Efficacy of two plant extracts against acne vulgaris: Initial results of microbiological tests and cell culture studies

Summary

Background

Acne vulgaris is a common skin disease characterized by increased sebum production, inflammation, and colonization of Propionibacterium acnes (P. acnes) on pilosebaceous follicles.

Aims

To determine the efficacy of two different plant extracts against P. acnes and to analyze the gene expression levels of IL‐1α, SRD5A1, and TNFα in HaCaT cells treated with these plant extracts.

Methods

Anti‐acne extract 1 (AE1) consisted of Juglans regia (walnut husk), Myrtus communis (myrtle leaves), Matricaria chamomilla (chamomilla flowers), Urtica dioica (stinging nettle leaves), and Rosa damascena (rose flowers). Anti‐acne extract 2 (AE2) contained Brassica oleracea var. botrytis (broccoli) and B. oleracea var. italica (cauliflower). The antimicrobial activities of the extracts were tested on two different P. acnes strains: the reference strain of P. acnes (ATCC 51277) and the clinical isolate from a patient. The minimum inhibitory concentration (MIC) of the extracts was determined using the broth dilution method. Human keratinocyte cells were used for in vitro tests. Gene expression analyses were performed with RT‐qPCR.

Results

The MIC values of the extracts were below 1/2048 µg/mL. In the gene expression analysis, AE1 increased the expression level of TNFα (1.1719, P < 0.0001), suppressed the expression level of IL‐1α, SRD5A1 (0.0588, P = 0.0231; 0.3081, P = 0.0351), respectively. AE2 suppressed gene expression level of IL‐1α, SRD5A1, TNFα (0.3815, P = 0.0254; 0.3418, P = 0.0271; 0.1997, P = 0.0623).

Conclusions

Both herbal extracts demonstrated strong antibacterial and anti‐inflammatory activity in this preliminary trial. In conclusion, the topical application of these botanical extracts can be good candidates for local acne treatment.

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Bacterial self-defense antibiotics release from organic-inorganic hybrid multilayer films for long-term anti-adhesion and biofilm inhibition properties.

Related Articles

Bacterial self-defense antibiotics release from organic-inorganic hybrid multilayer films for long-term anti-adhesion and biofilm inhibition properties.

Nanoscale. 2017 Dec 14;9(48):19245-19254

Authors: Xu Q, Li X, Jin Y, Sun L, Ding X, Liang L, Wang L, Nan K, Ji J, Chen H, Wang B

Abstract
Implant-associated bacterial infections pose serious medical and financial issues due to the colonization and proliferation of pathogens on the surface of the implant. The as-prepared traditional antibacterial surfaces can neither resist bacterial adhesion nor inhibit the development of biofilm over the long term. Herein, novel (montmorillonite/poly-l-lysine-gentamicin sulfate)8 ((MMT/PLL-GS)8) organic-inorganic hybrid multilayer films were developed to combine enzymatic degradation PLL for on-demand self-defense antibiotics release. Small molecule GS was loaded into the multilayer films during self-assembly and the multilayer films showed pH-dependent and linear growth behavior. The chymotrypsin- (CMS) and bacterial infections-responsive film degradation led to the peeling of the films and GS release. Enzyme-responsive GS release exhibited CMS concentration dependence as measured by the size of the inhibition zone and SEM images. Notably, the obtained antibacterial films showed highly efficient bactericidal activity which killed more than 99.9% of S. aureus in 12 h. Even after 3 d of incubation in S. aureus, E. coli or S. epidermidis solutions, the multilayer films exhibited inhibition zones of more than 1.5 mm in size. Both in vitro and in vivo antibacterial tests indicated good cell compatibility, and anti-inflammatory, and long-term bacterial anti-adhesion and biofilm inhibition properties.

PMID: 29188848 [PubMed - indexed for MEDLINE]

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Protecting Patient Privacy in Narratives: The Lifespan‐Brown Checklist for Appropriate Use of Patient Narratives

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Capecitabine and Temozolomide as a Promising Therapy for Advanced Thymic Atypical Carcinoid

AbstractBackground.Thymic atypical carcinoid (TAC) is a rare thymic neuroendocrine tumor that originates in the neuroendocrine system and lacks a standardized treatment. The combination of capecitabine (CAP) and temozolomide (TEM) is associated with an extremely high and long‐lasting response rate in patients with metastatic pancreatic neuroendocrine tumors. However, there is little evidence showing that the CAPTEM regimen is effective for TAC. For patients with unresectable or metastatic atypical carcinoid of the thymus, few treatment options are available, and the treatment efficacy is not satisfactory. To explore the efficacy and safety of the CAPTEM regimen against TAC, we conducted a retrospective review.Patients and Methods.A total of nine patients with advanced atypical carcinoid of the thymus in the China‐Japan Friendship Hospital were treated with capecitabine (750 mg/m2 twice daily, days 1–14) and temozolomide (200 mg/m2 once daily, days 10–14) every 28 days between 2014 and 2018. The disease control rate (DCR), progression‐free survival (PFS), and adverse effects after treatment were analyzed. The DCR was calculated by RECIST version 1.1. Progression‐free survival was calculated by the Kaplan‐Meier survival method.Results.A total of nine patients (six male and three female) were included. The median age at CAPTEM initiation was 50 years (range, 26–58). The median number of CAPTEM cycles was 8 (range, 3–23). The DCR was 89% (8/9), with eight patients achieving stable disease. Only one patient (11%) showed progressive disease. The median PFS was 8 months. Because we applied vitamin B6 and ondansetron before administering the drugs, the side effects of this regimen were very small. Adverse reactions were all below grade 3 and included myelosuppression and digestive tract reaction.Conclusion.Our results suggest that the CAPTEM regimen may be effective and well tolerated for the treatment of TAC. More evidence is needed to validate the effectiveness of this regimen.Implications for Practice.Capecitabine and temozolomide regimen is effective and well tolerated in patients with advanced thymic atypical carcinoid.

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First‐in‐Human Phase I Study of MBC‐11, a Novel Bone‐Targeted Cytarabine‐Etidronate Conjugate in Patients with Cancer‐Induced Bone Disease

AbstractLessons Learned. Results are consistent with MBC‐11 targeting and treating cancer‐induced bone lesions by concentrating cytarabine and etidronate at the site of disease.MBC‐11 was well tolerated, with an maximum tolerated dose of 5 mg/kg per day and myelosuppression as the principal toxicity.Treatment significantly reduced cancer cell activity in over half of bone lesions detected at baseline.MBC‐11 pharmacokinetic and pharmacodynamic parameters are consistent with the novel drug design goals, and encouraging results warrant further clinical development.Background.MBC‐11 is a first‐in‐class conjugate of the bone‐targeting bisphosphonate etidronate covalently linked to the antimetabolite cytarabine (araC). This first‐in‐human phase I dose escalation study assessed safety, tolerability, maximum tolerated dose (MTD), plasma pharmacokinetics, bone turnover, tumor biomarkers, and bone lesion activity by fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG‐PET/CT) imaging.Methods.Fifteen patients with advanced solid cancers and cancer‐induced bone disease (CIBD) were treated with 0.5–10 mg/kg per day of MBC‐11 administered daily for 5 days of every 4 weeks for up to four cycles.Results.Grade 1–2 myelosuppression, involving all lineages, was the principal toxicity. Two of three patients treated with 10 mg/kg experienced dose‐limiting grade 4 neutropenia and thrombocytopenia (adverse event [AE] duration ≤5 days); the MTD was 5 mg/kg. Four of five patients with pretreatment elevations of the bone resorption marker TRAP5b (tartrate resistant acid phosphatase‐5b) had persistent decrements. Six of 13 patients who reported baseline pain noted a reduction after MBC‐11. 18F‐FDG‐PET/CT imaging demonstrated partial metabolic responses in three patients and stable metabolic responses in three other patients. SUVmax (standard unit of emission normalized to total uptake) was reduced by at least 25% in 110 (52%) of 211 bone lesions. Significant activity was noted across all doses, and myelosuppression increased with dose.Conclusion.At MBC‐11 doses that were well tolerated, substantial reductions in metabolic activity of bone‐associated cancer cells provide a foundation for further disease‐directed efficacy studies.

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Eribulin Mesylate as Third or Subsequent Line Chemotherapy for Elderly Patients with Locally Recurrent or Metastatic Breast Cancer: A Multicentric Observational Study of GIOGer (Italian Group of Geriatric Oncology)‐ERIBE

AbstractBackground.Metastatic breast cancer (MBC) is highly prevalent in middle‐aged or elderly patients. Eribulin is a nontaxane microtubule inhibitor, approved for the treatment of pretreated MBC. This multicentric study (sponsored by GIOGer, Italian Group for Geriatric Oncology) was designed to assess the efficacy and tolerability of eribulin, according to parameters usually used in geriatric oncology.Subjects, Materials, and Methods.An observational study was conducted on 50 consecutive elderly patients with MBC. The primary endpoint was to evaluate the change in items score of comprehensive geriatric assessment (CGA) and health‐related quality of life (HRQL). Italian versions of the CGA and HRQL questionnaires were administered at baseline, before the third and fifth cycles, and then every three cycles until treatment discontinuation. Secondary endpoints were efficacy and safety.Results.Overall, both EQ‐5D scores and EQ‐5D‐3 L visual analogic scale did not significantly change from baseline; the percentage of subjects without problems doing usual activities tended to decrease during treatment (p for linear trend .018), and the percentage of patients with minor problems performing usual activities tended to increase (p for linear trend.012). Among CGA items, Instrumental Activities of Daily Living tended to decrease during treatment and Geriatric Depression Scale tended to increase. After 12 months follow‐up, 24 patients (out of 47) showed clinical benefits; median progression‐free survival was 4.49 months (2.10–10.33) and median OS was 7.31 months (3.70–14.03). The treatment was associated with mild toxicity.Conclusion.Eribulin treatment preserved quality of life and geriatric parameters included in the CGA, except for instrumental functioning and geriatric depression, in elderly patients with MBC.Implications for Practice.A collaboration between oncologist and geriatric specialists is essential in the management of patients with metastatic breast cancer, who are frequently elderly or frail. The assessment of geriatric parameters in the decision‐making process can contribute to direct toward the most appropriate therapeutic plan and preserve the quality of life of patients. Eribulin does not seem to affect quality of life or worsen the overall geriatric status; therefore, it can be considered a suitable option for elderly patients with metastatic breast cancer.

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Characterization of Comorbidities Limiting the Recruitment of Patients in Early Phase Clinical Trials

AbstractBackground.Early phase clinical trials evaluate the safety and efficacy of new treatments. The exclusion/inclusion criteria in these trials are usually rigorous and may exclude many patients seen in clinical practice. Our objective was to study the comorbidities limiting the participation of patients with breast, colorectal, or lung cancer in clinical trials.Materials and Methods.We queried ClinicalTrials.gov on December 31, 2016. We reviewed the eligibility criteria of 1,103 trials. Logistic regression analyses were completed, and exclusion was studied as a binary variable.Results.Out of 1,103 trials, 70 trials (6%) excluded patients >75 years of age, and 45% made no reference to age. Eighty‐six percent of trials placed restrictions on patients with history of prior malignancies. Regarding central nervous system (CNS) metastasis, 416 trials (38%) excluded all patients with CNS metastasis, and 373 (34%) only allowed asymptomatic CNS metastasis. Regarding chronic viral infections, 347 trials (31%) excluded all patients with human immunodeficiency virus, and 228 trials (21%) excluded all patients with hepatitis B or C infection. On univariate analysis, chemotherapy trials were more likely to exclude patients with CNS metastasis and history of other malignancies than targeted therapy trials. Multivariate analysis demonstrated that industry‐sponsored trials had higher odds of excluding patients with compromised liver function.Conclusion.Many clinical trials excluded large segments of the population of patients with cancer. Frequent exclusion criteria included patients with CNS metastasis, history of prior malignancies, and chronic viral infections. The criteria for participation in some clinical trials may be overly restrictive and limit enrollment.Implications for Practice.The results of this study revealed that most early phase clinic trials contain strict exclusion criteria, potentially excluding the patients who may be more likely to represent the population treated in clinical settings, leaving patients susceptible to unintended harm from inappropriate generalization of trial results. Careful liberalization of the inclusion/exclusion criteria in clinical trials will allow investigators to understand the benefits and drawbacks of the experimental drug for a broader population, and possibly improve recruitment of patients with cancer into clinical trials.

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Immune Checkpoint Inhibitors and the Risk of Allograft Rejection: A Comprehensive Analysis on an Emerging Issue

AbstractBackground.It is well known that the state of immune tolerance induced by broad immunosuppression to prevent allograft rejection leads to an increased risk of the development of cancer. One of the most promising new areas of cancer treatment has been the development of immune checkpoint inhibitors that target the cytotoxic T‐lymphocyte‐associated antigen 4 and programmed cell death protein 1/programmed death‐ligand 1 (PD‐L1) pathways. As a logical consequence, growing interest in these agents translated into their implementation in patients with transplant‐related malignancies. Because of overlapping and perhaps mutually exclusive mechanisms of action of transplant immunosuppression and cancer immunomodulation, it is critical to examine these interactions.Materials and Methods.We carried out a systematic search for review articles and case reports published between July 2014 and November 2017 using three engines: Usearch, PubMed, and Up‐to‐date.Results.Overall, there were 20 cases with 12 allograft rejections. The rejection rate associated with nivolumab was 73% (8/11) and with pembrolizumab it was 100% (2/2). The use of ipilimumab did not lead to rejection in any instance (0/4, 0%). Of the two patients treated with the sequential use of ipilimumab/nivolumab, one lost his allograft, yielding a rejection rate of 50%. The sequential use of ipilimumab/pembrolizumab led to a rejection rate of 100% (1/1, 100%).Conclusion.The use of agents that act on the PD‐L1 pathway are contraindicated in the face of solid organ allografts because of unacceptably high rates of irreversible allograft rejection. It appears that the use of ipilimumab may be tolerated as the mechanism is different from that of the PD‐L1 agents.Implications for Practice.Transplant rejection is a complex process that puts stress on patients and their families and can lead to tragic results. Significant advancements in the field of immunosuppression have led to the engenderment of agents devised to extend the survival of transplant recipients. The advent of immunomodulators in cancer therapy has been paradigm‐shifting; however, because of their mechanism of action, their use must be carefully considered in patients with allografts and concomitant cancer. It appears that ipilimumab can be administered safely in these patients but that agents acting on the programmed death‐ligand 1 pathway are contraindicated because of high rates of irreversible rejection.

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SMAD4 Mutation in Small Cell Transformation of Epidermal Growth Factor Receptor Mutated Lung Adenocarcinoma

AbstractThe large screening of exons 18 to 21 of the epidermal growth factor receptor (EGFR) gene may lead to the discovery of rare, atypical molecular alterations for which the sensitivity to tyrosine kinase inhibitors (TKIs) remains uncertain. We are reporting a rare exon 18 EGFR mutation (p.E709_710 > D) that confers sensitivity to second‐generation EGFR TKI (afatinib), lasting for 1 year. Tumor progression biopsy showed small cell lung cancer transformation, associated with a SMAD4 mutation.Key Points. A rare exon 18 epidermal growth factor receptor mutation with sensitivity to afatinib is reported.Small cell transformation was observed at tumor progression.Acquisition of a SMAD4 mutation was observed at tumor progression.

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“As Long as You Ask”: A Qualitative Study of Biobanking Consent—Oncology Patients’ and Health Care Professionals’ Attitudes, Motivations, and Experiences—the B‐PPAE Study

AbstractIntroduction.Consent to biobanking remains controversial, with little empirical data to guide policy and practice. This study aimed to explore the attitudes, motivations, and concerns of both oncology patients and health care professionals (HCPs) regarding biobanking.Materials and Methods.Qualitative interviews were conducted with oncology patients and HCPs purposively selected from five Australian hospitals. Patients were invited to give biobanking consent as part of a clinical trial and/or for future research were eligible. HCPs were eligible if involved in consenting patients to biobanking or to donate specimens to clinical trials.Results.Twenty‐two patients participated, with head and neck (36%) and prostate (18%) the most common cancer diagnoses; all had consented to biobanking. Twenty‐two HCPs participated, from across eight cancer streams and five disciplines. Themes identified were (a) biobanking is a "no brainer"; (b) altruism or scientific enquiry; (c) trust in clinicians, science, and institutions; (d) no consent—just do it; (e) respecting patient choice ("opt‐out"); (f) respectful timing of the request; (g) need for emotional/family support; (h) context of the biobanking request matters; and (i) factors for biobanking success.Discussion.These findings reinforced previous findings regarding high public trust in, and support for, biobanking. An initial opt‐in consent approach with the option of later opt‐out was favored by patients to respect and recognize donor generosity, whereas HCPs preferred an upfront opt‐out model. Factors impacting biobanking success included the context of the request for use in a trial or specific research question, pre‐existing patient and HCP rapport, a local institution champion, and infrastructure.Implications for Practice.Patients and health care professionals (HCPs) who experienced cancer biobanking consent were overwhelmingly supportive of biobanking. The motivations and approaches to seeking consent were largely mirrored between the groups. The findings of this study support the opt‐in model of biobanking favored by patients; however, HCPs preferred an opt‐out model. Both groups recognize the importance of making the request for biobanking at an appropriate time, preferably with emotional or family support, and respecting the timing of the request and privacy of the patient. Biobanking success can be promoted by hospital departments with a research focus by identifying an institutional biobanking champion and ensuring local infrastructure is available.

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Graphical Abstracts

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Meet Our Editorial Board Member

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Metabolic Stress and Inflammation: Implication in Treatment for Neurological Disorders

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Diabetes Mellitus to Neurodegenerative Disorders: Is Oxidative Stress Fueling the Flame?

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Hydrogen Sulfide in Physiological and Pathological Mechanisms in Brain

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Single-chain Fv Antibodies for Targeting Neurodegenerative Diseases

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Nutrition and Nutraceuticals in Neuroinflammatory and Brain Metabolic Stress: Implications for Neurodegenerative Disorders

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Oxidative Stress: Major Threat in Traumatic Brain Injury

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Autophagy and Mitochondria: Targets in Neurodegenerative Disorders

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Dehydroepiandrosterone (DHEA) for Depression: A Systematic Review and Meta-Analysis

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Bioinformatic Analysis Reveals Key Genes and Pathways in Aging Brain of Senescence-accelerated Mouse P8 (SAMP8)

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Characteristics and Follow-Up of 13 pedigrees with Gitelman syndrome

Abstract

Context

Gitelman syndrome (GS) is clinically heterogeneous. The genotype and phenotype correlation has not been well established. Though the long-term prognosis is considered to be favorable, hypokalemia is difficult to cure.

Objective

To analyze the clinical and genetic characteristics and treatment of all members of 13 GS pedigrees.

Methods

Thirteen pedigrees (86 members, 17 GS patients) were enrolled. Symptoms and management, laboratory findings, and genotype–phenotype associations among all the members were analyzed.

Results

The average ages at onset and diagnosis were 27.6 ± 10.2 years and 37.9 ± 11.6 years, respectively. Males were an average of 10 years younger and exhibited more profound hypokalemia than females. Eighteen mutations were detected. Two novel mutations (p.W939X, p.G212S) were predicted to be pathogenic by bioinformatic analysis. GS patients exhibited the lowest blood pressure, serum K⁺, Mg²⁺, and 24-h urinary Ca²⁺ levels. Although blood pressure, serum K⁺ and Mg²⁺ levels were normal in heterozygous carriers, 24-h urinary Na⁺ excretion was significantly increased. During follow-up, only 41.2% of patients reached a normal serum K⁺ level. Over 80% of patients achieved a normal Mg²⁺ level. Patients were taking 2–3 medications at higher doses than usual prescription to stabilize their K⁺ levels. Six patients were taking spironolactone simultaneously, but no significant elevation in the serum K⁺ level was observed.

Conclusion

The phenotypic variability of GS and therapeutic strategies deserve further research to improve GS diagnosis and prognosis. Even heterozygous carriers exhibited increased 24-h Na⁺ urine excretion, which may make them more susceptible to diuretic-induced hypokalemia.

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CD8‐positive Pseudolymphoma in Lues maligna and HIV with monoclonal TCR‐beta rearrangement

A 42‐year‐old Caucasian man suffered from disseminated plaques and ulcerated nodules for six weeks. He had weight loss and generalized lymphadenopathy. Underlying diseases were not known up till then. Based on a skin biopsy the diagnosis of CD8‐positive cutaneous T‐cell lymphoma, type mycosis fungoides was made in a pathological reference center for lymphoma. A reproducible TCR‐beta rearrangement was detectable. Before starting therapy, a new biopsy was taken and the previous diagnosis was re‐evaluated taking clinical images and symptoms into account. Based on both, the diagnosis of a CD8+ pseudolymphoma in lues maligna and HIV was made.

We highlight histopathologic clues for the correct diagnosis, and we emphasize the indispensability of clinical‐pathological correlation. Furthermore, we discuss the differential diagnosis of CD8+ lymphoproliferative disorders.

This article is protected by copyright. All rights reserved.

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Eosinophilic dermatosis of hematologic malignancy: Correlation of molecular characteristics of skin lesions and extracutaneous manifestations of hematologic malignancy

Background

Skin diseases are frequent in patients with chronic lymphocytic leukemia and other hematological neoplasias. Eosinophilic dermatosis of hematologic malignancy (ED) has long been considered a nonspecific cutaneous reaction pattern. Recently neoplastic cells have been shown to be present in ED thus challenging the classification as a nonspecific dermatosis.

Methods

We report 5 patients with ED in association with chronic lymphocytic leukemia (CLL). We further investigated the presence of neoplastic B‐cells in the skin infiltrate by immunohistochemistry and immunoglobulin heavy chain rearrangement and compared these to extracutaneous manifestations of CLL.

Results

The phenotype of the lymphocytic infiltrate was predominately CD3+ (range: 60‐90%). CD20+ and CD79a+ lymphocytes were less frequent accounting for up to 15% (range: absent – 15%). CD23+ lymphocytes represented up to 20% (range: absent – 20%) of the infiltrate. The analysis of the immunoglobulin heavy chain rearrangement in the skin specimens showed clonal rearrangements in 4/5 patients and in 3 of these 4 patients clones were identical to extracutaneous CLL manifestations.

Conclusion

Our data show that neoplastic B‐cells are very frequently found in ED when systematically evaluated. This findings support the hypothesis that leukemic cells play a pathogenetic role in eosinophilic dermatosis of hematologic malignancy.

This article is protected by copyright. All rights reserved.

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Primavera: A new therapeutical approach to vulvo‐vaginal atrophy

Abstract

Vulvovaginal atrophy is a condition that affects women, although it is mainly associated with the onset of menopause mainly due to hormonal changes vulvovaginal laxity and mucosal atrophy can also affect women at different life stages such as after pregnancy or for cancer patients who have undergone chemo or endocrine therapy. This condition negatively influence quality of life, sexual desire, and self‐confidence. Many therapies have been considered mainly with inconclusive or transient results in terms of benefit factor. Recently, a new non‐invasive product, containing hyaluronic acid, oligopeptides, and antioxidants was introduced to the market. Its name is "Primavera," by Renaissance, Italy. The aim of this product is to allow a vulvo‐vaginal biostimulation and considered simple, safe, and satisfactory.

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Performance of a constructed wetland as an upstream intervention for stormwater runoff quality management

Abstract

In most developing countries, stormwater runoff has had significant impacts on aquatic environment by directly causing pollution of receiving water and reduction in treatment performance of wastewater treatment plants. With increasing encroachment on natural wetlands in Uganda, constructed wetlands offer a feasible option for the environment to cope up and buffer the impact of pollutants from the ever-increasing urban masses. This study investigated the performance efficiencies of three configurations (varied by the substrate used) of microcosm wetlands to remove physicochemical parameters from stormwater runoff in Uganda. The parameters monitored included chemical oxygen demand (COD), total suspended solids (TSS), total nitrogen (TN), and total phosphorus (TP). Hydraulic retention times (HRTs) of 2, 4, 6, and 8 days were studied. The mean concentrations of the physicochemical parameters in the runoff were 219.4 ± 12.8 mg/L COD, 77.4 ± 8.3 mg/L TSS, 9.0 ± 0.4 mg/L TN, and 1.6 ± 0.1 mg/L TP. Configuration A, vegetated with cattail (Typha latifolia) and bulrush (Scirpus lacustris), achieved maximum COD removal of 75.9% (HRT = 6 days), TN removal of 72.8% (HRT = 8 days), and TP removal of 62.8% (HRT = 8 days). Configuration C, the control, with no substrate, achieved the highest TSS removal of 75.6%. The results suggest that vegetated microcosm constructed wetlands can potentially be used to pre-treat stormwater within the catchment. However, an upstream sedimentation process unit is required to enhance their performance and to avoid premature clogging of the wetlands by TSS. The pre-treated stormwater reduces pollutant load into wastewater treatment plants and consequently better raw water quality for water treatment plants.

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Greenhouse gas emissions vary in response to different biochar amendments: an assessment based on two consecutive rice growth cycles

Abstract

The efficiency of biochar to mitigate greenhouse gas (GHG) emission from rice paddy soils is not consistent. Furthermore, which factor dominates this mitigation efficiency is not clear. In the present 2-year greenhouse experiment, the effects of biochars derived from two feedstocks (wheat straw and saw dust) and two pyrolysis temperatures (500 °C and 700 °C), and applied at two different rates (0.5 wt% and 3 wt%) on methane (CH₄) and nitrous oxide (N₂O) emissions, and the total global warming potential (GWP_t), and GHG intensity (GHGI) were measured. The results showed that biochar applications did not alter GHG emission flux patterns in either rice cycle. In 2015, the N₂O emissions were 24.6–71.2% lower under six biochar treatments than under the urea control treatment. Moreover, total CH₄ emissions were mitigated by 13.3–92.6% and 27.7–53.5% under six and five biochar treatments in 2015 and 2016, respectively. Overall, lower GWP_t and GHGI were observed under most of the biochar treatments compared with the urea control treatment in both rice cycles. The multivariate analysis of variance (MANOVA) results of the data from both years suggested that the biochar effects on reducing GHG emissions changed with either individual factors or their interactive effects. The responses of the GWP_t and GHGI varied mainly with biochar application rate and pyrolysis temperature (P < 0.005); compared with that derived from a relatively low pyrolysis temperature and applied at a relatively low rate, biochar derived from a relatively high pyrolysis temperature and applied at a relatively high rate exerted relatively higher GWP_t and GHGI mitigation efficiencies. The influence of the feedstock source was not as prominent as the application rate and pyrolysis temperature, which will expand the scope of biochar applications.

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Monitoring polychlorinated dibenzo-p-dioxins/dibenzofurans and dioxin-like polychlorinated biphenyls in Africa since the implementation of the Stockholm Convention—an overview

Abstract

Polychlorinated dibenzo-p-dioxin (PCDDs), polychlorinated dibenzofurans (PCDF), and dioxin-like polychlorinated biphenyl (dl-PCB) are groups of toxic compounds released into the environment as unintentional by-products of combustion. They persist, bioaccumulate through the food chain, and cause adverse health effects. This review attempts to collate available information on the release of PCDD/Fs and dl-PCBs and other critical data relevant to their monitoring in Africa during the existence of the Stockholm Convention (SC). Much as the implementation of the SC may be lagging, literature showed that there has been encouraging efforts that have been made with respect to PCDDs/Fs and dl-PCBs monitoring in Africa. Results from a global monitoring study showed that PCDD/Fs released to air in Africa stood at 18–532 fg WHO₉₈ TEQ/M³ while dl-PCBs were 7–278 fg WHO₉₈ TEQ/m³. In human milk, the total concentration of PCDD/Fs, i.e., WHO 2005 TEQ LB has been reported to range from 0.5 ng/g fat to 12 ng/g fat. Fourteen laboratories in Africa participated in inter-laboratory assessments of persistent organic pollutants (POPs) with two specifically for PCDD/Fs analysis. This shows that some efforts are being made to boost capacity in Africa. Levels of PCDDs/Fs and dl-PCBs in clay consumed by pregnant women have been reported in Cameroon, Democratic Republic of Congo (DRC), Nigeria, Zimbabwe, Ĉote d'Ivoire, and Uganda with a maximum concentration of 103 pg TEQ/g. This finding was very significant since women are the most impacted through exposure to POPs, a fact that is acknowledged by the SC.

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ID Proteins May Reduce Aggressiveness of Thyroid Tumors

Abstract

ID genes have an important function in the cell cycle, and ID proteins may help identify aggressive tumors, besides being considered promising therapeutic targets. However, their role in thyroid tumors is still poorly understood. We examined ID expression and their correlation with diagnostic and prognostic features aiming to find a clinical application in differentiated thyroid carcinoma (DTC) cases. mRNA levels of ID1, ID2, ID3, and ID4 genes were quantified and their expression was observed by immunohistochemistry in 194 thyroid samples including 68 goiters, 16 follicular adenomas, 75 classic papillary thyroid carcinomas, 18 follicular variants of papillary thyroid carcinoma, 5 follicular thyroid carcinomas, and 1 anaplastic thyroid cancer, besides 11 normal thyroid tissues. DTC patients were managed according to standard protocols and followed up for M = 28 ± 16 months. ID2, ID3, and ID4 mRNA levels were higher in benign (2.0 ± 1.9; 0.6 ± 0.6; and 0.7 ± 1.0 AU, respectively) than those in malignant nodules (0.30 ± 0.62; 0.3 ± 0.3; and 0.2 ± 0.3 AU, respectively, p < 0.0001 for all three genes) and were associated with no extra thyroid invasion or metastasis at diagnosis. ID3 nuclear protein expression was higher in benign than that in malignant cells (5.2 ± 0.9 vs 3.0 ± 1.8 AU; p < 0.0001). On the contrary, the cytoplasmic expression of ID3 was higher in malignant than that in benign lesions (5.7 ± 1.5 vs 4.0 ± 1.4 AU; p < 0.0001). Our data indicate that ID genes are involved in thyroid tumorigenesis and suggest these genes act impeding the evolution of more aggressive phenotypes. The different patterns of their tissue expression may help identify malignancy and characterize thyroid lesion aggressiveness.

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Systematic review of outcomes and complications in non-implant based mastopexy surgery

Mastopexy is one of the most performed cosmetic surgery procedures in the U.S. Numerous studies of mastopexy techniques have been published in the past decades including case reports, retrospective reviews and prospective studies. However, to date, no study has investigated the overall complications or satisfaction rates associated with the wide spectrum of techniques.

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Propeller Flap Reconstruction of Irradiated Sarcoma Defects: A Comparison

: The treatment for soft tissue sarcomas has evolved to include radiotherapy, wide local excision and plastic surgical reconstruction. Goals of reconstruction for these irradiated defects are introduction of non-irradiated healthy tissue, tension-free closure and obliteration of potential dead-space. While many defects once required free tissue transfer for reconstruction, greater anatomical vascular pattern knowledge has led to the increasing use of propeller perforator flaps, islanded and transposed into the defect.

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The Importance of Sleep for Governmental Sectors, General Population and Industry – Asia-Pacific Economic Cooperation (APEC) Sleep Technology Agenda

Sleep is a field of study that encompasses several areas relevant to many of every country's governmental sectors, as well as industry and general population. The focus of this Letter will be to address how researching sleep can reduce health expenses, increase national productivity, bring awareness to public safety and facilitate health and medical related industry development based on the Sleep Technology Agenda (STA) [1] presented at the Asia-Pacific Economic Cooperation (APEC) meeting in Ho-Chi-Ming City, Vietnam, August 2017.

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The antifungal agent of silver nanoparticles activated by diode laser as light source to reduce C. albicans biofilms: an in vitro study

Abstract

Candida albicans is a normal flora caused fungal infections and has the ability to form biofilms. The aim of this study was to improve the antifungal effect of silver nanoparticles (AgNPs) and the light source for reducing the biofilm survival of C. albicans. AgNPs were prepared by silver nitrate (AgNO₃) and trisodium citrate (Na₃C₆H₅O₇). To determine the antifungal effect of treatments on C. albicans biofilm, samples were distributed into four groups; L + P+ was treatment with laser irradiation and AgNPs; L + P− was treatment with laser irradiation only; L − P+ was treatment with AgNPs only (control positive); L − P− was no treatment with laser irradiation or AgNPs (control negative). The growth of fungi had been monitored by measuring the optical density at 405 nm with ELISA reader. The particle size of AgNPs was measured by using (particle size analyzer) and the zeta potential of AgNPs was measured by using Malvern zetasizer. The PSA test showed that the particle size of AgNPs was distributed between 7.531–5559.644 nm. The zeta potentials were found lower than − 30 mV with pH of 7, 9 or 11. The reduction percentage was analyzed by ANOVA test. The highest reduction difference was given at a lower level irradiation because irradiation with a density energy of 6.13 ± 0.002 J/cm² resulted in the biofilm reduction of 7.07 ± 0.23% for the sample without AgNPs compared to the sample with AgNPs that increased the biofilm reduction of 64.48 ± 0.07%. The irradiation with a 450-nm light source had a significant fungicidal effect on C. albicans biofilm. The combination of light source and AgNPs provides an increase of biofilm reduction compared to the light source itself.

https://ift.tt/2FeWxvh

Surgical management of onychopapilloma, onychomatricoma, and subungual osteochondroma: Case series

Swagata A Tambe, Saba M M Ansari, Chitra S Nayak, Ramya Chokkar, Priyanka D Patil

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):143-147

The clinical diagnosis of benign and malignant nail tumors can be difficult. Dermoscopy can provide a clue to the diagnosis but nail biopsy is the gold standard in establishing the diagnosis. Here, we report three cases of rare nail tumors, that is, onychopapilloma, onychomatricoma, and subungual osteochondroma, which were diagnosed on histopathology and managed surgically.

https://ift.tt/2PRERtG

Fourth dimension in reconstruction of defects following excision of basal cell carcinoma of head and neck!

Kandasamy Mahadevan, Sridhar Sruthi, Shanmugam Sridevi, Rajamanoharan Vivek

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):110-119

Background: Basal cell carcinomas (BCCs) are the most common skin tumors of the face. Excision results in soft tissue defects that require reconstruction with the focus on form, function, and patient satisfaction. Aim: To analyze the reconstruction of BCC excision defects of the head and neck region using local flaps and skin grafts with respect to the four dimensions of oncological reconstruction: clearance, form, function, and patient satisfaction. Materials and Methods: This is a prospective study conducted on 88 patients who presented with BCC of the head and neck region and who were operated in our hospital from January 2015 to December 2016 with a minimum follow-up period of 6 months up to June 2017. All patients underwent wide local excision and reconstruction using appropriate local flaps or split-thickness skin graft (SSG). Patients were analyzed with respect to age, sex, site, size, reconstruction method, complications, and patient satisfaction using the customized Patient Satisfaction Questionnaire (PSQ), derived from PSQ III. Results: A total of 77.3% defects were immediately reconstructed using local flaps and 18.2% underwent SSG. All flaps and grafts survived well with a complication rate of 6.8%. Approximately 72.7% of patients had good satisfaction with the medical care and reconstruction. Conclusion: Post-excisional defects of BCC in the head and neck region have to be reconstructed with equal weightage to the four pillars of oncological reconstruction: clearance, form, function, and patient satisfaction. Flap reconstruction is ideal as it brings about reconstruction with patient satisfaction, which is indeed the fourth dimension in any reconstructive surgery.

https://ift.tt/2DdMtA1

Harmonic devices: The workhorse for surgical resection of vascular malformations

Chirayu Parwal, Lalit Choudhary, Anurag Pandey, Vivek Kumar, Puran Singh, Jessy Ragi

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):157-160

Management of vascular malformations is multimodal with documented role of surgical resection in specific facets of this condition. Surgical resection of these lesions is technically challenging owing to diffuse and relatively ill-defined extent with involvement of multiple tissue planes limitation of access and excessive intra-operative bleeding. An observational study was conducted in 24 cases taken up for surgical resection of vascular malformations. The cases were divided into two groups based on the hemostasis technique used: Group A: Harmonic shears (n = 12) (Ethicon Inc. Somerville, New Jersey, United States). Group B: Electrosurgery (monopolar/bipolar) with standard knot tying (n = 12). We conclude that use of harmonic scalpel in surgical resection causes less parallel tissue damage, secures haemostasis promptly, does not impede vision and aids surgical dissection thereby significantly reducing the operative time and improving the surgical outcome, typically in large vascular malformations of head and neck region.

https://ift.tt/2PMLQ7o

Gentle is better: The original “gentle technique” for fat placement in breast lipofilling

Pietro Gentile, Barbara De Angelis, Verdiana Di Pietro, Vittoria Amorosi, Maria G Scioli, Augusto Orlandi, Valerio Cervelli

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):120-126

Context: Breast lipofilling usually involves three different stages (harvesting, processing, and placement), and in each of these phases, adipocyte cells can be damaged. Our technique of fat placement is quite different from the others as we focus our attention on the last stage of fat graft procedure, which could explain the better results in graft survival. Aims: Our method is focused on eliminating any unnecessary manipulation of the graft so as to optimize graft retention and clinical outcomes: Controlled movement and slow rate of fat injection are the cornerstone of our technique and guarantee a nontraumatic fat transfer and a greater survival rate of adipocytes. Settings and Design: This was a retrospective cohort study. Materials and Methods: Of 120 patients (average age 41,5 years) affected by breast soft tissue defects, 60 were managed with the lipofilling procedure using fat graft injected by "Gentle technique." To establish the effects of the injection's procedure, we compared the results obtained in fat graft maintenance with a control group made up of 60 patients, treated with fat graft injection according to Coleman procedure. Statistical Analysis Used: Values are expressed as mean plus standard error and analyzed using Student's t test. Results: In patients treated with Gentle technique, we observed a 60.5% + 12.5% maintenance of contour restoring and three-dimensional volume after 1 year (P < 0.0001 vs. control group); we compared the results obtained with only 39% + 4.4% of the control group treated with fat graft injected according to Coleman. Conclusions: Controlled 26 movement and slow rate of fat injection are the cornerstone of our technique and guarantee a nontraumatic fat transfer and a greater 27 survival rate of adipocytes.

https://ift.tt/2DdRdG8

Maintenance of the anatomic contours in auricular reconstruction: The button technique

Brandon Worley, Joel L Cohen

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):150-152

Background and Objective: Reconstructing the contours of the auricle is a unique challenge. Various bolster techniques have been tried to help prevent complications such as hematoma, seroma, and morbidity. Here, we describe a simple technique using a button to maintain the natural ear contour when it is at risk of a poor aesthetic outcome. Materials and Methods: A 77-year-old man underwent resection of a squamous cell carcinoma of the postauricular skin on the right ear, which involved the helical margin. A skin graft was chosen to close the defect. However, on initial inspection of the repair, buckling of the scaphoid fossa, collapse of the antihelical fold, and notching of the helix were observed. When these buckling changes persisted even after the anesthesia-related swelling resolved the following day, a button bolster was placed for 2.5 weeks to provide support for the cartilage. Results: Standardized digital imaging revealed maintenance of the original contours and sulci of the ear with an excellent cosmetic result. Conclusion: Recreation of the auricular contours is critical for an excellent cosmetic outcome. Using a button bolster is worth considering as it is of low cost, can easily fit into the natural ear contours, and can provide a rigid structure to ensure maintenance of the ear shape.

https://ift.tt/2PRvcn3

Comparative (quantitative and qualitative) analysis of three different reagents for preparation of platelet-rich plasma for hair rejuvenation

Sukhbir Singh

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):127-131

Objective: The aim of this study was to compare the quantity and quality of platelets in platelet-rich plasma (PRP) samples prepared using three different reagents, namely, ethylenediaminetetraacetic acid (EDTA), sodium citrate, and acid citrate dextrose-A (ACD-A) solution. Materials and Methods: A prospective study was carried out in which all the 50 patients who attended the outpatient department for hair rejuvenation were enrolled for the study. All the patients had a history of hair fall with diffuse thinning of hair, Norwood Grades 2 and 3. Patients with complete hair loss were not included in the study. No specific randomization was carried out. All the patients were explained about the procedure and the use of vials containing the aforementioned three reagents. Then, 40mL blood was taken from each patient. Both quantitative and qualitative analyses of platelets were carried out on PRP samples. Quantitative analysis was done by using an automatic cell counter and cross-checking manually. Qualitative analysis was carried out by preparing smears from each of the three samples from each vial. All the patients were followed up at 4 weekly intervals for a duration of 6 months and then at the end of 1 year. All the patients received six sessions of PRP. Results: All the data were subjected to statistical analysis using Student's t-test, and P value of <0.001 was obtained in samples from ACD-A vials, which was statistically significant. In all the 50 patients, the samples collected in vials containing ACD-A yielded the maximum quantitative count and the best morphology of platelets under smear examination. Conclusion: Within the limits of this study, we would like to conclude that ACD-A vials should be used for collecting and processing blood for PRP preparation to obtain best results in hair rejuvenation.

https://ift.tt/2DemiZZ

Objective quantification of liposuction results

Alain J Azzi, Ann-Sophie Lafrenière, Alex Viezel-Mathieu, Thomas M Hemmerling, Mirko Gilardino

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):105-109

Currently, no reliable gold standard exists for the objective outcome measurement following liposuction. The purpose of this systematic review was to summarize reported methods of monitoring liposuction results by objectively measuring subcutaneous adipose tissue. A systematic literature search was performed to identify relevant articles that described techniques for objectively quantifying adipose tissue following traditional liposuction. The search included published articles in three electronic databases—Ovid MEDLINE, Embase, and PubMed. Subcutaneous adipose tissue was estimated using the following techniques: ultrasound, dual-energy X-ray absorptiometry, magnetic resonance imaging, computed tomography, and three-dimensional imaging volumetric analysis. Reported benefits of liposuction objective measurements included providing patients with a quantitative assessment of the liposuction results pre- and postoperatively, detecting significant changes in body fat deposits, and following patterns of fat redistribution. This review provides a summary of various techniques for quantification of liposuction results. More studies are needed to study the clinical relevancy and impact of the various imaging modalities reviewed as well as to develop automated volumetric measurement technology with improved accuracy, efficacy, and reproducibility.

https://ift.tt/2PMbadK

Mondor’s disease after aesthetic breast surgery: A case series and literature review

Alberto Goldman, Uwe Wollina

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):132-135

Background: Mondor's disease of the subcutaneous veins of the breast is an uncommon disorder. The etiology of Mondor's disease remains unclear. Usually, it is a self-limited disease. This condition has been associated with trauma, surgical biopsies, breast surgery (including silicone breast implant), physical activity, and a manifestation of breast cancer. Materials and Methods: This is a retrospective analysis of 652 female patients who underwent aesthetic breast surgery in the last 10 years. Results: We found three cases of Mondor's disease after plastic surgery of the breast (0.46%) and performed an analysis of the clinical aspects and therapeutic measures. The disease onset was a couple of weeks to 2 years after surgery, never within the first 2 weeks after surgery. We did not observe ulceration or breast cancer. Treatment was unnecessary in two patients, whereas hot compresses and nonsteroidal medical drugs were prescribed in one patient. All lesions healed within 2–3 weeks. Conclusion: Mondor's disease is a possible complication after aesthetic breast surgery but often runs a self-limiting course with spontaneous remission. It is important to exclude breast cancer. The patient should be informed that the disease runs a benign and self-limiting course.

https://ift.tt/2DeDkYh

Innovative skin hook

Saurabh Gupta, Devi P Mohapatra, Ravi K Chittoria, Elankumar Subbarayan, Sireesha K Reddy, Vinayak Chavan, Abhinav Aggarwal, Likhitha C Reddy

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):148-149

Skin hook is an important instrument for skin surgeries. There are situations, such as operating in a health camp or operating at a peripheral health center with a limited number of instruments, where skin hook is not available in the operation theater. We present an innovative design of skin hook, which can be prepared by surgeons in the operation theater with the help of readily available materials. The innovative skin hook is a simple, safe, and effective solution for performing skin surgeries in a limited-resource setup.

https://ift.tt/2PMsMX0

Extensive Nicolau syndrome following intramuscular injection of paracetamol in a patient who is HIV positive

Tasleem Arif, Konchok Dorjay

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):136-139

Nicolau syndrome (NS) is a type of adverse skin reaction occurring after parenteral drug injection. In certain conditions, it can cause ischemic necrosis of the skin and the underlying adipose tissue. The actual cause of NS is not clear though inflammation, vasospasm, and thromboembolic occlusion of blood vessels have been proposed. In this case presentation, we report an interesting case of a 30-year-old man who turned out be human immunodeficiency virus (HIV) positive on investigations, developed extensive purpuric lesions of his skin on left buttock and then spread to the trunk and shoulders after receiving intramuscular injection of paracetamol. With a suggestive history and further supported by clinical examination, a diagnosis of NS following injection of paracetamol was made. Though NS is considered to be rare, at times it can be devastating. Being a common procedure in the life of a health-care professional, the awareness regarding this entity is very essential. Despite intense medical literature search in, we could not find a single report of NS after intramuscular injection of paracetamol in a patient who is HIV positive, thus obliging this communication.

https://ift.tt/2Dalm90

A pocket-friendly and sustainable iontophoresis apparatus for palmoplantar hyperhidrosis: Advancement over a previously described homemade design

Sourabh Jain, Vivek K Dey, Nihit Agrawal

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):153-156

Introduction and Objectives: Tap water iontophoresis is a promising therapy for palmoplantar hyperhidrosis. Non-affordability and nonavailability of the marketed device restrict its usage for many patients hailing from villages or small cities. Materials and Methods: In an article named "A simple user-made iontophoresis device for palmoplantar hyperhidrosis" published previously in this journal, a simple inexpensive homemade device that runs on 12 V direct current battery was described. We made a small modification by using a 220–12 V alternate current to direct current semiconductor diode–based transformer for the current supply. Results: The added innovation made the device lightweight, cheaper, and usable with domestic electric supply at home/clinic. Sustained supply of current at same voltage without dip and non-requirement to change/replace battery are added advantages. Cost of the whole assembly is ₹310. Working and clinical efficacy of our device were comparable to the commercially available apparatus as reported by 13 patients who received thrice a week of 15min sessions with our device. Mild electric pricking sensation was felt by all patients. Four of thirteen reported that pricking sensation was a bit more with our device as compared to the marketed device. No calibration for intensity is available in our device. Conclusion: This simple to assemble and inexpensive device makes iontophoresis applicable in many needy patients with similar efficacy and few limitations compared to expensive marketed devices.

https://ift.tt/2PMaULO

Surgical management of onychoheterotopia

Chander Grover, Geetali Kharghoria

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):140-142

Onychoheterotopia (ectopic nail) is a rare condition characterized by the development of nail tissue, distinct from the normal nail unit. It is usually acquired following traumatic inoculation of nail matrix; the congenital variety being less common. The exact pathogenesis of the disease is not clear. It affects the dorsal aspect of fingers and toes mostly. Herein, we report a case of a 35-year-old man with post-traumatic onychoheterotopia of left middle finger, who was treated with surgical avulsion of the ectopic nail along with chemical matricectomy of the well-formed ectopic matrix. The patient had a satisfactory cosmetic outcome with normal growth of the nail unit and no recurrence. The report serves to highlight clinical presentation of acquired onychoheterotopia along with its surgical management.

https://ift.tt/2DeaS8T

Chemical peeling for nail disorders: Need for a systematic approach

Sidharth Sonthalia, Ramanjit Singh

Journal of Cutaneous and Aesthetic Surgery 2018 11(3):161-163



https://ift.tt/2PMaQf2

Using nitrogen and oxygen isotopes to access sources and transformations of nitrogen in the Qinhe Basin, North China

Abstract

Nitrate pollution in water is a common environmental problem worldwide. The Qinhe Basin (QHB) faces with the risk of eutrophication. To clarify nitrate pollution of river water, water chemical data, water isotope values (δD and δ¹⁸O–H₂O), and dual nitrate isotope values (δ¹⁵N–NO₃⁻ and δ¹⁸O–NO₃⁻) were used to discern sources and transformation mechanisms of nitrogen in the QHB. The nitrate concentrations of river water ranged from 0.71 to 20.81 mg L⁻¹. The δD and δ¹⁸O–H₂O values of river water varied from − 74 to −52‰ and from − 10.8 to − 7.2‰, with an average value of − 60‰ and − 8.2‰, respectively. The δ¹⁵N–NO₃⁻ and δ¹⁸O–NO₃⁻ values of nitrate ranged from − 6.7 to + 14.8‰ and from − 6.0 to + 5.6‰, with a mean value of + 4.6‰ and − 0.6‰, respectively. Assimilation by algae and the mixing of soil nitrogen, chemical fertilizer, sewage, and industrial wastewater could account for increasing δ¹⁵N–NO₃⁻ values. There was neither significantly positive nor negative correlation between δ¹⁵N–NO₃⁻ and δ¹⁸O–NO₃⁻ in river water, indicating that no obvious denitrification shifted isotopic values of nitrate in the QHB. Based on the dual isotopic values of nitrate and land use change in the watershed, it could be concluded that intensive nitrification dominated in the QHB, and dissolved nitrate was mainly derived from nitrification of ammonium in fertilizer, soil nitrogen, and domestic sewage. As the primary nitrate sources identified in the QHB, effective fertilization and afforestation can be taken to protect water resource from nitrate pollution.

https://ift.tt/2qLyGcR

Harmful weed to prospective adsorbent: low-temperature–carbonized Ipomoea carnea stem carbon coated with aluminum oxyhydroxide nanoparticles for defluoridation

Abstract

Gainful utilization of stems of the pernicious weed, Ipomoea carnea, to prepare good quality carbon and its modification with aluminum oxyhydroxide (AlOOH) nanoparticles for efficient defluoridation from contaminated drinking water is discussed in this paper. Surface functional groups are enhanced by functionalization of the carbons under acid treatment which acted as anchor to the AlOOH nanoparticles. Formation of AlOOH particles over the carbon surface is confirmed from X-ray diffractometry analysis. The AlOOH–carbon nanocomposite showed higher fluoride removal capacity than the neat AlOOH nanoparticles with a maximum removal capacity in the range of 46.55–53.71 mg g⁻¹. Reaction kinetics and isotherm studies showed that fluoride adsorption is quite feasible on the adsorbent surface. The column study showed the possibility of the adsorbent for large-scale applications. The adsorbent can be regenerated by a mild treatment with 0.1 N NaOH solutions. The adsorbent is highly capable for defluoridation from synthetic as well as fluoride-contaminated natural water and, thus, can be used as an alternative for commercial defluoridation adsorbents. The use of Ipomoea carnea for defluoridation can be a way of producing low-cost adsorbent material, and the use for such purposes may also be helpful to control the weed up to a good extent.

https://ift.tt/2PUGBmk

The environmental Kuznets curve by considering asymmetric oil price shocks: evidence from the top two

Abstract

This study is the first attempt to investigate the validity of the environmental Kuznets curve (EKC) hypothesis by considering the asymmetric oil price effects on the CO₂ emission in the USA and China. The oil prices were incorporated as an indicator (proxy) of energy consumption in order to avoid potential endogeneity problems and allow exploring the asymmetric effects of the energy fluctuation on the CO₂ release. The nonlinear autoregressive distributed lag (NARDL)–bound testing approach to cointegration of Shin et al. (2014) in the presence of structural break is used to identify both short-run and long-run dynamic relationships between real oil prices, per capita GDP, and per capita CO₂ emissions over the period 1976–2013. The results indicate that the inverted U-shaped EKC hypothesis is not supported in the short and long terms in both countries. Asymmetric findings suggest that positive and negative fluctuations in crude oil prices affect CO₂ emissions differently in the USA and China. Unlike China, rising energy prices in the USA could be a contributing factor in the fight against pollution. More taxation of fossil energy and renewable energy subsidies are recommended for the American economy. However, the growth priority seems to outweigh the environmental issue for the Chinese economy.

https://ift.tt/2De9zqb

Socio-geographic disparity in cardiorespiratory mortality burden attributable to ambient temperature in the United States

Abstract

Compared with relative risk, attributable fraction (AF) is more informative when assessing the mortality burden due to some environmental exposures (e.g., ambient temperature). Up to date, however, available AF-based evidence linking temperature with mortality has been very sparse regionally and nationally, even for the leading mortality types such as cardiorespiratory deaths. This study aimed to quantify national and regional burden of cardiorespiratory mortality (CRM) attributable to ambient temperature in the USA, and to explore potential socioeconomic and demographic sources of spatial heterogeneity between communities. Daily CRM and weather data during 1987–2000 for 106 urban communities across the mainland of USA were acquired from the publicly available National Morbidity, Mortality and Air Pollution Study (NMMAPS). We did the data analysis using a three-stage analytic approach. We first applied quasi-Poisson regression incorporated with distributed lag nonlinear model to estimate community-specific temperature-CRM associations, then pooled these associations at the regional and national level through a multivariate meta-analysis, and finally estimated the temperature-AF of CRM and performed subgroup analyses stratified by community-level characteristics. Both low and high temperatures increased short-term CRM risk, while temperature-CRM associations varied by regions. Nationally, the fraction of cardiorespiratory deaths caused by the total non-optimum, low, and high temperatures was 7.58% (95% empirical confidence interval, 6.68–8.31%), 7.15% (6.31–7.85%), and 0.43% (0.37–0.46%), respectively. Greater temperature-AF was identified in two northern regions (i.e., Industrial Midwest and North East) and communities with lower temperature and longitude, higher latitude, and moderate humidity. Additionally, higher vulnerability appeared in locations with higher urbanization level, more aging population, less White race, and lower socioeconomic status. Ambient temperature may be responsible for a large fraction of cardiorespiratory deaths. Also, temperature-AF of CRM varied considerably by geographical and climatological factors, as well as community-level disparity in socioeconomic status.

https://ift.tt/2PWILSt

Oxidative removal of recalcitrant organics in shale gas flowback fluid by the microwave-activated persulfate process

Abstract

Shale gas flowback fluid (SGF) is generated during shale gas extraction and typically contains a variety of toxic and refractory organic compounds. In this work, a microwave-activated persulfate process (MW-PS process) was developed to pretreat SGF. The major factors influencing the treatment efficiency of the MW-PS process (PS dose, initial pH, MW power, and reaction time) were optimized, and the synergetic effect (SE), degradation of recalcitrant matter, and energy consumption were systematically investigated. Results showed that the SE of the process reached a high index (i.e., 9.85), suggesting a significant synergetic effect of MW and PS. In addition, under the optimal MW-PS condition (PS dose of 2.5 g/L, MW power of 900 W, and initial pH of 2), chemical oxygen demand removal reached 66.40% in a short reaction time of 10 min. Other analyses demonstrated that benzene series compounds, organic acids, lipid substances, alkanes, antioxidants, and fluorescent dissolved organic matter in SGF were decomposed to smaller-molecule organic matter, suggesting that refractory and toxic organic matter was removed by the MW-PS treatment process. Overall, the results of this study showed that MW-PS technology is an effective and promising method to treat SGF once the operation parameters are optimized.

https://ift.tt/2PlRtKg

Influence of microalgae wastewater treatment culturing conditions on forward osmosis concentration process

Abstract

Forward osmosis is envisioned as a technology for microalgae concentration but fouling propensity during dewatering is currently a limiting factor that requires better understanding. The purpose of this study is to define the impact of microalgae culturing conditions on the downstream forward osmosis (FO) separation process—water recovery and microalgae harvesting. Chlorella vulgaris was cultivated in an outdoor lab-scale reactor fed with synthetic wastewater mimicking primary settled municipal influent under changing environmental conditions (temperature, solar radiation, nutrient balance) with varying hydraulic retention time. High efficiency of nutrient removal was achieved under all tested conditions but microalgae autoflocculation and lower rate of pollutant removal were observed with batches where culturing temperature (6.5–21 ^°C), solar irradiation rate (181 W/m²), and nitrogen/phosphorous ratio (2.9) were below the optimal range. Regarding FO concentration, high initial water fluxes (in the range of 18.2 to 19.5 L·m²·h⁻¹) and water extraction rate (60.1–83.9%) were observed in all subsequent FO concentration tests. Significant membrane fouling (microalgae deposition on surface) associated with poor biomass recovery from the FO cell was found to be dependent on exopolymeric substance accumulation, which was a response to non-optimal environmental culturing conditions.

https://ift.tt/2QrkosS

Study of Anti-PD-1 Antibody SHR-1210 Plus Apatinib as Second-Line Treatment of Advanced Esophageal Squamous Cell

Condition:   Esophageal Cancer
Intervention:   Drug: Apatinib+SHR-1210
Sponsor:   The First Affiliated Hospital of Zhengzhou University
Not yet recruiting

https://ift.tt/2SXY77L

Alpha Radiation Emitters Device for the Treatment of Cutaneous, Mucosal or Superficial Soft Tissue Neoplasia (DaRT)

Conditions:   Skin Cancer;   Mucosal Neoplasm of Oral Cavity;   Soft Tissue Neoplasm
Intervention:   Device: Radiation: Diffusing Alpha Radiation Emitters Therapy (DaRT)
Sponsor:   Alpha Tau Medical LTD.
Not yet recruiting

https://ift.tt/2zEwLL8

Treatment of alopecia areata: An Australian expert consensus statement

Abstract

Alopecia areata (AA) severity varies from a single small patch to complete loss of scalp hair, body hair, eyelashes and eyebrows. While 40% of all affected individuals only ever get one patch and will achieve a spontaneous complete durable remission within 6 months, 27% will develop additional patches but still achieve complete durable remission within 12 months and 33% will develop chronic AA. Without systemic treatment, 55% of individuals with chronic AA will have persistent multifocal relapsing and remitting disease, 30% will ultimately develop alopecia totalis and 15% will develop alopecia universalis. The unpredictable course and psychological distress attributable to AA contributes to the illness associated with AA. Numerous topical, intralesional and systemic agents are currently used to treat AA; however, there is a paucity of data evaluating their use, effectiveness and tolerability. Topical therapy, including topical glucocorticosteroids, minoxidil and immunotherapy, can be used in cases of limited disease. There are no universally agreed indications for initiating systemic treatment for AA. Possible indications for systemic treatment include rapid hair loss, extensive disease (≥50% hair loss), chronic disease, severe distress or a combination of these factors. Currently available systemic treatments include glucocorticosteroids, methotrexate, ciclosporin, azathioprine, dapsone, mycophenolate mofetil, tacrolimus and sulfasalazine. The optimal treatment algorithm has not yet been described. The purpose of this consensus statement is to outline a treatment algorithm for AA, including the indications for systemic treatment, appropriate choice of systemic treatment, satisfactory outcome measures and when to discontinue successful or unsuccessful treatment.

https://ift.tt/2qCKs92

Combined stereotactic body radiotherapy and trans-arterial chemoembolization as initial treatment in BCLC stage B–C hepatocellular carcinoma

Abstract

Purpose

We retrospectively evaluated the efficacy and safety of stereotactic body radiotherapy (SBRT) combined with trans-arterial chemoembolization (TACE) as initial therapy in Barcelona Clinic Liver Cancer (BCLC) system stage B–C hepatocellular carcinoma (HCC).

Patients and methods

Seventy-two patients received a single dose of TACE followed by SBRT 4 weeks later. All patients had tumor sizes ≥5 cm, at least 700 ml of disease-free liver, Child–Pugh (CP) score ≤ B7 and tumor nodules ≤5. SBRT dose, ranging from 6 × 5–8 Gy or 5–10 × 4 Gy, was individualized according to normal tissue constraints. No subsequent scheduled treatment was delivered unless disease progression was observed. Local control (LC), overall survival (OS), progression-free survival (PFS), response rate (RR), and toxicity were evaluated.

Results

The patients' characteristics were: median age 60 years (range 28–87 years); CP score A/B (n = 68/4); BCLC stage B/C (n = 51/21); solitary/multifocal (n = 37/35); portal vein invasion (n = 18). The median tumor size and GTV were 11.2 cm (range 5.0–23.6 cm) and 751 cm³ (range 41–4009 cm³), respectively. The median equivalent dose in 2 Gy per fraction (EQD2, α/β = 10) was 37.3 Gy2 (range, 28–72 Gy2). The median follow-up time was 16.8 months (range, 3–96 months). The objective RR was 68% and the 1‑year LC rate was 93.6% (95% CI, 87.6–100%). The median OS was 19.8 months (95% CI, 11.6–30.6 months). SBRT-related grade 3 or higher adverse gastrointestinal events and treatment-related death occurred in three (2.8%) and one patient (1.4%) respectively. No patient developed classical radiation-induced liver injury.

Conclusion

Our experience suggests that combined TACE and SBRT can be a safe and effective initial therapy for BCLC stage B–C HCC with appropriate patient selection. Further prospective trials are warranted.

https://ift.tt/2Pk9WXO

Acrodermatitis continua of Hallopeau with dense infiltration of IgG4‐positive cells in the lesional dermis

Abstract

Acrodermatitis continua of Hallopeau (ACH) is a rare acropustular subtype of psoriasis. The characteristic feature of ACH is chronic, painful and destructive disease affecting the hands and feet, especially the fingertips and toes. The pathogenic mechanisms of ACH have not been fully elucidated. We report a case of ACH whose skin lesions showed dense infiltration of IgG₄‐positive cells in the dermis.

This article is protected by copyright. All rights reserved.

https://ift.tt/2qDxoQN

Multiple cutaneous reticulohistiocytomas after haematopoietic cell transplantation: contribution of donor and host‐derived cells

Abstract

Reticulohistiocytoma or reticulohistiocytosis of the skin is a histiocytic disorder which is histologically characterized by the presence of numerous reticulohistiocytes: large histiocytes with an abundant eosinophilic cytoplasm. The aetiology of reticulohistiocytosis and the origin of reticulohistiocytes are unknown. Multiple cutaneous reticulohistiocytomas (MCR) is a reticulohistiocytosis of the skin that is characterized by generalized eruptions and an absence of articular symptoms or internal malignancies. Around 20 MCR cases have been reported in the literature, but the association between reticulohistiocytosis and haematopoietic cell transplantation (HCT) has not been described.

This article is protected by copyright. All rights reserved.

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Recruitment of CCR6+ Foxp3+ regulatory gastric infiltrating lymphocytes in Helicobacter pylori gastritis

Abstract

Helicobacter pylori (H. pylori) infection is associated with an inflammatory response in the gastric mucosa, leading to chronic gastritis, peptic ulcers, and gastric cancer. Increased T‐cell infiltration is found at sites of H. pylori infection. The CCR6⁺ subset of CD4⁺ regulatory T cells (Tregs), a newly characterized subset of Tregs, has been reported to contribute to local immune inhibition. However, whether CCR6⁺ Tregs are present in H. pylori gastritis, and what their relationship is to disease prognosis, remains to be elucidated. In this study, gastric infiltrating lymphocytes were isolated from endoscopic biopsy specimens of H. pylori gastritis patients and analyzed. We found that in gastric infiltrating lymphocytes, CCR6⁺ CD4⁺ CD25^high Tregs, which express high levels of CD45RO, are positively associated with more severe inflammation in gastric mucosa during H. pylori infection. Furthermore, the frequency of CCR6⁺ Tregs in gastric infiltrating lymphocytes, but not CCR6⁻ Tregs, is significantly increased in inflamed gastric tissues, which is inversely correlated with significantly lower expression of IFN‐γ⁺ CD8⁺ T cells. We also found that the frequency of CCR6⁺ Tregs is positively correlated with the frequency of CD4⁺ IFN‐γ⁺ T cells. In addition, the frequency of CCR6⁺ Tregs, but not that of CCR6⁻ Tregs, is significantly correlated with increased inflammation in H. pylori gastritis. This study demonstrates that immunosuppression in H. pylori gastritis might be related to the activity of CCR6⁺ Tregs, which could influence disease prognosis.

https://ift.tt/2PNftVX

Hydroxyurea‐induced dermatomyositis koebnerizing at the site of previous shingles

https://ift.tt/2QrgYWV

Distilled pyroligneous liquor obtained from Eucalyptus grandis and chitosan: physicochemical properties of the solution and films

Abstract

The pyroligneous liquor is a product obtained during the production of charcoal, with well-known antimicrobial activity. In this work, we characterized the physical chemistry properties of a formulation composed of distilled pyroligneous liquor (DPL), obtained from Eucalyptus grandis, and chitosan. A good interaction between the polymer and the solvent was observed. Auto-supported films were prepared with these systems and characterized with respect to their structure and photo-protection properties, water vapor permeability, and resistance to water and to thermal degradation. They present a semi-crystalline structure and are hygroscopic, but are stable under immersion for up to 7 days. The swelling degree in water is 300% in weight and the permeability to water vapor was between 30 and 45 g m⁻¹ h⁻¹ (for films with 80 to 10 μm, respectively). The obtained films are able to efficiently block the incident UVB and UVC radiation; the molar absorptivity decreases exponentially with increasing wavelength and is stable up to 300 °C. These properties confer desirable properties to the films, obtained from these precursors of a renewable source, to be used as coatings.

https://ift.tt/2T0ngyt

Cosmetics, Vol. 5, Pages 66: Biocellulose Masks as Delivery Systems: A Novel Methodological Approach to Assure Quality and Safety

Cosmetics, Vol. 5, Pages 66: Biocellulose Masks as Delivery Systems: A Novel Methodological Approach to Assure Quality and Safety

Cosmetics doi: 10.3390/cosmetics5040066

Authors: Paola Perugini Mariella Bleve Fabiola Cortinovis Antonio Colpani

Bacterial cellulose (BC) has become of great interest in recent years, as a delivery system in several areas of application, including food, drugs, and cosmetics, thanks to its exclusive advantages, such as high biocompatibility, water holding capacity, and good gas permeability. The novel approach of the authors has led to a protocol for checking the quality and safety of bacterial cellulose matrices in the manufacture of cosmetic masks. Two non-destructive techniques, near-infrared spectroscopy (NIR) and multiple light scattering (MLS), were used to verify different parameters affecting the quality of BC sheets, allowing cellulose masks to be checked over time. NIR spectroscopy allowed for discovering changes in the water content, depending on filling/packaging procedures, like flat-folding. Multiple light scattering was used to ascertain the stability of solutions in contact with masks. From a clinical standpoint, the cutaneous tolerability of biocellulose masks, and their effect on skin parameters, were evaluated through some specific &ldquo;in vivo&rdquo; tests. Also, a safety evaluation during application was conducted through different studies: a short-term one after single application, and a long-term one upon continued use.

https://ift.tt/2qE30FY

Shared gut, but distinct oral microbiota composition in primary Sjögren's syndrome and systemic lupus erythematosus

Publication date: Available online 9 November 2018

Source: Journal of Autoimmunity

Author(s): Taco A. van der Meulen, Hermie J.M. Harmsen, Arnau Vich Vila, Alexander Kurilshikov, Silvia C. Liefers, Alexandra Zhernakova, Jingyuan Fu, Cisca Wijmenga, Rinse K. Weersma, Karina de Leeuw, Hendrika Bootsma, Fred K.L. Spijkervet, Arjan Vissink, Frans G.M. Kroese

Abstract

Objective

Alterations in the microbiota composition of the gastro-intestinal tract are suspected to be involved in the etiopathogenesis of two closely related systemic inflammatory autoimmune diseases: primary Sjögren's syndrome (pSS) and systemic lupus erythematosus (SLE). Our objective was to assess whether alterations in gut and oral microbiota compositions are specific for pSS and SLE.

Methods

16S ribosomal RNA gene sequencing was performed on fecal samples from 39 pSS patients, 30 SLE patients and 965 individuals from the general population, as well as on buccal swab and oral washing samples from the same pSS and SLE patients. Alpha-diversity, beta-diversity and relative abundance of individual bacteria were used as outcome measures. Multivariate analyses were performed to test associations between individual bacteria and disease phenotype, taking age, sex, body-mass index, proton-pump inhibitor use and sequencing-depth into account as possible confounding factors.

Results

Fecal microbiota composition from pSS and SLE patients differed significantly from population controls, but not between pSS and SLE. pSS and SLE patients were characterized by lower bacterial richness, lower Firmicutes/Bacteroidetes ratio and higher relative abundance of Bacteroides species in fecal samples compared with population controls. Oral microbiota composition differed significantly between pSS patients and SLE patients, which could partially be explained by oral dryness in pSS patients.

Conclusions

pSS and SLE patients share similar alterations in gut microbiota composition, distinguishing patients from individuals in the general population, while oral microbiota composition shows disease-specific differences between pSS and SLE patients.

https://ift.tt/2RMpq3E

Novel mechanism for estrogen receptor alpha modulation of murine lupus

Publication date: Available online 8 November 2018

Source: Journal of Autoimmunity

Author(s): Melissa A. Cunningham, Mara Lennard Richard, Jena R. Wirth, Jennifer L. Scott, Jackie Eudaly, Phil Ruiz, Gary S. Gilkeson

Abstract

Female sex is a risk factor for lupus. Sex hormones, sex chromosomes and hormone receptors are implicated in the pathogenic pathways in lupus. Estrogen receptor alpha (ERα) knockout (KO) mice are used for defining hormone receptor effects in lupus. Prior studies of ERα KO in lupus have conflicting results, likely due to sex hormone levels, different lupus strains and different ERα KO constructs. Our objective was to compare a complete KO of ERα vs. the original functional KO of ERα (expressing a short ERα) on disease expression and immune phenotype, while controlling sex hormone levels. We studied female lupus prone NZM2410 WT and ERα mutant mice. All mice (n = 44) were ovariectomized (OVX) for hormonal control. Groups of each genotype were estrogen (E2)-repleted after OVX. We found that OVXed NZM mice expressing the truncated ERα (ERα short) had significantly reduced nephritis and prolonged survival compared to both wildtype and the complete ERαKO (ERα null) mice, but surprisingly only if E2-repleted. ERα null mice were not protected regardless of E2 status. We observed significant differences in splenic B cells and dendritic cells and a decrease in cDC2 (CD11b+CD8⁻) dendritic cells, without a concomitant decrease in cDC1 (CD11b-CD8a+) cells comparing ERα short to ERα null or WT mice. Our data support a protective role for the ERα short protein. ERα short is similar to an endogenously expressed ERα variant (ERα46). Modulating its expression/activity represents a potential approach for treating female-predominant autoimmune diseases.

https://ift.tt/2DtAsYr

Reduction in human hair graying by sterubin, an active flavonoid of Eriodictyon angustifolium

Publication date: Available online 8 November 2018

Source: Journal of Dermatological Science

Author(s): Nobuhiko Taguchi, Toshihiro Hata, Emi Kamiya, Ai Kobayashi, Hitomi Aoki, Takahiro Kunisada

https://ift.tt/2Fdkkfi

Sagittal skeletal correction using symphyseal miniplate anchorage systems

Abstract

Objectives

Aim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class 2 and Class 3 deformities.

Methods

A total of 58 miniplates applied to 29 growing patients were evaluated. The first group comprised 24 symphyseal miniplates applied to 12 patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34 symphyseal miniplates applied to 17 patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate–screw anchorage system were evaluated.

Results

The overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2 miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups.

Conclusions

Symphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class 2 deformity correction. However, the success rates regarding the two treatment modalities were comparable.

https://ift.tt/2FmfJHQ

Simultaneous Pheochromocytoma, Paraganglioma, and Papillary Thyroid Carcinoma without Known Mutation.

Simultaneous Pheochromocytoma, Paraganglioma, and Papillary Thyroid Carcinoma without Known Mutation.

Case Rep Endocrinol. 2018;2018:6358485

Authors: Rasquin L, Prater J, Mayrin J, Minimo C

Abstract
Background: Pheochromocytoma/paraganglioma is a rare tumor from neuroendocrine cells. 1/3rd of cases have germline mutations. Papillary thyroid carcinoma (PTC) is a common neoplasm from follicular cells of the thyroid. We report a case of pheochromocytoma/paraganglioma and PTC with negative testing for common mutations.
Case: 32-year-old male with incidental liver mass during laparoscopy for acute appendicitis. His symptoms included abdominal pain and profuse axillary hyperhidrosis. MRI showed an 11x12x14 cm cystic and solid mass in right adrenal gland, and 3.4x2.9x3.8 cm mass in porta hepatis. Urine metanephrines was elevated. After preoperative alpha-blockade, patient underwent total right adrenalectomy. Pathology report confirmed diagnosis of pheochromocytoma. According to the Grading system for Adrenal Pheochromocytoma and Paraganglioma (GAPP), tumor's score was 9, indicating poorly differentiated tumor. Ki67 index 5% and S100 were negative. Postoperatively, plasma free metanephrines normalized but plasma free normetanephrines remained elevated. Based on this biochemical profile, presence of paraganglioma was suspected. CT showed 4.2x3.5 cm round soft tissue mass in porta hepatis which increased in size from previous MRI. Simultaneously, PET scan identified a 1.5 cm thyroid mass. Calcitonin level was normal. Fine-needle aspiration was consistent with PTC. Resection of the mass and total thyroidectomy were performed with confirmation of paraganglioma S100 positive and PTC. Normetanephrines decreased to 283 (<148 pg/mL); free metanephrines remained normal. Gene mutation of EGLN1, FH, KIF1B, MEN1, NF1, RET, SDHAF2, SDHC, SDHD, TMEM127, VHL, and SDHA was negative.
Conclusion: Whether paraganglioma/pheochromocytoma/PTC combination is coincidental or resulted from an underlying unknown mutation cannot be excluded.

PMID: 30405919 [PubMed]

https://ift.tt/2D9HjVU

Sagittal skeletal correction using symphyseal miniplate anchorage systems

Abstract

Objectives

Aim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class 2 and Class 3 deformities.

Methods

A total of 58 miniplates applied to 29 growing patients were evaluated. The first group comprised 24 symphyseal miniplates applied to 12 patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34 symphyseal miniplates applied to 17 patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate–screw anchorage system were evaluated.

Results

The overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2 miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups.

Conclusions

Symphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class 2 deformity correction. However, the success rates regarding the two treatment modalities were comparable.

https://ift.tt/2FmfJHQ

CORRECTION

Publication date: Available online 9 November 2018

Source: Journal of the American Academy of Dermatology

Author(s):

https://ift.tt/2QvGMkW

Prognostic Factors, Treatment, and Survival in Cutaneous Pleomorphic Sarcoma

Publication date: Available online 8 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Maria A. Ibanez, Kyle Rismiller, Thomas Knackstedt

Abstract

Background

Limited information exists on the influence of demographics, tumor characteristics, and treatment on survival in cutaneous pleomorphic sarcoma (CPS).

Objective

To describe incidence rates and prognostic factors affecting survival in CPS.

Methods

National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data (1972-2013) was analyzed for 2423 patients diagnosed with CPS.

Results

Age-adjusted incidence rate was 0.152 cases per 100,000 person-years and was 4.5-fold higher in males than females. Male gender, white race, and increasing age over 40 were significantly associated with decreased overall survival. Head and neck tumors, tumors over 15mm, and with grade III or IV histology had significantly decreased survival. Surgical excision had a survival benefit compared no treatment. Radiation therapy did not provide a survival benefit. Patients with localized disease had the greatest survival followed by regional and distant disease.

Limitations

SEER data may not be reflective of all CPS patients. Recurrences, restaging, or additional non-mortality events over time are not tracked.

Conclusions

and Relevance: Tumor size, grade, gender, age at diagnosis, and race appear to influence survival as prognostic factors in CPS. Surgical tumor extirpation provides a survival benefit over no treatment whereas primary or adjuvant radiation does not provide a survival benefit.

https://ift.tt/2qCgm5y

Characterization of the thymus in Lrp4 myasthenia gravis: Four cases

Publication date: Available online 8 November 2018

Source: Autoimmunity Reviews

Author(s): Inga Koneczny, Dorit Rennspiess, Florit Marcuse, Myurgia Abdul Hamid, Marina Damas, Jos Maessen, Paul Van Schil, Abhishek Saxena, Paraskevi Zisimopoulou, Konstantinos Lazaridis, Mark Woodhall, Katerina Karagiorgou, John Tzartos, Socrates Tzartos, Marc H. De Baets, Peter C. Molenaar, Alexander Marx, Axel zur Hausen, Mario Losen, Pilar Martinez-Martinez

Abstract

Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction. Most patients have pathogenic autoantibodies against the acetylcholine receptor (AChR). In the last years a novel subpopulation of MG patients has been described that harbors antibodies against low-density lipoprotein receptor-related protein 4 (Lrp4), another postsynaptic neuromuscular antigen. In early-onset AChR MG (EOMG), the thymus plays an important role in immunopathogenesis, and early thymectomy is beneficial. It is still unknown if the thymus plays any role in Lrp4-MG. In this pilot study, we compared thymus samples from four patients with Lrp4-MG (one pre-treated with immunosuppressive drugs), four non-MG controls and five EOMG patients (not pretreated with immunosuppressive drugs). Immunohistochemistry of the Lrp4-MG thymi revealed normal architecture, with normal numbers and distribution of B-cells, lymphoid follicles and Hassall's corpuscles. Primary CD23⁺ lymphoid follicles were similarly infrequent in Lrp4-MG and control thymic sections. In none of the control or Lrp4-MG thymi did we find secondary follicles with CD10⁺ germinal centers. These were evident in 2 of the 5 EOMG thymi, where primary lymphoid follicles were also more frequent on average, thus showing considerable heterogeneity between patients. Even if characteristic pathological thymic changes were not observed in the Lrp4 subgroup, we cannot exclude a role for the thymus in Lrp4-MG pathogenesis, since one Lrp4-MG patient went into clinical remission after thymectomy alone (at one year follow-up) and two more improved after thymectomy in combination with immunosuppressive therapy.

https://ift.tt/2JQQ2O4

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 New non-invasive photo-identification technique for free-ranging giant anteaters (Myrmecophaga tridactyla) facilitates urgently needed field studies Lydia Möcklinghoff, Karl-L. Schuchmann, Marinêz I. Marques Pages: 2397-2411 | DOI: 10.1080/00222933.2018.1537407 Genetic and morphometric variation of the Blackcap (Sylvia atricapilla) on the Azores Archipelago reveals a recent range expansion Pedro Rodrigues, Joana Micael, Roberto Resendes, Ricardo Jorge Lopes, Jaime Albino Ramos, Regina Tristão Cunha Pages: 2413-2435 | DOI: 10.1080/00222933.2018.1539194 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.

Real-world use of sunitinib in Japanese patients with pancreatic neuroendocrine tumors: results from a post-marketing surveillance study

Abstract

Background

Sunitinib is approved for the treatment of progressive, well-differentiated pancreatic neuroendocrine tumors (pNETs) in patients with unresectable, locally advanced or metastatic disease. Safety and efficacy data in Japanese patients are limited. We report outcomes from a post-marketing surveillance study of sunitinib treatment in Japanese patients.

Methods

Sunitinib 37.5 mg once daily was orally administered in Japanese patients aged ≥ 15 years with pNETs. The primary endpoints included adverse events (AEs) occurring during the observation period of 168 days and objective response rate (ORR).

Results

Sunitinib was administered in 62 patients with pNETs. The median duration of treatment was 165 days. At 168 days from the start of treatment, 31 patients were still receiving sunitinib treatment and treatment continuation rate was 50.0%. Of the 31 patients who discontinued treatment, 18 (58.1%) discontinued because of AEs and 16 (51.6%) patients discontinued due to insufficient clinical effect. Of the 18 patients who discontinued due to AEs, 10 did so within 42 days of treatment initiation. The most common all-grade AEs were platelet count decreased (33.9%), diarrhea (29.0%), neutrophil count decreased (27.4%), hypertension (24.2%), and palmar-plantar erythrodysesthesia syndrome (24.2%). In the 51 patients eligible for the efficacy analysis, ORR was 13.7% (95% confidence interval, 5.7–26.3) and clinical benefit rate was 70.6%.

Conclusions

There were no new safety concerns in real-world use of sunitinib in Japanese patients with pNETs. The short treatment duration likely led to low tumor response. Appropriate AEs management through dose interruption/reduction is essential for sunitinib treatment success in this patient population.

https://ift.tt/2QuqSHr