Abandoning use of 1st generation SAD – a reply

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Cadaveric training – the solution for ultrasound-guided regional anaesthesia?

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Perineural or intravenous dexamethasone: do we still need catheters?

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Do I need ethics for this?

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Propofol infusion in children

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Abandoning first generation supraglottic airway devices

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Propofol infusion in children – a reply

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Hyaluronic acid fillers and hyaluronidase use in regional eye blocks

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A randomised placebo-controlled trial examining the effect on hand supination after the addition of a suprascapular nerve block to infraclavicular brachial plexus blockade

Summary

Some surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised, placebo-controlled study, our primary outcome measure was the amount of supination (as assessed by wrist angulation) 30 min after infraclavicular brachial plexus block, with (suprascapular group) or without (control group) a supplementary suprascapular block. All blocks were ultrasound-guided. The secondary outcome measure was an assessment by the surgeon of the intra-operative position of the hand. Considering only patients with successful nerve blocks, mean (SD) wrist angulation was lower (33 (27) vs. 61 (44) degrees; p = 0.018) and assessment of the hand position was better (11/11 vs. 6/11 rated as ‘good’; p = 0.04) in the suprascapular group. The addition of a suprascapular nerve block to an infraclavicular brachial plexus block can provide a better hand/forearm position for dorsal hand surgery.

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Issue Information – Editorial Board

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Risk of bias and methodological appraisal practices in systematic reviews published in anaesthetic journals: a meta-epidemiological study

Summary

The validity of primary study results included in systematic reviews plays an important role in drawing conclusions about intervention effectiveness and carries implications for clinical decision-making. We evaluated the prevalence of methodological quality and risk of bias assessments in systematic reviews published in the five highest-ranked anaesthesia journals since 2007. The initial PubMed search yielded 315 citations, and our final sample after screening consisted of 207 systematic reviews. One hundred and seventy-four reviews conducted methodological quality/risk of bias analyses. The Jadad scale was most frequently used. Forty-four of the 83 reviews that included high risk of bias studies re-analysed their data omitting these trials: 20 showed differences in pooled effect estimates. Reviews containing a greater number of primary studies evaluated quality less frequently than smaller reviews. Overall, the majority of reviews evaluated bias; however, many applied questionable methods. Given the potential effects of bias on summary outcomes, greater attention is warranted.

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Our latest Special Issue provides an update on rapidly evolving developments in palliative cancer care in Africa: https://t.co/qNzEZ96GBV

Our latest Special Issue provides an update on rapidly evolving developments in palliative cancer care in Africa: https://t.co/qNzEZ96GBV

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Last chance for @uicc International Cancer Study Grants - deadline 15th July https://t.co/ZYCVGBhfXb https://t.co/vV8wkBN6kl

Last chance for @uicc International Cancer Study Grants - deadline 15th July https://t.co/ZYCVGBhfXb https://t.co/vV8wkBN6kl

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Prevalence and risk factors of chronic rhinosinusitis in South Korea according to diagnostic criteria.

Prevalence and risk factors of chronic rhinosinusitis in South Korea according to diagnostic criteria.

Rhinology. 2016 Jul 10;

Authors: Kim JH, Cho C, Lee EJ, Suh YS, Choi BI, Kim KS

Abstract
BACKGROUND: We aimed to compare the prevalence and risk factors of chronic rhinosinusitis (CRS) using two different diagnostic criteria with the same statistical data from the Korean National Health and Nutrition Examination Survey in 2009.
METHODS: Symptom-based CRS was defined as CRS diagnosed by questionnaires related to nasal symptoms. Endoscopy-based CRS was defined based on endoscopic findings and nasal symptoms of symptom-based CRS.
RESULTS: The overall prevalence of CRS based on the different diagnostic criteria was as follows: symptom-based CRS was 10.78% (797 of 7,394) and endoscopy-based CRS was 1.20% (88 of 7,343). Comparing symptom-based CRS to endoscopy-based CRS showed slight agreement (kappa = 0.183 (0.150-0.216, 95% confidence interval)). Allergic rhinitis was identified as a common risk factor for CRS based on the two diagnostic criteria.
CONCLUSIONS: The prevalence and risk factors of CRS were quite different from each other according to the different criteria, even in the same population. Therefore, it would be important to consider what specific diagnostic criteria have been adopted in the studies comparing the prevalence of CRS.

PMID: 27395040 [PubMed - as supplied by publisher]

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The in vitro effect of xylitol on chronic rhinosinusitis biofilms.

The in vitro effect of xylitol on chronic rhinosinusitis biofilms.

Rhinology. 2016 Jul 10;

Authors: Jain R, Lee T, Hardcastle T, Biswas K, Radcliff F, Douglas R

Abstract
INTRODUCTION: Biofilms have been implicated in chronic rhinosinusitis (CRS) and may explain the limited efficacy of antibiotics. There is a need to find more effective, non-antibiotic based therapies for CRS. This study examines the effects of xylitol on CRS biofilms and planktonic bacteria.
METHODS: Crystal violet assay and spectrophotometry were used to quantify the effects of xylitol (5% and 10% solutions) against Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus. The disruption of established biofilms, inhibition of biofilm formation and effects on planktonic bacteria growth were investigated and compared to saline and no treatment.
RESULTS: Xylitol 5% and 10% significantly reduced biofilm biomass (S. epidermidis), inhibited biofilm formation (S. aureus and P. aeruginosa) and reduced growth of planktonic bacteria (S. epidermidis, S. aureus, and P. aeruginosa). Xylitol 5% inhibited formation of S. epidermidis biofilms more effectively than xylitol 10%. Xylitol 10% reduced S. epidermidis planktonic bacteria more effectively than xylitol 5%. Saline, xylitol 5% and 10% disrupted established biofilms of S. aureus when compared with no treatment. No solution was effective against established P. aeruginosa biofilm.
CONCLUSIONS: Xylitol has variable activity against biofilms and planktonic bacteria in vitro and may have therapeutic efficacy in the management of CRS.

PMID: 27394715 [PubMed - as supplied by publisher]

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Study finds no substantial harm from primary care melanoma screening

A new study of more than 1,000 primary care melanoma screenings in the western Pennsylvania area in 2014 suggests that overall the practice complies with the old medical maxim to "first do no harm." The numbers, released in Cancer, show that screenings...

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IJMS, Vol. 17, Pages 1108: MAL Daylight Photodynamic Therapy for Actinic Keratosis: Clinical and Imaging Evaluation by 3D Camera

Non-melanoma skin cancer is the most common skin cancer with an incidence that varies widely worldwide. Among them, actinic keratosis (AK), considered by some authors as in situ squamous cell carcinoma (SCC), are the most common and reflect an abnormal multistep skin cell development due to the chronic ultraviolet (UV) light exposure. No ideal treatment exists, but the potential risk of their development in a more invasive form requires prompt treatment. As patients usually present with multiple AK on fields of actinic damage, there is a need for effective, safe, simple and short treatments which allow the treatment of large areas. To achieve this, daylight photodynamic therapy (DL-PDT) is an innovative treatment for multiple mild actinic keratosis, well tolerated by patients. Patients allocated to the PDT unit, affected by multiple mild−moderate and severe actinic keratosis on sun-exposed areas treated with DL-PDT, were clinically evaluated at baseline and every three months with an Antera 3D, Miravex© camera. Clinical and 3D images were performed at each clinical check almost every three months. In this retrospective study, 331 patients (56.7% male, 43.3% female) were treated with DL-PDT. We observed a full clearance in more than two-thirds of patients with one or two treatments. Different responses depend on the number of lesions and on their severity; for patients with 1–3 lesions and with grade I or II AK, a full clearance was reached in 85% of cases with a maximum of two treatments. DL-PDT in general improved skin tone and erased sun damage. Evaluating each Antera 3D images, hemoglobin concentration and pigmentation, a skin color and tone improvement in 310 patients was observed. DL-PDT appears as a promising, effective, simple, tolerable and practical treatment for actinic damage associated with AK, and even treatment of large areas can be with little or no pain. The 3D imaging allowed for quantifying in real time the aesthetic benefits of DL-PDT’s increasing compliance.

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IJMS, Vol. 17, Pages 1103: Strawberry Achenes Are an Important Source of Bioactive Compounds for Human Health

Strawberries are highly appreciated for their taste, nutritional value and antioxidant compounds, mainly phenolics. Fruit antioxidants derive from achenes and flesh, but achene contribution to the total fruit antioxidant capacity and to the bioaccessibility after intake is still unknown. In this work, the content of total phenolic compounds, flavonoids, anthocyanins and antioxidant capacity (TEAC, FRAP and DPPH) of achenes and flesh were compared in non-digested as well as in gastric and intestinal extracts after in vitro digestion. Results showed that, despite strawberry achenes represent a small fraction of the fruit, their contribution to total fruit antioxidant content was more than 41% and accounted for 81% of antioxidant capacity (TEAC). Achenes have higher quantity and different quality of antioxidants in non-digested and digested extracts. Antioxidant release was higher in the in vitro gastric digested extracts, but digestion conditions did not only affect quantity but quality, resulting in differences in antioxidant capacity and highlighting the importance of simulating physiological-like extraction conditions for assessing fruit antioxidant properties on human health. These results give new insights into the use of strawberry achenes as a source of bioactive compounds to be considered in strawberry breeding programs for improving human health.

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IJMS, Vol. 17, Pages 1105: Nuclear Receptor Regulation of Aquaporin-2 in the Kidney

Aquaporin-2 (AQP2) is a vasopressin-regulated water channel responsible for regulating water reabsorption through the apical plasma membrane of the principal cells of renal collecting ducts. It has been found that dysregulation and dysfunction of AQP2 cause many disorders related to water balance in people and animals, including polyuria and dilutional hyponatremia. Classically, AQP2 mRNA and protein expression and its membrane translocation are regulated by systemic vasopressin involving short-term regulation of AQP2 trafficking to and from the apical plasma membrane and long-term regulation of the total amount of the AQP2 protein in the cell. Recently, increasing evidence has demonstrated that collecting duct AQP2 expression and membrane translocation are also under the control of many other local factors, especially nuclear receptors. Here, we briefly review the progress of studies in this area and discuss the role of nuclear receptors in the regulation of water reabsorption via affecting AQP2 expression and function.

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IJMS, Vol. 17, Pages 1102: Inhibition of AQP1 Hampers Osteosarcoma and Hepatocellular Carcinoma Progression Mediated by Bone Marrow-Derived Mesenchymal Stem Cells

The complex cross-talk between tumor cells and their surrounding stromal environment plays a key role in the pathogenesis of cancer. Among several cell types that constitute the tumor stroma, bone marrow-derived mesenchymal stem cells (BM-MSCs) selectively migrate toward the tumor microenvironment and contribute to the active formation of tumor-associated stroma. Therefore, here we elucidate the involvement of BM-MSCs to promote osteosarcoma (OS) and hepatocellular carcinoma (HCC) cells migration and invasion and deepening the role of specific pathways. We analyzed the function of aquaporin 1 (AQP1), a water channel known to promote metastasis and neoangiogenes. AQP1 protein levels were analyzed in OS (U2OS) and HCC (SNU-398) cells exposed to conditioned medium from BM-MSCs. Tumor cell migration and invasion in response to BM-MSC conditioned medium were evaluated through a wound healing assay and Boyden chamber, respectively. The results showed that the AQP1 level was increased in both tumor cell lines after treatment with BM-MSC conditioned medium. Moreover, BM-MSCs-mediated tumor cell migration and invasion were hampered after treatment with AQP1 inhibitor. These data suggest that the recruitment of human BM-MSCs into the tumor microenvironment might cause OS and HCC cell migration and invasion through involvement of AQP1.

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Issue 4 for volume 22 is out

Read more...

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Intraductal injection as an effective drug delivery route in the management of salivary gland diseases.

Intraductal injection as an effective drug delivery route in the management of salivary gland diseases.

Eur Arch Otorhinolaryngol. 2016 Jul 9;

Authors: Su CH, Lee KS, Tseng TM, Tseng H, Ding YF, Koch M, Hung SH

Abstract
While conservative approaches for chronic sialoadenitis are in current use, the utility of intraductal injection therapy remains unclear. The purpose of this study is to provide evidence that substances delivered through intraductal injection of the salivary gland are able to be effectively distributed throughout the gland. Methylene blue dye (0.1 %) was injected intraductally into a porcine parotid gland (5 ml) of one group and the porcine submandibular gland (1 or 2 ml, n = 6 for each preparation) of another group. After the injection, the ductal systems were evaluated, sectioned, and observed microscopically. Color area analysis was performed on submandibular gland sections, and the infiltration ratio of the dye was calculated. The papillae of both Stensen's and Wharton's duct openings were easily identified with intraductally delivered methylene blue dye. The dye infiltration began from the central ductal region of the gland and could be easily observed to gradually disperse to the peripheral regions in each acinar. There were no statistically significant differences in infiltration ratios between anterior, midline, and posterior section of the submandibular gland. Also, there were no statistically significant differences in the ratios between 1 and 2 ml injections at all the three section positions. This study demonstrated that desired substances can be evenly delivered throughout the salivary gland through intraductal injections. The use of intraductal injections might serve as a potential therapeutic procedure in the management of salivary gland diseases.

PMID: 27395068 [PubMed - as supplied by publisher]

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Myeloid Sarcoma: Presenting with Massive Cervical and Inguinal Lymphadenopathy.

Myeloid Sarcoma: Presenting with Massive Cervical and Inguinal Lymphadenopathy.

Head Neck Pathol. 2016 Jul 9;

Authors: Walsh JC, Arnold MG, Mohtashamian A

Abstract
A 21 year old Active Duty Marine presented with acute onset of diffuse lymphadenopathy and B-symptoms. Biopsy was conducted which demonstrated myeloid sarcoma. Myeloid sarcoma is diagnostic for AML but is only present in 2-8 % of patients with AML. Our article presents a classic presentation and histologic appearance and discusses the current status of the literature.

PMID: 27395055 [PubMed - as supplied by publisher]

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Gain-switched 311-nm Ti:Sapphire laser might be a potential treatment modality for atopic dermatitis.

Gain-switched 311-nm Ti:Sapphire laser might be a potential treatment modality for atopic dermatitis.

Lasers Med Sci. 2016 Jul 9;

Authors: Choi SY, Oh CT, Kwon TR, Kwon HJ, Choi EJ, Jang YJ, Kim HS, Chu H, Mun SK, Kim MN, Kim BJ

Abstract
Phototherapy with 311-nm narrowband-UVB (NBUVB) is an effective adjuvant treatment modality for atopic dermatitis (AD). In this study, we evaluated the therapeutic effect of the newly developed gain-switched 311-nm Ti:Sapphire laser device using a NC/Nga mouse AD model. A total number of 50 mice were used in this study. Atopic dermatitis (AD) was induced in mice by exposure to Dermatophagoides farina. These, NC/Nga mice were then treated with conventional 311-nm NBUVB or the newly developed gain-switched 311-nm Ti:Sapphire laser. The clinical features, dermatitis severity scores, and scratching behavior were assessed. In addition, serologic analyses including inflammatory cytokines and histological analyses were performed. Gain-switched 311-nm Ti:Sapphire laser improved the AD-like skin lesions, severity, and symptoms of AD in the NC/Nga mouse model. This new laser also modulated the immune response found in the AD model, including hyper-IgE, upregulated Th2 cytokines, and the Th2-mediated allergic inflammatory reaction. Gain-switched 311-nm Ti:Sapphire laser shows therapeutic promise via an immune-modulation mechanism in an AD mouse model. These data suggest that gain-switched 311-nm Ti:Sapphire laser may be useful as a targeted phototherapy modality for AD.

PMID: 27394442 [PubMed - as supplied by publisher]

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Object-Based Distinction between Building Shadow and Water in High-Resolution Imagery Using Fuzzy-Rule Classification and Artificial Bee Colony Optimization

Due to the high similarity of the spectra of urban water and building shadows, high-resolution satellite imagery often confuses and wrongly classifies these features. To address this problem, we propose an object-based method for distinguishing building shadow from water using an artificial bee colony algorithm. In the method, four spectral ratio bands are first calculated as additional input parameters for improving the accuracy of segmentation results. During the segmentation, a series of statistical factors, such as spectrum, ratio, and sharp features, are calculated to make up for defects in the high-resolution imagery. Finally, we propose a fuzzy-rule-based classifier to generate extraction rules. The classifier is based on artificial bee colony optimization, which employs the geometric mean (-mean) as fitness function. The proposed method was carried out on two test sites in Xiamen City. The experimental results based on GF-1 satellite date show that, compared with SVM method, the proposed method improved the overall accuracy of extraction by approximately 6% to 15% and the kappa coefficient values by approximately 0.1 to 0.2. The analysis of the extraction rules also proves that the red/NIR band and the length-width ratio band are significantly influenced by the distinction between building shadow and water.

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Detecting Safety Zone Drill Process Parameters for Uncoated HSS Twist Drill in Machining GFRP Composites by Integrating Wear Rate and Wear Transition Mapping

The previous research investigations informed that the tool wear of any machining operation could be minimized by controlling the machining factors such as speed, feed, geometry, and type of cutting tool. Hence the present research paper aims at controlling the process parameters to minimize the drill tool wear, during the machining of Glass Fiber Reinforced Polymer (GFRP) composites. Experiments were carried out to find the tool wear rate and a wear mechanism map of uncoated High Speed Steel (HSS) drill of 10 mm diameter was developed for the drilling of GFRP composite laminates. The surface micrograph images on the drill land surface displayed dominant wear mechanisms induced on HSS drill during machining of GFRP and they were found to be adhesive wear, adhesive and abrasive wear, abrasive wear, and diffusion and fatigue wear. A “safety wear zone” was identified on the wear mechanism map, where the minimum tool wear of the HSS drill occurs. From the safety zone boundaries, it was inferred that the drill spindle speed should be set between 1200 and 1590 rpm and feed rate must be set within a range of 0.10–0.16 mm/rev for GFRP work and HSS tool combination to enhance the service life of 10 mm HSS drills and to minimize the tool wear.

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Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

Objective. To identify factors predicting the need for insulin therapy in pregnancies complicated by gestational diabetes mellitus (GDM). Methods. A total of 1352 patients with GDM diagnosed by the 75-g/2-h oral glucose tolerance test (OGTT) were enrolled in this study. Univariate and multivariate analysis were performed; receiver operating characteristics (ROC) were also drawn. Results. There was a significant difference in factors such as maternal age, pregestational BMI, first visit SBP, first visit DBP, FBG of first visit, FBG at time of OGTT, 75-g OGTT glucose value (fasting, after 1 h and 2 h), and serum HbA1c level at diagnosis between patients with insulin therapy and patients with medical nutrition therapy (MNT) alone. Multivariate analysis showed that higher FBG at time of OGTT, first 75 g OGTT 2 h plasma glucose, and HbA1c concentration at diagnosis lead to more likely need of insulin therapy. Conclusion. The probability of insulin therapy can be estimated in pregnant women with GDM based on fasting and 2 h glucose values during OGTT and HbA1c value at diagnosis of GDM.

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BeiDou Satellites Assistant Determination by Receiving Other GNSS Downlink Signals

GNSS’s orbit determinations always rely on ground station or intersatellite links (ISL). In the emergency of satellite-to-ground links and ISL break-off, BeiDou navigation satellite system (BDS) satellites cannot determine their orbits. In this paper, we propose to add a spaceborne annular beam antenna for receiving the global positioning system (GPS) and global navigation satellite system (GLONASS) signals; therefore, the BDS satellites may be capable of determining their orbits by GPS/GLONASS signals. Firstly, the spectrum selection, the power isolation, the range of Doppler frequency shift, and changing rate are taken into account for the feasibility. Specifically, the L2 band signals are chosen for receiving and processing in order to prevent the overlapping of the receiving and transmitting signals. Secondly, the minimum number of visible satellites (MNVS), carrier-to-noise ratio (), dilution of precision (GDOP), and geometric distance root-mean-square (gdrms) are evaluated for acquiring the effective receiving antennas’ coverage ranges. Finally, the scheme of deploying 3 receiving antennas is proved to be optimal by analysis and simulations over the middle earth orbit (MEO), geostationary earth orbit (GEO), and the inclined geosynchronous satellite orbit (IGSO). The antennas’ structures and patterns are designed to draw a conclusion that installing GPS and GLONASS receivers on BDS satellites for emergent orbits determination is cost-effective.

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Optimal Method for Catastrophic Faults Diagnosis in RC Ladder Network

The RC ladder network has been analyzed for various catastrophic fault detection using minimal number of measurements. Generally, electronic circuit testing procedure is very exhaustive and includes higher cost; the presented approach will save fault diagnosis time. It is not possible to analyze the big RC ladder network to give the good fault coverage, so the ladder network has been broken into segments of different sizes. However, if segment size is small, it will cause more area overhead compared to bigger step size in terms of the interconnections and pins on the integrated circuit. A systematic and detailed analysis for one-step, two-step, three-step, and four-step RC ladder networks has been carried out for various faults and optimal step size is proposed. It has been investigated that three measurements are optimal to localize different catastrophic faults in a RC ladder network.

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Implications of Hydrogen Sulfide in Glucose Regulation: How H2S Can Alter Glucose Homeostasis through Metabolic Hormones

Diabetes and its comorbidities continue to be a major health problem worldwide. Understanding the precise mechanisms that control glucose homeostasis and their dysregulation during diabetes are a major research focus. Hydrogen sulfide (H2S) has emerged as an important regulator of glucose homeostasis. This is achieved through its production and action in several metabolic and hormone producing organs including the pancreas, liver, and adipose. Of importance, H2S production and signaling in these tissues are altered during both type 1 and type 2 diabetes mellitus. This review first examines how H2S is produced both endogenously and by gastrointestinal microbes, with a particular focus on the altered production that occurs during obesity and diabetes. Next, the action of H2S on the metabolic organs with key roles in glucose homeostasis, with a particular focus on insulin, is described. Recent work has also suggested that the effects of H2S on glucose homeostasis goes beyond its role in insulin secretion. Several studies have demonstrated important roles for H2S in hepatic glucose output and adipose glucose uptake. The mechanism of H2S action on these metabolic organs is described. In the final part of this review, future directions examining the roles of H2S in other metabolic and glucoregulatory hormone secreting tissues are proposed.

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Sleep Spindles as an Electrographic Element: Description and Automatic Detection Methods

Sleep spindle is a peculiar oscillatory brain pattern which has been associated with a number of sleep (isolation from exteroceptive stimuli, memory consolidation) and individual characteristics (intellectual quotient). Oddly enough, the definition of a spindle is both incomplete and restrictive. In consequence, there is no consensus about how to detect spindles. Visual scoring is cumbersome and user dependent. To analyze spindle activity in a more robust way, automatic sleep spindle detection methods are essential. Various algorithms were developed, depending on individual research interest, which hampers direct comparisons and meta-analyses. In this review, sleep spindle is first defined physically and topographically. From this general description, we tentatively extract the main characteristics to be detected and analyzed. A nonexhaustive list of automatic spindle detection methods is provided along with a description of their main processing principles. Finally, we propose a technique to assess the detection methods in a robust and comparable way.

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Comorbid Illness, Bowel Preparation, and Logistical Constraints Are Key Reasons for Outpatient Colonoscopy Nonattendance

Background. Colonoscopy nonattendance is a challenge for outpatient clinics globally. Absenteeism results in a potential delay in disease diagnosis and loss of hospital resources. This study aims to determine reasons for colonoscopy nonattendance from a Canadian perspective. Design. Demographic data, reasons for nonattendance, and patient suggestions for improving compliance were elicited from 49 out of 144 eligible study participants via telephone questionnaire. The 49 nonattenders were compared to age and sex matched controls for several potential contributing factors. Results. Nonattendance rates were significantly higher in winter months; the OR of nonattendance was 5.2 (95% CI, 1.6 to 17.0, ) in winter versus other months. Being married was positively associated with attendance. There was no significant association between nonattendance and any of the other variables examined. The top 3 reasons for nonattendance were being too unwell to attend the procedure, being unable to complete bowel preparation, or experiencing logistical challenges. Conclusions. Colonoscopy attendance rates appear to vary significantly by season and it may be beneficial to book more colonoscopies in the summer or overbook in the winter. Targets for intervention include more tailored teaching sessions, reminders, taxi chits, and developing a hospital specific colonoscopy video regarding procedure and bowel preparation requirements.

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Come celebrate the best of Welsh cancer research in with us in Cardiff. Email editor@ecancer .org to save your place! https://t.co/HRW3FHLSaZ

Come celebrate the best of Welsh cancer research in with us in Cardiff. Email editor@ecancer .org to save your place! https://t.co/HRW3FHLSaZ

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Discovery of new ovarian cancer signaling hub points to target for limiting metastasis: https://t.co/1cUoaY7qlx

Discovery of new ovarian cancer signaling hub points to target for limiting metastasis: https://t.co/1cUoaY7qlx

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A prospective randomised trial comparing insertion success rate and incidence of catheterisation-related complications for subclavian venous catheterisation using a thin-walled introducer needle or a catheter-over-needle technique

Summary

In clinical practice, both a thin-walled introducer needle and catheter-over-needle technique can be used to allow insertion of a guidewire during central venous catheterisation using the Seldinger technique. We compared the incidence of catheterisation-related complications (arterial puncture, haemothorax, pneumothorax, haematoma and catheter tip malposition) and insertion success rate for these two techniques in patients requiring right-sided subclavian central venous catheterisation. A total of 414 patients requiring infraclavicular subclavian venous catheterisation were randomly allocated to either a thin-walled introducer needle (needle group, n = 208) or catheter-over-needle technique (catheter group, n = 206). The catheterisation-related complication rate was lower in the needle group compared with the catheter group (5.8% vs. 15.5%; p = 0.001). Overall insertion success rates were similar (97.1% and 92.7% in the needle and catheter groups respectively; p = 0.046), although the first-pass success rate was higher in the needle group (62.0% vs. 35.4%; p < 0.001). We recommend the use of a thin-walled introducer needle technique for right-sided infraclavicular subclavian venous catheterisation.

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Total Protein Profile and Drug Resistance in Candida albicans Isolated from Clinical Samples

This study was done to assess the antifungal susceptibility of clinical isolates of Candida albicans and to evaluate its total protein profile based on morphological difference on drug resistance. Hundred and twenty clinical isolates of C. albicans from various clinical specimens were tested for susceptibility against four antifungal agents, namely, fluconazole, itraconazole, amphotericin B, and ketoconazole. A significant increase of drug resistance in clinical isolates of C. albicans was observed. The study showed 50% fluconazole and itraconazole resistance at 32 μg mL−1 with a MIC50 and MIC90 values at 34 and 47 and 36 and 49 μg mL−1, respectively. All isolates were sensitive to amphotericin B and ketoconazole. The SDS-PAGE protein profile showed a prevalent band of ~52.5 kDa, indicating overexpression of gene in 72% strains with fluconazole resistance. Since the opportunistic infections of Candida spp. are increasing along with drug resistance, the total protein profile will help in understanding the evolutionary changes in drug resistance and also to characterize them.

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Impact of Dental Implant Surface Modifications on Osseointegration

Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.

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Two Case Reports on Thalamic and Basal Ganglia Involvement in Children with Dengue Fever

There have been increasing numbers of case reports of dengue infection with unusual manifestations. Such unusual manifestations including acute liver failure and encephalopathy could be manifested even in the absence of significant plasma leakage. Further, severe organ involvement including nervous system involvement indicates severe dengue infection. However, neurological manifestations of dengue fever are rare. This is the first case report of dengue infection with thalamic and basal ganglia involvement in Sri Lanka.

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The Stegosaurus Plate Controversy

You live in the Jurassic and you've evolved giant, diamond-shaped bone plates that stick out the top of your neck, back and tail. Why, evolution, why??

-- Read more on ScientificAmerican.com

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Meet the world’s cutest and most endangered animals

From Asian unicorns to lemurs that eat nothing but poisonous bamboo shoots, there’s a wide range of animals facing extinction

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Therapeutic effect of apatinib-loaded nanoparticles on diabetes-induced retinal vascular leakage

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Cosmetics, Vol. 3, Pages 23: Sensitization and Clinically Relevant Allergy to Hair Dyes and Clothes from Black Henna Tattoos: Do People Know the Risk? An Uncommon Serious Case and a Review of the Literature

Henna (Lawsonia inermis L.) tattooing has been used in Egypt and India since ancient times. Today this temporary body art is becoming increasingly popular among young people. Various chemicals are added to henna to darken and enhance the definition of tattoos, especially para-phenylenediamine (PPD), which is a strong sensitizer known to cause cross sensitive reactions to azoic dyes and other para-amino compounds. We present the case of an 18-year-old girl who became clinically sensitive to textile dyes after having showed a serious reaction both to her first hair dying when she was 16 years old and following the application of a temporary henna tattoo when she was a kid. The evidence from our literature review showed 33 cases of manifest sensitization to hair dye and only one of observable contact allergy to both hair and textile dyes from henna tattoos. The sensitization of children may have long-life lasting consequences, because of cross-reaction to dyes and other chemicals contained in hair colourants, clothes and drugs. Since tattoos are very popular and globalization has increased the circulation of unauthorized products we point out the need for informative campaigns about the risk of sensitization caused by temporary tattoos.

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Meet the world’s cutest and most endangered animals

From Asian unicorns to lemurs that eat nothing but poisonous bamboo shoots, there’s a wide range of animals facing extinction

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The cancer stem-cell signaling network and resistance to therapy

Publication date: Available online 9 July 2016
Source:Cancer Treatment Reviews
Author(s): A. Carnero, Y. Garcia-Mayea, C. Mir, J. Lorente, I.T. Rubio, M.E. LLeonart
The study of cancer stem cells (CSCs) has shown that tumors are driven by a subpopulation of self-renewing CSCs that retain the capacity to engender the various differentiated cell populations that form tumors. The characterization of CSCs has indicated that CSCs are remarkably resistant to conventional radio- and chemo-therapy. Clinically, the remaining populations of CSC are responsible for metastasis and recurrence in patients with cancer, which can lead to the disease becoming chronic and incurable. Therefore, the elimination of CSCs is an important goal of cancer treatments. Furthermore, CSCs are subject to strong regulation by the surrounding microenvironment, which also impacts tumor responses. In this review, we discuss the mechanisms by which pathways that are defective in CSCs influence ultimately therapeutic and clinical outcomes.

Graphical abstract

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Bilateral Postoperative Cyst after Maxillary Sinus Surgery: Report of a Case and Systematic Review of the Literature

Purpose. We present a case of a bilateral postoperative maxillary cyst (PMC) and discuss this with a systemic review. Case Report and Literature Review. A 68-year-old female with pain and swelling on the right side of the face. MRI and CT showed a cystic tumors of the right and left maxillary sinus. Radical maxillary surgery via a Caldwell-Luc procedure had been performed 55 years ago and bilateral PMC was diagnosed. The PubMed database was searched for PMC within the last 30 years. Results. Together with the current case, we found 23 reports including 284 patients describing PMC. It was diagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. Initial symptoms were mostly pain with or without swelling. The main radiological sign was a unilocular radiolucency with a slight preference for the left side. Discussion. PMC is a long-term complication that can occur after maxillary sinus surgery and a second surgical approach is required in order to stop cystic expansion. Therefore, patients’ informed consent on this complication as well as a prolonged follow-up is recommended. Simple paranasal ultrasound or paranasal sinus plain radiography may lead to an earlier detection reducing interventional morbidity.

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Incidence, Prevalence, and Mortality Trends in Chronic Obstructive Pulmonary Disease over 2001 to 2011: A Public Health Point of View of the Burden

Background. An increase of chronic obstructive pulmonary disease (COPD) prevalence was reported in Canada despite the decline of the main risk factor. Objectives. To estimate incidence, prevalence, and mortality of COPD from 2001 to 2011 and establish the COPD burden by the evaluation of the age-period-cohort effects on incidence trends and the comorbidities prevalence estimations. Methods. A retrospective population-based cohort was built using Quebec health administrative data. Change in trends was measured by relative percentage of changes and by joinpoint regression. After a descriptive analysis of the trends, an age-period-cohort analysis was performed on incidence rates. Results. Overall increase in prevalence along with a decrease of incidence and all-cause mortality was observed. Over time, all age-standardized trends were higher in men than women. Despite higher rates, the number of incident and prevalent cases in women exceeds men since 2004. The curve analysis by age groups showed over time a downshift for both sexes in incidence and all-cause mortality. Further analysis showed the presence of a cohort effect in women. Conclusion. The burden of COPD has risen over time. Women younger than 65 years old have been identified as at-risk group for healthcare planning.

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Alternative Confidence Interval Methods Used in the Diagnostic Accuracy Studies

Background/Aim. It is necessary to decide whether the newly improved methods are better than the standard or reference test or not. To decide whether the new diagnostics test is better than the gold standard test/imperfect standard test, the differences of estimated sensitivity/specificity are calculated with the help of information obtained from samples. However, to generalize this value to the population, it should be given with the confidence intervals. The aim of this study is to evaluate the confidence interval methods developed for the differences between the two dependent sensitivity/specificity values on a clinical application. Materials and Methods. In this study, confidence interval methods like Asymptotic Intervals, Conditional Intervals, Unconditional Interval, Score Intervals, and Nonparametric Methods Based on Relative Effects Intervals are used. Besides, as clinical application, data used in diagnostics study by Dickel et al. (2010) has been taken as a sample. Results. The results belonging to the alternative confidence interval methods for Nickel Sulfate, Potassium Dichromate, and Lanolin Alcohol are given as a table. Conclusion. While preferring the confidence interval methods, the researchers have to consider whether the case to be compared is single ratio or dependent binary ratio differences, the correlation coefficient between the rates in two dependent ratios and the sample sizes.

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Accessibility to, Acceptability of, and Adherence to HIV/AIDS Prevention Services by Men Who Have Sex with Men: Challenges Encountered at Facility Level

The prevalence of HIV/AIDS among men who have sex with men (MSM) in Nairobi has been reported to be 16.4% which is a public health concern. The aim of this study was to determine factors that affected accessibility to, acceptability of, and adherence to HIV/AIDS prevention services by men who have sex with men in Nairobi County, Kenya. Methods. The study used a mixed methods design, applying both quantitative and qualitative methods. Results. Over 70% of MSM reported that TB drugs, antiretroviral drugs, lubricants, condoms, and other STI treatment services were accessible. However, 31.6% of MSM reported that discrimination at the health facility level was a hindrance to accessing HIV/AIDS prevention services while 26.3% reported encountering stigma. 48.4% of MSM consumed alcohol while taking of drugs was reported, at 36.1%. Conclusion. Discrimination and stigma adversely affected MSM seeking HIV/AIDS prevention services in health facilities. MSM engaged in alcohol and substance abuse that likely affected their health seeking behavior. Although most prevention services are reported as accessible, uptake of the same needs to be considered.

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Spectral Analysis of Chinese Medicinal Herbs Based on Delayed Luminescence

Traditional Chinese medicine (TCM) plays a critical role in healthcare; however, it lacks scientific evidence to support the multidimensional therapeutic effects. These effects are based on experience, and, to date, there is no advanced tool to evaluate these experience based effects. In the current study, Chinese herbal materials classified with different cold and heat therapeutic properties, based on Chinese medicine principles, were investigated using spectral distribution, as well as the decay probability distribution based on delayed luminescence (DL). A detection system based on ultraweak biophoton emission was developed to determine the DL decay kinetics of the cold and heat properties of Chinese herbal materials. We constructed a mathematical model to fit the experimental data and characterize the properties of Chinese medicinal herbs with different parameters. The results demonstrated that this method has good reproducibility. Moreover, there is a significant difference () in the spectral distribution and the decay probability distribution of Chinese herbal materials with cold and heat properties. This approach takes advantage of the comprehensive nature of DL compared with more reductionist approaches and is more consistent with TCM principles, in which the core comprises holistic views.

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Etodolac Containing Topical Niosomal Gel: Formulation Development and Evaluation

The present study aimed to investigate the delivery potential of Etodolac (ETD) containing topical niosomal gel. Niosomal formulations were prepared by thin film hydration method at various ratios of cholesterol and Span 60 and were evaluated with respect to particle size, shape, entrapment efficiency, and in vitro characteristics. Dicetyl phosphate (DCP) was also added in the niosomal formulation. Mean particle size of niosomal formulation was found to be in the range of 2 μm to 4 μm. Niosomal formulation N2 (1 : 1) ratio of cholesterol and surfactant displayed good entrapment efficiency (96.72%). TEM analyses showed that niosomal formulation was spherical in shape. Niosomal formulation (N2) displayed high percentage of drug release after 24 h (94.91) at (1 : 1) ratio of cholesterol : surfactant. Further selected niosomal formulation was used to formulate topical gel and was characterized with respect to its various parameters such as pH, viscosity, spreadability, ex vivo study, and in vivo potential permeation. Ex vivo study showed that niosomal gel possessed better skin permeation study than the plain topical gel. Further in vivo study revealed good inhibition of inflammation in case of topical niosomal gel than plain gel and niosomal formulation. The present study suggested that topical niosomal gel formulations provide sustained and prolonged delivery of drug.

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