Methicillin-resistant Staphylococcus aureus in health-care workers with cystic fibrosis in Sydney.

Related Articles

Methicillin-resistant Staphylococcus aureus in health-care workers with cystic fibrosis in Sydney.

Respirol Case Rep. 2018 Dec;6(9):e00378

Authors: Song Y, Keatley LR, Middleton PG

Abstract
Cystic Fibrosis (CF), the most common lethal inherited disorder in Australia, is associated with increased respiratory tract colonization/infection. Given that many adults with CF work as health-care workers (HCW), which has been associated with an increased risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization/infection, we examined these risks in 252 adults with CF at our centre between 2001-2015. Demographic and clinical characteristics, including pathogens, were compared for HCW and non-HCW groups. MRSA colonization/infection was found in 20 subjects, comprising 2/19 HCW, and 18/233 non-HCW (p = 0.66). Sixteen of these 20 subjects undertook eradication therapy, with success in 2/2 HCW and 5/14 non-HCW. This study showed that the rate of MRSA colonization/infection did not differ between adults with CF who work in the health-care setting versus other areas. This suggests that choosing a health-care profession does not necessarily result in an increased risk of MRSA colonization/infection for an adult with CF.

PMID: 30397479 [PubMed]

https://ift.tt/2DtnKZx

The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media.

Related Articles

The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media.

Microbiome. 2018 Nov 05;6(1):199

Authors: Coleman A, Wood A, Bialasiewicz S, Ware RS, Marsh RL, Cervin A

Abstract
BACKGROUND: Otitis media (OM) imposes a great burden of disease in indigenous populations around the world, despite a variety of treatment and prevention programs. Improved understanding of the pathogenesis of OM in indigenous populations is required to advance treatment and reduce prevalence. We conducted a systematic review of the literature exploring the upper airway and middle ear microbiota in relation to OM in indigenous children.
METHODS: Papers targeting microbiota in relation to OM in children < 18 years indigenous to Australia, New Zealand, North America, and Greenland were sought. MEDLINE, CINAHL, EMBASE, Cochrane Library, and Informit databases were searched using key words. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA guidelines.
RESULTS: Twenty-five papers considering indigenous Australian, Alaskan, and Greenlandic children were included. There were high rates of nasopharyngeal colonization with the three main otopathogens (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) in indigenous children with OM. Middle ear samples had lower rates of otopathogen detection, although detection rates increased when molecular methods were used. Pseudomonas aeruginosa and Staphylococcus aureus were commonly detected in middle ear discharge of children with chronic suppurative OM. There was a significant heterogeneity between studies, particularly in microbiological methods, which were largely limited to culture-based detection of the main otopathogens.
CONCLUSIONS: There are high rates of otopathogen colonization in indigenous children with OM. Chronic suppurative OM appears to be associated with a different microbial profile. Beyond the main otopathogens, the data are limited. Further research is required to explore the entire upper respiratory tract/middle ear microbiota in relation to OM, with the inclusion of healthy indigenous peers as controls.

PMID: 30396360 [PubMed - in process]

https://ift.tt/2PfHCpl

Evaluation of the Predictive and Prognostic Values of Stromal Tumor-Infiltrating Lymphocytes in HER2-Positive Breast Cancers treated with neoadjuvant chemotherapy

Abstract

Background

Stromal tumor-infiltrating lymphocytes (sTILs) have been identified as a predictive biomarker for response to neoadjuvant chemotherapy (NAC) and prognosis in human epidermal growth factor receptor 2 (HER2)-positive breast cancers. However, standardized scoring methods for use in clinical practice need to be established, and the optimal threshold of sTILs to predict pathological complete response (pCR) and prognosis in HER2+ breast cancers has not yet been defined.

Objective

The predictive and prognostic values of sTILs in patients with HER2-positive breast cancer treated with NAC were evaluated, with the aim to explore the optimal thresholds of sTILs and to investigate the feasibility of scoring methods in clinical practice.

Patients and Methods

A total of 143 core needle biopsy specimens of HER2-positive invasive breast cancers obtained from Chinese patients who had been treated with trastuzumab-based NAC followed by surgery between 2009 and 2015 were extracted from the pathology database of Fudan University Shanghai Cancer Center. sTIL levels in the pre-NAC core needle biopsy specimens were scored using methods recommended by the International TILs Working Group 2014. The associations between sTILs and pCR, disease-free survival (DFS), and overall survival (OS) were evaluated, and the optimal thresholds for predictive and prognostic values of sTILs were analyzed.

Results

First, sTILs were associated with a higher pCR rate in HER2-positive breast cancers. Univariate (per 10% sTILs: odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02–1.08, p = 0.001) and multivariate regression analyses (per 10% sTILs: OR 1.04, 95% CI 1.00–1.07, p = 0.034) indicated that sTILs as a continuous variable were a significant predictor of pCR in HER2-positive breast cancers. Receiver operating characteristics (ROC) curve analysis showed that a 20% threshold best distinguished the pCR subgroup from the non-pCR subgroup. The dichotomized sTILs with a threshold set at 20% was a strong predictor of pCR in the univariate (OR 0.25, 95% CI 0.12–0.52, p < 0.001) and multivariate analyses (OR 0.35, 95% CI 0.14–0.87, p = 0.024). Second, sTILs were associated with better prognosis in HER2-positive breast cancers. Univariate (DFS: hazard ratio [HR] 0.91, 95% CI 0.88–0.95, p < 0.001; OS: HR 0.88, 95% CI 0.83–0.94, p < 0.001), and multivariate analyses (DFS: HR 0.93, 95% CI 0.90–0.97, p < 0.001; OS: HR 0.92, 95% CI 0.86–0.98, p = 0.009) suggested that sTILs as a continuous variable had a strong predictive value for improved DFS and OS. As a binary variable with a threshold of 20%, univariate (DFS: HR 6.60, 95% CI 2.91–14.95, p < 0.001; OS: HR 10.29, 95% CI 2.37–44.66, p = 0.002) and multivariate analyses (DFS: HR 3.87, 95% CI 1.65–9.12, p = 0.002; OS: HR 4.74, 95% CI 1.02–22.01, p = 0.047) indicated that patients with ≥ 20% sTILs had a significantly better prognosis than the patients with < 20% sTILs.

Conclusions

Our study indicates that baseline sTILs scored by methods recommended by the International TILs Working Group in pre-NAC core needle biopsy specimens are significantly correlated with pCR and prognosis in HER2-positive breast cancers. A 20% threshold for sTILs may be a feasible diagnostic marker to predict pCR to NAC and prognosis in patients with HER2-positive breast cancers.

https://ift.tt/2yUYRlO

Acknowledgment of Reviewers 2016 and 2017

https://ift.tt/2PjlPgm

Acknowledgment of Reviewers 2016 and 2017

https://ift.tt/2PjlPgm

Antibiotics in hospital effluents: occurrence, contribution to urban wastewater, removal in a wastewater treatment plant, and environmental risk assessment

Abstract

The study presented the occurrence of antibiotics in 16 different hospital effluents, the removal of antibiotics in urban wastewater treatment plant (WWTP), and the potential ecotoxicological risks of the effluent discharge on the aquatic ecosystem. The total concentration of antibiotics in hospital effluents was ranged from 21.2 ± 0.13 to 4886 ± 3.80 ng/L in summer and from 497 ± 3.66 to 322,735 ± 4.58 ng/L in winter. Azithromycin, clarithromycin, and ciprofloxacin were detected the highest concentrations among the investigated antibiotics. The total antibiotic load to the influent of the WWTP from hospitals was 3.46 g/day in summer and 303.2 g/day in winter. The total antibiotic contribution of hospitals to the influent of the WWTP was determined as 13% in summer and 28% in winter. The remaining 87% in summer and 72% in winter stems from the households. The total antibiotic removal by conventional physical and biological treatment processes was determined as 79% in summer, whereas it decreased to 36% in winter. When the environmental risk assessment was performed, azithromycin and clarithromycin in the effluent from the treatment plant in winter posed a high risk (RQ > 10) for the aquatic organisms (algae and fish) in the receiving environment. According to these results, the removal efficiency of antibiotics at the WWTP is inadequate and plant should be improved to remove antibiotics by advanced treatment processes.

https://ift.tt/2z0nQ75

Improving of the Mg-Co nanoferrites efficiency for crude oil adsorption from aqueous solution by blending them with chitosan hydrogel

Abstract

The efficiency of the as-prepared Mg_0.25Co_0.75Fe₂O₄ spinel nanoparticles for adsorption of crude oil from aqueous solution was improved by blending them with chitosan hydrogel (CH) prepared using epichlorohydrin as cross-linker resulting (CH/Mg_0.25Co_0.75Fe₂O₄) nanocomposites. Mg_0.25Co_0.75Fe₂O₄ nanocrystals was prepared by the chemical co-precipitation method and characterized by using X-ray diffraction (XRD), infrared spectroscopy (FT-IR), scanning electron microscope (SEM), transmission electron microscope (TEM), and differential thermal analysis (DTA)/thermogravimetric analysis (TGA). DTA/TGA results showed that the net weight loss of the samples heated from room temperature up to 1000 °C lies in the range 2.2–26.5% weight, where the maximum weight loss appeared at 100 °C and 614 °C. The blending nanocomposites prepared, were characterized by FT-IR and SEM micrographs. The effect of the nanoparticles ratio on the water uptake of nanocomposites and their capability to adsorb the crude oil was estimated by the gravimetric method. TEM results showed that the average nanoparticle size (Z) of Mg_0.25Co_0.75Fe₂O₄ is 30.06 nm and the SEM illustrated the presence of a very clear and rough layer of pores which are homogenously arranged structures that could play an important role in the adsorption and stability of crude oil on polymers. The adsorption ability of crude oil from waste water on the CH/Mg_0.25Co_0.75Fe₂O₄ nanocomposites hydrogel was reported and it was found that the CH/Mg_0.25Co_0.75Fe₂O₄ with 95/5% ratio showed the improvement in the oil adsorption (72.5%) than the 0/100% one (50.2%). As a consequence, it is highly suggested that the potential of blending CH with Mg_0.25Co_0.75Fe₂O₄ to obtain CH/Mg_0.25Co_0.75Fe2O₄ for enhancing crude oil adsorption in oily waste water treatment with a low cost.

https://ift.tt/2yWrjDO

Production, characterization and effectiveness of cellulose acetate functionalized ZnO nanocomposite adsorbent for the removal of Se (VI) ions from aqueous media

Abstract

In this study, ZnO functionalized cellulose acetate nanocomposite (ZnO/CA NC) was synthesized using a simple chemical approach found to have a high surface area of 657.34 m²/g and utilized as adsorbents for the removal of Se (VI) from aqueous solutions. Investigations on X-ray diffraction (XRD) revealed that ZnO nanocomposite has a smaller crystallite size compared to ZnO nanoparticles which facilitated for reduced agglomeration confirmed by scanning electron microscopy (SEM). The ensuing properties of ZnO/CA NC displayed high maximum adsorption capacity of 160.5 mg/g for Se (VI) ions. Inner-sphere surface complexes on ZnO/CA NC under prevailing conditions for Se (VI) were discussed using FTIR spectroscopical results. In order to evaluate the removal efficiency, the effects of adsorbent dosage, pH, and temperature were thoroughly investigated. The amount of Se (VI) ions adsorbed on ZnO/CA NC was also determined by zeta potential. The fractional removal of pollutants (Se (VI)) was done using mass transfer model. In addition, prominent adsorption capacity was also tested utilizing concurrent anions (SO₄²⁻, Cl⁻, and F⁻) with reference to Se (VI) and cost prudent regenerability of adsorbent by NaOH solution was ascertained with anti-interference and recovery steps. ZnO/CA NC was obtained by simple chemical methodology and high surface adsorption capacities supply an encouraging technique for Se (VI) removal in water treatment applications.

https://ift.tt/2Oxq1Uu

Influence of salinity cycles in bioreactor performance and microbial community structure of membrane-based tidal-like variable salinity wastewater treatment systems

Abstract

A membrane bioreactor and two hybrid moving bed bioreactor-membrane bioreactors were operated for the treatment of variable salinity wastewater, changing in cycles of 6-h wastewater base salinity and 6-h maximum salinity (4.5 and 8.5 mS cm⁻¹ electric conductivity, which relate to 2.4 and 4.8 g L⁻¹ NaCl, respectively), under different hydraulic retention times (6, 9.5, and 12 h) and total solids concentrations (2500 and 3500 mg L⁻¹). The evaluation of the performance of the systems showed that COD removal performance was unaffected by salinity conditions, while BOD₅ and TN removals were significantly higher in the low-salinity scenario. The microbial community structure showed differences with respect to salinity conditions for Eukarya, suggesting their higher sensitivity for salinity with respect to Prokarya, which were similar at both salinity scenarios. Nevertheless, the intra-OTU distribution of consistently represented OTUs of Eukarya and Prokarya was affected by the different salinity maximums. Multivariate redundancy analyses showed that several genera such as Amphiplicatus (0.01–5.90%), Parvibaculum (0.27–1.19%), Thiothrix (0.30–1.19%), Rhodanobacter (2.81–5.85%), Blastocatella (0.21–2.01%), and Nitrobacter (0.80–0.99%) were positively correlated with BOD₅ and TN removal, and the ecological roles of these were proposed. All these genera were substantially more represented under low-salinity conditions (10–500% higher relative abundance), demonstrating that they might be of importance for the treatment of variable salinity wastewater. Evaluation of Eukarya OTUs showed that many of them lack a consistent taxonomic classification, which highlights the lack of knowledge of the diversity and ecological role of Eukaryotes in saline wastewater treatment processes. The results obtained will be of interest for future design and operation of salinity wastewater treatment systems particularly because little is known on the effect of variable salinity conditions in wastewater treatment.

https://ift.tt/2yVu6Nh

What works for jetlag? A systematic review of non-pharmacological interventions

Jetlag is a combination of travel fatigue and circadian misalignment resulting from air travel across time zones. Routinely recommended interventions based on circadian science include timely exposure to light and darkness (scheduled sleep), but the real-world effectiveness of these and other non-circadian strategies is unknown. We systematically reviewed the evidence for non-pharmacological interventions for jetlag. PubMed, EMBASE, Scopus, and Web of Science were searched. Studies reviewed (i) involved human participants undergoing air travel with a corresponding shift in the external light-dark cycle; (ii) administered a non-pharmacological intervention; (iii) had a control or comparison group; and (iv) examined outcomes such as jetlag symptoms, sleep, cognitive/physical performance, mood, fatigue, or circadian markers.

https://ift.tt/2DaL3Xk

Pleiotropic Effects of French Maritime Pine Bark Extract to Promote Healthy Aging

Rejuvenation Research, Ahead of Print.


https://ift.tt/2ATTrJ5

Developing air exchange rate models by evaluating vehicle in-cabin air pollutant exposures in a highway and tunnel setting: case study of Tehran, Iran

Abstract

The passengers inside vehicles could be exposed to high levels of air pollutants particularly while driving on highly polluted and congested traffic roadways. In order to study such exposure levels and its relation to the cabin ventilation condition, a monitoring campaign was conducted to measure the levels inside the three most common types of vehicles in Tehran, Iran (a highly air polluted megacity). In this regard, carbon monoxide (CO) and particulate matter (PM) were measured for various ventilation settings, window positions, and vehicle speeds while driving on the Resalat Highway and through the Resalat Tunnel. Results showed on average in-cabin exposure to particle number and PM₁₀ for the open windows condition was seven times greater when compared to closed windows and air conditioning on. When the vehicle was passing through the tunnel, in-cabin CO and particle number increased 100 and 30%, respectively, compared to driving on highway. Air exchange rate (AER) is a significant factor when evaluating in-cabin air pollutants level. AER was measured and simulated by a model developed through a Monte Carlo analysis of uncertainty and considering two main affecting variables, vehicle speed and fan speed. The lowest AER was 7 h⁻¹ for the closed window and AC on conditions, whereas the highest AER was measured 70 h⁻¹ for an open window condition and speed of 90 km h⁻¹. The results of our study can assist policy makers in controlling in-cabin pollutant exposure and in planning effective strategies for the protection of public health.

https://ift.tt/2JMFcbK

Process development of silica extraction from RHA: a cradle to gate environmental impact approach

Abstract

India is one of the major rice-producing countries. Rice husk is a major agricultural by-product from rice production, which is used as a fuel in boilers. Its use as fuel produces huge amounts of silica-rich rice husk ash (RHA). This paper aims at providing an overall assessment of environmental impacts associated with the extraction of silica from RHA—a process developed by our study group. The functional unit used in this study is production of 100 kg of silica. The analysis included the extraction and transportation of other raw materials; RHA was assumed to be processed at the site. The study was conducted in accordance with the international ISO 14040 procedural framework. LCA is performed using GaBi Education software, and five midpoint indicators are chosen to assess the environmental impacts of silica extraction. The overall climate change (CC) of the extraction process is 7.26 kg CO₂ equivalent per kg of silica produced. A high contribution of calcination to CC is attributed to the use of electricity. The comprehensive environmental impacts of silica-rich RHA resulting from processing of RHA and improvement options to achieve sustainable production are presented. The negative impacts that can be avoided during silica extraction are also discussed. It is observed that calcination is a major contributor to the overall environmental indicators. The work also stresses on the use of renewable energy for electricity generation, which would help in decreasing the overall greenhouse gas emissions during extraction while ensuring waste utilization.

https://ift.tt/2ARvIsT

Developing an electric vehicle urban driving cycle to study differences in energy consumption

Abstract

This paper develops a methodology for constructing a representative electric vehicle (EV) urban driving cycle as a basis for studying the differences in estimated energy consumption, taking Xi'an as an example. The test route is designed in accordance with the overall topological structure of the urban roads in the study region and the results of a traffic flow survey. Wavelet decomposition and reconstruction are utilized to preprocess the original data. Principal component analysis (PCA) is used to reduce the number of the kinetic parameters. The fuzzy C-means (FCM) clustering algorithm is used to cluster the driving segments. A representative EV urban driving cycle is constructed in accordance with the time proportions of three classes of driving segments and the correlation coefficients of the characteristic parameters. Finally, the differences in energy consumption estimates obtained using the constructed Xi'an EV urban driving cycle (XA-EV-UDC) and the international driving cycles are studied. The comparison shows that when international driving cycles are used to estimate the energy consumption and driving range of EVs, large relative errors will result, with energy consumption errors of 9.65 to 21.17% and driving range errors of 20.10 to 38.14%. Therefore, to accurately estimate energy consumption and driving range of EVs under real-world driving conditions, representative EV driving cycles for each typical city and region should be constructed.

https://ift.tt/2JMDZ45

Evaluation of mercury phytoavailability in Oxisols

Abstract

Mercury is a metal which is potentially toxic for the environment. Many factors control its retention in the soil, such as cation exchange capacity, pH, clay content, organic matter, and redox potential. It is important to know the phytotoxic effects of soil Hg to prevent environmental contamination and its entry into the food chain. Several analytical methods are used to measure metal phytoavailability in soils, but none has been reported for Hg in Oxisols, the most common soil class in Brazil and a very important soil class throughout the tropics. The aim of this study was to select the chemical extractor that best correlated the Hg levels in plants and the Oxisols. The soils used were classified as Dystrophic Red-Yellow Oxisol (LVAd) and Dystroferric Red Oxisol (LVdf), which were collected in the 0–0.2-m soil layer. The species selected for cultivation were a monocotyledon, oat (Avena sativa L. cv. São Carlos) and a eudicotyledon, common bean (Phaseolus vulgaris L. cv. Madrepérola). Each test plot was composed of a 500 cm³ pot filled with soil samples contaminated with HgCl₂. Treatments were arranged in a completely randomized design, with four replications. The experiment was conducted for 30 days. Mercury contents were separately extracted with the following extractors: USEPA 3051A, Mehlich-1, Mehlich-3, DTPA, and water. Mercury was determined by hydride generation atomic absorption spectroscopy. The extracted contents were correlated with the contents in the tissues of the plants' aerial part by the Pearson correlation. Although it is not considered a standard procedure to evaluate metal phytoavailable contents, the method that presented the best correlations between soil Hg and plant Hg was USEPA 3051A (r = 0.75*). As expected, the worst correlation was with water (r = 0.57* for common bean and r = 0,05^ns for oat).

https://ift.tt/2DrUa6J

Blue light-emitting diode in healthy vaginal mucosa—a new therapeutic possibility

Abstract

A healthy female genital mucosa has an ecosystem that remains in balance through interactions between endogenous and exogenous factors. The light-emitting diode (LED) is a device that emits light at different wavelengths, with varying color and effects. Blue light in humans is most commonly used for antimicrobial purposes and has been already applied to treat facial acne and gastric bacteria. Although blue LED therapy in humans has been reported, its properties against vaginal infections have not yet been investigated. This study aims to test the safety and effects of 401 ± 5 nm blue LED on healthy vaginal mucosa. Phase I clinical trial involving 10 women between 18 and 45 years old with healthy vaginal mucosa. The participants were illuminated by 401 ± 5 nm blue LED for 30 min and anamnesis, oncotic cytology, and pH measurement were made again after 21/28 days of treatment. In the re-evaluation, adverse effects were investigated. The mean age was 27 ± 5.4 years and one of the women was excluded due to interruption of use of oral contraceptives. Oncotic cytology done before and after therapy showed that the composition of the microflora remained normal in all participants. Vaginal pH remained unchanged in eight of the women and had a reduction in one woman (5.0–4.0). No adverse effects were observed during or after illumination. 401 ± 5 nm blue LED did not generate any adverse effects or pathogenic changes in the microflora and vaginal pH. The effects of 401 ± 5 nm blue LED still need to be tested in vulvovaginal pathogens. Trial registration number: NCT03075046

https://ift.tt/2QvIC5v

Are egg white face masks good for your skin?

Many people use egg white face masks as a way to boost the health of both oily and dry skin. However, there is little to no evidence to support the suggested benefits of these masks. We take a closer look at these alleged benefits and explain how to make an egg white face mask.

https://ift.tt/2DqQkuv

Removal of particulate matter and trace elements from ambient air by urban greenery in the winter season

Abstract

Particulate matter (PM) is one of the most harmful inhaled pollutants. When PM is emitted into the atmosphere, the only possible method for cleaning ambient air is through vegetation acting as biological filters for pollutants. However, in winter periods when the concentration of PM is usually the highest, the efficiency of plants is very low. The aim of this work was therefore to examine the accumulation of PM and selected trace elements (TE) by three species, evergreen coniferous Taxus baccata L. and Pinus nigra Arn., and deciduous Carpinus betulus L. during the winter season. The highest amounts of PM accumulated on the foliage of P. nigra, while TE on the leaves of C. betulus. Most of the PM accumulated on plant foliage belonged to the large fraction size (10–100 μm) and was deposited on the surface of foliage (_SPM). The concentration of four TE (Ni, Pb, Cd, and Sb) was higher in PM accumulated on foliage, while in the case of three other TE (Zn, Cr and Mg), their concentration was higher in plant tissue. The TE were recorded in all PM size fractions and were rather equally distributed between surface PM (_SPM) and in-wax PM (_WPM). These findings have implications for urban plantings in countries with short vegetative season, where tolerant conifer species and deciduous species which keep foliage through winter should be included in urban forest plantings due to their efficiency in the removal of pollutants from the air.

https://ift.tt/2DsdG3c

Modified Ramped Position for Endotracheal Intubation of Obese Patients

Conditions:   Obesity;   Anesthesia
Interventions:   Other: Modified ramped position;   Other: Ramped position
Sponsor:   Cairo University
Not yet recruiting

https://ift.tt/2JK2oHD

Panitumumab-IRDye800 and 89Zr-Panitumumab in Identifying Metastatic Lymph Nodes in Patients With Squamous Cell Head and Neck Cancer

Condition:   Cutaneous Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: Panitumumab-IRDye800;   Drug: Zirconium Zr-89 Panitumumab;   Device: Pinpoint IR IR9000 flourescence imaging system (FIS);   Device: SPY-PHI IR9000 flourescence imaging system (FIS);   Device: Explorer Air camera;   Device: PDE-NEO II camera;   Device: FIS-00 fluorescence imaging system (FIS);   Device: Da Vinci Firefly Imaging System;   Device: IGP-ELVIS-v4 Macroscopic Specimen Imager;   Device: Vevo 3100 LAZR-X;   Device: Pearl Triology Imaging System;   Device: Odyssey CLx Imaging System;   Device: Leica fluorescence microscope
Sponsors:   Stanford University;   National Institutes of Health (NIH);   National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2ASTV2h

Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus

Abstract

Purpose

To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood glucose control and pregnancy outcomes.

Methods

A total of 124 patients with gestational diabetes mellitus (GDM) were selected. Patients were randomly divided into two groups. The 60 patients in the control group received standard outpatient treatment, while the remaining 64 patients received a nurse's online guidance both through a mobile medical App installed on their phone and through regular offline clinical treatment in the mHealth group. Patients were treated for an average of 13 weeks and general conditions, compliance, blood glucose, glycosylated hemoglobin, weight gain, pregnancy, and neonatal outcomes were monitored in both groups longitudinally.

Results

The mHealth group demonstrated higher levels of compliance (83.3 ± 12.5% vs. 70.4 ± 10.1%, t = − 6.293, df = 122, p < 0.001), lower frequency of outpatient service (8.1 ± 1.3 vs. 11.2 ± 1.1, t = 14.285, df = 122, p < 0.001), lower hemoglobin A1C before delivery (4.7 ± 0.2 vs. 5.3 ± 0.3, t = 13.216, df = 122, p < 0.001) as well as the rates of off-target measurements both fasting (4.6 ± 0.4% vs. 8.3 ± 0.6%, t = 40.659, df = 122, p < 0.001) and 2 h post-prandial (7.9 ± 0.7% vs. 14.7 ± 0.8%, t = 50.746, df = 122, p < 0.001). Weight gain in the mHealth group was less than control group (3.2 ± 0.8 vs. 4.8 ± 0.7, t = 11.851, df = 122 p < 0.001).

Conclusion

Mobile health intervention management of gestational diabetes mellitus improves patients' compliance and blood glucose control, and reduces weight gain, thereby reducing the rates of complications in both pregnant women and fetuses during delivery during pregnancy.

https://ift.tt/2JRXs3L

Patient- versus physician-reported outcomes in prostate cancer patients receiving hypofractionated radiotherapy within a randomized controlled trial

Abstract

Purpose

The risk of developing acute radiotherapy(RT)-induced side effects may increase with hypofractionated RT. To detect treatment-related side effects, patient-reported outcomes (PROs) might be more reliable than physician-reported outcomes. Therefore, we tried to evaluate the rate of agreement between urinary and gastrointestinal (GI) side effects and the prevalence of side effects reported by patients and by physicians.

Methods

Data from a randomized controlled trial (RCT) comparing two hypofractionated RT schedules were used. Urinary (nocturia, incontinence, frequency, dysuria, and urgency) and GI (obstruction, diarrhea, vomiting, nausea, bloating, hemorragia, and incontinence) symptoms measured by the EORTC QLQ-C30 and PR-25 were used for PROs. The same symptoms were scored by the physician using the Common Terminology Criteria Adverse Events v4.0. Outcomes were reported at baseline, end of treatment, month 1, and month 3. PROs and physician-reported outcomes were converted in two categories (0 = no symptoms; 1 = symptoms of any severity) and were correlated using the kappa (κ) correlation statistics. Values below 0.40 were considered low agreement. In addition, the prevalence of symptoms was calculated.

Results

Data from 160 patients were used. The mean value for Cohen's κ was 0.31 (ranging between 0.04 and 0.55) and 0.23 (ranging between 0.04 and 0.47) for urinary and GI symptoms, respectively. Except for three symptoms at baseline, all symptoms reported by patients were higher than those reported by physicians.

Conclusion

There is low agreement between symptoms reported by patients and physicians, with high rates of underreporting by the physician.

https://ift.tt/2RJmtkj

Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy

Abstract

Background and purpose

In our institute, breast cancer patients undergoing adjuvant treatment are included in a protocol aimed to reduce cardiovascular morbidity (SAFE-2014, NCT2236806), assessing preclinical heart damage with heart speckle-tracking ultrasound. To develop a dose constraint related to subclinical heart damage, a reliable delineation of heart substructures based on a pre-existing guideline was made.

Patients and methods

Heart substructures of 16 left-sided breast cancer patients included in the SAFE protocol were delineated by five operators. For each substructure, a multi-contour delineation based on a majority vote algorithm (MCD) was created. A consensus-based delineation (CBD) was developed by an independent team of two blinded operators. Dice similarity coefficients (DSC) between volumes delineated by different operators and the MCD were collected and reported, as well as DSC between CBD and MCD.

Results

Mean DSCs between heart chambers delineated by each operator and the corresponding MCDs ranged between 0.78 and 0.96. Mean DSC between substructures delineated by all single operators and the corresponding MCD ranged between 0.84 and 0.94. Mean DSC between CBD and the corresponding MCD ranged from 0.89 to 0.97.

Conclusion

Results showed low inter-observer variability of heart substructure delineation. This constitutes an external validation of the contouring atlas used, allowing a reliable dosimetric assessment of these volumes within the SAFE-2014 trial.

https://ift.tt/2PSdmR7

Decreasing farm number benefits the mitigation of agricultural non-point source pollution in China

Abstract

Agricultural non-point source pollution causes global warming and the deterioration of air and water quality. It is difficult to identify and monitor the emission sources of agricultural pollution due to the large number of farms in China. Many studies focus on the technological aspect of achieving agricultural sustainability, but its socioeconomic aspect is poorly understood. Here, we report how group size (number of farms in a certain region) affects agricultural pollution governance through conducting a social science experiment. We found that when communication was allowed among group members, a small group size facilitated cooperation. Although deviations from the cooperation equilibrium occurred with time in all groups, the smaller the group size, the slower the cooperation equilibrium became frangible. These findings suggest that reducing number of farms and extending the length of farm property rights can benefit the mitigation of agricultural non-point pollution in China. Social science experiments can be a useful tool to understand the socioeconomic aspect of agricultural sustainability.

https://ift.tt/2Pf7W2N

β -Pinene moderates Cr(VI) phytotoxicity by quenching reactive oxygen species and altering antioxidant machinery in maize

Abstract

We examined the possible role of monoterpene β-pinene in providing protection against Cr(VI) toxicity in maize (Zea mays). Treatment with β-pinene (10 μM) significantly alleviated Cr(VI) accumulation and recuperated Cr(VI) caused decline in root and coleoptile growth in maize. β-Pinene addition caused a decline in Cr(VI)-induced accumulation of superoxide anion, hydroxyl ion, hydrogen peroxide and confirmed by in-situ detection of ROS using histochemical localization. It suggested that the β-pinene quenches/neutralizes enhanced ROS generated under Cr(VI) exposure. β-Pinene also reduced Cr(VI)-induced electrolyte leakage, thereby suggesting its role in membrane stabilization. Further, β-pinene regulated the activity of scavenging enzymes, thereby suggesting a role in modulating Cr(VI)-induced oxidative damage. In conclusion, our results suggest that the addition of β-pinene has a protective role against Cr(VI) stress and provides resistance to maize against Cr(VI) toxicity.

https://ift.tt/2QmRgD7

Outcome of Internal Neurolysis for Trigeminal Neuralgia without Neurovascular Compression and Its Relationship with Intraoperative Trigeminocardiac Reflex

Background: Internal neurolysis (IN) is an effective surgical treatment for trigeminal neuralgia (TN) without neurovascular compression (NVC) or postoperative recurrence. However, the trigeminal nerve is directly manipulated during the procedure, and there is a high incidence of trigeminocardiac reflex (TCR). The aim of this study was to retrospectively analyze the outcome of IN and to explore its relationship with the occurrence of intraoperative TCR. Methods: Surgical and anesthesia records of 27 TN patients who underwent surgical treatment with IN at our department between March 2010 and September 2016 were retrospectively analyzed. Patients were divided into 2 groups on the basis of the occurrence of TCR during surgery, and clinical characteristics were compared. Pain intensity was assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. Results: TCR was observed in 23 of 27 patients (85.2%); it manifested as obvious changes in mean arterial pressure and heart rate by at least 20% of the baseline values. Trigeminal nerve atrophy was found in 9 patients (33.3%). The immediate pain-free rate was 96.3%, and the "excellent" rate was 72.1% for follow-up, with a rate of numbness or hypesthesia of 97.1%. These outcomes were retrospectively compared between the TCR and non-TCR groups, and there was a nonsignificantly higher "excellent" rate in the TCR group than in the non-TCR group. Conclusions: This study demonstrated that IN is an effective treatment for TN without NVC and has a close relationship with intraoperative TCR. To our knowledge, this is the first research describing TCR during IN.
Stereotact Funct Neurosurg

https://ift.tt/2RG1COF

Re-Irradiation with Stereotactic Radiosurgery/Radiotherapy for Recurrent High-Grade Gliomas: Improved Survival in the Modern Era

Objective: The aim of this study was to evaluate the efficacy of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) as salvage therapy for recurrent high-grade glioma and to look at the overall efficacy of treatment with linear accelerator (LINAC)-based radiosurgery and fractionated radiotherapy. Methods: From 2010 to 2017, a total of 25 patients aged 23–74 years were re-irradiated with LINAC-based SRS and fSRT. Patients were treated to a median dose of 25 Gy in 5 fractions. Results: The median overall survival (OS) after (initial) diagnosis was 39 months with an actuarial 1-, 3-, and 5-year OS rate of 88, 56, and 30%, respectively. After treatment with SRS or fSRT, the median OS was 9 months with an actuarial 1-year OS rate of 29%. Local control, assessed for 28 tumors, after 6 months was 57%, while local control after 1 year was 39%. Three patients experienced local failure. There was no evidence of toxicity noted after SRS or fSRT throughout the follow-up period. Conclusion: SRS and fSRT remain a safe, reasonable, effective treatment option for re-irradiation following recurrent glioblastoma. Additionally, treatment volume may predict local control in the salvage setting.
Stereotact Funct Neurosurg

https://ift.tt/2DtiuFr

Optimising sampling patterns for bi-exponentially decaying signals

Publication date: Available online 6 November 2018

Source: Magnetic Resonance Imaging

Author(s): A. Reci, M.I. Ainte, A.J. Sederman, M.D. Mantle, L.F. Gladden

Abstract

A recently reported method, based on the Cramér-Rao Lower Bound theory, for optimising sampling patterns for a wide range of nuclear magnetic resonance (NMR) experiments is applied to the problem of optimising sampling patterns for bi-exponentially decaying signals. Sampling patterns are optimised by minimizing the percentage error in estimating the most difficult to estimate parameter of the bi-exponential model, termed the objective function. The predictions of the method are demonstrated in application to pulsed field gradient NMR data recorded for the two-component diffusion of a binary mixture of methane/ethane in a zeolite. It is shown that the proposed method identifies an optimal sampling pattern with the predicted objective function being within 10% of that calculated from the experiment dataset. The method is used to advise on the number of sampled points and the noise level needed to resolve two-component systems characterised by a range of ratios of populations and diffusion coefficients. It is subsequently illustrated how the method can be used to reduce the experiment acquisition time while still being able to resolve a given two-component system.

https://ift.tt/2PMMlyd

Redesigning Skin Cancer Early Detection and Care Using a New Mobile Health Application: Protocol of the SKIN Research Project, a Randomised Controlled Trial

Patients often detect melanoma themselves; therefore, regular skin self-examinations (SSEs) play an important role in the early detection and prompt treatment of melanoma. Mobile teledermoscopy is a technology that may facilitate consumer SSEs and rapid communication with a dermatologist. This paper describes the planned randomised controlled trial of an intervention to determine whether mobile technologies can help improve the precision of SSE in consumers. A randomised controlled trial will be conducted to evaluate mobile teledermoscopy-enhanced SSE versus naked-eye SSE. Participants in each group will conduct three home whole-body SSEs at baseline, 1 and 2 months, then present for a clinical skin examination (CSE) by a doctor after the 2-month SSE. Specifically, participants will identify skin lesions that meet the AC (asymmetry and colour) rule for detecting a suspicious skin spot. The primary outcomes are sensitivity and specificity of the skin lesions selected by the participants as needing attention by a doctor, compared to the clinical diagnosis by the dermatologist that will serve as the reference standard for this analysis. For the mobile teledermoscopy-enhanced SSE group, researchers will assess the number, location and type of lesions (1) sent by the participant via mobile teledermoscopy, (2) found at CSE or (3) missed by the participant. For the naked-eye SSE group, researchers will assess the number, location and type of lesions (1) recorded on their body chart by the participant, (2) found at CSE or (3) missed by the participant. Secondary outcomes are based on participants' self-reported data via online questionnaires.
Dermatology

https://ift.tt/2PdnKmE

Consumer Acceptance and Expectations of a Mobile Health Application to Photograph Skin Lesions for Early Detection of Melanoma

Background: Mobile teledermoscopy may facilitate skin self-examinations (SSEs) and further improve monitoring and detection of melanoma. Objective: To assess consumer acceptability and expectations of a mobile health app used to: (i) instruct SSE and (ii) conduct consumer-performed mobile teledermoscopy. Methods: People aged 18 years and above were invited to participate in either (i) an online survey or (ii) focus group in Brisbane, Australia. Participants were asked about their SSE practices, mobile teledermoscopy acceptance, and app design and functionality. The online survey responses and focus group discussions were coded by two researchers who conducted thematic analysis. Results: Four focus groups were held with a total of 28 participants; 88 participants completed the online survey. The mean ages of participants in the focus group and online survey were 46 and 38 years, respectively. There were more males in the focus groups (61%, 17/28) compared to the online survey (19%, 17/88). Regular SSEs were conducted by 56 (64%) of the online survey participants. Barriers to SSE were forgetfulness (44%), low self-perceived risk of melanoma (25%) and low confidence in conducting SSEs (25%). The large majority of online survey participants (95%) would consider sending photos of their skin lesions to a medical practitioner via an app. Focus group participants reported that they would accept using mobile teledermoscopy; however, they would prefer to use it to monitor lesions between face-to-face consultations. Conclusions: Overall, participants had positive views on using mobile teledermoscopy to send images of skin lesions to a dermatologist or other medical practitioner.
Dermatology

https://ift.tt/2OtEkcZ

Body Piercing: A National Survey in France

Background: There are no recent data available in France regarding body piercing (BP). Objective: We examined the demographics, motivations, quality of life, cutaneous conditions, and cutaneous side effects after BP within the French population. Methods: A representative sample of 5,000 individuals (aged 15 and over) from the general population responded to a survey online between April and August 2017. Data regarding demographics, BP characteristics (location, age at first piercing, hesitation, regrets, motivations, cutaneous side effects), tobacco, skin conditions (acne, contact eczema, atopic eczema, rosacea, psoriasis, vitiligo), and tattoos were collected. Respondents also filled an SF-12 quality of life questionnaire. Results: Overall, 12% of the respondents reported at least one BP (women: 19.4%, men: 8.4%, p #x3c; 0.01). The prevalence was highest among those aged between 25 and 34 years (25.8%). Individuals with BP were more likely to smoke (p #x3c; 0.01). The most common body parts for piercings were the external part of the ear (42%), the navel (24%), the tongue (15%), and the nose (11%). Gender differences included localization (belly button and nose for women, eyebrows for men) and motivations (embellishment of the body for women, individuality and sexuality for men). A total of 33.6% of the study participants reported having skin problems after BP, primarily infection (44%). Individuals with BPs were more likely to report having contact eczema, atopic dermatitis, and acne. BP was associated with a lower mental quality of life score. Conclusion: This is the largest epidemiological study on BP in France to date. It allows us to draw a precise current snapshot of French indi viduals with BP.
Dermatology

https://ift.tt/2PdnLHe

Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy

Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p #x3c; 0.001), tumor islands located in the epidermis (100%, p #x3c; 0.001), smaller vascular diameter (100%, p #x3c; 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p #x3c; 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p #x3c; 0.001) with a larger vascular diameter (50%, p #x3c; 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
Dermatology

https://ift.tt/2Ov5hgc

Gender difference and correlation between sexuality, thyroid hormones, cognitive, and physical functions in elderly fit

Abstract

Purpose

Sexuality in the elderly is related to psycho-physical well-being. Aim of this study was to analyze the correlation between sexual health, thyroid hormones, cognitive functions, and physical fitness in elderly population.

Methods

Fifty-one fit adults were recruited (age: 71.9 ± 5.3 years, 26 females and 25 males). Sexuality was evaluated using the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14) and the Sexual Attitude Scale (SAS). Thyroid function was assessed by measuring serum TSH, FT3, and FT4. Cognitive functions and depressive symptoms were evaluated by the Mini Mental State Examination (MMSE) test and Geriatric Depression Scale (GDS) scores. Subjects' physical fitness was evaluated using the following tests: Short Physical Performance Battery (SPPB), Handgrip test (HG), Timed Up and Go test (TUG), and 2-Minute step test (ST).

Results

CSFQ-14 positively correlated with MMSE (p < 0.05) and negatively with GDS (p < 0.05), while thyroid function was not correlated with sexuality, in both genders. A negative relationship between FT4 vs. weight, FT3 vs. HG and FT3/FT4 ratio vs. ST were found (p = 0.05) in females, while in males, it occurred for TSH vs. TUG (p < 0.05); a positive relationship existed in females between FT4 vs. ST (p < 0.05). Finally, CSFQ-14 was significantly correlated with SPPB (p < 0.05), CST, TUG, and ST (p < 0.01), in both genders.

Conclusion

We demonstrated a strict relationship between active sexuality, preserved cognitive function and appropriate physical fitness in elderly subjects, independently from gender. Our preliminary data suggest that in elderly fit population, peripheral thyroxin deiodination may be a useful predictor of better physical performance and more successful aging.

https://ift.tt/2JLShSS

Performances of Pichia kudriavzevii in decolorization, biodegradation, and detoxification of C.I. Basic Blue 41 under optimized cultural conditions

Abstract

The aim of this study was to evaluate the performances of Pichia kudriavzevii CR-Y103 yeast strain for the decolorization, biodegradation, and detoxification of cationic dye C.I. Basic Blue 41, a toxic compound to aquatic life with long-lasting effects. Under optimized cultural conditions (10.0-g L⁻¹ glucose, 0.2-g L⁻¹ yeast extract, and 1.0-g L⁻¹ (NH₄)₂SO₄), the yeast strain was able to decolorize 97.86% of BB41 (50 mg L⁻¹) at pH 6 within 4 h of incubation at 30 °C under shaken conditions (12,238.00-μg h⁻¹ average decolorization rate) and 100% within 12 h. The UV-Vis spectral analysis, high-performance liquid chromatography (HPLC), and Fourier-transform infrared spectroscopy (FTIR) analysis confirmed the complete decolorization and degradation of the BB41 dye by P. kudriavzevii CR-Y103. Also, other seven yeast strains, isolated from soil, as P. kudriavzevii (CR-Y108, CR-Y119, and CR-Y112), Candida tropicalis CR-Y128, Cyberlindnera saturnus CR-Y125, and Candida solani CR-Y124 have shown a promising decolorizing potential of azo-dye BB41 (99.89–76.09% decolorization). Phytotoxicity, cytotoxicity, and genotoxicity assays on Trifolium pratense and Triticum aestivum seedlings confirmed the high toxicity of BB41 dye (500 ppm), with inhibition on germination rate (%), root and shoot elongation, decreasing of mitoxic index value (with 34.03% in T. pratense and 40.25% in T. aestivum), and increasing the frequency of chromosomal aberrations (6.87 times in T. pratense and 6.25 times in T. aestivum), compared to control. The same biomarkers indicated the nontoxic nature of the BB41 degraded metabolite (500 ppm) obtained after P. kudriavzevii CR-Y103 treatment. Moreover, the healthy monkey kidney cells (Vero cells) had a low sensitivity to BB41 biodegraded products (250 μg mL⁻¹) (MTT cell viability assay) and revealed minor DNA damage (comet assay) compared to BB41 dye treatment. These findings show that P. kudriavzevii could be used in eco-friendly bioremediation technologies, applicable for reducing the toxicity of basic azo-dyes containing wastewaters.

https://ift.tt/2Dr2tQg

Effects of different composting strategies on methane, nitrous oxide, and carbon dioxide emissions and nutrient loss during small-scale anaerobic composting

Abstract

Composting is considered as one of the main sustainable methods for the treatment of livestock manure. In this study we investigated the effects of additives (urea and rice straw) on methane (CH₄), nitrous oxide (N₂O), and carbon dioxide (CO₂) emissions using a traditional Chinese pig slurry composting method over an 81-day period, as well as examining total organic carbon and total nitrogen loss. Four common treatment strategies were examined in this study: a control (MC), urea nitrogen addition (MN), composting using rice straw cover (MS_cover), and compost mixed with rice straw (MS_mix). Our results indicate that the addition of urea resulted in the lowest total CH₄ emissions and the highest N₂O emissions. MS_cover treatment had the highest and most significant effect on CH₄ emissions, while MS_mix treatment had the lowest CO₂ emissions. Carbon lost through CH₄ and CO₂ released during the experiment was 0.1–0.9 and 2.4–3.9% of total carbon loss, respectively, and nitrogen lost through N₂O release was 11.1–17.9% of total nitrogen. In general, although MS_mix, MS_cover, and MN treatments increased global warming potential by 21.4, 41.6, and 50.9% per kg of pig slurry, respectively, no statistical differences between the four treatments were recorded. By considering carbon and nitrogen conservation, as well as the improvement of the quality of compost and the mitigation of greenhouse gases (GHGs), the small-scale composting method of pig slurry alone is an acceptable environmentally friendly strategy for use in China.

https://ift.tt/2JKImwI

Effect of bisphosphonate treatment on the jawbone: an exploratory study using periapical and panoramic radiographic evaluation

Abstract

Objective

This cross-sectional study aimed to explore potential jawbone changes secondary to bisphosphonate (BP) treatment of osteoporosis using digital panoramic and periapical radiography.

Methods

Thirty-nine women, previously examined with dual-energy X-ray absorptiometry, were radiographed by digital panoramic and/or periapical radiography. On periapical radiographs, trabecular bone structure and fractal dimension analyses of the mandibular first molar and edentulous regions were performed. On panoramic radiographs, the mandibular cortical width (MCW) was calculated, and trabecular bone structure and fractal dimension analyses of the trabecular bone in the alveolar and basal bones were performed. The results were compared between patients treated or not treated with BP using linear regression analysis to adjust for potential confounding factors.

Results

The analyses of periapical and panoramic radiological images showed no statistical differences in the jawbones between groups after bisphosphonate use for mean intervals of 4.3 and 5 years; respectively. Although the mandibular cortical width on panoramic radiography was correlated with BP use, it was not noted to be statistically significant.

Conclusions

The trabecular parts of the alveolar and basal bones and the MCW were not significantly altered by BP treatment in patients with osteoporosis over 4.3–5 years, as detected by digital periapical and panoramic radiography. The low dosages of bisphosphonates used in the treatment of osteoporosis may explain this lack of change in MCW. Dental radiographs should not be considered as a method to monitor BP-induced jaw bone alterations among osteoporotic patients.

https://ift.tt/2Oxu0Au

The pivot point in transposition flap planning: concept and surgical implications

https://ift.tt/2F7zxON

Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 37-38

The online platform for Taylor & Francis Online content The following articles have been newly published in the issue Journal of Natural History, Volume 52, Issue 37-38 on Taylor & Francis Online: Articles A new species of Passalus (Passalus) from Atlantic Rainforest, with a key and checklist for the Brazilian Petrejus group (Coleoptera, Passalidae) Ingrid Mattos, José Ricardo Miras Mermudes Pages: 2351-2367 | DOI: 10.1080/00222933.2018.1536813 Revision of Chaetarthria Stephens (Coleoptera: Hydrophilidae) in China, with a key to the species in the Oriental Region Fenglong Jia, Shi-shuai Wang, Paul Aston Pages: 2369-2384 | DOI: 10.1080/00222933.2018.1532023 The planalto hermit, Phaethornis pretrei – a key species in a Neotropical savanna community in Central Brazil Francielle Paulina de Araújo, Diego Hoffmann, Marlies Sazima Pages: 2385-2396 | DOI: 10.1080/00222933.2018.1536767 The issue is in progress. To view all articles already published in this issue, please visit: https://www.tandfonline.com/toc/tnah20/52/37-38 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Determination of nicotine content in teeth submitted to prophylaxis and in-office bleaching by gas chromatography–mass spectrometry (GC-MS)

Abstract

Objectives

The objective of this study was to evaluate the dental color exposed to acute cigarette smoke treatment and quantify the amount of nicotine in samples exposed to cigarette smoke, after dental prophylaxis and after in-office bleaching.

Materials and methods

Sixty-nine healthy human molars were subjected to cigarette smoke in a cigarette machine. The teeth were divided into three groups: positive control, prophylaxis, and bleaching. Forty cycles of smoke exposition with duration of 15 min each were performed using 10 cigarettes (positive control). Dental prophylaxis was performed with a rotating brush and prophylaxis paste; in-office bleaching was performed with 35% hydrogen peroxide, in two sessions of three 15-min applications, with a 1-week interval between sessions. The color was evaluated at the baseline, after exposure to cigarette smoke, after dental prophylaxis, and after in-office bleaching. Teeth from each group were powdered and analyzed by gas chromatography–mass spectrometry in order to measure the amount of nicotine present in each group. Data from quantification of nicotine and color change were analyzed by one-way ANOVA and Tukey's test (α = 0.05).

Data for subjective and objective color evaluation, a perceptible dental darkening occurred in teeth after exposure to cigarette smoke. Dental prophylaxis was able to recover the original color of teeth however, only after bleaching teeth became whiter than at the baseline (p < 0.001). The amount of nicotine was significantly different and higher in positive control group (3.3 ± 1.3 μg/g of tooth), followed by the prophylaxis group (2.1 ± 1.4 μg/g) and the bleaching group (0.8 ± 0.3 μg/g) (p < 0.001).

Conclusions

Cigarette smoke penetrates into the dental structure. Dental prophylaxis and bleaching with 35% hydrogen peroxide can partially remove the nicotine from tobacco smoke. However, when in-office bleaching was applied, a more significant nicotine removal was achieved.

Clinical significance

Dental prophylaxis could remove most of the external nicotine-staining on the tooth surfaces while bleaching could further reduce the external and internal nicotine-staining of teeth.

https://ift.tt/2D73jka

Effectiveness and effect of non-vital bleaching on the quality of life of patients up to 6 months post-treatment: a randomized clinical trial

Abstract

Objectives

The aim of this study was to evaluate the esthetic perception of patients at 6 months after bleaching of non-vital teeth with 35% of hydrogen peroxide and 37% of carbamide peroxide using a walking bleach technique. We also assessed psychosocial impacts as well as the clinical effectiveness and stability of the color change.

Materials and methods

The teeth bleaching treatment was randomly assigned to two groups according to the bleaching agent used: G1 HP = 35% of hydrogen peroxide (n = 25) and G2 CP = 37% of carbamide peroxide (n = 25). The non-vital bleaching was performed in four sessions using the walking bleach technique. The color was objectively (ΔE) and subjectively (ΔSGU) evaluated. The esthetic perception and psychosocial factors were evaluated before treatment as well as one and 6 months post-treatment using Oral Health Impact Profile (OHIP) esthetics and Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ).

Results

The color change (ΔE) at 6 months (G1 = 14.53 ± 5.07 and G2 = 14.09 ± 6.61) for both color groups remained stable until the 6-month post-treatment (p > 0.05). There was a decrease in the values of OHIP esthetics and PIDAQ after treatment compared to the baseline (p < 0.05), and this effect was maintained 6 months post-treatment.

Conclusions

Both agents were highly effective and maintained the color stability at 6 months; this positively affected the esthetic perception and psychosocial impact of patients who also remained stable over time.

Clinical relevance

Non-vital bleaching produces a positive and stable impact on the esthetic perception and psychosocial factors at medium-term follow-ups.

https://ift.tt/2EAZeH6

Bone mineralization and vascularization in bisphosphonate-related osteonecrosis of the jaw: an experimental study in the rat

Abstract

Objectives

Pathogenesis of bisphosphonate-related osteonecrosis of the jaws (BRONJ) is not fully explained. An antiangiogenic effect of bisphosphonates (BPs) or an altered bone quality have been advocated. The aims of the present study were to analyze alveolar mandibular vascularization and bone quality in rats with BRONJ.

Materials and methods

Thirty-eight Sprague-Dawley rats were randomized into two groups: zoledronic acid (ZA), n = 27, and control (CTRL) n = 11. The ZA group received a weekly IV injection of ZA (100 μg/kg) during 10 weeks. The CTRL group received saline. After 6 weeks, extraction of the right mandibular molars was performed. Rats were sacrificed after 14 weeks. Microtomography characterized bone lesions and vascularization after injection of a radio-opaque material. Raman microspectroscopy evaluated bone mineralization.

Results

Fifty-five percent of ZA rats presented bone exposure and signs of BRONJ. None sign was found at the left hemimandible in the ZA group and in the CTRL group. Vascular density appeared significantly increased in the right hemimandibles of the CTRL group compared to the left hemimandibles. Vascularization was reduced in the ZA group. A significantly increased of the mineral-to-amide ratio was found in the alveolar bone of ZA rats by Raman microspectroscopy.

Conclusions

In a rat model of BRONJ, microtomography evidenced osteonecrosis in BRONJ. Raman spectroscopy showed an increased mineralization. Vascularization after tooth extraction was impaired by ZA.

Clinical relevance

Prolonged BP administration caused an increase in the mineralization and a quantitative reduction of the vascularization in the alveolar bone; both factors might be involved concomitantly in the BRONJ pathophysiology.

https://ift.tt/2CqSUf4

Cyclic fatigue resistance of R-Pilot, WaveOne Gold Glider, and ProGlider glide path instruments

Abstract

Objective

The aim of the present study was to compare the cyclic fatigue resistance of R-Pilot (VDW; Munich, Germany) with ProGlider (Denstply Sirona; Ballaigues, Switzerland) and WaveOne Gold Glider (Denstply Sirona; Ballaigues, Switzerland) glide path instruments.

Materials and methods

R-Pilot, ProGlider, and WaveOne Gold Glider instruments were collected (n = 15) and tested in a dynamic cyclic fatigue test device, which has an artificial canal with 60° angle of curvature and a 5-mm radius of curvature. All instruments were operated until fracture occurred, and both time to fracture (TF) and the lengths of the fractured fragments were recorded. Mean and standard deviations of TF and fragment length were calculated for each reciprocating system. TF data and fractured fragment length data were subjected to one-way ANOVA and post-hoc Tukey tests (P < 0.05). Also a Weibull analysis was performed on TF data.

Results

The cyclic fatigue resistance values of the WaveOne Gold Glider and R-Pilot were significantly higher than those of the ProGlider (P < 0.05), with no significant difference between them (P > 0.05). Weibull analysis revealed that WaveOne Gold Glider showed the highest predicted TF value for 99% survival rate, which was followed by R-Pilot and ProGlider. Regarding the length of the fractured tips, there were no significant differences among the instruments (P > 0.05).

Conclusions

The reciprocating WaveOne Gold Glider and R-Pilot instruments had significantly higher cyclic fatigue resistance than rotary ProGlider instruments.

Clinical relevance

This study reported that novel reciprocating glide path instruments exhibited higher cyclic fatigue resistance than rotating glide path instrument.

https://ift.tt/2C3LGSy

Double-blind, randomized controlled clinical trial on analgesic efficacy of local anesthetics articaine and bupivacaine after impacted third molar extraction

Abstract

Objective

The objective of this randomized controlled clinical trial (RCT) was to compare the effect of bupivacaine and articaine at habitual doses on pain intensity and the need for analgesics after lower third molar extraction.

Materials and methods

The final study sample comprised 50 Caucasian volunteers (26 males and 24 females; age range, 18–30 years) undergoing scheduled surgical extraction of impacted lower third molar. A computer-generated random sequence was used to allocate participants to the articaine (4%) or bupivacaine (0.5%) group. Surgeons and patients were blinded by labeling the articaine and bupivacaine carpules with numbers (1 and 2, respectively). Postoperative pain intensity (primary outcome) was evaluated with a visual analogue scale (VAS), while the requirement for and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes).

Results

VAS-measured pain intensity was significantly higher (p < 0.05) in the articaine group than in the bupivacaine group at all time points except for 8 h post-surgery (p = 0.052). Rescue medication was required by 13 (52%) patients in the articaine group and 8 (32%) patients in the bupivacaine group, although the difference did not reach statistical significance (p = 0.252). The groups did not significantly differ (p = 0.391) in the quality of the intraoperative anesthesia.

Conclusions

Bupivacaine is a valid alternative to articaine in third molar surgery and may offer residual anesthesia as a means of reducing postoperative pain. However, further well-designed RCTs are required in larger study populations to verify the effectiveness of bupivacaine to achieve residual analgesia after oral surgery.

Clinical relevance

These findings suggest that bupivacaine may be useful as a coadjuvant to control acute postoperative pain.

Trial registration

ACTRN12617001138370

https://ift.tt/2sBYFqQ

Oral health in Alzheimer’s disease: a multicenter case-control study

Abstract

Objectives

The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health.

Materials and methods

A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed.

Results

Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%).

Conclusions

After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality.

Clinical relevance

Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.

https://ift.tt/2PPKicY

The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study

Abstract

Objectives

Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children.

Materials and methods

A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children's Hospital. This study compared the period January 2010 through December 2012 when pharyngeal packing was applied according to local protocol (group A) with the period January 2013 till December 2015 when pharyngeal packing was no longer applied after removal from the protocol (group B). Data were collected for sex, age at operation, cleft lip/palate type, type of repair, lateral incisions, length of hospital stay, and complications in the first 6 weeks after surgery. Early complications included wound dehiscence, postoperative bleeding, infection, fever, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI).

Results

This study included 489 cleft lip/palate operations (group A n = 246, group B n = 243). A total of 39 (15.9%) early complications were recorded in group A and a total of 40 (16.5%) in group B. There were no significant differences (P = 0.902) in complications between the two groups; however, there was a significant difference (P < 0.001) in length of hospital stay between the two groups (group A 3.6 days vs group B 3.2 days).

Conclusion

Omitting routine placement of throat packs in cleft lip/palate surgery was not associated with an increased early postoperative complication rate. Therefore, the traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned.

Clinical relevance

The traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned.

https://ift.tt/2D9McOS

Influence of surface treatment on the performance of silorane-based composite resin in class I restorations: a randomized clinical trial

Abstract

Objectives

The aim of this study was to evaluate the clinical performance of silorane-based composite restorations applied after different surface treatments.

Materials and methods

This controlled and randomized clinical trial included 26 patients with class I restoration indications. The teeth were randomly assigned to the following treatments: control 1/G1, silorane specific self-etching adhesive (P90 self-etch primer and bond) + silorane-based composite resin (Filtek™ P90 low shrink posterior restorative); G2, 37% phosphoric acid + silorane specific self-etching adhesive + silorane-based composite resin; G3, blasting with aluminum oxide + silorane specific self-etching adhesive + silorane-based composite resin; and control 2/G4, self-etching adhesive (Adper™ SE Plus self-etch adhesive) + dimethacrylate-based composite resin (Filtek™ P60 posterior restorative). The clinical performance was evaluated at baseline and after 1 year.

Results

A total of 141 restorations were made and evaluated. For all clinical criteria evaluated, no significant difference was found between the surface treatments at baseline and after 1 year (p > 0.05). After 1 year, only the group with 37% phosphoric acid + silorane specific self-etching adhesive (G2) showed a significant reduction in marginal adaptation (p < 0.05).

Conclusion

In general, all surface treatments showed an adequate clinical performance for silorane-based composite resin in class I restorations. However, a reduction in the marginal adaptation after 1 year was found when additional phosphoric acid etching was used prior to silorane specific self-etching adhesive.

Clinical relevance

The use of phosphoric acid etching prior to specific self-etching adhesive can adversely affect the marginal adaptation of silorane-based restorations.

https://ift.tt/2Ez4Hhw

Effect of multiple autoclave cycles on the surface roughness of HyFlex CM and HyFlex EDM files: an atomic force microscopy study

Abstract

Aim

To compare the effect of autoclave cycles on the surface topography and roughness of HyFlex CM and HyFlex EDM instruments using atomic force microscopy (AFM) analysis.

Methodology

Eight new files of each brand were subdivided into four subgroups (n = 2/each subgroup). One group was allocated as the control group and not subjected to autoclave sterilization. The other three groups were subjected to different numbers (1, 5, and 10) of autoclave sterilization cycles. After the cycle instruments were subjected to AFM analysis. Roughness average (Ra) and the root mean square (RMS) values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way ANOVA and post hoc Tamhane tests at 5% significant level.

Results

The lowest Ra and RMS values were observed in the HyFlex EDM files that served as the control and in those subjected to a single cycle of autoclave sterilization (P < 0.05). The highest Ra and RMS values were observed in the HyFlex CM and HyFlex EDM files that were subjected to 10 cycles of autoclave sterilization (P < 0.05). The surface roughness values of the HyFlex CM group showed a significant increase after ten autoclave cycles, whereas those of the HyFlex EDM group exhibited a significant change after five autoclave cycles (P < 0.05).

Conclusions

Although the initial surface roughness values of the HyFlex EDM files were lower than those of the HyFlex CM files, the surface roughness values of the EDM files showed a statistically significant increase after 5 cycles of autoclave sterilization. In contrast, the surface roughness values of the HyFlex CM files did not increase until 10 cycles of autoclave sterilization.

Clinical relevance

Present study indicated that autoclave sterilization negatively affected the surface roughness of the tested NiTi files.

https://ift.tt/2GbzbCx

The potential association between periodontitis and non-alcoholic fatty liver disease: a systematic review

Abstract

Objectives

Many animal and human studies have shown associations between periodontitis and non-alcoholic fatty liver disease (NAFLD). Hence, the present systematic review sought to investigate such a potential association.

Methods

PubMed/Medline, Scopus, Embase, and Web of Science databases were thoroughly searched to identify all relevant studies. The eligibility criteria were all observational (cross-sectional studies, case-control, cohort studies, and case reports) and interventional studies that assessed the relationship between periodontitis and NAFLD in humans. Due to remarkable heterogeneity and inconsistency among the included studies, no statistical analyses were conducted.

Results

A total of 12 studies comprising 53,384 patients were included in the present systematic review. The sample size in the individual studies ranged from 52 to 24,470 patients. All studies except one found significant associations between clinical and/or microbial periodontal parameters and NAFLD. Eight studies found significant associations between clinical periodontal parameters and NAFLD. Four microbial studies found a significant association between periodontal pathogens, especially Porphyromonas gingivalis and NAFLD development and progression.

Conclusions

The available evidence suggests that periodontitis may be a risk factor for development and progression of NAFLD. However, due to limited number of prospective cohort studies included in this review along with the substantial heterogeneity among the included studies, further well-designed prospective cohort studies are highly warranted.

Clinical relevance

Given the potential association between periodontitis and NAFLD, it can be assumed that healthy periodontium may be essential for liver health.

https://ift.tt/2PHspwS

A randomized triple-blind crossover trial of a hydrocolloid-containing dentifrice as a controlled-release system for fluoride

Abstract

Objective

To evaluate retention of intraoral fluoride in biofilm and saliva, an experimental dentifrice containing hydrocolloid (tara gum) was used as a controlled-release system for fluoride (F).

Materials and methods

In a triple-blind randomized crossover trial with washout, 18 individuals used the following different dentifrices for a week: 100-TGF (sodium fluoride NaF associated with tara gum, 1100 mg/L), 50-TGF (50% NaF associated with tara gum + 50% free NaF, 1100 mg/L), PC (free NaF, 1100 mg/L), TG (with tara gum and without F), and placebo (without F or tara gum). On the seventh day of dentifrice use, biofilm was collected at 1 and 12 h, and saliva was collected up to 60 min and 12 h after the last toothbrushing. F concentrations were determined by physico-chemical analysis of fluoride using the hexamethyldisiloxane-facilitated diffusion technique. Data were subjected to two-way analysis of variance (repeated measures) and Spearman's correlation coefficient (p < 0.05) testing.

Results

No significant difference was observed with the same dentifrice regarding F retention in biofilm at 1 and 12 h after toothbrushing for the 100-TGF, placebo, and TG groups (p > 0.05). The highest area under the curve values in saliva were found for the 50-TGF, 100-TGF, and PC groups.

Conclusion

The dentifrice containing hydrocolloid as a controlled-release system for F promoted F retention in the oral cavity, even at 12 h after brushing.

Clinical relevance

Hydrocolloid added to dentifrices as a controlled-release system for F might contribute to a higher anti-caries effect.

Trial registration

NCT02809014

https://ift.tt/2D60hg6

Indoor phthalates from household dust in Qatar: implications for non-dietary human exposure

Abstract

Phthalates are ubiquitous semi-volatile organic compounds in the indoor environment present in various consumer products such as cosmetics, polyvinylchloride (PVC) flooring, food packing, and many others. Indoor phthalate concentrations were investigated in 15 buildings including 11 homes, 3 laboratories, and 1 from a hospital in Qatar. Dust samples were collected from vacuum cleaning bags usually used for cleaning homes, labs, and hospitals. The main objectives of this study was to determine the occurrence and concentration of phthalates in dust in Qatar and consequently to estimate the non-dietary human exposure. Eleven phthalates was analyzed. The major identified phthalate compounds at homes in Qatar were bis(2-ethylhexyl) phthalate unlabeled (DEHP) and diisononyl phthalate (DINP) at a geometric mean of 288 μg/g (median 395 μg/g) and 106 μg/g (median 101 μg/g) accounting for 57% and 23% of the total measured phthalates, respectively. The major phthalate compounds found in the first lab building were DEHP and DINP with a median of 4861 μg/g and 943 μg/g, respectively, accounting for 82% and 16% of the total phthalates. For the second lab building, the major phthalates were DEHP with a median of 466 μg/g, accounting for 20% of the total phthalates measured, and DINP median of 1725 μg/g, accounting for 71% of the total measured phthalates. The dust sample tested from hospital building had DEHP as the major phthalate compound with a median of 793 μg/g, accounting for 4.0% of the total measured phthalates, and DINP with a median of 19,626 μg/g, accounting for 94%. The estimated human non-dietary exposure for children, adults, and toddlers was based on phthalate concentrations (median) and found to be 225 ng/kg bw/day for children, 2328 ng/kg bw/day for adults, and 2099 ng/kg bw/day for toddlers.

https://ift.tt/2JJY5fB

Raman characterization of human skin aging

Abstract

Background

Skin aging is a complex biological process mixing intrinsic and extrinsic factors, such as sun exposure. At the molecular level, skin aging affects in particular the extracellular matrix proteins.

Materials and Methods

Using Raman imaging, which is a nondestructive approach appropriate for studying biological samples, we analyzed how aging modifies the matrix proteins of the papillary and reticular dermis. Biopsies from the buttock and dorsal forearm of volunteers younger than 30 and older than 60 were analyzed in order to identify chronological and photoaging processes. Analyses were performed on skin section, and Raman spectra were acquired separately on the different dermal layers.

Results

We observed differences in dermal matrix structure and hydration state with skin aging. Chronological aging alters in particular the collagen of the papillary dermis, while photoaging causes a decrease in collagen stability by altering proline and hydroxyproline residues in the reticular dermis. Moreover, chronological aging alters glycosaminoglycan content in both dermal compartments.

Conclusion

Alterations of the papillary and reticular dermal matrix structures during photo‐ and chronological aging were clearly depicted by Raman spectroscopy.

https://ift.tt/2qAmxqJ

Pathological complete response after neoadjuvant pembrolizumab and radiation

https://ift.tt/2FbAjub

Syringocystadenoma Papilliferum of the Anogenital Area and Buttocks: A Report of 16 Cases, Including Human Papillomavirus Analysis and HRAS and BRAF V600 Mutation Studies

Abstract: Syringocystadenoma papilliferum (SCAP) is a benign tumor most commonly located on the head and neck area often associated with nevus sebaceus. In its usual location, the human papillomavirus (HPV) DNA and mutations in the RAS/mitogen-activated protein kinase signaling pathway have been detected in SCAP. We studied 16 cases of SCAP in the anogenital areas and buttock where this neoplasm is rare and attempted to find out whether SCAP in these sites have different histopathological and molecular biological features. It seems that there is no significant difference between the morphology of anogenital SCAP and SCAP in other locations. Several tumors in our cohort demonstrated features resembling those seen in warts, but HPV DNA was not found in these lesions. On the contrary, we identified DNA of HPV high-risk types in some tumors without HPV-related morphology. Our study confirms the role of HRAS and BRAF V600 mutations in the pathogenesis of SCAP, including SCAP in the anogenital areas and buttock. Correspondence: Dmitry V. Kazakov, MD, PhD, Sikl's Department of Pathology, Charles University Medical Faculty Hospital, Alej Svobody 80, 304 60 Pilsen, Czech Republic (e-mail: kazakov@medima.cz). Supported in part by the Charles University Research Fund (Project number SVV-2018 - 260 391). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2JKHM21

Examination of Tar-Induced Verrucous Growths Reveals Absence of Human Papillomavirus

No abstract available

https://ift.tt/2SSMCOY

Neutropenic Fever and a Diffuse Hyperpigmented Papular Rash: Challenge

No abstract available

https://ift.tt/2JLbjIS

Cytoimmunofluorescence Diagnosis in Surgically Induced Pemphigus Foliaceus

Abstract: Pemphigus foliaceus is an autoimmune bullous disease with autoantibodies against desmoglein 1. Case reports of pemphigus after surgery have also been described, which may simulate an infection of the surgical wound, a contact dermatitis, or even a tumor recurrence. Cytoimmunofluorescence can help to establish a rapid diagnosis. Correspondence: Jorge Magdaleno-Tapial, MD, Department of Dermatology, Hospital General Universitario de Valencia, Avenue Tres Creus, 2, 46014 Valencia, Spain (e-mail: jormagta@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2SSnQyw

Multiple Pilomatricomas: A Retrospective Study and Literature Review

Abstract: Pilomatricoma is usually a single lesion. However, some patients present with more than one, a fact that has been reported in association with several systemic diseases. The aim of this analysis is to determine the prevalence of multiple pilomatricomas (MP) in our institution as well as to describe their clinical features and associated comorbidities. This is a retrospective analysis reviewing patients with a histological diagnosis of pilomatricoma registered in the database of the Pathology Department of our institution, from January 2005 to March 2017. One hundred ninety-five patients with histological criteria for pilomatricoma were registered. Fourteen (0.7%) of those patients suffered from MP. Among them, the most relevant findings were: 9 (64%) patients were women and 5 (36%) were men. The median age at diagnosis was 16 years. Seven (50%) had 2 pilomatricomas and 7 (50%) had more than 2. Two (14%) suffered from Steinert myotonic dystrophy (SMD). Regarding family background, 3 of them had relatives with pilomatricomas, one of them with pancreatic cancer, and another one with SMD. A total of 36 pilomatricomas were excised from those 14 patients with the following characteristics: The mean lesion size was 12 mm. The majority of the lesions (53%) were located on the head and neck. There was no recurrence or malignant transformation in any patient. Articles reporting on MP are scarce. We communicate 2 new familial MP without associated comorbidities. We would like to highlight that 2 of our patients with MP also developed SMD, an association previously reported. Thus, a thorough physical examination and inquiring about family history are of utmost importance for an early diagnosis of possible associated diseases. Correspondence: Laura Mesa-Álvarez, MD, Dermatology Department, Pontevedra University Hospital, EOXI, c/Simón Bolivar (Mollabao), s/n 36003, Pontevedra, Spain (e-mail: l.mesa.alvarez@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2JLbaoO