Scholar : ΑΚΟΗ - νέα αποτελέσματα

[PDF] Απεικονιστικά ευρήματα εγκεφάλου σε όψιμα πρόωρα νεογνά (Late preterm): Συσχέτιση με το νευροαναπτυξιακό προφίλ σε ηλικία δύο χρόνων

ΕΑΜ Καραϊσκου - 2018

Page 1. TΕΧΝΟΛΟΓΙΚΟ ΕΚΠΑΙΔΕΥΤΙΚΟ ΙΔΡΥΜΑ ΔΥΤΙΚΗΣ ΕΛΛΑΔΑΣ
ΔΙΑΤΜΗΜΑΤΙΚΟ ΠΡΟΓΡΑΜΜΑ ΜΕΤΑΠΤΥΧΙΑΚΩΝ ΣΠΟΥΔΩΝ ΤΜΗΜΑΤΩΝ
ΛΟΓΟΘΕΡΑΠΕΙΑΣ ΝΟΣΗΛΕΥΤΙΚΗΣ ΚΑΙ ΦΥΣΙΚΟΘΕΡΑΠΕΙΑΣ « Επιστήμες …

 

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Ακύρωση ειδοποίησης

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Scholar : Cricotracheal resection - νέα αποτελέσματα

[PDF] Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis

I Fiz, JC Koelmel, C Piazza, F Fiz, D Di Dio, Z Bittar… - Acta Otorhinolaryngologica …, 2018

… Regarding functional outcomes, the length of the resected segment was
strongly associated with … Longer resections were associated to recidivating
stenosis, perhaps implying that a … Complications after tracheal and cricotracheal …

 

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Scholar : ΣΤΟΜΑΤΙΚΗ - νέα αποτελέσματα

[PDF] Έρευνα ικανοποίησης εργαζομένων: μελέτη περίπτωσης εταιρίας καλλυντικών προϊόντων.

Μ Κοκολογιάννη, M Kokologianni - 2018

Page 1. Τ.Ε.Ι. ΚΡΗΤΗΣ ΣΧΟΛΗ ΔΙΟΙΚΗΣΗΣ ΚΑΙ ΟΙΚΟΝΟΜΙΑΣ ΤΜΗΜΑ
ΔΙΟΙΚΗΣΗΣ ΕΠΙΧΕΙΡΗΣΕΩΝ ΠΤΥΧΙΑΚΗ ΕΡΓΑΣΙΑ ΕΡΕΥΝΑ ΙΚΑΝΟΠΟΙΗΣΗΣ
ΕΡΓΑΖΟΜΕΝΩΝ: ΜΕΛΕΤΗ ΠΕΡΙΠΤΩΣΗΣ ΕΤΑΙΡΙΑΣ ΚΑΛΛΥΝΤΙΚΩΝ …

 

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Scholar : ΦΩΝΗ - νέα αποτελέσματα

[PDF] Umme Dunia, un romanzo italiano sulla Caduta di Costantinopoli

M CARACAUSI

Page 420. MARIA CARACAUSI Istituto di Studi Bizantini e Neoellenici Umme Dunia, un
romanzo italiano sulla Caduta di Costantinopoli Umme Dunia è il titolo di un romanzo
italiano del XIX secolo, ad opera di un non meglio identificato Alberto Furse2 …

 

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What to know about hyperpigmentation

Hyperpigmentation occurs when a person develops darker patches on the skin, such as age spots or melasma. Learn about the causes, types, and treatments for hyperpigmentation here.

https://ift.tt/2P3abBp

Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 39-40

The online platform for Taylor & Francis Online content The following articles have been newly published in the issue Journal of Natural History, Volume 52, Issue 39-40 on Taylor & Francis Online: Articles Butterflies (Lepidoptera: Papilionoidea) of Mount Kilimanjaro: Nymphalidae subfamily Helconiinae Steven D. Liseki, Richard I. Vane-Wright Pages: 2511-2552 | DOI: 10.1080/00222933.2018.1539780 The issue is in progress. To view all articles already published in this issue, please visit: https://www.tandfonline.com/toc/tnah20/52/39-40 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

DiODe: Directional Orientation Detection of Segmented Deep Brain Stimulation Leads: A Sequential Algorithm Based on CT Imaging

Background: Directional deep brain stimulation (DBS) allows steering the stimulation in an axial direction which offers greater flexibility in programming. However, accurate anatomical visualization of the lead orientation is required for interpreting the observed stimulation effects and to guide programming. Objectives: In this study we aimed to develop and test an accurate and robust algorithm for determining the orientation of segmented electrodes based on standard postoperative CT imaging used in DBS. Methods: Orientation angles of directional leads (Cartesia^TM; Boston Scientific, Marlborough, MA, USA) were determined using CT imaging. Therefore, a sequential algorithm was developed that quantitatively compares the similarity of the observed CT artifacts with calculated artifact patterns based on the lead's orientation marker and a geometric model of the segmented electrodes. Measurements of seven ground truth phantoms and three leads with 60 different configurations of lead implantation and orientation angles were analyzed for validation. Results: The accuracy of the determined electrode orientation angles was –0.6 ± 1.5° (range: –5.4 to 4.2°). This accuracy proved to be sufficiently high to resolve even subtle differences between individual leads. Conclusions: The presented algorithm is user independent and provides highly accurate results for the orientation of the segmented electrodes for all angular constellations that typically occur in clinical cases.
Stereotact Funct Neurosurg

https://ift.tt/2FKD5ah

Comparative Study of Robot-Assisted versus Conventional Frame-Based Deep Brain Stimulation Stereotactic Neurosurgery

Background/Aims: Technological advancements had a serious impact on the evolution of robotic systems in stereotactic neurosurgery over the last three decades and may turn robot-assisted stereotactic neurosurgery into a sophisticated alternative to purely mechanical guiding devices. Objectives: To compare robot-assisted and conventional frame-based deep brain stimulation (DBS) surgery with regard to accuracy, precision, reliability, duration of surgery, intraoperative imaging quality, safety and maintenance using a standardized setup. Methods: Retrospective evaluation of 80 consecutive patients was performed who underwent DBS surgery using either a frame-based mechanical stereotactic guiding device (n = 40) or a stereotactic robot (ROSA Brain, MedTech, Montpellier, France) (n = 40). Results: The mean accuracy of robot-assisted and conventional lead implantation was 0.76 mm (SD: 0.37 mm, range: 0.17–1.52 mm) and 1.11 mm (SD: 0.59 mm, range: 0.10–2.90 mm), respectively. We observed a statistically significant difference in accuracy (p #x3c; 0.001) when comparing lateral deviations between both modalities. Furthermore, a statistical significance was observed when investigating the proportion of values exceeding 2.00 mm between both groups (p = 0.013). In 8.75% (n = 7) of conventionally implanted leads, lateral deviations were greater than 2.0 mm. With a maximum value of 1.52 mm, this threshold was never reached during robot-guided DBS. The mean duration of DBS surgery could be reduced significantly (p #x3c; 0.001) when comparing robot-guided DBS (mean: 325.1 ± 81.6 min) to conventional lead implantation (mean: 394.8 ± 66.6 min). Conclusions: Robot-assisted DBS was shown to be superior to conventional lead implantation with respect to accuracy, precision and operation time. Improved quality control, continuous intraoperative monitoring and less manual adjustment likely contribute to the robotic system's reliability allowing high accuracy during lead implantation despite limited experience. Hence, robot-assisted lead implantation can be considered an appropriate and reliable alternative to purely mechanical devices.
Stereotact Funct Neurosurg

https://ift.tt/2r5OKWO

Long-Term Outcomes of Bilateral Pallidal Deep Brain Stimulation for X-Linked Dystonia and Parkinsonism

Background: X-linked dystonia parkinsonism (XDP) causes adult-onset progressive dystonia and parkinsonism, which may not respond to pharmacotherapy. Objective: Previous case reports have reported beneficial effects from bilateral pallidal (GPi) deep brain stimulation (DBS). Here, we report the long-term clinical outcomes of 3 patients treated at our center. Methods: All patients presented with medication refractory dystonia and parkinsonism. They were followed prospectively. Clinical evaluations included the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and the Unified Parkinson's Disease Rating Scale (UPDRS). Adverse events were recorded. Results: The average length of follow-up was 45.7 months. No serious adverse events occurred. All patients experienced an immediate and sustained improvement in dystonia. Mean percentage improvement in motor subscores of BFMDRS was 63.5% at the last follow-up visit. Parkinsonism was less responsive to neuromodulation, with a mean improvement in UPDRS-III of 39.5%. Standard pallidal stimulation parameters were used. Freezing of gait developed after DBS therapy in 2 patients, stimulation-induced in one and due to disease progression in the other. Conclusion: Bilateral pallidal DBS resulted in significant and sustained improvement in dystonia and moderate improvement in parkinsonism. Pallidal DBS represents an important treatment option for XPD for the management of motor symptoms.
Stereotact Funct Neurosurg

https://ift.tt/2FVsIk3

Dermoscopy of lipidised dermatofibroma: A morphological study of 13 cases

Abstract

Background/Objectives

The aim of this study was to evaluate the morphological findings of lipidised dermatofibromas under dermoscopic observation.

Methods

Dermoscopic examination of 13 cases of lipidised dermatofibromas was performed to evaluate specific dermoscopic criteria and patterns.

Results

The most frequently occurring dermoscopic features were as follows: (i) A yellowish homogenous pigmentation in all cases (100%); this pigmentation was total in 30.7%; (ii) White structures were seen in 46.1%, most of them were central white networks (38.4%); (iii) Pigment network was observed in 53.8%, most of them were peripheral delicate pigment networks (38.4%), but two cases showed an atypical pigment network; (iv) The presence of vascular structures was common (10 cases, 77%); (v) Regarding to dermoscopic patterns, five lipidised dermatofibromas (38.4%) showed a total yellowish homogeneous pattern; 38.4% an atypical pattern and 23.2% a 'central white network + peripheral delicate pigment network' pattern.

Conclusions

The dermoscopic recognition of a total yellowish homogeneous area or a yellowish colouration in the context of a dermatofibroma can be proposed to help suspecting a lipidised dermatofibroma.

https://ift.tt/2FSaMqu

Pruritic Linear Eruption in a 53-Year-Old Woman: Answer

No abstract available

https://ift.tt/2zrXw6f

Histopathological Findings and Increased D-Dimer Are Predictive Factors of Systemic Thromboses in Eosinophilic Granulomatosis With Polyangiitis

Abstract: Eosinophilic granulomatosis with polyangiitis (EGPA; ie, Churg–Strauss syndrome) is one of the antineutrophil cytoplasmic antibody–associated vasculitis syndromes. Although extravascular granulomatoses are a well-known histopathological feature, the diverse histopathologic spectrum of cutaneous lesions has not been described in detail. Thus, this study sought to investigate the possible correlation between the clinical features and histopathology of cutaneous lesions in EGPA cases, focusing on systemic thrombogenic conditions, such as visceral infarction and deep vein thrombosis. Fourteen cases of EGPA diagnosed at the Department of Dermatology in Asahikawa Medical University from 1977 to 2017 were clinically and histopathologically reviewed. In 6 (43%) cases, skin lesions were the initial manifestation of EGPA. Among the cutaneous lesions, purpura and erythema were the most common. Persistent proteinuria and macrohematuria were observed in only 2 myeloperoxidase–antineutrophil cytoplasmic antibody–positive cases. Systemic thrombotic symptoms, such as cerebral infarction and deep vein thrombosis, were detected in 5 (36%) cases, and, in 3 of those cases, thromboses in dermal or subcutaneous vessels were observed histopathologically. Elevation of plasma D-dimer level (>2.5 μg/mL) was significantly correlated with concomitant systemic thrombotic symptoms (P = 0.0152, Fischer exact test). The histopathological finding of thrombotic features and increased plasma D-dimer were predictive factors of EGPA accompanied with systemic thromboses, such as deep vein thromboses and cerebral infarction.

https://ift.tt/2P3T4zy

The “Line Sign” Is a Rapid and Efficient Diagnostic “Test” for Morphea: Clinicopathological Study of 73 Cases

Abstract: Histologic clues that facilitate rapid diagnosis of morphea at scanning magnification have been described but not well studied. We examined 73 cases of morphea and 42 control cases to determine the sensitivity and specificity of a novel histopathological feature—"the line sign (LS)"—a prominent, straight interface between subcutis and adjacent collagen. The sensitivity of LS was shown to be the most sensitive feature among 4 other existing histopathological features. Its specificity, however, was not the highest among the other features and needs to be evaluated further in future studies to confirm the usefulness of LS as a diagnostic tool for morphea.

https://ift.tt/2zvst9t

Impact of Dermoscopy and Reflectance Confocal Microscopy on the Histopathologic Diagnosis of Lentigo Maligna/Lentigo Maligna Melanoma

Background: Equivocal pigmented lesions of the head are usually biopsied to avoid inappropriate treatment. Clinical approach has evolved from simple visual examination to sophisticated techniques for selecting the biopsy sites. Objective: This study aimed to retrospectively evaluate the efficiency of dermoscopy (DE) and reflectance confocal microscopy (RCM) in sampling a histopathologically representative focus of lentigo maligna/lentigo maligna melanoma. Methods: Punch biopsies and surgical excisions of 72 patients, 37 men and 35 women (median age 70.6 years, range 39–90 years), affected by lentigo maligna/lentigo maligna melanoma of the head, sent from a single dermatology clinic, were reviewed for the presence of 5 histopathologic criteria: atypical junctional melanocytes, increased junctional melanocytes, follicular colonization, pagetoid spread and melanocytic junctional nests, plus other minor features. Forty-two patients were biopsied under DE and 30 under RCM guidance. Results: Accuracy of the 2 techniques in sampling a representative tissue overlapped in most cases, although RCM selected sites to biopsy with more histopathologic criteria, in particular pagetoid spread and melanocytic nests. Interestingly, with RCM, inflammation and melanophages were observed more in biopsy than in excision. False positive cases were not registered. Conclusion: Compared with the sampling at naked eye, our results show that DE and RCM help selecting the most appropriate areas for biopsies, thus allowing not only more robust histopathologic diagnoses, but also a more accurate microstaging of tumor.

https://ift.tt/2P1yFLq

Expanding the Morphologic Heterogeneity of Stromal Changes in Molluscum Contagiosum Infection

No abstract available

https://ift.tt/2zrWXcG

Ewing-Like Sarcoma: A Case of a Primary Cutaneous Primitive Neuroectodermal Tumor With Atypical Immunohistochemistry and Lack of Fusion Oncogene Detection

Abstract: We present a 25-year-old male patient with a primary cutaneous primitive neuroectodermal tumor (cPNET) with unusual immunohistochemistry and lack of fusion oncogene generation. The lesion expressed CD99 and WT-1, and the histological features were consistent with cPNET. Differential diagnoses such as rhabdomyosarcoma, desmoplastic small round blue cell tumor, hematolymphoid neoplasm, neuroblastoma, and CIC-DUX round cell sarcoma were ruled out based on immunohistochemistry, genetic studies, and histology. Previous cPNET cases have been published detailing abnormal immunochemistry and genetic expression. However, to our knowledge, fusion oncogene negativity in cPNET tumors has only been reported in one other published case series. These reports, including this study, reinforce the fact that a high index of suspicion should be used when diagnosing these tumors, regardless of immunohistochemical and genetic variability. This case highlights that the typical genetic and immunohistochemical features of cPNET may be more variable than previously thought. Future studies are needed to better understand these variations of cPNET.

https://ift.tt/2P1O8Lz

Late-Onset Facial Papular Elastorrhexis

Abstract: Papular elastorrhexis, a rare defect of dermal elastic fibers of unknown origin, usually involves the trunk and extremities of children or young adults. We report the case of a 62-year-old woman with multiple soft, skin-colored facial papules with histological findings characteristic of papular elastorrhexis. Awareness of this entity may allow for its proper identification outside the usual clinical setting.

https://ift.tt/2zpOCGg

Campbell de Morgan Spots (Cherry Angiomas) Show Endothelial Proliferation

Abstract: Campbell de Morgan spots (also known as adult hemangiomas, cherry angiomas, or senile angiomas) show clinical and histopathological features that make them distinct. Despite this, they are not included as benign vascular tumors in the current classification by the International Society for Vascular Anomalies (ISSVA). In the current study, we investigated the proliferation rate (Ki67) of the endothelia of 23 cases of Campbell de Morgan spots, as well as the immunoexpression of Wilms tumor protein 1 (WT1) by these vascular anomalies. The youngest patient was 24 years old (range: 24–80; mean: 52.61). Ten patients were women (43.48%). All cases showed intense cytoplasmic expression of WT1 by the endothelia in 80%–100% of the endothelial cells. Ki67 demonstrated proliferation by the endothelia of all vascular lesions. A mean of 1077.6 nuclei were evaluated per case. Eight cases showed a very low proliferation (less than 0.5% of the nuclei). In the other 15 cases, the proliferation ranged from 0.59% to 3.59% (mean: 1.89%).

https://ift.tt/2P46oDS

Whole Slide Imaging

No abstract available

https://ift.tt/2zvSFkl

Oncocytic Metaplasia in Melanocytic Tumors

Oncocytic metaplasia represents a histopathologic feature that can be observed in normal tissue such as salivary and lacrimal glands but may also constitute a degenerative metaplastic process as a result of repeated oxidative damage during cellular aging. Although cutaneous oncocytic metaplasia has been considered rare, the finding was seen in over one-third of melanocytic nevi prospectively evaluated, in one study. This case series reports on a small series of oncocytic melanocytic tumors, with the aim of describing this phenomenon in varied contexts and also describing the use of a mitochondrial antigen immunostain, which has not been previously reported.

https://ift.tt/2P2NFsn

Pruritic Linear Eruption in a 53-Year-Old Woman: Challenge

No abstract available

https://ift.tt/2ztBTm2

Plexiform Atypical Spitz Tumor With Rosette-Like Giant Cells: A Histologic and Immunohistochemical Study on a Case Suggesting Ganglioneuroblastic Differentiation Review of the Literature and Considerations on Histogenesis

Abstract: Spitz nevi, atypical Spitz tumors and Spitzoid melanoma, the three clinicopathologic forms that constitute the spectrum of the Spitz-type melanocytic lesions, share a histologic picture characterized by large spindle and/or epithelioid ganglion-like cells, with various admixtures of multinucleate bizarre cells. This remarkable cytology has always been interpreted as an unusual, as well as unexplained form of atypia. We report a case of atypical Spitz tumor with Homer Wright–like rosettes, a feature characteristic of ganglioneuroblastic proliferation. Furthermore, the ganglion-like cells of the tumor showed basophilic punctuation in the cytoplasm, reminiscent of Nissl substance, and a few cells, whether spindled or epithelioid, were positive to neuron-specific enolase and glial fibrillary acid protein. Based on our findings, we hypothesize that the outstanding similarity of the ganglion-like cells of Spitz tumors to the normal parasympathetic ganglion cells and to the cells of ganglioneuroma and ganglioneuroblastoma may not be fortuitous. Instead, it may represent the expression of a specific pattern of melanocytic differentiation, analogous to the neurotization of common and cellular blue nevi, although in this case, it would privilege the parasympathetic lineage over the Schwannian, perineural, or endoneural pathway. Our hypothesis is supported by the literature reports of rosette formation and frank ganglioneuroblastic differentiation in Spitz tumors and melanoma and by the demonstration that parasympathetic neurons take origin from the same tracts of the neural crest as other neural and melanocytic cells.

https://ift.tt/2P56knw

Primary Visceral Merkel Cell Carcinoma: A Case Report and Review of the Literature

Abstract: A 63-year-old white man with no significant previous medical or surgical history presented with painless jaundice after 3 weeks of dark urine, yellow stools, and a 9-pound weight loss. Bilirubin, aspartate transaminase, alanine transaminase, and alkaline phosphatase were elevated, and a computed tomography scan detected a 10-cm, ill-defined mass at the porta hepatis compressing the common bile duct. He underwent endoscopic retrograde cholangiopancreatography with stenting and ultrasound-guided biopsies. Histologic sections showed a neoplastic population of small ovoid cells with a high N:C ratio, nuclear hyperchromasia, "smoky" chromatin and abundant mitotic figures, and characteristic of high-grade neuroendocrine carcinoma (HGNECA). Immunohistochemistry showed synaptophysin, chromogranin, Golgi pattern CK20 reactivity, and strong diffuse expression of Merkel cell polyomavirus, supporting a diagnosis of Merkel cell carcinoma (MCC). A metastatic workup, including complete skin examination and positron emission tomography scan, revealed no other site of disease. Although this patient fits the classic demographic pattern for MCC, he lacks cutaneous involvement and significant risk factors for MCC including immunosuppression and concurrent or previous malignancy. Histologically, the differential diagnosis in this anatomical site is primary or occult metastatic organ-based small-cell HGNECA. Although pure nodal MCC accounts for a minute subset of MCC, it is almost exclusively described in superficial and extremity-draining nodal basins (eg, axillary or inguinal regions). Primary visceral nodal MCC accounts for fewer than 5 cases ever reported. This case illustrates the importance of recognizing the morphologic features characteristic of MCC, regardless of anatomical location, and the value of immunohistochemistry in diagnosis, which aid in differentiating it from non-MCC mimics. Development of targeted therapy has made distinction between MCC and non-MCC HGNECA increasingly important. This patient initially responded to PD-L1 inhibitor therapy but ultimately died with disease 10 months after diagnosis.

https://ift.tt/2zun5nf

Vulvar Tuberculosis Cutis Orificialis Concomitant to Pulmonary Tuberculosis: A Case Report

Abstract: Tuberculosis (TB) is a common condition with increasing incidence worldwide. Cutaneous TB represents a small portion of extrapulmonary TB. Health care professionals must be aware of cutaneous forms of TB to avoid delay in diagnosis and treatment. We present a case of a 59-year-old woman with vulvar TB cutis orificialis in association with pulmonary TB without any other involvement of genitourinary system. We discuss epidemiological aspects, classification, treatment, range of histopathological patterns, and use of ancillary techniques for diagnosis.

https://ift.tt/2P5tE4z

Facial Plaque in a Woman With Sjogren Syndrome: Answer

No abstract available

https://ift.tt/2zrlAWy

Heavily Pigmented Epithelioid Melanoma With Loss of Protein Kinase A Regulatory Subunit-α Expression

Abstract: Heavily pigmented melanocytic neoplasms are genotypically and phenotypically diverse. Recently, a subset of this histopathologic spectrum was shown to harbor recurrent genetic alterations in the gene-encoding protein kinase A regulatory subunit-α (PRKAR1A). To date, no histopathologic descriptions of melanomas arising from this pathway have been described. We present a case of a darkly pigmented papule arising on the posterior neck of a 28-year-old man. Microscopically, the heavily pigmented compound melanocytic proliferation was centered in the dermis with permeation into the superficial subcutis. Tumor cells were arranged in large confluent nests and fascicles and lacked maturation with descent. The epithelioid melanocytes were characterized by enlarged vesicular nuclei with prominent nucleoli, nuclear pleomorphism, and plentiful gray-brown granular cytoplasm. Mitotic figures were readily identified. By immunohistochemistry, melanocytes were positive for mutant BRAF V600E and showed loss of Prkar1α and p16 expression. A multiplex MART-1/tyrosinase/phosophohistone-H3 immunostain demonstrated an increased mitotic index in melanocytes. The combination of highly atypical cytomorphology and architecture, increased mitoses, and p16 expression loss compelled the diagnosis of melanoma. Overall, we present the first clinicopathologic description of a PRKAR1A-inactivated melanoma to highlight morphological features and discuss mimics that may enter the differential diagnosis.

https://ift.tt/2P4POnr

Verrucous Intertriginous Plaques: Answer

No abstract available

https://ift.tt/2zrldeC

Trichoblastic Carcinosarcoma of the Skin: A Case Report and Literature Review

Abstract: An 83-year-old man presented to the dermatology department for an ulcerated skin lesion of the back that had been increasing in size during the past 11 years. The physical examination revealed a well-defined, fleshy, reddish plaque measuring 10 × 20 cm in diameter with erosions and black areas on the surface. The patient underwent surgical excision with margins of 10 mm followed by a skin graft. Histologic section showed a lesion composed of 2 intimately intermingled epithelial and mesenchymal components associated with a basal cell carcinoma (BCC). Immunohistochemical examination showed epithelial cells that were positive for CK AE1/AE3 and p53, whereas stromal cells were positive for vimentin, CD10, and p53. BCC was positive for CD10. On the basis of these findings, a diagnosis of trichoblastic carcinosarcoma associated with BCC was made. Given the scarcity of data available in the literature regarding this diagnosis, no standard of care exists. No adjuvant treatment was provided and after 1 year of follow-up, the patient did not experience recurrence.

https://ift.tt/2P2rrXu

Is Immunohistochemical Screening of Cutaneous Leiomyomas for the Early Detection of Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome Justified?

No abstract available

https://ift.tt/2zun16Z

Atypical Varicella-Zoster Kaposi Varicelliform Eruption in Sézary Syndrome

Abstract: Patients with mycosis fungoides experience considerable morbidity and mortality from secondary bacterial and viral infections. Staphylococcus aureus, β-hemolytic streptococci, herpes simplex virus, and herpes zoster virus remain the most common infectious pathogens in this group of patients. With depressed cellular immunity and diminished skin barrier as the main precipitating risk factors, immunocompromised patients can often present with an atypical presentation of a common dermatologic condition. The case herein discusses a clinically atypical nonvesicular Kaposi varicelliform eruption secondary to a varicella-zoster virus in a patient with Sézary syndrome. Concurrent polypharmacy in these patients is also a risk factor for development of drug hypersensitivity reactions. However, given their immunocompromised status, first and foremost, a careful inspection should be made of every atypical skin eruption in search of an infectious etiology, and afterward, an appropriate treatment should be promptly initiated.

https://ift.tt/2P736Qe

3D Modeling and Mohs Surgery: A Novel Approach to Medical and Patient Education

No abstract available

https://ift.tt/2FHxHVd

Repair of a Midhelical Defect

No abstract available

https://ift.tt/2r8uqUQ

0.01% Hypochlorous Acid as an Alternative Skin Antiseptic: An In Vitro Comparison

OBJECTIVE Compare the in vitro efficacy of hypochlorous acid 0.01% (HA), povidone iodine 5% (PI), chlorhexidine gluconate 4% (CHG), and isopropyl alcohol 70% (IPA) against common skin microorganisms. MATERIALS AND METHODS Time-kill studies were conducted against methicillin-susceptible Staphylococcus aureus (MSSA) and Staphylococcus epidermidis (MSSE), methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE), Candida albicans, Corynebacterium species (striatum and amycolatum), Propionibacterium acnes, Pseudomonas aeruginosa, Streptococcus pyogenes, Staphylococcus capitis, and Staphylococcus xylosus. RESULTS Methicillin-resistant S. aureus: Bactericidal effect was immediate for HA and IPA. For PI and CHG, the effect occurred at 1 and 10 minutes, respectively. Methicillin-resistant S. epidermidis: Hypochlorous acid, IPA, and PI had immediate bactericidal effects, whereas CHG required 1 minute. Methicillin-susceptible Staphylococcus aureus: All agents had bactericidal effects at 1 minute. C. species, S. pyogenes, P. aeruginosa, and P. acnes: All antiseptics demonstrated immediate bactericidal effects. Methicillin-susceptible Staphylococcus epidermidis and S. capitis: Hypochlorous acid and IPA had immediate effect, whereas PI and CHG required 1 minute. C. albicans: Hypochlorous acid, IPA, and PI were immediately bactericidal, whereas CHG required 1 minute. S. xylosus: Hypochlorous acid and CHG were immediately bactericidal, whereas IPA and PI required 1 and 2 minutes, respectively. CONCLUSION In vitro studies of HA 0.01% were observed to have equal or more efficacious antiseptic properties compared with IPA, CHG, and PI. Future studies will be needed to investigate its role in periocular use.

https://ift.tt/2FS6Ypc

Reconstruction of a Defect of the Infratip and Soft Triangle

No abstract available

https://ift.tt/2r8upjK

Estimation of Prognosis in Invasive Cutaneous Melanoma: An Independent Study of the Accuracy of a Gene Expression Profile Test

BACKGROUND Cutaneous melanomas (CMs) with similar clinical and histopathologic features can harbor differing capacities for metastasis. A validated gene expression profile (GEP) test offers prognostic information by classifying CMs as low risk (Class 1A/1B) or high risk (Class 2A/2B) for metastasis. OBJECTIVE The authors sought to perform an independent study of the predictive accuracy of the GEP test, to determine what clinical and histopathologic features predict high-risk classification, and to evaluate how intermediate classes (1B & 2A) performed clinically. MATERIALS AND METHODS Using our institution's prospectively collected melanoma registry, the authors identified patients who had been treated for CM within the last 5 years and undergone GEP testing. Clinical, histopathologic, and outcomes data were analyzed. A subcohort of patients with known metastatic disease were identified and tested. RESULTS The GEP test accurately identified 77% of metastatic CMs as high risk (Class 2). The GEP had a negative predictive value of 99% for Class 1 CMs. Class 2 CMs were 22 times more likely to metastasize. CONCLUSION The GEP test's performance in our independent cohort corresponded with previous industry-sponsored studies and proved to be a helpful clinical prognostic tool with the potential to direct patient care protocols.

https://ift.tt/2FJIBKd

Reconstruction of a Large Scalp Defect Devoid of Periosteum

No abstract available

https://ift.tt/2SgfzDj

Responses to Topical Diphenylcyclopropenone as an Adjunct Treatment for In-Transit Melanoma: A Tertiary Referral Center Experience

BACKGROUND In-transit cutaneous metastases occur in 5% to 10% of patients with melanoma. Recently, topical diphenylcyclopropenone (DPCP) has been described as a treatment option. OBJECTIVE To evaluate efficacy of DPCP in treatment of in-transit cutaneous melanoma. METHODS The authors retrospectively reviewed the records of 13 consecutive patients with in-transit metastases treated with topical DPCP between March 1, 2013, and January 31, 2017. The authors recorded the response of in-transit cutaneous melanoma lesions treated with DPCP measured by clinical examination. RESULTS Among the 13 patients, 9 patients completed at least a 1-month course of DPCP treatment. Of these 9 patients, 6 (66.7%) maintained either stable disease or had a partial or complete regression, and 3 (33.3%) had progressive disease. Patients with less burden of disease (e.g., 25 lesions or plaques). Both patients who received DPCP alone had progression of their cutaneous lesions. One patient who did not become sensitized to DPCP died within 2 months, and his anergy likely reflecting immense burden of disease. CONCLUSION Topical DPCP is a low-cost, patient-applied treatment option for in-transit melanoma, most effective for patients with relatively low tumor burden and localized disease.

https://ift.tt/2DW4wfi

Treatment of Pediatric Treadmill Burn Contractures With Ablative Fractional Laser and Topical Triamcinolone Suspension

No abstract available

https://ift.tt/2Sdd6te

Plasma Exeresis Treatment for Epidermoid Cysts: A Minimal Scarring Technique

BACKGROUND Epidermoid cysts are cutaneous benign tumors commonly seen in young or middle-aged adults. Plasma exeresis is an innovative technique for several skin conditions: it causes ionization of the atmospheric gas between the proximal tip of the device and the tissue to be treated, creating sublimation of the tissue. OBJECTIVE To remove the cyst with a novel technique that allows a good cosmetic result. MATERIALS AND METHODS Patients with clinical diagnosis of at least one epidermal cyst, aged between 18 and 70 years were enrolled. A standardized procedure was used. After administration of topical and sometimes local anesthesia (for cysts bigger than 1 cm), a tiny hole was created with plasma exeresis. The content of the cyst was then extruded and Micro Hartman Alligator Ear Forceps pulled out the loosened capsule. RESULTS Twenty patients aged between 18 and 68 years were enrolled: 11 males (55%) and 9 females (45%). Twenty-eight cysts were successfully removed. The diameter ranged from 3 to 24 mm. No side effects were observed. The scar measured not more than 3 mm. CONCLUSION This study suggests that plasma exeresis could represent a good and safe option to remove noninfected cysts on cosmetic areas, although further study is required.

https://ift.tt/2DWHqW9

Three-Staged Reconstruction of a Nasal Defect

No abstract available

https://ift.tt/2Sd0IcF

Enhancement of Photodynamic Therapy for Bowen's Disease Using Plum-Blossom Needling to Augment Drug Delivery

BACKGROUND Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery. OBJECTIVE To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone. MATERIALS AND METHODS Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100–200 J/cm2). The ALA-PDT group received ALA cream and irradiation only. RESULTS At 6 weeks, the PBN-ALA-PDT and ALA-PDT groups achieved complete response (CR) rates of 77.78% (14/18 lesions) and 40% (7/20 lesions), respectively, (p

https://ift.tt/2DYgchL

Management of a Lower Eyelid Defect

No abstract available

https://ift.tt/2Sd0Fxv

Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience

BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients.

https://ift.tt/2DZFNqD

Basal Cell Adenoma of the Upper Lip Treated With Mohs Micrographic Surgery

No abstract available

https://ift.tt/2Sgfz6h

Retrospective Evaluation of the Safety of Large Skin Flap, Large Skin Graft, and Interpolation Flap Surgery in the Outpatient Setting

BACKGROUND As the number of cutaneous surgeries continues to increase, it is important to evaluate the safety of dermatologic surgery in the outpatient setting. OBJECTIVE The authors sought to determine postoperative bleeding, infection, dehiscence, and necrosis rates in office-based dermatologic surgery using large flap, large graft, and interpolation flap repairs. The authors evaluated the relationship between these complications and surgical site, closure type, repair size, antibiotic use, and antithrombotic use. METHODS Eligible patients were identified through searching the electronic medical records from one Mohs micrographic surgeon at University Hospitals Medical Center. Patient information, surgery characteristics, and complication information were collected. Univariate and multivariate analyses were conducted to reveal associations between each complication and closure type, repair size, repair site, antithrombotic use, and antibiotic use. RESULTS Three hundred and thirty-one reconstruction procedures after Mohs micrographic surgery and excision qualified for the study. The rates of postoperative infection, hemorrhage, hematoma, necrosis, and dehiscence were 5%, 0.3%, 2.4%, 3%, and 0.9%, respectively. CONCLUSION Complications were infrequent and non–life-threatening. The authors' results indicate that dermatologic surgery using large flaps, interpolation flaps, and large grafts is safe in the office setting.

https://ift.tt/2E1WIIU

Reliability of the Patient and Observer Scar Assessment Scale When Used With Postsurgical Scar Photographs

No abstract available

https://ift.tt/2Sd0BxL

Relationship Between Midface Volume Deficits and the Appearance of Tear Troughs and Nasolabial Folds

BACKGROUND Understanding interrelationships among aging facial features is important in facial aesthetics as a global treatment approach becomes standard. OBJECTIVE Examine empirical relationships between midface volume deficit and severity of tear troughs (TTs) and nasolabial folds (NLFs) in women and men of different racial/ethnic groups. METHODS A web-based study was administered to health panel members (aged 18–75 years). Participants compared their midface volume, TTs, and NLFs against photonumeric scales depicting degrees of severity. Linear regressions were conducted to assess the relationship of midface volume on severity of TTs and NLFs, controlling for demographic factors. RESULTS Of 4,086 participants (80.0% female), 3,553 had complete data. Increasing severity of midface volume deficit was associated with increasing severity of TTs and NLFs in both sexes (all p

https://ift.tt/2DXye3z

Review of the Evaluation and Treatment of Vasovagal Reactions in Outpatient Procedures

BACKGROUND A vasovagal reaction is a commonly encountered event in outpatient procedures. There is a paucity of discussion on vasovagal reactions (VVRs) in the dermatologic surgery literature. However, recent investigations in the physiology, evaluation, and treatment of VVRs have been reported in other specialties. OBJECTIVE A comprehensive review of the physiology, evaluation, treatment, and prevention of VVRs. MATERIALS AND METHODS A search as performed using the PubMed/MEDLINE databases. Search terms included "vasovagal," "vasovagal reaction," "syncope," "reflex syncope," "neurocardiogenic syncope," and "fainting." RESULTS Studies demonstrate greater understanding in the physiology of a vasovagal reaction. Although permanent sequelae are uncommon, it is important to respond in a prompt manner. A variety of treatment and prevention options are presented. CONCLUSION Vasovagal reactions should be carefully evaluated. Additional studies may provide greater data in understanding and managing vasovagal reactions.

https://ift.tt/2SdJE6j

Efficacy, Safety, and Subject Satisfaction After AbobotulinumtoxinA Treatment of Upper Facial Lines

BACKGROUND Botulinum toxins are the treatment of choice for wrinkles in the upper third of the face. OBJECTIVE The purpose of this study was to evaluate the efficacy, safety, and subject satisfaction of abobotulinumtoxinA (ABO) for treatment of upper facial lines. MATERIALS AND METHODS Subjects aged 35 to 50 years with moderate-to-severe upper facial lines were included in this study. Subjects received a maximum of 125 s.U. ABO in at least 2 indications with optional touch-up after 2 weeks. Assessments included wrinkle severity, global aesthetic improvement, subject satisfaction, and adverse events (AEs) 1, 3, and 6 months after treatment. RESULTS At Month 1, 100, 94, and 93% of subjects were responders in dynamic glabellar, lateral canthal, and forehead lines, respectively. All subjects were improved 1 month after treatment, and the majority of the subjects were still improved after 6 months. After treatment, most subjects were satisfied with the appearance of their face, felt better about themselves, and agreed that the treatment made them look the way they feel. Seven subjects (22%) had 8 ABO-related AEs (mild–moderate); headache was most commonly reported (9%). CONCLUSION AbobotulinumtoxinA effectively treated upper facial lines, with high patient satisfaction. Treatment was generally well-tolerated.

https://ift.tt/2E0TWUu

Reconstruction of Large Nasal Dorsum Defects

No abstract available

https://ift.tt/2SkUWGf

Systemic Therapy Use and Outcomes After Relapse from Preoperative Radiation and Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma

AbstractBackground.Multimodality therapy with preoperative radiation (RT) followed by extrapleural pneumonectomy (EP) for patients with operable malignant pleural mesothelioma (MPM) has demonstrated encouraging results. At relapse, there are few data on the tolerance and efficacy of systemic therapies after prior multimodality therapy.Materials and Methods.We conducted a retrospective analysis of patients with relapsed MPM after RT and EPP ± adjuvant chemotherapy to determine overall survival (OS; date of relapse to death) and the proportion of patients that received systemic therapy and associated response rate (RR). OS was estimated using Kaplan–Meier method and potential prognostic variables were examined.Results.Fifty‐three patients were included (2008–2016). Median OS was 4.8 months (median follow‐up 4.4 months, range 0.03–34.8). Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, disease‐free interval (DFI) <1 year, and hemoglobin ≤110 g/L at recurrence were associated with worse prognosis. Thirty‐six percent of patients received any systemic therapy, whereas it was omitted in 62% because of poor PS. RR was 15% (0 complete responses, 15% partial responses) in 13 individuals with response‐evaluable disease. Therapy was discontinued because of toxicity (6/15) or disease progression (5/15), and median number of cycles was four.Conclusion.Patients with relapsed MPM following RT and EPP, especially those with ECOG PS ≥2, DFI <1 year, and hemoglobin ≤110 g/L at recurrence, have poor prognosis and low RR to first‐line systemic therapy. Earlier detection and novel diagnostic markers of relapse as well as potential neoadjuvant or adjuvant systemic therapy should be investigated in future studies.Implications for Practice.The results of this study have reinforced the importance of careful selection of appropriate candidates for this combined‐modality approach and favor prompt detection of recurrence with early and regular postoperative imaging and biopsy of suspected relapsed disease along with rapid initiation of systemic therapy even in patients with very low burden of disease. Furthermore, with the emergence of new systemic agents targeting different histological subtypes of malignant pleural mesothelioma, histological sampling of recurrence could inform therapeutic decisions in the future.

https://ift.tt/2zpuJPp

Phase I, First‐in‐Human, Dose‐Escalation Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Vorolanib in Patients with Advanced Solid Tumors

AbstractLessons Learned. Pharmacokinetic results underscore that the vorolanib (X‐82) study design was successful without the need for further dose escalation beyond 400 mg once daily (q.d.).Therefore, the recommended dose of X‐82 as a single agent in patients with advanced cancer is 400 mg q.d.Background.Vorolanib (X‐82) is a novel, oral, multikinase vascular endothelial growth factor (VEGF) receptor/platelet‐derived growth factor (PDGF) receptor inhibitor that was developed on the same chemical scaffold as sunitinib, but designed to improve upon the safety profile while maintaining the efficacy of sunitinib. By targeting the VEGF and PDGF receptors, X‐82 was expected to disrupt tumor angiogenesis and be active in a broad spectrum of solid tumors. Therefore, we determined the maximum tolerated dose (MTD) and characterized the preliminary pharmacokinetics and clinical tumor response of X‐82 as a single agent in patients with advanced solid tumors.Methods.Adult patients with advanced solid tumors received X‐82 as tablets or capsules (once daily [q.d.] or b.i.d.) every 4 weeks. Patients were evaluated for response every 8 weeks, and continued treatment until disease progression or intolerable toxicity.Results.Fifty‐two patients received study treatment in 17 cohorts. X‐82 capsule dosing was as follows: cohorts 1–6 (20–400 mg q.d.) and cohorts 7–8 (140–200 mg b.i.d.). Patients in cohorts 9–17 received 50–800 mg q.d. tablet dosing. The median time on treatment was 58 days. X‐82 blood pharmacokinetics appeared dose‐independent with a t1/2 of 5.13 hours and 6.48 hours for capsule and tablet formulations, respectively. No apparent accumulation was observed after 21 days of daily dosing.Conclusion.X‐82 had a safety profile consistent with its mechanism of action. It has a short half‐life and was well tolerated by most patients. Study enrollment ended prior to the determination of the MTD because of the apparent saturation of absorption at 400–800 mg. The recommended dose of X‐82 as a single agent in patients with advanced cancer is 400 mg q.d.

https://ift.tt/2P5mtsU

List of Reviewers 2018

https://ift.tt/2r6Njrl

Use of a modified BAPRAS Delphi process for research priority setting in Plastic Surgery in the UK

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) aims to raise understanding of the profession, and to promote innovation, education, and research. The latter is the remit of its Research Committee.

https://ift.tt/2FSgR5U

Development of the Metabolic Syndrome: Study Design and Baseline Data of the Lufthansa Prevention Study (LUPS), A Prospective Observational Cohort Survey

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0767-6361

The Lufthansa Prevention Study (LUPS) study is a prospective observation of a healthy worker cohort to identify early changes in metabolism leading to the Metabolic Syndrome (MetS) and to analyze their relation to behavioral factors like nutrition, physical activity, psychological status, and to underlying genetic conditions. The LUPS study recruited a sample of 1.962 non-diabetic healthy adults between 25–60 years, employed at a flight base of Lufthansa Technik GmbH in Hamburg, Germany. Baseline assessments included anthropometric measures, blood and urine samples and medical history. Psychosocial variables, dietary habits and life-style risk factors were assessed via self-reported questionnaires.In this report we describe the study design and present baseline parameters including the prevalence of the MetS using different classification criteria. The MetS was present in 20% of male and 12% of female subjects according to the 'Harmonizing the metabolic syndrome' definition. The prevalence varies between 2.6% in male and 2.3% in female subjects up to 48% in male and 41% in female subjects according to different classification criteria of MetS.In conclusion, this first cross-sectional view on the LUPS data confirms the expectation that this cohort is rather healthy and thus provides the opportunity to analyze early changes associated with the development of the MetS. The LUPS study is registered as a clinical trial NCT01313156.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2THByVj

Estimation of implant size based on mammograms in immediate breast reconstruction

Abstract

Background

Implant size selection is a critical component of preoperative planning for immediate breast reconstruction. This paper introduces a novel formula, based on preoperative mammograms, for estimating implant volume in patients undergoing immediate breast reconstruction.

Methods

A retrospective analysis of 115 consecutive patients with immediate breast reconstruction following skin or nipple sparing mastectomy was performed. A calculated implant size was obtained using the formula, calculated implant size (ml) = π × height (cm) × [base width (cm) − 3]. The calculations were performed independently by two surgeons and based on the ipsilateral preoperative mammogram. The calculated implant size was compared with the actual implant size used during the surgery and results were analysed.

Results

The mean calculated and actual implant sizes were 376.03 ml and 324.49 ml, respectively. There was no difference found between calculated and actual implant sizes (t = − 1.704, p = 0.090), and there was a strong positive correlation between calculated and actual implant sizes (r = 0.7748, p < 0.00001). Further analysis revealed greater accuracy of the formula in patients with an estimated implant size of less than 350 ml, and a tendency to overestimate implant size in breasts with an estimated volume of more than 350 ml.

Conclusions

The mammography-based formula is a simple and practical method to estimate implant size preoperatively. Ultimately, implant selection for the best possible cosmetic outcome is a multifactorial process, of which breast volume is one consideration. This formula can serve as a useful adjunct for preoperative assessment.

Level of Evidence: Level III, diagnostic study.

https://ift.tt/2PToYUC

Impact of androgen deprivation therapy on apparent diffusion coefficient and T2w MRI for histogram and texture analysis with respect to focal radiotherapy of prostate cancer

Abstract

Purpose

Accurate prostate cancer (PCa) detection is essential for planning focal external beam radiotherapy (EBRT). While biparametric MRI (bpMRI) including T2-weighted (T2w) and diffusion-weighted images (DWI) is an accurate tool to localize PCa, its value is less clear in the case of additional androgen deprivation therapy (ADT). The aim of this study was to investigate the value of a textural feature (TF) approach on bpMRI analysis in prostate cancer patients with and without neoadjuvant ADT with respect to future dose-painting applications.

Methods

28 PCa patients (54–80 years) with (n = 14) and without (n = 14) ADT who underwent bpMRI with T2w and DWI were analyzed retrospectively. Lesions, central gland (CG), and peripheral zone (PZ) were delineated by an experienced urogenital radiologist based on localized pre-therapeutic histopathology. Histogram parameters and 20 Haralick TF were calculated. Regional differences (i. e., tumor vs. PZ, tumor vs. CG) were analyzed for all imaging parameters. Receiver-operating characteristic (ROC) analysis was performed to measure diagnostic performance to distinguish PCa from benign prostate tissue and to identify the features with best discriminative power in both patient groups.

Results

The obtained sensitivities were equivalent or superior when utilizing the TF in the no-ADT group, while specificity was higher for the histogram parameters. However, in the ADT group, TF outperformed the conventional histogram parameters in both specificity and sensitivity. Rule-in and rule-out criteria for ADT patients could exclusively be defined with the aid of TF.

Conclusions

The TF approach has the potential for quantitative image-assisted boost volume delineation in PCa patients even if they are undergoing neoadjuvant ADT.

https://ift.tt/2r63gxZ

Neonatal gut colonisation by Staphylococcus aureus strains with certain adhesins and superantigens is negatively associated with subsequent development of atopic eczema

Abstract

Background

Insufficient early immune stimulation may predispose to atopic disease. Staphylococcus aureus, a skin and gut colonizer, produces the B‐cell mitogen protein A and T‐cell activating superantigens. Early gut colonization by S. aureus strains that possess the superantigens encoded by enterotoxin gene (egc) cluster and the elastin‐binding protein, is negatively associated with development of atopic eczema.

Objectives

To investigate whether these findings could be replicated in a second birth‐cohort, FARMFLORA and, secondly, whether nasal colonization by S. aureus also relates to subsequent atopic eczema development.

Methods

Faecal samples and nasal swabs from infants in the FARMFLORA birth‐cohort (N=65) were cultured for S. aureus. Individual strains were distinguished by RAPD (random amplified polymorphic DNA) and assessed for adhesin and superantigen gene carriage by PCR. Atopic eczema at 18 months of age was related to nasal and gut S. aureus colonisation patterns during the first 2 months of life (well before onset of eczema).

Results

S. aureus colonisation per se was unrelated to subsequent eczema development. However, gut S. aureus strains from the infants who subsequently developed atopic eczema less frequently carried the ebp gene, encoding elastin‐binding protein, and superantigen genes encoded by the egc, as compared to strains from children who remained healthy. Nasal colonization by S. aureus was less clearly related to subsequent eczema development.

Conclusion

The results precisely replicate our previous observations and may suggest that mucosal colonisation by certain S. aureus strains provides immune stimulation that strengthens the epithelial barrier and counteracts the development of atopic eczema.

This article is protected by copyright. All rights reserved.

https://ift.tt/2PSBQKJ

Social media and psoriasis treatment: What are people saying on Twitter?

Abstract

Almost half of households use the internet for seeking health related information. Because there is no regulation over the accuracy of this information, disease myths and unconventional remedies may be perpetuated. There are few studies that have used social media as a tool to assess people's perception of psoriasis or its treatment. Our aim was to evaluate commonly discussed psoriasis treatments on the social media site Twitter.

This article is protected by copyright. All rights reserved.

https://ift.tt/2Rfl5Wu

Gene expression profiling in aggressive digital papillary adenocarcinoma sheds light on the architecture of a rare sweat gland carcinoma

Abstract

Background

Sweat gland carcinomas are rare cutaneous adnexal malignancies. Aggressive digital papillary adenocarcinoma (ADPA) represents a very rare sub‐entity, thought to arise almost exclusively from sweat glands of the fingers and toes. The aetiology of sweat gland carcinomas and ADPA is largely unknown. ADPAs are most likely driven by somatic mutations. However, somatic mutation patterns are largely unexplored, creating barriers to the development of effective therapeutic approaches to the treatment of ADPA.

Objective

To investigate the transcriptome profile of ADPA using a sample of eight formalin‐fixed, paraffin embedded (FFPE) tissue samples of ADPA and healthy control tissue.

Methods

Transcriptome profiling was performed using the Affymetrix PrimeView Human Gene Expression Microarray and findings were validated via reverse‐transcription of RNA and real‐time qPCR.

Results

Transcriptome analyses showed increased tumour expression of 2,266 genes, with significant involvement of cell cycle, ribosomal and crucial cancer pathways. Our results furthermore point to tumour‐overexpression of FGFR2 (p = 0.001).

Conclusions

Our results indicate the involvement of crucial oncogenic driver pathways, highlighting cell cycle and ribosomal pathways in the aetiology of ADPA. Suggested tumour‐overexpression of FGFR2 raises the hope that targeting the FGF/FGFR axis might be a promising treatment for ADPA and probably for the overall group of sweat gland carcinomas.

This article is protected by copyright. All rights reserved.

https://ift.tt/2PSQGAS

Cadmium exposure alters steroid receptors and proinflammatory cytokine levels in endothelial cells in vitro: a potential mechanism of endocrine disruptor atherogenic effect

Abstract

Background

Cadmium (Cd) is a widespread environmental pollutant that causes alterations in human health acting as endocrine disruptor. Recent data suggest that cardiovascular system might be a contamination target tissue, since Cd is found in atheromatic plaques. Thus, the purpose of this study was to evaluate the consequence of Cd exposure of endothelial cells in vitro to evaluate detrimental effect in vascular system by a potential sex-steroid hormone receptor-dependent mechanism(s).

Methods

To this aim, Human Umbilical Vein Endothelial Cells (HUVECs) were cultured and exposed to several concentrations of cadmium chloride (CdCl₂) for different interval times.

Results

CdCl₂ exposure of HUVECs induced a significant increase of ERβ and Cyp19a1 at both mRNA and protein levels, while a drastic dose-dependent decrease of AR expression level was observed after 24 h of exposure. On the contrary, an increase of PhAR^ser308 as well as a reduction of PhGSK-3β^ser9 and PhAKT^ser473 was detected after 1 h treatment. This effect was consistently reduced by GSK inhibition. Furthermore, CdCl₂ abolished DHT-induced cell proliferation in HUVECs suggesting an antagonist-like effect of Cd on AR-mediated signaling. Remarkable, after 6 h CdCl₂—treatment, a relevant increase in TNF-α, IL-6 and IL-8 mRNA was observed and this effect was blocked by the presence of an ERβ-selective antagonist. Moreover, Cd-induced TxR1 overexpression, likely, correlated with the activation of p38 MAPK/NF-κB pathway.

Conclusion

In conclusion, our study demonstrates for the first time that Cd alters sex-steroid hormone receptors level and activity likely affecting intracellular signaling linked to a proinflammatory state in endothelial cells. This alteration might possibly lead to endothelial cell injury and vascular dysfunction and could be a mechanism of gender-specific atherogenic damages induced by endocrine disruptors and, thus, induce atherogenic events with increased risk of cardiovascular diseases in individuals exposed to this endocrine disruptor.

https://ift.tt/2RfoXHl

Linac-based radiosurgery or fractionated stereotactic radiotherapy with flattening filter-free volumetric modulated arc therapy in elderly patients

Abstract

Aim

The aim of this study was to analyze the feasibility and clinical results of linear accelerator (linac-)based stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) with flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) in elderly patients affected by brain metastases (BMs).

Patients and methods

Patients selected for the present analysis were ≥65 years old with a life expectancy of >3 months, a controlled or synchronous primary tumor, and <10 BMs with a diameter <3 cm. All patients were treated with FFF linac-based SRS/SFRT. The prescribed total dose (15–30 Gy/1–5 fractions) was based on BM size and proximity to organs at risk (OAR). Toxicity was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. MedCalc v18.2 (MedCalc Software, Ostend, Belgium) was used for statistical analysis.

Results

From April 2014 to December 2017, 40 elderly patients with 110 BMs were treated by FFF linac-based SRS/SFRT. With a median follow-up of 28 months (range 6–50 months), median and 1‑year overall survival were 9 months and 39%, respectively; median intracranial progression-free survival was 6 months. At the time of the analysis, local control was reported in 109/110 BMs (99.1%): 12 BMs had a complete response; 51 a partial response; 46 showed stable disease. One BM (0.9%) progressed after 2 months. BM volume (<1 cc) and higher SRS/SFRT dose correlated to treatment response (p = 0.01 and p = 0.0017, respectively). No adverse events higher than grade 2 were observed.

Conclusion

The present findings highlight the feasibility, safety, and effectiveness of FFF linac-based SRS/SFRT in elderly patients with BMs.

https://ift.tt/2QmAF5I

Vitamin D receptor ApaI, TaqI, BsmI, and FokI polymorphisms and psoriasis susceptibility: an updated meta‐analysis

Summary

Background

Vitamin D is considered a regulator of the immune system, and its polymorphisms have been associated with psoriasis in some but not all reports.

Aim

To explore whether vitamin D receptor (VDR) polymorphisms are associated with susceptibility to psoriasis.

Methods

Meta‐analyses were conducted to determine the associations between psoriasis and the VDR ApaI, TaqI, BsmI and FokI polymorphisms in all participants, and stratified by ethnic group.

Results

In total, 16 studies on VDR polymorphisms and psoriasis were included in this meta‐analysis, which involved 2086 patients and 2182 controls. The meta‐analysis indicated an association between psoriasis and the VDR TaqI TT genotype in Caucasian (OR = 1.29, 95% CI = 1.00–1.66, P < 0.05), but not in Asian (OR = 1.32, 95% CI = 0.89–1.96, P = 0.16) populations. However, no association was found between psoriasis and the VDR TaqI polymorphism using dominant, allele contrast or homozygous contrast models. No association was found between psoriasis and either the VDR ApaI, BsmI or FokI polymorphisms by meta‐analyses of the allele contrast, recessive, or dominant models or homozygous contrast models in the overall, Caucasian or Asian populations.

Conclusion

This meta‐analysis showed that polymorphisms in VDR ApaI, BsmI and FokI are not associated with psoriasis susceptibility in overall, Caucasian or Asian populations. However, the VDR TaqI polymorphism is associated with psoriasis susceptibility in Caucasian populations.

https://ift.tt/2RjUKXH

Comparison of NODDI and spherical mean signal for measuring intra-neurite volume fraction

Publication date: Available online 26 November 2018

Source: Magnetic Resonance Imaging

Author(s): Hua Li, Rahul Nikam, Vinay Kandula, Ho Ming Chow, Arabinda K. Choudhary

Abstract

Purpose

Neurite orientation dispersion and density imaging (NODDI) is a clinically feasible approach to measure intra-neurite volume fraction (f_in). However, the sophisticated fitting procedure takes several hours. And the NODDI model relied on several questionable assumptions. Recent analytical work demonstrated that f_in could be simply calculated from the spherical mean signal (MEANS) averaged over all gradient directions with a more solid theoretical foundation. The current study aims to compare NODDI and MEANS for measuring f_in in human brain and investigate the potential of MEANS as a fast approach in clinics.

Methods

NODDI f_in and MEANS f_in were measured and compared on the same dataset. NODDI f_in was obtained using the NODDI MATLAB Toolbox. MEANS f_in is the product of the spherical mean signal and 2bD/π, where D is the intra-neurite intrinsic diffusivity.

Results

NODDI f_in and MEANS f_in maps are similar. The voxel-by-voxel correlation suggests that NODDI f_in and MEANS f_in are approximately equivalent to each other.

Conclusion

MEANS may have potential to serve a fast and simple approach to estimate f_in in clinics.

https://ift.tt/2zuJ6SJ

Independent Contributions of Semantic and Phonological Working Memory to Spontaneous Speech in Acute Stroke

Publication date: Available online 26 November 2018

Source: Cortex

Author(s): Randi C. Martin, Tatiana T. Schnur

Abstract

Patients with left hemisphere stroke often have language deficits which impair their ability to produce phrases and sentences. One possible source of these speech impairments is the disruption of verbal working memory (WM). Single-case studies of chronic stroke have suggested the existence of a WM capacity specific to maintaining semantic information that is critical for preparing multiple words in phrases prior to speech onset (Martin & Freedman, 2001; Martin & He, 2004; Martin, Miller, & Vu, 2004; Freedman, Martin, & Biegler, 2004). The current study tested this hypothesis by examining spontaneous narrative language production and working memory capacities in a large sample of individuals at the acute stage of stroke (N=36), prior to the reorganization of function or strategy development. Here we show using a multiple regression approach that patients' semantic but not phonological WM capacity had an independent contribution in predicting phrasal elaboration and increasing utterance length whereas patients' phonological but not semantic WM capacity had an independent contribution in predicting a more rapid speech rate. Importantly, neither WM capacity independently predicted grammatical abilities in speech, implying that the other relations did not result from overall severity. These results indicate that separable semantic and phonological WM components exist that support different aspects of narrative speech. To our knowledge, this is the first study to examine spontaneous speech in a large group of acute stroke patients demonstrating a critical relationship between working memory and the ability to produce more words in phrases and longer utterances.

https://ift.tt/2SeMJmz

Resting state functional connectivity and neural correlates of face-name encoding in patients with ischemic vascular lesions with and without the involvement of the left inferior frontal gyrus

Publication date: Available online 26 November 2018

Source: Cortex

Author(s): Alana X. Batista, Paulo R. Bazán, Adriana B. Conforto, Maria da Graça M. Martins, Maurício Hoshino, Sharon. S. Simon, Benjamin Hampstead, Eberval Gadelha Figueiredo, Marcia P. Castro, Debora Michelan, Edson Amaro, Eliane C. Miotto

Abstract

Face-name association is a relevant ability for social interactions and involves the ventral and dorsolateral prefrontal cortices, particularly in the left hemisphere, bilateral hippocampal, fusiform gyrus and occipital regions. Previous studies demonstrated the primary role of the hippocampus for this ability in healthy subjects. However, no study has examined the participation of the left inferior frontal area, specially the left inferior frontal gyrus (LIFG) in patients with ischemic vascular lesions. In the present study we addressed this issue and investigated the neural correlates and resting state functional connectivity of face-name memory encoding in ischemic patients with LIFG or without lesions in the left IFG (nLIFG) and healthy controls (HC) using fMRI. The main results showed that the nLIFG group demonstrated efficient compensation related to encoding and performance on face-name learning and recognition memory task, in addition to similar brain areas activated during task performance compared to healthy controls. Some of these areas were more activated in nLIFG group, indicating a compensation mechanism. In contrast, the LIFG group showed worse behavior performance, and no signs of an efficient compensation mechanism. Functional connectivity analysis suggested that the left IFG region seems to be important for maintaining the connectivity of the right fusiform gyrus or, perhaps, lesion in this area is associated to maladaptive reorganization. Our findings highlight the relevant role of the left IFG in face-name learning and encoding, possibly as a primary region in addition to the bilateral hippocampal formation and fusiform gyrus.

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Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 39-40

The online platform for Taylor & Francis Online content The following articles have been newly published in the issue Journal of Natural History, Volume 52, Issue 39-40 on Taylor & Francis Online: Articles A new Chilean genus and species of land planarian (Platyhelminthes: Tricladida, Geoplaninae) with cephalic retractor muscle and adenodactyl Verónica N. Bulnes, José H. Grau, Fernando Carbayo Pages: 2553-2566 | DOI: 10.1080/00222933.2018.1538468 The issue is in progress. To view all articles already published in this issue, please visit: https://www.tandfonline.com/toc/tnah20/52/39-40 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Nomograms for incident risk of postpartum type 2 diabetes in Chinese women with gestational diabetes

Abstract

Worldwide the prevalence of type 2 diabetes (T2D) is increasing. Using the 2010 ADA criteria, the burden for China is already especially high. Gestational diabetes mellitus (GDM) is one of the major predictors of subsequent diabetes. A systematic review assessed the risk as seven‐fold but the studies were heterogenous² Incidence varies with socioeconomic status and ethnicity.

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