Combined effects of rat Schwann cells and 17β-estradiol in a spinal cord injury model

Abstract

Spinal cord injury (SCI) is a devastating traumatic event which burdens the affected individuals and the health system. Schwann cell (SC) transplantation is a promising repair strategy after SCI. However, a large number of SCs do not survive following transplantation. Previous studies demonstrated that 17β-estradiol (E2) protects different cell types and reduces tissue damage in SCI experimental animal model. In the current study, we evaluated the protective potential of E2 on SCs in vitro and investigated whether the combination of hormonal and SC therapeutic strategy has a better effect on the outcome after SCI. Primary SC cultures were incubated with E2 for 72 h. In a subsequent experiment, thoracic contusion SCI was induced in male rats followed by sustained administration of E2 or vehicle. Eight days after SCI, DiI-labeled SCs were transplanted into the injury epicenter in vehicle and E2-treated animals. The combinatory regimen decreased neurological and behavioral deficits and protected neurons and oligodendrocytes in comparison to vehicle rats. Moreover, E2 and SC significantly decreased the number of Iba-1+ (microglia) and GFAP⁺ cells (astrocyte) in the SCI group. In addition, we found a significant reduction of mitochondrial fission-markers (Fis1) and an increase of fusion-markers (Mfn1 and Mfn2) in the injured spinal cord after E2 and SC treatment. These data demonstrated that E2 protects SCs against hypoxia-induced SCI and improves the survival of transplanted SCs.

https://ift.tt/2EN7aQu

Mise en ligne du N° 2, volume 63 (avril 2018) de la revue 'Annales de chirurgie plastique esthétique'

Vol 63 - N°2 - avril 2018 P. 105-189 © 2018, Elsevier Masson SAS

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Broadening the Sonographic Spectrum of Vascular Anomalies

F. Alfageme
Actas Dermosifiliogr 2018;109:199

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Translation and Cross-Cultural Adaptation of Health Assessment Tools

S. Ortiz-Gutiérrez, A. Cruz-Avelar
Actas Dermosifiliogr 2018;109:202-6

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Gorlin Syndrome

I. Palacios-Álvarez, R. González-Sarmiento, E. Fernández-López
Actas Dermosifiliogr 2018;109:207-17

Abstract - Full text - PDF

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Photodynamic Therapy Interventions in Facial Photodamage: A Systematic Review

G. Sanclemente, V. Ruiz-Cañas, J.M. Miranda, A.P. Ferrín, P.A. Ramirez, G.N. Hernandez
Actas Dermosifiliogr 2018;109:218-29

Abstract - Full text - PDF

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Dupilumab for the Treatment of Atopic Dermatitis

S. Ferreira, T. Torres
Actas Dermosifiliogr 2018;109:230-40

Abstract - Full text - PDF

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A 12-Day Course of Imiquimod 5% for the Treatment of Actinic Keratosis: Effectiveness and Local Reactions

C. Serra-Guillén, E. Nagore, B. Llombart, O. Sanmartín, C. Requena, L. Calomarde, C. Guillén
Actas Dermosifiliogr 2018;109:248-53

Abstract - Full text - PDF

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Reconstructive methods in Mohs micrographic surgery in Uruguay: A bidirectional descriptive cohort analysis

J. Navarrete, J. Magliano, M. Martínez, C. Bazzano
Actas Dermosifiliogr 2018;109:254-61

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Zika Virus: Cutaneous Manifestations in 3 Patients

A. Cosano-Quero, V. Velasco-Tirado, M.P. Sánchez Seco, L. Manzanedo-Bueno, M. Belhassen-García
Actas Dermosifiliogr 2018;109:e13-6

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Bilateral Annular Plaques on the Hands and Forearms

E. Rozas-Muñoz, J.F. Mir-Bonafé, E. Serra-Baldrich
Actas Dermosifiliogr 2018;109:263-4

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Fast-growing Tumor of the Eyelid

C.A. Morales-Cardona, C. Rodríguez-Zakzuk, A. Téllez-Lozada
Actas Dermosifiliogr 2018;109:265-6

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Immediate Lymph Node Dissection on Detection of Sentinel Lymph Node Involvement Does Not Increase Survival in Cutaneous Melanoma

D. Morgado-Carrasco, A. Combalia, X. Fustà-Novell, L. Ferrandiz
Actas Dermosifiliogr 2018;109:267-8

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Linear Palmoplantar Keratoderma

A. Imbernón-Moya, A. Aguilar-Martínez, E. Vargas-Laguna
Actas Dermosifiliogr 2018;109:269

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Ultrasound-Guided, Minimally Invasive Resection of a Digital Glomus Tumor

J. Domínguez-Cruz, A. Ortiz-Prieto, P. Martín-Carrasco, J. Conejo-Mir
Actas Dermosifiliogr 2018;109:271-3

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Our Experience With Strain Elastography in 2 Cases of Suspected Malignant Subcutaneous Lesions

A. Vilas-Sueiro, F. Alfageme-Roldán, P. Nájera, G. Roustán
Actas Dermosifiliogr 2018;109:274-6

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Durable response to bevacizumab in adults with recurrent pilocytic astrocytoma

CNS Oncology, Ahead of Print.


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Slow Elevation in Protein C Activity without a PROC Mutation in a Neonate with Intracranial Hemorrhage

AJP Rep 2018; 08: e68-e70
DOI: 10.1055/s-0038-1639614

Severe protein C (PC) deficiency leads to purpura fulminans and stroke in newborns. However, the clinical impact of plasma PC activity on the development of neonatal cerebral disease remains elusive. We report a case of hemorrhagic stroke associated with neonatal asphyxia and severe PC deficiency. Plasma PC and protein S activity 7 days after birth was 12% and 43%, respectively. No PROC mutation was found. PC levels did not exceed 20% until 2 months of age, even in the absence of consumption coagulopathy or vitamin K deficiency. Neither thromboembolic nor hemorrhagic events occurred during the infusion of activated PC concentrate (twice weekly, up to 68 days after birth). The PC activity levels gradually increased to the standard value for age by 9 months of age. The present case showed that neonatal PC deficiency without a PROC mutation caused an intracranial hemorrhage before a slow increase in PC activity.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Pilot Study of Intra-Aortic Balloon Occlusion to Limit Morbidity in Patients with Adherent Placentation Undergoing Cesarean Hysterectomy

AJP Rep 2018; 08: e57-e63
DOI: 10.1055/s-0038-1641736

Objective We study whether using an intra-aortic balloon (IAB) during cesarean hysterectomy decreases delivery morbidity in patients with suspected morbidly adherent placentation. Study Design This is a retrospective cohort study of deliveries complicated by suspected abnormal placentation between 2009 and 2016 comparing maternal and neonatal outcomes with an IAB placed prior to cesarean hysterectomy versus no IAB. The primary outcome included quantified blood loss (QBL). Results Thirty-five cases were reviewed, 16 with IAB and 19 without IAB. No difference was seen in median QBL between the two groups (1,351 vs. 1,397 mL; p = 0.90). There were no significant differences in overall surgical complications (19% IAB, 21% no IAB; p = 0.86), bladder complications (12 vs. 21%; p = 0.66), intensive care unit admissions (12 vs. 26%; p = 0.41), surgical duration (2.9 vs. 2.8 hour; p = 0.83), or blood transfusions (median 2 vs. 2; p = 0.27) between the two groups. There was one groin hematoma at the balloon site that was managed conservatively. There were no complications involving thrombosis or limb ischemia in the IAB group. Conclusion While we did not detect statistically significant differences, larger studies may be warranted given the potential for extreme morbidity in these cases. This study highlights the potential use of an IAB in the management of these cases.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Preclinical Labor-and-Delivery Shadowing: The Impact on Medical Students' Perceptions of Obstetrics and Gynecology

AJP Rep 2018; 08: e64-e67
DOI: 10.1055/s-0038-1641723

Objective We sought to determine the impact of preclinical exposure (shadowing) to labor and delivery (L&D) on medical students' perceptions of obstetrics and gynecology (OB/GYN). Study Design We administered a written survey to rising third-year medical students at a single center prior to any clerkship. We described motivation/deterrents for shadowing among students, and experiences/perceptions of those students who shadowed. Results In total, 119/136 (86%) students completed the survey. Of those, 29% participated in shadowing on L&D. Participating students were more likely to be female (79 vs. 21%; p < 0.01) and in their first year (85%). Ninety-one percent participated because they wanted more exposure to OB/GYN, whereas only 53% they were interested in OB/GYN. Students who did not shadow indicated not having enough time as the main reason. After participation, 82% had more perspective on OB/GYN than prior to shadowing. Ninety-seven percent felt that the experience was worthwhile; 62% stated based on their experience that they were likely to consider a career in OB/GYN. All students who participated stated that they would opt to shadow again if given the opportunity. Conclusion Students who have L&D shadowing exposure report very positive experiences and express desire for increased opportunities. OB/GYN departments may consider increasing availability of L&D shadowing opportunities for preclinical medical students.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Neurocysticercosis in Pregnancy

AJP Rep 2018; 08: e51-e56
DOI: 10.1055/s-0038-1639615

The normal physiologic changes during pregnancy contribute to nutritional, metabolic, and immunologic adjustments, which can have an impact on the presentation of several diseases. New onset seizures during pregnancy and the postpartum can be attributed to several etiologies. Patient demographic data as well as personal and social histories are key in determining the etiology of new onset seizures. Neurocysticercosis (NCC), a commonly overlooked etiology, must be included in the differential diagnosis of patients with new onset seizures coming from NCC endemic areas. The diagnosis is based on a combination of clinical findings, exposure history, imaging, and serology. We present two cases of patients with NCC that became symptomatic during pregnancy or postpartum period. We will review the epidemiology, clinical manifestations, and management of NCC in pregnancy.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Same Phenotype in Children with Growth Hormone Deficiency and Resistance

By definition, about 2.5% of children show a short stature due to several causes. Two clinical conditions are characterized by serum IGF-I low levels, idiopathic GH deficiency (IGHD), and GH insensitivity (GHI), and the phenotypic appearance of these patients may be very similar. We studied two children with short stature and similar phenotypes. The first case showed frontal bossing, doll face, acromicria, and truncal obesity, with a GH peak

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EM Nerd-Behind the Veil of Science

  On March 26th 2018, the New York Times published an article by Gina Kolata, For Many Strokes, There's an Effective Treatment. Why Aren't Some Doctors Offering It?, examining the efficacy of tPA in acute ischemic stroke. The article was dismissive and misleading. In response, I sent a letter to the editor which I fear […]

EMCrit Project by Rory Spiegel.

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Repurposing drugs in oncology (ReDO)—selective PDE5 inhibitors as anti-cancer agents

Pan Pantziarka, Vidula Sukhatme, Sergio Crispino, Gauthier Bouche, Lydie Meheus and Vikas P Sukhatme

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Risk sharing agreements, present and future

Francisco R Gonçalves, Susana Santos, Catarina Silva and Gabriela Sousa

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Statistical Evaluation of Trace Metals, TSH and T 4 in Blood Serum of Thyroid Disease Patients in Comparison with Controls

Abstract

The present study is based on the measurement of concentrations of selected trace metals (Fe, Zn, Cu, Co, Mn, Ni, Cr, Cd and Pb) and thyroid hormones (TSH and T₄) in blood serum of hypothyroid and hyperthyroid patients in comparison with healthy donors/controls in order to establish the imbalances of the trace metals in diseased subjects. The serum samples were digested in HNO₃-HClO₄ mixture and quantification of the metals was performed by flame atomic absorption spectrometry. Average levels of Fe, Ni, Cu, Cr, Pb and TSH were found to be significantly higher (p < 0.05) in the serum of hypothyroid patients compared with other donor categories, while mean concentrations of Mn, Cd and T₄ were significantly elevated in the serum of hyperthyroid patients compared with other donor groups (p < 0.05). The correlation pattern of trace metals in the serum of patient groups revealed significantly different mutual associations compared with the controls. PCA and CA pointed out the interferences of the toxic metals with essential metals in the serum of both patient groups compared with the controls. Most of the metals exhibited noticeable disparities in their concentrations based on gender, food habits and tobacco use for all donor groups. Thus, the pathogenesis of thyroid diseases is significantly affecting the essential trace and toxic metals balance in both patients groups.

https://ift.tt/2GCc8l4

Effect of Low-Selenium/High-Fat Diet on Pig Peripheral Blood Lymphocytes: Perspectives from Selenoproteins, Heat Shock Proteins, and Cytokines

Abstract

The aim of the present study was to clarify the effect of low selenium (Se)/high fat on the mRNA expression of selenoproteins, heat shock proteins (HSPs) and cytokines in pig peripheral blood lymphocytes. Forty crossbred boar piglets with healthy lean body weights of 10 kg were randomly divided into four treatment groups (group C, group L-Se, group H-fat, and group L-Se-H-fat) (n = 10/group) and fed with the corresponding diet for 16 weeks. The pig peripheral blood lymphocytes were extracted, and the mRNA expression of selenoproteins, HSPs, and cytokines was measured. Most mRNA levels for selenoproteins decreased in group L-Se, group H-fat, and group L-Se-H-fat, except Gpx1, Gpx2, Selt, and Selm, which were elevated in group H-fat. At the same time, low-Se/high-fat diet increased the expression of HSPs (HSP40, HSP60, HSP70, and HSP90) and inflammatory cytokines (IL-1α, IL-1β, IL-6, IL-8, IL-9, iNOS, COX-2, NF-κB, and TNF-α) in group L-Se, group H-fat, and group L-Se-H-fat, and genes in group L-Se-H-fat showed greater increases. Also, low-Se/high-fat diet inhibits the expression of TGF-β1 and IFN-γ. In summary, a low-Se/high-fat diet can cause relevant selenoprotein expression changes and promote the expression of pro-inflammatory factors and HSPs, and low Se enhances the expression of HSPs and inflammation factors induced by high fat. This information is helpful for understanding the effects of low-Se and high-fat diet on pig peripheral blood lymphocytes.

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Selenoprotein N Was Required for the Regulation of Selenium on the Uterine Smooth Muscle Contraction in Mice

Abstract

Selenium (Se) is an essential micronutrient affecting various aspects of health. The balance of the Se concentration has an important protective and promoter effect on physiological function in inducing muscular disorders in smooth muscle. Selenoprotein N (SelN) is closely related to Ca²⁺ release. The present study aimed to determine the effects and mechanism of action of dietary Se on uterine smooth muscle contraction via SelN using a mouse model. Quantitative polymerase chain reaction (qPCR) analysis was performed to detect mRNA levels. Western blotting was performed to detect protein levels. The results of the immunohistochemical analysis showed that Se had an effect on the uterine smooth muscle. The Se-supplement increased the release of Ca²⁺, Ca²⁺-calmodulin (CaM) expression, myosin light chain kinase (MLCK) expression, and myosin light chain (MLC) phosphorylation but did not affect ROCK and RhoA in uterine smooth muscle. Furthermore, the lack of Se showed an opposite impact. The effects of Se regulation were closely related to SelN. The interference of mouse SelN was performed on the uterine smooth muscle cell. Additionally, the results displayed the regulation of Se on the release of Ca²⁺, CaM expression, MLCK expression, and MLC phosphorylation were significant inhibited, and there was no effect on ROCK and RhoA. In conclusion, Se played an important role in regulating the process of contraction in uterine smooth muscle with SelN.

https://ift.tt/2q65VY3

Association of Elements with Schizophrenia and Intervention of Selenium Supplements

Abstract

The purpose of this study is to explore more trace elements (zinc, potassium, copper, iron, boron, manganese, selenium, chromium and cadmium elements) in addition to calcium, magnesium, lead and arsenic in the sera of patients with schizophrenia and the general population in China and to determine the effect of selenium on schizophrenia patients. Participants were collected from the Pingyin County Mental Health Hospital and Pingyin County. A t test was used to analyse the differences between schizophrenia patients and healthy subjects, and element content differences in gender. Logistic multivariate regression analysis was applied to analyse the influence of elements to schizophrenia. Repeated measures analysis of variance was used to analyse differences in the elements after 1 and 3 months. Mn, Se, Cd, Pb, Ca, Cu and Fe were lower than those in the normal group, and B, Cr, As, K and Mg were higher than those in the control group. The odd ratios (ORs) of serum As and serum K were 2.624 and 1.035, respectively. The ORs of sera Cr, Mn, Se, Ca and Cu were all below one. After intervention of 'selenium weikang' about 1 and 3 months, the serum As was decreased and the serum selenium and copper were increased. Cr, Mn, Se, Ca and Cu might have beneficial, statistically significant effects on schizophrenia. Elements As and K might be harmful to schizophrenia with statistical significance. After selenium supplementation, the schizophrenia patients improved in some factors, like the appetite and memory, and the As element decreased.

https://ift.tt/2GyAmfN

Effects of Se and Cd Co-treatment on the Morphology, Oxidative Stress, and Ion Concentrations in the Ovaries of Laying Hens

Abstract

This study aims at revealing the effects of the combined treatment of selenium and cadmium on ovary morphology, oxidative stress, and 28 kinds of ion concentrations in laying hens. In this experiment, 128 healthy 31-week-old chickens were selected and divided into four treatment groups, three of which were separately fed the basic diets supplemented with either Se or Cd or both Se and Cd for 90 days, and the remaining group was fed the basic diet and treated as a control. The chickens were sacrificed for collecting ovarian tissues. Morphological structure and ultrastructure analysis of ovaries in the Cd-treated group revealed ovarian damage, with decreased activities of SOD and GPx, along with increased levels of MDA and H₂O₂. Cd treatment also resulted in disturbances in ion balance. The concentrations of Ca, Ti, Cu, Zn, and Ba were significantly reduced, while the concentrations of Fe, Mo, and Cd were significantly increased when compared with the control group. Interestingly, the damages caused by cadmium were alleviated in the Se+Cd-treated group. These results indicate that selenium can alleviate cadmium-induced ovarian damages.

https://ift.tt/2GF0Bl2

The Inflammatory Potential of Dietary Manganese in a Cohort of Elderly Men

Abstract

Manganese is an essential nutrient that may play a role in the production of inflammatory biomarkers. We examined associations between estimated dietary manganese intake from food/beverages and supplements with circulating biomarkers of inflammation. We further explored whether estimated dietary manganese intake affects DNA methylation of selected genes involved in the production of these biomarkers. We analyzed 1023 repeated measures of estimated dietary manganese intakes and circulating blood inflammatory biomarkers from 633 participants in the Normative Aging Study. Using mixed-effect linear regression models adjusted for covariates, we observed positive linear trends between estimated dietary manganese intakes and three circulating interleukin proteins. Relative to the lowest quartile of estimated intake, concentrations of IL-1β were 46% greater (95% CI − 5, 126), IL-6 52% greater (95% CI − 9, 156). and IL-8 32% greater (95% CI 2, 71) in the highest quartiles of estimated intake. Estimated dietary manganese intake was additionally associated with changes in DNA methylation of inflammatory biomarker-producing genes. Higher estimated intake was associated with higher methylation of NF-κβ member activator NKAP (Q4 vs Q1: β = 3.32, 95% CI − 0.6, 7.3). When stratified by regulatory function, higher manganese intake was associated with higher gene body methylation of NF-κβ member activators NKAP (Q4 vs Q1: β = 10.10, 95% CI − 0.8, 21) and NKAPP1 (Q4 vs Q1: β = 8.14, 95% CI 1.1, 15). While needed at trace amounts for various physiologic functions, our results suggest estimated dietary intakes of manganese at levels slightly above nutritional adequacy contribute to inflammatory biomarker production.

https://ift.tt/2q6Wjwq

Iodine-Rich Herbs and Potassium Iodate Have Different Effects on the Oxidative Stress and Differentiation of TH17 Cells in Iodine-Deficient NOD.H-2 h4 Mice

Abstract

Iodine-rich herbs such as seaweed, kelp, and sea tangle were widely used to treat various types of goiter with good effect and without any adverse side effects in China. When compared with potassium iodate (PI), iodine-rich herbs had a positive effect on the recovery of goiter resulting from iodine deficiency without any obvious harmful effects. In NOD.H-2^h4 mice, an autoimmune thyroiditis-prone model, iodine excess can increase infiltration of lymphocytes and structural damage of the thyroid follicles, hence resulting in thyroiditis. Until now, there has been little research on the comparative effects of PI and iodine-rich herbs on thyroid in an autoimmune thyroiditis-prone model. This study was designed to compare the different effects of iodine-rich herbs and PI on the thyroid gland in iodine-deficient NOD.H-2^h4 mice. Excessive intake of PI cause oxidative injury in the thyroid gland and increase the risk of autoimmune thyroiditis, while iodine-rich herbs cause less oxidative injury, significantly enhancing antioxidant capacity, and inhibit the high differentiation of Th17 cells in the thyroid glands of NOD.H-2^h4 mice.

https://ift.tt/2GAfRPL

Correction to: Mercury Exposure: Protein Biomarkers of Mercury Exposure in Jaraqui Fish from the Amazon Region

Abstract

In the affiliation section, Luiz Fabricio Zara's affiliation "Pontifical Catholic University of Goiás (PUC), Goiânia, GO, Brazil" was incorrect. The correct affiliation is College of Planaltina, UnB - University of Brasília, Distrito Federal, Brazil

https://ift.tt/2q927Fu

Trace Element and Heavy Metal Levels in Colorectal Cancer: Comparison Between Cancerous and Non-cancerous Tissues

Abstract

Cases of colorectal cancer (CRC) have increased dramatically in Middle Eastern and other Asian countries. Many studies indicate an important role of environmental factors, including trace elements as an etiology of cancer. This study aims to assess the concentration of eight trace elements in cancerous and adjacent non-cancerous tissues in case of CRC. In a cross-sectional study, conducted between March 2015 and February 2016, zinc (Zn), chromium (Cr), manganese (Mn), tin (Sn), copper (Cu), aluminum (Al), lead (Pb), and iron (Fe) levels were evaluated among patients suffering from CRC. All the patients underwent a full colonoscopy. Multiple samples were taken from cancerous lesions and adjacent healthy tissues that kept a minimum distance of 10 cm from the lesions. These specimens were kept at −80 °C. The classic flame atomic absorption spectroscopy (FAAS) method was applied in this study. The mean age of the study population was 55.6 ± 12.8. The median of Zn, Cr, Cu, Al, and Pb in cancerous tissues was significantly higher than that of healthy tissues (P < 0.05). Nevertheless, the median of Mn, Sn, and Fe was significantly lower than that of non-cancerous tissues (P < 0.05). Between colon and rectal specimens, we did not find a difference between Cr and Al levels and Zn, Sn, and Cu levels in cancerous and healthy tissues, respectively. We revealed that gender and history of smoking may influence the level of some trace elements. We revealed that the levels of eight elements were significantly different for cancerous and healthy tissues. This may play a role in developing CRC. These findings reflect the importance of environmental pollution in this setting.

https://ift.tt/2uK518B

Speciation of As(ΙΙΙ)/As(V) and Total Inorganic Arsenic in Biological Fluids Using New Mode of Liquid-Phase Microextraction and Electrothermal Atomic Absorption Spectrometry

Abstract

In this paper, a new extraction method based on countercurrent liquid–liquid microextraction (CLLME) has been developed for the extraction and preconcentration of inorganic arsenic (iAs) in plasma and urine samples prior to their analysis by electrothermal atomic absorption spectrometry (ETAAS). In this method, firstly, 5 ml of water is added to the extraction vessel. Then 30.0 μl of the extracting solvent is added to it in order for the extracting solvent to be placed in the narrow-necked vessel. In total, 10 ml of a standard solution or a pretreated real sample is added to the sample container and it is connected to the extraction vessel via a connector. While opening the embedded valve at the bottom of the sample container and the one in the extraction vessel, the sample solution flows into the extracting solvent with the same flow rate, leading to the successful extraction of metal ligand into the extracting organic solvent. Under the optimum conditions, calibration curves are linear in the range of 0.1–50 μg l⁻¹, and limit of detections (LODs) are in the range of 0.03–0.05 μg l⁻¹. The enhancement factor and enrichment factor were in the range of 220–240 and 198–212, respectively. Repeatability (intra-day) and reproducibility (inter-day) of method based on seven replicate measurements of 5.0 μg l⁻¹ of arsenic were in the range of 2.3–3.5% and 4.0–5.7%, respectively. The applicability of the proposed CLLME and ETAAS methods was demonstrated by analyzing the iAs in spiked urine and plasma samples. The obtained recoveries of the arsenic in the range of 92–107% indicated the excellent capability of the developed method for speciation of arsenic from plasma and urine samples.

Graphical Abstract

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Mercury Exposure: Protein Biomarkers of Mercury Exposure in Jaraqui Fish from the Amazon Region

Abstract

This study presents data on the extraction and characterization of proteins associated with mercury in the muscle and liver tissues of jaraqui (Semaprochilodus spp.) from the Madeira River in the Brazilian Amazon. Protein fractionation was carried out by two-dimensional electrophoresis (2D-PAGE). Mercury determination in tissues, pellets, and protein spots was performed by graphite furnace atomic absorption spectrometry (GFAAS). Proteins in the spots that showed mercury were characterized by electrospray ionization tandem mass spectrometry (ESI-MS/MS). The highest mercury concentrations were found in liver tissues and pellets (426 ± 6 and 277 ± 4 μg kg⁻¹), followed by muscle tissues and pellets (132 ± 4 and 86 ± 1 μg kg⁻¹, respectively). Mercury quantification in the protein spots allowed us to propose stoichiometric ratios in the range of 1–4 mercury atoms per molecule of protein in the protein spots. The proteins characterized in the analysis by ESI-MS/MS were keratin, type II cytoskeletal 8, parvalbumin beta, parvalbumin-2, ubiquitin-40S ribosomal S27a, 39S ribosomal protein L36 mitochondrial, hemoglobin subunit beta, and hemoglobin subunit beta-A/B. The results suggest that proteins such as ubiquitin-40S ribosomal protein S27a, which have specific domains, possibly zinc finger, can be used as biomarkers of mercury, whereas mercury and zinc present characteristics of soft acids.

https://ift.tt/2GBOq8l

Iron: a Strong Element in the Pathogenesis of Chronic Hyperglycaemia After Acute Pancreatitis

Abstract

Evidence shows an association between markers of iron metabolism and glucose metabolism in type 2 diabetes mellitus. Acute pancreatitis is the largest contributor to diabetes of the exocrine pancreas. However, the pathogenesis of new-onset pre-diabetes or diabetes after pancreatitis remains unclear. This study aimed to investigate associations between markers of iron metabolism and glucose metabolism following acute pancreatitis. Fasting blood samples were collected to analyse markers of glucose metabolism (haemoglobin A1c) and iron metabolism (hepcidin, ferritin, and soluble transferrin receptor). Participants were categorised into two groups: normoglycaemia after acute pancreatitis and chronic hyperglycaemia after acute pancreatitis. Binary logistic and linear regression analyses were conducted, and potential confounders were adjusted for in multivariable analyses. A total of 83 individuals following an episode of acute pancreatitis were included, of whom 19 developed chronic hyperglycaemia. Hepcidin was significantly increased in individuals with chronic hyperglycaemia after acute pancreatitis in two adjusted models (p = 0.045 and p = 0.048). Ferritin was significantly decreased in individuals with chronic hyperglycaemia after acute pancreatitis in three adjusted models (p = 0.016, p = 0.009, and p = 0.011). Soluble transferrin receptor was not significantly associated with chronic hyperglycaemia after acute pancreatitis. These findings suggest that iron metabolism is significantly altered in individuals with chronic hyperglycaemia after acute pancreatitis and may provide better insights into the pathogenesis of new-onset diabetes after pancreatitis.

https://ift.tt/2q6Yhgp

Alleviation of Arsenic-Induced Pulmonary Oxidative Damage by GSPE as Shown during In vivo and In vitro Experiments

Abstract

A long-term exposure to arsenic may lead to lung damage due to oxidative stress. In this context, GSPE can play a major role as a strong antioxidant. Our study attempted to reveal the connection between arsenic-induced lung injury and the antagonistic effect of GSPE. For this purpose, BEAS-2B cells and Kunming mice were exposed to different dosages of As₂O₃ and GSPE. Oxidative stress indicators were detected both in vivo and in vitro. Cell survival rate and morphological changes in the lung tissue (H&E staining) were evaluated as well. It was exhibited that As₂O₃ increased oxidative stress both in vivo and in vitro and decreased cells viability. In contrast, higher cell survival rate was revealed in the group treated with arsenic plus GSPE after 24 h as compared to that in the arsenic group. GSPE effectively reduced oxidative stress levels, along with increasing antioxidant capacity. In vivo experiments in arsenic-exposed group showed alveolar septum to be significantly thickened with considerable capillary congestion and invasion by inflammatory cells. After the intervention with GSPE, there seemed to be a dramatic reversal of morphology with thinning of the alveolar septum, decrease in capillary congestion, and number of inflammatory cells. This had shown that GSPE can effectively reduce the levels of oxidative stress, induced by arsenic in mice lung tissue. Conversely, antioxidant enzymes or products were increased. The experiment proved that GSPE can protect the lungs from oxidative damage induced by arsenic, and it may also be used as an antagonist against arsenic injuries.

https://ift.tt/2GCdJaq

Zinc Metabolism and Metallothioneins

Abstract

Among the trace elements, zinc is one of the most used elements in biological systems. Zinc is found in the structure of more than 2700 enzymes, including hydrolases, transferases, oxyreductases, ligases, isomerases, and lyases. Not surprisingly, it is present in almost all body cells. Preserving the stability and integrity of biological membranes and ion channels, zinc is also an intracellular regulator and provides structural support to proteins during molecular interactions. It acts as a structural element in nucleic acids or other gene-regulating proteins. Metallothioneins, the low molecular weight protein family rich in cysteine groups, are involved significantly in numerous physiological and pathological processes including particularly oxidative stress. A critical role of metallothioneins (MT) is to bind zinc with high affinity and to serve as an intracellular zinc reservoir. By releasing free intracellular zinc when needed, MTs mediate the unique physiological roles of zinc. MT expression is induced by zinc elevation, and thus, zinc homeostasis is maintained. That MT mediates the effects of zinc, besides having strong radical scavenging effects, points to the critical part it plays in oxidative stress. The present review aims to give information on metallothioneins, which have critical importance in the metabolism and molecular pathways of zinc.

https://ift.tt/2q6Yf8h

Network Analysis of Se-and Zn-related Proteins in the Serum Proteomics Expression Profile of the Endemic Dilated Cardiomyopathy Keshan Disease

Abstract

Keshan disease (KD) is an endemic cardiomyopathy with high mortality. Selenium (Se) and zinc (Zn) deficiencies are closely related to KD. The molecular mechanism of KD pathogenesis is still unclear. There are only few studies on the interaction of trace elements and proteins associated with the pathogenesis of KD. In this study, isobaric tags for relative and absolute quantitation (iTRAQ)-coupled two-dimensional liquid chromatography tandem mass spectrometry (2DLC-MS/MS) technique analysis was used to analyze the differential expression of proteins from serum samples. Comparative Toxicogenomics Database (CTD) was used to screen Se- and Zn-associated proteins. Then, pathway and network analyses of Se- and Zn-associated proteins were constituted by Cytoscape ClueGO and GeneMANIA plugins. One hundred and five differentially expressed proteins were obtained by 2DLC-MS/MS, among them 19 Se- and 3 Zn-associated proteins. Fifty-two pathways were identified from ClueGO and 1 network from GeneMANIA analyses. The results showed that Se-associated proteins STAT3 and MAPK1 and Zn-associated proteins HIF1A and PARP1, the proteins involved in HIF-1 signaling pathway and apoptosis pathway, may play significant roles in the pathogenesis of KD. The approach of this study would be also beneficial for further dissecting molecular mechanism of other trace element-associated disease.

https://ift.tt/2GCuQZN

Growth Performance, Mineral Digestibility, and Blood Characteristics of Ostriches Receiving Drinking Water Supplemented with Varying Levels of Chelated Trace Mineral Complex

Abstract

The effects of water supplementation of chelated trace minerals (CTM, which is named Bonzaplex designed with chelate compounds technology) on growth performance, apparent total tract digestibility (ATTD) of minerals, and some blood metabolites, TM, and antioxidant enzyme values in African ostriches were investigated from 8 to 12 months of age. A total of 20 8-month-old ostriches (five birds in five replicate pens) was randomly allocated into one of the following four treatments: (1) control (basal diet + tap water), (2) low CTM (basal diet +100 mg/bird/day CTM powder in tap water), (3) medium CTM (basal diet +1 g/bird/day CTM powder in tap water), and (4) high CTM (basal diet +2 g/bird/day CTM powder in tap water). Compared with control, medium CTM improved (P < 0.05) daily weight gain and ATTD of phosphorous, zinc, and copper in 12-month-old ostriches. Furthermore, the feed conversion ratio was lower, and ATTD of magnesium was higher in the medium- and high-CTM groups than that in the control group (P < 0.05). At the end of the trial, ostriches receiving high-CTM treatment exhibited the lower (P < 0.05) serum triglyceride and very low-density lipoprotein cholesterol concentrations and higher copper levels compared to those of the control treatment. Supplementation of higher amounts of CTM (medium and high CTM) also increased the activity of serum superoxide dismutase (P < 0.05). No differences were detected for other blood parameters including glucose, total protein, albumin, cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, iron, magnesium, and glutathione peroxidase values. In conclusion, supplementation of CTM at the level of 1 g/bird/day to the drinking water can be recommended for improving growth performance, mineral absorption, and antioxidant status of ostriches fed diets containing the recommended levels of inorganic TM.

https://ift.tt/2q6YaBv

Prostatic-Specific Antigen Levels in Men from Two Andean Cities of Peru

High Altitude Medicine &Biology, Ahead of Print.


https://ift.tt/2vb0TP4

A Systematic Review and Meta-Analysis Reveals Altered Drug Pharmacokinetics in Humans During Acute Exposure to Terrestrial High Altitude—Clinical Justification for Dose Adjustment?

High Altitude Medicine &Biology, Ahead of Print.


https://ift.tt/2HsDAoK

Cold Susceptibility of Digit Stumps Resulting from Amputation After Freezing Cold Injury in Elite Alpinists

High Altitude Medicine &Biology, Ahead of Print.


https://ift.tt/2vb0QTo

Exploration of Acute Phase Proteins and Inflammatory Cytokines in Early Stage Diagnosis of Acute Mountain Sickness

High Altitude Medicine &Biology, Ahead of Print.


https://ift.tt/2HqEa6M

Progression of urothelial carcinoma in situ of the urinary bladder: a switch from luminal to basal phenotype and related therapeutic implications

Abstract

The stratification of bladder cancer into luminal and basal tumors has recently been introduced as a novel prognostic system in patient cohorts of muscle-invasive bladder cancer or high-grade papillary carcinomas. Using a representative immunohistochemistry panel, we analyzed luminal and basal marker expression in a large case series (n = 156) of urothelial carcinoma in situ (CIS), a precancerous lesion that frequently progresses to muscle-invasive disease. The majority of CIS cases was characterized by a positivity for luminal markers (aberrant cytokeratin (CK) 20 85% (132/156), GATA3 median Remmele score (score of staining intensity (0–3) multiplied with percentage of positive cells (0–4)): 12, estrogen receptor (ER) β Remmele score > 2: 88% (138/156), human epidermal growth factor receptor 2 (Her2) Dako score 3+ 32% (50/156), Her2 Dako score 2+ 33% (51/156)), and marginal expression of basal markers (CK5/6+ 2% (3/156), CK14+ 1% (2/156)). To further investigate phenotypic stability during disease progression, we compared 48 pairs of CIS and invasive tumors from the same biopsy. A highly significant loss of luminal marker expression (p < 0.001) was observed in the course of progression whereas an increase of basal marker expression (p < 0.01) was noted in the invasive compartment. Importantly, 91% of CIS cases demonstrated a positivity for at least one of the two predictive markers Her2 and ERβ, indicating that the analysis of Her2 and ERβ may help to identify CIS-patient subgroups prone to more efficient targeted treatment strategies. Larger prospective and biomarker-embedded clinical trials are needed to confirm and validate our preliminary findings.

https://ift.tt/2vb0OLg

In papillary thyroid carcinoma, expression by immunohistochemistry of BRAF V600E, PD-L1, and PD-1 is closely related

Abstract

Immune checkpoint inhibitor therapies targeting PD-L1/PD-1 have been shown to be effective in treating several types of human cancer. In papillary thyroid carcinoma (PTC), little is known about the expression of PD-L1/PD-1 in the tumor microenvironment or its potential correlation with BRAF V600E mutation status. In this study, we examined the expression of PD-L1, PD-1, and BRAF V600E in PTC by immunohistochemistry and investigated the clinical significance of expression status. We studied the expression of PD-L1, PD-1, and BRAF V600E by immunohistochemical staining in 110 cases of PTC with a diameter > 1 cm. Cases with a background of chronic lymphocytic thyroiditis (CLT) were excluded, as differentiating lymphocytes in the context of CLT from tumor-infiltrating lymphocytes (TILs) is difficult. We classified PD-L1+/PD-1+ expression as type 1 (41%), PD-L1−/PD-1− as type 2 (17%), PD-L1+/PD-1− as type 3 (5%), and PD-L1−/PD-1+ as type 4 (37%). Significant correlations were found between expression of BRAF V600E and that of PD-L1 and PD-1. The positive correlation observed between expression of BRAF V600E and PD-L1/PD-1 suggests that immunotherapies targeting PD-L1/PD-1 might be effective for PTC patients with the BRAF V600E mutation, which are refractory to radioiodine therapy.

https://ift.tt/2HpNFCW

Pathology of idiopathic non-cirrhotic portal hypertension

Abstract

Idiopathic non-cirrhotic portal hypertension is an under-recognized vascular liver disease of unknown etiology, characterized by clinical signs of portal hypertension in the absence of cirrhosis. By definition, any disorder known to cause portal hypertension in the absence of cirrhosis and any cause of chronic liver disease must be excluded to make a diagnosis of idiopathic non-cirrhotic portal hypertension. However, the diagnosis is often difficult because the disease resembles cirrhosis and there is no gold standard test. Liver biopsy is an essential tool: it is able to exclude cirrhosis and other causes of portal hypertension and it allows the identification of the characteristic lesions. Nonetheless, the histological diagnosis of idiopathic non-cirrhotic portal hypertension is not always straightforward, in particular by needle biopsy samples, because there is no pathognomonic lesion, but rather a variety of vascular changes which are unevenly distributed, very subtle, and not all necessarily identified in a single specimen. Pathologists should be able to recognize several patterns of injury, involving portal/periportal areas as well as parenchymal structures.The histological features of idiopathic non-cirrhotic portal hypertension are described in this review, focusing on their interpretation in needle biopsy specimens.

https://ift.tt/2vb0Lz4

Dual JAK1 and STAT3 mutations in a breast implant-associated anaplastic large cell lymphoma

https://ift.tt/2HqnHPG

Postoperative radiotherapy is dispensable for OSCC patients with micrometastases in lymph nodes

Abstract

Lymph node metastasis is a decisive factor for performing postoperative radiotherapy for oral squamous cell carcinoma (OSCC). However, whether OSCC patients with only micrometastasis need postoperative radiotherapy is unclear. In this study, OSCC patients (n = 311) with negative (n = 247), only micrometastasis (n = 44) and macrometastasis (n = 20) were detected and selected by HE staining. Micrometastasis was re-assessed using immunohistochemical staining of cytokeratin (CK) in HE-negative patients to find out the false negative cases. The results indicated that, among the negative lymph node cases (n = 247), the positive rate of CK was 4.94% (n = 12). Besides, the clinical features of the primary tumor in relation to the only micrometastatic status and the value of the postoperative radiotherapy on the only micrometastasis patients were evaluated. Patients with only micrometastasis had higher T stage and inferior worst pattern of invasion (WPOI) than patients without micrometastasis, but they had longer overall survival (OS), metastasis-free survival (MFS), and disease-free survival (DFS) than macrometastasis patients. However, the survival time of only micrometastasis patients with or without postoperative radiotherapy was comparable, even in patients with inferior WPOI. Radiotherapy, however, may only benefit patients with IV/V levels of micrometastasis. These data indicated that postoperative radiotherapy is dispensable for only micrometastasis OSCC patients.

https://ift.tt/2vhVeqy

Interobserver variability in the H&E-based assessment of tumor budding in pT3/4 colon cancer: does it affect the prognostic relevance?

Abstract

Tumor budding is a mostly accepted adverse prognostic factor in colorectal carcinoma. It is on the cusp of a widespread use after agreement was reached recently on uniform assessment criteria. We investigated whether the interobserver variability has a direct influence on the prognostic relevance in pT3/4 colon cancer in the background of different levels of experience of the investigators. In total, six investigators with different levels of experience evaluated tumor budding on H&E slides in 244 cases with primary diagnosed (2002–2011) colon carcinoma (pT3/4, N+/−, M0). High-grade tumor budding/budding grade 3 (defined as majority assessment among the investigators) was significantly associated with an adverse outcome (overall survival p = 0.03, cancer-specific survival p = 0.08) and the occurrence of distant metastasis (p = 0.009). However, a detailed analysis of the rating results of the individual investigators revealed that only ratings of one investigator (advanced resident) were associated with an adverse outcome (p = 0.01 cancer-specific survival, overall survival p = 0.09, distant metastasis p = 0.002). The results of another investigator (consultant) were significantly associated with distant metastasis (p = 0.007). The kappa values among the investigators have a range between 0.077 and 0.357 (median 0.166). Total agreement of all investigators existed in 109 cases (44.7%). Our results demonstrate that the evaluation of tumor budding on H&E slides in pT3/4 colon cancer goes along with a considerable interobserver variability among investigators of different levels of experience. Furthermore, our results reveal that these findings directly influence the prognostic value.

https://ift.tt/2HjOpcO

Role of ancillary techniques in profiling unclassified laryngeal malignancies

Abstract

Laryngeal biopsies, contrary to biopsies from many other sites of the body, very often contain minute amounts of tumour tissue that may consist of morphologically undifferentiated tumour only. In haematoxylin- and eosin-stained sections, there may be no indicative features of what specific tumour entity that is present. In the larynx, particularly small round cell neoplasms, primary or metastatic, often cause a diagnostic dilemma and where an incorrect diagnosis can induce substantial clinical consequences for the patient (e.g., primary neuroendocrine carcinomas vs metastatic variants, certain sarcomas). If sufficient/representative material has been obtained, the application of immunohistochemistry and/or molecular techniques should in virtually every case reveal the true nature of the malignancy. In cases with sparse amount of material, and therefore a limited number of sections to be cut, a careful and thoughtful stepwise approach is necessary to ascertain a reliable diagnosis, or at least guide the clinician to the most likely diagnoses. With today's advanced and widely available technology with an abundance of markers to discriminate different tumours, the use of the term "undifferentiated" should be largely unnecessary. In the exceptional, and indeed exceedingly rare cases, when a classification is not possible, even after repeat biopsy, we suggest that the laryngeal neoplasm is better termed "unclassified malignant neoplasm" rather than "undifferentiated malignant neoplasm".

https://ift.tt/2vhVdTw

Variable X-chromosome inactivation and enlargement of pericentral glutamine synthetase zones in the liver of heterozygous females with OTC deficiency

Abstract

Ornithine transcarbamylase (OTC) deficiency is an X-linked disorder that causes recurrent and life-threatening episodes of hyperammonemia. The clinical picture in heterozygous females is highly diverse and derives from the genotype and the degree of inactivation of the mutated X chromosome in hepatocytes. Here, we describe molecular genetic, biochemical, and histopathological findings in the livers explanted from two female patients with late-onset OTC deficiency. Analysis of X-inactivation ratios by DNA methylation-based assays showed remarkable intra-organ variation ranging from 46:54 to 82:18 (average 70:30, n = 37), in favor of the active X chromosome carrying the mutation c.583G>C (p.G195R), in the first patient and from 75:25 to 90:10 (average 82:18, n = 20) in favor of the active X chromosome carrying the splicing mutation c.663+1G>A in the second patient. The X-inactivation ratios in liver samples correlated highly with the proportions of OTC-positive hepatocytes calculated from high-resolution image analyses of the immunohistochemically detected OTC in frozen sections that was performed on total area > 5 cm². X-inactivation ratios in blood in both female patients corresponded to the lower limit of the liver values. Our data indicate that the proportion of about 20–30% of hepatocytes expressing the functional OTC protein is not sufficient to maintain metabolic stability. X-inactivation ratios assessed in liver biopsies taken from heterozygous females with X-linked disorders should not be considered representative of the whole liver.

https://ift.tt/2HqEcvq

Misses and near misses in diagnosing nodular fasciitis and morphologically related reactive myofibroblastic proliferations: experience of a referral center with emphasis on frequency of USP6 gene rearrangements

Abstract

Although harmless, reactive and benign neoplastic myo-/fibroblastic proliferations represent a diagnostic challenge in routine surgical pathology practice as reflected by their frequency among consultation cases. In addition to resembling each other, the prototypical nodular fasciitis (NF) and NF-like lesions can be mistaken for low-grade or aggressive sarcomas. USP6 translocation was reported recently as the molecular driver and potential diagnostic marker of NF. We reviewed 71 lesions with a diagnosis of NF (n = 48) or NF-like myofibroblastic proliferations (n = 23) and screened them for USP6 translocation by fluorescence in situ hybridization (FISH). Only one third of NFs were correctly diagnosed by submitting pathologists while one third was initially judged as malignant. NF was mentioned in the differential diagnosis in only half of the cases. A high Ki67/mitotic index, misleading immunohistochemistry (false-positive h-caldesmon), and unusual sites/circumscription were main causes behind overdiagnosis as malignant. FISH analysis revealed USP6 translocation in 74.4% of NF cases. None of the reactive/reparative myofibroblastic proliferations showed USP6 translocation. NF is still significantly misdiagnosed by general surgical pathologists, with a higher tendency toward overdiagnosis of malignancy. Inclusion of NF in the differential diagnosis of any fibromyxoid soft tissue lesion and awareness of its diverse morphology are mandatory to avoid misdiagnoses with the risk of disastrous overtreatment. In the appropriate clinicopathological context, USP6 gene translocation is a valuable adjunct for diagnosis of NF, particularly in limited biopsies. Absence of the USP6 gene translocation in NF-like reparative pseudosarcomatous myofibroblastic proliferations underlines their reactive nature and distinguishes them from NF which is currently considered a benign neoplasm with a self-limiting "transient" growth phase.

https://ift.tt/2vhVciq

Prognostic significance of 1p36 locus deletion in adenoid cystic carcinoma of the salivary glands

Abstract

Adenoid cystic carcinoma (AdCC) of the salivary glands is characterized by MYB-NFIB or MYBL1-NFIB fusion, prolonged but relentlessly progressive clinical course with frequent recurrences, and development of distant metastasis resulting in high long-term mortality. Currently, no effective therapy is available for patients with advanced non-resectable and/or metastatic disease. Complicating the clinical management of this patient group is the lack of prognostic markers. The purpose of this study is to investigate the prognostic value of 1p36 loss in patients with AdCC. The presence of 1p36 deletion and gene fusions involving the MYB, NFIB, and MYBL1 genes in a cohort of 93 salivary gland AdCCs was studied using fluorescence in situ hybridization. These results were statistically correlated with clinical data and outcome. Deletion of 1p36 in AdCC was identified in 13 of 85 analyzable cases (15.29%). MYB-NFIB fusion was detected in 57/85 (67.1%), MYBL1-NFIB fusion in 12/85 (14.1%), MYB-X fusion in 4/85 (4.7%), MYBL1-X in 4/85 (4.7%), and NFIB-X in 2/85 (2.4%) of AdCC cases. None of the 1p36-deleted samples showed MYBL1 rearrangement. Statistical analysis demonstrated a significant correlation between 1p36 deletion and advanced tumor stage and solid histology (p = 0.0061 and 0.0007, respectively). Kaplan-Meier survival curves showed statistically significant correlations between 1p36 deletion and decreased overall survival, disease-specific survival, recurrence-free interval, and recurrence-free survival, all of which were maintained in multivariate analysis. We demonstrate that 1p36 deletion can serve as an indicator of unfavorable outcome of patients with salivary gland AdCC.

https://ift.tt/2HkRZTZ

Duodenal histological features in suspected non-celiac gluten sensitivity: new insights into a still undefined condition

https://ift.tt/2vhV96e

Extra-osseous Ewing sarcoma of the pancreas: case report with radiologic, pathologic, and molecular correlation, and brief review of the literature

Abstract

In 2002, due to extensive histomorphologic, immunohistochemical, and cytogenetic similarities, the World Health Organization unified undifferentiated small round blue cell neoplasms of soft tissue and bone (previously segregated as Ewing sarcoma or Primitive Neuroectodermal tumor) into one category: Ewing family of tumors (EFT). Osseous EFT are more common, and while extra-osseous EFT can occur anywhere in the body, those of the pancreas are rare and likely to be seen in the second decade of life in the head of the pancreas. We report the case of a 39-year-old Caucasian male with a large heterogeneously enhancing mass in the pancreatic body. Pathologic examination showed a malignant round blue cell tumor diffusely positive for CD99, chromogranin, and synaptophysin; Ki-67 proliferation index was greater than 80%. FISH showed EWSR1 gene rearrangement in 90% of cells and Archer FusionPlexTM-targeted RNA sequencing analysis identified the EWSR1-FLI1 fusion transcript. The diagnosis of EFT of the pancreas was rendered. Unfortunately, the patient had minimal improvement and was transitioned to oral pain medications to continue care at a different institution.

https://ift.tt/2HlV9Xz

The more the micropapillary pattern in stage I lung adenocarcinoma, the worse the prognosis—a retrospective study on digitalized slides

Abstract

Although the majority of lung adenocarcinomas show mixed pattern, only the predominant component is taken into account according to the novel classification. We evaluated the proportion of different patterns and their impact on overall survival (OS) and disease-free survival (DFS). Patterns were recorded according to predominance and their proportions were rated and calculated by objective area measuring on digitalized, annotated slides of resected stage I lung adenocarcinomas. Spearman's rank correlation, Kaplan-Meier models and the log rank test were used for statistical evaluation. Two hundred forty-three stage I adenocarcinoma were included. Lepidic pattern is more frequent in tumours without recurrence (20 vs. 8%), and lepidic predominant tumours have favourable prognosis (OS 90.5%, DFS 89.4%), but proportions above 25% are not associated with improving outcome. Solid and micropapillary patterns are more frequent in patients with recurrence (48 vs. 5% and 13 vs. 4%) and predominance of each one is associated with unfavourable prognosis (OS 64.1%, DFS 56.3% and OS 28.1%, DFS 28.1%, respectively). Above 25%, a growing proportion of solid or micropapillary pattern is not associated with worsening prognosis. In contrast, tumours having micropapillary pattern as secondly predominant form a different intermediate group (OS 51.1%, DFS 57.8%). Our study was based on measured area of each growth pattern on all available slides digitalized. This is the most precise way of determining the size of each component from the material available. We propose using predominant and secondly predominant patterns for prognostic purposes, particularly in tumours having solid or micropapillary patterns.

https://ift.tt/2vfC4l9

Molecular evidence of JAK2 p.V617F mutated pure erythroid leukemia arising from polycythemia vera

https://ift.tt/2Hn1NwY

Shedding Light on the Reality of Smart Girls

https://ift.tt/2IXKNdH

Menstrual Knowledge and Taboo TV Commercials: Effects on Self-Objectification among Italian and Swedish Women

Abstract

Despite menstruation being a physiological phenomenon in women's life, social research has highlighted that there are still many taboos, also conveyed by advertising, which prevent an open discourse on the topic and can have negative impacts on women's well-being. The present study examined the influence of the exposure to existing TV advertisements for sanitary napkins depicting menstruation as a taboo on self-objectification in women from Italy (n = 160) and Sweden (n = 159). To do so, we also investigated the moderating role of menstrual knowledge in this relationship. Our findings showed that in the Italian sample, exposure to the taboo TV commercial led to more self-objectification especially for participants with lower knowledge of menstruation. These effects did not occur for their Swedish counterparts, showing no differences in self-objectification when women were exposed to the taboo advertisement. The present results are discussed in light of cultural differences in sexual and menstrual education between the two countries. Theoretical and practical implications are drawn.

https://ift.tt/2qwqGMY

A Test of the Three-Component Model of Gender-Based Prejudices: Homophobia and Transphobia Are Affected by Raters’ and Targets’ Assigned Sex at Birth

Abstract

The present study tested a three-component model of homophobia and transphobia that differentiates between general and specifically gender-based social threats that motivate these prejudices. A sample of 187 female and 107 male heterosexual U.S. college undergraduates were randomly assigned to complete survey measures of homophobia and transphobia with either born-female (lesbian and female-to-male transgender, respectively) or born-male (gay man and male-to-female transgender, respectively) targets, as well as measures of religious fundamentalism, right wing authoritarianism, aggression, and ambivalent sexism. The participant by target-gender interaction for transphobia showed that transphobia was particularly high for male participants judging born-male transgender targets. Possibly reflecting a fear of any social non-conformity, religious fundamentalism and right wing authoritarianism were positively correlated with homophobia and transphobia regardless of participant or target gender. Possibly reflecting specific fears among men about threats to male privilege, physical aggression proneness was strongly positively correlated with homophobia and transphobia for men judging a male target. Aggression proneness was also positively correlated with homophobia for women judging a female target. Possibly reflecting specific fears among women about threats to female social roles, benevolent sexism was only positively correlated with transphobia for female but not for male participants, with no target-gender difference. Benevolent sexism was also correlated with homophobia for female participants judging a male target. These findings were largely supportive of the three-component model of gender-based prejudice.

https://ift.tt/2IXKLCB

Her/His Ethics? Managerial Ethics in Moral Decision-Making from a Contextual, Gendered, and Relational Perspective

Abstract

For the last decades, the question of differences in the moral judgments of women and men and the role of an "ethics of care" versus an "ethics of justice" have been debated. The aim of the present study was to explore the gendered aspects of leaders' moral judgments and how they interact with more communal (health/welfare services) versus agentic (banking) organizational contexts. Using qualitative-interpretative analysis, 50 men and women Israeli managers participated in in-depth interviews focused on the ways they construct, understand, and react to ethical work dilemmas. Results suggested that both gender and organizational context contributed to shaping the managers' understandings and decisions regarding the ethical dilemmas in their work. Additionally, the relational target of the dilemma (i.e., clients, employees, supervisors) and situational variables (e.g., ambiguity) affected their moral judgments. Although feminist scholars often have claimed that the ethics of care is excluded from organizational discourse, our findings show that the ethics of care is a significant model for understanding managerial moral judgments. We discuss implications for managers and consultants regarding training of responsible leaders who can represent different moral orientations in their work with multiple stakeholders.

https://ift.tt/2qxuAFs

Responding to Sexual Objectification: The Role of Emotions in Influencing Willingness to Undertake Different Types of Action

Abstract

Women may respond to being sexual objectified in different ways, such as confronting the perpetrator, ignoring the action, blaming oneself or considering the action as flattering. However, there has been little research looking at what predicts each of these different responses. The present research assessed the role of emotions in promoting and deterring different anticipated responses to sexual objectification. In both Studies 1 (n = 189) and 2 (n = 187), female participants were asked to imagine themselves in a situation where they received an inappropriate sexual comment. Participants then rated the emotions they believed they would feel and how they thought they would act in the situation. I found that expecting feelings of anger resulted in women thinking they would confront the perpetrator (i.e., undertake an active response) and that expecting disgust negatively predicted the belief that they would view the action as flattering (i.e., anticipate a benign response). By contrast, expecting shame resulted in women believing they would blame themselves (i.e., undertake a self-blame response). Study 2 also found that expecting pride was positively associated with anticipating a benign response. These findings suggest that the emotions that women expect to feel influence their anticipated responses to sexual objectification. It is, therefore, important to consider the emotional reactions that women have to instances of sexual objectification.

https://ift.tt/2EMxH0c

Empowering Mimicry: Female Leader Role Models Empower Women in Leadership Tasks Through Body Posture Mimicry

Abstract

In two studies we investigated the behavioral process through which visible female leader role models empower women in leadership tasks. We proposed that women tend to mimic the powerful (open) body postures of successful female role models, thus leading to more empowered behavior and better performance on a challenging leadership task, a process we called empowering mimicry. In Study 1, we experimentally manipulated the body posture of the male and female role models and showed that 86 Swiss college women mimicked the body posture of the female (ingroup) but not the male (outgroup) role model, thus leading to more empowered behavior and better performance on a public speaking task. In Study 2, we investigated the boundary conditions of this process and showed that empowering mimicry does not extend to exposures to non-famous female models among 50 Swiss college women. These findings suggest that nonverbal mimicry is one important mechanism through which female leader role models inspire women performing a challenging leadership task. From a practice perspective, our research underscores the importance of female leaders' visibility because visibility can drive other women's advancement in leadership by affording women the opportunity to mimic and be empowered by successful female role models.

https://ift.tt/2qzFsCw

Examining the Roles of Self-Objectification and Appearance Expectations in Young Women’s Indoor Tanning Behavior

Abstract

Indoor tanning among U.S. young women is a major public health concern that increases risk for skin cancer. Many young women engage in indoor tanning despite the risks, and prior evidence suggests that appearance-related motivations for tanning may outweigh health concerns. The present study examined appearance expectations as a mediator of the association between young women's self-objectification and indoor tanning behavior. Emerging adult college women (n = 332, 18–19-years-old; 66.9% White) provided reports of their self-objectification (operationalized as body surveillance), appearance-related tanning expectations, body esteem, and indoor tanning behavior. Results revealed that higher levels of self-objectification were indirectly associated with women's higher likelihood of indoor tanning. This association was mediated by positive appearance expectations for tanning. These associations appeared to be robust: The mediational model was significant whether body esteem was included as a control variable or not; whether the behavioral outcome was lifetime or past-year indoor tanning; and whether the sample included only White participants or was ethnically heterogeneous. Results suggest that young women who more frequently engage in self-objectification are more likely to engage in indoor tanning and that this association is explained in part by young women's positive appearance-related expectations for tanning. Furthermore, the findings point to indoor tanning as an important and understudied correlate of self-objectification. A deeper understanding of women's appearance-related motivations to tan may in turn facilitate the development of more effective interventions for this high-risk behavior, which remains troublingly common among young women in the United States.

https://ift.tt/2EMEOpx

Narratives of Israeli Women in Retirement: Rewriting the Gender Contract

Abstract

In the present study, we analyze how older Israeli women narrate, make sense of, and negotiate their lives after retirement. By center-staging women in their life periods of after-care work and paid work, we join emerging feminist research that aims at correcting the middle-age bias in gender studies and the gender bias in retirement studies. We conducted semi-structured in-depth interviews with 20 Israeli Jewish heterosexual women of varied class backgrounds who retired in the last 10 years. Conceptualizing retirement as an embedded experience and using the concept of gender contract as an analytical tool, we highlight how retired women employed two contradictory discourses, familial and individualistic, both prominent in the Israeli context, to renegotiate and rewrite the gender contract. They did so by constituting themselves as autonomous and independent subjects whose past devotion to others alongside their arduous labor has granted them the right to space and time of their own. They also redefine their maternal role so they keep their motherly duties to help "as much as needed" but on their own terms. Our study shows that putting older women at the center requires rethinking existing concepts. It reveals that individualism as a meaning system is not relevant to all equally, rather it depends on the intersection of a person's gender with stage in life, and that the gender contract varies not only by geographical and social location but also across the life-course.

https://ift.tt/2qyuayt

Gender, Masculinity Threat, and Support for Transgender Rights: An Experimental Study

Abstract

We explore how gender, attitudes about traditional gender roles, and threats to masculinity and femininity affect U.S. participants' support for transgender rights. First, we present analyses using data from the 2016 pilot survey of the American National Election Survey (ANES) showing how men and women differ in their attitudes toward transgender people as measured by thermometer ratings toward transgender people and questions about perceptions of whether they are victims of discrimination. Next, we describe our randomized laboratory experiment, testing three hypotheses/predictions: (a) that men are less supportive of transgender people and rights than women are, (2) that threatening a man's masculinity increases opposition to transgender rights whereas threatening a woman's femininity has no effect, and (3) that this effect will be stronger among men who report that their gender identity is very important to them. Consistent with existing scholarship, we find that women are more supportive of transgender rights compared to men. More importantly, we also find that threatened masculinity is an even better predictor of opposition to transgender rights than gender identity. In short, we find that attitudes toward transgender people and rights are closely linked with the way people think and feel about their own gender identity and expectations of gender performance.

https://ift.tt/2ISplH5

Editorial Board

https://ift.tt/2ENxGsW

The Value and Significance of 25(OH) and 1,25(OH) vitamin D serum levels in adult coeliac patients: A review of the literature

Within the wide spectrum of symptoms and alteration of systems that characterizes CeD, several studies indicate a low-level of vitamin D, therefore recent guidelines suggest its evaluation at the time of diagnosis. This review examines the data from existing studies in which vitamin D has been assessed in CeD patients. Our review indicates that most of the studies on vitamin D in adult CeD report a 25 (OH) vitamin D deficiency at diagnosis that disappears when the patient goes on a gluten-free diet, independently of any supplementation.

https://ift.tt/2JMF7oi

Entecavir Or Tenofovir Monotherapy Prevents HBV Recurrence In Liver Transplant Recipients: A 5-Year Follow-Up Study After Hepatitis B Immunoglobulin Withdrawal

Recent data suggest that oral third-generation nucleos(t)ide analogs (NA) monoprophylaxis following hepatitis B immunoglobulin (HBIg) withdrawal may be effective to prevent HBV reinfection after liver transplantation (LT).

https://ift.tt/2EMsyFz

THE EPIDEMIOLOGY OF BUDD-CHIARI SYNDROME IN FRANCE

Epidemiological data is lacking on primary Budd-Chiari syndrome (BCS) in France.

https://ift.tt/2JITkSS

Acomparison study between Magniview high definition white light endoscopy in detecting villous atrophy coeliac disease: A single centre pilot study

Coeliac disease may be missed at gastroscopy. We aimed to assess the sensitivity of Pentax optical zoom technology endoscopes in detecting duodenal villous atrophy and the ease of image interpretation by non-coeliac specialists.

https://ift.tt/2IVMvMA

The effect of small or diminutive adenomas at baseline colonoscopy on the risk of developing metachronous advanced colorectal neoplasia: KASID multicenter study

The clinical significance of diminutive or small adenomas remains ill defined.

https://ift.tt/2JMEXgG

FAECAL HIGH MOBILITY GROUP BOX 1 IN CHILDREN WITH CELIAC DISEASE: A PILOT STUDY.

Celiac disease (CD) is a gluten-related immunological disorder resulting in inflammatory enteropathy.

https://ift.tt/2EMEneW

Is immediate postoperative fibrosis-4 really a good predictor of liver failure following hepatocellular carcinoma curative surgery?

https://ift.tt/2JHCMLf

Comparison of Efficacy of Colonoscopy between the Morning and Afternoon: A Systematic Review and Meta-Analysis

Colonoscopy performed in the afternoon, rather than morning, has been reported to be associated with lower rates of adenoma and polyp detection (ADR and PDR) and cecal intubation (CIR). This meta-analysis evaluated the efficacy of afternoon colonoscopy relative to morning colonoscopy.

https://ift.tt/2EM9SG0

Endoscopic Papillary Large Balloon Dilation in patients with large biliary stones and periampullary diverticula: results of a multicentric series

Stone extraction represents the most frequent indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic papillary large balloon dilation (EPLBD) is a recent introduced approach consisting of an endoscopic papillary large balloon dilation following limited endoscopic sphyncterotomy (ES), wich has been proven to be safe and effective for extraction of large common bile duct (CBD) stones. Peri-ampullary diverticula (PAD) are described in 10–20% of patients undergoing ERCP. Aim of our study is to evaluate efficacy and safety of EPLBD for the extraction of large biliary stones in patients with PAD.

https://ift.tt/2JMEV8y

COMBINED MULTICHANNEL INTRALUMINAL IMPEDANCE AND pH MONITORING IS HELPFUL IN MANAGING CHILDREN WITH SUSPECTED GASTRO-OESOPHAGEAL REFLUX DISEASE

Gastro-oesophageal reflux is very common in the paediatric age group. There is no single and reliable test to distinguish between physiologic and pathological gastro-oesophageal reflux, and this lack of clear distinction between disease and normal can have a negative impact on the management of children.

https://ift.tt/2IY5QwR

Endoscopic Treatment of Anastomotic Leaks — A Tailored Approach

https://ift.tt/2JMVn8r

Different biochemical patterns in Type II and Type III mixed cryoglobulinemia in HCV positive patients

Reversible cryoprecipitability of proteins is observed as a concomitant feature of immune complex formation. Mixed cryoglobulinemia (MC) is systemic vasculitis, associated with mixed IgM and IgG cryoglobulins (CGs) showing rheumatoid factor (RF) activity. It is frequently associated with hepatitis C virus (HCV). This study investigates the presence of IgG RF and anti-nuclear antibodies (ANA) in cryoprecipitates of patients with Type III and Type II MC, to understand the biochemical patterns associated with different types of MC to a greater degree.

https://ift.tt/2EMTZz7

Adherence to quality criteria improves concordance between transient elastography and ElastPQ for liver stiffness assessment — a multicenter retrospective study

Assessment of liver stiffness provides important diagnostic and prognostic information in patients with chronic liver disease.

https://ift.tt/2JJtrCy

Corrigendum to “Differences in liver stiffness values obtained with new ultrasound elastography machines and fibroscan: A comparative study” [Dig. Liver Dis. 49 (2017) 802–808]

The authors wish to inform readers of the below error:

https://ift.tt/2EModSW

Food, microbiome and colorectal cancer

You are what you eat. This adage has been confirmed by many studies demonstrating the high impact of nutrition on risk of cardiovascular diseases, many malignancies and other diseases. Dietary factors are of major relevance in the evolution of colorectal carcinoma. Various aspects are involved in colorectal carcinoma pathogenesis including genetics, lifestyle, age, chronic inflammation and others. It has only recently been recognized that the gut microbiota might reflect an important missing link in the interaction between diet and subsequent colorectal carcinoma development.

https://ift.tt/2JNTmJ8

USEFULNESS OF CONTRAST-ENHANCED ULTRASOUND (CEUS) IN INFLAMMATORY BOWEL DISEASE (IBD)

Intestinal ultrasonography has emerged as a cheap, non-invasive and readily accessible modality for the assessment of a number of gastroenterological diseases. Over the last decade, particularly due to the widespread use of biological agents in Inflammatory Bowel Disease (IBD), guidelines regarding management and follow-up advise more regular disease assessment and surveillance in order to guide treatment adjustments, and provide more personalised care. Given the young age of the majority of patients with IBD the availability of an alternative modality to harmful radiation or the risks of endoscopy for this indication offers an appealing advantage.

https://ift.tt/2IYdd7x

Comment on “Correlation of CT indicators of NSCLC and pathological features and the expression level of p53 and c-myc”

L'articolo Comment on "Correlation of CT indicators of NSCLC and pathological features and the expression level of p53 and c-myc" sembra essere il primo su European Review.

https://ift.tt/2veJs0h

MiR-137 attenuates spinal cord injury by modulating NEUROD4 through reducing inflammation and oxidative stress

OBJECTIVE: To explore the role of microRNA (miR) 137 in spinal cord injury and its mechanism.

MATERIALS AND METHODS: The model of spinal cord injury in mice was established to detect the recovery differences of grip strength in upper and lower limbs of mice. The expressions of miR-137 and neuronal differentiation 4 (NEUROD4) were detected at the same time. The inflammation level and the oxidative stress response after spinal cord injury were subsequently detected after overexpression of miR-137. Target genes of miR-137 were identified by bioinformatics. Finally, dual-luciferase reporter gene assay was used to identify the target genes of miR-137.

RESULTS: By establishing the model of spinal cord injury in mice, the strength of upper and lower limbs recovered after 7 days of injury in mice. The expression of miR-137 in spinal cord injury was found to decrease in a time-dependent manner by quantitative Real-time polymerase chain reaction (qRT-PCR), while the expression of NEUROD4 gradually increased. Inflammation indicators and oxidative stress level were found to be significantly higher after spinal cord injury. However, the inflammation level and oxidative stress were significantly reduced after transfection of miR-137. Finally, we predicted the target gene of miR-137 through bioinformatics website and found that NEUROD4 was a potential target gene of miR-137. Using dual luciferase reporter assays, we found that NEUROD4 bound to miR-137. After overexpression of miR-137, the expression of NEUROD4 was significantly reduced. Overexpression of NEUROD4 could promote spinal cord injury inflammation and oxidative stress. After intracellular transfection of NEUROD4 and miR-137 at the same time, the inflammation level and oxidative stress of spinal cord injury decreased significantly.

CONCLUSIONS: These results suggested that miR-137 promoted the recovery of spinal cord injury by degrading NEUROD4 to relieve the spinal cord inflammation and the progression of oxidative stress, thus promoting the recovery of spinal cord injury.

L'articolo MiR-137 attenuates spinal cord injury by modulating NEUROD4 through reducing inflammation and oxidative stress sembra essere il primo su European Review.

https://ift.tt/2HoefMQ

Expression of nitric oxide synthase in the retina of monocular deprivation amblyopia rats

OBJECTIVE: Amblyopia or lazy eye is a common visual problem affecting children that cannot correct with lenses. Nitric oxide synthase (NOS) is a critical enzyme that regulates the activity of nitric oxide (NO), a key signaling molecule with multiple roles in many tissues. Among its many activities, NOS has been proposed to be required for normal eye development and altered NOS expression can lead to perturbations in eye development and vision.

MATERIALS AND METHODS: To examine the potential role of neuronal NOS (nNOS) in vision loss, we generated a model of monocular deprivation amblyopia in rats. After suturing one eye, we examined several parameters of neural activity and nNOS expression in the retina 7, 14 and 28 days later.

RESULTS: We found the rapid and progressive loss of neural activity in the retina of sutured eyes compared to non-treated and control eyes. The sutured eyes also showed decreased expression of nNOS at the protein and mRNA levels, indicating a strong correlation between nNOS expression and retina activity.

CONCLUSIONS: These data suggest a potential role for nNOS activity in vision loss, opening potential avenues for therapeutic intervention.

L'articolo Expression of nitric oxide synthase in the retina of monocular deprivation amblyopia rats sembra essere il primo su European Review.

https://ift.tt/2vfN55N

Psychometric Properties of the Canadian Nurse Informatics Competency Assessment Scale

Assessment of nursing informatics competencies has gained momentum in the scholarly literature in response to the increased need for resources available to support informatics capacity in nursing. The purpose of this study was to examine the factor structure and internal consistency reliability of the Canadian Nurse Informatics Competency Assessment Scale, a newly developed 21-item measure based on published entry-to-practice informatics competencies for RNs. For this study, 2844 nurses completed the Canadian Nurse Informatics Competency Assessment Scale through a cross-sectional survey. Exploratory principal component analysis with oblique promax rotation revealed a four-component/factor structure for the 21-item Canadian Nurse Informatics Competency Assessment Scale, explaining 61.04% of the variance. Item loading per each component reflected the original Canadian Association of Schools of Nursing grouping of nursing informatics competency indicators, as per three key domains of competency: information and knowledge management (α = .85); professional and regulatory accountability (α = .81); and use of information and communication technology in the delivery of patient care (α = .87) with the exception of one item (Indicator 3), which loaded into the category of foundational information and communication technology skills (α = .81). This study provided preliminary evidence for the construct validity of the entry-to-practice competency domains and the factor structure and reliability of the Canadian Nurse Informatics Competency Assessment Scale among practicing nurses. Further testing among nurses in other settings and among nursing students is recommended. Dr Kleib received an establishment grant from the Faculty of Nursing at the University of Alberta in support of her research program. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Corresponding author: Manal Kleib, PhD, RN, Faculty of Nursing, 5-112 Edmonton Clinic Health Academy, 11405 87 Ave, University of Alberta, Edmonton, Alberta, Canada T6G 1C9 (manal.kleib@ualberta.ca). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2vhTkWW

Ontology Development for Patient Education Documents Using a Professional- and Patient-Oriented Delphi Method

Written patient education materials are essential to motivate and help patients to participate in their own care, but the production and management of a large collection of high-quality and easily accessible patient education documents can be challenging. Ontologies can aid in these tasks, but the existing resources are not directly applicable to patient education. An ontology that models patient education documents and their readers was constructed. The Delphi method was used to identify a compact but sufficient set of entities with which the topics of documents may be described. The preferred terms of the entities were also considered to ensure their understandability. In the ontology, readers may be characterized by gender, age group, language, and role (patient or professional), whereas documents may be characterized by audience, topic(s), and content, as well as the time and place of use. The Delphi method yielded 265 unique document topics that are organized into seven hierarchies. Advantages and disadvantages of the ontology design, as well as possibilities for improvements, were identified. The patient education material ontology can enhance many applications, but further development is needed to reach its full potential. The permission for the study was granted by Hospital District of Southwest Finland (decision #71/2012). The Delphi participants received written information about the study and were informed of their right to refuse to participate or to withdraw their consent at any time. This study was conducted as part of the activities of the IKITIK consortium and funded by the Academy of Finland (funding decision #139884 and #140323) and the Finnish Funding Agency for Innovation (project #644/31/15). Project #644/31/15 was cofunded by BCB Medical Oy, Fujitsu Finland Oy, and Lingsoft Oy. The funding bodies were not involved in the design or execution of the study or in preparing the manuscript. This work was conducted using the Protégé resource, which is supported by grant GM10331601 from the National Institute of General Medical Sciences of the US National Institutes of Health. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Corresponding author: Juho Heimonen, MSc, Department of Future Technologies, 20014 Turun yliopisto, Finland (juho.heimonen@utu.fi). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2HjAgMT

A Woman with Black Beads in Her Stomach: Severe Gastric Ulceration Caused by Yttrium-90 Radioembolization

Radioembolization (RE) is a selective internal radiation therapy (SIRT) delivering targeted, high-dose, intra-arterial radiation directly to the vascular supply of liver tumors. Complications can occur due to aberrant deposition or migration of radiation microspheres into nontarget locations, including normal hepatic parenchyma, lungs, pancreas, and upper gastrointestinal (UGI) tract. We report a case of gastric ulcers due to yttrium-90 (90Y) seed migration to the stomach to alert clinicians to this rare cause of gastric injury. A 57-year-old woman with stage IV breast cancer with liver and lung metastases presented to the hospital with 2 months of worsening nausea and vomiting. Two months prior, she had received SIRT with 90Y microspheres without complications. Upper GI endoscopy showed diffuse gastritis and extensive antral ulceration. Biopsies revealed black, spherical foreign bodies, consistent with 90Y microspheres, documenting radiation injury. Radiation-induced UGI ulceration is caused by direct radiation injury from beta-radiation. Delay in diagnosis may be due to the nonspecificity of symptoms and temporal delay of symptom onset from SIRT, which was 2 months in our patient. Also, complaints may be attributed erroneously to adjuvant chemotherapy or widespread metastatic disease. Clinicians must consider radiation-associated toxicity in any SIRT-treated patient developing abdominal symptoms.

https://ift.tt/2EMljxi

Technologies to monitor the health of loaded skin tissues

There are many situations where the skin and underlying soft tissues are compromised by mechanical loading in the form or pressure, or pressure in combination with shear. If sustained, this can lead to damage ...

https://ift.tt/2H0rdkD

Quantitative MR thermometry based on phase-drift correction PRF shift method at 0.35 T

Noninvasive magnetic resonance thermometry (MRT) at low-field using proton resonance frequency shift (PRFS) is a promising technique for monitoring ablation temperature, since low-field MR scanners with open-c...

https://ift.tt/2qwKXRR

Electrical performance of PEDOT:PSS-based textile electrodes for wearable ECG monitoring: a comparative study

Wearable textile electrodes for the detection of biopotentials are a promising tool for the monitoring and early diagnosis of chronic diseases. We present a comparative study of the electrical characteristics ...

https://ift.tt/2GYHtCx

Incidence, Prevalence, and Survival of Patients with Idiopathic Pulmonary Fibrosis in the UK

Abstract

Introduction

Recent developments in the care of patients with idiopathic pulmonary fibrosis have the potential to improve survival rates. Population-based estimates of the current disease burden are needed to evaluate the future impact of newly approved therapies. The objective of this study is to describe incidence, prevalence, and survival of idiopathic pulmonary fibrosis patients in the UK.

Methods

Between 2000 and 2012, a patient cohort (N = 9,748,108), identified from Clinical Practice Research Datalink primary care data, was used to identify incident and prevalent cases of idiopathic pulmonary fibrosis–clinical syndrome. Incident cases were followed up to identify deaths. Poisson and Cox regressions were used to calculate incidence rate ratios (IRR) and hazard ratios for mortality, respectively. Adjustments were made for age, gender, and strategic health authority. Survival from diagnosis was estimated using Kaplan–Meier analysis.

Results

In total 1491 and 4527 incident cases were identified using narrow and broad idiopathic pulmonary fibrosis–clinical syndrome definitions, respectively. Incidence and prevalence increased during the study. Compared with 2000, a near 80% increase in incidence was observed by 2012 [IRR 1.78 (95% CI 1.50–2.11; broad definition)], despite an observed decrease using the narrow definition [0.50 (0.38–0.65)]. Median survival was 3.0 years (95% CI 2.8–3.1) and 2.7 years (95% CI 2.5–3.0) in broad (n = 2168) and narrow case sets (n = 996), respectively. No significant changes in survival were observed.

Conclusions

Idiopathic pulmonary fibrosis incidence rates have increased since 2000 and survival remains poor. These results provide a benchmark against which the effects of future treatment changes can be measured.

Funding

InterMune UK and Ireland (now part of F. Hoffman La Roche).

https://ift.tt/2qxiMTp

A Review of the Clinical Usefulness of Selective Laser Trabeculoplasty in Exfoliative Glaucoma

Abstract

In the last decade, selective laser trabeculoplasty (SLT) has been commonly used in the management of several different types of glaucoma, as either primary or adjunct therapy. The technique has an excellent safety profile and is at least as effective as argon laser trabeculoplasty. Although the actual mechanism of action of SLT remains unclear, evidence has shown that it does not induce morphologically evident trabecular meshwork alterations. SLT's non-disruptive mode of action offers the advantage of repeatability. Exfoliation glaucoma (XFG) is a secondary open-angle glaucoma with unfavorable intraocular pressure (IOP) characteristics, which typically carries a poorer long-term prognosis than primary open-angle glaucoma. Consequently, patients with XFG often need multiple medications to achieve IOP levels that prevent disease progression. Because complicated pharmacotherapy regimens undermine the long-term tolerability and compliance of patients with XFG, options such as SLT may decrease the burden of multiple therapies and ultimately improve prognosis. In fact, SLT may be a particularly attractive option in XFG because the pigment-laden trabecular tissue of these patients enhances the absorption of laser energy and thus augments the biologic effects induced by this treatment. The current article reviews the postulated mechanisms of action of SLT, discusses practical aspects of SLT therapy, and examines selected peer-reviewed literature pertaining to the clinical usefulness of this modality in XFG patients.

https://ift.tt/2EMCfDV

Decline in Buprenorphine/Naloxone Prescriptions in a State Medicaid Population Following Formulary Conversion from Suboxone to Bunavail

Abstract

Introduction

A large, statewide, fee-for-service Medicaid plan recently (October 2015) executed a complete switch from sublingual buprenorphine–naloxone [(SLBN), Suboxone^®] to buccal buprenorphine–naloxone [(BBN), Bunavail^®] on its preferred drug formulary. This complete formulary switch provided an opportunity to assess dynamic changes in prescribing patterns, patient/physician acceptance, and indices of potential misuse/diversion.

Methods

For the period January 1, 2015 through December 31, 2016, two datasets were analyzed: prescriptions and associated costs for buprenorphine–naloxone (BN) products and urine toxicology test results for patients in the Medicaid plan. The dataset comprised 1370 unique providers ordering 643,225 prescriptions for opioid addiction therapy. Patient and order volumes, and the rate of monthly positive laboratory values for opioid molecules and cocaine were reviewed. A targeted survey of physicians treating opioid-dependent patients with state Medicaid plan coverage was also conducted.

Results

Upon plan conversion to BBN, there was a rapid increase in monthly BBN prescriptions mirrored by a rapid decrease in SLBN prescriptions. Peak in BBN prescriptions (2633 in November 2015) was approximately 60% lower than peak in SLBN prescriptions (6531 in July 2015). An unexpected finding was a 68% reduction of the overall BN market, indicating that many BN prescriptions were abandoned. The reduction was associated with quarterly cost savings to the Medicaid plan of approximately $3.5 million. Toxicology results indicated a reduction in drug positivity (defined as positivity for cocaine and/or any opioids except buprenorphine and methadone) from 13–16% in 2015 to less than 10% in 2016. Heroin positivity decreased from approximately 9% in December 2015 to an average of less than 1% during the last quarter of 2016, while positivity for norbuprenorphine, the major metabolite of buprenorphine, showed a marked increase in 2016 vs 2015. Among physicians who responded to the targeted survey most rated BBN as more difficult to abuse or misuse than SLBN.

Conclusion

The rapid reduction in the overall BN market following a complete formulary switch from SLBN to BBN was associated with quarterly savings of $3.5 million for the state Medicaid plan. Toxicology data suggest that this cost saving was realized in the context of improved physician and patient adherence to treatment protocols. The changing market dynamics can potentially be explained by a number of contributory factors, including a reduction of diversion and illicit distribution of BN following formulary conversion. These results are considered hypothesis-generating and future research should systematically compare the propensity for diversion and abuse of BN products using various epidemiological tracking tools.

Funding

BioDelivery Sciences International, Inc.

https://ift.tt/2qw0MZI

Correction to: Recognizing Gynecological Cancer in Primary Care: Risk Factors, Red Flags, and Referrals

The article "Recognizing Gynecological Cancer in Primary Care: Risk Factors, Red Flags, and Referrals", written by Garth Funston, Helena O'Flynn, Neil A. J. Ryan, Willie Hamilton, Emma J. Crosbie was originally published electronically on the publisher's internet portal (currently Springer-Link) on March 07, 2018 without open access.

https://ift.tt/2IY9R4r

Impact of a Health Management Program on Healthcare Outcomes among Patients on Augmentation Therapy for Alpha 1-Antitrypsin Deficiency: An Insurance Claims Analysis

Abstract

Introduction

Alpha 1-antitrypsin deficiency (AATD) is a genetic disorder which reduces serum alpha 1-antitrypsin (AAT or alpha1-proteinase inhibitor, A1PI) and increases the risk of chronic obstructive pulmonary disease (COPD). Management strategies include intravenous A1PI augmentation, and, in some cases, a health management program (Prolastin Direct^®; PD).

Objectives

This study compared clinical and economic outcomes between patients with and without PD program participation.

Methods

This retrospective study included commercial and Medicare Advantage health insurance plan members with ≥ 1 claim with diagnosis codes for COPD and ≥ 1 medical or pharmacy claim including A1PI (on index date). Outcomes were compared between patients receiving only Prolastin^® or Prolastin^®-C (PD cohort) and patients who received a different brand without PD (Comparator cohort). Demographic and clinical characteristics were captured during 6 months pre-index. Post-index exacerbation episodes and healthcare utilization and costs were compared between cohorts.

Results

The study sample comprised 445 patients (n = 213 in PD cohort; n = 232 in Comparator cohort), with a mean age 55.5 years, 50.8% male, and 78.9% commercially insured. The average follow-up was 822 days (2.25 years), and the average time on A1PI was 747 days (2.04 years). Few differences were observed in demographic or clinical characteristics. Adjusting for differences in patient characteristics, the rate of severe exacerbation episodes was reduced by 36.1% in the PD cohort. Adjusted total annual all-cause costs were 11.4% lower, and adjusted mean respiratory-related costs were 10.6% lower in the PD cohort than the Comparator cohort. Annual savings in all-cause total costs in the PD cohort relative to the Comparator cohort was US$25,529 per patient, largely due to significantly fewer and shorter hospitalizations.

Conclusions

These results suggest that comprehensive health management services may improve both clinical and economic outcomes among patients with COPD and AATD who receive augmentation therapy.

Funding

Grifols Shared Services of North America, Inc.

https://ift.tt/2qwTkNN

Factors predictive of neoadjuvant versus adjuvant chemoradiotherapy in locally advanced rectal cancer and the impact on overall survival

Abstract

Objectives

We investigated the effect of neoadjuvant versus adjuvant chemoradiotherapy on overall survival as well as the impact of demographic and clinical factors for the selection of each approach utilizing the National Cancer Data Base.

Methods

Adult patients with stage II and stage III adenocarcinoma of the rectum diagnosed from 2004 to 2013 were included. Chi-square analysis was used to compare demographic variables and clinical stage between the patients receiving neoadjuvant and adjuvant chemoradiotherapy. Univariate and multivariate logistic regression modeling was used to identify factors predictive of each treatment strategy. Kaplan-Meier and log-rank analysis and Cox proportional hazard modeling along with propensity score matching using variables known at the time of treatment sequence decision was performed to determine the effect on survival. A separate survival analysis was conducted including margin status to illustrate its effect on survival relative to adjuvant or neoadjuvant chemoradiation therapy.

Results

A total of 20,114 patients were identified: 17,612 (87.6%) received neoadjuvant chemoradiotherapy. Factors associated with receipt of neoadjuvant chemoradiotherapy on multivariate analysis include the following: income greater than $46,000 (p < 0.01), treatment at an academic institution (p < 0.01), living greater than 50 miles from the treatment facility (p < 0.01), and year of diagnosis (p < 0.01). Compared to adjuvant chemoradiotherapy, neoadjuvant chemoradiotherapy was associated with a decreased risk of death on multivariate analysis (p = 0.05). When taking margin status into account, margin positivity in neoadjuvant chemoradiotherapy (NCRT) patients was shown to be a poor prognostic factor. Margin-negative NCRT patients had improved survival compared to margin negative adjuvant chemoradiotherapy (ACRT) patients.

Conclusions

The use of neoadjuvant chemoradiotherapy for locally advanced rectal cancer is possibly associated with an overall survival benefit compared to ACRT subject to the limitations of this analysis. Margin status affects survival greatly.

https://ift.tt/2Hr4ICk