No abstract available
https://ift.tt/2ObR5cJ
Τετάρτη 12 Σεπτεμβρίου 2018
Short and long-term impact of remifentanil on thermal detection and pain thresholds after cardiac surgery: A randomised controlled trial
BACKGROUND The clinical relevance of the suggested hyperalgesic effects of remifentanil is still unclear, especially in the long term. OBJECTIVE The current study evaluated the impact of remifentanil on thermal thresholds 3 days and 12 months after surgery, measured with Quantitative Sensory Testing. DESIGN A prospective, single-blind, randomised controlled trial. SETTING A tertiary care teaching hospital in The Netherlands, from 2014 to 2016. PATIENTS A total of 126 patients aged between 18 and 85 years, undergoing cardiothoracic surgery via sternotomy (coronary artery bypass grafts and/or valve replacement) were included. Exclusion criteria were BMI above 35 kg m−2, history of cardiac surgery, chronic pain conditions, neurological conditions, allergy to opioids or paracetamol, language barrier and pregnancy. INTERVENTIONS Patients were allocated randomly to receive intra-operatively either a continuous remifentanil infusion or intermittent intra-operative fentanyl as needed in addition to standardised anaesthesia with propofol and intermittent intravenous fentanyl at predetermined time points. MAIN OUTCOME MEASURES Warm and cold detection and pain thresholds 3 days and 12 months after surgery. In addition the use of remifentanil, presence of postoperative chronic pain, age, opioid consumption and pre-operative quality of life were tested as a predictor for altered pain sensitivity 12 months after surgery. RESULTS Both warm and cold detection, and pain thresholds, were not significantly different between the remifentanil and fentanyl groups 3 days and 12 months after surgery (P > 0.05). No significant predictors for altered pain sensitivity were identified. CONCLUSION Earlier reports of increased pain sensitivity 1 year after the use of remifentanil could not be confirmed in this randomised study using Quantitative Sensory Testing. This indicates that remifentanil plays a minor role in the development of chronic thoracic pain. Still, the relatively high incidence of chronic thoracic pain and its accompanying impact on quality of life remain challenging problems. TRIAL REGISTRY REGISTRATION ClinicalTrials.gov identifier NCT02031016. TRIAL REGISTRATION The study was registered at EudraCT (ref: 2013-000201-23) and ClinicalTrials.gov (https://ift.tt/2Mq69Sn). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP Correspondence to Catherijne A.J. Knibbe, Department of Clinical Pharmacy, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands Tel: +31 30 609 26 12; e-mail: c.knibbe@antoniusziekenhuis.nl Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology
https://ift.tt/2NDBaqp
https://ift.tt/2NDBaqp
Utility of TERT Promoter Mutations for Cutaneous Primary Melanoma Diagnosis
Abstract: Telomerase reverse transcriptase (TERT) promoter mutations are commonly found in malignant melanomas but rare in melanocytic nevi. To assess its potential diagnostic utility for the distinction of melanoma from nevus, we determined the TERT promoter mutation status of 86 primary melanomas, 72 melanocytic nevi, and 40 diagnostically problematic melanocytic proliferations. Of the 86 melanomas, 67 (77.9%) were TERT-positive, defined as harboring a hotspot TERT promoter mutation at positions -124C>T, -124_125CC>TT, -138_139CC>TT, or -146C>T. Of the 72 nevi, only 1 (1.4%) was TERT-positive. Of the 40 diagnostically uncertain melanocytic proliferations, 2 (5.0%) were TERT-positive. TERT positivity as a test for melanoma versus nevus had an accuracy of 87.3% [95% confidence interval (CI), 81.1–92.1], a sensitivity of 77.9% (95% CI, 68.9–85.4), a specificity of 98.6% (95% CI, 95.8–100), a positive predictive value of 98.5% (95% CI, 95.6–100), and a negative predictive value of 78.9% (95% CI, 72.6–85.4). Our results indicate that hotspot TERT promoter mutation status may be a useful ancillary parameter for the diagnosis of melanoma. In particular, the high specificity of these mutations for melanoma indicates the presence of a TERT promoter mutation in a melanocytic neoplasm associated with diagnostic controversy, or uncertainty should increase concern for a melanoma. Correspondence: Nancy E. Thomas, MD, PhD, Department of Dermatology, University of North Carolina, 2159 Genomic Science Building, CB#7287, Chapel Hill, NC 27599 (e-mail: nthomas@med.unc.edu). This work was funded by the National Cancer Institute grants R21CA134368, R33CA160138, R03CA199487 to K. Conway and N.E. Thomas, P01CA206980 to M. Berwick and N.E. Thomas, and P30CA016086 to H.S. Earp. This work was also supported by the Lineberger Comprehensive Cancer Center Bioinformatics Core. The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2Mqoy1p
https://ift.tt/2Mqoy1p
Facial Phaeohyphomycosis in an Immunocompetent Individual: A Rare Presentation of a Rare Fungus
Abstract: Phaeohyphomycosis is a rare mycotic infection caused by heterogenous groups of dematiaceous fungi involving the skin and subcutaneous tissue. Here, we report a case of cutaneous phaeohyphomycosis presenting as cauliflower-like verrucous lesion over the face in an immunocompetent individual. Histopathology showed suppurative granulomatous inflammation replete with pigmented broad fungal hyphae which is stained with periodic acid–Schiff stain, Grocott's methanamine silver stain, Schmorl's stain, and Masson-Fontana stain. Culture showed black-colored colonies identified as Exophiala spinifera. Correspondence: Nandita Kakkar, MD, Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India-160012 (e-mail: nandita_kakkar@yahoo.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2NCiFmo
https://ift.tt/2NCiFmo
Pigmented Facial Contact Dermatitis to Benzyl Salicylate: A Comparative Histopathological and Immunohistochemical Study of the Involved Skin and the Positive Patch Test Site
Abstract: Pigmented contact dermatitis (PCD) is a noneczematous variant of allergic contact dermatitis, and benzyl salicylate is one of its causes. This type of PCD shows nonlichenoid interface dermatitis with pigment incontinence. We aimed to characterize the earliest histopathological changes of this reaction. A 51-year-old man presented with persistent facial eruption composed of hyperpigmented and hypopigmented macules due to exposure to benzyl salicylate present in his aftershave. The biopsies obtained from hyperpigmented and hypopigmented macules, and from the positive patch test site to benzyl salicylate, showed a nonlichenoid focal vacuolar interface dermatitis with mononuclear cells in the papillary dermis and around the pilosebaceous units, along with melanophages. A MART-1 immunostain showed intact melanocytes in all 3 biopsies. A Fontana–Masson stain demonstrated intact melanin in the basal cell layer of a facial hyperpigmented macule and the patch test site, but melanin was reduced in the biopsy taken from a hypopigmented facial macule. There were more epidermal and dermal CD1a+ Langerhans cells in the patch test biopsy than in the other 2 biopsies. Most of the mononuclear cells were CD3+. The CD4+ to CD8+ ratio was approximately 1:1 in the facial macules; yet, CD4+ cells outnumbered CD8+ cells in the patch test biopsy. There were a few TIA-1+ cells in all 3 biopsies. In conclusion, the earliest histopathological and immunophenotypical events in PCD due to benzyl salicylate are similar to those of longer-standing lesions, i.e., a nonlichenoid focal interface dermatitis involving the epidermis and pilosebaceous unit, along with dermal melanophages. Correspondence: Hiba Zaaroura, MD, Department of Dermatology, Rambam Health Care Campus, The Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel 3109601 (e-mail: hiba_zaroura@yahoo.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2MqiXs2
https://ift.tt/2MqiXs2
Histopathology of Hand–Foot–Mouth Disease in Adults and Criteria for Differentiation From Erythema Multiforme
Background: Hand–foot–mouth disease (HFMD) is a common contagious viral infection usually affecting infants and children. Recently, literature on HFMD in adults is increasing. It has been reported that adults often present with unusual exanthems with similarities to erythema multiforme (EM). No study has so far compared the histologic features of HFMD with those of EM. Methods: Histopathologic features in 7 biopsies of 6 adult patients with HFMD are compared with biopsies from 9 patients with EM to identify the best criteria for differentiation. Results: HFMD and EM both have a perivascular lymphocytic infiltrate together with epidermal necrosis, spongiosis, ballooning, and reticular alteration. However, large numbers of neutrophils in parakeratosis (P
https://ift.tt/2MqiB4G
https://ift.tt/2MqiB4G
Atypical Varicella-Zoster Kaposi Varicelliform Eruption in Sézary Syndrome
Abstract: Patients with mycosis fungoides experience considerable morbidity and mortality from secondary bacterial and viral infections. Staphylococcus aureus, β-hemolytic streptococci, herpes simplex virus, and herpes zoster virus remain the most common infectious pathogens in this group of patients. With depressed cellular immunity and diminished skin barrier as the main precipitating risk factors, immunocompromised patients can often present with an atypical presentation of a common dermatologic condition. The case herein discusses a clinically atypical nonvesicular Kaposi varicelliform eruption secondary to a varicella-zoster virus in a patient with Sézary syndrome. Concurrent polypharmacy in these patients is also a risk factor for development of drug hypersensitivity reactions. However, given their immunocompromised status, first and foremost, a careful inspection should be made of every atypical skin eruption in search of an infectious etiology, and afterward, an appropriate treatment should be promptly initiated. Correspondence: Silvija P. Gottesman, MD, 1991 Marcus Avenue, Ste 300, Lake Success, NY 11042 (e-mail: silvija.gottesman@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2ND6sOd
https://ift.tt/2ND6sOd
Formation characteristics of carbonaceous and nitrogenous disinfection by-products depending on residual organic compounds by CGS and DAF
Abstract
Allogenic organic matter (AOM) composed of extracellular and intracellular organic matter (EOM and IOM) is a major precursor of halogenated carbonaceous and nitrogenous disinfection by-products (C-DBPs and N-DBPs) upon chlorination. The EOM and IOM extracted from Microcystis aeruginosa were analyzed based on bulk parameters and organic fractions with different molecular weight by liquid chromatography with organic carbon detection (LC-OCD). It investigated the efficiency of a conventional gravity system (CGS) and dissolved air flotation (DAF) in the removal of organic precursors, together with measurement of the formation of four major trihalomethanes (THMs) and haloacetonitriles (HANs) in treated water upon chlorination. The results showed that EOM accounted for 59% of building blocks and humic substances, whereas for IOM, 54% were low molecular weight (LMW) neutrals. Both CGS and DAF showed 57–59% removal of dissolved organic carbon (DOC) from EOM and IOM. Regarding DON removal, DAF was found to be more effective, i.e., 8% higher than CGS for EOM. Moreover, the removal of LMW acids and neutrals (not easy to remove and are major precursors of DBPs) from EOM and IOM by DAF was higher than from CGS. The amounts of DBPs measured in all the samples treated for interchlorination were much lower than in the samples for prechlorination. Although the precursors of EOM had a higher concentration than in IOM, THMs and HANs were detected for IOM at a higher concentration, which might be attributed to higher amounts of aromatic, aliphatic moisture and protein compounds in the IOM. Comparatively, DAF showed lower THM and HAN values than CGS water, particularly for IOM. Also, DAF showed a sharp decrease in THMs and an insignificant increase in HANs according to time.
https://ift.tt/2x9SKsN
Prospective study on metal ceramic crowns in private practice settings: 20-year results
Abstract
Objectives
Posterior metal ceramic crowns are still widely used as a standard treatment. The aim of this study was to obtain long-term data on their clinical performance.
Material and Methods
Ten private practitioners participated in this prospective practice-based study. Patients were provided with two crowns each. Two groups were formed. The single crown group comprised 95 patients with 190 crowns. The retainer crown group comprised 138 patients with fixed dental prostheses and 276 retainer crowns.
Results
For the primary outcome "loss of tooth or crown," 20-year survival rates of 78.8% in the single crown group and 67.8% in the retainer crown group were found. Veneering ceramic defects occurred rather frequently, resulting in respective 20-year technical success rates of 74.2% for single crowns and 62.9% for retainer crowns. However, veneering ceramic defects causing crown losses were very rare events.
Conclusions
The results contribute to our knowledge on long-term outcomes of treatments with metal ceramic crowns and show high survival and success rates over 20 years.
Clinical relevance
Posterior metal ceramic crowns are a highly reliable option in private practice settings.
https://ift.tt/2oZGnv0
Human health risks of Hg, As, Mn, and Cr through consumption of fish, Ticto barb ( Puntius ticto ) from a tropical river, Bangladesh
Abstract
Metals tend to accumulate in higher organisms, e.g., fish and human through biomagnification effects in food chain. So, their presence in any component of the environment has become a global ecosystem and health concern. Here, we measured four health concerned metals like As, Cr, Mn, and Hg via inductively coupled plasma-mass spectrometry (ICP-MS) and analyzed applying some chemometrics for the assessment of human health risk through consumption of Puntius ticto, a very commonly consumed small fish in Bangladesh. The average concentration (wet weight) of metals was in the following descending order: Hg (0.006 mg/kg) > Cr (0.004 mg/kg) > Mn (0.003 mg/kg) > As (0.002 mg/kg). Hg level exceeded the provisional tolerable weekly intake (PTWI), and all other metals were within the permissible limit. The estimated daily intake (EDI) index of heavy metals showed that all the concentration levels were under the recommended daily intake (RDA) except Hg. Increased level of Hg is of particular concern to human health due to its biomagnification nature and can cause several neurological and physiological disorders including kidney failure. The total target hazard quotients (TTHQs) and carcinogenic risk (CR) matrices revealed that the intakes of Hg and As through fish consumption were higher than the recommended values, indicating consumers' remain non-carcinogenic and carcinogenic (THQ > 1; CR > 10−5) health risks for lifetime consumption. Multivariate analyses (cluster and principal component) explained the sources of heavy metals in the study area originating from both anthropogenic and geological origin.
https://ift.tt/2D1BgEz
Baccharis dracunculifolia (Asteraceae) essential oil toxicity to Culex quinquefasciatus (Culicidae)
Abstract
The control of mosquitoes by means of chemical insecticides has been a problem, mainly due to the possibility of resistance developed by insects to xenobiotics. For this reason, demand for botanical insecticides has increased. In this sense, the present work aims to verify the susceptibility and morphological and biochemical alterations of Culex quinquefasciatus larvae after exposure to essential oil (EO) of leaves of Baccharis dracunculifolia. To observe the larvicidal action, larvae were exposed to EO at concentrations of 25, 50, 100, and 200 mg/L, until their emergence to adults. The control group was exposed to deionized water and dimethyl sulfoxide. Morphological analyses were also carried out using hematoxylin and eosin, mercury bromophenol blue, Nile blue, and periodic acid Schiff. Biochemical analyses of total glucose, triacylglyceride (TAG), protein, and acetylcholinesterase levels were performed. The phytochemical analysis of the EO showed (E)-nerolidol as the major compound (30.62%). Larvae susceptibility results showed a LC50 of 34.45 mg/L for EO. Morphological analysis showed that there were histological changes in midgut. For biochemical analyses, the glucose level in the larvae exposed to EO for 24 h decreased significantly, unlike the TAG levels, which increased. The total protein level of the larvae also increased after exposure for 24 h, and acetylcholinesterase levels decreased significantly. Taking all our data into account, we can conclude that EO causes destabilization in larva, leading to histological changes, metabolic deregulation and, consequently, their death.
https://ift.tt/2QsEcN9
Stress response of NAD + -dependent formate dehydrogenase in Gossypium hirsutum L. grown under copper toxicity
Abstract
Cotton (Gossypium hirsutum L.), which is not directly involved in the food chain, appears to be a suitable candidate to remove heavy metals from the food chain and to be a commercial plant which could be planted in contaminated soils. The key point of this approach is selection of the right genotype, which has heavy metal resistance or hyperaccumulation properties. Therefore, in the present study, two G. hirsutum genotypes, Erşan-92 and N-84S, were grown under copper stress and investigated to obtain further insights about the heavy metal tolerance mechanisms of plants by focusing on the expression of NAD+-dependent formate dehydrogenase (FDH). In accordance with the results, which were obtained from RT-PCR analysis and activity measurements, in the Erşan-92 root tissue, FDH activity increased significantly with increasing metal concentrations and a 6.35-fold higher FDH activity was observed in the presence of 100-μM Cu. As opposed to Erşan-92, the maximum FDH activity in the roots of N-84S, which were untreated with copper as the control plants, was measured as 0.0141-U mg−1 g−1 FW, and the activity decreased significantly with the increasing metal concentrations. The metallothionein (GhMT3a) transcript level of the plants grown in a medium containing different Cu concentrations showed nearly the same pattern as that of the FDH gene transcription. It was observed that while the tolerance of N-84S in the lower Cu concentration reduces remarkably, Erşan-92 continues to struggle up to 100-μM Cu. The results of the SOD analysis also confirm this activity of Erşan-92 against the Cu stress.
https://ift.tt/2COL3xj
Facile synthesis of Fe 3 O 4 @MOF-100(Fe) magnetic microspheres for the adsorption of diclofenac sodium in aqueous solution
Abstract
In this research, the adsorptive removal of diclofenac sodium, one of the representative pharmaceuticals and personal care products, from aqueous solution using Fe3O4@MOF-100(Fe) magnetic microspheres was studied for the first time. The Fe3O4@MOF-100(Fe) microspheres exhibit strong magnetism and stability, which were observed as a core-shell structure. The maximum adsorption capacity of Fe3O4@MOF-100(Fe) for diclofenac sodium can reach 377.36 mg L−1, which was higher than most of the adsorbents reported. The adsorption kinetics follows the pseudo-second-order kinetic equation. And the adsorption equilibrium of DCF can be described with Langmuir isotherm. In the cycle experiment, Fe3O4@MOF-100(Fe) material performed high adsorption efficiency for low-concentration diclofenac sodium solution, and the removal rate can still reach 80% after 5 cycles of adsorption without desorption. The mechanisms including electrostatic interaction, H-bond interaction, and π-π interaction that coexisted in the adsorption processes would be of benefit to enhance the adsorption capacity. The Fe3O4@MOF-100(Fe) magnetic microspheres offer exciting opportunities for further application.
https://ift.tt/2QsE5RJ
Lifestyle chemical carcinogens associated with mutations in cell cycle regulatory genes increases the susceptibility to gastric cancer risk
Abstract
In the present study, we correlated the various lifestyle habits and their associated mutations in cell cycle (P21 and MDM2) and DNA damage repair (MLH1) genes to investigate their role in gastric cancer (GC). Multifactor dimensionality reduction (MDR) analysis revealed the two-factor model of oral snuff and smoked meat as the significant model for GC risk. The interaction analysis between identified mutations and the significant demographic factors predicted that oral snuff is significantly associated with P21 3′UTR mutations. A total of five mutations in P21 gene, including three novel mutations in intron 2 (36651738G > A, 36651804A > T, 36651825G > T), were identified. In MLH1 gene, two variants were identified viz. one in exon 8 (37053568A > G; 219I > V) and a novel 37088831C > G in intron 16. Flow cytometric analysis predicted DNA aneuploidy in 07 (17.5%) and diploidy in 33 (82.5%) tumor samples. The G2/M phase was significantly arrested in aneuploid gastric tumor samples whereas high S-phase fraction was observed in all the gastric tumor samples. This study demonstrated that environmental chemical carcinogens along with alteration in cell cycle regulatory (P21) and mismatch repair (MLH1) genes may be stimulating the susceptibility of GC by altering the DNA content level abnormally in tumors in the Mizo ethic population.
https://ift.tt/2CQAEkP
FGF23 beyond Phosphotropic Hormone
Publication date: Available online 11 September 2018
Source: Trends in Endocrinology & Metabolism
Author(s): Yuichi Takashi, Seiji Fukumoto
Fibroblast growth factor (FGF) 23 is a bone-derived phosphotropic hormone that regulates phosphate and vitamin D metabolism. FGF23 mainly affects kidney function via the FGF receptor (FGFR)/α-Klotho complex. The physiological roles of FGF23 and α-Klotho in the regulation of mineral homeostasis have been well established. In addition, recent studies have reported that FGF23 has various effects on many other tissues, sometimes in an α-Klotho-independent manner, especially under pathological conditions. However, how FGF23 works in these tissues without α-Klotho is not entirely clear. Here we review the recent reports concerning the actions of FGF23 on various tissues and discuss the remaining questions about FGF23.
https://ift.tt/2p3zSqS
Scholar : Compost Science & Utilization, Volume 26, Issue 2, 2018 is now available online on Taylor & Francis Online
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Scholar : Atmosphere-Ocean, Volume 56, Issue 3, July 2018 is now available online on Taylor & Francis Online
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Scholar : These new articles for Latin American Business Review are available online
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Facial perception of infants with cleft lip and palate with/without the NAM appliance
Abstract
Objective
This study aimed to assess adults' subjective perception of infants with a unilateral cleft lip and palate (UCLP) with and without a nasoalveolar molding (NAM) appliance compared to those of controls concerning (1) adult gaze patterns and (2) emotional valence.
Methods
This interdisciplinary study was performed by (1) the Department of Orthodontics and (2) the Department for Psychiatry and Psychotherapy, University Medical Center Goettingen, using eye tracking and a 10-point Likert scale questionnaire. Eye movements and valence rating of 30 unaffected adults (15 women, 15 men; mean age: 25.5 years, standard deviation [SD] = 7.5) were recorded while presenting them infants in three picture categories (1) infant with UCLP, (2) infant with UCLP and inserted NAM appliance and (3) infant without UCLP. Total fixation time in two main areas of interest (AOI upper/lower face) was measured according to picture category as well as participants' valence rating regarding infants' appearance.
Results
In pictures of infants with UCLP or UCLP and NAM appliance participants had longer fixation times on AOI lower face compared to reconstructed pictures of infants without UCLP. No significant effect of a NAM appliance on gaze patterns could be detected. The valence of pictures of infants with UCLP was rated more negative compared to pictures of unaffected infants. An inserted NAM appliance improved this rating.
Conclusions
The results bolster the assumption that facial disruptions like UCLP alter adults' perception of infants. Even though the NAM appliance is not able to re-establish usual adult gaze patterns, it can help to improve adults' emotional assessment.
https://ift.tt/2Nb532b
Facial perception of infants with cleft lip and palate with/without the NAM appliance
Abstract
Objective
This study aimed to assess adults' subjective perception of infants with a unilateral cleft lip and palate (UCLP) with and without a nasoalveolar molding (NAM) appliance compared to those of controls concerning (1) adult gaze patterns and (2) emotional valence.
Methods
This interdisciplinary study was performed by (1) the Department of Orthodontics and (2) the Department for Psychiatry and Psychotherapy, University Medical Center Goettingen, using eye tracking and a 10-point Likert scale questionnaire. Eye movements and valence rating of 30 unaffected adults (15 women, 15 men; mean age: 25.5 years, standard deviation [SD] = 7.5) were recorded while presenting them infants in three picture categories (1) infant with UCLP, (2) infant with UCLP and inserted NAM appliance and (3) infant without UCLP. Total fixation time in two main areas of interest (AOI upper/lower face) was measured according to picture category as well as participants' valence rating regarding infants' appearance.
Results
In pictures of infants with UCLP or UCLP and NAM appliance participants had longer fixation times on AOI lower face compared to reconstructed pictures of infants without UCLP. No significant effect of a NAM appliance on gaze patterns could be detected. The valence of pictures of infants with UCLP was rated more negative compared to pictures of unaffected infants. An inserted NAM appliance improved this rating.
Conclusions
The results bolster the assumption that facial disruptions like UCLP alter adults' perception of infants. Even though the NAM appliance is not able to re-establish usual adult gaze patterns, it can help to improve adults' emotional assessment.
https://ift.tt/2Nb532b
MRI-guided localization of the dominant intraprostatic lesion and dose analysis of volumetric modulated arc therapy planning for prostate cancer
Abstract
Purpose
Primary radiation therapy is a curative treatment option for prostate cancer. The aim of this study was to evaluate the detection of the dominant intraprostatic lesion (DIL) with magnetic resonance imaging (MRI) for radiotherapy treatment planning, the comparison with transrectal ultrasound (TRUS)-guided biopsies and the examination of the dose distribution in relation to the DIL location.
Materials and methods
In all, 54 patients with treatment planning MRI for primary radiotherapy of prostate cancer from 03/2015 to 03/2017 at the Universitätsklinikum Würzburg were identified. The localization of the DIL was based on MRI with T2- and diffusion-weighted imaging. After registration of the MR image sets within Pinnacle3 (Philips Radiation Oncology Systems, Fitchburg, WI, USA), the dose distribution was analyzed. The location of the DIL was compared to the pathology reports in a side-based manner.
Results
The DIL mean dose (Dmean) was 77.51 ± 0.77 Gy and in 50/51 cases within the tolerance range or exceeded the prescribed dose. There was a significant difference in Dmean between ventral (n = 21) and dorsal (n = 30) DIL (77.87 ± 0.67 vs. 77.26 ± 0.77 Gy; p = 0.005). MRI-guided localization showed an accuracy and sensitivity of up to 78.8% and 82.1% for inclusion of secondary lesions, respectively.
Conclusion
Up to 82.1% of histologically verified intraprostatic lesions were identified in the context of MRI-guided radiotherapy treatment planning. As expected, dorsal DIL tend to be minimally underdosed in comparison to ventral DIL. Adequate dose coverage was achieved in over 98% of patients.
https://ift.tt/2x5ANvi
Reference method for digital surface measurement of target lesions in vitiligo: a comparative analysis
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2Qu1jqy
Diagnostic Accuracy of Content Based Dermatoscopic Image Retrieval with Deep Classification Features
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2Mpmuqf
Cabozantinib in Combination With Cetuximab in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Cancer
Conditions: Head and Neck Squamous Cell Cancer; Recurrent Head and Neck Squamous Cell Cancer; Metastatic Head and Neck Squamous Cell Cancer
Interventions: Drug: Cabozantinib; Drug: Cetuximab
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2NIGPvL
Interventions: Drug: Cabozantinib; Drug: Cetuximab
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2NIGPvL
Exercise and Pain Neuroscience Education for Patients With Neck Pain: Impact on Pain and Disability
Condition: Neck Pain
Interventions: Other: Pain neuroscience education (PNE) and traditional exercise; Other: Pain neuroscience education (PNE) and suspension exercise
Sponsor: Aveiro University
Not yet recruiting
https://ift.tt/2xaUsZY
Interventions: Other: Pain neuroscience education (PNE) and traditional exercise; Other: Pain neuroscience education (PNE) and suspension exercise
Sponsor: Aveiro University
Not yet recruiting
https://ift.tt/2xaUsZY
S-1 Combined With IMRT Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Carcinoma
Condition: Nasopharyngeal Carcinoma
Intervention: Drug: S-1
Sponsor: Fudan University
Recruiting
https://ift.tt/2x8YCBN
Intervention: Drug: S-1
Sponsor: Fudan University
Recruiting
https://ift.tt/2x8YCBN
Xenotransplantation of Primary Cancer Samples in Zebrafish Embryos
Conditions: Liver Cancer; Pancreatic Cancer; Gastric Cancer; Esophageal Cancer; Colo-rectal Cancer; Gall Bladder Cancer; Biliary Tract Cancer
Interventions: Drug: Fluorouracil; Drug: Lederfolin; Drug: Oxaliplatin; Drug: Irinotecan; Drug: Docetaxel; Drug: Cisplatin; Drug: Epirubicin; Drug: Gemcitabine; Drug: Nab paclitaxel
Sponsors: University of Pisa; Azienda Ospedaliero, Universitaria Pisana
Recruiting
https://ift.tt/2NIGGIJ
Interventions: Drug: Fluorouracil; Drug: Lederfolin; Drug: Oxaliplatin; Drug: Irinotecan; Drug: Docetaxel; Drug: Cisplatin; Drug: Epirubicin; Drug: Gemcitabine; Drug: Nab paclitaxel
Sponsors: University of Pisa; Azienda Ospedaliero, Universitaria Pisana
Recruiting
https://ift.tt/2NIGGIJ
Visuomotor learning and unlearning in children and adolescents with Tourette syndrome
Publication date: Available online 11 September 2018
Source: Cortex
Author(s): Soyoung Kim, Stephen R. Jackson, Maddie Groom, Georgina M. Jackson
Abstract
Tourette syndrome (TS) is a childhood-onset neurological condition characterised by an evolving repertoire of chronic motor tics and one or more phonic tics. Tics, like habits, are inflexible and repetitive behaviours that are acquired over a period of time. It has been proposed that tics arise in TS as a result of increased habit learning: which may bias the child to acquire automatic behaviours (i.e. tics) more readily than is normal and make it harder to unlearn maladaptive habits once they have been acquired. Using a well-established visuomotor adaptation task, we investigated motor learning in a group of children and adolescents with a clinical diagnosis of TS relative to a group of age and gender matched typically developing individuals. In particular, we quantified differences in the strength and quality of motor learning and unlearning in TS, and the consolidation of motor learning over a 24 hour washout period. We demonstrated that there was a marginally significant decrease in learning rate in the individuals with TS relative to age and gender matched typically developing controls. However, this effect was not associated with tic severity and could be entirely accounted for by the severity of co-occurring ADHD symptoms. Thus, once ADHD symptoms had been accounted for, there were no between group differences in learning rate or the degree of learning observed. By contrast, and more importantly, we found that following learning the rate of forgetting (unlearning) was significantly negatively associated with motor tic severity, such that individuals with more severe tics took longer to unlearn previously learnt motor patterns of behavior. This finding is consistent with the proposal that TS is associated with alterations in the striatal habit learning system and with the view that TS may make it harder to unlearn maladaptive motor habits once they have been acquired.
https://ift.tt/2x4yjxu
Neutrophils: Novel key players in Rheumatoid Arthritis. Current and future therapeutic targets
Publication date: Available online 11 September 2018
Source: Autoimmunity Reviews
Author(s): Irene Cecchi, Ivan Arias de la Rosa, Elisa Menegatti, Dario Roccatello, Eduardo Collantes-Estevez, Chary Lopez-Pedrera, Nuria Barbarroja
Abstract
Rheumatoid Arthritis (RA) is a complex systemic autoimmune disease in which various cell types are involved. Among them, neutrophils have been recognized as important players in the onset and the progression of RA. The pathogenic role of neutrophils in RA lies in the alteration of several processes, including increased cell survival and migratory capacity, abnormal inflammatory activity, elevated oxidative stress and an exacerbated release of neutrophil extracellular traps. Through these mechanisms, neutrophils can activate other immune cells, thus perpetuating inflammation and leading to the destruction of the cartilage and bone of the affected joint.
Given the considerable contribution of neutrophils to the pathophysiology of RA, several studies have attempted to clarify the effects of various therapeutic agents on this subtype of leukocyte.
To date, recent studies have envisaged the role of new molecules on the pathogenic profile of neutrophils in RA, which could represent novel targets in future therapies.
In this review, we aim to review the pathogenic role of neutrophils in RA, the effect of conventional treatments and biologic therapies, and the new, potential targets of neutrophil-derived molecules for the treatment of RA.
https://ift.tt/2MnprI6
Association between itch and cancer in 16,925 pruritus patients: Experience at a tertiary care center
Publication date: Available online 11 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Valerie A. Larson, Olive Tang, Sonja Stander, Sewon Kang, Shawn G. Kwatra
Abstract
Background
Pruritus has been associated with cancer. However, limited data is available on the types of underlying malignancy associated with pruritus.
Objective
We sought to characterize the association between pruritus and different cancer types, as well as variations by racial group.
Methods
Cross-sectional study of patients ≥ 18 years old seen at the Johns Hopkins Health System from 2013-2017. Patients with pruritus were compared to patients without pruritus. Analyses were stratified by race.
Results
Patients with pruritus are more likely to have concomitant malignancy than those without pruritus (OR 5.76; 95% CI 5.53-6.00). Most strongly associated are cancers of the liver, gallbladder and biliary tract, hematopoietic system, and skin. Compared to whites, black patients more frequently have soft tissue, dermatological, and hematological malignancies, and less frequently have liver, respiratory, GI, and gynecological malignancies.
Limitations
Cross-sectional design precludes analysis of the temporal association between pruritus and malignancy. The study is limited to a single tertiary care center.
Conclusion
Pruritus is most strongly associated with cancers of the liver, skin, and hematopoietic system. Black patients with pruritus have a higher likelihood of skin, soft tissue, and hematological malignancies than whites, while whites have higher likelihood of liver, respiratory, GI, and gynecological malignancies.
https://ift.tt/2OatXvb
Cross-Sectional Survey on Disease Severity in Japanese Patients with Harlequin Ichthyosis/Ichthyosis: Syndromic Forms and Quality-of-Life Analysis in a Subgroup
Publication date: Available online 11 September 2018
Source: Journal of Dermatological Science
Author(s): Chiaki Murase, Takuya Takeichi, Akitaka Shibata, Masahiro Nakatochi, Fumie Kinoshita, Akiharu Kubo, Kimiko Nakajima, Norito Ishii, Hiroo Amano, Koji Masuda, Hiroshi Kawakami, Takuro Kanekura, Ken Washio, Masayuki Asano, Kazuya Teramura, Eijiro Akasaka, Mikiko Tohyama, Yutaka Hatano, Toyoko Ochiai, Shinichi Moriwaki
ABSTRACT
Background
Congenital ichthyoses (CIs) adversely affect quality of life (QOL) in patients. However, the effects of CIs on patient QOL have not been studied sufficiently.
Objective
To investigate the association between disease severity and QOL in patients with harlequin ichthyosis (HI) and ichthyosis: syndromic forms (ISFs)
Methods
Clinical information of patients with HI and ISFs from 2010 to 2015 were obtained from 100 dermatology departments/divisions of principal institutes/hospitals throughout Japan. We examined the relationship between disease severity and QOL in patients with HI and ISFs. Patients who were aged 8 years or older and participated in a multicenter retrospective questionnaire survey in Japan were assessed by dermatology life quality index (DLQI, range of 0 - 30) and clinical ichthyosis score (range of 0 - 100).
Results
Netherton syndrome patients had a significantly higher risk of allergy to food or environmental allergens than patients with other phenotypes. KID syndrome patients showed a significantly higher risk of skin infections than patients with other phenotypes.
Complete data on DLQI were obtained from 13 patients, whose median age was 21 (8-71) years. Nine patients were male, and 4 were female. Systemic retinoids were administrated to 2 of the 3 HI patients. The Spearman's correlation coefficient between the clinical ichthyosis score and DLQI was 0.611 (P < 0.05).
Conclusion
We confirmed that Netherton syndrome and KID syndrome patients have a higher risk of allergy to food or environmental allergens and of skin infections, respectively. QOL impairment correlates with disease severity in HI and ISFs patients.
https://ift.tt/2CNr3eB
MicroRNA-340 inhibits squamous cell carcinoma cell proliferation, migration and invasion by downregulating RhoA
Publication date: Available online 11 September 2018
Source: Journal of Dermatological Science
Author(s): Huina Wang, Weinan Guo, Qiang Jian, Ke Xue, Min Huang, Sumin Chi, Chunying Li, Chengxin Li
Abstract
Background
MicroRNAs are reported to play an important role in tumor growth and metastasis, including squamous cell carcinoma (SCC). Accumulative evidence has revealed that dysregulated miR-340 expression contributed to the carcinogenesis and development of various cancers.
Objective
The aim of the current study was to investigate the role and the underlying mechanism of miR-340 in SCC cell proliferation, migration and invasion.
Methods
Quantitative real-time PCR was performed to examine the expression of miR-340 in SCC tissues and cell lines. The function of miR-340 in SCC was investigated through Cell Counting Kit-8, wound healing, transwell migration and invasion assays. Bioinformatics analysis, luciferase reporter assay, western blotting and immunohistochemical analysis were conducted to predict and confirm the target gene of miR-340.
Results
In the present study, we first found that miR-340 was significantly decreased in both SCC tissues and cell lines. Moreover, ectopic expression of miR-340 remarkably attenuated SCC cell proliferation, migration and invasion, whereas inhibition of endogenous miR-340 promoted cell proliferation, migration and invasion in vitro. Our subsequent bioinformatics analysis and luciferase reporter assay showed that RhoA was a novel direct target of miR-340 in SCC cell, and the knockdown of RhoA expression rescued the effect of miR-340 inhibition on SCC cell proliferation, migration and invasion. More importantly, the expression of RhoA and miR-340 was negatively correlated in SCC tissues.
Conclusion
Our findings demonstrate the tumor suppressor role of miR-340 in SCC by directly regulating RhoA. Therefore, restoration of miR-340 expression can be a potential therapeutic approach for SCC treatment.
https://ift.tt/2NFcJcc
Management of clinical and subclinical actinic keratoses with histological and immunohistochemical assessments by confocal microscopy
Dermatologic Therapy, EarlyView.
https://ift.tt/2x8Pf4T
Tofacitinib as the potent treatment for refractory pemphigus: A possible alternative treatment for pemphigus
Dermatologic Therapy, EarlyView.
https://ift.tt/2NAb8Ez
Toxic adjuvants alter the function and phenotype of dendritic cells to initiate adaptive immune responses induced by oral Helicobacter pylori vaccines
Helicobacter, EarlyView.
https://ift.tt/2x6LwWm
A Polygenic Score for Higher Educational Attainment is Associated with Larger Brains
Abstract
People who score higher on intelligence tests tend to have larger brains. Twin studies suggest the same genetic factors influence both brain size and intelligence. This has led to the hypothesis that genetics influence intelligence partly by contributing to the development of larger brains. We tested this hypothesis using four large imaging genetics studies (combined N = 7965) with polygenic scores derived from a genome-wide association study (GWAS) of educational attainment, a correlate of intelligence. We conducted meta-analysis to test associations among participants' genetics, total brain volume (i.e., brain size), and cognitive test performance. Consistent with previous findings, participants with higher polygenic scores achieved higher scores on cognitive tests, as did participants with larger brains. Participants with higher polygenic scores also had larger brains. We found some evidence that brain size partly mediated associations between participants' education polygenic scores and their cognitive test performance. Effect sizes were larger in the population-based samples than in the convenience-based samples. Recruitment and retention of population-representative samples should be a priority for neuroscience research. Findings suggest promise for studies integrating GWAS discoveries with brain imaging to understand neurobiology linking genetics with cognitive performance.https://ift.tt/2x00ayP
Frontoparietal Networks Mediate the Behavioral Impact of Alpha Inhibition in Visual Cortex
Abstract
Alpha oscillations are known to play a central role in the functional inhibition of visual cortices, but the mechanisms involved are poorly understood. One noninvasive method for modulating alpha activity experimentally is through the use of flickering visual stimuli that "entrain" visual cortices. Such alpha entrainment has been found to compromise visual perception and affect widespread cortical regions, but it remains unclear how the interference occurs and whether the widespread activity induced by alpha entrainment reflects a compensatory mechanism to mitigate the entrainment, or alternatively, a propagated interference signal that translates to impaired visual processing. Herein, we attempt to address these questions by integrating alpha entrainment into a modified Posner cueing paradigm, while measuring the underlying dynamics using magnetoencephalography. Our findings indicated that alpha entrainment is negatively related to task performance, such that as neural entrainment increases on the attended side (relative to the unattended side) accuracy decreases. Further, this attentional biasing is found to covary robustly with activity in the frontoparietal attention network. Critically, the observed negative entrainment effect on task accuracy was also fully mediated by activity in frontoparietal regions, signifying a propagation of the interfering alpha entrainment signal from bottom-up sensory to top-down regulatory networks.https://ift.tt/2Mt0SJW
Priority Switches in Visual Working Memory are Supported by Frontal Delta and Posterior Alpha Interactions
Abstract
Visual working memory (VWM) distinguishes between representations relevant for imminent versus future perceptual goals. We investigated how the brain sequentially prioritizes visual working memory representations that serve consecutive tasks. Observers remembered two targets for a sequence of two visual search tasks, thus making one target currently relevant, and the other prospectively relevant. We show that during the retention interval prior to the first search, lateralized parieto-occipital EEG alpha (8–14 Hz) suppression is stronger for current compared with prospective search targets. Crucially, between the first and second search task, this difference in posterior alpha lateralization reverses, reflecting the change in priority states of the two target representations. Connectivity analyses indicate that this switch in posterior alpha lateralization is driven by frontal delta/low-theta (2–6 Hz) activity. Moreover, this frontal low-frequency signal also predicts task performance after the switch. We thus obtained evidence for large-scale network interactions underlying the flexible shifting between the priority states of multiple memory representations in VWM.https://ift.tt/2x5hYsd
Dentate Granule Neurons Generated During Perinatal Life Display Distinct Morphological Features Compared With Later-Born Neurons in the Mouse Hippocampus
Abstract
In nonhuman mammals and in particular in rodents, most granule neurons of the dentate gyrus (DG) are generated during development and yet little is known about their properties compared with adult-born neurons. Although it is generally admitted that these populations are morphologically indistinguishable once mature, a detailed analysis of developmentally born neurons is lacking. Here, we used in vivo electroporation to label dentate granule cells (DGCs) generated in mouse embryos (E14.5) or in neonates (P0) and followed their morphological development up to 6 months after birth. By comparison with mature retrovirus-labeled DGCs born at weaning (P21) or young adult (P84) stages, we provide the evidence that perinatally born neurons, especially embryonically born cells, are morphologically distinct from later-born neurons and are thus easily distinguishable. In addition, our data indicate that semilunar and hilar GCs, 2 populations in ectopic location, are generated during the embryonic and the neonatal periods, respectively. Thus, our findings provide new insights into the development of the different populations of GCs in the DG and open new questions regarding their function in the brain.https://ift.tt/2MmEK3M
Inhibitory Neuron Activity Contributions to Hemodynamic Responses and Metabolic Load Examined Using an Inhibitory Optogenetic Mouse Model
Abstract
Hemodynamic signals are routinely used to noninvasively assess brain function in humans and animals. This work examined the contribution of inhibitory neuron activity on hemodynamic responses captured by changes in blood flow, volume and oxygenation in the cortex of lightly anesthetized mice. Because cortical activity is not commonly initiated by inhibitory neurons, experiments were conducted to examine the neuronal activity properties elicited by photo-stimulation. We observed comparable increases in neuronal activity evoked by forelimb and photo-stimulation; however, significantly larger increases in blood flow and volume were produced by photo-stimulation of inhibitory neurons compared with forelimb stimulation. Following blockade of glutamate and GABA-A receptors to reduce postsynaptic activity contributions, neuronal activity was reliably modulated and hemodynamic changes persisted, though slightly reduced. More importantly, photo-stimulation-evoked changes in blood flow and volume were suppressed by 75–80% with the administration of a nitric oxide synthase inhibitor, suggesting that inhibitory neurons regulate blood flow mostly via nitric oxide. Lastly, forelimb and photo-stimulation of excitatory neurons produced local decreases in blood oxygenation, while large increases were generated by photo-stimulation of inhibitory neurons. Estimates of oxygen metabolism suggest that inhibitory neuron activity has a small impact on tissue metabolic load, indicating a mismatch between the metabolic demand and blood flow regulation properties of inhibitory and excitatory neurons.https://ift.tt/2x4lH9D
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