Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women

AbstractBackground

Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals.

Objectives

This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population.

Methods

We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease).

Results

During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities.

Conclusions

Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.

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Reply: Bioresorbable Scaffold Thrombosis: A Multifactorial Phenomenon Also Involving Hypersensitivity Inflammation?

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More Appropriate Cardiovascular Risk Screening Through Understanding Complex Phenotypes: Mind the Gap

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Chronic Chagas Heart Disease Management: From Etiology to Cardiomyopathy Treatment

Abstract

Trypanosoma cruzi (T. cruzi) infection is endemic in Latin America and is becoming a worldwide health burden. It may lead to heterogeneous phenotypes. Early diagnosis of T. cruzi infection is crucial. Several biomarkers have been reported in Chagas heart disease (ChHD), but most are nonspecific for T. cruzi infection. Prognosis of ChHD patients is worse compared with other etiologies, with sudden cardiac death as an important mode of death. Most ChHD patients display diffuse myocarditis with fibrosis and hypertrophy. The remodeling process seems to be associated with etiopathogenic mechanisms and neurohormonal activation. Pharmacological treatment and antiarrhythmic therapy for ChHD is mostly based on results for other etiologies. Heart transplantation is an established, valuable therapeutic option in refractory ChHD. Implantable cardioverter-defibrillators are indicated for prevention of secondary sudden cardiac death. Specific etiological treatments should be revisited and reserved for select patients. Understanding and management of ChHD need improvement, including development of randomized trials.

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PCI Versus CABG in Patients With Type 1 Diabetes and Multivessel Disease

AbstractBackground

It is unknown if coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) may offer a survival benefit in patients with type 1 diabetes (T1D) in need of multivessel revascularization.

Objectives

This study sought to determine if patients with T1D and multivessel disease may benefit from CABG compared with PCI.

Methods

In an observational cohort study, the authors included all patients with T1D who underwent a first multivessel revascularization in Sweden from 1995 to 2013. The authors used the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) register, the Swedish National Diabetes Register, and the Swedish National Patient Register to retrieve information about patient characteristics and outcomes. They estimated hazard ratios (HRs) adjusted for confounders with 95% confidence intervals (CIs) for all-cause and coronary heart disease mortality, myocardial infarction, repeat revascularization, stroke, and heart failure using inverse probability of treatment weighting based on propensity scores.

Results

In total, 683 patients who underwent CABG and 1,863 patients who underwent PCI were included. During a mean follow-up of 10.6 years, 53% of patients in the CABG group and 45% in the PCI group died. PCI, compared with CABG, was associated with a similar risk of all-cause mortality (HR: 1.14; 95% CI: 0.99 to 1.32), but higher risks of death from coronary heart disease (HR: 1.45; 95% CI: 1.21 to 1.74), myocardial infarction (HR: 1.47; 95% CI: 1.23 to 1.78), and repeat revascularization (HR: 5.64; 95% CI: 4.67 to 6.82). No differences in risks of stroke or heart failure were found.

Conclusions

Notwithstanding the inclusion of patients with T1D who might not have been able to undergo CABG in the PCI group we found that PCI, compared with CABG, was associated with higher rates and risks of coronary heart disease mortality, myocardial infarction, and repeat revascularizations. Our findings indicate that CABG may be the preferred strategy in patients with T1D in need of multivessel revascularization.

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ABIM/ACC Competency-Based Education Pilot in Internal Medicine and Cardiovascular Disease

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Type 1 Diabetes, Coronary Disease Complexity, and Optimal Revascularization Strategy

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Reply: Left Ventricle Assist Device Recovery Should Include Recovery of Ventilatory and Autonomic Nervous System Abnormalities

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Relationship of PCSK9 and Urinary Thromboxane Excretion to Cardiovascular Events in Patients With Atrial Fibrillation

AbstractBackground

Soluble proprotein convertase subtilisin/kexin type 9 (PCSK9) has been shown to be predictive of cardiovascular events (CVEs) in patients who are at high cardiovascular risk. No data on the effect of PCSK9 levels in patients with atrial fibrillation (AF) are available.

Objectives

This study investigated the association between PCSK9 and CVEs in AF as well as the relationship between PCSK9 and urinary 11-dehydro-thromboxane B₂ (11-dh-TxB₂), a marker of platelet activation.

Methods

We conducted a prospective, single-center cohort study, including 907 patients with AF treated with vitamin K antagonists (3,865 patient-years), to assess CVEs, including fatal and nonfatal myocardial infarction, ischemic stroke, and cardiovascular death. At admission, plasma PCSK9 and urinary 11-dh-TxB₂ (n = 852) were measured. The population was divided into tertiles of PCSK9 for the analysis.

Results

The mean age of patients was 73.5 ± 8.2 years, and 43.0% were women. At follow-up, 179 CVEs (4.6%/year) occurred: 43 (15.3%), 49 (15.5%), and 87 (28.0%) in the first, second, and third tertiles of PCSK9, respectively (log-rank test p = 0.009). Patients with CVEs had higher median PCSK9 compared with those without (1,500 pg/ml [IQR: 1,000 to 2,300 pg/ml] vs. 1,200 pg/ml [IQR: 827 to 1,807 pg/ml], respectively; p < 0.001). Multivariable Cox regression analysis showed that the third versus the first tertile of PCSK9 (hazard ratio: 1.640; 95% confidence interval: 1.117 to 2.407; p = 0.012), female sex, age, diabetes, smoking, heart failure, previous cerebrovascular and cardiac events, digoxin use, and total cholesterol to high-density lipoprotein cholesterol ratio were associated with CVEs. In 682 patients not treated with antiplatelet therapy, circulating PCSK9 and 11-dh-TxB₂ were significantly correlated (Spearman's rho: 0.665; p < 0.001).

Conclusions

Plasma PCSK9 levels are associated with an increased risk of CVEs in patients with AF. The direct correlation between PCSK9 and 11-dh-TxB₂ suggests PCSK9 as a mechanism potentially implicated in platelet activation.

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JACC Instructions for Authors

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Exploration of PCSK9 as a Cardiovascular Risk Factor: Is There a Link to the Platelet?

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Diversity Matters

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Long-Term Prognostic Value of Gasping During Out-of-Hospital Cardiac Arrest

AbstractBackground

Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR).

Objectives

This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes.

Methods

The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health–funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009. The association between gasping and 1-year survival with favorable neurological function, defined as a Cerebral Performance Category (CPC) score ≤2 was estimated using multivariable logistic regression.

Results

The rates of 1-year survival with a CPC score of ≤2 were 5.4% (98 of 1,827) overall, and 20% (36 of 177) and 3.7% (61 of 1,643) for individuals with and without spontaneous gasping or agonal respiration during CPR, respectively. In multivariable analysis, 1-year survival with CPC ≤2 was independently associated with younger age (odds ratio [OR] for 1 SD increment 0.57; 95% confidence interval [CI]: 0.43 to 0.76), gasping during CPR (OR: 3.94; 95% CI: 2.09 to 7.44), shockable initial recorded rhythm (OR: 16.50; 95% CI: 7.40 to 36.81), shorter CPR duration (OR: 0.31; 95% CI: 0.19 to 0.51), lower epinephrine dosage (OR: 0.47; 95% CI: 0.25 to 0.87), and pulmonary edema (OR: 3.41; 95% CI: 1.53 to 7.60). Gasping combined with a shockable initial recorded rhythm had a 57-fold higher OR (95% CI: 23.49 to 136.92) of 1-year survival with CPC ≤2 versus no gasping and no shockable rhythm.

Conclusions

Gasping during CPR was independently associated with increased 1-year survival with CPC ≤2, regardless of the first recorded rhythm. These findings underscore the importance of not terminating resuscitation prematurely in gasping patients and the need to routinely recognize, monitor, and record data on gasping in all future cardiac arrest trials and registries.

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Effect of the FDA Regulatory Approach on the 0/1-h Algorithm for Rapid Diagnosis of MI

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A Natural Biomarker Deserving Attention: Gasping Following Primary Cardiac Arrest

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Bioresorbable Scaffold Thrombosis: A Multifactorial Phenomenon Also Involving Hypersensitivity Inflammation?

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Cardioprotective Effects of HSP72 Administration on Ischemia-Reperfusion Injury

AbstractBackground

Although early reperfusion is the most desirable intervention after ischemic myocardial insult, it may add to damage through oxidative stress.

Objectives

This study investigated the cardioprotective effects of a single intravenous dose of heat shock protein-72 (HSP72) coupled to a single-chain variable fragment (Fv) of monoclonal antibody 3E10 (3E10Fv) in a rabbit ischemia-reperfusion model. The Fv facilitates rapid transport of HSP72 into cells, even with intact membranes.

Methods

A left coronary artery occlusion (40 min) reperfusion (3 h) model was used in 31 rabbits. Of these, 12 rabbits received the fusion protein (Fv-HSP72) intravenously. The remaining 19 control rabbits received a molar equivalent of 3E10Fv alone (n = 6), HSP72 alone (n = 6), or phosphate-buffered saline (n = 7). Serial echocardiographic examinations were performed to assess left ventricular function before and after reperfusion. Micro–single-photon emission computed tomography imaging of ^99mTc-labeled annexin-V was performed with micro–computed tomography scanning to characterize apoptotic damage in vivo, followed by gamma counting of the excised myocardial specimens to quantify cell death. Histopathological characterization of the myocardial tissue and sequential cardiac troponin I measurements were also undertaken.

Results

Myocardial annexin-V uptake was 43% lower in the area at risk (p = 0.0003) in Fv-HSP72–treated rabbits compared with control animals receiving HSP72 or 3E10Fv alone. During reperfusion, troponin I release was 42% lower and the echocardiographic left ventricular ejection fraction 27% higher in the Fv-HSP72–treated group compared with control animals. Histopathological analyses confirmed penetration of 3E10Fv-containing molecules into cardiomyocytes in vivo, and treatment with Fv-HSP72 showed fewer apoptotic nuclei compared with control rabbits.

Conclusions

Single-dose administration of Fv-HSP72 fusion protein at the time of reperfusion reduced myocardial apoptosis by almost one-half and improved left ventricular functional recovery after myocardial ischemia-reperfusion injury in rabbits. It might have potential to serve as an adjunct to early reperfusion in the management of myocardial infarction.

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Left Ventricle Assist Device Recovery Should Include Recovery of Ventilatory and Autonomic Nervous System Abnormalities

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Experiences of pregnant women receiving osteopathic care

Publication date: Available online 11 September 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Anna Sheraton, Julie Streckfuss, Sandra Grace
The state of women's health during pregnancy and in the post-natal period can have profound and long-term effects on their own health and that of their children. Women are increasingly seeking complementary and alternative therapies during pregnancy. The aim of this study was to explore the experiences of women who received osteopathic treatment during pregnancy.MethodThis phenomenological study used semi-structured interviews with pregnant patients who were undergoing osteopathic care in northern NSW and south-east Queensland, Australia. Data were analysed thematically.ResultsOsteopathic care provided symptom relief, particularly for low back and pelvic pain. Participants wanted a natural childbirth with minimal medical intervention if possible. Osteopathic care was perceived as helping prepare women's bodies for birth and in so doing helped alleviate anxieties associated with childbirth and with entering the mainstream medical system.ConclusionsPregnant women receiving osteopathic care reported experiencing physical and mental health benefits both during pregnancy and in the post-natal period.



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The responses of two native plant species to soil petroleum contamination in the Yellow River Delta, China

Abstract

Petroleum contamination is a significant environmental problem in the Yellow River Delta. The responses of two native salt-tolerant plant species, alfalfa (Medicago sativa) and bristle grass (Setaria uiridis Beauv), to soil petroleum contamination were investigated at five levels between 0 and 2.0% (w/w). Results showed that the total, aboveground and underground plant biomasses of both species were significantly reduced by petroleum contamination (p < 0.05), with the inhibition enhanced with increased petroleum levels. However, the emergence rate of bristle grass was promoted by petroleum contamination. Following 100 days of exposure, the number of soil petroleum degraders increased greatly, with a trend of initial increase followed by a decrease at 1.5% contamination or higher. Compared to bulk soils, bacteria-degrading alkanes, total hydrocarbons and PAHs in alfalfa rhizosphere soils increased by 1.33–4.18-, 0.85–3.01- and 4.12–12.75-fold, respectively, with an increase of 2.80–10.00-, 4.42–14.44- and 7.30–26.00-fold in bristle grass rhizosphere soils, respectively. The greatest number of petroleum degraders in bristle grass rhizosphere soils resulted in the highest petroleum degradation rate. Bristle grass may be the optimal species for petroleum remediation in the studied area.

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Effects of abamectin on bullfrog tadpoles: insights on cytotoxicity

Abstract

Abamectin is one of the most used pesticides worldwide. However, investigations about its effects on amphibian populations are rare. Thus, the present study sought to investigate possible cytotoxic effects on Lithobates catesbeianus tadpoles exposed to low abamectin concentrations diluted in water. Accordingly, four experimental groups were set: negative control, positive control (cyclophosphamide—40 mL L⁻¹), abamectin at concentrations 36 μg a.i./L (ABA36 group), and 72 μg a.i./L (ABA72 group), applied as Kraft® 36EC. The micronucleus test was conducted and other nuclear abnormalities in peripheral blood erythrocytes were checked after 24, 48, and 72 h of exposure to the treatments. The total of other nuclear abnormalities was influenced by the treatments, whereas the frequency of micronuclei was influenced by the exposure time. Such frequency was higher in the animals comprising the ABA72 group, which was assessed 72 h after the exposure had begun. The total of other nuclear abnormalities was influenced by the treatments. Animals in the positive control, ABA36, and ABA72 groups showed similar frequency of these abnormalities at 48 and 72 h. However, this frequency was statistically higher than that of animals in their respective negative control groups. Thus, the present study confirmed the hypothesis that the exposure of L. catesbeianus tadpoles to abamectin caused cytotoxic effects on them, although this exposure lasted short and the concentrations were low. It disclosed prospects for variations in the nucleus of erythrocytes circulating in amphibians, a fact that may provide an important/complementary approach for the detection of cytotoxicity caused by abamectin exposure.

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Chapter 22 Mycobiome and Gut Inflammation

Publication date: 2018
Source:Immunity and Inflammation in Health and Disease
Author(s): Elizabeth A. Witherden, David L. Moyes
The current age of high throughput sequencing has revealed to us the amazing complexity and extent of the microbial communities we play host to. Moreover, we are now beginning to understand just how dynamic the interactions between the host and members of these communities are. These interactions are diverse, and the variations in these communities observed between individuals are dependent on a multitude of different microbial and host factors, including inflammatory status. More importantly, it is becoming clear that different disease states are linked to significant changes in the makeup of these communities. While much energy has gone into defining these changes in bacterial communities, there is clear and growing evidence that shifts in host fungal communities (mycobiome) are also intimately linked with disease. In this chapter, we will explore the associations and potential role that the mycobiome plays in gut inflammatory diseases.



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Implicating anaesthesia and the perioperative period in cancer recurrence and metastasis

Abstract

Cancer, currently the leading cause of death in the population aged less than 85 years, poses a significant global disease burden and is anticipated to continue to increase in incidence in both developed and developing nations. A substantial proportion of cancers are amenable to surgery, with more than 60% of patients undergoing tumour resection. Up to 80% of patients will receive anaesthesia for diagnostic, therapeutic or palliative intervention. Alarmingly, retrospective studies have implicated surgical stress in disease progression that is predominantly characterised by metastatic disease—the primary cause of cancer-associated mortality. Our understanding of the mechanisms of surgical stress and impact of perioperative interventions is, however, far from complete. Accumulating evidence from preclinical studies suggests that adrenergic-inflammatory pathways may contribute to cancer progression. Importantly, these pathways are amenable to modulation by adapting surgical (e.g. minimally invasive surgery) and anaesthetic technique (e.g. general vs. neuraxial anaesthesia). Disturbingly, drugs used for general anaesthesia (e.g. inhalational vs. intravenous anaesthesia and potentially opioid analgesia) may also affect behaviour of tumour cells and immune cells, suggesting that choice of anaesthetic agent may also be linked to adverse long-term cancer outcomes. Critically, current clinical practice guidelines on the use of anaesthetic techniques, anaesthetic agents and perioperative adjuvants (e.g. anti-inflammatory drugs) during cancer surgery do not take into account their potential effect on cancer outcomes due to a lack of robust prospective data. To help address this gap, we provide an up-to-date review of current clinical evidence supporting or refuting the role of perioperative stress, anaesthetic techniques and anaesthetic agents in cancer progression and review pre-clinical studies that provide insights into biological mechanisms.

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Detailed characterisation of STC-1 cells and the pGIP/Neo sub-clone suggests the incretin hormones are translationally regulated

Publication date: October 2017
Source:Peptides, Volume 96
Author(s): Anna L. Gillespie, Xiaobei Pan, Anna Marco-Ramell, Caroline Meharg, Brian D. Green
STC-1 is a heterogeneous plurihormonal cell line producing several prominent gut peptide hormones. pGIP/Neo is a genetically selected sub-clone of STC-1 with augmented levels of glucose-dependent insulinotropic peptide (GIP). Morphometric parameters, hormone concentrations, mRNA transcripts, hormone immunocytochemistry and nutrient utilisation/production of these two cell lines were compared. Proglucagon-derived peptides (Glucagon-like peptide-1 (GLP-1) and – 2(GLP-2)) were lower in sub-clone cells than progenitor cells. High Content Analysis found altered intracellular GLP-1, GIP, cholecystokinin (CCK) and peptide YY (PYY) levels and differing hormone co-localisation. The proportion pGIP/Neo cells containing GIP immunoreactivity (82%) was greater than STC-1 (65%), as were the proportion with 'GIP only', 'GLP−1+GIP' or 'GIP+PYY' immunoreactivity. Most surprisingly mRNA transcripts of the proglucagon and GIP genes were inversely correlated to the levels of their translated peptides. This strongly suggests that proglucagon and GIP are encoded on 'translationally regulated genes' – a characteristic possessed by other endocrine hormones. Metabolomic profiling revealed differences in cellular nutrient utilisation/production and that under normal culture conditions both cell lines exhibit signs of overflow metabolism. These studies provide an insight into the metabolism and properties of these valuable cells, suggesting for the first time that incretin hormone genes are translationally regulated.



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Cognitive reserve and long-term change in cognition in aging and preclinical Alzheimer’s disease

Publication date: Available online 11 September 2017
Source:Neurobiology of Aging
Author(s): Anja Soldan, Corinne Pettigrew, Qing Cai, Jiangxia Wang, Mei-Cheng Wang, Abhay Moghekar, Michael I. Miller, Marilyn Albert
We examined if baseline level of cognitive reserve (CR) and of Alzheimer's disease (AD) biomarkers modify the rate of change in cognition among individuals with normal cognition at baseline (n=303, mean baseline age = 57 years, mean follow-up = 12 years); 66 participants subsequently developed Mild Cognitive Impairment (MCI) or dementia due to AD. CR was indexed by years of education, reading, and vocabulary measures. AD biomarkers were measured with a composite score composed of measures of amyloid, phosphorylated tau and neurodegeneration. Higher CR scores were associated with better cognitive performance, but did not modify the rate of change in cognition among those who remained cognitively normal, nor among those who progressed to MCI prior to symptom onset, independent of baseline biomarker levels. However, higher CR scores were associated with faster cognitive decline after symptom onset of MCI. These results suggest that the mechanism by which CR mediates the relationship between pathology and cognitive function is by delaying the onset of symptoms rather than reducing the rate of cognitive decline.



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Hyaluronic acid microneedle patch for the improvement of crow's feet wrinkles

Abstract

Hyaluronic acid (HA) has an immediate volumizing effect, due to its strong water-binding potential, and stimulates fibroblasts, causing collagen synthesis, with short- and long-term effects on wrinkle improvement. We investigated the efficacy and safety of HA microneedle patches for crow's feet wrinkles. Using a randomized spilt-face design, we compared microneedle patches with a topical application containing the same active ingredients. We enrolled 34 Korean female subjects with mild to moderate crow's feet wrinkles. The wrinkle on each side of the subject's face was randomly assigned to a HA microneedle patch or HA essence application twice a week for 8 weeks. Efficacy was evaluated at weeks 2, 4, and 8. Skin wrinkles were measured as average roughness using replica and PRIMOS. Skin elasticity was assessed using a cutometer. Two independent blinded dermatologists evaluated the changes after treatment using the global visual wrinkle assessment score. Subjects assessed wrinkles using the subject global assessment score. Skin wrinkles were significantly reduced and skin elasticity significantly increased in both groups, although improvement was greater in the patch group at week 8 after treatment. In the primary and cumulative skin irritation tests, the HA microneedle patch did not induce any skin irritation. The HA microneedle patch is more effective than the HA essence for wrinkle improvement and is a safe and convenient without skin irritation.

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Histopathologic Features of Cutaneous Leishmaniasis and Use of CD1a Staining for Amastigotes in Old World and New World Leishmaniasis

Abstract

Background

Positive CD1a staining of leishmania has been reported in Old World leishmaniasis, but the sensitivity of such staining for other leishmania species is unknown.

Methods

A retrospective review was done on skin biopsies of proven cutaneous leishmaniasis based on histology, immunohistochemistry, culture, and/or PCR. We assessed the pattern of inflammation present and assessed for CD1a (MTB1 clone) positivity in amastigotes. Patients without a clearly documented travel history to delineate Old versus New World leishmaniasis and cases without tissue for CD1a staining were excluded.

Results

Various patterns of granulomatous inflammation were observed including sarcoidal (31%), diffuse (25%), suppurative and granulomatous (25%), palisaded (13%), and lichenoid (6%). CD1a staining was positive in amastigotes in 9/16 cases (56%). Five of 7 (71%) cases of Old World disease were CD1a positive, while 4/9 cases (44%) of New World cases were positive.

Conclusions

Multiple patterns of granulomatous inflammation occur in cutaneous leishmaniasis. Our results confirm CD1a (MTB1 clone) can be a diagnostic adjunct to highlight amastigotes in biopsies of cutaneous leishmaniasis, with variable positivity in both Old World and New World forms of the disease. As 44% of cases were CD1a negative in our cohort, there are significant limitations to this screening approach.

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Spatial variation of multiple air pollutants and their potential contributions to all-cause, respiratory, and cardiovascular mortality across China in 2015–2016

Publication date: November 2017
Source:Atmospheric Environment, Volume 168
Author(s): Huan Chen, Yun Lin, Qiong Su, Liqiu Cheng
Association of serious air pollution with adverse health effects in China has become a matter of public concern. However, many of studies that focused on a single air pollutant or a single city in China have rarely reflected the overall potential contribution of air pollution to unfavorable health outcomes. Therefore, our study estimated the spatial variation of particulate matter (PM2.5 and PM10) and gaseous pollutants (SO2, NO2, CO, and O3). Moreover, an additive approach was conducted to evaluate their overall potential contributions to mortality across China in 2015–2016 using the exposure-response coefficients. The results showed that cities with relatively high PM2.5 and PM10 concentrations were mainly distributed in the North China Plain (NCP). The average annual PM2.5 and PM10 concentrations in the NCP was 75.0 ± 14.7 and 131.2 ± 21.6 μg m⁻³. The potential contributions of six air pollutants ranged from 6.5% (95% confidence interval (CI): 5.4–7.5%) to 25.7% (95% CI: 22.2–28.9%) in all-cause mortality, from 6.5% (95% CI: 4.7–8.3%) to 24.9% (95% CI: 18.6–30.9%) in respiratory mortality, and from 7.0% (95% CI: 5.3–8.6%) to 29.5% (95% CI: 24.3–34.5%) in cardiovascular mortality. Many cities with high potential contributions of the multiple air pollutants were in the NCP. NCP had the average potential contribution of 20.0% (95% CI: 17.2–22.6%) in all-cause mortality, 19.5% (95% CI: 14.5–24.3%) in respiratory mortality, and 23.0% (95% CI: 18.8–27.0%) in cardiovascular mortality. Besides, the Taklimakan Desert (TD) also had high potential contribution of 19.9% (95% CI: 17.1–22.4%) in all-cause mortality, 19.5% (95% CI: 14.3–24.3%) in respiratory mortality, and 23.5% (95% CI: 19.2–27.5%) in cardiovascular mortality.



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Greenhouse gas emissions from heavy-duty natural gas, hybrid, and conventional diesel on-road trucks during freight transport

Publication date: November 2017
Source:Atmospheric Environment, Volume 168
Author(s): David C. Quiros, Jeremy Smith, Arvind Thiruvengadam, Tao Huai, Shaohua Hu
Heavy-duty on-road vehicles account for 70% of all freight transport and 20% of transportation-sector greenhouse gas (GHG) emissions in the United States. This study measured three prevalent GHG emissions – carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) – from seven heavy-duty vehicles, fueled by diesel and compressed natural gas (CNG), and compliant to the MY 2007 or 2010 U.S. EPA emission standards, while operated over six routes used for freight movement in California. Total combined (tractor, trailer, and payload) weights were 68,000 ± 1000 lbs. for the seven vehicles. Using the International Panel on Climate Change (IPCC) radiative forcing values for a 100-year time horizon, N2O emissions accounted for 2.6–8.3% of total tailpipe CO2 equivalent emissions (CO2-eq) for diesel vehicles equipped with Diesel Oxidation Catalyst, Diesel Particulate Filter, and Selective Catalytic Reduction system (DOC + DPF + SCR), and CH4 emissions accounted for 1.4–5.9% of CO2-eq emissions from the CNG-powered vehicle with a three-way catalyst (TWC). N2O emissions from diesel vehicles equipped with SCR (0.17–0.30 g/mi) were an order of magnitude higher than diesel vehicles without SCR (0.013–0.023 g/mi) during highway operation. For the vehicles selected in this test program, we measured 11–22% lower CO2-eq emissions from a hybrid compared to conventional diesel vehicles during transport over lower-speed routes of the freight transport system, but 20–27% higher CO2-eq emissions during higher-speed routes. Similarly, a CNG vehicle emitted up to 15% lower CO2-eq compared to conventional diesel vehicles over more neutral-grade highway routes, but emitted up to 12% greater CO2-eq emissions over routes with higher engine loads.

Graphical abstract

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The vaccines and antibodies associated with Als3p for treatment of Candida albicans infections

Publication date: Available online 11 September 2017
Source:Vaccine
Author(s): Xue Sui, Lan Yan, Yuan-ying Jiang
Candida albicans is the most common fungal microorganism in healthy individuals, as well as the cause of high mortality infections in high-risk hosts such as immunocompromised patients. Antifungal vaccines and monoclonal antibodies useful for active or passive immunizations have recently generated considerable excitement for the treatment of fungal infections. The cell wall proteins of C. albicans, which are crucial for virulence and pathogenicity, are attractive target antigens. Als3p, a member of the C. albicans agglutinin-like sequence (ALS) family, is a hyphal-specific glycophosphatidylinositol cell wall protein that plays a key role in the interaction with host cells. The abundance of Als3p on the hyphal surface makes it an attractive target. For example, the NDV-3 vaccine, targeted at the N-terminus of Als3p, has entered a preparation of Phase 2 clinical trial. The Als3p-specific antibodies include monoclonal antibodies (MAbs) 3-A5, MAb 113, and scFv3. In addition, MAb C7, MAb 3D9.3 and MAb 2G8, which were supposed to be identifying other targets, have also provided good protection by recognizing Als3p. In this review, we summarize the functions of Als3p and highlight the development of the vaccines and the antibodies that are associated, directly or indirectly, with this protein.



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The impact of 10-valent and 13-valent pneumococcal conjugate vaccines on hospitalization for pneumonia in children: A systematic review and meta-analysis

Publication date: Available online 11 September 2017
Source:Vaccine
Author(s): Cristiano Alicino, Chiara Paganino, Andrea Orsi, Matteo Astengo, Cecilia Trucchi, Giancarlo Icardi, Filippo Ansaldi
BackgroundThis systematic review and meta-analysis aimed at summarizing available data on the impact of PCV10 and PCV13 in reducing the incidence of CAP hospitalizations in children aged <5years.MethodsA systematic search of the literature was conducted. We included time-series analyses and before-after studies, reporting the incidence of hospitalization for pneumonia in the periods before and after the introduction of PCV10 or PCV13 into the immunization program. Pooled estimates of Incidence Rate Ratio (IRR) were calculated by using a random-effects meta-analytic model. Results were stratified according to age-groups (<24months and 24–59months) and case definitions of pneumonia (clinically and radiologically confirmed pneumonia).ResultsA total of 1533 potentially relevant articles were identified. Of these, 12 articles were included in the analysis. In children aged <24months, the meta-analysis showed a reduction of 17% (95%CI: 11–22%, p-value<0.001) an of 31% (95%CI: 26–35%, p-value<0.001) in the hospitalization rates respectively for clinically and radiologically confirmed pneumonia, respectively, after the introduction of the novel PCVs.In children aged 24–59months, the meta-analysis showed a reduction of 9% (95%CI: 5–14%, p-value<0.001) and of 24% (95%CI: 12–33%, p-value<0.001) in the hospitalization rates for clinically and radiologically confirmed pneumonia, respectively, after the introduction of the novel PCVs.High heterogeneity was detected among studies evaluating the hospitalization rate for clinically and radiologically confirmed pneumonia.ConclusionsThe results of this study revealed a significant impact of PCV10 and PCV13 in reducing the hospitalizations for pneumonia, particularly in children aged <24months and for radiologically confirmed disease. Further appropriately designed studies, comparing the impact of PCV10 and PCV13, are needed in order to obtain solid data on which to establish future immunization strategies.



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Transcriptomic and bioinformatics analysis of the early time-course of the response to prostaglandin F2 alpha in the bovine corpus luteum

Publication date: October 2017
Source:Data in Brief, Volume 14
Author(s): Heather Talbott, Xiaoying Hou, Fang Qiu, Pan Zhang, Chittibabu Guda, Fang Yu, Robert A. Cushman, Jennifer R. Wood, Cheng Wang, Andrea S. Cupp, John S. Davis
RNA expression analysis was performed on the corpus luteum tissue at five time points after prostaglandin F2 alpha treatment of midcycle cows using an Affymetrix Bovine Gene v1 Array. The normalized linear microarray data was uploaded to the NCBI GEO repository (GSE94069). Subsequent statistical analysis determined differentially expressed transcripts ± 1.5-fold change from saline control with P ≤ 0.05. Gene ontology of differentially expressed transcripts was annotated by DAVID and Panther. Physiological characteristics of the study animals are presented in a figure. Bioinformatic analysis by Ingenuity Pathway Analysis was curated, compiled, and presented in tables. A dataset comparison with similar microarray analyses was performed and bioinformatics analysis by Ingenuity Pathway Analysis, DAVID, Panther, and String of differentially expressed genes from each dataset as well as the differentially expressed genes common to all three datasets were curated, compiled, and presented in tables. Finally, a table comparing four bioinformatics tools' predictions of functions associated with genes common to all three datasets is presented. These data have been further analyzed and interpreted in the companion article "Early transcriptome responses of the bovine mid-cycle corpus luteum to prostaglandin F2 alpha includes cytokine signaling" [1].



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Data on the density of xanthophores in a whole scale of goldfish acclimated to white or black background color

Publication date: October 2017
Source:Data in Brief, Volume 14
Author(s): Kanta Mizusawa, Yutaka Yamamura, Satoshi Kasagi, José Miguel Cerdá-Reverter, Akiyoshi Takahashi
The data presented in this article are related to the research article entitled "Expression of genes for melanotropic peptides and their receptors for morphological color change in goldfish Carassius auratus" (Mizusawa et al., In press) [1]. This article describes data on the density of xanthophores in the scales of goldfish acclimated to white or black background color. To determine the effects of acclimation history during long-term background color adaptation, fish were transferred from a white tank to a white or black tank and vice versa halfway through the acclimation process. To observe xanthophores, the iridophore layer was scraped from the scale and the pteridine/carotenoid pigments were aggregated. The number of xanthophores was calculated after image processing.



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Technoeconomic assumptions adopted for the development of a long-term electricity supply model for Cyprus

Publication date: October 2017
Source:Data in Brief, Volume 14
Author(s): Constantinos Taliotis, Emanuele Taibi, Mark Howells, Holger Rogner, Morgan Bazilian, Manuel Welsch
The generation mix of Cyprus has been dominated by oil products for decades. In order to conform with European Union and international legislation, a transformation of the supply system is called for. Energy system models can facilitate energy planning into the future, but a large volume of data is required to populate such models. The present data article provides information on key modelling assumptions and input data adopted with the aim of representing the electricity supply system of Cyprus in a separate research article. Data in regards to renewable energy technoeconomic characteristics and investment cost projections, fossil fuel price projections, storage technology characteristics and system operation assumptions are described in this article.



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The effect of laser power, blood perfusion, thermal and optical properties of human liver tissue on thermal damage in LITT

Abstract

In this work, the finite-element method (FEM) was used to predict the temperature distribution, and the thermal damage volume in human liver tissue subjected to laser in laser-induced interstitial thermotherapy (LITT). The effect of laser power, blood perfusion, and thermal and optical properties on maximum temperature and thermal damage volume were predicted using the finite-element method. A computer program was written in visual basic language, which was verified by comparing its result with data published elsewhere. The bio-heat equation together with the effect of linear laser source were used to simulate heat transfer through tissue from which the temperature distributions, and the subsequent thermal damage, were obtained based on Arrhenius equation. In this mathematical model for LITT, it was found that increasing laser power, absorption, and scattering coefficient increased the damage zone while increasing tissue water content, perfusion rate, and tissue anisotropy factor decreased the damage zone. These findings are important aspects for doctors in the pre-estimation of the damage zone before starting the therapy so as to kill only the desired zone.

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A semi-analytical model for the influence of temperature on sound propagation in sintered metal fiber materials

Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Shuwei Ren, Fengxian Xin, Tian Jian Lu, Chuanzeng Zhang
A semi-analytical model is developed to predict the influence of temperature on the sound absorbing performance of sintered metal fiber materials (SMFMs) by extending the Johnson-Champoux-Allard-Lafarge (JCAL) model. In this model, three micro-structure factors of the SMFMs – the Kozeny number and the thermal and viscous shape factors – are calculated by applying the multi-scale asymptotic method (MAM), and the temperature effect is taken into account by considering the variations of the thermo-physical parameters of saturated air with temperature. Key transport parameters (e.g., viscous and thermal permeability, tortuosity, viscous and thermal characteristic lengths) are then directly determined by fiber diameter and porosity of the material. High-efficiency of the semi-analytical model is demonstrated for estimating the influence of topological parameters upon sound absorption under different temperatures. The transport parameters obtained by the proposed model agree well with those calculated using fully numerical simulations. Also, the model predictions are in accordance with existing experimental measurements at different temperatures. The model reveals not only the underlying mechanisms of temperature effect on sound propagation in porous metals, but also provides a theoretical guideline for the sound absorption application of SMFMs in high temperature environments.

Graphical abstract

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Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attention-deficit/hyperactivity disorder

Publication date: November 2017
Source:Research in Developmental Disabilities, Volume 70
Author(s): Tai-Ling Liu, Nai-Wen Guo, Ray C. Hsiao, Huei-Fan Hu, Cheng-Fang Yen
This study investigated the relationship of bullying victimization and perpetration with the levels of intelligence, attention, and executive function in children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The experiences of bullying involvement in 105 children with ADHD were assessed using the Chinese version of the School Bullying Experience Questionnaire. Their scores for four intelligence indexes on the Wechsler Intelligence Scale for Children 4th Edition-Chinese version were determined. Their levels of attention and executive function were assessed using the Comprehensive Nonverbal Attention Test Battery. The results of logistic regression analyses indicated that a high Perceptual Reasoning Index was significantly associated with a decreased risk of being victims of bullying. A high level of executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. Bullying victimization and perpetration in children with ADHD having a low PRI and low executive function should be routinely surveyed.



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Immune Checkpoint Therapy With Nivolumab Esophageal Squamous Cell Carcinoma

Condition:   Esophageal Squamous Cell Carcinoma
Intervention:   Drug: Nivolimumab+Carboplatin/paclitaxel+Radiation
Sponsor:   New York University School of Medicine
Recruiting - verified September 2017

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INCAGN01876 in Combination With Immune Therapies in Subjects With Advanced or Metastatic Malignancies

Conditions:   Advanced Malignancies;   Metastatic Malignancies
Interventions:   Drug: INCAGN01876;   Drug: Epacadostat;   Drug: Pembrolizumab
Sponsor:   Incyte Biosciences International Sàrl
Not yet recruiting - verified August 2017

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Characterization of cadmium-resistant Klebsiella pneumoniae MCC 3091 promoted rice seedling growth by alleviating phytotoxicity of cadmium

Abstract

Cadmium (Cd) phytotoxicity in agricultural land is a major global concern now-a-days resulting in very poor yield. Plant growth-promoting rhizobacteria (PGPR)-mediated bioremediation is one of the convenient strategies for detoxification of Cd from the soil and for plant growth promotion under Cd stress. The selected strain K5 was identified as Klebsiella pneumoniae based on MALDI-TOF MS ribosomal protein and 16S rDNA sequence-based homology. The strain possessed several PGP traits viz. IAA production (3413 μg/mL), phosphate solubilization (80.25 ppm), ACC deaminase activity (40 ng α-ketobutyrate/mg protein/h), N₂ fixation ability (1.84 μg N₂ fixed/h), etc. and has the highest Cd resistance (4000 μg/mL) among Cd-resistant PGPR so far reported. This strain efficiently accumulated Cd and remained viable under Cd stress as confirmed by AAS-TEM-EDX analysis and viability test, respectively. The significant (p < 0.05) positive effect of the strain was reflected in various plant growth parameters like increased seed germination (50 to 90%), root length (5-fold), shoot length (about 2-fold), root fresh weight (> 2-fold), and shoot fresh weight (1.23-fold) under Cd stress compared with uninoculated set. Moreover, the positive impact of this strain on antioxidant enzyme activity (CAT, MDA, SOD) and several other biochemical parameters (proline, α-amylase, protease, total sugar, total protein, chlorophyll content) were also measured that favors plant growth promotion under Cd stress. Besides, the K5 strain also decreased stress-ethylene level under Cd stress and reduction of Cd accumulation in seedling (> 1.5-fold) was conducive to alleviate Cd phytotoxicity. Hence, K. pneumoniae strain K5 can be used as a phytostimulating and Cd-bioremediating biofertilizer for sustainable agriculture in heavy metal-contaminated sites.

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MAPK Signalling Pathway in Cancers: Olive Products as Cancer Preventive and Therapeutic Agents

Publication date: Available online 11 September 2017
Source:Seminars in Cancer Biology
Author(s): Ilaria Peluso, Nagendra Sastry Yarla, Roberto Ambra, Gianni Pastore, George Perry
The mitogen-activated protein kinases (MAPKs) are fundamental in inflammation and cancer control, through the crosstalk between the redox regulated nuclear factor E2-related factor 2 (Nrf2) and nuclear factor-kB (NFκB) gene expression. MAPKs regulate various cellular activities involved in cancer progression, including proliferation, apoptosis and immune escape and blockade of upstream kinases is a current therapeutic strategy. However, these therapies are associated with some adverse effects and with the paradoxical activation of the MAPKs pathway. In the context of cancer prevention and treatment, it has been suggested that dietary factors, are able to modulate cancer initiation and progression by interacting with the MAPKs. Within these dietary factors, virgin olive oil (VOO) is of particular interest due to its content in squalene, already used as drug delivery system in cancer therapy. The aim of this review is to discuss the studies pointing to the effects of olive-derived foodstuff and nutraceuticals on MAPKs signalling cascades. The reviewed experimental studies suggest that the stress-activated JNK and p38 MAPKs could be targets of olive-derived nutraceuticals. The latter, including phytochemicals from olive cultivation and processing wastes, could be adjuvants in chemotherapies, whereas VOO could be considered a "natural delivery system" of bioactive phytochemicals due to its high content in squalene.



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Lymphatic Drainage System of the Brain: A Novel Target for Intervention of Neurological Diseases

Publication date: Available online 10 September 2017
Source:Progress in Neurobiology
Author(s): Bao-Liang Sun, Li-hua Wang, Tuo Yang, Lei-lei Mao, Jing-yi Sun, Ming-feng Yang, Hui Yuan, Robert A. Colvin, Xiao-yi Yang
The belief that the vertebrate brain functions normally without classical lymphatic drainage vessels has been held for many decades. On the contrary, new findings show that functional lymphatic drainage does exist in the brain. The brain lymphatic drainage system is composed of basement membrane-based perivascular pathway, a brain-wide glymphatic pathway, and cerebrospinal fluid (CSF) drainage routes including sinus-associated meningeal lymphatic vessels and olfactory/cervical lymphatic routes. The brain lymphatic systems function physiological as a route of drainage for interstitial fluid (ISF) from brain parenchyma to nearby lymph nodes. Brain lymphatic drainage helps maintain water and ion balance of the ISF, waste clearance, and reabsorption of macromolecular solutes. A second physiological function includes communication with the immune system modulating immune surveillance and responses of the brain. These physiological functions are influenced by aging, genetic phenotypes, sleep-wake cycle, and body posture. The impairment and dysfunction of the brain lymphatic system has crucial roles in age-related changes of brain function and the pathogenesis of neurovascular, neurodegenerative, and neuroinflammatory diseases, as well as brain injury and tumors. In this review, we summarize the key component elements (regions, cells, and water transporters) of the brain lymphatic system and their regulators as potential therapeutic targets in the treatment of neurologic diseases and their resulting complications. Finally, we highlight the clinical importance of ependymal route-based targeted gene therapy and intranasal drug administration in the brain by taking advantage of the unique role played by brain lymphatic pathways in the regulation of CSF flow and ISF/CSF exchange.



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Severity of Writer’s Cramp is Related to Faulty Motor Preparation

Abstract

We characterized, in 37 writer's cramp (WC) patients and 14 healthy volunteers (HV), the buildup of motor representations contralateral ("intended") and ispsilateral ("unintended") to the movement to be produced and the excitability changes in left primary motor cortex during the early reaction time (RT) of a pre-cued reaching movement to pick up a pen with either hand to write. We also tested the excitability of interhemispheric pathways from right dorsal premotor and motor cortices to left motor cortex. During early RT (1) the motor cortex excitability of unintended muscle representations did not decrease in patients as in HV and (2) the connection from the contralateral dorsal premotor cortex to the "intended" motor representation did not function in patients. In HV, the efficiency of intracortical GABA-ergic circuits at rest predicted the degree of excitability changes in the intended motor representation in the early RT. This was not true in patients who had lower efficiency of GABA-ergic circuits. Interestingly, the more severe was the writing impairment, the higher was the level of excitability in the intended and unintended motor representations. It demonstrates, for the first time, that abnormal motor preparation influences the severity of the writing impairment in WC patients.

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Scholar : These new articles for Archives and Manuscripts are available online

The online platform for Taylor & Francis Online content New for Archives and Manuscripts and online now on Taylor & Francis Online: Miscellany Perspectives on records and archives: an update from the Royal Commission Australian Society of Archivists National Conference Thursday 20 October 2016 Parramatta Justice Jennifer Coate Pages: 1-10 | DOI: 10.1080/01576895.2017.1366819 To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Scholar : Critical Discourse Studies, Volume 14, Issue 5, November 2017 is now available online on Taylor & Francis Online

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The online platform for Taylor & Francis Online content Critical Discourse Studies, Volume 14, Issue 5, November 2017 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Articles The strategic ritual of emotionality in Chinese and Australian hard news: a corpus-based study Changpeng Huan Pages: 461-479 | DOI: 10.1080/17405904.2017.1352002 The field-specific representation of climate change in factual television: a multimodal critical discourse analysis Andrea Sabine Sedlaczek Pages: 480-496 | DOI: 10.1080/17405904.2017.1352003 Sacralisation of contested territory in nationalist discourse: a study of Milošević's and Putin's public speeches Aleksandar Pavković Pages: 497-513 | DOI: 10.1080/17405904.2017.1360191 The topography of masculine normativities in South Africa Erez Levon , Tommaso M. Milani & E. Dimitris Kitis Pages: 514-531 | DOI: 10.1080/17405904.2017.1342678 Language and gender in female celebrity chef cookbooks: cooking to show care for the family and for the self Kelsi Matwick Pages: 532-547 | DOI: 10.1080/17405904.2017.1309326 Real women: objectivity versus situatedness in Critical Discourse Studies Rowan R. Mackay Pages: 548-568 | DOI: 10.1080/17405904.2017.1320297 BOOK REVIEWS The politics of fear: what right wing populist discourses mean Elie Friedman Pages: 569-571 | DOI: 10.1080/17405904.2017.1325383 Ecolinguistics: language, ecology and the stories we live by Robert Poole Pages: 571-574 | DOI: 10.1080/17405904.2017.1299018 Editorial Board Editorial Board Pages: ebi-ebi | DOI: 10.1080/17405904.2017.1373995 To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Scholar : These new articles for Behavioral Sciences of Terrorism and Political Aggression are available online

The online platform for Taylor & Francis Online content New for Behavioral Sciences of Terrorism and Political Aggression and online now on Taylor & Francis Online: BEST STUDENT PAPER SOCIETY FOR TERRORISM RESEARCH INTERNATIONAL ANNUAL CONFERENCE 2017 Identities "Betwixt and between': analysing Belgian representation in 'homegrown' extremism Paige V. Pascarelli Pages: 1-24 | DOI: 10.1080/19434472.2017.1374988 QHW publishes new thematic cluster on ADHD International Journal of Qualitative Studies on Health and Well-being (QHW) is an open access peer reviewed scientific journal that provides a forum for the exchange of data, knowledge, theoretical framework and methods on health and well-being.Read the journal's thematic cluster on ADHD today. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Crescentic splinter haemorrhages reflect stroke pathophysiology in hypereosinophilic syndrome

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Dermatoscope-guided suturing for an open wound adjacent to the lacrimal sac and the nasolacrimal duct

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Fluconazole-induced Sweet's syndrome: A novel association

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ESSFN Mission

Stereotact Funct Neurosurg 2017;95:289

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WSSFN Society News

Stereotact Funct Neurosurg 2017;95:287

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ASSFN Society News

Stereotact Funct Neurosurg 2017;95:288

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Chromatin: Probing a piRNA paradox

Nature Reviews Genetics. doi:10.1038/nrg.2017.76

Author: Darren J. Burgess

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Harnessing ancient genomes to study the history of human adaptation

Nature Reviews Genetics. doi:10.1038/nrg.2017.65

Authors: Stephanie Marciniak & George H. Perry

http://ift.tt/2eYUi2O

Double-Pedicled Free Deep Inferior Epigastric Perforator Flap for the Coverage of Thigh Soft-Tissue Defect

Summary: Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy. A double-pedicled free DIEP flap (756 cm2) was harvested and anastomosed to the transverse branch of the lateral femoral circumflex artery and a lateral branch of the popliteal artery (P1). The flap survived completely without serious complications, and the patient was able to walk with crutches 3 months postoperatively. This is the first case report of a free bipedicled DIEP flap for the coverage of a thigh defect in a male patient.

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Type 2 diabetes and cardiovascular prevention: the dogmas disputed

Abstract

In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo. Other trials with newer diabetes drugs, including empagliflozin and canagliflozin (two sodium-glucose co-transporter-2 inhibitors), liraglutide and semaglutide (two GLP-1 receptor agonists) succeeded in demonstrating CV benefit in people with type 2 diabetes. In the last two decades, the equation "diabetes equals myocardial infarction" have contributed to the development of preventive therapy for risk factors in diabetes. In both primary and secondary prevention, the diabetic patients with high rates of statin and aspirin treatment have improved CV outcome, as compared with non-users. The drugs used to reduce glucose levels in patients with type 2 diabetes seem important for the ultimate cardiovascular outcome: the combination of intensive glycemic control, when safely attainable, with newer diabetes drugs (empagliflozin, canagliflozin, liraglutide, and semaglutide) may decrease the incidence of MACE, nephropathy and retinopathy. Moreover, depending on the drug used, CV mortality and heart failure may also be reduced.

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BRAF wild-type malignant melanoma developing on a thermal burn

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Type 2 diabetes and cardiovascular prevention: the dogmas disputed

Abstract

In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo. Other trials with newer diabetes drugs, including empagliflozin and canagliflozin (two sodium-glucose co-transporter-2 inhibitors), liraglutide and semaglutide (two GLP-1 receptor agonists) succeeded in demonstrating CV benefit in people with type 2 diabetes. In the last two decades, the equation "diabetes equals myocardial infarction" have contributed to the development of preventive therapy for risk factors in diabetes. In both primary and secondary prevention, the diabetic patients with high rates of statin and aspirin treatment have improved CV outcome, as compared with non-users. The drugs used to reduce glucose levels in patients with type 2 diabetes seem important for the ultimate cardiovascular outcome: the combination of intensive glycemic control, when safely attainable, with newer diabetes drugs (empagliflozin, canagliflozin, liraglutide, and semaglutide) may decrease the incidence of MACE, nephropathy and retinopathy. Moreover, depending on the drug used, CV mortality and heart failure may also be reduced.

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Editorial Board

Publication date: September 2017
Source:Aggression and Violent Behavior, Volume 36





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Endoscopic diode laser therapy for chronic radiation proctitis

Abstract

The purpose of this study is to determine the effectiveness of endoscopic diode laser therapy in patients presenting rectal bleeding due to chronic radiation proctitis (CRP). A retrospective analysis of CRP patients who underwent diode laser therapy in a single institution between 2010 and 2016 was carried out. The patients were treated by non-contact fibers without sedation in an outpatient setting. Fourteen patients (median age 77, range 73–87 years) diagnosed with CRP who had undergone high-dose radiotherapy for prostatic cancer and who presented with rectal bleeding were included. Six required blood transfusions. Antiplatelet (three patients) and anticoagulant (two patients) therapy was not suspended during the treatments. The patients underwent a median of two sessions; overall, a mean of 1684 J of laser energy per session was used. Bleeding was resolved in 10/14 (71%) patients, and other two patients showed improvement (93%). Only one patient, who did not complete the treatment, required blood transfusions after laser therapy; no complications were noted during or after the procedures. Study findings demonstrated that endoscopic non-contact diode laser treatment is safe and effective in CRP patients, even in those receiving antiplatelet and/or anticoagulant therapy.

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Inter-vender and test-retest reliabilities of resting-state functional magnetic resonance imaging: Implications for multi-center imaging studies

Publication date: December 2017
Source:Magnetic Resonance Imaging, Volume 44
Author(s): Hyeong Su An, Won-Jin Moon, Jae-Kyun Ryu, Ju Yeon Park, Won Sung Yun, Jin Woo Choi, Geon-Ho Jahng, Jang-Yeon Park
This prospective multi-center study aimed to evaluate the inter-vendor and test-retest reliabilities of resting-state functional magnetic resonance imaging (RS-fMRI) by assessing the temporal signal-to-noise ratio (tSNR) and functional connectivity. Study included 10 healthy subjects and each subject was scanned using three 3T MR scanners (GE Signa HDxt, Siemens Skyra, and Philips Achieva) in two sessions. The tSNR was calculated from the time course data. Inter-vendor and test-retest reliabilities were assessed with intra-class correlation coefficients (ICCs) derived from variant component analysis. Independent component analysis was performed to identify the connectivity of the default-mode network (DMN). In result, the tSNR for the DMN was not significantly different among the GE, Philips, and Siemens scanners (P=0.638). In terms of vendor differences, the inter-vendor reliability was good (ICC=0.774). Regarding the test-retest reliability, the GE scanner showed excellent correlation (ICC=0.961), while the Philips (ICC=0.671) and Siemens (ICC=0.726) scanners showed relatively good correlation. The DMN pattern of the subjects between the two sessions for each scanner and between three scanners showed the identical patterns of functional connectivity. The inter-vendor and test-retest reliabilities of RS-fMRI using different 3T MR scanners are good. Thus, we suggest that RS-fMRI could be used in multicenter imaging studies as a reliable imaging marker.



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Reproducibility and relative stability in magnetic resonance imaging indices of tumor vascular physiology over a period of 24h in a rat 9L gliosarcoma model

Publication date: December 2017
Source:Magnetic Resonance Imaging, Volume 44
Author(s): Tavarekere N. Nagaraja, Rasha Elmghirbi, Stephen L. Brown, Lonni R. Schultz, Ian Y. Lee, Kelly A. Keenan, Swayamprava Panda, Glauber Cabral, Tom Mikkelsen, James R. Ewing
PurposeThe objective was to study temporal changes in tumor vascular physiological indices in a period of 24h in a 9L gliosarcoma rat model.MethodsFischer-344 rats (N=14) were orthotopically implanted with 9L cells. At 2weeks post-implantation, they were imaged twice in a 24h interval using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). Data-driven model-selection-based analysis was used to segment tumor regions with varying vascular permeability characteristics. The region with the maximum number of estimable parameters of vascular kinetics was chosen for comparison across the two time points. It provided estimates of three parameters for an MR contrast agent (MRCA): i) plasma volume (vp), ii) forward volumetric transfer constant (K^trans) and interstitial volume fraction (ve, ratio of K^trans to reverse transfer constant, kep). In addition, MRCA extracellular distribution volume (VD) was estimated in the tumor and its borders, along with tumor blood flow (TBF) and peritumoral MRCA flux. Descriptors of parametric distributions were compared between the two times. Tumor extent was examined by hematoxylin and eosin (H&E) staining. Picrosirus red staining of secreted collagen was performed as an additional index for 9L cells.ResultsTest-retest differences between population summaries for any parameter were not significant (paired t and Wilcoxon signed rank tests). Bland-Altman plots showed no apparent trends between the differences and averages of the test-retest measures for all indices. The intraclass correlation coefficients showed moderate to almost perfect reproducibility for all of the parameters, except vp. H&E staining showed tumor infiltration in parenchyma, perivascular space and white matter tracts. Collagen staining was observed along the outer edges of main tumor mass.ConclusionThe data suggest the relative stability of these MR indices of tumor microenvironment over a 24h duration in this gliosarcoma model.



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MRI characteristics of the glia limitans externa: A 7T study

Publication date: December 2017
Source:Magnetic Resonance Imaging, Volume 44
Author(s): Kiyotaka Suzuki, Kenichi Yamada, Kazunori Nakada, Yuji Suzuki, Masaki Watanabe, Ingrid L. Kwee, Tsutomu Nakada
PurposeTo perform a systematic analysis of the intrinsic contrast parameters of the FLAIR hyperintense rim (FHR), a thin layer of high intensity covering the entire surface of the cerebral cortex detected on fluid-attenuated inversion recovery (FLAIR) sequence T2 weighted imaging performed on a 7T system, in an attempt to identify its anatomical correlate.MethodsFast spin echo inversion recovery (FSE-IR) and cardiac-gated fast spin echo (FSE) images were obtained with defined parameters in eight normal volunteers on a 7 T MRI system to determine T2 and proton density, T1 characteristics. K-means clustering analysis of parameter sets was performed using MATLAB version R2015b for the purpose of identifying the cluster reflecting FHR. The results were subsequently confirmed by independent component analysis (ICA) based on T1 behavior on FSE-IR using a MATLAB script of FastICA algorithm.ResultsThe structure giving rise to FHR was found to have a unique combination of intrinsic contrast parameters of low proton density, long T2, and disproportionally short T1. The findings are in strong agreement with the functional and structural specifics of the glia limitans externa (GLE), a structure composed of snuggled endfeet of astrocytes containing abundant aquaporin-4 (AQP-4), the main water channel of the brain.ConclusionIntrinsic contrast parameters of FHR reflect structural and functional specifics of the GLE, and their values are highly dependent on the physiologic functionality of AQP-4. Microscopic imaging on a 7T system and analysis of GLE contrast parameters can be developed into a method for evaluating AQP-4 functionality.



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Perceptual Visual Skills in Delayed Language Developed Children

Publication date: Available online 9 September 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Eman Mostafa
AimTo evaluate Perceptual visual skills in delayed language developed children.Material and methodsThe relation between visual skills and language has not been rigorously examined in previous investigations. This is a case-control study which comprised of 25 preschool children with Delayed Language Development (DLD) (cases) and 25 typically developed children (control). Exclusion criteria: any neurological or visual impaired disorder. All children had undergone Intelligent Quotient (I.Q) using Stanford Binet (IV edition), Attention Deficit Hyperactivity disorder Test (ADHDT) and Illinois Test of Psycholinguistic Abilities (ITPA). The performance of cases was surprisingly superior to the performance of controls in all visual skills. Moreover, it was significantly different in visual closure (P value=0.027) and visual memory (P value=0.005).ConclusionReading disorders that may develop in children with DLD are more related to language than to visual skills. DLD has some strong perceptual skills such as visual closure and visual memory. This should be taken in consideration while planning a strategy for language therapy.



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Issue Information - TOC

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Continuing Professional Development Quiz

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Issue Information - JEB

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The use of mobile health applications in school dental screening

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Continuing Professional Development Calendar

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Personalized/Precision Dentistry – The Future of Dentistry?

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Chromatin: Probing a piRNA paradox

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Harnessing ancient genomes to study the history of human adaptation

Ancient genomes can inform our understanding of the history of human adaptation through the direct tracking of changes in genetic variant frequency across different geographical locations and time periods. The authors review recent ancient DNA analyses of human, archaic hominin, pathogen, and domesticated animal and plant genomes, as well as the insights gained regarding past human evolution and behaviour.

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Leaching variations of heavy metals in chelator-assisted phytoextraction by Zea mays L. exposed to acid rainfall

Abstract

Chelant-enhanced phytoextraction method has been put forward as an effective soil remediation method, whereas the heavy metal leaching could not be ignored. In this study, a cropping-leaching experiment, using soil columns, was applied to study the metal leaching variations during assisted phytoextraction of Cd- and Pb-polluted soils, using seedlings of Zea mays, applying three different chelators (EDTA, EDDS, and rhamnolipid), and artificial rainfall (acid rainfall or normal rainfall). It showed that artificial rainfall, especially artificial acid rain, after chelator application led to the increase of heavy metals in the leaching solution. EDTA increased both Cd and Pb concentrations in the leaching solution, obviously, whereas EDDS and rhamnolipid increased Cd concentration but not Pb. The amount of Cd and Pb decreased as the leaching solution increased, the patterns as well matched LRMs (linear regression models), with R-square (R ²) higher than 90 and 82% for Cd and Pb, respectively. The maximum cumulative Cd and Pb in the leaching solutions were 18.44 and 16.68%, respectively, which was amended by EDTA and acid rainwater (pH 4.5), and followed by EDDS (pH 4.5), EDDS (pH 6.5), rhamnolipid (0.5 g kg⁻¹ soil, pH 4.5), and rhamnolipid (pH 6.5).

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Intralesional excision combined with intralesional cryosurgery for the treatment of oversized and therapy-resistant keloids of the neck and ears

Abstract

This prospective case study presents a new method for the treatment of oversized and therapy-resistant keloids of the neck and ears employing intralesional excision combined with intralesional cryosurgery. The keloids were excised in an intralesional approach, and the remaining base and lateral margins of the scar tissue were frozen using intralesional cryoneedles. After complete thawing of the frozen tissues, the margins of the scar were approximated and sutured. The follow-up period extended over 18–24 months. Over a period of 12 months, the scars gradually flattened with no hypopigmentation. No signs of recurrence of the keloids were seen. Intralesional excision of oversized and therapy-resistant keloids combined with intralesional cryosurgery could well be an additional tool to the plastic surgical armamentarium, for treating this group of patients.

Level of Evidence: Level IV, therapeutic study.

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Acne Scars: How Do We Grade Them?

Abstract

Acne vulgaris is a chronic inflammatory skin disease that can lead to permanent scarring. Although grading scales exist for acne scarring, there are many limitations, and there is still a need for a well validated gold standard scale for use in clinical practice or research trials. An objective measure of scar severity should be a component of global acne severity evaluations. This manuscript reviews currently available acne scar grading modalities: lesion counting; subjective self-assessment; Acne Scar Rating Scale (ASRS); evaluator-based qualitative and quantitative scarring grading systems; Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA); Global Scale for Acne Scar Severity (SCAR-S); and imaging. Despite the varying tools, most of the currently available scales do not account for scar color, depth, or change over time. A new, validated scale is needed that would allow for a more objective and accurate assessment of scar progression over time to assist with effective treatment and research.

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Helicobacter pylori infection and extragastric diseases in 2017

Abstract

The huge variety of extragastric diseases linked to Helicobacter pylori infection is widely known, and new studies are conducted every year on this topic. Neurological disorders and metabolic syndrome are some of the main issues debated in the most recent literature. Articles on the association of H. pylori with skin diseases, inflammatory bowel diseases, immunologic impairment, kidney dysfunction, allergic asthma, and respiratory diseases have been published as well. In this perspective, eradication therapy for this infection could become a mandatory measure in prevention strategy.

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Genomics of Helicobacter pylori

Abstract

As Helicobacter pylori infects half the world's population and displays an extensive intraspecies diversity, genomics is a powerful tool to understand evolution and disease, to identify factors that confer higher risk of severe sequelae, and to find new approaches for therapy both among bacterial and host targets. In line with these objectives, this review article summarizes the major findings in Helicobacter genomics in papers published between April 2016 and March 2017.

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Gastric cancer: Basic aspects

Abstract

Gastric cancer is one of the most incident and deadliest malignancies in the world. Gastric cancer is a heterogeneous disease and the end point of a long and multistep process, which results from the stepwise accumulation of numerous (epi)genetic alterations, leading to dysregulation of oncogenic and tumor suppressor pathways. Gastric cancer stem cells have emerged as fundamental players in cancer development and as contributors to gastric cancer heterogeneity. For this special issue, we will report last year's update on the gastric cancer molecular classification, and in particular address the gastric cancer groups who could benefit from immune checkpoint therapy. We will also review the latest advances on gastric cancer stem cells, their properties as gastric cancer markers and therapeutic targets, and associated signaling pathways. The understanding of the molecular basis underlying gastric cancer heterogeneity and of the role played by gastric cancer stem cells in cancer development and heterogeneity is of major significance, not only for identifying novel targets for cancer prevention and treatment, but also for clinical management and patient stratification for targeted therapies.

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Other Helicobacters, gastric and gut microbiota

Abstract

The current article is a review of the most important and relevant literature published in 2016 and early 2017 on non-Helicobacter pylori Helicobacter infections in humans and animals, as well as interactions between H. pylori and the microbiota of the stomach and other organs. Some putative new Helicobacter species were identified in sea otters, wild boars, dogs, and mice. Many cases of Helicobacter fennelliae and Helicobacter cinaedi infection have been reported in humans, mostly in immunocompromised patients. Mouse models have been used frequently as a model to investigate human Helicobacter infection, although some studies have investigated the pathogenesis of Helicobacters in their natural host, as was the case for Helicobacter suis infection in pigs. Our understanding of both the gastric and gut microbiome has made progress and, in addition, interactions between H. pylori and the microbiome were demonstrated to go beyond the stomach. Some new approaches of preventing Helicobacter infection or its related pathologies were investigated and, in this respect, the probiotic properties of Saccharomyces, Lactobacillus and Bifidobacterium spp. were confirmed.

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Diagnosis of Helicobacter pylori infection

Abstract

Important progress is being made in endoscopic methods which allow clinicians to predict the presence of Helicobacter pylori based on characteristics of gastric mucosa and to obtain targeted biopsies. There are also important developments in molecular methods with various techniques derived from standard PCR, applied both on gastric biopsies and stool specimens. Progress is being made in microfluidic systems to get a reliable diagnosis in a very short time. The interest of the ¹³C urea breath test has been confirmed as well as stool antigen tests. Attempts are being made to find biological markers of premalignant conditions by serology, other than pepsinogens.

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Helicobacter: Inflammation, immunology and vaccines

Abstract

Helicobacter pylori is usually acquired in early childhood and the infection persists lifelong without causing symptoms. In a small of cases, the infection leads to gastric or duodenal ulcer disease, or gastric cancer. Why disease occurs in these individuals remains unclear, however the host response is known to play a very important part. Understanding the mechanisms involved in maintaining control over the immune and inflammatory response is therefore extremely important. Vaccines against H. pylori have remained elusive but are desperately needed for the prevention of gastric carcinogenesis. This review focuses on research findings which may prove useful in the development of prognostic tests for gastric cancer development, therapeutic agents to control immunopathology, and effective vaccines.

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Abstracts

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Keyword Index

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Pathogenesis of Helicobacter pylori infection

Abstract

Helicobacter pylori is responsible for the most commonly found infection in the world's population. It is the major risk factor for gastric cancer development. Numerous studies published over the last year provide new insights into the strategies employed by H. pylori to adapt to the extreme acidic conditions of the gastric environment, to establish persistent infection and to deregulate host functions, leading to gastric pathogenesis and cancer. In this review, we report recent data on the mechanisms involved in chemotaxis, on the essential role of nickel in acid resistance and gastric colonization, on the importance of adhesins and Hop proteins and on the role of CagPAI-components and CagA. Among the host functions, a special focus has been made on the escape from immune response, the ability of bacteria to induce genetic instability and modulate telomeres, the mechanism of autophagy and the deregulation of micro RNAs.

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Treatment of Helicobacter pylori infection 2017

Abstract

This review summarizes important studies regarding Helicobacter pylori therapy published from April 2016 to April 2017. The main themes that emerge involve studies assessing the efficacy of bismuth and nonbismuth quadruple regimens. While in recent years, much of the emphasis on the use of bismuth has focussed on its utility in a second-line setting, an increasing number of studies this year have shown excellent efficacy in first-line therapy. The efficacy of bismuth as a second-line after sequential and concomitant therapy was particularly noteworthy. Antibiotic resistance was more intensely studied this year than for a long time, and definite trends are presented regarding an increase in resistance, including the fact that clarithromycin resistance in particular is now at a level where the continued use of clarithromycin triple therapy first-line as a mainstream treatment is not recommended. Another exciting trend to emerge this year is the utility of vonoprazan as an alternative to PPI therapy, especially in resistant and difficult-to-treat groups.

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Epidemiology of Helicobacter pylori infection

Abstract

The study of Helicobacter pylori genetic variability brought us interesting data on the history of mankind. Based on multilocus sequence typing and more recently on whole-genome sequencing, paleomicrobiology still attracts the attention of global researchers in relation to its ancestor roots and coexistence with humans. Three studies determining the prevalence of virulence factors illustrates the controversial results obtained since 30 years by studies trying to associate prevalence of different virulence markers and clinical outcomes of H. pylori infection. Three articles analyzed the prevalence and risk of multiple (genetically distinct isolates) and mixed (susceptible and resistant isolates) infections. A number of studies confirm that H. pylori prevalence is falling worldwide especially in the developed world and in children but that the level of infection is higher in certain ethnic minorities and in Migrants. There is little new in identifying the mode of H. pylori transmission though intrafamilial spread appears to be important. There have, however, been some interesting papers on the presence of the organism in food, water, and the oral cavity.

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Helicobacter pylori, gastric cancer and other gastrointestinal malignancies

Abstract

In a retrospective study performed in California, U.S.A., ca. 3% of patients with gastric intestinal metaplasia (GIM) developed gastric cancer (GC) within a median time period of 4.6 years after diagnosis of GIM. This observation stresses the importance of targeted surveillance even in regions with a low GC prevalence. Patients with alcoholic liver disease as well as survivors of colorectal and lobular breast cancer were found to be at increased risk of secondary GC. A population-based Chinese study confirmed "serologic biopsy" as a useful screening tool for stratifying the individual risk of developing GC. Concerning GC therapy, a post hoc analysis of the MAGIC trial reported that regression of lymph node metastases, but not the tumor regression itself, predicts overall survival. Furthermore, in patients with high microsatellite instable tumors, perioperative chemotherapy leads to an increased risk of mortality. Two studies confirmed that eradication therapy is worthwhile as an initial treatment for gastric mucosa-associated lymphoid tissue (MALT) lymphoma irrespective of the H. pylori infection status and stage. An increased risk of a second primary malignancy including GC was observed in these patients treated with immuno/chemotherapy but not in patients treated solely with an H. pylori eradication treatment. With respect to gastrointestinal malignancies other than GC, discrepant data have been published regarding the association of H. pylori with pancreatic cancer whereas no association has been reported with esophageal squamous cell carcinoma. The majority of published studies still support an association of H. pylori with colon neoplasms.

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Issue Information

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Helicobacter pylori infection in children

Abstract

Helicobacter pylori infection in children differs from that in adults, from the point of view of epidemiology, host response, clinical features, related diseases, and diagnosis, as well as treatment strategies.

The prevalence of H. pylori infection, in both children and adults, is decreasing in the Western World as well as in some developing countries, which contrasts with the increase in childhood asthma and allergic diseases. Recurrent abdominal pain is not specific during H. pylori infection in children. The role of H. pylori infection and failure to thrive, children's growth, type I diabetes mellitus (T1DM) and celiac disease remains controversial.

The main initial diagnosis is based on upper digestive endoscopy with biopsy-based methods. Nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. The infection eradication control is based on validated noninvasive tests.

The main cause of treatment failure of H. pylori infection is its clarithromycin resistance. We recommend standard antibiotic susceptibility testing of H. pylori in pediatric patients prior to the initiation of eradication therapy. H. pylori treatment in children should be based on an evaluation of the rate of eradication in the local population, a systematic use of a treatment adapted to the susceptibility profile and a treatment compliance greater than 90%. The last meta-analysis in children did not show an advantage for sequential therapy when compared to a 14-day triple therapy.

Finally, the high rate of antibiotic resistance responsible for therapy failure in recent years justifies the necessity of a novel vaccine to prevent H. pylori infection in children.

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30th anniversary of the European helicobacter & microbiota study group!

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Author Index

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Helicobacter pylori infection and nonmalignant diseases

Abstract

A substantial decrease in Helicobacter pylori-associated peptic ulcer disease has been observed during the last decades. Drug-related ulcers as well as idiopathic ulcers are becoming predominant and are more refractory to treatment; however, H. pylori infection still plays an important role in ulcer bleeding and recurrence after therapy. The effect of H. pylori eradication upon functional dyspepsia symptoms has been reviewed in this article and generally confirms the results of previous meta-analyses. Additional evidence suggests a lack of impact upon the quality of life, in spite of improvement in symptoms. The association of H. pylori with gastroesophageal reflux disease and Barrett's esophagus remains controversial with a majority of published studies showing a negative association. Furthermore, a strong inverse relationship between the presence of H. pylori and the esophageal eosinophilia was also reported. Several studies and a review addressed the role of H. pylori in autoimmune gastritis and pernicious anemia. The association of the above still remains controversial. Finally, the necessity of routine endoscopy and H. pylori eradication before bariatric surgery is discussed. Several studies suggest the rationale of preoperative upper endoscopy and H. pylori eradication prior to surgery. However, the prevalence of H. pylori infection prior to surgery in these studies generally reflects the overall prevalence of the infection in the particular geographic area. In addition, results on the role of H. pylori in developing postoperative complications remain controversial.

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