Scholar : ΑΠΟΚΑΤΑΣΤΑΣΗ - νέα αποτελέσμ

[PDF] Εμπλουτισμοί σε εσωτερικά νερά της Ελλάδας: η περίπτωση της λίμνης Αμβρακίας

Ε Πατσέα - 2018

… περιλαμβάνει: α) την αποκατάσταση φυσικών πληθυσμών (restocking),
β) την πρόσθεση νέου είδους (addition) και γ)την αποκατάσταση
κατεστραμμένου οικοσυστήματος (augmentation). Οι εμπλουτισμοί …

ΑΤΟΜΑ ΜΕ ΟΠΤΙΚΗ ΑΝΑΠΗΡΙΑ: ΤΑ ΚΙΝΗΤΡΑ ΚΑΙ ΤΑ ΕΜΠΟΔΙΑ ΣΤΗ ΜΕΤΑΛΥΚΕΙΑΚΗ ΕΚΠΑΙΔΕΥΣΗ

Ε Θεοδωράκου - 2018

… Αρχικά διερευνήθηκαν οι Μέσοι Όροι και οι Τυπικές Αποκλίσεις για τους λόγους, τις
προσδοκίες, τα οφέλη, τα εμπόδια και τους τρόπους αντιμετώπισης τους, τους τρόπους
υποστήριξης από τον εκπαιδευτή ενηλίκων και την επαγγελματική τους αποκατάσταση …

Γνώσεις και απόψεις φοιτητών νοσηλευτικής για θέματα επιληψίας

Χ ΚΑΡΑΣΟΥΛΗ, Ε ΚΟΚΑ - 2018

… Τα αίτια της επιληψίας διαφέρουν ανάλογα με την ηλικία του ατόμου ενώ μπορεί να είναι
γενετικά ή επίκτητα. Τα συμπτώματα, η κλινική εικόνα, η διάρκεια και η μετακριτική
αποκατάσταση διαφέρουν ανάλογα με το είδος της επιληπτικής κρίσης …

Προσωπική, κοινωνική, εκπαιδευτική και επαγγελματική εξέλιξη αποφοίτων σε Σχολεία Δεύτερης Ευκαιρίας: Η περίπτωση των ΣΔΕ Φλώρινας, Αμυνταίου και …

Α ΜΑΣΣΗ - 2018

… παράγοντες υποκίνησης των εκπαιδευομένων για την παρακολούθηση
μαθημάτων στα Σ.Δ.Ε., αφορούν την προσωπική ικανοποίηση δηλαδή την
επιθυμία να τελειώσουν κάτι που οι περισσότεροι είχαν αφήσει …

Τα Προγράμματα Κατάρτισης Ενηλίκων στο Τομέα της Ένδυσης, και η επιρροή της ρομποτικής στην Απασχολησιμότητα των Καταρτιζομένων

Ε Γκαϊδατζή - 2018

… Η αλματώδης αύξηση της ρομποτικής και στον κλάδο της παραγωγής ενδυμάτων, έρχεται
σε αντίθεση με τους παραδοσιακούς τρόπους, που ενώ είναι χρήσιμοι, δεν είναι
ανταγωνιστικοί στην μελλοντική επαγγελματική αποκατάσταση των καταρτιζομένων …

[PDF] Μελέτη και κατασκευή κυλινδρικού τυμπάνου με ελεγχόμενο αριθμό περιστροφών για συλλογή νανοδομημένων ινωδών πολυμερών

Α Σαρακίνης - 2018

… προσωρινά, σε επαφή με το πολύπλοκο περιβάλλον των ιστών του ανθρώπινου σώματος,
με σκοπό την αποκατάσταση της δομικής ακεραιότητας και της λειτουργίας των ιστών» …
αντικατάσταση και/ή την αποκατάσταση της λειτουργίας των τραυματισμένων ή …

Υδρογεωλογικό καθεστώς λεκάνης Θριασίου Πεδίου με έμφαση στα γεωυδραυλικά χαρακτηριστικά των υδροφόρων οριζόντων και στην ποιότητα των υπόγειων υδάτων

Δ Ερμίδης - 2018

… των υδρογεωλογικών συνθηκών που επικρατούν στην περιοχή μέσα από
την διερεύνηση της υδραυλικής σχέσης των υδροφορέων με την θάλασσα,
την διερεύνηση των ποιοτικών χαρακτηριστικών του υπόγειου νερού με …

[PDF] Ο ρόλος του κοινοτικού νοσηλευτή στη διαχείριση της ψυχικής νόσου στην κοινότητα

Δ ΣΤΕΡΓΙΟΠΟΥΛΟΥ - 2018

Page 1. ΤΕΙ ΔΥΤΙΚΗΣ Ε ΣΧΟΛΗ ΕΠΑΓΓΕΛΜΑΤΩΝ ΥΓ ΤΜΗΜΑ ΝΟΣΗΛ
ΠΤΥΧΙΑΚΗ Ε «Ο ΡΟΛΟΣ ΤΟΥ ΚΟΙΝΟΤΙΚ ΔΙΑΧΕΙΡΙΣΗ ΤΗΣ ΨΥΧΙΚΗΣ ΝΟ
ΣΠΟΥΔΑΣΤΡΙΑ ΕΙΣΗΓΗΤΗΣ 1 ΤΕΙ ΔΥΤΙΚΗΣ ΕΛΛΑΔΑΣ ΕΠΑΓΓΕΛΜΑΤΩΝ …

[PDF] Η σχιζοφρένεια στους ενήλικες και η σύγχρονη νοσηλευτική παράμβαση

Ν ΧΑΡΤΣΕΝΚΟ - 2018

… Σκοπός: Σκοπός της παρούσας εργασίας είναι η ανασκόπηση της
σχιζοφρένειας στους ενήλικες και των συμπτωμάτων της, η πορεία της νόσου,
η θεραπεία της, καθώς και η φροντίδα που πρέπει να παρέχεται από τους …

[PDF] Αξιολόγηση και εκτίμηση του πόνου με χρήση διεπαφών εγκεφάλου υπολογιστή και μεθόδους μηχανικής μάθησης.

Α Καλησπεράτης - 2018

Page 1. ΤΕΧΝΟΛΟΓΙΚΟ ΕΚΠΑΙΔΕΥΤΙΚΟ ΙΔΡΥΜΑ ΗΠΕΙΡΟΥ ΤΜΗΜΑ ΜΗΧΑΝΙΚΩΝ
ΠΛΗΡΟΦΟΡΙΚΗΣ Τ.Ε. ΠΤΥΧΙΑΚΗ ΕΡΓΑΣΙΑ ΑΞΙΟΛΟΓΗΣΗ ΚΑΙ ΕΚΤΙΜΗΣΗ ΤΟΥ ΠΟΝΟΥΜΕ
ΧΡΗΣΗ ΔΙΕΠΑΦΩΝ ΕΓΚΕΦΑΛΟΥ ΥΠΟΛΟΓΙΣΤΗ ΚΑΙ ΜΕΘΟΔΟΥΣ ΜΗΧΑΝΙΚΗΣ ΜΑΘΗΣΗΣ …

 

Δημιουργία λίστας των ειδοποιήσεών μου

Ακύρωση ειδοποίησης

Αυτή η ειδοποίηση αποστέλλεται από τον Μελετητή Google. Ο Μελετητής Google είναι μια υπηρεσία που παρέχεται από την Google.

Scholar : Undersea "Hyperbaric Medicine" - νέα αποτελέσματα

Qualified Clinical Data Registries: How Wound Care Practitioners Can Make the Most Out of the Merit-Based Incentive Payment System

CE Fife, D Walker, KA Eckert - Advances in Wound Care, 2018

… Table 2. Examples of wound care and hyperbaric medicine improvement activities
approved by the Centers of Medicare and Medicaid Services, which can also be used
for Maintenance of Certification in Undersea and Hyperbaric Medicine 20 …

[PDF] Микроциркуляция в коже верхних конечностей и параметры центральной гемодинамики при часовом дыхании чистым кислородом

АП Памова, АВ Суворов, АА Федорович - Регионарное кровообращение и …, 2018

… 2015;42(1):9-13. 5. Camporesi EM, Bosco G. Hyperbaric oxygen pre treat-
ment and preconditioning. Undersea Hyperb Med. 2014; 41(3):259-263 …
9. Jain KK. Textbook of Hyperbaric Medicine. Springer International …

[PDF] Fiziologija ljudskog ronjenja

A Boroš - 2018

Page 1. SVEUČILIŠTE U ZAGREBU PRIRODOSLOVNO MATEMATIČKI FAKULTET
BIOLOŠKI ODSJEK ZAGREB FACULTY OF SCIENCE BIOLOGICAL DEPARTMENT
ZAGREB Fiziologija ljudskog ronjenja Human diving physiology Almos Boroš …

[PDF] IDENTIFIKASI TANDA DAN GEJALA PENYAKIT DEKOMPRESI PADA PENYELAM TRADISIONAL DI DESA BOKORI KECAMATAN SOROPIA

KKR INDONESIA, PK KENDARI

Page 1. IDENTIFIKASI TANDA DAN GEJALA PENYAKIT DEKOMPRESI PADA PENYELAM
TRADISIONAL DI DESA BOKORI KECAMATAN SOROPIA KABUPATEN KONAWE KARYA
TULIS ILMIAH Diajukan Sebagai Salah Satu Syarat Untuk Melakukan Pendidikan …

 

Δημιουργία λίστας των ειδοποιήσεών μου

Ακύρωση ειδοποίησης

Αυτή η ειδοποίηση αποστέλλεται από τον Μελετητή Google. Ο Μελετητής Google είναι μια υπηρεσία που παρέχεται από την Google.

Dynamics of antimicrobial resistance of Helicobacter pylori isolates in the Smolensk region of Russian Federation

Helicobacter, EarlyView.


https://ift.tt/2CMRCjs

Successful Helicobacter pylori eradication therapy improves symptoms of chronic constipation

Helicobacter, EarlyView.


https://ift.tt/2Cl344r

Safety and Utility of Hybrid Depth Electrodes for Seizure Localization and Single-Unit Neuronal Recording

Background: Invasive electrode monitoring provides more precise localization of epileptogenic foci in patients with medically refractory epilepsy. The use of hybrid depth electrodes that include microwires for simultaneous single-neuron monitoring is becoming more widespread. Objective: To determine the safety and utility of hybrid depth electrodes for intracranial monitoring of medically refractory epilepsy. Methods: We reviewed the medical charts of 53 cases of medically refractory epilepsy operated on from 2006 to 2017, where both non-hybrid and hybrid microwire depth electrodes were used for intracranial monitoring. We assessed the localization accuracy and complications that arose to assess the relative safety and utility of hybrid depth electrodes compared with standard electrodes. Results: A total of 555 electrodes were implanted in 52 patients. The overall per-electrode complication rate was 2.3%, with a per-case complication rate of 20.8%. There were no infections or deaths. Serious or hemorrhagic complications occurred in 2 patients (0.4% per-electrode risk). Complications did not correlate with the use of any particular electrode type, and hybrids were equally as reliable as standard electrodes in localizing seizure onset zones. Conclusions: Hybrid depth electrodes appear to be as safe and effective as standard depth electrodes for intracranial monitoring and provide unique opportunities to study the human brain at single-neuron resolution.
Stereotact Funct Neurosurg

https://ift.tt/2IXT0Qc

The importance of ethics in dermatopathology: a fellow’s perspective

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2QTy0wL

Mononuclear phagocyte system function and nanoparticle pharmacology in obese and normal weight ovarian and endometrial cancer patients

Abstract

Purpose

Obesity may alter mononuclear phagocyte system (MPS) function and the pharmacology and efficacy of nanoparticles therapies, such as PEGylated liposomal doxorubicin (PLD). We aimed to evaluate the relationships between hormone and chemokine mediators of MPS function and the pharmacokinetic (PK) exposure of PLD in obese and normal weight patients with ovarian and endometrial cancer.

Methods

Hormone and chemokine mediators in obese and normal weight ovarian and endometrial cancer patients were measured. A separate pharmacology study was performed that evaluated the relationship between serum hormone concentrations, MPS function, and PK disposition of PLD in refractory ovarian cancer patients.

Results

Univariate analysis revealed a significant relationship between serum estradiol and body mass index (OR 8.64, 95% CI 2.67–28.0, p < 0.001). Estrone and testosterone concentrations were positively correlated with MPS function (ρ = 0.57 and 0.53, p = 0.14 and 0.18, respectively) and inversely correlated with PLD PK exposure (ρ = − 0.75 and − 0.76, respectively, p = 0.02 for both).

Conclusions

Higher MPS function resulting in reduced PLD exposure is a potential mechanism for reduced efficacy of PLD and other nanoparticles observed in obese patients with cancer. PK simulations suggest higher doses of PLD are required in obese patients to achieve similar exposures as standard dosing in normal weight patients.

https://ift.tt/2Ep5Dp0

Issue Information

Dermatologic Therapy, Volume 31, Issue 5, September/October 2018.


https://ift.tt/2EqwUrf

Antimicrobial peptides activity in the skin

Skin Research and Technology, EarlyView.


https://ift.tt/2OpnxfQ

Interactive thermal tissue reactions of 7‐MHz intense focused ultrasound and 1‐MHz and 6‐MHz radiofrequency on cadaveric skin

Skin Research and Technology, EarlyView.


https://ift.tt/2IYHWm5

Diagnostic and Prognostic Relevance of Red Blood Cell Distribution Width for Vascular Aging and Cardiovascular Diseases

Rejuvenation Research, Ahead of Print.


https://ift.tt/2AcK9Y5

18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot study

Sharonjeet Kaur, Nusrat Shafiq, Sunil Dogra, BR Mittal, Savita Verma Attri, Ajay Bahl, Tarun Narang, Keshavamurthy Vinay, Sujit Rajagopalan, Samir Malhotra

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):660-666

Background: Psoriasis is a systemic inflammatory disorder associated with an increased risk of cardiovascular disease. Objective: To evaluate the utility of [[18]F]-fluorodeoxyglucose positron emission tomography/computed tomography in identifying vascular and systemic inflammation in psoriasis patients with moderate-to-severe disease and to analyze its usefulness in assessing the effect of systemic treatment. Methods: This was a randomized, double-blind pilot study conducted in a tertiary care center. Baseline standardized uptake value score was estimated by18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with moderate-to-severe psoriasis and compared with historical controls. Patients were then randomized using computer-generated randomization list into methotrexate or placebo (with or without pioglitazone) groups.18F-fluorodeoxyglucose positron emission tomography/computed tomography was repeated at 12 weeks and composite standardized uptake value score determined. The correlation between Psoriasis Activity and Severity Index and SUVmax was assessed. Results: A total of 16 patients were randomized to different treatment groups. Significant increase in mean SUVmax was observed in the ascending aorta in psoriasis patients as compared to historical controls (2.03 ± 0.53 vs 1.51 ± 0.36, P < 0.03). There was no difference in composite standardized uptake value score after 12 weeks of treatment in any of the treatment groups (P = 0.82), although an improvement in Psoriasis Activity and Severity Index score in the methotrexate arm was observed. No correlation was found between mean SUVmax and Psoriasis Activity and Severity Index scores in various aortic segments (r = 0.3–0.7). Limitations: Small sample size, short follow-up, historical controls, exclusion of patients with comorbid conditions and lack of surrogate markers of systemic inflammation. Conclusion: 18F-fluorodeoxyglucose positron emission tomography imaging showed higher vascular inflammation in ascending aorta of psoriasis patients as compared to historical controls. Systemic treatment with methotrexate and pioglitazone did not influence the vascular inflammation in the short term.

https://ift.tt/2QS4fMT

A treatise on topical corticosteroids in dermatology. Use, misuse and abuse

Debabrata Bandyopadhyay

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):761-762



https://ift.tt/2QS4O9t

Histoid leprosy presenting with figurate lesions: A unique and rare presentation

Angoori Gnaneshwar Rao, Amit Kolli, Syeda Saba Farheen, Uday Deshmukh Reddy, Aparna Karanam, Kranthi Jagadevapuram, Ruhi Haqqani

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):736-739



https://ift.tt/2Ab11hV

N-acetylcysteine in dermatology

Mohammad Adil, Syed Suhail Amin, Mohd Mohtashim

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):652-659

N-acetylcysteine is a mucolytic drug which is commonly used as an antidote for acetaminophen toxicity. It is a thiol compound, which acts as a donor of cysteine, leading to replenishment of glutathione and thus acts as an antioxidant. It also has anti-inflammatory effects, alters the levels of neurotransmitters, inhibits proliferation of fibroblasts and keratinocytes and causes vasodilatation. Due to these actions, n-acetylcysteine has found use in several dermatologic conditions in systemic and topical form. The drug has been used as an adjuvant in the management of conditions such as toxic epidermal necrolysis, drug hypersensitivity syndrome, trichotillomania, skin picking disorders and onychotillomania, ichthyoses, contact dermatitis, atopic dermatitis, melasma, pseudoporphyria, connective tissue diseases, wound healing and alopecia. It also has a role in protection from radiation-induced skin damage including photo-ageing, photocarcinogenesis and radiation dermatitis. Most indications in dermatology are supported by case reports, small case series and small trials. Higher quality of evidence is needed for its wider use. The drug is cheap and is generally safe with few adverse effects. Thus a greater role is possible for use of n-acetylcysteine in various skin conditions. This review explores the various uses of n-acetylcysteine in the field of dermatology, the evidence supporting the same, the possible mechanisms of action and the adverse effects of the drug.

https://ift.tt/2QSIVqB

Differential expression of capecitabine-induced hand foot syndrome on paretic limb

Tapaswini Tripathy, Bhabani STP Singh, Debasmita Behera, Bikash Ranjan Kar

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):720-722



https://ift.tt/2AcJaHu

Four views of trichomycosis axillaris: Clinical, Wood's lamp, dermoscopy and microscopy

Vishal Gupta, Vinod Kumar Sharma

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):748-749



https://ift.tt/2AcJaqY

A study of prevalence of autoantibodies in patients with lichen planus from Mumbai, India

Kinjal Deepak Rambhia, Vidya Kharkar, Vandana Pradhan, Manisha Patwardhan, Kanjaksha Ghosh, Uday S Khopkar

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):667-671

Background: Lichen planus is a common chronically relapsing autoimmune skin condition with poorly understood etiology. Apart from cellular immunity, presence of various antibodies has been hypothesized. Various studies have found the presence of serum anti-nuclear antibody, anti-mitochondrial antibody, anti-desmoglein 1 and 3 antibodies, anti-keratinocyte antibody and anti-thyroglobulin antibody in patients of cutaneous and oral lichen planus. Aim: To study the prevalence of autoantibodies and the clinical spectrum of disease in an Indian patient subpopulation with lichen planus. Methods: A cross-sectional epidemiological study comprising 100 lichen planus patients was conducted in the dermatology outpatient department of Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India. Serum concentrations of circulating anti-nuclear antibodies, anti-desmoglein 1 antibody, anti-desmoglein 3 antibody, anti-keratinocyte antibodies, anti-mitochondrial antibodies and anti-thyroglobulin antibodies were determined by indirect immunofluorescence. Pairs of groups were compared using "Student's t-test" for normally distributed continuous data. The "χ2-test" was used for the categorical variables as needed. Statistical significance was set at P < 0.05. Results: It was found that 65 (65%) patients showed the presence of at least one of the six autoantibodies that we studied, while 35 (35%) tested negative for all six of them. Positivity of anti-keratinocyte antibody in 26 (26%), anti-nuclear antibody in 22 (22%), anti-desmoglein 1 antibody in 19 (19%), anti-desmoglein 3 antibody in 16 (16%), anti-mitochondrial antibody in 9 (9%) and anti-thyroglobulin antibody in 6 (6%) patients was detected. It was observed that 55 (71.4%) patients of cutaneous lichen planus, 6 (46.1%) patients of mucosal lichen planus and 4 (40%) patients of cutaneous and mucosal lichen planus overlap showed presence of at least one autoantibody. Conclusion: This study provides the serological parameters of a population of lichen planus from western India. Presence of autoantibodies in lichen planus suggests the possible role of humoral immunity in lichen planus. Identifying antibodies linked to lichen planus may help in identifying suitable diagnostic tests and therapeutic targets. Well-controlled studies with larger sample size are the need of the hour to confirm the role of humoral immunity in lichen planus. Limitations: Studies with a larger number of patients as well as controls should be undertaken to further evaluate the role of autoantibodies in lichen planus.

https://ift.tt/2QS4ojp

Medical journalism and social media: A boon and a bane?

Saumya Panda

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):647-651



https://ift.tt/2AbEh1x

Proposed global drooping and wrinkles classification and scoring system for aging face with validation and experience on 54 Indian subjects

Suruchi Garg, Nishat Khan, Shyamkumar Makadia

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):672-677

Background: Aging is an inevitable biological change, but understanding the process of aging of face is important to customize the treatment options for facial rejuvenation. Evidence-based estimation of global facial aging is necessary for the validation of various treatment modalities. Aims: Classification and implementation of a scoring system for aging face based upon volume loss and surface changes as evident by drooping of different areas of the face and appearance of fine and deep wrinkles, respectively, and to apply this drooping–wrinkles classification on 54 participants to evaluate and understand the validity of scoring. Methods: An observational study was conducted, and scores were calculated based on 13 parameters (7 areas of drooping and 6 areas of wrinkles on the face) at Aura Skin Institute, Chandigarh, India. Accordingly, age was divided in different age groups followed by clinical estimation of facial age and calculation of scores. Results: According to our classification and scoring system, 61% (33 out of 54) of the participants were correlated with their chronological age group. Out of the remaining 21 (39%) participants who were aging faster, 13 (24%) were in the age group of 25–35 years. Approximately one-fourth of the patients in the age groups 36–45 and 46–55 years were aging faster. Only 1 patient had scores showing younger age in comparison to chronological age. Overall, there was a good correlation between the calculated score and the chronological age of patients. Moreover, a gradual increase in scores was noticed with increasing age groups. Conclusions: This is a new clinical classification and scoring system for facial age which is much easier to apply in daily clinical practice for easy calculation of baseline scores and customizing their antiaging treatment options. Moreover, it will also make it easier to compare the efficacy of treatment in their future follow-ups. The limitation of this study is that it has been proposed for all skin types but validation has been done only for Indian participants.

https://ift.tt/2QS4iIz

Dermatoscopy of multiple piloleiomyomas with disseminated and segmental distribution

Mirjana Popadić, Dimitrije Brasanac, Mirjana Milinković, Danijela Milčić

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):726-729



https://ift.tt/2Ab0Bbl

A prospective study of the epidemiological and clinical patterns of recurrent dermatophytosis at a tertiary care hospital in India

Sucheta Pathania, Shivaparkash M Rudramurthy, Tarun Narang, Uma N Saikia, Sunil Dogra

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):678-684

Background: Recurrent and clinically unresponsive dermatophytosis is being increasingly encountered in our country. It runs a protracted course with exacerbations and remissions. However, there is little information regarding the extent of the problem and the characteristics of recurrent dermatophytosis in published literature. Aims: We sought to determine the prevalence, risk factors and clinical patterns of recurrent dermatophytosis in our institution. We also investigated the causative dermatophyte species and antifungal susceptibility patterns in these species. Methods: One hundred and fifty patients with recurrent dermatophytosis attending the outpatient department of the Postgraduate Institute of Medical Education and Research, Chandigarh, India were enrolled in the study conducted from January 2015 to December 2015. A detailed history was obtained in all patients, who were then subjected to a clinical examination and investigations including a wet preparation for direct microscopic examination, fungal culture and antifungal susceptibility tests. Results: Recurrent dermatophytosis was seen in 9.3% of all patients with dermatophytosis in our study. Trichophyton mentagrophytes was the most common species identified (36 patients, 40%) samples followed by T. rubrum (29 patients, 32.2%). In-vitro antifungal susceptibility testing showed that the range of minimum inhibitory concentrations (MIC) on was lowest for itraconazole (0.015–1), followed by terbinafine (0.015–16), fluconazole (0.03–32) and griseofulvin (0.5–128) in increasing order. Limitation: A limitation of this study was the absence of a suitable control group (eg. patients with first episode of typical tinea). Conclusion: Recurrence of dermatophytosis was not explainable on the basis of a high (MIC) alone. Misuse of topical corticosteroids, a high number of familial contacts, poor compliance to treatment over periods of years, and various host factors, seem to have all contributed to this outbreak of dermatophytosis in India.

https://ift.tt/2QS3Xph

Congenital alopecia of eyebrow

Deepak Jakhar, Chander Grover

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):743-744



https://ift.tt/2Ac359s

Acral angioosteoma cutis: A rare case

Senay Erdogan-Durmus, Selver Ozekinci, Enver Yarikkaya, Nurhan Erzurumluoglu

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):685-686

Acral angioosteoma cutis is a rare and benign cutaneous lesion clinically characterized by an exophytic growth resembling pyogenic granuloma on the acral skin; first described in 2006. Its pathogenesis is still unclear while well-formed capillaries, pale stroma, bland fibroblast-like cells, and multiple tiny spicules of woven bone constitute the histological hallmarks. Here, we present a case of acral angioosteoma cutis in a 34-year-old man to increase awareness regarding this rare condition.

https://ift.tt/2QSfgxE

Transepidermal elimination: Historical evolution, pathogenesis and nosology

Hiral Shah, Anup Kumar Tiwary, Piyush Kumar

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):753-757



https://ift.tt/2AbWGLr

Bilateral “turkey ear” as a cutaneous manifestation of lupus vulgaris

Yingjie Lu, Hongmiao Wang, Hua Zheng, Xiao Li

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):687-689

Lupus vulgaris is a common form of cutaneous tuberculosis in China, mostly involving the head and neck region. Turkey ear is a clinically descriptive term, used for a massively enlarged earlobe with bluish-red or violaceous indurated plaques and nodules, which can be a sign of lupus vulgaris. A 47-year-old female presented with edema and reddish ulcerated lesions on both ears which was diagnosed as lupus vulgaris by conventional laboratory investigations and the patient showed good response to antituberculous therapy. Occurrence of turkey ears in lupus pernio (sarcoidosis) should also be mentioned here as this presentation was originally described in this condition. Two case reports of turkey ear have been reported with cutaneous tuberculosis (not bilateral). However, occurrence of bilateral turkey ears in cutaneous tuberculosis has not been described so far in the literature.

https://ift.tt/2QS3N19

Reversible twisted and rolled hairs due to manual twisting: Two case reports

Di-Qing Luo, Juan-Hua Liu, Rashmi Sarkar, Yu-Kun Zhao, Fang Wang, Hui-Hui Wu

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):763-763



https://ift.tt/2Acdm5s

Revisiting the role of the slit-skin smear in the diagnosis of Indian post-kala-azar dermal leishmaniasis

Aradhana Bhargava, V Ramesh, Sandeep Verma, Poonam Salotra, Manju Bala

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):690-695

Background: Post kala azar dermal leishmaniasis (PKDL) is a neglected dermatosis that develops as a sequel to kala azar after apparent complete treatment. Being a non life threatening condition, patients often delay treatment thereby maintaining a reservoir of infection. The diagnosis of PKDL rests on the demonstration of the parasite in tissue smears, immune diagnosis by detection of parasite antigen or antibody in blood, or detection and quantitation of parasite DNA in tissue specimens. Sophisticated molecular tests are not only expensive but also need skilled hands and expensive equipment. To be useful, diagnostic methods must be accurate, simple and affordable for the population for which they are intended. Aims: This study was designed to assess functionality and operational feasibility of slit-skin smear examination. Methods: Sensitivity and specificity was evaluated by performing slit-skin smear and histo-pathological examination in 46 PKDL patients and the results were compared with the parasite load in both the slit aspirate and tissue biopsy specimens by performing quantitative Real-time PCR (Q-PCR). Results: The slit-skin smear examination was more sensitive than tissue biopsy microscopy. The parasite loads significantly differed among various types of clinical lesions (P < 0.05). The threshold of parasite load for detection by SSS microscopy was 4 parasites/μl in slit aspirate and 60 parasites/μg tissue DNA in tissue biopsy while that for tissue microscopy was 63 parasites/μl and 502 parasites/μg tissue DNA respectively. As detection of Leishmania donovani bodies may be challenging in inexperienced hands, the microscopic structure of these has been detailed along with a comprehensive discussion of pre analytical, analytical and post analytical variables affecting its identification. To facilitate the diagnosis of PKDL, some scenarios have been suggested taking into consideration the clinical, epidemiological, immunological and microscopic aspects. Conclusion: Such evidence based medicine helps minimize intuition, systematize clinical experience and provides a diagnostic rationale as sufficient grounds for a clinical decision.

https://ift.tt/2QSKV26

Adverse cutaneous events after laser epilation in patients with photodermatosis

Laura Cubells Sánchez, Blanca Ferrer Guillén, José Luis Sánchez Carazo, Amparo Pérez Ferriols

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):718-720



https://ift.tt/2AcJ8iQ

Study of the relation between two common cyclooxygenase 2 gene polymorphisms with risk of developing and subtypes of vitiligo in Egyptian patients

Samar Abdallah M Salem, Dalia Gamal Aly, Khalda Sayed Amr, Mahmound Fawzy Abdel-Hamid

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):696-700

Background/Purpose: Genetic factors play an important role in the pathogenesis of vitiligo. Cyclooxygenase 2 (COX2) gene induced by ultraviolet radiation controls the synthesis of prostaglandins, which are are found to be beneficial in treating vitiligo. COX2 gene polymorphism has been previously evaluated in Chinese population. We aimed to study the relation between two common COX2 gene polymorphisms with vitiligo and its subtypes amongEgyptian patients. Patients and Methods: This study included 200 participants (100 vitiligo patients and 100 healthy controls). COX2-765G/C and -1195A/G gene polymorphism was studied by restriction fragment length polymorphism polymerase chain reaction analysis and the results were compared between the two groups and among different subtypes of vitiligo. Results: Frequency of COX2-1195 AA, AG, GG genotypes showed no significant association among patients with vitiligo (P = 0.626, 0.321, 0.08, respectively); those with generalized vitiligo (P = 0.739, 0.291, 0.101, respectively) and those with segmental vitiligo (P = 0.410, 1.00, 0.676, respectively) compared to the control group. Regarding COX2-765G/C genotypes, GG genotype was more frequent among patients with vitiligo [84 (84%)] compared to controls [63 (63%)] (P = 0.001). GC genotype was significantly less frequent [15 (15%)] among patients compared to controls [32 (32%)] (P = 0.005). Generalized and segmental types of vitiligo also showed no significant difference in the frequency of COX2-765G/C genotypes compared with controls. Limitations: Being a pilot study, a relatively small number of participants were included. Conclusion: COX2-1195A/G gene polymorphism is not associated with the risk of developing vitiligo or with vitiligo subtypes. COX2-765 GG genotype is associated with vitiligo, especially of the generalized type.

https://ift.tt/2QS3C5Z

Docetaxel induced pellagroid dematitis

Preema Sinha, Aradhana Sood, Sukriti Baveja, Vikas Pathania

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(6):723-725



https://ift.tt/2AchaE0

Methotrexate polyglutamate levels and co-distributions in childhood acute lymphoblastic leukemia maintenance therapy

Abstract

Purpose

Methotrexate polyglutamates (MTXpg) facilitate incorporation of thioguanine nucleotides into DNA (DNA-TG, the primary cytotoxic thiopurine metabolite and outcome determinant in MTX/6-mercaptopurine treatment of childhood ALL). We hypothesized that mapping erythrocyte levels of MTXpg with 1–6 glutamates and their associations with DNA-TG formation would facilitate future guidelines for maintenance therapy dosing.

Methods and results

Summed MTX with 1–6 glutamates resolved by LCMS [median (interquartile): 5.47 (3.58–7.69) nmol/mmol hemoglobin] was in agreement with total MTX by radio ligand assay. In 16,389 blood samples from 1426 ALL maintenance therapy patients, MTXpg3 21.0 (15.2–27.4)% was the predominant metabolite, and MTXpg1 (the maternal drug) constituted 38.6 (27.2–50.2)% of MTXpg1–6. All subsets correlated; the strongest associations were between metabolites with similar polyglutamate lengths. Correlations of MTXpg1 with MTXpg2 and MTXpg3,4,5,6 were r_s = 0.68 and r_s = 0.25–0.42, respectively. Intercorrelations of MTXpg3,4,5,6 were all r_s ≥ 0.51. MTXpg4 accounted for 29.8 (24.7–33.3)% of MTXpg3–6, yet explained 96% of the summed MTXpg3–6 variation. MTXpg1–4, MTXpg1–6, MTXpg2–6 and MTXpg3 were all associated with DNA-TG levels (p < 0.00001), but collinearity precluded identification of the most informative subset.

Conclusions

Measuring erythrocyte MTXpg4 simplifies and can replace longer chain MTXpg monitoring. Resolving individual MTXpg identifies samples that are unsuitable for dose guidance due to high levels of MTXpg1 remaining in the plasma fraction because of recent MTX intake. All tested MTXpg subsets correlated with DNA-TG and may be used for ALL maintenance therapy dose adjustments, but the most informative subset remains to be identified.

https://ift.tt/2IWwxTB

Awakening the “guardian of genome”: reactivation of mutant p53

Abstract

The role of tumor suppressor protein p53 is undeniable in the suppression of cancer upon oncogenic stress. It induces diverse conditions such as cell-cycle arrest, cell death, and senescence to protect the cell from carcinogenesis. The rate of mutations in p53 gene nearly accounts for 50% of the human cancers. Upon mutations, the conformation gets altered and becomes non-native. Mutant p53 displays long half-life and accumulates in the nucleus and interacts with oncoproteins to promote carcinogenesis and these interactions present a formidable challenge for clinicians in therapy of the disease. Variety of approaches have been developed, through which native-like function of p53 can be restored, such as restoration of the native-like structure of p53, activating the p53 family members, etc. Modern scientific techniques have led to the discovery of a variety of molecules to reactivate mutant p53 and restore its transcriptional activity. These compounds include small molecules, various peptides, and phytochemicals. In this review article, we comprehensively discuss these molecules to reactivate mutant p53 to restore the normal function with a particular focus on molecular mechanisms.

https://ift.tt/2OthfvG

Long-term endothelial dysfunction in irradiated vessels: an immunohistochemical analysis

Abstract

Background

Microvascular free flap reconstruction has become a standard technique in head and neck reconstructive surgery. Pre-operative radiotherapy is associated with a higher incidence of free flap malperfusion and the need for operative revision. Irradiated vessels present characteristic histomorphological and structural changes. Alterations in endothelial cells of irradiated arteries remain incompletely investigated especially with regard to long-term changes in endothelial dysfunction supporting an intraluminal pro-thrombotic and pro-inflammatory milieu.

Methods

Endothelial expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E‑ and P‑selectin, endothelial NO-synthase (eNOS), thrombomodulin and plasminogen activator inhibitor-1 (PAI-1) in irradiated and non-irradiated arteries was analysed using immunohistochemistry and Remmele scale grading. The average radiation dose was 58.7 ± 7.0 Gy; the time interval between end of radiation and tissue sampling was 106.0 ± 86.8 months.

Results

Endothelial expression of ICAM-1, VCAM-1, E‑ and P‑selectin as well as PAI-1 was significantly increased in previously irradiated arteries compared with non-irradiated controls, whereas thrombomodulin and eNOS expression did not show any differences. However, when comparing non-irradiated free flap arteries with irradiated arteries from the head and neck area in respective individuals, eNOS expression was significantly lower in irradiated vessels whereas ICAM-1, VCAM-1, E‑/p-Selectin and PAI-1 showed significantly higher expression levels.

Conclusion

There is ongoing endothelial dysfunction in terms of increased expression of pro-thrombotic and pro-inflammatory markers in irradiated arteries even years after radiotherapy. Treating this endothelial dysfunction might reduce the complication rates associated with microvascular free flap reconstructions in irradiated patients.

https://ift.tt/2EnvbTg

Influence of static forces on the expression of selected parameters of inflammation in periodontal ligament cells and alveolar bone cells in a co-culture in vitro model

Abstract

Objective

Aim of this study was to investigate the impact of human PDL-derived fibroblasts (HPDF) and human alveolar bone-derived osteoblasts (HABO) co-culture on the expression of cytokines involved in tissue remodeling using an in vitro compressive force (CF) model.

Materials and methods

Static compressive force (CF) of 47.4 g/cm² was applied on mono- and co-cultured HPDFs and HABOs for 1, 2, or 4 h at 30 °C. TNFA, PTGS2, and IL6 gene expressions were determined by quantitative real-time polymerase chain reaction. TNF, PGE₂, and IL6 concentrations were measured using enzyme-linked immunosorbent assay.

Results

In mono-culture, TNFA, PTGS2, and IL6 gene expressions were upregulated under CF as compared to controls for each time period in both cell types. PGE₂ increased at 1 and 2 h in both cell types, and IL6 increased only at 2 and 4 h in HPDFs. Co-culture alleviated the force-induced increase of the expression of TNFA, PTGS2, IL6, PGE2, and IL6 in HPDFs at any time point. In HABOs, co-cultivation decreased the expression of PGE₂ after 1 h and 4 h, and that of IL6 after 1 h compared to mono-culture.

Conclusions

CF application on co-cultures of HPDFs and HABOs causes significant changes of TNFA, PTGS2, and IL6 gene expressions and PGE₂ and IL6 production in comparison to mono-culture indicating intercellular communication.

Clinical relevance

Mechanical stimulation of HPDFs and HABOs in co-culture induces a different gene expression pattern than stimulation of individual cell types alone. Co-culture might therefore be a relevant method to elucidate periodontal regeneration during orthodontic therapy.

https://ift.tt/2EkbsnK

Strategies to reduce readmissions for hyponatremia after transsphenoidal surgery for pituitary adenomas

Abstract

Purpose

Disorders of water balance, particularly hyponatremia from altered antidiuretic hormone (ADH) secretion, are a common post-operative complication of transsphenoidal surgery (TSS). We present our results from implementation of a 2-week 1.5 liter/daily fluid restriction on readmission rates for hyponatremia.

Methods

A retrospective chart review was performed on 295 patients that underwent TSS for pituitary adenomas at the University of Colorado, between March 2014 and March 2017. Groups were divided into those before and after the implementation of a two-week, 1.5 liter daily fluid restriction and measurement of a serum sodium level 7 days (+/− 2 days) after discharge. A standard-of-care approach for variable degrees of hyponatremia was also utilized to guide hyponatremia management. Patient demographics, hospital course, post-operative complication rates, and rates of hospital admissions for hyponatremia were then evaluated.

Results

Readmissions for symptomatic hyponatremia within 30 days of TSS occurred in 9 of 118 (7.6%) of patients prior to fluid restriction implementation and in four of 169 (2.4%) of patients in the post-implementation, fluid-restricted group (p-value = 0.04): a 70% reduction in hospitalizations. The two groups were similarly matched for pituitary tumor sub-type, age and gender. None of these factors were predictive for hyponatremia. Importantly, the mild fluid restriction did not result in any hospital readmissions for hypernatremia.

Conclusions

Mild fluid restriction (to 1.5 liters daily), in addition to a single post-operative serum sodium level, is an effective approach to preventing readmission for hyponatremia after TSS for pituitary adenomas.

https://ift.tt/2AbM6Eg

Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis

Abstract

Purpose

Polycystic ovary syndrome (PCOS) is a common disorder affecting up to 15% of women in the reproductive age. Prior studies suggest that PCOS can be associated with mood and psychiatric disorders. The purpose of this study is to examine the prevalence of any psychiatric disorder in women with PCOS.

Methods

We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through February 08, 2017 for studies that examined the prevalence of any psychiatric disorder in adolescents or adults with a clinical or biochemical diagnosis of PCOS. We used a random-effects model to generate pooled estimates and 95% confidence intervals (CI).

Results

We included 57 studies reporting on 172,040 patients. The majority of studies addressed depression and anxiety. Studies had fair methodological quality although most estimates were unadjusted. Women with PCOS were more likely to have a clinical diagnosis of depression (odds ratio (OR), 2.79; 95% CI, 2.23–3.50), anxiety (OR, 2.75; 95% CI, 2.10–3.60), bipolar disorder (OR, 1.78; 95% CI, 1.43–2.23) and obsessive compulsive disorder (OCD) (OR, 1.37; 95% CI 1.22–1.55), but not social phobia or panic disorder. Using various scales, the severity of symptoms of depression, anxiety, obsessive compulsive disorder, and somatization disorders were higher compared to women without PCOS.

Conclusions

PCOS is associated with an increased risk of diagnosis of depression, anxiety, bipolar disorder, and obsessive compulsive disorder. It is associated with worse symptoms of depression, anxiety, OCD, and somatization. Screening for these disorders to allow early intervention may be warranted.

https://ift.tt/2QRhXzw

New modified Friedewald formulae for estimating low-density lipoprotein cholesterol according to triglyceride levels: extraction and validation

Abstract

Purpose

The most commonly used method for estimating low-density lipoprotein cholesterol (LDLC) is Friedewald formula (FF). This study aims to extract and validate new modified Friedewald formulae for estimating LDLC according to triglyceride (TG) levels in Iranians.

Methods

Total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), LDLC, and TG were measured in 5030 fasted subjects. The original FF was used for estimating LDLC. Data were divided into training and validation data sets. For extracting modified Friedewald formulae, linear regression was used with TG as independent and TC, HDLC, and directly measured LDLC (D-LDLC) as dependent variables, respectively. An overall modified formula was extracted for TG concentrations <400 mg/dL. The specific modified formulae were extracted for different TG categories. The performance of the modified formulae was assessed in the validation data set.

Results

The overall derived formula for calculating LDLC was M-LDLC = TC–HDLC–TG/4. The coefficients of TG (specific TG terms) in modified formulae were 2.7, 3.7, 4.6, and 5 for TG <100, 100–200, 200–300, and 300–400 mg/dL, respectively. Compared to the original FF, applying a new modified formula with TG/4 to a validation data set provided a less mean difference (4.03 vs. 10.86 mg/dL), greater kappa coefficient (0.691 vs. 0.505), and better subject classification (80.8 vs. 67.1%). After applying modified formulae with specific TG terms, the difference between M-LDLC and D-LDLC decreased to 1.41 mg/dL.

Conclusions

Modified formulae were developed and validated for LDLC estimation that compared to the original FF, provided more accurate estimation of LDLC and better classification of subjects. These findings shall be useful for preventive, diagnostic, and therapeutic purposes.

https://ift.tt/2AblzqU

Primary hyperparathyroidism in prostate cancer: guilty or not guilty?

https://ift.tt/2QRhCwK

The association of smoking and risk of diabetic retinopathy in patients with type 1 and type 2 diabetes: a meta-analysis

Abstract

Purpose

To clarify the relevance between smoking and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus.

Methods

Published evidence were searched in MEDLINE and EMBASE from the databases began until Feb. 2017. Studies evaluating the association between smoking and diabetic retinopathy or evaluating the risk factors of diabetic retinopathy including smoking were included.

Results

Totally 73 studies were identified, among which 19 studies included type 1 diabetes patients and 56 studies included type 2 diabetes patients. In type 1 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers (risk ratio (RR) = 1.23, 95% CI 1.14, 1.33, P < 0.001), and the risk of proliferative diabetic retinopathy also significantly increased in smokers (RR = 1.48, 95% CI 1.20, 1.81, P < 0.001). In type 2 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly decreased in smokers (RR = 0.92, 95% CI 0.86, 0.98, P = 0.02) and the risk of proliferative diabetic retinopathy also significantly decreased in smokers (RR = 0.68, 95% CI 0.61, 0.74, P < 0.001).

Conclusions

Compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers with type 1 diabetes while significantly decreased in smokers with type 2 diabetes. However, this result did not change the importance of smoking cessation for public health.

https://ift.tt/2Ab9ge2

Cabergoline for the treatment of bromocriptine-resistant invasive giant prolactinomas

Abstract

Purpose

Few studies have specifically focused on the effect of cabergoline on invasive giant prolactinomas (IGPs) resistant to bromocriptine. This study aims to evaluate whether cabergoline could be used as an effective therapy for patients with bromocriptine-resistant IGPs.

Methods

This retrospective study included 15 patients with bromocriptine-resistant IGPs who received treatment at our department during 2007–2015. Cabergoline was administered in all 15 patients, with the dose adjusted depending on the prolactin response of each patient. Parameters for outcome assessment included prolactin level, pituitary function, tumor size, improvement of the clinical symptoms, visual field defects, drug tolerance, and disease recurrence.

Results

Cabergoline was effective for the treatment of the patients with bromocriptine -resistant IGPs as represented by normalization of the prolactin level in 12/15 patients; improvement or normalization of the pituitary function in 4/5 patients with hypopituitarism; significant reduction in tumor size in 14/15 patients; and relief of the clinical symptoms in 11/15 patients. All 15 patients showed good tolerance to cabergoline. In addition, no recurrence was observed during the mean follow-up period of 63.47 (range 30–145) months.

Conclusions

Data of this retrospective study demonstrate that cabergoline is an excellent option for the treatment of patients with bromocriptine-resistant IGPs.

https://ift.tt/2QRhTjg

Predictors of surgical outcome and early criteria of remission in acromegaly—some controversial issues

https://ift.tt/2Ab5NvV

Efficacy and safety of long-acting pasireotide in patients with somatostatin-resistant acromegaly: a multicenter study

Abstract

Introduction

Pasireotide, a multi-somatostatin receptor (SSTR)-ligand with high affinity for SSTR₅ was recently approved for acromegaly treatment.

Patients and methods

A retrospective multicenter study investigating the efficacy and safety of long-acting (LAR) pasireotide treatment in 35 patients (20 males) with active acromegaly (28 macroadenomas).

Results

Mean baseline insulin-like growth factor-1 (IGF-1) at diagnosis was 3.1 ± 1.3 × ULN. All but five patients have undergone pituitary surgery and six received sellar radiotherapy. All remained with active acromegaly despite first-generation somatostatin analogue (SSA) treatment. Immediately before pasireotide-LAR initiation, eighteen patients were under SSA monotherapy and one with pegvisomant. The remaining patients received combination therapy with SSA and pegvisomant, n = 9 (two received cabergoline also); SSA and cabergoline, n = 4; pegvisomant and cabergoline, n = 1. Two were untreated. Mean IGF-1 was 1.76 ± 0.9 ULN before pasireotide. Pasireotide-LAR starting dose was 40 mg/4 weeks in most patients. IGF-1 normalized in 19 patients, IGF-1 between 1-1.2 × ULN was reached in five, and in additional two patients IGF-1 was significantly suppressed. No effect was seen in nine patients. Pasireotide dose was reduced by 20 mg in six patients with excellent response, with preserved IGF-1 control in five. Severe headaches in six patients disappeared or improved with pasireotide. Side effects consisted of symptomatic cholelithiasis in one patient and deterioration of glucose control in 22 patients, requiring initiation or intensification of antidiabetic treatment in seventeen. One patient developed diabetic ketoacidosis.

Conclusions

In the real-life scenario ~54% of patients with acromegaly resistant to first-generation SSA, may normalize IGF-1 with pasireotide; however, 63% experienced glucose control deterioration.

https://ift.tt/2QRhPQy

Brown Adipose Tissue (BAT) detection by 18 F-FDG PET and thyroid hormone level(s)—a systematic review

https://ift.tt/2AbFBkR

A novel nonsense EIF1AX mutation identified in a thyroid nodule histologically diagnosed as oncocytic carcinoma

https://ift.tt/2QRhNrU

Insights on the phenotypic heterogenity of 11β-hydroxylase deficiency: clinical and genetic studies in two novel families

Abstract

Purpose

11β-hydroxylase deficiency accounts for 5% of congenital adrenal hyperplasia cases. Diagnosis suspiction is classically based on the association between abnormal virilization, precocious puberty, and hypertension in 46XX or 46XY subjects. We investigated two families with siblings presenting with opposed clinical features, and provided a review of the mechanisms involved in mineralocorticoid-dependent phenotypic heterogeneity.

Methods

The coding region of the CYP11B1 gene of 4 patients was sequenced and familial segregation was confirmed. Clinical characterization and blood steroid profile were performed.

Results

Family 1 comprised a female and a male siblings who presented in middle childhood with genital ambiguity (Prader II) and precocious puberty, respectively, associated with hypertension. In the second decade of life, the woman had three full-term pregnancies, and then evolved normotensive with no treatment over a 5-year follow up. On the other hand, her brother had hypertensive end-organ damage at age 24. In family 2, a 2.9 year-old boy presented with precocious puberty and hypertension, whereas his 21 days-old sister had genital ambiguity (Prader III) and salt wasting. A homozygous exon 4 splice site mutation was identified (IVS4ds-1G > A; c.799 G > A) in family 1, while a nonsense mutation in exon 6 (p. Q356X; c.1066 C > T) was found in family 2.

Conclusion

CYP11B1 mutations were associated with highly variable phenotypes, from mild to severe virilization, and early-onset hypertension or salt wasting. Further analysis of variants in other hypertension-related genes, steroid synthesis and metabolism compensatory pathways, and/or the investigation of chimeric CYP11B genes are needed to clarify the phenotypic heterogeneity in 11β-hydroxylase deficiency.

https://ift.tt/2AaaMNl

Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study

Abstract

Aim

Hypothyroidism is a common clinical problem that is successfully treated with hormone substitutes in the form of levothyroxine (LT4). LT4 is a drug with a narrow therapeutic index and is usually administered by strict rules, standardly at least half an hour before breakfast. The aim of this study was to investigate a possible effect of different timings of administration on thyroid function status and lipid profile.

Methods

The study included patients with the diagnosis of primary hypothyroidism, which were using a stable dose of levothyroxine. They were randomized into three different groups regarding the timing of LT4 administration in a crossover fashion. Each timing regimen lasted for at least 8 weeks; timing regimen A—half an hour before breakfast; timing regimen B—an hour before the main meal of the day; timing regimen C—at bedtime (minimally 2 h after dinner). The hormones (TSH, fT3, fT4) and lipid profile (triglycerides, HDL-, LDL-, and total cholesterol) were measured before the study, at the beginning of every timing regimen and at the end of the study.

Results

Altogether, 84 patients finished the study. Different timings of LT4 administration were non-inferior in comparison to the standard one and between each other. Median differences in TSH level between baseline and timing regimens were: baseline vs. A = −0.017 95% C.I. (−0.400–0.192); baseline vs. B = −0.325 95% C.I. (−0.562–0.023); baseline vs. C = −0.260 95% C.I. (−0.475–0.000). There were no statistically significant differences in either TSH, fT4, or fT3 when compared between all three timing regimens of LT4 administration and the baseline. There were no statistically significant differences in any of the lipid profile parameters (triglycerides, HDL-, LDL-, and total cholesterol) when compared between all three timing regimens of LT4 administration and the baseline.

Conclusion

The three investigated timing regimens of LT4 administration were equally efficient and offer additional options regarding the treatment individualization.

https://ift.tt/2QRhsp8

Temporal relationship of sleep apnea and acromegaly: a nationwide study

Abstract

Purpose

Patients with acromegaly have an increased risk of sleep apnea, but reported prevalence rates vary largely. Here we aimed to evaluate the sleep apnea prevalence in a large national cohort of patients with acromegaly, to examine possible risk factors, and to assess the proportion of patients diagnosed with sleep apnea prior to acromegaly diagnosis.

Methods

Cross-sectional multicenter study of 259 Swedish patients with acromegaly. At patients' follow-up visits at the endocrine outpatient clinics of all seven university hospitals in Sweden, questionnaires were completed to assess previous sleep apnea diagnosis and treatment, cardiovascular diseases, smoking habits, anthropometric data, and S-IGF-1 levels. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Patients suspected to have undiagnosed sleep apnea were referred for sleep apnea investigations.

Results

Of the 259 participants, 75 (29%) were diagnosed with sleep apnea before the study start. In 43 (57%) of these patients, sleep apnea had been diagnosed before the diagnosis of acromegaly. After clinical assessment and sleep studies, sleep apnea was diagnosed in an additional 20 patients, yielding a total sleep apnea prevalence of 37%. Higher sleep apnea risk was associated with higher BMI, waist circumference, and index finger circumference. Sleep apnea was more frequent among patients with S-IGF-1 levels in the highest quartile.

Conclusion

Sleep apnea is common among patients with acromegaly, and is often diagnosed prior to their acromegaly diagnosis. These results support early screening for sleep apnea in patients with acromegaly and awareness for acromegaly in patients with sleep apnea.

https://ift.tt/2Ab1IYB

Melatonin treatment suppresses appetite genes and improves adipose tissue plasticity in diet-induced obese zebrafish

Abstract

Purpose

Overweight and obesity are important risk factors for diabetes, cardiovascular diseases, and premature death in modern society. Recently, numerous natural and synthetic compounds have been tested in diet-induced obese animal models, to counteract obesity. Melatonin is a circadian hormone, produced by pineal gland and extra-pineal sources, involved in processes which have in common a rhythmic expression. In teleost, it can control energy balance by activating or inhibiting appetite-related peptides. The study aims at testing effects of melatonin administration to control-fed and overfed zebrafish, in terms of expression levels of orexigenic (Ghrelin, orexin, NPY) and anorexigenic (leptin, POMC) genes expression and morphometry of visceral and subcutaneous fat depots.

Methods

Adult male zebrafish (n = 56) were divided into four dietary groups: control, overfed, control + melatonin, overfed + melatonin. The treatment lasted 5 weeks and BMI levels of every fish were measured each week. After this period fishes were sacrificed; morphological and morphometric studies have been carried out on histological sections of adipose tissue and adipocytes. Moreover, whole zebrafish brain and intestine were used for qRT-PCR.

Results

Our results demonstrate that melatonin supplementation may have an effect in mobilizing fat stores, in increasing basal metabolism and thus in preventing further excess fat accumulation. Melatonin stimulates the anorexigenic and inhibit the orexigenic signals.

Conclusions

It seems that adequate melatonin treatment exerts anti-obesity protective effects, also in a diet-induced obesity zebrafish model, that might be the result of the restoration of many factors: the final endpoint reached is weight loss and stabilization of weight gain.

https://ift.tt/2QRhrl4

Strategies to reduce readmissions for hyponatremia after transsphenoidal surgery for pituitary adenomas

Abstract

Purpose

Disorders of water balance, particularly hyponatremia from altered antidiuretic hormone (ADH) secretion, are a common post-operative complication of transsphenoidal surgery (TSS). We present our results from implementation of a 2-week 1.5 liter/daily fluid restriction on readmission rates for hyponatremia.

Methods

A retrospective chart review was performed on 295 patients that underwent TSS for pituitary adenomas at the University of Colorado, between March 2014 and March 2017. Groups were divided into those before and after the implementation of a two-week, 1.5 liter daily fluid restriction and measurement of a serum sodium level 7 days (+/− 2 days) after discharge. A standard-of-care approach for variable degrees of hyponatremia was also utilized to guide hyponatremia management. Patient demographics, hospital course, post-operative complication rates, and rates of hospital admissions for hyponatremia were then evaluated.

Results

Readmissions for symptomatic hyponatremia within 30 days of TSS occurred in 9 of 118 (7.6%) of patients prior to fluid restriction implementation and in four of 169 (2.4%) of patients in the post-implementation, fluid-restricted group (p-value = 0.04): a 70% reduction in hospitalizations. The two groups were similarly matched for pituitary tumor sub-type, age and gender. None of these factors were predictive for hyponatremia. Importantly, the mild fluid restriction did not result in any hospital readmissions for hypernatremia.

Conclusions

Mild fluid restriction (to 1.5 liters daily), in addition to a single post-operative serum sodium level, is an effective approach to preventing readmission for hyponatremia after TSS for pituitary adenomas.

https://ift.tt/2AbM6Eg

Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis

Abstract

Purpose

Polycystic ovary syndrome (PCOS) is a common disorder affecting up to 15% of women in the reproductive age. Prior studies suggest that PCOS can be associated with mood and psychiatric disorders. The purpose of this study is to examine the prevalence of any psychiatric disorder in women with PCOS.

Methods

We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through February 08, 2017 for studies that examined the prevalence of any psychiatric disorder in adolescents or adults with a clinical or biochemical diagnosis of PCOS. We used a random-effects model to generate pooled estimates and 95% confidence intervals (CI).

Results

We included 57 studies reporting on 172,040 patients. The majority of studies addressed depression and anxiety. Studies had fair methodological quality although most estimates were unadjusted. Women with PCOS were more likely to have a clinical diagnosis of depression (odds ratio (OR), 2.79; 95% CI, 2.23–3.50), anxiety (OR, 2.75; 95% CI, 2.10–3.60), bipolar disorder (OR, 1.78; 95% CI, 1.43–2.23) and obsessive compulsive disorder (OCD) (OR, 1.37; 95% CI 1.22–1.55), but not social phobia or panic disorder. Using various scales, the severity of symptoms of depression, anxiety, obsessive compulsive disorder, and somatization disorders were higher compared to women without PCOS.

Conclusions

PCOS is associated with an increased risk of diagnosis of depression, anxiety, bipolar disorder, and obsessive compulsive disorder. It is associated with worse symptoms of depression, anxiety, OCD, and somatization. Screening for these disorders to allow early intervention may be warranted.

https://ift.tt/2QRhXzw

New modified Friedewald formulae for estimating low-density lipoprotein cholesterol according to triglyceride levels: extraction and validation

Abstract

Purpose

The most commonly used method for estimating low-density lipoprotein cholesterol (LDLC) is Friedewald formula (FF). This study aims to extract and validate new modified Friedewald formulae for estimating LDLC according to triglyceride (TG) levels in Iranians.

Methods

Total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), LDLC, and TG were measured in 5030 fasted subjects. The original FF was used for estimating LDLC. Data were divided into training and validation data sets. For extracting modified Friedewald formulae, linear regression was used with TG as independent and TC, HDLC, and directly measured LDLC (D-LDLC) as dependent variables, respectively. An overall modified formula was extracted for TG concentrations <400 mg/dL. The specific modified formulae were extracted for different TG categories. The performance of the modified formulae was assessed in the validation data set.

Results

The overall derived formula for calculating LDLC was M-LDLC = TC–HDLC–TG/4. The coefficients of TG (specific TG terms) in modified formulae were 2.7, 3.7, 4.6, and 5 for TG <100, 100–200, 200–300, and 300–400 mg/dL, respectively. Compared to the original FF, applying a new modified formula with TG/4 to a validation data set provided a less mean difference (4.03 vs. 10.86 mg/dL), greater kappa coefficient (0.691 vs. 0.505), and better subject classification (80.8 vs. 67.1%). After applying modified formulae with specific TG terms, the difference between M-LDLC and D-LDLC decreased to 1.41 mg/dL.

Conclusions

Modified formulae were developed and validated for LDLC estimation that compared to the original FF, provided more accurate estimation of LDLC and better classification of subjects. These findings shall be useful for preventive, diagnostic, and therapeutic purposes.

https://ift.tt/2AblzqU

Primary hyperparathyroidism in prostate cancer: guilty or not guilty?

https://ift.tt/2QRhCwK

The association of smoking and risk of diabetic retinopathy in patients with type 1 and type 2 diabetes: a meta-analysis

Abstract

Purpose

To clarify the relevance between smoking and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus.

Methods

Published evidence were searched in MEDLINE and EMBASE from the databases began until Feb. 2017. Studies evaluating the association between smoking and diabetic retinopathy or evaluating the risk factors of diabetic retinopathy including smoking were included.

Results

Totally 73 studies were identified, among which 19 studies included type 1 diabetes patients and 56 studies included type 2 diabetes patients. In type 1 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers (risk ratio (RR) = 1.23, 95% CI 1.14, 1.33, P < 0.001), and the risk of proliferative diabetic retinopathy also significantly increased in smokers (RR = 1.48, 95% CI 1.20, 1.81, P < 0.001). In type 2 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly decreased in smokers (RR = 0.92, 95% CI 0.86, 0.98, P = 0.02) and the risk of proliferative diabetic retinopathy also significantly decreased in smokers (RR = 0.68, 95% CI 0.61, 0.74, P < 0.001).

Conclusions

Compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers with type 1 diabetes while significantly decreased in smokers with type 2 diabetes. However, this result did not change the importance of smoking cessation for public health.

https://ift.tt/2Ab9ge2

Cabergoline for the treatment of bromocriptine-resistant invasive giant prolactinomas

Abstract

Purpose

Few studies have specifically focused on the effect of cabergoline on invasive giant prolactinomas (IGPs) resistant to bromocriptine. This study aims to evaluate whether cabergoline could be used as an effective therapy for patients with bromocriptine-resistant IGPs.

Methods

This retrospective study included 15 patients with bromocriptine-resistant IGPs who received treatment at our department during 2007–2015. Cabergoline was administered in all 15 patients, with the dose adjusted depending on the prolactin response of each patient. Parameters for outcome assessment included prolactin level, pituitary function, tumor size, improvement of the clinical symptoms, visual field defects, drug tolerance, and disease recurrence.

Results

Cabergoline was effective for the treatment of the patients with bromocriptine -resistant IGPs as represented by normalization of the prolactin level in 12/15 patients; improvement or normalization of the pituitary function in 4/5 patients with hypopituitarism; significant reduction in tumor size in 14/15 patients; and relief of the clinical symptoms in 11/15 patients. All 15 patients showed good tolerance to cabergoline. In addition, no recurrence was observed during the mean follow-up period of 63.47 (range 30–145) months.

Conclusions

Data of this retrospective study demonstrate that cabergoline is an excellent option for the treatment of patients with bromocriptine-resistant IGPs.

https://ift.tt/2QRhTjg

Predictors of surgical outcome and early criteria of remission in acromegaly—some controversial issues

https://ift.tt/2Ab5NvV

Efficacy and safety of long-acting pasireotide in patients with somatostatin-resistant acromegaly: a multicenter study

Abstract

Introduction

Pasireotide, a multi-somatostatin receptor (SSTR)-ligand with high affinity for SSTR₅ was recently approved for acromegaly treatment.

Patients and methods

A retrospective multicenter study investigating the efficacy and safety of long-acting (LAR) pasireotide treatment in 35 patients (20 males) with active acromegaly (28 macroadenomas).

Results

Mean baseline insulin-like growth factor-1 (IGF-1) at diagnosis was 3.1 ± 1.3 × ULN. All but five patients have undergone pituitary surgery and six received sellar radiotherapy. All remained with active acromegaly despite first-generation somatostatin analogue (SSA) treatment. Immediately before pasireotide-LAR initiation, eighteen patients were under SSA monotherapy and one with pegvisomant. The remaining patients received combination therapy with SSA and pegvisomant, n = 9 (two received cabergoline also); SSA and cabergoline, n = 4; pegvisomant and cabergoline, n = 1. Two were untreated. Mean IGF-1 was 1.76 ± 0.9 ULN before pasireotide. Pasireotide-LAR starting dose was 40 mg/4 weeks in most patients. IGF-1 normalized in 19 patients, IGF-1 between 1-1.2 × ULN was reached in five, and in additional two patients IGF-1 was significantly suppressed. No effect was seen in nine patients. Pasireotide dose was reduced by 20 mg in six patients with excellent response, with preserved IGF-1 control in five. Severe headaches in six patients disappeared or improved with pasireotide. Side effects consisted of symptomatic cholelithiasis in one patient and deterioration of glucose control in 22 patients, requiring initiation or intensification of antidiabetic treatment in seventeen. One patient developed diabetic ketoacidosis.

Conclusions

In the real-life scenario ~54% of patients with acromegaly resistant to first-generation SSA, may normalize IGF-1 with pasireotide; however, 63% experienced glucose control deterioration.

https://ift.tt/2QRhPQy

Brown Adipose Tissue (BAT) detection by 18 F-FDG PET and thyroid hormone level(s)—a systematic review

https://ift.tt/2AbFBkR

A novel nonsense EIF1AX mutation identified in a thyroid nodule histologically diagnosed as oncocytic carcinoma

https://ift.tt/2QRhNrU

Insights on the phenotypic heterogenity of 11β-hydroxylase deficiency: clinical and genetic studies in two novel families

Abstract

Purpose

11β-hydroxylase deficiency accounts for 5% of congenital adrenal hyperplasia cases. Diagnosis suspiction is classically based on the association between abnormal virilization, precocious puberty, and hypertension in 46XX or 46XY subjects. We investigated two families with siblings presenting with opposed clinical features, and provided a review of the mechanisms involved in mineralocorticoid-dependent phenotypic heterogeneity.

Methods

The coding region of the CYP11B1 gene of 4 patients was sequenced and familial segregation was confirmed. Clinical characterization and blood steroid profile were performed.

Results

Family 1 comprised a female and a male siblings who presented in middle childhood with genital ambiguity (Prader II) and precocious puberty, respectively, associated with hypertension. In the second decade of life, the woman had three full-term pregnancies, and then evolved normotensive with no treatment over a 5-year follow up. On the other hand, her brother had hypertensive end-organ damage at age 24. In family 2, a 2.9 year-old boy presented with precocious puberty and hypertension, whereas his 21 days-old sister had genital ambiguity (Prader III) and salt wasting. A homozygous exon 4 splice site mutation was identified (IVS4ds-1G > A; c.799 G > A) in family 1, while a nonsense mutation in exon 6 (p. Q356X; c.1066 C > T) was found in family 2.

Conclusion

CYP11B1 mutations were associated with highly variable phenotypes, from mild to severe virilization, and early-onset hypertension or salt wasting. Further analysis of variants in other hypertension-related genes, steroid synthesis and metabolism compensatory pathways, and/or the investigation of chimeric CYP11B genes are needed to clarify the phenotypic heterogeneity in 11β-hydroxylase deficiency.

https://ift.tt/2AaaMNl

Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study

Abstract

Aim

Hypothyroidism is a common clinical problem that is successfully treated with hormone substitutes in the form of levothyroxine (LT4). LT4 is a drug with a narrow therapeutic index and is usually administered by strict rules, standardly at least half an hour before breakfast. The aim of this study was to investigate a possible effect of different timings of administration on thyroid function status and lipid profile.

Methods

The study included patients with the diagnosis of primary hypothyroidism, which were using a stable dose of levothyroxine. They were randomized into three different groups regarding the timing of LT4 administration in a crossover fashion. Each timing regimen lasted for at least 8 weeks; timing regimen A—half an hour before breakfast; timing regimen B—an hour before the main meal of the day; timing regimen C—at bedtime (minimally 2 h after dinner). The hormones (TSH, fT3, fT4) and lipid profile (triglycerides, HDL-, LDL-, and total cholesterol) were measured before the study, at the beginning of every timing regimen and at the end of the study.

Results

Altogether, 84 patients finished the study. Different timings of LT4 administration were non-inferior in comparison to the standard one and between each other. Median differences in TSH level between baseline and timing regimens were: baseline vs. A = −0.017 95% C.I. (−0.400–0.192); baseline vs. B = −0.325 95% C.I. (−0.562–0.023); baseline vs. C = −0.260 95% C.I. (−0.475–0.000). There were no statistically significant differences in either TSH, fT4, or fT3 when compared between all three timing regimens of LT4 administration and the baseline. There were no statistically significant differences in any of the lipid profile parameters (triglycerides, HDL-, LDL-, and total cholesterol) when compared between all three timing regimens of LT4 administration and the baseline.

Conclusion

The three investigated timing regimens of LT4 administration were equally efficient and offer additional options regarding the treatment individualization.

https://ift.tt/2QRhsp8

Temporal relationship of sleep apnea and acromegaly: a nationwide study

Abstract

Purpose

Patients with acromegaly have an increased risk of sleep apnea, but reported prevalence rates vary largely. Here we aimed to evaluate the sleep apnea prevalence in a large national cohort of patients with acromegaly, to examine possible risk factors, and to assess the proportion of patients diagnosed with sleep apnea prior to acromegaly diagnosis.

Methods

Cross-sectional multicenter study of 259 Swedish patients with acromegaly. At patients' follow-up visits at the endocrine outpatient clinics of all seven university hospitals in Sweden, questionnaires were completed to assess previous sleep apnea diagnosis and treatment, cardiovascular diseases, smoking habits, anthropometric data, and S-IGF-1 levels. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Patients suspected to have undiagnosed sleep apnea were referred for sleep apnea investigations.

Results

Of the 259 participants, 75 (29%) were diagnosed with sleep apnea before the study start. In 43 (57%) of these patients, sleep apnea had been diagnosed before the diagnosis of acromegaly. After clinical assessment and sleep studies, sleep apnea was diagnosed in an additional 20 patients, yielding a total sleep apnea prevalence of 37%. Higher sleep apnea risk was associated with higher BMI, waist circumference, and index finger circumference. Sleep apnea was more frequent among patients with S-IGF-1 levels in the highest quartile.

Conclusion

Sleep apnea is common among patients with acromegaly, and is often diagnosed prior to their acromegaly diagnosis. These results support early screening for sleep apnea in patients with acromegaly and awareness for acromegaly in patients with sleep apnea.

https://ift.tt/2Ab1IYB

Melatonin treatment suppresses appetite genes and improves adipose tissue plasticity in diet-induced obese zebrafish

Abstract

Purpose

Overweight and obesity are important risk factors for diabetes, cardiovascular diseases, and premature death in modern society. Recently, numerous natural and synthetic compounds have been tested in diet-induced obese animal models, to counteract obesity. Melatonin is a circadian hormone, produced by pineal gland and extra-pineal sources, involved in processes which have in common a rhythmic expression. In teleost, it can control energy balance by activating or inhibiting appetite-related peptides. The study aims at testing effects of melatonin administration to control-fed and overfed zebrafish, in terms of expression levels of orexigenic (Ghrelin, orexin, NPY) and anorexigenic (leptin, POMC) genes expression and morphometry of visceral and subcutaneous fat depots.

Methods

Adult male zebrafish (n = 56) were divided into four dietary groups: control, overfed, control + melatonin, overfed + melatonin. The treatment lasted 5 weeks and BMI levels of every fish were measured each week. After this period fishes were sacrificed; morphological and morphometric studies have been carried out on histological sections of adipose tissue and adipocytes. Moreover, whole zebrafish brain and intestine were used for qRT-PCR.

Results

Our results demonstrate that melatonin supplementation may have an effect in mobilizing fat stores, in increasing basal metabolism and thus in preventing further excess fat accumulation. Melatonin stimulates the anorexigenic and inhibit the orexigenic signals.

Conclusions

It seems that adequate melatonin treatment exerts anti-obesity protective effects, also in a diet-induced obesity zebrafish model, that might be the result of the restoration of many factors: the final endpoint reached is weight loss and stabilization of weight gain.

https://ift.tt/2QRhrl4

Cortical Balance Between ON and OFF Visual Responses Is Modulated by the Spatial Properties of the Visual Stimulus

Abstract

The primary visual cortex of carnivores and primates is dominated by the OFF visual pathway and responds more strongly to dark than light stimuli. Here, we demonstrate that this cortical OFF dominance is modulated by the size and spatial frequency of the stimulus in awake primates and we uncover a main neuronal mechanism underlying this modulation. We show that large grating patterns with low spatial frequencies drive five times more OFF-dominated than ON-dominated neurons, but this pronounced cortical OFF dominance is strongly reduced when the grating size decreases and the spatial frequency increases, as when the stimulus moves away from the observer. We demonstrate that the reduction in cortical OFF dominance is not caused by a selective reduction of visual responses in OFF-dominated neurons but by a change in the ON/OFF response balance of neurons with diverse receptive field properties that can be ON or OFF dominated, simple, or complex. We conclude that cortical OFF dominance is continuously adjusted by a neuronal mechanism that modulates ON/OFF response balance in multiple cortical neurons when the spatial properties of the visual stimulus change with viewing distance and/or optical blur.

https://ift.tt/2yia1AC

Prevention of Dermatitis in Epoxy Exposed Workers

Conditions:   Contact Dermatitis;   Sensitization Dermatitis
Intervention:   Device: Fluorescence visualization (feedback)
Sponsors:   Aarhus University Hospital;   Arbejdsmiljøforskningsfonden;   Vestas Wind Power;   Siemens Gamesa Renewable Energy;   Skane University Hospital;   Herning Hospital;   National Research Centre for the Working Environment, Denmark;   Aalborg Universitetshospital
Not yet recruiting

https://ift.tt/2yeM8Kc

Effects of Mobilization and Perceptive Rehabilitation on Patients With Fibromyalgia Syndrome

Condition:   Fibromyalgia
Interventions:   Other: Perceptive Rehabilitation;   Other: Mobilisation Techniques
Sponsor:   European University of Lefke
Not yet recruiting

https://ift.tt/2yHtLNg

Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients: Influence of the disease severity and therapy on the ovarian reserve

Abstract

Purpose

Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve.

Methods

AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded.

Results

AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLE patients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLE patients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLE patients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01).

Conclusions

SLE patients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.

https://ift.tt/2AbfTwV

Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients: Influence of the disease severity and therapy on the ovarian reserve

Abstract

Purpose

Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve.

Methods

AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded.

Results

AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLE patients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLE patients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLE patients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01).

Conclusions

SLE patients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.

https://ift.tt/2AbfTwV

Maternal estradiol and progesterone concentrations among singleton spontaneous pregnancies during the first trimester

Abstract

Background

Pregnancy hormonal milieu represents a crucial determinant of fetal outcome. We aim to determine 17β-estradiol (E₂) and progesterone (PGT) concentrations in spontaneous pregnancies during the first trimester. In addition, we aim to determine E₂ concentrations as a function of gestational age (GA) and PGT.

Methods

Between November 2015 and March 2017, 104 healthy women of at least 18 years undergoing medical consultation for voluntary interruption of pregnancy were enrolled in an observational study at University Hospital ASST Fatebenefratelli Sacco, Milan, Italy. Only singleton pregnancies between 5⁺⁰ and 13⁺⁶ weeks of gestation were eligible. First trimester ultrasound scans were performed for dating and one fasting venous blood sample was collected for E₂ and PGT determinations.

Results

E₂ and PGT concentrations steadily increased according to GA. The correlation between E₂ on a logarithmic scale and PGT concentrations was expressed by the following equation, explaining 12.6% of E₂ variance: logE₂ = 2.57 + 0.1 × PGT, (r = 0.34, p < 0.001). By performing a multivariable linear regression analysis adjusted for variables significantly correlated with E₂ concentrations, we obtained a model explaining the 53.5% of E₂ variance. The final equation to determine E₂ concentrations among Caucasian women was: logE₂ = 1.96 + 0.01 × GA + 0.004 × PGT.

Conclusions

Gestational week-specific reference intervals are reported for maternal E₂ and PGT concentrations during early pregnancy, further providing a model for E₂ assessment in this period. This will represent a starting point for further evaluations between twin and ART pregnancies, as well as to potentially improve pregnancy outcome and future health of the offspring.

https://ift.tt/2yityAK

Comparison of diagnostic effects of infrared imaging and bitewing radiography in proximal caries of permanent teeth

Abstract

This study aimed to compare the diagnostic efficacy of VistaCam iX intraoral camera system using infrared light and bitewing radiography for detection of proximal caries in permanent teeth. This in vitro study was performed on 108 teeth. The proximal surfaces of the teeth were examined for caries using ICDAS II criteria, bitewing radiography, and the Proxi head of VistaCam iX. The teeth were then sectioned and histologically analyzed (gold standard). Data were analyzed using SPSS version 25 via the correlation test at P < 0.05 level of significance. The overall and segmental sensitivity and specificity values were calculated for (1) the contact area and higher regions, (2) below the contact area to the cementoenamel junction (CEJ), and (3) below the CEJ. Radiography had the highest specificity. VistaCam had the highest overall and segmental sensitivity for enamel caries. Radiography had the highest segmental sensitivity for dentin. In region 1, VistaCam had the highest sensitivity and lowest specificity, and radiography and ICDAS II had the highest specificity and lowest sensitivity. In region 2, radiography showed the highest sensitivity and specificity. VistaCam had the lowest sensitivity and ICDAS II had the lowest specificity in this region. In region 3, VistaCam did not detect any caries and radiography had a better performance than ICDAS II. The specificity value was equal for both methods. VistaCam had the highest diagnostic efficacy among the three methods for caries in region 1; however, bitewing radiography had a superior efficacy in regions 2 and 3.

https://ift.tt/2AatPXT

Systematic analysis of parameters predicting pathological axillary status (ypN0 vs. ypN+) in patients with breast cancer converting from cN+ to ycN0 through primary systemic therapy (PST)

Abstract

Optimization of axillary staging among patients converting from clinically node-positive disease to clinically node-negative disease through primary systemic therapy is needed. We aimed at developing a nomogram predicting the probability of positive axillary status after chemotherapy based on clinical/pathological parameters. Patients from study arm C of the SENTINA trial were included. Univariable/multivariable analyses were performed for 13 clinical/pathological parameters to predict a positive pathological axillary status after chemotherapy using logistic regression models. Odds ratios and 95%-confidence-intervals were reported. Model performance was assessed by leave-one-out cross-validation. Calculations were performed using the SAS Software (Version 9.4, SAS Institute Inc., Cary, NC, USA). 369 of 553 patients in Arm C were included in multivariable analysis. Stepwise backward variable selection based on a multivariable analysis resulted in a model including estrogen receptor (ER) status (odds ratio (OR) 3.916, 95% confidence interval (CI) 2.318–6.615, p < 0.001), multifocality (OR 2.106, 95% CI 1.203–3.689, p = 0.0092), lymphovascular invasion (OR 9.196, 95% CI 4.734–17.864, p < 0.001), and sonographic tumor diameter after PST (OR 1.034, 95% CI 1.010–1.059, p = 0.0051). When validated, our model demonstrated an accuracy of 70.2% using 0.5 as cut-point. An area under the curve of 0.81 was calculated. The use of individual parameters as predictors of lymph node status after chemotherapy resulted in an inferior accuracy. Our model was able to predict the probability of a positive axillary nodal status with a high accuracy. The use of individual parameters showed reduced predictive performance. Overall, tumor biology was the strongest parameter in our models.

https://ift.tt/2pRggGO

Monitoring treatment response in patients affected by actinic keratosis: dermoscopic assessment and metalloproteinases evaluation after piroxicam 0.8% and sunfilter cream

Dermatologic Therapy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OqCVJ2

Pretarsal roll augmentation with dermal hyaluronic acid filler injection

Abstract

Pretarsal roll augmentation with dermal hyaluronic acid filler injection focuses on restoring pretarsal fullness. This study aimed to introduce a method of pretarsal roll augmentation with dermal hyaluronic acid filler injection and establish the level of difficulty, safety, and effectiveness of this method. Eighty female patients were enrolled in this study. Hyaluronic acid filler was used to perform pretarsal roll augmentation. Physician and patient satisfaction at 1 month and 4 months after surgery was investigated. The level of satisfaction was graded from points 1 to 5. The patient satisfaction and physician scores were 4.7 ± 1.1 (mean ± standard deviation) points at 1 month and 4.8 ± 0.9 points at 4 months and 4.6 ± 0.9 points at 1 month and 4.8 ± 1.0 points at 4 months, respectively. No major complications were observed. Our technique provided a natural and younger appearance with pretarsal fullness. This technique was easy to perform for the restoration of pretarsal fullness, and it improved periorbital contouring, rejuvenated the pretarsal roll, and provided excellent esthetic results.

Level of Evidence: Level V, therapeutic study.

https://ift.tt/2RVeUIa

Response to Critical appraisal of LIBERTY AD CHRONOS: reply from authors

British Journal of Dermatology, EarlyView.


https://ift.tt/2IXQCcn

Response to critical appraisal of LIBERTY AD CHRONOS

British Journal of Dermatology, EarlyView.


https://ift.tt/2OnCzCS

Shared Decision Making in Psoriasis: A Systematic Review of Quantitative and Qualitative Studies

Abstract

Background

Patients with psoriasis face numerous treatment and self-management decisions. Shared decision making is a novel approach where patients' preferences and values are considered in cooperation with healthcare professionals before making treatment decisions.

Objective

The objective of this systematic review was to explore what is illuminated in psoriasis research regarding shared decision making, and to estimate the effects of shared decision-making interventions in this context.

Methods

Qualitative, quantitative, and mixed-methods studies were eligible for inclusion. We searched six electronic databases up to January 2018. Two reviewers independently applied inclusion and quality criteria. The SPIDER framework was used to identify eligibility criteria for study inclusion. Narrative and thematic syntheses were utilized to identify prominent themes emerging from the data.

Results

A total of 23 studies were included in the review. Of these, we included 18 studies (19 papers) to describe what was illuminated with regard to shared decision making in psoriasis research. Four major themes emerged: interpersonal communication; exchange of competence and knowledge; different world view; and involvement and preference, organized under two analytical themes; "Co-creation of decisions" and "Organization of treatment and treatment needs". For shared decision-making effects, we included four controlled studies. These varied in scope and interventional length and showed limited use of shared decision making-specific outcome measures, reflecting the early stage of the literature. Because of study heterogeneity, a meta-synthesis was not justified.

Conclusions

There appears to be a need to strengthen the relationship between medical doctors and patients with psoriasis. The evident lack of knowledge about each other's competence and the lack of self-efficacy for both patients and providers challenges the basic principles of shared decision making. The effects of shared decision making in psoriasis are inconclusive, and more research appears necessary to determine the possible benefits of shared decision-making interventions.

https://ift.tt/2IWfP74