Fracture Toughness Testing of Dental Restoratives: a Critical Evaluation

Abstract

Purpose of Review

We intend by this short critical review to highlight important aspects regarding the mechanical testing of fracture toughness. The final aim is to increase the awareness to the test sensitivity, ultimately increasing the quality and reliability of reported testing results.

Recent Findings

In a well-intended attempt to facilitate testing procedures or provide alternatives for testing material interfaces, authors are resorting to adaptation of testing methodologies without proper theoretical and experimental validation. The assumption of validity in such cases endangers the perpetration of testing strategies that are not safeguarded by sound theoretical bases. The use of improper statistical treatments based on extreme-value distributions further aggravates this scenario.

Summary

We supply here some directions for authors concerning method selection, interpretation of data scatter, statistical treatment, and possibilities for test validation.

https://ift.tt/2L0hqfo

Beyond JAAD - October 2018

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Andrew Bronin, Robert Phelps, Robert Sidbury

https://ift.tt/2N1x7jO

Methotrexate for alopecia areata: a systematic review and meta-analysis

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Kevin Phan, Vignesh Ramachandran, Deshan Frank Sebaratnam

Abstract

Background

Methotrexate has been used both as an adjunct for low-risk maintenance therapy after initiation with corticosteroids for alopecia areata (AA) and as standalone therapy in some investigations, based on a lack of definitive evidence/guidelines.

Objective

To (1) determine the efficacy and risks associated with methotrexate therapy for AA (2) determine differences efficacy of combination with corticosteroids versus standalone treatment, and (3) determine relative efficacy of methotrexate in adult versus pediatric populations.

Methods

A systematic review and meta-analysis was performed according to recommended PRISMA guidelines.

Results

Methotrexate has reasonable effectiveness in patients with severe AA, and that adults appear to be more responsive to methotrexate treatment compared to pediatric cases. Methotrexate in conjunction with corticosteroids result in higher good/complete response rates compared to those treated with methotrexate alone. A large proportion of recurrence rates occurred in the setting of tapering treatment. Complication rates were acceptable and similar between adults and pediatric cases.

Limitations

Studies reviewed were retrospective observational studies with heterogeneity between centers in terms of dosages/protocols for methotrexate use in AA, and adjunctive treatments with a lack of data beyond one year.

Conclusion

Methotrexate is an effective monotherapy or adjunct to corticosteroid in the treatment of severe AA.

https://ift.tt/2KIwOOd

Surgical Pearl: A Granny Sliding Knot for High Tension Closures

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Jeffrey F. Scott, Mona Ascha, Whitney Pollard, Jeremy S. Bordeaux

https://ift.tt/2N3tytt

Ustekinumab treatment for neutrophilic dermatoses associated with Crohn’s disease: a multicenter-retrospective study

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Tullia de Risi-Pugliese, Philippe Seksik, Jean-David Bouaziz, François Chasset, Philippe Moguelet, Jean-Marc Gornet, Anne Bourrier, Aurélien Amiot, Laurent Beaugerie, Camille Francès, Sarah Guégan, Ustek-CDND study group

https://ift.tt/2KOwg9O

Drug-Induced Phototoxicity: A Systematic Review

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Whan B. Kim, A.J. Shelley, K. Novice, J. Joo, H.W. Lim, S.J. Glassman

Abstract

Background

Phototoxicity has been attributed to numerous oral drugs over the past 60 years.

Objective

Determine the quality of evidence supporting suspected phototoxicity from oral drugs

Methods

MEDLINE and EMBASE databases were searched for all studies containing original data for drug-induced phototoxicity published between May 1959 and December 2016. Study quality was assessed using a modified GRADE scale.

Results

The review included 240 eligible studies with a total of 2466 subjects. There were 1134 cases of suspected phototoxicity associated with 129 drugs. Most associations were supported by either very low-quality or low-quality evidence (89.1% of the studies). Medications supported by stronger evidence were vemurafenib, non-steroidal anti-inflammatory drugs (NSAIDs), and antibiotics, specifically fluoroquinolones and tetracyclines. The most frequently reported drugs were: vemurafenib, voriconazole, doxycycline, hydrochlorothiazide, amiodarone, and chlorpromazine. Photobiologic evaluation was performed in only 56 studies (23.3%), while challenge-rechallenge was done in 10% of cases.

Limitations

Only English-language publications were reviewed. Phototoxicity cases incorrectly termed photoallergy would not have been included.

Conclusions

Most purported associations between oral drugs and phototoxicity are not supported by high-quality evidence. Despite the variable quality of data, clinicians should be aware of the possible consequences of chronic use of culprit drugs.

https://ift.tt/2N2T95T

The ALT-70 Predictive Model Outperforms Thermal Imaging for the Diagnosis of Lower Extremity Cellulitis: A Prospective Evaluation

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): David G. Li, Anna K. Dewan, Fan Di Xia, Hasan Khosravi, Cara Joyce, Arash Mostaghimi

Abstract

Background

We previously demonstrated dermatology consultation to substantially reduce cellulitis misdiagnosis rates; however, broad implementation is impractical due to existing practice patterns and reimbursement systems. Meanwhile, efforts to improve diagnostic accuracy have culminated in point-of-care tools, including the ALT-70 predictive model for lower extremity cellulitis and thermal imaging.

Objective

To prospectively evaluate the performance of ALT-70 and thermal imaging in diagnosing lower extremity cellulitis in a head-to-head comparison.

Methods

We collected ALT-70 and thermal imaging data from patients with presumed lower extremity cellulitis and compared classification measures and accuracy for ALT-70, thermal imaging, and combination testing (ALT-70 plus thermal imaging).

Results

We enrolled 67 patients with ALT-70 and thermal imaging data. ALT-70 conferred the highest sensitivity (97.8%) and negative predictive value (90.9%), while combination testing had the highest specificity (71.4%) and positive predictive value (86.6%). ALT-70 had improved classification measures compared to thermal imaging. Combination testing conferred a marginal benefit to ALT-70 alone.

Limitations

Single-center design may limit generalizability.

Conclusion

ALT-70 outperformed thermal imaging in diagnosing lower extremity cellulitis. The accuracy of the ALT-70 was high and consistent with previously published reports. Broad implementation of ALT-70 into clinical practice may decrease misdiagnosis rates of lower extremity cellulitis.

https://ift.tt/2KN4xGf

Mohs micrographic surgery (MMS) with MART-1 immunostaining for atypical intraepidermal melanocytic proliferation (AIMP)

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Jeremy R. Etzkorn, Olivia S. Jew, Thuzar M. Shin, Joseph F. Sobanko, Donald E. Neal, Christopher J. Miller

Abstract

Background

The efficacy of Mohs micrographic surgery (MMS) for atypical intraepidermal melanocytic proliferation (AIMP) is unknown.

Objective

To ascertain the frequency of diagnostic change to melanoma (upstaging) and the frequency of local recurrence after MMS for AIMP. A secondary outcome was the frequency of subclinical spread (defined as the requirement for greater than one stage of MMS to achieve tumor-free margins).

Methods

Retrospective, cross-sectional study of 223 AIMP (with 92.4% located on the head, neck, hand, foot, or pretibial leg) treated with MMS with MART-1 immunostaining.

Results

Upstaging to unequivocal MIS or invasive melanoma was identified in 18.8% (42/223) of all AIMP. The local recurrence rate was 0% (0/223) with a mean follow-up time of 2.7 years (998 days). Subclinical spread was present in 23.8% (53/223) of AIMP.

Limitations

Single site, retrospective design, observational study, lack of objective criteria to diagnose AIMP

Conclusion

MMS with MART-1 immunostaining achieves excellent local control of specialty-site AIMP and permits definitive removal of subclinical spread prior to reconstruction. The central debulking excision should be evaluated with formalin-fixed paraffin-embedded sections, since a significant percentage of AIMP are reclassified as MIS or invasive melanoma.

https://ift.tt/2N3txWr

Pigmentation of basal cell carcinoma is inversely associated with tumor aggressiveness in Asian patients

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Hye-Rim Moon, Tae Jun Park, Ki Woong Ro, Hwa Jung Ryu, Soo Hong Seo, Sang Wook Son, Il-Hwan Kim

https://ift.tt/2KMK2JG

Intralesional Immunotherapy for the Treatment of Warts: A Network Meta-analysis

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Samar Salman, Mohamed Shehata Ahmed, Ahmed Mohamed Ibrahim, Omar Mohamed Mattar, Hassan El-Shirbiny, Sameh Sarsik, Ahmed M. Afifi, Ruba Marwan Anis, Nadim Aiman Yakoub Agha, Abdelrahman Ibrahim Abushouk

Abstract

Background

Without clear evidence, selecting among the existing immunotherapeutic options for warts remains challenging.

Objective

Through network meta-analyses, we aimed to evaluate the comparative efficacy of different intralesional immunotherapeutic modalities.

Methods

We included randomized controlled trials (RCTs) comparing intralesional immunotherapeutic modalities to cryotherapy, placebo or imiquimod. All outcomes were presented as odds ratio (OR) with 95% confidence-interval. Both conventional and network meta-analyses (with a frequentist approach) were conducted on R software. The P-score was used to rank different treatments.

Results

Network meta-analysis of 17 RCTs (1676 patients) showed that PPD (OR=39.56), MMR (OR=17.46) and INF-β (OR=15.55) had the highest efficacy in terms of complete recovery at the primary site, compared to placebo. Regarding complete recovery at the distant site, autoinoculation (OR=79.95), PPD (OR=42.95) and MMR (OR=15.39) were all statistically superior to placebo. According to the P-score, MMR was more effective than other modalities in reducing recurrence rate at the same site.

Limitations

Relatively-small sample size in some comparisons and variability in baseline characteristics.

Conclusion

PPD and MMR were the most effective in achieving complete primary and distant recovery (along with autoinoculation for distant recovery) and reducing the recurrence rate at the same site, compared to cryotherapy and other immunotherapeutic modalities.

https://ift.tt/2N56cUb

Efficacy, Safety, and Comparison of Sonic Hedgehog Inhibitors in Basal Cell Carcinomas: A Systematic Review and Meta-Analysis

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Pingxing Xie, Philippe Lefrançois

Abstract

Background

Sonic Hedgehog Inhibitors (SHHi) provide an additional treatment option for basal cell carcinomas (BCC), especially for metastatic or locally advanced BCC. However, studies have been heterogeneous and lacking direct comparisons between molecules.

Objective

To determine the efficacy and safety of SHHi, as a class of molecules, for treating BCC, and to compare them individually.

Methods

We performed a PRISMA-compliant systematic review of studies followed by a meta-analysis.

Results

Eighteen articles were included in our meta-analysis; sixteen articles were combined for efficacy and sixteen for safety. In locally advanced BCC, Overall Response Rates (ORR) were similar for vismodegib and sonidegib (69% vs. 57%), but not Complete Response Rates (31% vs. 3%). In metastatic disease, the ORR of vismodegib was 2.7-fold higher than the ORR of sonidegib (39% vs. 15%). For side effects affecting a majority of patients, combined prevalences were 67.1%, 54.1% and 57.7% for muscle spasms, dysgeusia, and alopecia, respectively, in similar proportions for sonidegib and vismodegib. Patients receiving sonidegib experienced more upper GI distress than patients receiving vismodegib.

Conclusions

SHHi as a class lead to partial responses for locally advanced BCC disease. Side effects are similar across molecules, common, associated with high discontinuation rates, and warrant discussion beforehand.

https://ift.tt/2KHT4Ys

Topical Glycopyrronium Tosylate for the Treatment of Primary Axillary Hyperhidrosis: Results from the ATMOS-1 and ATMOS-2 Phase 3 Randomized Controlled Trials

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Dee Anna Glaser, Adelaide A. Hebert, Alexander Nast, William P. Werschler, Lawrence Green, Richard Mamelok, Janice Drew, John Quiring, David M. Pariser

Abstract

Background

Glycopyrronium tosylate (GT) is a topical anticholinergic developed for once-daily treatment of primary axillary hyperhidrosis.

Objective

Assess the efficacy and safety of GT for primary axillary hyperhidrosis.

Methods

ATMOS-1 and ATMOS-2 were replicate randomized, double-blind, vehicle-controlled, 4-week phase 3 trials. Patients were randomized 2:1 to GT 3.75% or vehicle applied once daily to each axilla for 4 weeks. Coprimary endpoints were responder rate (≥4-point improvement from Baseline) on Item 2 (sweating severity) of the Axillary Sweating Daily Diary (ASDD), a newly developed patient-reported outcome, and absolute change from Baseline in axillary gravimetric sweat production at Week 4. Safety evaluation included treatment-emergent adverse events (TEAEs).

Results

Pooled data, consistent with individual trial results show significantly more GT-treated patients achieved ASDD Item 2 response versus vehicle (59.5% vs 27.6%) and had reduced sweat production from Baseline (-107.6mg/5min vs -92.1mg/5min) at Week 4 (P<0.001 for both coprimary endpoints). Most TEAEs were mild or moderate and infrequently led to discontinuation.

Limitations

Short trial duration and inherent challenges in gravimetrically assessing sweat production.

Conclusions

Daily, topically-applied GT over 4 weeks reduced sweating severity as measured by ASDD-Item 2, reduced sweat production as measured gravimetrically, and was generally well tolerated in primary axillary hyperhidrosis patients.

https://ift.tt/2N2l2eb

Antiandrogen therapy with spironolactone for the treatment of hidradenitis suppurativa

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Nicole M. Golbari, Martina L. Porter, Alexa B. Kimball

Abstract

Background

Hormonal therapy is a potential treatment for hidradenitis suppurativa (HS). However, little data exists describing the efficacy of spironolactone in HS treatment.

Objective

To assess whether spironolactone treatment improves HS disease severity and patient reported pain.

Methods

We performed a single center chart review of female HS patients treated with spironolactone between 2000 and 2017. Primary outcome measurements included the HS Physician Global Assessment (HSPGA), Hurley Staging, inflammatory lesion count, fistula count, and a numeric rating scale for pain.

Results

Subjects on average were exposed to 75mg of spironolactone daily over a 7.1-month follow-up period. Patients achieved significant disease improvement with regards to pain (Δ-1.5, P=.01), inflammatory lesions (Δ-1.3, P=.02), and HSPGA (Δ-0.6, P<.001). As expected, no change was found for Hurley stage (Δ0, P=.32) or fistulas (Δ0, P=.73). There was no difference in improvement between subjects who received less than 75mg daily (n= 25, average 45mg/day) and those who received greater than 100mg daily (n=21, average 112mg/day).

Limitations

Retrospective nature, limited sample size, and variations in severity measures documented were limiting factors.

Conclusions

Management of HS with spironolactone reduces lesion count, HSPGA and pain. Lower doses appear to be effective and may be an appropriate option for patients with tolerability concerns.

https://ift.tt/2KHSWrW

“Comparing the eighth and the seventh editions of the ajcc staging system and the brigham and women’s hospital alternative staging system for cutaneous squamous cell carcinoma: implications for clinical practice”

Publication date: Available online 10 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): J. Cañueto, J. Burguillo, D. Moyano-Bueno, A. Viñolas-Cuadros, A. Conde-Ferreirós, Luis Antonio Corchete-Sánchez, J. Pérez-Losada, C. Román-Curto

Abstract

Background

The new 8^th edition of the American Joint Committee on Cancer (AJCC) staging system incorporates changes regarding cutaneous squamous cell carcinoma (CSCC).

Objectives

We aimed to compare the 8^th edition of the AJCC (AJCC-8) staging system with the previous 7^th edition (AJCC-7) and the Brigham and Women's Hospital alternative staging system, to identify their usefulness and the utility of their risk factors in defining prognostic groups in CSCC.

Methods

A series of 186 CSCCs of the head and neck was retrospectively collected. All three staging systems were compared in their ability to predict poor prognosis. Binary logistic regression models were built to determine which risk factors were most relevant.

Results

Poor prognosis was mainly associated with T2-AJCC-7, with T2b/T3-BWH's and with T3-AJCC-8. The AJCC-8 and the BWH's staging systems displayed overlap between each other in predicting poor prognosis and both were superior to the AJCC-7. The new risk factors incorporated into the AJCC-8 and the poor degree of differentiation were independently associated with poor outcome.

Limitations

Retrospective study and few cases with bone invasion.

Conclusions

The AJCC-8 is more distinctive, monotonous and homogeneous than the AJCC-7 and shows some overlap in the stratification of tumors with the BWH's system.

https://ift.tt/2MZNiy6

The joint toxicity effect of five antibiotics and dibutyl phthalate to luminescent bacteria ( Vibrio fischeri )

Abstract

Antibiotics and phthalate esters are two kinds of emerging pollutants and are ubiquitous in the aquatic ecosystem. To date, few studies analyzed the combined toxicity of the mixtures of antibiotics and phthalate esters, and their joint toxicity effect mode remains unknown. Here, we investigated the single and joint toxicity of dibutyl phthalate (DBP) and five antibiotics, namely, oxytetracycline hydrochloride (OTC), chlortetracycline hydrochloride (CTC), sulfamethazine (SMZ), sulfamerazine (SMR), and sulfadiazine (SD), to luminescent bacteria of Vibrio fischeri. The median effect concentration (EC₅₀) values of the test chemicals were ranked as CTC (6.67 mg/L) > OTC (25.12 mg/L) > SD (67.61 mg/L) > SMR (141.51 mg/L) > DBP (148.38 mg/L) > SMZ (245.07 mg/L). The joint toxicities of the binary mixtures of antibiotics and DBP were evaluated by the concentration addition (CA) and independent action (IA) models. The joint toxicity effects of CTC-DBP, OTC-DBP, SMZ-DBP, SMR-DBP, and SD-DBP all appeared to be synergism. Our study revealed that sulfonamides combined with DBP could be as toxic as or even more toxic than tetracycline. Thus, the joint toxicity effect should be considered when assessing the ecological risks of binary or multicomponent pollutants.

https://ift.tt/2zzs7kT

Several newly discovered Mo-enriched plants with a focus on Macleaya cordata

Abstract

Phytoremediation as an alternative strategy has been a widespread attention. The screening of enriched plants and hyperaccumulators is the key of the strategy. So this study examined the status of heavy metal pollution in molybdenum (Mo) mine soils, metal accumulation in plants growing on mine, and their tolerance strategies. The analysis of 14 soils and 27 plant samples in mining area showed that Mo, zinc (Zn), and cadmium (Cd) concentrations exceeded soil safety standards and their levels varied in 27 plant samples. Mo was the heavy pollution with an average total content of 256.1 mg/kg in soils. As Mo-enriched plants, Mo concentrations of Macleaya cordata (Willd.) R. Br. and Morus australis Poir. were 704.4 and 772.4 mg/kg, respectively. M. cordata was selected as the research material, due to its high biomass. Molybdenum significantly decreased the biomass and photosynthesis of M. cordata at high concentration (> 200 μmol/L), but its biomass and photosynthesis reached the maximum after 50 μmol/L Mo treatment, respectively. Analysis of the subcellular distribution and chemical speciation showed that Mo was distributed a certain way in the extracts and that this suggested that it may be present in cell wall and soluble fraction of roots (51.9–63.9%; 26.1–44.7%) or shoots (30.0–44.4%; 47.3–56.0%) and complexed to organic acid, pectate, oxalate, and protein. This might be responsible for the adaptation of M. cordata to Mo stress. Therefore, M. cordata could serve as a potential plant to utilize for the phytoremediation of Mo-contaminated soil.

https://ift.tt/2u7Epf7

Relationship between transient severe motion of the liver in gadoxetic acid or iodinated contrast agent-enhanced imaging and arterial oxygen saturation and heart rate changes

Publication date: Available online 10 July 2018

Source: Magnetic Resonance Imaging

Author(s): Akihiko Kanki, Tsutomu Tamada, Toshinori Abe, Hiroyuki Ikenaga, Koji Yoshida, Katsuyoshi Ito

Abstract

Purpose

To clarify the relationship between transient sever motion artifact in arterial phase (TSMA) and changes in peripheral capillary oxygen saturation (SpO₂) and heart rate (HR) after contrast media administration during MRI or CT of the liver.

Methods

87 patients undergoing 61 MRI examination with gadoxetic acid or 26 CT examination with iodinated contrast were included. Dynamic contrast-enhanced imaging (DCEI) was obtained at four vascular phase acquisitions. Reviewers extracted the segmental data of SpO₂ and HR in each phase from consecutive data in DCE-CT or DCE-MRI. In addition, reviewers scored for respiratory motion in each phase using 5-point scale. Patients with an arterial score of 4–5, and other phase scores of 1–2 were considered to be exhibiting TSMA.

Results

In gadoxetic acid, mean SpO₂ of arterial phase was significantly lower than three other phases (P = 0.045 to P < 0.001). However, the decrease in SpO₂ in arterial phase compared with other phases was <1%. Mean HR in gadoxetic acid or iodinated contrast agent was highest in the portal-phase. The incidence of TSM was 0% in patients with iodinated contrast agent and was 8.2% (5/61 patients; TSM group) in patients with gadoxetic acid, respectively. In addition, there was no significant difference in mean SpO₂ of arterial phase between the TSM group (97.5% ± 1.08%) and non-TSM group (96.4% ± 1.85%) (P = 0.219).

Conclusion

The slight decrease in SpO₂ in arterial phase is not associated with TSMA.

https://ift.tt/2KIvHy1

3D Printed Electrodes for Improved Gas Reactant Transport for Electrochemical Reactions

3D Printing and Additive Manufacturing, Ahead of Print.


https://ift.tt/2L4aBpZ

Emerging contaminants removal by granular activated carbon obtained from residual Macauba biomass

Abstract

The removal of emergent contaminants via adsorption on granular activated carbon, prepared from Macauba palm, has been studied, contributing to the recovery of the residual biomass, endocarp, obtained in the Macauba palm oil extraction process. The material was characterized by different techniques, such as Raman spectroscopy, thermal analysis, adsorption/desorption of N₂, zeta potential, and scanning electron microscopy. The N₂ adsorption studies showed that the material presents wide micropores and narrow mesopores, and has a surface area of 907.0 m² g⁻¹. Its maximum adsorption capacity towards the three main emerging contaminants (bisphenol A, ethinylestradiol, and amoxicillin) is much higher than that obtained with benchmark adsorbents (0.148, 0.104, and 0.072 mmol g⁻¹, respectively). The influence of temperature and pH on the adsorption was also analyzed, allowing an improved description of the adsorption mechanism and showing very promising results.

https://ift.tt/2ul2eiu

Concentrations of PCDD/Fs in the neighborhood of a hazardous waste incinerator: human health risks

Abstract

In 1996–1998, a wide surveillance program was initiated in the vicinity of a new hazardous waste incinerator (HWI) placed in Constantí (Catalonia, Spain), which started its regular operations in 1999. The program was aimed at assessing the environmental impact of the facility on the surrounding environment, as well as to evaluate the potential risks for the population living in the neighborhood. Since then, among other measurements, the concentrations of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) have been periodically determined in soil and herbage samples. This study shows the results, corresponding to the period 2013–2016. Data were compared with those obtained in the baseline survey (1996–1998), as well as with those of the previous survey (2011–2012). The median PCDD/F concentrations in soils were 0.44 and 0.33 ng toxic equivalent (I-TEQ)/kg in 2015 and 2016, respectively, with a significant decrease in relation to the baseline survey, and a non-significant decrease between 2015 and 2016. In turn, PCDD/F levels in vegetation showed some fluctuations over time, being the concentrations of PCDD/Fs in 2013 very similar to those found in 2012 (1.11 and 1.23 ng I-TEQ/kg, respectively). These concentrations notably decreased along the three last campaigns (0.16, 0.23, and 0.17 ng I-TEQ/kg in 2014, 2015, and 2016, respectively). These changes would be more related to a number of environmental factors rather than to a variation of PCDD/F emissions by the HWI. With respect to human health risks, exposure to PCDD/Fs in the area under potential influence of the HWI is not of concern, as the current environmental concentrations of PCDD/Fs do not mean additional carcinogenic or non-carcinogenic risks for the local population.

https://ift.tt/2KOesvu

Valorization of biochars from pinewood gasification and municipal solid waste torrefaction as peat substitutes

Abstract

Gasification and torrefaction have both gained significant interest as bioenergy techniques. During biomass gasification together with fuel gas, carbon-rich solid substances are produced, whereas torrefaction process is mainly used to prepare a final product with higher calorific value and carbon content than the feedstock, through a low temperature pyrolysis. Both materials (carbon wastes from gasification and torrefied product) could be classified as alternatives to biochar obtained from slow pyrolysis of biomass. The use of biochar, typically from the slow pyrolysis of biomass, as soil amendment and, more recently, as growing media components has been widely researched. However, to our knowledge, no studies have compared the use of biochar from gasification and torrefaction as growing media component for growing media formulation. The objective of this work was to study the effect of two biochars on peat-based growing media: a pinewood gasification biochar (BG) and a biochar (BT) obtained by torrefaction of the organic fraction of municipal solid waste. Growing media mixing PT (peat) with 50%vol of BG or BT were prepared and characterized according to their chemical, thermal and hydrophysical properties. Phytotoxic experiments and growth of Lolium perenne were also performed. Results indicated that peat substitution in growing media by BG and BT at a 50%vol ratio improved their hydrophysical properties. Specifically, bulk density increased more than 50%, air space increased by 43%, the increment of the total porosity was 20%, and, finally, the water holding capacity increased by 18.3%. Significantly, a positive effect on plant biomass production (yield increment: 274%) was observed after addition of BT, whereas no significant differences were observed after addition of BG biochar. Therefore, it can be concluded that both BT and BG could be used as peat substitutes in growing media formulation.

https://ift.tt/2N1hf0J

Comparative effect of organic amendments on physio-biochemical traits of young and old bean leaves grown under cadmium stress: a multivariate analysis

Abstract

The current study investigated the influence of organic amendments on cadmium (Cd) uptake and its effects on biochemical attributes of young and old leaves of bean. Bean seedlings were exposed to two levels of Cd (25 and 100 μM) in the presence and absence of different levels of ethylenediaminetetraacetic acid (EDTA) and citric acid (CA). An increase in Cd concentration in growth medium significantly enhanced Cd accumulation in bean roots and shoot. Cadmium stress increased the production of H₂O₂ which resulted in lipid peroxidation and decreased chlorophyll contents. The presence of organic amendments significantly affected Cd accumulation and toxicity to bean plants. Application of EDTA alleviated Cd toxicity in terms of chlorophyll contents, H₂O₂ contents, and lipid peroxidation possibly by chelating toxic Cd ions, and as such forming Cd-EDTA complexes. The presence of CA decreased Cd toxicity by decreasing its uptake. The biochemical responses (H₂O₂ contents, lipid peroxidation, and chlorophyll contents) of bean plants were more severely affected by Cd treatments in old leaves compared to young leaves. This study shows that the effect of CA and EDTA on biochemical behavior of Cd varies greatly with applied levels of Cd and amendments as well as the age of leaves. Based on the results, it is proposed that the presence of organic amendments can greatly affect biogeochemical behavior of Cd in the soil-plant system (ecosystem).

https://ift.tt/2L2KSOF

The diagnostic accuracy of increased late night salivary cortisol for Cushing’s syndrome: a real-life prospective study

Abstract

Introduction and aim

A prompt diagnosis of Cushing's Syndrome (CS) in high-risk populations is mandatory: 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and urinary-free cortisol (UFC) are recommended, despite thresholds calculated in retrospective studies. Our aim was to study the diagnostic accuracy of LNSC measured with chemiluminescence assay in a prospective study, confirming discrepancies with mass spectrometry (MS).

Materials and methods

We enrolled 117 controls and 164 suspected CS (CS = 47, non-CS = 117). In case of increased LNSC, high clinical suspicion of CS or adrenal incidentaloma, patients were hospitalized to exclude/confirm CS.

Results

LNSC levels were higher in patients with suspected CS, CS, and non-CS than controls. Considering 16 nmol/L as threshold for CS, overall LNSC revealed SE 97% and SP 84% in the whole group of subjects considered, achieving positive/negative likelihood ratio of 5.56/0.045, respectively. 35 out of 81 subjects with increased LNSC were non-CS (15 diabetic and 20 obese): considering only those patients with increased likelihood to have a CS (the non-CS patients) SP decreased to 70%, and further reduced to 60% if we discharged subjects with adrenal incidentaloma. MS analyses reduced partially the number of false-positive LNSC.

Conclusions

LNSC measured in automated chemiluminescence is reliable in clinical practice: it present a high diagnostic accuracy to exclude hypercortisolism in patients with normal cortisol levels. MS could be used to reduce the number of false-positive results; nevertheless, some non-CS subjects with functional hypercortisolism could have a mild impairment of cortisol rhythm.

https://ift.tt/2L21NUG

RAGE and Its Ligands: Molecular Interplay Between Glycation, Inflammation, and Hallmarks of Cancer—a Review

Abstract

Risk of cancer especially of colon, breast, and pancreas is high in diabetic and obese patients, with potential involvement of augmented expression of RAGE (receptor for advanced glycation end products) and its ligands, namely AGEs (advanced glycation end products), HMGB1 (high-mobility group box 1 protein), and S100 group of proteins. Studies have reported the involvement of RAGE activation by its ligands in growth and survival of cancers, including metastasis and poor prognosis. We propose that this receptor-ligand axis provides the molecular link between certain pre-existing states as hypoxia, hyperglycemia, glycation, inflammation, oxidative stress, and onset of cancers. The chronic inflammatory, hyperglycemic milieu accompanied by glycoxidative stress as in diabetes and obesity, concomitant with the formation of RAGE ligands, instigates RAGE and cancer stem cells, leading to the oncogenic transformation of normal and pre-malignant tissues towards development of neoplasms. We have aimed to elucidate the complete signalling map initiated upon RAGE-ligand splicing, from oncogenesis to progression, epithelial-mesenchymal transition, invasion, cancer stem cell renewal, chemo-resistance, and cancer relapse. We have attributed the complex molecular functions of RAGE-ligand signalling cues to every aspect of cancer promotion, explaining the central network in bridging glycation, inflammation, oxidation, and the hallmarks of cancer. Underlining the substantial requisite for anti-neoplastic agents targeting RAGE and its ligands, we have explicitly discoursed RAGE and its allied components (AGEs, soluble RAGE, RAGE gene polymorphisms) as potential diagnostic and prognostic biomarkers for prompt detection of cancers and implication in impending RAGE-ligand directed, novel combinatorial, and targeted onco-therapeutics.

https://ift.tt/2m697Rn

Severe Graves’ Orbitopathy occurring in a patient with thyroid hemiagenesis

https://ift.tt/2L2QkBl

Pattern of dysphagia after swallowing-sparing intensity-modulated radiotherapy (IMRT) of head and neck cancers: results of a mono-institutional prospective study

Abstract

Background and purpose

A prospective instrumental assessment of late dysphagia using swallowing organs at risk (SWOARs)-sparing IMRT for nasopharyngeal and oropharyngeal cancers.

Materials and methods

Objective instrumental assessment included fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VFS) at baseline, and at 6 and 12 months after treatment. FEES assessed the pharyngeal residue according to the Farneti pooling score (P-score) as follows: 4–5 no dysphagia; 6–7 mild dysphagia; 8–9 moderate dysphagia; 10–11 severe dysphagia. Three different consistencies were tested for the P‑score: liquid (L), semisolid (SS), and solid (S). VFS assessed penetration-aspiration according to the Penetration-Aspiration Scale (PAS) and two different consistencies of the bolus were tested: thin liquid barium (L) and paste barium (S).

Results

38 patients were evaluable. There was a significant worsening of the P‑score at 6 months both for SS (p = 0.015) and S (p < 0.001), which persisted only for S at 12 months (p < 0.0001). Similarly, there was a significant worsening of the PAS score at 6 and 12 months (p = 0.065 and 0.039, respectively) for the S bolus. Overall, 3–7 and 10–14% aspiration after L and S was observed, respectively.

Conclusions

Promising results using a SWOARs-sparing IMRT technique are reported. Therefore, treatment plans should be optimized for reducing doses to these structures.

https://ift.tt/2NES3y7

Stellenwert der stereotaktischen Radiotherapie für das nichtresezierte Pankreaskarzinom

https://ift.tt/2KZ0kvm

Neoadjuvante Chemotherapie vor radikaler Hysterektomie beim Zervixkarzinom – Response ist nicht Überleben

https://ift.tt/2KUl22F

Adjustment of insulin doses when switching from glargine 100 U/ml or detemir to degludec: an observational study

Abstract

Background

Degludec is a long-acting insulin with a longer duration of action and a greater day-to-day reproducibility of absorption in comparison with previous long-acting insulin formulations. The aim is the definition of the change in insulin needs in patients switching from detemir/glargine to degludec in real-life conditions.

Methods

In this retrospective cohort observational study, all outpatients with either type 1 or type 2 diabetes, starting therapy with degludec insulin—after a prior treatment with either detemir or glargine insulin for at least 6 months—were included.

Results

The analysis was performed on 266 patients, 172 and 96 with type 1 and type 2 diabetes, respectively. The equations describing the relationship between baseline and follow-up doses of basal insulin (6 months) were Y = 3.39 + 0.78X and Y = 0.44 + 0.69X, in patients receiving detemir/glargine either once or twice daily, respectively (Y = degludec dose at 6 months and X = basal insulin dose at switch). The corresponding equations for prandial insulin doses were y = 1.83 + 0.83*x and y = 2.85 + 0.80*x for those on pre-switch once or twice-daily basal insulin, respectively. In type 2 diabetes, the switch was associated with a reduction of basal insulin doses only in those with a prior twice-daily treatment with basal insulin. The reduction of prandial insulin reached statistical significance only in patients previously treated with basal insulin once daily.

Conclusions

The present results provide a suggestion for a simple method for the adjustment of basal and prandial insulin doses in type 1 diabetic patients, switching from glargine or detemir to degludec.

https://ift.tt/2zlKMjL

Self-reported quantity, compulsiveness and motives of exercise in patients with eating disorders and healthy controls: differences and similarities

Abstract

Background

Compulsive exercise (CE) is a frequent symptom in patients with eating disorders (EDs). It includes, in addition to quantitatively excessive exercise behaviour, a driven aspect and specific motives of exercise. CE is generally associated with worse therapy outcomes. The aims of the study were to compare self-reported quantity of exercise, compulsiveness of exercise as well as motives for exercise between patients with anorexia nervosa (AN), bulimia nervosa (BN) and healthy controls (HC). Additionally, we wanted to explore predictors of compulsive exercise (CE) in each group.

Methods

We investigated 335 female participants (n = 226 inpatients, n = 109 HC) and assessed self-reported quantity of exercise, compulsiveness of exercise (Compulsive Exercise Test), motives for exercise (Exercise Motivations Inventory-2), ED symptoms (Eating Disorder Inventory-2), obsessive-compulsiveness (Obsessive-Compulsive Inventory-Revised), general psychopathology (Brief Symptom Inventory-18) and depression (Beck Depression Inventory-2).

Results

Both patients with AN and BN exercised significantly more hours per week and showed significantly higher CE than HC; no differences were found between patients with AN and BN. Patients with EDs and HC also partly varied in motives for exercise. Specific motives were enjoyment, challenge, recognition and weight management in patients with EDs in contrast to ill-health avoidance and affiliation in HC. Patients with AN and BN only differed in regard to exercise for appearance reasons in which patients with BN scored higher. The most relevant predictor of CE across groups was exercise for weight and shape reasons.

Conclusions

Exercise behaviours and motives differ between patients with EDs and HC. CE was pronounced in both patients with AN and BN. Therefore, future research should focus not only on CE in patients with AN, but also on CE in patients with BN. Similarities in CE in patients with AN and BN support a transdiagnostic approach during the development of interventions specifically targeting CE in patients with EDs.

https://ift.tt/2N1OQrs

Cultural Adaptation and Piloting of a Smoking Cessation Intervention for Smokers With HIV

Conditions:   Hiv;   Cigarette Smoking
Intervention:   Behavioral: Computer delivered smoking cessation counseling
Sponsor:   Johns Hopkins University
Recruiting

https://ift.tt/2u61xdU

Changes in the Microenvironment of HPV-induced Head and Neck Cancers in West Indies and Metropolitan Population

Condition:   Immunotherapy
Intervention:   Biological: Immunotherapy
Sponsors:   University Hospital Center of Martinique;   European Georges Pompidou Hospital
Recruiting

https://ift.tt/2zu6XnQ

Cost analysis of a wait-and-see strategy after radiochemotherapy in distal rectal cancer

Abstract

Background

Nonoperative management (NOM) of rectal cancer after radiochemotherapy (RtChx) in patients with a clinical complete response is an emerging strategy with the goal to improve quality of life without compromising cure rates. However close monitoring with both magnetic resonance imaging (MRI) and rectoscopy is required for the early detection of possible local regrowths. We therefore performed a cost analysis comparing the costs of immediate surgery with the costs for MRI and rectoscopy during surveillance as in the upcoming CAO/ARO/AIO-16 trial.

Methods

MRIs and rectoscopies of patients with a clinical complete response after RtChx over the course of 5 years were simulated and compared with immediate surgery after RtChx. Transition probabilities between health stages (no evidence of disease, local regrowth and salvage surgery, distant failure) were derived from the literature. Costs for ambulatory imaging and endoscopic studies were calculated according to the "Gebührenordnung für Ärzte" (GOÄ), costs for surgery based on the diagnosis-related groups system. Three different scenarios with higher costs for salvage surgery or higher regrowth rates were simulated.

Results

A patient without disease recurrence will generate costs for MRI and rectoscopy of 6344 € over 5 years compared with costs of 14,511 € for immediate radical surgery. When 25% local regrowths with subsequent salvage surgery were included in the model, the average costs per patient are 8299 €. In our simulations a NOM strategy was cost-saving compared with immediate surgery in all three scenarios.

Conclusion

A NOM strategy with an intensive surveillance using MRI and rectoscopy will produce costs that are expected to remain below those of immediate surgery.

https://ift.tt/2uhPPfs

Current and future treatment of hidradenitis suppurativa

British Journal of Dermatology, EarlyView.


https://ift.tt/2KMwQF2

A Chinese herbal medicine preparation (PTQX) for children with moderate to severe atopic eczema: a pilot RCT

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2N3ahbN

Methotrexate restores the function of peripheral blood regulatory T cells in psoriasis vulgaris via the CD73/AMPK/mTOR pathway

British Journal of Dermatology, EarlyView.


https://ift.tt/2KMwK08

Correction to: Brevibacillus laterosporus isolated from the digestive tract of honeybees has high antimicrobial activity and promotes growth and productivity of honeybee’s colonies

The original publication of this paper contains a mistake. The correct affiliation no. 3 is shown in this paper.

https://ift.tt/2zoX1MA

A theoretical and experimental study of the temporal reduction in UV protection provided by a facial day cream

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KJExeO

Process optimization via response surface methodology in the physico-chemical treatment of vegetable oil refinery wastewater

Abstract

The present paper investigates the efficiency of coagulation/flocculation process using aluminum sulfate as coagulant and CHT industrial flocculent as coagulant aid/flocculent in the treatment of vegetable oil refinery wastewater (VORW). The process optimization was conducted in two steps, jar test experiments for preliminary evaluation to identify the most influencing factors and response surface methodology using Box–Behnken design to investigate the effects of three major factors and their interactions. The variables involved were the coagulant concentration (X₁), flocculent dosage (X₂), and initial pH (X₃) of water samples, while the responses were COD removal (Y1) and residual turbidity (Y2). The optimal conditions obtained by solving the quadratic regression models, as well as by analyzing the response surface contour plots, were as follows: 2.4 g/L of coagulant (aluminum sulfate), 60.05 mg/L of flocculent, and about 9.23 as initial pH. Under these conditions, the coagulation/flocculation treatment was able to achieve 99% of COD removal with total turbidity elimination (100% removal). Analysis of variance showed high variance coefficient (R²) values of 0.929 and 0.836 for COD and turbidity removals, respectively, thus ensuring a satisfactory adjustment of the second-order regression model with the experimental data. This statistical design methodology was demonstrated as an efficient and feasible approach for the optimization of coagulation/flocculation treatment.

https://ift.tt/2KHMlOk

New applied pharmacological approach/trend on utilization of agro-industrial wastes

Abstract

This study aimed to transform the locally available lignocellulosic residual palm frond (PF) and rice straw (RS) wastes into multifunction added products like methylated cellulose and sulfated and phosphorylated hemicelluloses by simple processes. Hydrolysis with 2 N sulfuric acid was the most suitable reaction for microcrystalline cellulose production. The characteristics of the prepared products were studied to obtain the optimum reaction conditions. Palm frond hemicellulose (PFHC) recorded the highest antimicrobial activity against Staphylococcus aureus, Escherichia coli, and Candida albicans (22, 22, 26 mm), respectively, and phosphorylated palm frond hemicellulose (PPFHC) exhibited the highest potential antioxidant activity of approximately 60%, suggesting a possible correlation between the two bioactivities. Most of extracted celluloses and their derivatives had a variety of promising probiotic activities which are expected to reduce the side effects of the gastric mucosa and possibly play a role in curing the gastric ulcer. Accordingly, the determination of anti-inflammatory and gastroprotective activity results revealed that methylcellulose, sulfated and phosphorylated hemicelluloses showed anti-inflammatory and gastroprotective activities and the capability of all tested compounds to ameliorate the ethanol-induced gastric ulcer in rats' stomach. All results recommended PF and RS and their derivatives to be used as a medicinal food.

https://ift.tt/2m4Ub5X

CH 4 flux and methanogen community dynamics from five common emergent vegetations in a full-scale constructed wetland

Abstract

To investigate the effects of emergent plants on CH₄ efflux and elucidate the key factors responsible for these effects, annual monitoring of CH₄ emissions and methanogen community dynamics in a full-scale constructed wetland (CW) was conducted. Five emergent plants (Typha orientalis, Cyperus alternifolius, Arundo domax, Iris pseudacorus, and Thalia dealbata) commonly used in CWs were selected for investigation. The greatest CH₄ flux (annual mean 19.4 mg m⁻² h⁻¹) was observed from I. pseudacorus, while the lowest CH₄ flux (7.1 mg m⁻² h⁻¹) was observed from Thalia dealbata. The CH₄ flux from five emergent plants showed marked seasonal variation. Total nitrogen (TN) and total phosphorous (TP) were weakly correlated with CH₄ emissions, whereas total carbon (TC) and root biomass of plants were positively correlated with CH₄ emissions. Quantitative real-time PCR (q-PCR) analysis indicated that the gene abundance of eubacterial 16S rRNA, particulate methane monooxygenase (pmoA) and methyl coenzyme M reductase (mcrA) significantly differed among plant species. Differences in TC, root biomass, and dissolved oxygen (DO) caused by plant species were potential factors responsible for differences in methanogens, methanotrophs, and CH₄ emissions. Methanobacteriaceae, Methanoregulaceae, Methanomicrobiaceae, and Methanosarcinaceae were the dominant families of methanogens. The pathways of methanogenesis from the five emergent plants differed, with the main pathway being hydrogenotrophic, while both hydrogenotrophic and acetotrophic methanogens were involved in A. domax. Redundancy analysis (RDA) further indicated that emergent plant types had a profound influence on the methanogenic communities. Taken together, these results suggest emergent plant species can significantly influence CH₄ fluxes in CW through microbial communities, biochemical pathways for methanogenesis, TC, and DO. Furthermore, plant species in CWs should be considered an important factor in evaluating greenhouse gases emission. Finally, it is necessary to effectively manage CWs vegetation to maximize their environmental benefits.

Graphical abstract

ᅟ

https://ift.tt/2J5zj7q

Dentin pretreatment with Er:YAG laser and sodium ascorbate to improve the bond strength of glass fiber post

Abstract

Root-filled teeth that received fiber posts most frequently fail at the adhesive interface between resin cement and dentin. The objective of this study is to evaluate the effect of Er:YAG laser and/or sodium ascorbate (SA) on bond strength, microhardness of dentin, and penetration depth of cement into dentinal tubules. Forty-eight bovine incisor roots were endodontically treated, post spaces were prepared and equally divided into four groups (n = 12): G1—distilled water (control); G2—10% SA (10 min); G3—Er:YAG laser (150 mJ/4 Hz/40 s), and G4—Er:YAG laser + 10% SA. Glass fiber posts were cemented and roots sectioned into slices. In the first slice, the push-out bond strength (MPa) and failures were analyzed by confocal laser scanning microscope (CLSM). The second slice was subjected to microhardness test (KHN) and CLSM to assess the cement penetration. ANOVA and Tukey test were used for bond strength and microhardness data and Kruskal-Wallis and Dunn tests for the cement penetration (α = .05). The SA-treated samples had higher bond strength (10.02 ± 5.45a), similar to Er:YAG laser (9.91 ± 4.62a) and Er:YAG laser + SA (8.09 ± 4.07a). The least values (P < .05) were found on control (4.02 ± 2.39b). Significant differences were observed on root thirds (P < .05): cervical > middle > apical. There was a predominance of adhesive failures. The microhardness test revealed no differences between groups (P > .05). The experimental groups (G2, G3, and G4) had highest penetration into dentinal tubules when compared to the control (G1). Dentin pretreatments with Er:YAG laser or SA improved bond strength of cement-post-dentin interfaces; however, no synergistic effect of both treatments combined was observed.

https://ift.tt/2m5bxj6

Three new Brazilian cases of 17α-hydroxylase deficiency: clinical, molecular, hormonal, and treatment features

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


https://ift.tt/2u3ViXY

Symptomatic Rathke cleft cyst in paediatric patients – clinical presentations, surgical treatment and postoperative outcomes – an analysis of 38 cases

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


https://ift.tt/2zm2K5J

Autoimmune liver disease serology in acute hepatitis E virus infection

Publication date: Available online 7 July 2018

Source: Journal of Autoimmunity

Author(s): Benedetta Terziroli Beretta-Piccoli, Paolo Ripellino, Claudio Gobbi, Andreas Cerny, Adriana Baserga, Claudia Di Bartolomeo, Florian Bihl, Gaia Deleonardi, Laura Melidona, Ana Gabriela Grondona, Giorgina Mieli-Vergani, Diego Vergani, Luigi Muratori, Swiss Autoimmune Hepatitis Cohort Study Group

Abstract

The etiology of autoimmune hepatitis (AIH) is unknown, though hepatotropic viruses may be potential triggers. Hepatitis E virus (HEV) infection, an increasingly recognized cause of acute hepatitis, has been misdiagnosed as AIH due to the occurrence of autoantibodies during its acute phase. It has also been suggested that HEV infection may lead to or unmask AIH. The HEV seroprevalence has been ascertained in patients with AIH, but the prevalence of AIH-related autoantibodies in patients with HEV infection has not been systematically tested. We aimed to investigate whether acute HEV infection is associated with the presence of AIH-relevant autoantibodies, following the liver autoimmune serology guidelines of the International AIH Group. We tested 48 patients with acute HEV infection. Half of them had at least one autoantibody, 17% two autoantibodies. Anti-nuclear antibody (ANA) were detected in 16 (33%), anti-smooth muscle antibody (SMA) in 10 (21%), and anti-neutrophil cytoplasmic antibody (ANCA) in 7 (14.6%). Of note, two patients showed SMA with VG or VGT patterns and five had ANA with homogeneous appearance, both being typical of AIH type 1. Other AIH-specific autoantibodies were negative. Atypical anti-mitochondrial antibody, without evidence of primary biliary cholangitis, was positive in one patient, disappearing at follow-up. Follow-up (median 12 months) serum was available from seven autoantibody positive patients: two became negative, while five remained positive, although no patient developed AIH to date. In conclusion, autoantibodies are frequently present during acute HEV infection, indicating that HEV should always be excluded before diagnosing AIH. Importantly, a minority of patients with acute hepatitis E develops AIH-specific autoantibodies, and, though they did not progress to autoimmune liver disease in the short-term, they warrant long-term monitoring.

https://ift.tt/2m4O3KW

Catastrophic antiphospholipid syndrome: Lessons from 14 cases successfully treated in a single center. A narrative report

Publication date: Available online 7 July 2018

Source: Journal of Autoimmunity

Author(s): Amelia Ruffatti, Giustina De Silvestro, Piero Marson, Marta Tonello, Antonia Calligaro, Maria Favaro, Teresa Del Ross, Ariela Hoxha, Elena Mattia, Vittorio Pengo

Abstract

The study aimed to evaluate the clinical significance of laboratory findings in patients with catastrophic antiphospholipid syndrome (CAPS) and to report the effects of a well-defined treatment protocol in 14 consecutive cases.

Thirteen patients (12 presenting one and one presenting two episodes of CAPS) were consecutively treated and monitored between 1986 and 2017. Antiphospholipid antibody (aPL) characteristics of the patients were compared with those of 64 matched controls (45 antiphospholipid syndrome patients and 19 aPL carriers) who did not develop CAPS during the same mean follow-up period (12 years ± 9.9 SD).

Triple aPL positivity (IgG/IgM anticardiolipin + IgG/IgM anti-β2Glycoprotein I + lupus anticoagulants) significantly prevailed in the CAPS patients with respect to the controls (p = 0.003). IgG anticardiolipin and IgG anti-β2Glycoprotein I mean antibody titers of the CAPS patients were significantly higher than those of the controls (p = 0.0018 and p = 0.003, respectively). Triple therapy (anticoagulation + plasma exchange + steroids) was administered to all the CAPS cases except for one. Beginning in 2009, intravenous immunoglobulin infusion has also been included in the triple therapy protocol (six patients). All the patients recovered from CAPS; five showed renal failure and one a I-II class New York Heart Association (NYHA) dilated cardiomyopathy. Long-term outcomes of CAPS included a gradual worsening of renal failure in one patient who required hemodialysis 30 years after the acute episode. Renal function improved in the other four patients. The patient affected with dilated cardiomyopathy worsened to a II class NYHA over a five year period. Currently all the patients are alive.

A specific antiphospholipid antibody profile could be considered a risk factor associated to CAPS. Early use of a defined treatment protocol based on triple therapy either or not associated with IVIG was associated with recovery in all CAPS patients.

https://ift.tt/2zhP23Z

The association between reproductive success with persistent organochlorine pollutants residue in feathers of spur-winged lapwing ( Vanellus spinosus L.)

Abstract

The reproductive and breeding success of wader species is negatively affected by various anthropogenic factors, including persistent organochlorine pollutants (POPs). We aimed to study the association of POPs in feathers with the reproductive success of the spur-winged lapwing (Vanellus spinosus). For this purpose, data on reproductive parameters and feather samples were collected from a breeding population consisting of 19 pairs near Boğazkent district in Antalya, Turkey. Mean concentrations of total polychlorinated biphenyls (ΣPCBs) and organochlorine pesticides (ΣOCPs) were found to be 54 ± 16 ng/g and 520 ng/g in all samples, respectively. In particular, PCB 151 and β-hexachlorocyclohexane had a negative association the various reproductive parameters in the species under consideration. Fledgling success (n = 25) was calculated to be 37.4%, which was negatively associated with the ΣOCP concentrations (r = − 0.99, p = 0.01). According to the results, POP residues are one of the associated factors on the reproductive success of spur-winged lapwing along, with agricultural activity and predation. It is indicated that the species needs a protection plan for prevention declining reproductive success and population size species in Turkey. Besides, our results suggest that bird feathers are a non-destructive bio-monitoring tools to estimate of contamination levels of organic pollutants in a population.

https://ift.tt/2uigdGa

Scholar : Chinese Archives of Otolaryngology-Head and Neck Surgery, Year 2018, Issue 05 -New Issue Alert.

New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Chinese Archives of Otolaryngology-Head and Neck Surgery. Year 2018 Issue 05 is now available on CAOD. In this issue: Clinical analysis of Madelung's disease (多发性对称性脂肪瘤病临床分析) LIU Jianmin, CAO Shuwei, YANG Zhongyuan, Department of Otolaryngology Head and Neck Surgery, Deyang Hospital, Chengdu University of TCM, People's Hospital of Deyang City, Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center ...... page:229-232 Relationship between indexes of the anterior inferior cerebellar artery, the basilar artery and the blood lipid level in patients with sudden deafness (突发性聋患者小脑下前动脉、基底动脉与血脂水平关系) WANG Han, GENG Yuanyuan, HUO Yingjie, LI Jianbin, WANG Yanlei, Department of Otolaryngology, Central Hospital of China National Petroleum Corporation ...... page:233-236 2018 nian ben kan zhi jie shi yong suo lue yu de yi xue ci hui (2018年本刊直接使用缩略语的医学词汇) ...... page:236 Styloid process syndrome with head and neck pain as the initial symptom (以头颈部疼痛为首发症状的茎突综合征分析) WANG Zhenxiao, CAO Xiaoming, ZHANG Aobo, LU Cheng, LIU Liangfa, Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Department of Otolaryngology, Dezhou People's Hospital ...... page:237-239 yi bi zhong ge chuan kong wei zhu yao zheng zhuang de xi tong xing hong ban lang chuang 1 li (以鼻中隔穿孔为主要症状的系统性红斑狼疮1例) LENG Hui, SUN Haibo, LV Hong ...... page:240 Application of enhanced recovery after surgery in patients after endoscopic septoplasty (加速康复外科在鼻中隔偏曲矫正术中的应用研究) WU Xifu, KONG Weifeng, WANG Weihao, ZHOU Shaoli, XU Huiqing, YANG Qintai, Department of Otolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Department of Anesthesia, the Third Affiliated Hospital of Sun Yat-sen University ...... page:241-245 zhong guo er bi yan hou tou jing wai ke guo ji er bi yan hou tou jing wai ke za zhi wang luo yuan cheng tou gao shen gao xi tong shi yong shuo ming (《中国耳鼻咽喉头颈外科》、《国际耳鼻咽喉头颈外科杂志》网络远程投稿审稿系统使用说明) ...... page:245 Modified septoplasty with three high tension lines resection (三线减张法鼻中隔成形术的主观和客观疗效分析) WANG Tong, ZANG Hongrui, LI Yunchuan, ZHOU Bing, HAN Demin, Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education ...... page:246-250 Intranasal endoscopic dacryocystorhinostomy for chronic dacryocystitis (经鼻内镜泪囊鼻腔吻合术51例疗效分析) CHEN Xiaodong, PENG Jingjing, SHI Zhaohui, QIAO Li, ZHA Dingjun, CHEN Fuquan, Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Medical University of Airforce, Department of Otolaryngology, Second People's Hospital of Shanxi Province, Senna Otolaryngology Head and Neck Surgery Hospital ...... page:251-254 zhong guo yi liao bao jian guo ji jiao liu cu jin hui er bi yan hou tou jing wai ke fen hui 2018 nian hui zuo hua xia er bi yan hou tou jing wai ke lun tan tong zhi (中国医疗保健国际交流促进会耳鼻咽喉头颈外科分会2018年会暨华夏耳鼻咽喉头颈外科论坛通知) ...... page:254 Evaluation of bony change in noninvasive fungal sinusitis with computed tomography (非侵袭性真菌性鼻-鼻窦炎患者鼻窦骨质改变的CT评估) TIAN Peng, ZOU Hua, WANG Jingyi, LIU Xiang, DANG Hua, CHEN Qiujian, PAN Zhong, MA Yun, WU Fan, OU Huangshuang, Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital ...... page:255-258 Analysis of the surgical efficacy for patients with severe obstructive sleep apnea hypopnea syndrome and metabolic syndrome (手术对重度阻塞性睡眠呼吸暂停低通气综合征合并代谢综合征患者疗效分析) HUA Na, LI Xianhua, JIANG Tao, GUO Ying, Department of Otolaryngology, Zhongshan Hospital Affliated to Dalian University ...... page:259-261 Application of modified Maury cuff-leak test to evaluate laryngeal passage before extubation (改良Maury气囊漏气试验在成人拔管前评估咽喉通道的应用) BAO Weiliang, TANG Shixiong, WANG Yaowen, CHENG Peng, CHEN Xudong, CHEN Xing, LI Chunlin, KONG Deqiu, Medical School of Ningbo University, Department of Otolaryngology, the First Hospital of Ningbo ...... page:262-264 wan gu xing bi chu xue de chu xue bu wei ji zhi liao tan tao (顽固性鼻出血的出血部位及治疗探讨) KE Juying ...... page:265-266 deng li zi fu zhu bi nei jing xia shuang jin lu fa shang zuo zuo hou bi kong xi rou qie chu shu (等离子辅助鼻内镜下双进路法上颌窦后鼻孔息肉切除术) MA Qinglin, LIU Zemin, LI Wenjie ...... page:267-268 she jia zhuang she guan nang zhong 3 li (舌甲状舌管囊肿3例) XIAO Shufen, LI Xiaoming, TAO Zhenfeng, CHEN Kun ...... page:269-270 lei ji mi zou shen jing de bu dian xing hunt zong he zheng 3 li (累及迷走神经的不典型Hunt综合征3例) LI Haixia, ZHANG Zuoran, HU Haili ...... page:271-272 fu fa xing zuo gu gu liu bing fa dan zhi liu ji mi lu zuo guan 1 li (复发性颞骨骨瘤并发胆脂瘤及迷路瘘管1例) MA Shuaishuai, GUAN Guofang, ZHANG Dejun, HAO Yanru, GUO Yingzuo, ZHU Zhiling ...... page:273-274 Application and prospect of enhanced recovery after surgery in otolaryngology (加速康复外科理念在耳鼻咽喉头颈外科中的应用价值) ZHANG Yu, SONG Xicheng ...... page:275-278 Diagnostic value of narrow band imaging in laryngeal cancer: A meta-analysis (窄带成像技术诊断喉癌价值的Meta分析) HOU Yun, SHE Ningning, ZHANG Xiaobing, Department of Otolaryngology Head and Neck Surgery, the First Hospital of Lanzhou University, the First Clinical Medical College of Lanzhou University ...... page:279-284 mei guo ting li xue nian hui hui yi yi ti mu lu you ci kui shi mei guo ting li xue yan fa fang xiang (美国听力学年会会议议题目录 由此窥视美国听力学研发方向) ZHANG Hua ...... page:285-286+284 di 16 jie ting li xuan yun zhen liao ji shu yan tao ban hui yi ji yao (第16届听力眩晕诊疗技术研讨班会议纪要) ZHANG Dai, BI Jingzuo ...... page:287-288 CAOD TOC Alerts Note Thank you for choosing CAOD Table of Contents (TOC) Alert Service. You are receiving this email because you have requested to receive information from CAOD as a registered user of our Table of Content Alert for journals. To manage your TOC Alerts, please click here. For all enquiries, problems or suggestions regarding this service, please contact info@oriprobe.com. China/Asia on Demand (CAOD) Customer Service

Scholar : Stomatology, Year 2018, Issue 06 -New Issue Alert.

New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Stomatology. Year 2018 Issue 06 is now available on CAOD. In this issue: chuan chen pi su dui kou qiang lin zhuang xi bao ai xi bao cal-27 zeng zhi qian yi he qin xi de ying xiang (川陈皮素对口腔鳞状细胞癌细胞Cal-27增殖、迁移和侵袭的影响) HOU Chunning, ZHANG Xuesong, LI Guolin ...... page:481-484 ke - xin jie gou dian fang xian wei mo dui mc3t3-e1 xi bao ti wai zao qi cheng gu fen hua de ying xiang ("壳-芯"结构电纺纤维膜对MC3T3-E1细胞体外早期成骨分化的影响) HU Zuoying, CHEN Hanbang, CHEN Gang, ZHOU Xuefeng, LIU Jun, ZHANG Feimin ...... page:485-490 gao zhi ruan si liao zeng jia fei pang fu he ya zhou yan xiao shu mo xing si xian song tuo lv de yan jiu (高脂软饲料增加肥胖复合牙周炎小鼠模型丝线松脱率的研究) YU Ting, ZHAO Li, ZHANG Jincai, XUAN Dongying ...... page:491-494 bu tong liu dong xing fu he shu zhi he cai liao zai duan shi chao guang qiang zhao she xia de ju he xiao guo (不同流动性复合树脂核材料在短时超光强照射下的聚合效果) LIU Fangyu, NIE Rongrong, MENG Xiangfeng, XU Shaoping ...... page:495-498 suz12 zai she lin ai zhong de biao da ji lin chuang yi yi (SUZ12在舌鳞癌中的表达及临床意义) HU Huijun, LI Zhongwu, WANG Qiong, WU Yaping, YANG Jianrong ...... page:499-502+513 ya zuo zuo zuo dan bao jun ci ji shu tu zhuang xi bao ji huo yan zheng fan ying (牙龈卟啉单胞菌刺激树突状细胞激活炎症反应) SONG Liang, XU Bin, LIU Yang, LIU Liuhui, ZHENG Yicai, XIAO Guozuo, SHI Xiaojun ...... page:503-507 he tang ti dan bai l29 zai ya zuo lin zhuang xi bao ai zhong biao da de lin chuang bing li yi yi (核糖体蛋白L29在牙龈鳞状细胞癌中表达的临床病理意义) XUE Jiao, DUAN Qingyun, YANG Shaobin, PANG Baoxing, YUAN Rongtao ...... page:508-513 nd:yag ji guang he er:yag ji guang zhi liao zhong du ya zhou yan de xiao guo guan cha (Nd:YAG激光和Er:YAG激光治疗重度牙周炎的效果观察) CAO Ying, WU Wenlei, XUE Yaqin, SUN Weibin ...... page:514-517 liang zhong fan ban fang shi zai xia zuo zhong di wei zu sheng zhi chi ba chu zhong de liao xiao yan jiu (两种翻瓣方式在下颌中低位阻生智齿拔除中的疗效研究) WANG Lingxiao, LI Jun, DAN Zhaochen, GAO Zhenhua ...... page:518-522 cad/cam quan ci sui gao qian ti zai ya ti que sun zhong de lin chuang ying yong yan jiu (CAD/CAM全瓷髓高嵌体在牙体缺损中的临床应用研究) ZHANG Lei, RU Feiyazulati, HE Huiyu, GE Fei ...... page:523-527 wu chuang jian ce kou qiang bai ban ji lin ai zhong ren ru tou liu bing du ji fen xing (无创检测口腔白斑及鳞癌中人乳头瘤病毒及分型) YANG Liqun, XIAO Zuo, LI Chenzuo, WU Wenzuo, SHEN Xuemin, ZHOU Zengtong, FAN Zuo, SHI Linjun ...... page:528-532 210 li gen guan zhi liao shi bai bing li de gen jian x xian pian he zhui xing shu ct de ying xiang xue fen xi (210例根管治疗失败病例的根尖X线片和锥形束CT的影像学分析) YU Xiaozuo, WU Daming, WANG Xinyang, LIU Weihong ...... page:533-536 guan yu cai yong ke ji qi kan xue shu bu duan wen xian jian ce xi tong (amlc) de sheng ming (关于采用《科技期刊学术不端文献检测系统(AMLC)》的声明) ...... page:536 di yi mo ya que shi bu tong xiu fu fang fa de yao he jie chu te zheng yan jiu (第一磨牙缺失不同修复方法的咬合接触特征研究) HAN Zuo, ZENG Xiaoyan, SUN Yazhou, HU Jian ...... page:537-542 cbct jie he wei chuang ji shu yu chuan tong ji shu ba chu mai fu duo sheng ya de lin chuang bi jiao (CBCT结合微创技术与传统技术拔除埋伏多生牙的临床比较) NI Weijia, LIN Xiaopeng, YAO Fang ...... page:543-547 kou qiang yi xue za zhi kai tong guan fang gong gong wei xin fu wu hao (《口腔医学》杂志开通官方公共微信服务号) ...... page:547 ying yong t-scan xi tong dui xie zhuang que sun huan ya zuo jie chu de yan jiu (应用T-scanⅢ系统对楔状缺损患牙接触的研究) NIE Jingjing, FENG Jiafei ...... page:548-551 ju he suo gan jun yu da chang ai guan xi de yan jiu jin zhan (具核梭杆菌与大肠癌关系的研究进展) CHEN Yulian, SUN Ying ...... page:552-555 zheng ji teng tong de lin chuang yan jiu (正畸疼痛的临床研究) WU Zuo, ZUO Weinan, ZHANG Xuewen, WANG Hua, CHEN Wenjing ...... page:556-559 chang yong zheng ji bao chi qi de dui bi yan jiu (常用正畸保持器的对比研究) ZUO Weinan, XU Zuozhangyuan, WU Zuo, WANG Hua, CHEN Wenjing ...... page:560-562+568 fu he shui ning jiao zhi jia zai gu zu zhi gong cheng zhong de ying yong (复合水凝胶支架在骨组织工程中的应用) cheng , ZHANG Feimin ...... page:563-568 guang dong li liao fa zai kou qiang zhong zhi ti zhou wei yan zhong de ying yong jin zhan (光动力疗法在口腔种植体周围炎中的应用进展) ZHOU Linzuo, GU Yingxin, LAI Hongchang ...... page:569-572 shang qi dao fen xi de yan jiu jin zhan (上气道分析的研究进展) XU Zuozhangyuan, ZUO Weinan, CHEN Wenjing ...... page:573-576 CAOD TOC Alerts Note Thank you for choosing CAOD Table of Contents (TOC) Alert Service. You are receiving this email because you have requested to receive information from CAOD as a registered user of our Table of Content Alert for journals. To manage your TOC Alerts, please click here. For all enquiries, problems or suggestions regarding this service, please contact info@oriprobe.com. China/Asia on Demand (CAOD) Customer Service