histogram analysis parameters and histopathology depend on p16 status.

https://ift.tt/2NglVUi

Photochemical oxidation of di- n -butyl phthalate in atmospheric hydrometeors by hydroxyl radicals from nitrous acid

Abstract

The photochemical oxidation of di-n-butyl phthalate (DBP) by ^•OH radicals from nitrous acid (HONO) in atmospheric hydrometeors was explored by two techniques, steady-state irradiation, and laser flash photolysis (LFP). The effects of atmospheric liquid parameters on DBP transformation were systematically evaluated, showing that DBP does not react with HONO directly and ^•OH-initiated reactions are crucial steps for consumption and transformation of DBP. Two reaction channels are operative: ^•OH addition and hydrogen atom abstraction. The overall rate constant for the reaction of DBP with ^•OH is 5.7 × 10⁹ M⁻¹ s⁻¹, and its specific rate constant for addition is 3.7 × 10⁹ M⁻¹ s⁻¹ determined by using laser flash photolysis technique. Comparing the individual reaction rate constant for aromatic ring addition with the total rate constant, the majority of the ^•OH radicals (about 65%) attack the aromatic ring. The major transformation products were identified by GC-MS, and the trends of their yields derived from both ring addition and H-abstraction with time are discussed. These results provide important insights into the photochemical transformation of DBP in atmospheric hydrometeors and contribute to atmospheric aerosol chemistry.

https://ift.tt/2CmspwM

Evaluation of anthropometric parameters of central obesity in Pakistani children aged 5–12 years, using receiver operating characteristic (ROC) analysis

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

https://ift.tt/2CkPqjp

Coagulase-Negative Staphylococcus Skin and Soft Tissue Infections

Abstract

Coagulase-negative staphylococcus organisms may be normal flora of human skin, however these bacteria can also be pathogens in skin and soft tissue infections. A summary of skin and soft tissue infections caused by coagulase-negative staphylococcus species is provided in this review. We conducted a search of the PubMed database using the following terms: abscess, auricularis, biofilm, capitis, cellulitis, coagulase, contaminant, cyst, draining, epidermidis, felon, folliculitis, furuncle, haemolyticus, hominis, indolent, infection, lugdunensis, mecA, microbiome, negative, osteomyelitis, paronychia, saprophyticus, skin, simulans, sinus, soft, staphylococcus, systemic, tissue, virulence, virulent, and vulvar. The relevant papers, and their references, generated by the search were reviewed. Skin and soft tissue infections have been observed to be caused by many coagulase-negative staphylococcus organisms: Staphylococcus auricularis, Staphylococcus capitis, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus lugdunensis, Staphylococcus saprophyticus, and Staphylococcus simulans. Coagulase-negative staphylococcus skin infections predominantly present as abscesses and paronychia. They are most common in elderly patients or those individuals who are immunosuppressed, and tend to be broadly susceptible to antibiotic treatment. In conclusion, albeit less common, coagulase-negative staphylococcus organisms can result in skin and soft tissue infections, particularly in older and/or immunocompromised individuals. A review of the literature found that coagulase-negative staphylococcus organisms are most commonly grown in cultures of abscesses and paronychia. Therefore, coagulase-negative staphylococcal organisms should not always be considered as contaminants or normal flora, but rather as causative pathogens. They are usually susceptible to antibiotics used to treat methicillin-sensitive Staphylococcus aureus.

https://ift.tt/2MQoUTS

Hair and Scalp Changes in Cutaneous and Systemic Lupus Erythematosus

Abstract

Cutaneous and systemic lupus erythematosus (SLE) commonly involves the hair and scalp. Alopecia can result from direct activity of disease on the scalp or from the state of physical stress in the form of telogen effluvium. Discoid lupus erythematosus and lupus panniculitis/profundus are known to cause scarring alopecia, while accumulation of recent studies has shown that non-scarring alopecia in SLE may have different subtypes, comprising lupus erythematosus-specific and lupus erythematosus-nonspecific changes on histology. This review aims to summarize the clinical pattern, trichoscopic, histopathological, and direct immunofluorescence features of different types of alopecia in cutaneous and systemic lupus erythematosus, as well as exploring their relationship with SLE disease activity.

https://ift.tt/2Q4WqUD

Levels and sources of organic compounds in fine ambient aerosols over National Capital Region of India

Abstract

The study presents the spatial and temporal variation of fine ambient aerosols (PM_2.5) over National Capital Region (NCR), India, during January to June 2016. The investigation includes three sampling sites, one in Delhi and two in the adjoining states of Delhi (Uttar Pradesh and Haryana), across NCR, India. The average PM_2.5 concentration was highest for Delhi (128.5 ± 51.5 μg m⁻³) and lowest for Mahendragarh, Haryana (74.5 ± 28.7 μg m⁻³), during the study period. Seasonal variation was similar for all the sites with highest concentration during winter and lowest in summer. PM_2.5 samples were analysed for organic compounds using gas chromatograph (GC). The concentration of three organic compound classes, n-alkanes (C11–C35), polycyclic aromatic hydrocarbons (PAHs), and phthalates, present in PM_2.5 samples has been reported. Diagnostic ratios for n-alkanes demonstrated that biogenic emissions were dominant over Mahendragarh while major contributions were observed from petrogenic emissions over Delhi and Modinagar, Uttar Pradesh. Molecular diagnostic ratios were calculated to distinguish between different sources of PAHs, which revealed that the fossil fuel combustion (diesel and gasoline emissions), traffic emissions, and biomass burning are the major source contributors. Health risk associated with human exposure of phthalates and PAHs was also assessed as daily intake (DI, ng kg⁻¹ day⁻¹) and lung cancer risk, respectively. Backward trajectory analysis explained the local, regional, and long-range transport routes of PM_2.5 for all sites. Principal component analysis (PCA) results summarized that the vehicular emissions, biomass burning, and plastic burning were the major sources of the PAHs and phthalates over the sampling sites.

https://ift.tt/2Q7gtSm

Earthworms as plug flow reactors: a first-order kinetic study on the gut of the vermicomposting earthworm Eudrilus eugeniae

Abstract

Earthworms are commonly referred as environmental engineers and their guts are often compared with chemical reactors. However, modeling experiments to substantiate it are lacking. The aim of this study was to use established reactor models, particularly PFR, on the gut of the vermicomposting earthworm Eudrilus eugeniae to understand more on its digestion. To achieve the objective, a mathematical model based on first-order kinetics was framed and used to determine the pattern of digestion rates of nutrient indicators, namely total carbon (%), total nitrogen (%), C/N ratio, ¹³C (‰), and ¹⁵N (‰) at five intersections (pre-intestine, foregut, midgut A, midgut B, and hindgut) along the gut of E. eugeniae. The experimental results revealed that the concentrations of TC, TN, ¹³C, and ¹⁵N decreased during gut transit, whereas C/N ratio increased. The first-order model demonstrated that all the nutrients exhibit a linear pattern of digestion during gut transit, which supports the PFR model. On this basis, the present study concludes that the gut of E. eugeniae functions as PFR.

https://ift.tt/2MRSJ6V

Influence of physician evaluation portals on orthodontist selection by patients

Abstract

Objective

This survey aimed to determine the influence of physician evaluation portals (PEP) on a patient's choice of physicians, particularly orthodontists.

Materials and methods

Questionnaires were used to collect sociodemographic data, reasons for orthodontist selection, type of Internet use, as well as information on the knowledge, use and evaluation of 14 popular PEPs. A total of 506 questionnaires were evaluated, and a descriptive statistical evaluation was conducted using the χ² test.

Results

The majority of the respondents selected orthodontists on the basis of personal recommendations by other physicians (35%), family/friends (33%) or patient referral (14%). Currently, the most popular portals in Germany, which are mostly found through Internet searches, are jameda.de (36%) and arztauskunft.de (19%). A total of 5% of the respondents have already used a PEP to evaluate a physician. Moreover, 70% of the respondents described PEPs as helpful, 28% as recommendable and 2% use PEPs regularly. Knowledge of PEPs is correlated with the level of educational attainment (p = 0.024) and the frequency of Internet use (p < 0.001).

Conclusion

On the selection of healthcare providers, particularly orthodontists, PEPs have little influence. Patients select physicians on the basis of personal recommendations. Physicians' concerns about negative evaluations on PEPs are unfounded given the low level of awareness of PEPs by the general populace.

https://ift.tt/2PD6BOW

Kinematic posture analysis of orthodontists in their daily working practice

Abstract

Purpose

The aim of this study is to conduct a kinematic analysis of occupational posture in orthodontists.

Methods

A representative sample of 21 (13 female/8 male) residents in orthodontics and orthodontists was studied. The CUELA system collects kinematic data of the occupational posture. Alongside the kinematic analysis, the tasks performed on-site were also subject to a detailed computerized analysis. Data analysis comprised the evaluation and comparison of joint angle distribution in accordance with ergonomic standards categorized as neutral, moderate or awkward posture.

Results

The most common activities were executed in a seated position. During "treatment" (28% of total time) participants most often worked with a straight back (84.7%), whereas a "bent or twisted" torso posture was observed 23.4% of the time. For head and cervical spine, the 75th and 95th percentiles presented worse (higher) values during treatment as compared to non-orthodontic activities. The seated position next to the patient during treatment showed a stronger inclination of the thoracic spine to the right and an inclination of the lumber spine to the left.

Conclusions

Orthodontists do take characteristic postures during treatment activities with highest angle values. The postures differ in the area of head and cervical spine with regard to the various activities carried out in the 3 categories.

https://ift.tt/2Cjm4lN

Influence of physician evaluation portals on orthodontist selection by patients

Abstract

Objective

This survey aimed to determine the influence of physician evaluation portals (PEP) on a patient's choice of physicians, particularly orthodontists.

Materials and methods

Results

Conclusion

https://ift.tt/2PD6BOW

A systematic review of financial implications of air pollution on health in Asia

Abstract

Economic losses due to health-related implications of air pollution were huge and incurred significant burdens towards healthcare providers. The objective of this study is to systematically review published literature on the financial implications of air pollution on health in Asia. Four databases: PubMed, Scopus, NHS Economic Evaluation Database (NHS EED), and Web of Science (WoS) were used to identify all the relevant articles. It was limited to all articles that had been published in the respected databases from January 2007 until March 2017. Twenty-four articles were included in this review. Five of the 24 studies (20.8%) reported financial implications of air pollution-related disease through value of statistical life (VOSL) which ranged from USD180 million to USD2.2 billion, six (25%) studies used cost of illness (COI) to evaluate air pollution-related morbidity and found that the cost ranged from USD5.4 million to USD9.1 billion. Another six studies (25%) used a combination of VOSL and COI for both mortality and morbidity valuation and found that the financial implications ranging from USD253 million to USD2.9 billion. Thirteen (54.2%) studies reported healthcare cost associated with both hospital admission and outpatient visit, five (20.1%) on hospital admission only, and one (4.2%) on outpatient visit only. Economic impacts of air pollution can be huge with significant deterioration of health among the Asians.

https://ift.tt/2NkAdDe

Application of magnesium peroxide (MgO 2 ) nanoparticles for toluene remediation from groundwater: batch and column studies

Abstract

In the present study, magnesium peroxide (MgO₂) nanoparticles were synthesized by electro-deposition process and characterized by X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The batch experiments were conducted to evaluate the MgO₂ half-life (600 mg/L) in groundwater under various temperatures (4, 15, and 30 °C) and initial pH (3, 7, and 12). The effect of Fe²⁺ ions (enhanced oxidation) on the toluene remediation by MgO₂ was also investigated. Nanoparticles were injected to sand-packed continuous-flow columns, and toluene removal (50 ppm) was studied within 50 days at 15 °C. The results indicated that the half-life of MgO₂ at pH 3 and 12 were 5 and 15 days, respectively, in comparison to 10 days at the initial pH 7 and 15 °C. The nanoparticles showed 20 and 7.5 days half-life at 4 and 30 °C temperatures, respectively. Injection of Fe²⁺ ions indicated an impressive effect on toluene removal by MgO₂, and the contaminant was completely removed after 5 and 10 days, in the batch and column experiments, respectively. Confocal laser scanning microscope (CLSM) analysis indicated that the attached biofilm had a significant role in the decontamination of groundwater. Comparison of bioremediation and enhanced oxidation resulted in a considerable insight into the application of magnesium peroxide in groundwater remediation.

Graphical abstract

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https://ift.tt/2ClqYP3

Peri‐implant inflammation and marginal bone level changes around dental implants in relation to proximity with and bone level of adjacent teeth

Australian Dental Journal, Volume 0, Issue ja, -Not available-.

https://ift.tt/2Q6zqog

Kinematic posture analysis of orthodontists in their daily working practice

Abstract

Purpose

The aim of this study is to conduct a kinematic analysis of occupational posture in orthodontists.

Methods

Results

Conclusions

https://ift.tt/2Cjm4lN

Environmental exposure of anthropogenic micropollutants in the Prut River at the Romanian-Moldavian border: a snapshot in the lower Danube river basin

Abstract

The Prut River, the second longest tributary of the Danube river, was investigated for a wide range of anthropogenic organic pollutants to fill the data gap on environmental contamination in eastern European surface waters. In this study, the occurrence of a wide range of organic pollutants was measured along the transboundary Prut River, between Sculeni and Branza in 2010–2012. Using two different analytical methods, gas chromatography coupled to mass spectrometry and liquid chromatography coupled to high-resolution mass spectrometry, over 300 compounds were screened for and 88 compounds were determined in the Prut River. In general, the chemicals occurred at low levels. At the last sampling site upstream of the confluence with the Danube river at Branza, the highest average concentrations (≥ 100 ng L⁻¹) were determined for the artificial sweetener acesulfame, the pharmaceuticals metformin, 4-acetamidoantipyrene, and 4,4,5,8-tetramethylchroman-2-ol, the antioxidants 2,4-di-tert-butylphenol, 3-tert-butyl-4-hydroxyanisol, and 3,5-di-tert-butyl-4-hydroxy-toluene, the personal care products HHCB (galaxolide), 4-phenyl-benzophenone, and octyl dimethyl-p-aminobenzoic acid, the industrial chemical diphenylsulfone, and the sterol cholesterol. Low concentrations of agricultural pesticides occurred in the catchment. At Branza, the total accumulated load of all measured compounds was calculated to be almost 19 kg day⁻¹. In comparison to the Rhine River, the loads in the Prut, determined with same LC-HRMS method for the same set of analytes, were two orders of magnitude lower. Discharge of wastewater without proper treatment from the city of Iasi in the Jijia catchment (Romania) as well as from the city of Cahul (Moldova) revealed a distinct increase in concentrations and loads in the Prut at Frasinesti and Branza. Thus, an implementation of wastewater treatment capacities in the Prut River basin would considerably reduce the loads of micropollutants from urban point sources.

https://ift.tt/2ClRcAT

Telemedical Deep Brain Stimulation: Merits and Limitations

Stereotact Funct Neurosurg

https://ift.tt/2PzcNYu

Enhancement by Nano-Diamino-Tetrac of Antiproliferative Action of Gefitinib on Colorectal Cancer Cells: Mediation by EGFR Sialylation and PI3K Activation

Abstract

Drug resistance complicates the clinical use of gefitinib. Tetraiodothyroacetic acid (tetrac) and nano-diamino-tetrac (NDAT) have been shown in vitro and in xenografts to have antiproliferative/angiogenic properties and to potentiate antiproliferative activity of other anticancer agents. In the current study, we investigated the effects of NDAT on the anticancer activities of gefitinib in human colorectal cancer cells. β-Galactoside α-2,6-sialyltransferase 1 (ST6Gal1) catalyzes EGFR sialylation that is associated with gefitinib resistance in colorectal cancers, and this was also investigated. Gefitinib inhibited cell proliferation of HT-29 cells (K-ras wild-type), and NDAT significantly enhanced the antiproliferative action of gefitinib. Gefitinib inhibited cell proliferation of HCT116 cells (K-ras mutant) only in high concentration, and this was further enhanced by NDAT. NDAT enhancedd gefitinib-induced antiproliferation in gefitinib-resistant colorectal cancer cells by inhibiting ST6Gal1 activity and PI3K activation. Furthermore, NDAT enhanced gefitinib-induced anticancer activity additively in colorectal cancer HCT116 cell xenograft-bearing nude mice. Results suggest that NDAT may have an application with gefitinib as combination colorectal cancer therapy.

https://ift.tt/2NnsKni

Radiostrontium transport in plants and phytoremediation

Abstract

Radiostrontium is a common product of nuclear fission and was emitted into the environment in the course of nuclear weapon tests as well as from nuclear reactor accidents. The release of ⁹⁰Sr and ⁸⁹Sr into the environment can pose health threats due to their characteristics such as high specific activities and easy access in human body due to its chemical analogy to calcium. Radiostrontium enters the human food chain by the consumption of plants grown on sites comprising fission-derived radionuclides. For humans, Sr is not an essential element, but, due to solubility in water and homology with calcium, once interred in the body, it gets deposited in bones and in teeth. This concern has drawn the attention of researchers throughout the globe to develop sustainable treatment processes to remediate soil and water resources. Nowadays, phytoremediation has become a promising approach for the remediation of large extents of toxic heavy metals. Some of the plants have been reported to accumulate Sr inside their biomass but detailed mechanisms at genetic level are still to be uncovered. However, there is inadequate information offered to assess the possibility of this remediation approach. This review highlights phytoremediation approach for Sr and explains in detail the uptake mechanism inside plants.

https://ift.tt/2wKfQG7

Immediate implant placement following 1-year treatment with oral versus intravenous bisphosphonates: a histomorphometric canine study on peri-implant bone

Abstract

Objectives

Bisphosphonates (BPs) are anti-resorptive medications with inhibitory effects on osteoclasts which decrease bone turnover. The present study aimed to assess the early effects of BPs on peri-implant bone.

Materials and methods

Twelve female mongrel dogs were assigned to one control and two experimental groups as follows: 12 months of oral alendronate (ALN, 3.5 mg/kg/week) or intravenous (IV) pamidronate (PAM, 1 mg/kg/week) for experimental groups. Following 8 weeks after implant insertion, the specimens were sacrificed, histological evaluation was performed, and C-terminal telopeptide of collagen I (CTx) analysis was performed on serums.

Results

PAM demonstrated the greatest marginal bone level (MBL), 2.64 ± 0.48, followed by ALN and control, 2.5 ± 0.4 and 0.66 ± 0.5 respectively. The least bone-implant contact was observed in PAM group (%39 ± 0.03) while it was significantly greater in the control group (p < 0.05). PAM and ALN demonstrated < 10 CTx levels versus > 300 in controls.

Conclusion

It is assumed that long-term oral or IV BP therapy decreases marginal bone resorption and osseointegration. These changes were more accentuated in IV BP administration. CTx does not seem to be a precise predictor for bisphosphonate-related osteonecrosis of the jaw.

Clinical relevance

BPs impair peri-implant bone remodeling and this phenomena may be effective for reducing resorption at esthetic zone implants; however, decrease in osseointegration may be a concern for implant treatment in patients receiving BPs.

https://ift.tt/2Ci5jak

Aesthetic dermatology: What's new, what's true?

Dermatologic Therapy, EarlyView.

https://ift.tt/2NOuN0z

Heavy metal leaching and plant uptake in mudflat soils amended with sewage sludge

Abstract

The leaching and uptake of Cd, Cu, Pb, and Zn by maize (Zea mays L.) in mudflat saline-alkali soils amended by sewage sludge was examined using a greenhouse leaching column experiment. Application of sewage sludge caused decreased pH, increased DOC, and increased Cd, Cu, Pb, and Zn concentrations in leachates. The similar temporal dynamics of DOC and the metal concentrations in leachates suggested complexation of the metals with DOC. There was downward movement of metals as evidenced by the metal enrichment in the bottom layer (20–40-cm depth) of leaching columns (p < 0.05). The enrichment of metals was contributed by the acid-soluble/exchangeable fraction (EX), reducible fraction (RG), oxidizable fraction (OXI), and residual fraction (RES), indicating redistribution of leached metals from the top 20-cm layer. The sewage sludge application also enhanced plant uptake of metals. However, even under the greatest sludge application rate (150 g kg⁻¹), very small proportions, averagely 0.65% and 0.35%, of the applied metals were leached and taken up by maize, respectively, over the experimental period. Long-term field-scale research is warranted for further investigation of the effects of sewage sludge amendment on heavy metal fractionation and distribution in mudflat soil-plant-water system.

https://ift.tt/2Ci8IpC

Application of Photoacoustic Methods and Confocal Microscopy for Monitoring of Therapeutic Response in Plaque Psoriasis

Psoriasis is prone to relapses and requires long-term therapy that may induce a range of adverse effects; therefore, an efficient and early detection of relapses is desirable. In this study, photoacoustic imaging and confocal laser scanning microscopic (CLSM) methods were investigated for their suitability in psoriasis follow-up examinations. Using a high-resolution photoacoustic system, the vascular structures of 11 psoriatic patients and 6 healthy volunteers were investigated. No differences were detected with respect to the average vessel diameter and vasculature per unit volume in the tissue of healthy volunteers and non-lesional and lesional skin areas of psoriatic patients. By means of CLSM, the diameters of the dermal papillae of 6 volunteers and 6 psoriatic patients were determined. The diameters of the dermal papillae of the healthy volunteers (0.074 ± 0.006 mm) revealed no significant difference when compared to non-lesional skin areas of psoriatic patients (0.079 ± 0.005 mm). The results obtained for the lesions in psoriatic patients showed a significant difference (Wilcoxon test, p = 0.028) between the diameters of the dermal papillae of the lesional skin areas (0.114 ± 0.012 mm) and the non-lesional skin areas (0.079 ± 0.005 mm). Thus, CLSM can be applied for monitoring psoriasis follow-up examinations.
Skin Pharmacol Physiol 2018;31:308–315

https://ift.tt/2MRCgQ8

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Τετάρτη 5 Σεπτεμβρίου 2018

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