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Κυριακή 27 Ιουνίου 2021

The Role of the Skin Microbiota in the Modulation of Cutaneous Inflammation‐ Lessons from the Gut

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Abstract

Inflammation is a vital defence mechanism used to protect the body from invading pathogens, but dysregulation can lead to chronic inflammatory disorders such as psoriasis and atopic dermatitis. Differences in microbiota composition have been observed in patients with inflammatory skin conditions compared with healthy individuals, particularly within lesions. There is also increasing evidence accumulating to support the notion that the microbiome contributes to the onset or modulates the severity of inflammatory diseases. Despite the known protective effects of orally administered lactic acid bacteria against inflammation, few studies have investigated the potential protective effects of topical application of bacteria on skin health and even fewer have looked at the potential anti-inflammatory effects of skin commensals. If lack of diversity and reduction in the abundance of specific commensal strains is observed in inflammatory skin lesions, and it is known that commensal bacteri a can produce anti-inflammatory compounds, we suggest that certain members of the skin microbiota have anti-inflammatory properties that can be harnessed for use as topical therapeutics in inflammatory skin disorders.

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Can plantar fibroblast implantation protect amputees from skin injury? A recipe for skin augmentation

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Abstract

Skin injuries remain a persistent problem for users of lower-limb prostheses despite sustained progress in prosthesis design. One factor limiting the prevention of skin injuries is that skin on the residual limb is not suited to bear the mechanical loads of ambulation. One part of the body that is suited to this task is the sole of the foot. Here, we propose a novel strategy to actively augment skin's tolerance to load, increasing its resistance to mechanically induced injuries. We hypothesise that the load tolerance of skin can be augmented by autologous transplantation of plantar fibroblasts into the residual limb dermis. We expect that introducing plantar fibroblasts will induce the overlying keratinocytes to express plantar-specific keratins leading to a tougher epidermis. Using a computational finite element model of a weight-bearing residual limb, we estimate that skin deformation (a key driver of pressure ulcer injuries) could be halved by reprogramming skin to a plantar- like phenotype. We believe this strategy could yield new progress in pressure ulcer prevention for amputees, facilitating rehabilitation and improving quality of life for patients.

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Severe acute orthostatic headache: spontaneous intracranial hypotension (SIH)

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BMJ Case Rep. 2021 Jun 25;14(6):e243179. doi: 10.1136/bcr-2021-243179.

ABSTRACT

The most common cause of spontaneous intracranial hypotension headache is a cerebrospinal fluid (CSF) leakage, but the underlying mechanisms remain unknown. Intracranial hypotension is characterised by diffuse pachymeningeal enhancement on cranial MRI features, low CSF pressure and orthostatic headaches mostly caused by the dural puncture. We report a 31-year-old woman who presented to our services with reports of continuous severe bifrontal headache, which increased on sitting up and resolved on lying down. MRI of the cervical and lumbosacral spine showed signs of CSF leak; hence, patient was diagnosed with spontaneous intracranial hypotension headache. A CT-guided epidural blood patch was done at L4-5 with fibrin glue injected at the site of leak. The patient's signs and symptoms improved after the procedure.

PMID:34172480 | DOI:10.1136/bcr-2021-243179

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Perceptual awareness negativity: a physiological correlate of sensory consciousness

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Trends Cogn Sci. 2021 Jun 22:S1364-6613(21)00146-7. doi: 10.1016/j.tics.2021.05.009. Online ahead of print.

ABSTRACT

Much research on the neural correlates of consciousness (NCC) has focused on two evoked potentials, the P3b and the visual or auditory awareness negativity (VAN, AAN). Surveying a broad range of recent experimental evidence, we find that repeated failures to observe the P3b during conscious perception eliminate it as a putative NCC. Neither the VAN nor the AAN have been dissociated from consciousness; furthermore, a similar neural signal correlates with tactile consciousness. These awareness negativities can be maximal contralateral to the evoking stimulus, are likely generated in underlying sensory cortices, and point to the existence of a generalized perceptual awareness negativity (PAN) reflecting the onset of sensory consciousness.

PMID:34172384 | DOI:10.1016/j.tics.2021.05.009

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Comparative Analysis of Cortical Auditory Evoked Potential in Cochlear Implant Users

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Ear Hear. 2021 Jun 23. doi: 10.1097/AUD.0000000000001075. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary goal of the study was to investigate electrical cortical auditory evoked potentials (eCAEPs) at maximum comfortable level (MCL) and 50% MCL on three cochlear implant (CI) electrodes and compare them with the acoustic CAEP (aCAEPs), in terms of the amplitude and latency of the P1-N1-P2 complex. This was achieved by comparing the eCAEP obtained with the method described and stimulating single electrodes, via the fitting software spanning the cochlear array and the aCAEP obtained using the HEARLab system at four speech tokens.

DESIGN: Twenty MED-EL (MED-EL Medical Electronics, Innsbruck, Austria) CI adult users were tested. CAEP recording with HEARLab System was performed with speech tokens /m/, /g/, /t/, and /s/ in free field, presented at 55 dB SPL. eCAEPs were recorded with an Evoked Potential device triggered from the MAX P rogramming Interface (MED-EL Medical Devices) with 70 msec electrical burst at 0.9 Hz at the apical (1), middle (6), and basal (10 or 11) CI electrode at their MCL and 50% MCL.

RESULTS: CAEP responses were recorded in 100% of the test subjects for the speech token /t/, 95% for the speech tokens /g/ and /s/, and 90% for the speech token /m/. For eCAEP recordings, in all subjects, it was possible to identify N1 and P2 peaks when stimulating the apical and middle electrodes. This incidence of detection decreased to an 85% chance of stimulation at 50% MCL on the same electrodes. A P1 peak was less evident for all electrodes. There was an overall increase in latency for stimulation at 50% MCL compared with MCL. There was a significant difference in the amplitude of adjacent peaks (P1-N1 and N1-P2) for 50% MCL compared with MCL. The mean of the maximum cross-correlation values were in the range of 0.63 to 0.68 for the four speech tokens. The distribution of the calculated time shift , where the maximum of the cross-correlation was found, was distributed between the speech tokens. The speech token /g/ had the highest number of valid cross-correlations, while the speech token /s/ had the lowest number.

CONCLUSIONS: This study successfully compared aCAEP and eCAEP in CI users. Both acoustic and electrical P1-N1-P2 recordings obtained were clear and reliable, with good correlation. Latency increased with decreasing stimulation level, while amplitude decreased. eCAEP is potentially a better option to verify speech detection at the cortical level because it (1) uses direct stimulation and therefore creates less interference and delay of the sound processor and (2) creates more flexibility with the recording setup and stimulation setting. As such, eCAEP is an alternative method for CI optimization.

PMID:34172688 | DOI:10.1097/AUD.0000000000001075

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Multicentric Intra/Extracranial Cystic Facial Nerve Schwannoma: Case Report and Review of Literature

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Abstract

To report a case of facial nerve schwannoma which presented a diagnostic and management challenge because of unusual multicentric cystic presentation. A 25-year-old female patient with a history of deep facial pain, parotid gland swelling and normal facial function showed multiple expansive cystic lesions of the temporal bone and parotid gland which turned out to be multicentric cystic facial nerve schwannomas. One should be keep this diagnosis in mind when dealing with a cystic lesions of the temporal bone and parotid gland.

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FACE-Q craniofacial module: Part 2 Psychometric properties of newly developed scales for children and young adults with facial conditions

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J Plast Reconstr Aesthet Surg. 2021 Mar 25:S1748-6815(21)00098-X. doi: 10.1016/j.bjps.2021.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: The FACE-Q Craniofacial Module is a patient-reported outcome measure designed for patients aged 8 to 29 years with conditions associated with a facial difference. In part 1, we describe the psychometric findings for the original CLEFT-Q scales tested in patients with cleft and noncleft facial conditions. The aim of this study was to examine psychometric performance of new FACE-Q Craniofacial Module scales.

METHODS: Data were collected between December 2016 and December 2019 from patients aged 8 to 29 years with conditions associated with a visible or functional facial difference. Rasch measurement theory (RMT) analysis was used to examine psychometric properties of each scale. Scores were transformed from 0 (worst) to 100 (best) for tests of construct validity.

RESULTS: 1495 particip ants were recruited with a broad range of conditions (e.g., birthmarks, facial paralysis, craniosynostosis, craniofacial microsomia, etc.) RMT analysis resulted in the refinement of 7 appearance scales (Birthmark, Cheeks, Chin, Eyes, Forehead, Head Shape, Smile), two function scales (Breathing, Facial), and an Appearance Distress scale. Person separation index and Cronbach alpha values met criteria. Three checklists were also formed (Eye Function, and Eye and Face Adverse Effects). Significantly lower scores on eight of nine scales were reported by participants whose appearance or functional difference was rated as a major rather than minor or no difference. Higher appearance distress correlated with lower appearance scale scores.

CONCLUSION: The FACE-Q Craniofacial Module scales can be used to collect and compare patient reported outcomes data in children and young adults with a facial condition.

PMID:34172403 | DOI:10.1016/j.bjps.2021.03.009

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Lymphography change after liposuction: Possible neo-lymphangiogenesis by surgical trauma

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J Plast Reconstr Aesthet Surg. 2021 Jun 3:S1748-6815(21)00258-8. doi: 10.1016/j.bjps.2021.05.006. Online ahead of print.

NO ABSTRACT

PMID:34172402 | DOI:10.1016/j.bjps.2021.05.006

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New European Medicines Agency approval: Tucatinib in association with trastuzumab and capecitabine for the treatment of HER2-positive metastatic breast cancer previously treated

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Bull Cancer. 2021 Jun 22:S0007-4551(21)00175-2. doi: 10.1016/j.bulcan.2021.04.004. Online ahead of print.

NO ABSTRACT

PMID:34172272 | DOI:10.1016/j.bulcan.2021.04.004

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SEC61G identified as a prognostic biomarker of head and neck squamous cell carcinoma

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Eur Arch Otorhinolaryngol. 2021 Jun 25. doi: 10.1007/s00405-021-06955-7. Online ahead of print.

ABSTRACT

PURPOSE: It is of obvious interest to identify clinical prognosis-related oncogenes in HNSCC (head and neck squamous cell carcinoma).

METHODS: Based on the available datasets within the TCGA (The Cancer Genome Atlas) and the GEO (Gene Expression Omnibus) databases, the potential mechanism of action of the SEC61G (SEC61 translocon subunit gamma) gene in HNSCC tumorigenesis was explored by several bioinformatics approaches.

RESULTS: There was a higher expression level of SEC61G in primary HNSCC tumor tissues than in normal tissues. Moreover, highly expressed SEC61G was statistically associated with the poor survival prognosis of HNSCC patients. When HPV (human papilloma virus) was considered, we also observed a relatively lower proportion of "arm-level gain" and "high amplification" types of CNA (copy-number alteration) in the HNSCC-HPV (+) group than in the HNSCC-HPV (-) group. Additionally, we identified SEC61G CAN-correlated genes, such as CCT6A (chaperonin-containing TCP1 subunit 6A) and HUS1 (HUS1 checkpoint clamp component), and found a correlation between SEC61G copy-number segments and prognosis related to overall and progression-free survival intervals of HNSCC patients. Moreover, the molecular regulation mechanisms of the spliceosome, ribosome, proteasome degradation, cell adhesion, and immune infiltration of B and CD8+ T cells may contribute to the involvement of SEC61G in the pathogenesis of HNSCC.

CONCLUSIONS: The SEC61G gene was identified for the first time as a prognostic biomarker of HNSCC. The detailed underlying mechanism merits further research.

PMID:34173014 | DOI:10.1007/s00405-021-06955-7

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Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia

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Eur Arch Otorhinolaryngol. 2021 Jun 26. doi: 10.1007/s00405-021-06938-8. Online ahead of print.

ABSTRACT

PURPOSE: To review functional and subjective benefit after implantation of an active transcutaneous bone conduction device (BCD) in patients with congenital microtia with atresia or stenosis of the external auditory canal.

METHODS: Retrospective chart analysis and questionnaire on the subjective impression of hearing ( Speech, Spatial and Qualities of Hearing Scale (SSQ-B) of patients treated between 2012 and 2015.

RESULTSRESULTS: 18 patients (24 ears) with conductive or mixed hearing loss in unilateral (n = 10) or bilateral (n = 8) atresia were implanted with a BCD. No major complications occurred after implantation. Preoperative unaided air conduction pure tone average at 0.5, 1, 2 and 4 kHz (PTA 4 ) was 69.2 ± 11.7 dB, while postoperative aided PTA 4 was 33.4 ± 6.3 dB, resulting in a mean functional hearing gain of 35.9 +/- 15.6 dB. Preoperatively, the mean monosyllabic word recognition score was 22.9 % ± 22.3 %, which increased to 87.1 % +/- 15.1 % in the aided condition. The Oldenburger Sentence Test at S0N0 revealed a decrease in signal-to-noise-ratio from - 0.58 ± 4.40 dB in the unaided to - 5.67 ± 3.21 dB in the postoperative aided condition for all patients investigated. 15 of 18 patients had a subjective benefit showing a positive SSQ-B score (mean 1.7).

CONCLUSION: The implantation of an active bone conduction device brings along subjective and functional benefit for patients with conductive or combined hearing loss.

PMID:34173875 | DOI:10.1007/s00405-021-06938-8

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