Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 02/25/18

Κυριακή 25 Φεβρουαρίου 2018

Laryngitis

Laryngitis: An inflammation of the larynx. Inflammation of the larynx is most often caused by viral infections. In these cases, other symptoms, such as sore throat, cough, difficulty swallowing, and fever, generally occur. The voice changes may persist after the fever and other symptoms of acute infection have resolved. Laryngitis can also occur as a result of irritation to the vocal cords. People such as singers, cheerleaders, or even small children after bouts of screaming may find that they become hoarse or speak with a 'gravelly' voice after prolonged overuse. Environmental causes of irritation of the airway that can result in inflammation of the larynx include exposure to tobacco smoke or other chemicals.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
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Erratum

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The patient's perspective on breast radiotherapy: Initial fears and expectations versus reality

BACKGROUND

Although the efficacy and toxicity of breast radiotherapy (RT) has been studied extensively, to the authors' knowledge little is known regarding the patient's perspective on the modern breast RT experience. To better inform future patients and providers, the authors explored patient perceptions of their RT experience.

METHODS

Consecutive patients who were free of disease recurrence and who had been treated between 2012 and 2016 were surveyed regarding their original fears, how short-term and long-term toxicities compared with initial expectations, and how pretreatment beliefs concerning RT compared with the actual experience.

RESULTS

A total of 502 patients were surveyed, with a response rate of 65% (327 patients). The median patient age and posttreatment follow-up was 59 years and 31 months, respectively. Approximately 83% of patients (269 patients) underwent breast conservation therapy. Although approximately 68% of patients (221 patients) endorsed that they initially had little to no knowledge regarding RT, approximately 47% (152 patients) reported that they had heard frightening stories. Approximately 2% of patients (6 patients) agreed that the negative stories they previously heard about RT were actually true. Approximately 92% of patients treated with breast conservation (247 patients) and 81% of patients who underwent mastectomy (47 patients) agreed with the statement “If future patients knew the real truth about RT, they would be less scared about treatment.” Approximately 83% (272 patients) and 84% (274 patients), respectively, of all patients reported the overall severity of short-term and long-term side effects to be better than or as expected.

CONCLUSIONS

Breast RT is associated with misconceptions and fears. Patients' experiences with modern breast RT appear to be superior to expectations, and the majority of patients in the current study agreed that their initial negative impressions were unfounded. Cancer 2017. © 2017 American Cancer Society.

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IJERPH, Vol. 15, Pages 396: Epidemiological Characteristics and Space-Time Analysis of the 2015 Dengue Outbreak in the Metropolitan Region of Tainan City, Taiwan

IJERPH, Vol. 15, Pages 396: Epidemiological Characteristics and Space-Time Analysis of the 2015 Dengue Outbreak in the Metropolitan Region of Tainan City, Taiwan

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15030396

Authors: Ting-Wu Chuang Ka-Chon Ng Thi Nguyen Luis Chaves

The metropolitan region of Tainan City in southern Taiwan experienced a dengue outbreak in 2015. This manuscript describes basic epidemiological features of this outbreak and uses spatial and temporal analysis tools to understand the spread of dengue during the outbreak. The analysis found that, independently of gender, dengue incidence rate increased with age, and proportionally affected more males below the age of 40 years but females above the age of 40 years. A spatial scan statistic was applied to detect clusters of disease transmission. The scan statistic found that dengue spread in a north-south diffusion direction, which is across the North, West-Central and South districts of Tainan City. Spatial regression models were used to quantify factors associated with transmission. This analysis indicated that neighborhoods with high proportions of residential area (or low wetland cover) were associated with dengue transmission. However, these association patterns were non-linear. The findings presented here can help Taiwanese public health agencies to understand the fundamental epidemiological characteristics and diffusion patterns of the 2015 dengue outbreak in Tainan City. This type of information is fundamental for policy making to prevent future uncontrolled dengue outbreaks, given that results from this study suggest that control interventions should be emphasized in the North and West-Central districts of Tainan city, in areas with a moderate percentage of residential land cover.

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Glioblastoma-activated pericytes support tumor growth via immunosuppression

Abstract

Glioblastoma multiforme is the most common and aggressive primary brain tumor, with an extremely poor prognosis. The lack of detailed knowledge about the cellular and molecular mechanisms involved in glioblastoma development restricts the design of efficient therapies. A recent study using state-of-art technologies explores the role of pericytes in the glioblastoma microenvironment. Glioblastoma-activated pericytes develop an immunosuppressive phenotype, reducing T-cell activation through the induction of an anti-inflammatory response. Strikingly, pericytes support glioblastoma growth in vitro and in vivo. Here, we describe succinctly the results and implications of the findings reported in pericytes' and glioblastomas' biology. The emerging knowledge from this study will be essential for the treatment of brain tumors.

Glioblastoma-activated pericytes develop an immunosuppressive phenotype, reducing T-cell activation through the induction of an anti-inflammatory response. Pericytes support glioblastoma growth in vitro and in vivo.

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Validating the pivotal role of the immune system in low-dose radiation-induced tumor inhibition in Lewis lung cancer-bearing mice

Abstract

Although low-dose radiation (LDR) possesses the two distinct functions of inducing hormesis and adaptive responses, which result in immune enhancement and tumor inhibition, its clinical applications have not yet been elucidated. The major obstacle that hinders the application of LDR in the clinical setting is that the mechanisms underlying induction of tumor inhibition are unclear, and the risks associated with LDR are still unknown. Thus, to overcome this obstacle and elucidate the mechanisms mediating the antitumor effects of LDR, in this study, we established an in vivo lung cancer model to investigate the participation of the immune system in LDR-induced tumor inhibition and validated the pivotal role of the immune system by impairing immunity with high-dose radiation (HDR) of 1 Gy. Additionally, the LDR-induced adaptive response of the immune system was also observed by sequential HDR treatment in this mouse model. We found that LDR-activated T cells and natural killer cells and increased the cytotoxicity of splenocytes and the infiltration of T cells in the tumor tissues. In contrast, when immune function was impaired by HDR pretreatment, LDR could not induce tumor inhibition. However, when LDR was administered before HDR, the immunity could be protected from impairment, and tumor growth could be inhibited to some extent, indicating the induction of the immune adaptive response by LDR. Therefore, we demonstrated that immune enhancement played a key role in LDR-induced tumor inhibition. These findings emphasized the importance of the immune response in tumor radiotherapy and may help promote the application of LDR as a novel approach in clinical practice.

We demonstrate that immune enhancement plays a key role in low-dose radiation (LDR)-induced tumor inhibition. Our findings emphasize the importance of immune response in tumor radiotherapy and may help promote the application of LDR as a novel approach in clinical practice.

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Establishment and validation of a two-step screening scheme for improved performance of serological screening of nasopharyngeal carcinoma

Abstract

Nasopharyngeal carcinoma (NPC), which is closely associated with Epstein–Barr virus (EBV), is one of the most prevalent cancers in southeast China. Most NPC patients are diagnosed at late stage due to inconspicuous symptoms at the early stage, and the prognosis of these patients is poor. The early diagnosis rate of NPC could be significantly increased by serological screening, but the positive predictive value (PPV) is relatively low. A simple two-step serological screening scheme was established to improve the PPV of the screening strategy and was validated by a prospective cohort. Serum antibodies specific for EBNA1, Zta, Thymidine Kinase (TK), EAD, EAR, and VCA were detected by enzyme-linked immunosorbent assay. The combination of EBNA1/IgA and VCA/IgA was used in the first step of screening, and anti-early antigens (EAs) were used in the second step of screening. EAD/IgA was the most prominent marker in the second step of screening, and other anti-EAs were complementary to EAD/IgA. As validated by a prospective cohort including 4200 participants, using the combination of EAD/IgA and TK/IgA in the second step decreased the number of high-risk participants from 128 to 27, and increased the PPV from 4.69% to 18.52%, with only one very early-stage case missed. The two-step screening scheme provides a standardized approach for NPC screening with an improved PPV and may be used in future field studies. With this two-step serological screening method, more people benefit from the screening program without increasing the need for fiberoptic endoscopy.

A simple two-step screening scheme was established to improve the PPV of the screening, with the combination of EBNA1/IgA and VCA/IgA in the first step of screening and anti-EAs in the second step. The PPV could be increased from 4.69% in the first step of screening to 18.52% after the second step of screening. With this two-step serological screening, more people could be benefited from the screening program.

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Altered density, composition and microanatomical distribution of infiltrating immune cells in cutaneous squamous cell carcinoma of organ transplant recipients

Summary

Background

The inflammatory tumor microenvironment is crucial for effective tumor control and long-term immunosuppression has been identified as a major risk factor for skin carcinogenesis. In solid organ transplant recipients (OTR) undergoing long-term pharmacologic immunosuppression an increased incidence of cutaneous squamous cell carcinoma (SCC) and more aggressive tumor growth compared to immunocompetent patients (IC) has been reported.

Objectives

To determine the density and phenotype of immune cells infiltrating SCC and surrounding skin in OTR, and to characterize the microanatomical distribution patterns in comparison to IC.

Methods

We analyzed immune cell infiltrates within SCC and at defined regions of interest (ROI) of tumor- surrounding skin in formalin-fixed paraffin-embedded (FFPE) tissue of 20 renal transplant patients and 18 carefully matched IC by high-resolution semi-automated microscopy on complete tissue sections stained for CD4, CD8, CD20 and CD68.

Results

The overall immune cell density of SCC arising in OTR was significantly reduced compared to IC. Particularly CD4+ infiltrates at the directly invasive margin and tumor vicinity, intratumoral CD8+ T cell densities and the overall density of CD20+ tumor-infiltrating B cells (TIL-B) were significantly reduced in tissue of OTR.

Conclusions

Immune cells infiltrates within SCC and at defined ROI of tumor-surrounding skin in OTR differ markedly in their composition and microanatomical distribution compared to tumors arising in IC. Our findings substantially broaden the understanding of how long-term systemic immunosuppression modulates the local inflammatory microenvironment in the skin and at the site of invasive SCC.

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Laparoscopic repair of vesicovaginal fistulae with a transperitoneal approach at Universitas Gadjah Mada Urological Institute: a case report

A vesicovaginal fistula is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. In addition, the sequelae f...

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Upregulation of extraneuronal TRPV1 expression in chronic rhinosinusitis with nasal polyps.

Upregulation of extraneuronal TRPV1 expression in chronic rhinosinusitis with nasal polyps.

Rhinology. 2018 Feb 24;:

Authors: Tóth E, Tornóczky T, Kneif J, Perkecz A, Katona K, Piski Z, Kemény Á, Gerlinger I, Szolcsányi J, Kun J, Pintér E

Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is a multifactorial upper airway disease with unclear etiology. Neuronal Transient Receptor Potential Vanilloid 1 (TRPV1) and Ankyrin 1 (TRPA1) channels have been implicated in the pathogenesis of CRS. We aimed to detect the expression of extraneuronal TRPV1 and TRPA1 receptors in nasal polyp (NP) tissue samples.
METHODOLOGY: Samples were obtained from fourty-two CRS pateints with nasal polyp and sixteen healthy controls to measure receptor gene expression by quantitative PCR, protein localization by immunohistochemistry and cytokine profile by multiplex bead immunoassay.
RESULTS: Non-neuronal TRPV1, TRPA1 receptors were expressed in biopsy samples of NP. A population of mast cells and macrophages were immunopositive for TRPV1 and TRPA1. A fraction of plasma cells expressed TRPV1 but not TRPA1 and neither receptor was present on eosinophils. The local gene expression of extraneuronal TRPV1, TRPA1 receptors was also proven. TRPV1 mRNA levels were significantly increased in CRSwNP patients with asthma and allergic rhinitis compared to their NP counterparts.
CONCLUSIONS: Elevated TRPV1 levels in comorbid asthma and allergy may have a function in CRSwNP. Subpopulation-specific TRPV1 presence on plasma and mast cells can indicate delicate roles in regulating activation and release of inflammatory mediators.

PMID: 29476616 [PubMed - as supplied by publisher]

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EPOS2012 has better specificity compared to IDSA2012 for diagnosing acute bacterial rhinosinusitis.

EPOS2012 has better specificity compared to IDSA2012 for diagnosing acute bacterial rhinosinusitis.

Rhinology. 2018 Feb 24;:

Authors: Seresirikachorn K, Snidvongs K, Chitsuthipakorn W, Ruksakul W, Chusakul S, Kanjanaumporn J, Aeumjaturapat S

Abstract
BACKGROUND: Acute bacterial rhinosinusitis (ABRS) is a subtype of acute rhinosinusitis (ARS). To prevent excessive antibiotic prescribing, clinical criteria for diagnosing ABRS are presented in two major international guidelines from European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS2012) and the Infectious Diseases Society of America (IDSA2012). This study aims to assess accuracy of these criteria.
METHODOLOGY: Patients with ARS were recruited. Clinical features were collected including discolored nasal discharge, facial pain, fever, double sickening, symptoms persisting longer than 10 days, and elevated serum C reactive protein (CRP) and erythrocyte sedimentation rate (ERS). Using middle meatal bacterial culture as a reference, accuracy of EPOS2012 and IDSA2012 criteria were analyzed.
RESULTS: Eighty-eight patients (age 43.2+/-14.5 years, 67% female) with ARS were recruited. Using the two criteria for diagnosing ABRS, EPOS2012 and IDSA2012 have sensitivity of 50% (95%CI: 38%-62%) versus 69% (95%CI: 57%-79%), specificity of 63% (95%CI: 43%-79%) versus 46% (95%CI: 28%-65%), and accuracy of 53% versus 63%, respectively.
CONCLUSION: Both EPOS2012 and IDSA2012 had modest accuracy. EPOS2012 had less sensitivity but a better specificity compared to IDSA2012. This suggests that IDSA2012 diagnostic criteria may contribute to inappropriate use of antibiotics due to poorer specificity.

PMID: 29476192 [PubMed - as supplied by publisher]

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Characteristics of macrolide responders in persistent post-surgical rhinosinusitis.

Characteristics of macrolide responders in persistent post-surgical rhinosinusitis.

Rhinology. 2018 Feb 24;:

Authors: Oakley GM, Christensen JM, Sacks R, Earls P, Harvey RJ

Abstract
INTRODUCTION: The anti-inflammatory effects of long term low dose macrolide therapy have shown benefit in the management of diffuse panbronchiolitis. Dramatic responses to macrolide in the upper airway are seen but our understanding of the patient phenotype predisposing to macrolide response in chronic rhinosinusitis (CRS) is poor.
METHODS: A case control study was performed in a tertiary level rhinology practice of consecutive chronic rhinosinusitis patients placed on a 3-month low dose macrolide therapy after failing at least 3 months of corticosteroid irrigation therapy post-endoscopic sinus surgery. Patients were defined as a macrolide responder when having near normal endoscopy after a 3-month period of clarithromycin treatment. Patient characteristics of smoking, asthma, atopy status, revision surgery, symptom severity (SNOT-22) along with biomarkers from serum and tissue histopathology results were compared between groups.
RESULTS: Of twenty-eight consecutive macrolide treated patients, 19 responders were compared to 9 non-responders. The groups were similar in age, female gender, non-smoking, asthma, and atopy. Macrolide response was associated with a lack of tissue eosinophilia (more than 10/HPF) and lower serum eosinophilia. Neutrophil expression was similar in tissue and serum. Squamous metaplasia was overexpressed in non-responders.
CONCLUSION: Low tissue and serum eosinophilia, and absence of tissue squamous metaplasia may predict a CRS phenotype suitable to a trial of long-term macrolide therapy when surgery and topical therapy has failed.

PMID: 29476191 [PubMed - as supplied by publisher]

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Frightened by the perpetrator’s voice: Startle responsivity and cognitive processing predict earwitness speaker identification

Publication date: Available online 25 February 2018
Source:Biological Psychology
Author(s): Maartje J. Schreuder, Thomas Meyer, Alana C. Krix
This study was inspired by the case of a robbery victim who was startled and reminded of the crime upon hearing a stranger’s voice, while not clearly recognizing the speaker. To investigate whether specific voices can modulate startle reactions and thereby predict speaker identification, we presented an audio hijack scenario to 84 participants and afterwards asked them to identify the perpetrator among neutral and negative speech fragments, while measuring flash-evoked eye-blink startle responses. Furthermore, we addressed data-driven cognitive processing during the audio scenario as a potential moderator in voice discrimination. Negative speech and the perpetrator’s voice led to potentiated startle. Enhanced startle was positively associated with voice discrimination, but only in neutral speech fragments. In negative fragments, this association was weakened as a function of self-reported levels of data-driven processing during encoding. Thus, startle responses can generally predict accurate voice recognition, but speech emotionality and cognitive processing moderate this relationship.

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This Idea is Brilliant: writing about knowing

How we get at the truth is a big deal for thinkers in a collection of essays, edited by a great popular science impresario

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Knife-wielding robot makes it a piece of cake to divide dessert

Cakebot will help keep all your dinner guests sweet by slicing up pudding with precision - but beware fat-finger errors

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This Idea is Brilliant: writing about knowing

Knife-wielding robot makes it a piece of cake to divide dessert

Differences and similarities in early vocabulary development between children with hearing aids and children with cochlear implant enrolled in 3-year auditory verbal intervention

Publication date: May 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 108
Author(s): Lone Percy-Smith, Maria Hallstrøm, Jane Lignel Josvassen, Jeanette Hølledig Mikkelsen, Lena Nissen, Eveline Dieleman, Per Cayé-Thomasen
ObjectiveThe overall objective of this study was to evaluate the implementation of a Nordic Auditory Verbal (AV) intervention for children with all degrees and types of hearing impairment (HI) using all kinds of hearing technology. A first specific objective was to identify differences and similarities in early vocabulary development between children with cochlear implant (CI) compared with children with hearing aids (HAs)/Bone anchored hearing aids (Bahs) enrolled in a 3-year AVprogram, and to compare the group of children with HI to a control group of children with normal hearing (NH). A second specific objective was to study universal neonatal hearing screening (UNHS) using the 1-3-6 Early Hearing Detection and Intervention (EHDI) guidelines.IntroductionEffect of AV intervention for children with HI using different hearing technology is not thoroughly studied. It is relevant to question, whether children with mild to moderate HI encounter the same intensive need for AV intervention as children with congenital deafness.MethodsA longitudinal and comparative study design was used involving two cohorts of children, i.e. 36 children with CI and 19 children with HA/Bahs. The children were the first in Denmark to receive a 3-year AV intervention by formally trained AV-practitioners. Children were tested annually with standardized speech and language tests, i.e. Peabody Picture Vocabulary test, Reynell test and a Danish test for active vocabulary, Viborgmaterialet. Categorical variables were compared using Fischer's exact test and continuous variables were compared using Wilcoxon-Mann-Whitney test, as data was not normally distributed.ResultsMedian age of diagnosis was 6 months and median age at intervention was 13 and 12 months respectively. There was no statistically significant difference between the two groups in terms of scores according to age equivalency for the three tests. However, there was a significant difference between children with HI regardless of hearing technology and children with NH.ConclusionChildren with HI progressed over a three-year period, but they did not reach the same level as children with NH. The high completion rate of 98,2% of families over a three-year period indicates the relevance of AV practice in a Nordic country. Children were diagnosed later than 3 months and intervention also started later than recommended. A result that warrants further investigation.

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Clinical usefussslness of glycated albumin in the diagnosis of diabetes: Results from an Italian study

Publication date: Available online 24 February 2018
Source:Clinical Biochemistry
Author(s): Chiara Bellia, Martina Zaninotto, Chiara Cosma, Luisa Agnello, Giulia Bivona, Mariela Marinova, Bruna Lo Sasso, Mario Plebani, Marcello Ciaccio
ObjectivesGlycated Albumin (GA) has been proposed as a screening marker for diabetes in Asian countries in the last years. Nevertheless, few studies have been conducted in Caucasian population. The aim of this study is to evaluate the clinical usefulness of GA in diabetes diagnosis in Caucasian asymptomatic subjects considered at risk of diabetes based on medical history and Fasting Plasma Glucose (FPG).Design and methodsThree hundred and thirty-four Caucasian subjects having one or more risk factor for diabetes, and/or FPG ranging from 5.6 mmol/L to 6.9 mmol/L with no symptoms for diabetes were enrolled in this study. Plasma GA was measured by an enzymatic method (quantILab Glycated Albumin) on ILab Taurus instrument (Instrumentation Laboratory - A Werfen Company).ResultsGA median levels were 13.2% (IQR:12.2–14.4). Eighteen subjects (5.4%) were classified as diabetics based on their HbA1c. According to the ROC curve analysis, GA identified subjects with diabetes with a sensitivity of 72.2% (95% CI: 46.5–90.3) and a specificity of 71.8% (95% CI: 66.5–76.7) (AUC: 0.80; 95% CI: 0.75–0.84; P < 0.0001) at the cut-off of 14%. The cut-off of 13.5% was associated to a higher sensitivity 88.9% (95%CI: 65.3–98.6) and a specificity of 60.4% (95%CI, 54.8–65.9).ConclusionsThis study confirms the clinical usefulness of GA for the diagnosis of diabetes in Caucasian subjects at risk for diabetes. More studies are required to clarify the role of GA in relation to the other diagnostic criteria for diabetes.

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Reflex and reflective testing strategies for early detection of pituitary dysfunction

Publication date: Available online 24 February 2018
Source:Clinical Biochemistry
Author(s): Manal Elnenaei, Derek Minney, David B. Clarke, Andrew Kumar-Misir, Syed Ali Imran
ObjectiveThe clinical presentation of pituitary dysfunction is typically variable and may often be insidious, resulting in delayed diagnosis by up to decades. The complexity of presentation and difficulty in pattern recognition of first line hormone tests result in challenges in early diagnosis of this condition. The aim of this study was to determine the impact of reflective testing and interpretive commenting on the early detection and management of such cases from primary care.MethodsProspective audit over 12 months in which first line pituitary target organ hormones were identified via a reflex algorithm in the laboratory information system. Selected tests were reviewed by a laboratory clinician and decision made on reflective testing and interpretive commenting based on available clinical information and previous result trends. Patients who had a laboratory intervention were followed up to determine the clinical outcome.ResultsOut of 1099 patients identified, additional testing was made for 214. Interpretative comments were subsequently added to reports of 196 patients, 48 (25%) of whom were referred to endocrinology and 35 (73%) of these were directly related to the laboratory intervention. Eleven other patients had outcomes related to the intervention. Pituitary related conditions (insufficiency and/or adenoma) were found in 29 patients, 24 of which were identified as a result of laboratory intervention.ConclusionsThis study highlights the clinical value of laboratory intervention in aiding early detection of pituitary dysfunction and may avoid the disease burden of delayed management.

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Use of a model for A1c formation to estimate average glucose operative between short-interval measurements of %A1c

Publication date: Available online 24 February 2018
Source:Clinical Biochemistry
Author(s): Douglas F. Stickle, Jay H. Herman, Ross Molinaro
BackgroundEstimated average glucose (AG) is generally reported along with hemoglobin A1c measurements according to a standard calculation. Given a normal red blood cell lifetime of 120 days, serial A1c measurements at intervals <120 days are not completely independent. For short interval measurements, a change in AG (ΔAG) necessarily underestimates the change in average glucose operative during the interval (ΔG). We use a model for kinetics of HbA1c to evaluate the theoretical relationship between ΔAG and ΔG for HbA1c measurements made at intervals between 0 and 120 days.MethodsFrom any given starting point for A1c, step changes in G were simulated using model calculations to determine the extent to which A1c could change as a function of the interval of exposure. Values for ΔAG were compared to the operative ΔG as a function of the interval between A1c measurements.ResultsResults of model simulations are a single graph for relationship of ΔAG to ΔG as a function of the interval between A1c measurements. ΔAG for (15, 30, 45, 60, 76, and 90) day intervals underestimated operative ΔG by (73, 51, 34, 21, 11, and 5)%, respectively.ConclusionsModel calculations predict the relationship between changes in estimated average glucose to changes in operative glucose for serial A1c measurements made at intervals <120 days. Given that serial measurements of A1c made at short intervals are not uncommon in practice, physicians may find this information to be useful.

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Use of health services in the last year of life and cause of death in people with intellectual disability: a retrospective matched cohort study

Objective

To describe the cause of death together with emergency department presentations and hospital admissions in the last year of life of people with intellectual disability.

Method

A retrospective matched cohort study using de-identified linked data of people aged 20 years or over, with and without intellectual disability who died during 2009 to 2013 in Western Australia. Emergency department presentations and hospital admissions in the last year of life of people with intellectual disability are described along with cause of death.

Results

Of the 63 508 deaths in Western Australia from 2009 to 2013, there were 591 (0.93%) decedents with a history of intellectual disability. Decedents with intellectual disability tended to be younger, lived in areas of more social disadvantage, did not have a partner and were Australian born compared with all other decedents. A matched comparison cohort of decedents without intellectual disability (n=29 713) was identified from the general population to improve covariate balance.

Decedents with intellectual disability attended emergency departments more frequently than the matched cohort (mean visits 3.2 vs 2.5) and on average were admitted to hospital less frequently (mean admissions 4.1 vs 6.1), but once admitted stayed longer (average length of stay 5.2 days vs 4.3 days). People with intellectual disability had increased odds of presentation, admission or death from conditions that have been defined as ambulatory care sensitive and are potentially preventable. These included vaccine-preventable respiratory disease, asthma, cellulitis and convulsions and epilepsy.

Conclusion

People with intellectual disability were more likely to experience potentially preventable conditions at the end of their lives. This indicates a need for further improvements in access, quality and coordination of healthcare to provide optimal health for this group.

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Effectiveness of Systemic Treatments for Pyoderma Gangrenosum:A Systematic Review of Observational Studies & Clinical Trials

Summary

Background

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis with substantial morbidity. Currently, there is no consensus on gold-standard treatments.

Objectives

Our primary objective was to review the effectiveness of systemic therapy for PG.

Methods

We searched Cochrane Central, Cochrane DSR, EMBASE, MEDLINE, PubMed, and Web of Science for 24 systemic therapies for PG. Primary outcomes were complete healing and clinical improvement; secondary outcomes were time-to-healing and adverse effects.

Results

We found 3,326 citations, of which 375 articles underwent full-text review, and 41 studies met inclusion criteria. There were 704 participants amongst 26 retrospective cohort studies, 3 prospective cohort studies, 7 case series, 1 case-control study, 2 open-label trials, and 2 randomized controlled trials (RCT). Systemic corticosteroids were the most studied (n=32 studies), followed by cyclosporine (n=21), biologics (n=16), and oral dapsone (n=11). One RCT (STOP-GAP, n=121) showed that prednisolone and cyclosporine were similar, with 15-20% complete healing at 6-weeks and 47% at 6-months. Another RCT (n=30) found that infliximab was superior to placebo at 2-weeks (46% vs. 6% response), with 21% complete healing rate at 6-weeks. Two uncontrolled trials showed 60% and 37.5% healing in four months with canakinumab and infliximab, respectively; other data suggest that patients with concurrent IBD may benefit from biologics. The remaining studies were of poor quality and small sample sizes, though supported the use of corticosteroids, cyclosporine, and biologics.

Conclusions

Systemic corticosteroids, cyclosporine, infliximab, and canakinumab had the most evidence in treating PG. However, current literature is limited to small and lower-quality studies with substantial heterogeneity.

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Use of emollients and topical glucocorticoids among adolescents with eczema – datafrom the population-based birth cohort BAMSE

Summary

Background

Knowledge regarding how adolescents treat their eczema is sparse.

Objectives

To explore the use of emollients and topical glucocorticoids in adolescents with eczema in relation to sex and disease severity, and to study dispensing patterns of topical glucocorticoids.

Methods

Questionnaire-based data on symptoms of eczema, eczema severity and treatment with emollients and topical glucocorticoids were obtained from 3,108 adolescents in the Swedish population-based birth cohort BAMSE. Severity of reported eczema was evaluated with the BAMSE Eczema Severity Score (BESS) in a questionnaire and with the Patient-Oriented Eczema Measure in clinically examined subjects with current eczema (n = 247). Information on dispensed topical glucocorticoids was obtained from the Swedish Prescribed Drug Register.

Results

In all, 10% reported eczema in the preceding year: 73% mild, 17% moderate and 10% severe according to BESS. Almost all used emollients, whereas use of topical glucocorticoids was reported by 55%, with no significant difference between sexes. The likelihood of treatment with emollients and topical glucocorticoids increased when the adolescents had symptoms of current eczema (OR_A_dj 5.95, 95% CI 1.90-18.8), but not if they had more severe eczema compared to mild eczema (OR_A_dj 1.57, 95% CI 0.58-4.25). Among those with reported eczema, 24% had a topical glucocorticoid dispensed in the preceding year and among those with moderate to severe current eczema 25% had dispensed a potent topical glucocorticoid.

Conclusions

This population-based study indicates that adolescents with eczema are undertreated or completely untreated, even those with severe eczema.

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Novel in vivo observations of scrotal Nannizzia gypsea infection

Abstract

Tinea cruris is a common dermatophytosis, which usually firstly involved the intertriginous fold near the scrotum. Although dermatophytes may colonize the scrotum, they typically do not infect scrotal skin. However, tinea of scrotum is seldom reported as a specific type of Microsporum gypseum infection, presenting as white-paint-dot appearance, scutular-like or pseudomembranous-like lesions in immunocompromised or immunocompetent patients^1-6. According to the newest taxonomy, M. gypseum is now called Nannizia gypsea⁷. Herein we report novel in vivo observations of five cases of scrotal tinea caused by N. gypsea (formerly Microsporum gypseum) in immunocompetent patients.

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Association between childhood atopic dermatitis, cutaneous, extracutaneous and systemic infections

Abstract

Atopic dermatitis (AD) is associated with higher risk of skin infections. US population-based studies found that childhood AD is associated with increased risk of caregiver-reported extra-cutaneous infections. We sought to confirm whether AD in childhood is associated with increased rates of healthcare diagnosed cutaneous and extra-cutaneous infections.

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Unique clinical and serological features of bullous pemphigoid associated with dipeptidyl peptidase-4 inhibitors

Abstract

Recently, several cases of bullous pemphigoid (BP) associated with the use of a dipeptidyl peptidase-4 (DPP-4) inhibitor, a type of antihyperglycemic drug, have been reported (DPP4i-BP).^1,2 Béné reported a strong association between DPP-4 inhibitor use and the risk of BP.³ The juxtamembranous extracellular non-collagenous 16a (NC16a) domain of type XVII collagen (COL17, also termed BP180) is a major target epitope of autoantibodies in BP.⁴ A recent study found that BP cases whose autoantibodies bound to BP180 at regions other than NC16a exhibited a non-inflammatory phenotype with fewer erythemas. Intriguingly, half of these cases had taken DPP-4 inhibitors at the time of development of BP.⁵ In this study, we explored whether DPP4i-BP exhibited any unique clinical and serological features as suggested by the previous study.

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Tanning Addiction: Conceptualisation, Assessment, and Correlates

Abstract

Background

Research into problematic tanning (or ‘tanning addiction’) has markedly increased over the past few years. Although several excessive tanning instruments exist, most of these are psychometrically poor, not theoretically anchored, and have mainly been used on small samples.

Objective

Against this background, a new tanning addiction scale was developed based on a specific theoretical approach utilising core addiction criteria.

Methods

A scale comprising seven items (i.e. salience/craving, mood modification, tolerance, withdrawal, conflict, relapse/loss of control, and problems) was administered online to a cross-sectional convenience sample of 23,537 adults (M_age=35.8 years, SD=13.3), together with an assessment of demographic factors, the five-factor model of personality, and symptoms of obsessive-compulsive disorder, anxiety and depression.

Results

A confirmatory factor analysis showed that a one-factor model showed an optimal fit with the data collected (RMSEA=.050 [90% CI=.047–.053], CFI=.99, TLI=.99). High factor loadings (.781–.905, all p<.001) and coefficient omega indicator of reliability (ω=.941 [95% CI=.939–.944]) were also found using the new scale. In a multiple linear regression analysis, tanning addiction was positively associated with being female, not being in a relationship, extroversion, neuroticism, anxiety and obsessive-compulsiveness. It was also found that educational level, intellect/openness and depression were inversely associated with tanning addiction.

Conclusions

The new scale, Bergen Tanning Addiction Scale (BTAS), showed good psychometric properties, and is the first scale to fully conceptualise tanning addiciton within a contemporary addiction framework. Given this, the BTAS may potentially assist future clinical practice in providing appropriate patient care, prevention and disease management.

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Incidence and Prevalence of Rosacea: A Systematic Review and Meta-Analysis

Abstract

Background

The exact prevalence and incidence of rosacea remain unknown, although it is a common condition associated with severe non-cutaneous diseases. We performed a systematic review of published literature to examine the global incidence and prevalence of rosacea.

Methods

A systematic review of population-based studies reporting the incidence and/or prevalence of rosacea was performed using three electronic medical databases, PubMed, EMBASE, and Web of Science. Data were extracted, and a proportion meta-analysis was performed to obtain pooled proportions.

Results

A total of 32 studies were included examining a total of 41 populations with 26,519,836 individuals. 22 populations were from Europe, three from Africa, four from Asia, nine from North America, and three from South America. The pooled proportion of rosacea was 5.46% (95% CI 4.91-6.04) in the general population and 2.39% (95% CI 1.56-3.39) among dermatology outpatients. Self-reported rosacea gave higher prevalence estimates than rosacea diagnosed by clinical examination, suggesting a low specificity of questionnaires based on symptoms. Rosacea affected both women (5.41%, (CI 95% 3.85-7.23)) and men (3.90% (CI 95% 3.04-4.87)), and mostly those aged 45-60 years.

Conclusion

We estimated the global prevalence of rosacea based on published data and found that 5.46% of the adult population is affected. However, the prevalence of rosacea depended on the diagnostic method with higher estimates in questionnaire studies and lower estimates in health registries.

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Incidence of Sexual Dysfunction Among Patients with Hidradenitis Suppurativa: a population based retrospective analysis

Abstract

Given the devastating psychological impact of hidradenitis suppurativa (HS), and since the disease process commonly affects intimate body regions, patients with the disease may be at risk for sexual dysfunction (SD). While SD has been established among HS patients through qualitative studies using instruments not validated for this context,the burden of SD has not been described in a population of HS patients.

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Recent advances in viral vectors in veterinary vaccinology.

Recent advances in viral vectors in veterinary vaccinology.

Curr Opin Virol. 2018 Feb 21;29:1-7

Authors: Baron MD, Iqbal M, Nair V

Abstract
Viral vectored vaccines, particularly using vectors such as adenovirus, herpesvirus and poxviruses, are used widely in veterinary medicine, where this technology has been adopted much more quickly than in human medicine. There are now a large number of programmes to develop viral vector vaccine platforms for humans and very similar or identical vectors are being developed for veterinary medicine. The shared experiences of developing these new vaccine platforms across the two disciplines is accelerating progress, a striking example of the value of a 'One Health' approach. In particular, there is growing use of adenoviruses, either replicating or replication-incompetent, to create new vaccines for use in livestock or companion animals. Live replicating avian herpesvirus vectors are increasingly used as vaccines against poultry diseases.

PMID: 29477122 [PubMed - as supplied by publisher]

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Biodegradation of atrazine from wastewater using moving bed biofilm reactor under nitrate-reducing conditions: A kinetic study.

Biodegradation of atrazine from wastewater using moving bed biofilm reactor under nitrate-reducing conditions: A kinetic study.

J Environ Manage. 2018 Feb 21;212:506-513

Authors: Derakhshan Z, Ehrampoush MH, Mahvi AH, Ghaneian MT, Mazloomi SM, Faramarzian M, Dehghani M, Fallahzadeh H, Yousefinejad S, Berizi E, Bahrami S

Abstract
In this study employed an anoxic moving bed biofilm reactor (AnMBBR) to evaluate the effects of hydraulic and toxic shocks on performance reactor. The results indicated a relatively good resistance of system against exercised shocks and its ability to return to steady-state conditions. In optimal conditions when there was the maximum rate of atrazine and soluble chemical oxygen demand (COD) removal were 74.82% and 99.29% respectively. Also, atrazine biodegradation rapidly declines in AnMBBR from 74% ± 0.05 in the presence of nitrate to 9.12% only 3 days after the nitrate was eliding from the influent. Coefficients kinetics was studied and the maximum atrazine removal rate was determined by modified Stover & Kincannon model (Umax = 9.87 gATZ/m3d). Results showed that AnMBBR is feasible, easy, affordable, so suitable process for efficiently biodegrading toxic chlorinated organic compounds such as atrazine. Also, its removal mechanism in this system is co-metabolism.

PMID: 29477120 [PubMed - as supplied by publisher]

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An exploratory study on differences in cumulative plantar tissue stress between healing and non-healing plantar neuropathic diabetic foot ulcers.

An exploratory study on differences in cumulative plantar tissue stress between healing and non-healing plantar neuropathic diabetic foot ulcers.

Clin Biomech (Bristol, Avon). 2018 Feb 19;53:86-92

Authors: van Netten JJ, van Baal JG, Bril A, Wissink M, Bus SA

Abstract
BACKGROUND: Mechanical stress is important in causing and healing plantar diabetic foot ulcers, but almost always studied as peak pressure only. Measuring cumulative plantar tissue stress combines plantar pressure and ambulatory activity, and better defines the load on ulcers. Our aim was to explore differences in cumulative plantar tissue stress between people with healing and non-healing plantar diabetic foot ulcers.
METHODS: We analyzed a subgroup of 31 patients from a randomized clinical trial, treated with a removable offloading device for their plantar diabetic forefoot ulcer. We measured in-device dynamic plantar pressure and daily stride count to calculate cumulative plantar tissue stress at the ulcer location and associated this with ulcer healing and ulcer surface area reduction at four weeks (Student's t and chi-square test for significance, Cohen's d for effect size).
FINDINGS: In 12 weeks, 68% (n = 21) of the ulcers healed and 32% (n = 10) did not. No statistically significant differences were found for cumulative plantar tissue stress, plantar pressure or ambulatory activity between people with healed and not-healed ulcers. Cumulative plantar tissue stress was 25% lower for people with healed ulcers (155 vs. 207 MPa·s/day; P = 0.71; Effect size: d = 0.29). Post-hoc analyses in the 27 patients who self-reported to be adherent to wearing the device showed that cumulative plantar tissue stress was 49% lower for those who reached ≥75% ulcer surface area reduction at four weeks (140 vs. 275 MPa·s/day; P = 0.09; d = 0.76); smaller differences and effect sizes were found for peak pressure (24%), peak pressure-time integral (30%) and ambulatory activity (26%); (P-value range: 0.14-0.97; Cohen's d range: 0.14-0.70).
INTERPRETATION: Measuring cumulative plantar tissue stress may provide insight beyond that obtained from plantar pressure or ambulatory activity alone, with regard to diabetic foot ulcer healing using removable offloading devices. These explorative findings provide baseline data for further studies on this relevant topic.

PMID: 29477099 [PubMed - as supplied by publisher]

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Addressing the public health concerns of Fetal Alcohol Spectrum Disorder: Impact of stigma and health literacy.

Addressing the public health concerns of Fetal Alcohol Spectrum Disorder: Impact of stigma and health literacy.

Drug Alcohol Depend. 2018 Feb 14;185:266-270

Authors: Corrigan PW, Shah BB, Lara JL, Mitchell KT, Simmes D, Jones KL

Abstract
BACKGROUND: Fetal alcohol spectrum disorders (FASD) are a group of developmental disabilities that may result from the mother's consumption of alcohol during pregnancy. The present study examined the effects of health literacy and stigma on the public health agenda for preventing FASD.
METHODS: Three hundred and forty-one participants were sampled to ascertain levels of endorsement of the public health priorities of FASD, and FASD health literacy. Stigma towards women who consume alcohol during pregnancy, and towards biological mothers of children with FASD were operationalized using ratings of difference and disdain.
RESULTS: Public stigma towards women who consume alcohol during pregnancy was greater than stigma towards biological mothers of children with FASD. Research participants with higher FASD literacy were more likely to endorse the prevention priorities of FASD, but also more likely to endorse greater stigma towards biological mothers of children with FASD. Interestingly, those who endorsed greater stigma supported the public health priorities of FASD more strongly. Female research participants more strongly supported the prevention priorities of FASD than male participants. Male participants were more likely to endorse stigma than female participants.
CONCLUSIONS: Stigma experienced by biological mothers of children with FASD generalizes to women who consume alcohol while pregnant. Some results were contrary to expectations: stigma was positively associated with health literacy and endorsement of prevention priorities of FASD. Reasons for these findings are speculated and should be tested in future research.

PMID: 29477086 [PubMed - as supplied by publisher]

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Development of an immunoaffinity column for the highly sensitive analysis of bisphenol A in 14 kinds of foodstuffs using ultra-high-performance liquid chromatography tandem mass spectrometry.

Development of an immunoaffinity column for the highly sensitive analysis of bisphenol A in 14 kinds of foodstuffs using ultra-high-performance liquid chromatography tandem mass spectrometry.

J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Feb 13;1080:50-58

Authors: Yao K, Wen K, Shan W, Xie S, Peng T, Wang J, Jiang H, Shao B

Abstract
An immunoaffinity clean-up material based on a monoclonal antibody (mAb) has been prepared for concentrating and purifying bisphenol A (BPA) in 14 kinds of foodstuffs at trace level. Haptens and immunogen of bisphenol A have been synthesized and comprehensively characterized. An mAb towards BPA was prepared and cross-reactivities with 14 BPA analogues were below 5%. The prepared antibody was coupled to N-hydroxysuccinimide-activated Sepharose 4B to manufacture an immunoaffinity column (IAC), which was applied to purify BPA in 14 kinds of foodstuffs. The analyte was then detected by means of ultra-high-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Under the optimized conditions, compared with two traditional SPE clean-up methods, the IAC showed better selectivity (matrix effect <16.8%) and higher sensitivity. The limits of detection for BPA in 14 kinds of foodstuffs ranged from 0.001 μg L-1 to 0.01 μg kg-1, and the limits of quantification were in the range from 0.003 μg L-1 to 0.04 μg kg-1. The recoveries of BPA from spiked samples ranged from 82.0% to 104.9%, with RSDs below 13.8%. Besides, the IAC exhibited good reusability, with 40% column capacity remaining and no significant loss of recovery after 25 application cycles in real sample detection. These results demonstrated that the developed IAC-UPLC-MS/MS approach has wide applicability for purifying and detecting BPA in various foodstuffs.

PMID: 29477067 [PubMed - as supplied by publisher]

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Preparation and structural characterization of regioselective 4-O/6-O-desulfated chondroitin sulfate.

Preparation and structural characterization of regioselective 4-O/6-O-desulfated chondroitin sulfate.

Carbohydr Res. 2018 Feb 02;460:8-13

Authors: Han W, Li Q, Lv Y, Wang Q, Zhao X

Abstract
The sulfation pattern plays a crucial role in chondroitin sulfate (CS) biological activity, and preparation of CS with defined structure is essential for accurate pharmacological study. In this study, we focused on the preparation of regioselective 4-O/6-O-desulfated CS derived from porcine, employing a dimethyl sulfoxide-methanol (DMSO-MeOH) method and an N-methyl-N-(trimethylsilyl) -trifluoroacetamide (MTSTFA) method CS, respectively. Results showed that the sulfate at C4 position (4-O-S) of N-acetylgalactosamine (GalNAc) was selectively removed by the DMSO-MeOH method, and the sulfate at C6 position (6-O-S) of GalNAc was selectively removed by the MTSTFA method. Structures of desulfated CS were characterized by means of FT-IR, NMR and disaccharide composition analysis. The preparations of regioselective 4-O/6-O-desulfated CS are powerful for the study of structure-activity relationship of CS.

PMID: 29476992 [PubMed - as supplied by publisher]

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Prenatal exposure to ambient temperature variation increases the risk of common cold in children.

Prenatal exposure to ambient temperature variation increases the risk of common cold in children.

Ecotoxicol Environ Saf. 2018 Feb 21;154:221-227

Authors: Lu C, Miao Y, Zeng J, Jiang W, Shen YM, Deng Q

Abstract
BACKGROUND: Common cold is a frequent upper respiratory tract infection, but the role of ambient temperature in the infection is unclear.
OBJECTIVE: We investigated the role of prenatal exposure to diurnal temperature variation (DTV), the difference between the daily maximal and minimal temperatures, in the risk of common cold in children.
METHODS: We conducted a cohort study of 2598 preschool children in Changsha, China. Occurrence of common cold during the past year was surveyed using questionnaire. We then estimated each child's prenatal exposure to DTV during pregnancy. Multivariate logistic regression model was used to examine the association between occurrence of common cold and prenatal exposure to DTV in terms of odds ratios (OR) and 95% confidence interval (CI).
RESULTS: About 45% children have common cold (≥3 times) during the past year. We found that common cold in children was associated with maternal DTV exposure during pregnancy, particularly during the first trimester with adjusted OR (95% CI) = 1.27 (1.10-1.46). Male and atopic children were more susceptible to the effect of DTV during pregnancy. The risk of common cold due to DTV is higher in children living in the suburban areas and the bigger houses and in those exposed to environmental tobacco smoke, mold/dampness, new furniture and redecoration. We observed that the risk of common cold in children has been increased in recent years due to increasing DTV.
CONCLUSIONS: Common cold in children was associated with maternal exposure to temperature variation during pregnancy, suggesting that the risk of common cold may originate in pregnancy.

PMID: 29476971 [PubMed - as supplied by publisher]

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Situated teaching improves empathy learning of the students in a BSN program: A quasi-experimental study.

Situated teaching improves empathy learning of the students in a BSN program: A quasi-experimental study.

Nurse Educ Today. 2018 Feb 13;64:138-143

Authors: Lee KC, Yu CC, Hsieh PL, Li CC, Chao YC

Abstract
BACKGROUND: Empathy is an important clinical skill for nursing students, but it is a characteristic difficult to teach and assess.
OBJECTIVE: To evaluate the effect of situated teaching on empathy learning among undergraduate nursing students.
DESIGN: A cohort study with pre-post-test quasi-experimental design.
PARTICIPANTS AND SETTING: The 2nd-year students were enrolled from two BSN programs.
METHODS: The teaching program was completed over 4 months on the basis of experiential learning theory which integrated the following four elements: classroom-based role play, self-reflection, situated learning and acting. The Jefferson Scale of Empathy-Health Profession-Student version was administered before and after the program. Objective Structure Clinical Examination (OSCE) was administered at the end of program and a rubrics scale was used to measure empathy. A generalized estimation equation was used to identify the effect of subjective empathy, and an independent t-test was used for the objective assessment between two groups.
RESULTS: A total of 103 students were enrolled. The results showed that subjective empathy increased significantly in experimental group. In the Objective Structured Clinical Examination, examiners and standard patients gave significantly higher empathy scores to the situated teaching group than the control group.
CONCLUSIONS: The present study indicated that situated teaching can improve empathy learning of the nursing students. However different methods of assessment of empathy produce different results. We therefore recommend that multiple measurements from difference perspectives are preferable in the assessment of empathy.

PMID: 29476960 [PubMed - as supplied by publisher]

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Ultrasound parametric imaging of hepatic steatosis using the homodyned-K distribution: An animal study.

Ultrasound parametric imaging of hepatic steatosis using the homodyned-K distribution: An animal study.

Ultrasonics. 2018 Feb 15;87:91-102

Authors: Fang J, Zhou Z, Chang NF, Wan YL, Tsui PH

Abstract
Hepatic steatosis is an abnormal state where excess lipid mass is accumulated in hepatocyte vesicles. Backscattered ultrasound signals received from the liver contain useful information regarding the degree of steatosis in the liver. The homodyned-K (HK) distribution has been demonstrated as a general model for ultrasound backscattering. The estimator based on the first three integer moments (denoted as "FTM") of the intensity has potential for practical applications because of its simplicity and low computational complexity. This study explored the diagnostic performance of HK parametric imaging based on the FTM method in the assessment of hepatic steatosis. Phantom experiments were initially conducted using the sliding window technique to determine an appropriate window size length (WSL) for HK parametric imaging. Subsequently, hepatic steatosis was induced in male Wistar rats fed a methionine- and choline-deficient (MCD) diet for 0 (i.e., normal control), 1, 2, 4, 6, and 8 weeks (n = 36; six rats in each group). After completing the scheduled MCD diet, ultrasound B-mode and HK imaging of the rat livers were performed in vivo and histopathological examinations were conducted to score the degree of hepatic steatosis. HK parameters μ (related to scatterer number density) and k (related to scatterer periodicity) were expressed as functions of the steatosis stage in terms of the median and interquartile range (IQR). Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance levels of the μ and k parameters. The results showed that an appropriate WSL for HK parametric imaging is seven times the pulse length of the transducer. The median value of the μ parameter increased monotonically from 0.194 (IQR: 0.18-0.23) to 0.893 (IQR: 0.64-1.04) as the steatosis stage increased. Concurrently, the median value of the k parameter increased from 0.279 (IQR: 0.26-0.31) to 0.5 (IQR: 0.41-0.54) in the early stages (normal to mild) and decreased to 0.39 (IQR: 0.29-0.45) in the advanced stages (moderate to severe). The areas under the ROC curves obtained using (μ, k) were (0.947, 0.804), (0.914, 0.575), and (0.813, 0.604) for the steatosis stages of ≥mild, ≥moderate, and ≥severe, respectively. The current findings suggest that ultrasound HK parametric imaging based on FTM estimation has great potential for future clinical diagnoses of hepatic steatosis.

PMID: 29476945 [PubMed - as supplied by publisher]

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Aberrant resting-state functional brain networks in dyslexia: Symbolic mutual information analysis of neuromagnetic signals.

Aberrant resting-state functional brain networks in dyslexia: Symbolic mutual information analysis of neuromagnetic signals.

Int J Psychophysiol. 2018 Feb 21;:

Authors: Dimitriadis SI, Simos PG, Fletcher JΜ, Papanicolaou AC

Abstract
Neuroimaging studies have identified a variety of structural and functional connectivity abnormalities in students experiencing reading difficulties. The present study adopted a novel approach to assess the dynamics of resting-state neuromagnetic recordings in the form of symbolic sequences (i.e., repeated patterns of neuromagnetic fluctuations within and/or between sensors). Participants were 25 students experiencing severe reading difficulties (RD) and 27 age-matched non-impaired readers (NI) aged 7-14 years. Sensor-level data were first represented as symbolic sequences in eight conventional frequency bands. Next, dominant types of sensor-to-sensor interactions in the form of intra and cross-frequency coupling were computed and subjected to graph modeling to assess group differences in global network characteristics. As a group RD students displayed predominantly within-frequency interactions between neighboring sensors which may reflect reduced overall global network efficiency and cost-efficiency of information transfer. In contrast, sensor networks among NI students featured a higher proportion of cross-frequency interactions. Brain-reading achievement associations highlighted the role of left hemisphere temporo-parietal functional networks, at rest, for reading acquisition and ability.

PMID: 29476872 [PubMed - as supplied by publisher]

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A new LAMP-based assay for the molecular diagnosis of toxoplasmosis: comparison with a proficient PCR assay.

A new LAMP-based assay for the molecular diagnosis of toxoplasmosis: comparison with a proficient PCR assay.

Int J Parasitol. 2018 Feb 21;:

Authors: Varlet-Marie E, Sterkers Y, Perrotte M, Bastien P, 'Molecular Biology' working group of the French National Reference Centre for Toxoplasmosis

Abstract
Toxoplasmosis is generally a benign infection caused by the protozoan parasite Toxoplasma gondii but can have severe consequences in fetuses of mothers infected during pregnancy (congenital toxoplasmosis) and immunocompromised individuals. PCR-based diagnostic tests have become crucial for its diagnosis. However, this molecular diagnosis essentially relies upon laboratory-developed methods and suffers from a lack of standardization, leading to great variation in methods and performance among laboratories. With the need for accreditation of clinical microbiological laboratories, the use of commercial PCR kits has become an attractive alternative; but thorough evaluation of newly commercialized kits by proficient groups is necessary before any recommendation can be made to parasitology laboratories by health authorities or learned societies. Here, we compared the performance of an original commercial method, the Iam TOXO Q-LAMP (DiaSorin®), using Loop-mediated isothermal amplification (LAMP) technology, with our reference laboratory-developed method using real-time PCR. The kit was first tested using amniotic fluid (AF) and plasma samples (either negative or spiked with live T. gondii tachyzoites at different concentrations (from 7 to 105 tachyzoites/mL)). It was then assessed using a cohort of 11 AF, five placental and 32 blood clinical samples preserved at -20°C. For the processing of placental/blood samples, a pretreatment step was used, which did not strictly follow the manufacturer's recommendations. The practical ease of use and compliance with good laboratory practices were also evaluated. Although the LAMP assay was less sensitive than the laboratory-developed method at very low parasite concentrations (0.1 T. gondii genome equivalents/mL), the two methods yielded identical results qualitatively and, in some instances, quantitatively, particularly for AF samples.

PMID: 29476868 [PubMed - as supplied by publisher]

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Comparative study on the physicochemical and functional properties of the mucilage in the carpel of Nymphaea odorata using ultrasonic and classical heating extractions.

Comparative study on the physicochemical and functional properties of the mucilage in the carpel of Nymphaea odorata using ultrasonic and classical heating extractions.

Int J Biol Macromol. 2018 Feb 21;:

Authors: Wu W, Tu C, Yang W, Wang H, Chang C, Chung J, Lu M, Liao W

Abstract
The cooked carpel of Nymphaea odorata has a large amount of transparent mucilage; however, the basic characteristics of this mucilage have not yet been reported. This study compared the physicochemical and functional properties of this mucilage obtained using conventional hot water extraction (HWM) and ultrasonic-assisted extraction (UAM). Neither HWM nor UAM affected the viability of mouse skin fibroblasts (NIH/3T3) below 100 μg/mL. UAM had a higher yield production, phenol concentration, and in vitro antioxidant activity, but lower viscosity and water-holding capacity than for HWM. The Fourier transform infrared spectra revealed that the dialyzed HWM and UAM, named HWMD and UAMD, respectively, appeared major spectral differences at 1730 cm-1 and 1605 cm-1, implying that the degree of methylation was different between HWMD and UAMD. Compared to HWMD, UAMD in low-molecular weight polysaccharides increased. Evidently, the basic characteristics of native mucilage in the carpel of N. odorata were greatly changed by various extractions. Nevertheless, sugar analysis indicated that glucuronic acid was the mainly composition of HWMD and UAMD.

PMID: 29476852 [PubMed - as supplied by publisher]

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A potential role for Eph receptor signalling during migration of corneal endothelial cells.

A potential role for Eph receptor signalling during migration of corneal endothelial cells.

Exp Eye Res. 2018 Feb 21;:

Authors: Walshe J, Richardson NA, Al Abdulsalam NK, Stephenson SA, Harkin DG

Abstract
The corneal endothelium is a monolayer of epithelial cells that lines the posterior surface of the cornea and is essential for maintenance of corneal transparency. Wound healing within the corneal endothelium typically occurs through cell spreading and migration rather than through proliferation. The mechanisms that control corneal endothelial cell migration are unclear. In this study we demonstrate that cultures of corneal endothelial cells display reduced migration in scratch wound assays, and reduced levels of E-cadherin mRNA, following suppression of ligand-activated Eph receptor signalling by treatment with lithocholic acid. Two Eph receptors, EphA1 and EphA2, were subsequently detected in corneal endothelial cells, and their potential involvement during migration was explored through gene silencing using siRNAs. EphA2 siRNA reduced levels of mRNA for both EphA2 and N-cadherin, but increased levels of mRNA for both EphA1 and E-cadherin. No effect, however, was observed for EphA2 siRNA on migration. Our results indicate a potential role for Eph receptor signalling during corneal endothelial cell migration via changes in cadherin expression. Nevertheless, defining a precise role for select Eph receptors is likely to be complicated by crosstalk between Eph-mediated signalling pathways.

PMID: 29476773 [PubMed - as supplied by publisher]

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Telomere length was similar in school age children with bronchopulmonary dysplasia and allergic asthma.

Telomere length was similar in school age children with bronchopulmonary dysplasia and allergic asthma.

Acta Paediatr. 2018 Feb 24;:

Authors: Henckel E, Svenson U, Nordlund B, Berggren Broström E, Hedlin G, Degerman S, Bohlin K

Abstract
AIM: Inflammation is a major factor in the pathophysiology of bronchopulmonary dysplasia (BPD) and it contributes to accelerated telomere shortening and cellular aging. This study aimed to determine its effect on telomere length and lung function in school-aged children born preterm with BPD.
METHODS: We examined 29 children with BPD, born preterm in Stockholm county 1998-99, along with 28 children with allergic asthma born at term matched for age and gender. At 10 years of age, we measured relative telomere length (RTL) in blood by quantitative polymerase chain reaction, lung function by spirometry and inflammation by fractional exhaled nitric oxide and blood cytokines.
RESULTS: RTL was not different in preterm born with BPD compared to term born children with asthma. The gender effect was strong in both groups; girls had significantly longer median RTL than boys (1.8 versus 1.5, p<0.01). Short RTL was associated with low forced expiratory flow, also after adjusting for gender, but was not affected by severity of BPD or on-going inflammation.
CONCLUSION: Telomere length was similar in 10-year-old children born preterm with a history of BPD and term-born children with allergic asthma. However, impaired lung function and male gender were associated with short telomeres. This article is protected by copyright. All rights reserved.

PMID: 29476624 [PubMed - as supplied by publisher]

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Assessment of voice, speech and communication changes associated with cervical spinal cord injury.

Assessment of voice, speech and communication changes associated with cervical spinal cord injury.

Int J Lang Commun Disord. 2018 Feb 24;:

Authors: Johansson K, Seiger Å, Forsén M, Holmgren Nilsson J, Hartelius L, Schalling E

Abstract
BACKGROUND: Respiratory muscle impairment following cervical spinal cord injury (CSCI) may lead to reduced voice function, although the individual variation is large. Voice problems in this population may not always receive attention since individuals with CSCI face other, more acute and life-threatening issues that need/receive attention. Currently there is no consensus on the tasks suitable to identify the specific voice impairments and functional voice changes experienced by individuals with CSCI.
AIMS: To examine which voice/speech tasks identify the specific voice and communication changes associated with CSCI, habitual and maximum speech performance of a group with CSCI was compared with that of a healthy control group (CG), and the findings were related to respiratory function and to self-reported voice problems.
METHODS & PROCEDURES: Respiratory, aerodynamic, acoustic and self-reported voice data from 19 individuals (nine women and 10 men, aged 23-59 years, heights = 153-192 cm) with CSCI (levels C3-C7) were compared with data from a CG consisting of 19 carefully matched non-injured people (nine women and 10 men, aged 19-59 years, heights = 152-187 cm).
OUTCOMES & RESULTS: Despite considerable variability of performance, highly significant differences between the group with CSCI and the CG were found in maximum phonation time, maximum duration of breath phrases, maximum sound pressure level and maximum voice area in voice-range profiles (all p = .000). Subglottal pressure was lower and phonatory stability was reduced in some of the individuals with CSCI, but differences between the groups were not statistically significant. Six of 19 had voice handicap index (VHI) scores above 20 (the cut-off for voice disorder). Individuals with a vital capacity below 50% of the expected for an equivalent reference individual performed significantly worse than participants with more normal vital capacity. Completeness and level of injury seemed to impact vocal function in some individuals.
CONCLUSIONS & IMPLICATIONS: A combination of maximum performance speech tasks, respiratory tasks and self-reported information on voice problems help to identify individuals with reduced voice function following CSCI. Early identification of individuals with voice changes post-CSCI, and introducing appropriate rehabilitation strategies, may help to minimize development of maladaptive voice behaviours such as vocal strain, which can lead to further impairments and limitations to communication participation.

PMID: 29476590 [PubMed - as supplied by publisher]

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Emotional food cravings predicts poor short-term weight loss following laparoscopic sleeve gastrectomy.

Emotional food cravings predicts poor short-term weight loss following laparoscopic sleeve gastrectomy.

Br J Health Psychol. 2018 Feb 24;:

Authors: Janse Van Vuuren MA, Strodl E, White KM, Lockie PD

Abstract
OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) incidence has increased worldwide. However, a proportion of patients achieve inadequate weight loss and some experience weight regain. Little is known of the influence of eating beliefs and behaviours in response to cravings on early weight loss trajectory. This study aimed to identify the post-surgery eating cravings that predicted patients not achieving excess weight loss outcome (EWL) at 6-8 months post-LSG.
DESIGN: A total of 106 (80.7% female) participants who underwent LSG from four sites completed the questionnaires at 4-6 weeks post-bariatric surgery and 6 months post-LSG. Achieving <40% EWL at 6-month follow-up was included as the outcome variable, and the nine subscales of the Food Cravings Questionnaire-Trait version (FCQ-T) were included as potential predictors of that change.
METHODS: Logistic regression was used to examine the relationship between EWL and the nine subscales of the FCQ-T (intentions to eat, positive reinforcement, negative reinforcement, lack of control, preoccupation with food, feelings of hunger, negative affect, emotions experienced before or during food cravings or eating, and guilty feelings).
RESULTS: Participants lost an average 64% EWL (SD = 21% EWL) 6-8 months after LSG surgery. Results indicated the overall model was significant and, of the nine variables, the emotional food craving subscale (adjusted OR = 4.19, p = .018) predicted a failure to achieve EWL.
CONCLUSION: Emotional food cravings experienced 4-6 weeks following LSG may predict poor weight loss outcomes at 6 months. Statement of contribution What is already known on this subject? The prevalence of obesity has reached epidemic proportions worldwide. Bariatric surgery is currently the most viable and cost-effective treatment for obesity and shows sustainability. Laparoscopic sleeve gastrectomy (LSG) is now the most common procedure. Not all patients achieve excess weight loss outcome (EWL) following LSG. What does this study add? Emotional food cravings contribute to weight loss outcomes at 6 months' post-LSG surgery. Emotional food cravings may be a maladaptive coping mechanism that represents important area for early psychological intervention.

PMID: 29476589 [PubMed - as supplied by publisher]

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Cost-effectiveness of omalizumab for the treatment of Chronic Spontaneous Urticaria.

Cost-effectiveness of omalizumab for the treatment of Chronic Spontaneous Urticaria.

Br J Dermatol. 2018 Feb 24;:

Authors: Kanters TA, Thio HB, Hakkaart L

Abstract
BACKGROUND: Chronic spontaneous urticaria (CSU) is a skin disease, with itchy hives and / or angioedema that last for at least 6 weeks without an obvious external trigger.
OBJECTIVES: The objective of this study was to determine the cost-effectiveness of omalizumab relative to standard of care (SoC; up to 4 times the daily dose of H1-antihistaminics) for the Netherlands from a societal perspective.
METHODS: The Markov model used consisted of five health states based on Urticaria Activity Score over seven days (UAS7). Model settings and characteristics of the Dutch patient population were based on an online survey among clinical experts and were validated during an expert committee meeting. Transition probabilities were derived from the GLACIAL trial. Healthcare consumption, quality of life (using EQ-5D) and productivity losses were derived from a burden of illness study (ASSURE-CSU) among 93 Dutch patients. Healthcare consumption and productivity losses were valued using the Dutch costing manual. Comparator treatment was SoC, consisting of (up dosed) antihistamines. A ten-year time horizon was used.
RESULTS: The incremental cost-effectiveness ratio (ICER) of omalizumab versus SoC was €17,502 per quality adjusted life year (QALY) gained. Productivity costs played an important role in the value of the ICER; discarding productivity costs resulted in an ICER of €85,310 per QALY.
CONCLUSIONS: Omalizumab is cost-effective compared to SoC. The outcomes of this study were used to establish omalizumab as third-line treatment in the Dutch treatment guidelines for CSU. This article is protected by copyright. All rights reserved.

PMID: 29476533 [PubMed - as supplied by publisher]

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High-Accuracy Mass Spectrometry Based Screening Method for the Discovery of Cysteine Containing Peptides in Animal Venoms and Toxins.

High-Accuracy Mass Spectrometry Based Screening Method for the Discovery of Cysteine Containing Peptides in Animal Venoms and Toxins.

Methods Mol Biol. 2018;1719:335-348

Authors: van Oosten LN, Pinkse MWH, Pieterse M, Escoubas P, Verhaert PDEM

Abstract
Venom and toxin samples derived from animal origins are a rich source of bioactive peptides. A high proportion of bioactive peptides that have been identified in venom contain one or more disulfide bridges, which are thought to stabilize tertiary structure, and therefore influence the peptides' specificity and activity. In this chapter, we describe a label-free mass spectrometry-based screening workflow specifically to detect peptides that contain inter- and intramolecular disulfide bonds, followed by elucidation of their primary structure. This method is based on the determination of the normalized isotope shift (NIS) and the normalized mass defect (NMD) of peptides, two parameters which are heavily influenced by the presence of sulfur in a peptide, where cysteines are the main contributing residues. Using ant defensive secretions as an example, we describe the initial fractionation of the venom on strong cation exchange followed by nanoflow HPLC and mass spectrometry. High resolution zoom scan spectra of high-abundance peptides are acquired, allowing an accurate determination of both monoisotopic and average mass, which are essential for calculation of NMD and NIS. Candidate peptides exhibiting relative low NMD and high NIS values are selected for targeted de novo sequencing. By fine-tuning the collision energy for optimal fragmentation of each selected precursor ions, the full sequence of several novel inter- and intramolecular disulfide bond containing ant defensive peptides can be established.

PMID: 29476522 [PubMed - in process]

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Heterogeneity of Focal Adhesions and Focal Contacts in Motile Fibroblasts.

Heterogeneity of Focal Adhesions and Focal Contacts in Motile Fibroblasts.

Methods Mol Biol. 2018;1745:205-218

Authors: Gladkikh A, Kovaleva A, Tvorogova A, Vorobjev IA

Abstract
Cell-extracellular matrix (ECM) adhesion is an important property of virtually all cells in multicellular organisms. Cell-ECM adhesion studies, therefore, are very significant both for biology and medicine. Over the last three decades, biomedical studies resulted in a tremendous advance in our understanding of the molecular basis and functions of cell-ECM adhesion. Based on morphological and molecular criteria, several different types of model cell-ECM adhesion structures including focal adhesions, focal complexes, fibrillar adhesions, podosomes, and three-dimensional matrix adhesions have been described. All the subcellular structures that mediate cell-ECM adhesion are quite heterogeneous, often varying in size, shape, distribution, dynamics, and, to a certain extent, molecular constituents. The morphological "plasticity" of cell-ECM adhesion perhaps reflects the needs of cells to sense, adapt, and respond to a variety of extracellular environments. In addition, cell type (e.g., differentiation status, oncogenic transformation, etc.) often exerts marked influence on the structure of cell-ECM adhesions. Although molecular, genetic, biochemical, and structural studies provide important maps or "snapshots" of cell-ECM adhesions, the area of research that is equally valuable is to study the heterogeneity of FA subpopulations within cells. Recently time-lapse observations on the FA dynamics become feasible, and behavior of individual FA gives additional information on cell-ECM interactions. Here we describe a robust method of labeling of FA using plasmids with fluorescent markers for paxillin and vinculin and quantifying the morphological and dynamical parameters of FA.

PMID: 29476471 [PubMed - in process]

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Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Asian Practice: Perspectives for Surgical Pathology and Cytopathology.

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Asian Practice: Perspectives for Surgical Pathology and Cytopathology.

Endocr Pathol. 2018 Feb 23;:

Authors: Bychkov A, Jung CK, Liu Z, Kakudo K

Abstract
The introduction of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was initiated and promoted by pathologists. Recent Asian studies added new knowledge to the existing literature to aid a better understanding of NIFTP. Our original data and the results of a meta-analysis suggest that the initial rate of NIFTP has been overestimated, averaging 9.1% (95% confidence interval [CI] 6.0-12.7%) of all papillary thyroid cancers worldwide. The incidence of NIFTP in the Asian population (1.6%, 95% CI 0.9-2.5%; 7 studies) is significantly lower than that reported in the non-Asian series (13.3%, 95% CI 9.0-18.3%; 18 studies). Such difference could be attributed to various perceptions of histological diagnostic thresholds, different nature of papillary thyroid carcinoma, and different approaches in the management of thyroid nodules. The active surveillance for indeterminate nodules and NIFTP, largely represented in the indeterminate cytologic categories, promoted by Japanese institutions establishes a new paradigm to reduce overtreatment of these patients. The lower prevalence of NIFTP in the Asian series indicates a low impact on the risk of malignancy in cytopathology, as it was demonstrated in our original multi-institutional cohort of thyroid nodules, and may predict a low impact on the performance of commercial molecular tests. Several Korean studies addressed the issue of BRAF mutation in NIFTP, which prompted the current refinement of the diagnostic criteria for NIFTP. Our survey of Asian pathologists found that the term NIFTP has not been universally adopted in the local practice. Endocrine pathologists must promote the new entity through provision of educational activities.

PMID: 29476382 [PubMed - as supplied by publisher]

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Dysplastic features relevant to malignant transformation in atrophic epithelium of oral submucous fibrosis: a preliminary study

Abstract

Background

The grading of oral epithelial dysplasia (OED) is not applicable to oral submucous fibrosis (OSMF) cases due to the presence of atrophic epithelium. The mucosal margins associated with resected OSCC specimens are often closely related to transformed cells. In this study, we compared the histomorphological alterations (dysplastic features) in the atrophic epithelium of OSMF patients with the mucosal margins of OSCC associated with OSMF (OSCC-OSMF).

Methods

We evaluated 17 dysplastic features in 37 patients with OSMF (biopsy site: buccal mucosa) and 37 patients with OSCC-OSMF (mucosal margins involving buccal mucosa) using histopathological staining.

Results

Dysplastic features, such as keratin pearls within rete ridges, nuclear pleomorphism, and atypical mitotic figures, were not observed in the epithelium of the OSMF or OSCC-OSMF groups. Basal cell hyperplasia (p=0.016), abnormal superficial mitosis (p=0.010), increased nuclear-cytoplasmic ratio (p=0.034), and hyperchromasia (p=0.031) were predominantly seen in the OSCC-OSMF group. We found no statistically significant differences in the following parameters: irregular epithelial stratification (p=1.00), loss of basal cell polarity (p=0.237), presence of drop-shaped rete ridges (p=0.077), increased number of mitotic figures (p=0.154), premature keratinization in single cells (p=0.499), anisonucleosis (p=0.289), anisocytosis (p=0.079), cellular pleomorphism (p=0.317), and increased number and size of nucleoli (p=0.129).

Conclusion

Increased basal cell layer hyperplasia, abnormal superficial mitosis, increased nuclear-cytoplasmic ratio, and hyperchromasia are high-risk features for OSMF, and affected patients should be followed on a priority basis for the early detection of OSCC.

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Cochlear dead regions: Using the Threshold Equalising Noise (TEN) test to improve the assessment of potential cochlear implant candidates - The Oxford experience.

Cochlear dead regions: Using the Threshold Equalising Noise (TEN) test to improve the assessment of potential cochlear implant candidates - The Oxford experience.

Clin Otolaryngol. 2018 Feb 24;:

Authors: Moualed D, Humphries J, Ramsden JD

Abstract
The Threshold Equalising Noise (TEN) test can be used to detect cochlear dead regions Patients with cochlear dead regions may gain limited benefit from conventional amplification The TEN test can be used to assess selected cochlear implant candidates who do not meet pure tone audiometry criteria for implantation Our patients with cochlear dead regions had good outcomes following cochlear implantation This article is protected by copyright. All rights reserved.

PMID: 29476691 [PubMed - as supplied by publisher]

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Linicopathological analysis of head and neck rhabdomyosarcoma: A series of 10 cases and literature review head and neck rhabdomyosarcoma.

Linicopathological analysis of head and neck rhabdomyosarcoma: A series of 10 cases and literature review head and neck rhabdomyosarcoma.

Med Oral Patol Oral Cir Bucal. 2018 Feb 24;:

Authors: Pontes FS, de Oliveira J, de Souza L, de Almeida O, Fregnani E, Vilela R, Miranda-Silva W, Fonseca F, Pontes H

Abstract
OBJECTIVE: To describe the clinicopathological characteristics of a series of head and neck rhabdomyosarcoma (RMS) and to review the literature.
STUDY DESIGN: Cases diagnosed as RMS affecting the head and neck region were retrospectively retrieved from the files of two Brazilian institutions from January 2006 to January 2017. Data on clinical features (sex, age and affected site), microscopic subtype, immunohistochemical results, treatment employed and follow-up status were obtained from the patient's medical charts.
RESULTS: During the period considered, 10 cases of RMS were identified. Females predominated (4M:6F), the mean age at diagnosis was 16.5 years-old and the orbit was the most affected site (4 cases). Microscopically, most cases were classified as embryonal RMS (6 cases) and the Desmin/Myogenin/Myo-D1 immunohistochemical positivity was useful to confirm the diagnosis. Chemotherapy and radiotherapy were applied to 9 and 8 patients respectively, whereas 2 patients were treated by surgery. Recurrences occurred in 3 patients and distant metastasis in 2 cases. Nine patients were alive in their last follow-up, 3 of them with disease, whereas 1 patient died due to the disease.
CONCLUSION: Head and neck RMS is an aggressive malignant neoplasm which demands especial concern to achieve early diagnosis and successful treatment.

PMID: 29476676 [PubMed - as supplied by publisher]

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Factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment of head and neck cancer.

Factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment of head and neck cancer.

Med Oral Patol Oral Cir Bucal. 2018 Feb 24;:

Authors: Nogueira T, Adorno M, Mendonça E, Leles C

Abstract
BACKGROUND: Facial disfigurement has been considered one of the most challenging consequences of the surgical treatment for head and neck cancer patients, mainly due to the importance of the facial region for the personal identity, body self-image and interpersonal interactions, which might affect negatively the quality of life. The aim of this study was to assess factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment.
MATERIAL AND METHODS: Clinical data were retrieved from 103 patient's medical records and quality of life data were collected using the Functional Assessment of Cancer Therapy (FACT-H&N) questionnaire. Moreover, the degree of facial disfigurement was classified by means of a specific ordinal scale.
RESULTS: Data from the FACT-H&N questionnaire showed that the domain directly related to head and neck symptoms was considered the most impacted, while emotional domain was the least affected. Lower quality of life was associated with sequels in the neck and/or lower third of the face (β=-0.39; p=0.001), a higher level of disfigurement (β=-0.29; p=0.016) and female gender (β=-0.20; p=0.038).
CONCLUSIONS: Disfigurement due to surgical treatment was significantly associated with the functional dimension of the patients, especially in extensive sequels in the cervical and lower regions of the face.

PMID: 29476675 [PubMed - as supplied by publisher]

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Upregulation of extraneuronal TRPV1 expression in chronic rhinosinusitis with nasal polyps.

Upregulation of extraneuronal TRPV1 expression in chronic rhinosinusitis with nasal polyps.

Rhinology. 2018 Feb 24;:

Authors: Tóth E, Tornóczky T, Kneif J, Perkecz A, Katona K, Piski Z, Kemény Á, Gerlinger I, Szolcsányi J, Kun J, Pintér E

PMID: 29476616 [PubMed - as supplied by publisher]

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Πληροφορίες

Κυριακή 25 Φεβρουαρίου 2018

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