No abstract availablehttps://ift.tt/2FHxHVd
Δευτέρα 26 Νοεμβρίου 2018
3D Modeling and Mohs Surgery: A Novel Approach to Medical and Patient Education
No abstract availablehttps://ift.tt/2FHxHVd
0.01% Hypochlorous Acid as an Alternative Skin Antiseptic: An In Vitro Comparison
OBJECTIVE Compare the in vitro efficacy of hypochlorous acid 0.01% (HA), povidone iodine 5% (PI), chlorhexidine gluconate 4% (CHG), and isopropyl alcohol 70% (IPA) against common skin microorganisms. MATERIALS AND METHODS Time-kill studies were conducted against methicillin-susceptible Staphylococcus aureus (MSSA) and Staphylococcus epidermidis (MSSE), methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE), Candida albicans, Corynebacterium species (striatum and amycolatum), Propionibacterium acnes, Pseudomonas aeruginosa, Streptococcus pyogenes, Staphylococcus capitis, and Staphylococcus xylosus. RESULTS Methicillin-resistant S. aureus: Bactericidal effect was immediate for HA and IPA. For PI and CHG, the effect occurred at 1 and 10 minutes, respectively. Methicillin-resistant S. epidermidis: Hypochlorous acid, IPA, and PI had immediate bactericidal effects, whereas CHG required 1 minute. Methicillin-susceptible Staphylococcus aureus: All agents had bactericidal effects at 1 minute. C. species, S. pyogenes, P. aeruginosa, and P. acnes: All antiseptics demonstrated immediate bactericidal effects. Methicillin-susceptible Staphylococcus epidermidis and S. capitis: Hypochlorous acid and IPA had immediate effect, whereas PI and CHG required 1 minute. C. albicans: Hypochlorous acid, IPA, and PI were immediately bactericidal, whereas CHG required 1 minute. S. xylosus: Hypochlorous acid and CHG were immediately bactericidal, whereas IPA and PI required 1 and 2 minutes, respectively. CONCLUSION In vitro studies of HA 0.01% were observed to have equal or more efficacious antiseptic properties compared with IPA, CHG, and PI. Future studies will be needed to investigate its role in periocular use.https://ift.tt/2FS6Ypc
Reconstruction of a Defect of the Infratip and Soft Triangle
No abstract availablehttps://ift.tt/2r8upjK
Estimation of Prognosis in Invasive Cutaneous Melanoma: An Independent Study of the Accuracy of a Gene Expression Profile Test
BACKGROUND Cutaneous melanomas (CMs) with similar clinical and histopathologic features can harbor differing capacities for metastasis. A validated gene expression profile (GEP) test offers prognostic information by classifying CMs as low risk (Class 1A/1B) or high risk (Class 2A/2B) for metastasis. OBJECTIVE The authors sought to perform an independent study of the predictive accuracy of the GEP test, to determine what clinical and histopathologic features predict high-risk classification, and to evaluate how intermediate classes (1B & 2A) performed clinically. MATERIALS AND METHODS Using our institution's prospectively collected melanoma registry, the authors identified patients who had been treated for CM within the last 5 years and undergone GEP testing. Clinical, histopathologic, and outcomes data were analyzed. A subcohort of patients with known metastatic disease were identified and tested. RESULTS The GEP test accurately identified 77% of metastatic CMs as high risk (Class 2). The GEP had a negative predictive value of 99% for Class 1 CMs. Class 2 CMs were 22 times more likely to metastasize. CONCLUSION The GEP test's performance in our independent cohort corresponded with previous industry-sponsored studies and proved to be a helpful clinical prognostic tool with the potential to direct patient care protocols.https://ift.tt/2FJIBKd
Reconstruction of a Large Scalp Defect Devoid of Periosteum
No abstract availablehttps://ift.tt/2SgfzDj
Responses to Topical Diphenylcyclopropenone as an Adjunct Treatment for In-Transit Melanoma: A Tertiary Referral Center Experience
BACKGROUND In-transit cutaneous metastases occur in 5% to 10% of patients with melanoma. Recently, topical diphenylcyclopropenone (DPCP) has been described as a treatment option. OBJECTIVE To evaluate efficacy of DPCP in treatment of in-transit cutaneous melanoma. METHODS The authors retrospectively reviewed the records of 13 consecutive patients with in-transit metastases treated with topical DPCP between March 1, 2013, and January 31, 2017. The authors recorded the response of in-transit cutaneous melanoma lesions treated with DPCP measured by clinical examination. RESULTS Among the 13 patients, 9 patients completed at least a 1-month course of DPCP treatment. Of these 9 patients, 6 (66.7%) maintained either stable disease or had a partial or complete regression, and 3 (33.3%) had progressive disease. Patients with less burden of disease (e.g., 25 lesions or plaques). Both patients who received DPCP alone had progression of their cutaneous lesions. One patient who did not become sensitized to DPCP died within 2 months, and his anergy likely reflecting immense burden of disease. CONCLUSION Topical DPCP is a low-cost, patient-applied treatment option for in-transit melanoma, most effective for patients with relatively low tumor burden and localized disease.https://ift.tt/2DW4wfi
Treatment of Pediatric Treadmill Burn Contractures With Ablative Fractional Laser and Topical Triamcinolone Suspension
No abstract availablehttps://ift.tt/2Sdd6te
Plasma Exeresis Treatment for Epidermoid Cysts: A Minimal Scarring Technique
BACKGROUND Epidermoid cysts are cutaneous benign tumors commonly seen in young or middle-aged adults. Plasma exeresis is an innovative technique for several skin conditions: it causes ionization of the atmospheric gas between the proximal tip of the device and the tissue to be treated, creating sublimation of the tissue. OBJECTIVE To remove the cyst with a novel technique that allows a good cosmetic result. MATERIALS AND METHODS Patients with clinical diagnosis of at least one epidermal cyst, aged between 18 and 70 years were enrolled. A standardized procedure was used. After administration of topical and sometimes local anesthesia (for cysts bigger than 1 cm), a tiny hole was created with plasma exeresis. The content of the cyst was then extruded and Micro Hartman Alligator Ear Forceps pulled out the loosened capsule. RESULTS Twenty patients aged between 18 and 68 years were enrolled: 11 males (55%) and 9 females (45%). Twenty-eight cysts were successfully removed. The diameter ranged from 3 to 24 mm. No side effects were observed. The scar measured not more than 3 mm. CONCLUSION This study suggests that plasma exeresis could represent a good and safe option to remove noninfected cysts on cosmetic areas, although further study is required.https://ift.tt/2DWHqW9
Enhancement of Photodynamic Therapy for Bowen's Disease Using Plum-Blossom Needling to Augment Drug Delivery
BACKGROUND Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery. OBJECTIVE To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone. MATERIALS AND METHODS Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100–200 J/cm2). The ALA-PDT group received ALA cream and irradiation only. RESULTS At 6 weeks, the PBN-ALA-PDT and ALA-PDT groups achieved complete response (CR) rates of 77.78% (14/18 lesions) and 40% (7/20 lesions), respectively, (phttps://ift.tt/2DYgchL
Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience
BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients.https://ift.tt/2DZFNqD
Basal Cell Adenoma of the Upper Lip Treated With Mohs Micrographic Surgery
No abstract availablehttps://ift.tt/2Sgfz6h
Retrospective Evaluation of the Safety of Large Skin Flap, Large Skin Graft, and Interpolation Flap Surgery in the Outpatient Setting
BACKGROUND As the number of cutaneous surgeries continues to increase, it is important to evaluate the safety of dermatologic surgery in the outpatient setting. OBJECTIVE The authors sought to determine postoperative bleeding, infection, dehiscence, and necrosis rates in office-based dermatologic surgery using large flap, large graft, and interpolation flap repairs. The authors evaluated the relationship between these complications and surgical site, closure type, repair size, antibiotic use, and antithrombotic use. METHODS Eligible patients were identified through searching the electronic medical records from one Mohs micrographic surgeon at University Hospitals Medical Center. Patient information, surgery characteristics, and complication information were collected. Univariate and multivariate analyses were conducted to reveal associations between each complication and closure type, repair size, repair site, antithrombotic use, and antibiotic use. RESULTS Three hundred and thirty-one reconstruction procedures after Mohs micrographic surgery and excision qualified for the study. The rates of postoperative infection, hemorrhage, hematoma, necrosis, and dehiscence were 5%, 0.3%, 2.4%, 3%, and 0.9%, respectively. CONCLUSION Complications were infrequent and non–life-threatening. The authors' results indicate that dermatologic surgery using large flaps, interpolation flaps, and large grafts is safe in the office setting.https://ift.tt/2E1WIIU
Reliability of the Patient and Observer Scar Assessment Scale When Used With Postsurgical Scar Photographs
No abstract availablehttps://ift.tt/2Sd0BxL
Relationship Between Midface Volume Deficits and the Appearance of Tear Troughs and Nasolabial Folds
BACKGROUND Understanding interrelationships among aging facial features is important in facial aesthetics as a global treatment approach becomes standard. OBJECTIVE Examine empirical relationships between midface volume deficit and severity of tear troughs (TTs) and nasolabial folds (NLFs) in women and men of different racial/ethnic groups. METHODS A web-based study was administered to health panel members (aged 18–75 years). Participants compared their midface volume, TTs, and NLFs against photonumeric scales depicting degrees of severity. Linear regressions were conducted to assess the relationship of midface volume on severity of TTs and NLFs, controlling for demographic factors. RESULTS Of 4,086 participants (80.0% female), 3,553 had complete data. Increasing severity of midface volume deficit was associated with increasing severity of TTs and NLFs in both sexes (all phttps://ift.tt/2DXye3z
Review of the Evaluation and Treatment of Vasovagal Reactions in Outpatient Procedures
BACKGROUND A vasovagal reaction is a commonly encountered event in outpatient procedures. There is a paucity of discussion on vasovagal reactions (VVRs) in the dermatologic surgery literature. However, recent investigations in the physiology, evaluation, and treatment of VVRs have been reported in other specialties. OBJECTIVE A comprehensive review of the physiology, evaluation, treatment, and prevention of VVRs. MATERIALS AND METHODS A search as performed using the PubMed/MEDLINE databases. Search terms included "vasovagal," "vasovagal reaction," "syncope," "reflex syncope," "neurocardiogenic syncope," and "fainting." RESULTS Studies demonstrate greater understanding in the physiology of a vasovagal reaction. Although permanent sequelae are uncommon, it is important to respond in a prompt manner. A variety of treatment and prevention options are presented. CONCLUSION Vasovagal reactions should be carefully evaluated. Additional studies may provide greater data in understanding and managing vasovagal reactions.https://ift.tt/2SdJE6j
Efficacy, Safety, and Subject Satisfaction After AbobotulinumtoxinA Treatment of Upper Facial Lines
BACKGROUND Botulinum toxins are the treatment of choice for wrinkles in the upper third of the face. OBJECTIVE The purpose of this study was to evaluate the efficacy, safety, and subject satisfaction of abobotulinumtoxinA (ABO) for treatment of upper facial lines. MATERIALS AND METHODS Subjects aged 35 to 50 years with moderate-to-severe upper facial lines were included in this study. Subjects received a maximum of 125 s.U. ABO in at least 2 indications with optional touch-up after 2 weeks. Assessments included wrinkle severity, global aesthetic improvement, subject satisfaction, and adverse events (AEs) 1, 3, and 6 months after treatment. RESULTS At Month 1, 100, 94, and 93% of subjects were responders in dynamic glabellar, lateral canthal, and forehead lines, respectively. All subjects were improved 1 month after treatment, and the majority of the subjects were still improved after 6 months. After treatment, most subjects were satisfied with the appearance of their face, felt better about themselves, and agreed that the treatment made them look the way they feel. Seven subjects (22%) had 8 ABO-related AEs (mild–moderate); headache was most commonly reported (9%). CONCLUSION AbobotulinumtoxinA effectively treated upper facial lines, with high patient satisfaction. Treatment was generally well-tolerated.https://ift.tt/2E0TWUu
Systemic Therapy Use and Outcomes After Relapse from Preoperative Radiation and Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma
AbstractBackground.Multimodality therapy with preoperative radiation (RT) followed by extrapleural pneumonectomy (EP) for patients with operable malignant pleural mesothelioma (MPM) has demonstrated encouraging results. At relapse, there are few data on the tolerance and efficacy of systemic therapies after prior multimodality therapy.Materials and Methods.We conducted a retrospective analysis of patients with relapsed MPM after RT and EPP ± adjuvant chemotherapy to determine overall survival (OS; date of relapse to death) and the proportion of patients that received systemic therapy and associated response rate (RR). OS was estimated using Kaplan–Meier method and potential prognostic variables were examined.Results.Fifty‐three patients were included (2008–2016). Median OS was 4.8 months (median follow‐up 4.4 months, range 0.03–34.8). Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, disease‐free interval (DFI) <1 year, and hemoglobin ≤110 g/L at recurrence were associated with worse prognosis. Thirty‐six percent of patients received any systemic therapy, whereas it was omitted in 62% because of poor PS. RR was 15% (0 complete responses, 15% partial responses) in 13 individuals with response‐evaluable disease. Therapy was discontinued because of toxicity (6/15) or disease progression (5/15), and median number of cycles was four.Conclusion.Patients with relapsed MPM following RT and EPP, especially those with ECOG PS ≥2, DFI <1 year, and hemoglobin ≤110 g/L at recurrence, have poor prognosis and low RR to first‐line systemic therapy. Earlier detection and novel diagnostic markers of relapse as well as potential neoadjuvant or adjuvant systemic therapy should be investigated in future studies.Implications for Practice.The results of this study have reinforced the importance of careful selection of appropriate candidates for this combined‐modality approach and favor prompt detection of recurrence with early and regular postoperative imaging and biopsy of suspected relapsed disease along with rapid initiation of systemic therapy even in patients with very low burden of disease. Furthermore, with the emergence of new systemic agents targeting different histological subtypes of malignant pleural mesothelioma, histological sampling of recurrence could inform therapeutic decisions in the future.
https://ift.tt/2zpuJPp
Phase I, First‐in‐Human, Dose‐Escalation Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Vorolanib in Patients with Advanced Solid Tumors
AbstractLessons Learned. Pharmacokinetic results underscore that the vorolanib (X‐82) study design was successful without the need for further dose escalation beyond 400 mg once daily (q.d.).Therefore, the recommended dose of X‐82 as a single agent in patients with advanced cancer is 400 mg q.d.Background.Vorolanib (X‐82) is a novel, oral, multikinase vascular endothelial growth factor (VEGF) receptor/platelet‐derived growth factor (PDGF) receptor inhibitor that was developed on the same chemical scaffold as sunitinib, but designed to improve upon the safety profile while maintaining the efficacy of sunitinib. By targeting the VEGF and PDGF receptors, X‐82 was expected to disrupt tumor angiogenesis and be active in a broad spectrum of solid tumors. Therefore, we determined the maximum tolerated dose (MTD) and characterized the preliminary pharmacokinetics and clinical tumor response of X‐82 as a single agent in patients with advanced solid tumors.Methods.Adult patients with advanced solid tumors received X‐82 as tablets or capsules (once daily [q.d.] or b.i.d.) every 4 weeks. Patients were evaluated for response every 8 weeks, and continued treatment until disease progression or intolerable toxicity.Results.Fifty‐two patients received study treatment in 17 cohorts. X‐82 capsule dosing was as follows: cohorts 1–6 (20–400 mg q.d.) and cohorts 7–8 (140–200 mg b.i.d.). Patients in cohorts 9–17 received 50–800 mg q.d. tablet dosing. The median time on treatment was 58 days. X‐82 blood pharmacokinetics appeared dose‐independent with a t1/2 of 5.13 hours and 6.48 hours for capsule and tablet formulations, respectively. No apparent accumulation was observed after 21 days of daily dosing.Conclusion.X‐82 had a safety profile consistent with its mechanism of action. It has a short half‐life and was well tolerated by most patients. Study enrollment ended prior to the determination of the MTD because of the apparent saturation of absorption at 400–800 mg. The recommended dose of X‐82 as a single agent in patients with advanced cancer is 400 mg q.d.
https://ift.tt/2P5mtsU
Use of a modified BAPRAS Delphi process for research priority setting in Plastic Surgery in the UK
The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) aims to raise understanding of the profession, and to promote innovation, education, and research. The latter is the remit of its Research Committee.
https://ift.tt/2FSgR5U
Development of the Metabolic Syndrome: Study Design and Baseline Data of the Lufthansa Prevention Study (LUPS), A Prospective Observational Cohort Survey
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0767-6361
The Lufthansa Prevention Study (LUPS) study is a prospective observation of a healthy worker cohort to identify early changes in metabolism leading to the Metabolic Syndrome (MetS) and to analyze their relation to behavioral factors like nutrition, physical activity, psychological status, and to underlying genetic conditions. The LUPS study recruited a sample of 1.962 non-diabetic healthy adults between 25–60 years, employed at a flight base of Lufthansa Technik GmbH in Hamburg, Germany. Baseline assessments included anthropometric measures, blood and urine samples and medical history. Psychosocial variables, dietary habits and life-style risk factors were assessed via self-reported questionnaires.In this report we describe the study design and present baseline parameters including the prevalence of the MetS using different classification criteria. The MetS was present in 20% of male and 12% of female subjects according to the 'Harmonizing the metabolic syndrome' definition. The prevalence varies between 2.6% in male and 2.3% in female subjects up to 48% in male and 41% in female subjects according to different classification criteria of MetS.In conclusion, this first cross-sectional view on the LUPS data confirms the expectation that this cohort is rather healthy and thus provides the opportunity to analyze early changes associated with the development of the MetS. The LUPS study is registered as a clinical trial NCT01313156.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2THByVj
Estimation of implant size based on mammograms in immediate breast reconstruction
Abstract
Background
Implant size selection is a critical component of preoperative planning for immediate breast reconstruction. This paper introduces a novel formula, based on preoperative mammograms, for estimating implant volume in patients undergoing immediate breast reconstruction.
Methods
A retrospective analysis of 115 consecutive patients with immediate breast reconstruction following skin or nipple sparing mastectomy was performed. A calculated implant size was obtained using the formula, calculated implant size (ml) = π × height (cm) × [base width (cm) − 3]. The calculations were performed independently by two surgeons and based on the ipsilateral preoperative mammogram. The calculated implant size was compared with the actual implant size used during the surgery and results were analysed.
Results
The mean calculated and actual implant sizes were 376.03 ml and 324.49 ml, respectively. There was no difference found between calculated and actual implant sizes (t = − 1.704, p = 0.090), and there was a strong positive correlation between calculated and actual implant sizes (r = 0.7748, p < 0.00001). Further analysis revealed greater accuracy of the formula in patients with an estimated implant size of less than 350 ml, and a tendency to overestimate implant size in breasts with an estimated volume of more than 350 ml.
Conclusions
The mammography-based formula is a simple and practical method to estimate implant size preoperatively. Ultimately, implant selection for the best possible cosmetic outcome is a multifactorial process, of which breast volume is one consideration. This formula can serve as a useful adjunct for preoperative assessment.
Level of Evidence: Level III, diagnostic study.
https://ift.tt/2PToYUC
Impact of androgen deprivation therapy on apparent diffusion coefficient and T2w MRI for histogram and texture analysis with respect to focal radiotherapy of prostate cancer
Abstract
Purpose
Accurate prostate cancer (PCa) detection is essential for planning focal external beam radiotherapy (EBRT). While biparametric MRI (bpMRI) including T2-weighted (T2w) and diffusion-weighted images (DWI) is an accurate tool to localize PCa, its value is less clear in the case of additional androgen deprivation therapy (ADT). The aim of this study was to investigate the value of a textural feature (TF) approach on bpMRI analysis in prostate cancer patients with and without neoadjuvant ADT with respect to future dose-painting applications.
Methods
28 PCa patients (54–80 years) with (n = 14) and without (n = 14) ADT who underwent bpMRI with T2w and DWI were analyzed retrospectively. Lesions, central gland (CG), and peripheral zone (PZ) were delineated by an experienced urogenital radiologist based on localized pre-therapeutic histopathology. Histogram parameters and 20 Haralick TF were calculated. Regional differences (i. e., tumor vs. PZ, tumor vs. CG) were analyzed for all imaging parameters. Receiver-operating characteristic (ROC) analysis was performed to measure diagnostic performance to distinguish PCa from benign prostate tissue and to identify the features with best discriminative power in both patient groups.
Results
The obtained sensitivities were equivalent or superior when utilizing the TF in the no-ADT group, while specificity was higher for the histogram parameters. However, in the ADT group, TF outperformed the conventional histogram parameters in both specificity and sensitivity. Rule-in and rule-out criteria for ADT patients could exclusively be defined with the aid of TF.
Conclusions
The TF approach has the potential for quantitative image-assisted boost volume delineation in PCa patients even if they are undergoing neoadjuvant ADT.
https://ift.tt/2r63gxZ
Neonatal gut colonisation by Staphylococcus aureus strains with certain adhesins and superantigens is negatively associated with subsequent development of atopic eczema
Abstract
Background
Insufficient early immune stimulation may predispose to atopic disease. Staphylococcus aureus, a skin and gut colonizer, produces the B‐cell mitogen protein A and T‐cell activating superantigens. Early gut colonization by S. aureus strains that possess the superantigens encoded by enterotoxin gene (egc) cluster and the elastin‐binding protein, is negatively associated with development of atopic eczema.
Objectives
To investigate whether these findings could be replicated in a second birth‐cohort, FARMFLORA and, secondly, whether nasal colonization by S. aureus also relates to subsequent atopic eczema development.
Methods
Faecal samples and nasal swabs from infants in the FARMFLORA birth‐cohort (N=65) were cultured for S. aureus. Individual strains were distinguished by RAPD (random amplified polymorphic DNA) and assessed for adhesin and superantigen gene carriage by PCR. Atopic eczema at 18 months of age was related to nasal and gut S. aureus colonisation patterns during the first 2 months of life (well before onset of eczema).
Results
S. aureus colonisation per se was unrelated to subsequent eczema development. However, gut S. aureus strains from the infants who subsequently developed atopic eczema less frequently carried the ebp gene, encoding elastin‐binding protein, and superantigen genes encoded by the egc, as compared to strains from children who remained healthy. Nasal colonization by S. aureus was less clearly related to subsequent eczema development.
Conclusion
The results precisely replicate our previous observations and may suggest that mucosal colonisation by certain S. aureus strains provides immune stimulation that strengthens the epithelial barrier and counteracts the development of atopic eczema.
This article is protected by copyright. All rights reserved.
https://ift.tt/2PSBQKJ
Social media and psoriasis treatment: What are people saying on Twitter?
Abstract
Almost half of households use the internet for seeking health related information. Because there is no regulation over the accuracy of this information, disease myths and unconventional remedies may be perpetuated. There are few studies that have used social media as a tool to assess people's perception of psoriasis or its treatment. Our aim was to evaluate commonly discussed psoriasis treatments on the social media site Twitter.
This article is protected by copyright. All rights reserved.
https://ift.tt/2Rfl5Wu
Gene expression profiling in aggressive digital papillary adenocarcinoma sheds light on the architecture of a rare sweat gland carcinoma
Abstract
Background
Sweat gland carcinomas are rare cutaneous adnexal malignancies. Aggressive digital papillary adenocarcinoma (ADPA) represents a very rare sub‐entity, thought to arise almost exclusively from sweat glands of the fingers and toes. The aetiology of sweat gland carcinomas and ADPA is largely unknown. ADPAs are most likely driven by somatic mutations. However, somatic mutation patterns are largely unexplored, creating barriers to the development of effective therapeutic approaches to the treatment of ADPA.
Objective
To investigate the transcriptome profile of ADPA using a sample of eight formalin‐fixed, paraffin embedded (FFPE) tissue samples of ADPA and healthy control tissue.
Methods
Transcriptome profiling was performed using the Affymetrix PrimeView Human Gene Expression Microarray and findings were validated via reverse‐transcription of RNA and real‐time qPCR.
Results
Transcriptome analyses showed increased tumour expression of 2,266 genes, with significant involvement of cell cycle, ribosomal and crucial cancer pathways. Our results furthermore point to tumour‐overexpression of FGFR2 (p = 0.001).
Conclusions
Our results indicate the involvement of crucial oncogenic driver pathways, highlighting cell cycle and ribosomal pathways in the aetiology of ADPA. Suggested tumour‐overexpression of FGFR2 raises the hope that targeting the FGF/FGFR axis might be a promising treatment for ADPA and probably for the overall group of sweat gland carcinomas.
This article is protected by copyright. All rights reserved.
https://ift.tt/2PSQGAS
Cadmium exposure alters steroid receptors and proinflammatory cytokine levels in endothelial cells in vitro: a potential mechanism of endocrine disruptor atherogenic effect
Abstract
Background
Cadmium (Cd) is a widespread environmental pollutant that causes alterations in human health acting as endocrine disruptor. Recent data suggest that cardiovascular system might be a contamination target tissue, since Cd is found in atheromatic plaques. Thus, the purpose of this study was to evaluate the consequence of Cd exposure of endothelial cells in vitro to evaluate detrimental effect in vascular system by a potential sex-steroid hormone receptor-dependent mechanism(s).
Methods
To this aim, Human Umbilical Vein Endothelial Cells (HUVECs) were cultured and exposed to several concentrations of cadmium chloride (CdCl2) for different interval times.
Results
CdCl2 exposure of HUVECs induced a significant increase of ERβ and Cyp19a1 at both mRNA and protein levels, while a drastic dose-dependent decrease of AR expression level was observed after 24 h of exposure. On the contrary, an increase of PhARser308 as well as a reduction of PhGSK-3βser9 and PhAKTser473 was detected after 1 h treatment. This effect was consistently reduced by GSK inhibition. Furthermore, CdCl2 abolished DHT-induced cell proliferation in HUVECs suggesting an antagonist-like effect of Cd on AR-mediated signaling. Remarkable, after 6 h CdCl2—treatment, a relevant increase in TNF-α, IL-6 and IL-8 mRNA was observed and this effect was blocked by the presence of an ERβ-selective antagonist. Moreover, Cd-induced TxR1 overexpression, likely, correlated with the activation of p38 MAPK/NF-κB pathway.
Conclusion
In conclusion, our study demonstrates for the first time that Cd alters sex-steroid hormone receptors level and activity likely affecting intracellular signaling linked to a proinflammatory state in endothelial cells. This alteration might possibly lead to endothelial cell injury and vascular dysfunction and could be a mechanism of gender-specific atherogenic damages induced by endocrine disruptors and, thus, induce atherogenic events with increased risk of cardiovascular diseases in individuals exposed to this endocrine disruptor.
https://ift.tt/2RfoXHl
Linac-based radiosurgery or fractionated stereotactic radiotherapy with flattening filter-free volumetric modulated arc therapy in elderly patients
Abstract
Aim
The aim of this study was to analyze the feasibility and clinical results of linear accelerator (linac-)based stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) with flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) in elderly patients affected by brain metastases (BMs).
Patients and methods
Patients selected for the present analysis were ≥65 years old with a life expectancy of >3 months, a controlled or synchronous primary tumor, and <10 BMs with a diameter <3 cm. All patients were treated with FFF linac-based SRS/SFRT. The prescribed total dose (15–30 Gy/1–5 fractions) was based on BM size and proximity to organs at risk (OAR). Toxicity was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. MedCalc v18.2 (MedCalc Software, Ostend, Belgium) was used for statistical analysis.
Results
From April 2014 to December 2017, 40 elderly patients with 110 BMs were treated by FFF linac-based SRS/SFRT. With a median follow-up of 28 months (range 6–50 months), median and 1‑year overall survival were 9 months and 39%, respectively; median intracranial progression-free survival was 6 months. At the time of the analysis, local control was reported in 109/110 BMs (99.1%): 12 BMs had a complete response; 51 a partial response; 46 showed stable disease. One BM (0.9%) progressed after 2 months. BM volume (<1 cc) and higher SRS/SFRT dose correlated to treatment response (p = 0.01 and p = 0.0017, respectively). No adverse events higher than grade 2 were observed.
Conclusion
The present findings highlight the feasibility, safety, and effectiveness of FFF linac-based SRS/SFRT in elderly patients with BMs.
https://ift.tt/2QmAF5I
Vitamin D receptor ApaI, TaqI, BsmI, and FokI polymorphisms and psoriasis susceptibility: an updated meta‐analysis
Summary
Background
Vitamin D is considered a regulator of the immune system, and its polymorphisms have been associated with psoriasis in some but not all reports.
Aim
To explore whether vitamin D receptor (VDR) polymorphisms are associated with susceptibility to psoriasis.
Methods
Meta‐analyses were conducted to determine the associations between psoriasis and the VDR ApaI, TaqI, BsmI and FokI polymorphisms in all participants, and stratified by ethnic group.
Results
In total, 16 studies on VDR polymorphisms and psoriasis were included in this meta‐analysis, which involved 2086 patients and 2182 controls. The meta‐analysis indicated an association between psoriasis and the VDR TaqI TT genotype in Caucasian (OR = 1.29, 95% CI = 1.00–1.66, P < 0.05), but not in Asian (OR = 1.32, 95% CI = 0.89–1.96, P = 0.16) populations. However, no association was found between psoriasis and the VDR TaqI polymorphism using dominant, allele contrast or homozygous contrast models. No association was found between psoriasis and either the VDR ApaI, BsmI or FokI polymorphisms by meta‐analyses of the allele contrast, recessive, or dominant models or homozygous contrast models in the overall, Caucasian or Asian populations.
Conclusion
This meta‐analysis showed that polymorphisms in VDR ApaI, BsmI and FokI are not associated with psoriasis susceptibility in overall, Caucasian or Asian populations. However, the VDR TaqI polymorphism is associated with psoriasis susceptibility in Caucasian populations.
https://ift.tt/2RjUKXH
Comparison of NODDI and spherical mean signal for measuring intra-neurite volume fraction
Publication date: Available online 26 November 2018
Source: Magnetic Resonance Imaging
Author(s): Hua Li, Rahul Nikam, Vinay Kandula, Ho Ming Chow, Arabinda K. Choudhary
Abstract
Purpose
Neurite orientation dispersion and density imaging (NODDI) is a clinically feasible approach to measure intra-neurite volume fraction (fin). However, the sophisticated fitting procedure takes several hours. And the NODDI model relied on several questionable assumptions. Recent analytical work demonstrated that fin could be simply calculated from the spherical mean signal (MEANS) averaged over all gradient directions with a more solid theoretical foundation. The current study aims to compare NODDI and MEANS for measuring fin in human brain and investigate the potential of MEANS as a fast approach in clinics.
Methods
NODDI fin and MEANS fin were measured and compared on the same dataset. NODDI fin was obtained using the NODDI MATLAB Toolbox. MEANS fin is the product of the spherical mean signal and 2bD/π, where D is the intra-neurite intrinsic diffusivity.
Results
NODDI fin and MEANS fin maps are similar. The voxel-by-voxel correlation suggests that NODDI fin and MEANS fin are approximately equivalent to each other.
Conclusion
MEANS may have potential to serve a fast and simple approach to estimate fin in clinics.
https://ift.tt/2zuJ6SJ
Independent Contributions of Semantic and Phonological Working Memory to Spontaneous Speech in Acute Stroke
Publication date: Available online 26 November 2018
Source: Cortex
Author(s): Randi C. Martin, Tatiana T. Schnur
Abstract
Patients with left hemisphere stroke often have language deficits which impair their ability to produce phrases and sentences. One possible source of these speech impairments is the disruption of verbal working memory (WM). Single-case studies of chronic stroke have suggested the existence of a WM capacity specific to maintaining semantic information that is critical for preparing multiple words in phrases prior to speech onset (Martin & Freedman, 2001; Martin & He, 2004; Martin, Miller, & Vu, 2004; Freedman, Martin, & Biegler, 2004). The current study tested this hypothesis by examining spontaneous narrative language production and working memory capacities in a large sample of individuals at the acute stage of stroke (N=36), prior to the reorganization of function or strategy development. Here we show using a multiple regression approach that patients' semantic but not phonological WM capacity had an independent contribution in predicting phrasal elaboration and increasing utterance length whereas patients' phonological but not semantic WM capacity had an independent contribution in predicting a more rapid speech rate. Importantly, neither WM capacity independently predicted grammatical abilities in speech, implying that the other relations did not result from overall severity. These results indicate that separable semantic and phonological WM components exist that support different aspects of narrative speech. To our knowledge, this is the first study to examine spontaneous speech in a large group of acute stroke patients demonstrating a critical relationship between working memory and the ability to produce more words in phrases and longer utterances.
https://ift.tt/2SeMJmz
Resting state functional connectivity and neural correlates of face-name encoding in patients with ischemic vascular lesions with and without the involvement of the left inferior frontal gyrus
Publication date: Available online 26 November 2018
Source: Cortex
Author(s): Alana X. Batista, Paulo R. Bazán, Adriana B. Conforto, Maria da Graça M. Martins, Maurício Hoshino, Sharon. S. Simon, Benjamin Hampstead, Eberval Gadelha Figueiredo, Marcia P. Castro, Debora Michelan, Edson Amaro, Eliane C. Miotto
Abstract
Face-name association is a relevant ability for social interactions and involves the ventral and dorsolateral prefrontal cortices, particularly in the left hemisphere, bilateral hippocampal, fusiform gyrus and occipital regions. Previous studies demonstrated the primary role of the hippocampus for this ability in healthy subjects. However, no study has examined the participation of the left inferior frontal area, specially the left inferior frontal gyrus (LIFG) in patients with ischemic vascular lesions. In the present study we addressed this issue and investigated the neural correlates and resting state functional connectivity of face-name memory encoding in ischemic patients with LIFG or without lesions in the left IFG (nLIFG) and healthy controls (HC) using fMRI. The main results showed that the nLIFG group demonstrated efficient compensation related to encoding and performance on face-name learning and recognition memory task, in addition to similar brain areas activated during task performance compared to healthy controls. Some of these areas were more activated in nLIFG group, indicating a compensation mechanism. In contrast, the LIFG group showed worse behavior performance, and no signs of an efficient compensation mechanism. Functional connectivity analysis suggested that the left IFG region seems to be important for maintaining the connectivity of the right fusiform gyrus or, perhaps, lesion in this area is associated to maladaptive reorganization. Our findings highlight the relevant role of the left IFG in face-name learning and encoding, possibly as a primary region in addition to the bilateral hippocampal formation and fusiform gyrus.
https://ift.tt/2DY03bY
Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 39-40
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Nomograms for incident risk of postpartum type 2 diabetes in Chinese women with gestational diabetes
Abstract
Worldwide the prevalence of type 2 diabetes (T2D) is increasing. Using the 2010 ADA criteria, the burden for China is already especially high. Gestational diabetes mellitus (GDM) is one of the major predictors of subsequent diabetes. A systematic review assessed the risk as seven‐fold but the studies were heterogenous2 Incidence varies with socioeconomic status and ethnicity.
This article is protected by copyright. All rights reserved.
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