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Τρίτη 21 Δεκεμβρίου 2021

Paracrine mechanisms of endothelial progenitor cells in vascular repair

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Via histochem

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Acta Histochem. 2021 Dec 17;124(1):151833. doi: 10.1016/j.acthis.2021.151833. Online ahead of print.

ABSTRACT

Endothelial progenitor cells (EPCs) play an important role in repairing damaged blood vessels and promoting neovascularization. However, the specific mechanism of EPCs promoting vascular repair is still unclear. Currently, there are two different views on the repair of damaged vessels by EPCs, one is that EPCs can directly differentiate into endothelial cells (ECs) a nd integrate into injured vessels, the other is that EPCs act on cells and blood vessels by releasing paracrine substances. But more evidence now supports the latter. Therefore, the paracrine mechanisms of EPCs are worth further study. This review describes the substances secreted by EPCs, some applications based on paracrine effects of EPCs, and the studies of paracrine mechanisms in cardiovascular diseases--all of these are to support the view that EPCs repair blood vessels through paracrine effects rather than integrating directly into damaged vessels.

PMID:34929523 | DOI:10.1016/j.acthis.2021.151833

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Filler-induced complications of the lips: 10 years experience with intralesional laser treatment and refinements

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J Plast Reconstr Aesthet Surg. 2021 Nov 15:S1748-6815(21)00586-6. doi: 10.1016/j.bjps.2021.11.042. Online ahead of print.

ABSTRACT

BACKGROUND: The number of minimally invasive cosmetic procedures has steadily increased every year. In the last decade, the rates of filler injection reactions have also increased. This study presents our experience in the management and treatment of permanent filler complications to the lips. Undoubtedly, in these adverse reactions, the lips are the hallmark that most stigmatizes an unnatural look of the face.

METHODS: One hundred and eighty-one patients (168 female and 13 male) with permanent filler complications to the lips were treated from September of 2009 to September of 2019 at the University Hospital of Modena. One hundred and thirty-five patients underwent intralesional laser treatment (ILT). Forty-six patients underwent a stab incision and drainage and 10 of these patients had solid and cal cified nodules and therefore underwent a combined technique. Thirty-three patients underwent further cosmetic procedures.

RESULTS: In 95% of patients there was a clinical improvement of which complete resolution in 38.7% and partial improvement in 34.2% of cases. Nine patients stopped the treatment because they were not satisfied. No patient was considered to have worsened after the treatment. Thirty-three patients underwent further treatments.

CONCLUSIONS: A systematic combined approach between antibiotic therapy and treatments (ILT and a stab incision) represents the best therapeutic approach in dealing with permanent fillers complications to the lips. This treatment modality allows both the removal of the foreign material and the inflammatory reaction with low morbidity and little cosmetic disfigurement. Further cosmetic procedures may be applied to improve aesthetic appearance once most of the non-resorbable substance has been removed.

PMID:34930702 | DOI:10.1016/j.bjps.2021.11.042

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Cerebrospinal Fluid Leak Detection with a Carbon Nanotube-Based Field-Effect Transistor Biosensing Platform

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ACS Appl Mater Interfaces. 2021 Dec 21. doi: 10.1021/acsami.1c19120. Online ahead of print.

ABSTRACT

Cerebrospinal fluid (CSF) leakage may lead to life-threatening complications if not detected promptly. However, gel electrophoresis, the gold-standard test for confirming CSF leakage by detecting beta2-transferrin (β2-Tf), requires 3-6 h and is labor-intensive. We developed a new β2-Tf detection platform for rapid identification of CSF leakage. The three-step design, which includes two steps of affinity chromatography and a rapid sensing step using a semiconductor-enriched single-walled carbon nanotube field-effect transistor (FET) sensor, circumvented the lack of selectivity that antitransferrin antibody exhibits for transferrin isoforms and markedly shortened the detection time. Furthermore, three different sensing configurations for the FET sensor were investigated for obtaining the optimal β2-Tf sensing results. Finally, body fluid (CSF and serum) tests employing our three-step strategy demonstrated high sensitivity, suggesting its potential to be used as a rapid diagnostic tool for CSF leakage.

PMID:34932323 | DOI:10.1021/acsami.1c19120

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Δευτέρα 20 Δεκεμβρίου 2021

Assessment of deep inferior epigastric perforator flap perfusion with near-infrared fluorescence: A pilot study and description of a standardized working protocol

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J Plast Reconstr Aesthet Surg. 2021 Nov 16:S1748-6815(21)00590-8. doi: 10.1016/j.bjps.2021.11.043. Online ahead of print.

ABSTRACT

Fat necrosis (FN) is a common complication after autologous breast reconstruction (ABR) using a free flap, which can influence reconstruction outcome and patient satisfaction. Intraoperative near-infrared fluorescence imaging using indocyanine green (ICG) permits the visualization of flap perfusion. The aim of this study was to assess the effect of near-infrared fluorescence on FN incidence in patients undergoing an ABR with a deep inferior epigastric perforator flap (DIEP) and to propose a standard working protocol for this technique. In this prospective study, patients undergoing one-sided ABR with a DIEP were included. The standard DIEP procedure was complemented with near-infrared fluorescence imaging using the fluorescent tracer ICG to evaluate flap perfusion. This cohort was compared to a retrospectiv e cohort of DIEP procedures without near-infrared fluorescence imaging. Patients and surgery characteristics, as well as postoperative complications, were registered and compared. In both cohorts, 24 patients were included. No significant differences were present between patients and surgery characteristics, including no difference in duration of surgery. In the prospective and retrospective group, the incidence of FN was 4.2% and 33%, respectively (p-value = 0.023). Moreover, microsurgeons were positive about using near-infrared fluorescence as it either provided additional information about perfusion or confirmed the clinical assessment. Our pilot study showed a significant decrease of FN in patients undergoing an ABR with a DIEP when near-infrared fluorescence imaging was used to assess flap perfusion. This study provides a standardized working protocol for near-infrared fluorescence imaging. In the future, large multicenter studies should focus on the quantification of near-infr ared fluorescence imaging.

PMID:34924327 | DOI:10.1016/j.bjps.2021.11.043

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Κυριακή 19 Δεκεμβρίου 2021

Iron Deficiency Is Associated with Maternal Hypothyroxinemia in the Third Trimester of Pregnancy

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Clinical Thyroidology, Volume 33, Issue 12, Page 526-528, December 2021.
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Bispecific antibodies targeting CD3 in oncology and hematology

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Bull Cancer. 2021 Oct;108(10S):S181-S194. doi: 10.1016/j.bulcan.2021.06.003.

ABSTRACT

Bispecific therapies targeting CD3, so-called T-cell engagers (TCE), belong to the new spectrum of anti-tumor immunotherapies stimulating T-lymphocytes. TCE are unique constructs targeting the MHC-independent CD3 epsilon subunit (CD3e) and a tumor antigen. To date, only blinatumomab have reached market agreements in lymphoid malignancies with constructs targeting CD3exCD19. Other TCE are in advances development, with promising results targeting CD20 and BSMA in lymphoma and myeloma. These successes have relaunched the development of TCE in solid tumors, bringing mixed results so far (notably in terms of tolerance). Still, TCE pave the way to new immunotherapy in tumors considered to be refractory to inhibitors of immune checkpoints such as prostate cancer or colorectal cancer.

PMID:34920802 | DOI:10.1016/j.bulcan.2021.06.003

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CARTi: The French-speaking group for the harmonization of immune monitoring in patients treated with CAR-T cells

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Bull Cancer. 2021 Oct;108(10S):S141-S142. doi: 10.1016/j.bulcan.2021.06.006.

NO ABSTRACT

PMID:34920796 | DOI:10.1016/j.bulcan.2021.06.006

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CAR-T cell: Toxicities issues: Mechanisms and clinical management

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Bull Cancer. 2021 Oct;108(10S):S117-S127. doi: 10.1016/j.bulcan.2021.05.003.

ABSTRACT

CAR-T cells are modified T cells expressing a chimeric antigen receptor targeting a specific antigen. They have revolutionized the treatment of B cell malignancies (aggressive lymphomas, B-ALL), and this has raised hopes for application in many other pathologies (myeloma, AML, solid tumors, etc.). However, these therapies are associated with novel and specific toxicities (cytokine release syndrome and neurotoxicity). These complications, although mostly managed in a conventional hospitalization unit, can sometimes be life threatening, leading to admission of patients to the intensive care unit. Management relies mainly on anti-IL6R (tocilizumab) and corticosteroids. However, the optimal treatment regimen is still a matter of debate, and the management of the most severe forms is even less well codified. In addition to CRS and ICANS, infections, cytope nia and hypogammaglobulinemia are other frequent complications. This article reviews the mechanisms, risk factors, clinical presentation, and management of these toxicities.

PMID:34920794 | DOI:10.1016/j.bulcan.2021.05.003

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The Voice Problem Impact Scales (VPIS)

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Patient-reported outcome measures (PROMs) are important for systematically assessing a person's perspectives and experiences with disease to inform clinical decision-making. However, PROMs can occasionally fail to capture subtle differences amongst subgroups. In response to this problem, the aim of the current study was to examine the convergent validity of four patient-reported voice activity and participation scales to better reflect and describe the impact of a voice problem in a patient's work, home, social and overall life.
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Πέμπτη 16 Δεκεμβρίου 2021

Impact of duration of residual inhibition on tinnitus masking in patients with and without hearing impairment

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Indranil Chatterjee, Geeta Gore

Indian Journal of Otology 2021 27(3):131-139

Introduction: Residual inhibition (RI) is described as a temporary reduction in the loudness of tinnitus as a result of stimulation from a noise. Aim: This study is aimed to determine the efficacy of durational aspects of tinnitus masking on self-reported tinnitus handicapped measures in patients with and without hearing impairment. Sample Size: Sixty participants were included and divided into two groups – Group A (mean age 44.7, standard deviation [SD] 12.02) included tinnitus participants with normal hearing and Group B (mean age 43.81, SD 12.79) included participants with hearing impairment. Methodology: Audiological evaluation was done after a detailed case history visual analog scale (VAS) and tinnitus handicapped inventory (THI) were used pre- and post-therapy to assess the severity of tinnitus. Tinnitus masking was done at the level MML + 20 dB at matched frequency of the tinnitus. Each group had three subgroups of ten participants for masking duration– 15, 20, and 30 min of RI. The therapy was terminated when the tinnitus disappeared or after 1 month (5 days a week). Statistical analysis was performed using Paired t-test, Independent t-test, and ANOVA. Results: There was a significant difference in the effect of tinnitus masking for pre- and post-data among different masking durations measured in VAS and THI irrespective of hearing status. 30-min masking duration can be used as a standardized norm for tinnitus masking. Conclusion: Thus, the study provides a structured temporal course for providing tinnitus masking.
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Difficult Airway Management in a Patient With Hereditary Hemorrhagic Telangiectasia

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To the Editor In reference to the recent publication by Safi et al regarding rapid sequence induction and intubation in a patient with hereditary hemorrhagic telangiectasia (HHT), I would like to congratulate the authors on a successful outcome. Also, I would like to suggest that, rather than mask ventilation after induction of anesthesia, consideration be given to awake fiber-optic oral/nasal intubation, as directed by the preoperative assessment, to establish the airway in patients with HHT undergoing elective procedures. Rapid sequence induction and emergency tracheostomy, in that order, could then be further on in the difficult airway algorithm, if needed, as in this case.
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The Effect of Tongue-Tie Release on Speech Articulation and Intelligibility

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Ear Nose Throat J. 2021 Dec 15:1455613211064045. doi: 10.1177/01455613211064045. Online ahead of print.

ABSTRACT

OBJECTIVE: The relationship between ankyloglossia and speech is controversial. The objective of this study was to determine the effect of tongue-tie release on speech articulation and intelligibility.

METHODS: A prospective cohort study was conducted. Pediatric patients (>2 years of age) being referred for speech concerns due to ankyloglossia were assesse d by a pediatric otolaryngologist, and speech articulation was formally assessed by a speech language pathologist using the Goldman-Fristoe Test of Articulation 2 (GFTA-2). Patients then underwent a tongue-tie release procedure in clinic. After 1 month, speech articulation was reassessed with GFTA-2. Audio-recordings of sessions were evaluated by independent reviewers to assess speech intelligibility before and after tongue-tie release.

RESULTS: Twenty-five participants were included (mean age 3.7 years; 20 boys). The most common speech errors identified were phonological substitutions (80%) and gliding errors (56%). Seven children (28%) had abnormal lingual-alveolar and interdental sounds. Most speech sound errors (87.9%) were age/developmentally appropriate. GFTA-2 standard scores before and after tongue-tie release were 85.61 (SD 9.75) and 87.54 (SD 10.21), respectively, (P=.5). Mean intelligibility scores before and after tongue-tie release were 3.15 (SD .22) and 3.21 (SD .31), respectively, (P=.43).

CONCLUSION: The majority of children being referred for speech concerns thought to be due to ankyloglossia had age-appropriate speech errors at presentation. Ankyloglossia was not associated with isolated tongue mobility related speech articulation errors in a consistent manner, and there was no benefit of tongue-tie release in improving speech articulation or intelligibility.

PMID:34911396 | DOI:10.1177/01455613211064045

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