Background: The prevalence of narrow-band ultraviolet B (NB-UVB) use in Europe for moderate and severe psoriasis is unknown, because national registries for psoriasis do not monitor this treatment. Objectives: To quantify the use of phototherapy, biologics or conventional treatments in psoriasis, in a setting where European Medicines Agency (EMA) eligibility criteria for biologics were strictly applied, and phototherapy was included among first-line treatments. Methods: We followed a cohort of 1,090 patients who were referred to the only centre entitled to prescribe biologics and phototherapy during a 5-year period. Results: The cumulative number of treatment cycles was: 1,047 with NB-UVB phototherapy, 650 with systemic treatments and 239 with biologics; 754 patients received at least 1 course of NB-UVB phototherapy, 422 at least 1 course with a systemic treatment and 137 with a biologic; 595 patients were treated only with phototherapy. Conclusions: Regular use of NB-UVB as first-line treatment for moderate and severe psoriasis and adherence to the EMA eligibility criteria for biologics led to a relatively restricted use of biologics.
Dermatology
https://ift.tt/2CJMMUR
Δευτέρα 10 Σεπτεμβρίου 2018
Epidemiological and Clinical Patterns of Kaposi Sarcoma: A 16-Year Retrospective Cross-Sectional Study from Yaoundé, Cameroon
Background: The burden of Kaposi sarcoma (KS) is increasing fast among HIV-infected populations, but the disease remains desperately underexplored in Cameroon, where the burden of HIV is high. Methods: This is a retrospective cross-sectional study carried out over a period of 16 years (January 2001 to December 2016) at the HIV day care unit of the Central Hospital of Yaoundé, Cameroon. The diagnosis was based on clinical aspects and histological confirmation, and we used a preconstructed questionnaire for data collection through patients' electronic and physical files. Results: Among 14,220 files reviewed, 316 cases of KS were identified, yielding a cumulative incidence of 2.2%. In the end, 266 patients (55% male) were included in this study. The patients' age ranged from 17 to 72 years, with a mean of 37.8 ± 9.5 years. KS was the presenting manifestation of HIV in 89.8% of the cases. Cutaneous lesions occurred more often (81.6%), mainly located on the lower limbs (47.7%); mucous lesions were found in 15.8% of the patients, while 8 patients (3.0%) had associated visceral lesions. The lesions predominantly were lymphedemas (28.6%) and papulonodules (21.1%). At the diagnosis of KS, the median CD4 count was 175 cells/mm3 (interquartile range 80.5–288.5), and 150 patients (56.6%) had CD4 counts #x3c; 200 cells/mm3. Conclusions: KS is frequent among our HIV-infected patients; it seems to occur most often at a younger adult age and represents one of the presenting manifestations of HIV/AIDS in our context. It seems to equally affect men and women, occurring more often when CD4 counts are #x3c; 200 cells/mm3.
Dermatology
https://ift.tt/2QmyFaS
Dermatology
https://ift.tt/2QmyFaS
Gender differences in doxorubicin pharmacology for subjects with chemosensitive cancers of young adulthood
Abstract
Purpose
For many cancers, adolescents and young adults (AYA) have worse outcomes than for children and adults. Many factors may contribute to the AYA survival gap, including differences in biology, therapeutic intent, and adherence to therapy. It has been observed that male AYAs have poorer outcomes than females. The purpose of this work was to test the proposition that gender-related pharmacologic factors may account for a component of the AYA survival gap.
Patients and methods
A prospective, multi-institutional pharmacologic study of 79 patients in total with chemosensitive cancers (Ewing sarcoma, osteosarcoma and Hodgkin lymphoma) was conducted, with conventional doxorubicin treatment. Pharmacokinetic data of 13 children, 40 AYAs and 13 adults were valid for analysis. Population pharmacokinetics models were developed for doxorubicin and its metabolite doxorubicinol based on the data created in this study. Consequently, model-based analysis was conducted to investigate the relevant topics.
Results
The clearance of doxorubicinol (normalized to body surface area), the main active metabolite of doxorubicin, appears faster in male AYAs than female (p = 0.04, 95% CI 0.1–3.9 L/h). The exposure of doxorubicinol (normalized to dose) is lower in male AYA than female (p = 0.03, 95% CI − 0.005 to − 0.0002 h/L). These might be correlated to the observed difference on nadir neutrophil count between male AYA and female (p = 0.027, 95% CI 0.09–1.4).
Conclusion
Gender-related differences in doxorubicin pharmacology may account for worse outcomes for male AYAs with chemosensitive cancers compared to females. These findings may reduce the AYA survival gap compared to other age groups.
https://ift.tt/2NuP6Dn
Characterization of bacterial and microbial eukaryotic communities associated with an ephemeral hypoxia event in Taihu Lake, a shallow eutrophic Chinese lake
Abstract
While the important roles of microbial communities in oceanic hypoxic zones were beginning to be understood, little is known about microbial community associated with this phenomenon in shallow lakes. To address this deficit, both the bacterial and microbial eukaryotic communities of an ephemeral hypoxic area of Taihu Lake were characterized. The hypoxia provided nutritional niches for various bacteria, which results in high abundance and diversity. Specific bacterial groups, such as vadinBC27 subgroup of Bacteroidetes, Burkholderiales, Rhodocyclales, Pseudomonas, and Parcubacteria, were dominated in hypoxic sites and relevant to the fermentation, denitrification, nitrification, and sulfur metabolism. Conversely, most of microbial eukaryotes disappeared along with the decline of DO. An unexpected dominance of fungi was observed during hypoxia, which partly explained by the accumulation of toxic algae. Mucor was the single dominant genus in the hypoxic zone. We proposed that this group might cooperate with bacterial communities in the anaerobic degradation of algal biomass and woody materials. Generally, the hypoxic microbiome in shallow lakes is mainly involved in fermentative metabolism depending on phytodetritus and is potentially influenced by terrestrial sources. This study provided new insights into the unique microbiome in short-term hypoxia in shallow lakes and lays the foundation for studies that will enhance our understanding of the microbial players associated with hypoxia and their adaption strategy on the global scale.
https://ift.tt/2Nr4Hnt
Results from a Monocentric Long‐Term Analysis of 23 Patients with Ovarian Sertoli‐Leydig Cell Tumors
AbstractBackground.Sertoli‐Leydig cell tumors (SLCTs) represent less than 0.5% of ovarian tumors. Because of the rarity of this tumor and its peak in frequency at around 25 years of age, this study aimed to describe SLCT management strategies.Objective.The objective of this study was to determine the management (i.e., conservative surgery and adjuvant chemotherapy) of ovarian SLCTs.Results.This retrospective analysis included 23 patients treated for ovarian SLCTs. A centralized pathologic review of the tumors was conducted. Patients were referred to or treated in our institution for an ovarian SLCT between 1994 and 2015. The median age at diagnosis was 33 years (range, 4–82 years). According to the 2014 Federation of Gynecology and Obstetrics classification, tumors were classified as stage Ia (n = 15: well differentiated, n = 1; of intermediate differentiation, n = 8; undifferentiated, n = 4; and undefined, n = 2), stage Ib (n = 1), stage Ic1 (n = 5), stage IIb (n = 1), and stage IIIc (n = 1). Surgery was conservative in 13 patients (Ia, n = 7; Ib, n = 1; Ic1, n = 5) and radical in 10 patients (Ia, n = 8; IIb, n = 1; IIIc, n = 1). Seven patients received adjuvant chemotherapy with a cisplatin‐based regimen (Ia, n = 2; Ic1, n = 3; IIb, n = 1) or docetaxel + gemcitabine (IIIc, n = 1). Median follow‐up was 61 months (range, 15–252 months). Eight patients experienced a relapse (Ia, n = 2; Ib, n = 1; Ic1, n = 3; IIb, n = 1; IIIc, n = 1). Of these, six had at least one peritoneal carcinomatosis, and four died (Ic1, n = 2; IIb, n = 1; and Ia, n = 1). Two patients had a local relapse (one uterus and one ovary) and survived without disease after relapse treatment. The median time between the initial treatment and relapse was 28 months (range 9–70).Conclusion.Conservative surgery was safe for patients with stage Ia ovarian SLCTs. The place of conservative surgery for stage Ic1 remains to be defined. The best chemotherapy regimen remains to be defined.Implications for Practice.For stage Ia disease, conservative surgery (in women of reproductive age) was safe and effective for treating ovarian Seroli‐Leydig cell tumors. Adjuvant chemotherapy should be proposed for stage Ia when poor prognostic factors are present (poor differentiation, retiform pattern, or heterologous elements). For stage Ic1 and more severe stages, radical surgery and adjuvant chemotherapy should be considered. The combination of bleomycin, etoposide, and cisplatin was the most frequently used regimen, but the best chemotherapy regimen remains to be defined.
https://ift.tt/2x3AbFW
Distinguishing histopathologic features of acantholytic dermatoses and the pattern of acantholytic hypergranulosis
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2O4FXhF
Specialized group intervention for compulsive exercise in inpatients with eating disorders: feasibility and preliminary outcomes
Abstract
Background
Patients with eating disorders (ED) often suffer from compulsive exercise behavior, which is associated with lower short-term response to treatment and poorer long-term outcome. Evidence-based interventions specifically targeting compulsive exercise behavior have been scarce so far. We developed a manualized group therapeutic approach integrating cognitive-behavioral therapy, exercise therapy and exposure with response management to promote healthy exercise behavior. Our objective was to examine the feasibility and acceptance of this new approach as add-on to regular inpatient treatment in a pilot study. Additionally, we wanted to estimate preliminary effect sizes.
Methods
Thirty-two female, adolescent and adult eating disordered inpatients were recruited. According to the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), twenty-six patients met criteria for Anorexia nervosa (AN), two for Bulimia nervosa and four for eating disorder not otherwise specified. Semi-structured interviews were conducted for qualitative evaluation of feasibility and acceptance of the new intervention. Patients completed the Commitment to Exercise Scale (CES) and the Compulsive Exercise Test (CET) for assessment of compulsive exercise, the Eating Disorder Inventory-2 for assessment of eating disorder pathology, the Beck Depression Inventory-II and Brief Symptom Inventory for assessment of depressive and general psychopathology and the Emotion Regulation Skills Questionnaire for assessment of emotion regulation before the beginning and at the end of the group intervention. Additionally, weight gain was monitored.
Results
Feasibility of our approach was confirmed. All patients reported a high satisfaction with both structure and content of the group. Between pre- and post-intervention, patients showed significant reductions in compulsive exercise (effect size CES: 1.44; effect size CET total: 0.93), drive for thinness (effect size: 0.48), depressive symptoms (effect size: 0.36), general psychopathology (effect size: 0.29) and acceptance of emotions (effect size: − 0.62). Patients with AN also showed significant mean weight gain during the intervention (effect size: − 0.44).
Conclusions
Results of our pilot study indicate that our integrative approach to compulsive exercise in ED patients might represent a promising new therapeutic option. Feasibility and acceptance of the intervention were confirmed. Preliminary effect sizes on most outcomes were promising. As improvements in Body-mass-index, eating disorder and general psychopathology are also to be expected by routine inpatient treatment, a large randomized trial is currently underway to evaluate the efficacy of this new intervention.
https://ift.tt/2CJ2iQS
Prevalence of disturbed eating behavior and associated symptoms of anxiety and depression among adult males and females with type 1 diabetes
Abstract
Background
The increased prevalence of disturbed eating behaviors (DEB), depression, and anxiety in type 1 diabetes (T1D) is generally well established; however the majority of existing research to date has focused on female adolescents and young adults. Data on males and older females is scarce. The aim of this study was to assess prevalence of DEB and symptoms of depression and anxiety among adult males and females with type 1 diabetes, to investigate differences between individuals scoring below and above the cut-off on psychopathology, and to examine patterns of eating disorder psychopathology by age and weight.
Methods
A total of 282 adults with type 1 diabetes aged 18–79 years participated in the study. Measures included the Diabetes Eating Problem Survey – Revised (DEPS-R), the Hospital Anxiety and Depression Scale (HADS), and clinical data from the Norwegian Quality Improvement of Laboratory Examinations (NOKLUS) system.
Results
A total of 20.3% of the whole sample (13.3% among males and 24.8% among females) scored above the DEPS-R cut-off score for DEB. As for depression and anxiety, the prevalence in the whole sample was 6.2% and 19.0%, respectively. The prevalence was generally higher in females than males across all psychopathology measures. HbA1c was significantly associated with the DEPS-R total score (p < .01) among females, but not with depression and anxiety. Mean DEPS-R score decreased with increasing age, and when our previous reported data from children and adolescents are included, a peak prevalence in DEB in adolescence and young adult age is demonstrated.
Conclusions
The results of this study point to the need for increased awareness of psychological comorbidity among adults with type 1 diabetes, in particular young adult females. Screening is recommended to secure early detection and subsequent intervention for these individuals.
https://ift.tt/2Qqle9Q
Anti‐inflammatory and antiradical effects of a 2% diosmin cream in a human skin organ culture as model
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2x1dgvu
Minimally invasive approaches to axillary osmidrosis treatment: A comparison between superficial liposuction with automatic shaver curettage, subcutaneous laser treatment, and microwave‐based therapy with a modified technique
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2O6ds3h
Lead exposure from households and school settings: influence of diet on blood lead levels
Abstract
Lead is known as a potent toxicant to human health, particularly for children while their central nervous system is developing. The aim of this study was to investigate the associations between blood lead levels (BLLs) and lead exposure in the children's diet, home, and school environments. A cross-sectional study was conducted with 153 children aged 1–4 years, in four day care centers (DCCs), where a high prevalence of lead exposure was previously found. Lead determination by graphite furnace atomic absorption spectrometry (GF-AAS) was performed for venous blood, drinking water collected in the DCCs, and the 24-h diet (n = 64). Environmental screenings were conducted to evaluate lead concentrations in the tableware, buildings, and playground items in all DCCs and children's homes (n = 18) by using a field-portable X-ray fluorescence analyzer (FP-XRF). The BLL mean was 2.71 μg dL−1. Means for 24-h lead concentrations in the diet were 1.61 and 2.24 μg kg−1 of body weight (BW) in two DCCs. Lead concentrations in the water supply were lower than 2 μg L−1. More than 11% of the DCCs' environmental analyses presented lead concentrations higher than or equal to 1 mg cm−2, as defined by the USEPA. The diet was not found to be a risk factor for lead exposure, but households and DCC settings raised concern. Children's exposure to lead in DCC environments, where they spend the most part of their weekdays, appeared to be relevant.
Graphical abstract
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https://ift.tt/2MlbUAV
Adsorption of basic and reactive dyes from aqueous solution onto Intsia bijuga sawdust-based activated carbon: batch and column study
Abstract
The adsorption behavior of basic, methylene blue (MB), and reactive, remazol brilliant violet 5R (RBV), dyes from aqueous solution onto Intsia bijuga sawdust-based activated carbon (IBSAC) was executed via batch and column studies. The produced activated carbon was characterized through Brunauer-Emmett-Teller (BET) surface area and pore structural analysis, proximate and ultimate, scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR). Batch studies were performed to investigate the effects of contact time, initial concentration, and solution pH. The equilibrium data for both MB and RBV adsorption better fits Langmuir model with maximum adsorption capacity of 434.78 and 212.77 mg/g, respectively. Kinetic studies for both MB and RBV dyes showed that the adsorption process followed a pseudo-second-order and intraparticle diffusion kinetic models. For column mode, the breakthrough curves were plotted by varying the flow rate, bed height, and initial concentration and the breakthrough data were best correlated with the Yoon-Nelson model compared to Thomas and Adams-Bohart model. The adsorption activity of IBSAC shows good stability even after four consecutive cycles.
https://ift.tt/2oWpSzH
Roles of hydrophobic and hydrophilic fractions of dissolved organic matter in sorption of ketoprofen to biochars
Abstract
Hydrophobic acid (HoA) and hydrophilic neutral (HiN) are two major fractions of dissolved organic matter (DOM). Their role in the sorption of ketoprofen (KTP) to wheat straw-derived biochars pyrolyzed at 300 °C (WS300) and 700 °C (WS700) was investigated to further probe the mechanisms responsible. WS700 has much higher pore volume and specific surface area (SSA) than WS300. Loading of HoA and HiN resulted in surface coverage of biochars. HoA with larger molecular size led to more pore blockage of biochars than HiN. Higher HoA binding affinity also caused a stronger competition with KTP on biochars. These factors reduced the accessibility of sorption sites for KTP, and significantly inhibited KTP sorption to biochar of lower SSA (i.e., WS300) by HoA. Water solubility (Sw) of KTP was slightly enhanced (3%) in the presence of HoA. In contrast, the presence of HiN reduced (22%) Sw of KTP. The decreased Sw of KTP by HiN exerted a more dominant influence than its competitive and loading effects, thus led to apparent enhanced sorption of KTP, especially to biochar of higher SSA (i.e., WS700). The results demonstrated the diverse effects of HoA and HiN on KTP sorption, which is helpful in understanding pharmaceutical-DOM-biochar interactions and environmental behaviors of pharmaceuticals.
https://ift.tt/2MlUWCa
Utilization of freshwater mussel ( Lamellidens marginalis ) for the isolation of proteins through pH shift processing: characterization of isolates
Abstract
Study was conducted to use underutilized freshwater mussel (Lamellidens marginalis) for the recovery of proteins using pH shift method and to study the functionality and characteristics of the recovered isolates. From the pH range tested (pH 2.0–13.0), maximum protein yields were obtained during solubilization at pH 2.0 and pH 13.0 (p < 0.05). During the protein recovery process, pH 13.0 was found to have minimal effect on proteins resulting in higher protein yields compared to pH 2.0. Isolates obtained by both acidic and alkaline solubilization processes had low stability and poor gel network. Total lipid content, total myoglobin, and pigment contents were reduced significantly (p < 0.05) during pH shift processing, resulting in whiter protein isolates and protein gels. All the essential amino acids were present in the isolates recovered by acid and alkaline solubilization, indicating the complete recovery of amino acids. No microbial counts were observed in any of the isolates prepared using acid and alkaline-aided processing. Acid and alkaline solubilization (pH shift) process was found to be promising for the recovery of proteins from underutilized freshwater mussel thus by reducing the supply demand gap.
https://ift.tt/2oWwuhr
Air pollution control and flue gas desulfurization residues from Polish copper smelting facility as adsorbents of Pb(II) and Cu(II) from aqueous solutions
Abstract
This study aimed at evaluation of air pollution control residues (APCR) and flue gas desulfurization residues (FGDR) from copper foundry in Southwestern Poland as adsorbents of Cu(II) and Pb(II) from simulated wastewater. Studies of the impact of pH and adsorbent dose, as well as sorption isotherms, and kinetic and thermodynamic studies were conducted in a series of batch experiments. The maximum adsorption capacities were equal to 42.9 mg g−1 Cu(II) and 124.4 mg g−1 Pb(II) for APCR and 98.8 mg g−1 Cu(II) and 124.7 mg g−1 Pb(II) for FGDR, which was comparable to mineral adsorbents examined in other studies. Adsorption isotherms followed the Langmuir model, except for Pb(II) for FGDR, which followed Freundlich model. Sorption kinetics for both materials was properly expressed by pseudo-second-order equation. Mean adsorption energy parameter suggested that the adsorption might have occurred via physical bonding. Thermodynamic study revealed that adsorption was spontaneous and endothermic for Cu(II) and not spontaneous and exothermic for Pb(II), with lower temperature favoring the process. The results suggested that both materials had high affinity towards Cu(II) and Pb(II) ions and could be conducted industrial scale research for consideration as potential adsorbents from aqueous solutions.
https://ift.tt/2MlUOCG
Interaction Between Lactate and Uric Acid is Associated With a Higher Prevalence of Metabolic Syndrome: A Community-Based Study
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0672-0908
Background Increased blood lactate or uric acid (UA) levels are associated with an increased risk of metabolic syndrome (MS). The aim of this study was to investigate the effect of an interactive association between blood lactate and UA levels on MS. Methods This community-based cross-sectional study included 2584 Chinese subjects aged ≥ 18 years. Participants were classified into 3 groups based on lactate or UA level tertiles or into 9 groups based on a combination of lactate and UA level tertiles. Results The serum high-sensitivity C-reactive protein (hs-CRP) and homeostatic model assessment of insulin resistance (HOMA-IR) levels and odds ratios (ORs) for MS increased across the blood lactate or UA level tertiles (all P for trend<0.05). Interactions between lactate and UA with hs-CRP level, HOMA-IR level, and ORs for MS (P<0.05 for all interactions) were also observed. The adjusted ORs for MS in participants in the third tertile of lactate and UA levels, in the third tertile of lactate levels and first tertile of UA levels, and in the first tertile of lactate levels and third tertile of UA levels were 6.02 (95% CI 2.87–12.64, P<0.001), 2.92 (95% CI 1.39–6.10, P=0.005), and 2.70 (95% CI 1.23–5.96, P=0.014), respectively, compared with those in the first tertiles of both lactate and UA levels. Conclusion The interaction between lactate and UA is associated with a higher prevalence of MS in the Chinese population.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Inherited Forms of Primary Hyperaldosteronism: New Genes, New Phenotypes and Proposition of A New Classification
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0713-0629
Primary aldosteronism is a common cause of endocrine hypertension. It results from the excess production of aldosterone by the adrenal cortex and is related to increased morbidity and mortality. Most cases of PA are sporadic but inherited patterns of the disease have been reported in the literature. Four forms of familial hyperaldosteronism (FH-I- FH-IV) are currently recognized, and the genetic basis has been clarified in recent years. In FH-I patients, aldosterone excess is produced by a CYP11B1/CYP11B2 fusion gene and it is suppressed by glucocorticoid treatment. FH-II is caused by mutations in the inwardly rectifying chloride channel CLCN2. FH-III is caused by mutations in KCNJ5, a gene coding for an inward rectifier K+ channel and mutations in the T-type calcium channel subunit CACNA1H cause FH-IV. In this review we summarize the knowledge on inherited forms of primary aldosteronism, the genetic alterations that cause them and the implications it may have for the classification. Based on current evidence, we propose the term "familial hyperaldosteronism" to refer only to inherited forms of primary aldosteronism with a known genetic basis.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Sarcopenia – Endocrinological and Neurological Aspects
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0672-1007
Sarcopenia in geriatric patients is often associated with or even caused by changes of the endocrine and nervous system. The multifactorial pathogenesis of sarcopenia and additional multimorbidity in geriatric patients makes it difficult to study distinct pathogenic pathways leading to sarcopenia. Patients suffering from diabetes, Cushing's syndrome, chronic kidney disease, Klinefelter's syndrome or motor neuron diseases, such as amyotrophic lateral sclerosis for example are known to have impaired muscle property and reduced physical performance. These patients are typically younger and suffer from conditions caused by a known molecular disease mechanism and a peculiar sarcopenic phenotype. Therefore, these sequelae can serve as prototypic disease models to study isolated endocrinological and neurodegenerative causes for sarcopenia. This review focuses on diseases whose etiopathogenesis of muscle impairment is known. The idea is to use these diseases as proof of principles to develop a classification algorithm of sarcopenia in the elderly to make a more mechanism-oriented therapy be possible.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Selected trace elements and metals in groundwater within Permian sediments near Olkusz (Zn-Pb ore mining region, S Poland)
Abstract
The extensive mining of Zn-Pb ores in the Olkusz region resulted in significant changes of both water table level and chemical composition of water in all aquifers in the area. This was caused by intensive dewatering of mining excavations and development of a thick aeration zone reaching 150 m in a central part of the area. That created favorable conditions for oxidation of metal sulfides occurring in the ore-bearing dolomites (Middle Triassic) and started the process of forming readily soluble hydroxysulphates which then migrated to lower aquifers, including the Permian. As a result of those processes, various metals and other elements toxic to the water environment appeared in leaks observed in mine galleries. Changes in concentrations of selected elements (Fe, Mn, Zn, Pb, Cu, Ba, Ni, Co, As, Cr, Hg, Tl, Ag, Cd, B) in mine waters over the period of the last nearly 50 years were described. Water samples were collected from exploratory boreholes, piezometers, and wells located in investigated area inflows and seepages occurring in shafts and drifts excavated in Permian conglomerates. Mean concentrations of metals (Pb, Cd, Cr, Hg, Tl) and other toxic elements were surprisingly low; Pb, 3.94 μg/L; Cd, 0.2 μg/L; Cr, up to 2.26 μg/L; Hg, 0.25 μg/L; Tl, 3.59 μg/L; and As, 6.31 μg/L. However, the observed concentrations varied significantly over time, reaching respectively up to 190 μg Pb/L, 60 μg Cd/L, 15.6 μg Cr/L, 2.67 μg Hg/L, 81.3 μg Tl/L, and 155 μg As/L.
https://ift.tt/2oWBwe5
Are morphologic and topographic alterations of the mandibular fossa after fixed functional treatment detectable on tomograms? Visual classification and morphometric analysis
Abstract
Aim
The goal was to evaluate if changes in morphology and topography of the mandibular fossa after Functional Mandibular Advancer (FMA) treatment are detectable on tomograms. Furthermore, the suitability of digital tomograms (DT) over magnetic resonance imaging (MRI) for this particular question was investigated.
Materials and methods
In all, 25 patients (14 female, 11 male) with a skeletal class II malocclusion received treatment with a FMA. DTs were available prior to (T1) and after (T2) FMA treatment. A total of 50 temporomandibular joints were investigated. The mandibular fossae were evaluated metrically and visually regarding treatment-induced alterations. A p < 0.05 was set as the level for statistical significance for all tests. Results were compared to the results of a recent MRI study.
Results
Visual inspection of all 50 joints in the DT at T1 and T2 revealed no alterations of the fossa shape in the sagittal plane; 24 patients showed identical morphology of right and left joints. The metrical analysis revealed no significant changes regarding width, depth and ratio thereof between T1 and T2. There also were no bilateral differences. Another 18 different distance measurements between porion, mandibular fossa, articular eminence and pterygoid fossa showed no significant changes. There was no detectable proof of a fossa shift.
Conclusions
No changes in the sagittal plane, mandibular fossa, the articular tubercle, or a possible fossa shift were found in the DT of class II patients after FMA treatment. DT and MRI measurements and the visual inspection revealed identical findings; thus, DT appears to be a valuable research tool for sagittal analysis of mandibular fossa changes.
https://ift.tt/2oU76Jp
Radiosurgery of vestibular schwannoma: prognostic factors for hearing outcome using 3D-constructive interference in steady state (3D-CISS)
Abstract
Purpose
Stereotactic radiosurgery (SRS) is an effective treatment for vestibular schwannoma (VS). Three-dimensional (3D) constructive interference in steady state (CISS) is the preferred magnetic resonance imaging (MRI) sequence for evaluating signal changes in the inner ear endolymph. Previous studies demonstrated a correlation between pretreatment cochlear signal intensity in 3D-CISS and posttherapeutic hearing outcomes. The purpose of our study was to compare 3D-CISS sequences before and after primary SRS of unilateral VSs to evaluate the effect of radiosurgery on the 3D-CISS signal intensities of cochlea and sacculus/utriculus.
Methods
We retrospectively reviewed 47 patients with unilateral VS treated with SRS. The neuroradiological MRI datasets were analysed to evaluate the signal intensity of the inner ear structure, tumour size, Koos grade, tumour volume, and infiltration of the cochlear aperture before therapy and at follow-up. The differences in these signal intensities before SRS and at follow-up were correlated with clinical symptoms, cochlear radiation dose, tumour volume and infiltration of the cochlear aperture.
Results
No differences were found between signal intensities in cochlea and utriculus/sacculus before and after SRS and no correlation with clinical symptoms, cochlear radiation dose, tumour volume, Koos grade or infiltration of the cochlear aperture (all p > 0.05).
Conclusion
Our study supports the theory of a complex interaction causing alteration of the endolymph protein concentration and not a direct dependency on the SRS. Use of modern dosing schemes will have a positive impact on clinical outcome with preservation of hearing in patients with VS.
https://ift.tt/2oUjTeD
Modelling the relationship between poverty, environment, and institutions: a panel data study
Abstract
The paper examines the relationship between poverty and CO2 emission. We contribute by using a global panel data of 146 countries over the period 1996–2014 and by focusing on the role of institution in poverty and environmental degradation nexus. The main findings are that the non-linearity relationship between poverty and CO2 emission could prompt a further increase in the poverty and environmental degradation. However, an increase in the institutional quality leads to a reduction in poverty and more protection to the environment. The main policy recommendation is that all countries need to improve their institutional framework so that reduction of poverty and environmental degradation can occur.
https://ift.tt/2oVt9PX
Ecological degradation of an inland river basin and an evaluation of the spatial and distance effect on willingness to pay for its improvement
Abstract
Improvements in the ecological attributes of inland rivers have been projected to provide considerable non-market benefits, and the monetary valuation of these attributes has steadily increased over the past several decades. The present study addresses the spatial heterogeneity of the public's preference for ecological attributes and the distance-decay effect of willingness to pay (WTP) to improve various attributes of the river basin. The results revealed that spatial heterogeneity exists among the individuals; for example, the respondents of Liangzhou County prefer a large improvement in the natural landscape, forest coverage, and eco-tourism and are willing to pay 491.89, 369.32, and 338.37 yuan per year, respectively, for one unit improvement in these ecological attributes. Similarly, the respondents of Jinchang County value and are willing to pay 447.60, 431.81, and 318.18 yuan for one unit improvement in tourism, forest coverage, and natural landscape, respectively. Furthermore, the results from the random parameter logit model show a significant distance-decay effect of the household WTP for ecological attributes. For example, the respondents living within 5 km of the river are willing to pay more money, that is, 832.61, 365.62, and 353.05 yuan per year for improving the natural landscape, water quantity, and grass cover, respectively. As the distance from the river increases, the corresponding WTP decreases, meaning that the respondents (users) living near the Shiyang River Basin are willing to pay more for ecological attribute improvement than those living far away from the river.
https://ift.tt/2Mhg5xl
Impaired glucagon secretion in patients with fulminant type 1 diabetes mellitus
Abstract
Purpose
Fulminant type 1 diabetes mellitus (FT1DM), characterized by rapid and almost complete destruction of pancreatic β-cells, is a newly identified subtype of type 1 diabetes mellitus. Although, the pathophysiology of this condition remains still unclear, histological evidence suggests that not only β-cells but also α-cells of pancreatic islets are reduced in number in FT1DM. However, the ability of glucagon secretion in patients with this condition has remained largely uncharacterized. We therefore examined glucagon secretion in patients with FT1DM and compared that with patients with other types of diabetes mellitus.
Methods
Fasting glucagon levels as well as glucagon secretion induced by intravenous administration of arginine were measured in hospitalized 83 patients with diabetes mellitus, including 4 with FT1DM, 18 with type 1 diabetes mellitus (T1DM), 40 with type 2 diabetes mellitus (T2DM), 5 with slowly progressive insulin-dependent diabetes mellitus (SPIDDM), and 16 with pancreatic diabetes mellitus (PDM).
Results
The area under the curve for serum glucagon levels after arginine infusion in FT1DM patients was significantly smaller than that in T1DM, T2DM, or SPIDDM patients but was similar to that in PDM patients. The fasting serum glucagon level of FT1DM patients was lower than that of T1DM or T2DM patients but did not significantly differ from that of SPIDDM or PDM patients.
Conclusions
These results suggest that glucagon secretion is impaired in patients with FT1DM.
https://ift.tt/2O4o8PP
Cervical Lymph Node Fine-Needle Aspiration and Needle-Wash Thyroglobulin Reflex Test for Papillary Thyroid Carcinoma
Abstract
Fine-needle aspiration (FNA) cytology coupled with needle-wash thyroglobulin (FNA-Tg) testing is recommended for cervical lymph node (LN) biopsies in patients with a history of papillary thyroid carcinoma (PTC). However, the procedure has not been standardized with the assay for FNA-Tg testing. A standard operating procedure (SOP) has been generated at our facility for cervical LN FNAs with Tg reflex testing on patients with a history of PTC. The procedure requires FNA cytology to be reviewed first, and all cases not positive for PTC are reflexed for FNA-Tg testing with the Beckman Access thyroglobulin assay. The thyroglobulin cutoff value is ≤ 1.0 ng/mL. From 2016 to 2017, 117 patients, including 71 women and 46 men, were identified as having a history of PTC. Patients' clinical characteristics were collected from medical records. A total of 143 LN biopsies were investigated for these patients. The results show that four out of 11 (36.4%) non-diagnostic LNs and five out of five (100%) atypical/suspicious LNs tested positive for FNA-Tg. Among these nine patients with positive thyroglobulin testing, LN metastases were proven histologically for all nine patients, and two patients were treated with LN ablation. Out of 68 LNs positive for PTC, three had FNA-Tg results. FNA-Tg testing was ordered for unknown reasons on two positive LNs (> 5000 ng/mL thyroglobulin) from one patient. The third LN was tested due to non-classic morphology, and the result was less than the cutoff value. Three patients with negative LN biopsies were tested to have elevated (> 1.0 ng/mL) thyroglobulin levels. One patient (FNA-Tg ng/mL) was proven to have multiple metastatic LNs through follow-up surgery. However, no positive LN was identified for the other two patients who had FNA-Tg level of 4.1 ng/mL and 37 ng/mL respectively. This is likely due to contamination, as these two patients had intact thyroids. In our practice, the FNA-Tg test is a very useful adjunct test to LN FNA specimens with a non-positive diagnosis in patients with a history of PTC. Furthermore, FNA-Tg testing increases diagnostic sensitivity among non-diagnostic and atypical/suspicious LNs. However, FNA-Tg testing should not substitute conventional cytology due to the following reasons: (1) false-negative thyroglobulin lab results; (2) PTC with loss of thyroglobulin expression; (3) LN metastasis from other origins; and (4) false-positive thyroglobulin testing due to blood contamination in patients who are not completely athyrotic.
https://ift.tt/2N25rQn
Impaired glucagon secretion in patients with fulminant type 1 diabetes mellitus
Abstract
Purpose
Fulminant type 1 diabetes mellitus (FT1DM), characterized by rapid and almost complete destruction of pancreatic β-cells, is a newly identified subtype of type 1 diabetes mellitus. Although, the pathophysiology of this condition remains still unclear, histological evidence suggests that not only β-cells but also α-cells of pancreatic islets are reduced in number in FT1DM. However, the ability of glucagon secretion in patients with this condition has remained largely uncharacterized. We therefore examined glucagon secretion in patients with FT1DM and compared that with patients with other types of diabetes mellitus.
Methods
Fasting glucagon levels as well as glucagon secretion induced by intravenous administration of arginine were measured in hospitalized 83 patients with diabetes mellitus, including 4 with FT1DM, 18 with type 1 diabetes mellitus (T1DM), 40 with type 2 diabetes mellitus (T2DM), 5 with slowly progressive insulin-dependent diabetes mellitus (SPIDDM), and 16 with pancreatic diabetes mellitus (PDM).
Results
The area under the curve for serum glucagon levels after arginine infusion in FT1DM patients was significantly smaller than that in T1DM, T2DM, or SPIDDM patients but was similar to that in PDM patients. The fasting serum glucagon level of FT1DM patients was lower than that of T1DM or T2DM patients but did not significantly differ from that of SPIDDM or PDM patients.
Conclusions
These results suggest that glucagon secretion is impaired in patients with FT1DM.
https://ift.tt/2O4o8PP
Are morphologic and topographic alterations of the mandibular fossa after fixed functional treatment detectable on tomograms? Visual classification and morphometric analysis
Abstract
Aim
The goal was to evaluate if changes in morphology and topography of the mandibular fossa after Functional Mandibular Advancer (FMA) treatment are detectable on tomograms. Furthermore, the suitability of digital tomograms (DT) over magnetic resonance imaging (MRI) for this particular question was investigated.
Materials and methods
In all, 25 patients (14 female, 11 male) with a skeletal class II malocclusion received treatment with a FMA. DTs were available prior to (T1) and after (T2) FMA treatment. A total of 50 temporomandibular joints were investigated. The mandibular fossae were evaluated metrically and visually regarding treatment-induced alterations. A p < 0.05 was set as the level for statistical significance for all tests. Results were compared to the results of a recent MRI study.
Results
Visual inspection of all 50 joints in the DT at T1 and T2 revealed no alterations of the fossa shape in the sagittal plane; 24 patients showed identical morphology of right and left joints. The metrical analysis revealed no significant changes regarding width, depth and ratio thereof between T1 and T2. There also were no bilateral differences. Another 18 different distance measurements between porion, mandibular fossa, articular eminence and pterygoid fossa showed no significant changes. There was no detectable proof of a fossa shift.
Conclusions
No changes in the sagittal plane, mandibular fossa, the articular tubercle, or a possible fossa shift were found in the DT of class II patients after FMA treatment. DT and MRI measurements and the visual inspection revealed identical findings; thus, DT appears to be a valuable research tool for sagittal analysis of mandibular fossa changes.
https://ift.tt/2oU76Jp
Scholar : Canadian Water Resources Journal / Revue canadienne des ressources hydriques, Volume 43, Issue 3, September 2018 is now available online on Taylor & Francis Online
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CT-guided interstitial HDR-brachytherapy for recurrent glioblastoma multiforme: a 20-year single-institute experience
Abstract
Purpose
To report our results of computed tomography-guided interstitial high-dose-rate (HDR) brachytherapy (BRT) in the treatment of patients with recurrent inoperable glioblastoma multiforme (GBM).
Patients and methods
Between 1995 and 2014, 135 patients were treated with interstitial HDR BRT for inoperable recurrent GBM located within previously irradiated volumes. Patient's median age was 57.1 years (14–82 years). All patients were pretreated with surgery, postoperative external beam radiation therapy (EBRT) and systemic chemotherapy (ChT). The median recurrent tumor volume was 42 cm3 (2–207 cm3). The prescribed HDR dose was median 40 Gy (30–50 Gy) delivered in twice-daily fractions of 5.0 Gy over consecutive days. No repeat surgery or ChT was administered in conjunction with BRT. Survival from BRT, progression-free survival (PFS), toxicity as well as the impact of several prognostic factors were evaluated.
Results
At a median follow-up of 9.2 months, the median overall survival following BRT and the median PFS were 9.2 and 4.6 months, respectively. Of the prognostic variables evaluated in univariate analysis, extent of surgery at initial diagnosis, tumor volume at recurrence, as well as time from EBRT to BRT reached statistical significance, retained also in multivariate analysis. Eight patients (5.9%) developed treatment-associated complications including intracerebral bleeding in 4 patients (2.9%), symptomatic focal radionecrosis in 3 patients (2.2%), and severe convulsion in 1 patient (0.7%).
Conclusions
For patients with recurrent GBM, interstitial HDR BRT is an effective re-irradiation method for even larger tumors providing palliation without excessive toxicity.
https://ift.tt/2oWkHzY
Treatment outcomes of radiotherapy for primary spinal cord glioma
Abstract
Purpose
Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen.
Methods
We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82%) received postoperative RT, 6 (13%) underwent definitive RT without surgery, and 2 (5%) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy).
Results
In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2‑year overall survival and progression-free survival rates were 74 and 54%, respectively. Overall, 13 (32%) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with diverse prognosis. In grade IV tumors, seeding developed in 45%. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50%, p < 0.001).
Conclusion
To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.
https://ift.tt/2x0jStj
Novel Facial Cream Containing Carnosine Inhibits Formation of Advanced Glycation End-Products in Human Skin
Background: Accumulation of advanced glycation end-products (AGEs) in skin has been associated with skin aging. Inhibition of glycation of proteins of extracellular matrix may help skin texture and appearance. The objective of the study was to demonstrate the antiglycation activity of topically applied carnosine and novel facial cream (FC) containing carnosine in human skin explants ex vivo. Methods: Glycation was induced in human skin explants by methylglyoxal (MG) in culture media. FC containing carnosine (FC-CARN) or carnosine in aqueous solution (AQ-CARN) was applied topically on skin explants. Levels of AGEs carboxymethyl-lysine (CML) and pentosidine were determined in the epidermis and dermis of skin sections and were used to calculate antiglycation activity. Results: Exposure to MG led to increases in CML and pentosidine in skin explants. Antiglycation effect for AQ-CARN was CML: –64 and –41%, pentosidine: –48 and 42% in epidermis and reticular dermis respectively. Antiglycation effect for FC-CARN was CML: –150 and –122%, pentosidine: –108 and –136%, in epidermis and reticular dermis respectively. Conclusion: Topically applied carnosine protects against the glycation induced by MG. Novel FC-CARN significantly reduced levels of AGEs in both epidermis and reticular dermis in human skin explants.
Skin Pharmacol Physiol 2018;31:324–331
https://ift.tt/2Ny7paD
Skin Pharmacol Physiol 2018;31:324–331
https://ift.tt/2Ny7paD
Tretinoin Loaded Nanoemulsion for Acne Vulgaris: Fabrication, Physicochemical and Clinical Efficacy Assessments
Background and Aim: Acne vulgaris is a common inflammatory skin condition which is treated using Tretinoin (TRE), a widely used retinoid. Nano emulations (NEs) are colloidal nano-sized particles that enhance the therapeutic efficacy of TRE and minimize adverse effects. This study is aimed at developing a TRE-loaded NE (NE-TRE) and at assessing the therapeutic effects of the formulation in acne vulgaris lesions, compared to conventional 0.05% TRE emulsion. Method: The high energy emulsification method was used to make NE-TRE. After obtaining stable NE, particle characterization and physicochemical properties were evaluated under accelerated conditions. Conducting a clinical study, we compared the therapeutic effects of NE-TRE and 0.05% TRE emulsion by comparing the number of acne lesions and porphyrin production in both sides of the face. Results and Conclusion: We successfully developed stable nanoparticles. It was a stable oil-in-water emulsion with particle size of about 150 nm, and containing circular and separated particles. In a pilot clinical study, the number of acne lesions as well as the size and intensity of porphyrin production significantly reduced after topical application of NE-TRE. This formula shows proper efficiency and good loading capacity of TRE in the drug delivery system.
Skin Pharmacol Physiol 2018;31:316–323
https://ift.tt/2x2dj9P
Skin Pharmacol Physiol 2018;31:316–323
https://ift.tt/2x2dj9P
Anatomical accuracy of standard-practice tractography algorithms in the motor system - A histological validation in the squirrel monkey brain
Publication date: Available online 10 September 2018
Source: Magnetic Resonance Imaging
Author(s): Kurt G. Schilling, Yurui Gao, Iwona Stepniewska, Vaibhav Janve, Bennett A. Landman, Adam W. Anderson
Abstract
For two decades diffusion fiber tractography has been used to probe both the spatial extent of white matter pathways and the region to region connectivity of the brain. In both cases, anatomical accuracy of tractography is critical for sound scientific conclusions. Here we assess and validate the algorithms and tractography implementations that have been most widely used - often because of ease of use, algorithm simplicity, or availability offered in open source software. Comparing forty tractography results to a ground truth defined by histological tracers in the primary motor cortex on the same squirrel monkey brains, we assess tract fidelity on the scale of voxels as well as over larger spatial domains or regional connectivity. No algorithms are successful in all metrics, and, in fact, some implementations fail to reconstruct large portions of pathways or identify major points of connectivity. The accuracy is most dependent on reconstruction method and tracking algorithm, as well as the seed region and how this region is utilized. We also note a tremendous variability in the results, even though the same MR images act as inputs to all algorithms. In addition, anatomical accuracy is significantly decreased at increased distances from the seed. An analysis of the spatial errors in tractography reveals that many techniques have trouble properly leaving the gray matter, and many only reveal connectivity to adjacent regions of interest. These results show that the most commonly implemented algorithms have several shortcomings and limitations, and choices in implementations lead to very different results. This study should provide guidance for algorithm choices based on study requirements for sensitivity, specificity, or the need to identify particular connections, and should serve as a heuristic for future developments in tractography.
https://ift.tt/2NueWal
Ethyl 2,4-dicarboethoxy pantothenate, a derivative of pantothenic acid, prevents cellular damage initiated by environmental pollutants through Nrf2 activation
Publication date: Available online 9 September 2018
Source: Journal of Dermatological Science
Author(s): Mariko Yokota, Shoichi Yahagi, Hitoshi Masaki
Abstract
Background
Recently, environmental pollutants have become a concern not only for respiratory organs but also for skin-related human health, because skin is localized at the border between the human body and the external environment and is easily influenced by environmental pollutants.
Objective
Here, we investigated the effects of a novel pantothenic acid (PA) derivative, ethyl 2,4-dicarboethoxy pantothenate (EDCEP), on a diesel particulate extract (DPE) as a representative environmental pollutant that generates reactive oxygen species (ROS) through the activation of aryl hydrocarbon receptor (AHR) signaling.
Methods
We characterized the effects of PA and EDCEP on normal human epidermal keratinocytes (NHEKs) exposed to DPE or H2O2 as a general oxidative stress stimulator. Cell viability and intracellular ROS levels were evaluated using the 3-(4,5-dimethyl-2-thiazoyl)-2,5-diphenyltetrazolium bromide (MTT) assay and the 2',7'-dichlorodihydrofluorescein diacetate (DCFDA) assay, respectively. Further, we investigated the substantial effects and the underlying mechanism of EDCEP, which elicited a reduction of intracellular ROS.
Results
PA and EDCEP restored the decreases of cell viability induced by DPE and also repressed the up-regulation of CYP1A1 mRNA expression induced by DPE. Interestingly, the effects of PA and EDCEP on intracellular ROS levels showed different responses. EDCEP reduced intracellular ROS levels stimulated by DPE or by exposure to H2O2. EDCEP suppressed the secretion of tumor necrosis factor (TNF-α) and reduced the level carbonylated proteins in reconstructed human epidermal equivalents topically treated with DPE. EDCEP up-regulated the mRNA expression levels of nuclear factor E2-related factor 2 (Nrf2), γ-glutamyl cysteine synthase (γ-GCS), heme oxygenase-1 (HO-1) and NAD(P)H: quinone oxidoreductase-1 (NQO1) and in addition, increased intracellular glutathione (GSH) levels.
Conclusion
EDCEP reduces cellular damage initiated by environmental pollutants by stimulating the intracellular defense system against ROS through the activation of Nrf2, and by interfering with AHR signaling pathway activation.
Graphical abstract
https://ift.tt/2wZ4JZd
Single and multiple ascending-dose study of glucagon-receptor antagonist RN909 in type 2 diabetes: a phase 1, randomized, double-blind, placebo-controlled trial
Abstract
Purpose
This first-in-human study assessed safety, immunogenicity, pharmacokinetics, and pharmacodynamics of RN909, a monoclonal antibody antagonist of the glucagon receptor, in type 2 diabetes (T2DM) subjects.
Methods
This study enrolled 84 T2DM subjects receiving stable metformin regimens. Forty-four subjects were randomized to receive single escalating doses of RN909 (0.3 to 6 mg/kg subcutaneously (SC), or 1 mg/kg intravenously (IV)), or placebo; 40 subjects were randomized to receive multiple escalating doses (50 to 150 mg SC) or placebo every 4 weeks for 12 weeks.
Results
RN909 was well tolerated; treatment-related elevated liver function tests (LFTs) were observed in 4/33 (12.1%) and 5/32 (15.6%) subjects treated with single and multiple doses, respectively, versus 1/10 (10%) and 0 in the respective placebo groups. RN909 dose-normalized AUCinf increased more than dose-proportionally following single SC doses, and after multiple doses, accumulation ratios ranged from 1.3 to 3.4. The incidence of antidrug antibodies (ADA) was 33% after single doses and 50% after multiple doses. RN909 produced dose-dependent, durable fasting plasma glucose (FPG)-lowering at day 29 (mean change −20.6 to −97.5 mg/dL) and day 85 (mean change; −27.2 to −43.5 mg/dL) after single and multiple doses, respectively. HbA1c also was reduced after single (mean change −0.30% to −1.44%), and multiple doses (−0.83% to −1.56%).
Conclusion
RN909 was well tolerated after single and multiple doses in T2DM subjects, with diarrhea and elevated LFTs the most frequent adverse events. The appearance of ADA did not affect pharmacokinetics or efficacy. Robust lowering of FPG and HbA1c was observed.
https://ift.tt/2Qg3nSO
Ectopic thyroids have lower computed tomography attenuation values than orthotopic thyroids
Abstract
Purpose
To determine whether ectopic thyroid had the same computed tomography (CT) value as orthotopic thyroid.
Methods
Twenty-one patients with 23 ectopic thyroids and 23 controls with orthotopic thyroids underwent CT scans and were included in this retrospective study. The CT images were reviewed in a blinded fashion by two radiologists. Independent-Samples T-test was used for comparison of CT attenuation values between two groups.
Results
Ectopic thyroids had significantly lower non-enhanced attenuation (91.04 ± 5.97 Hounsfield Units vs. 106.56 ± 4.06 Hounsfield Units, P = 0.038) and contrast-enhanced attenuation (141.32 ± 6.42 Hounsfield Units vs. 169.82 ± 4.30 Hounsfield Units, P = 0.001) values than orthotopic thyroids.
Conclusions
Ectopic thyroids have lower CT attenuation values than orthotopic thyroids probably due to the structural or functional abnormalities. The dysgenesis and pathological changes of the ectopic thyroids may contribute to functional deficiency which finally leads to decrease of the CT attenuation values.
https://ift.tt/2wZqCYs
Single and multiple ascending-dose study of glucagon-receptor antagonist RN909 in type 2 diabetes: a phase 1, randomized, double-blind, placebo-controlled trial
Abstract
Purpose
This first-in-human study assessed safety, immunogenicity, pharmacokinetics, and pharmacodynamics of RN909, a monoclonal antibody antagonist of the glucagon receptor, in type 2 diabetes (T2DM) subjects.
Methods
This study enrolled 84 T2DM subjects receiving stable metformin regimens. Forty-four subjects were randomized to receive single escalating doses of RN909 (0.3 to 6 mg/kg subcutaneously (SC), or 1 mg/kg intravenously (IV)), or placebo; 40 subjects were randomized to receive multiple escalating doses (50 to 150 mg SC) or placebo every 4 weeks for 12 weeks.
Results
RN909 was well tolerated; treatment-related elevated liver function tests (LFTs) were observed in 4/33 (12.1%) and 5/32 (15.6%) subjects treated with single and multiple doses, respectively, versus 1/10 (10%) and 0 in the respective placebo groups. RN909 dose-normalized AUCinf increased more than dose-proportionally following single SC doses, and after multiple doses, accumulation ratios ranged from 1.3 to 3.4. The incidence of antidrug antibodies (ADA) was 33% after single doses and 50% after multiple doses. RN909 produced dose-dependent, durable fasting plasma glucose (FPG)-lowering at day 29 (mean change −20.6 to −97.5 mg/dL) and day 85 (mean change; −27.2 to −43.5 mg/dL) after single and multiple doses, respectively. HbA1c also was reduced after single (mean change −0.30% to −1.44%), and multiple doses (−0.83% to −1.56%).
Conclusion
RN909 was well tolerated after single and multiple doses in T2DM subjects, with diarrhea and elevated LFTs the most frequent adverse events. The appearance of ADA did not affect pharmacokinetics or efficacy. Robust lowering of FPG and HbA1c was observed.
https://ift.tt/2Qg3nSO
Correction to: Adrenocortical incidentalomas and bone: from molecular insights to clinical perspectives
The original version of this article unfortunately contained a mistake in Figure 1. There is a typo in the word "osteoclastogenesis" and the word "activity" is missing in the same entity. It should be "osteoclastogenesis" instead of "osteoclestogenesis".
https://ift.tt/2CD9SMB
Ectopic thyroids have lower computed tomography attenuation values than orthotopic thyroids
Abstract
Purpose
To determine whether ectopic thyroid had the same computed tomography (CT) value as orthotopic thyroid.
Methods
Twenty-one patients with 23 ectopic thyroids and 23 controls with orthotopic thyroids underwent CT scans and were included in this retrospective study. The CT images were reviewed in a blinded fashion by two radiologists. Independent-Samples T-test was used for comparison of CT attenuation values between two groups.
Results
Ectopic thyroids had significantly lower non-enhanced attenuation (91.04 ± 5.97 Hounsfield Units vs. 106.56 ± 4.06 Hounsfield Units, P = 0.038) and contrast-enhanced attenuation (141.32 ± 6.42 Hounsfield Units vs. 169.82 ± 4.30 Hounsfield Units, P = 0.001) values than orthotopic thyroids.
Conclusions
Ectopic thyroids have lower CT attenuation values than orthotopic thyroids probably due to the structural or functional abnormalities. The dysgenesis and pathological changes of the ectopic thyroids may contribute to functional deficiency which finally leads to decrease of the CT attenuation values.
https://ift.tt/2wZqCYs
Dynamic changes in the distribution of facial and abdominal adipose tissue correlated with surgical treatment in acromegaly
Abstract
Purpose
Acromegaly is a systemic metabolic disease. Growth hormone (GH) have a significant impact on adipose tissue (AT). A huge reduction of serum GH after surgical treatment may cause substantial AT redistribution. The objective of this study was to illustrate the dynamic changes in distribution of facial and abdominal AT correlated with surgical treatment in patients with acromegaly.
Methods
Abdominal AT in 17 acromegaly patients (group 1) was studied longitudinally preoperatively and 1 month to 1 year postoperatively. The facial and abdominal subcutaneous AT (fSAT and aSAT) of another 17 acromegaly patients (group 2) were compared with 7 nonfunctional pituitary adenoma (NFPA) controls.
The areas of fSAT, aSAT, and visceral adipose tissue (VAT) were obtained by MRI and quantified by image analysis software, and intrahepatic lipid (IHL) was assessed by 1H magnetic resonance spectroscopy (MRS).
Results
Abdominal adipose tissue (aSAT, VAT, and IHL) increased overall after surgical treatment. However, IHL first decreased and then continuously increased during the follow-up. Compared with the increased amount of aSAT, the fSAT amount decreased after surgical treatment. The inconsistency of this phenomenon did not appear in the NFPA control subjects.
Conclusion
The perioperative dynamic distribution of the facial and abdominal fat in acromegaly revealed regional differences in the intricate effect of GH on adipose tissue. Reduction of serum GH after surgical treatment of acromegaly was associated with dynamic increases of IHL, abdominal visceral, and subcutaneous fat, but a reduction of facial subcutaneous fat.
https://ift.tt/2NvpGFn
Cutaneous Arteriolosclerosis Is Not Specific to Ischemic Hypertensive Leg Ulcers
Background: The histological characteristic of hypertensive leg ulcers (HLU) is the presence of "arteriolosclerosis." The pertinence of performing a skin biopsy to diagnose HLU is questionable, as cutaneous arteriolosclerosis may be related to patient comorbidities. The objective here was to evaluate the frequency of arteriolosclerosis in skin leg biopsies performed in patients without ulcer and in control patients with HLU. Methods: We performed a retrospective study between January 2013 and July 2014. Patients were included if they had undergone a deep skin biopsy on the lower limbs, in the absence of any leg ulcer. Controls were patients with typical HLU. Results: Fifty-eight patients and 6 controls were included. Hypertension was present in 25 patients (43%). Arteriolosclerosis, defined as fibrous endarteritis, was present in 35 out of 58 patients (60%) and in all of the controls. No hyalinosis or hyperplastic proliferative arteriolosclerosis was observed in the patients or controls. Only age was an independent factor associated with the presence of cutaneous arteriolosclerosis (p #x3c; 0.0001). Conclusion: Cutaneous arteriolosclerosis is significantly and independently associated with age. Thus, skin biopsy seems not to be necessary for the diagnosis of HLU but only for a differential diagnosis.
Dermatology
https://ift.tt/2oRQ5Q2
Dermatology
https://ift.tt/2oRQ5Q2
Polymorphous Light Eruption: Phototherapy-Based Desensitization Versus Intramuscular Steroids – Who Is Right, Who Is Wrong?
Dermatology
https://ift.tt/2x854sX
Day light photodynamic therapy with BF‐200 ALA: A case series
Dermatologic Therapy, EarlyView.
https://ift.tt/2x1cf62
Facial nevus depigmentosus getting remarkable repigmentation by treatment with a 308‐nm excimer laser: A case report
Dermatologic Therapy, EarlyView.
https://ift.tt/2Nu3iwb
Potential of guava leaves for mitigating methane emissions and modulating ruminal fermentation characteristics and nutrient degradability
Abstract
Guava leaves (Psidium guajava, GL), a high-phenolic- and flavonoid-containing plant resource capable of substituting the high-quality forage, may help in mitigating ruminal methane (CH4) emission without adverse impact on nutrient degradability if supplemented at an appropriate level. In order to test this hypothesis, rumen fermentation, CH4 production, and nutrient degradability of GL either solely or as a substitute of berseem hay (Trifolium alexandrinum, BH) were evaluated in a diet containing 50:50 concentrate to roughage. Five different levels of GL (0, 12.5, 25, 37.5, and 50%) were tested in vitro after 24 h incubation using a semi-automated gas production (GP) system. The current findings indicated that merely the presence of GL resulted in significantly lower values for cumulative GP (P < 0.001), CH4 emission (P < 0.05), truly degraded dry matter (TDDM; P < 0.001), truly degraded organic matter (TDOM; P < 0.001), and ammonia nitrogen (NH3-N) concentration (P < 0.001); however, pH (P < 0.001) and partitioning factor (P < 0.001) were higher. The total and individual volatile fatty acid (VFA) concentrations were drastically declined with GL as compared to BH (P < 0.05). A negative linear correlation was recorded between the levels of GL and GP including CH4 production (P < 0.05). The addition of GL up to 25% did not pose any negative effect on both TDDM and TDOM values along with NH3-N concentration. In addition, the inclusion of GL up to 25% did not affect the total or individual VFA concentration. Conclusively, in a medium concentrate diet, use of 25% GL and 25% BH in animal diet could be a promising alternative for mitigating the CH4 production without any deleterious effect on nutrient degradability.
https://ift.tt/2wZMN0B
The process of climate change in mass media discourse using the example of Polish and international editions of “Newsweek” magazine
Abstract
The main objective of the article is to conduct a critical media discourse analysis as presented in the Polish and international editions of the "Newsweek" magazine in the years 2001–2006 and 2012–2016; the subject of which was climate change. The introduction provides the definitions of the key terms, such as: the greenhouse effect and critical discourse analysis (CDA). The theoretical part presents the most important assumptions of the CDA and presents a characteristic of the weekly. The results of the conducted quantitative and qualitative analysis partially lead to varying conclusions. Based on the CDA, the hypothesis was assumed that more attention was provided to climate change in the international (English) edition of "Newsweek", than in the Polish-language edition. Rejected in turn was the hypothesis, according to which, more importance to climate change and their repercussions was provided in the discourse within the last 5 years of publication of the weekly than in the discourse from the years 2001–2006. As a result of comparison of both discourses, the disturbing fact that media discourse did not present and encourage among the readers an active stance in favour of the climate was noticed. It is the task of this influential weekly, the message of which reaches many people, not only to provide knowledge and shape specific values or view, but also to encourage and popularise attitudes in favour of the climate. If man wants to continue to live on earth, then one of their goals is to modify the form of discourse by entities responsible for its form.
https://ift.tt/2wYdeop
Dynamic changes in the distribution of facial and abdominal adipose tissue correlated with surgical treatment in acromegaly
Abstract
Purpose
Acromegaly is a systemic metabolic disease. Growth hormone (GH) have a significant impact on adipose tissue (AT). A huge reduction of serum GH after surgical treatment may cause substantial AT redistribution. The objective of this study was to illustrate the dynamic changes in distribution of facial and abdominal AT correlated with surgical treatment in patients with acromegaly.
Methods
Abdominal AT in 17 acromegaly patients (group 1) was studied longitudinally preoperatively and 1 month to 1 year postoperatively. The facial and abdominal subcutaneous AT (fSAT and aSAT) of another 17 acromegaly patients (group 2) were compared with 7 nonfunctional pituitary adenoma (NFPA) controls.
The areas of fSAT, aSAT, and visceral adipose tissue (VAT) were obtained by MRI and quantified by image analysis software, and intrahepatic lipid (IHL) was assessed by 1H magnetic resonance spectroscopy (MRS).
Results
Abdominal adipose tissue (aSAT, VAT, and IHL) increased overall after surgical treatment. However, IHL first decreased and then continuously increased during the follow-up. Compared with the increased amount of aSAT, the fSAT amount decreased after surgical treatment. The inconsistency of this phenomenon did not appear in the NFPA control subjects.
Conclusion
The perioperative dynamic distribution of the facial and abdominal fat in acromegaly revealed regional differences in the intricate effect of GH on adipose tissue. Reduction of serum GH after surgical treatment of acromegaly was associated with dynamic increases of IHL, abdominal visceral, and subcutaneous fat, but a reduction of facial subcutaneous fat.
https://ift.tt/2NvpGFn
Correction to: Adrenocortical incidentalomas and bone: from molecular insights to clinical perspectives
The original version of this article unfortunately contained a mistake in Figure 1. There is a typo in the word "osteoclastogenesis" and the word "activity" is missing in the same entity. It should be "osteoclastogenesis" instead of "osteoclestogenesis".
https://ift.tt/2CD9SMB
Asymptomatic hyperkeratotic linear plugs on the right hand of a young woman
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2oVUEbO
Neutrophilic fixed drug eruption: a mimic of neutrophilic dermatoses
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2wXZFoc
Nephrogenic systemic fibrosis: in a child with primary hyperoxaluria
Clinical and Experimental Dermatology, EarlyView.
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Conventional and combination topical photodynamic therapy for basal cell carcinoma: systematic review and meta‐analysis
British Journal of Dermatology, EarlyView.
https://ift.tt/2Mf5S4G
Alopecia areata: a review of disease pathogenesis
British Journal of Dermatology, EarlyView.
https://ift.tt/2MYaKjQ
Outcomes for Invasive Melanomas Treated With Mohs Micrographic Surgery: A Retrospective Cohort Study
BACKGROUND Mohs micrographic surgery (MMS) has been used effectively to treat invasive melanoma. OBJECTIVE To further study the safety and efficacy of MMS in the treatment of invasive melanoma. METHODS AND MATERIALS A retrospective cohort study evaluated 123 melanomas excised using MMS with MART-1 immunostain. Local recurrence, metastasis, overall survival, and disease-free survival rates were calculated. These were compared with historical controls. RESULTS Among included patients, 78 were men (63%) and 45 were women (37%), with a mean age of 66.48 years. Mean follow-up time was 1,273 days (3.49 years). Local recurrence was identified in 2/123 (1.63%; 95% confidence interval, 0.20%–5.75%) lesions. Local recurrence was identified in 1/70 (1.43%; 95% confidence interval, 0.04%–7.70%) of head and neck cases. Tumor location was head and neck in 70 lesions (56.9%). Overall survival was 95.12% and disease-specific survival was 100%. CONCLUSION Mohs micrographic surgery is an effective treatment method for invasive melanoma, as evidenced by low recurrence rates and high rates of disease-free survival. Address correspondence and reprint requests to: Catherine A. Degesys, MD, Department of Dermatology, University of North Carolina-Chapel Hill, 410 Market Street #400, Chapel Hill, NC 27516, or e-mail: abbie.degesys@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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https://ift.tt/2NwybAf
Micrographic Surgery and Dermatologic Oncology Fellowship Selection Criteria
BACKGROUND Obtaining a fellowship position for Micrographic Surgery and Dermatologic Oncology (MSDO) is becoming very competitive. Applicant qualities desired by MSDO fellowship directors have not been previously explored in a systematic way. OBJECTIVE To characterize the prevailing practices of selecting MSDO fellows. METHODS AND MATERIALS Cross-sectional study based on an anonymous online survey of MSDO fellowship directors. RESULTS There were 34 completed surveys. Selection criteria with the highest importance to fellowship directors were the ability to work well and get along with others, interview, work ethic, and letter of recommendation from the Mohs micrographic surgery director at the applicant's residency. The criteria with the lowest importance were advanced degrees, medical licensing examination scores, and membership in Alpha Omega Alpha. Specific applicant factors that were looked upon most positively by fellowship directors include applicant from own institution and applicant's personal reasons and circumstances, whereas factors that were most unfavorable include applicant's desire to practice in the same city/area as the fellowship location and graduate of foreign medical school. CONCLUSION Although variations existed, MSDO fellowship directors collectively placed greater importance on criteria that reflect interpersonal skills than on objective measures of academic performance, which highlights the importance of "fit." Address correspondence and reprint requests to: Hao Feng, MD, MHS, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY 10016, or e-mail: haofeng625@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 Web site (https://ift.tt/2bw6lgr). 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.
https://ift.tt/2MfaF61
https://ift.tt/2MfaF61
Trends in Medicare Billing Among Mohs Surgeons in the United States During 2012: A Retrospective Cohort Study
BACKGROUND It is important to understand variability in practice patterns of Mohs surgeons. OBJECTIVE To examine the practice patterns of physicians performing Mohs micrographic surgery (MMS) in the United States. METHODS and Materials This retrospective cohort study of the 2012 Medicare Physician and Other Supplier Public Use Files includes all physicians who billed Medicare for MMS. RESULTS The authors found 2,067 physicians who billed Medicare for MMS in 2012. American College of Mohs Surgery (ACMS) members took a significantly higher average number of head and neck (H&N) and trunk layers compared with American Society for Mohs Surgery (ASMS) members and those with no membership (p
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https://ift.tt/2O5dpVw
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