Late-occurring nivolumab-induced cryptogenic organising pneumonia mimicking lung progression in a patient with metastatic non–small cell lung cancer

Publication date: November 2017
Source:European Journal of Cancer, Volume 85
Author(s): Linda Mahjoubi, Anas Gazzah, Aurélien Marabelle, François Le Roy Ladurie, Olivier Lambotte, Caroline Caramella, Julien Adam, Benjamin Besse, Jean-Charles Soria




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A systematic review of economic evaluation in pancreatic ductal adenocarcinoma

Publication date: November 2017
Source:European Journal of Cancer, Volume 86
Author(s): Claire Gérard, Philippe Fagnoni, Angélique Vienot, Christophe Borg, Samuel Limat, Franck Daval, François Calais, Julie Vardanega, Marine Jary, Virginie Nerich
ObjectivesThe economic evaluation (EE) of healthcare interventions has become a necessity. However, high quality needs to be ensured in order to achieve validated results and help making informed decisions. Thus, the objective of the present study was to systematically identify and review published pancreatic ductal adenocarcinoma-related EEs and to assess their quality.MethodsSystematic literature research was conducted in PubMed and Cochrane to identify published EEs between 2000 and 2015. The quality of each selected EE was assessed by two independent reviewers, using the Drummond's checklist.ResultsOur systematic review was based on 32 EEs and showed a wide variety of methodological approaches, including different perspectives, time horizon, and cost effectiveness analyses. Nearly two-thirds of EEs are full EEs (n = 21), and about one-third of EEs had a Drummond score ≥7, synonymous with 'high quality'. Close to 50% of full EEs had a Drummond score ≥7, whereas all of partial EEs had a Drummond score <7 (n = 11).ConclusionsOver the past 15 years, a lot of interest has been evinced over the EE of pancreatic ductal adenocarcinoma (PDAC) and its direct impact on therapeutic advances in PDAC. To provide a framework for health care decision-making, to facilitate transferability and to lend credibility to health EEs, their quality must be improved. For the last 4 years, a tendency towards a quality improvement of these studies has been observed, probably coupled with a context of rational decision-making in health care, a better and wider spread of recommendations and thus, medical practitioners' full endorsement.



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Accuracy of screening women at familial risk of breast cancer without a known gene mutation: Individual patient data meta-analysis

Publication date: November 2017
Source:European Journal of Cancer, Volume 85
Author(s): Xuan-Anh Phi, Nehmat Houssami, Maartje J. Hooning, Christopher C. Riedl, Martin O. Leach, Francesco Sardanelli, Ellen Warner, Isabelle Trop, Sepideh Saadatmand, Madeleine M.A. Tilanus-Linthorst, Thomas H. Helbich, Edwin R. van den Heuvel, Harry J. de Koning, Inge-Marie Obdeijn, Geertruida H. de Bock
IntroductionWomen with a strong family history of breast cancer (BC) and without a known gene mutation have an increased risk of developing BC. We aimed to investigate the accuracy of screening using annual mammography with or without magnetic resonance imaging (MRI) for these women outside the general population screening program.MethodsAn individual patient data (IPD) meta-analysis was conducted using IPD from six prospective screening trials that had included women at increased risk for BC: only women with a strong familial risk for BC and without a known gene mutation were included in this analysis. A generalised linear mixed model was applied to estimate and compare screening accuracy (sensitivity, specificity and predictive values) for annual mammography with or without MRI.ResultsThere were 2226 women (median age: 41 years, interquartile range 35–47) with 7478 woman-years of follow-up, with a BC rate of 12 (95% confidence interval 9.3–14) in 1000 woman-years. Mammography screening had a sensitivity of 55% (standard error of mean [SE] 7.0) and a specificity of 94% (SE 1.3). Screening with MRI alone had a sensitivity of 89% (SE 4.6) and a specificity of 83% (SE 2.8). Adding MRI to mammography increased sensitivity to 98% (SE 1.8, P < 0.01 compared to mammography alone) but lowered specificity to 79% (SE 2.7, P < 0.01 compared with mammography alone).ConclusionIn this population of women with strong familial BC risk but without a known gene mutation, in whom BC incidence was high both before and after age 50, adding MRI to mammography substantially increased screening sensitivity but also decreased its specificity.



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Assessing value in breast reconstruction - a systematic review of cost-effectiveness studies

Breast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high value care models.

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87th Annual Meeting of the American Thyroid Association October 18–22, 2017, Victoria, British Columbia, Canada

Angela M. Leung and Mingzhao Xing
2017 ATA Annual Meeting Co-Chairs.

 We are excited that the 87th annual meeting of the American Thyroid Association (ATA) is almost upon us! On behalf of the Program Committee, we look forward to welcoming attendees and their guests to the annual meeting that will be held October 18–22, 2017, at the Fairmont Empress and Victoria Conference Centre in Victoria, British Columbia, Canada. Over this past year, the committee, comprised of experts from all thyroid disciplines, has thoughtfully worked to put together a program featuring the latest advances in basic, translational, and clinical thyroidology. Read More….

The post 87th Annual Meeting of the American Thyroid Association October 18–22, 2017, Victoria, British Columbia, Canada appeared first on American Thyroid Association.

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Cardiac pathologic findings in three unusual cases of sudden cardiac death related to anorexiant drugs

Publication date: Available online 9 October 2017
Source:Human Pathology
Author(s): Ornella Leone, Valentina Agostini, Alberto Foà, Bruna Cerbelli, Cira Rosaria Tiziana di Gioia, Mariarosaria Aromatario, Costantino Ciallella, Joaquin Lucena, Giulia d'Amati
Amphetamine congeners can be prescribed as anorexiant drugs, despite their potential side effects, including cardiac toxicity. However, the morphologic features of cardiac damage related to protracted use of these compounds are unknown. We provide a detailed description of cardiac autopsy findings in three cases of sudden death associated with protracted use of high-doses of phendimetrazine and/or phenylpropanolamine or bupropion prescribed as anorexiants, in association with other compounds. The main cardiac findings were similar in all three cases: i) mild–moderate hypertrophy of the left ventricle and/or the septum; ii) myocardial non-ischemic scarring (mid-mural and/or sub-epicardial) appearing as discrete foci or with a band/like morphology; iii) mild–moderate intramural small vessel disease, in absence of significant epicardial coronary artery stenosis; iv) acute/recent inflammatory lesions consistent with toxic myocarditis. In summary, the detailed pathology examination of the heart in these three cases revealed myocardial lesions identical to those reported in catecholamine myocardial damage, in all their various stages of evolution. In presence of a clinical history of long-term intake of anorexiants of this category, it is most important at autopsy to recognize and correctly interpret the acute and chronic myocardial lesions of the type herein described, since they represent an anatomical substrate for arrhythmic death.



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Calf hemodialysate hypothesis: Nutritive value plus placebo effect

Publication date: November 2017
Source:Medical Hypotheses, Volume 109
Author(s): Sergei V. Jargin




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Reactions between methylglyoxal and its scavengers in-vivo appear to be catalyzed enzymatically

Publication date: Available online 9 October 2017
Source:Medical Hypotheses
Author(s): Benjamin Szwergold
Methylglyoxal (MGO) is an important contributor to the development of diabetic complications. In this paper I propose that MGO, not detoxified by the glyoxalase system, is removed from circulation by MGO-scavengers. Furthermore, since rates of reactions between MGO and its scavengers in-vitro are low, I propose that in-vivo these reactions are catalyzed enzymatically.



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M. biceps femoris - a wolf in sheep’s clothing: The downside of a lower limb injury prevention training

Publication date: Available online 9 October 2017
Source:Medical Hypotheses
Author(s): Thomas Ertelt, Thomas Gronwald
Both, hamstring and ACL injuries are amongst the most typical injuries, particularly in change of direction and high speed running sports. They're also difficult to treat. Therefore, in the past few years, sports medicine practitioners and exercise scientists have mainly been focusing on the de velopment and implementation of preventive programs in order to reduce the number of lower limb injuries, mainly by improving knee alignment. A number of studies have been able to prove the success of these training interventions, which are mainly addressing sensorimotor abilities and plyometric activities. The number of non‐contact hamstring injuries has nevertheless been on the rise, particularly in sports like soccer and football. Therefore, the purpose of the following article is to introduce the hypothesis that the above‐mentioned training interventions have a massive influence on the activation patterns on the targeted muscle group, and on the biceps femoris in particular. Muscle function and the resulting internal load are directly related to muscle architec ture at the insertion. Training induced adaptations in hamstring activation patterns can thus lead to an increased injury susceptibility. In this case, a simulation model that directly relates to an acute deceleration maneuver provides valuable insights into the function of the biceps femoris muscle, especially when the rate of activity and the muscle geometry at the insertion area are taken into consideration. We conclude that there needs to be a greater individualization of pre vention programs, especially in regards to anatomical requirements, in order to further reduce injury rates in elite sports. Moreover, it would also seem reasonable to apply a similar approach to aspects of chronic pain such as chronic non‐specific low back pain.



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Organizational downsizing and alcohol use: A national study of U.S. workers during the Great Recession

Publication date: February 2018
Source:Addictive Behaviors, Volume 77
Author(s): Michael R. Frone
Organizational downsizing, which represents the reduction of an organization's workforce, results in a stressful work environment for those who survive the downsizing. However, we know little about the association between surviving an organizational downsizing and employee alcohol use. This study explored the association between exposure to organizational downsizing and four dimensions of alcohol use during the Great Recession. Also explored were the moderating influences of length of recession exposure, state drinking culture, gender, age, education, family income, and financial demands. Data for this study came from a national telephone survey of U.S. workers that was conducted from December 2008 to April 2011 (N=2296). The results revealed that exposure to organizational downsizing was positively associated with usual frequency of drinking, number of drinks consumed per usual drinking occasion, and both the frequency of binge drinking and drinking to intoxication. Length of exposure to the recession moderated the association between organizational downsizing exposure and usual number of drinks consumed. The conditional effects revealed that this association became stronger as length of exposure to the recession increased. Furthermore, age moderated the associations between organizational downsizing exposure and the usual number of drinks consumed and the frequency of binge drinking and intoxication. The conditional effects revealed that these associations were positive and significant among young survivors (ages 40 or younger), but were nonsignificant among middle-aged survivors (over 40years of age). State drinking culture, gender, education, family income, and financial demands did not moderate the associations between organizational downsizing exposure and alcohol use.



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When the party continues: Impulsivity and the effect of employment on young adults' post-college alcohol use

Publication date: February 2018
Source:Addictive Behaviors, Volume 77
Author(s): I.M. Geisner, J. Koopmann, P. Bamberger, M. Wang, M.E. Larimer, I. Nahum-Shani, S. Bacharach
BackgroundThe transition from college to work is both an exciting and potentially high risk time for young adults. As students transition from academic settings to full-time employment, they must navigate new social demands, work demands, and adjust their drinking behaviors accordingly. Research has shown that there are both protective factors and risk factors associated with starting a new job when it comes to alcohol use, and individual differences can moderate these factors.Method1361 students were recruited from 4 geographically diverse universities and followed 1month pre- and 1month post-graduation. Drinking frequency, quantity, consequences, and impulsivity were assessed.ResultsFull-time employment was related to increased drinking quantity but not related to changes in other drinking outcomes. However, impulsivity moderated the relationship between employment and drinking. For those reporting higher levels of impulsivity at baseline, full-time employment was associated with an increase in drinking variables (quantity and frequency), whereas drinking was unaffected by full-time employment status among those reporting lower levels of impulsivity. Implications for future research are discussed.



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Smoking and drinking behaviors of military spouses: Findings from the Millennium Cohort Family Study

Publication date: February 2018
Source:Addictive Behaviors, Volume 77
Author(s): Daniel W. Trone, Teresa M. Powell, Lauren M. Bauer, Amber D. Seelig, Arthur V. Peterson, Alyson J. Littman, Emily C. Williams, Charles C. Maynard, Jonathan B. Bricker, Edward J. Boyko
Introduction: The associations between stressful military experiences and tobacco use and alcohol misuse among Service members are well documented. However, little is known about whether stressful military experiences are associated with tobacco use and alcohol misuse among military spouses. Methods: Using 9872 Service member–spouse dyads enrolled in the Millennium Cohort Family Study, we employed logistic regression to estimate the odds of self-reported cigarette smoking, risky drinking, and problem drinking among spouses by Service member deployment status, communication regarding deployment, and stress associated with military-related experiences, while adjusting for demographic, mental health, military experiences, and Service member military characteristics. Results: Current cigarette smoking, risky drinking, and problem drinking were reported by 17.2%, 36.3%, and 7.3% of military spouses, respectively. Current deployment was not found to be associated with spousal smoking or drinking behaviors. Communication about deployment experiences with spouses was associated with lower odds of smoking, but not with risky or problem drinking. Spouses bothered by communicated deployment experiences and those who reported feeling very stressed by a combat-related deployment or duty assignment had consistently higher odds of both risky and problem drinking. Conclusions: Our findings suggest that contextual characteristics about the deployment experience, as well as the perceived stress of those experiences, may be more impactful than the simple fact of Service member deployment itself. These results suggest that considering the impact of deployment experiences on military spouses reveals important dimensions of military community adaptation and risk.



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Testing weight motives and guilt/shame as mediators of the relationship between alcohol use and physical activity

Publication date: February 2018
Source:Addictive Behaviors, Volume 77
Author(s): Tonya Dodge, Paige Clarke
ObjectivesTest whether weight motives and guilt/shame mediate the positive relationship between physical activity and alcohol use among college-attending young adults.DesignA longitudinal design was employed.MethodYoung adults who were attending college (N=371) completed two self-administered questionnaires separated by approximately one month. Heavy episodic drinking was assessed at Time 1. Vigorous physical activity, moderate physical activity, weight motives, and guilt/shame were assessed at Time 2.ResultsResults are consistent with weight motives as a mediator of the positive relationship between heavy episodic drinking and vigorous physical activity. Results were inconsistent with guilt/shame as a mediator of this relationship. There was no statistically significant relationship between heavy episodic drinking and moderate physical activity.ConclusionsHeavy episodic drinking was related to vigorous but not to moderate physical activity in the subsequent 30-days. Furthermore, the results are consistent with weight motives as a mediator of the relationship between alcohol use and vigorous physical activity.



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E-cigarette use among treatment-seeking smokers: Moderation of abstinence by use frequency

Publication date: February 2018
Source:Addictive Behaviors, Volume 77
Author(s): Emily N. Subialka Nowariak, Rebecca K. Lien, Raymond G. Boyle, Michael S. Amato, Laura A. Beebe
IntroductionEmerging literature suggests that frequency of use of electronic cigarettes (e-cigarettes) may be an important moderating variable in the relationship between e-cigarette use and smoking cessation. However, few studies have focused specifically on treatment-seekers, a group that may differ in important ways from smokers in the general population. This study looks at the relationship between e-cigarette use frequency and abstinence among a sample of treatment-seeking tobacco users.MethodsSeven-month follow-up survey data from N=2760 treatment-seeking tobacco users who utilized statewide tobacco quitlines in three states were used to assess the relationship between 30-day point prevalence abstinence and e-cigarette use frequency at follow-up. E-cigarette use was examined in two ways. First, we looked at any use in the past 30days versus no use. Additionally, past 30-day e-cigarette use frequency was categorized into four groups: 0days, 1–5days – infrequent, 6–29days – intermediate, 30days – daily. Logistic regression models were constructed predicting 30-day point prevalence tobacco abstinence.ResultsBoth infrequent (AOR=0.35; CI=0.20–0.59) and intermediate (AOR=0.50; CI=0.32–0.80) past 30-day e-cigarette use were associated with lower rates of tobacco abstinence versus no past 30-day use. However, daily e-cigarette users (AOR=1.16; CI=0.71–1.70) had similar 30-day abstinence when compared to non-users.ConclusionsResults from this study of treatment-seekers support findings from studies of general population tobacco users that suggest frequency of e-cigarette use is an important moderating variable in the relationship between e-cigarette use and tobacco cessation. Future studies should employ more refined measures of e-cigarette use.



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Sexual orientation disparities in prescription drug misuse among a nationally representative sample of adolescents: Prevalence and correlates

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The comparison of pinch strength among female typists and female non-typists

Publication date: Available online 9 October 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Zahra Rojhani-Shirazi, Ladan Hemmati, Zahra Saadat, Zeinab Shirzadi
BackgroundTyping is a common activity involving repetitive motion that can increase the risk of work-related injuries. To the best of our knowledge, the effect of typing on the pinch strength has not been investigated so far.ObjectiveTo investigate the pinch strength amongst female typists and non-typists.MethodThirty female typists and 30 female non-typists, aged 20–30 years old, participated in this prospective study. The pinch strength of the second, third, fourth and fifth fingers of the dominant hand was measured in a sitting position, using a pinch gauge. The data were analyzed using independent sample t-test.ResultsThe results showed that there were significant differences in the pinch strength of the second, third and fourth fingers between the two groups. The strength of these fingers was reduced more than that in female non-typists.ConclusionOur results suggest that pinch strength might have decreased in female typists due to sharing common attentional resources, muscle fiber composition, and muscle fiber fatigue.



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A Practical Guide About Tattooing in Patients with Chronic Skin Disorders and Other Medical Conditions

Abstract

With tattoos becoming increasingly mainstream, dermatologists are more and more often consulted by patients who are considering getting an ornamental, cosmetic, or even a medical tattoo, and who subsequently ask for advice. This includes not only patients with chronic skin diseases such as psoriasis or atopic dermatitis but also patients with other medical conditions. This review first explores the reasons why patients may want to get a tattoo and aims to offer some key information to dermatologists on what they should know about tattooing and the main risks associated with this procedure. Second, the risks and recommendations of tattooing in patients with specific skin diseases are described more in detail, and the relative and strict contraindications discussed, including the necessity to discontinue certain treatments that could influence the outcome of the procedure and the final result. Our aim was to provide dermatologists with the current knowledge they need to help their patients make adequate and informed choices on skin art, focusing specifically on considerations in patients with chronic skin conditions. Finally, other aspects regarding some general systemic conditions and concomitant diseases that the patient could present are also addressed. In particular, the risks of tattooing in patients with diabetes, coagulation disorders, heart conditions, immunosuppressive treatments, and pregnancy are discussed.

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Update on tumor-infiltrating lymphocytes (TILs) in breast cancer, including recommendations to assess TILs in residual disease after neoadjuvant therapy and in carcinoma in situ: a report of the International Immuno-Oncology Biomarker Working Group on Breast Cancer

Publication date: Available online 9 October 2017
Source:Seminars in Cancer Biology
Author(s): Maria Vittoria Dieci, Nina Radosevic-Robin, Susan Fineberg, Gert van den Eynden, Nils Ternes, Frederique Penault-Llorca, Giancarlo Pruneri, Timothy M. D'Alfonso, Sandra Demaria, Carlos Castaneda, Joselyn Sanchez, Sunil Badve, Stefan Michiels, Veerle Bossuyt, Federico Rojo, Baljit Singh, Torsten Nielsen, Giuseppe Viale, Seong-Rim Kim, Stephen Hewitt, Stephan Wienert, Sybille Loibl, David Rimm, Fraser Symmans, Carsten Denkert, Sylvia Adams, Sherene Loi, Roberto Salgado
Morphological evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer is gaining momentum as evidence strengthens the clinical relevance of this immunological biomarker. TILs in the post-neoadjuvant residual disease setting are acquiring increasing importance as a stratifying marker in clinical trials, considering the raising interest on immunotherapeutic strategies after neoadjuvant chemotherapy. TILs in ductal carcinoma in situ, with or without invasive carcinoma, represent an emerging area of clinical breast cancer research. The aim of this report is to update pathologists, clinicians and researchers on TIL assessment in both the post-neoadjuvant residual disease and the ductal carcinoma in situ settings. The International Immuno-Oncology Working Group proposes a method for assessing TILs in these settings, based on the previously published International Guidelines on TIL Assessment in Breast Cancer. In this regard, these recommendations represent a consensus guidance for pathologists, aimed to achieve the highest possible consistency among future studies.



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Response of MG63 osteoblasts on bacterial challenge is dependent on the state of differentiation

Summary

The present in-vitro-study examines molecular processes relevant during bone homeostasis after Aggregatibacter actinomycetemcomitans (A.a.) and Porphyromonas gingivalis (P.g.) infection with a focus on the differentiation level of osteoblasts. Regenerative processes are often hindered by the recurrence of bacterial infections, which can ultimately provoke a severe destruction of bone tissue. To get more detailed insights into such a complex scenario, we have used undifferentiated MG63 osteoblast-like cells as an experimental paradigm to examine the impact of two oral pathogens, A.a. and P.g., on proliferation, cytotoxicity, and osteogenic differentiation. Cell culture experiments were performed to analyze cellular behavior. The level of genes interfering with bone tissue integrity (matrix metalloproteinases and their tissue inhibitors) and osteogenic markers (alkaline phosphatase, Runx2, human β-defensin-2) was compared in undifferentiated versus differentiated MG63 cells using real-time polymerase chain reaction. Functional activity of matrix metalloproteinases was quantified by zymography. Western Blot analysis was used to verify the phosphorylation state of mitogen-activated protein kinases p38 and extracellular-signal regulated kinases ERK1/2. When co-cultured with undifferentiated MG63 cells, oral pathogens provoked distinct cellular effects. Only A.a. reduced cell proliferation, increased cell death, and induced osteogenic differentiation. A comparison of the MMP network stability in the presence of oral pathogens revealed a partial sensitivity towards P.g. but not A.a. Thus, beside the proof of concept that MG63 cells co-cultured with oral pathogens can serve as an in-vitro-model for mimicking destructive and regenerative events after bacterial infections, our data indicate that double infections might counterbalance otherwise positive effects.

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Antibacterial effect and bond strength of a modified dental adhesive containing the peptide nisin

Publication date: Available online 9 October 2017
Source:Peptides
Author(s): Meixuan Su, Shunyi Yao, Lisha Gu, Zihua Huang, Sui Mai
This study attempted to incorporate the antibacterial peptide nisin into an etch-and-rinse dental adhesive to evaluate the antibacterial activity of the modified adhesive against Streptococcus mutans and the bond strength. Single Bond 2 was used as a negative control, and nisin was incorporated at 1%, 3%, and 5% (w/v). The antibacterial activity against S. mutans was evaluated using the film contact test, the agar diffusion test, XTT assays and confocal laser scanning microscopy (CLSM). The microtensile bond strength (μTBS) of the modified dental adhesive was also evaluated. The cured nisin-incorporated dental adhesive exhibited a significant inhibitory effect on the growth of S. mutans (P<0.05), and the inhibitory effect was strengthened as the nisin concentration increased (P<0.05). However, no significant differences in the agar diffusion test were found for the cured nisin-incorporated adhesives compared with the control group. Based on XTT results and CLSM images, the cured nisin-incorporated adhesive interfered with the adherence of S. mutans and the integrity of its biofilms (P<0.05). Compared with the control group, the 1% nisin group did not exhibit a significant difference in μTBS (P>0.05), whereas the 3% and 5% nisin groups displayed decreased bond strength (P<0.05).



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