Medicine by Sfakianakis G. Alexandros: 11/25/18

Sunday, November 25, 2018

Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Rhinology. 2018 Nov 24;:

Authors: Lundberg M, Haapaniemi A, Hagstrom J, Juteau S, Hernberg M, Makitie AA, Vento SI

Abstract
BACKGROUND: To describe a cohort of sinonasal mucosal melanoma (SNMM) patients, and to assess if choice of surgical approach (open versus endoscopic) has impact on survival.
METHODOLOGY: Adequate data on clinical presentation, treatment, and recurrence pattern were available for 58 consecutive patients treated for SNMM at the Helsinki University Hospital (HUH) between 1983 and 2016.
RESULTS: The 5-year disease-specific survival (DSS) was 27% and overall survival 25% for the whole cohort. The 3-year DSS for patients treated with curative intent with endoscopic surgery was comparable to open surgery (56% and 51%, respectively). Patients with tumours arising from the paranasal sinuses and patients with Stage IV disease had significantly worse prognosis compared with other locations and Stage III patients. All patients who had disease persistence at three months after primary treatment succumbed to SNMM. Post-operative radiotherapy did not affect survival significantly, but a trend towards improved local control was observed.
CONCLUSIONS: Local control after endoscopic surgery was comparable to open surgery. Small tumours without local or locoregional spread had improved prognosis, independent of surgical approach. Disease persistence after treatment with curative intent led to death invariably.

PMID: 30471227 [PubMed - as supplied by publisher]

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Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Rhinology. 2018 Nov 24;:

Authors: Reychler G, Domachowski C, Latiers AC, Jamar F, Rombaux P

Abstract
BACKGROUND: Treatment of chronic rhinosinusitis (CRS) aims to treat the underlying inflammation or infection. Although the optimal modality of administration remains controversial, inhalation route is usually preferred. The aim of this systematic review was to summarize the efficacy of intranasal corticoisteroids or antibiotics delivery by nebulization on symptoms, histology, endoscopy scores, nasal obstruction, clinical outcomes and quality of life in CRS.
METHOD: This systematic review followed the PRISMA guidelines. Randomized controlled, comparative and cohort studies evaluating effects of treatment by nebulization in sinusitis were identified and reviewed from two databases (PubMed and Scopus). Two reviewers independently assessed study quality and reviewed the selected studies.
RESULTS: 600 references were retrieved and 12 studies evaluating 377 patients were included in the systematic review. Different devices were used. Efficacy of nasal delivery by nebulization was systematically observed on symptoms and size of polyps and frequently on inflammatory parameters in all studies. The presence of polyps improved the efficacy of the nebulization. This way of delivery appears not convincing regarding antibiotics. Few side effects were noted in the retrieved studies and only for nebulized antibiotics.
CONCLUSIONS: This systematic review highlighted that based on the present literature nebulization is not better than nasal spray to the delivery of corticosteroids due to the positive results on symptoms, endoscopic appearance and histological outcomes. For antibiotics delivery, the nebulization is not of added value.

PMID: 30471226 [PubMed - as supplied by publisher]

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Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Rhinology. 2018 Nov 24;:

Authors: Lee EJ, Hwang CS, Kim KS

Abstract
BACKGROUND: Several previous studies have shown that serum 25(OH)D deficiency is associated with increased risk of chronic rhinosinusitis (CRS) in adults and also correlated with disease severity. We aimed to investigate the correlation between serum 25(OH)D level and endoscopy-based CRS in adults using the Korean National Health and Nutrition Examination Survey.
METHODS: The data were based on the Korean National Health and Nutrition Examination Survey from 2008 to 2011. Diagnosis of endoscopy-based CRS was based on endoscopic findings of mucopurulent rhinorrhea in the middle meatus or nasal polyps, with nasal symptoms satisfying symptom-based CRS based on European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria. Nasal symptoms included nasal obstruction, anterior/posterior nasal drip, facial pain, and the loss of smell. Serum 25(OH) D level was defined as deficient (less than 20 ng/mL), insufficient (20-29.9 ng/mL), or sufficient (less than or equal to 30 ng/mL).
RESULTS: The serum 25(OH)D level in the CRS group was 19.293 'plus or minus' 7.035 ng/mL, which was higher than that of the control group (18.057 'plus or minus' 6.56 ng/mL, p = 0.0072). Among symptom combinations of endoscopy-based CRS, some combinations with mucopurulent rhinorrhea at the middle meatus were significantly related to normal serum 25(OH)D level.
CONCLUSION: Low serum 25(OH)D level might not be associated with increased prevalence of CRS in Korean adults; rather, patients with CRS showed higher serum 25(OH)D levels than the control group. Thus, these results, contradicting those of previous studies, should be further verified in other countries to investigate the role of the serum 25(OH)D in CRS.

PMID: 30471225 [PubMed - as supplied by publisher]

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Non-hypoxic pharmacological stabilisation of Hypoxia Inducible Factor 1α: effects on dopaminergic differentiation of human neural stem cells.

Non-hypoxic pharmacological stabilisation of Hypoxia Inducible Factor 1α: effects on dopaminergic differentiation of human neural stem cells.

Eur J Neurosci. 2018 Nov 24;:

Authors: Hey SM, Jensen P, Ryding M, Martínez-Serrano A, Kristensen BW, Meyer M

Abstract
Parkinson's disease is a neurodegenerative disease resulting in degeneration of midbrain dopaminergic neurons. Exploratory studies using human fetal tissue or predifferentiated stem cells have suggested that intracerebral transplantation of dopaminergic precursor cells may become an effective treatment for patients with Parkinson's disease. However, strategies for dopaminergic stem cell differentiation vary widely in efficiency, and better methods still need to be developed. Hypoxia Inducible Factor 1 (HIF-1) is a transcription factor involved in the regulation of genes important for cellular adaption to hypoxia and low glucose supply. HIF-1 is to a large degree regulated by the availability of oxygen as in its presence, the subunit HIF-1α is degraded by HIF prolyl hydroxylase enzymes (HPHs). Stabilisation of HIF-1α through inhibition of HPHs has been shown to increase dopaminergic differentiation of stem cells and to protect dopaminergic neurons against neurotoxins. This study investigated the effects of non-competitive (FG-0041) and competitive (Compound A and JNJ-42041935) HIF-1α stabilising compounds on the dopaminergic differentiation of human neural stem cells. Treatment with all HPH inhibitors at high oxygen tension (20%) resulted in HIF-1α stabilisation as assessed by immunocytochemistry for HIF-1α and detection of increased levels of vascular endothelial growth factor in the conditioned culture medium. Following 10 days of HIF-1α stabilisation, the cultures displayed a slightly reduced proliferative activity and significantly increased relative levels of tyrosine hydroxylase-positive dopaminergic neurons. In conclusion, HIF-1α stabilisation may represent a promising strategy for the generation of dopaminergic neurons intended for use in experimental in vitro studies and cell replacement therapies. This article is protected by copyright. All rights reserved.

PMID: 30471165 [PubMed - as supplied by publisher]

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Cancer epigenetics and the potential of epigenetic drugs for treating solid tumors.

Cancer epigenetics and the potential of epigenetic drugs for treating solid tumors.

Expert Rev Anticancer Ther. 2018 Nov 23;:

Authors: Liu Z, Gao Y, Li X

Abstract
INTRODUCTION: Epigenetic modification without DNA sequence mutation plays an important role in cancer development. Some small molecular inhibitors targeting key epigenetic molecules have been approved by the Food and Drug Administration to treat hematological malignancies. However, the anticancer effects of these drugs on solid tumors are not satisfactory, and the mechanisms of action remain largely unknown. Areas covered: The review summarizes the latest research on cancer epigenetics and discusses the potentials and limitations of using epigenetic drugs to treat solid tumors. An analysis of possible reasons for epigenetic drug treatment failure in solid tumors in some clinical trials is discussed along with prospects for future development. Expert commentary: Next-generation small molecule inhibitors will target novel epigenetic regulators with high cancer specificity. Combined modalities exploiting epigenetic drugs with chemo-/radiotherapy, molecular-targeting drugs and immunotherapy will be able to effectively treat solid tumors in the near future.

PMID: 30470148 [PubMed - as supplied by publisher]

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Spontaneous Regression of Atypical Teratoid Rhabdoid Tumor Without Therapy in a Patient With Uncommon Regional Inactivation of SMARCB1 ( hSNF5/INI1).

Spontaneous Regression of Atypical Teratoid Rhabdoid Tumor Without Therapy in a Patient With Uncommon Regional Inactivation of SMARCB1 ( hSNF5/INI1).

Pediatr Dev Pathol. 2018 Nov 23;:1093526618814696

Authors: Peterson JEG, Bavle A, Mehta VP, Rauch RA, Whitehead WE, Mohila CA, Su JM, Adesina AM

Abstract
Atypical teratoid/rhabdoid tumor (ATRT) is a high-grade central nervous system tumor, with poor prognosis despite intensive multimodal therapy. Loss of nuclear immunostaining for INI1 due to inactivation of the hSNF5/INI1 tumor suppressor gene is pathognomonic of ATRT. We present a patient with congenital ATRT, who had spontaneous tumor regression without therapy, and is disease-free 4 years later. Tumor histopathology showed rhabdoid cells characteristic of ATRT, but immunohistochemistry revealed heterogeneous loss of nuclear INI1 staining. The populations of INI1-intact and INI1-deficient cells were separated by laser microdissection, for molecular analysis with DNA sequencing and fluorescence in situ hybridization. The INI1-negative cells were found to harbor a heterozygous deletion and truncating mutation of the hSNF5/INI1 locus, while the INI1-intact cells had 2 copies of the wild-type INI1 gene. To our knowledge, this is the first report of spontaneous regression of ATRT, with molecular heterogeneity for SMARCB1 inactivation, with no radiographic signs of recurrence at 4 years after diagnosis.

PMID: 30470167 [PubMed - as supplied by publisher]

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Fetal midline anomalies: Diagnosis and counselling part 2: Septal anomalies.

Fetal midline anomalies: Diagnosis and counselling part 2: Septal anomalies.

Eur J Paediatr Neurol. 2018 Nov 08;:

Authors: Leombroni M, Khalil A, Liberati M, D'Antonio F

PMID: 30470535 [PubMed - as supplied by publisher]

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Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Rhinology. 2018 Nov 24;:

Authors: Reychler G, Domachowski C, Latiers AC, Jamar F, Rombaux P

PMID: 30471226 [PubMed - as supplied by publisher]

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Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Rhinology. 2018 Nov 24;:

Authors: Lee EJ, Hwang CS, Kim KS

PMID: 30471225 [PubMed - as supplied by publisher]

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Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Rhinology. 2018 Nov 24;:

Authors: Lundberg M, Haapaniemi A, Hagstrom J, Juteau S, Hernberg M, Makitie AA, Vento SI

PMID: 30471227 [PubMed - as supplied by publisher]

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Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Rhinology. 2018 Nov 24;:

Authors: Reychler G, Domachowski C, Latiers AC, Jamar F, Rombaux P

PMID: 30471226 [PubMed - as supplied by publisher]

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"J Psychosom Res"[jour]; +18 new citations

18 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

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Sleep in cluster headache revisited: Results from a controlled actigraphic study.

Sleep in cluster headache revisited: Results from a controlled actigraphic study.

Cephalalgia. 2018 Nov 23;:333102418815506

Authors: Lund NL, Snoer AH, Jennum PJ, Jensen RH, Barloese MCJ

Abstract
BACKGROUND AND AIM: Cluster headache attacks exhibit a nocturnal predilection, but little is known of long-term sleep and circadian rhythm. The aim was to compare actigraphy measures, firstly in episodic cluster headache patients in bout and in remission and, secondly, to compare each disease phase with controls.
METHODS: Episodic cluster headache patients (ICHD III-beta), from the Danish Headache Center and healthy, age- and sex-matched controls participated. Sleep and activity were measured using actigraphy continuously for 2 weeks, along with sleep diaries and, for patients, also attack registration.
RESULTS: Patients in bout (n = 17, 2.3 attacks/day) spent more time in bed (8.4 vs. 7.7 hours, p = 0.021) and slept more (7.2 vs. 6.6 hours, p = 0.036) than controls (n = 15). In remission (n = 11), there were no differences compared with controls. Neither were there differences between patients in the two disease phases. In five patients, attacks/awakenings occurred at the same hour several nights in a row.
CONCLUSION: Actigraphy offers the possibility of a continuous and long study period in a natural (non-hospital) environment. The study indicates that sleep does not differ between the bout and remission phase of episodic cluster headache. The repeated attacks/awakenings substantiate that circadian or homeostatic mechanisms are involved in the pathophysiology. The protocol was made available at ClinicalTrials.gov (NCT02853487).

PMID: 30470143 [PubMed - as supplied by publisher]

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Greater progression of coronary artery calcification is associated with clinically relevant cognitive impairment in type 1 diabetes.

Greater progression of coronary artery calcification is associated with clinically relevant cognitive impairment in type 1 diabetes.

Atherosclerosis. 2018 Nov 08;280:58-65

Authors: Guo J, Nunley KA, Costacou T, Miller RG, Rosano C, Edmundowicz D, Orchard TJ

Abstract
BACKGROUND AND AIMS: We assessed the predictive role of coronary artery calcification (CAC) in clinically relevant cognitive impairment in 148 middle-aged individuals with childhood-onset type 1 diabetes (T1D) from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study.
METHODS: Baseline CAC was measured in 1996-98 and repeated 4-8 years later. Per extensive neuropsychological testing in 2010-15, 28% (41/148) of participants met the study definition of clinically relevant cognitive impairment (two or more of 7 select test scores ≥1.5SD worse than demographically appropriate published norms). Logistic regression models with backward selection were constructed for statistical analysis.
RESULTS: Mean age and T1D duration at first CAC measure were 37 and 29 years, respectively. A greater burden of initial CAC was associated with cognitive impairment determined 14 years later. Compared to Agatston score = 0, odds ratio (OR) and 95% confidence intervals (CI) of 0<-100, 100<-300 and >300 were 1.4 (0.6, 3.6), 2.3 (0.6, 9.7), and 7.9 (1.6, 38.5), respectively. With both initial and progression of CAC in the multivariable model, backward selection retained only CAC progression, showing it was significantly associated with cognitive impairment (OR [95% CI]: 1.7 [1.1, 2.9]). In those with an initial CAC>0, CAC density was marginally, inversely, associated with cognitive impairment when controlling for CAC volume (OR [95%CI]: 0.3 (0.1, 1.2), p value = 0.078).
CONCLUSIONS: Greater CAC burden was associated with clinically relevant cognitive impairment in middle-aged adults with childhood-onset T1D. CAC progression appears to be a more powerful predictor than initial calcification.

PMID: 30471556 [PubMed - as supplied by publisher]

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NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: The NU-TRY(HIV) randomized cross-over trial.

NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: The NU-TRY(HIV) randomized cross-over trial.

Atherosclerosis. 2018 Nov 14;280:51-57

Authors: Pirro M, Francisci D, Bianconi V, Schiaroli E, Mannarino MR, Barsotti F, Spinozzi A, Bagaglia F, Sahebkar A, Baldelli F

Abstract
BACKGROUND AND AIMS: Despite hypercholesterolemia has been recognized to increase cardiovascular risk in human immunodeficiency virus (HIV)-infected patients, cholesterol-lowering therapy is underused in this population, due to fear of drug-drug interactions with antiretroviral therapy (ART). We investigated the effects of a nutraceutical combination (NC) on lipid profile, proprotein convertase subtilisin/kexin type 9 (PCSK9), subclinical inflammation and arterial stiffness in ART-treated HIV-infected patients.
METHODS: This was a prospective randomized open-label trial with a cross-over design including 30 stable HIV-infected patients on ART with low-density lipoprotein cholesterol (LDL-C) >115 mg/dL, not taking lipid-lowering treatment. After a 3-week lipid stabilization period, the effects associated with 3 months of an oral NC containing red yeast rice and berberine vs. no active treatment (noNC) were assessed for plasma total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), lipoprotein(a), PCSK9, high-sensitivity C-reactive protein (hs-CRP) levels and aortic pulse wave velocity (aPWV).
RESULTS: At baseline, significant correlations between PCSK9 levels, age (rho = -0.51, p=0.004), waist circumference (rho = 0.36, p=0.005) and CD4+ cell count (rho = -0.40, p=0.027) were observed. NC treatment effects corrected for noNC were significant for TC (-14%, p<0.001), LDL-C (-19%, p<0.001), PCSK9 (-12%, p=0.02), hs-CRP (-14%, p=0.03) and aPWV (-6%, p=0.005). No significant effects were observed for HDL-C, TG and lipoprotein(a). NC treatment was safe and no significant alterations in muscle, liver and immunovirological parameters were observed. No carry over effect was recorded.
CONCLUSIONS: The tested NC significantly reduced plasma cholesterol and PCSK9 levels, attenuated subclinical inflammation and improved arterial stiffness in stable HIV-infected patients on ART.

PMID: 30471555 [PubMed - as supplied by publisher]

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Exposure to high solar radiation reduces self-regulated exercise intensity in the heat outdoors.

Exposure to high solar radiation reduces self-regulated exercise intensity in the heat outdoors.

Physiol Behav. 2018 Nov 21;:

Authors: Otani H, Kaya M, Tamaki A, Goto H, Maughan RJ

Abstract
High radiant heat load reduces endurance exercise performance in the heat indoors, but this remains unconfirmed in outdoor exercise. The current study investigated the effects of variations in solar radiation on self-regulated exercise intensity and thermoregulatory responses in the heat outdoors at a fixed rating of perceived exertion (RPE). Ten male participants completed 45-min cycling exercise in hot outdoor environments (about 31 °C) at a freely chosen resistance and cadence at an RPE of 13 (somewhat hard). Participants were blinded to resistance, pedal cadence, distance and elapsed time and exercised at three sunlight exposure conditions: clear sky (mean ± SD: 1072 ± 91 W·m-2; HIGH); thin cloud (592 ± 32 W·m-2; MID); and thick cloud (306 ± 52 W·m-2; LOW). Power output (HIGH 96 ± 22 W; MID 103 ± 20 W; LOW 108 ± 20 W) and resistance were lower in HIGH than MID and LOW (P < .001). Pedal cadence was lower, the core-to-skin temperature gradient was narrower, body heat gain from the sun (SHG) was greater and thermal sensation was higher with increasing solar radiation and all variables were different between trials (P < .01). Mean skin temperature was higher in HIGH than MID and LOW (P < .01), but core temperature was similar between trials (P = .485). We conclude that self-regulated exercise intensity in the heat outdoors at a fixed RPE of somewhat hard is reduced with increasing solar radiation because of greater thermoregulatory strain, perceived thermal stress and SHG. This suggests that reduced self-selected exercise intensity during high solar radiation exposure in the heat may prevent excessive core temperature rise.

PMID: 30471385 [PubMed - as supplied by publisher]

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Psychological responses, muscle damage, inflammation, and delayed onset muscle soreness to high-intensity interval and moderate-intensity continuous exercise in overweight men.

Psychological responses, muscle damage, inflammation, and delayed onset muscle soreness to high-intensity interval and moderate-intensity continuous exercise in overweight men.

Physiol Behav. 2018 Nov 21;:

Authors: Farias-Junior LF, Browne RAV, Freire YA, Oliveira-Dantas FF, Lemos TMAM, Galvão-Coelho NL, Hardcastle SJ, Okano AH, Aoki MS, Costa EC

Abstract
We compared in-task affect to HIIE and MICE, and its relationship with time spent at different metabolic domains, perceived exertion (RPE), self-efficacy, enjoyment, and future intention of exercise in overweight inactive men. Muscle damage and soreness, and inflammation were assessed post-exercise. Fifteen participants (28.9 ± 5.0 yr; 29.2 ± 3.8 kg/m2) completed a HIIE (10 × 1 min at 100% Vmax, 1 min recovery) and MICE (20 min at 55-59% VO2reserve) session. Affect, alertness, RPE, and self-efficacy were assessed in-task, and enjoyment and future intention post-task. At baseline, 24 and 48 h, creatine kinase, lactate dehydrogenase, interleukin-6 and -10, tumor necrosis factor alpha, and muscle soreness were assessed. Affect (-3.1 ± 1.8 vs. 0.8 ± 1.8, P < .001) and self-efficacy (70 ± 15 vs. 90 ± 15%, P < .001) were lower, while RPE and alertness were higher in HIIE compared to MICE (Ps ≤ 0.02). Affect was negatively correlated with RPE in HIIE (r = -0.90) and MICE (r = -0.72), and time spent above respiratory compensation point in HIIE (r = -0.59). Affect was positively correlated with self-efficacy in MICE (r = 0.74). Enjoyment, future intention, muscle damage and soreness, and inflammation were similar between HIIE and MICE post-exercise. Therefore, in-task HIIE was experienced as unpleasant compared to MICE, but the psychological and physiological responses post-task were similar in overweight inactive men.

PMID: 30471384 [PubMed - as supplied by publisher]

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The impact of a competitive learning environment on hormonal and emotional stress responses and skill acquisition and expression in a medical student domain.

The impact of a competitive learning environment on hormonal and emotional stress responses and skill acquisition and expression in a medical student domain.

Physiol Behav. 2018 Nov 21;:

Authors: Cook CJ, Crewther BT

Abstract
The concept of competition has implications for educational contexts, as hormonal and emotional changes under competitive stress can modulate learning and memory processes. This study examined the impact of a competitive learning environment and associated hormonal and emotional responses on skill acquisition and expression in a medical domain. Using a cross-over design, sixteen male medical students participated in a competitive (in pairs facing each other) and non-competitive (alone) learning situation. In each treatment, an instructional video was followed by a timed straight-line suture evaluation with anxiety and competitiveness recorded. Salivary testosterone (T) and cortisol (C) were assessed at rest, before and after evaluation to quantify changes in T (ΔT) and C (ΔC). These procedures were followed by two sessions of self-directed training before retesting. Paired learning produced a larger positive ΔT (5.9-7.8% vs. 2.0-5.3%) and ΔC (7.6% vs. 3.3%), which was accompanied by more anxiety and elevated competitiveness (p < .01). Anxiety declined and suturing abilities improved over time (p < .001), irrespective of the learning approach, with resting C concentrations decreasing when learning alone (p < .05). Some ΔT and ΔC measures correlated (r = 0.40 to 0.65) with anxiety and competitive desire with paired learning only, whereas the ΔC was linked to suturing performance (r = -0.35) when learning alone. In summary, a tacit competition in a natural learning situation promoted more pronounced hormonal and emotional responses. However, skill acquisition and its expression improved to a similar extent in both situations of competitive and non-competitive assessment. Different adaptive pathways for skill expression and development emerged from this work.

PMID: 30471383 [PubMed - as supplied by publisher]

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Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Similar survival outcome after endoscopic and open approaches for sinonasal mucosal melanoma.

Rhinology. 2018 Nov 24;:

Authors: Lundberg M, Haapaniemi A, Hagstrom J, Juteau S, Hernberg M, Makitie AA, Vento SI

PMID: 30471227 [PubMed - as supplied by publisher]

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Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Rhinology. 2018 Nov 24;:

Authors: Reychler G, Domachowski C, Latiers AC, Jamar F, Rombaux P

PMID: 30471226 [PubMed - as supplied by publisher]

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Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults.

Rhinology. 2018 Nov 24;:

Authors: Lee EJ, Hwang CS, Kim KS

PMID: 30471225 [PubMed - as supplied by publisher]

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Very serious limitations in systematic review summarizing how minimally invasive techniques compare with defective restoration replacement render it not useful for making clinical decisions.

Very serious limitations in systematic review summarizing how minimally invasive techniques compare with defective restoration replacement render it not useful for making clinical decisions.

J Am Dent Assoc. 2018 Nov 19;:

Authors: Brignardello-Petersen R

PMID: 30470392 [PubMed - as supplied by publisher]

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Excessive gingival display treated with 2-piece segmental Le Fort I osteotomy: A case report.

Excessive gingival display treated with 2-piece segmental Le Fort I osteotomy: A case report.

J Am Dent Assoc. 2018 Nov 20;:

Authors: Hichijo N, Furutani M, Kuroda S, Tanaka E

Abstract
BACKGROUND: The demand for orthognathic surgery has increased worldwide. Women with jaw deformity tend to have a worse quality of life than men owing to the deformity's negative effects on body image, low self-esteem, lack of self-confidence, and dissatisfaction with life. Therefore, they wish for more reliable treatment options.
CASE DESCRIPTION: A woman aged 25 years and 9 months sought treatment for a convex profile and excessive gingival display caused by a skeletal Class II jaw-base relationship. Gingival exposure was up to 6.5 millimeters at full smile. She chose orthognathic surgery, and the authors performed a 2-piece segmental Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. After active orthodontic treatment, the protrusive profile was improved, and an acceptable occlusion and an attractive smile were achieved.
PRACTICAL IMPLICATIONS: It is hoped that 2-piece segmental Le Fort I osteotomy becomes a common treatment option for patients with protrusive profiles and excessive gingival displays.

PMID: 30470390 [PubMed - as supplied by publisher]

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Geospatial distribution of periodontists and US adults with severe periodontitis.

Geospatial distribution of periodontists and US adults with severe periodontitis.

J Am Dent Assoc. 2018 Nov 20;:

Authors: Eke PI, Lu H, Zhang X, Thornton-Evans G, Borgnakke WS, Holt JB, Croft JB

Abstract
BACKGROUND: In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
METHODS: The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones.
RESULTS: Approximately 60% of adults 30 through 79 years lived within 5 miles of a periodontist, 73% within 10 miles, 85% within 20 miles, and 97% within 50 miles. Proximity to a periodontist varied widely. In urban areas, 95% of adults resided within 10 miles of a periodontist and 100% within 20 miles. Only 24% of adults in rural areas lived within 10 miles of a periodontist. Most periodontists (96.1%) practiced in urban areas, clustering along the eastern and western coasts and in the Midwest, 3.1% in urban clusters elsewhere, and 0.8% in rural areas. Ratios of fewer than 8,000 adults with periodontitis to 1 or more periodontists within 10 miles were clustered mostly in the Northeast, central East Coast, Florida, West Coast, Arizona, and Midwest.
CONCLUSIONS: In this study, the authors identified wide variations in geographic proximity to a practicing periodontist for adults with severe periodontitis.
PRACTICAL IMPLICATIONS: Dental practitioners may provide preventive care and counseling for periodontitis and referrals for specialty care. Geographic proximity to specialized periodontal care may vary widely by locality.

PMID: 30470389 [PubMed - as supplied by publisher]

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Clomiphene citrate induces nuclear translocation of the TFEB transcription factor and triggers apoptosis by enhancing lysosomal membrane permeabilization.

Clomiphene citrate induces nuclear translocation of the TFEB transcription factor and triggers apoptosis by enhancing lysosomal membrane permeabilization.

Biochem Pharmacol. 2018 Nov 21;:

Authors: Li W, Lin J, Shi Z, Wen J, Li Y, Liu Z, Diao A

Abstract
The autophagy-lysosome pathway plays a central role in cellular homeostasis by regulating the cellular degradative machinery. The transcription factor EB (TFEB) regulates the biogenesis and function of both lysosomes and autophagosomes, and enhancement of TFEB function has emerged as an attractive therapeutic strategy for lysosome-related disorders. However, little is known about the role of TFEB activation in regulating the cellular fate. Here, we describe that clomiphene citrate (CC), a selective estrogen receptor modulator, promotes nuclear translocation of TFEB and increases lysosomal biogenesis in HeLa and MDA-MB-231 cells. Treatment with CC inhibits cell viability and causes apoptosis by increasing the release of proteases cathepsin B (CatB) and cathepsin D (CatD) from lysosomes into the cytosol. In contrast, knockdown of TFEB rescues the cells from CC-induced cell death. Furthermore, CC-induced TFEB activation also enhances the autophagy flux in HeLa cells. Knockdown of autophagy-related gene 7 (ATG7) significantly decreases the CC-induced CatB and CatD release and cell death, suggesting that autophagy contributes to the lysosomal membrane permeabilization (LMP) caused by CC. Altogether, these findings have broad implications for our understanding of TFEB function and provide new insights into CC pharmacological therapy.

PMID: 30471247 [PubMed - as supplied by publisher]

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TSPYL5-mediated inhibition of p53 promotes human endothelial cell function.

TSPYL5-mediated inhibition of p53 promotes human endothelial cell function.

Angiogenesis. 2018 Nov 23;:

Authors: Na HJ, Yeum CE, Kim HS, Lee J, Kim JY, Cho YS

Abstract
Testis-specific protein, Y-encoded like (TSPYL) family proteins (TSPYL1-6), which are members of the nucleosome assembly protein superfamily, have been determined to be involved in the regulation of various cellular functions. However, the potential role of TSPYL family proteins in endothelial cells (ECs) has not been determined. Here, we demonstrated that the expression of TSPYL5 is highly enriched in human ECs such as human umbilical vein endothelial cells (HUVECs) and human pluripotent stem cell-differentiated ECs (hPSC-ECs). Importantly, TSPYL5 overexpression was shown to promote EC proliferation and functions, such as migration and tube formation, by downregulating p53 expression. Adriamycin-induced senescence was markedly blocked by TSPYL5 overexpression. In addition, the TSPYL5 depletion-mediated loss of EC functions was blocked by p53 inhibition. Significantly, TSPYL5 overexpression promoted angiogenesis in Matrigel plug and wound repair in a mouse skin wound healing model in vivo. Our results suggest that TSPYL5, a novel angiogenic regulator, plays a key role in maintaining endothelial integrity and function. These findings extend the understanding of TSPYL5-dependent mechanisms underlying the regulation of p53-related functions in ECs.

PMID: 30471052 [PubMed - as supplied by publisher]

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Subclinical atherosclerosis in psoriatic disease: relation to endocan, TNF-α, age of onset, and body fat.

Subclinical atherosclerosis in psoriatic disease: relation to endocan, TNF-α, age of onset, and body fat.

Int J Dermatol. 2018 Nov 23;:

Authors: Elkamshoushi AM, Omar SS, El Abd AM, Hassan SZ, Sultan EA, Abd Elkawy E

Abstract
BACKGROUND: Psoriasis is a common multisystem inflammatory disease with several associated comorbidities. Serological markers to detect associated subclinical atherosclerosis in psoriatic patients are needed. We aimed to study serum endocan levels in psoriasis vulgaris and its relation to severity of psoriasis, systemic inflammation, associated atherosclerosis, obesity, and the possible factors affecting its level in psoriatic patients.
METHODS: This study was conducted on 30 moderate-severe psoriasis vulgaris patients and 30 healthy controls. Body mass index, body fat percent, and PASI assessments were done. Serum endocan and tumor necrosis factor-α levels were measured by ELISA. Carotid artery intima-media thickness measurement by high-resolution ultrasound was performed.
RESULTS: Psoriasis patients showed significantly higher serum tumor necrosis factor-α and endocan levels (P1 = 0.008, P2 = 0.003). Additionally, there was a statistically significant difference between mean carotid artery intima-media thickness of both groups (P = 0.005). Serum endocan levels positively correlated with PASI score (P = 0.002), tumor necrosis factor-α levels (P < 0.001), mean carotid artery intima-media thickness (P = 0.001), and body mass index (P < 0.001) in the patients group. Additionally, the age of onset of disease negatively correlated with serum endocan (P = 0.003).
CONCLUSION: Serum endocan is a promising marker of severity of psoriasis and associated atherosclerosis. Early onset psoriasis is associated with higher serum endocan levels. Body mass index is positively correlated with serum endocan levels. The positive correlation of endocan and tumor necrosis factor-α supports the regulatory effect of the cytokine on endocan production and suggests the role of endocan as an inflammatory marker.

PMID: 30471086 [PubMed - as supplied by publisher]

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Is there an association between indoor allergens and the severity of atopic dermatitis?

Is there an association between indoor allergens and the severity of atopic dermatitis?

Int J Dermatol. 2018 Nov 23;:

Authors: Cid BJ, Perez-Mateluna G, Iturriaga C, Zambrano MJ, Vives MI, Valenzuela PM, Borzutzky A

Abstract
BACKGROUND: Atopic dermatitis (AD) is a multifactorial inflammatory skin disease with frequent hypersensitivity to allergens. However, the role of exposure to indoor allergens on AD severity is unclear.
METHODS: Children aged 0-17 years with active AD from central Chile were recruited; disease severity was evaluated with SCORAD and POEM scores. A home environment survey was applied to parents. Bedroom dust samples were collected for all subjects and analyzed by multiplex assay to quantify dust mite (Der p1, Der f1), dog (Can f1), cat (Fel d1), and alternaria alternata (Alt a1) allergens.
RESULTS: Twenty-five children aged 3.9 ± 3.8 years were included. Fifty-two percent were female. Mean SCORAD was 29 ± 14 (range 11-61), and mean POEM was 10.7 ± 6.2. No direct association was found between tobacco exposure, pet ownership, aerosol use, visible dust, or home carpets/rugs with SCORAD (all P > 0.05). Dust samples from all homes had Can f1 and Fel d1 allergens, regardless of pet ownership. Homes that had indoor dogs or cats had significantly higher amounts of these allergens (P < 0.001). Forty percent of homes had dust mite allergens, and none had alternaria alternata. Children with AD living in homes with elevated dust mite and animal dander allergen concentrations had higher SCORAD than those from homes with low allergen concentrations (40 ± 13 vs. 26 ± 13, P = 0.025).
CONCLUSIONS: High concentrations of indoor allergens may influence AD severity in children. Further studies assessing indoor allergens and allergen sensitization are warranted to fully evaluate the role of indoor allergens on AD.

PMID: 30471085 [PubMed - as supplied by publisher]

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Syphilitic balanitis of Follmann: two case reports.

Syphilitic balanitis of Follmann: two case reports.

Int J Dermatol. 2018 Nov 23;:

Authors: Platsidaki E, Tsimbos I, Vassis P, Tzanetakou V, Rigopoulos D, Kontochristopoulos G

PMID: 30471083 [PubMed - as supplied by publisher]

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Abrogation of transforming growth factor-β-induced tissue fibrosis in mice with a global genetic deletion of Nox4.

Abrogation of transforming growth factor-β-induced tissue fibrosis in mice with a global genetic deletion of Nox4.

Lab Invest. 2018 Nov 23;:

Authors: Wermuth PJ, Mendoza FA, Jimenez SA

Abstract
Excessive connective tissue deposition in skin and various internal organs is characteristic of systemic sclerosis (SSc). The profibrotic growth factor TGF-β plays a crucial role in SSc pathogenesis. The expression of NADPH oxidase 4 (NOX4), a critical mediator of oxidative stress, is potently stimulated by TGF-β. Here, we evaluated the effect of NOX4 on the development of TGF-β-induced tissue fibrosis. C57BL6/J control mice and Nox4 knockout mice were implanted subcutaneously with osmotic pumps containing either saline or 2.5 µg TGF-β1. After 28 days, skin and lung samples were isolated for histopathologic analysis, measurement of hydroxyproline content and gene expression analysis. Histopathology of skin and lungs from normal C57BL6/J mice treated with TGF-β1 showed profound dermal fibrosis and peribronchial and diffuse interstitial lung fibrosis. In contrast, TGF-β-treated Nox4 knockout mice showed normal skin and lung histology. Hydroxyproline levels in TGF-β-treated C57BL6/J mice skin and lungs demonstrated significant increases, however, hydroxyproline content of TGF-β-treated Nox4 knockout mice tissues was not changed. Expression of various profibrotic and fibrosis-associated genes was upregulated in skin and lungs of TGF-β1-treated C57BL6/J mice but was not significantly changed in TGF-β1-treated Nox4 knockout mice. The induction of skin and lung tissue fibrosis by TGF-β1 parenteral administration in mice was abrogated by the genetic deletion of Nox4 confirming that NOX4 is an essential mediator of the profibrotic effects of TGF-β. These results suggest Nox4 inhibition as a potential therapeutic target for SSc and other fibroproliferative disorders.

PMID: 30470772 [PubMed - as supplied by publisher]

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Patient preferences for attributes of topical anti-psoriatic medicines.

Patient preferences for attributes of topical anti-psoriatic medicines.

J Dermatolog Treat. 2018 Nov 23;:1-19

Authors: Vasconcelos V, Teixeira A, Almeida V, Teixeira M, Ramos S, Torres T, Sousa Lobo JM, Almeida IF

Abstract
Background Patient preferences should be considered when prescribing topical treatments to drive up adherence and improve clinical outcomes. Objetive The aim of this work was to identify the most important attributes of topical medicines for psoriasis treatment in the patients' view, and explore the sociodemographic and clinical determinants of these preferences. Methods A questionnaire for the evaluation of the relevancy given to specific attributes of topical medicines used for psoriasis treatment was developed (PSO-TOPAP) and was applied to a total of seventy-nine patients, members of the Portuguese Association of Psoriasis (PSOPortugal) or outpatients of a dermatology unit of a central hospital. Results Overall, attributes belonging to the formulation and application domains were greatly valued over attributes related with the container. Only a small number of patient preferences was influenced by age, gender, duration of the disease and age at first diagnosis. Limitations Our findings need to be verified in larger and more diverse patient samples, before generalization can be made. Conclusion The insight obtained in this work can provide guidance to pharmaceutical drug product design and has also potential to improve patient care through the acknowledgement of patient preferences in clinical practice.

PMID: 30470146 [PubMed - as supplied by publisher]

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Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Clinical efficacy of intranasal drug delivery by nebulization in chronic rhinosinusitis: a systematic review.

Rhinology. 2018 Nov 24;:

Authors: Reychler G, Domachowski C, Latiers AC, Jamar F, Rombaux P

PMID: 30471226 [PubMed - as supplied by publisher]

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Prevalence, Characterization, and Impact of Voice Disorders in Fado Singers.

Prevalence, Characterization, and Impact of Voice Disorders in Fado Singers.

J Voice. 2018 Nov 20;:

Authors: Pestana PM, Vaz-Freitas S, Manso MC

Abstract
INTRODUCTION: Fado is a genre of urban folk music from Portugal characterized by some particularities. Some indictions in the study point this population of singers to be at higher risk of developing voice disorders.
AIM: This study aims to provide estimates of the prevalence of voice disorders in Fado singers, and to characterize the professional practice and the impact of voice disorders on their careers.
METHODS: This is a cross sectional study based on a self-administered questionnaire split into six parts and 55 questions.
RESULTS: A gender-balanced sample of 111 singers was achieved. Most of them recorded at least once. Winter and spring were found to be the most difficult seasons in which to sing. The overall prevalence of self-reported voice disorders was 39.6%, significantly higher in females. Almost all sought clinical guidance. Vocal fold nodules, functional dysphonia, and vocal fold polyp were the most common diagnoses. Vocal fatigue and hoarseness were the main symptoms reported. Nearly half of the singers had to cancel shows due to voice disorders.
CONCLUSION: Fado singers reveal both a relative high prevalence of voice disorders and related concerns, even though some discrepancies were found regarding other apparently similar singer populations. These results lead support the need for further investigation regarding the risk or protective factors influencing voice disorders.

PMID: 30470594 [PubMed - as supplied by publisher]

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How Much Loading Does Water Resistance Voice Therapy Impose on the Vocal Folds? An Experimental Human Study.

How Much Loading Does Water Resistance Voice Therapy Impose on the Vocal Folds? An Experimental Human Study.

J Voice. 2018 Nov 20;:

Authors: Laukkanen AM, Geneid A, Bula V, Radolf V, Horáček J, Ikävalko T, Kukkonen T, Kankare E, Tyrmi J

Abstract
OBJECTIVES: Water resistance voice therapy applies phonation into water through a tube. This study investigates how strenuous this therapy can be for the vocal folds in terms of impact stress (IS). It further examines whether it is possible to estimate the IS using the contact quotient (CQ) and maximum derivative from an electroglottogram (EGG).
STUDY DESIGN: Experimental study.
METHODS: A male participant sustained a rounded back vowel [u:] or [o:] at a comfortable speaking pitch and loudness, and phonated into a silicone "Lax Vox" tube submerged 2 cm in water. High-speed videolaryngoscopy was performed with a rigid scope. Oral air pressure (Poral) was registered in a mouthpiece through which an endoscope was inserted into the larynx. An EGG was recorded.
RESULTS: The CQEGG from the EGG and the closed quotient from the glottal width (CQarea) increased, while the maximum glottal amplitude and absolute value of derivative minimum (dmin) and also the derivative maximum from the EGG decreased for phonation into water. Normalized amplitude quotient from the glottal width variation also decreased but the change was not significant.
CONCLUSIONS: Based on the glottal area findings, water resistance therapy does not seem to increase vocal fold loading (in terms of increased IS) even if the increase of CQarea, and CQEGG suggest so. CQEGG may qualitatively correspond to that of area, but the reliability of CQ (from the glottal area or the EGG) and the maximum derivative from the EGG as estimates of IS in semiocclusion exercises warrant further studies.

PMID: 30470593 [PubMed - as supplied by publisher]

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Pulmonary metastasis of mesonephric-like adenocarcinoma arising from the uterine body: a striking mimicry of follicular thyroid carcinoma.

Pulmonary metastasis of mesonephric-like adenocarcinoma arising from the uterine body: a striking mimicry of follicular thyroid carcinoma.

Histopathology. 2018 Nov 24;:

Authors: Yamamoto S, Sakai Y

Abstract
Mesonephric adenocarcinoma (MNAC) is a rare neoplasm that presumably develops from the mesonephric remnants, occurring mostly in the uterine cervix and, to a lesser extent, the vagina, uterine body, ovary, and para-adnexal soft tissues. Histologically, MNAC exhibits a variety of architectural growth patterns, even within the same tumour, including tubular, glandular, papillary, solid, and retiform, and therefore may be confused with more common carcinomas of Müllerian origin. Moreover, the tubules with luminal eosinophilic secretions, a common characteristic of MNACs, may result in consideration of thyroidal carcinoma when tumours spread beyond the pelvis. Immunohistochemistry can identify the mesonephric nature of the tumour, that is, negative for hormone receptors and positive for CD10, calretinin, and GATA binding protein 3 (GATA3) in variable degrees This article is protected by copyright. All rights reserved.

PMID: 30471132 [PubMed - as supplied by publisher]

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Contribution of cone-beam computed tomography in the decision of surgical management for bone lesions of the maxillofacial region.

Contribution of cone-beam computed tomography in the decision of surgical management for bone lesions of the maxillofacial region.

J Craniomaxillofac Surg. 2018 Oct 19;:

Authors: Santos AA, Yamamoto-Silva FP, Torres EM, Valladares-Neto J, Figueiredo PTS, Leite AF, Silva MAG

Abstract
The aim of this study was to evaluate the contribution of cone-beam computed tomography (CBCT) in the decision of surgical management for bone lesions of the maxillofacial region. It is a retrospective cross-sectional observational study that includes a sample of panoramic radiography (PR) and CBCT from patients with some type of bone lesion in the maxillofacial region. PR and CBCT images were evaluated by three previously assessed examiners, specialists in oral and maxillofacial surgery. Each image was evaluated randomly, and a surgical procedure was suggested, initially in PR and then in CBCT. The obtained results were submitted to the McNemar test to evaluate the frequencies of changes in the surgical management between the first and the second evaluation in PR and CBCT, and intra-examiner and inter-examiner agreements were analyzed by the Cohen's kappa test. The level of significance was set at 5% (p < 0.05). Intra-examiner agreement increases when CBCT is used. Inter-examiner agreement was low, independently of the evaluated exam, which shows that the choice of treatment plan is examiner-dependent and not exam-dependent. CBCT increases the certainty of the professional in the evaluation of the bone lesions of the maxillofacial region; however, it does not change the indication of the treatment type.

PMID: 30470468 [PubMed - as supplied by publisher]

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The fitting accuracy of pre-bend reconstruction plates and their impact on the temporomandibular joint.

The fitting accuracy of pre-bend reconstruction plates and their impact on the temporomandibular joint.

J Craniomaxillofac Surg. 2018 May 18;:

Authors: Wurm MC, Hagen J, Nkenke E, Neukam FW, Schlittenbauer T

Abstract
BACKGROUND: Various causes for bone defects of the lower jaw have been described. As a result, patients often suffer from compromised aesthetics and a loss of, or reduction in, important physiological functions, such as swallowing, breathing, and speaking. A change in the shape of the lower jaw can impair the natural occlusion and leads to an atypical or modified position of the temporomandibular joint. Titanium reconstruction plates are the standard approach to jaw reconstruction, and are used for temporary bridging of a jaw defect or fixation of a bone graft. Conventionally these plates are intraoperatively adjusted to the mandible by the surgeon. Computer-aided manufacturing, computer-aided design, and rapid prototyping have gained increasing importance in the field of medicine, as they allow the production of individual models of the lower jaw, with the possibility of preoperatively bending the reconstruction plates. In this retrospective study, the accuracy of pre-bent titanium plates and their effect on the temporomandibular joint situation in comparison with intraoperatively curved plates will be discussed.
MATERIALS AND METHODS: Patients who attended our department for lower jaw reconstruction between March 2013 and February 2015 were included in this retrospective study. Within that time 20 patients were treated with pre-bent reconstruction plates (group 1). 20 comparable patients were selected with reconstruction and conventional intraoperative bending (group 2). To evaluate the accuracy of the plates and the condylar position, postoperative cone beam computed tomograms and computed tomograms were used to assess the bone-plate distance at 12 defined points and four angles in axial reconstruction. The results were compared, statistically evaluated, and discussed.
RESULTS: Regarding the maximum bone-plate distances and the sum of distances, there was a significant difference between the accuracy of the pre-bent and the conventionally bent reconstruction plates (p = 0.022, p = 0.048). Regarding the condylar position, there was no significant difference between both methods (p = 0.867).
CONCLUSION: The results of this study show that a better fitting accuracy can be achieved using pre-bent plates. Preparation of the plates proves to be advantageous and meaningful, especially in complex bone defects and deformations of the lower jaw. Nevertheless, concerning the position of the temporomandibular joint, no significant difference could be ascertained between the shown methods, contradicting several studies.

PMID: 30470467 [PubMed - as supplied by publisher]

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Expression of immunoregulatory molecules PD-L1 and PD-1 in oral cancer and precancerous lesions: A cohort study of Japanese patients.

Expression of immunoregulatory molecules PD-L1 and PD-1 in oral cancer and precancerous lesions: A cohort study of Japanese patients.

J Craniomaxillofac Surg. 2017 May 10;:

Authors: Kouketsu A, Sato I, Oikawa M, Shimizu Y, Saito H, Takahashi T, Kumamoto H

Abstract
OBJECTIVE: An association of the programmed cell death-1 (PD-1) and its ligand PD-L1 with various types of malignant tumors has been established. This study aimed to investigate the role of the PD-L1/PD-1 pathway in oral squamous cell carcinoma (OSCC) and oral epithelial precursor lesions (OEPL).
MATERIALS AND METHODS: We examined 106 OSCC and 79 OEPL specimens for PD-L1 and PD-1 expression by immunohistochemistry. The results were compared with clinicopathological features of OSCC patients.
RESULTS: In OSCC and OEPL specimens, PD-L1 expression was detected predominantly in epithelial or carcinoma cells, whereas PD-1 expression was found mainly in infiltrating or stromal lymphocytes. Seventy-two OSCC (67.9%) and 21 OEPL (26.6%) specimens were positive for PD-L1, and 73 OSCC (68.9%) and 23 OEPL (29.2%) specimens were positive for PD-1. PD-L1 and PD-1 expression levels were significantly different between OEPL and OSCC specimens (P < 0.001). There were significant positive correlations between PD-L1 and PD-1 expression in OEPL and OSCC specimens (P < 0.001). PD-L1 and PD-1 immunoreactivity was significantly associated with tumor size (P < 0.05). PD-L1 and PD-1 immunoreactivity in cases with advanced TNM staging was significantly higher than that in low staging cases (P < 0.01). There were significant correlations between PD-L1 and PD-1 expression in OSCC specimens and pathological variables such as stromal lymphocytic reaction (P < 0.05) and invasion depth (P < 0.01).
CONCLUSION: PD-L1 and PD-1 immunohistochemical status may be related to carcinogenesis, tumor progression, and prognosis in oral epithelial lesions. Agents targeting PD-1 and PD-L1 might be useful for OSCC treatment.

PMID: 30466788 [PubMed - as supplied by publisher]

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Chinese medicine CGA formula ameliorates liver fibrosis induced by carbon tetrachloride involving inhibition of hepatic apoptosis in rats.

Chinese medicine CGA formula ameliorates liver fibrosis induced by carbon tetrachloride involving inhibition of hepatic apoptosis in rats.

J Ethnopharmacol. 2018 Nov 21;:

Authors: Tian H, Liu L, Li Z, Liu W, Sun Z, Xu Y, Wang S, Liang C, Hai Y, Feng Q, Zhao Y, Hu Y, Peng J

Abstract
ETHNOPHARMACOLOGICAL REVELVANCE: CGA consisting of Cordyceps sinensis mycelia polysaccharide, gypenosides and amygdalin, was demonstrated to be the effective components formula in Fuzheng Huayu (FZHY) capsule, a traditional Chinese medicine approved by China food and drug administration for treatment of liver fibrosis and to inhibit transforming growth factor-β1 (TGF-β1) signaling, previously.
AIM OF THE STUDY: To evaluate the effects of CGA on hepatic apoptosis in liver fibrosis induced by carbon tetrachloride (CCl4).
MATERIALS AND METHODS: The hepatic injury and histology was detected by serum biomarker assay and hematoxylin-eosin staining. The hepatic collagen was illustrated by Sirius red staining and hydroxyproline (Hyp) concentration. The hepatic stellate cells (HSCs) activation and hepatic apoptosis was visualized by immunohistochemical analysis of α-smooth muscle actin (α-SMA) and terminal deoxynucleotidyl transferase-mediated dUPT nick-end labeling (TUNEL) assay respectively. The protein expression of collagen type I (Col-I), α-SMA, TGF-β1, Fas, tumor necrosis factor receptor 1 (TNF-R1), cleaved-caspase-8, cleaved-caspase-10, cleaved-caspase-9, cleaved-caspase-3, mitochondrial Bcl-2, Bcl-2 associated X protein (Bax), Bcl-2 homologous antagonist/killer (Bak), cytochrome C and cytoplasmic cytochrome C was detected by western-blot.
RESULTS: CGA or FZHY ameliorated liver histological changes, decreasing serum alanine aminotransferase, aspartate aminotransferase, hepatic Hyp, TUNEL positive-stained area, and down-regulated the protein expression of α-SMA, TGF-β1, Col-I, Fas, TNF-R1, cleaved-caspase-8, cleaved-caspase-10, cleaved-caspase-9, and cleaved-caspase-3, mitochondrial Bax, Bak, and cytoplasmic Cytochrome C, while restored the expression of mitochondrial Bcl-2 and cytochrome C.
CONCLUSION: CGA formula ameliorates liver fibrosis induced by CCl4, which is correlated to its inhibition on hepatic apoptosis.

PMID: 30471378 [PubMed - as supplied by publisher]

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Bioassay-guided isolation of active compounds from Adenosma buchneroides essential oil as mosquito repellent against Aedes albopictus.

Bioassay-guided isolation of active compounds from Adenosma buchneroides essential oil as mosquito repellent against Aedes albopictus.

J Ethnopharmacol. 2018 Nov 21;:

Authors: Ma Y, Li M, Zhang H, Sun H, Su H, Wang Y, Du Z

Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: A folk herb Adenosma buchneroides found in the previous ethnobotanical investigation plays an important role as an insect repellent among the Aini people in southwest of China, but the active compounds responsible for repellent activity of the plant have not yet been investigated.
AIM OF THE STUDY: The main purpose of the study is to identify the active components of the essential oil which responsible for its repellent activity against Aedes albopictus to support the usage of the plant as mosquito repellent by Aini people. In addition, to supply a class of potential alternatives characterized carvacrol analogues to develop natural repellent products.
MATERIAL AND METHODS: The essential oil from aerial part of Ad. buchneroides was extracted by hydrodistillation. A systematic bioassay-guided isolation of repellent compounds from the essential oil was conducted through chromatographic fractionation combined with in-cage mosquito repellent bioassay. The identification of the essential oil components was accomplished by GC-MS and GC-FID techniques. The structural elucidation of compounds was performed on the basis of IR, HR-ESI-MS and NMR. Larvicidal activity and cytotoxicity of all repellent compounds also tested by larval bioassays and MTS assays, respectively. Structure-activity relationship (SAR) of carvacrol analogues was investigated by in-cage mosquito repellent bioassay.
RESULTS: The essential oil of the plant showed strong mosquito repellent activity with minimum effective dosage (MED) of 0.019 ± 0.007mg/cm2, compared to reference standard N,N-diethyl-3-methylbenzamide (DEET) (0.031 ± 0.014mg/cm2). 26 compounds representing 97.8% of the essential oil were identified. Carvacrol, carvacrol methyl ether and a new fragrant compound, adenosmin A (1) were found to be repellent compounds by systematic bioassay-guided isolation, with MEDs in the range of 0.011-0.125mg/cm2. An investigation on SAR of carvacrol analogues led to the discover of three analogues with further lower MEDs (0.002-0.009mg/cm2) than that of DEET, and other three compounds with similar MEDs (0.029-0.039mg/cm2) to that of DEET. Carvacrol (LD50 of 24.8 ppm) was the best larvicide among tested repellent compounds. The essential oil and repellent compounds against seven mammalian cell lines revealed low or no cytotoxicity.
CONCLUSIONS: Scientific evidences reported here validate the plant's traditional use as insect repellent and imply promising application of the essential oil and carvacrol analogues as natural mosquito repellents.

PMID: 30471377 [PubMed - as supplied by publisher]

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Implementation of influenza point-of-care-testing and patient-cohorting during a high-incidence season: a retrospective analysis of impact on infection prevention and control and clinical outcomes.

Implementation of influenza point-of-care-testing and patient-cohorting during a high-incidence season: a retrospective analysis of impact on infection prevention and control and clinical outcomes.

J Hosp Infect. 2018 Nov 21;:

Authors: Youngs J, Marshall B, Farragher M, Whitney L, Glass S, Pope C, Planche T, Riley P, Carrington D

Abstract
BACKGROUND: During high-incidence influenza seasons, a robust infection prevention and control policy is imperative to reduce nosocomial transmission of influenza.
AIM: To assess the impact of Emergency Department (ED) influenza point-of-care-testing (POCT) and influenza-ward patient-cohorting on infection prevention and control and clinical outcomes.
METHODS: Influenza POCT was operational in our adult ED from 21st January 2018 and an influenza-ward from 25th January 2018. A retrospective 'before-after' analysis was performed with pre-intervention defined as 1st November 2017-20th January 2018 and post-intervention 21st January-30th April 2018. Primary outcome was rate of hospital-acquired influenza (HAI). Secondary outcomes included antiviral prescription and length of stay. The length of time inpatients remain influenza RNA detected by polymerase chain reaction (PCR) was also analysed.

PMID: 30471317 [PubMed - as supplied by publisher]

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Adoptive cellular therapies: the current landscape.

Adoptive cellular therapies: the current landscape.

Virchows Arch. 2018 Nov 23;:

Authors: Rohaan MW, Wilgenhof S, Haanen JBAG

Abstract
For many cancer types, the immune system plays an essential role in their development and growth. Based on these rather novel insights, immunotherapeutic strategies have been developed. In the past decade, immune checkpoint blockade has demonstrated a major breakthrough in cancer treatment and has currently been approved for the treatment of multiple tumor types. Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TIL) or gene-modified T cells expressing novel T cell receptors (TCR) or chimeric antigen receptors (CAR) is another strategy to modify the immune system to recognize tumor cells and thus carry out an anti-tumor effector function. These treatments have shown promising results in various tumor types, and multiple clinical trials are being conducted worldwide to further optimize this treatment modality. Most successful results were obtained in hematological malignancies with the use of CD19-directed CAR T cell therapy and already led to the commercial approval by the FDA. This review provides an overview of the developments in ACT, the associated toxicity, and the future potential of ACT in cancer treatment.

PMID: 30470934 [PubMed - as supplied by publisher]

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Precision immunoprofiling by image analysis and artificial intelligence.

Precision immunoprofiling by image analysis and artificial intelligence.

Virchows Arch. 2018 Nov 23;:

Authors: Koelzer VH, Sirinukunwattana K, Rittscher J, Mertz KD

Abstract
Clinical success of immunotherapy is driving the need for new prognostic and predictive assays to inform patient selection and stratification. This requirement can be met by a combination of computational pathology and artificial intelligence. Here, we critically assess computational approaches supporting the development of a standardized methodology in the assessment of immune-oncology biomarkers, such as PD-L1 and immune cell infiltrates. We examine immunoprofiling through spatial analysis of tumor-immune cell interactions and multiplexing technologies as a predictor of patient response to cancer treatment. Further, we discuss how integrated bioinformatics can enable the amalgamation of complex morphological phenotypes with the multiomics datasets that drive precision medicine. We provide an outline to machine learning (ML) and artificial intelligence tools and illustrate fields of application in immune-oncology, such as pattern-recognition in large and complex datasets and deep learning approaches for survival analysis. Synergies of surgical pathology and computational analyses are expected to improve patient stratification in immuno-oncology. We propose that future clinical demands will be best met by (1) dedicated research at the interface of pathology and bioinformatics, supported by professional societies, and (2) the integration of data sciences and digital image analysis in the professional education of pathologists.

PMID: 30470933 [PubMed - as supplied by publisher]

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Fully automated real-time PCR for EGFR testing in non-small cell lung carcinoma.

Fully automated real-time PCR for EGFR testing in non-small cell lung carcinoma.

Virchows Arch. 2018 Nov 23;:

Authors: Colling R, Bancroft H, Langman G, Soilleux E

Abstract
Molecular testing for mutations in the EGFR gene is commonplace for patients with non-small cell lung cancer (NSCLC). These patients are often very sick and management decisions need to be made urgently. In many cases, the results of molecular testing are needed the same day, in order to start targeted therapy and allow maximum benefit for patients. The Idylla™ EGFR Mutation Test offers rapid results within three hours of requesting. This study aimed to assess the concordance of Idylla™ EGFR Mutation Test results with current standard tests. Forty formalin-fixed, paraffin-embedded NSCLC tumour cases (20 EGFR mutant and EGFR 20 wild type) were analysed by the Idylla™ EGFR Mutation Test (CE-IVD) and compared with PCR and NGS methodologies. The overall concordance between Idylla™ and standard testing was 92.5% (95% CI 80.14% to 97.42%) and the specificity of Idylla™ was 100% (95% CI 83.89% to 100%). The sensitivity was affected by loss of tumour content in tissue blocks in a small number of NGS cases; however, comparing Idylla™ with PCR alone, there was 100% concordance (95% CI 89.85% to 100%). The Idylla™ EGFR Mutation Test shows comparative accuracy to routine PCR testing for the most common EGFR mutations in NSCLC. The Idylla™ also offers significantly reduced turn-around times compared with existing modalities and therefore the platform would be a useful addition to many molecular diagnostics units.

PMID: 30470932 [PubMed - as supplied by publisher]

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A personal technical experience and results of a modified end-to-side technique of pancreatojejunostomy: A 350 patients retrospective cohort study.

A personal technical experience and results of a modified end-to-side technique of pancreatojejunostomy: A 350 patients retrospective cohort study.

Eur J Surg Oncol. 2018 Nov 10;:

Authors: Liu H, He A, Liu K, Jiang Z, Zhang F, Li X, He Y, Tao K, Wang L, Yue S

Abstract
BACKGROUND: In pancreatoduodenectomy，the treatment of pancreatic stump is a critical step, pancreaticoduodenectasis and hemorrhage are the two most common complications, which are closely related to the operation of pancreaticojejunostomy and because leaks from this incur major morbidity and mortality. We describe the special technical experience of a modified end-to-side pancreatojejunostomy(mPJ): surgical methods which combine jejunal decompression tube with pancreatic duct jejunal parachute monolayer suture，and report on the outcome of the consecutive 350 patients.
METHOD: From December 2009 to December 2016, 350 pancreatic resections were performed by a single surgeon which are consecutive. Data were retrieved from a prospectively collected Institutional database, and used for the present retrospective evaluation. Post-operative pancreatic fistulas (POPF) were stratified with the Fistula Risk Score (FRS), based on the 2005-International Study Group of Pancreatic Fistula classification (ISGPFc) and on the subsequent 2016-revised version (ISGPSc).
RESULTS: ISGPFc POPF occurred in 67/350 (19.14%): grade A in 48/350 (13.71%), grade B in 16/350 (4.57%) and grade C in 3/350 (0.86%). On the ISGPSc, POPF rate averaged 5.43%: grade B in 16/350 (4.57%) and grade C in 3/350 (0.86%). POPF rate associated with high FRS was 22.6%/9.7% (ISGPFc/ISGPSc). With low and intermediate FRS, POPFs were 5.3%/1.3% (ISGPFc/ISGPSc) and 25.7%/6.9% (ISGPFc/ISGPSc) respectively. Re-operation rate was 0.86%. In-hospital mortality rate was 0.86% and specific mortality rate for POPF was 0.86%.
CONCLUSIONS: The mPJ technique is associated with a POPF rate which was less than expected, especially for "difficult" pancreas with high FRS (soft gland texture and small duct). A larger prospective series is needed in addition to comparative studies with other techniques for robust assessment.

PMID: 30470530 [PubMed - as supplied by publisher]

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Systematic review analysis of robotic and transanal approaches in TME surgery- A systematic review of the current literature in regard to challenges in rectal cancer surgery.

Systematic review analysis of robotic and transanal approaches in TME surgery- A systematic review of the current literature in regard to challenges in rectal cancer surgery.

Eur J Surg Oncol. 2018 Nov 15;:

Authors: Grass JK, Perez DR, Izbicki JR, Reeh M

Abstract
Several patients' and pathological characteristics in rectal surgery can significantly complicate surgical loco regional tumor clearance. The main factors are obesity, short tumor distance from anal verge, bulky tumors, and narrow pelvis, which have been shown to be associated to poor surgical results in open and laparoscopic approaches. Minimally invasive surgery has the potential to reduce perioperative morbidity with equivalent short- and long-term oncological outcomes compared to conventional open approach. Achilles' heel of laparoscopic approaches is conversion to open surgery. High risk for conversion is evident for patients with bulky and low tumors as well as male gender and narrow pelvis. Hence, patient's characteristics represent challenges in rectal cancer surgery especially in minimally invasive approaches. The available surgical techniques increased remarkably with recently developed and implemented improvements of minimally invasive rectal cancer surgery. The controversial discussions about sense and purpose of these novel approaches are still ongoing in the literature. Herein, we evaluate, if latest technical advances like transanal approach or robotic assisted surgery have the potential to overcome known challenges and pitfalls in rectal cancer surgery in demanding surgical cases and highlight the role of current minimally invasive approaches in rectal cancer surgery.

PMID: 30470529 [PubMed - as supplied by publisher]

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Cancer epigenetics and the potential of epigenetic drugs for treating solid tumors.

Cancer epigenetics and the potential of epigenetic drugs for treating solid tumors.

Expert Rev Anticancer Ther. 2018 Nov 23;:

Authors: Liu Z, Gao Y, Li X

PMID: 30470148 [PubMed - as supplied by publisher]

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Three-dimensional growth of tibial shaft ossification in the human fetus: a digital-image and statistical analysis.

Three-dimensional growth of tibial shaft ossification in the human fetus: a digital-image and statistical analysis.

Surg Radiol Anat. 2018 Nov 23;:

Authors: Baumgart M, Wiśniewski M, Grzonkowska M, Badura M, Szpinda M, Pawlak-Osińska K

Abstract
PURPOSES: Tibial shaft ossification in terms of its size and growth may be criticalin describing both the fetal stage and maturity, and in identifying innate disorders. The present study was executed to quantitatively assess ossification of the tibial shaft, taking its morphometric linear, planar and volumetric parameters into account.
MATERIALS AND METHODS: With the use of methods of CT, digital-image analysis and statistics, the evolutionof tibial shaft ossification in 47 spontaneously aborted human fetuses at the age of 17-30 weeks was studied.
RESULTS: Without any male-female and right-left morphometric differences, the best fit growth dynamics fortibial shaft ossification was modelled by the following functions: y = 5.312 + 0.034 × (age)2 ± 0.001 (R2 = 0.89) for its length, y = - 2.855 + 0.307 × age ± 0.009 (R2 = 0.96) for its proximal transverse diameter, y = - 0.758 + 0.153 × age ± 0.005 (R2 = 0.88) for its middle transverse diameter, y = - 1.844 + 0.272 × age ± 0.09 (R2 = 0.90) for its distal transverse diameter, y = - 40.263 + 0.258 × (age)2 ± 0.007 (R2 = 0.94) for its projection surface area, and y = - 287.996 + 1.186 × (age)2 ± 0.037 (R2 = 0.92) for its volume. The femoral-to-tibial ossification length ratio was 1.15 ± 0.1.
CONCLUSIONS: The size of tibial shaft ossification displays neither sex nor laterality differences. Tibial shaft ossification follows quadratic functions with respect to its length, projection surface area and volume, and linear functions with respect to its proximal, middle and distal transverse diameters. The obtained morphometric data of tibial shaft ossification are considered normative age-specific references of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.

PMID: 30470878 [PubMed - as supplied by publisher]

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The pterygopalatine fossa: morphometric CT study with clinical implications.

The pterygopalatine fossa: morphometric CT study with clinical implications.

Surg Radiol Anat. 2018 Nov 23;:

Authors: Vuksanovic-Bozaric A, Vukcevic B, Abramovic M, Vukcevic N, Popovic N, Radunovic M

Abstract
PURPOSE: The pterygopalatine fossa is a deep viscerocranial space containing the maxillary artery and nerve, the pterygopalatine ganglion, and the nerve of the pterygoid canal (vidian nerve). The endoscopic approach to this area relies on adequate preoperative imaging, such as computed tomography (CT). The aim was to determine the morphometric characteristics of the pterygopalatine fossa and its communications, including several previously unpublished measurements.
METHODS: 100 CT scans (56 male and 44 female patients) were analyzed. The axial, coronal, and sagittal slices, together with the three-dimensional reconstructions, were used in the study.
RESULTS: The central diameter and the length of the foramen rotundum, the vertical diameter and the length of the pterygoid (vidian) canal, and the diameter of the sphenopalatine foramen were significantly larger in men. The central diameters of the foramen rotundum and the vidian canal were significantly smaller than their anterior and posterior transverse diameters. The vidian canal length of 12.1 mm indicates the presence of the type 3 VC with a sensitivity of 83% and a specificity of 85%.
CONCLUSION: Several new descriptions of the pterygopalatine fossa are presented here (such as the angle between the sphenopalatine foramen and the vidian canal, a new aspect in the understanding of the FR, and the distance between the posterior wall of the maxillary sinus to the vidian canal and the foramen rotundum), which might prove useful in the comprehension of the anatomy of the pterygopalatine fossa.

PMID: 30470877 [PubMed - as supplied by publisher]

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