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Τετάρτη 17 Ιανουαρίου 2018
Scholar : These new articles for South African Theatre Journal are available online
A Study of the Cost-effectiveness of Fenestrated/branched EVAR Compared with Open Surgery for Patients with Complex Aortic Aneurysms at 2 Years
Publication date: Available online 17 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Morgane Michel, Jean-Pierre Becquemin, Jean Marzelle, Céline Quelen, Isabelle Durand-Zaleski
ObjectivesThe aim was to assess the cost-effectiveness of fenestrated and branched stent grafts (f/b EVAR) compared with open surgical repair (OSR) in thoraco-abdominal or complex abdominal aortic aneurysms (TAAA/AAA) at 2 years.MethodsTwo matched cohorts of patients with TAAA or complex AAA were compared after a follow-up of two years. Patients included in the WINDOW French multicentre prospective registry were treated by f/b EVAR, and OSR patients were extracted from the French national hospital discharge database. All cause mortality was assessed along with readmissions and hospital costs. The association between treatment and 2 year mortality was assessed by uni/multivariate Cox regression analyses using pre- and post-operative characteristics. Incremental cost-effectiveness ratios (ICER) were estimated for para/juxtarenal AAA, and infra- and supra-diaphragmatic TAAA.ResultsA total of 268 high risk patients were treated by f/b EVAR and 1678 average or low risk patients were treated with OSR during the same period. Mortality did not significantly differ between the groups (14.9% vs. 11.8%, p = .150) and multivariate Cox regressions did not find an association between 2 year mortality and treatment. Similar proportions of patients were readmitted at least once (69.7% with f/b EVAR vs. 64.2% with OSR, p = .096) but f/b EVAR patients had more readmissions on average (2.2 vs. 1.7, p = .001). Two year hospital costs were higher in the f/b EVAR group (€46,039 vs. €22,779, p < .001). At 2 years, f/b EVAR was dominated (more expensive and less effective), except in the supra-diaphragmatic TAAA subgroup with an ICER of €42,195,800 per death averted.Conclusionsf/b EVAR in high risk patients offers similar 2 year mortality to OSR performed in lower risk patients but at a higher cost. The cost is mainly driven by the cost of the stent graft, which is not compensated for by lower healthcare resource consumption. Further studies are necessary to evaluate the cost-effectiveness in low risk f/b EVAR patients who may experience fewer complications.
http://ift.tt/2DeYTVw
Commentary on “Predictors of Change in the Ankle Brachial Index with Exercise”
Publication date: Available online 17 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Pere Altes, Secundino Llagostera
http://ift.tt/2Didtjc
A Prospective Study to Evaluate Complete Wound Healing and Limb Salvage Rates After Angiosome Targeted Infrapopliteal Balloon Angioplasty in Patients with Critical Limb Ischaemia
Publication date: Available online 17 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Ahmed Elbadawy, Haitham Ali, Mahmoud Saleh, Ayman Hasaballah
Objective/BackgroundTo evaluate complete wound healing and limb salvage rates in patients with critical limb ischaemia (CLI) with concurrent foot ulceration/gangrene who underwent angiosome targeted infrapopliteal balloon angioplasty.MethodsThis was a prospective observational study. In total, 212 patients who underwent successful infrapopliteal balloon angioplasty to assist wound healing and achieve limb salvage were included from June 2014 to March 2016. Propensity score matching was developed to compare complete wound healing, 1 year amputation free survival (AFS), and limb salvage rates between the two study groups (direct revascularisation [DR] and indirect revascularisation [IR]).ResultsDirect flow to the foot wounds based on the angiosome principle was achieved in 117 legs (55.2%) versus 95 legs (44.8%) that represented the IR group. Seventy-three matched pairs were obtained to minimise intergroup differences in baseline characteristics. Twelve months after angioplasty, the complete wound healing rates were 80.8% and 63.0% (p = .02), AFS rates were 72.6% and 61.6% (p = .164), and limb salvage rates were 90.4% and 82.2% (p = .148) in the DR and IR groups, respectively.ConclusionThis study suggests that the complete wound healing rate is better when the target foot lesion receives direct perfusion following the angiosome concept, whereas limb salvage and AFS rates were not significantly different among the DR and IR groups.
http://ift.tt/2Ba0bPI
Commentary on “Catheter Injected Bone Marrow Mesenchymal Stem Cells Induce Efficacious Occlusion of Arteriovenous Nidus in a Chronic Swine Model”
Publication date: Available online 17 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Byung-Boong Lee
http://ift.tt/2DjhL9X
Catheter Injected Bone Marrow Mesenchymal Stem Cells Induce Efficacious Occlusion of Arteriovenous Nidus in a Swine Model
Publication date: Available online 17 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Joseph Touma, Jianping Dai, Andre Gaston, Marianne Gervais, Eric Allaire
ObjectivesArteriovenous malformations (AVMs) are complex vascular lesions. Surgical excision is the treatment of choice, but is often not achievable. Embolo-sclerotherapy alone is associated with high recurrence rates. This study tested the hypothesis that seeding hydrogel conditioned bone marrow derived mesenchymatous stem cells (BM-MSCs) in an AVM nidus model induces solid microvascular occlusion through endoluminal tissue growth.MethodsAVMs were modelled as arteriovenous microvascular nidus, using swine rete mirabile, a plexiform intracranial structure composed of arterial microvessels that extensively anastomose. A right carotid-jugular fistula was created to generate high flow in the rete, and bone marrow was aspirated. At day 14, cultured BM-MSCs marked with a red fluorochrome were incorporated into a hyaluronic acid hydrogel, and injected through a catheter into the rete mirabile, using femoral access. In specific groups microsphere embolisation immediately preceded gel injection. At day 28, the swine were euthanased and the rete mirabile harvested for qualitative and quantitative analysis of microvessel lumen occlusion.ResultsActual transfer of PKH26 labelled cells in rete was confirmed. In a first phase of the study, five swine died as a result of neurological events, prompting reductions of the injected volumes. Twenty-three animals survived until day 28. Injection of BM-MSC loaded hydrogel (n=6) significantly increased the occlusion rate compared with injection of acellular hydrogel (n=7) (10% [range, 10–12%] vs. 26% [range, 20–41%], p=.016). Injection of BM-MSC loaded hydrogel immediately after microspheres (n=6) enhanced the occlusion rate compared with embolic microspheres alone (n=6) (50% [range 46–56%] vs. 22% [range, 15–27%] p=.045). Microsphere injection resulted in vascular luminal thrombus formation. Injection of BM-MSCs induced endoluminal growth of vascular smooth muscle cells with cell proliferation and a dense collagen rich extracellular matrix.ConclusionThe luminal occlusion pattern of a microvascular AVM like structure can be changed from thrombus to solid cellular accumulation. The possibility of injecting living cells in a microvascular network, in a chronic survival model, provides new tools for research and treatment of AVMs and other microvascular diseases.
http://ift.tt/2Ba6LWr
Scholar : Pediatric Hematology and Oncology, Volume 34, Issue 6-7, September - October 2017 is now available online on Taylor & Francis Online
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Efficacy and Safety Study of Benralizumab for Patients With Severe Nasal Polyposis
Interventions: Biological: Benralizumab 30 mg SC + Mometasone Furoate; Biological: Matching placebo SC + Mometasone Furoate
Sponsor: AstraZeneca
Not yet recruiting
http://ift.tt/2B9UelS
STEREO-POSTOP 01 (PostOperative Hypofractionated Stereotactic Body Radiotherapy ) - GORTEC 2017-03
Intervention: Radiation: postoperative hypofractionated stereotactic radiotherapy
Sponsors: Centre Jean Perrin; GORTEC (Groupe d'Oncologie Radiothérapie Tête et Cou)
Not yet recruiting
http://ift.tt/2DkRsQX
Scholar : Acta Oto-Laryngologica, Volume 138, Issue 2, February 2018 is now available online on Taylor & Francis Online
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Carboxytherapy for treatment of localized chronic plaque psoriasis: Clinical and histopathologic evaluation
Summary
Background
Multiple treatment options are introduced in treatment of chronic localized plaque psoriasis but with poor adherence and poor patients' satisfaction resulting in poor treatment outcome.
Objective
In this pilot study, we investigated the safety and efficacy of carboxytherapy in treatment of chronic localized plaque psoriasis.
Methods
Thirty adult patients with chronic localized plaque psoriasis were enrolled in this study. The patients received carboxytherapy injection once/week for 8 weeks. Patients were clinically and histpathologically evaluated 2 weeks after the last treatment. Clinical response was evaluated by investigator's global assessment, total sign score, and 5-point scale for perilesional erythema. We performed 10-point visual analog scale for patient's satisfaction, and side effects. Three months after the last session we evaluate recurrence using 10-point scale.
Results
Carboxytherapy achieved treatment success in 26.6% according to investigator's global assessment and total sign score and 70% of the patients demonstrated absence of perilesional erythema. Patients were satisfied with no reported side effects. Recurrence area was within 1% -10% of the baseline area in 83.3% of the improved patients.
http://ift.tt/2DqfTM4
Scholar : Electric Power Components and Systems, Volume 45, Issue 15, September 14, 2017 is now available online on Taylor & Francis Online
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Scholar : Philosophical Magazine, Volume 98, Issue 5, February 2018 is now available online on Taylor & Francis Online
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Fabrication of poly(ethylene glycol)-coated mesoporous nanocomposite ZnO@Fe2O3 for methotrexate delivery: An integrated nanoplatform for dual-mode cancer therapy
Publication date: Available online 17 January 2018
Source:European Journal of Pharmaceutical Sciences
Author(s): Azam S. Alavi, Azadeh Meshkini
Although chemotherapy is an effective strategy for treatment of tumor cells, the non-specific distribution of chemotherapy drugs and their poor aqueous solubility result in impaired treatment and cause serious side effects in patients. In this study, mesoporous ZnO@Fe2O3 nanocomposite was fabricated and used as a platform for drug delivery. ZnO@Fe2O3 nanocomposite showed a high capacity for the adsorption of chemotherapy drug, methotrexate (MTX). Drug-loaded nanoparticle was coated with poly(ethylene glycol) (PEG), leading to the enhanced colloidal stability and good cytocompatibility. In order to improve tumor selective targeting of PEG-coated nanoparticles, it was also decorated with folic acid. Fabricated drug delivery system (F-P-M-ZnO@Fe2O3) was characterized by FT-IR, TGA, zeta potential, and UV–Visible spectroscopy. F-P-M-ZnO@Fe2O3 nanoparticles showed spatio-temporal drug release which was precisely controlled by pH and UVA light. In vitro biological studies on breast cancer cell lines (MCF-7 and T47D cells) revealed that F-P-M-ZnO@Fe2O3 nanoparticles can be internalized by clathrin-mediated endocytosis in energy-dependent and folate receptor-dependent manner. Cytotoxicity experiments showed that the treatment of tumor cells with both F-P-M-ZnO@Fe2O3 nanoparticle and UV irradiation causes better synergistic effect in inducing cellular apoptosis than the free drug and UV irradiation alone. Induction of apoptosis occurred following the mitochondrial membrane disruption and caspase activation. Moreover, F-P-M-ZnO@Fe2O3 did not affect normal cells, indicating the selective cytotoxic effect of fabricated nanosystem. From these data, F-P-M-ZnO@Fe2O3 is a dual-responsive nanoplatform which could be considered as an appropriate candidate for targeted chemo-phototherapy in cancer.
Graphical abstract
http://ift.tt/2DoUItH
Antibacterial properties of Latarcin 1 derived cell-penetrating peptides
Publication date: 30 March 2018
Source:European Journal of Pharmaceutical Sciences, Volume 115
Author(s): Deepthi Poornima Budagavi, Archana Chugh
Cell-penetrating peptides (CPPs) and antimicrobial peptides (AMPs) share certain physicochemical parameters such as amphipathicity, hydrophobicity, cationicity and pI, due to which these two groups of peptides also exhibit overlapping functional characteristics. In our current work, we have evaluated antimicrobial properties of cell-penetrating peptides derived from Latarcin1. Latarcin derived peptide (LDP) exhibited antimicrobial activity against representative microorganisms tested and bactericidal effect against methicillin resistant Staphylococcus aureus (MRSA), which was used as model organism of study in the present work. However, LDP exhibited cytotoxicity against HeLa cells. Further, nuclear localization sequence (NLS) was fused to LDP and interestingly, LDP-NLS showed antimicrobial effect against bacteria, showed bactericidal effect against MRSA and also did not exhibit cytotoxicity in HeLa cells till the highest concentrations tested. Thus, our results inferred that fusion of NLS to LDP significantly reduced cytotoxicity of LDP against HeLa cells (Ponnappan and Chugh, 2017) and exhibited significantly higher cell-penetrating activity in MRSA in comparison to LDP alone. Consolidated results of uptake assays, time-kill assays and PI membrane damage assays show that LDP killed MRSA mainly by membrane damage, where as LDP-NLS might have intracellular targets. Owing to its cell-penetrating activity in HeLa cells and antimicrobial activity against MRSA, LDP-NLS efficiently inhibited intracellular infection of MRSA in HeLa cells as observed in invasion assays. Hence, our results suggest that LDP-NLS is a dual action peptide with AMP and CPP activity and could be potential candidate as peptide antibiotic and drug delivery vector in both mammalian and bacterial cells.
Graphical abstract
http://ift.tt/2DoUvXr
Development and applications of a physiologically-based model of paediatric oral drug absorption
Publication date: 30 March 2018
Source:European Journal of Pharmaceutical Sciences, Volume 115
Author(s): T.N. Johnson, J.J. Bonner, G.T. Tucker, D.B. Turner, M. Jamei
There is increasing interest in paediatric drug absorption and the development of biopharmaceutics tools to facilitate the development of oral formulations for neonates, infants and children. We describe the development and application of a physiologically-based model of paediatric drug absorption applicable from full term birth onwards. Paediatric age-specific parameters were included for salivary flow, gastric pH, gastric emptying (and associated food effects) and duodenal bile salt concentrations and the associated algorithms were integrated into a dissolution, absorption and metabolism model as part of a PBPK platform. For other parameters, there was either evidence for no age-related changes or a lack of data, so that adult values were applied. An initial assessment of the model was carried out by simulating the oral absorption of theophylline, paracetamol and ketoconazole over a range of paediatric ages. The absorption of the first two drugs, both BCS class 1 compounds, was predicted to be slower in early neonates compared to older age groups (median tmax values of 3 vs 2h, respectively), but with invariant fraction absorbed (fa). This is in agreement with clinical observations. The tmax of ketoconazole, a BCS class 2 compound, was predicted to be about 1h in both neonates and adults, but the fa value was higher in the former (0.87 vs 0.69).There is clearly a need to expand the components of the model as new information on the ontogeny of GI tract parameters becomes available, and to assess it against more in vivo data with evidence of specific age-related changes in oral drug absorption.
Graphical abstract
http://ift.tt/2Drcso6
Lamotrigine loaded poly-ɛ-(d,l-lactide-co-caprolactone) nanoparticles as brain delivery system
Publication date: Available online 16 January 2018
Source:European Journal of Pharmaceutical Sciences
Author(s): Hussein O. Ammar, Mahmoud M. Ghorab, Azza A. Mahmoud, Iman M. Higazy
Management of epilepsy requires brain delivery therapy, therefore, this study was aimed to prepare lamotrigine loaded poly-ɛ-(d,l-lactide-co-caprolactone) (PLCL) nanoparticles using spontaneous emulsification solvent diffusion method. Nanoparticles for brain delivery required to have a particle size <200 nm, polydispesity index <0.2 and a sustained drug release properties. For such aim different factors were considered in preparing the nanoparticles as PLCL monomers' ratio, type of organic solvent used to prepare the nanoparticles, amount of PLCL and Pluronic®F127 in the nanoparticles. Prepared nanoparticles were characterized for their shape, particle size, polydispersity index, zeta potential, encapsulation efficiency, drug loading capacity, process yield and in-vitro drug release pattern. The in-vivo investigation for brain delivery of selected nanoparticles delivered by intravenous route was investigated in rats and compared to that for oral tablet. The obtained nanoparticles were spherical in shape. The amount of surfactant and PLCL affected the properties of the obtained nanoparticles. Using a mixture of organic solvent in preparing the nanoparticles improved its properties. The nanoparticles prepared using PLCL with monomers' ratio of 25:75, had particle size value of 125 nm, polydispersity value of 0.184, zeta potential value of −39 mV and encapsulation efficiency of 99%, was selected to study its efficacy to deliver the drug to the brain. The tested nanoparticles showed higher values of Tmax, Cmax, AUC, and MRT in homogenized rat brain, compared to oral lamotrigine tablet, while the bioavailability of the oral tablet was higher in rat plasma compared to that for the nanoparticles. This reflects that brain was the main distribution site for tested nanoparticles, and plasma was the main distribution site for oral tablets. This confirms the goal of the selected formulation as brain delivery nanoparticles.
Graphical abstract
http://ift.tt/2Dmnjjn
Model and methods to assess hepatic function from indocyanine green fluorescence dynamical measurements of liver tissue
Publication date: Available online 16 January 2018
Source:European Journal of Pharmaceutical Sciences
Author(s): Chloe Audebert, Irene E. Vignon-Clementel
The indocyanine green (ICG) clearance, presented as plasma disappearance rate is, presently, a reliable method to estimate the hepatic "function". However, this technique is not instantaneously available and thus cannot been used intra-operatively (during liver surgery). Near-infrared spectroscopy enables to assess hepatic ICG concentration over time in the liver tissue. This article proposes to extract more information from the liver intensity dynamics by interpreting it through a dedicated pharmacokinetics model. In order to account for the different exchanges between the liver tissues, the proposed model includes three compartments for the liver model (sinusoids, hepatocytes and bile canaliculi). The model output dependency to parameters is studied with sensitivity analysis and solving an inverse problem on synthetic data. The estimation of model parameters is then performed with in-vivo measurements in rabbits (El-Desoky et al. 1999). Parameters for different liver states are estimated, and their link with liver function is investigated. A nonlinear (Michaelis-Menten type) excretion rate from the hepatocytes to the bile canaliculi was necessary to reproduce the measurements for different liver conditions. In case of bile duct ligation, the model suggests that this rate is reduced, and that the ICG is stored in the hepatocytes. Moreover, the level of ICG remains high in the blood following the ligation of the bile duct. The percentage of retention of indocyanine green in blood, which is a common test for hepatic function estimation, is also investigated with the model. The impact of bile duct ligation and reduced liver inflow on the percentage of ICG retention in blood is studied. The estimation of the pharmacokinetics model parameters may lead to an evaluation of different liver functions.
Graphical abstract
http://ift.tt/2DoUm6l
Scholar : These new articles for Annals of GIS are available online
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Nature of Emotion Categories: Comment on Cowen and Keltner
Publication date: February 2018
Source:Trends in Cognitive Sciences, Volume 22, Issue 2
Author(s): Lisa Feldman Barrett, Zulqarnain Khan, Jennifer Dy, Dana Brooks
Cowen and Keltner (2017) published the latest installment in a longstanding debate about whether measures of emotion organize themselves into categories or array themselves more continuously along affective dimensions. We discuss several notable features of the study and suggest future studies should consider asking questions more directly about physical and psychological variation within emotion categories as well as similarities between categories.
http://ift.tt/2mHRGqf
Editors, Contents, Cover details
Publication date: February 2018
Source:Trends in Cognitive Sciences, Volume 22, Issue 2
http://ift.tt/2DqOBoU
Memory as Perception of the Past: Compressed Time inMind and Brain
Publication date: February 2018
Source:Trends in Cognitive Sciences, Volume 22, Issue 2
Author(s): Marc W. Howard
In the visual system retinal space is compressed such that acuity decreases further from the fovea. Different forms of memory may rely on a compressed representation of time, manifested as decreased accuracy for events that happened further in the past. Neurophysiologically, "time cells" show receptive fields in time. Analogous to the compression of visual space, time cells show less acuity for events further in the past. Behavioral evidence suggests memory can be accessed by scanning a compressed temporal representation, analogous to visual search. This suggests a common computational language for visual attention and memory retrieval. In this view, time functions like a scaffolding that organizes memories in much the same way that retinal space functions like a scaffolding for visual perception.
http://ift.tt/2mFcgrf
Histological features and outcome of inverted type-A melanocytic nevi
Abstract
The presence of enlarged epithelioid/spindled nests located deep in the reticular dermis of a biphasic melanocytic neoplasm can mimic melanoma arising in a preexisting nevus, causing over-interpretation of malignancy. We aimed to define the clinicopathologic significance of epithelioid/spindled nests in melanocytic nevi. Retrospectively using clinical and histologic information, we characterized 121 patients with a single lesion showing epithelioid/spindled melanocytes in the reticular dermis or subcutaneous fat, surrounded by melanophages, sometimes blending in with the adnexa. The majority of nevi occurred in women in the ages of 10 to 39 years, where the most frequent presentation was a changing mole. While 78% of the lesions displayed an anatomic (Clark's) level of IV-V, there was no ulceration, significant regression or inflammation. Up to two mitoses were found in only 12% of the cases, not correlating with the severity of cytological atypia. No recurrence or metastasis occurred during 45.5 months (mean) of clinical follow up in 26 patients. Notwithstanding the deep dermal extension, these findings suggest a benign histopathology and clinical outcome. Having compared the overlapping histopathology and clinical features between deep penetrating/clonal nevus and combined nevus, we posit that "inverted type A nevus" might be considered a variant of the two.
http://ift.tt/2DcxweF
Patient-reported symptoms before palliative radiotherapy predict survival differences
Abstract
Background
Widely used prognostic scores, e. g., for brain or bone metastases, are based on disease- and patient-related factors such as extent of metastases, age and performance status, which were available in the databases used to develop the scores. Few groups were able to include patient-reported symptoms. In our department, all patients were assessed with the Edmonton Symptom Assessment System (ESAS, a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of 0–10) at the time of treatment planning since 2012. Therefore, we analyzed the prognostic impact of baseline ESAS symptom severity.
Methods
Retrospective review of 102 patients treated with palliative radiotherapy (PRT) between 2012 and 2015. All ESAS items were dichotomized (below/above median). Uni- and multivariate analyses were performed to identify prognostic factors for survival.
Results
The most common tumor types were prostate, breast and non-small cell lung cancer, predominantly with distant metastases. Median survival was 6 months. Multivariate analysis resulted in six significant prognostic factors. These were ESAS pain while not moving (median 3), ESAS appetite (median 5), Eastern Cooperative Oncology Group (ECOG) performance status, pleural effusion/metastases, intravenous antibiotics at start or within 2 weeks before PRT and no systemic cancer treatment.
Conclusions
Stronger pain while not moving and reduced appetite (below/above median) predicted significantly shorter survival. Development of new prognostic scores should include patient-reported symptoms and other innovative parameters because they were more important than primary tumor type, age and other traditional baseline parameters.
http://ift.tt/2mP0w64
Scholar : These new articles for CoDesign are available online
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Scholar : Contemporary Music Review, Volume 36, Issue 5, October 2017 is now available online on Taylor & Francis Online
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Reliability and Validity of iscorEB (Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa)
Summary
Background
Epidermolysis bullosa (EB) is a group of rare and currently incurable genetic blistering disorders. As more pathogenic driven therapies are being developed, the need for EB-specific validated outcomes measures designed for use in clinical trials is becoming important.
Objectives
We previously reported on development of an instrument for scoring clinical outcomes of research for Epidermolysis Bullosa (iscorEB), a new combined clinician and patient reported outcomes tool. We proceeded to test the reliability and construct validity of iscorEB in this study.
Methods
Observational study consisting of independent one-day assessments (6 assessors) at 2 academic hospitals. The assessments consisted of iscorEB clinician (iscorEB-c), Birmingham Epidermolysis Bullosa Severity (BEBS), and global severity assessment for physicians; and iscorEB patient (iscorEB-p), Quality of Life in Epidermolysis Bullosa (QOLEB) and Children's Dermatology Life Quality Index (CDLQI) for patients. Construct validity and intra-class correlation coefficients (ICC) for inter-observer, intra-observer, and test-retest reliability were calculated.
Results
Thirty one patients with a mean age of 19.5 years (1.8-45.2) were included. Disease severity was mild in 42%, moderate in 29% and severe in 29% of cases. The inter-observer ICC was 0.96 for both the clinician-reported section of iscorEB-c and BEBS. The ICC for intra-observer reliability was 0.91 and 0.70 for the skin and mucosal domains of iscorEB-c, respectively. Cronbach's alpha for iscorEB-c was 0.89. iscorEB-p's test-retest reliability was 0.97, and Cronbach's alpha was 0.84. The clinical score differentiated between subjects with mild, moderate and severe disease, and both clinical and patient subscores discriminated between recessive dystrophic EB and other EB subtypes.
Conclusion
iscorEB has robust reliability and construct validity, including strong ability to distinguish EB types and severities. Further studies are planned to test its responsiveness to change.
This article is protected by copyright. All rights reserved.
http://ift.tt/2ENTgOt
Localised inflammatory reactions at sites of subcutaneous methotrexate injections during treatment with ultraviolet B
Abstract
Ultraviolet B (UVB) phototherapy may be used in combination with methotrexate to treat psoriasis. When given in high doses as chemotherapy, methotrexate can induce a "radiation recall" reaction where a rash develops at sites of previous exposure to sunlight or radiotherapy, and where keratinocyte necrosis is a prominent histopathological finding1. However, this reaction does not seem to occur when methotrexate, given orally in conventional dermatological doses, is combined with UVB2, 3.
This article is protected by copyright. All rights reserved.
http://ift.tt/2FHRcJ7
The use of methotrexate in adolescents: contraception, confidentiality and consent
The British Association of Dermatologist's recently published guidelines for safe and effective prescribing of methotrexate address on- and off-licence use in adults and children,1 but should more attention be paid to the group in between, adolescents?
This article is protected by copyright. All rights reserved.
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Scholar : These new articles for Crystallography Reviews are available online
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High lithium tolerance of Apocynum venetum seeds during germination
Abstract
Identification and use of lithium (Li) accumulator plants is a promising strategy to remediate Li-contaminated soil. Apocynum venetum is reported as a Li accumulator. However, its tolerance to Li salt during germination is still unknown. The primary aim of this study was to investigate the effects of two Li salts on seed germination of A. venetum. At the same concentrations, germination percentages in LiCl solution were higher than that in Li2CO3 solution. At 25 °C, seeds germinated to 4–90% at 0–400 mmol L−1 LiCl and 3–91% at 0–150 mmol L−1 Li2CO3. Low concentration (0–50 mmol L−1) of LiCl did not significantly affect germination percentage. The simulated critical value (when germination percentage is 50%) in LiCl solution is 196 mmol L−1, and 36 mmol L−1 for Li2CO3. Activity of α-amylase, contents of MDA, soluble sugar, and proline were dramatically affected by Li salts, especially at medium and late germination stages. When compared with control, α-amylase activity of seeds under 25 mmol L−1 LiCl and 10 mmol L−1 Li2CO3 did not show significant difference. Germination percentage and index, radicle length, and physiological parameters indicate A. venetum seeds are highly tolerant to Li salts during germination, especially LiCl.
http://ift.tt/2EQFM4r
Scholar : These new articles for Environmental Claims Journal are available online
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E-Bike–Related Trauma in Children and Adults
Source:The Journal of Emergency Medicine
Author(s): Itai Gross, Daniel J. Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BackgroundElectric bike (e-bike) usage is growing worldwide, and so is the e-bike–related injury rate.ObjectiveThis study was undertaken to characterize e-bike–related injuries.MethodsData of all e-bike–related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike–related injuries were then analyzed separately and compared.ResultsForty-eight patients suffering from e-bike–related injuries presented to our trauma center between January 1, 2014 and December 31, 2016. Seventeen (35%) patients were <18 years of age and 40 (85%) were male. The overall most common mechanism of injury was falling off the e-bike in 24 patients (50%), followed by collision with a static object in 9 patients (18.8%). Head (38%) and facial (33%) injuries were most common in children. In adult patients, orthopedic trauma was predominant, with extremity fractures in 35 (73%) followed by significant lacerations in 14 patients (29%). Severe trauma (Injury Severity Score >15) was found in 17 (35%) patients. The duration of hospital stay was 10.8 ± 6 days, 12 patients (25%) required a stay in the intensive care unit, and 21 patients (43.7%) required surgery. Compared to adults, children (<18 years of age) had significantly more head and face injuries (p = 0.05).ConclusionOur study suggests that e-bike–related trauma may involve serious injuries and have typical injury patterns that resemble those seen in motorcycle-related injuries. Children are more likely to suffer head and face injuries because of their higher head to body ratio. We suggest that these injuries should therefore be triaged appropriately, preferably to a medical facility with proper trauma capabilities.
http://ift.tt/2mN9ZLr
Dermoscopy of basal cell carcinoma
Summary
Dermoscopy is widely used in dermatological practice. The method increases the accuracy of basal cell carcinoma (BCC) detection. Pigmented and nonpigmented variants of basal cell carcinoma present different dermoscopic features. Specific dermoscopy criteria have been recognized in different subtypes of BCC. Differentiation of superficial BCC from other subtypes is the most important issue, as it may determine further management decisions.
http://ift.tt/2rhAjlh
Influence of highly concentrated fluoride dentifrices on remineralization characteristics of enamel in vitro
Abstract
Objectives
The aim of this in vitro study was to evaluate the role of highly fluoridated dentifrice on remineralization characteristics of lowly and highly pre-demineralized enamel artificial caries lesions.
Methods
Bovine enamel specimens were prepared (pH 4.95; 21 days) and discriminated in either lowly [L] or highly [H] pre-demineralized artificial caries lesions. Specimens with a mean ΔZbaseline,L (95% CI) of 5120 (4995; 5245) vol.% × μm and a mean ΔZbaseline,H of 8187 (8036; 8339) vol.% × μm were selected and randomly allocated to 12 groups (n = 20). Treatments during pH-cycling (28 days; 6 × 60 min demineralization/day) were brushing 2×/day with fluoride-free (0 ppm F− [L0/H0]), 1100 ppm F− [L1100/H1100], 2800 ppm F− [L2800/H2800], 5000 ppm F− [L5000/H5000], 5000 ppm F− + glycerin [L5000 + glycerin/H5000 + glycerin], and 5000 ppm F− + TCP [L5000 + TCP/H5000 + TCP] containing dentifrices. Dentifrice slurries were prepared with deionized water (1:3wt/wt). After cycling specimens presenting lesion surface loss were discarded and for the remaining 202 specimens, transversal microradiographic (TMR) analyses (ΔZpH-cycle/LDpH-cycle) were performed again. Changes in mineral loss (ΔΔZ = ΔZbaseline − ΔZpH-cycle) and lesion depth (ΔLD = LDbaseline − LDpH-cycle) were calculated.
Results
Significant differences for ΔΔZ could be found between L0, L1100, and L5000 as well as H0, H1100, and H2800/H5000 (p ≤ 0.01; ANCOVA). Except for 0 ppm F−, higher ΔΔZ could be found in highly compared with lowly demineralized specimens (p ≤ 0.004; ANCOVA). After pH-cycling, a second lesion front could only be observed in H5000 and H5000 + TCP. The correlation between ΔΔZ and F− was moderate for lowly and highly demineralized lesions (rL = 0.591; pL < 0.001; rH = 0.746; pH < 0.001), indicating a fluoride dose response for both.
Conclusion
For both baseline substrate conditions, a dose response for fluoride could be revealed.
Clinical significance
Remineralization characteristics of enamel directly depended on baseline mineral loss.
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Publication date: September 2017 Source: Free Radical Biology and Medicine, Volume 110 Author(s): Lucía Fernández-del-Río, Anish Nag, Elen...
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Abstract Noise pollution is a major factor of environmental complaints in many cities, which has significant impacts on human health. As a...
