Polymerization pattern characterization within a resin-based composite cured using different curing units at two distances

Abstract

Objectives

To investigate the relationship of the irradiance-beam-profile areas from six different light-curing units (LCUs) with the degree of conversion (DC), microhardness (KH), and cross-link density (CLD) throughout a resin-based composite (RBC) cured at two clinically relevant distances, and to explore the correlations among them.

Materials and methods

A mapping approach was used to measure DC using micro-Raman spectroscopy, KH using a Knoop indentor on a hardness tester, and %KH reduction after ethanol exposure, as an indicator for CLD within a nano-hybrid RBC increment (n = 3) at various depths. These sample composites were cured from two distances while maintaining the radiant exposure, using six different light-curing units: one quartz-tungsten-halogen; two single and three multiple-emission-peak light-emitting-diode units. Irradiance beam profiles were generated for each LCU at both distances, and localized irradiance values were calculated. Points across each depth were analyzed using repeated measures ANOVA. Correlations across multiple specimen locations and associations between beam uniformity corresponding with polymerization measurements were calculated using linear mixed models and Pearson correlation coefficients.

Results

Significant non-uniform polymerization patterns occurred within the specimens at various locations and depths. At 2-mm curing distance, the localized DC = 52.7–76.8%, KH = 39.0–66.7 kg/mm², and %KH reduction = 26.7–57.9%. At 8-mm curing distance, the localized DC = 50.4–78.6%, KH = 40.3–73.7 kg/mm², and %KH reduction = 28.2–56.8%. The localized irradiance values were weakly correlated with the corresponding DC, KH, and %KH reduction, with only a few significant correlations (p < 0.05).

Conclusions

Although significant differences were observed at each depth within the specimens, the localized irradiance values for all LCUs did not reflect the polymerization pattern and did not seem to have a major influence on polymerization patterns within the RBC, regardless of the curing distance.

Clinical relevance

Commonly used LCUs do not produce uniform polymerization regardless of the curing distance, which may contribute to the risk of RBC fracture.

http://bit.ly/2WRehBP

Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT)

Abstract

Objectives

This retrospective study evaluated the visibility, location, and morphology of the primary maxillary ostium (PMO), as well as the presence and number of accessory maxillary ostia (AMO) in the maxillary sinus using cone beam computed tomography (CBCT).

Materials and methods

CBCT scans with a large field of view with both maxillary sinuses entirely visible, acquired from February 2016 to February 2018, were initially screened. Patients were included if there was no history of surgical intervention/trauma in the sinus region. Two observers evaluated the CBCTs for PMO and AMOs independently. PMO and AMOs were evaluated in axial, coronal, and sagittal CBCT views. In case of disagreement, a third observer served as a referee. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition to assess for potential influencing factors.

Results

A total of 184 patients (368 maxillary sinuses) were included. PMO was present and patent in 346 (94.0%) of the 368 analyzed sinuses. Most of the PMOs were located above the attachment of and in the middle third of the inferior turbinate (76.1%) and exhibited a slit shape (71.1%). An AMO was present in 167 (45.5%) of the 368 analyzed sinuses, and 66 (17.9%) sinuses had multiple AMOs. Gender and sinus mucosa morphology were found to be influencing factors for the patency of the PMO. Furthermore, gender seems to be influencing the presence of an AMO.

Conclusions

Most of the analyzed maxillary sinus cavities in the present population had a patent PMO. Being male and having morphological changes of the sinus mucosa were factors associated with a reduced prevalence of a patent PMO.

Clinical relevance

A maxillary sinus with pathological findings of the mucosa seems to have a reduced prevalence of patent PMOs. Therefore, clinicians should take care to assess any clinical and radiographical sign indicating a potential maxillary sinusitis prior to surgical interventions in this region, especially in cases with planned sinus floor elevation.

http://bit.ly/2RPBKzo

Enhancement of gasworks groundwater remediation by coupling a bio-electrochemical and activated carbon system

Abstract

Here, we show the electrical response, bacterial community, and remediation of hydrocarbon-contaminated groundwater from a gasworks site using a graphite-chambered bio-electrochemical system (BES) that utilizes granular activated carbon (GAC) as both sorption agent and high surface area anode. Our innovative concept is the design of a graphite electrode chamber system rather than a classic non-conductive BES chamber coupled with GAC as part of the BES. The GAC BES is a good candidate as a sustainable remediation technology that provides improved degradation over GAC, and near real-time observation of associated electrical output. The BES chambers were effectively colonized by the bacterial communities from the contaminated groundwater. Principal coordinate analysis (PCoA) of UniFrac Observed Taxonomic Units shows distinct grouping of microbial types that are associated with the presence of GAC, and grouping of microbial types associated with electroactivity. Bacterial community analysis showed that β-proteobacteria (particularly the PAH-degrading Pseudomonadaceae) dominate all the samples. Rhodocyclaceae- and Comamonadaceae-related OTU were observed to increase in BES cells. The GAC BES (99% removal) outperformed the control graphite GAC chamber, as well as a graphite BES and a control chamber both filled with glass beads.

http://bit.ly/2GyLlbS

Using multi-integrated biomarker indexes approach to assess marine quality and health status of marine organism: a case study of Ruditapes philippinarum in Laizhou Bay, China

Abstract

With the progress of technology and the deepening of understanding of biological monitoring, much more attention has been paid to the multiple evaluation of marine pollution monitoring. In view of this, our study aimed at establishing a multi-integrated biomarker indexes approach to evaluate marine condition systematically and comprehensively. In the current study, sampling was conducted in Laizhou Bay, China (S1, S2, and S3) in May, August, and October of 2015. And then, multi-integrated biomarker indexes approach was applied to assess marine PAHs pollution, select appropriate biomarkers, and evaluate marine environmental quality and health status of the clams of Ruditapes philippinarum. As the results showed, S2 was the most PAHs-polluted site while S1 was the least polluted site, and the levels of tPAHs in seawater and sediments ranged from 69.78 to 315.30 ng/L and 163.19 to 565.17 ng/g d.w., respectively. And all three sampling sites had different sources of PAHs. IBR represented DNA damage (F value), the expression of SOD, EROD activity, GST activity, and LPO could be served as biomarkers to monitor the PAHs pollution in Laizhou Bay. And MPI suggested the quality of all three sites: S1 was generally favorable, S2 was moderately polluted, and S3 was lightly polluted. BRI values showed that the order of health status of R. philippinarum was S1 > S3 > S2.

http://bit.ly/2GklV2o

Orchard management under the effects of climate change: implications for apple, plum, and almond growing

Abstract

The authors analyzed certain species and varieties of fruit tree in which applied crop technology is used and also undergoes the effects of climate change. The aim is to extend productive crop varieties, resistant to disease and pests, in order to obtain superior yields. The research was conducted in orchards located in northwestern Romania (on 8.59 ha), intensively cultivated with apple, plum, and almond species. The blooming period of the species and fruit production was studied in 2009, the first year of the farm's commercial production, and then compared to figures from 2016 to see the changes that occurred. Climatic conditions were studied throughout the period of existence of the farm (2002–2016). To determine the influence of the climatic factor on the blooming and production periods, respectively, every year is considered having pre-blooming, blooming, and ripening periods. It was found that climate change influences the annual biological cycle of the trees: the vegetative rest period of the trees shortens, the tree vegetation begins earlier in the spring, and the blooming period is advanced by as much as 10 days compared to normal cultivated varieties. All these factors have direct repercussions on the quantity of production.

http://bit.ly/2GuMu4q

Comparison of different sequential extraction procedures for mercury fractionation in polluted soils

Abstract

Three sequential extraction procedures (SEPs), modified Tessier, modified BCR, and CIEMAT, were compared for mercury fractionation in polluted soils. With satisfactory total mercury recovery, the modified Tessier and modified BCR SEPs were comparable with each other in terms of extraction efficiency in equivalent mercury fractions, whereas both SEPs were not as efficient as the CIEMAT SEP. However, the CIEMAT SEP might underestimate the oxidizable mercury fractions due to the humic and fulvic complexes instead of the organic matter of the other two SEPs. For mercury bioavailability identification, based on Pearson correlation analysis, all fractions in each SEP were significantly correlated with mercury uptake in Ipomoea aquatica, causing difficulty in comparison. Partial correlation analysis indicated that the mobile mercury fractions extracted by the first step in all three SEPs had a positive correlation with mercury uptake by plant, while mercury bound to organic matter extracted by both modified Tessier and modified BCR SEPs presented negative correlation with mercury uptake by plant which was in contrast to CIEMAT SEP. Meanwhile, clearly positive correlations between mercury fractions extracted by the former three steps of CIEMAT SEP and mercury uptake in Ipomoea aquatica were observed, demonstrating that CIEMAT SEP provided more accurate results related to Hg bioavailability than did the other two SEPs.

http://bit.ly/2Skn8ND

Algae turf scrubber and vertical constructed wetlands combined system for decentralized secondary wastewater treatment

Abstract

Water shortage is a current problem faced by many regions. The deterioration of water bodies driven by the directly discard of untreated wastewater worsens the water shortage and implies in more costly treatments to meet local standards for water quality. In rural areas, the problem is even worse, once conventional centralized treatment plants do not encompass them. Decentralized treatment systems must present low-cost, local availability, standards-meeting efficiency, and simplified operation. The present study examines the combined use of algae turf scrubber and down-flow vertical constructed wetlands for a University's sanitary wastewater treatment. After a hydraulic detention time of 21 days, the unit was able to reach 49%, 48%, 98%, 82%, 99.2%, 70.1%, 44%, 83%, 72%, 86%, 69%, 95%, and 99.9% for conductivity, total soluble solids, turbidity, apparent color, N-NH₃, total nitrogen, P-soluble, total carbon, chemical oxygen demand, inorganic carbon, TOC, Escherichia coli, and total coliforms. In accord to the Brazilian standard ABNT 13969/97, the treated effluent is eligible for reuse in floor and sidewalks washing, garden irrigation, and landscaping purposes.

http://bit.ly/2GyIGPM

Varenicline-induced symmetrical drug-related intertriginous and flexural exanthema

Chun-Yu Cheng, Chuang-Wei Wang, Fang-Ying Wang, Wen-Hung Chung

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):209-211



http://bit.ly/2WUkGMm

Subclinical atherosclerosis and cardiovascular markers in patients with lichen planus: A case–control study

Soheila Nasiri, Afsaneh Sadeghzadeh-Bazargan, Reza Mahmoud Robati, Hamid Reza Haghighatkhah, Shima Younespour

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):138-144

Background: Lichen planus is an idiopathic and chronic inflammatory disease that affects the skin and the mucous membranes, and has been associated with an increased risk for cardiovascular diseases. Hyperhomocysteinemia has been regarded as a risk factor for atherosclerosis and cardiovascular diseases. Increased plasma fibrinogen levels are also associated with increased risk of myocardial infarction. Objective: The main aim of this study is the evaluation of common carotid artery mean intima media wall thickness, serum fibrinogen and homocysteine levels in patients with lichen planus. Methods: Forty-three patients with lichen planus and 43 age, gender and body mass index (BMI) matched healthy controls (from general population without the disease) were included in this study. Results: Compared to the healthy controls, patients had statistically significant greater mean intima media wall thickness of the common carotid artery. Moreover, a positive correlation was observed between lichen planus and increased serum homocysteine and c-reactive protein levels. Limitations: The main limitation of this study is the small sample size due to the time limitation and financial constraints. Conclusion: Early diagnosis of atherosclerosis in patients with lichen planus might afford better prophylaxis, including weight control and/or lipid profile monitoring. Measurement of the mean intima media wall thickness of the common carotid artery by duplex high-resolution B-mode ultrasound scanning could be beneficial as a valuable method for early diagnosis of atherosclerosis in lichen planus.

http://bit.ly/2RLKBlS

Predictors of serological cure after treatment in patients with early syphilis: A retrospective observational study in Thailand

Charussri Leeyaphan, Preawphan Punyaratabandhu, Sukhum Jiamton, Natchaya Junsuwan, Pornchai Chirachanakul, Pattriya Chanyachailert, Viboon Omcharoen

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):235-235

Background: Some patients with early syphilis who receive appropriate treatment do not reach a serological cure and have a persistent titer which does not meet the criteria for treatment failure (serofast state). Aims: This retrospective study aimed to determine the prevalence of serological cure and the serofast state as well as the factors associated with serological cure after treatment of patients with early syphilis. Methods: A serological cure was defined as occurring when there was a ≥4-fold decrease in nontreponemal titer, whereas patients with a ≥4-fold increase were considered as having either a treatment failure or reinfection. Nontreponemal titers that neither increased nor decreased ≥4-fold after treatment were considered to be in a serofast state. Seroreversion was defined as occurring when there was a negative test within 12 months of treatment. Results: There were 179 patients with a mean age of 31.9 years; 174 (97.2%) were men, and 125 (70%) were HIV patients. Of the total, 174 (98%; 95% confidence interval 94.82–99.42%) patients achieved a serological cure, whereas five were in a serofast state 12 months after treatment. Those five serofast patients were all HIV-positive men, of which 4 (80%) had secondary-stage syphilis, a CD4 count ≤200 cells/μl and a titer <1:8. In a bivariate analysis, a serological cure was associated with a baseline Venereal Disease Research Laboratory >1:16 titers (P = 0.018), and a CD4 cell count >200 cells/μl in 6 months preceding treatment (P = 0.016). The median time to a serological cure was 96 days. Only 22 (12.3%) of the patients achieved seroreversion at 12 months after treatment. Limitations: A retrospective medical record review is likely to have a selection bias, and in our study, 196 (52%) patients were excluded due to missing information. Conclusions: Most patients with early syphilis who achieved a serological cure at 12 months after treatment had high baseline Venereal Disease Research Laboratory titers and CD4 cell counts. However, only 22 (12.3%) had a negative Venereal Disease Research Laboratory titer after 1 year of treatment.

http://bit.ly/2WZVlRw

Psoriasis increases the risk of concurrent inflammatory bowel disease: A population-based nationwide study in Korea

Jin Yong Lee, Sungchan Kang, Jung Min Bae, Seong Jin Jo, Seong-Joon Koh, Hyun-Sun Park

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):145-152

Background: The epidemiology of the association between psoriasis and inflammatory bowel disease is poorly defined and remains controversial. Aim: To evaluate the prevalence of inflammatory bowel disease in patients with psoriasis compared with the general population. Methods: We searched the nationwide health claims database between 2011 and 2015 and evaluated the prevalence of inflammatory bowel disease, including Crohn's disease and ulcerative colitis. Results: Prevalence of inflammatory bowel disease, Crohn's disease and ulcerative colitis in patients with psoriasis vs the general population in 2011 were 0.16, 0.05 and 0.12% vs 0.08, 0.03 and 0.06%, respectively, which increased significantly with time between 2011 and 2015. Patients with psoriasis consistently revealed higher standardized prevalence (age and sex adjusted) of inflammatory bowel disease, Crohn's disease and ulcerative colitis compared with the general population. Subgroup analysis revealed the highest risk of prevalent inflammatory bowel disease in patients younger than 19 years (crude odds ratio 5.33, 95% confidence interval 3.74–7.59). Severe psoriasis demonstrated higher odds of inflammatory bowel disease (odds ratio 2.96, 95% confidence interval 2.54–3.45) than mild psoriasis (odds ratio 1.68, 95% confidence interval 1.51–1.88). Limitations: Limited data for doing adjustment and cross-sectional study design. Conclusions: Psoriasis patients revealed higher risk of inflammatory bowel disease. In particular, young patients and those with severe psoriasis may require closer monitoring and comprehensive management.

http://bit.ly/2RPFxwH

Pentazocine induced skin ulcers: An 'easy to miss' diagnosis

Rajsmita Bhattacharjee, Rahul Mahajan

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):224-225



http://bit.ly/2WLNkQ1

Linking of psoriasis with osteopenia and osteoporosis: A cross-sectional study

Antonio Martinez-Lopez, Gonzalo Blasco-Morente, Maria Sierra Giron-Prieto, Miguel Angel Arrabal-Polo, Maria Luque-Valenzuela, Juan de Dios Luna-Del Castillo, Jesus Tercedor-Sanchez, Salvador Arias-Santiago

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):153-159

Background/Purpose: Psoriasis is a multisystem disease which has been related to vitamin-D deficiency through chronic inflammation. This psoriasis-related inflammatory state and vitamin-D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis. Methods: A total of 185 subjects were studied; 58 psoriatic patients who had not been under systemic or biological treatment were included. Age, gender, body mass index, phosphocalcic metabolic parameters and hip and lumbar (L4) bone mineral density data were collected. These variables were compared with those collected in 61 healthy controls and 67 patients with osteopenia/osteoporosis. Results: Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients. Limitations: The main limitations are those of cross-sectional studies, such as a lack of follow up period, and a male predominance in the psoriatic group, which is corrected employing a multivariate analysis with an adjusted model for confounding factors. Conclusions: Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density.

http://bit.ly/2RLKsyQ

Recurrent pyogenic granuloma over nevus flammeus

Sharma Shruti, Fouzia Siraj, Vasanthi Ramesh, V Ramesh

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):236-236



http://bit.ly/2WQEvEA

A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities

Rashmi Sarkar, Vijay Kumar Garg, Annie Jain, Divya Agarwal, Anupama Wagle, Frederic Flament, Michèle Verschoore

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):160-168

Background: Regular exposure to ultraviolet rays is high in India, where most Indians present Fitzpatrick skin phototypes IV and V. Aims: To evaluate the efficacy and compare the effectiveness of two sunscreen products on Indian skin types IV and V with pigmentation irregularities. Methods: A randomized, uncontrolled and investigator-blinded, single-center study enrolled adult men and women (18–45 years) with Fitzpatrick skin phototypes IV (28° < individual typological angle <10°) and V (10° < individual typological angle < −30°) with pigmentary abnormalities seen on the face in adults (actinic lentigines and postinflammatory hyperpigmentation), who did not use sunscreens. Participants were randomized (1:1) to either of the two marketed sunscreen products, Product A (sun protection factor 50 PA+++) or Product B (sun protection factor 19 PA+++), applied twice daily before sun exposure for ≥2 h. Primary objectives aimed at assessing possible improvement in hyperpigmented spots and overall skin appearance after 12 weeks of use. Evaluation of skin radiance and skin color was done by means of L'Oréal color chart and colorimetric measurements (Chromameter®). Results: Among the 230 enrolled participants, 216 (93.91%) completed the study. The clinical assessment of the density of pigmented spots and skin radiance showed significant (P < 0.001) improvement in both groups during all visits. The qualitative (participant perception) and quantitative (Chromameter®) data indicated improvement in pigmentation from Week 0 to Week 12. Both products were well-tolerated. Limitations: The study was conducted over a rather short period of time (12 weeks) at a single location. Conclusions: This is the first study conducted on Indian skin phototypes IV and V under real-life conditions. It demonstrated the effect of regular sunscreen usage in the prevention of certain signs of skin photoaging such as increased pigmentation or pigmentary abnormalities, thus providing support and assistance to clinicians in suggesting the use of efficient sun-screening products to patients.

http://bit.ly/2RLKnLy

The histopathological and dermoscopic correlation of primary cutaneous mucinous carcinoma

Chun-Yu Cheng, Yau-Li Huang, Tseng-Tong Kuo, Sindy Hu

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):215-220



http://bit.ly/2WQ99xL

Crusted nipple and areola: A new aetiology of secondary hyperkeratosis of the nipple and areola

Dhaifallah A Alenizi

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):169-170

Hyperkeratosis of the nipple and areola is a rare condition first described by Tauber in 1923. Less than 100 cases have been reported in the literature. Hyperkeratosis of the nipple and areola presents as hyperkeratotic, hyperpigmented plaques on the nipple and areola. It is more common in females. An 18-year-old female patient presented with hyperkeratotic, plaque-like, hard crusts on both nipples and areolas. The examining physician could successfully remove this crust using his finger. The crust had accumulated as a result of the patient's reluctance to touch or clean the breast area due to psychological issues. A crusted nipple and areola may occur as a secondary condition due to a patient's reluctance to touch or clean their breasts.

http://bit.ly/2RPVzqj

Bead retention test in koilonychia

T Muhammed Razmi, Dipankar De

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):229-230



http://bit.ly/2WTy0kb

Primary mucinous carcinoma of skin with a trichoadenomatous component: A rare case report

Athota Kavitha, Chennamsetty Kavya, Kovi Sneha, Chennamsetty Teja

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):171-174

Primary mucinous carcinoma of the skin is a rare subtype of eccrine sweat gland tumors. Differentiating it from metastatic adenocarcinomas is important in the management of this condition. We report the case of a 55-year-old female presenting with a painless nodule, which was subsequently diagnosed as primary mucinous carcinoma of skin with a trichoadenomatous component. The possibility of a metastatic adenocarcinoma was ruled out by performing ultrasound abdomen, total body computed tomography, mammogram and colonoscopy.

http://bit.ly/2RPtPlU

Syringocystadenoma papilliferum with coexisting hydrocystoma

Uma Keyal, Anil Kumar Bhatta, Yeqiang Liu

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):236-236



http://bit.ly/2WS3pU5

Ultrasound assessment of enthesis thickness in psoriasis and psoriatic arthritis: A cross-sectional study

Dario Graceffa, Claudio Bonifati, Viviana Lora, Pier Luigi Saraceni, Catia De Felice, Maria Sole Chimenti, Roberto Perricone, Aldo Morrone

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):175-181

Background: The inflammatory involvement of the enthesis in the course of psoriasis is accompanied by structural abnormalities detectable by ultrasound. The most common of these abnormalities is the thickening of the tendon at the insertion site. Aims: The aim of the present study was to compare the thickness of entheses of patients with psoriatic arthritis, only skin psoriasis, and healthy controls. Methods: A cross-sectional study was conducted in a cohort of patients affected with either only skin psoriasis or psoriatic arthritis as well as in a control group. Eight entheses sites were scanned by ultrasound bilaterally. The following entheseal characteristics were collected and recorded in a predefined database: entheseal thickness, bone erosions, enthesis calcifications (enthesophytes), presence of blood flow, and presence of bursitis. All the detected entheseal changes were scored, and the data was statistically analyzed. Results: The major differences in enthesis thickness between only skin psoriasis and psoriatic arthritis patients were found at the following sites: (i) olecranon tuberosity, (ii) superior pole of the patella, and (iii) medial epicondyle of femur. The thickness of the medial collateral ligament at the site of the femoral origin was increased in psoriatic arthritis, but not in both only skin psoriasis and healthy controls. The score obtained by adding the thickness of all the 8 examined entheses for each patient showed significant differences among the three groups (psoriatic arthritis: 81.3; only skin psoriasis 74.4; Controls: 67.6; P < 0.0001). Interestingly, we found that in psoriatic arthritis patients, the highest enthesis thickening was seen in entheses affected by bone erosions. Limitations: The small sample of patients studied is a limiting factor in this study. Conclusions: Our data demonstrated that the ultrasound measurement of the enthesis thickness enables a distinction between patients with psoriatic arthritis from those with only skin psoriasis. It is a useful method to improve diagnostic accuracy, especially in patients without clear clinical signs of enthesitis.

http://bit.ly/2RPtK1A

Medical device regulation in India: What dermatologists need to know

Sandeep Lahiry, Rajasree Sinha, Suparna Chatterjee

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):133-137



http://bit.ly/2WTbpoa

An observational study on glabellar wrinkle patterns in Indians

Amala Kamat, Trisha Quadros

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):182-189

Background: Botulinum A exotoxin is an established treatment for glabellar frown lines, crow's feet, and horizontal furrows of the forehead. The glabella is probably the most common site for botulinum toxin treatment in Asians. Five glabellar contraction patterns have been classified in earlier studies based on eyebrow approximation, depression, and elevation. Unfortunately, this was found to be confusing by many practitioners. Indians, as all Asians, have smaller muscles compared to the European population, and there is no consensus on the optimal dosage per injection site or concentration of toxin to be used. Aims: (a) Identification and classification of glabellar wrinkle patterns in Indians. (b) Optimization of the minimal effective dose of toxin per site. Materials and Methods: Retrospective photographic analysis of 200 patients who received botulinum toxin for the first time to treat glabellar wrinkles was conducted. The wrinkle patterns were identified and classified by the authors based on the prevalence of perpendicular and transverse glabellar lines, nasal, and forehead wrinkles. Results: Six patterns were identified: (1) 11 (2) U (3) Pi (4) X (5) W (6) I. The relevant muscles were identified and doses optimized for those sites. Limitations: The doses mentioned in this study are not universal for all patients and toxin units would have to be altered and individualized according to the bulk of the facial muscles and individual needs. Conclusion: The investigators classification, injection patterns, and dosage may provide valuable guidance to facial esthetic treatment.

http://bit.ly/2RPtC26

Primary cutaneous marginal zone B-cell lymphoma of vulva in a pregnant woman

Jiaoqing Tang, Jihui Chen, Hongjie Liu, Lin Wang

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):211-214



http://bit.ly/2WRGAA7

Onychomatricoma: Clinical, dermoscopy and ultrasound findings

Denise Gamé, Ane Jaka, Carlos Ferrándiz

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):190-191



http://bit.ly/2RPVxyH

Acquired acrodermatitis enteropathica secondary to sleeve gastrectomy

Birgül Özkesici Kurt, Ceren Memiş İrican, Betül Ünal, Mehmet A Çiftçioğlu, Soner Uzun

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):220-223



http://bit.ly/2WQErEQ

Bilateral agminated skin-colored papules and nodules on the dorsum of the hands

Adane Ayele, Georgios Kravvas, Richard B Weller, Asok Biswas

Indian Journal of Dermatology, Venereology, and Leprology 2019 85(2):192-194



http://bit.ly/2RLKhna

Effect of EDTA and NTA on cadmium distribution and translocation in Pennisetum purpureum Schum cv. Mott

Abstract

The primary objective of this research was to investigate the cadmium (Cd) distribution in Pennisetum purpurem (Napier grass) in the presence of 30 mg/L of Cd and different types and concentrations of chelating agents (ethylenediaminetetraacetic acid disodium dihydrate (EDTA), nitrilotriacetic acid (NTA), and EDTA-NTA mixtures). Plant samples were collected every 15 d during a 105-d experimental period. Accumulation of Cd in each part of the plant was determined using atomic absorption spectrometer (AAS), and the distribution of Cd was determined by laser ablation inductively coupled plasma mass spectrometer (LA-ICP-MS) and synchrotron radiation micro X-ray fluorescence (SR-micro-XRF). The highest concentrations of Cd accumulation of 889 ± 53 mg kg⁻¹ in the underground part (roots) and 265 ± 26 mg kg⁻¹ in the aboveground part (stems and leaves) in the presence of 1:1 M ratio of Cd:EDTA after 30 d of exposure were observed. Plants grown in the presence of either NTA or EDTA-NTA mixtures showed significant lower Cd accumulation levels. The LA-ICP-MS analysis showed that Cd was primarily accumulated in the aboveground part (stems and leaves), especially in the xylem and intercalary meristem. In addition, translocation factor was very low. Thus, P. purpurem could be considered as a candidate plant for cadmium phytostabilization.

http://bit.ly/2BuhKwW

Rapid and versatile pre-treatment for quantification of multi-walled carbon nanotubes in the environment using microwave-induced heating

Abstract

The concerns regarding potential environmental release and ecological risks of multi-walled carbon nanotubes (MWCNTs) rise with their increased production and use. As a result, there is the need for an analytical method to determine the environmental concentration of MWCNTs. Although several methods have been demonstrated for the quantification of well-characterized MWCNTs, applying these methods to field samples is still a challenge due to interferences from unknown characteristics of MWCNTs and environmental media. To bridge this gap, a recently developed microwave-induced heating method was investigated for the quantification of MWCNTs in field samples. Our results indicated that the microwave response of MWCNTs was independent of the sources, length, and diameter of MWCNTs; however, the aggregated MWCNTs were not able to convert the microwave energy to heat, making the method inapplicable. Thus, a pre-treatment process for dispersing bundled MWCNTs in field samples was crucial for the use of the microwave method. In the present paper, a two-step pre-treatment procedure was proposed: the aggregated MWCNTs loaded environmental samples were first exposed to high temperature (500 °C) and then dispersed by using an acetone-surfactant solution. A validation study was performed to evaluate the effectiveness of the pre-treatment process, showing that an 80–120% recovery range of true MWCNT loading successfully covered the microwave-measured MWCNT mass.

http://bit.ly/2TBxiG9

Limitations imposed by conventional fine bubble diffusers on the design of a high-loaded membrane bioreactor (HL-MBR)

Abstract

The operation of membrane bioreactors (MBRs) at higher than usual mixed liquor suspended solids (MLSS) concentrations may enhance the loading rate treatment capacity while minimizing even further the system's footprint. This requires operating the MBR at the highest possible MLSS concentration and biomass activity (e.g., at high loading rates and low solid retention times (SRTs)). Both a negative effect of the MLSS concentrations and a positive effect of the SRT on the oxygen transfer have been reported when using conventional fine bubble diffusers. However, most of the evaluations have been carried out either at extremely high SRTs or at low MLSS concentrations eventually underestimating the effects of the MLSS concentration on the oxygen transfer. This research evaluated the current limitations imposed by fine bubble diffusers in the context of the high-loaded MBR (HL-MBR) (i.e., high MLSS and short SRT—the latter emulated by concentrating municipal sludge from a wastewater treatment plant (WWTP) operated at a short SRT of approximately 5 days). The high MLSS concentrations and the short SRT of the original municipal sludge induced a large fraction of mixed liquor volatile suspended solids (MLVSS) in the sludge, promoting a large amount of sludge flocs that eventually accumulated on the surface of the bubbles and reduced the free water content of the suspension. Moreover, the short SRTs at which the original municipal sludge was obtained eventually appear to have promoted the accumulation of surfactants in the sludge mixture. This combination exhibited a detrimental effect on the oxygen transfer. Fine bubble diffusers limit the maximum MLSS concentration for a HL-MBR at 30 g L⁻¹; beyond that point is either not technically or not economically feasible to operate; an optimum MLSS concentration of 20 g L⁻¹ is suggested to maximize the treatment capacity while minimizing the system's footprint.

http://bit.ly/2BC5pan

Taking the bait: species taking oral rabies vaccine baits intended for raccoons

Abstract

Raccoon rabies in eastern USA is managed by strategically distributing oral rabies vaccine (ORV) baits. The attractiveness, palativity, density, and non-target species bait take affect ORV effectiveness. We examined raccoon and non-target species differences in investigating/removing fish-meal polymer and coated sachet baits applied to simulate two aerial bait distribution densities. Bait densities of 150 baits/km² and 75 baits/km² were evaluated, respectively, in zones expected to have high and low raccoon densities. Three primary non-target species visited baits: coyotes, white-tailed deer, and feral swine. The proportion of bait stations visited by raccoons during 1 week observation periods ranged from 50 to 70%, exceeding non-target species visitation. Raccoon take rates for visited baits averaged from 59 to 100%. Raccoon visitation was similar for both bait densities, indicating a proportionally greater quantity of baits were taken in the higher bait density zone. Coyote visitation rates ranged from 16 to 26%, with take rates for visited baits between 46 and 100%. Coyotes were expected to take baits intended for raccoons, because similar baits are applied to vaccinate coyotes. Deer regularly investigated but rarely took baits. Feral swine were in low abundance in the high bait density zone (higher human density) and visited ≤ 1% of baits there but visited baits at frequencies similar to coyotes and deer in the low-density zone and were likely to take encountered baits (63–100%). Non-target bait consumption could be a concern in some circumstances for achieving sufficient raccoon sero-conversion rates.

http://bit.ly/2TDsH6r

Adjunctive antimicrobial photodynamic therapy using methylene blue/ethanol formulation in experimental periodontitis in diabetic rats: short-term results

Abstract

The aim of this study was to evaluate the effect of an MB experimental formulation (ethanol 20%) in aPDT used as an adjuvant to scaling and root planing (SRP) in the periodontal treatment of diabetic rats. Forty male Wistar rats received streptozotocin-intraperitonial injections to induce diabetes. After 14 days, 5 animals were allocated in the non-ligate group (NLG), and 35 animals received ligature at the first right mandibular molar to induce periodontitis. After 7 days, the ligature was removed and the animals were randomized into 4 groups: LG (without treatment, n = 5), SRPG (SRP, n = 10), aPDTW (SRP+aPDT-MB/water, n = 10), and aPDTEt (SRP + aPDT-MB/water/ethanol/carboxymethylcellulose, n = 10). Animals were euthanized after 7 days. Data of bone loss (BL) area, degree of inflammatory cell response, and collagen fibers percentages were statistically analyzed (p < 0.05). Percentage of animals that presented mild and severe inflammatory infiltrate was 10% and 40% for SRPG, 20% and 30% for aPDTW, and 50% and 0% for aPDTEt, respectively. BL area (mm²) was statistically higher in the LG (0.39 ± 0.15) than NLG (0.05 ± 0.02). aPDTEt showed the lowest value of BL (0.08 ± 0.03), followed by aPDTW (0.21 ± 0.15) and SRPG (0.31 ± 0.18). Statistical differences were verified between aPDTEt and SRPG. In relation to the LG, aPDTEt, aPDTW, and SRPG recovered the equivalent 80%, 46%, and 20% of the BL. aPDTEt showed collagen content statistically higher than SRPG and LG, and presented higher mean values than NLG (p > 0.05). Our findings showed aPDTEt presented promising results. aPDT using MB/ethanol can have potential as an adjunctive periodontal treatment in diabetics.

http://bit.ly/2GxL4pG

Navigation-guided fibula free flap for mandibular reconstruction – a proof of concept study

To analyze a novel technique of supporting fibula free flap harvest and fabrication with intraoperative navigation technology.

http://bit.ly/2USl903

Multiple lymphatic-venous anastomoses in reducing the risk of lymphedema in melanoma patients undergoing complete lymph node dissection. A retrospective case-control study

Sentinel lymph node biopsy (SLNB) is an indispensable surgical procedure in staging and management of intermediate-thick melanomas. Although recent studies have demonstrated that complete lymph node dissection (CLND) does not improve 3-years specific survival, its utility in increasing the disease-free period and the control of local disease remains confirmed. The most frequent complication related to CLND is lymphedema, which may affect up to 20% of patients undergoing CLND. The preventive use of lymphatic-venous micro-anastomoses could avoid this complication.

http://bit.ly/2tfupiZ

Effects of acetaminophen in oxidative stress and neurotoxicity biomarkers of the gastropod Phorcus lineatus

Abstract

The growing use of pharmaceutical drugs has become a major environmental issue considering that these substances (or their metabolites) end up inevitably in sewage waters after excretion. In the wild, these chemicals may affect non-target organisms, and their potential toxicity is not sufficiently studied, a reality that is particularly true for marine organisms. Acetaminophen (also known as paracetamol) is known to be toxic in high dosages, namely, by triggering oxidative effects. These effects may be potentiated in marine organisms subjected to contamination resulting from large human settlements along coastal areas. In order to assess how different exposure regimes (acute vs. chronic) may affect aquatic wildlife, individuals of the gastropod species Phorcus lineatus were acutely (96 h) and chronically (28 days) exposed to ecologically relevant concentrations of acetaminophen. The effects were evaluated through the quantification of selected biomarkers—catalase (CAT), glutathione-S-transferase (GST), and cholinesterase (ChE) activities. The results from acute exposure showed no significant effects in all three biomarkers, but chronically exposed organisms showed significant increases in the activities of CAT and ChEs. The data show that P. lineatus triggered a defensive biological response in the presence of acetaminophen, and also show that realistically low levels of acetaminophen can exert adaptive changes with unknown consequences.

http://bit.ly/2WTbg3J

Immune checkpoints and the regulation of tolerogenicity in dendritic cells: Implications for autoimmunity and immunotherapy

Publication date: Available online 8 February 2019

Source: Autoimmunity Reviews

Author(s): Samanta C. Funes, Amaranta Manrique de Lara, María J. Altamirano-Lagos, Juan P. Mackern-Oberti, Jorge Escobar-Vera, Alexis M. Kalergis

Abstract

The immune system is responsible for defending the host from a large variety of potential pathogens, while simultaneously avoiding immune reactivity towards self-components. Self-tolerance has to be tightly maintained throughout several central and peripheral processes; immune checkpoints are imperative for regulating the immunity/tolerance balance. Dendritic cells (DCs) are specialized cells that capture antigens, and either activate or inhibit antigen-specific T cells. Therefore, they play a key role at inducing and maintaining immune tolerance. DCs that suppress the immune response have been called tolerogenic dendritic cells (tolDCs). Given their potential as a therapy to prevent transplant rejection and autoimmune damage, several strategies are under development to generate tolDCs, in order to avoid activation and expansion of self-reactive T cells. In this article, we summarize the current knowledge relative to the main features of tolDCs, their mechanisms of action and their therapeutic use for autoimmune diseases. Based on the literature reviewed, autologous antigen-specific tolDCs might constitute a promising strategy to suppress autoreactive T cells and reduce detrimental inflammatory processes.

http://bit.ly/2E0UJU9

Pemphigus and mucous membrane pemphigoid: An update from diagnosis to therapy

Publication date: Available online 7 February 2019

Source: Autoimmunity Reviews

Author(s): Alessio Buonavoglia, Patrizia Leone, Rosanna Dammacco, Giuseppe Di Lernia, Massimo Petruzzi, Domenico Bonamonte, Angelo Vacca, Vito Racanelli, Franco Dammacco

Abstract

Pemphigus diseases (PDs) and mucous membrane pemphigoid (MMP) are a group of immune-mediated mucocutaneous disorders clinically characterized by the formation of blisters, erosions and ulcers. The skin and mucous membranes are predominantly affected, with the oropharyngeal mucosa as the initially involved site. Ocular involvement is also a frequent feature of these diseases. Because of the considerable overlap in their clinical presentations, the diagnosis of PDs vs. MMP can be challenging. A recognition of their specific immunological and histopathologic features is crucial in the differential diagnosis. Treatment modalities include systemically administered corticosteroids, steroid-sparing immunosuppressive agents, and biologic therapies (rituximab, intravenous immunoglobulins, and anti-tumor necrosis factor agents). Topical, oral, conjunctival, or intralesional corticosteroids as well as anti-inflammatory drugs and antibiotics are prescribed as needed.

http://bit.ly/2GwEn7x

Microvascular heart involvement in systemic autoimmune diseases: The purinergic pathway and therapeutic insights from the biology of the diseases

Publication date: Available online 7 February 2019

Source: Autoimmunity Reviews

Author(s): De Lorenzis Enrico, Gremese Elisa, Bosello Silvia, Nurmohamed Michael Tuahier, Sinagra Gianfranco, Ferraccioli Gianfranco

Abstract

Heart involvement – often asymptomatic – is largely underestimated in patients with systemic autoimmune diseases (SADs). Cardiovascular events are more frequent in patients with SADs compared to the general population, owing to the consequences of inflammation and autoimmunity and to the high prevalence of traditional risk factors. Coronary microvascular disease (CMD) is a form of cardiac involvement that is increasingly recognised yet still largely neglected. CMD, the incapacity of the coronary microvascular tree to dilate when myocardial oxygen demand increases or when there is a microvascular spasm (or subclinical myocarditis), is increasingly reported because of the widespread use of new cardiac imaging tools, even in a subclinical phase. The assessment of myocardial coronary flow reserve (CFR) emerged as the most effective clinical tool to detect microvascular damage. The potential causes of microvascular damage, molecular and cellular inflammation along with a pathological CD39-CD73 axis, need always to be considered because data show that they play a role in the occurrence of acute coronary syndromes, heart failure and arrhythmias, even in the early asymptomatic stage. Data suggest that controlling disease activity by means of methotrexate, biologic drugs, antimalarial medications, statins and aspirin, according to indication, might reduce the cardiovascular risk related to macrovascular and microvascular damage in most patients with SADs, provided that they are used early and timely to control diseases. The need of new biomarkers and a careful assessment of myocardial CFR emerged as the most effective clinical tool to detect microvascular damage.

http://bit.ly/2GuuVS0

Blindsight

Publication date: Available online 8 February 2019

Source: Cortex

Author(s): James Danckert, Marco Tamietto, Yves Rossetti

http://bit.ly/2MU5jir

Type 1 and type 2 iodothyronine deiodinases in the thyroid gland of patients with huge goitrous Hashimoto’s thyroiditis

Abstract

Purpose

The serum free triiodothyronine (FT₃)/free thyroxine (FT₄) ratio in patients with huge goitrous Hashimoto's thyroiditis (HG-HT) is relatively high. We investigated the cause of high FT₃/FT₄ ratios.

Methods

We measured the serum FT₃, FT₄, and thyrotropin (TSH) levels of seven patients with HG-HT who had undergone a total thyroidectomy. Eleven patients with papillary thyroid carcinoma served as controls. The activities and mRNA levels of type 1 and type 2 iodothyronine deiodinases (D1 and D2, respectively) were measured in the thyroid tissues of HG-HT and perinodular thyroid tissues of papillary thyroid carcinoma.

Results

The TSH levels in the HG-HT group were not significantly different from those of the controls. The FT₄ levels in the HG-HT group were significantly lower than those of the controls, whereas the FT₃ levels and FT₃/FT₄ ratios were significantly higher in the HG-HT group. The FT₃/FT₄ ratios in the HG-HT group who had undergone total thyroidectomy and received levothyroxine therapy decreased significantly to normal values. Both the D1 and D2 activities in the thyroid tissues of the HG-HT patients were significantly higher than those of the controls. However, the mRNA levels of both D1 and D2 in the HG-HT patients' thyroid tissues were comparable to those of the controls. Interestingly, there were significant correlations between the HG-HT patients' D1 and D2 activities, and their thyroid gland volume or their FT₃/FT₄ ratios.

Conclusions

Our results indicate that increased thyroidal D1 and D2 activities may be responsible for the higher serum FT₃/FT₄ ratio in patients with HG-HT.

http://bit.ly/2SgcYO9

Type 1 and type 2 iodothyronine deiodinases in the thyroid gland of patients with huge goitrous Hashimoto’s thyroiditis

Abstract

Purpose

The serum free triiodothyronine (FT₃)/free thyroxine (FT₄) ratio in patients with huge goitrous Hashimoto's thyroiditis (HG-HT) is relatively high. We investigated the cause of high FT₃/FT₄ ratios.

Methods

We measured the serum FT₃, FT₄, and thyrotropin (TSH) levels of seven patients with HG-HT who had undergone a total thyroidectomy. Eleven patients with papillary thyroid carcinoma served as controls. The activities and mRNA levels of type 1 and type 2 iodothyronine deiodinases (D1 and D2, respectively) were measured in the thyroid tissues of HG-HT and perinodular thyroid tissues of papillary thyroid carcinoma.

Results

The TSH levels in the HG-HT group were not significantly different from those of the controls. The FT₄ levels in the HG-HT group were significantly lower than those of the controls, whereas the FT₃ levels and FT₃/FT₄ ratios were significantly higher in the HG-HT group. The FT₃/FT₄ ratios in the HG-HT group who had undergone total thyroidectomy and received levothyroxine therapy decreased significantly to normal values. Both the D1 and D2 activities in the thyroid tissues of the HG-HT patients were significantly higher than those of the controls. However, the mRNA levels of both D1 and D2 in the HG-HT patients' thyroid tissues were comparable to those of the controls. Interestingly, there were significant correlations between the HG-HT patients' D1 and D2 activities, and their thyroid gland volume or their FT₃/FT₄ ratios.

Conclusions

Our results indicate that increased thyroidal D1 and D2 activities may be responsible for the higher serum FT₃/FT₄ ratio in patients with HG-HT.

http://bit.ly/2SgcYO9

Immune Checkpoint Inhibitors for Treating Advanced Cutaneous Squamous Cell Carcinoma

Abstract

Cutaneous squamous cell carcinoma (CSCC) is one of the most common human malignancies, and the incidence is increasing with time. High mutational loads, known infiltration with lymphocytes, and programmed death (PD)-ligand 1 (PD-L1) expression suggest that immune checkpoint inhibitors, such as PD-1 inhibitors, may show utility in treating CSCC, similar to response see in other solid tumor types. Recently, the robust responsiveness of CSCCs to the PD-1 inhibitor cemiplimab was revealed in the results of a combined phase I/II clinical trial, with an overall response rate of 50% and a durable response exceeding 6 months in 57% of responders. Compared to prior systemic therapies with scant data for efficacy and safety, cemiplimab is a breakthrough therapy, the first systemic drug approved for advanced CSCCs. Other immune checkpoint inhibitors have shown promise through case reports and series, and are currently in clinical development for CSCCs.

http://bit.ly/2SkoO9R

Oesophagectomy and Chest Wall and Respiratory Function

Conditions:   Esophageal Cancer;   Esophagectomy;   Respiratory Function Loss
Interventions:   Other: 3D motion capture system;   Other: Incentive spirometry;   Other: Questionnaires
Sponsor:   Imperial College London
Not yet recruiting

http://bit.ly/2MWSXpV

The Bacterial Composition of the Stomach in Reflux Disease

Conditions:   GORD;   Oesophageal Cancer;   Oesophageal Reflux;   Gastric Cancer;   Gastro Esophageal Reflux;   Oesophageal Carcinoma;   Barrett Esophagus;   Esophagitis
Intervention:   Diagnostic Test: No intervention but patients are undergoing an upper GI endoscopy and biopsies for clinical purposes
Sponsor:   Imperial College London
Recruiting

http://bit.ly/2SCb5KR

Combination of stereotactic radiotherapy and targeted therapy: patterns-of-care survey in German-speaking countries

Abstract

Introduction

Stereotactic body radiotherapy (SBRT) is increasingly used in metastasized patients receiving targeted/immunotherapy. Information on safety and effectivity of concurrent SBRT and targeted/immunotherapy remains limited, resulting in a lack of consensus on treatment strategies. This study aimed to investigate how SBRT-experienced centers in German-speaking countries combine both therapies.

Materials and methods

Patterns-of-care of combined treatment with SBRT and targeted/immunotherapy were assessed in 27 radiation oncology centers (19 German, 1 Austrian and 7 Swiss centers). A survey was performed to analyze the details of SBRT, SBRT planning and combined modality treatment. Consensus was defined as ≥75% agreement among participants.

Results

Most participants (60%) were university centers. SBRT for oligometastases has been performed since the year 2008 (median, range 1997–2016), since then a median of 140 cases (5–1100) of SBRT have been performed. In all, 67% performed concurrent SBRT and targeted agents. BRAF inhibitors and VEGF/EGFR inhibitors (bevacizumab [90%], erlotinib [11%], sorafenib [19%], lapatinib [4%]) were considered a contraindication. Bevacizumab was never given simultaneously with SBRT; other agents were given concurrently in 7–52% of centers. A majority (59%) paused targeted agents 1 week before/after SBRT. Only 1 center reduced SBRT dose when combined with targeted agents.

Conclusion

Although evidence for safety and efficacy of concurrent SBRT and targeted agents is limited, it is regularly performed outside of clinical trials. The survey showed consensus not to combine SBRT with antiangiogenic agents, especially bevacizumab. Furthermore, SBRT with concurrent BRAF inhibitors should be practiced with caution and BRAF inhibitors should be paused at least 1 week before SBRT.

http://bit.ly/2DYVzAS

The value of pretreatment serum butyrylcholinesterase level as a novel prognostic biomarker in patients with cervical cancer treated with primary (chemo-)radiation therapy

Abstract

Background

Deficiency in butyrylcholinesterase (BChE), a condition commonly noticed in liver damage, inflammation, and malnutrition, has previously been associated with impaired prognosis in different malignancies. The aim of the present study was to investigate the value of pretreatment serum BChE levels as a prognostic biomarker in patients with cervical cancer treated with primary (chemotherapy-[chemo-])radiation therapy.

Methods

We retrospectively evaluated data of a consecutive series of patients with cervical cancer treated with primary (chemo-)radiation therapy between 1998 and 2015. Pretreatment serum BChE levels were correlated with clinico-pathological parameters and response to treatment. Uni- and multivariate survival analyses were performed to assess the association between decreased serum BChE levels and progression-free (PFS), cancer-specific (CSS), and overall survival (OS).

Results

A total of 356 patients were eligible for inclusion into the present study. The median (IQR) pretreatment serum BChE level was 6180 (4990–7710) IU/l. Lower serum BChE levels were associated with lower BMI (p < 0.001), advanced tumor stage (p = 0.04), poor treatment response (p = 0.002), the occurrence of disease recurrence (p = 0.003), and the risk of death (p < 0.001). In uni- and multivariate analyses, low pretreatment serum BChE levels were independently associated with shorter PFS (HR 1.8 [1.2–2.6]; p = 0.002), CSS (HR 2.2 [1.4–3.5], p < 0.001), and OS (HR 2.0 [1.4–2.9]; p < 0.001).

Conclusions

Low pretreatment serum BChE levels are associated with advanced tumor stage and poor response to treatment, and serve as an independent prognostic biomarker for shorter PFS, CSS, and OS in patients with cervical cancer treated with primary (chemo-)radiation therapy.

http://bit.ly/2GwETlM

LICHENOID FOLLICULITIS OF THE SCALP IN FOUR PATIENTS WITH ICHTHYOSIFORM SKIN DISORDERS AND CICATRICIAL ALOPECIA

Ichthyosis is a heterogeneous group of inherited skin disorders characterized by a defect of keratinization. Patients diagnosed with lamellar ichthyosis (LI) and some ichthyosiform syndromes, such as the Conradi–Hünermann‐Happle syndrome (CHHS), usually present with hair loss. Even though only few dermatologic complaints carry as many emotional overtones as hair loss, there is extremely little data available in the literature regarding scalp histopathologic features on ichthyosis. A better understanding of scalp changes in such context may result in new therapeutic strategies that in turn would enhance patients' self‐steem and quality of life. The aim of this paper is to describe the scalp histopathologic findings of four young patients with cicatricial alopecia: three diagnosed as having LI and the fourth with CHHS.

This article is protected by copyright. All rights reserved.

http://bit.ly/2E0zFx2

A rare pitfall in the molecular interpretation of BRAF V600E status in melanoma in the setting of BRAF V600E‐mutated chronic lymphocytic leukemia/small lymphocytic lymphoma

BRAF mutation status is a critical predictive and prognostic biomarker in guiding management of unresectable and metastatic melanoma.¹ We recently observed a case of BRAF V600E‐mutated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) intermixed with BRAF V600E wild‐type melanoma reported to harbor BRAF V600E mutation on molecular testing. Our observation underscores the importance of appropriate tumor selection for molecular studies and knowledge of mutational status of co‐existing tumors.

This article is protected by copyright. All rights reserved.

http://bit.ly/2GtcD3A

Plamacytoid dendritic cells in granulomatous variant of mycosis fungoides.

Introduction

Granulomatous mycosis fungoides (MF) is a rare variant in which granulomas are associated with other typical signs of MF. Its prognosis is worse than that of classical MF. Plasmacytoid dendritic cells (PDC) are a subset of Interferon (IFN) producing dendritic cells that link the innate and the adaptative immune responses. They have also been related to tolerance to certain tumors such as melanoma.

Materials and methods

In this paper, we examined for the presence of CD123+ PDC in six cases of granulomatous MF from our archives.

Results

We found clusters of 10 or more positive cells in three of six cases of granulomatous MF (two women and a man, in their 6^th and 7^th decade). Although in two of these three cases the granulomatous response was extensive, in the other, it only represented 10% of the infiltrate of the biopsy. In all three cases, the granulomas were epithelioid, sarcoidal type.

Conclusions

CD123+ PDC can be identified in granulomatous MF. The pathogenic and prognostic role of this finding requires further clarification.

This article is protected by copyright. All rights reserved.

http://bit.ly/2DYkRPF

Sweet syndrome with pseudocarcinomatous hyperplasia: A case report and review of the literature

Abstract:

Pseudocarcinomatous (pseudoepitheliomatous) hyperplasia represents reactive epidermal change mimicking squamous cell carcinoma (SCC), owing to a variety of inflammatory and neoplastic phenomena, including deep fungal infections, CD30‐positive lymphomas, and others. We report a case of Sweet syndrome (SS) arising in a patient with acute myelogenous leukemia, with persistent orolabial involvement which mimicked SCC both clinically and microscopically, but resolved entirely with adequate corticosteroid treatment. Clinicians should be aware that neutrophilic dermatoses such as SS and pyoderma gangrenosum may rarely exhibit pseudocarcinomatous epidermal changes similar to those seen in soft tissue infections and other inflammatory dermatoses.

This article is protected by copyright. All rights reserved.

http://bit.ly/2Gtcygi

Fate of 14 C-acetyl sulfamethoxazole during the activated sludge process

Abstract

Compared to antibiotic parent molecule, human metabolites are generally more polar and sometimes not less toxic in wastewater. However, most researches focus on the fate of parent molecule. Therefore, behaviors of human metabolites are little known. Moreover, though much has been done on the fate of antibiotics during activated sludge process, there are still some limitations and gaps. In the present study, [Ring-¹⁴C] acetyl sulfamethoxazole (¹⁴C-Ac-SMX) was used to investigate the fate of human metabolite of SMX during activated sludge process at environmentally relevant concentration. At the end of 216 h, 3.1% of the spiked activity in the initial aqueous phase was mineralized, 50% was adsorbed onto the solid phase, and 36.5% still remained in the aqueous phase, indicating that adsorption, not biodegradation, was the main dissipation pathway. In the existence of microbial activities, accumulation into the solid phase was much higher, which was less bioavailable by chemical sequential extraction. The multimedia kinetic model simultaneously depicted the fate of Ac-SMX in the gas, aqueous, and solid phases, and demonstrated that microbially accelerated accumulation onto the solid phase was attributed to lower desorption rate from the solid phase to the aqueous phase, where adsorption rate was not the key factor. Therefore, Ac-SMX cannot be efficiently mineralized and remain in the aqueous or the solid phases. The accumulation in the solid phase is less bioavailable and is hard to be desorbed in the existence of microbial activities, and should not be easily degraded, and may lead to the development of antibiotic-resistant bacteria and genes after discharge into the environment.

http://bit.ly/2TDBvJI

Exposure-complaint relationships of various environmental odor sources in Styria, Austria

Abstract

In the planning and authorization process of industrial plants or agricultural buildings, it needs to be ensured that odor emissions do not annoy nearby residents in an unacceptable way. Previous studies have shown that odor-hour frequency is an important predictor for odor annoyance. However, odor-hour frequencies can be assessed for day and night separately. The present study relates complaint rates with different odor types and different metrics of frequency calculated via a dispersion model. Binary logistic regression analyses show that odor type and frequency of odor-hours are important predictors for complaints, while type of residential area does not increase the predictive value of the model. The combination of calculated frequency of day time odor-hours and type of odor explains complaint rates best. It is recommended to keep odor emissions as low as possible, especially for highly annoying odor types.

http://bit.ly/2BqkprA

Correction to: Evaluation of 167 Gene Expression Classifier ( GEC ) and ThyroSeq v2 Diagnostic Accuracy in the Preoperative Assessment of Indeterminate Thyroid Nodules: Bivariate/HROC Meta-analysis

The original version of the article unfortunately contained an error.

http://bit.ly/2Sl0TqU

Investigating adsorption performance of heavy metals onto humic acid from sludge using Fourier-transform infrared combined with two-dimensional correlation spectroscopy

Abstract

Efforts to improve sludge resource utilization have become increasingly important. In this study, humic acid (HA) was extracted from sludge samples collected from a sewage treatment plant, and then used for the adsorption of heavy metals. We used two-dimensional correlation spectroscopy (2D-COS) integrated with Fourier-transform infrared spectroscopy (FTIR) to explore the adsorption between sludge HA (HA) and three metal ions (Cu, Ni, and Pb). The resulting adsorbing data conformed to the isotherm of Langmuir adsorption. The maximum capacity values (q_m) were 5.34, 1.49, and 26.29.8 mg/g for Cu, Ni, and Pb, respectively. The data from 2D-FTIR-COS analysis showed that the susceptibility of the functional group followed the order 2300 → 1130 → 1330 → 1480 → 1580 cm⁻¹ for Cu(II) and Ni(II), and 2300 → 1130 → 1330 → 1480 → 1200 → 1580 cm⁻¹ for Pb(II). The sludge HA with Pb(II) showed more adsorption sites than sludge HA with Cu(II) and Ni(II), and these adsorption sites could preferentially bond with Pb(II) at × 1 compared with Cu(II) and Ni(II). Our findings indicate that 2D-FTIR-COS technology has great potential for application as a useful tool for understanding the adsorption mechanism between adsorbents with heavy metals.

http://bit.ly/2THOxGc

Efficacy and Safety of Mirikizumab (LY3074828) in the Treatment of Moderate‐to‐Severe Plaque Psoriasis: Results from a Randomised Phase 2 Study

Abstract

Background and Objectives

Inhibiting the interleukin (IL)‐23 cytokine in patients with psoriasis has demonstrated high levels of skin clearance. In this Phase 2 (AMAF, NCT02899988), multicentre, double‐blind trial, we investigated the efficacy and safety of three dose groups of mirikizumab (LY3074828), a p19‐directed IL‐23 antibody, compared to placebo in patients with moderate‐to‐severe plaque psoriasis.

Methods

Adult patients were randomised 1:1:1:1 to receive placebo (N=52), mirikizumab 30 mg (N=51), 100 mg (N=51), or 300 mg (N=51) subcutaneously at Weeks 0 and 8. The primary objective was to evaluate superiority of mirikizumab to placebo in achieving a 90% improvement in the Psoriasis Area and Severity Index (PASI 90) response at Week 16. Comparisons were done using logistic regression analysis with treatment, geographic region and previous biologic therapy in the model. Missing data were imputed as nonresponse.

Results

Ninety‐seven percent of patients completed the first 16 weeks of Study AMAF. The primary endpoint was met for all mirikizumab dose groups versus placebo, with PASI 90 response rates at Week 16 of 0%, 29.4% (p=0.009), 58.8% (p<0.001) and 66.7% (p<0.001) for patients receiving placebo, mirikizumab 30 mg, 100 mg and 300 mg, respectively. There were 2 (1.3%) serious AEs in mirikizumab‐treated patients compared to 1 (1.9%) placebo‐group patient.

Conclusions

At Week 16, 66.7% of patients treated with mirikizumab 300 mg at 8‐week intervals achieved PASI 90. The percentage of patients reporting at least one treatment‐emergent adverse event was similar among patients treated with placebo or mirikizumab.

This article is protected by copyright. All rights reserved.

http://bit.ly/2ShX99v

Intravenous immunoglobulin G use in patients with chronic inflammatory demyelinating polyneuropathy: An uncommon cause of drug‐induced discoid lupus erythematosus

Abstract

Drug‐induced chronic cutaneous lupus erythematosus, or drug‐induced discoid lupus erythematosus, is a rare cutaneous phenomenon. Various medications have been associated with drug‐induced discoid lupus erythematosus including fluorouracile agents, especially tegafur and uraciltegafur, and TNF‐α antagonists such as infliximab or etanercept. Recent literature has described a case series of six patients receiving IgG immunoglobulin for chronic inflammatory demyelinating polyneuropathy with subsequent presentations of discoid lupus erythematosus. We present a patient with chronic inflammatory demyelinating polyneuropathy who developed discoid lupus erythematosus secondary to IgG immunoglobulin.

http://bit.ly/2TFbABs

Clinical and genetic features of Chinese patients with lichen and macular primary localized cutaneous amyloidosis

Summary

Background

Primary localized cutaneous amyloidosis (PLCA) is a chronic pruritic skin disorder. The genetic basis of familial (f)PLCA involves mutations in the oncostatin M receptor (OSMR) and interleukin‐31 receptor A (IL31RA) genes, but the disease pathophysiology is not fully understood.

Aim

To investigate the OSMR mutation spectrum in patients with sporadic (s)PLCA/fPLCA, lichen/macular PLCA in mainland China.

Methods

This study was carried out on 64 patients with sPLCA, along with 36 with fPLCA and 10 unaffected individuals collected from 23 unrelated Chinese families. Genomic DNA was extracted from peripheral blood samples. Mutation screening of 17 OSMR exons was performed by Sanger sequencing.

Results

PLCA lesions are typically localized to the shins, forearm and back. Sequence analysis of OSMR exons demonstrated that the OSMR missense mutation rate in patients with fPLCA (63.89%) was significantly higher than that in patients with sPLCA (34.38%). The male/female ratio of patients carrying a homozygous OSMR mutation (0.29) was significantly lower than that of patients carrying a heterozygous OSMR mutation (1.08; P < 0.05) and of patients with wildtype OSMR (1.75; P < 0.01). Age of onset of PLCA with OSMR homozygous mutation (median age 20 years) was earlier than that of PLCA with OSMR heterozygous mutation (median age 32 years; P < 0.01) or PLCA with wildtype genotype (median age 32 years; P < 0.01).

Conclusion

The present data indicate OSMR mutations as not only the main cause of fPLCA, but also the potential source of the pathogenesis of sPLCA, although the exact molecular mechanism remains unknown.

http://bit.ly/2GuNIwx

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

Summary

Background

Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM).

Aims

We performed a pooled adjusted meta‐analysis of comparative studies to investigate the relationship between HS and DM.

Methods

A systematic review and meta‐analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. OR was used as the summary effect size.

Results

From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non‐HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85–2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50–1.91; P < 0.001).

Conclusions

To our knowledge, our systematic review and meta‐analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69‐fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.

http://bit.ly/2DXyRZG

Cutaneous shrinkage after surgical resection of facial skin tumors: a prospective study on 100 surgical specimens

Abstract

Histological reports of skin tumor excisions frequently describe a lesser margin than the clinical excision margin. This study was aimed to evaluate the degree of shrinkage occurring in facial cutaneous specimens after excision and formalin fixation, and to assess the role of potentially influential factors.

Our prospective study on 100 surgical specimens from 06/01/2017 to 10/31/2017 showed a mean shrinkage from in vivo (before excision) to in vitro (after 24h formalin fixation) of 12.8% in length and 11.2% in width for the surgical specimens, and of 10.3% and 9.7%, respectively for the tumor (p<0.001). Shrinkage was greater for squamous cell carcinomas than basal cell carcinomas. No relevant differences were found for age, gender, body mass index, tobacco and alcohol use, phototype and anatomical units of the face.

Clinicians, surgeons and dermatopathologists should be aware of this expected range of shrinkage to appropriately interpret the histological results and the margins.

This article is protected by copyright. All rights reserved.

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Validation of the Greek version of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


http://bit.ly/2UN9Xlm

Toxicity and developmental effect of cucurbitacin E from Citrullus colocynthis L. (Cucurbitales: Cucurbitaceae) against Spodoptera litura Fab. and a non-target earthworm Eisenia fetida Savigny

Abstract

Pest management with natural botanical insecticides is a significant implementation for the sustainability of agroecosystem by reducing the unnecessary risk from the inputs of synthetic insecticides. In this research, we isolated the bioactive compound cucurbitacin E from Citrullus colocynthis (L.) Schrad, and their toxicological effects were screened against different larval instars of Spodoptera litura. The bioactive compound cucurbitacin E was chemically characterized through TLC, FT-IR, and NMR analyses. The larval mortality bioassay revealed that the larvae exposed to cucurbitacin E at the discriminating dose of 50 ppm display higher mortality rate against second (93.8%), third (86.4%), and fourth (73.2%) instar respectively. The lethal concentrations (LC₅₀ and LC₉₀) was detected as 15.84 and 67.60 ppm for third instar respectively. The sub-lethal concentration of cucurbitacin E (2, 4, and 6 ppm) intentionally altered the percentage of survival, pupation, fecundity, and egg hatchability of S. litura. Moreover, antifeedant activity of cucurbitacin E was analyzed using choice-based test. In addition, we found the toxic effects of cucurbitacin E (50 and 100 ppm) and chemical pesticides (cypermethrin and monocrotophos) against terrestrial beneficial earthworm Eisenia fetida, and the result revealed that cucurbitacin E has no harmful effect on non-target organism. Hence, the present study reveals that cucurbitacin E might be a part of a new biorational product alternative to synthetic pesticides.

http://bit.ly/2Gy1zlx

Modelling aggregate exposure to pesticides from dietary and crop spray sources in UK residents

Abstract

Human exposure to pesticide mixtures can occur from the diet and other sources. Realistic exposure and risk assessments should include multiple sources and compounds and include the relative hazards of the different compounds. The EU-funded Euromix project is developing new web-based tools to facilitate these calculations. A case study is presented that exemplifies their use for a population of UK residents, including exposure from crop-spraying. A UK pesticide usage survey provided information on real pesticide combinations applied to crops of wheat, potatoes, sugar beet and dessert apples. This information was combined with outputs from two alternative simulation models of spray drift to estimate dermal, oral and inhalation exposures of residents. These non-dietary exposures were combined with dietary exposure estimates using the Monte Carlo Risk Assessment software to produce a distribution of aggregated and cumulative exposures. Compounds are weighted by relative potency to generate a measure of overall risk. Uncertainty quantification was also included in the distribution of exposures. These tools are flexible to allow diverse sources of exposure and can provide important information to decision-makers and help to prioritise testing of pesticide mixtures. Including non-dietary sources changed the prioritisation of pesticide mixtures, when compared to dietary exposure alone.

http://bit.ly/2E1DO3N