Combination therapy versus monotherapy in the treatment of recalcitrant warts: A clinical and immunological study

Summary

Background

Treatment of recalcitrant warts represents a continuing therapeutic challenge. Combination therapies can help improve treatment response, decrease adverse effects, and reduce recurrence.

Objective

To compare the efficacy, safety and immunological effects of a combined acitretin‐intralesional Candida antigen against acitretin alone and Candida antigen alone for intractable warts.

Methods

Sixty adult patients with intractable warts were included in this study. Patients were subdivided into three groups, each containing 20 patients. Acitretin alone was taken by patients of group I, Candida antigen alone was injected in patients of group II, and group III received a combination of intralesional Candida antigen and acitretin. Serum cytokine levels of IL‐10 and IFN‐γ were measured before and after therapy in the studied groups.

Results

Total resolution of warts was achieved in 8 patients (40%) of the acitretin alone group, 9 patients (45%) of the Candida antigen alone group and 15 patients (75%) of the combination therapy group. The therapeutic response was statistically higher in the combined acitretin‐Candida antigen group as compared with either agent alone. Adverse effects were non‐significant in the three groups. There were no statistically significant differences in the serum levels of IFN‐γ and IL‐10 between responders and non‐responders after therapy in the three studied groups.

Conclusion

The combination therapy of acitretin + Candida antigen is superior to either agent alone. Serum cytokine levels of IL‐10 and IFN‐γ were not associated with clearance or persistence of warts in any of the studied groups.

http://bit.ly/2EZ08wH

Sterol‐standardized phytopharmaceutical from ground cherry: Corticoid‐like properties on human keratinocytes and fibroblasts and its effects in a randomized double‐blind placebo‐controlled clinical trial

Summary

Background

Topical corticosteroids have been the most commonly prescribed drugs to treat skin inflammation, but their uses can lead to several adverse effects. Nowadays, new pharmacological strategies have been evaluated to improve dermatologic efficacy and reduce adverse effects, including natural products.

Objectives

The aim of this study was to evaluate and compare the effects of a plant sterol standardized supercritical CO₂ phytopharmaceutical of Physalis angulata L. with hydrocortisone on the immune and inflammatory mediators, and skin repair components production. Moreover, we studied effects of both products on the skin microcirculation and temperature in a double‐blind placebo‐controlled clinical trial.

Methods

Both products were evaluated on the immune (IL‐6, IL‐10, INF‐γ, TNF‐α, and IL‐1α), inflammatory (COX‐2, LOX, PLA₂, PGE₂, LTB₄, histamine, and NF‐κB), and repair components (TGF‐β, GM‐CSF, collagen, and GAG) production on human keratinocytes and fibroblast in non‐stimulated and LPS‐stimulated conditions. Indeed, in a randomized double‐blind placebo‐controlled clinical trial, we evaluated the effects of the both creams on the skin microcirculation and temperature using laser Doppler and infrared thermometer, respectively.

Results

Physalis angulata acted on the skin, modulating immune status and inflammatory response producing corticoid‐like effects, but different of hydrocortisone, increased skin repair factors. The effects of phytopharmaceutical cream in the clinical trial promoted a better reduction in skin microcirculation and temperature than hydrocortisone.

Conclusions

Taken together, the results indicate that sterol standardized CO₂ supercritical preparation of P angulata is a new and innovative phytopharmaceutical with multiple pharmacological effects potentially useful as human skin protective product, particularly against cutaneous inflammatory disorders.

http://bit.ly/2EYuHBH

1927‐nm fiber‐optic diode laser: A novel therapeutic option for facial steatocystoma multiplex

Summary

Steatocystoma multiplex (SM) is a cutaneous disorder that presents with multiple yellowish intradermal cysts originating from the pilosebaceous ducts. Although various treatments have been attempted to improve cosmetic outcomes, no optimal treatment strategy has been established to date. A 41‐year‐old man presented with a 10‐year history of multiple skin‐colored papulonodules over his entire body. He was diagnosed with SM, and we treated his facial SM with a 1927‐nm diode laser. Two treatment sessions at a 5‐week interval led to cosmetically excellent outcomes. There was no recurrence at the 8‐month follow‐up. Herein, we present a case of SM that was successfully treated with a 1927‐nm fiber‐optic diode laser.

http://bit.ly/2EYIf1c

Primary cutaneous embryonal rhabdomyosarcoma with desmoplastic growth pattern and anaplastic lymphoma kinase overexpression. Report of a case with special emphasis on the differential diagnosis

http://bit.ly/2Qe3oW0

Giant cutaneous pleomorphic fibroma: an unusual presentation

http://bit.ly/2Vgag9c

Scholar : Molecular and Clinical Oncology - Volume:10 Number:2

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TABLE OF CONTENTS February-2019 Volume 10 Issue 2

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Androgen receptor and soy isoflavones in prostate cancer (Review) Monika Kmetová Sivoňová, Peter Kaplán, Zuzana Tatarková, Lucia Lichardusová, Róbert Dušenka, Jana Jurečeková View Abstract ❯
Prognostic and therapeutic role of HER2 expression in micropapillary carcinoma of the bladder (Review) Francesca Sanguedolce, Davide Russo, Vito Mancini, Oscar Selvaggio, Beppe Calo, Giuseppe Carrieri, Luigi Cormio View Abstract ❯
Clinical significance of Stathmin1 expression and epithelial‑mesenchymal transition in curatively resected gastric cancer Bin Ke, Xiao‑Fan Guo, Ning Li, Liang‑Liang Wu, Bin Li, Ru‑Peng Zhang, Han Liang View Abstract ❯
Inflammatory breast cancer in 210 patients: A retrospective study on epidemiological, anatomo‑clinical features and therapeutic results Maroua Manai, Pascal Finetti, Nesrine Mejri, Salma Athimni, Daniel Birnbaum, François Bertucci, Khaled Rahal, Amor Gamoudi, Max Chaffanet, Mohamed Manai, Hamouda Boussen View Abstract ❯
Metastasis of pulmonary adenocarcinoma to the palatine tonsil Lena Zaubitzer, Nicole Rotter, Christoph Aderhold, Timo Gaiser, Frederic Jungbauer, Benedikt Kramer, Beatrice Kuhlin, Carsten Thorn, Anne Lammert View Abstract ❯
Intestinal obstruction caused by primary adenosquamous cell carcinoma of the small intestine: A case report and review of the literature Naotake Funamizu, Yukio Nakabayashi, Katsushi Dairaku, Kenta Tomori, Yuki Hiramoto, Kazunao Kurihara View Abstract ❯
Vessel wall magnetic resonance imaging findings and surgical treatment in nilotinib‑associated cerebrovascular disease: A case report Kohei Suzuki, Junkoh Yamamoto, Shingo Kakeda, Seishiro Takamatsu, Ryo Miyaoka, Takehiro Kitagawa, Takeshi Saito, Yoshiteru Nakano, Shigeru Nishizawa View Abstract ❯
Histological complete response with nivolumab for renal cell carcinoma with multiple metastases: A case report Suguru Shirotake, Go Kaneko, Koji Nagata, Masafumi Oyama, Koshiro Nishimoto View Abstract ❯
Poorly differentiated pulmonary synovial sarcoma with SYT gene amplification: A case report Xiaoyan Li, Dan Wu, Yuhui Zheng, Huanxing Yang, Yinghong Yang View Abstract ❯
Core needle biopsy promotes lung metastasis of breast cancer: An experimental study Yongqiang Fu, Fangming Guo, Haohao Chen, Yiping Lin, Xiaoyan Fu, Hui Zhang, Mingxing Ding View Abstract ❯
Protective effects of genistein and melatonin on mouse liver injury induced by whole‑body ionising radiation Gonca Hanedan Uslu, Emine Canyilmaz, Lasif Serdar, Şafak Ersöz View Abstract ❯
Pembrolizumab-induced autoimmune encephalitis in a patient with advanced non-small cell lung cancer: A case report Maiko Niki, Aya Nakaya, Takayasu Kurata, Kahori Nakahama, Hiroshige Yoshioka, Toshihiko Kaneda, Kayoko Kibata, Makoto Ogata, Shosaku Nomura View Abstract ❯
Complete remission of peritoneal dissemination of colon cancer by alternate‑day S‑1 and oxaliplatin plus bevacizumab treatment and maintenance chemotherapy comprising alternate‑day S‑1 plus bevacizumab: A case report Nobuhiro Nitori, Ayu Kato, Tomoaki Deguchi, Jumpei Nakadai, Ayako Tada, Makoto Takahashi, Rumiko Umeda, Naoteru Miyata, Mikinori Kataoka, Tomohisa Kadomura, Hajime Higuchi, Hirotoshi Ebinuma, Atsushi Kato, Takashi Hatori, Yoshifumi Ikeda, Masaru Miyazaki View Abstract ❯
Improved prognosis of low baseline neutrophil‑to‑lymphocyte ratio is significantly exclusive in breast cancer patients with high absolute counts of lymphocytes Yukie Fujimoto, Hiromi Ozawa, Tomoko Higuchi, Yoshimasa Miyagawa, Ayako Bun, Michiko Imamura, Yasuo Miyoshi View Abstract ❯
Impact of the occurrence of new lesions on the survival of patients who undergo chemotherapy for metastatic colorectal cancer Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Tatsunari Fukuoka, Shinji Matsutani, Shinichiro Kashiwagi, Kosei Hirakawa, Masaichi Ohira View Abstract ❯
Tolerability and safety of real‑world use of pomalidomide in patients with relapsed/refractory multiple myeloma Eiseki Usami, Michio Kimura, Shoya Takenaka, Mina Iwai, Hitomi Teramachi, Tomoaki Yoshimura View Abstract ❯
Pulmonary cement embolism following balloon kyphoplasty: The impact of a procedural complication in a new era for lung cancer management Daniela Marta Rodrigues, Daniela Patrícia Cunha Machado, Sérgio André Campainha Fernandes, Ana Maria Paixão Barroso View Abstract ❯
Isolated adrenocorticotropic hormone deficiency potentially induced by nivolumab following pseudo‑progression in clear cell renal cell carcinoma: A case report Nobuki Furubayashi, Takahito Negishi, Tomoharu Uozumi, Dai Takamatsu, Koichi Shiraishi, Daisuke Hirose, Motonobu Nakamura View Abstract ❯
Elevated IL‑6/IL‑1Ra ratio as a prognostic biomarker of poor chemotherapy efficacy in Chinese patients with metastatic NSCLC, validated in a Caucasian patient cohort Fang Liu, Benoît Sansas, Xavier Préville, Romain Gineste, Jialei Wang, Hui Yu, Xia Meng, Romain Micol, Luc Barraud View Abstract ❯
Human immunodeficiency virus‑negative multicentric Castleman's disease coexistent with Kaposi's sarcoma on 18F‑FDG PET/CT: A case report Jae Pil Hwang, Jiyoon Kim, Jung Mi Park View Abstract ❯

20-22 September, 2018, Metropolitan Hotel, Athens, Greece 23nd World Congress on Advances in Oncology & 22th International Symposium on Molecular Medicine 18-19 September 2018, Pre-Congress Workshop: 'MicroRNA Analysis'

28-30 March, 2019, Tawana Hotel, Bangkok, Thailand 23 rd International Symposium on Molecular Medicine

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BCG Therapy for Type 1 Diabetes: Restoration of Balanced Immunity and Metabolism

Publication date: Available online 29 December 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Willem M. Kühtreiber, Denise L. Faustman

The bacillus Calmette–Guerin (BCG) vaccine is a microorganism developed as a vaccine for tuberculosis 100 years ago and used as therapy for bladder cancer 40 years ago. More recently, BCG has shown therapeutic promise for type 1 diabetes (T1D) and several other autoimmune diseases. In T1D, BCG restored blood sugars to near normal, even in patients with advanced disease of >20 years duration. This clinically important effect may be driven by resetting of the immune system and the shifting of glucose metabolism from overactive oxidative phosphorylation, a state of minimal sugar utilization, to aerobic glycolysis, a state of high glucose utilization, for energy production. The mechanistic findings support the Hygiene Hypothesis and reveal the immune and metabolic synergy of mycobacterial reintroduction in modern humans.

http://bit.ly/2AnnCaN

Diffusion kurtosis imaging of endometrial carcinoma: Correlation with histopathological findings

Publication date: Available online 30 December 2018

Source: Magnetic Resonance Imaging

Author(s): Ichiro Yamada, Junichiro Sakamoto, Daisuke Kobayashi, Naoyuki Miyasaka, Kimio Wakana, Noriko Oshima, Akira Wakabayashi, Yukihisa Saida, Ukihide Tateishi, Yoshinobu Eishi

Abstract

Purpose

In this study, we aimed to determine the usefulness of diffusion kurtosis imaging (DKI) as a noninvasive method for the evaluation of tumor invasion depth, histological grade, and lymph node metastasis in patients with endometrial carcinoma (EMC).

Materials and methods

Our institutional review board approved this retrospective study and waived informed consent. In total, 24 patients suspected of having EMC were examined by a 1.5-T magnetic resonance imaging. DKI data were obtained using a single-shot echo-planar imaging sequence with four b values (0, 500, 1000, and 2000 s/mm²). Kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) maps were generated and compared with histopathological findings.

Results

K maps from all patients identified the junctional zone as a distinct high-K zone (1.443 ± 0.362). This zone was significantly different from the zone of endometrium and outer myometrium (0.678 ± 0.179 and 0.694 ± 0.113, respectively; P < 0.001). K and D values of all EMCs were significantly different from those of all normal uterine wall layers. K and D values were significantly correlated with histological grades of endometrioid adenocarcinomas (r = 0.799, P < 0.001 and r = −0.799, P < 0.001, respectively), while ADC values were not (r = −0.243, P = 0.382). Metastatic and nonmetastatic lymph nodes showed significantly different K (P = 0.001) and D (P = 0.001) values, but not ADC values (P = 0.827).

Conclusions

DKI may be clinically useful for the noninvasive evaluation of depth of tumor invasion, histological grade, and lymph node metastasis in patients with EMC.

http://bit.ly/2VjM4ms

The Co-occurrence of Pitch and Rhythm Disorders in Congenital Amusia

Publication date: Available online 30 December 2018

Source: Cortex

Author(s): Marie-Élaine Lagrois, Isabelle Peretz

Abstract

The most studied form of congenital amusia is characterized by a difficulty with detecting pitch anomalies in melodies, also referred to as pitch deafness. Here, we tested for the presence of associated deficits in rhythm processing, beat in particular, in pitch deafness. In Experiment 1, participants performed beat perception and production tasks with musical excerpts of various genres. The results show a beat finding disorder in six of the ten assessed pitch-deaf participants. In order to remove a putative interference of pitch variations with beat extraction, the same participants were tested with percussive rhythms in Experiment 2 and showed a similar impairment. Furthermore, musical pitch and beat processing abilities were correlated. These new results highlight the tight connection between melody and rhythm in music processing that can nevertheless dissociate in some individuals.

http://bit.ly/2QZ6tOW

Human Reproductive Sciences

http://www.jhrsonline.org/currentissue.asp?sabs=n

From the editors desk Madhuri Patil Journal of Human Reproductive Sciences 2018 11(4):303-305

Preimplantation genetic testing: Its evolution, where are we today? Firuza Rajesh Parikh, Arundhati Sitaram Athalye, Nandkishor Jagannath Naik, Dattatray Jayaram Naik, Rupesh Ramesh Sanap, Prochi Fali Madon Journal of Human Reproductive Sciences 2018 11(4):306-314 Preimplantation genetic testing (PGT) is an early form of prenatal genetic diagnosis where abnormal embryos are identified, thereby allowing transfer of genetically normal embryos. This technology has become an integral part of Assisted Reproductive Technology (ART) procedures. Initial experiments with animals as early as 1890 and those in the mid and later part of the last century paved the forward path of ART and PGT. This review article covers the evolution of PGT and is a pointer toward current and fast-evolving technology, allowing scientists and doctors to better comprehend human reproduction, and ensure healthy pregnancy outcomes.

Psychosocial aspects of therapeutic donor insemination Ansha Patel, P. S. V. N. Sharma, Pratap Kumar Journal of Human Reproductive Sciences 2018 11(4):315-319 The experience of delays in conception or possibility of remaining childless has the potential to create considerable psychological discomfort. In couples with severe male factor infertility, therapeutic intrauterine insemination using donor sperms (TDI) is offered as a treatment, second to in vitro fertilization using donor sperms. TDI is lucrative, less invasive, and a hopeful treatment. However, there are intricacies associated with it. Its immediate outcomes involve limited success rates, nonresponse, and chances of implantation failures, miscarriages, and multifetal pregnancies. Due to this, couples experience distress when they are advised to undergo three to six cycles of TDI in order to meet the expectations of having a baby. TDI has long-term issues on the triad comprising the “recipients,” the “donors,” and the “the children born out of TDI.” Nevertheless, managing psychosocial needs for couples undergoing TDI and other treatments in Indian clinics are grey areas of the conventional treatment pathway. The present review expands on the psychological issues and needs in couples opting for TDI.

"In cycles of dreams, despair, and desperation:" Research perspectives on infertility specific distress in patients undergoing fertility treatments Ansha Patel, P. S. V. N. Sharma, Pratap Kumar Journal of Human Reproductive Sciences 2018 11(4):320-328 “Emotional distress in infertility” is a broad expression that loosely denotes anxiety, depression, grief, crisis, depleting psychological well-being, and all forms of affective and interpersonal disturbances faced by individuals with infertility. The distress is usually associated with involuntary childlessness as it is an unwelcoming event. The developmental crisis associated with childlessness poses a threat to one's sense of self at all levels (individual, family and social). Distress may begin before or during treatments as a person experiences the loss of control over attaining parenthood, anxiety or dejection after the diagnosis, treatments, its complications particularly its limited success rates. This paper reviews the basic concepts, theoretical models related to infertility specific distress (ISD). It elaborates on the effects of individual and treatment-specific variables on ISD with special highlights gathered from the national and international research.

Examination of Y-chromosomal microdeletions and partial microdeletions in idiopathic infertility in East Hungarian patients Attila Mokánszki, Anikó Ujfalusi, Éva Gombos, István Balogh Journal of Human Reproductive Sciences 2018 11(4):329-336 Purpose: The aim of this study was to establish the Y chromosome microdeletion and partial AZFc microdeletion/duplication frequency firstly in East Hungarian population and to gain information about the molecular mechanism of the heterogeneous phenotype identified in males bearing partial AZFc deletions and duplications. Materials and Methods: Exactly determined sequences of azoospermia factor (AZF) region were amplified. Lack of amplification was detected for deletion. To determine the copy number of DAZ and CDY1 genes, we performed a quantitative analysis. The primers flank an insertion/deletion difference, which permitted the polymerase chain reaction products to be separated by polyacrylamide gel electrophoresis. Statistical Analysis Used: Mann–Whitney/Wilcoxon two-sample test, Kruskal–Wallis test, and two-sample t-probe were used for statistical analysis. Results: AZFbc deletion was detected only in the azoospermic cases; AZFc deletion occurred significantly more frequently among azoospermic patients, than among oligozoospermic males. The frequency of gr/gr deletions was significantly higher in the oligozoospermic patients than in the normospermic group. The b2/b3 deletion and partial duplications were not different among our groups, while b1/b3 deletion was found only in the azoospermic group. In infertile males and in normozoospermic controls, similar Y haplogroup distribution was detected with the highest frequency of haplogroup P. The gr/gr deletion with P haplogroup was more frequent in the oligozoospermic group than in the normozoospermic males. The b2/b3 deletion with E haplogroup was the most frequent, found only in the normozoospermic group. Conclusions: Y microdeletion screening has prognostic value and can affect the clinical therapy. In case of Y chromosome molecular genetic aberrations, genetic counseling makes sense also for other males in the family because these types of aberrations are transmittable (from father to son 100% transmission).

A study on balanced chromosomal translocations in couples with recurrent pregnancy loss Pritti K Priya, Vineet V Mishra, Priyankur Roy, Hetvi Patel Journal of Human Reproductive Sciences 2018 11(4):337-342 Background: Recurrent pregnancy loss (RPL) is an obstetric complication that affects couples in their reproductive age. Chromosomal abnormalities, mainly balanced rearrangements, could commonly be present in couples with RPL. Aim: The purpose of this study is to evaluate the contribution of chromosomal abnormalities and balanced reciprocal translocations, in particular occurring in either of the partners, resulting in RPL. Materials and Methods: A retrospective cytogenetic study was carried out on 152 individuals (76 couples) having a history of RPL. The cases were analyzed using G-banding and fluorescence in situ hybridization, wherever necessary. Results: Chromosomal abnormalities were observed in 3.2% of the total RPL cases, of which balanced translocations were observed in 4 (80%) individuals and marker chromosome was detected in 1 (20%) individual. All balanced translocations comprised reciprocal translocations, and no cases of Robertsonian translocations were detected in our study. Among reciprocal translocation carriers, three were male and one was female. Polymorphic variants were noted in 8 (5.3%) individuals. Conclusions: Chromosomal analysis is an important etiological investigation in couples with RPL. Balanced translocations are the most commonly detected chromosomal abnormalities in such couples. Thus, these couples are the best candidates for offering prenatal genetic diagnosis, thereby ensuring a better reproductive outcome.

Circulating levels of vitamin D3 and leptin in lean infertile women with polycystic ovary syndrome Ayman Shehata Dawood, Adel Elgergawy, Ahmed Elhalwagy Journal of Human Reproductive Sciences 2018 11(4):343-347 Objective: The objective of this study is to measure levels of Vitamin D3 and leptin and assess their relation of each to the pathogenesis of polycystic ovary syndrome (PCOS). Design: This was a cohort observational study. Settings: This study was conducted at the Department of Obstetrics and Gynecology, Tanta University. Materials and Methods: Ninety lean women were enrolled in this study and were allocated into two groups with 45 patients in each group: the first group (study group) who are lean women with PCOS and the second group (control group) who are the lean infertile patients without PCOS. Blood samples were collected and tested for study parameters. Results: There were no significant differences regarding demographic characteristics between both groups. The differences were in ovarian volume and hormonal profiles. Serum leptin was found to be significantly increased in lean PCOS than in control groups. Vitamin D3 levels were found to be lower in the lean PCOS group than in control group. Conclusion: Lean PCOS women are a unique group with specific hormonal profiles different from the typical PCOS profiles. Leptin and Vitamin D3 may have a role in the pathogenesis of lean PCOS, but large studies are still required regarding this unique group.

Effect of insulin sensitizers on raised serum anti-mullerian hormone levels in infertile women with polycystic ovarian syndrome Neeti Chhabra, Sonia Malik Journal of Human Reproductive Sciences 2018 11(4):348-352 Context: Increased circulating insulin levels contribute to hyperandrogenism in polycystic ovarian syndrome (PCOS) which causes a derangement in folliculogenesis, thus contributing to polycystic morphogenesis of the ovaries and a higher than normal anti-Mullerian hormone (AMH). A high AMH is an indicator of either stubborn anovulation or a predictor of ovarian hyperstimulation syndrome. Hence, it is postulated that the use of insulin sensitizers will reduce insulin resistance, hyperandrogenism, and subsequently serum AMH levels and will convert anovulatory cycles to ovulatory. Aim: To study the effect of insulin sensitizers on raised serum AMH levels in infertile women with PCOS. Settings and Design: This was a prospective interventional randomized single tertiary center study. Methodology: The study was conducted from August 2015 to April 2016. Infertile patients with PCOS as defined by the Rotterdam criteria with raised AMH (>5 ng/ml) levels were enrolled in the study under strict inclusion and exclusion criteria. The sample size was 105 patients. Cycle regularity, day 2–antral follicle count (AFC), luteinizing hormone, AMH levels, modified Ferriman–Gallwey score (mFGS), and acne score were recorded before starting the intervention. Patients were randomized into three equal groups of 35 each. Group A received metformin alone, Group B metformin plus myoinositol, and Group C only myoinositol. After completion of 3 months of pretreatment, the same parameters were rechecked. Statistical Analysis Used: Univariate analysis and Chi-square test were used for statistical analysis. Results: Of 105 patients, 95 completed treatment and the rest 10 dropped out. There was a reduction in AMH in all groups of insulin sensitizers with significant fall in the metformin only group. Cycle regularity, reduction in AFC, mFGS, and grade of acne were also obtained. Conclusions: Therapy with insulin sensitizers in PCOS women with raised AMH reduces the AMH levels, converts irregular menstrual cycles to regular, and reduces clinical hyperandrogenism.

Window of implantation is significantly displaced in patients with adenomyosis with previous implantation failure as determined by endometrial receptivity assay Nalini Mahajan, Simrandeep Kaur, Maria Ruiz Alonso Journal of Human Reproductive Sciences 2018 11(4):353-358 Background: Adenomyosis is associated with implantation failure and poor reproductive performance in IVF/ICSI cycles. Aims: To compare if window of implantation (WOI) is displaced in patients having adenomyosis compared to controls using endometrial receptivity array (ERA) test. Settings and Design: Retrospective Case control study. 374 patients with previous one or more IVF failures who underwent ERA test between 2013-2016 at our centre were enrolled. Patients were divided into two groups; Group A-36 patients with adenomyosis (study group) and Group B- 338 patients without adenomyosis (controls). Statistical Analysis: Normality assumptions for continuous variables were tested using Kolmogorov Smirnov test. Mean values of two groups were compared using Student's t-independent test. Frequency data by categories were compared using Chi-square/Fisher's exact test. Risk ratio and 95% confidence limits were calculated. P < 0.05 was considered for statistical significance. Results: WOI was displaced (Non Receptive ERA) significantly in adenomyosis 47.2% (17/36) compared to controls 21.6% (73/338) (P < 0.001, CI-8.7%-42.5%) making risk ratio of displaced WOI in adenomyosis versus controls to be 2:1. The incidence of RIF was 66.6% in adenomyosis compared to 34.9% in controls (P < 0.001, CI- 15.5%-47.9%). Pregnancy rate after personalized embryo transfer in adenomyosis group was 62.5%, signifying displaced WOI as a cause of implantation failure in adenomyosis patients with previous implantation failure. Conclusions: Our study suggests it is prudent to evaluate Endometrial receptivity before embryo transfer in patients with adenomyosis to avoid wastage of good embryos.

Knowledge about age-related decline in fertility and oocyte cryopreservation: A national survey Karissa C Hammer, Alyssa N Kahan, Louis F Fogg, Mark A Walker, Jennifer E Hirshfeld-Cytron Journal of Human Reproductive Sciences 2018 11(4):359-364 Context: Women worldwide are delaying childbearing, but are they aware of the age-related decline in fertility? Aims: The aim of this study is to investigate awareness of age-related decline in fertility and oocyte cryopreservation. Settings and Design: A primary analysis of a cross-sectional electronic survey with a nationally representative sample of nulliparous women aged 25–45 years. Subjects and Methods: A national online survey performed March 4–March 9, 2016. Statistical Analysis Used: A linear regression model and ANOVA tests were performed. Results: A total of 1213 women completed the survey. A significant difference was discovered in fecundity knowledge between women who identified as in a partnership compared to those who did not. Partnered women were more likely to respond “know a lot” about the age-related decline in fertility, whereas unpartnered women were more likely to respond “never heard of it” (P < 0.01). Partnered women are also more likely to respond that they would have made different life choices had they been more knowledgeable about fertility at a younger age (P = 0.01). The majority of the survey population had heard of oocyte cryopreservation but did not know much about it. Conclusions: Slightly over half of participants had an understanding of the natural age-related decline in fertility. Having a partner significantly increased the likelihood that a woman reported more knowledge about fertility. More effort is necessary to educate all women on assisted reproductive technologies and the natural age-related decline in fertility, specifically single women of childbearing age.

The Short Treatment Allocation Tool for Eating Disorders: current practices in assigning patients to level of care

Abstract

Objective

The Short Treatment Allocation Tool for Eating Disorders (STATED) is a new evidence-based algorithm developed to match patients to the most clinically appropriate and cost-effective level of care (Geller et al., 2016). The objective of this research was to examine the extent to which current practices are in alignment with STATED recommendations.

Method

Participants were 179 healthcare professionals providing care for youth and/or adults with eating disorders. They completed an online survey and rated the extent to which three patient dimensions (medical stability, symptom severity, and readiness) were used in assigning patients to each of five levels of care.

Results

The majority of analyses testing a priori hypotheses based on the STATED were statistically significant (all p's < .001), in the direction of STATED recommendations. However, a strict coding scheme evaluating the extent to which ratings were fully consistent with the STATED showed inconsistency rates ranging from 17 to 55% across the five levels of care, with the greatest inconsistencies involving the use of readiness information, and the lowest involving the use of medical stability information.

Discussion

Although practices were generally aligned with the STATED recommendations, readiness information was used least consistently in assigning patients to level of care.

http://bit.ly/2BM8hAI

Issue Information

http://bit.ly/2EXXqXD

Editorial

http://bit.ly/2EWnQK4

Botulinum toxin blocks mast cells and prevents rosacea like inflammation

Publication date: Available online 28 December 2018

Source: Journal of Dermatological Science

Author(s): Jae Eun Choi, Tyler Werbel, Zhenping Wang, Chia Chi Wu, Tony L. Yaksh, Anna Di Nardo

Abstract

Background

Rosacea is a chronic inflammatory skin condition whose etiology has been linked to mast cells and the antimicrobial peptide cathelicidin LL-37. Individuals with refractory disease have demonstrated clinical benefit with periodic injections of onabotulinum toxin, but the mechanism of action is unknown.

Objectives

To investigate the molecular mechanism by which botulinum toxin improves rosacea lesions.

Methods

Primary human and murine mast cells were pretreated with onabotulinum toxin A or B or control. Mast cell degranulation was evaluated by β-hexosaminidase activity. Expression of botulinum toxin receptor Sv2 was measured by qPCR. The presence of SNAP-25 and VAMP2 was established by immunofluorescence. In vivo rosacea model was established by intradermally injecting LL-37 with or without onabotulinum toxin A pretreatment. Mast cell degranulation was assessed in vivo by histologic counts. Rosacea biomarkers were analyzed by qPCR of mouse skin sections.

Results

Onabotulinum toxin A and B inhibited compound 48/80-induced degranulation of both human and murine mast cells. Expression of Sv2 was established in mouse mast cells. Onabotulinum toxin A and B increased cleaved SNAP-25 and decreased VAMP2 staining in mast cells respectively. In mice, injection of onabotulinum toxin A significantly reduced LL-37-induced skin erythema, mast cell degranulation, and mRNA expression of rosacea biomarkers.

Conclusions

These findings suggest that onabotulinum toxin reduces rosacea-associated skin inflammation by directly inhibiting mast cell degranulation. Periodic applications of onabotulinum toxin may be an effective therapy for refractory rosacea and deserves further study.

http://bit.ly/2Rk4jcm

Incorporating reference guided priors into calibrationless parallel imaging reconstruction

Publication date: Available online 28 December 2018

Source: Magnetic Resonance Imaging

Author(s): Qingyong Zhu, Wei Wang, Jing Cheng, Xi Peng

Abstract

Purpose

To propose and evaluate a new calibrationless parallel imaging method aimed at further improving the reconstruction accuracy of the accelerated multi-channel MR images.

Method

We introduce a new calibrationless parallel imaging method. On top of exploiting joint sparsity cross channels of the target image to be reconstructed, it incorporates similar priors on the grey-level intensity and edge orientation, which both come from a high-spatial resolution reference image that can be easily obtained in many clinical MRI scenarios. The mixed l₂-l₁ norm is used to enforce joint sparsity and a multi-scale gradient orientation operator is applied to extract fine edges from the reference image. Additionally, this optimization problem can be solved via a non-linear conjugate gradient algorithm with line search in this work.

Results

The proposed method is compared with the existing state-of-the-art auto-calibration and calibrationless parallel imaging techniques. The experiments on different in-vivo brain MR datasets show that the proposed method has the superior performance in terms of both artifacts suppression and details preservation.

Conclusion

The reference guided calibrationless parallel imaging method can significantly improve the performance of joint reconstruction of target channel images. Even when the reduction factor is high, it can keep edge structures well.

http://bit.ly/2AiLSuM

Right hemisphere superiority for executive control of attention

Publication date: Available online 29 December 2018

Source: Cortex

Author(s): Alfredo Spagna, Tae Hyeong Kim, Tingting Wu, Jin Fan

http://bit.ly/2rVw10G

18F-choline PET/CT incidental thyroid uptake in patients studied for prostate cancer

Abstract

Purpose

Thyroid incidental uptake is defined as a thyroid uptake incidentally detected by imaging examinations performed for non-thyroid disease. The aim of this study was to establish the prevalence and the pathological nature of focal thyroid incidental uptake (FTIU) among patients studied with 18F-choline-PET/CT.

Materials and methods

We retrospectively evaluated 368 patients who performed 18F-choline-PET/CT between June 2016 and August 2018. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) and the mean SUV (SUVmean) of the thyroid gland and of the FTIU; every focal thyroid uptake deviating from physiological distribution and background was considered FTIU. Final diagnosis of FTIU was obtained by cytological or histological examination after surgery.

Results

The average SUVmax and SUVmean of thyroid gland in population were 3 and 1.8. Among 368 patients, FTIU was identified in nine cases (2.4%) and eight underwent further investigations to determine the nature. Two FTIU were classified as malignant (thyroid carcinoma), whereas five were benign (three nodular hyperplasia, one follicular adenoma, one Hurtle cell adenoma) and one indeterminate at cytological examination. In malignant lesions, average SUVmax was 9.6 and 4.5, respectively, while average SUVmean was 5.3 and 2.9, respectively. Average SUVmax and SUVmean of benign lesions were 4.9 and 3.2 and of the indeterminate lesion 5 and 3, respectively.

Conclusions

18F-choline-PET/CT FTIU may be a relevant diagnostic reality, which requires further investigations and affects management, especially considering that, despite being mainly benign, also malignancy is possible.

http://bit.ly/2ETjhPI

18F-choline PET/CT incidental thyroid uptake in patients studied for prostate cancer

Abstract

Purpose

Thyroid incidental uptake is defined as a thyroid uptake incidentally detected by imaging examinations performed for non-thyroid disease. The aim of this study was to establish the prevalence and the pathological nature of focal thyroid incidental uptake (FTIU) among patients studied with 18F-choline-PET/CT.

Materials and methods

We retrospectively evaluated 368 patients who performed 18F-choline-PET/CT between June 2016 and August 2018. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) and the mean SUV (SUVmean) of the thyroid gland and of the FTIU; every focal thyroid uptake deviating from physiological distribution and background was considered FTIU. Final diagnosis of FTIU was obtained by cytological or histological examination after surgery.

Results

The average SUVmax and SUVmean of thyroid gland in population were 3 and 1.8. Among 368 patients, FTIU was identified in nine cases (2.4%) and eight underwent further investigations to determine the nature. Two FTIU were classified as malignant (thyroid carcinoma), whereas five were benign (three nodular hyperplasia, one follicular adenoma, one Hurtle cell adenoma) and one indeterminate at cytological examination. In malignant lesions, average SUVmax was 9.6 and 4.5, respectively, while average SUVmean was 5.3 and 2.9, respectively. Average SUVmax and SUVmean of benign lesions were 4.9 and 3.2 and of the indeterminate lesion 5 and 3, respectively.

Conclusions

18F-choline-PET/CT FTIU may be a relevant diagnostic reality, which requires further investigations and affects management, especially considering that, despite being mainly benign, also malignancy is possible.

http://bit.ly/2ETjhPI

Ichthyosiform sarcoidosis: a mimic of leprosy?

http://bit.ly/2Va7FgW

Lupus erythematosus profundus in a patient with dermatomyositis

http://bit.ly/2QaHjrm