Πέμπτη 14 Φεβρουαρίου 2019
A 14‐year review of a UK teledermatology service: experience of over 40 000 teleconsultations
Summary
Background
There is a paucity of published evidence of established teledermatology (TD) services in the UK. An in‐house TD service using store‐and‐forward technology was set up at a large regional dermatology department in 2004.
Aim
To review the TD service at our centre, including teleconsultation numbers, coding of diagnoses and patient outcomes.
Methods
Retrospective data were retrieved using the electronic patient database, from 31 July 2004 to 31 July 2018. More detailed information on patient outcomes was obtained from patient notes and histology records. A paper questionnaire was distributed to 100 patients to obtain patient feedback.
Results
In total, 40 201 teleconsultations were made over 14 years, and 64% of cases were coded (n = 25 555), of which 77% were lesions. The most common coded lesions were benign naevus (25%), seborrhoeic keratosis (22%) and basal cell carcinoma (19%). Of the total number of cases, 50% were discharged to their general practitioner with advice, 34% were booked for surgery and 16% were booked for a face‐to‐face appointment. In the survey, 82% of patients surveyed felt that the service was 'good' or 'very good'. A detailed study between 1 January 2015 and 1 January 2016 showed that there were 383 patients (10%) with no diagnosis made following teleconsultation, suggesting diagnostic uncertainty. Reasons for this included lack of diagnostic features, possibility of malignancy and service factors. Within this cohort, there was 68% diagnostic concordance.
Conclusions
We have set up a successful TD service at a UK centre, which has prevented 16 282 face‐to‐face appointments over 14 years. Patient feedback has been very good. Review of cases with diagnostic uncertainty provides important information for service improvement and has not previously been documented.
http://bit.ly/2SRmabe
Patient Satisfaction and Patients' Family or Significant Other Perceptions After OnabotulinumtoxinA Treatment: A Prospective Cross-Sectional Study
BACKGROUND OnabotulinumtoxinA treatment is associated with improved emotional well-being in patients. OBJECTIVE This study aimed to determine satisfaction with onabotulinumtoxinA treatment in patients naive to neurotoxin treatment and patients with previous experience with the procedure and evaluate treatment impact on patients' partners, "significant others," or close family members. MATERIALS AND METHODS Patients' satisfaction and their family's/significant other's perception to treatment outcome were assessed in a prospective, cross-sectional study using standardized questionnaires. RESULTS OnabotulinumtoxinA treatment was associated with high patient satisfaction ranging from 80% to 100%. Study patients (61 patients) reported that their faces appeared to be more balanced and symmetrical (mean difference, 1.05) and that they looked much better in photographs (mean difference, 1.43), with their significant others also noting the improvement in appearance. Overall, 98% of patients expressed that they would undergo retreatment, and 100% expressed that they would recommend the procedure to others. The main obstacle for treatment repetition was economic constraints (26%). CONCLUSION OnabotulinumtoxinA treatment is one of the most precise and predictable cosmetic treatments available, with high patient satisfaction (97%). A positive outcome of onabotulinumtoxinA treatment, as expressed by patients surveyed using standardized questionnaires, was the appreciation and acceptance by those in close contact with them. Address correspondence and reprint requests to: José R. Montes, MD, FACS, FACCS, Ophthalmology Dpeartment, University of Puerto Rico, 735 Ponce de León Avenue, Suite 813, San Juan, Puerto Rico 00917, or e-mail: jrmontes@jrmontes.com J.R. Montes is a speaker and trainer for Allergan, Galderma, and Merz. The study was conducted without any support from Allergan, manufacturer of onabotulinumtoxinA (Botox). Nevertheless, Allergan funded the publication of the study. R.V. Ubale is an employee of Cactus Communications who was funded by Allergan for providing writing and editorial assistance. The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
http://bit.ly/2TKFcNH
http://bit.ly/2TKFcNH
Clinical Thyroidology®High-Impact Articles
FREE ACCESS through February 28, 2019
Read Now:
Greetings From the Editor of Clinical Thyroidology
Angela M. Leung
Treatment of Hyperthyroidism Decreases but Does Not Completely Abolish the Increased Risk of Cardiovascular-Related Hospitalization
Natalia Genere and Marius N. Stan
Iodine Content Is Low or Absent in Some U.S. Multivitamin and Prenatal Vitamin Brands
Charles H. Emerson
Is It Time to Update the Classification for Radioiodine-Refractory Differentiated Thyroid Cancer?
Edward B. Silberstein, Guest Associate Editor
Patients with Advanced Thyroid Cancer Containing TRK Fusions May Benefit from Recently FDA-Approved Larotrectinib
Brian W. Kim
The post Clinical Thyroidology<sup>®</sup>High-Impact Articles appeared first on American Thyroid Association.
http://bit.ly/2N8dcRB
Organo-modification of montmorillonite for enhancing the adsorption efficiency of cobalt radionuclides from aqueous solutions
Abstract
Montmorillonite clay was organically modified with thoron (TH) and was employed as an adsorbent for removal of cobalt(II) radionuclides from aqueous solutions. Batch adsorption experiments, under several operational parameters such as pH, contact time, initial adsorbate concentration, adsorbent dosage, ionic strength, and temperature, were conducted to determine the optimum conditions for efficient removal of cobalt(II) radionuclides. The obtained data showed that almost complete removals were achieved for cobalt(II) at pH values ≥ 3.5 using TH-modified montmorillonite (TMM), while only 63% were obtained by unmodified clay at pH ≥ 5.4. Adsorption kinetic data of cobalt(II) were better fitted by the pseudo-second order kinetic model and its adsorption rate was controlled by film diffusion. Both Langmuir and Freundlich models had the ability to well describe the equilibrium data of cobalt(II) radionuclides at the studied temperatures. The adsorption capacity of TMM (0.85 mmol/g) was found to be not only nine times that of unmodified montmorillonite (0.097 mmol/g), but also higher than those reported in literature using various unmodified and modified clays. Thermodynamic parameters (ΔH°, ΔS°, and ΔG°) were calculated. Among the examined desorbing agents, both Al3+ and EDTA were succeeded to desorb most of cobalt(II) radionuclides (desorption % ~ 90%) loaded onto TMM. The results of this study clarified that TMM can be considered as an effective adsorbent for removal of cobalt(II) radionuclides from aqueous solutions.
http://bit.ly/2tr3IYt
Letter to the Editor – Sentinel lymph node biopsy in melanoma: Which hot nodes should be harvested and is blue dye really necessary?
The article by Ranson et al., "Sentinel lymph node biopsy in melanoma: which hot nodes should be harvested and is blue dye really necessary?"1 is generating much academic debate. The responses thus far seem to focus on advocating the continued use of blue dye due to the potential for higher false negative rates using radiocolloid tracer injection alone.
http://bit.ly/2GJ0Ga3
Ammonia exposure induced abnormal expression of cytokines and heat shock proteins via glucose metabolism disorders in chicken neutrophils
Abstract
Ammonia (NH3) is a highly irritant, alkaline gas. Atmospheric emission of NH3 was recognized as an environmental challenge. As a global issue, the NH3 emission survey with spatially detailed information demonstrated that the sources of atmospheric NH3 include agriculture (livestock wastes, fertilizers) and some industrial activities. As an environmental pollution, excessive NH3 exposure can induce many bird dysfunction. Neutrophils respond to multiple invading pathogens through different mechanisms. In order to investigate the effect of NH3 exposure on broilers' neutrophil, 1-day-old broilers were treated with/without NH3 for 28 days. We extracted neutrophils from peripheral blood of chicken with/without NH3 exposure and subsequently stimulated with PMA. Changes of cytokines and inflammatory bodies, heat shock proteins (HSPs), and glucose metabolism of neutrophil were examined in both cases. We not only explored that the index associated with inflammation changed due to NH3 exposure but also observed the status of neutrophils which was treated with PMA stimulation. After NH3 exposure, IL-1β and IL-6 were significantly increased on broilers neutrophil. Inflammatory-related factors (NLRP3, ASC, and caspase-1) were significantly elevated. The mRNA expression of HSP70 and HSP90 was increased significantly. All glucose metabolism indicators were reduced. In summary, we concluded that NH3 enhanced inflammation and disrupted glucose metabolism, and increased the expression of HSPs and inflammatory factors. In addition, the sensitivity of neutrophils to exogenous stimuli was diminished. This information can not only be used to evaluate the damage of NH3-spiked neutrophils to chickens, but also provide clues for human health pathophysiology caused by excess NH3, providing valuable information for NH3 risk management.
http://bit.ly/2BC2TRk
MiRNA-3653 Is a Potential Tissue Biomarker for Increased Metastatic Risk in Pancreatic Neuroendocrine Tumours
Abstract
Pancreatic neuroendocrine tumours (PNETs) are relatively uncommon, accounting for 1–2% of all pancreatic neoplasms. Tumour grade (based on the Ki67 proliferative index and mitotic rate) is associated with metastatic risk across large cohorts; however, predicting the behaviour of individual tumours can be difficult. Therefore, any tool which could further stratify metastatic risk may be clinically beneficial. We sought to investigate microRNA (miRNA) expression as a marker of metastatic disease in PNETs. Tumours from 37 patients, comprising 23 with locoregional disease (L) and 14 with distant metastases (DM), underwent miRNA profiling. In total 506 miRNAs were differentially expressed between the L and DM groups, with four miRNAs (miR-3653 upregulated, and miR-4417, miR-574-3p and miR-664b-3p downregulated) showing statistical significance. A database search demonstrated that miRNA-3653 was associated with ATRX abnormalities. Mean survival between the two groups was correlated with mean expression of miRNA-3653; however, this did not reach statistical significance (p = 0.204). Although this is a small study, we conclude that miRNA-3653 upregulation may be associated with an increased risk of metastatic disease in PNETS, perhaps through interaction with ATRX and the alternate lengthening of telomeres pathway.
http://bit.ly/2DJ5OHV
Different light-activation systems associated with dental bleaching: a systematic review and a network meta-analysis
Abstract
Objectives
A systematic review and a network meta-analysis were performed to answer the following research question: "Is there any light-activation protocol capable of improving color change efficacy when associated with an in-office bleaching gel in adults?"
Material and methods
A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without date and/or language restrictions in April 23, 2017 (updated on March 30, 2018). IADR abstracts (1990–2018), unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials conducted in adults that included at least one group treated with in-office dental bleaching with light activation were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A random-effects Bayesian-mixed treatment comparison (MTC) model was used to combine light-activated versus light-free in-office bleaching with direct light-free comparison trials. A meta-analysis with independent analysis (high- and low-concentrate hydrogen peroxide [HP]) was conducted for color change (∆E*, ∆SGU).
Results
After the removal of duplicates, title, and abstract screening, 28 studies remained. Nine were considered to be at a low RoB, five were at a high RoB, and the remaining were at an unclear RoB. The MTC analysis showed no significant difference in color change (ΔE* and ΔSGU) between light-activation protocols and light-free in-office bleaching, regardless of the HP concentration in the efficacy of the bleaching.
Conclusion
No type of light-activated in-office bleaching was superior to light-free in-office bleaching for both high- and low-concentrate in-office bleaching gels (PROSPERO—CRD42017078743).
Clinical relevance
Although many times dental professionals use "laser whitening" as a form of marketing, this study confirmed that no type of light-activation for in-office bleaching can improve the bleaching efficacy.
http://bit.ly/2IeD6UT
Pentito
I'm sorry I doubted it,and you were right, it waspartially because I'm prone to
http://bit.ly/2tp8fLk
http://bit.ly/2tp8fLk
Quality of Life in Prostate Cancer Patients Receiving Hypofractionated vs Conventional Radiotherapy
This phase 3 randomized clinical trial assesses differences in health-related quality of life between men with low-risk prostate cancer who are treated with hypofractionated vs conventional radiotherapy.
http://bit.ly/2GG4p8g
http://bit.ly/2GG4p8g
Trends in Smoking and e-Cigarette Use Among US Patients With Cancer, 2014-2017
This cross-sectional study of data from the National Health Interview Survey analyzes the prevalence of e-cigarette use in US patients with cancer.
http://bit.ly/2tm3YIl
http://bit.ly/2tm3YIl
Therapeutic Options for Neuroendocrine Tumors
This systematic review and meta-analysis examines randomized clinical trials to assess the safety and efficacy of medications used for patients with gastrointestinal and pancreatic neuroendocrine tumors.
http://bit.ly/2GG49WQ
http://bit.ly/2GG49WQ
Role of Monthly High-Dose Vitamin D Supplementation in Cancer Prevention
To the Editor Scragg et al address an issue of major current interest—the role of vitamin D in cancer prevention. We commend the authors for acknowledging several confounding factors in their study that could nullify any association between vitamin D and cancer incidence. These factors include the proportion of participants (approximately 25%) with vitamin D deficiency.
http://bit.ly/2tnFcI0
http://bit.ly/2tnFcI0
Role of Monthly High-Dose Vitamin D Supplementation in Cancer Prevention—In Reply
In Reply Peiris and colleagues commented on the null effect of vitamin D supplementation on incident cancer in the ViDA study, which is based primarily on possible differential effects on disease risk between daily vs monthly doses of vitamin D supplementation. In our article, we acknowledged that monthly dosing may be less effective than daily dosing for preventing cancer, and we agree that if this finding is true, increased variability in vitamin D levels associated with monthly dosing would be a possible mechanism. For example, daily or weekly dosing of vitamin D is more effective than bolus dosing (ie, monthly) in preventing acute respiratory infections, particularly in people with vitamin D deficiency. However, the recent null findings for incident cancer reported in the VITAL study, in which a daily dose of vitamin D was administered, suggest that the frequency of dosing is not important for cancer prevention.
http://bit.ly/2GLdDjB
http://bit.ly/2GLdDjB
Evaluating Risks and Benefits of Evolving Systemic Treatments of Neuroendocrine Tumors
In recent years, the number of treatments for metastatic, well-differentiated gastrointestinal and pancreatic neuroendocrine tumors (NETs) has expanded significantly. New medications for tumor control as well as symptom control include somatostatin analogues, everolimus, sunitinib, telotristat, and lutetium Lu 177 (177Lu)-dotatate. These new therapies have been approved based on randomized clinical trials—an effort that has required international cooperation given the relative scarcity of metastatic NETs.
http://bit.ly/2tjZbXW
http://bit.ly/2tjZbXW
Error in Figure
In the Original Investigation by Unger et al, published online in JAMA Oncology on January 10, 2019, there was an error in Figure 3C. The number above the bar was 6318 but should have been 6317. This article has been corrected online.
http://bit.ly/2GOXLNh
http://bit.ly/2GOXLNh
Ageing profiles of Caucasian and Chinese cohorts – focus on hands skin
Topographic, colour and biophysic ageing profile of dorsal hand skin from a Caucasian and a Chinese cohort.
Abstract
Objective
In spite of hand care being a dynamic segment of skin care, hands skin physiology has been receiving little attention in comparison to facial skin. In the present study, we aimed at gathering a comprehensive set of skin data from the dorsal part of the hand to study age related‐changes in two ethnic groups (Caucasian and Chinese).
Methods
Skin topographic, skin colour/colour heterogeneities, skin chromophores and skin biophysical measurements of 116 Caucasian and Chinese female volunteers aged 30–65 years old were collected in Ireland and in China as part of a cross‐sectional study.
Results
Topographic alterations happened at both micro and macro scales with a noticeable delay in the onset of 10 years for the Chinese cohort. Similar evolution of skin colour with ageing was observed between the two cohorts and strong dissimilarities were seen when it came to colour heterogeneities and melanin hyper concentration, with a 20‐year delay in severity for the Chinese cohort. A similar sharp drop of skin hydration occurred when reaching the 60's regardless of the group and substantial differences were recorded for skin biomechanical properties of the skin.
Conclusion
These results provide additional insights about hand skin physiology in relation to ageing and ethnic differences, especially when put into perspective with what is currently known about facial ageing. This research yield additional material for hand cream product rationale and strategies for mitigating the appearance of ageing hands.
Résumé
Objectif
Même si le soin pour les mains demeure un segment dynamique en termes de ventes de produits cosmétiques, peu d'études se sont penchées sur la physiologie de la peau des mains en comparaison du visage. Le but de cette étude est d'élucider les changements de la partie dorsale de la main induits par le vieillissement, au sein de deux groupes ethniques (Caucasienne et Chinoise).
Methodes
Des mesures de la topographie, de couleur et de distribution de la couleur, de chromophores et des propriétés biophysiques de la peau de la main ont été collectées sur 116 sujets féminins d'origine caucasienne ou chinoise, âgées entre 30 et 65 ans, en Irlande et en Chine dans le cadre d'une étude cross‐sectionnelle.
Resultats
Des altérations de la topographie de la peau ont été observés à plusieurs échelles, micro et macroscopique, avec néanmoins un délai de 10 ans dans la détérioration de la peau en faveur du panel Chinois. Au niveau de la couleur, des évolutions similaires ont été mesurées dans les deux panels, avec cependant de fortes dissimilarités pour ce qui est de la distribution de la couleur de la peau et de l'hyperconcentration de mélanine, avec des changements retardés de 20 ans en faveur du panel d'origine chinoise. Un déclin d'hydratation significatif s'est produit à partir de la soixantaine dans les deux panels étudiés tandis que des différences flagrantes ont été relevées en ce qui concerne les propriétés biomécaniques de la peau.
Conclusion
Ces résultats offre des données supplémentaires sur la physiologie de la peau des mains lors du vieillissement cutané et sur les différences à prendre en compte entre deux groupes ethniques très distincts, surtout si l'on considère les différences avec le vieillissement du visage. Cette étude fournit un support additionnel pour la conception de crèmes pour les mains et les stratégies à mettre en place pour atténuer l'apparence de mains âgées.
http://bit.ly/2GpQLH6
Veiled Potential of Secretagogin in Diabetes: Correlation or Coincidence?
Publication date: Available online 13 February 2019
Source: Trends in Endocrinology & Metabolism
Author(s): Anand Kumar Sharma, Radhika Khandelwal, Yogendra Sharma
Secretagogin (SCGN) is a calcium sensor protein enriched in neuroendocrine cells in general and pancreatic β-cells in particular. SCGN regulates insulin secretion through several Ca2+-dependent interactions. Recent studies implicate SCGN in the β-cell physiology and extracellular insulin function, making it an intriguing candidate in diabetes research. Here, we propose a conjoining theme of diversified SCGN function in diabetes pathology. In our opinion, SCGN is an attractive therapeutic candidate ascribed by its role in β-cell maintenance and neuronal functions and in the efficacy of insulin. To scrutinize the therapeutic prospects of SCGN, we abridge putative diabetes-related properties of SCGN and put forth strategies to determine the precise role of SCGN in the pathogenesis/preclusion of diabetes.
http://bit.ly/2EaoGkD
The role of conflict, feedback, and action comprehension in monitoring of action errors: Evidence for internal and external routes
Publication date: Available online 14 February 2019
Source: Cortex
Author(s): Cortney M. Howard, Louisa L. Smith, H. Branch Coslett, Laurel J. Buxbaum
Abstract
The mechanisms and brain regions underlying error monitoring in complex action are poorly understood, yet errors and impaired error correction in these tasks are hallmarks of apraxia, a common disorder associated with left hemisphere stroke. Accounts of monitoring of language posit an internal route by which production planning or competition between candidate representations provide predictive signals that monitoring is required to prevent error, and an external route in which output is monitored using the comprehension system. Abnormal reliance on the external route has been associated with damage to brain regions critical for sensory-motor transformation and a pattern of gradual error 'clean-up' called conduite d'approche (CD). Action pantomime data from 67 participants with left hemisphere stroke were consistent with versions of internal route theories positing that competition signals monitoring requirements. Support Vector Regression Lesion Symptom Mapping (SVR-LSM) showed that lesions in the inferior parietal, posterior temporal, and arcuate fasciculus/superior longitudinal fasciculus predicted action conduite d'approche, overlapping the regions previously observed in the language domain. A second experiment with 12 patients who produced substantial action CD assessed whether factors impacting the internal route (action production ability, competition) versus external route (vision of produced actions, action comprehension) influenced correction attempts. In these 'high CD' patients, vision of produced actions and integrity of gesture comprehension interacted to determine successful error correction, supporting external route theories. Viewed together, these and other data suggest that skilled actions are monitored both by an internal route in which conflict aids in detection and correction of errors during production planning, and an external route that detects mismatches between produced actions and stored knowledge of action appearance. The parallels between language and action monitoring mechanisms and neuroanatomical networks pave the way for further exploration of common and distinct processes across these domains.
Graphical abstract
http://bit.ly/2X3qpzN
Introduction to Impairments of short-term memory buffers: do they exist?
Publication date: Available online 13 February 2019
Source: Cortex
Author(s): Costanza Papagno, Tim Shallice
http://bit.ly/2X2xoZS
The skin rejuvenation associated treatment—Fraxel laser, Microbotox, and low G prime hyaluronic acid: preliminary results
Abstract
Minimally invasive facial rejuvenation procedures reached an all-time high in the 2016. This reveals a growing interest in a smoother, younger, and tighter look accessible using the esthetic medicine tools like botulinum toxin and dermal filler injections, laser, and microdermabrasion. Forty-five patients from 35 to 52 years old (medium age 43.8), 38 women and 7 men underwent 5 sessions of Fraxel laser, 1 session of very low G prime HA, and Microbotox injection treatments from January 2016 and January 2017, were included in this study. In this study, we demonstrated that the usage of three treatments together, like mBTX, Volite, and Fractional laser, have a better result despite every single technique alone. The clinical result showed 98% (44 patients, 6 males, 38 females) of the patients had a smoother skin surface, brighter, more hydrated, and elastic skin; 68% of our patients (31 patients, 5 males, 26 females) showed less skin defects and staining as well as less small wrinkles, thanks to Fraxel laser treatment; 98% (44 patients, 6 males, 38 females) showed tighter skin with less sebaceous gland secretion. The aim of this study was to demonstrate that the combination of three techniques acts better and faster than single treatment to contrast facial aging and to improve skin texture and quality.
http://bit.ly/2GI6YH1
Surgical Pearl: Use of a Gasket for Finger Tourniquet
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Burcu Beksac, Ercan Caliskan
http://bit.ly/2S2BVrb
Live remote control of an in vivo reflectance confocal microscope allows diagnosis of basal cell carcinoma at the bedside on a patient 2,500 miles away: A novel tele-RCM approach
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Gennady Rubinstein, Jason Garfinkel, Manu Jain
http://bit.ly/2WZLATe
Sun Exposure Risks in Recipients of Solid Organ and Bone Marrow Transplant Athletes
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): María V. de Gálvez, Jose M. Ruiz Sánchez, María Navarrete-de Gálvez, José Aguilera, Magdalena de Troya-Martín, Francisco Rivas-Ruiz, Enrique Herrera-Ceballos
http://bit.ly/2S5upfz
Reply to ”Response to ‘Hydrochlorothiazide use and risk of nonmelanoma skin cancer: a nationwide case-control study from Denmark’ ”
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Sidsel Arnspang Pedersen, Anton Pottegård
http://bit.ly/2WZ7gPo
Successful Utilization of Optical Coherence Tomography as a Non-Invasive, Bedside Imaging Technique To Identify Residual Nodular Basal Cell Carcinoma at Well-Healed and Clinically Unidentifiable Biopsy Site
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Hao Feng, Mitalee P. Christman, Jon Holmes, Roy G. Geronemus
http://bit.ly/2S2t8Wy
A comparison of apremilast monotherapy and combination therapy for psoriatic arthritis in a real life setting: data from the Leeds Combined Psoriatic Service
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Giuseppina Abignano, Nafisa Fadl, Mira Merashli, Claire Vandevelde, Jane Freeston, Dennis McGonagle, Helena Marzo-Ortega LMS
http://bit.ly/2X3u5By
Improving Non-attendance Rates Among Pediatric Patients with Medicaid or Private Insurance
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Sofia B. Chaudhry, Elaine Siegfried, Umar A. Sheikh, Cassandra Simonetta, Niraj Butala, Eric Armbrecht
Abstract
Background
Access to dermatologists by Medicaid-insured patients is low. Higher clinic non-attendance (NA) among Medicaid-insured patients may impact provider decisions to accept these patients.
Objectives
To determine the effect of different scheduling policies on the NA among children seen at a pediatric dermatology clinic.
Methods
This retrospective review compared NA for three different scheduling policies implemented over 3 consecutive years. Scheduling policies utilized were a first-available open scheduling, a 2-week in advance and a 4-week in advance scheduling policy. Subset analysis was performed by clinic location and insurance type.
Results
The interval between scheduling and appointment date was directly related to NA rates, with higher rates for Medicaid-insured, compared to privately-insured patients. Open scheduling was associated with a 37% NA rate for Medicaid-insured, compared to 18% for privately-insured patients. A 4-week scheduling policy significantly decreased the Medicaid NA rate to 19%, compared to 7% for privately-insured patients. A 2-week policy further decreased the NA rate to 11% for Medicaid and 4% for privately insured patients.
Limitations
Retrospective study that could not track same-day cancellations.
Conclusions
Decreasing the interval between scheduling and appointment dates can significantly decrease NA. This strategy may help dermatologists incorporate more Medicaid-insured patients into their practice.
http://bit.ly/2S2YTyy
Response to ‘Hydrochlorothiazide use and risk of nonmelanoma skin cancer: a nationwide case-control study from Denmark’
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Ard van Veelen, Johannes T.H. Nielen, Robin van Geel, Sander Croes
http://bit.ly/2X5ekdx
Keratoacanthomas: A Review of Excised Specimens
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): Mitchell Gibbons, Alexander Ernst, Ashaki Patel, Eric Armbrecht, Ramona Behshad
http://bit.ly/2S2t5tQ
Drugs used for neurological and psychiatric conditions increase the risk of bullous pemphigoid: a case-control study
Publication date: Available online 13 February 2019
Source: Journal of the American Academy of Dermatology
Author(s): O. Varpuluoma, J. Jokelainen, A.-K. Försti, M. Turpeinen, M. Timonen, L. Huilaja, K. Tasanen
http://bit.ly/2X5e91R
Evaluation of the sensitivity of R1ρ MRI to pH and macromolecular density
Publication date: Available online 14 February 2019
Source: Magnetic Resonance Imaging
Author(s): Syed O. Ali, Petros Fessas, Joshua D. Kaggie, Fulvio Zaccagna, Gavin Houston, Scott Reid, Martin J. Graves, Ferdia A. Gallagher
Abstract
The tumor microenvironment is characteristically acidic and this extracellular acidosis is known to play a role in carcinogenesis and metastasis and can affect tumor chemosensitivity and radiosensitivity. Intracellular pH has been used as a possible biomarker of salvageable tissue in ischemic stroke. A non-invasive MRI-based approach for the determination and imaging of cerebral pH would be a powerful tool in cancer diagnosis and monitoring, as well as stroke treatment planning. Several pH-based MRI imaging approaches have been proposed but for these to be useful, disentangling the effects of pH from other parameters which may affect the measured MRI signal is crucial to ensure accuracy and specificity. R1 relaxation in the rotating frame (R1ρ) is an example of a method that has been proposed to probe pH in vivo using MRI. In this study, we have investigated the relationship between R1ρ, pH, and macromolecular density in vitro using phantoms and in human volunteers. Here we show that the rate of R1ρ relaxation (=1/T1ρ) varies with pH but only in the presence of macromolecules. At constant pH, phantom macromolecular density inversely correlated with R1ρ. R1ρ imaging of the normal human brain demonstrated regional heterogeneity with significant differences between structurally distinct regions, which are likely to be independent of pH. For example, R1ρ was higher in the basal ganglia compared to grey matter and higher in grey matter compared to white matter. We conclude that R1ρ cannot be reliably used to image tissue pH without deconvolution from the effects of local tissue macromolecular composition.
http://bit.ly/2X1kmM6
Effects of PCSK9 inhibitors on LDL cholesterol, cardiovascular morbidity and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background and aims
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors determine a wide reduction of LDL cholesterol, greater than other lipid-lowering agents. The present meta-analysis is aimed at the assessment of PCSK9 inhibitors effect on LDL Cholesterol, cardiovascular morbidity and all-cause mortality.
Methods and results
A Medline and Clinicaltrials.gov search for eligible studies until December 1, 2017, was performed. All randomized trials (> 12 weeks) comparing PCSK-9 inhibitors with placebo or active drugs were retrieved. Primary endpoints: (a) LDL cholesterol at endpoint; (b) Major cardiovascular events (MACE); (c) All-cause mortality. Data extraction was performed independently by two of the authors, and conflicts resolved by a third investigator. A total of 38 trials fulfilling the inclusion criteria were identified, with mean duration of 36.4 weeks. The reduction of LDL cholesterol at endpoint, versus placebo, ezetimibe, and high-dose statins was − 65.3 [− 69.6, − 60.9]%, − 57.7 [− 68.3;− 47.0]%, and − 34.5 [− 40.8;− 28.1]%, respectively, with alirocumab possibly showing a smaller effect than the other drugs of the class. Treatment with PCSK9 inhibitors was associated with a reduction in the incidence of MACE (Mantel–Haenszel Odds Ratio [MH-OR] 0.83 [0.78, 0.88]), with significant effects of alirocumab and evolocumab only. The number needed to treat for 2 years for preventing one event was 89. All-cause mortality and cardiovascular mortality were not reduced by treatment with PCSK-9 inhibitors (MH-OR 0.94 [0.84, 1.04] and 0.97[0.86;1.09]).
Conclusions
PCSK-9 inhibitors are effective in reducing LDL cholesterol and the incidence of major cardiovascular events in high-risk patients. Bococizumab does not show significant effects on MACE.
Registration number
PROSPERO-CRD42018087640.
http://bit.ly/2TLgsVn
Evaluation of human electroencephalogram change for sensory effects of fragrance
Abstract
Background
The stabilizing effect of lavender and the arousal effect of peppermint essential oils are acknowledged and used widely in aromatherapy and the cosmetics industry. However, no evaluation method confirms the effects of essential oils through quantitative and objective electroencephalogram (EEG) results; instead, only a psychological and subjective method exists. Therefore, this study aims to create a new emotional cosmetic evaluation paradigm using EEG values. Moreover, it enables quantitative interpretation of the results in addition to the subjective survey outcomes.
Methods
For this study, 12 healthy female Korean participants were recruited and three fragrances were used. The EEG results were collected for 3 minutes (1 minute each before, during, and after inhalation of every fragrance).
Results
The quantitative EEG outcomes indicate changes in the participant's brainwaves before and after inhalation. Significant changes in the EEG were observed. Based on the results, the effects of fragrances were confirmed to be stabilizing for lavender, and arousing for peppermint and coffee aroma. Furthermore, the subjective questionnaire results indicate similar tendency as that of the quantitative EEG results.
Conclusion
In addition to psychological and subjective assessments, our emotional evaluation method can verify the cosmetic fragrance effects through quantitative and objective results.
http://bit.ly/2GqMJ1d
Late fusion of deep and shallow features to improve discrimination of actinic keratosis from normal skin using clinical photography
Abstract
Background
Actinic keratosis (AK) is a common premalignant skin lesion that can potentially progress to squamous cell carcinoma. Appropriate long‐term management of AK requires close patient monitoring in addition to therapeutic interventions. Computer‐aided diagnostic systems based on clinical photography might evolve in the future into valuable adjuncts to AK patient management. The present study proposes a late fusion approach of color‐texture features (shallow features) and deep features extracted from pre‐trained convolutional neural networks (CNN) to boost AK detection accuracy on clinical photographs.
Materials and Methods
System uses a sliding rectangular window of 50 × 50 pixels and a classifier that assigns the window region to either the AK or the healthy skin class. 6010 and 13 915 cropped regions of interest (ROI) of 50 × 50 pixels of AK and healthy skin, respectively, from 22 patients were used for system implementation. Different support vector machine (SVM) classifiers employing shallow or deep features and their late fusion using the max rule at decision level were compared with the McNemar test and Yule's Q‐statistic.
Results
Support vector machine classifiers based on deep and shallow features exhibited overall competitive performances with complementary improvements in detection accuracy. Late fusion yielded significant improvement (6%) in both sensitivity (87%) and specificity (86%) compared to single classifier performance.
Conclusion
The parallel improvement of sensitivity and specificity is encouraging, demonstrating the potential use of our system in evaluating AK burden. The latter might be of value in future clinical studies for the comparison of field‐directed treatment interventions.
http://bit.ly/2BvgI3Z
Ten Years experience using the Johnson Square Procedure for Lentigo Maligna
Abstract
Lentigo maligna (LM) accounts for 4‐15% of all melanomas with risk of progression to lentigo maligna melanoma (LMM) estimated to be as high as 20% or as low as 5%. Due to the size, location and sub‐clinical spread of these lesions, margin control can be difficult. Clearance rates 24‐70% have been reported when using standard excision with 5mm margins and bread‐loaf histological processing Recurrence rates of 7‐20%.
This article is protected by copyright. All rights reserved.
http://bit.ly/2DE4uq1
Temporal change of the accumulation of persistent organic pollutants (POPs) and polycyclic aromatic hydrocarbons (PAHs) in lichens in Switzerland between 1995 and 2014
Abstract
The aim of this study was to assess the temporal change of atmospheric deposition patterns of persistent organic pollutants (POPs) and polycyclic aromatic hydrocarbons (PAHs) in Switzerland between 1995 and 2014 by a passive biomonitoring with lichens. Lichen tissues sampled at 16 representative sites in the same season of 1995 and 2014 were analyzed for a total of 94 individual and 27 sum parameters of POPs and PAHs by means of gas chromatography-mass spectrometry (GC/MS). The comparative analyses showed a decrease of 40 to 80% (medians) for most of the POPs and PAHs concentration in lichens at all site categories. Reduction in tissue concentration of the polychlorinated dibenzo-p-dioxins/furans (PCDD/PCDFs), such as the highly toxic 2,3,7,8-TetraCDD and the TEQ according to WHO (2005) were 66% and 73%, respectively. For the dioxin- and non-dioxin-like PCBs, a decrease of 67% and 58% was found. The average decrease of 30 organochlorine pesticides and insecticides (OCPs) was 65%, with a 94% decrease for lindane. For the 27 PAHs and for benzo(a)pyrene, an average decrease of 58% and 59% was found. Polybrominated diphenyl ethers (PBDE) showed reduced concentrations in lichens at rural and agglomeration sites, but an increase of contamination was observed at industrial and road traffic sites. The direct comparison of changes of POPs and PAHs concentrations in lichens and of emissions between 1995 and 2014 revealed consistent results. The results of this study highlight for the first time in biota the positive effect of emission regulation of POPs in Switzerland.
http://bit.ly/2DFIR8u
Tumor Cavity Recurrence after Stereotactic Radiosurgery of Surgically Resected Brain Metastases: Implication of Deviations from Contouring Guidelines
Background: Significant heterogeneity exists in target volumes for postoperative stereotactic radiosurgery (SRS) for brain metastases. A set of contouring guidelines was recently published, and we investigated the impact of deviations. Methods: Patients (n = 41) undergoing single-fraction Gamma Knife SRS following surgical resection of brain metastases from 2011 to 2017 were retrospectively reviewed. SRS included the entire contrast-enhancing cavity with heterogeneity in inclusion of the surgical tract and no routine margin along the dura or clinical target volume margin. Follow-up MR imaging was fused with SRS plans to assess patterns of failure. Results: The median follow-up was 11.1 months with a median prescription of 18 Gy. There were 5 local failures: infield (n = 3, 60%), surgical tract (n = 1, 20%), and marginal #x3e; 5 mm from the resection cavity (n = 1, 20%). No marginal failures #x3c; 5 mm or dural margin failures were noted. For deep lesions (n = 13), 62% (n = 8) had the entire tract covered. The only tract recurrence was in a deep lesion without coverage of the surgical tract (n = 1/5). Conclusion: In this small preliminary experience, despite no routine inclusion of the dural tract or bone flap, no failures were noted in these locations. Omission of the surgical tract in deep lesions may increase failure rates.
Stereotact Funct Neurosurg
http://bit.ly/2tkmD7p
Stereotact Funct Neurosurg
http://bit.ly/2tkmD7p
Theoretical and experimental modeling of interstitial laser hyperthermia with surface cooling device using Nd 3+ -doped nanoparticles
Abstract
To improve methods of laser hyperthermia for the treatment of bulk malignant neoplasms, an urgent task is the development of techniques and devices that automatically control heating at a given tissue depth and ensure its uniformity. The article proposes the concept of a system for performing hyperthermia with real-time spectroscopic temperature control and surface cooling, which allows to record spectra of diffusely scattered radiation and fluorescent signal from various depths of biological tissues by the means of the variation of the angle and distance between the fiber source of laser radiation and the receiving fiber. Theoretical and experimental modeling of the spatial distribution of diffusely scattered radiation and temperature inside the tissue with a fiber optic device providing surface cooling of the irradiated tissue, and recording spectral information from a given depth in real time, is presented. Simulation of radiation propagation in biological tissues, depending on the distance between the source and the receiver and the angle of their tilt, was carried out using the Monte Carlo method. Modeling of the temperature distribution inside the tissues was carried out by means of a numerical solution of the heat conduction equation. Experimental modeling was carried out on phantoms of biological tissues simulating their scattering properties as well as accumulation of the investigated nanoparticles doped with Nd3+ ions. It was shown that inorganic nanoparticles doped with rare-earth Nd3+ ions can be used as temperature labels for feedback to the therapeutic laser. According to the results of the theoretical simulation, optimal configurations of the relative arrangement of the fibers were chosen, as well as the optimum surface cooling temperatures for the given power densities. The heating of the phantom of the neoplasm containing the investigated nanoparticles doped with Nd3+ ions by laser radiation with an 805-nm wavelength and power density of 1 W/cm2 up to 42 °C at a depth of 1 cm while maintaining the surface temperature within the limits of the norm was demonstrated.
http://bit.ly/2X32z76
Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study
Abstract
To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15–20 kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization—control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25 W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25 W peak powers in pulsed mode). Larynx and proximal trachea were excised, prepared for histopathology, and digital morphometric analysis. Measurements in and within each group were analyzed (Kruskal-Wallis and Dunn test) with a level of significance of p < 0.05. Incision width was not different between the groups, as well as in the powers used in CDL (p = 0.161) and electrocautery group (p = 0.319). The depth of the incisions was smaller in the Laser group compared to control (p = 0.007), and in the electrocautery compared to control (p = 0.026). Incision area was smaller in CDL compared with the control (p = 0.027), and not different between laser and electrocautery groups (p = 0.199). The lateral thermal damage produced by electrocautery was the largest, with a significant difference between laser and electrocautery (p = 0.018), and between electrocautery and control (p = 0.004), whereas the comparison between laser and control showed no significant differences (p = 0.588). The posterior laryngofissure incision using a 980-nm CDL is feasible resulting in smaller incisional area and less lateral thermal damage.
http://bit.ly/2S2Expg
Effects of low-level laser therapy on the organization of articular cartilage in an experimental microcrystalline arthritis model
Abstract
The aim of this study was to evaluate the effects of low-level laser therapy using the gallium arsenide laser (λ = 830 nm) on the articular cartilage (AC) organization from knee joint in an experimental model of microcrystalline arthritis in adult male Wistar rats. Seventy-two animals were divided into three groups: A (control), B (induced arthritis), and C (induced arthritis + laser therapy). The arthritis was induced in the right knee using 2 mg of Na4P2O7 in 0.5 mL of saline solution. The treatments were daily applied in the patellar region of the right knee after 48 h of induction. On the 7th, 14th, and 21st days of treatment, the animals were euthanized and their right knees were removed and processed for structural and biochemical analysis of the AC. The chondrocytes positively labeled for the TUNEL reaction were lower in C than in B on the 14th and 21st days. The content of glycosaminoglycans and hydroxyproline in A and C was higher than B on the 21st day. The amount of tibial TNF-α in B and C was lower than in A. The amount of tibial BMP-7 in B and C was higher than in A. The femoral MMP-13 was lower in B and C than for A. The tibial TGF-β for C was higher than the others. The femoral ADAMT-S4 content of A and C presented similar and inferior data to B on the 21st day. The AsGa-830 nm therapy preserved the content of glycosaminoglycans, reduced the cellular changes and the inflammatory process compared to the untreated group.
http://bit.ly/2X5zsjs
Lasers for Becker’s nevus
Abstract
Becker's nevus is a common pigmented dermatosis, usually featured by ipsilateral pigmented patch with hypertrichosis. Becker's nevus is often treated with various types of lasers although other regimens are available. However, clinical outcomes appear inconsistent among studies. To summarize the clinical outcomes of Becker's nevus treated with lasers via literature review. A variety of lasers had been used alone or in combination to treat Becker's nevus. Laser wavelengths used for Becker's nevus ranged from 504 to 10,600 nm, while the number of treatment varied from 1 to 12 sessions. The clinical outcomes were mixed although combination of lasers with different wavelengths appeared to achieve a better efficacy. Adverse effects were usually mild to moderate erythema. While lasers are relatively safe, their efficacy for Becker's nevus is moderate. It seems that combination therapy could improve the outcome. However, trials in larger group of patients are required to validate the efficacy of each type of lasers for Becker's nevus.
http://bit.ly/2S2tAUB
Minimally invasive erbium laser treatment for selected snorers
Abstract
The aim of this paper is to present our results and experience in the treatment of snoring using the non-ablative Erbium: Yttrium Aluminum Garnet (Er:YAG) laser. Twenty-four patients (18 male and 6 female) with snoring problems due to soft palate hypertrophy were treated with 3 treatment procedures with Er:YAG 2940-nm laser (long pulse mode, 10 Hz, fluence 1.8–2.0 J/cm2) performed at 2-week intervals. The treatment procedures were performed in outpatient settings. One treatment session lasts 15–20 min. Subjective (questionnaires) and objective (polygraph) outcome measures were assessed at baseline and 3 months after the final laser treatment. Wilcoxon Signed Rank was used to compare before and after scores. All polygraph variables showed some improvement 3 months after the end of treatment; however, only the reduction of the number of hypopnea episodes per hour was statistically significant (p = 0.034). In 13/24 patients, snoring time accounted for less than 5% of the sleep time after the treatment compared to 6/24 patients at baseline. The questionnaire survey showed statistically significant improvement in the quality of sleep and life of the patients as well as their partners after Er:YAG treatment (p < 0.001). The assessment of daytime sleepiness using the Epworth scale also improved 3 months after the end of treatment (p = 0.010). Based on our observations, the treatment of snoring with the Er:YAG laser is an effective and non-invasive therapeutic method. Further studies with long-term follow-up and a control group are warranted to confirm the promising results obtained in case series.
http://bit.ly/2X3dhuv
Voice improvement in patients with recurrent respiratory papillomatosis after combined treatment with cidofovir and CO 2 laser surgery
Abstract
Mechanical debulking of laryngeal papillomas is associated with voice disorders due to impairment of the vocal fold's mucosa. Intraepithelial injection of cidofovir reduces damage to the laryngeal structures and thus improves vocal parameters. The aim of our study was to compare vocal quality before and after cidofovir and CO2 laser treatment by means of objective phoniatric parameters and to obtain evidence concerning voice outcomes. The vocal parameters of 42 patients with RRP were assessed before and after intralesional cidofovir and CO2 laser debulking treatment (Lumenis AcuPulse 40 CO2 laser, wavelength 10.6 μm; Lumenis Ltd., Yokneam, Israel). The laser was used in SuperPulse™ mode with power tailored on the target structures (average 7 W). The depth of tissue penetration was 1 mm with a single burst of energy lasting 0.3 ms. Most of the patients had previously undergone traditional surgery (1–105 procedures); in 7/42, the video stroboscopic examination revealed extensive scar tissue covering the mucosa of the vocal folds, limiting the mucosal wave. The significance level for all calculations was p < 0.05. Statistical analysis was performed using Statistica 10 by StatSoft Polska. The methodology included subjective voice evaluation (GRBAS), videostroboscopy, analysis of the acoustic laryngeal tone (MDVP), spectrographic analysis, and voice handicap index (VHI). The GRBAS scale during spontaneous conversation revealed better phonation results after cidofovir treatment in all 42 patients. Scars were not observed in the presented group. In the MDVP laryngeal tone analysis before surgery parameters defining the amplitude and frequency of laryngeal tone were significantly elevated compared to the state after surgery. After treatment, both jitter and shimmer were reduced in all subjects. Even more pronounced changes were observed in the spectrographic analysis. In all analyzed patients, there was a significant reduction in VHI scores showing improvement in voice self-assessment. A satisfactory improvement in voice quality was observed in all RRP patients treated with cidofovir and CO2 laser.
http://bit.ly/2S2tmgd
Influence of Er:YAG laser pulse duration on the long-term stability of organic matrix and resin-dentin interface
Abstract
The purpose of this study was to explore the influence of Er:YAG laser irradiation with different pulse durations on the organic matrix, micromorphology of the hybrid layer (HL), and bond strength over time. Sixty caries-free human molars were cut to obtain flat dentin surfaces which were randomly divided into 4 groups: control (not irradiated–G1) and laser groups (80 mJ/2 Hz) with pulse duration ranging between 50 (G2), 300 (G3), and 600 μs (G4). A self-etch adhesive system (Universal 3M ESPE) was applied on pre-treated dentin surfaces and cylinders of resin composite were built up and stressed in a universal testing machine (μSBS) at 24 h and after12 months (n = 12). In addition, 3 other dentin-bonded specimens were prepared as previously described for each group with the adhesive doped with 0.1 wt% Rhodamine B to analyze hybrid layer morphology under Confocal Laser Microscope Scanning (CLMS). Organic matrix and collagen fibrils were analyzed by second harmonic generation (SGH). Two-way ANOVA and Tukey's test detected significantly higher μSBS values for the control group, whereas the lower values were observed in all laser groups at 24 h (p < 0.05). Storage in artificial saliva did not reduce μSBS in all groups. The low signal emitted by SHG images below the irradiated area demonstrated thermal damage of the collagen matrix. CLMS images of laser groups exhibited thicker and irregular resin-dentin interfaces than the control group. Regardless of the pulse duration, Er:YAG laser pre-treatment altered the organic matrix and HL formation which resulted in low μSBS values at 24 h. The alterations on dentin's organic structure did not jeopardize the μSBS after 1 year of saliva storage.
http://bit.ly/2X3dfTp
Cosmetics, Vol. 6, Pages 10: A New Carrier for Advanced Cosmeceuticals
Cosmetics, Vol. 6, Pages 10: A New Carrier for Advanced Cosmeceuticals
Cosmetics doi: 10.3390/cosmetics6010010
Authors: Pierfrancesco Morganti Maria-Beatrice Coltelli
Cosmetic products are generally formulated as emulsions, ointments, solutions or powders containing active ingredients. According to EU legislation, a cosmetic product is “any substance or preparation intended to be placed in contact with the various external parts of the human body with a view exclusively or mainly to cleaning, perfuming them, changing their appearance, and/or correcting body odors and/or protecting them or keeping them in good conditions”. However, science advancement in both active carriers and ingredients has streamlined the process through which many cosmetic products by their delivery systems can induce modifications on the skin physiology. This is the reason why Reed and Kligman redefined these products as “cosmeceuticals”, which refers to the combination of cosmetics and pharmaceuticals. Until recently, the term of cosmeceuticals has not had legal significance. The so-called cosmeceuticals, in fact, may induce modifications on the skin physiology, modifying, for example, transepidermal water loss, keratinocytes cohesion and turnover, modulating the inflammatory cascade, and/or altering the surface microbiota by the activity of the preservatives content. For these reasons, they are claimed to have medical or drug-like benefits. Naturally, their effectiveness on minor skin disorders or mild skin abnormalities has to be shown by in vitro and in vivo studies. On the other hand, their formulations contain emulsifiers, preservatives, and other chemicals which, by their cumulative use, may provoke side effects, such as allergic and/or sensitization phenomena. Moreover, many ingredients and packaging for such products are not biodegradable. In this study, we would like to introduce an innovative category of cosmeceuticals made by biodegradable nonwoven tissues. These cosmeceutical tissues, produced through the use of natural fibers, may bind different active ingredients and therefore become effective as antibacterial, anti-inflammatory, sun-protective, whitening, or anti-aging products, depending on the ingredient(s) used. Differently from the usual cosmetics, they do not contain preservatives, emulsifiers, colors, and other chemicals. They can be applied as dried tissue on wet skin, remaining in loco for around 30 min, slowly releasing the active ingredients entrapped into the fibers. It is interesting to underline that the tissue, acting as a carrier, has its own effectiveness via chitin and lignin polymers with an antibacterial and anti-inflammatory activity. When hydrolyzed by the human microbiota enzymes, they give rise to ingredients used as cell nourishment or energy. This paper will review part of the scientific research results, supporting this new category of biodegradable cosmetic products known as facial mask sheets.
http://bit.ly/2SyVUDj
The adsorption behavior of multiple contaminants like heavy metal ions and p-nitrophenol on organic-modified montmorillonite
Abstract
Stearyl trimethyl ammonium chloride (STAC) and ethylenediamine (En) were successfully implanted into montmorillonite (MMt) interlayer to fabricate the novel adsorbent STAC-En-MMt for the simultaneous adsorption of Cu2+, Zn2+, and p-nitrophenol (PNP). X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, elemental analyzer, zeta potential analyzer, inductively coupled plasma mass spectrometry, and UV–visible spectrophotometer were used to investigate the microstructure characteristics of STAC-En-MMt and their adsorption capacity of target contaminants. Four factors such as pH, the molar ratio between En and STAC (REn/STAC), the adsorption time (ATime), and the adsorption temperature (ATemp) were selected to investigate the adsorption capacities of Cu2+, Zn2+, and PNP onto STAC-En-MMt in ternary solution. The results indicated that the total simultaneous adsorption of Cu2+, Zn2+, and PNP onto STAC-En-MMt adsorbent with REn/STAC = 0.75 reached up to 260.27 mmol·kg−1 under the condition of pH = 6, ATemp = 40 °C, and ATime = 60 min. After three regenerations, there was still a good performance in the adsorption of STAC-En-MMt. The Langmuir adsorption isotherm indicated that the adsorption of heavy metals and PNP onto adsorbents were single-layer surface adsorption. Nonlinear adsorption kinetics simulation indicated that chemical adsorption occupied a predominant position in Cu2+ and Zn2+ adsorption, while PNP adsorption depended on physical adsorption. Compared with Zn2+, Cu2+ had higher affinity for the adsorption sites on STAC-En-MMt. However, the pore blocking caused by the Cu2+ and Zn2+ adsorption had a remarkably adverse effect on PNP adsorption.
http://bit.ly/2tlW0yQ
Field-aged biochar reduces the greenhouse gas balance in a degraded vegetable field treated by reductive soil disinfestation
Abstract
Reductive soil disinfestation (RSD) is proposed as a pre-plant, non-chemical soil disinfestation technique to control several soilborne phytosanitary issues. However, limited information is available on the evaluation of greenhouse gas (GHG) balance and soil quality during the soil remediation process as affected by RSD method. A 44-day field experiment including four different treatments was conducted to investigate the effects of conventional RSD and field-aged biochar-amended RSD on GHG balance and soil quality in a degraded vegetable field. Results showed that the conventional RSD application can significantly decrease the soil nitrate (NO3−) concentrations and electrical conductivity (EC) and oxidation-reduction potential (Eh) by 51.4–67.3%, 5.3–23.6%, and 10.9–15.1%, respectively, while significantly increase soil pH and cation exchange capacity (CEC) by 0.37–0.42 units and 7.8–32.2%, respectively, in relation to the control (CK). Compared with the conventional RSD treatment, aged biochar-amended RSD significantly reduced soil NO3− concentrations, EC and Eh. No significant differences on CH4 emissions were observed among all the treatments during the experimental period. However, the conventional RSD application significantly increased the cumulative nitrous oxide (N2O) and carbon dioxide (CO2) emissions by 66.2–124.7% and 64.3–130.0%, respectively, and thus resulted in a significant GHG balance of 64.1–130.1% in relation to the CK. On the contrary, although resulted in more N2O emissions compared with the conventional RSD treatment, aged biochar-amended RSD significantly reduced the cumulative CO2 emissions and thus had an overall decrease in GHG balance by 20.7–28.7%. Therefore, aged biochar-amended RSD can simultaneously achieve lower GHG balance and better improvement of soil quality in degraded vegetable field, and thus can be utilized as an effective technology for soil remediation in intensive vegetable production.
http://bit.ly/2Gv8DR5
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Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
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