A novel histopathological scoring system for patients with oral squamous cell carcinoma

Abstract

Objectives

Tumor invasion into blood and/or lymphatic vessels, perineural invasion, and histopathological grading are evaluated to assess the biological aggressiveness of oral squamous cell carcinoma (OSCC). We aim to assess the prognostic impact of a novel scoring system, based upon the aforementioned histological parameters.

Materials and methods

Retrospective chart review of 334 patients with treatment-naive squamous cell carcinoma of the oral cavity. Statistical analysis was performed using univariate and multivariate analysis. Histological grade G1 or G2 were assigned 0 points and G3 or G4 1 point. Invasion of the lymphatic vessels, blood vessels, or perineural space was given 1 point. Zero points were given, when invasion was not detectable. The final score was conducted through addition of each parameter. Therefore, our scoring system ranged between 0 and 4 points.

Results

T-classification (p < 0.001), N-classification (p < 0.001), UICC stage (p < 0.001), extracapsular spread (p < 0.001), locoregional recurrence (p < 0.001), and overall survival (p < 0.001) were significantly associated with the OSCC-Histoscore. In multivariate analysis, T-classification (p = 0.001), N-classification (p = 0.039), resection margins (p = 0.038), and OSCC-Histoscore (p < 0.001) were independent prognostic markers for overall survival rate.

Conclusion

Our presented OSCC-Histoscore serves as a strong independent prognostic parameter for 5-year overall survival (OS) and predicts OS better than T-classification, N-classification, and resection margins.

Clinical relevance

Our presented histoscore improves prediction of the overall survival of patients with OSCC.

http://bit.ly/2sGAEMg

High efficiency inactivation of microalgae in ballast water by a new proposed dual-wave UV-photocatalysis system (UVA/UVC-TiO 2 )

Abstract

A new synergistic method was developed to inactivate marine microalgae using combined longwave ultraviolet (UVA) and shortwave ultraviolet (UVC)-photocatalysis (UVA/UVC-TiO₂) technology. Five kinds of representative marine microalgae in three phyla were used as inactivating targets to examine the inactivation effect. Compared with the photocatalytic systems using UVA or UVC alone as the light source, the algae inactivation ratio in the newly developed system increased by 0.31 log or 0.19 log, and the chlorophyll a removal rate increased by 17.5% or 9.7%, respectively. Total suspended solids (TSS) of the seawater did not cause remarkable impact on the inactivation process, and the increase of UV radiation intensity improved the treatment effect significantly. Further, UVA/UVC-TiO₂ treatment causes irreversible damage to microalgae cell membrane. The content of lipid peroxidation product malondialdehyde (MDA) increased rapidly within a short period of time, and a large number of proteins leaked out. The results of this study indicated that UVA/UVC-TiO₂ was an effective method to solve the challenge of efficient inactivation of plankton in ballast water containing a high density of suspended matter.

http://bit.ly/2WbEfj1

Epicardial adipose tissue is a predictor of decreased kidney function and coronary artery calcification in youth- and early adult onset type 2 diabetes mellitus

Abstract

Purpose

To examine the association of epicardial and pericardial fat volume (EFV, PFV) with cardiovascular risk factors and kidney function in Native Americans of southwestern heritage with youth and early adult onset type 2 diabetes mellitus (T2DM) versus healthy controls.

Methods

Using computed tomography, we quantified EFV and PFV in 149 Native Americans (92 women, 57 men), 95 of which had T2DM (38 diagnosed prior to age 20 years). Duration of T2DM, mean carotid arterial mass (AM), coronary artery calcification (CAC), IL-6, and estimated glomerular filtration rate eGFR_cr(CKD-EPI) were measured.

Results

EFV and PFV were associated with BMI (r = 0.37, p < 0.0001; r = 0.26, p = 0.001) and did not differ between onset age-groups and controls (p > 0.05). EFV was associated with AM only in controls (r = 0.51, p < 0.0001). After adjustment for BMI, T2DM duration, HbA1C, age, and sex, EFV was a predictor of CAC and IL-6 concentrations in early adult onset T2DM (β = 0.05 ± 0.02 cm³, p = 0.03; β = 0.05 ± 0.01 pg/ml/cm³, p = 0.002). EFV and PFV were independent predictors of reduced eGFR_cr(CKD-EPI) in the youth onset T2DM group (β = −0.3 ± 0.08 ml/min/cm³, p = 0.001; β = −0.25 ± 0.05 ml/min/cm³, p < 0.0001).

Conclusions

Epicardial fat volume may be a risk factor for heart disease in individuals with early adult onset T2DM and a predictor of decreased kidney function in individuals with youth onset T2DM.

http://bit.ly/2HEOzx1

Unknown primary (CUP) of the head and neck : No advantages of bilateral radiotherapy, the strategy of ipsilateral radiotherapy can be recommended for the adjuvant treatment

Bilateral vs ipsilateral adjuvant radiotherapy in patients with cancer of unknown primary of the head and neck: An analysis of the clinical outcome and radiation‐induced side effects

Nguyen‐Son Le  Stefan Janik MD, PhD  Helmut Simmel MD  Boban M. Erovic MD, PD, MBA

First published: 19 January 2019 https://doi.org/10.1002/hed.25637

This work was presented at the 61st Annual Meeting of the Austrian Society of Oto‐Rhino‐Laryngology – Head and Neck Surgery, Vienna, Austria

Abstract

Background

The purpose of this study was to analyze and compare ipsilateral and bilateral adjuvant radiotherapy in patients with cancer of unknown primary (CUP) of the head and neck.

Methods

Overall survival, recurrence‐free survival, and radiation‐induced side effects were assessed in 76 patients with CUP who underwent ipsilateral (n = 29) or bilateral (n = 47) radiotherapy.

Results

At a median follow‐up of 41 months, the 5‐year overall survival and recurrence‐free rate were 67.9% and 71.5%, respectively. No statistically significant difference between ipsilateral and bilateral radiotherapy could be found regarding 5‐year overall survival, recurrence‐free survival, occurrence of a primary tumor, and distant metastasis. The analysis of radiation‐induced acute side effects showed a significant benefit of ipsilateral radiotherapy.

Conclusion

As the main parameters of the study regarding the outcome and radiation‐induced side effects showed no advantages of bilateral radiotherapy, the strategy of ipsilateral radiotherapy can be recommended for the adjuvant treatment of CUP patients.

Acanthosis Nigricans & Metabolic Syndrome : Metabolic syndrome refers to a clustering of metabolic risk factors including central obesity, glucose intolerance, hyperinsulinemia, low HDL cholesterol, high triglycerides and hypertension. High prevalence of Acanthosis Nigricans (AN) in subjects with metabolic syndrome. Also there was a positive correlation between severity of Acanthosis Nigricans (AN) and Metabolic syndrome.

Acanthosis nigricans: A cutaneous marker for metabolic syndrome p. 16

Nirali Girish Shah, Swapna S Khatu, Neeta R Gokhale, Yuvraj E More, Deepak Khismatrao

DOI:10.4103/mjdrdypu.mjdrdypu_44_18  

Background: Acanthosis Nigricans (AN) is an easily identifiable dermatoses characterized by thickened, hyperpigmented plaques. Metabolic syndrome refers to a clustering of metabolic risk factors including central obesity, glucose intolerance, hyperinsulinemia, low HDL cholesterol, high triglycerides and hypertension. AN is a skin marker associated with this syndrome. Aims and Objectives: This study aimed to determine the relationship between AN and metabolic syndrome by studying its clinico-epidemiological features and also the relation of severity of AN over neck with metabolic syndrome. Methodology: This is a case-control study. One hundred consecutive patients of AN attending dermatology OPD of a tertiary care hospital were included in this study. They were evaluated for AN and severity of AN over neck was assessed. Age and sex matched 100 controls were included in the study. Epidemiological, clinical and anthropometric characteristics (height, weight, waist circumference) were measured of all the cases and controls. Body Mass Index (BMI) was calculated. Fasting Blood Sugar, High Density Lipoprotein and Serum Triglyceride levels were estimated. Result: The average age of the patients was 32.4 years and females (62%) were more than the males (38%). Neck was involved in all the patients. There was statistically significant correlation of increasing severity of AN with each component of Metabolic syndrome. On comparing between cases and controls, each component of metabolic syndrome was raised in cases as compared to the controls. 70% cases had Metabolic syndrome which was statistically significant. Conclusion: There was a high prevalence of AN in subjects with metabolic syndrome. Also there was a positive correlation between severity of AN and Metabolic syndrome.

Correction to: Potential revenue and breakeven of energy storage systems in PJM energy markets

The original publication of this paper contains a mistake.

http://bit.ly/2FSCT79

Diagnosis and Treatment Monitoring of a Patient with Gastrointestinal Stromal Tumor by Next‐Generation Sequencing and Droplet Digital Polymerase Chain Reaction Assay of a PDGFRA Mutation in Plasma‐Derived Cell‐Free Tumor DNA

AbstractIn patients with a suspected malignancy, standard‐of care management currently includes histopathologic examination and analysis of tumor‐specific molecular abnormalities. Herein, we present a 77‐year‐old patient with an abdominal mass suspected to be a gastrointestinal stromal tumor (GIST) but without the possibility to collect a tumor biopsy. Cell‐free DNA extracted from a blood sample was analyzed for the presence of mutations in GIST‐specific genes using next generation sequencing. Furthermore, liquid biopsies were used to monitor the levels of mutant DNA copies during treatment with a tumor‐specific mutation droplet digital PCR assay that correlated with the clinical and radiological response. Blood‐based testing is a good alternative for biopsy‐based testing. However, it should only be applied when biopsies are not available or possible to obtain because overall, in only 50%–85% of the cell‐free plasma samples is the known tumor mutation detected.

http://bit.ly/2T8P7MT

Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies

AbstractBackground.There has been a significant increase in the use of immunotherapy and cannabis recently, two modalities that have immunomodulatory effects and may have possible interaction. We evaluated the influence of cannabis use during immunotherapy treatment on response rate (RR), progression‐free survival (PFS), and overall survival (OS).Subjects, Materials, and Methods.In this retrospective, observational study, data were collected from the files of patients treated with nivolumab in the years 2015–2016 at our hospital, and cannabis from six cannabis‐supplying companies. Included were 140 patients (89 nivolumab alone, 51 nivolumab plus cannabis) with advanced melanoma, non‐small cell lung cancer, and renal clear cell carcinoma. The groups were homogenous regarding demographic and disease characteristics. A comparison between the two arms was made.Results.In a multivariate model, cannabis was the only significant factor that reduced RR to immunotherapy (37.5% RR in nivolumab alone compared with 15.9% in the nivolumab‐cannabis group (p = .016, odds ratio = 3.13, 95% confidence interval 1.24–8.1). Cannabis use was not a significant factor for PFS or OS. Factors affecting PFS and OS were smoking (adjusted hazard ratio [HR] = 2.41 and 2.41, respectively (and brain metastases (adjusted HR = 2.04 and 2.83, respectively). Low performance status (adjusted HR = 2.83) affected OS alone. Tetrahydrocannabinol and cannabidiol percentages did not affect RR in any group (p = .393 and .116, respectively).Conclusion.In this retrospective analysis, the use of cannabis during immunotherapy treatment decreased RR, without affecting PFS or OS and without relation to cannabis composition. Considering the limitations of the study, further prospective clinical study is needed to investigate possible interaction.Implications for Practice.Although the data are retrospective and a relation to cannabis composition was not detected, this information can be critical for cannabis users and indicates that caution is required when starting immunotherapy.

http://bit.ly/2AXNOsK

Field experiment on the effects of sepiolite and biochar on the remediation of Cd- and Pb-polluted farmlands around a Pb–Zn mine in Yunnan Province, China

Abstract

The effects of sepiolite and biochar on the contents of available nutrients (N, P, and K); the chemical forms and available contents of Cd and Pb in soils; the biomass and growth of maize; and the contents of nutrients, Cd, and Pb in maize were studied in situ in Cd- and Pb-polluted farmlands around the Lanping Pb–Zn mine in Yunnan Province, China. Results demonstrated that sepiolite did not influence the contents of available nutrients in soils, although it significantly increased the pH value and decreased available Cd (CaCl₂-extractable and exchangeable) contents and exchangeable and reducible Pb. Moreover, sepiolite increased the biomass in the aboveground part of maize, resulting in the reduction of Cd contents in maize plants and grains by 25.6–47.5%. Meanwhile, the biochar increased the contents of available nutrients in soils and decreased the contents of exchangeable Pb in soils and biomass in the aboveground part of maize plants and grains; decreased the Cd contents in maize stems and grains by 26.7% and 24.6%, respectively; and decreased the Pb content in roots by 16.2%. However, neither sepiolite nor biochar had considerable influence on the Pb content in maize grains. According to a correlation analysis, soil pH has extremely significant negative correlations with available Cd content in soils, which in turn have extremely significant positive correlation with the Cd content in maize plants and grains. These results revealed that sepiolite increases soil pH and decreases Cd bioavailability in farmland soils around the Pb–Zn mine. Furthermore, biochar increases the contents of available nutrients in farmland soils and the maize yield. Sepiolite and biochar both decrease the contents and transfer coefficients of Cd in maize plants and grains and are, thus, applicable to the immobilization remediation of Cd-polluted farmlands.

http://bit.ly/2AWO77g

Real-World Adequacy of Glycaemic Control in Treatment-Naïve Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin Monotherapy at the Maximum Tolerated Dose: The Reload Study

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0824-6607

Background Metformin, in the absence of contraindications or intolerance, is recommended as first-line treatment for patients with type 2 diabetes mellitus (T2DM). This observational, retrospective study assessed the real-world adequacy of glycaemic control in Greek patients with T2DM initiating metformin monotherapy at maximum tolerated dose. Methods Included patients received metformin monotherapy for ≥24 months; relevant patient data were collected immediately prior to metformin initiation (baseline) and at other prespecified time points. The primary objective was to report, after 9 months of metformin treatment, the percentage of patients with baseline glycated haemoglobin (HbA1c) levels ≥6.5% (≥48 mmol/mol) achieving HbA1c<6.5%. Secondary objectives included the assessment of time spent with poor glycaemic control and time to treatment intensification. A sensitivity analysis assessed the percentage of patients with baseline HbA1c≥7% (≥53 mmol/mol) achieving HbA1c<7% (<53 mmol/mol). Results Of the enrolled patients (N=316), 247 had baseline HbA1c ≥6.5%; following 9 months on metformin, 90 (36.4%) patients achieved HbA1c<6.5% (mean HbA1c change−1.3% [−14 mmol/mol]). Median time of exposure to HbA1c ≥6.5% was 23.4 months and time to treatment intensification was 28.0 months. The sensitivity analysis revealed that the proportion of patients achieving HbA1c<7.0% was 50% (mean HbA1c change −1.6% [−17 mmol/mol]). Conclusion Irrespective of HbA1c target assessed, most patients with T2DM do not achieve the recommended HbA1c goals after 9 months on metformin while remained on monotherapy for up to 24 months. Addressing clinical inertia could improve disease outcomes and, possibly, economic burden.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://bit.ly/2T54Wny

Role of Vasopressin Receptor 2 and 3 in ACTH-Secreting Tumors and their Potential Therapeutic Implications

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0808-4227

Purpose We investigated the expression of vasopressin receptor 2 and 3 on corticotrophin tumor cells, their role in regulating ACTH secretion, and their potential therapeutic implications. Methods We retrospectively assessed 52 hospitalized patients with pathologically confirmed ACTH-secreting tumors. The expression of vasopressin receptor 2 and 3 was explored via qualitative and quantitative immunohistochemistry analyses. The role of vasopressin receptors in regulating ACTH secretion was further studied in the AtT-20 cell line. Results Among 50 cases of pituitary corticotrophin adenoma, 31 were vasopressin receptor 2 positive, 38 were vasopressin receptor 3 positive, and 24 were both vasopressin receptor 2 and 3 positive. Two patients with ectopic ACTH syndrome were vasopressin receptor 3 positive, and one was also vasopressin receptor 2 positive. In 12 patients who underwent bilateral inferior petrosal sinus sampling before surgery, the central ACTH increment ratio after desmopressin stimulation was correlated with vasopressin receptor 2 but not with vasopressin receptor 3 staining intensity. In an in vitro study, the expression of both vasopressin receptor 2 and 3 on AtT-20 cells was confirmed. The vasopressin receptor 2 antagonist Tolvaptan inhibited desmopressin-induced ACTH secretion in a dose-dependent manner. Conclusions Both vasopressin receptor 2 and 3 are expressed in ACTH-secreting tumors. Vasopressin receptor 2 rather than vasopressin receptor 3 is the primary receptor that seems to mediate the ACTH response in corticotrophin tumors. A vasopressin receptor 2 antagonist can inhibit ACTH secretion induced by desmopressin in AtT-20 cells.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://bit.ly/2AY7dtH

Convergence analysis of China’s energy intensity at the industrial sector level

Abstract

China's industrial energy consumption accounted for approximately 70% of national energy demand in the past four decades. Regarding energy demand and environmental pollution, success in controlling energy demand and reducing energy intensity for industrial sectors in China would play a crucial role for the country's sustainable growth problems. To formulate targeted energy plans, the features and characters of China's industrial energy intensity should be carefully evaluated. In this study, a carefully designed econometric model that considers different technological factors including indigenous R&D and technology spillovers from foreign direct investment and trade under a united framework is applied to investigate the β-convergence characteristics for China's industrial energy intensity by employing a panel dataset covering China's 34 industrial sectors over 2000–2010. The results verify the existence of β-convergence in industrial energy intensity during the sample period. For the industrial sectors overall and the light industrial sectors, the empirical results indicate that indigenous R&D and technology spillovers from FDI and imports are beneficial in curbing energy intensity. However, technology spillover through exports makes it harder to reduce energy intensity. In addition, not all technological factors have played a significant role in reducing energy intensity for the heavy industrial sectors.

http://bit.ly/2RI3H1c

Streptococcus mutans serotypes and Collagen‐Binding Proteins Cnm/Cbm in Children with Caries analyzed by PCR

Summary

Streptococcus mutans, a primary bacterium associated with dental caries, has four known clinical serotypes (c, e, f, and k). Some serotypes, presence of multiple serotypes and strains with collagen‐binding proteins (CBP, Cnm and Cbm) have been linked with systemic disease. Evaluation of S. mutans serotype distribution and caries association is needed in the United States. The purpose of this study was to evaluate the prevalence of S. mutans serotypes from two cohorts of African American children in rural Alabama using 3 sample types (saliva, plaque, and individual S. mutans isolates) by PCR detection for association with caries. Detection of CBP was also performed by PCR. In total, 129 children were evaluated and overall prevalence of serotypes were: serotype c(98%), e(26%), f(7%), and k(52%). Serotype c was statistically associated with higher caries scores in older children (p<0.001) and serotype k was statistically more likely in females (p=0.004). Fourteen percent of children had CBP. Thirteen S. mutans isolates from 5 children tested positive for both CBP. This study is the first to report on prevalence of S. mutans serotypes in a US population using the PCR‐based approach. The frequency of serotype k in this study is the highest reported in any population, illustrating the need for further study to determine prevalence of this clinically relevant serotype in the US. This is the first study to report S. mutans isolates with both Cnm and Cbm in the same strain, and further analysis is need to determine the clinical significance of these strains.

This article is protected by copyright. All rights reserved.

http://bit.ly/2FIrSpP

Distinguishing pustular psoriasis and acute generalized exanthematous pustulosis (AGEP) on the basis of plasmacytoid dendritic cells (PDCs) and MxA protein

Background

Distinguishing acute generalized exanthematous pustulosis (AGEP) and pustular psoriasis (PS) can be challenging. Staining for plasmacytoid dendritic cells, or PDCs (producer of IFN‐α/β),[1] and MxA (an IFN‐α/β inducible protein)[2] may help discriminate these entities.

Methods

Forty‐three cases of AGEP and PS were compiled from two academic institutions. All cases were examined for CD123+ PDCs, eosinophils, acanthosis, papillomatosis, suprapapillary plate thinning, tortuous dilated capillaries, single necrotic keratinocytes, papillary dermal edema, vasculitis, eosinophil exocytosis, intraepidermal pustules, and subcorneal pustules. A subset of cases (n=26) was stained with MxA.

Results

Perivascular and intraepidermal PDCs, dilated tortuous vessels and MxA expression in the dermal inflammatory infiltrate, were significantly (p<0.05) in favor of a diagnosis of PS. The absence of PDCs and presence of eosinophils favored a diagnosis of AGEP (p<0.05).

Conclusions

We found compelling evidence for the use of CD123 to highlight PDCs in these cases. The presence of PDCs and expression of MxA in dermal inflammatory infiltrate, as well as absence of eosinophils and presence of tortuous dilated capillaries favored a diagnosis of PS. Expression of MxA in the dermal infiltrate corresponds with a Th1 pathway in PS, and may indicate a Th1 component in the early initial phase of AGEP.

This article is protected by copyright. All rights reserved.

http://bit.ly/2UaSRO2

PLATELET RICH PLASMA IN ANDROGENETIC ALOPECIA: A SYSTEMATIC REVIEW

In recent years, dozens of manufacturers and clinics have been promoting the use of platelet rich plasma (PRP) procedures for skin and hair regeneration. Well‐designed randomized controlled studies for these procedures are lacking. In this communication, we review the efficacy and safety of PRP procedures for androgenetic alopecia from multiple published peer‐reviewed studies. The conclusion of our analysis is that until the present moment there is not enough evidence for the use of PRP procedures in the treatment of androgenetic alopecia. We hope that this review will help practitioners and patients to make better‐informed treatment decisions.

This article is protected by copyright. All rights reserved.

http://bit.ly/2S0ypBL

PAM3 supports the generation of M2-like macrophages from lupus patient monocytes and improves disease outcome in murine lupus

Publication date: Available online 22 January 2019

Source: Journal of Autoimmunity

Author(s): Begum Horuluoglu, Defne Bayik, Neslihan Kayraklioglu, Emilie Goguet, Mariana J. Kaplan, Dennis M. Klinman

Abstract

Systematic Lupus Erythematosus (SLE) is an autoimmune syndrome of unclear etiology. While T and B cell abnormalities contribute to disease pathogenesis, recent work suggests that inflammatory M1-like macrophages also play a role. Previous work showed that the TLR2/1 agonist PAM3CSK4 (PAM3) could stimulate normal human monocytes to preferentially differentiate into immunosuppressive M2-like rather than inflammatory M1-like macrophages. This raised the possibility of PAM3 being used to normalize the M1:M2 ratio in SLE. Consistent with that possibility, monocytes from lupus patients differentiated into M2-like macrophages when treated with PAM3 in vitro. Furthermore, lupus-prone NZB x NZW F1 mice responded similarly to weekly PAM3 treatment. Normalization of the M2 macrophage frequency was associated with delayed disease progression, decreased autoantibody and inflammatory cytokine synthesis, reduced proteinuria and prolonged survival in NZB x NZW F1 mice. The ability of PAM3 to bias monocyte differentiation in favor of immunosuppressive macrophages may represent a novel approach to the therapy of SLE.

http://bit.ly/2W910UG

The long-term prognosis of heart diseases for different metabolic phenotypes: a systematic review and meta-analysis of prospective cohort studies

Abstract

Purpose

This meta-analysis aimed to assess the association of different categories of weight and metabolic status with risk of heart diseases including myocardial infarction (MI), cardiovascular diseases (CVDs), and heart failure (HF).

Methods

Data from relevant studies were identified systematically by searching PubMed and Scopus search engines up to 29 May 2018. Prospective studies were included in the analyses with metabolically healthy normal weight (MHNW) as the reference. Pooled RRs and 95% CI were calculated using random-effects or fixed-effect models when appropriate. Subgroup analysis was applied to define possible sources of heterogeneity.

Results

Overall, 21 studies (n = 778,401 participants) were eligible for the present meta-analysis. Generally, the risk of CVDs for all metabolic phenotypes in metabolically unhealthy obese increased compared with the MHNW group. A significant positive association between all metabolic phenotypes and the risk of HF was also observed expect for MHOW (RR = 1.10, 95% CI: 0.60–2.00, P = 0.76) and MHO phenotypes (RR = 0.96, 95% CI: 0.25–3.77, P = 0.95). Moreover, MUHO phenotype was associated with greater risk of MI compared with the MHNW phenotype (RR = 1.82, 95% CI: 1.50–2.22, P < 0.001, respectively).

Conclusions

Our findings showed that all metabolically unhealthy phenotypes in different categories of weight were associated with increased incident of CVDs/HF and MI. Furthermore, healthy overweight and obese subjects had increased risk of CVDs.

http://bit.ly/2RFj9Lk

Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition

Publication date: Available online 21 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Nikhil Dhingra, Lauren Meshkov Bonati, Erica B. Wang, Margaret Chou, Jared Jagdeo

Transgender individuals may transition to their identified gender through social, hormonal, and procedural methods by using a multidisciplinary team of health care providers, including dermatologists. In this review, we discuss the medical and aesthetic dermatologic needs related to the transitioning of transgender patients and provide therapeutic and procedural recommendations. In addition to routine cutaneous conditions, dermatologists may need to treat hormonal therapy–related complications. Acumen for genital dermatology and familiarity with gender reassignment surgery is important for the dermatologist caring for a transgender patient. From a structural standpoint, transgender beauty poses a unique aesthetic task. We identify key differences in the facial structure and physique of males versus those of females. Dermatologists may have a tremendous impact on the lives of transgender individuals who seek to realize their gender identity.

http://bit.ly/2FSGPET

The Association between Obesity and Hyperhidrosis: A Nationwide, Cross Sectional Study of 2.77 Million Israeli Adolescents

Publication date: Available online 21 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Nadav Astman, Itay Friedberg, Jakob Wikstrom, Estela Derazne, Orit Pinhas-Hamiel, Arnon Afek, Michal Freireich-Astman, Aviv Barzilai, Tarif Bader, Gilad Twig

http://bit.ly/2FHJYbt

Dermatology Impact on the Care of Children with Chronic Graft-versus-Host Disease of the Skin

Publication date: Available online 21 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Anna Cristina Garza-Mayers, L. Elizabeth Anderson, JiaDe Yu, Jennifer T. Huang

http://bit.ly/2FSGG4j

Communicative Misalignment in Autism Spectrum Disorder

Publication date: Available online 22 January 2019

Source: Cortex

Author(s): Harshali Wadge, Rebecca Brewer, Geoffrey Bird, Ivan Toni, Arjen Stolk

Abstract

Communication deficits are a defining feature of Autism Spectrum Disorder (ASD), manifest during social interactions. Previous studies investigating communicative deficits have largely focused on the perceptual biases, social motivation, cognitive flexibility, or mentalizing abilities of isolated individuals. By embedding autistic individuals in live non-verbal interactions, we characterized a novel cause for their communication deficits. Adults with ASD matched neurotypical individuals in their ability and propensity to generate and modify intelligible behaviors for a communicative partner. However, they struggled to align the meaning of those behaviors with their partner when meaning required referencing their recent communicative history. This communicative misalignment explains why autistic individuals are vulnerable in everyday interactions, which entail fleeting ambiguities, but succeed in social cognition tests involving stereotyped contextual cues. These findings illustrate the cognitive and clinical importance of considering social interaction as a communicative alignment challenge, and how ineffective human communication is without this key interactional ingredient.

http://bit.ly/2FRzCos

Strong insecticidal potential of methanol extract of Ferulago trifida fruits against Anopheles stephensi as malaria vector

Abstract

Many researchers have focused on controlling pest insects and vectors by natural products because of their low environmental pollution. The present study was conducted to evaluate the antioxidant and larvicidal activities of chloroform and methanol extracts of the leaves, fruits, roots, and isolated coumarin compounds (prantschimgin, oxypeucedanin, and 6-hydroxymethylherniarin) of Ferulago trifida from the Apiaceae family against Anopheles stephensi as one of the main malaria vectors. For insecticidal evaluation, A. stephensi larvae were exposed to different concentrations of the extracts and pure compounds (0.625–1280 ppm) according to the WHO protocol. The mortality percentages were measured 24 h after treatment and lethal concentration values were calculated. In addition, radical scavenging activities of the mentioned extracts and compounds were measured by the DPPH method. The methanol extract of fruits showed potent insecticidal properties with LC₅₀ and LC₉₀ values of 2.94 and 18.12 ppm, respectively. The chloroform extracts of the fruits and leaves were the second and third extracts with larvicidal effects. Among pure compounds, only oxypeucedanin showed moderate toxicity against A. stephensi with LC₅₀ and LC₉₀ values of 116.54 and 346.41 ppm, respectively. The antioxidant activities of the methanol extracts of leaves and fruits were stronger than other extracts with IC₅₀ values of 155.83 and 159.32 ppm, respectively. In conclusion, the methanol extract of F. trifida fruits can be used as a potent bio-insecticide in green control programs of mosquitoes, especially A. stephensi.

http://bit.ly/2DrRsgn

Argon laser-assisted hypotony model in the rabbit

Abstract

To investigate whether ocular hypotony formation with 360 degrees endocyclophotocoagulation is possible. Twelve male New Zealand White rabbits were used. Entire ciliary body epithelium was destructed with green laser photocoagulation after pars plana lensectomy and anterior vitrectomy in six rabbits. Endocyclophotocoagulation was not performed to the remaining six rabbits (control group). Intraocular pressure (IOP) was measured preoperatively and followed up everyday in the first week and weekly until the end of month one. All of the rabbits were sacrificed and ciliary bodies were left for gross and light microscopic examination. Mean baseline IOPs were similar in laser and non-laser group (14.8 ± 1.4 (range 12.2–17.3) vs 14.4 ± 1.4 (range 12.2–15.9), p = 0.650). Mean IOP was 6.6 ± 0.45 mmHg (range 5.9–7.1) in the laser group and 11.5 ± 1.2 mmHg (range 10.2–13.4) in the non-laser group in postoperative day 1. IOP was below 4 mmHg in all eyes on the second day and after in laser group. In the macroscopic evaluation, the entire ciliary body had a white (loss of pigmentation) and atrophic appearance in all of the eyes in the laser-treated group compared to non-laser group. In the laser group, light microscopic examination demonstrated a severe 360 degrees disruption of ciliary processes. Ciliary processes were covered with fibrin exudation consisting of fibroblasts. There was a mild inflammation with disruption or atrophy of ciliary body epithelium with cystic vacuolar degeneration. Three hundred sixty degrees endocyclophotocoagulation yielded severe ciliary epithelium damage. IOP reduction started very early and continued in hypotonic levels during follow up period.

http://bit.ly/2S6z05e

A retrospective comparison of thulium laser en bloc resection of bladder tumor and plasmakinetic transurethral resection of bladder tumor in primary non-muscle invasive bladder cancer

Abstract

Bladder cancer is currently considered the most common malignancy of the urinary tract. Thulium laser en bloc resection of bladder tumor (TmLRBT) and plasmakinetic transurethral resection of bladder tumor (PK-TURBT) are two alternative common procedures used in our department to manage patients with primary non-muscle invasive bladder cancer (NMIBC) over the past decade. In this work, the safety and efficacy of TmLRBT were retrospectively compared to those of PK-TURBT in patients with primary NMIBC. From January 2013 to December 2015, 256 patients diagnosed with primary NMIBC were selected for this retrospective study. A total of 136 consecutive patients diagnosed with primary NMIBC were enrolled in the TmLRBT group. A similar historical cohort of 120 consecutive patients who underwent PK-TURBT was used to compare the two procedures. Clinical data, including age, gender, tumor characteristics, operation duration, hospitalization, irrigation, catheterization, and intraoperative and postoperative complications, were recorded. There were no significant differences in age, gender, mean tumor size, mean tumor number, tumor location, or risk between the TmLRBT and PK-TURBT groups. The TmLRBT group was associated with a significantly shorter operation duration (25.96 ± 21.19 min vs 37.18 ± 25.77 min, P = 0.018) and a shorter hospitalization time (3.11 ± 1.05 days vs 5.24 ± 2.06 days, P = 0.036). The postoperative irrigation time (6.33 ± 4.05 h vs 14.76 ± 6.28 h, P = 0.027) and catheterization time (2.03 ± 1.61 days vs 4.27 ± 1.17 days, P = 0.035) in the TmLRBT group were lower than those in the PK-TURBT group. No significant differences in fever and rebleeding were found in the TmLRBT and PK-TURBT groups. There were no significant differences in the overall, low-risk, intermediate-risk, and high-risk recurrence-free rates between the two groups (P = 0.43, P = 0.68, P = 0.71, and P = 0.24, respectively). The proportion of bladder detrusor muscle (BDM) identified in pathologic specimens of the TmLRBT group was higher than that in the PK-TURBT group (P = 0.006). TmLRBT may reduce operation duration time, hospitalization time, postoperative irrigation time, and catheterization time. TmLRBT is considered safer and more effective in treating primary NMIBC. Recurrence-free rates did not differ between groups.

http://bit.ly/2HtkTTg

The retinal pigment epithelial response after retinal laser photocoagulation in diabetic mice

Abstract

To investigate the characteristics of regenerated retinal pigment epithelial (RPE) cells after retinal laser photocoagulation in diabetic mice. C57BL/6J mice were used to induce diabetes using intraperitoneal injection of streptozotocin. The proliferation of RPE cells after laser photocoagulation was determined using the 5-ethynyl-2′-deoxyuridine (EdU) assay in both diabetic and wild-type mice. The morphological changes of RPE cells were evaluated by using Voronoi diagram from immunostaining for ß-catenin. Characteristics of regenerated cells were evaluated by quantifying the mRNA and protein levels of RPE and epithelial-mesenchymal transition (EMT) markers. There were significantly less EdU-positive cells in laser-treated areas in diabetic mice than wild-type mice. Hexagonality was extensively lost in diabetic mice. Many EdU-positive cells were co-localized with Otx2-positive cells in the center of the laser-treated areas in wild-type mice, but only EdU-positive cells were widely distributed in diabetic mice. Quantitative analysis of mRNA and protein levels showed that the expression levels of RPE markers, Pax6, Mitf, and Otx2, were significantly decreased in RPE of diabetic mice compared with that of wild-type mice, whereas the expression levels of EMT markers, vimentin and fibronectin, were significantly increased. The proliferation and hexagonality of regenerating RPE cells were impaired after laser photocoagulation, and the regenerated RPE cells lost their original properties in diabetic mice. Further clinical research is needed to elucidate the RPE response after laser photocoagulation in diabetic patients.

http://bit.ly/2S7y6W9

Effects of Nd:YAG laser irradiation on the growth of Candida albicans and Streptococcus mutans : in vitro study

Abstract

The purpose of this study was to evaluate the effects of Nd:YAG laser with flat-top handpiece on the in vitro growth of Candida albicans and Streptococcus mutans. The incidence of C. albicans (opportunistic commensal) and S. mutans (facultatively anaerobic) infections is increasing, despite available treatments. Cultures of Streptococcus mutans and Candida albicans were irradiated using Nd:YAG laser (LightWalker, Fotona) with flat-top handpiece (Genova, LightWalker, Fotona) at the following parameters: group G1: 0.25 W, 10 Hz, 15 s, 3 J and group G2: 1 W, 10 Hz, 60s, 59 J. The results were evaluated directly and 24 h after irradiation using a quantitative culture method (estimation of colony-forming units in 1 ml of suspension, cfu/ml), and microscopic analysis with Janus green stain and compared with control group in which laser was not applied. C. albicans was reduced by 20 up to 54% for G1, and for G2 by 10 up to 60% directly after the application. The cfu/ml values for S. mutans decreased by 13% (p = 0.1771) for G1 and 89% (p < 0.0001) for G2. In both test groups 24 h after the application, the number of colony-forming units decreased by 15–46% for G1 and by 15–64% for G2. The arrested cell division, increasing the surface area and increasing the number of metabolically inactive cells, were observed in morphometric analysis. Macroscopic and microscopic analyses revealed a reduction in cell number and a significant decrease of cell metabolism after laser application for both C. albicans and S. mutans.

http://bit.ly/2Ht0vSb

Low-level laser irradiation modulates the proliferation and the osteogenic differentiation of bone marrow mesenchymal stem cells under healthy and inflammatory condition

Abstract

The aim of this in vitro study was to evaluate the effects of low-level laser therapy (LLLT) at different energy intensities on proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) under healthy and inflammatory microenvironments. Human BMSCs and BMSCs from inflammatory conditions (i-BMSCs, BMSCs treated with tumor necrosis factor α; TNF-α) were subject to LLLT (Nd:YAG;1064 nm) at different intensities. We designed one control group (without irradiation) and four testing groups (irradiation at 2, 4, 8, and 16 J/cm²) for both BMSCs and i-BMSCs. Cell proliferation was measured using colony-forming unit fibroblast assay and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide assay. Osteogenic capacity of cells was determined by alkaline phosphatase (ALP) staining, ALP activity assay, Alizarin Red S staining and the mRNA transcript levels of genes runt-related transcription factor 2 (Runx2), ALP, and osteocalcin. Moreover, the effects of LLLT on secretion of TNF-α in BMSCs and i-BMSCs were measured by enzyme-linked immunosorbent assay. Our results demonstrated LLLT could significantly promote BMSC proliferation and osteogenesis at densities of 2 and 4 J/cm². LLLT at density of 8 J/cm² could promote the proliferation and osteogenesis of i-BMSCs. However, LLLT at 16 J/cm² significantly suppressed the proliferation and osteogenesis of BMSCs both in healthy and in inflammatory microenvironment. Moreover, we also found that the expression of TNF-α was obviously inhibited by LLLT at 4, 8, and 16 J/cm², in an inflammatory microenvironment. Considering these findings, LLLT could improve current in vitro methods of differentiating BMSCs under healthy and inflammatory microenvironments prior to transplantation.

http://bit.ly/2S6ySTi

Photobiomodulation modulates the resolution of inflammation during acute lung injury induced by sepsis

Abstract

Sepsis is a big health problem and one of the most common causes of acute lung injury (ALI) leading to high mortality. Pro-resolving mediators play an important role in abrogating the inflammation and promoting tissue homeostasis restoration. ALI treatment is still a clinical health problem, so new therapies are needed. Here, we evaluated the effect of photobiomodulation treatment on the resolution process of ALI induced by lipopolysaccharide (LPS). Male Balb/c mice were submitted to LPS (ip) or vehicle and irradiated or not with light emitting diode (LED) 2 and 6 h after LPS or vehicle injection, and the parameters were investigated 3 and 7 days after the injections. Our results showed that after 3 days of LED treatment the blood and bronchoalveolar lavage (BAL) cells as well as interleukins (IL) including IL-6 and IL-17 were reduced. No differences were observed in the bone marrow cells, tracheal reactivity, and lipoxin A4 and resolvin E2. Indeed, after 7 days of LED treatment the bone marrow cells, lymphocytes, and lipoxin A4 were increased, while IL-6, IL-17, and IL-10 were decreased. No differences were observed in the blood cells and tracheal reactivity. Thus, our results showed that LED treatment attenuated ALI induced by sepsis by modulating the cell mobilization from their reserve compartments. In addition, we also showed later effects of the LED up to 7 days after the treatment. This study proposes photobiomodulation as therapeutic adjuvant to treat ALI.

http://bit.ly/2HpifxH

Adipose-derived mesenchymal stem cells treatments for fibroblasts of fibrotic scar via downregulating TGF-β1 and Notch-1 expression enhanced by photobiomodulation therapy

http://bit.ly/2W9lmgJ

Pyogenic granuloma over the venous component of a mixed vascular malformation

A 52‐year‐old man presented with a rapidly growing red tumor on the central neckline. It had appeared over a congenital flat and pinkish vascular lesion that involved the shoulder and the upper anterior area of his chest. Intermingled with the pinkish stain, there were also some blue nodules several millimeters in diameter. Histopathologic examination revealed that the full lesion was a mixed venous‐capillary malformation. The red tumor was excised and diagnosed as a pyogenic granuloma developing over the venous component of the vascular malformation. To our knowledge, a pyogenic granuloma growing over a venous malformation had not yet been described.

This article is protected by copyright. All rights reserved.

http://bit.ly/2T7PMhs

Facial pustules due to drug‐induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms may histopathologically mimic eosinophilic pustular folliculitis: a case report

Pustules with facial and/or neck edema is one characteristic feature of drug‐induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) at the early stage. Although several retrospective histopathologic studies on DIHS/DRESS have been reported, the detailed histopathologic findings of facial pustules for DIHS/DRESS are unavailable. We herein report a case of DIHS/DRESS with facial pustules that was histopathologically similar to eosinophilic pustular folliculitis (EPF). Eosinophilic infiltration into dilated follicles and sebaceous glands, which is highly characteristic of EPF, was detected in pustules due to DIHS/DRESS in this case. There are numerous pathophysiological similarities between DIHS/DRESS and EPF, which may cause their histopathologic similarity. Our findings suggest that facial pustules of DIHS/DRESS may histopathologically mimic EPF.

This article is protected by copyright. All rights reserved.

http://bit.ly/2B04xvH

A primary cutaneous vascular neoplasm with histologic features of anastomosing hemangioma

Anastomosing hemangioma (AH) is a relatively novel variant of benign vascular tumors originally described in the genitourinary tract. Although AH was subsequently documented in various anatomic locations, a primary AH of the skin has not been reported in the literature. The current case report documents a vascular lesion with histologic features reminiscent of an anastomosing hemangioma. A 41‐year‐old female patient underwent an excision of a painful nodule on the leg. Histologic examination showed a well‐circumscribed vascular lesion composed of anastomosing sinusoidal capillary‐sized vessels, several intravascular fibrin thrombi, rare intraluminal nucleated red blood cells, and focal intracytoplasmic hyaline globules. As AH was hitherto only documented in extracutaneous sites, most dermatopathologists are probably not familiar with this variant of hemangioma. The current case report details the morphologic features of a potential example of a primary cutaneous AH to increase awareness of this distinctive hemangioma variant to dermatopathologists. Larger studies of vascular lesions with similar histologic features and immunohistochemical profiles are warranted to investigate the potential existence of primary AH in the skin.

This article is protected by copyright. All rights reserved.

http://bit.ly/2TegLru

Lucio Phenomenon mimicking antiphospholipid syndrome: the occurrence of antiphospholipid antibodies in a leprosy patient

Lucio phenomenon is an atypical reaction of leprosy, characterized by vasculitic lesions that can mimic antiphospholipid syndrome (APS) clinically. Distinguishing the two can be difficult as antiphospholipid autoantibodies could be present in patients with leprosy. We report on a 32‐year‐old female patient presenting with a sudden onset of fever, hemorrhagic bullae, and skin necrosis on her lower legs. She was treated for APS due to the presence of antiphospholipid antibodies but had an inadequate response. A skin biopsy was done that revealed thrombotic vasculopathy and necrotizing vasculitis associated with aggregation of foam cells in the perivascular area and subcutis, with acid‐fast positive bacilli in the histiocytes and blood vessel walls. Direct immunofluorescence showed IgM, C3, and fibrinogen deposition in the superficial and deep dermal blood vessels. The pathology confirmed the diagnosis of Lucio phenomenon and appropriate therapy was given. It is essential to evaluate the patient comprehensively, including clinical, serological, and pathological aspects, to obtain the correct diagnosis.

This article is protected by copyright. All rights reserved.

http://bit.ly/2AZ7jRR

Expression of p15 in a spectrum of spitzoid melanocytic neoplasms

Background

Accurate classification of spitzoid melanocytic lesions is difficult due to overlapping clinical and histopathologic features between Spitz nevi, atypical Spitz tumors (ASTs), and spitzoid melanomas. Expression of p16 (CDKN2A) has been used as a marker of spitzoid lesions. However, its expression may be variable. p15 is a tumor suppressor encoded by CDKN2B, loss of which has been recently shown to promote transition from nevus to melanoma. We sought to determine whether p15 is a useful immunohistochemical marker to distinguish Spitz nevi from spitzoid melanomas, and to compare p15 and p16 staining in this population.

Methods

Immunohistochemistry for p15 and p16 was performed on Spitz nevi (n=19), ASTs (n=41), and spitzoid melanomas (n=17). Immunoexpression was categorized by a four‐tiered system: 0 (negative), 1+ (weak), 2+ (moderate), 3+ (strong).

Results

3+/strong p15 staining was observed in 68.4% of Spitz nevi, 34.2% of ASTs, and 17.7% of spitzoid melanomas. By contrast, we observed 3+ p16 staining in roughly equivalent percentages of Spitz nevi (57.9%), ASTs (56.1%), and spitzoid melanomas (58.8%).

Conclusion

These data illustrate that p15 may be more useful than p16 as a biomarker to help distinguish benign from malignant spitzoid lesions.

This article is protected by copyright. All rights reserved.

http://bit.ly/2T5VwZ9