Viral Immunology, Ahead of Print.
https://ift.tt/2MuI8gZ
Τετάρτη 15 Αυγούστου 2018
Chemokine CXCL10 and Coronavirus-Induced Neurologic Disease
Plasma Kallistatin Levels in Children with Community-Acquired Pneumonia
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2MToxUV
Plasma Kallistatin Levels in Children with Community-Acquired Pneumonia
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2nHH2k5
Coexistence of medullary thyroid carcinoma and recurrent non-functional pituitary adenoma: a case report
Medullary thyroid carcinoma and pituitary adenoma are neuroendocrine tumors and their coexistence has not been reported in the literature, previously. Medullary thyroid carcinoma is a neoplasm of the thyroid g...
https://ift.tt/2w9DcUH
Stem Cells in Dermatology and Anti-aging Care of the Skin
Multipotent stem cells have paved the way for new applications and deeper understanding in regenerative medicine and the pathophysiology of aging. During skin aging, cumulative photodamage, exhaustion of endogenous stem cell populations, mechanical stress, and increased fibrosis lead to skin with decreased epidermal thickness and compromised dermal integrity. Various studies characterizing dermatologic stem cell populations and its coordination with one another during wound healing have uncovered how these components can act as a skin aging therapy.
https://ift.tt/2MNcV5v
Mesenchymal Stem Cells and Stromal Vascular Fraction for Hair Loss
The current state of the applicability of cell therapy for the treatment of various conditions of hair loss reveals a promising and potentially effective role. Further research, based on published work to date, is indicated to further explore the potential roles of autologous fat grafting, mesenchymal stem cells, and stromal vascular fraction therapy. The authors' evolving experience matches these promising scientific findings.
https://ift.tt/2nDNF6K
Microneedling with Biologicals
Microneedling is a popular and cost-effective treatment with little down time. The application of topical agents to enhance outcomes is common practice. Microchannels created with nonthermal needling close at 4 hours to 6 hours due to fibrin plugs. Channels created with thermal needling or fractional laser stay open longer and enhance drug or biological uptake more due to the dermal sponge injury pattern that is created. Nonthermal microneedling devices may need Food and Drug Administration clearance, which also notes that dermaceuticals should be considered drugs in many cases.
https://ift.tt/2MSx7mv
Mesothelial Stem Cells and Stromal Vascular Fraction
Autologous human fat-derived mesenchymal stem cells are present in stromal vascular fraction. Stromal vascular fraction can be easily and safely extracted from lipoaspirate. The regenerative, antiinflammatory and immunomodulatory effects of stromal vascular fraction are being documented in ongoing therapeutic response studies.
https://ift.tt/2PditIf
Introduction
The use of biologicals for clinical use is rapidly increasing. One of the logical questions is what constitutes a biological? The official definition of biological products by the Food and Drug Administration is "Biological products can be composed of sugars, proteins, or nucleic acids, or a combination of these substances. They may also be living entities, such as cells and tissues. Biologics are made from a variety of natural resources—human, animal, and microorganism—and may be produced by biotechnology methods."
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Platelet-Rich Plasma for Hair Loss
Given substantial advances in hair regrowth research and platelet-rich plasma (PRP) science, a review of currently used systems and results is informative for physicians using a biologics approach to hair restoration. Overall positive clinical response to the use of PRP in androgenetic and alopecia areata patients is observed. The effects on hair density, count, and thickness were demonstrated through multiple clinical trials. Use as an adjunct to hair transplantation and with other technologies is also described. When compared with traditional oral/topical treatments, the lack of identifiable complications and convenience of treatment provide a positive outlook for future use and investigation.
https://ift.tt/2PdKrUi
Platelet-Rich Plasma for Skin Rejuvenation and Tissue Fill
Platelet preparations, including platelet-rich plasma and platelet-rich fibrin matrix, have been used to improve wound healing, recovery time, and cosmetic outcomes for facial rejuvenation. Bioactive growth factors released from platelets are the putative agents in producing a reparative tissue reaction in the treated area. Different methods of processing the patients' blood will yield different types of platelet preparations with different components and properties, and it is important to understand these differences and their potential implications. More robust studies are necessary to better understand the nuances of these preparations and their optimal use.
https://ift.tt/2MSN64l
Lasers, Microneedling, and Platelet-Rich Plasma for Skin Rejuvenation and Repair
Skin resurfacing for the purpose of rejuvenation and repair continues to evolve with the development of noninvasive or minimally invasive surgical substitutes. Advances in laser therapy, microneedling, and platelet-rich plasma have reinvigorated research in wound repair and regenerative science. An overall positive clinical response toward the use of platelet-rich plasma as an adjuvant to fractional photothermolysis and percutaneous collagen induction is observed. Its effect on post-treatment adverse symptoms, erythema, edema, crusting, and clinical outcomes in rejuvenation are summarized in this article. The lack of identifiable complications and convenience of treatment provides a positive outlook for future use and investigations.
https://ift.tt/2nFfMCB
Hair Biology
Healthy hair is vital to identity. Understanding the intricate anatomy and physiology of hair provides insight into the aging process and the eventual loss of either hair pigmentation or hair shafts. There are several biologics available that have enabled altering or slowing the aging process of hair, but, unfortunately, no agent exists that can reverse the natural course. The commonly used biologics are discussed.
https://ift.tt/2MSwYiX
Biologic Treatments Are Our Future, but a More Regulated One
There is very little question that development of biological products is a large part of facial plastic surgery's future. Our colleagues in plastic surgery have embraced these technologies and are moving forward with them.
https://ift.tt/2PdZGMK
A General Approach to Facial Palsy
Management of facial palsy can be daunting. This article presents a conceptual framework for classification and therapeutic management of facial palsy.
https://ift.tt/2nFLoZ1
14 ways to lose weight without diet or exercise
Strict diets can be challenging to follow, and people may not always have the time or ability to exercise. However, a variety of simple lifestyle changes can help people lose weight and improve their health. These include taking probiotics, getting enough sleep, and thoroughly chewing food. Learn more here.
https://ift.tt/2nF09v1
Resolution of Atypical Lichen Myxedematosus After Sofosbuvir-Velpatasvir Treatment for Hepatitis C
This case report describes a patient with lichen myxedematosus that resolved after sofosbuvir-velpatasvir treatment for hepatitis C infection.
https://ift.tt/2MNFvE2
https://ift.tt/2MNFvE2
A Case of Pigmented Longitudinal Melanonychia
A man in his 40s presented to the dermatology clinic for evaluation of a dark brown longitudinal pigment band covering his left second toenail; the lesion appeared 12 months prior, had been growing, and was asymptomatic. What is your diagnosis?
https://ift.tt/2Pc0a68
https://ift.tt/2Pc0a68
Safety Risk of Dermatoscope Magnets in Patients With Cardiovascular Implanted Electronic Devices
This observational cross-sectional study assesses the magnets in 3 different dermatoscopes to determine their ability to disrupt the functionality of pacemakers, defibrillators, and other implanted devices in patients.
https://ift.tt/2MR39iO
https://ift.tt/2MR39iO
Aprepitant for the Treatment of Pruritus in Sézary Syndrome
This randomized clinical trial assesses whether treatment with the neurokinin 1 receptor antagonist aprepitant decreases pruritus vs placebo in patients with Sézary syndrome.
https://ift.tt/2nEDleN
https://ift.tt/2nEDleN
Self-reported Patient Motivations for Seeking Cosmetic Procedures
This multicenter observational study assesses the importance of self-reported factors that motivate patients to undergo minimally invasive cosmetic surgical procedures.
https://ift.tt/2MORUYf
https://ift.tt/2MORUYf
Interpretation of Melanocytic Lesions in the Digital Era vs Traditional Microscopy
This study of 87 pathologists compares the use of digital whole-slide imaging vs traditional microscopy in pathologists' ability to accurately interpret melanocytic lesions and reproduce correct diagnoses.
https://ift.tt/2PbZVIg
https://ift.tt/2PbZVIg
The impact of allergen exposure and specific immunotherapy on circulating blood cells in allergic rhinitis
Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the nasal mucosa with well described local immune responses during allergen exposure. The frequent association of AR with general extra-nasal s...
https://ift.tt/2MpLuSw
Does Viewing a Third Molar Informed Consent Video Decrease Patients’ Anxiety?
Publication date: Available online 15 August 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Daniel M. Laskin, Shaden Alfaqih, Caroline K. Carrico
Abstract
Purpose
Prior to having impacted third molars removed, patients are frequently asked to view a brief video describing the operation and its benefits and risks. The purpose of this study was to determine whether such information reduces or increases their anxiety level.
Patients and methods
In this prospective cohort study, 100 patients presenting for consultation regarding removal of their impacted third molars completed a form asking them to grade their anxiety level before and after viewing the informational video as calm, slightly anxious, moderately anxious and very anxious.
Results
Thirty-one percent reported increased anxiety after viewing the video. Only 12% showed a decrease, and in 57% there was no change (28 % were still slightly, moderately or very anxious). When the pre and post-viewing anxiety levels were scored, it showed a statistically significant increase in anxiety post-viewing.
Conclusions
Viewing this video increased, or did not reduce, the anxiety level in a significant number of patients. Therefore, it is important to complement this video with positive verbal and written reinforcement of such aspects as patient comfort, procedural safety and adequate pain control.
https://ift.tt/2vL9Cpb
Odontogenic necrotizing fasciitis: a systematic review of the literature
Abstract
Background
While odontogenic soft tissue infections of the head and neck are common, progression to necrotizing fasciitis is relatively rare. Necrotizing fasciitis is a potentially life-threatening and rapidly progressive soft tissue infection that can lead to significant skin and soft tissue loss, mediastinitis, vascular thrombosis or rupture, limb loss, organ failure, and death.
Methods
A PubMed literature search was conducted for case reports and case series on odontogenic necrotizing fasciitis. Individual patient data was analyzed and compiled and demographic, treatment, microbiology, and mortality data were extracted. Fisher's exact test was used to examine the relationship between death from odontogenic necrotizing fasciitis and diabetes mellitus (DM) and human immunodeficiency virus (HIV) positivity.
Results
A total of 58 studies totaling 164 patients were identified. Thirty-three patients had DM and 3 were HIV +. All patients underwent aggressive surgical debridement and treatment with IV antibiotics. Twenty patients were also treated with hyperbaric oxygen. There were 16 deaths reported, for a mortality rate of 9.8%. The mortality rate among patients with DM was 30.3 and 0% among HIV positive patients. There was a statistically significant increase in the mortality rate in DM patients with odontogenic necrotizing fasciitis (p = 0.0001, odds ratio for death 9.1).
Conclusions
Necrotizing fasciitis arising from odontogenic infection is a rapidly progressive and life-threatening illness. Prompt recognition of the infection, aggressive and often serial surgical debridement, and aggressive broad-spectrum antibiotics are necessary to prevent serious morbidity and mortality. Patients with diabetes mellitus are at a significantly increased risk of death from odontogenic necrotizing fasciitis.
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The Positive Effect of Sialendoscopy with Irrigation Lavage for Sialadenitis without Sialolithiasis or Stenosis
ORL
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Predictability of Preoperative Carotid Artery Corrected Flow Time for Hypotension After Spinal Anesthesia in Patients Undergoing Cesarean Section
Condition: Cesarean Section
Intervention: Diagnostic Test: Doppler sonographic measurement
Sponsor: Yonsei University
Not yet recruiting
https://ift.tt/2PcAkPp
Intervention: Diagnostic Test: Doppler sonographic measurement
Sponsor: Yonsei University
Not yet recruiting
https://ift.tt/2PcAkPp
Imaging With a PET Agent for Detection of Cancers of the Head and Neck
Condition: Head and Neck Cancer
Interventions: Drug: [18F]- PARPi; Diagnostic Test: PET/CT Scans
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2MLsfji
Interventions: Drug: [18F]- PARPi; Diagnostic Test: PET/CT Scans
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2MLsfji
Nutritional Course of Care After Surgical Treatment at the Patients Affected by a Cancer of the Head and by the Neck
Conditions: Nutrition Disorders; Head and Neck Cancer
Intervention: Other: Experimental group
Sponsor: Centre Hospitalier Universitaire, Amiens
Recruiting
https://ift.tt/2PczIcz
Intervention: Other: Experimental group
Sponsor: Centre Hospitalier Universitaire, Amiens
Recruiting
https://ift.tt/2PczIcz
Scapular Bronchogenic Cyst in a Girl Presenting as Recurrent Cellulitis: A Case Report and Review of the Literature
Bronchogenic cysts are rare, congenital cysts originating from respiratory epithelium and typically found within the chest. Cutaneous bronchogenic cysts are exceedingly uncommon, with only 19 reported cases in the scapular region and almost exclusively occurring in male patients. Herein, we present the case of a female patient with recurrent cellulitis secondary to a bronchogenic cyst, which was diagnosed after surgical excision. We also provide a review of the literature to consolidate the current understanding of cutaneous scapular bronchogenic cysts. To our knowledge, this is the first such case reported from Canada.
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Qualität von Patienteninformationsbroschüren zum atopischen Ekzem
Zusammenfassung
Hintergrund
Wie bei anderen chronischen Erkrankungen spielt die Informationsvermittlung zu Erkrankungen und ihrer Therapie beim atopischen Ekzem (AE) eine große Rolle. Aus der Literatur ist bekannt, dass Informationsbroschüren häufig nicht den Anforderungen der evidenzbasierten Patienteninformation entsprechen.
Ziel der Arbeit
Ziel dieser Arbeit war es daher, die Qualität von Informationsbroschüren zum AE zu untersuchen.
Material und Methoden
Insgesamt wurden 35 Broschüren in die Studie eingeschlossen. Diese stammen von Selbsthilfegruppen, aus dem Internet und aus Arztpraxen der Fachrichtungen Allgemeinmedizin, Pädiatrie und Dermatologie sowie Apotheken in der Stadt Regensburg. Die Qualitätsanalyse wurde mittels DISCERN-Instrument durchgeführt.
Ergebnisse
Die untersuchten 35 Patienteninformationsbroschüren zum Thema AE wiesen nahezu alle relevante Mängel auf und waren qualitativ im Mittel- und Unterfeld anzusiedeln. Keine der Broschüren verfügte über eine sehr gute Qualität. Lediglich 3 Broschüren wurden als „gut" bewertet.
Diskussion
Die Standards der evidenzbasierten Patienteninformation werden von einem Großteil der Informationsbroschüren zum Thema AE nicht erfüllt. Es ist von einem Versorgungsmangel an qualitativ hochwertiger Information auszugehen. Eine Verbesserung der vorhandenen Informationsmaterialen sowie ein Abgleich von EBPI(evidenzbasierte Patienteninformation)-Standards und dem Informationsbedarf von AE-Patienten sollten Gegenstand künftiger Forschung sein.
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A prospective diagnostic study on povidone–iodine retention in lesions suspected to be squamous cell carcinoma or keratoacanthoma
Australasian Journal of Dermatology, EarlyView.
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Complete resolution and periodic recurrence of multiple postradiation atypical vascular lesions
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2PbjRuL
Subungual Bowen disease. Complete remission 14 years post‐photodynamic therapy (PDT)
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2ML548F
Clinical Manifestation of Hyper IgE Syndrome Including Otitis Media
Abstract
Purpose of Review
The hyper IgE syndromes (HIES) comprise a group of rare primary immunodeficiency disorders (PIDDs), which are characterized by extremely high serum IgE levels, eczema, recurrent skin and pulmonary infections. Both autosomal dominant (AD) HIES due to STAT3 mutations and autosomal recessive (AR) HIES due to PGM3, SPINK5, DOCK8 and TKY2 mutations have been reported. Here, we aim to summarize and compare the major clinical manifestations of different subtypes of HIES. We will also discuss otitis media, which usually do not get enough attention in HIES. Update and familiarity with these clinical features will help to make a better diagnose, assessment and treatment of HIES.
Recent Findings
Although hyper serum IgE levels have been identified in PGM3 deficiency and Comel–Netherton syndrome, PGM3 and SPINK5 genes were not included in the list of genetic etiologies of AR-HIES by the Expert Committee of the International Union of Immunological Societies until 2015. The identification of these HIES-causing genes greatly promoted the pathogenic mechanism studies of HIES. Also, in recent years, more clinical manifestations, which were often not of concern in HIES patients, have been shown to be highly related to HIES. For example, a significantly high frequency of vascular and gastrointestinal abnormities has been reported in STAT3-deficient AD-HIES patients. These new findings might help to provide new clues to the functional study of these HIES-related genes.
Summary
This review summarizes and compares the major clinical manifestations of different subtypes of HIES, and we suggest that the incidence and severity of otitis media should not be underestimated in HIES patients.
https://ift.tt/2OCCM0u
Tips for Seeing Patients via Telemedicine
Abstract
Purpose of Review
Telemedicine is a technology that permits patients to be seen at a distance. This review describes different types of telemedicine, why they might be useful for a practice, what equipment is needed, and how to select and schedule patients.
Recent Findings
The use of synchronous telemedicine is increasing rapidly and has surpassed 50% of ambulatory encounters in some instances. Management of patients is particularly germane for an allergy practice since it is an outpatient specialty with patients who live in widely distributed locations with limited access to allergists. With utilization of digital exam equipment, in vitro tests for diagnosis, and spirometry at the patient location, there are few clear advantages of seeing patients in-person over virtual visits.
Summary
Telemedicine is here today. As its use increases, it is critical that allergy specialists embrace this new technology.
https://ift.tt/2P91zdR
Effects of quercetin on human oral keratinocytes during re-epithelialization: an in vitro study
Publication date: Available online 15 August 2018
Source: Archives of Oral Biology
Author(s): Miyashaer Hujiahemaiti, Xiaolin Sun, Jing Zhou, Huixin Lv, Xue Li, Manlin Qi, Minghan Chi, Chunyan Li, Yanmin Zhou
Abstract
Background
The width of keratinized mucosa plays an important role in esthetic and functional outcomes of dental implants. Lack of keratinized mucosa may lead to poor oral hygiene and greater soft-tissue recession. This study aimed at assessing the potential of quercetin in promoting human oral keratinocyte (HOK) proliferation and re-epithelializationin vitro.
Materials and Methods
HOK were detected in the absence or presence of test substances. The Cell Counting Kit-8 was used to assess cell viability and proliferation capacity. Re-epithelization was assessed using a keratinocyte monolayer scratch assay. Cell migration was monitored via Transwell chambers. Porphyromonas gingivalis lipopolysaccharide was used to stimulate keratinocytes for mimicking the inflammatory situation. mRNA expression of inflammatory cytokines (interleukin-1beta, IL-1β and tumor necrosis factor alpha, TNF-α), cell adhesion molecules (Integrin-α6, Integrin-β4), and growth factors (transforming growth factor beta 1,TGF-β1 and transforming growth factor beta 3, TGF-β3) were estimated using RT-qPCR. Protein contents of TGF-β1 and TGF-β3 were investigated by enzyme-linked immunosorbent assay.
Results
Multiplex analysis revealed that quercetin enhances HOK proliferation via an upregulation of adhesion molecules (Integrin-α6β4). Additionally, re-epithelialization rate was significantly greater in the presence of quercetin than in the control (P < 0.01). Furthermore, 20 µM of quercetin increases both mRNA and protein levels of TGF-β3 under basal and wound conditions without affecting TGF-β1 production. Expressions of pro-inflammatory cytokines were downregulated by quercetin treatment.
Conclusion
Quercetin promotes HOKs proliferation and oral re-epithelialization in vitro.
https://ift.tt/2MeYWt4
Expression of biological mediators during orthodontic tooth movement: A systematic review
Publication date: Available online 15 August 2018
Source: Archives of Oral Biology
Author(s): L. Vansant, M. Cadenas De Llano-Pérula, A. Verdonck, G. Willems
Abstract
Objectives
The aim of the present systematic review was to offer a timeline of the events taking place during orthodontic tooth movement(OTM).
Materials and methods
Electronic databases PubMed, Web of Science and EMBASE were searched up to November 2017. All studies describing the expression of signaling proteins in the periodontal ligament(PDL) of teeth subjected to OTM or describing the expression of signaling proteins in human cells of the periodontal structures subjected to static mechanical loading were considered eligible for inclusion for respectively the in-vivo or the in-vitro part. Risk of bias assessment was conducted according to the validated SYRCLE's RoB tool for animal studies and guideline for assessing quality of in-vitro studies for in-vitro studies.
Results
We retrieved 7583 articles in the initial electronic search, from which 79 and 51 were finally analyzed. From the 139 protein investigated, only the inflammatory proteins interleukin(IL)-1β, cyclooxygenase(COX)-2 and prostaglandin(PG)-E2, osteoblast markers osteocalcin and runt-related transcription factor(RUNX)2, receptor activator of nuclear factor kappa-B ligand(RANKL) and osteoprotegerin(OPG) and extracellular signal–regulated kinases(ERK)1/2 are investigated in 10 or more studies.
Conclusion
The investigated proteins were presented in a theoretical model of OTM. We can conclude that the cell activation and differentiation and recruitment of osteoclasts is mediated by osteocytes, osteoblasts and PDL cells, but that the osteogenic differentiation is only seen in stem cell present in the PDL. In addition, the recently discovered Ephrin/Ephs seem to play an role parallel with the thoroughly investigated RANKL/OPG system in mediating bone resorption during OTM.
https://ift.tt/2Bek1ik
Effects of quercetin on human oral keratinocytes during re-epithelialization: an in vitro study
Publication date: Available online 15 August 2018
Source: Archives of Oral Biology
Author(s): Miyashaer Hujiahemaiti, Xiaolin Sun, Jing Zhou, Huixin Lv, Xue Li, Manlin Qi, Minghan Chi, Chunyan Li, Yanmin Zhou
Abstract
Background
The width of keratinized mucosa plays an important role in esthetic and functional outcomes of dental implants. Lack of keratinized mucosa may lead to poor oral hygiene and greater soft-tissue recession. This study aimed at assessing the potential of quercetin in promoting human oral keratinocyte (HOK) proliferation and re-epithelializationin vitro.
Materials and Methods
HOK were detected in the absence or presence of test substances. The Cell Counting Kit-8 was used to assess cell viability and proliferation capacity. Re-epithelization was assessed using a keratinocyte monolayer scratch assay. Cell migration was monitored via Transwell chambers. Porphyromonas gingivalis lipopolysaccharide was used to stimulate keratinocytes for mimicking the inflammatory situation. mRNA expression of inflammatory cytokines (interleukin-1beta, IL-1β and tumor necrosis factor alpha, TNF-α), cell adhesion molecules (Integrin-α6, Integrin-β4), and growth factors (transforming growth factor beta 1,TGF-β1 and transforming growth factor beta 3, TGF-β3) were estimated using RT-qPCR. Protein contents of TGF-β1 and TGF-β3 were investigated by enzyme-linked immunosorbent assay.
Results
Multiplex analysis revealed that quercetin enhances HOK proliferation via an upregulation of adhesion molecules (Integrin-α6β4). Additionally, re-epithelialization rate was significantly greater in the presence of quercetin than in the control (P < 0.01). Furthermore, 20 µM of quercetin increases both mRNA and protein levels of TGF-β3 under basal and wound conditions without affecting TGF-β1 production. Expressions of pro-inflammatory cytokines were downregulated by quercetin treatment.
Conclusion
Quercetin promotes HOKs proliferation and oral re-epithelialization in vitro.
https://ift.tt/2MeYWt4
Expression of biological mediators during orthodontic tooth movement: A systematic review
Publication date: Available online 15 August 2018
Source: Archives of Oral Biology
Author(s): L. Vansant, M. Cadenas De Llano-Pérula, A. Verdonck, G. Willems
Abstract
Objectives
The aim of the present systematic review was to offer a timeline of the events taking place during orthodontic tooth movement(OTM).
Materials and methods
Electronic databases PubMed, Web of Science and EMBASE were searched up to November 2017. All studies describing the expression of signaling proteins in the periodontal ligament(PDL) of teeth subjected to OTM or describing the expression of signaling proteins in human cells of the periodontal structures subjected to static mechanical loading were considered eligible for inclusion for respectively the in-vivo or the in-vitro part. Risk of bias assessment was conducted according to the validated SYRCLE's RoB tool for animal studies and guideline for assessing quality of in-vitro studies for in-vitro studies.
Results
We retrieved 7583 articles in the initial electronic search, from which 79 and 51 were finally analyzed. From the 139 protein investigated, only the inflammatory proteins interleukin(IL)-1β, cyclooxygenase(COX)-2 and prostaglandin(PG)-E2, osteoblast markers osteocalcin and runt-related transcription factor(RUNX)2, receptor activator of nuclear factor kappa-B ligand(RANKL) and osteoprotegerin(OPG) and extracellular signal–regulated kinases(ERK)1/2 are investigated in 10 or more studies.
Conclusion
The investigated proteins were presented in a theoretical model of OTM. We can conclude that the cell activation and differentiation and recruitment of osteoclasts is mediated by osteocytes, osteoblasts and PDL cells, but that the osteogenic differentiation is only seen in stem cell present in the PDL. In addition, the recently discovered Ephrin/Ephs seem to play an role parallel with the thoroughly investigated RANKL/OPG system in mediating bone resorption during OTM.
https://ift.tt/2Bek1ik
Antiphospholipid syndrome: An update on risk factors for pregnancy outcome
Publication date: Available online 15 August 2018
Source: Autoimmunity Reviews
Author(s): De Carolis Sara, Tabacco Sara, Rizzo Francesca, Giannini Andrea, Botta Angela, Salvi Silvia, Garufi Cristina, Benedetti Panici Pierluigi, Lanzone Antonio
Abstract
Background
The optimal treatment of women with primary antiphospholipid syndrome (APS) is still debated. About 20–30% of women with APS remain unable to give birth to healthy neonates despite conventional treatment, consisting of prophylactic-dose heparin and low-dose aspirin. These cases are defined "refractory obstetric APS". The early identification of risk factors associated with poor pregnancy outcome could be the optimal strategy to establish criteria for additional therapies, such as hydroxychloroquine, steroids, intravenous immunoglobulin, and plasma exchange.
Purpose
The aim of the present study was to review current literature about risk factors for poor pregnancy outcome.
Search methods.
The PubMed database was used to search for peer-reviewed original and review articles concerning risk factors for pregnancy outcome in APS from 1st January 1990 to 15th January 2018.
Outcomes.
History of pregnancy morbidity and/or thrombosis, the association with SLE and/or other autoimmune diseases are well known history-based predictive factors for obstetrical complications, such as miscarriage, maternal venous thromboembolism, intrauterine foetal demise, preeclampsia, and neonatal death. Moreover, laboratory findings associated with poor pregnancy outcome are: triple antiphospholipid antibodies aPL positivity, double aPL positivity, single aPL positivity, false-positive IgM for CMV, and hypocomplementemia. Triple positivity is confirmed as the most significant risk factor by a large body of evidence.
Furthermore, the abnormal uterine arteries Doppler velocimetry results are confirmed to be strongly associated with poor pregnancy outcomes in APS. The good performance of the uterine arteries velocimetry, as a negative predictive factor, was reported by different studies. On the contrary, in case of abnormal uterine arteries results, the relevance of a careful surveillance is highlighted for the high risk of maternal-foetal complications. Nevertheless, this tool is a late indicator to suggest any additional treatments.
Conclusions
In order to prevent obstetrical complications and establish the optimal combination therapy, the knowledge at preconception or at the beginning of pregnancy of risk factors associated with poor pregnancy outcome could be a crucial step for management and treatment of APS. In addition, in the preconception assessment a regimen with low-dose aspirin, folic acid, and vitamin D supplementation should be offered, and a treatment strategy has to be established (conventional vs additional therapy). In fact, additional treatment has to be tailored for each patient.
https://ift.tt/2vL3LA2
The role of stress in the mosaic of autoimmunity. An overlooked association
Publication date: Available online 14 August 2018
Source: Autoimmunity Reviews
Author(s): Kassem Sharif, Abdulla Watad, Louis Coplan, Benjamin Lichtbroun, Alec Krosser, Michael Lichtbroun, Nicola Luigi Bragazzi, Howard Amital, Arnon Afek, Yehuda Shoenfeld
Abstract
Stress is defined as the pscyophysiological reaction in which the steady state is disturbed or threatened. Stress is not always perceived as a negative response. Stress results when environmental demands exceed an individuals' adaptive capacities. Autoimmune diseases are heterogeneous group of chronic diseases which occur secondary to loss of self antigen tolerance. The etiopathogenesis of autoimmune disease is uncertain. Genetic factors as well as environmental factors appear to interplay, leading to a cascade of events resulting in disease onset. Stress has been postulated to play a role in disease onset in the genetically susceptible patients. During the stress response, catecholamines and glucocorticoids are released from locus coeruleus and adrenal gland. These biomolecules exert control over various immune cells in the innate and adaptive arms of the immune system, thereby altering the cytokine profile released. The increase of IL-4 promotes T-helper 2 (Th2) cell differentiation, while the decrease in IL-12 and the increased IL-10 production reduce the number of T-helper 1 (Th1) cells.. The relationship between stress and autoimmune diseases is intricate. Stress has been shown to be associated with disease onset, and disease exacerbations in rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, Graves' disease as well as other autoimmune conditions. In certain conditions such as psoriasis, stress has been implicated in delaying lesion clearance upon the application of standard treatment regimes. Finally, psychological therapy and cognitive behavioral therapy aimed to reduce stress levels was shown to be effective in influencing better outcomes in many autoimmune diseases. The purpose of this paper is to closer inspect the clinical evidence regarding the role of stress on influencing the various aspects of disease entities.
https://ift.tt/2OBODfj
Prevention of Earlobe Keloid Recurrence After Excision: Assessment of the Value of Presurgical Injection of Triamcinolone
The ear is commonly involved in keloid formation, being often pierced. This study estimates the value of pre-excision triamcinolone injection of earlobe keloid, by comparing recurrence rates in patients who only received postexcision triamcinolone injection to those who had it administered before and after excision. The prospective intervention study involved 18 keloid lesions in as many consenting patients who presented with pedunculated earlobe keloid from January 2005 to January 2007. Triamcinolone doses were administered 10 mg/cm of lesion or sutured excision site. Each patient was followed-up for 10 years. Aggregate length of keloid lesions at presentation was 24.4 cm in Group A and 26.5 cm in Group B. Aggregate length of postexcision sutured wound in Group A was 16.1 cm, and 14.8 cm in Group B. Group A patients received a total of 1610 mg of triamcinolone, while a total of 4660 mg of same drug was administered to Group B patients, among whom 3180 mg was delivered presurgically. Total number of clinic visits during the course of treatment in Group A was 10, while that of Group B was 22. No patient with recurrent keloid was recorded in both groups. The authors concluded that there is no advantage to presurgical injection of triamcinolone when excision is considered as part of treatment protocol of a keloid lesion. This study helps to eliminate an ostensibly needless part of a commonly used treatment protocol. Address correspondence and reprint requests to Bayo Aluko-Olokun, FMCDS, Department of Facial Surgery, National Hospital, Abuja, Nigeria; E-mail: balukoolokun@gmail.com Received 1 March, 2018 Accepted 11 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2ODcMlU
https://ift.tt/2ODcMlU
Effect of Mannitol Infusion on Optic Nerve Injury After Acute Traumatic Subarachnoid Hemorrhage and Brain Injury
The primary aim of this paper is to investigate the neuroprotective and antiinflammatory effects of mannitol on optic nerve injury after acute traumatic subarachnoid hemorrhage and brain injury in rat models. Traumatic brain injury (TBI) and traumatic subarachnoid hemorrhage (tSAH) were produced by a custom-made weight-drop impact acceleration device. Thirty male Wistar rats were divided into 3 groups. Group I (n = 10) was the sham group, group II (n = 10) received TBI, and group III (n = 10) received TBI + mannitol (1 mg/kg intravenously). Optic nerve tissue glutathione peroxidase (GPx) and interleukin 1 beta (IL-1β) levels were measured 4 hours after the trauma. The authors used Kruskal–Wallis variance analysis and Mann–Whitney U tests for statistical analysis. Optic nerve tissue GPx levels were significantly higher in group III than in groups I and II (P
https://ift.tt/2Mf1GGM
https://ift.tt/2Mf1GGM
Lingual Nerve Entrapment in Fused Submandibular and Sublingual Salivary Glands: A Unique Finding
Lingual nerve (LN) is one among the 3 branches of posterior division of mandibular nerve. It might get entrapped in the infratemporal fossa by lateral pterygoid muscle, pterygospinous ligament, or lateral pterygoid plate. Its entrapment in the submandibular region has not been reported yet. A unique entrapment of LN in the fused submandibular and sublingual salivary glands in a cadaver was reported. The deep parts of the submandibular and sublingual salivary glands were completely fused with each other. The LN passed through the center of the fused part. Histologically both submandibular and sublingual salivary glands had both mucous and serous acini. Though this entrapment might not cause any functional problems, it might get injured during various surgical procedures of the submandibular region. Address correspondence and reprint requests to Satheesha B. Nayak, MSc, PhD, Professor of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Madhav Nagar, Manipal 576104, Karnataka State, India; E-mail: sathish.nayak@manipal.edu Received 9 May, 2018 Accepted 16 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2Mht873
https://ift.tt/2Mht873
Syngnathia
Syngnathia is a congenital fusion of the upper and lower jaws. Its occurrence poses a significant challenge to feeding and its management is challenging to both the surgeon and the anaesthetist. Reports in the literature are mainly clinical reports or case series. To the knowledge of the authors and from the available literature, this is only the fourth report from Nigeria. The presentation and successful management of a Nigerian female neonate with congenital syngnathia is described and reviewed with literature. Address correspondence and reprint requests to Timothy O. Aladelusi, FWACS, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria 200001; E-mail: drtimmylee@gmail.com Received 28 March, 2018 Accepted 15 June, 2018 The authors disclose no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2ODcqf4
https://ift.tt/2ODcqf4
A Modified Pre-auricular Approach in the Treatment of Orbital Zygomatic Maxillary Complex Fractures
Objective: This study aimed to evaluate the safety of a modified pre-aricular approach in the treatment of orbital zygomatic maxillary complex fractures. Methods: This was a retrospective study of clinical data from 108 adults who were diagnosed with orbital zygomatic maxillary complex fractures and undergo open reduction and internal fixation through a modified pre-auricular approach. Exophthalmometry and limitation of extraocular muscle movement were determined using a Hertel exophthalmometer or synoptophore examination respectively. Primary complications were recorded, and postoperative facial nerve injury was tested by electrophysiologic analysis. Results: All patients received satisfied functional and cosmetic results at least 6 moths postoperatively. There were 2 cases (1.85%) involving complete or incomplete facial nerve injury confirmed by electrophysiologic analysis. The incidence of other postoperative complications including a hematoma rate of 1.85% patients and permanent hypesthesia or paresthesia in 2.78% of patients, and no cases of clinically significant temporal hollowing, alopecia, infection, or unacceptable scars encountered during a mean follow-up period of 2 years. Conclusion: A modified pre-auricular approach with dissection deep to the temporalis fascia offers a safe and reliable surgical technique for accessing the malar arch in orbital zygomatic maxillary complex fractures. Address correspondence and reprint requests to Zhengkang Li, MD and Yuan Deng, PhD, MD, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China; E-mails: lizhengkang58@hotmail.com, ophden@163.com Received 15 May, 2018 Accepted 16 June, 2018 This work was supported by the National Natural Science Foundation of China (81501605), the Chenguang Plan of the Shanghai Education Development Foundation (16CG16) and the Science and Technology Commission of Shanghai (17DZ2260100). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2P8m5ex
https://ift.tt/2P8m5ex
Anthropometric Analysis of the Nigerian Face: Any Conformity to the Neoclassical Canons?
This study defines the facial anthropometric and aesthetic measurements in young Nigerians. This is a prospective cohort study involving facial anthropometric measurement in young adults without craniofacial abnormalities. Ten anthropometric measurements (upper facial height (tr-n), mid-facial height (n-sn), lower facial height (sn-gn), height of auricle (sa-sba) bilaterally, intercanthal width (en-en), palpebral fissure width (en-ex) bilaterally, face width (zy-zy), nose width (al-al), mouth width (ch-ch) and the interincisal distance) were determined. Proportions were compared with neoclassic cannons, published North American and Asian norms 151 individuals consisting of 50 males and 51 females with age range from 16 to 31 (23.9 + 2.49) were enrolled. Only 1% of the study population had equal facial thirds, the midface was the shortest of the facial thirds and the male gender generally had larger mean values of the facial dimensions than the female gender. About half of the participants had the lower third > upper third > middle third, the intercanthal width was equal to the nasal width in only about a tenth of the participants and less than the nasal width in majority (88.1%) of the participants and the mean interincisal distance was 51.1 (SD ± 6.997). The anthropometric measurements from this Nigerian study do not conform to the neoclassical cannons. Racially sensitive facial canons and measurements are advocated during reconstructive and aesthetic interventions in the craniofacial region. Address correspondence and reprint requests to Timothy Olukunle Aladelusi, BDS, FWACS, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria 200001; E-mail: drtimmylee@gmail.com Received 13 April, 2018 Accepted 3 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2ODchs2
https://ift.tt/2ODchs2
Retained Eyeglasses in the Orbital Cavity After Penetrating Facial Trauma
This study describes a 68-year-old man who was presented to the emergency department with left orbital cavity penetration by his eyeglasses. The eyeglasses had entered the orbit and at presentation his eyesight could not be measured. The foreign body was extracted carefully and panfacial bone fractures were then reduced through lateral rhinotomy combined with a lip-splitting incision. When planning removal of an unusual foreign body from the orbital cavity, care should be taken not to injure the optic nerve, periorbital musculatures, or the eyeball. Address correspondence and reprint requests to Il Gyu Kang, MD, Department of Otolaryngology-Head & Neck Surgery, Gil Medical Center, Guwol-dong 1198, Namdong-gu, Incheon City 405-760, Republic of Korea; E-mail: eyik@naver.com Received 18 May, 2018 Accepted 18 June, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
https://ift.tt/2P8LULz
https://ift.tt/2P8LULz
Clinical Manifestation of Hyper IgE Syndrome Including Otitis Media
Abstract
Purpose of Review
The hyper IgE syndromes (HIES) comprise a group of rare primary immunodeficiency disorders (PIDDs), which are characterized by extremely high serum IgE levels, eczema, recurrent skin and pulmonary infections. Both autosomal dominant (AD) HIES due to STAT3 mutations and autosomal recessive (AR) HIES due to PGM3, SPINK5, DOCK8 and TKY2 mutations have been reported. Here, we aim to summarize and compare the major clinical manifestations of different subtypes of HIES. We will also discuss otitis media, which usually do not get enough attention in HIES. Update and familiarity with these clinical features will help to make a better diagnose, assessment and treatment of HIES.
Recent Findings
Although hyper serum IgE levels have been identified in PGM3 deficiency and Comel–Netherton syndrome, PGM3 and SPINK5 genes were not included in the list of genetic etiologies of AR-HIES by the Expert Committee of the International Union of Immunological Societies until 2015. The identification of these HIES-causing genes greatly promoted the pathogenic mechanism studies of HIES. Also, in recent years, more clinical manifestations, which were often not of concern in HIES patients, have been shown to be highly related to HIES. For example, a significantly high frequency of vascular and gastrointestinal abnormities has been reported in STAT3-deficient AD-HIES patients. These new findings might help to provide new clues to the functional study of these HIES-related genes.
Summary
This review summarizes and compares the major clinical manifestations of different subtypes of HIES, and we suggest that the incidence and severity of otitis media should not be underestimated in HIES patients.
https://ift.tt/2OCCM0u
Tips for Seeing Patients via Telemedicine
Abstract
Purpose of Review
Telemedicine is a technology that permits patients to be seen at a distance. This review describes different types of telemedicine, why they might be useful for a practice, what equipment is needed, and how to select and schedule patients.
Recent Findings
The use of synchronous telemedicine is increasing rapidly and has surpassed 50% of ambulatory encounters in some instances. Management of patients is particularly germane for an allergy practice since it is an outpatient specialty with patients who live in widely distributed locations with limited access to allergists. With utilization of digital exam equipment, in vitro tests for diagnosis, and spirometry at the patient location, there are few clear advantages of seeing patients in-person over virtual visits.
Summary
Telemedicine is here today. As its use increases, it is critical that allergy specialists embrace this new technology.
https://ift.tt/2P91zdR
Rapamycin for refractory discoid lupus erythematosus
Dermatologic Therapy, EarlyView.
https://ift.tt/2MjV0Hu
Praktische Fortbildung: Ästhetik up to date
Vom 24. bis 28. Juli 2018 fand die 26. Fortbildungswoche für praktische Dermatologie und Venerologie in München statt. Als wesentlicher Bestandteil hat sich auf dem Kongress die ästhetische Medizin etabliert, nicht zuletzt auch aufgrund des von der Arbeitsgemeinschaft für Ästhetische Dermatologie und Kosmetologie (ADK) organisierten Kurses, der fundierte, praxisnahe Fortbildung für ästhetisch tätige Hautärzte bot.
https://ift.tt/2vF0uCr
Niedrig dosiertes rotes Laserlicht scheint Haarausfall zu stoppen
Bei androgenetischer Alopezie ist Laserlicht möglicherweise am wirksamsten. Ein indirekter Vergleich per Netzwerk-Metaanalyse findet für dieses Verfahren die stärksten Therapieeffekte.
https://ift.tt/2OF9ApT
Kliniken müssen Ärzten mehr bieten als nur Geld
Um junge Mediziner auch an abseits gelegenen oder kleineren Klinikstandorten zu halten, braucht es kreative Karrieremöglichkeiten. Wie es gehen könnte, zeigten Kliniker auf dem Hauptstadtkongress.
https://ift.tt/2Owt4wA
Drei Monate DSGVO — Habe ich in meiner Praxis alles beachtet?
Am 25.5.2018 ist die neue europäische Datenschutzgrundverordnung (DSGVO) in Kraft getreten. Parallel wurde das Bundesdatenschutzgesetz (BDSG) neu gefasst. Diese Gesetzesänderungen bringen umfangreiche neue Verpflichtungen für die Ärzteschaft mit sich.
https://ift.tt/2BecwIe
Hyaluron-Filler in der Dermatologie
Filler auf der Basis von Hyaluronsäure (HA-Filler) sind die am häufigsten verwendeten „Soft-Tissue-Filler". Profunde anatomische Grundkenntnisse der Gesichtsregion und deren Alterungsprozesse, die geeignete Patientenauswahl, sichere HA-Filler, weitreichende Erfahrung in den Injektionstechniken und umfassendes Wissen in der Vorbeugung und Behandlung von möglichen Komplikationen sind essenzielle Grundvoraussetzungen dieses komplexen Therapieverfahrens.
https://ift.tt/2OD0gmf
Tonsillectomy complicated by jugular vein thrombosis and pulmonary embolism
Abstract
To report an unusual and life-threatening complication of routine tonsillectomy, and review the relevant medical literature. A Medline database search was performed to identify reports of thromboembolic complications of tonsillectomy. Thromboembolic complications following tonsillectomy are rare, and no previously reported cases of post-operative jugular vein thrombosis and pulmonary embolism are described. We report a case of an 18-year old previously healthy woman who presented with a sub-massive pulmonary embolus following tonsillectomy. It is believed that the embolus originated from a post-operative jugular vein thrombosis. This is the first report of jugular vein thrombosis and pulmonary embolism following tonsillectomy. Knowledge of this potentially life-threatening complication is vital for otolaryngologists routinely performing this procedure.https://ift.tt/2KSKlhz
Left ventricular assist device for ventricular recovery of anabolic steroid-induced cardiomyopathy
Abstract
Herein we report a case of a 26-year-old gentleman with severe cardiomyopathy likely secondary to anabolic-androgenic steroid (AAS) abuse who received a HeartMate II (Abbott Laboratories, Abbott Park, IL) left ventricular assist device (LVAD) for rapidly deteriorating heart failure with hemodynamic compromise. Following 18 months on LVAD support, excellent recovery of ventricular function was achieved to allow for LVAD discontinuation. Given that active substance abuse is a contraindication to heart transplantation, few options remain for patients with AAS induced heart failure. Our case demonstrates that LVAD therapy can be an important intervention for bridging to candidacy, recovery or destination therapy.https://ift.tt/2P88vI5
Anterior and posterior cruciate ligament agenesis
Abstract
Congenital absence of the cruciate ligament is a rare condition with a prevalence of 0.017 per 1000 live births. This study reports a case of congenital absence of the anterior and posterior cruciate ligaments of the left knee associated to a type 1A fibular hemimelia, and a contribution to the existing hypotheses on knee ligaments development. According to medical literature the anomaly begins to develop around the seventh–eighth week of pregnancy. Patients with a cruciate ligament agenesis will often need a knee replacement at one point in their lives.https://ift.tt/2KQqZJH
Middle colic vein draining to splenic vein: a rare anatomic variation encountered during a right hemicolectomy
Abstract
Right or subtotal colectomy either open or laparoscopic may be a challenging operation owing to technical difficulties. One of these, is to identify a safe and adequate dissection plane, ligating and dissecting lymph nodes around middle colic vessels. The purpose of this study was to depict a rare anatomic variation of middle colic vein (MCV) draining to splenic vein. We report the case of a 55-year-old male patient, who was subjected to a right hemicolectomy for an adenocarcinoma in the ascending colon. During dissecting the transverse mesocolon from the greater omentum, for complete mesocolic excision (CME), we encountered that the MCV drained in the splenic vein. With respect of this rare anatomic variability, CME was completed without hemorrhage. Our aim is to depict that deep knowledge of MCV anatomy and its variations is of paramount importance to achieve CME and to avoid dangerous or massive bleeding.https://ift.tt/2P4jAdj
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