Πέμπτη, 19 Ιανουαρίου 2017

Screening of inorganic and organic contaminants in floodwater in paddy fields of Hue and Thanh Hoa in Vietnam

Abstract

In the rainy season, rice growing areas in Vietnam often become flooded by up to 1.5 m water. The floodwater brings contaminants from cultivated areas, farms and villages to the rice fields resulting in widespread contamination. In 2012 and 2013, the inorganic and organic contaminants in floodwater was investigated in Thanh Hoa and Hue. Water samples were taken at 16 locations in canals, paddy fields and rivers before and during the flood. In total, 940 organic micro-pollutants in the water samples were determined simultaneously by GC-MS method with automatic identification and quantification system (AIQS), while ICP-MS was used for determination of ten trace elements in the samples. The concentrations of 277 organic micro-pollutants and ten elements (As, Cu, Cd, Cr, Co, Pb, Zn, Fe, Mn, Al) ranged from 0.01 to 7.6 μg L−1 and 0.1 to 3170 μg L−1, respectively, in the floodwater. Contaminants originated from industrial sources (e.g. PAH) were detected at low concentrations, ranged from 0.01 to 0.18 μg L−1, while concentrations of pollutants originated from domestic sources (e.g. sterols, pharmaceuticals and personal care products and pesticides) were ranged from 0.01 to 2.12 μg L−1. Isoprocarb had the highest detection frequency of 90%, followed by isoprothiolane (88%) and fenobucarb (71%). The results indicated that contaminants in floodwater come from untreated wastewater from villages, and the agricultural activities are the major sources of increased pesticides resuspended in the floodwater in this study.



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LSP1, a Responsive Protein from Meyerozyma guilliermondii, Elicits Defence Response and Improves Glycyrrhizic Acid Biosynthesis in Glycyrrhiza uralensis Fisch Adventitious Roots

Abstract

This research explored the effects of protein and polysaccharide in Meyerozyma guilliermondii on active compounds in Glycyrrhiza uralensis Fisch adventitious roots. In this study, a responsive protein LSP1 was purified from the Meyerozyma guilliermondii since the excellent induction. The contents of total flavonoids (3.46 mg · g−1), glycyrrhizic acid (0.41 mg · g−1), glycyrrhetinic acid (0.41 mg · g−1) and polysaccharide (94.49 mg · g−1) in adventitious root peaked at LSP1 group, which were 1.6, 3.4, 2.4, 2.0-fold that of control, respectively. Besides, the responsive protein LSP1 significantly activated the defense signaling, mitogen-activated protein kinases and extremely up-regulated the expression of defense-related genes and functional genes involved in glycyrrhizic acid biosynthesis. This article is protected by copyright. All rights reserved



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Mechanisms Involved in Enhancement of Matrix Metalloproteinase-9 Expression in Macrophages by Interleukin-33

ABSTRACT

Endothelial transmigration of macrophages is accomplished by matrix metalloproteinase (MMP)-induced degradation of the basement membrane and extracellular matrix components. Macrophages up-regulate MMP-9 expression and secretion upon immunological challenges and require its activity for migration during inflammatory responses. Interleukin (IL)-33 is a recently discovered pro-inflammatory cytokine that belongs to the IL-1 family. The aim of this study was to elucidate the mechanisms underlying IL-33-induced MMP-9 expression in the mouse monocyte/macrophage line RAW264.7. IL-33 increased MMP-9 mRNA and protein expression in RAW264.7 cells. Blockage of IL-33-IL-33 receptor (ST2L) binding suppressed IL-33-mediated induction of MMP-9. IL-33 induced phosphorylation and nuclear translocation of extracellular signal-regulated kinase 1/2 (ERK1/2) and nuclear factor-kappa B (NF-κB). Chromatin immunoprecipitation indicated that IL-33 increased c-fos recruitment to the MMP-9 promoter. Reporter assay findings also revealed that IL-33 stimulated the transcriptional activity of activator protein 1 (AP-1). Pre-treatment of the cells with a specific inhibitor of ERK1/2 and NF-κB attenuated the IL-33-induced activation of AP-1 subunits, transcriptional activity of AP-1, and expression of MMP-9. We also demonstrated that ERK-dependent activation of cAMP response element binding protein (CREB) is a key step for AP-1 activation by IL-33. These results indicate an essential role of ERK/CREB and NF-κB cascades in the induction of MMP-9 in monocytes/macrophages through AP-1 activation. This article is protected by copyright. All rights reserved



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STIM-1 and ORAI-1 Channel Mediate Angiotensin-II-Induced Expression of Egr-1 in Vascular Smooth Muscle Cells

Abstract

An upregulation of Egr-1 expression has been reported in models of atherosclerosis and intimal hyperplasia and, various vasoactive peptides and growth promoting stimuli have been shown to induce the expression of Egr-1 in vascular smooth muscle cells (VSMC). Angiotensin-II (Ang-II) is a key vasoactive peptide that has been implicated in the pathogenesis of vascular diseases. Ang-II elevates intracellular Ca2+ through activation of the store-operated calcium entry (SOCE) involving an inositol-3-phosphate receptor (IP3R)-coupled depletion of endoplasmic reticular Ca2+ and a subsequent activation of the stromal interaction molecule 1 (STIM-1) /Orai-1 complex. However, the involvement of IP3R/STIM-1/Orai-1-Ca2+-dependent signaling in Egr-1 expression in VSMC remains unexplored. Therefore, in the present studies, we have examined the role of Ca2+ signaling in Ang-II-induced Egr-1 expression in VSMC and investigated the contribution of STIM-1 or Orai-1 in mediating this response. 2-aminoethoxydiphenyl borate (2-APB), a dual non-competitive antagonist of IP3R and inhibitor of SOCE, decreased Ang-II-induced Ca2+ release and attenuated Ang-II-induced enhanced expression of Egr-1 protein and mRNA levels. Egr-1 upregulation was also suppressed following blockade of calmodulin and CaMKII. Furthermore, RNA interference-mediated depletion of STIM-1 or Orai-1 attenuated Ang-II-induced Egr-1 expression as well as Ang-II-induced phosphorylation of ERK1/2 and CREB. In addition, siRNA-induced silencing of CREB resulted in a reduction in the expression of Egr-1 stimulated by Ang-II. In summary, our data demonstrate that Ang-II-induced Egr-1 expression is mediated by STIM-1/Orai-1/Ca2+-dependent signaling pathways in A-10 VSMC. This article is protected by copyright. All rights reserved



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Five interesting facts about massage therapy - Hometown Focus


Five interesting facts about massage therapy
Hometown Focus
Massage might clear your sinuses. I know this to ... “Massage therapy does not treat cancer in any way, shape, or form,” said Barre Cassileth, founding chief of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center in Manhattan ...

and more »


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NEAT1: A novel cancer-related long non-coding RNA

Abstract

Aberrant overexpression of the long non-coding RNA NEAT1 (nuclear paraspeckle assembly transcript 1) has been documented in different types of solid tumours, such as lung cancer, oesophageal cancer, colorectal cancer and hepatocellular carcinoma, in which its high levels are associated with poor prognosis. In contrast, NEAT1 is downregulated in acute promyelocytic leukaemia where it promotes leucocyte differentiation. In this review, we provide an overview of current evidence concerning the oncogenic role and potential clinical utilities of NEAT1. Further investigations are warranted to elucidate the upstream and downstream mechanisms of NEAT1 overexpression.



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Broad and conserved immune regulation by genetically heterogeneous melanoma cells

While mutations drive cancer, it is less clear to what extent genetic defects control immune mechanisms and confer resistance to cytotoxic T lymphocyte (CTL)-based immunotherapy. Here we studied the reactions of malignant and benign melanocyte lines to CTL using flow cytometry and gene expression analyses. We found rapid and broad upregulation of immune regulatory genes, essentially triggered by CTL-derived IFNγ and augmented by TNFα. These reactions were predominantly homogenous, independent of oncogenic driver mutations and similar in benign and malignant cells. The reactions exhibited both pro- and anti-tumorigenic potential and primarily corresponded to mechanisms that were conserved, rather than acquired, by mutations. Similar results were obtained from direct ex vivo analysis of the tumor microenvironment. Thus, immune regulation in the tumor landscape may often be driven by conserved mechanisms, which may explain why T cell-based immunotherapy can provide durable benefits with relatively infrequent escape.

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PanIN neuroendocrine cells promote tumorigenesis via neuronal crosstalk

Nerves are a notable feature of the tumor microenvironment in some epithelial tumors, but their role in the malignant progression of pancreatic ductal adenocarcinoma (PDAC) is uncertain. Here we identify dense innervation in the microenvironment of precancerous pancreatic lesions, known as pancreatic intraepithelial neoplasms (PanIN), and describe a unique subpopulation of neuroendocrine PanIN cells that express the neuropeptide substance P (SP) receptor Neurokinin 1-R (NK1-R). Using organoid culture, we demonstrated that sensory neurons promoted the proliferation of PanIN organoids via SP-NK1-R signaling and Stat3 activation. Nerve-responsive neuroendocrine cells exerted trophic influences and potentiated global PanIN organoid growth. Sensory denervation of a genetically engineered mouse model of PDAC led to loss of Stat3 activation, a decrease in the neoplastic neuroendocrine cell population, and impaired PanIN progression to tumor. Overall, our data provide evidence that nerves of the PanIN microenvironment promote oncogenesis, likely via direct signaling to neoplastic neuroendocrine cells capable of trophic influences. These findings identify neuroepithelial crosstalk as a potential novel target in PDAC treatment.

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Out-RANKing BRCA1 in Mutation Carriers

Beyond prophylactic mastectomy, there are currently very few options available to BRCA1 mutation carriers to help reduce their risk of developing breast cancer. An effective prevention therapy therefore remains a pressing area of need. Accumulating evidence points to amplification of the progesterone signaling axis in precancerous tissue from BRCA1 mutation carriers. Given that RANKL is an important paracrine mediator of hormonal signaling in breast tissue, there has been considerable interest in exploring a potential role for this pathway in oncogenesis. Recent findings indicate that the RANK and NF-κB pathways are aberrantly activated in luminal progenitor cells resident in preneoplastic BRCA1mut/+ breast tissue. The augmented proliferation of these cells and their predilection for DNA damage suggest that they are prime cellular targets for basal-like cancers arising in BRCA1 mutation carriers. The end result is a hyperactive pathway, initiated by progesterone and amplified by DNA damage–induced NF-κB signaling, that likely accounts for the susceptibility of BRCA1mut/+ luminal progenitor cells to oncogenesis and tissue specificity. Specific targeting of this progenitor subset has revealed a compelling new prevention strategy for these and possibly other high-risk women. Cancer Res; 77(3); 1–6. ©2017 AACR.

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MicroRNA-145 Modulates N6 methyladenosine Levels by Targeting the 3' Untranslated mRNA Region of the N6-methyladenosine binding YTH Domain Family 2 Protein [Gene Regulation]

N6 methyladenosine (m6A) is a prevalent modification present in the mRNAs of higher eukaryotes. YTH domain family 2 (YTHDF2), an m6A reader protein, can recognize mRNA m6A sites to mediate mRNA degradation. However, the regulatory mechanism of YTHDF2 is poorly understood. To this end, we investigated the post transcriptional regulation of YTHDF2. Bioinformatics analysis suggested that the microRNA miR 145 might target the 3′-untranslated region (3′UTR) of YTHDF2 mRNA. The levels of miR 145 were negatively correlated with those of YTHDF2 mRNA in clinical hepatocellular carcinoma (HCC) tissues, and immunohistochemical staining revealed that YTHDF2 was closely associated with malignancy of HCC. Interestingly, miR 145 decreased the luciferase activities of 3′UTR of YTHDF2 mRNA. Mutation of predicted miR 145 binding sites in the 3′UTR of YTHDF2 mRNA abolished the miR 145 induced decrease in luciferase activity. Over-expression of miR-145 dose dependently down regulated YTHDF2 expression in HCC cells at the levels of both mRNA and protein. Conversely, inhibition of miR-145 resulted in the up-regulation of YTHDF2 in the cells. Dot blot analysis and immunofluorescence staining revealed that the overexpression of miR-145 strongly increased m6A levels relative to those in control HCC cells, and this increase could be blocked by YTHDF2 overexpression. Moreover, miR-145 inhibition strongly decreased m6A levels, which was rescued by the treatment with a small interfering RNA based YTHDF2 knockdown. Thus, we conclude that miR-145 modulates m6A levels by targeting the 3′UTR of YTHDF2 mRNA in HCC cells.

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microRNA-processing Enzymes Are Essential for Survival and Function of Mature Retinal Pigmented Epithelial Cells in Mice [Neurobiology]

Age-related macular degeneration (AMD) is a major cause of irreversible vision loss. The neovascular or "wet" form of AMD can be treated to a varying degree with anti-angiogenic drugs, but geographic atrophy (GA) is an advanced stage of the more prevalent "dry" form of AMD for which there is no effective treatment. Development of GA has been linked to loss of the microRNA (miRNA)-processing enzyme DICER1 in the mature retinal pigmented epithelium (RPE). This loss results in the accumulation of toxic transcripts of Alu transposable elements which activate the NLRP3 inflammasome and additional downstream pathways that compromise the integrity and function of the RPE. However, it remains unclear whether the loss of miRNA processing and subsequent gene regulation in the RPE due to DICER1 deficiency also contributes to RPE cell death. To clarify the role of miRNAs in RPE cells, we used two different mature RPE cell-specific Cre recombinase drivers to inactivate either Dicer1 or DiGeorge syndrome critical region 8 (Dgcr8), thus removing RPE miRNA regulatory activity in mice by disrupting two independent and essential steps of miRNA biogenesis. In contrast with prior studies, we found that loss of each factor independently led to strikingly similar defects in the survival and function of the RPE and retina. These results suggest that the loss of miRNAs also contributes to RPE cell death and loss of visual function and could affect the pathology of dry AMD.

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The Ssl2245-Sll1130 toxin-antitoxin system mediates heat-induced programmed cell death in Synechocystis sp. PCC6803 [Genomics and Proteomics]

Two putative heat responsive genes, ssl2245 and sll1130 constitute an operon that also has characteristics of a toxin-antitoxin system, thus joining several enigmatic features. Closely related orthologs of Ssl2245 and Sll1130 exist in widely different bacteria, which thrive under environments with large fluctuations in temperature and salinity, among which some are thermo-epilithic biofilm forming cyanobacteria. Transcriptome analyses revealed that the CRISPR genes as well as several hypothetical genes were commonly up-regulated in Δssl2245 and Δsll1130 mutants. Genes coding for heat shock proteins and pilins were also induced in ∆sll1130. We observed that the majority of cells in a ∆sll1130 mutant strain remained unicellular and viable after prolonged incubation at high temperature, 50oC. In contrast the wild type formed large cell clumps of dead and live cells, indicating the attempt to form biofilms under harsh conditions. Further, we observed that Sll1130 is a heat-stable ribonuclease, whose activity was inhibited by Ssl2245 at optimal temperatures, but not at high temperatures. In addition, we demonstrated that Ssl2245 is physically associated with Sll1130 by electrostatic interactions, thereby inhibiting its activity at optimal growth temperature. This association is lost upon exposure to heat, leaving Sll1130 to exhibit its ribonuclease activity. Thus, the activation of Sll1130 leads to the degradation of cellular RNA, thereby heat-induced programmed cell death that in turn supports the formation of a more resistant biofilm for the surviving cells. We suggest to designate Ssl2245 and Sll1130 as MazE and MazF respectively.

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The N-terminus specifies the switch between transport modes of the human serotonin transporter [Protein Structure and Folding]

The serotonin transporter (SERT) and other monoamine transporters operate in either a forward transport mode, where the transporter undergoes a full transport cycle, or an exchange mode, where the transporter seesaws through half-cycles. Amphetamines trigger the exchange-mode leading to substrate efflux. This efflux was proposed to rely on the N-terminus, which was suggested to adopt different conformations in the inward-, outward-facing and amphetamine-bound states. This prediction was verified by tryptic digestion of SERT-expressing membranes: in the absence of Na+, the N-terminus was rapidly digested. Amphetamine conferred protection against cleavage suggesting a relay between the conformational states of the hydrophobic core and the N-terminus. We searched for a candidate segment, which supported the conformational switch, by serial truncation removing 22 (ΔN22), 32 (ΔN32) or 42 (ΔN42) N-terminal residues. This did not affect surface expression, inhibitor binding and substrate influx. However, amphetamine-induced efflux by SERT-ΔN32 or SERT-ΔN42 (but not by SERT-ΔN22) was markedly diminished. We examined the individual steps in the transport cycle by recording transporter-associated currents: The recovery rate of capacitive peak - but not of steady-state - currents was significantly lower for SERT-ΔN32 than that of wild-type SERT and SERT-ΔN22. Thus, the exchange mode of SERT-ΔN32 was selectively impaired. Our observations show that the N-terminus affords the switch between transport modes. The findings are consistent with a model, where the N-terminus acts as a lever to support amphetamine-induced efflux by SERT.

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Perspective: The Promise of Proteomics in the Study of Oncogenic Viruses [Perspective]

Oncogenic viruses are responsible for about 15% human cancers. This article explores the promise and challenges of viral proteomics in the study of the oncogenic human DNA viruses, HPV, McPyV, EBV and KSHV. These viruses have coevolved with their hosts and cause persistent infections. Each virus encodes oncoproteins that manipulate key cellular pathways to promote viral replication and evade the host immune response. Viral proteomics can identify cellular pathways perturbed by viral infection, identify cellular proteins that are crucial for viral persistence and oncogenesis, and identify important diagnostic and therapeutic targets.



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HIV infection model of chronic obstructive pulmonary disease in mice

Cigarette smoke usage is prevalent in HIV+ patients and, despite highly active antiretroviral therapy (HAART), these individuals develop an accelerated form of chronic obstructive pulmonary disease (COPD). Studies investigating the mechanisms of COPD development in HIV have been limited by the lack of suitable mouse models. Here we describe a model of HIV induced COPD in wild type mice using EcoHIV, a chimeric HIV capable of establishing chronic infection in immunocompetent mice. A/J mice were infected with EcoHIV and subjected to whole body cigarette smoke exposure. EcoHIV was detected in alveolar macrophages of mice. Compared to uninfected mice, concomitant EcoHIV infection significantly reduced forced expiratory flow (FEF) 50%/forced vital capacity (FVC) and enhanced distal airspace enlargement following cigarette smoke exposure. Lung IL-6, G-CSF, neutrophil elastase, cathepsin G and MMP9 expression was significantly enhanced in smoke-exposed EcoHIV-infected mice. These changes coincided with enhanced IBα, ERK1/2, p-38 and STAT3 phosphorylation and lung cell apoptosis. Thus, the EcoHIV smoke exposure mouse model reproduces several of the pathophysiologic features of HIV-related COPD in humans, indicating that this murine model can be utilized to determine key parameters of HIV-related COPD and to test future therapies for this disorder.



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Gas puzzlers: American regulators investigate Fiat Chrysler for emissions cheating

Print section Print Rubric:  The Italian-American carmaker is in regulators’ headlights over emissions Print Headline:  Gas puzzlers Print Fly Title:  Fiat Chrysler UK Only Article:  standard article Issue:  The 45th president Fly Title:  Gas puzzlers Main image:  An exhausting process An exhausting process THE priorities of America’s Environmental Protection Agency (EPA) will doubtless change under Donald Trump. Mr Trump may well relax emissions rules for carmakers in return for concessions, such as keeping production in America rather than relocating to Mexico or other lower-cost countries. So it is perhaps no coincidence that on January 12th, before conditions change, the agency took action against Fiat Chrysler Automobile. It accused FCA (whose chairman, John Elkann, sits on the board of The Economist’s parent company) of using software in 104,000 Dodge ...

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A helluva handover: What Donald Trump’s appointments reveal about his incoming administration

20170121_FBP001_0.jpg

Print section Print Rubric:  The drama of the transition is over, and the new president’s team is largely in place. Now for the drama of government Print Headline:  A helluva handover Print Fly Title:  The Trump administration UK Only Article:  standard article Issue:  The 45th president Fly Title:  A helluva handover Location:  WASHINGTON, DC Main image:  20170121_FBP001_0.jpg HOLED up in Trump Tower, the New York citadel he seems reluctant to leave, Donald Trump detected a tsunami of excitement in the national capital before his inauguration on January 20th. “People are pouring into Washington in record numbers,” he tweeted. In fact the mood in Washington, DC, where Mr Trump won 4% of the vote on November 8th, was more obviously one of apathy and disdain for his upcoming jamboree. Even the ...

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Assessing Work-Related Musculoskeletal Symptoms Among Otolaryngology Residents

Previous studies have suggested that musculoskeletal symptoms are common among practicing otolaryngologists. Early training can be the ideal time to foster knowledge of ergonomics and develop safe work habits, however, little data exists regarding musculoskeletal symptoms in residents. The purpose of this study was to identify and characterize musculoskeletal symptoms in a preliminary sample of otolaryngology residents.

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Nasal Septal Perforation Secondary to Systemic Bevacizumab

A case of nasal septal perforation secondary to systemic bevacizumab therapy for ovarian cancer is reported. Bevacizumab is a vascular endothelial growth factor A (VEGF-A) inhibitor that is becoming more widely utilized in the oncologic community. There is only one prior report of septal perforation secondary to bevacizumab in the Otolaryngology specific literature. The purpose of this report is: 1) to raise awareness and discuss the literature surrounding the sinonasal complications of bevacizumab and 2) provide workup and treatment recommendations based on the sum of the available literature.

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Long-term outcomes of endolymphatic sac shunting with local steroids for Meniere's disease

To evaluate the long-term efficacy of endolymphatic sac shunt techniques with and without local steroid administration.

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Cochlear implantation for single-sided deafness and tinnitus suppression

To quantify the potential effectiveness of cochlear implantation for tinnitus suppression in patients with single-sided deafness using the Tinnitus Handicap Inventory.

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Cochlear implantation in an NPC patient post-irradiation presenting with electrode array extrusion through the posterior canal wall

Cochlear implant is a viable rehabilitation option for sensorineural hearing loss in post-irradiated patients [1,2]. The retro-cochlear auditory pathways appear to remain functionally intact in the long term in patients who have had irradiation for nasopharyngeal carcinoma, [3] and the overall hearing outcomes post-cochlear implant were similar in post-irradiated patients and patients who had no prior irradiation [4].

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Isolated sphenoid sinus opacification: A systematic review

Unilateral sphenoid sinus opacification (SSO) on imaging is a common incidental radiologic finding. Inflammatory sinus disease is rarely isolated to one sinus cavity therefore SSO raises the potential for neoplastic etiology. The clinical significance of SSO was evaluated and compared to maxillary sinus opacification (MSO).

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Extended use of perioperative antibiotics in head and neck microvascular reconstruction

Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant – especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24 hours post-operatively. Currently, there is no consensus on appropriate antibiotic regimen or duration at this time. This study investigates the outcomes of a 7-day perioperative antibiotic regimen after microvascular reconstruction of the head and neck at our institution.

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Surgical timing for facial paralysis after temporal bone trauma

To explore surgical timing of facial paralysis after temporal bone trauma.

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Prevalence and determinants of current and secondhand smoking in Greece: results from the Global Adult Tobacco Survey (GATS) study

Objectives

Greece is one of the leading tobacco-producing countries in European Union, and every year over 19 000 Greeks die from tobacco-attributable diseases. The aim of the present study was to provide nationally representative estimates on current and secondhand smoking prevalence in Greece and their determinants.

Design

Cross-sectional.

Setting

Greece.

Participants

A total of 4359 individuals participated in the Global Adult Tobacco Survey (GATS), a household survey of adults ≥15 years old (overall response rate 69%). They were selected through a multistage geographically clustered sampling design with face-to-face interview.

Primary and secondary outcome measures

In 2013, we investigated the prevalence of current and secondhand smoking and their determinants. Univariate and logistic regression analysis was used in order to identify possible risk factors associated with the prevalence of current and secondhand smoking.

Results

The prevalence of current smoking was 38.2% (95% CI 35.7% to 40.8%), and the mean number of cigarettes smoked per day was 19.8. Multivariate analysis confirmed that male gender (OR=3.24; 95% CI 2.62 to 4.00), age groups (25–39, OR=4.49; 95% CI 3.09 to 8.46 and 40–54, OR=3.51; 95% CI 1.88 to 5.87) and high school education (OR=1.97; 95% CI 1.41 to 2.74) were independently associated with the current smoking. Remarkably, responders with primary or less education had the lowest prevalence of current smoking (p<0.001). The prevalence of exposure to secondhand smoke at work, home and restaurants, was 52.3%, 65.7% and 72.2%. In total, 90.0% (95% CI 87.8% to 91.9%) of Greek population is exposed to tobacco smoke (current smoking and secondhand smoke).

Conclusions

Our results revealed an extremely high prevalence of current smoking and exposure to secondhand smoke among the adult population and a positive gradient between education and current smoking. These findings are alarming and implementation of comprehensive tobacco control and prevention strategies could be impactful in fighting the tobacco epidemic in Greece.



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Protocol of a feasibility study for cognitive assessment of an ageing cohort within the Southeast Asia Community Observatory (SEACO), Malaysia

Introduction

There is a growing proportion of population aged 65 years and older in low-income and middle-income countries. In Malaysia, this proportion is predicted to increase from 5.1% in 2010 to more than 15.4% by 2050. Cognitive ageing and dementia are global health priorities. However, risk factors and disease associations in a multiethnic, middle-income country like Malaysia may not be consistent with those reported in other world regions. Knowing the burden of cognitive impairment and its risk factors in Malaysia is necessary for the development of management strategies and would provide valuable information for other transitional economies.

Methods and analysis

This is a community-based feasibility study focused on the assessment of cognition, embedded in the longitudinal study of health and demographic surveillance site of the South East Asia Community Observatory (SEACO), in Malaysia. In total, 200 adults aged ≥50 years are selected for an in-depth health and cognitive assessment including the Mini Mental State Examination, the Montreal Cognitive Assessment, blood pressure, anthropometry, gait speed, hand grip strength, Depression Anxiety Stress Score and dried blood spots.

Discussion and conclusions

The results will inform the feasibility, response rates and operational challenges for establishing an ageing study focused on cognitive function in similar middle-income country settings. Knowing the burden of cognitive impairment and dementia and risk factors for disease will inform local health priorities and management, and place these within the context of increasing life expectancy.

Ethics and dissemination

The study protocol is approved by the Monash University Human Research Ethics Committee. Informed consent is obtained from all the participants. The project's analysed data and findings will be made available through publications and conference presentations and a data sharing archive. Reports on key findings will be made available as community briefs on the SEACO website.



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Improving care standards for patients with spinal trauma combining a modified e-Delphi process and stakeholder interviews: a study protocol

Introduction

Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop ‘expertly defined’ and agreed standards of care across the majority of disciplines involved for these patients.

Methods and analysis

A modified e-Delphi process will be used to gain consensus for best practice across specific clinical early care areas for the patient with TSCI; invited participants will include clinicians across Australia with relevant and significant expertise. A rapid literature review will identify available evidence, including any current guidelines from 2005 to 2015. Level and strength of evidence identified, including areas of contention, will be used to formulate the first round survey questions and statements. Participants will undertake 2–3 online survey rounds, responding anonymously to questionnaires regarding care practices and indicating their agreement or otherwise with practice standard statements. Relevant key stakeholders, including patients, will also be interviewed face to face.

Ethics and dissemination

Ethics approval for this study was obtained by the NSW Population & Health Services Research Ethics Committee on 14 January 2016 (HREC/12/CIPHS/74). Seeking comprehensive understanding of how the variation in early care pathways and treatment can be addressed to achieve optimal patient outcomes and economic costs; the overall aim is the agreement to a consistent approach to the triage, treatment, transport and definitive care of acute TSCI victims. The agreed practice standards of care will inform the development of a Clinical Pathway with practice change strategies for implementation. These standards will offer a benchmark for state-wide and potentially national policy.



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Utility of social media and crowd-sourced data for pharmacovigilance: a scoping review protocol

Introduction

Adverse events associated with medications are under-reported in postmarketing surveillance systems. A systematic review of published data from 37 studies worldwide (including Canada) found the median under-reporting rate of adverse events to be 94% in spontaneous reporting systems. This scoping review aims to assess the utility of social media and crowd-sourced data to detect and monitor adverse events related to health products including pharmaceuticals, medical devices, biologics and natural health products.

Methods and analysis

Our review conduct will follow the Joanna Briggs Institute scoping review methods manual. Literature searches were conducted in MEDLINE, EMBASE and the Cochrane Library from inception to 13 May 2016. Additional sources included searches of study registries, conference abstracts, dissertations, as well as websites of international regulatory authorities (eg, Food and Drug Administration (FDA), the WHO, European Medicines Agency). Search results will be supplemented by scanning the references of relevant reviews. We will include all publication types including published articles, editorials, websites and book sections that describe use of social media and crowd-sourced data for surveillance of adverse events associated with health products. Two reviewers will perform study selection and data abstraction independently, and discrepancies will be resolved through discussion. Data analysis will involve quantitative (eg, frequencies) and qualitative (eg, content analysis) methods.

Dissemination

The summary of results will be sent to Health Canada, who commissioned the review, and other relevant policymakers involved with the Drug Safety and Effectiveness Network. We will compile and circulate a 1-page policy brief and host a 1-day stakeholder meeting to discuss the implications, key messages and finalise the knowledge translation strategy. Findings from this review will ultimately inform the design and development of a data analytics platform for social media and crowd-sourced data for pharmacovigilance in Canada and internationally.

Registration details

Our protocol was registered prospectively with the Open Science Framework (https://osf.io/kv9hu/).



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Maori patients' experiences and perspectives of chronic kidney disease: a New Zealand qualitative interview study

Objectives

To explore and describe Māori (the indigenous people of New Zealand) patients' experiences and perspectives of chronic kidney disease (CKD), as these are largely unknown for indigenous groups with CKD.

Design

Face-to-face, semistructured interviews with purposive sampling and thematic analysis.

Setting

3 dialysis centres in New Zealand (NZ), all of which offered all forms of dialysis modalities.

Participants

13 Māori patients with CKD and who were either nearing the need for dialysis or had started dialysis within the previous 12 months.

Results

The Māori concepts of whakamā (disempowerment and embarrassment) and whakamana (sense of self-esteem and self-determination) provided an overarching framework for interpreting the themes identified: disempowered by delayed CKD diagnosis (resentment of late diagnosis; missed opportunities for preventive care; regret and self-blame); confronting the stigma of kidney disease (multigenerational trepidation; shame and embarrassment; fear and denial); developing and sustaining relationships to support treatment decision-making (importance of family/whānau; valuing peer support; building clinician–patient trust); and maintaining cultural identity (spiritual connection to land; and upholding inner strength/mana).

Conclusions

Māori patients with CKD experienced marginalisation within the NZ healthcare system due to delayed diagnosis, a focus on individuals rather than family, multigenerational fear of dialysis, and an awareness that clinicians are not aware of cultural considerations and values during decision-making. Prompt diagnosis to facilitate self-management and foster trust between patients and clinicians, involvement of family and peers in dialysis care, and acknowledging patient values could strengthen patient engagement and align decision-making with patient priorities.



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Secondhand smoke risk perception and smoke-free rules in homes: a cross-sectional study in Barcelona (Spain)

Objective

To describe the voluntary adoption of smoke-free homes in Spain among general population and to identify variables associated with its voluntary adoption.

Methods

Cross-sectional study of a representative sample (n=731) of the adult population (>26 years) of Barcelona, Spain, in 2013–2014. We defined smoking rules inside the households as complete indoor rules (when smoking was not allowed inside the house), and partial or absent indoor rules (when smoking was allowed in some designated places inside the house or when smoking was allowed everywhere) and described them according to the perceived risk of the secondhand smoke (SHS) exposure. We calculated the prevalence and prevalence ratios (PR) according to sociodemographic variables.

Results

57.4% of households had complete indoor smoke-free rules. The prevalence of households with complete indoor rules was higher among women (PRa: 1.15; 95% CI 1.00 to 1.33), married (PRa: 1.18; 95% CI 1.01 to 1.38), never-smokers (PRa: 2.68; 95% CI 2.06 to 3.50) and in households where a minor lived (PRa: 1.40; 95% CI: 1.20–1.65). Believe that breathing tobacco smoke from smokers is dangerous for non-smokers (PRa: 1.77; 95% CI: 1.06–2.97) is associated with the voluntary adoption of complete indoor smoke-free home.

Conclusions

Risk perceptions of SHS exposure were associated with the voluntary adoption of indoor smoke-free homes.



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Selecting patients with non-ST-elevation acute coronary syndrome for coronary angiography: a nationwide clinical vignette study in the Netherlands

Objective

Cardiac guidelines recommend that the decision to perform coronary angiography (CA) in patients with Non-ST-Elevation Acute Coronary Syndrome (NST-ACS) is based on multiple factors. It is, however, unknown how cardiologists weigh these factors in their decision-making. The aim was to investigate the importance of different clinical characteristics, including information derived from risk scores, in the decision-making of Dutch cardiologists regarding performing CA in patients with suspected NST-ACS.

Design

A web-based survey containing clinical vignettes.

Setting and participants

Registered Dutch cardiologists were approached to complete the survey, in which they were asked to indicate whether they would perform CA for 8 vignettes describing 7 clinical factors: age, renal function, known coronary artery disease, persistent chest pain, presence of risk factors, ECG findings and troponin levels. Cardiologists were divided into two groups: group 1 received vignettes ‘without’ a risk score present, while group 2 completed vignettes ‘with’ a risk score present.

Results

129 (of 946) cardiologists responded. In both groups, elevated troponin levels and typical ischaemic changes (p<0.001) made cardiologists decide more often to perform CA. Severe renal dysfunction (p<0.001) made cardiologists more hesitant to decide on CA. Age and risk score could not be assessed independently, as these factors were strongly associated. Inspecting the factors together showed, for example, that cardiologists were more hesitant to perform CA in elderly patients with high-risk scores than in younger patients with intermediate risk scores.

Conclusions

When deciding to perform in-hospital CA (≤72 hours after patient admission) in patients with suspected NST-ACS, cardiologists tend to rely mostly on troponin levels, ECG changes and renal function. Future research should focus on why CA is less often recommended in patients with severe renal dysfunction, and in elderly patients with high-risk scores. In addition, the impact of age and risk score on decision-making should be further investigated.



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Radiation-induced lung metastasis development is MT1-MMP-dependent in a triple-negative breast cancer mouse model

Radiation-induced lung metastasis development is MT1-MMP-dependent in a triple-negative breast cancer mouse model

British Journal of Cancer advance online publication, January 19 2017. doi:10.1038/bjc.2016.448

Authors: Gina Bouchard, Hélène Therriault, Sameh Geha, Rachel Bujold, Caroline Saucier & Benoit Paquette



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Phase II randomised discontinuation trial of the MET/VEGF receptor inhibitor cabozantinib in metastatic melanoma

Phase II randomised discontinuation trial of the MET/VEGF receptor inhibitor cabozantinib in metastatic melanoma

British Journal of Cancer advance online publication, January 19 2017. doi:10.1038/bjc.2016.419

Authors: Adil Daud, Harriet M Kluger, Razelle Kurzrock, Frauke Schimmoller, Aaron L Weitzman, Thomas A Samuel, Ali H Moussa, Michael S Gordon & Geoffrey I Shapiro



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Enrichment of putative PAX8 target genes at serous epithelial ovarian cancer susceptibility loci

Enrichment of putative PAX8 target genes at serous epithelial ovarian cancer susceptibility loci

British Journal of Cancer advance online publication, January 19 2017. doi:10.1038/bjc.2016.426

Authors: Siddhartha P Kar, Emily Adler, Jonathan Tyrer, Dennis Hazelett, Hoda Anton-Culver, Elisa V Bandera, Matthias W Beckmann, Andrew Berchuck, Natalia Bogdanova, Louise Brinton, Ralf Butzow, Ian Campbell, Karen Carty, Jenny Chang-Claude, Linda S Cook, Daniel W Cramer, Julie M Cunningham, Agnieszka Dansonka-Mieszkowska, Jennifer Anne Doherty, Thilo Dörk, Matthias Dürst, Diana Eccles, Peter A Fasching, James Flanagan, Aleksandra Gentry-Maharaj, Rosalind Glasspool, Ellen L Goode, Marc T Goodman, Jacek Gronwald, Florian Heitz, Michelle A T Hildebrandt, Estrid Høgdall, Claus K Høgdall, David G Huntsman, Allan Jensen, Beth Y Karlan, Linda E Kelemen, Lambertus A Kiemeney, Susanne K Kjaer, Jolanta Kupryjanczyk, Diether Lambrechts, Douglas A Levine, Qiyuan Li, Jolanta Lissowska, Karen H Lu, Jan Lubiński, Leon F A G Massuger, Valerie McGuire, Iain McNeish, Usha Menon, Francesmary Modugno, Alvaro N Monteiro, Kirsten B Moysich, Roberta B Ness, Heli Nevanlinna, James Paul, Celeste L Pearce, Tanja Pejovic, Jennifer B Permuth, Catherine Phelan, Malcolm C Pike, Elizabeth M Poole, Susan J Ramus, Harvey A Risch, Mary Anne Rossing, Helga B Salvesen, Joellen M Schildkraut, Thomas A Sellers, Mark Sherman, Nadeem Siddiqui, Weiva Sieh, Honglin Song, Melissa Southey, Kathryn L Terry, Shelley S Tworoger, Christine Walsh, Nicolas Wentzensen, Alice S Whittemore, Anna H Wu, Hannah Yang, Wei Zheng, Argyrios Ziogas, Matthew L Freedman, Simon A Gayther, Paul D P Pharoah & Kate Lawrenson



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Tissue-based next generation sequencing: application in a universal healthcare system

Tissue-based next generation sequencing: application in a universal healthcare system

British Journal of Cancer advance online publication, January 19 2017. doi:10.1038/bjc.2016.452

Authors: Seán O Hynes, Brendan Pang, Jacqueline A James, Perry Maxwell & Manuel Salto-Tellez



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A phase III randomised controlled trial of erlotinib vs gefitinib in advanced non-small cell lung cancer with EGFR mutations

A phase III randomised controlled trial of erlotinib vs gefitinib in advanced non-small cell lung cancer with EGFR mutations

British Journal of Cancer advance online publication, January 19 2017. doi:10.1038/bjc.2016.456

Authors: J J Yang, Q Zhou, H H Yan, X C Zhang, H J Chen, H Y Tu, Z Wang, C R Xu, J Su, B C Wang, B Y Jiang, X Y Bai, W Z Zhong, X N Yang & Y L Wu



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Progressive epigenetic dysregulation in neuroendocrine tumour liver metastases



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Reducing Treatment Doses in Head and Neck Cancer to Improve QOL - Cancer Network


Reducing Treatment Doses in Head and Neck Cancer to Improve QOL
Cancer Network
In this video, Barbara Burtness, MD, of the Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut, discusses efforts to reduce treatment doses in order to lessen long-term side effects and improve quality of life (QOL) among patients ...



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The regulatory role of long noncoding RNAs in cancer

With the advances in genomic analysis technologies, especially next-generation RNA sequencing, a large number of new transcripts have been discovered, leading to better understanding of long noncoding RNAs (lncRNAs). Recent investigations have provided firm evidence for the critical roles of lncRNAs in chromatin modification, gene transcription, RNA splicing, RNA transport and translation. In vitro and in vivo studies have also proven that aberrant lncRNA expression is essential for the initiation and progression of cancers.

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Potential of glycative stress targeting for cancer prevention

Glycative stress from endogenous and exogenous advanced glycation end-products (AGEs) has been implicated to cancer development and progression. Dicarbonyl compounds, the main AGE precursors and crosslinked AGE forms may directly react with proteins, lipids and nucleic acids, modify their structure and affect tissue microenvironment. They may also induce elevation of reactive oxygen species (ROS) and enhance cellular oxidative stress, an important regulator of cancer hallmarks. Moreover, the activation of AGE-receptor for AGE (RAGE) signalling pathways mediates inflammation, oxidative stress, autophagy and apoptosis leading to genomic instability and cancer initiation.

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Miguel Ferrer Cause of Death: Granger Leaves 'NCIS: Los Angeles' After Cancer Battle - Daily Disruption


Daily Disruption

Miguel Ferrer Cause of Death: Granger Leaves 'NCIS: Los Angeles' After Cancer Battle
Daily Disruption
According to the National Cancer Institute, there are 3.2 new cases of larynx cancer per 100,000 men and women in 2016. In the same year, around 13,430 individuals have died due to this condition. The survival rate for this disease, however, is ...

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Determination of Origin and Intended Use of Plutonium Metal Using Nuclear Forensic Techniques

After the dissolution of the Soviet Union in the early 1990s, a large number of incidents of illegal possession and trafficking of nuclear materials were reportedn [1]. Illicit activities involving nuclear materials still pose a great threat to international security as these materials have the potential to be used for nuclear terrorism. Nuclear forensics is a multi-disciplinary scientific field that was established to investigate the origin and intended use of interdicted nuclear materials [2–7].

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The regulatory role of long noncoding RNAs in cancer

With the advances in genomic analysis technologies, especially next-generation RNA sequencing, a large number of new transcripts have been discovered, leading to better understanding of long noncoding RNAs (lncRNAs). Recent investigations have provided firm evidence for the critical roles of lncRNAs in chromatin modification, gene transcription, RNA splicing, RNA transport and translation. In vitro and in vivo studies have also proven that aberrant lncRNA expression is essential for the initiation and progression of cancers.

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Potential of glycative stress targeting for cancer prevention

Glycative stress from endogenous and exogenous advanced glycation end-products (AGEs) has been implicated to cancer development and progression. Dicarbonyl compounds, the main AGE precursors and crosslinked AGE forms may directly react with proteins, lipids and nucleic acids, modify their structure and affect tissue microenvironment. They may also induce elevation of reactive oxygen species (ROS) and enhance cellular oxidative stress, an important regulator of cancer hallmarks. Moreover, the activation of AGE-receptor for AGE (RAGE) signalling pathways mediates inflammation, oxidative stress, autophagy and apoptosis leading to genomic instability and cancer initiation.

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Mature cystic teratoma of the ovary: a cutting edge overview on imaging features

Abstract

Mature cystic teratoma (MCT) is the most common neoplasm of the ovary and includes at least two well- differentiated germ cell layers. Different combinations of mature tissue derivatives with varying arrangements in the tumour cause a wide spectrum of radiological presentation ranging from a purely cystic mass to a complex cystic mass with a considerable solid component. In different imaging modalities, each radiological feature reflects a specific pathologic equivalent that forms because of diverse compositions of histological components. Understanding uncommon findings as well as the classic signs with basic knowledge of pathological equivalents permits a more accurate diagnosis and guides adequate treatment. In this review, radiological features of MCT in different imaging modalities (US, CT, MR imaging) including specific signs and useful radiological artefacts with brief emphasis on pathological basics are discussed.

Teaching points

Ovarian mature cystic teratomas (MCTs) have a wide spectrum of radiological presentation.

Each radiological feature of MCT reflects a specific pathologic equivalent.

Understanding radiological signs with basic knowledge of pathology can permit a more accurate diagnosis.



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Actualités en cancérologie digestive à l’UEGW 2016



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Determination of Origin and Intended Use of Plutonium Metal Using Nuclear Forensic Techniques

After the dissolution of the Soviet Union in the early 1990s, a large number of incidents of illegal possession and trafficking of nuclear materials were reportedn [1]. Illicit activities involving nuclear materials still pose a great threat to international security as these materials have the potential to be used for nuclear terrorism. Nuclear forensics is a multi-disciplinary scientific field that was established to investigate the origin and intended use of interdicted nuclear materials [2–7].

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IRF4 rs12203592 functional variant and melanoma survival

Abstract

Inherited genetic factors may modulate clinical outcome in melanoma. Some low to medium risk genes in melanoma susceptibility play a role in melanoma outcome. Our aim was to assess the role of the functional IRF4 SNP rs12203592 in melanoma prognosis in two independent sets (Barcelona N=493 and Essen N=438). Genotype association analyses showed that the IRF4 rs12203592 T allele increased the risk of dying from melanoma in both sets (Barcelona: Odds Ratio [OR]=6.53, 95%CI 1.38 to 30.87, Adj P=0.032; Essen: OR=1.68, 95%CI 1.04 to 2.72, Adj P=0.035). Survival analyses only showed significance for the Barcelona set (Hazard ratio=4.58, 95% CI 1.11 to 18.92, Adj. P=0.036). This SNP was also associated with tumor localization, increasing the risk of developing melanoma in Head or Neck (OR=1.79, 95%CI 1.07 to 2.98, Adj P=0.032) and protecting from developing melanoma in the trunk (OR=0.59, 95%CI 0.41 to 0.85, Adj P=0.004). These findings suggest for the first time that IRF4 rs12203592 plays a role in the modulation of melanoma outcome and confirms its contribution to the localization of the primary tumor. This article is protected by copyright. All rights reserved.



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Thyroid cancer after hysterectomy on benign indications: Findings from an observational cohort study in Sweden

Abstract

To investigate the association between hysterectomy and thyroid cancer subtypes based on histopathology. We did a nationwide, population-based, cohort study from 1973 to 2009 in Sweden. We identified as our study population all women above 18 years of age during the period between January 1, 1973 and December 31, 2009 from the Register of Population (n= 5.704,202) Individual case ascertainment of primary thyroid cancer subtypes were restricted to 1993-2009 based on histological pathologic-anatomical-diagnosis from the Cancer Register. Thyroid cancer subtypes were categorized based on histological morphology as: papillary, follicular, and others (including anaplastic and medullary thyroid carcinoma). Information on benign hysterectomy derived from the Swedish Inpatient Register. Women with a hysterectomy (exposed) were compared to women not having had a hysterectomy (unexposed) using Cox's proportional hazard ratios (HRs). The adjusted HR for papillary thyroid cancer was significantly increased in exposed as compared to unexposed women (HR 1.70, 95% CI 1.04-2.79). There was no significant association between hysterectomy and follicular carcinoma or other thyroid cancers. There was a clear shift in the occurrence of thyroid cancer towards a lower attained age at the time of diagnosis among the exposed but no significant difference in overall survival when comparing exposed and unexposed (HR 1.02, 95% CI 0.48-2.16) Hysterectomy was associated with an increased risk for subsequent papillary thyroid cancer and diagnosis at a younger age compared to women not having had a hysterectomy but there were no differences in survival. This article is protected by copyright. All rights reserved.



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Niacin intake and incident adult-onset atopic dermatitis in women

Supplemental nicotinamide, a derivative of niacin, has been reported to decrease transepidermal water loss. However, in this analysis including 67,643 women from the Nurses’ Health Study 2, niacin intake was not protective for atopic dermatitis.

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Notch signaling in T cells is essential for allergic airway inflammation, but expression of Notch ligands Jagged1 and Jagged2 on dendritic cells is dispensable

Although Notch signaling in T cells is critical for development of T helper2 cell-driven house-dust mite mediated allergic airway inflammation in mice, expression of the Notch ligands Jagged1 and Jagged2 on dendritic cells is dispensable.

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Allergen-dependent oxidant formation requires purinoceptor activation of ADAM 10 and prothrombin



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JAK1 gain-of-function causes an autosomal dominant immune dysregulatory and hypereosinophilic syndrome

Germline JAK1 gain-of-function mutations cause autosomal dominant immune dysregulation and hypereosinophilia with eosinophilic infiltration of the gastrointestinal tract, massive hepatosplenomegaly and severe atopic dermatitis that can be successfully treated with ruxolitinib, an oral JAK1/2 inhibitor.

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Patient-Reported Outcomes Associated With Survival in Early-Stage CRC

Certain patient-reported outcomes including fatigue and emotional support are associated with survival outcomes in patients with early-stage colorectal cancer. (Source: CancerNetwork)

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Ciattarelli raises $283K for gubernatorial bid, challenges Guadagno to debates - MyCentralJersey.com


MyCentralJersey.com

Ciattarelli raises $283K for gubernatorial bid, challenges Guadagno to debates
MyCentralJersey.com
Ciattarelli, who disclosed last week he is being treated for oropharyngeal cancer, which affects the throat and tonsils, unleashed an attack on Guadagno, saying that her website outlining her platform is “shamefully light on specifics and substance ...

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Investigation of heavy metal pollution in eastern Aegean Sea coastal waters by using Cystoseira barbata , Patella caerulea , and Liza aurata as biological indicators

Abstract

In order to have an extensive contamination profile of heavy metal levels (Cd, Cu, Fe, Mn, Ni, Pb, and Zn), seawater, sediment, Patella caerulea, Cystoseira barbata, and Liza aurata were investigated by using inductively coupled plasma-atomic emission spectrometry (ICP-AES). Samples were collected from five coastal stations along the eastern Aegean Sea coast (Turkey) on a monthly basis from July 2002 through May 2003. According to the results of this study, heavy metal levels were arranged in the following sequence: Fe > Pb > Zn > Mn > Ni > Cu > Cd for water, Fe > Cu > Mn > Ni > Zn > Pb > Cd for sediment, Fe > Zn > Mn > Pb > Ni > Cd > Cu for C. barbata, Fe > Zn > Mn > Ni > Pb > Cu > Cd for P. caerulea, and Fe > Zn > Mn > Cu > Ni > Pb > Cd for L. aurata. Moreover, positive relationships between Fe in water and Mn in water, Fe in sediment and Mn in sediment, Fe in C. barbata and Mn in C. barbata, Fe in P. caerulea and Mn in P. caerulea, and Fe in L. aurata and Mn in L. aurata may suggest that these metals could be originated from the same anthropogenic source. C. barbata represented with higher bioconcentration factor (BCF) values, especially for Fe, Mn, and Zn values. This observation may support that C. barbata can be used as an indicator species for the determinations of Fe, Mn, and Zn levels. Regarding Turkish Food Codex Regulation’s residue limits, metal values in L. aurata were found to be lower than the maximum permissible levels issued by Turkish legislation and also the recommended limits set by FAO/WHO guidelines. The results of the investigation indicated that P. caerulea, L. aurata, and especially C. barbata are quantitative water-quality bioindicators and biomonitoring subjects for biologically available metal accumulation for Aegean Sea coastal waters.



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Herbicides and trace metals in urban waters in Melbourne, Australia (2011–12): concentrations and potential impact

Abstract

Urban stormwater samples were collected from five aquatic systems in Melbourne, Australia, on six occasions between October 2011 and March 2012 and tested for 30 herbicides and 14 trace metals. Nineteen different herbicides were observed in one or more water samples from the five sites; chemicals observed at more than 40% of sites were simazine (100%), MCPA (83%), diuron (63%) and atrazine (53%). Using the toxicity unit (TU) concept to assess potential risk to aquatic ecosystems, none of the detected herbicides were considered to pose an individual, group or collective short-term risk to fish or zooplankton in the waters studied. However, 13 herbicides had TU values suggesting they might have posed an individual risk to primary producers at the time of sampling. Water quality guideline levels were exceeded on many occasions for Cd, Cu, Cr, Pb and Zn. Similarly, RQmed and RQmax exceeded 1 for Cd, Cr, Cu, Mn, Ni, Pb, V and Zn. Almost all the metals screened exceeded a log10TU of −3 for every trophic level, suggesting that there may have been some impact on aquatic organisms in the studied waterbodies. Our data indicate that Melbourne’s urban aquatic environments may be being impacted by approved domestic, industrial and sporting application of herbicides and that stormwater quality needs to be carefully assessed prior to reuse. Further research is required to understand the performance of different urban stormwater wetland designs in removing pesticides and trace metals. Applying the precautionary principle to herbicide regulation is important to ensure there is more research and assessment of the long-term ‘performance’ standard of all herbicides and throughout their ‘life cycle’. Implementing such an approach will also ensure government, regulators, decision makers, researchers, policy makers and industry have the best possible information available to improve the management of chemicals, from manufacture to use.



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Influence of Inflammation and Atherosclerosis in Atrial Fibrillation

Abstract

Background

Inflammation markers have been associated with cardiovascular diseases including atrial fibrillation. This arrhythmia is the most frequent, with an incidence of 38/1000 person-years.

Purpose of Review

The aims of this study are to discuss the association between inflammation, atherosclerosis and atrial fibrillation and its clinical implications.

Recent Findings and Summary

Atherosclerosis is a chronic inflammatory disease and inflammation is a triggering factor of atherosclerotic plaque rupture. In addition to coronary artery disease, clinical conditions identified as risk factors for atrial fibrillation (AF) are also associated with the inflammatory state such as obesity, diabetes mellitus, hypertension, heart failure, metabolic syndrome and sedentary lifestyle. Biomarkers of inflammation, oxidative stress, coagulation, and myocardial necrosis have been identified in patients with atrial fibrillation and these traditional risk factors. Some markers of inflammation were identified as predictors of recurrence of this arrhythmia, subsequent myocardial infarction, stroke by embolism, and death. Thus, approaches to manipulate the inflammatory pathways may be therapeutic interventions, benefiting patients with AF and increased inflammatory markers.



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Zika Virus—What the Otolaryngologist Should Know

This review summarizes information on the Zika virus, its clinical courses, and diagnosis to educate otolaryngologists about relevant diagnostic, therapeutic, and preventive measures.

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Endoscopic Repair of Tympanic Membrane Perforations

This Viewpoint discusses the advantage of the transcanal endoscopic approach for tympanoplasty.

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Incorrect Numbers at Risk in Figure

In the Original Investigation titled “Cetuximab and Radiotherapy in Laryngeal Preservation for Cancers of the Larynx and Hypopharynx: A Secondary Analysis of a Randomized Clinical Trial,” published in the September issue of JAMA Otolaryngology–Head & Neck Surgery,1 incorrect values for the numbers of patients at risk appeared in Figure 2A. At day 30, the numbers of patients at risk should be 34 for CRT (cetuximab plus radiotherapy) and 25 for radiotherapy alone (not 3 and 2). This article was corrected online.

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Characteristics of Low Gestational Age Newborns Undergoing Tracheotomy

This cohort analysis of extremely low gestational age newborns in the Trial of Late Surfactant evaluates the use of mean airway pressure as an indicator of the need for tracheotomy.

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Unusual Cause of Anemia and Positive Fecal Occult Blood Test

A man presented with edema of the lower leg and suspected venous thrombosis; computed tomography revealed an esophageal intraluminal tubular mass of soft-tissue density originating just below the pyriform recessus and extending through the esophagus in the stomach lumen. What is your diagnosis?

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EMR Implementation and Otolaryngologist Productivity

This observational study examines the association between transitioning to an electronic medical record system and physician productivity in otolaryngology.

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Prosthetic Voice Rehabilitation Following Laryngectomy

Total laryngectomy (TL) as an operation has evolved since it was first performed by Billroth in 1873, and has declined in use as the primary treatment for advanced laryngeal cancer. This decline in use has been arguably associated with a decline in survival rates. Less controversial is the critical requirement to provide alaryngeal patients with acceptable forms of voice restoration, which include electrolarynx, esophageal speech, and indwelling tracheoesophageal prostheses (TEP). Of these, the use of TEP has been shown to significantly improve patient quality of life, self-esteem, and sexual function with concomitant decrease in symptoms of depression and anxiety. Objective assessments of voice restoration outcomes, including TEP device life, are necessary to properly counsel patients and engage in shared decision making about voice restoration after laryngectomy.

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Chronic Sinusitis and Risk of Head and Neck Cancer in US Elderly

This study uses SEER-Medicare data to evaluate the associations of chronic sinusitis with subsequent head and neck cancers, including nasopharyngeal cancer, human papillomavirus–related oropharyngeal cancer, and nasal cavity and paranasal sinus cancer.

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Voice Change, Odynophagia, and Neck Pain Following a Sneeze

A man experienced sudden voice change, odynophagia, and neck pain following a single sneeze; laryngoscopy showed hematoma of the true vocal fold and laryngeal surface of the epiglottis with normal vocal fold movement and complete glottic closure. What is your diagnosis?

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Survival and Surgical Outcomes for Pediatric Head and Neck Melanoma

This cohort study uses information from the National Cancer Data Base to examine the survival, demographic, tumor, and treatment characteristics of pediatric head and neck melanoma.

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Surgical treatment For T4 Oropharyngeal Cancer

To the Editor The article by Zenga et al on the role of surgery for T4 oropharyngeal cancer was interesting, but I believe it had several omissions that add to the limitations. The most problematic issue with the analysis was the inherent bias in a comparison between 2 groups, 1 that undergoes the therapy (surgery) and 1 that does not, when the latter group has patients who either medically or technically cannot receive the therapy.

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Increases in the Rate of Age-Related Hearing Loss in the Older Old

This medical record review uses audiometric evaluations at an academic medical center to determine if the rate of age-related hearing loss is constant in the older old.

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January 2017 Issue Highlights



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Parental Knowledge of Obstructive Sleep-Disordered Breathing

This study develops a questionnaire to measure parents’ understanding of adenotonsillectomy for obstructive sleep-disordered breathing as an aid in decision making and outcomes research.

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Otolaryngologist—Beware of Zika

The recent introduction of the Zika virus into the Western hemisphere and its unprecedented and rapid spread represent a great challenge to the otolaryngologist. The article by Arnaoutakis and Padhya discusses the issues confronting otolaryngologists in dealing with this phenomenon.

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Office-Based vs OR Management of Recurrent Respiratory Papillomatosis

This medical record review of adult patients with recurrent respiratory papillomatosis investigates whether demographic or disease characteristics differ between patients undergoing office-based vs traditional operating room surgical treatment approaches.

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A Tracheal Mass

A woman had a cervical tracheal mass on magnetic resonance imaging for cervical spine pain; flexible fiber-optic nasolaryngoscopy demonstrated a smooth hypervascular mass arising from the posterior membranous trachea. What is your diagnosis?

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Effect of Insurance Status on Children With Cochlear Implantation

This study reviews the achievement of fundamental auditory recognition and sound imitation in children with cochlear implants and investigates whether underinsured patients would achieve these goals in a delayed manner.

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A Man With Objective Tinnitus

A man had recurrent episodes of unilateral high-pitched “clicking” in his right ear followed by vertigo that lasted 3 to 4 seconds but no hearing loss, aural fullness, autophony, or headache. What is your diagnosis?

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In the Shadow of the Greatest Hyena

For over a million years, humans competed with the largest hyenas who ever lived.

-- Read more on ScientificAmerican.com
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Tissue-based next generation sequencing: application in a universal healthcare system



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Enrichment of putative PAX8 target genes at serous epithelial ovarian cancer susceptibility loci



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Phase II randomised discontinuation trial of the MET/VEGF receptor inhibitor cabozantinib in metastatic melanoma



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Radiation-induced lung metastasis development is MT1-MMP-dependent in a triple-negative breast cancer mouse model



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A phase III randomised controlled trial of erlotinib vs gefitinib in advanced non-small cell lung cancer with EGFR mutations



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[Editorial] What to expect for China's health in the future

2017 will be a crucial year for the future direction of health care in China, not only because of the upcoming reshuffle of the top Chinese leadership—the Politburo Standing Committee—but also because of the 13th 5-year plan on health care (2016–20), which was officially issued by China's State Council on Jan 10. The plan represents the political health manifesto of the Communist Party.

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[Editorial] A cure for Crohn's disease by 2032

In today's Lancet, Séverine Vermeire and colleagues report the results of FITZROY, a phase 2 randomised controlled trial that compared the JAK1 inhibitor filgotinib with placebo for clinical remission in patients with moderate-to-severe Crohn's disease. Although modestly sized, short-term, and preliminary, the study offers promise for several reasons: the different approach to cytokine blockade, oral dosing, stratification by prior treatment with anti-TNF compounds, and the use of meaningful patient-reported outcomes.

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[Correspondence] Health policies for migrant children in Europe and Australia

More than 300 000 children seeking asylum were registered in the 28 European Union (EU) member states during 2015, including 88 700 unaccompanied minors. These children have considerable health-care needs primarily because of mental health problems, but also as a result of infectious disorders and lack of basic health care (such as immunisations).1

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[Correspondence] 25 years after Intoxicated by My Illness: challenges for medical humanities

Communicating with patients at the end of life is regarded as a difficult task, and speaking openly about death is often avoided.1,2 Around 50% of patients are informed about their diagnosis and prognosis in many European countries. Silence conspiracies are fairly common3—defined as the agreement between health professionals and relatives or carers to hide from the patient information related to their clinical condition.

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[Correspondence] Psychological aid following medical crises in China

On Oct 3, 2016, a doctor was fatally attacked by the patient's family member in China. Resentment, helplessness, confusion, and fear again damaged the already fragile doctor–patient relationship. Many have attributed the deterioration in this relationship to media, policy, patients, or doctors, in an apparent attempt to look for someone to blame. But in this recent case, an innocent paediatrician was attacked by a new father whose baby died of congenital disease. In denial, depression, and anger, the new father vented his grief on the doctor, with tragic consequences.

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[Department of Error] Department of Error

Lublin F, Miller DH, Freedman MS, et al. Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet 2016; 387: 1075–84—In this Article, the list of principal investigators in the appendix has been updated. This correction has been made to the online version as of Jan 19, 2017.

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[Perspectives] Governance for the future of global health

This year will see major changes in leadership at WHO and at the Global Fund to Fight AIDS, Tuberculosis and Malaria, and probably in some other health-related multilateral organisations as well. History has shown that an able leader at the helm can make a difference. However, governance, organisational culture and performance, and funding equally define a leader's effectiveness. In the case of multilateral institutions, these are complex matters given the conflicting interests of their multiple stakeholders.

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[Correspondence] Guillain-Barré syndrome: surveillance and cost of treatment strategies

As Hugh Willison and colleagues describe,1 intravenous immunoglobulin (IVIg) and plasma exchange (PLEX) are equally efficacious in treating Guillain-Barré syndrome and the therapeutic decision is largely justified by greater convenience. Because PLEX is cheaper than IVIg, it has been suggested that PLEX should be considered first-line therapy for Guillain-Barré syndrome in resource-constrained environments.2

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[Comment] Access to Medicine Index—what about sustainability?

A pharmaceutical company representative described the Access to Medicine Index 2016 as “a force for good, and not yet another stick with which to beat industry”.1 The Access to Medicine Index 2016,1 which will be presented at a public meeting later this month at the time of the WHO Executive Board meeting in Geneva, ranks the top 20 research-based pharmaceutical companies on their efforts to improve access to medicine in low-income and middle-income countries (LMICs). And those companies with high ranking tout their success to their stockholders and the media.

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[World Report] Bulgaria attempts to combat discrimination against Roma

Innovative schemes in Bulgaria are enabling young Roma to study medicine while others are encouraging Roma people to become health mediators. Jacqui Thornton reports from Sofia.

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[Comment] The Lancet–CAMS Health Summit 2017: a call for abstracts from China

The Lancet and the Chinese Academy of Medical Sciences (CAMS) have held two successful health summits in 2015 and 2016 in Beijing, China. We are thrilled to be involved in the exciting and rapid progress of medical research in China, and will continue to support China's health science research. We invite abstract submissions from China for The Lancet–CAMS Health Summit 2017, to be held on Oct 13–14 in Beijing. Submissions are invited from all aspects of health science including, but not limited to: translational medicine, clinical medicine, public health, global health, health policy, the environment and ecological systems and health, health professionalism, and medical education.

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[World Report] Calls for medically safe heroin mount in Canada

Canada is rapidly scaling up supervised injection facilities to tackle a surge in heroin overdoses. The move is welcomed by experts but several are calling for further measures. Paul C Webster reports.

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[Comment] Offline: Tackling the despair of England's NHS

It is with exquisite sadness that anyone concerned with the future of health care in England now observes the present broken covenant of trust between government and medical profession. I cannot recall a time since 1980 (the year I became a medical student) when the confidence doctors and politicians have in one another has been so low, when the dialogue between them has been so bitter. Ever since the creation of the Royal College of Physicians in 1518, the profession has served at the pleasure of government.

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[World Report] Suicide in Indigenous Australians: a “catastrophic crisis”

Suicide prevention programmes for Indigenous Australians have been reported to be failing. An Indigenous-led national response to the crisis is needed, say experts. Sophie Cousins reports.

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[Perspectives] Conrad Shawcross: art in search of discovery

“I remember seeing a car parked here and there in Hackney, London, with an intriguing contraption made of metal rods, an antenna or two, and maybe some ropes protruding from the roof. I imagined it was the work of a wonderfully batty investigator who had some idiosyncratic notions about extra-terrestrial life or a new form of communication”, says Ken Arnold, Creative Director at the Wellcome Trust and Copenhagen's Medical Museion, when I ask him when he first came across British sculptor and artist Conrad Shawcross.

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American Thyroid Association Experts Debate Benefits and Challenges of New ATA Guidelines for Managing Hyperthyroidism and Thyrotoxicosis

In a stimulating new Roundtable Discussion, a distinguished panel of leading physicians and clinical researchers highlight the key changes, new topics, and areas of ongoing controversy in the “2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.The Roundtable Discussion and the American Thyroid Association (ATA) guidelines are available free on the website of Thyroid, the official peer-reviewed journal of the ATA, published by Mary Ann Liebert, Inc., publishers.

Led by Moderator Douglas S. Ross, MD, Harvard Medical School and Massachusetts General Hospital, Boston, the Roundtable features panelists Victor J. Bernet, MD, Mayo Clinic and Mayo Clinic College of Medicine, Jacksonville, FL;  David S. Cooper, MD, The Johns Hopkins University School of Medicine, Baltimore, MD; Gilbert Daniels, MD, Harvard Medical School and Massachusetts General Hospital; Jacqueline Jonklaas, MD, PhD, Georgetown University, Washington, DC; John C. Morris, MD, Mayo Clinic, Rochester, MN; Elizabeth N. Pearce, MD, Boston University School of Medicine; Mary Samuels, MD, Oregon Health & Science University, Portland; and Julie Ann Sosa, MD, MA, Duke Cancer Institute and Duke Clinical Research Institute, Duke University, Durham, NC.

The panelists, all members of the American Thyroid Association and some of whom were on the task force that developed the previous management guidelines in 2011, highlighted the major changes in the 2016 guidelines, which included an increase in the number of recommendations from 100 to 124 and an expanded focus on more unusual cases of thyrotoxicosis. The spirited and informative discussion also focused on important changes in the new guidelines, including new paradigms for determining the etiology of thyrotoxicosis, new approaches to monitor response to anti-thyroid drugs such as measures of thyrotropin receptor antibodies, new data supporting the safety of long-term use of anti-thyroid drugs, and new approaches to manage hyperthyroidism in women who want to become pregnant.

“These guidelines provide a significant update compared to the previous version published in 2011 because they integrate recent studies and developments in practice trends. They form a detailed and balanced framework for the diagnosis and management of patients with different etiologies of thyrotoxicosis that is based on the currently available evidence,” says Peter A. Kopp, MD, Editor-in-Chief of Thyroid and Professor of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago.

“The updated guidelines have refined several important aspects of diagnosis and management of patients with hyperthyroidism based upon new knowledge and technology.  The panel’s discussion focused upon several of the more common issues regarding application of new recommendations.  I found it to be both simulating and informative.” says John C. Morris, MD, President of the American Thyroid Association, Professor of Medicine, Mayo Clinic, Rochester, Minnesota.

The Roundtable was supported by Quidel.

About the Journal
Thyroid, the official journal of the American Thyroid Association, is an authoritative peer-reviewed journal published monthly online with open access options and in print. The Journal publishes original articles and timely reviews that reflect the rapidly advancing changes in our understanding of thyroid physiology and pathology, from the molecular biology of the cell to clinical management of thyroid disorders. Complete tables of content and a sample issue may be viewed on the Thyroid website. The complete Thyroid Journal Program includes the highly valued abstract and commentary publication Clinical Thyroidology, led by Editor-in-Chief Jerome M. Hershman, MD and published monthly, and the groundbreaking videojournal companion VideoEndocrinology, led by Editor Gerard Doherty, MD and published quarterly. Complete tables of content and sample issues may be viewed on the Thyroid website.

About the Society
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA delivers its mission — of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health — through several key endeavors: the publication of highly regarded professional journals, Thyroid, Clinical Thyroidology, and VideoEndocrinology; annual scientific meetings; research grant programs for young investigators, biennial clinical and research symposia; support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease and thyroid cancer. The ATA promotes thyroid awareness and information through its online Clinical Thyroidology for the Public (distributed free of charge to over 11,000 patients and public subscribers) and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet.

About the Publisher
Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Diabetes Technology & Therapeutics, Journal of Women’s Health, and Metabolic Syndrome and Related Disorders. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry’s most widely read publication worldwide. A complete list of the firm’s more than 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.

The post American Thyroid Association Experts Debate Benefits and Challenges of New ATA Guidelines for Managing Hyperthyroidism and Thyrotoxicosis appeared first on American Thyroid Association.



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The new article is now available. The Keio Journal of Medicine

[ Advance Publication ] [ Title ] Differential X Chromosome Inactivation Patterns during the Propagation of Human Induced Pluripotent Stem Cells [ Author ] Tomoko Andoh-Noda,Wado Akamatsu,Kunio Miyake,Tetsuro Kobayashi,Manabu Ohyama,Hiroshi Kurosawa,Takeo Kubota,Hideyuki Okano [ Advance Pub. date ] 2017-01-20 [ DOI ] http://ift.tt/2jdMRSi

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Surgical Pain Management: A Complete Guide to Implantable and Interventional Pain Therapies , S Narang, A Weisheipl and EL Ross (editors)

<span class="paragraphSection"><span style="font-style:italic;">Surgical Pain Management: A Complete Guide to Implantable and Interventional Pain Therapies</span>, NarangS, WeisheiplA and RossEL (editors). Published by Oxford University Press. Pp. 408. Price $115. ISBN 978-0-19-937737-4</span>

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Endothelial dysfunction in the early postoperative period after major colon cancer surgery

<span class="paragraphSection"><strong>Background.</strong> Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide pathway postoperatively.<strong>Methods.</strong> Patients undergoing elective colon cancer surgery (n = 31) were included in this prospective observational cohort study. Endothelial function, as measured using the reactive hyperaemia index (RHI), was assessed non-invasively using digital pulse tonometry. RHI and plasma concentrations of L-arginine, asymmetric dimethylarginine (ADMA), dihydrobiopterin and biopterin metabolites, tetrahydrobiopterin (BH4) and total biopterin were measured before surgery, at four h after surgery and at postoperative day one and two. Cardiac troponin I was measured before surgery and once daily on postoperative days one to four.<strong>Results.</strong> Preoperative RHI was 1.86 (1.64 – 2.11) and decreased significantly during the observation period (linear mixed effects model of serial measurements, <span style="font-style:italic;">P = </span>0.015). Both L-arginine (<span style="font-style:italic;">P</span> < 0.001) and ADMA (<span style="font-style:italic;">P = </span>0.024) decreased during the postoperative period. All biopterin metabolites were significantly decreased after surgery. A significant positive correlation was found between logAUC(l-arginine/ADMA) and logAUC(RHI) (<span style="font-style:italic;">P = </span>0.015) and between logAUC(L-arginine/ADMA) and logAUC(BH4) (<span style="font-style:italic;">P = </span>0.015). None of the patients had cardiac troponin I elevations.<strong>Conclusions.</strong> RHI was attenuated in the first days after colon cancer surgery indicating acute endothelial dysfunction. Endothelial dysfunction correlated with disturbances in the L-arginine – nitric oxide pathway. Our findings provide a rationale for investigating the hypothesized association between acute endothelial dysfunction and cardiovascular complications after non-cardiac surgery.<strong>Clinical trial registration.</strong> NCT02344771.</span>

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Advances in Anesthesia . TM McLoughlin, FV Salinas and L Torsher (editors)

<span class="paragraphSection"><span style="font-style:italic;">Advances in Anesthesia</span>. McLoughlinTM, SalinasFV and TorsherL (editors). Published by Elsevier. Pp. 213. Price $175. ISBN 978-0-323-35605-3</span>

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Paravertebral block in paediatric abdominal surgery—a systematic review and meta-analysis of randomized trials

<span class="paragraphSection">The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done. Relevant studies were randomized clinical trials in patients 0–18 years old comparing PVB (single shot or continuous catheter) with any comparator and analgesic medication. Pain scores, rescue analgesia and adverse events were compared.The systematic reviews identified six trials enrolling 358 paediatric patients. PVB medications included bupivacaine, ropivacaine, lidocaine, and fentanyl. Surgical procedures included inguinal herniorraphy, cholecystectomy, and appendectomy. The standardized mean difference in early pain scores favoured PVB: 0.85 [95% confidence interval (CI) 0.12–1.58] at 4–6 h and 0.64 (95% CI 0.28–1.00) at 24 h. One study reported a reduced length of stay. Parental [odds ratio (OR) 5.12 (95% CI 2.59–10.1)] and surgeon [OR 6.05 (95% CI 2.25–16.3)] satisfaction were higher in those receiving a PVB. No major complications occurred with a PVB.PVB resulted in minimally improved pain scores for up to 24 h after surgery, reduced rescue analgesia requirements, and increased surgeon and parental satisfaction. PVB is a good alternative to caudal and ilioinguinal block in paediatric abdominal surgery.</span>

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