Τρίτη 2 Οκτωβρίου 2018
Effects of metabolic abnormalities, hyperandrogenemia and clomiphene on liver function parameters among Chinese women with polycystic ovary syndrome: results from a randomized controlled trial
Abstract
Purpose
To investigate the effects of metabolic abnormalities, hyperandrogenemia and ovulation induction by clomiphene/acupuncture on liver function parameters among women with polycystic ovary syndrome (PCOS).
Methods
This is a secondary analysis of a randomized controlled trial. All 1000 subjects were diagnosed as PCOS by modified Rotterdam criteria. Liver function parameters, metabolic panel and hormone profile were measured at baseline and after treatment. The relationship between liver parameters with metabolic, hormonal parameters and ovulation induction was examined.
Results
PCOS women with metabolic syndrome had higher liver enzyme levels but lower bilirubin and bile acid levels than without. PCOS women with hyperandrogenemia had higher liver enzyme, bilirubin levels than without. Correlation analyses showed that worsening of metabolic parameters was associated with higher liver enzyme levels but lower bilirubin and bile acid levels, while increased androgen levels were associated with higher liver enzyme, bilirubin and bile acid levels. Ovulation induction with clomiphene citrate could decrease bilirubin and bile acid levels, while acupuncture had no obvious effect on liver function.
Conclusions
Among PCOS women, metabolic abnormalities and hyperandrogenemia impaired different liver function parameters. Clomiphene could decrease the bilirubin and bile acid levels while acupuncture had no obvious effect on liver function.
https://ift.tt/2OvwaVj
Sporadic pemphigus foliaceus and class II human leucocyte antigen allele associations in the white British and Indo‐Asian populations in the UK
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Pdt9pG
Screening and diagnosis of oral cancer: a critical quality appraisal of clinical guidelines
Abstract
Objectives
To assess the quality of clinical practice guidelines (CPGs) on screening and diagnosis of oral cancer and to describe the characteristics of their recommendations.
Materials and methods
We systematically searched EMBASE, MEDLINE, CPG' websites, and dentistry and oncology scientific societies to identify CPGs that were related to screening and diagnosis of oral cancer. The quality of selected CPGs was independently assessed by four appraisers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The inter-appraiser agreement was assessed. We performed a descriptive analysis of the recommendations included in the selected CPGs.
Results
Eight CPGs were selected. The overall agreement among reviewers was considered very good (ICC: 0.823; 95% CI: 0.777–0.861). The median scores of the six AGREE II domains were as follows: "scope and purpose" 97.9% (IQR: 96.2–100.0%); "stakeholder involvement" 86.1% (IQR: 69.8–93.1%); "rigor of development" 75.3% (IQR: 64.2–94.3%); "clarity of presentation" 91.7% (IQR: 82.6–94.4%); "applicability" 53.1% (IQR: 19.3–74.2%); and "editorial independence" 83.3% (IQR: 67.2–93.8%). Four CPGs were assessed as "recommended", four "recommended with modifications", and none "not recommended". Twenty-three recommendations were provided, mostly with a low or very low level of evidence.
Conclusion
The methodological quality of CPGs on screening and diagnosis of oral cancer is moderate. The "applicability" domain scored the lowest. Most recommendations were based on a low o very low level of evidence.
Clinical relevance
Greater efforts are needed to provide healthcare based on high-quality evidence-based CPGs in this field.
https://ift.tt/2O08qZX
Phytohormones enhanced drought tolerance in plants: a coping strategy
Abstract
Drought stress is a severe environmental constraint among the emerging problems. Plants are highly vulnerable to drought stress and a severe decrease in yield was recorded in the last few decades. So, it is highly desirable to understand the mechanism of drought tolerance in plants and consequently enhance the tolerance against drought stress. Phytohormones are known to play vital roles in regulating various phenomenons in plants to acclimatize to varying drought environment. Abscisic acid (ABA) is considered the main hormone which intensifies drought tolerance in plants through various morpho-physiological and molecular processes including stomata regulation, root development, and initiation of ABA-dependent pathway. In addition, jasmonic acid (JA), salicylic acid (SA) ethylene (ET), auxins (IAA), gibberellins (GAs), cytokinins (CKs), and brassinosteroids (BRs) are also very important phytohormones to congregate the challenges of drought stress. However, these hormones are usually cross talk with each other to increase the survival of plants in drought conditions. On the other hand, the transgenic approach is currently the most accepted technique to engineer the genes responsible for the synthesis of phytohormones in drought stress response. Our present review highlights the regulatory circuits of phytohormones in drought tolerance mechanism.
https://ift.tt/2O3TQRh
Co-contamination of antibiotics and metals in peri-urban agricultural soils and source identification
Abstract
To identify the dominant sources of contamination in peri-urban land, this study investigated the concentrations and distributions of antibiotics and metals in agricultural soil of this area. An index of landscape development intensity (LDI) was used to characterize the distribution of human disturbance-related land use. The results showed that total antibiotic concentration in the soil reached 395.55 μg/kg and that chlortetracycline was the predominant antibiotic compound, with a relatively high mean concentration of 30.62 μg/kg. In soils, the mean concentrations of Cu, Zn, and Pb were 38.41, 127.88, and 56.61 mg/kg and those of Al, Fe, and K were 83.73, 24.17, and 23.42 g/kg, respectively. A redundancy analysis showed that the landscape pattern in a 300-m buffer zone can well explain the variation in the concentrations of antibiotics and metals (24%, p < 0.05). The LDI in the 300-m buffer zone significantly correlated with the concentrations of total antibiotics and total amounts of Cu and Zn in the soil, suggesting that the risk of soil contamination increases with the intensity of anthropogenic activities. A structural equation modeling analysis indicated that Al, Cu, and Zn could significantly aggravate accumulation of tetracycline antibiotics in the soil, whereas there were only significantly direct paths from Cu to ciprofloxacin and norfloxacin. Overall, the results showed that aggravated co-contamination of antibiotics and metals occurs in agricultural soil under intensive human disturbance.
https://ift.tt/2QsEx1q
Keratosis Pilaris Rubra with Mucin Deposition
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xVsJhj
Self-injurious behaviour in patients with anorexia nervosa: a quantitative study
Abstract
Background
Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the prevalence of self-injurious behaviour, its characteristics and its emotion-regulation function in patients with anorexia nervosa or an eating disorder not otherwise specified (n = 136).
Methods
A cross-sectional design using a self-report questionnaire. Mann–Whitney U-tests were conducted to compare the background and clinical variables between patients with self-injurious behaviour and patients without this type of behaviour. Changes in emotional state before and after self-injurious behaviour were tested by Wilcoxon signed rank tests.
Results
Our results showed a 41% prevalence of self-injurious behaviour in the previous month. Patients who performed self-injurious behaviour had a statistically significant longer treatment history for their eating disorder than those who did not. Whereas 55% of self-injuring patients had a secondary psychiatric diagnosis, only 21% of participants without self-injurious behaviour did. Regarding the impact of self-injurious behaviour, our results showed a significant increase in "feeling relieved" and a significant decrease in "feeling angry at myself", "feeling anxious" and "feeling angry at others". This indicates that self-injurious behaviour can be regarded as an emotion-regulation behaviour. Participants were usually aware of the causes of their self-injurious behaviour acts.
Conclusions
Professionals should systematically assess the occurrence of self-injurious behaviour in eating disorder patients, pay special attention to patients with more severe and comorbid psychopathology, and those with a long treatment history. This assessment should be followed by a functional analysis of the self-injurious behaviour and by effective therapeutic interventions alongside the eating disorder treatment.
https://ift.tt/2QqEaV8
Assessment of elemental composition and properties of copper smelter-affected dust and its nano- and micron size fractions
Abstract
A comprehensive approach has been developed to the assessment of composition and properties of atmospherically deposited dust in the area affected by a copper smelter. The approach is based on the analysis of initial dust samples, dynamic leaching of water soluble fractions in a rotating coiled column (RCC) followed by the determination of recovered elements and characterization of size, morphology and elemental composition of nano-, submicron, and micron par ticles of dust separated using field-flow fractionation in a RCC. Three separated size fractions of dust (<0.2, 0.2–2, and >2 μm) were characterized by static light scattering and scanning electron microscopy, whereupon the fractions were analyzed by ICP-AES and ICP-MS (after digestion). It has been evaluated that toxic elements, which are characteristics for copper smelter emissions (As, Cu, Zn), are accumulated in fraction >2 μm. At the same time, up to 2.4, 3.1, 8.2, 6.7 g/kg of As, Cu, Zn, Pb, correspondently, were found in nanoparticles (<0.2 μm). It has been also shown that some trace elements (Sn, Sb, Ag, Bi, and Tl) are accumulated in fraction <0.2, and their content in this fraction may be one order of magnitude higher than that in the fraction >2 μm, or the bulk sample. It may be assumed that Sn, Sb, Ag, Bi, Tl compounds are adsorbed onto the finest dust particles as compared to As, Cu, Zn compounds, which are directly emitted from the copper smelter as microparticles.
https://ift.tt/2IylMqx
Factors associated with false‐negative pathologic diagnosis of calciphylaxis
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2IyL9Zr
Investigation of high‐frequency hearing loss and outer hair cell function of the cochlea in patients with psoriasis: a case–control study
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2NdzIqJ
Efficacy of localized hand and foot phototherapy: a review of patients treated in a teaching hospital setting
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xTorXS
Differential expression of interferon‐induced genes and other tissue‐based biomarkers in acute graft‐versus‐host disease vs. lupus erythematosus in skin
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Ndzv6V
Public engagement lectures targeting prospective medical students: an opportunity for dermatology
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xVhN3k
Risk factors for development of systemic lupus erythematosus in patients with cutaneous lupus: a retrospective review
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Nh3ivq
Cutaneous hyperpigmentation and familial gastrointestinal stromal tumour associated with KIT mutation
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xVhtBE
Acitretin as a successful treatment for Hailey–Hailey disease
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Nhv1w3
The nose as the predominant site for pemphigus foliaceous
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xVbEnH
Systematic review and meta‐analysis of prevalence of dermatological toxicities associated with vemurafenib treatment in patients with melanoma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2NjpFR1
Penile necrobiosis lipoidica: case report and literature review
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xTU4R8
A rare case of a tattoo‐induced morphoea reaction
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2NlgVdf
Cutaneous chromoblastomycosis effectively treated with local heat monotherapy
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2xTKgpU
Homocysteine plasma levels in patients affected by hidradenitis suppurativa: an Italian experience
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2NiSJrI
The effect of NB‐UVB on noncultured melanocyte and keratinocyte transplantation in treatment of generalized vitiligo using two different donor‐to‐recipient ratios
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2xVMuVZ
Effect of platelet‐rich plasma on proliferation and migration in human dermal fibroblasts
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2Nirldl
Effectiveness of short‐pulse width Nd:YAG in laser hair reduction
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2xVSkH3
Low‐fluence Q‐switched Nd:YAG laser for the treatment of melasma in Asian patients
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2NffQDr
Skin surface lipid differences in sensitive skin caused by psychological stress and distinguished by support vector machine
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2xUbddg
Hypereosinophilia successfully treated with the novel antihistamine bilastine
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2IwWmcK
Competitive adsorption and desorption of arsenate, vanadate, and molybdate onto the low-cost adsorbent materials alum water treatment sludge and bauxite
Abstract
When low-cost adsorbents are being used to remove contaminant ions (e.g. arsenate, vanadate, and molybdate) from wastewater, competitive adsorption/desorption are central processes determining their removal efficiency. Competitive adsorption of As, V, and Mo was investigated using equimolar oxyanion concentrations in single, binary, and tertiary combinations in adsorption isotherm and pH envelope studies while desorption of previously adsorbed oxyanions was examined in solutions containing single and binary oxyanion combinations. The low-cost adsorbent materials used were alum water treatment sludge (amorphous hydroxy-Al) and bauxite ore (crystalline Al oxides). Adsorption isotherm and pH envelope studies showed that Mo had only a small effect in decreasing adsorption of As and V but V and As had substantial and similar effects in reducing adsorption of the other. As had a greater effect than V in reducing adsorption of Mo and it was concluded that the affinity of oxyanions for the surfaces of water treatment sludge and bauxite followed the order As > V >> Mo. In 0.3 M NaCl electrolyte, desorption of previously adsorbed oxyanions amounted to 0.3–3.4% for V and As, and 11–20% for Mo. As had approximately four times greater effect than Mo in increasing desorption of V while V had about three times the effect of Mo in increasing desorption of As. Thus, the order of oxyanions in inducing desorption of the other oxyanions (i.e. As on V and As) was the same as that for adsorption selectivity: As > V >> Mo. Water treatment sludge was a more effective adsorbent than bauxite because it had a greater adsorption capacity for all three anions and, in addition, they were held more strongly so desorption in the background electrolyte was proportionately less. It was concluded that at similar molar concentrations, arsenate would tend to reduce adsorption of vanadate as well as displace vanadate already held on adsorbent surfaces while both anions will compete effectively with molybdate. The limiting factor for simultaneous removal of As, V, and Mo from multielement solutions by adsorption will therefore be the removal of Mo.
https://ift.tt/2zO27A6
Sublethal effects of chronic exposure to CdO or PbO nanoparticles or their binary mixture on the honey bee ( Apis millefera L.)
Abstract
Cadmium and lead-based nanotechnologies are increasingly used in agricultural, industrial, and biological processes; however, potential adverse effects of nanomaterials on honey bees had not been assessed. In this study, effects of exposures to sublethal concentrations of PbO and CdO nanoparticles (NPs), either separately or in combination on honey bee (Apis mellifera) workers, were assessed. Honey bee workers were orally exposed for 9 days under laboratory conditions to sublethal concentrations (20% of LC50) of CdO (0.01 mg/ml−) and PbO (0.65 mg/ml−) NPs either separately or combined. Effects on survival, feeding rate, activity of acetylcholinesterase (AChE), and expression of selected stress-related detoxifying enzymes were quantified. Survival and feeding rates decreased particularly in bees fed sugar syrup containing CdO NPs or binary mixtures of NPs of both metal oxides. Expressions of genes involved in detoxification of xenobiotics were affected by various combinations. Expression of catalase was 13.6-fold greater in bees consumed sugar syrup diet containing binary mixture of sublethal concentrations of both CdO and PbO NPs than it was in unexposed, control bees. AChE activity in heads of honey bees was inhibited by 3.8-, 3.0-, and 2.8-fold relative to control, respectively, in response to exposure to Cd or/and Pb oxide NPs. This result indicates potential neurotoxic effects of these NPs to honey bees. CdO NPs exhibited greater potency to honey bees. Overall, sublethal concentrations of CdO or/and PbO NPs resulted in detrimental effects on honeybee workers.
https://ift.tt/2ycBYJ5
Combined effects of new complete denture fabrication and simplified dietary advice on nutrient intake in edentulous elderly patients for 6 months
Abstract
Objective
The aim was to evaluate the combined effects of a new complete denture fabrication and simple dietary advice (using unique pamphlets) by dentists on nutrient intake in edentulous elderly patients.
Materials and methods
A randomized controlled trial was performed on edentulous elderly patients who were randomly allocated to either an intervention or a control group. The intervention group received a new complete denture and simple dietary advice, whereas the control group received a new complete denture and denture care advice. The outcomes of this trial (nutrient intakes) were calculated using a brief-type self-administered diet history questionnaire (BDHQ) and assessed at three time points (pretreatment and 3 and 6 months post-treatment).
Results
At 3 months post-treatment, the intake of several nutrients such as proteins (p = 0.004), magnesium (p < 0.001), and vitamin B1 (p = 0.014) was significantly higher in the intervention group than the control group, whereas at 6 months post-treatment, plant protein (p = 0.028) intake was significantly higher in the intervention group than the control group. On the contrary, animal protein (p = 0.049) and vitamin B12 (p = 0.028) intakes were significantly higher in the control group.
Conclusions
New complete denture fabrication with simple dietary advice might improve nutrient intake in elderly edentulous patients; however, the effect is probably short term.
Clinical significance
New complete denture fabrication along with simple dietary advice by dentists might improve nutrient intake in edentulous elderly patients. Therefore, regular use of these interventions in the dental setting might have long-term effects on nutrient intake in elderly edentulous patients.
Trial registration
UMIN-CTR Clinical Trial, unique trial number: UMIN000017879
https://ift.tt/2zO7Vd3
Quantitative evaluation of skin shrinkage associated with non-invasive skin tightening: a simple method for reproducible linear measurement using microtattoos
Abstract
Non-invasive skin-tightening devices can induce thermal denaturation and skin shrinkage via externally applied radiofrequency emissions or high-frequency ultrasound. Therefore, the purpose of this study is to develop and test a method for measurement of skin reduction associated with application of such energy devices. Twenty-five healthy participants with mild to moderate skin laxity of the arms were enrolled. Pinpoint microtattoos were placed at each of the treatment sites to delineate two 6 × 12 cm rectangles per subject. A non-stretchable filament, tape and marking pen apparatus was used to measure the size of each rectangle before treatment and at follow-up visit by two blinded investigators. After randomization, one side received a single pass with a radiofrequency device (6.78 MHz), while the contralateral side received multiple passes. Participants underwent two treatment sessions to each side 2 weeks apart, and returned for follow-up 4 weeks after the second treatment. Length and area measurement were analyzed to assess precision and accuracy of measurements and to compare efficacy of treatment between pre- and post-treatment. Concordance correlation coefficients (CCC) demonstrated substantial inter-investigator reliability and precision in length measurements (CCC, 0.94 to 0.98 in pre-treatment; 0.95 to 0.98 in post-treatment). Measurements at the 6-week post-treatment follow-up demonstrated a statistically significant skin reduction in all six of the measured parameters. A simple skin measurement method requiring minimal instrumentation can quantitatively evaluate skin shrinkage associated with non-invasive skin-tightening devices.
https://ift.tt/2IwGzux
Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0741-6801
Introduction In Germany, inpatient rehabilitation is a well-established additive option in the therapeutic concept for children and adolescents with diabetes. However, its contribution in pediatric diabetes care is not known exactly. Our objective was to analyze inpatient rehabilitation in pediatric diabetes over eight years in Germany. Methods We requested secondary data from the German Statutory Pension Insurance Scheme to evaluate all completed inpatient rehabilitations for children and adolescents with diabetes (ICD-code E10-14) reimbursed by this institution between 2006 and 2013. For each type of diabetes, we analyzed the distribution of admissions by year, age-group, sex, nationality, and other documented diagnoses. All analyses were conducted via remote computing with IBM SPSS Version 24. Results Between 2006 and 2013, 5,403 admissions to inpatient rehabilitation for 4,746 children and adolescents with diabetes were documented. For type 1 diabetes (T1D; 88.5% of admissions), the number of yearly admissions increased from 458 in 2006 to 688 in 2013 (p=0.013), especially for age-group>5-10. The increase for type 2 diabetes (T2D) was not significant. Admissions were more frequent for girls (53.6%, p≤0.001), age>10-15 years (42.8%, p=0.001), and German nationality (98.5%). Obesity (T1D: 11.1%; T2D: 87.9%) and mental disorders (T1D: 11.6%; T2D: 27.4%) were the most frequent documented diagnoses in addition to diabetes. Conclusion This study provides a comprehensive overview of inpatient rehabilitation for children and adolescents with diabetes over many years in Germany. Until 2013, inpatient rehabilitation remained important in pediatric diabetes care, especially for children with mental disorders or obesity.
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© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Association of benzene exposure with insulin resistance, SOD, and MDA as markers of oxidative stress in children and adolescents
Abstract
Benzene is a ubiquitous environmental pollutant with various health effects. It is reported that benzene exposure might be associated with insulin resistance in elderly adults. The aim of this study is to investigate the association between urinary benzene metabolite, trans, trans-muconic acid (t,t-ma) and markers of oxidative stress and insulin resistance in children and adolescents. This cross-sectional study was conducted in 2017 among 86 children and adolescents, aged 6–18 years, living in Isfahan, Iran. t,t-ma was measured as urinary benzene metabolite and homeostasis model assessment (HOMA-IR) was determined as an index of insulin resistance. Moreover, malondialdehyde (MDA) and superoxide dismutase (SOD) were assessed as oxidative stress markers. We found significant association between insulin resistance, fasting blood glucose, and fasting blood insulin with t,t-ma (p values = 0.002, 0.03, and 0.001, respectively). Results of this study indicate that benzene metabolite in higher concentrations in comparison with lower concentrations is associated with increased risk of insulin resistance. Moreover, after adjustment for age, sex, and household passive smoking, statistically significant increase were documented in SOD and MDA (4.49- and 3.54-fold, respectively) in intermediate levels of t,t-ma vs. low levels of t,t-ma (p values = 0.01 and 0.034, respectively). To the best of our knowledge, this is the first study in its kind in the pediatric age group. It showed that benzene exposures, even in environmental levels, might be associated with insulin resistance and oxidative stress in children and adolescents. Further longitudinal studies are necessary to assess the clinical impacts of this finding.
https://ift.tt/2xUOIoo
Catheter-Based Computed Tomography Angiography in Anterolateral Thigh Perforator Mapping of Chinese Patients
J reconstr Microsurg
DOI: 10.1055/s-0038-1672129
Background During reconstructive surgery, anterolateral thigh (ALT) flap harvest is challenging due to variation and uncertainty in perforator distribution. We performed a pilot study to identify the predictive value of catheter-based computed tomography angiography (C-CTA) and traditional CTA (T-CTA) in ALT perforator mapping for patients whose ALT perforators were difficult to identify. Methods Thirty-four consecutive T-CTA/C-CTA-mapped ALT flaps were evaluated for extremity reconstruction. The perforator location, origin, and course were compared between T-CTA/C-CTA imaging and intraoperative findings. The mapping efficiency of T-CTA and C-CTA was compared thoroughly. Results Among the 34 ALT thigh flaps, 117 (36) of the 130 perforators identified intraoperatively were visible on C-CTA (T-CTA) in a subgroup of Chinese limb trauma patients with limited activity. C-CTA showed a satisfactory efficiency in perforator mapping, which was much better than the efficiency of T-CTA. C-CTA also showed a much better sensitivity (90.00 vs. 27.69%), specificity (94.74 vs. 66.67%), and accuracy (91.07 vs. 36.69%), and a much lower false-positive (1.68 vs. 26.53%), and false-negative rate (10.00 vs. 72.31%). Moreover, C-CTA could accurately predict the origin and septocutaneous or intramuscular course in all identified perforators. All flaps were elevated successfully and survived. Conclusions C-CTA outperforms T-CTA in the preoperative perforator mapping of ALT flaps in a subgroup of Chinese limb trauma patients. C-CTA should be the method of choice for perforator mapping in patients whose ALT flaps are intended for extremity reconstruction.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2y9JC7d
The effect of age, gender, and time between blood draw and start of centrifugation on the size outcomes of platelet-rich fibrin (PRF) membranes
Abstract
Objectives
Platelet-rich fibrin (PRF) has been utilized in regenerative dentistry as a supra-physiological concentrate of autologous growth factors capable of stimulating tissue regeneration. Due to the variability in the macroscopic morphology/size of PRF membranes observed between patients, we were interested in studying the effects of patient age, gender, and time between blood draw and the start of centrifugation on the size outcomes of PRF membranes. Despite PRF therapy being increasingly more popular in private practice, to date, no study has investigated the effects of the delay between blood draw and the start of centrifugation in a clinical setting.
Materials and methods
A total of 60 patients enrolled in this study were divided into 6 groups of 10 patients each, including male and female patients categorized into age groups 21–40, 41–60, and 61–80 years. From each patient, a total of five PRF membranes were fabricated from 10-mL tubes following centrifugation starting after 0, 30, 60, 90, and 120 s. In total, 300 PRF membranes were produced in this study to investigate the effects of patient age, gender, and time on the size outcomes of PRF membranes.
Results
A longer delay by the clinician before starting centrifugation following blood draw led to a smaller final size of PRF membranes. At 90 s following blood draw, a significant (13%) reduction in PRF membrane size was observed. After 120 s, a significant (23%) reduction was observed. Additionally, female patients had on average 17% larger membranes compared to men (p < 0.05, 300 samples). Lastly, the size outcomes of the PRF membranes was largest in patients aged 61–80, followed by those aged 41–60 and 21–40. However, no statistically significant differences in PRF membrane sizes were reported between age groups.
Conclusions
The time at which a centrifugation procedure begins following blood draw is critical to optimize the size outcomes of PRF membranes. In general, approximately 15 s is required per tube to harvest 9–10 cc of blood. Therefore, a 60- to 90-s interval between blood draw and the start of centrifugation should be a parameter that is respected by clinicians to avoid significant changes in the macroscopic morphology/size of fabricated PRF membranes. Furthermore, females and older patients produced larger membranes, likely due to lower red blood cell counts derived from their peripheral blood.
Clinical relevance
The findings from the present study demonstrate that on average, a clinician has approximately 60–90 s between blood draw and the start of the centrifugation cycle to produce standard-sized PRF membranes. Shortly thereafter, a significant reduction in size is observed. Additionally, females and older patients were found to produce larger PRF membranes. Centrifugation protocols may therefore be adapted accordingly.
https://ift.tt/2O3w8ox
Biomechanical response of a submerged, rosette-forming macrophyte to wave action in a eutrophic lake on the Yungui Plateau, China
Abstract
Few studies have focused on the biomechanical responses of submerged, rosette-forming macrophytes to wave action, water depth, or their co-occurrence in naturally eutrophic systems. The plant architecture, root anchorage strength-related traits, leaf morphology, and biomechanics of Vallisneria natans inhabiting a range of water depths were examined along three transects (T1, T2, and T3) in a eutrophic lake, Lake Erhai, in Yunnan Province, China. These transects were exposed to weak wave action and hyper-eutrophication (T1), moderate wave action and eutrophication (T2), or strong wave action and eutrophication (T3). The results showed that V. natans was mainly distributed at intermediate depths, with the widest colonization depth in T1. The values of plant architecture, root anchorage strength-related traits, leaf morphology, and biomechanics were generally highest in T3 and smallest in T2. Along the depth gradient, these values were generally highest at 3.5, 2.5, and 2.5 m for the plants growing in T1, T2, and T3, respectively. These findings suggest that V. natans adopts a "tolerance" strategy to cope with the effects of strong wave action in eutrophic habitats and an "avoidance" strategy when exposed to moderate wave action in eutrophic areas. Since the absence of an avoidance strategy increases the resistance to low-light stress at the expense of increased drag forces, there is a limit to the wave action that V. natans can withstand. This study indicates that biomechanics could be important when determining the distribution pattern of V. natans in Lake Erhai.
https://ift.tt/2Ovhl55
Effects of site-specific climatic conditions on the radial growth of the lichen biomonitor Xanthoria parietina
Abstract
The protocols commonly applied in surveys with lichens as biomonitors of airborne trace elements require analyses of samples derived from thalli or parts of thalli grown in the last year before sampling, under the postulation that samples of the same size are of the same age. Unfortunately, the influence of ecological site-specific factors on lichen growth is still largely ignored, so that samples of the same size collected in environmentally and climatically diverse sites might actually differ in age. This work aims at quantifying the influence of climatic conditions on the radial growth rates (RaGRs) of Xanthoria parietina, one of the most popular lichen biomonitors. RaGR was monitored in seven populations distributed along an altitudinal transect of 30 km in the Classical Karst (NE Italy), from 20 to 500 m above sea level. For c. 17 months, lobe growth was measured seasonally with a digital calliper, and site-specific climatic variables were monitored by means of thermo-hygrometric sensors and implemented by meteorological data. Finally, the lobe growth of X. parietina was modelled as a function of 18 environmental variables. Results revealed that thalli of relatively dry sites had significantly lower seasonal RaGR with respect to moister ones. Considering that cumulative precipitations were equally distributed along the transect, it was concluded that RaGR of X. parietina is affected negatively by high air temperatures and positively by high relative humidity. The importance of RaGR variation in lichen bioaccumulation studies is critically discussed.
https://ift.tt/2Iyonkc
Efficient water decontamination using layered double hydroxide beads nanocomposites
Abstract
Ni-Al-CO3-layered double hydroxide (LDH) with Ni:Al ratio (3:1) and their nanocomposites with alginate and chitosan beads were prepared and examined for their efficiency in removal of Cd2+ and Cu2+ ions from wastewater. Different parameters such as contact time, pH value, adsorbent weight, and heavy metal ion concentration on the removal efficiency were examined and reported. The prepared beads were examined using X-ray diffraction (XRD), TEM, SEM, and FTIR. Our results revealed a successful preparation of the LDH in rhombohedral hexognal crystal form and the alginate-LDH-chitosan beads. The optimized batch experiment conditions in ambient room temperature were found to be 2 g/L adsorbent dose, 50 mg/L initial concentration of meal, contact time of 2 h, and pH ~ 5 and 6 for removal of Cu2+ and Cd2+, respectively. The adsorption process was well fitted with Langmuir and Freundlich isotherm models (higher R2), with trivial advantage for Freundlich approach. Kinetic studies showed that the adsorption of both Cd2+ and Cu2+ followed the pseudo-second-order. The current study demonstrated that the Ni-Al-CO3 LDH and their novel alginate-chitosan-based nanocomposite could be further tailored and used as efficient adsorbents for the uptake of heavy metals from wastewater.
https://ift.tt/2Ne9l3L
Safety and Efficacy of Nivolumab in Treating Oral Proliferative Verrucous Leukoplakia
Condition: Leukoplakia, Oral
Intervention: Drug: Nivolumab
Sponsors: Dana-Farber Cancer Institute; Bristol-Myers Squibb
Not yet recruiting
https://ift.tt/2Iw4WIQ
Intervention: Drug: Nivolumab
Sponsors: Dana-Farber Cancer Institute; Bristol-Myers Squibb
Not yet recruiting
https://ift.tt/2Iw4WIQ
Durvalumab (MEDI4736) With Cetuximab in Previously Treated Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
Conditions: Recurrent Head and Neck Cancer; Head and Neck Cancer; Head and Neck Neoplasms; Metastatic Cancer
Interventions: Drug: Durvalumab; Drug: Cetuximab
Sponsors: Trisha Wise-Draper; AstraZeneca
Recruiting
https://ift.tt/2Ri9jLs
Interventions: Drug: Durvalumab; Drug: Cetuximab
Sponsors: Trisha Wise-Draper; AstraZeneca
Recruiting
https://ift.tt/2Ri9jLs
A Study of Several Radiation Doses for Patients With Progression on Immunotherapy/Checkpoint Inhibitors
Conditions: Metastatic Cancer; Melanoma Cancer; Lung Cancer; Bladder Cancer; Renal Cancer; Head/Neck Cancers
Interventions: Radiation: Stereotactic Body Radiotherapy; Biological: checkpoint inhibitor
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2IxYD7A
Interventions: Radiation: Stereotactic Body Radiotherapy; Biological: checkpoint inhibitor
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2IxYD7A
Micropapular Cutaneous Sarcoidosis Reviewed
Background: Micropapular cutaneous sarcoidosis (MPCS) is a rare variant of sarcoidosis. Herein we review the literature and include a recent case of MPCS discussing pathogenesis, diagnosis, treatment, and prognosis. Method: A review was conducted using the terms "micropapular sarcoidosis" and "micropapular sarcoid." A recent case of a 50-year-old male patient with biopsy-identified MPCS was also included in the review. Results: In total, 12 cases with an aggregate of 18 patients were included in the review. Presentation among all patients was consistent, with scattered, occasionally pruritic, faintly erythematous shiny white papules. Skin biopsy demonstrated noncaseating granulomas. Systemic prednisone, oxytetracycline, and hydroxychloroquine, as well as topical betamethasone, were used for therapy. Conclusion: In our review there does not seem to be a clear link as to the definite cause of the MPCS. While the relationships to tuberculosis and autoimmunity seem to be often emphasized, there was no clear association with either etiology.
Dermatology
https://ift.tt/2RhSP62
Dermatology
https://ift.tt/2RhSP62
Scholar : These new articles for Critical Inquiry in Language Studies are available online
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Versatility of iron-rich steel waste for the removal of high arsenic and sulfate concentrations in water
Abstract
The aim of this work is to evaluate the application of a steel waste, basic oxygen furnace sludge (BOFS), rich in iron, to treat water contaminated with elevated arsenic and sulfate concentrations. In the first step, three doses (10, 60, and 80 g L−1) of BOFS were tested to investigate the removal of As(III) and As(V) (67 mg L−1) and sulfate (3700 mg L−1) separately from an aqueous solution. In the second step, the efficacies of BOFS (10 g L−1) and commercial ZVI (5 g L−1) were compared to simultaneously remove arsenic and sulfate. The pH of the feed solution was adjusted to 2.5 and monitored during the experiment. The use of BOFS achieved arsenic removal up to 92% and sulfate removal of nearly 40% after 72 h of contact time. Use of BOFS also increased the solution pH to 12. Similar removal levels were achieved with both BOFS and ZVI. These results confirm the potential application of BOFS to remove high arsenic and sulfate concentrations from acidic solutions. The data obtained here should be used as a basis for further studies on the remediation of acid mine drainage with high concentrations of arsenic and sulfate using an abundant and low-cost steel waste.
https://ift.tt/2zKMTvC
NMR characterizing mixed wettability under intermediate-wet condition
Publication date: Available online 2 October 2018
Source: Magnetic Resonance Imaging
Author(s): Jie Wang, Lizhi Xiao, Guangzhi Liao, Yan Zhang, Yushi Cui, Zhe Sun, Yu Dong, Lin Hu
Abstract
Applying the concept of effective relaxivity to characterize wettability is based on the configuration of fluid distributions in porous media. However, in mixed-wet porous media with intermediate-wet patches (homogeneous wetting region), effective surface relaxivity cannot fully characterize wettability because fluid distributions are not directly corresponding to wetting patch distributions. Patches with different wettability interact with the same fluid differently, which leads to different surface relaxivity. The distribution of this kind surface relaxivity from porous media saturated with single fluid matches mixed wettability distribution. Here, we apply decay due to diffusion in internal field plus Carr-Purcell-Meiboom-Gill (DDIF-CPMG) method to obtain T2 and the pore size distribution correlation. The variation of surface relaxivity obtained from the correlation map is used to characterize wettability distributions of mixed-wet porous media. In this paper, we also redefine a parameter based on surface relaxivity distribution to evaluate mixed wettability under intermediate-wet condition. The experiment results with limestones show that, after wettability alteration of the sample, the distribution of the surface relaxivity is changed and closely correlated with pore size distribution, which demonstrates the features of mixed wettability under intermediate-wet conditions.
https://ift.tt/2ygvOrN
Dynamics of ionic liquids in poly(vinyl alcohol) porous scaffold. Low field NMR study
Publication date: Available online 1 October 2018
Source: Magnetic Resonance Imaging
Author(s): Carlos Mattea, Bulat Gizatullin, Siegfried Stapf
Abstract
In this study molecular dynamics of ionic liquids in poly(vinyl alcohol) scaffolds were investigated. The binary poly(vinyl alcohol) – ionic liquid (PVA-IL) compound was prepared from initial solutions of water, ionic liquid (IL) and poly(vinyl alcohol) (PVA) at different concentrations. Subsequently water was evaporated under open conditions, leaving the scaffold/IL system of interest. Low field nuclear magnetic resonance (NMR) relaxation and diffusion measurements, as well as 2D T1-T2 correlated NMR experiments were performed to determine specific local and translational dynamics properties at different time scales. Data suggest that during water evaporation, partial demixing of IL from the polymeric matrix leaves the remaining solvent confined in the porous structure formed by the PVA polymer. The results show that the translational diffusion, as well as the local rotational molecular dynamics is comparable to the bulk liquid state. Moreover, in partial saturation conditions, diffusion shows enhancements relative to the bulk.
https://ift.tt/2Rlrd0b
Pesticide residues in Indian raw honeys, an indicator of environmental pollution
Abstract
Honey has multifaceted beneficial properties, but polluted environment and unapproved apicultural practices have led to its contamination. In this study, QuEChERS method followed by chromatographic analysis by GC-μECD/FTD and GC-MS was validated and used for determination of 24 pesticides in 100 raw honey samples from various floral origins of Northern India. Matrix-matched calibrations showed that the method was selective and linear (r2 > 0.99) with detection limit < 9.1 ng g−1 for all the studied pesticides except for monocrotophos (21.3 ng g−1). The average recoveries at different fortification levels ranged from 86.0 to 107.7% with relative standard deviation < 20%. Pesticide residues were detected in 19.0% samples, and most prevalent compounds detected were dichlorvos in 6.0% samples followed by monocrotophos (5.0%), profenofos (5.0%), permethrin (4.0%), ethion (3.0%), and lindane (3.0%) with concentrations ranging from 58.8 to 225.5, from 96.0 to 430.1, from 14.6 to 43.2, from 27.8 to 39.6, from 25.6 to 28.0, and from 19.6 to 99.2 ng g−1, respectively. Honey samples originating from cotton, sunflower, and mustard crops (33.3%) that tested positive for pesticide residues were found to be significantly higher (p < 0.05) than the honey originating from natural and fruity vegetation (13.5%). Therefore, considering the contamination of environmental compartments due to extensive application of pesticides in the study area and their potential for subsequent transfer to honey by the expeditious bees, the results of present study proclaim that honey may be used as an indicator of environmental pollution. Further, estimated daily intakes of all contaminants were found to be at levels well below their acceptable daily intakes suggesting that consumption of honeys at current levels does not pose deleterious effects on human health. However, precautionary measures should always be taken considering the customary honey feeding in infants and cumulative effect of these chemicals in the foreseeable future.
https://ift.tt/2xT9MvH
Endocrine paraneoplastic syndromes in patients with neuroendocrine neoplasms
Abstract
Objective
Our aim was to assess the prevalence of endocrine paraneoplastic syndromes (EPNS) in neuroendocrine neoplasms (NENs) and estimate its impact on patient outcomes.
Design
This is a retrospective analysis of 834 patients with NENs (611 gastrointestinal, 166 thoracic, 57 of unknown and various other primary origin). We included 719 consecutive NEN patients treated at EKPA-Laiko Hospital, Athens, Greece and 115 patients with lung carcinoid (LC) treated at Uppsala University Hospital, Uppsala, Sweden. EPNS diagnosis was based on standard criteria.
Methods
Twenty-one patients with EPNS were detected: 16 with ectopic Cushing's syndrome (ECS), one with hypercalcaemia due to parathyroid hormone-related protein (PTHrP) secretion, three with hypercalcitonaemia and one patient with dual secretion of calcitonin and beta-human chorionic gonadotropin (β-HCG). All tumours were well-differentiated; 10 patients had Stage IV disease at diagnosis.
Results
The prevalence of EPNS in the Greek cohort was 1.9%, whereas that of ECS among LC patients in both centres was 6.7%. Median overall survival (OS) for patients with EPNS was 160.7 months (95%CI, 86–235.4) and median event-free survival (EFS) was 25.9 months (95%CI, 0–57.2). Patients presenting with EPNS prior to NEN diagnosis had longer EFS compared to patients with synchronous or metachronous EPNS (log-rank P = 0.013). Patients with ECS of extra-thoracic origin demonstrated shorter OS and EFS compared to patients with ECS of lung or thymic origin (log-rank P = 0.001 and P < 0.001, respectively). LC patients with and without ECS were comparable in 5-year and 10-year OS rates (66.7% and 33.3% versus 89.8% and 60.2%, respectively; 95%CI [189.6–300.4 months], log-rank P = 0.94) and in median EFS, 67 versus 183 months, 95%CI [50.5–207.5], log-rank P = 0.12).
Conclusion
EPNS are relatively rare in patients with NENs and mainly concern well-differentiated tumours of the foregut. Among patients with EPNS, LC-related ECS may not adversely affect patient outcomes when diagnosed prior to NEN and effectively been treated.
https://ift.tt/2RdLhRQ
Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study
Abstract
Objectives
To evaluate the effects of 10% carbamide peroxide (CP) with two different thickeners, carbopol (CPc) and natrosol (CPn), on color variation (CV), tooth sensitivity (TS), and cytotoxicity (CC).
Methods
Seventy subjects were distributed into the CPc or CPn groups (n = 35), in a parallel group, randomized, controlled, single-blind clinical trial. Bleaching gels were used by volunteers for 4 h daily for 2 weeks. Color evaluation was performed using a reflectance spectrophotometer, before bleaching treatment (BT), immediately after the first and second weeks of BT, and 1 week and 1 month after BT ended. TS was evaluated using two pain scales, before, during, and after BT. CC was evaluated using MTT after exposure of MDPC-23 cells to the bleaching gels for 4 h. Epoxy replicas of the subjects teeth were made before and after BT and analyzed using a scanning electronic microscope. The data was analyzed using statistical methods.
Results
CV and TS showed similar variation between both bleaching gels (p ≤ 0.05). None of the protocols affected cellular metabolism or the surface morphology of enamel.
Conclusions
Bleaching gels with carbopol and natrosol as thickening agents produced similarly effective tooth bleaching and TS, but did not cause cytotoxicity.
Clinical relevance
Natrosol could be an alternative as a thickener used in bleaching gels due to its similar bleaching effect and TS when compared with Carbopol.
https://ift.tt/2DO04zY
Endocrine paraneoplastic syndromes in patients with neuroendocrine neoplasms
Abstract
Objective
Our aim was to assess the prevalence of endocrine paraneoplastic syndromes (EPNS) in neuroendocrine neoplasms (NENs) and estimate its impact on patient outcomes.
Design
This is a retrospective analysis of 834 patients with NENs (611 gastrointestinal, 166 thoracic, 57 of unknown and various other primary origin). We included 719 consecutive NEN patients treated at EKPA-Laiko Hospital, Athens, Greece and 115 patients with lung carcinoid (LC) treated at Uppsala University Hospital, Uppsala, Sweden. EPNS diagnosis was based on standard criteria.
Methods
Twenty-one patients with EPNS were detected: 16 with ectopic Cushing's syndrome (ECS), one with hypercalcaemia due to parathyroid hormone-related protein (PTHrP) secretion, three with hypercalcitonaemia and one patient with dual secretion of calcitonin and beta-human chorionic gonadotropin (β-HCG). All tumours were well-differentiated; 10 patients had Stage IV disease at diagnosis.
Results
The prevalence of EPNS in the Greek cohort was 1.9%, whereas that of ECS among LC patients in both centres was 6.7%. Median overall survival (OS) for patients with EPNS was 160.7 months (95%CI, 86–235.4) and median event-free survival (EFS) was 25.9 months (95%CI, 0–57.2). Patients presenting with EPNS prior to NEN diagnosis had longer EFS compared to patients with synchronous or metachronous EPNS (log-rank P = 0.013). Patients with ECS of extra-thoracic origin demonstrated shorter OS and EFS compared to patients with ECS of lung or thymic origin (log-rank P = 0.001 and P < 0.001, respectively). LC patients with and without ECS were comparable in 5-year and 10-year OS rates (66.7% and 33.3% versus 89.8% and 60.2%, respectively; 95%CI [189.6–300.4 months], log-rank P = 0.94) and in median EFS, 67 versus 183 months, 95%CI [50.5–207.5], log-rank P = 0.12).
Conclusion
EPNS are relatively rare in patients with NENs and mainly concern well-differentiated tumours of the foregut. Among patients with EPNS, LC-related ECS may not adversely affect patient outcomes when diagnosed prior to NEN and effectively been treated.
https://ift.tt/2RdLhRQ
Laitinen’s Subgenual Cingulotomy: Anatomical Location and Case Report
Background: The widespread use of deep brain stimulation (DBS) for movement disorders has renewed the interest in DBS for psychiatric disorders. Lauri Laitinen was a pioneer of stereotactic psychosurgery in the 1950s to 1970s, especially by introducing the subgenual cingulotomy. Our aim here was to verify the anatomical target used by Laitinen, to report on a patient who underwent this procedure, and to review the literature. Materials and Methods: The records of Helsinki University Hospital were searched for psychosurgical cases performed between 1970 and 1974. Alive consenting patients were interviewed and underwent a brain MRI. Results: We found 1 patient alive who underwent subgenual cingulotomy in 1971 for obsessive thoughts, anxiety, and compulsions, diagnosed at that time as "schizophrenia psychoneurotica." MRI showed bilateral subgenual cingulotomy lesions (254 and 160 mm3, respectively). The coordinates of the center of the lesions in relation to the midcommissural point for the right and left, respectively, were: 7.1 and 7.9 mm lateral; 0.2 mm inferior and 1.4 mm superior, and 33.0 and 33.9 anterior, confirming correct subgenual targeting. The patient reported retrospective satisfactory results. Conclusions: The lesion in this patient was found to be in the expected location, which gives some verification of the correct placement of Laitinen's subgenus cingulotomy target.
Stereotact Funct Neurosurg
https://ift.tt/2OvxqYK
Stereotact Funct Neurosurg
https://ift.tt/2OvxqYK
More than keratitis, ichthyosis, and deafness: multisystem effects of lethal GJB2 mutations
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Evelyn Lilly, Christopher G. Bunick, Alexander M. Maley, Shali Zhang, Mary K. Spraker, Amy J. Theos, Karina L. Vivar, Lucia Seminario-Vidal, Adam E. Bennett, Robert Sidbury, Yasushi Ogawa, Masashi Akiyama, Barbara Binder, Smail Hadj-Rabia, Raffaella A. Morotti, Earl J. Glusac, Keith A. Choate, Gabriele Richard, Leonard M. Milstone
Abstract
Background
Infant death in KID syndrome is recognized; its association with specific genotypes and pathophysiology is inadequately understood.
Objective
To discover characteristics that account for poor outcomes in lethal KID syndrome.
Methods
We collected four new cases and nine previously reported, genotyped cases of lethal KID syndrome. We performed new molecular modeling of the lethal mutants GJB2 p.A88V and GJB2 p.G45E.
Results
Infant death occurred in all patients with GJB2 p.G45E and p.A88V; it is unusual with other GJB2 mutations. Early death with those two "lethal" mutations is likely multifactorial: during life all had at least one serious infection; most had poor weight gain and severe respiratory difficulties; many had additional anatomic abnormalities. Structural modeling of GJB2 p.G45E identified no impact on the salt bridge previously predicted to account for abnormal central CO2 sensing of GJB2 p.A88V.
Limitations
Clinical review was retrospective.
Conclusion
GJB2 p.G45E and p.A88V are the only KID syndrome mutations associated with uniform early lethality. Those electro-physiologically severe mutations in GJB2 reveal abnormalities in many organs in lethal KID syndrome. All KID syndrome patients may have subtle abnormalities beyond eyes, ears and skin. Early genotyping of KID syndrome births will inform prognostic discussion.
https://ift.tt/2IvnXLu
Opioid Prescribing for Acute Postoperative Pain After Cutaneous Surgery
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Jonathan J. Lopez, Nafisseh S. Warner, Christopher J. Arpey, Christian L. Baum, Jerry D. Brewer, Clark C. Otley, Halena M. Gazelka, Randall K. Roenigk
Abstract
Background
Little information is available to predict which patients require opioid analgesia following cutaneous surgery. When opioids are indicated, information is lacking regarding the optimal opioid agent selection and dosage.
Objective
To make recommendations for opioid prescription after cutaneous surgery.
Methods
A PubMed literature search was conducted to review the available literature. Recommendations are presented on the basis of available evidence and the opinion of the authors.
Results
Most patients undergoing cutaneous surgery do not require opioid analgesia. For those who do, the pain duration warranting opioid analgesia is generally less than 36 hours. Opioid refill requests warrant a follow-up visit to ascertain the cause of ongoing pain after excisional procedures.
Limitations
The recommendations are not based on prospective randomized trials.
Conclusions
The presented recommendations for opioid prescription practice are derived from available evidence, recommendations, and expert opinion.
https://ift.tt/2zLi9KV
Prognostic value of the Breslow/diameter ratio in cutaneous melanoma
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Antonio Piñero-Madrona, Alvaro Jesús Goméz-Ruiz, Guadalupe Ruiz-Merino, Enrique Martínez-Barba, Pablo Cerezuela-Fuentes, José Neptuno Rodríguez-López, Juan Cabezas-Herrera
https://ift.tt/2Iw6Edf
Guideline-Based Medicine Grading based upon the Guidelines of Care for Ambulatory Atopic Dermatitis Treatment in the United States
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Alan B. Fleischer
Abstract
Purpose
This study was designed to assess the adherence to evidence-based guideline of care for atopic dermatitis (AD).
Methods
To characterize AD treatment for United States, ambulatory visits from the 2006 to 2015 National Ambulatory Medical Care Survey were analyzed. For each medication prescription, a grade was assigned based upon the American Academy of Dermatology (AAD) treatment guidelines for topical and systemic medications. A composite grade, analogous to the US academic grading system, from A to F, based upon all visit prescriptions was calculated.
Results
Across specialty groups, prescribing differences were noted. Systemic corticosteroids were more likely to be prescribed by family and general physicians (FPGP) and less likely by pediatricians. Dermatologists were more likely than other specialties to prescribe nonsedating antihistamines, which lack a guideline-base supporting their use. Depending upon modeling of care assumptions, all physician specialty visits earned mean guideline-based grades of B or C in their care of AD patients.
Limitations
The clinical, social, and demographic factors influencing prescribing behavior cannot be completely assessed using extant data.
Conclusions
This preliminary study demonstrates that physicians may benefit from reviewing guidelines of care and there may be an educational gap in the implementation of these guidelines.
https://ift.tt/2zKIg4X
Association of multiple primary melanomas with malignancy risk: a population-based analysis of the Surveillance, Epidemiology, and End Results Program database from 1973-2014
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Emily D. Cai, Susan M. Swetter, Kavita Y. Sarin
Abstract:
Background
Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM). We hypothesized that individuals with MPM may have increased predisposition to developing internal malignancies.
Objective
To identify the risk of subsequent malignancies in MPM patients.
Methods
Multiple primary standardized incidence ratios were analyzed for individuals with ≥1, ≥2 and ≥3 primary melanomas (PM) in the SEER database from 1973-2014.
Results
223,799 individuals with ≥1, 19,709 with ≥2 and 3,995 with ≥3 PM were identified. Risks of subsequent internal malignancy increased with number of PM, with observed to expected (O/E) ratios of 0.99, 1.14, and 1.23 (p<0.05) for patients with at least one, two and three PM respectively. Internal malignancy was higher in younger MPM patients and those with superficial spreading melanoma. The most common malignancies amongst MPM patients include breast, prostate, thyroid, soft tissue, brain, kidney, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. Risk of subsequent cutaneous melanoma increased with O/E ratios of 8.09, to 22.52, to 41.03 (p<0.05) respectively.
Limitations
SEER records limited information about pigmentation phenotypes, histology, and treatments.
Conclusion
Patients with MPM have increased risk of subsequent internal and cutaneous malignancies and may benefit from tight adherence to age-specific cancer screening.
https://ift.tt/2Ix5oXd
Trends in utilization of topical medications for treatment of rosacea in the United States (2005-2014) – a cohort analysis
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Hadar Lev-Tov, Joanne S. Rill, Guodong Liu, Joslyn S. Kirby
https://ift.tt/2zLjhyv
Cost Analysis of a Store and Forward Teledermatology Consult System in Philadelphia
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Xiaoshi Yang, John S. Barbieri, Carrie L. Kovarik
Abstract
Background
Store-and-forward (SAF) teledermatology (TD) has the potential to increase access to timely, high-quality care for underserved populations. However, the cost-effectiveness of TD for underserved populations is uncertain.
Objective
This study evaluates the potential cost savings associated with a SAF TD program implemented for an underserved population in the city health clinics of urban Philadelphia.
Methods
We performed a retrospective analysis of SAF TD consultations for 700 outpatients managed in 12 Philadelphia primary care clinics. Primary care providers (PCPs) were asked to specify a treatment plan, as well as the type of care for the patient, in the absence of the TD service. Analysis compared cost of each patient case using the TD consult model versus conventional care.
Results
Twenty-seven percent (189/700) of in-person dermatology clinic visits and 3.29% (23/700) of emergency room (ER) visits were avoided using TD. Compared to conventional care, mean expected cost savings were $10.00-$52.65 per TD consult. In sensitivity analyses, these estimated savings remained positive across a range of parameters.
Limitations
The cost analysis relies on several assumptions regarding the cost of care, and indirect costs were not included.
Conclusion
Teledermatology can be a cost saving model while increasing access to dermatologic care.
https://ift.tt/2Ix0adX
Infertility and Teratogenicity after Paternal Exposure to Systemic Dermatologic Medications: A Systematic Review
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): George A. Zakhem, Catherine C. Motosko, Euphemia W. Mu, Roger S. Ho
Abstract
Background
This systematic review assesses effects of paternal exposure of dermatologic medications, using the former US Food and Drug Administration (FDA) pregnancy categories as a benchmark.
Objective
To assess whether systemic dermatologic medications can cause infertility and teratogenicity when taken by men.
Methods
Category D and X dermatologic medications were identified; a systematic review of the literature and reviews of the FDA Adverse Events Reporting System (FAERS) and prescribing information were performed to identify effects on male fertility and teratogenicity. Secondary search was performed to assess for other systemic dermatologic medications causing teratogenicity or infertility following paternal exposure.
Results
Thirteen medications met inclusion criteria. Nineteen of 1,032 studies were included after systematic review of the literature. Studies evaluating medication effects with paternal exposure were identified for 10 of 13 evaluated medications, and evidence of a negative effect was identified for 6 medications.
Limitations
We did not encounter any studies for 3 medications that met inclusion criteria. Information submitted to the FAERS may not reflect incidence of side effects.
Conclusions
Many former pregnancy category D and X systemic dermatologic medications also have effects on male fertility. More research and better-quality studies are required in this area, particularly assessing potential teratogenicity.
https://ift.tt/2zM9doY
"Treatment of male pattern alopecia with platelet-rich plasma: a double blind controlled study with analysis of platelet number and growth factor levels"
Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Bruno L. Rodrigues, Silmara AL. Montalvão, Rebeca BB. Cancela, Francesca AR. Silva, Aline Urban, Stephany C. Huber, José Luiz RC Júnior, José Fábio SD. Lana, Joyce M. Annichinno-Bizzacchi
ABSTRACT
Background
Promising results were described with platelet-rich plasma (PRP) in androgenetic alopecia that could be associated to platelet number and growth factor levels.
Objective
Analyze the platelet number and growth factor levels in PRP and its correlation with hair growth parameters evaluated by TrichoScan.
Methods
Twenty-six patients randomized to receive four subcutaneous injections of PRP or saline. Hair growth, hair density, and percentage of anagen hairs were evaluated before, after and three months after the last injection using TrichoScan method. Growth factors (PDGF, EGF and VEGF) were measured by Luminex method.
Results
We demonstrated a significant increase in hair count (p = 0.0016), hair density (p = 0.012) and percentage of anagen hairs (p = 0.007) in PRP group when compared to control group, without correlation with platelet counts or quantification of the growth factors in PRP.
Conclusion
Our data favors the use of PRP as therapeutic alternative in the treatment of androgenetic alopecia. The lack of association between platelet count, PDGF, EGF and VEGF levels and clinical improvement suggest that other mechanisms could be involved in this response.
Limitations
Other growth factors that could be related with PRP response were not evaluated
https://ift.tt/2Ix02Lv
Beyond JAAD January 2019
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Andrew Bronin, Robert Phelps, Robert Sidbury
https://ift.tt/2zM558j
Lower Socioeconomic Status is Associated with Delayed Access to Care for Infantile Hemangioma, a Cohort Study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Erina Lie, Kevin J. Psoter, Katherine B. Püttgen
ABSTRACT
Background
Early specialist evaluation during rapid proliferative growth of complicated infantile hemangiomas (IH) is crucial. Health disparities and barriers of access-to-care for children with IH have not been examined.
Objective
Investigate whether socioeconomic status (SES) is associated with age at subspecialist presentation for IH evaluation.
Method
Retrospective cohort study of 804 children presenting to a large academic hospital. Primary outcome was age at initial presentation. Covariates included demographic, socioeconomic, geographic, and clinical characteristics. Medicaid or Children's Health Insurance Program (CHIP) were proxies for lower SES. Analysis of covariance, χ2 tests, and generalized ordered logistic regressions were performed.
Results
Children with lower SES had higher odds of presenting after 3 months of age (OR 2.11, 95% CI 1.31-3.38). In the subset that qualified for institutional care management program (ICMP), no risk factors were associated with delayed presentation.
Limitations
Use of insurance and economic distress as proxies for SES; exclusion of uninsured children may underestimate racioethnic effects; single academic center study limiting generalizability.
Conclusions
Children with IH and lower SES were more likely to present later to specialists, but those enrolled in an ICMP did not, suggesting that integrated ICMPs may mitigate disparities and delayed access-to-care for IH among lower SES populations.
https://ift.tt/2Ix52zR
Gabor-Domain Optical Coherence Tomography to Aid in Mohs Resection of Basal Cell Carcinoma
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Patrice Tankam, Jonathan Soh, Cristina Canavesi, Mara Lanis, Adam Hayes, Andrea Cogliati, Jannick P. Rolland, Sherrif F. Ibrahim
https://ift.tt/2zKx2gA
Evaluating the cost-effectiveness of teldermatology
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): John S. Barbieri, Xiaoshi Yang, Carrie L. Kovarik
https://ift.tt/2Ix4UjR
Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Shanthi Narla, Jonathan I. Silverberg
Abstract
Background
Little is known about the risk and predictors of autoimmune diseases in children and adults.
Objective
To determine the prevalence, predictors and excess costs of autoimmune disease in AD patients.
Methods
Cross-sectional study of the 2002–2012 National Inpatient Sample, including a ∼20% sample of all US hospitalizations (n=87,053,155 adults and children).
Results
The prevalence [95% confidence interval {CI95}] of autoimmune disease was higher in adults (7.9% [7.3-8.5%] vs. 5.7 [5.7-5.8%]) and children (2.0% [1.7-2.3%] vs. 1.0% [0.9-1.1%]) with vs. without AD. In multivariable logistic regression models controlling for socio-demographics, adult (adjusted odds ratio [CI95]: 1.45 [1.32-1.8]) and pediatric (2.08 [1.73-2.50]) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 12 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had higher cost of inpatient care with $2.5-$50 million excess annual costs.
Conclusions
Adults and children with AD had increased cutaneous and extra-cutaneous autoimmune disorders, which were associated with a considerable cost-burden.
https://ift.tt/2zKwZBq
A systematic review and meta-analysis of the regional and age-related differences of atopic dermatitis clinical characteristics
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Yik Weng Yew, Jacob P. Thyssen, Jonathan I. Silverberg
Abstract
Background
Previous studies found conflicting results about the commonality of different atopic dermatitis (AD) signs and symptoms.
Objective
To determine the prevalences of AD characteristics and differences by region and age.
Methods
A systematic review was performed of all published studies in MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan electronic periodical services and CiNii that analyzed the proportion of AD characteristics. Two reviewers performed study title/abstract review and data abstraction.
Results
One hundred and one studies reported proportion of AD features with sufficient data for meta-analysis. The most prevalent AD features were pruritus, lichenification and xerosis. There were differences of AD characteristics by study region. Flexural involvement was less commonly reported in India, America and Iran. East Asian studies reported more erythroderma, truncal, extensor, scalp and auricular involvement. Southeast Asian studies reported more exudative eczema, truncal involvement, lichenification and prurigo nodules. Studies from Iran reported more head, face and neck involvement, pityriasis alba, and xerosis. Studies from Africa reported more papular lichenoid lesions, palmar hyperlinearity, ichthyosis and orbital darkening.
Limitations
Heterogeneity between studies and limited reporting of certain AD clinical characteristics.
Conclusions
AD characteristics are heterogeneous and vary by region and age.
https://ift.tt/2Ix4MRp
Bullae for You: The Increasing Importance and Implications of Drug-induced Bullous Pemphigoid
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Warren R. Heymann
https://ift.tt/2zM9cBq
The role of TERT promoter mutations in differentiating recurrent nevi from recurrent melanomas: a retrospective, case-control study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Kara E. Walton, Erin M. Garfield, Bin Zhang, Victor L. Quan, Katherine Shi, Lauren S. Mohan, Alexandra M. Haugh, Timothy VandenBoom, Pedram Yazdan, Maria Cristina Isales, Elnaz Panah, Pedram Gerami
Abstract
Background
Repigmentation at previous biopsy sites pose a significant diagnostic dilemma given clinical and histologic similarities between recurrent nevi and locally recurrent melanoma. While common in melanoma, the role of TERT promoter mutations (TPMs) in recurrent nevi is unknown.
Objective
We investigated the role of TPMs in recurrent nevi and whether the presence of hotspot TPM distinguishes recurrent nevi from locally recurrent melanoma. We also characterized clinical and histologic features differentiating these lesions.
Methods
We analyzed 11 locally recurrent melanomas, 17 recurrent nevi, and melanoma and nevus controls to determine TPM status. We also assessed clinical and histologic features of the recurrent groups.
Results
Hotspot TPMs were more common in recurrent melanomas compared to recurrent nevi (p=0.008). Recurrent melanomas were more likely to have solar elastosis (p=0.0047), multi-layering of melanocytes in the epidermis (p=0.0221), adnexal involvement (p=0.0069), and epidermal consumption (p=0.0204). Recurrent nevi had intra-epidermal atypia limited to the area above the scar (p<0.0001) and occurred earlier after the original biopsy (p<0.0008). Solar elastosis, months to recurrence, and hotspot TPM were independently associated with recurrent melanoma in multivariate analysis.
Limitations
This was a retrospective study.
Conclusion
Hotspot TPMs are significantly more frequent in recurrent melanomas and may serve as a diagnostic clue in histologically ambiguous cases.
https://ift.tt/2IvOacV
Acne Disparities in Native Americans
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Shannon W. Zullo, Melody Maarouf, Vivian Y. Shi
https://ift.tt/2zKNldj
Correction
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s):
https://ift.tt/2Ix4kmb
Trends in the Incidence and Survival of Eccrine Malignancies in the United States: A SEER Population-Based Study
Publication date: Available online 1 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Raghav Tripathi, Harib H. Ezaldein, Jeffrey F. Scott, Jeremy S. Bordeaux
https://ift.tt/2zL1IhG
An empirical model for the evaluation of the dissolution rate from a DNAPL - contaminated area
Abstract
This paper investigates dynamic variation in the morphologic distribution of dense non-aqueous phase liquids (DNAPLs), which take into account the coupled mass transfer. Experiments were carried out in a 2D tank representing a reconstructed aquifer model. DNAPL dissolution rates were investigated over a wide range of DNAPL saturations, several source configurations, and different hydraulic conditions. Morphometric indexes are presented that take into consideration further factors affecting the dissolution process. Local information regarding transport parameters related to the characteristics of the medium was obtained through a neural network and an optimization algorithm applied to experimental tracer tests. The history of DNAPL source architecture, in terms of saturation, indentation grade, and orientation, was determined by image analysis. Dissolved concentrations were registered and mass transfer rate coefficients were obtained for a wide range of source-zone configurations. A statistical analysis was performed to develop a constitutive equation that is descriptive of the mass transfer rate as a function of source-zone metric characteristics. A new empirical dissolution model using the proposed morphometric parameters is presented and compared with other models. The mass transfer correlation reported incorporates morphometric parameters and considers the complex and variable architecture of non-miscible contaminants. The proposed correlation can be used for an initial assessment of non-aqueous phase liquid (NAPL) dissolution rates over a wide range of saturation (residual and non-residual) conditions and different aqueous phase velocities within the NAPL source zone.
https://ift.tt/2OrLsuk
Performance of full-scale coagulation-flocculation/DAF as a pre-treatment technology for biodegradability enhancement of high strength wastepaper-recycling wastewater
Abstract
Paper mill wastewater leads to a serious damage on the environment owing to the high content of organic matters, suspended solids, toxic substances, and lignin. Hence, exploring new treatment technologies is the passion of environmental engineers to minimize the effluent impact on the environment and cleaner production aspects. This research focused on the performance of full-scale coagulation-fluctuation/DAF system for pre-treatment of high strength wastepaper-recycling wastewater and its effect on biodegradability improvement. To optimize unit performance, optimum coagulant and flocculant doses were firstly determined by jar test without prior change and adjustment of pH in lab-scale experiments. The optimum dosages were obtained by 1500 mg L−1 polyaluminum chloride (PACl) as coagulant coupled with 40 mg L−1 cationic polyacrylamide (C-PAM) as flocculant. Percentage removals of 39 ± 10, 6.8 ± 3.6, 31.0 ± 6.7, 24.0 ± 3.8, and 33.0 ± 20.0 were achieved for COD, sCOD, BOD5, sBOD5, and color, respectively. The average BOD5 to COD ratio after pre-treatment increased from 0.44 to 0.5, whereas the ratio of sBOD5/sCOD dropped from 0.65 to 0.53. A superior effectiveness in reduction of TSS (98.1%) and VSS (98.4%) was also achieved. The results show that the application process is able to prevent malfunction operation in the following bioreactors which is obtainable through bio-treatability enhancement of pre-treated wastewater and reducing the risks of clogging and sludge washout. Attached growth processes are suggested to be applied in the further anaerobic/aerobic processes because of high proportion of soluble fraction of COD in the effluent to avoid poor floc formation and dispersed growth problems.
https://ift.tt/2IwVgh9
Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 33-34
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Multiple cellular neurothekeomas in a middle‐aged woman including the lower extremity: A case report and review of the current literature
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2NXW3xM
Restructuring Dental Education to Facilitate Access to Oral Health Care
Abstract
Purpose of Review
To review recent literature evaluating how current models of dental education are contributing to reducing oral health disparities in the USA. Recent innovations in dental schools' curricula and admissions processes will be examined, as well as how oral health disparities have driven the education and subsequent expansion of the allied dental workforce.
Recent Findings
Dental school curricula and admissions changes have had minimal impact on reducing oral health disparities. Subsequently, educational innovations have resulted in the traditional duties of dentists being performed by dental therapists, advanced dental hygiene practitioners, and independent dental hygienists.
Summary
Public perception is that extended employment of allied dental professionals has resulted in improved access and delivery of dental care to underserved members of the population. Development of a diversified oral health workforce that provides team-based, inter-professional care will help decrease the oral health inequities that exist in the USA.
https://ift.tt/2RhzNwO
Prediction of femtosecond laser ablation profile on human teeth
Abstract
To predict the laser ablation profile on dental hard tissue which will enable the user to optimize laser parameters so as to carry out the laser treatment with minimal tissue damage. The present study constructs a mathematical model to predict the ablation profile based on Gaussian beam distribution of laser intensity and correlates the model with experimentally obtained ablation parameters (effective Gaussian beam radius, ablation threshold fluence, and effective energy penetration depth). To obtain the ablation parameters, laser ablation experiments were carried out on dental hard tissues using Ti:Sapphire femtosecond laser (800 nm, 100 fs, 10 kHz). The method is further extended to predict the ablation rate and efficiency as well. The profile predicted from the mathematical model is compared with that of experimental results. It is found that the predicted ablation profile agrees well with the experimental profile for both enamel and dentin except a slight deviation at higher fluence for dentin. The calculated ablation rate is comparable to that of experimental results whereas for ablation efficiency appreciable deviation is observed in the case of dentin. The model succinctly predicts the ablation profile, ablation rate, and ablation efficiency which will enable to perform dental surgery at optimized laser processing conditions with high precision thus reducing the tissue damage appreciably. Once the details of lesion are known through proper diagnostic tools, the method enables the user to readily obtain optimum laser parameters. It can be used as a handy reference for dentists to perform damage-free surgery, ensuring quicker healing.
https://ift.tt/2zLlnOD
Iatrogenic subcutaneous facial emphysema secondary to a Class V dental restoration: a case report
Australian Dental Journal, Volume 0, Issue ja, -Not available-.
https://ift.tt/2NfgHnN
Real‐world database examining the association between hydroxychloroquine and retinopathy in Taiwan
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xSJd9P
Scholar : ΓΛΩΣΣΙΤΙΣ - νέα αποτελέσματα
[PDF] STUDY OF SERUM Ig A CONCENTRATION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CONTROL"
DV Sommanek, JG Chawda, DM Patel, MJ Gondalia… - GLOBAL JOURNAL FOR …, 2018
… There are no specific or pathognomic oral manifestation associated with
diabetes, however various oral conditions exacerbated in diabetes patients
are gingival and periodontal disease, median rhomboid glossitis, oral …
diabetes, however various oral conditions exacerbated in diabetes patients
are gingival and periodontal disease, median rhomboid glossitis, oral …
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[PDF] Long-term nutrition needs and management. Weight-regain and management. Sue Cummings, MS, RD, LDN
S Cummings
… Page 6. SIGNS AND SYMPTOMS Iron Fatigue, low productivity, spoon
shaped nails / vertical ridges, glossitis B12 Numbness / tingling fingers and
toes, glossitis, fatigue, depression, dementia, gait ataxia Folic Acid …
shaped nails / vertical ridges, glossitis B12 Numbness / tingling fingers and
toes, glossitis, fatigue, depression, dementia, gait ataxia Folic Acid …
| | |
[PDF] Restoring Physiology in Iron-Deficient Organisms Using Small Molecules
MD Burke, AS Grillo - US Patent App. 15/542,596, 2018
… chronic iron overload, ineffective erythropoiesis); fatigue, lethargy; dizziness;
headaches; shortness of breath; ringing in ears; taste disturbances; restless
leg syndrome; pallor; flattened; brittle nails (spoon nail); angular stomatitis …
headaches; shortness of breath; ringing in ears; taste disturbances; restless
leg syndrome; pallor; flattened; brittle nails (spoon nail); angular stomatitis …
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Examination, Diagnosis, and Treatment Planning
RB Quinonez, JR Christensen - Pediatric Dentistry, 2019
… Visualization. Palpation. Assessment of function. Normal color. Range of motion.
Absence of lesions. Redness/glossitis. Ulceration/herpes, aphthous, or other
infection, trauma. Deviation/cranial nerve damage. Limited movement/cerebral …
Absence of lesions. Redness/glossitis. Ulceration/herpes, aphthous, or other
infection, trauma. Deviation/cranial nerve damage. Limited movement/cerebral …
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Nirapel Forte Uses
AK Plus
… Isolated cases: aphthous stomatitis, glossitis, oesophageal lesions, intestinal stenosis,
diaphragmatic lower colon disturbances, such as non-specific haemorrhagic colitis and
exacerbation of ulcerative colitis or Crohn's disease, constipation and pancreatitis …
diaphragmatic lower colon disturbances, such as non-specific haemorrhagic colitis and
exacerbation of ulcerative colitis or Crohn's disease, constipation and pancreatitis …
| | |
Promex Uses
Q An, QK Ao, QK Yi
… Common: Nausea, vomiting, gastric irritations, abdominal pain, diarrhoea, constipation,
dry mouth. Rare: Stomatitis/aphthous ulcerations. Very Rare: Glossitis, peptic ulcer,
pancreatitis. Hepato-biliary disorders: Very Rare: Impaired hepatic function and cholestasis …
dry mouth. Rare: Stomatitis/aphthous ulcerations. Very Rare: Glossitis, peptic ulcer,
pancreatitis. Hepato-biliary disorders: Very Rare: Impaired hepatic function and cholestasis …
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Ginal V Uses
V Ginal
… metronidazole potentiates the effect of indirect anticoagulants; disulfiram
may develop acute psychosis and impaired consciousness; lansoprazole
possible glossitis, stomatitis and / or the appearance of dark color language; …
may develop acute psychosis and impaired consciousness; lansoprazole
possible glossitis, stomatitis and / or the appearance of dark color language; …
| | |
[HTML] Mono Mak Uses
M Mak
… vertigo. Gastrointestinal System Disorders: Abdominal pain, constipation, diarrhea,
dyspepsia, flatulence, gastric ulcer, gastritis, glossitis, hemorrhagic gastric ulcer,
hemorrhoids, loose stools, melena, nausea, vomiting. Hearing …
dyspepsia, flatulence, gastric ulcer, gastritis, glossitis, hemorrhagic gastric ulcer,
hemorrhoids, loose stools, melena, nausea, vomiting. Hearing …
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[HTML] Methadon HCl Sandoz Uses
MHC Sandoz
… Endocrine: hypogonadism. Gastrointestinal: abdominal pain, anorexia, biliary tract
spasm, constipation, dry mouth, glossitis. Hematologic: reversible thrombocytopenia
has been described in opioid addicts with chronic hepatitis …
spasm, constipation, dry mouth, glossitis. Hematologic: reversible thrombocytopenia
has been described in opioid addicts with chronic hepatitis …
| | |
Physiology and Pathophysiology of Digestion, Part 3
DN Granger, J Morris, PR Kvietys - … Series on Integrated Systems Physiology: From …, 2018
Page 1. Page 2. Page 3. Physiology and Pathophysiology of Digestion Part 3 Page
4. ii Colloquium Digital Library of Life Sciences The Colloquium Digital Library of Life
Sciences is an innovative information resource for researchers …
4. ii Colloquium Digital Library of Life Sciences The Colloquium Digital Library of Life
Sciences is an innovative information resource for researchers …
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Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
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