Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 28 Μαΐου 2017

Deficiency of filaggrin regulates endogenous cysteine protease activity, leading to impaired skin barrier function

Summary

Background

Atopic dermatitis (AD) is a common inflammatory skin disorder, characterized by skin barrier defects and enhanced allergen priming. Null mutations in the filaggrin gene (FLG) are strongly associated with moderate to severe AD, but the pathways linking barrier dysfunction and cutaneous inflammation are still largely unknown.

Aim

To assess alteration of endogenous cysteine protease activity in FLG-deficient keratinocytes, and to determine whether the alteration in cysteine protease activity affects epidermal barrier function and associated gene and protein expression.

Methods

We established a stable FLG knockdown cell line, and reconstructed epidermal equivalents in vitro. Barrier function of the reconstructed epidermis, the barrier-associated genes and proteins, and the activity of endogenous cysteine proteases were tested. Inhibitors of cysteine proteases were used to further evaluate the role of endogenous cysteine proteases in epidermal barrier function.

Results

FLG knockdown induced impaired epidermal barrier function. Microarray, western blotting and fluorescence staining showed reduced expression of K10, ZO-1, E-cadherin, claudin-1 and occludin in FLG knockdown keratinocytes. Compared with cysteine protease activity in control cells, protease activity was dramatically enhanced in FLG knockdown keratinocytes. Furthermore, administration of cysteine protease inhibitors significantly recovered expression of K10 and tight junction proteins, and the barrier defect induced by FLG deficiency.

Conclusions

This is the first observation of elevated endogenous cysteine protease activity in FLG-deficient keratinocytes, which may play an important role in impaired barrier function in AD skin. Modulation of cysteine protease activity might be a novel therapeutic approach for AD treatment.



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Skin involvement as the first symptom of rapidly progressive ALK-positive systemic anaplastic large cell lymphoma

Summary

Systemic anaplastic large cell lymphomas (sALCLs) comprise a heterogeneous group of relatively rare T-cell non-Hodgkin lymphomas that are characterized by CD30 expression. Anaplastic lymphoma kinase (ALK)-positive ALCL is a type of sALCL that commonly involves lymph nodes and extranodal sites. Skin involvement usually presents as tumours, nodules and ulcers. We describe an unusual case of ALK-positive ALCL in an 11-year-old Chinese boy, who initially presented with skin eruption with rapid progression and poor prognosis. This case emphasizes the value of clinical factors to predict the prognosis of ALK-positive sALCL, and we recommend close collaboration between dermatologists, pathologists and haematologists/oncologists to assure the correct diagnosis and treatment.



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A recent-onset ulcerated nodular plaque on the scalp



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Preclinical pilot study monitoring topical drug penetration and dermal bioavailability of a peptidase inhibitor from different galenic formulations into pig dermis, using cutaneous microdialysis

Summary

Background

Cutaneous microdialysis (CM) is an ex vivo technique that allows study of tissue chemistry, including bioavailability of actual tissue concentration of unbound drug in the interstitial fluid of the body.

Aim

To test the penetration and dermal bioavailability of galenic formulations of the small-molecule IP10.C8, a dual-protease inhibitor of the dipeptidyl peptidase and aminopeptidase families.

Methods

Using CM, we tested the penetration and dermal bioavailability of IP10.C8 into the dermis and subcutis of pigs, and determined the tissue concentration of IP10.C8 enzymatically, using an enzyme activity assay (substrate Gly-Pro-pNA) and high performance liquid chromatography.

Results

Dermal bioavailability was enhanced by using microemulsion or the addition of the penetration enhancer oleic acid to a hydroxyethylcellulose (HEC) gel formulation. Dermal bioavailability was also enhanced when galenic formulations were prepared with higher pH (7.5 vs. 6.5) or higher drug concentration (5% vs. 1%) in HEC gel.

Conclusion

It seems possible, using CM for topical skin penetration testing in anaesthetized domestic pigs, to test the bioavailability of newly designed drugs. However, the experimental time is limited due to the anaesthesia, and is dependent on drug recovery. Validation of this technique for routine use is challenging, and more experiments are needed to validate this preclinical set-up.



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Topical capsaicin 8% for the treatment of neuropathic itch conditions



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Integration of reflectance confocal microscopy into clinical practice for the management of lentigo maligna



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Actinic keratosis. Or maybe not?



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Systematic review of the diagnosis of scabies in therapeutic trials

Summary

Human scabies (infestation with the mite Sarcoptes scabiei var hominis) causes a significant disease burden worldwide, yet there are no agreed diagnostic guidelines. We aimed to determine whether a consistent approach to diagnosing scabies has been used for published scabies therapeutic trials. The data sources used were the MEDLINE, Embase and Cochrane databases, from 1946 to 29 August 2013. Eligible studies were trials of therapeutic interventions against scabies in human subjects, published in English, enrolling patients with scabies, and using various therapeutic interventions. Language was a limitation of this study as some relevant trials published in languages other than English may have been excluded. Each study was reviewed by two independent authors, who assessed the clinical examination and testing approaches used for scabies diagnosis in the included studies. We found that of 71 included trials, 40 (56%) specified which clinical findings were used for diagnosis, which were predominantly rash, rash distribution, pruritus and mite burrows. Parasitological testing was used in 63% of trials (n = 45) and was used more frequently in clinic-based than in field studies. Nearly one-quarter of trials (24%, n = 17) did not define the diagnostic method used. Overall, the diagnostic approaches were poorly described, prohibiting accurate comparison of existing studies. This review further supports the need for consensus diagnostic guidelines for scabies.



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Osteolytic lesions: osteitis fibrosa cystica in the setting of severe primary hyperparathyroidism

A 58-year-old female patient presented with several weeks history of significant bilateral knee pain. Initial knee radiographs demonstrated lucencies of the bony cortex while extensive osteolytic lesions on a routine chest radiograph were suggestive of multiple myeloma or bony metastases. Biochemical investigation revealed primary hyperparathyroidism with renal insufficiency. A parathyroid adenoma was demonstrated on a neck ultrasound and sestamibi scan and subsequently confirmed by histology. We illustrate a case of primary hyperparathyroidism with osteitis fibrosa cystica and brown tumours which were initially mistaken for malignant disease.



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Streptococcus bovis prosthetic valve endocarditis associated with silent colonic carcinoma

A 75-year-old woman was admitted to our hospital with a 3-month history of fever. Of note, she had a bioprosthetic mitral valve replacement 1 year prior to admission. Streptococcus bovis was isolated from three sets of blood cultures. An echocardiogram showed a flickering mass attached to the bioprosthesis. Her blood culture became sterile by the fourth day of ceftriaxone therapy. In spite of the absence of gastrointestinal symptoms, screening colonoscopy revealed an invasive colonic adenocarcinoma. The association linking S. bovis endocarditis and colonic tumours is well recognised. However, despite early reports of this association by Klein et al in 1979, a large number of practising physicians remain unaware of this phenomenon. This lack of awareness results in lost opportunities for early diagnosis and, consequently, improved outcome in such patients. Our report emphasises this association in an area with a low incidence of S. bovis endocarditis.



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Ichthyosis linearis circumflexa with bamboo hair: challenges in the diagnosis and management

A 15-year-old boy had persistent and refractory erythroderma since early childhood. His parents noticed polycyclic skin lesions and hair fragility around the age of 5 years. He was treated by a local untrained practitioner for more than 3 years without any significant improvement, and he developed weight gain, thinning of skin, muscle weakness and growth retardation. He was evaluated in 2015 and found to have iatrogenic Cushing's disease with severe skeletal complications and pituitary-adrenal-gonadal suppression, which persisted despite gradual withdrawal of steroids.



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A rare case of bilateral lens dislocations

Description

A 39-year-old man presented to our hospital following transfer from a rural site with an acute right eye anterior lens dislocation following a traumatic blow to the head. He had been hit 7 days prior and had suffered gradual vision loss in the right eye since then. Visual acuity was counting fingers at 1 m in his right eye and perception of light in his left eye. He had an intraocular pressure (IOP) of 50 mm Hg in his right eye on arrival. He had a CT head non-contrast performed. The axial (figure 1) and sagittal (figures 2 and 3) slices demonstrated a right eye anterior lens dislocation and a left eye posterior lens dislocation. The left eye had been injured 3 years prior and the patient had not sought treatment for it at the time. On examination, the left eye was found to...



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Novel dermoscopic findings in mudi-chood disease – a case report



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Sometimes pain originating from a non-odontogenic pathologic condition is mistaken as endodontic illness, leading to misdiagnosis.

http://otorhinolaryngology-crete.blogspot.com/2017/05/adenoid-cystic-carcinoma-of-maxillary.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Subclinical hypothyroidism (SCH) has been associated with atherosclerosis and increased risk of ischemic stroke.

http://otorhinolaryngology-crete.blogspot.com/2017/05/subclinical-hypothyroidism-and-risk-of.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

The global state of psoriasis disease epidemiology: a workshop report

Summary

The International Psoriasis Council, a global nonprofit organization dedicated to innovation across the full spectrum of psoriasis, led a symposium to discuss the current state of psoriasis epidemiology and to introduce the vision and development of a Global Psoriasis Atlas. The symposium was held on 9 September 2015 at the 45th annual meeting of the European Society for Dermatological Research, Rotterdam, the Netherlands. Collectively, these presentations highlighted challenges associated with assessing psoriasis epidemiology and emphasized the urgent need for an authoritative resource to clarify psoriasis disease burden on a global scale.



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Atenolol Versus Propranolol for Treatment of Infantile Hemangiomas During the Proliferative Phase: A Retrospective Noninferiority Study

Abstract

Background/Objectives

The nonselective beta-blocker propranolol is the current criterion standard for treatment of infantile hemangiomas (IHs) and the first therapy that the U.S. Food and Drug Administration has approved for the condition, but concern about adverse effects, such as bronchospasm, hypoglycemia, and sleep disturbances, has sparked interest in the use of alternative agents such as the selective β1 antagonist atenolol. Our aim was to compare the efficacy and adverse effect profiles of atenolol with those of propranolol in the treatment of IHs in a retrospective noninferiority trial.

Methods

Twenty-seven children with IHs treated with atenolol according to the Cleveland Clinic foundation's standardized clinical assessment and management plan (SCAMP) met inclusion criteria and were compared with a matched group of 53 children with IHs treated with propranolol. Three reviewers assessed response to therapy using a modified version of the previously validated Hemangioma Activity Score (HAS).

Results

The mean change in HAS was −2.94 ± 1.20 for patients treated with atenolol and −2.96 ± 1.42 for those treated with propranolol. There was no statistically significant difference in pre- and posttreatment modified HAS scores between the two groups (p = 0.60). There was no significant difference in the overall rate of adverse effects (p = 0.10), although 11% of patients treated with propranolol experienced reactive airway symptoms, whereas this was not seen in any of the patients treated with atenolol.

Conclusion

Our study supports previous findings that atenolol is at least as effective as propranolol for treatment of IHs and poses less risk of bronchospasm. Our SCAMP proposes guidelines for dosing and monitoring parameters.



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Computer-assisted orthognathic surgery: evaluation of mandible registration accuracy and report of the first clinical cases of navigated sagittal split ramus osteotomy

Intraoperative navigation is a helpful tool in complex anatomical regions or procedures. The mobility of the mandible in relation to the skull base limits the use of navigation tools on the lower jaw if the reference device is installed on the forehead. A new workflow that allows navigation-assisted sagittal split osteotomy in orthognathic surgery using a separate non-invasive mandibular registration technique has been developed. An evaluation of accuracy in different anatomical regions and with different registration techniques was performed on skull models and skulls with movable mandibles.

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Oral lichenoid dysplasia and exophytic oral verrucous hyperplasia: Mythical entities of oral pathology

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Publication date: Available online 27 May 2017
Source:Oral Oncology
Author(s): A. Thirumal Raj




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Editorial Board/Aims & Scope

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Publication date: June 2017
Source:Oral Oncology, Volume 69





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In Memoriam – Crispian Scully 1945–2017

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Publication date: June 2017
Source:Oral Oncology, Volume 69
Author(s): Jatin P. Shah




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If a butterfly flaps its wings in the Amazon, do we form an Inflammasome?

Publication date: June 2017
Source:Molecular Immunology, Volume 86
Author(s): Ashley Mansell




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Editorial Board/ Publication Information

Publication date: June 2017
Source:Molecular Immunology, Volume 86





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Autofluorescence spectroscopy for nerve-sparing laser surgery of the head and neck—the influence of laser-tissue interaction

Abstract

The use of remote optical feedback systems represents a promising approach for minimally invasive, nerve-sparing laser surgery. Autofluorescence properties can be exploited for a fast, robust identification of nervous tissue. With regard to the crucial step towards clinical application, the impact of laser ablation on optical properties in the vicinity of structures of the head and neck has not been investigated up to now. We acquired 24,298 autofluorescence spectra from 135 tissue samples (nine ex vivo tissue types from 15 bisected pig heads) both before and after ER:YAG laser ablation. Sensitivities, specificities, and area under curve(AUC) values for each tissue pair as well as the confusion matrix were statistically calculated for pre-ablation and post-ablation autofluorescence spectra using principal component analysis (PCA), quadratic discriminant analysis (QDA), and receiver operating characteristics (ROC). The confusion matrix indicated a highly successful tissue discrimination rate before laser exposure, with an average classification error of 5.2%. The clinically relevant tissue pairs nerve/cancellous bone and nerve/salivary gland yielded an AUC of 100% each. After laser ablation, tissue discrimination was feasible with an average classification accuracy of 92.1% (average classification error 7.9%). The identification of nerve versus cancellous bone and salivary gland performed very well with an AUC of 100 and 99%, respectively. Nerve-sparing laser surgery in the area of the head and neck by means of an autofluorescence-based feedback system is feasible even after ER-YAG laser-tissue interactions. These results represent a crucial step for the development of a clinically applicable feedback tool for laser surgery interventions in the oral and maxillofacial region.



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Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ  = 808 nm GaAlAs diode laser or chlorhexidine: in vitro study

Abstract

Preservation of implant biocompatibility following peri-implantitis treatments is a crucial issue in odontostomatological practice, being closely linked to implant re-osseointegration. Our aim was to assess the responses of osteoblast-like Saos2 cells and adult human bone marrow-mesenchymal stromal cells (MSCs) to oxidized titanium surfaces (TiUnite®, TiU) pre-treated with a 808 ± 10 nm GaAlAs diode laser operating in non-contact mode, in continuous (2 W, 400 J/cm2; CW) or pulsed (20 kHz, 7 μs, 0.44 W, 88 J/cm2; PW) wave, previously demonstrated to have a strong bactericidal effect and proposed as optional treatment for peri-implantitis. The biocompatibility of TiU surfaces pre-treated with chlorhexidine digluconate (CHX) was also evaluated. In particular, in order to mimic the in vivo approach, TiU surfaces were pre-treated with CHX (0.2%, 5 min); CHX and rinse; and CHX, rinse and air drying. In some experiments, the cells were cultured on untreated TiU before being exposed to CHX. Cell viability (MTS assay), proliferation (EdU incorporation assay; Ki67 confocal immunofluorescence analysis), adhesion (morphological analysis of actin cytoskeleton organization), and osteogenic differentiation (osteopontin confocal immunofluorescence analysis; mineralized bone-like nodule formation) analyses were performed. CHX resulted cytotoxic in all experimental conditions. Diode laser irradiation preserved TiU surface biocompatibility. Notably, laser treatment appeared even to improve the known osteoconductive properties of TiU surfaces. Within the limitations of an in vitro experimentation, this study contributes to provide additional experimental basis to support the potential use of 808 ± 10 nm GaAlAs diode laser at the indicated irradiation setting, in the treatment of peri-implantitis and to discourage the use of CHX.



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Survivin in autoimmune diseases

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Publication date: Available online 28 May 2017
Source:Autoimmunity Reviews
Author(s): G. Gravina, C. Wasen, M.J. Garcia-Bonete, M. Turkkila, M.C. Erlandsson, S. Töyrä Silfverswärd, M. Brisslert, R. Pullerits, K.M. Andersson, G. Katona, M.I. Bokarewa
Survivin is a protein functionally important for cell division, apoptosis, and possibly, for micro-RNA biogenesis. It is an established marker of malignant cell transformation. In non-malignant conditions, the unique properties of survivin make it indispensable for homeostasis of the immune system. Indeed, it is required for the innate and adaptive immune responses, controlling differentiation and maintenance of CD4+ and CD8+ memory T-cells, and in B cell maturation. Recently, survivin has emerged as an important player in the pathogenesis of autoimmune diseases. Under the conditions of unreserved inflammation, survivin enhances antigen presentation, maintains persistence of autoreactive cells, and supports production of autoantibodies. In this context, survivin takes its place as a diagnostic and prognostic marker in rheumatoid arthritis, psoriasis, systemic sclerosis and pulmonary arterial hypertension, neuropathology and multiple sclerosis, inflammatory bowel diseases and oral lichen planus. In this review, we summarise the knowledge about non-malignant properties of survivin and focus on its engagement in cellular and molecular pathology of autoimmune diseases. The review highlights utility of survivin measures for clinical applications. It provides rational for the survivin inhibiting strategies and presents results of recent reports on survivin inhibition in modern therapies of cancers and autoimmune diseases.



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Comparative Clinical Characteristics and Natural History of Three Variants of Sclerosing Cholangitis: IgG4-Related SC, PSC/AIH and PSC alone

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Publication date: Available online 28 May 2017
Source:Autoimmunity Reviews
Author(s): Min Lian, Bo Li, Xiao Xiao, Yue Yang, Pan Jiang, Li Yan, Chunyan Sun, Jun Zhang, Yiran Wei, Yanmei Li, Weihua Chen, Xiang Jiang, Qi Miao, Xiaoyu Chen, Dekai Qiu, Li Sheng, Jing Hua, Ruqi Tang, Qixia Wang, M. Eric Gershwin, Xiong Ma
There is increased interest and recognition of the clinical variants of Sclerosing Cholangitis (SC) namely IgG4-SC, PSC/AIH overlap and PSC. For most Centers, the characteristic of IgG4-SC has not been thoroughly clinically compared with other Sclerosing Cholangitis variants. Further there are relatively few PSC/AIH overlap patients and the clinical outcome is not well characterized, especially for the PSC/AIH overlap syndrome. Our objective herein is to review and clarify the differences and similarities of the natural history of IgG4-SC, the PSC/AIH overlap and PSC alone. We also place in perspective the diagnostic value of serum IgG4 for IgG4-SC and investigate biomarkers for predicting the prognosis of Sclerosing Cholangitis. In this study, we took advantage of our large and well-defined patient cohort to perform a retrospective cohort study including 57 IgG4-SC, 36 PSC/AIH overlap patients, and 55 PSC patients. Firstly, as expected, we noted significant differences amongst immunoglobulin profiles and all patients exhibited similar cholestatic profiles at presentation. Cirrhotic events were found in 20 of total 57 IgG4-SC, 15 of 36 PSC/AIH overlap, and 18 of 55 PSC patients. Serum IgG4 was elevated in 92.65% of IgG4-SC patients with an 86% sensitivity and 98% specificity for diagnosis. IgG4-SC patients had a better treatment response at 6-month and 1-year than PSC/AIH patients, while the latter responded better with steroids than PSC patients. Importantly the adverse outcome-free survival of IgG4-SC patients was reduced, unlike earlier reports, and therefore similar to the PSC/AIH overlap syndrome. Serum IgG and total bilirubin were useful to predict long-term survival of IgG4-SC and PSC/AIH, respectively. In conclusion, serum IgG4 ≧ 1.25 ULN shows an excellent predictability to distinguish IgG4-SC among SC patients. IgG4-SC appears to be immune-mediated inflammatory process, while PSC/AIH overlap more tends to be cholestatic disease.



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Repeated pulses of methyl-prednisolone with reduced doses of prednisone improve the outcome of class III, IV and V lupus nephritis: An observational comparative study of the Lupus-Cruces and lupus-Bordeaux cohorts

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Publication date: Available online 28 May 2017
Source:Autoimmunity Reviews
Author(s): Guillermo Ruiz-Irastorza, Amaia Ugarte, Cecile Saint-Pastou, Estibaliz Lazaro, Amalur Iza, Lionel Couzi, Ramon Saenz, Christophe Richez, Sabrina Porta, Patrick Blanco
ObjectiveTo compare the clinical course of patients with class III, IV and V lupus nephritis (LN) treated at Hospital Universitario Cruces (CC) and at Bordeaux University Hospital (BC).MethodsThe Lupus-Cruces nephritis protocol combines pulses of 125mg of methyl-prednisolone with each fortnightly pulse of cyclophosphamide and prednisone ≤30mg/day with tapering over 12–14weeks until 2.5–5mg/day. The BC followed international lupus nephritis guidelines, combining high-dose prednisone and either mycophenolate mofetil or cyclophosphamide, followed by maintenance therapy with low dose prednisone and immunosuppressive drugs. The main outcomes were complete renal remission (CR) and glucocorticoid toxicity.Results44 patients from BC and 29 CC were included. The mean maximum prednisone dose was 42.5 (BC) vs. 21mg/day (CC), p<0.001. The average 6-month prednisone dose was 21 (BC) vs. 8.3mg/d (CC), p<0.001.The mean number of methyl-prednisolone pulses was 3 (BC) vs. 9.3 (CC), p<0.001. HCQ was used by 64% (BC) vs. 100% (CC), p<0.001.CR rates were 30% (BC) vs. 69% (CC), p=0.001, and 42% (BC) vs. 86% (CC), p<0.001, at 6 and 12months, respectively. Patients from the CC more frequently achieved CR (adjusted HR 3.8, 95%CI 2.05–7-09). The number of pulses of methyl-prednisolone were associated with CR (adjusted HR 1.09, 95%CI 1.03–1.15). Patients in the CC had a lower risk of GC-related side effects (adjusted HR 0.19, 95%CI 0.04–0.89).ConclusionThe Lupus-Cruces nephritis protocol improves the outcome of LN. Repeated methyl-prednisolone pulses help reduce the dose of oral glucocorticoids and enhance clinical response.



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Very Early and Early Systemic Sclerosis in the Spanish Scleroderma Registry (RESCLE) Cohort

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Publication date: Available online 28 May 2017
Source:Autoimmunity Reviews
Author(s): Luis Trapiella Martínez, José Bernardino Díaz López, Luis Caminal Montero, Carles Tolosa Vilella, Alfredo Guillén del Castillo, Dolores Colunga Argüelles, Manuel Rubio Rivas, Nerea Iniesta Arandia, María Jesús Castillo Palma, Luis Sáez Comet, María Victoria Egurbide Arberas, Norberto Ortego-Centeno, Mayka Freire, Jose Antonio Vargas Hitos, Juan José Ríos Blanco, Jose Antonio Todolí Parra, Mónica Rodríguez Carballeira, Adela Marín Ballvé, Antonio Javier Chamorro Fernández, Xavier Pla Salas, Ana Belén Madroñero Vuelta, Manuel Ruiz Muñoz, Vicent Fonollosa Pla, Carmen Pilar Simeón Aznar
ObjectivesAccording to the existence of subclinical organ involvement pre-scleroderma should be divided into two subsets: very early and early disease. Pre-scleroderma patients included in the Spanish Scleroderma Registry (RESCLE) Cohort were reclassified into subsets. Differences were evaluated and the risk of progression to definite systemic sclerosis was estimated.MethodsThe characteristics of very early and early SSc patients were compared. A logistic regression model was used to determine the risk factors of progression.Results1632 patients were included, 36 (2.2%) in the very early subset and 111 (6.8%) in the early subset. There were no differences in sex, age at disease onset, duration of Raynaud's phenomenon, antinuclear antibodies or capillaroscopic findings. Three (8.3%) very early SSc patients evolved to definite SSc, 2 (5.6%) of them meeting the ACR/EULAR 2013 criteria, unlike 31 (28%) early SSc patients, 20 (24%) of them meeting the criteria (p=0.034). Digestive involvement was an independent risk factor of progression (OR 17; 95% CI, 6.1–47.2).ConclusionsThe classification of early forms of scleroderma identifies patients with different prognostic risk of progression. The evolution to definite SSc is more frequent in early than in very early SSc patients. Digestive involvement is a risk factor of progression. An active assessment of organ damage in preclinical stages allows a correct classification and risk stratification, with implications for monitoring and treatment.



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Recent advances in our understanding of giant cell arteritis pathogenesis

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Publication date: Available online 28 May 2017
Source:Autoimmunity Reviews
Author(s): Maxime Samson, Marc Corbera-Bellalta, Sylvain Audia, Ester Planas-Rigol, Laurent Martin, Maria Cinta Cid, Bernard Bonnotte
Giant cell arteritis (GCA) is a granulomatous vasculitis affecting large arteries, especially the aorta and the extracranial branches of the external carotid artery. Its exact pathogenesis is not fully understood but major progress has been made in recent years, leading to new therapeutic targets like inhibition of the interleukin-6 pathway or the modulation of immune checkpoints. The cause of GCA has not been clearly identified but it is thought that GCA occurs on a genetic background and is triggered by unknown environmental factors that could activate and lead to the maturation of dendritic cells localized in the adventitia of normal arteries. These activated dendritic cells then produce chemokines which trigger the recruitment of CD4+ T cells, which in turn become activated, proliferate and polarize into Th1 and Th17 cells, which produce IFN-γ and IL-17, respectively. Exposed to IFN-γ, endothelial cells and vascular smooth muscle cells produce chemokines leading to the recruitment of further Th1 cells, CD8+ T cells and monocytes. The latter differentiate into macrophages, which, when persistently exposed to IFN-γ, form giant cells, the histological hallmark of GCA. With the contribution of vascular smooth muscle cells, immune cells then trigger the destruction and remodeling of the arterial wall, thus leading to the formation of a neo-intima resulting in progressive occlusion of the arterial lumen, which is responsible for the ischemic symptoms of GCA. In this paper, we review recent progress in our understanding of GCA pathogenesis in the fields of genetics, epigenetics, infections, immunology and vascular remodeling.



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Acute otitis media in children: a vaccine‐preventable disease?

Marco Aurélio Palazzi Sáfadi, Daniel Jarovsky
Braz J Otorhinolaryngol 2017;83:241-2

Texto Completo - PDF

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Diagnostic value of repeated Dix‐Hallpike and roll maneuvers in benign paroxysmal positional vertigo

Cenk Evren, Nevzat Demirbilek, Mustafa Suphi Elbistanlı, Füruzan Köktürk, Mustafa Çelik
Braz J Otorhinolaryngol 2017;83:243-8

Resumo - Texto Completo - PDF

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Sound generator associated with the counseling in the treatment of tinnitus: evaluation of the effectiveness

Andressa Vital Rocha, Maria Fernanda Capoani Garcia Mondelli
Braz J Otorhinolaryngol 2017;83:249-55

Resumo - Texto Completo - PDF

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Difficult septal deviation cases: open or closed technique?

Sultan Şevik Eliçora, Duygu Erdem, Hüseyin Işık, Murat Damar, Aykut Erdem Dinç
Braz J Otorhinolaryngol 2017;83:256-60

Resumo - Texto Completo - PDF

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The role of facial canal diameter in the pathogenesis and grade of Bell's palsy: a study by high resolution computed tomography

Onur Celik, Gorkem Eskiizmir, Yuksel Pabuscu, Burak Ulkumen, Gokce Tanyeri Toker
Braz J Otorhinolaryngol 2017;83:261-8

Resumo - Texto Completo - PDF

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Thyroid gland invasion in advanced squamous cell carcinoma of the larynx and hypopharynx

João Mangussi‐Gomes, Fernando Danelon‐Leonhardt, Guilherme Figner Moussalem, Nicolas Galat Ahumada, Cleydson Lucena Oliveira, Flávio Carneiro Hojaij
Braz J Otorhinolaryngol 2017;83:269-75

Resumo - Texto Completo - PDF

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Comparison of microRNA profiles between benign and malignant salivary gland tumors in tissue, blood and saliva samples: a prospective, case‐control study

Ovgu Cinpolat, Zeynep Nil Unal, Onur Ismi, Aysegul Gorur, Murat Unal
Braz J Otorhinolaryngol 2017;83:276-84

Resumo - Texto Completo - PDF

http://ift.tt/2rbcUAj

Obstructive sleep apnea in postmenopausal women: a comparative study using drug induced sleep endoscopy

Soo Kweon Koo, Gun Young Ahn, Jang Won Choi, Young Jun Kim, Sung Hoon Jung, Ji Seung Moon, Young Il Lee
Braz J Otorhinolaryngol 2017;83:285-91

Resumo - Texto Completo - PDF

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Pulmonary hypertension evaluation by Doppler echocardiogram in children and adolescents with mouth breathing syndrome

Marcela Silva Lima, Carolina Maria Fontes Ferreira Nader, Letícia Paiva Franco, Zilda Maria Alves Meira, Flavio Diniz Capanema, Roberto Eustáquio Santos Guimarães, Helena Maria Gonçalves Becker
Braz J Otorhinolaryngol 2017;83:292-8

Resumo - Texto Completo - PDF

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Airway reconstruction: review of an approach to the advanced‐stage laryngotracheal stenosis

Mohamad Ahmad Bitar, Randa Al Barazi, Rana Barakeh
Braz J Otorhinolaryngol 2017;83:299-312

Resumo - Texto Completo - PDF

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LS CE‐Chirp® vs. Click in the neuroaudiological diagnosis by ABR

Michelle Cargnelutti, Pedro Luis Cóser, Eliara Pinto Vieira Biaggio
Braz J Otorhinolaryngol 2017;83:313-7

Resumo - Texto Completo - PDF

http://ift.tt/2rbqROL

Ophthalmic complications of endoscopic sinus surgery

Malgorzata Seredyka‐Burduk, Pawel Krzysztof Burduk, Malgorzata Wierzchowska, Bartlomiej Kaluzny, Grazyna Malukiewicz
Braz J Otorhinolaryngol 2017;83:318-23

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Role of cervical vestibular evoked myogenic potentials (cVEMP) and auditory brainstem response (ABR) in the evaluation of vestibular schwannoma

Deepa Aniket Valame, Geeta Bharat Gore
Braz J Otorhinolaryngol 2017;83:324-9

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Combined ocular and cervical vestibular evoked myogenic potential in individuals with vestibular hyporeflexia and in patients with Ménière's disease

Tatiana Rocha Silva, Luciana Macedo de Resende, Marco Aurélio Rocha Santos
Braz J Otorhinolaryngol 2017;83:330-40

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Deep neck abscesses: study of 101 cases

Thiago Pires Brito, Igor Moreira Hazboun, Fernando Laffite Fernandes, Lucas Ricci Bento, Carlos Eduardo Monteiro Zappelini, Carlos Takahiro Chone, Agrício Nubiato Crespo
Braz J Otorhinolaryngol 2017;83:341-8

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Postoperative otorhinolaryngologic complications in transnasal endoscopic surgery to access the skull base

Ricardo Landini Lutaif Dolci, Marcel Menon Miyake, Daniela Akemi Tateno, Natalia Amaral Cançado, Carlos Augusto Correia Campos, Américo Rubens Leite dos Santos, Paulo Roberto Lazarini
Braz J Otorhinolaryngol 2017;83:349-55

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Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review

Guilherme Constante Preis Sella, Edwin Tamashiro, Wilma Terezinha Anselmo‐Lima, Fabiana Cardoso Pereira Valera
Braz J Otorhinolaryngol 2017;83:356-63

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First branchial cleft fistula: a difficult challenge

Corneliu Mircea Codreanu, Corneliu Codreanu, Margareta Codreanu
Braz J Otorhinolaryngol 2017;83:364-6

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Vertebral artery dissection: an important differential diagnosis of vertigo

Maíra da Rocha, Bruno Higa Nakao, Evandro Maccarini Manoel, Guilherme Figner Moussalem, Fernando Freitas Ganança
Braz J Otorhinolaryngol 2017;83:367-9

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Ethics is the best professional policy

Aracy Pereira Silveira Balbani
Braz J Otorhinolaryngol 2017;83:370

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