Early cancer detection through saliva is real health care reform

While the public and media focus their attention on stalled health care reform at the public policy level, they overlook real health care reforms that could significantly improve public health, increase access and lower costs. With the exception of advancements for certain cancers, including breast, cervical and prostate, cancer diagnoses generally rely on the invasive, expensive and time-consuming process of tissue biopsy.

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Tubal ligation and ovarian cancer risk in African American women

Abstract

Purpose

Tubal ligation has been associated with reduced risk of epithelial ovarian cancer (EOC) in studies of primarily white women, but less is known about the association in African American (AA) women. We sought to evaluate the associations among 597 invasive ovarian cancer cases and 742 controls of AA descent recruited from the African American Cancer Epidemiology Study, a population-based case–control study in 11 geographical areas in the US.

Methods

Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potentially confounding factors.

Results

An inverse association between tubal ligation and EOC was observed that was not statistically significant (OR 0.88, 95% CI 0.68–1.14). However, an inverse association with EOC risk was observed among women who had a tubal ligation at age 35 years or older (OR 0.64; 95% CI 0.41–0.98), but not among those who had a tubal ligation before age 35 (OR 0.98; 95% CI 0.74–1.29) (p for interaction = 0.08). The association also varied considerably by tumor subtype. A strong inverse association was observed for endometrioid tumors (OR 0.31, 95% CI 0.14–0.70), whereas associations with mucinous (OR 0.87, 95% CI 0.36–2.12) and serous (OR 0.94, 95% CI 0.71–1.24) tumors were weaker and not statistically significant. A statistically non-significant positive association for clear cell tumors (OR 1.84, 95% CI 0.58–5.82) was based on a low number of cases.

Conclusions

Our findings show that tubal ligation may confer a reduced risk for EOC among AA women that is comparable to the associations that have been previously observed in primarily white populations.

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Characterization and functional analysis of a MYB gene ( GbMYBFL ) related to flavonoid accumulation in Ginkgo biloba

Abstract

Flavonoids are a group of metabolites in Ginkgo biloba thought to provide health benefits. R2R3-MYB transcription factors (TFs) play key roles in the transcriptional regulation of the flavonoid biosynthesis in plants. In this study, an R2R3-MYB transcription factor gene, GbMYBFL, was isolated from G. biloba and characterized. Results of bioinformatic analysis indicated that GbMYBFL is more closely related to the R2R3-MYB involved in flavonoid biosynthesis and displayed high similarity to MYB from other plants. The genmomic sequence of GbMYBFL had three exons and two introns, with its upstream sequence containing cis-acting regulatory elements Myb binding site, Myc recognition sites, and light, SA, MeJA responsive elements. Subcellular localization analysis indicates that GbMYBFL was located in the nucleus. Quantitative real-time PCR revealed that GbMYBFL was expressed in leaves, stems, roots, young fruits, male flower and female flower, and the level of transcription in male flower and leaves were higher than that in female flower, stems, roots, and young fruits. During G. biloba leaf growth, the transcription of GbMYBFL is positively correlated with the flavonoid content, suggesting that the GbMYBFL is involved in the flavonoid biosynthesis. Overexpression of GbMYBFL under the control of the CaMV35S promoter in Ginkgo callus notably enhanced the accumulation of flavonoids and anthocyanin compared with non-transformed callus. This finding suggested that GbMYBFL positively related to flavonoid biosynthesis, and the overexpression of GbMYBFL was sufficient to induce flavonoids and anthocyanin accumulation.

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Motivational interviewing for periodontal disease

This review of motivational interviewing (MI) as an adjunct to periodontal treatment only included 5 papers reporting 4 studies. The review provides limited evidence to suggest that MI might have a positive effect but more higher quality research is needed.

The post Motivational interviewing for periodontal disease appeared first on National Elf Service.

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Phase I dose escalation and pharmacokinetic study on the nanoparticle formulation of polymeric micellar paclitaxel for injection in patients with advanced solid malignancies

Summary

Background Polymeric micellar paclitaxel (PM-paclitaxel) is a novel Cremophor EL-free, nanoparticle-encapsulated paclitaxel formulation administered through intravenous injection. The primary objective of this phase I trial was to determine the first cycle dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) of PM-paclitaxel. Secondary objectives included the evaluation of the safety, antitumor activity, and pharmacokinetic (PK) profile of PM-paclitaxel in patients with advanced malignancies. Methods The PM-paclitaxel dose was escalated from 175 mg/m² (level 1) to 435 mg/m² (level 5). PM-paclitaxel was intravenously administered to patients for 3 h without premedication on day 1 of a 21-day cycle. Results Eighteen patients with confirmed advanced malignancies received PM-paclitaxel. DLT included grade 4 neutropenia (four patients) and grade 3 numbness (one patient), which occurred in one of the six patients who received 300 mg/m² (level 3) PM-paclitaxel and all three patients who were treated with 435 mg/m² PM-paclitaxel. Thus, the MTD of PM-paclitaxel was determined as 390 mg/m² (level 4). Acute hypersensitive reactions were not observed. Partial response was observed in six of 18 patients (33.3%), three of whom had prior exposure to paclitaxel chemotherapy. The peak concentration and area under the curve values of paclitaxel increased with increasing dosage, indicating that PM-paclitaxel exhibits linear PKs. Conclusions PM-paclitaxel showed high MTD without additional toxicity, and exhibited desirable antitumor activity. The recommended dose of PM paclitaxel for phase II study is 300 mg/m².

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Alcoholic cardiomyopathy

Alcoholic cardiomyopathy: disease of the heart muscle caused by damage from excess alcohol consumption and the toxic effects of alcohol on the heart muscle. Alcoholic cardiomyopathy, like other types of cardiomyopathy, can lead to heart failure.

See cardiomyopathy.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
We Bring Doctors' Knowledge To You

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A novel technique for correcting the over-corrected gynaecomastia using stacked acellular dermal matrix

Abstract

The 'saucer-shaped deformity' is the undesirable outcome following over-resection of gynaecomastia. Correction can be challenging, lipomodelling may be unfavourable or unpredictable, and autologous grafts often require additional unwanted scars. We present a case of unilateral gynaecomastia over-resection where disks of acellular dermal matrix (ADM) were interwoven in the subdermal, intrapectoral, and interpectoral planes to correct the areolar cavity. A routine review at 17 months showed maintained projection of the areola, and the patient was delighted with the natural contour.

Level of Evidence: Level V, therapeutic study.

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Proliferation inhibition of cisplatin-resistant ovarian cancer cells using drugs screened by integrating a metabolic model and transcriptomic data

Abstract

Objectives

If screening to find effective drugs is possible, the inhibition of proliferation using existing drugs can be a practical strategy to control the drug resistance of cancer. Development of a system-oriented strategy to find effective drugs was the main aim of this research.

Materials and methods

An algorithm (transcriptional regulated flux balance analysis [TRFBA]) integrating a generic human metabolic model with transcriptomic data was used to identify genes affecting the growth of drug-resistant cancer cells. Drugs that inhibit activation of the target genes were found and their effect on the proliferation was experimentally evaluated.

Results

Experimental assessments demonstrated that TRFBA improves the prediction of cancer cell growth in comparison with previous algorithms. The algorithm was then used to propose the system-oriented strategy to search drugs effective in limiting the growth rate of the cisplatin-resistant A2780 epithelial ovarian cancer cell. Experimental evaluations resulted in the selection of azathioprine, terbinafine, hydralazine and sodium valproate that appropriately inhibit the proliferation of resistant cancer cells while minimally affecting normal cells. Furthermore, experimental data indicate that the selected drugs are synergistic and can be used in combination therapies.

Conclusions

The proposed strategy was successful to identify drugs effective on the viability of resistant cancer cells. This strategy can enhance the potency of treatments for drug-resistant cancer cells and provides the possibility of using existing drugs.

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Erratum to: comparison between inflammation-related markers in peri-implant crevicular fluid and clinical parameters during osseointegration in edentulous jaws

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Carpal spasm in a girl as initial presentation of celiac disease: a case report

Celiac disease is an immune-mediated disorder elicited by ingestion of gluten in genetically susceptible persons. This disorder is characterized by specific histological changes of the small intestine mucosa r...

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Erratum to: comparison between inflammation-related markers in peri-implant crevicular fluid and clinical parameters during osseointegration in edentulous jaws

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Male Cystoscopy Procedure | PreOp® Patient Education

Male Cystoscopy Procedure | PreOp® Patient Education
http://ift.tt/2eT5RFE
Patient Education Company

Your doctor has recommended that you undergo a Cystoscopy. But what does that actually mean?

The lower urinary tract allows your body to store and release urine.
It's made up of two parts, the bladder and the urethra.

Your bladder is a hollow organ that expands as it fills with urine. Because it is made of muscular tissue, it can also contract and force urine to pass out of the body, through the urethra. Your urethra carries urine from the bladder all the way through the opening in the penis.

Your doctor feels that it is necessary to examine the interior of the urethra and bladder, to try to determine the cause of a problem that you may be having.

Symptoms that may call for a routine Cystoscopy include:

* Persistent infection of the urinary tract
* Bladder stones
* Bleeding while urinating
* Irritation due to polyps, or
* Changes to the bladder caused by cancer.

Cystoscopy is a simple procedure during which your doctor will insert a well-lubricated, instrument called a cystoscope through your urethra and into your bladder.

The cystoscope allows your doctor to visually inspect the interior of your bladder. It also allows your doctor to remove small pieces of tissue for later examination and even to crush small bladder stones, should any be present.

Any tissue that your doctor removes from your bladder will be sent immediately to a laboratory for analysis. Your doctor will ask the laboratory to check for any sign of cancer or other abnormality.

So make sure that you ask your doctor to carefully explain the reasons behind this recommendation.

Your Procedure:

On the day of your operation, you will be asked to put on a surgical gown.

You may receive a sedative by mouth and an intravenous line may be put in.

You will then be transferred to the operating table.

Once on the table, your feet and legs will be placed in an elevated position with your knees apart.

You'll be asked to urinate so the amount of urine remaining in the bladder can be measured.

The nurse will swab the penis with an antiseptic solution.

Your doctor will then lift your penis upward.

A well-lubricated cystoscope is gently inserted into the urethra, the opening at the head of the penis, and slowly guided inward.

When the cystoscope reaches the back of the penis, your doctor will pull the penis downward in order to create a straight path into the bladder.

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Genetic regulation of adipose tissue transcript expression is involved in modulating serum triglyceride and HDL-cholesterol

Publication date: 20 October 2017
Source:Gene, Volume 632
Author(s): Satria P. Sajuthi, Neeraj K. Sharma, Mary E. Comeau, Jeff W. Chou, Donald W. Bowden, Barry I. Freedman, Carl D. Langefeld, John S. Parks, Swapan K. Das
Dyslipidemia is a major contributor to the increased cardiovascular disease and mortality associated with obesity and type 2 diabetes. We hypothesized that variation in expression of adipose tissue transcripts is associated with serum lipid concentrations in African Americans (AAs), and common genetic variants regulate expression levels of these transcripts. Fasting serum lipid levels, genome-wide transcript expression profiles of subcutaneous adipose tissue, and genome-wide SNP genotypes were analyzed in a cohort of non-diabetic AAs (N=250). Serum triglyceride (TRIG) and high density lipoprotein-cholesterol (HDL-C) levels were associated (FDR<0.01) with expression level of 1021 and 1875 adipose tissue transcripts, respectively, but none associated with total cholesterol or LDL-C levels. Serum HDL-C-associated transcripts were enriched for salient biological pathways, including branched-chain amino acid degradation, and oxidative phosphorylation. Genes in immuno-inflammatory pathways were activated among individuals with higher serum TRIG levels. We identified significant cis-regulatory SNPs (cis-eSNPs) for 449 serum lipid-associated transcripts in adipose tissue. The cis-eSNPs of 12 genes were nominally associated (p<0.001) with serum lipid level in genome wide association studies in Global Lipids Genetics Consortium (GLGC) cohorts. Allelic effect direction of cis-eSNPs on expression of MARCH2, BEST1 and TMEM258 matched with effect direction of these SNP alleles on serum TRIG or HDL-C levels in GLGC cohorts. These data suggest that expressions of serum lipid-associated transcripts in adipose tissue are dependent on common cis-eSNPs in African Americans. Thus, genetically-mediated transcriptional regulation in adipose tissue may play a role in reducing HDL-C and increasing TRIG in serum.



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New: Health Alert Network (HAN) No. 406 - Hurricane Harvey—Clinical Guidance for Carbon

Carbon monoxide (CO) is an odorless, colorless, poisonous gas that can cause sudden illness and death if present in sufficient concentration in the ambient air. During a significant power outage, persons using alternative fuel or power sources such as generators or gasoline powered engine tools such as pressure washers might be exposed to toxic CO levels if the fuel or power sources are placed inside or too close to the exterior of the building causing CO to build up in the structure. The purpose of this HAN advisory is to remind clinicians evaluating persons affected by the storm to maintain a high index of suspicion for CO poisoning.

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Letter to the editor regarding the paper by Loquai C ‘Use of complementary and alternative medicine: a multicenter cross-sectional study in 1089 melanoma patients’

We read with interest the article by Loquai C et al. entitled 'Use of complementary and alternative medicine: a multicenter cross-sectional study in 1089 melanoma patients' in the January issue of the European Journal of Cancer [1].

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SGK1, the New Player in the Game of Resistance: Chemo-Radio Molecular Target and Strategy for ...

... Lang PA, Graf D, Boini KM, Lang KS, Klingel K, Kandolf R, Lang F: Cell volume, the serum and glucocorticoid inducible kinase 1 and the liver.

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miR-93-5p/IFNAR1 axis promotes gastric cancer metastasis through activating the STAT3 signaling pathway

Publication date: 1 November 2017
Source:Cancer Letters, Volume 408
Author(s): Dong-Hong Ma, Bo-Sheng Li, Jing-Jing Liu, Yu-Feng Xiao, Xin Yong, Shu-Ming Wang, Yu-Yun Wu, Hong-Bin Zhu, Dong-Xu Wang, Shi-Ming Yang
Aberrant expression of microRNAs (miRNAs) plays an important role in gastric cancer (GC) development. miR-93-5p has shown opposing functions in different types of cancers, but the exact expression pattern and molecular mechanism of miR-93-5p in GC development remain to be elucidated. Here, we reported that miR-93-5p expression was increased in GC tissues compared with the adjacent normal tissues and that its overexpression was correlated with distant metastasis and poor survival in GC patients. miR-93-5p knockdown inhibited the migration, invasion and proliferation of GC cells in vitro and in vivo, while its overexpression displayed an opposite result. Using an mRNA microarray, we found that miR-93-5p significantly downregulated IFNAR1 expression in GC cells, which was further identified as a direct target of miR-93-5p. IFNAR1 knockdown promoted GC cell migration and invasion, but its restoration could rescue GC cell migration and invasion induced by miR-93-5p overexpression. Moreover, miR-93-5p-IFNAR1 axis increased MMP9 expression via STAT3 pathway in GC cells. Taken together, we reveal that miR-93-5p overexpression is associated with the poor survival of GC patients and miR-93-5p-IFNAR1 axis promotes GC metastasis through activation of STAT3 pathway.



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AP1G1 is involved in cetuximab-mediated downregulation of ASCT2-EGFR complex and sensitization of human head and neck squamous cell carcinoma cells to ROS-induced apoptosis

Publication date: 1 November 2017
Source:Cancer Letters, Volume 408
Author(s): Xiaoan Tao, Yang Lu, Songbo Qiu, Yi Wang, Jun Qin, Zhen Fan
In this study, we expanded our recent work showing that ASCT2, a Na⁺-dependent neutral amino acid transporter that plays a major role in glutamine uptake in cancer cells, is physically associated with EGFR in human head and neck squamous cell carcinoma cells and in several other types of cancer cells. We found in our current study that ASCT2 can be downregulated by cetuximab, an approved anti-EGFR therapeutic antibody, via cetuximab-induced EGFR endocytosis independently of cetuximab-mediated inhibition of EGFR tyrosine kinase. We further found that ASCT2-EGFR association involves the adaptor-related protein complex 1 gamma 1 subunit (AP1G1), a subunit of clathrin-associated adaptor protein complex 1, which plays a role in membrane protein sorting in endosomes after receptor-mediated endocytosis. We found that AP1G1 is physically associated with both ASCT2 and EGFR and, together with those molecules, forms a heterotrimeric molecular complex. Knockdown of AP1G1 lowered the level of ASCT2-EGFR association, inhibited cetuximab-mediated internalization of ASCT2-EGFR complex, and decreased intracellular glutamine uptake and glutathione biosynthesis. These findings suggest a new therapeutic strategy to overcome cetuximab resistance in cancer cells through combination of cetuximab, which co-targets ASCT2 along with EGFR, with an ROS-inducing agent.



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Everolimus selectively targets vemurafenib resistant BRAFV600E melanoma cells adapted to low pH

Publication date: 1 November 2017
Source:Cancer Letters, Volume 408
Author(s): Jessica Ruzzolini, Silvia Peppicelli, Elena Andreucci, Francesca Bianchini, Francesca Margheri, Anna Laurenzana, Gabriella Fibbi, Nicola Pimpinelli, Lido Calorini
Vemurafenib, a BRAF inhibitor, elicits in ∼80% of BRAF^V600E-mutant melanoma patients a transient anti-tumor response which precedes the emergence of resistance. We tested whether an acidic tumor microenvironment may favor a BRAF inhibitor resistance. A375M6 BRAF^V600E melanoma cells, either exposed for a short period or chronically adapted to an acidic medium, showed traits compatible with an epithelial-mesenchymal transition, reduced proliferation and high resistance to apoptosis. Both types of acidic cells treated with vemurafenib did not change their proliferation, distribution in cell cycle and level of p-AKT, in contrast to cells grown at standard pH, which showed reduced proliferation, cell cycle arrest and ERK/AKT inhibition. Even after treatment with trametinib (MEK inhibitor) acidic cell features did not change. Then, since both types of acidic cells exhibited high p-p70S6K, i.e. active mTOR signaling, we tested everolimus, an mTOR inhibitor, which was efficient in inducing apoptosis in acidic cells without affecting melanoma cells grown at standard pH.Our results indicate that an acidic microenvironment may cooperate in inducing a BRAF inhibitor resistance in melanoma cells and a combined therapy with everolimus could be used to overcome that resistance.



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Develop an awareness of the use of #radiopharmaceuticals in older patients and understand the risks:… https://t.co/dJBwnhNHNY

Develop an awareness of the use of #radiopharmaceuticals in older patients and understand the risks:… https://t.co/dJBwnhNHNY

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Cases are rare, but children have died while under dental sedation

They might swallow a liquid sedative or inhale laughing gas. Once it kicks in, they will be conscious but calmer so the dentist can do extensive work.

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Airway management: Utilizing radiologist expertise and neuroimaging with head and neck masses.

Airway management: Utilizing radiologist expertise and neuroimaging with head and neck masses.

J Clin Anesth. 2017 Aug 30;42:96-97

Authors: Yao J, Rao D

PMID: 28865299 [PubMed - as supplied by publisher]

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Untreated oral cavity cancer: Long-term survival and factors associated with treatment refusal.

Related Articles

Untreated oral cavity cancer: Long-term survival and factors associated with treatment refusal.

Laryngoscope. 2017 Sep 02;:

Authors: Cheraghlou S, Kuo P, Mehra S, Yarbrough WG, Judson BL

Abstract
OBJECTIVE: Oral cavity cancer is the most common malignant disease of the head and neck. The natural course of the disease is poorly characterized and unavailable for patient consideration during initial treatment planning. Our primary objective was to outline this natural history, with a secondary aim of identifying predictors of treatment refusal.
STUDY DESIGN: Retrospective review of adult patients with oral cavity cancer who refused surgery that was recommended by their physician in the National Cancer Database.
METHODS: Demographic, tumor, and survival variables were included in the analyses. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted.
RESULTS: Patients who were older, uninsured, had government insurance, or had more advanced disease were more likely to go untreated. Survival among untreated patients was poor, but there was a small proportion of patients surviving long term. Five-year survival rates ranged from 31.1% among early-stage patients to 12.6% among stage 4 patients.
CONCLUSION: Although the natural course of oral cavity cancer carries a poor prognosis, there are a number of patients with longer-than-expected survival. The survival estimates may provide supplemental information for patients deciding whether to pursue treatment. In addition to age and extent of disease, system factors such as insurance status and facility case volume are associated with a patient's likelihood of refusing treatment.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 28865100 [PubMed - as supplied by publisher]

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Epidemiology and survival outcomes of sinonasal verrucous carcinoma in the United States.

Related Articles

Epidemiology and survival outcomes of sinonasal verrucous carcinoma in the United States.

Laryngoscope. 2017 Sep 02;:

Authors: Alonso JE, Han AY, Kuan EC, Suh JD, John MAS

Abstract
INTRODUCTION: Verrucous carcinoma (VC) is a rare, variant of squamous cell carcinoma with benign cytohistopathologic features and a generally favorable prognosis. Epidemiologic and clinical outcomes data are lacking as a result of limited cases of sinonasal VC.
OBJECTIVE: To describe the incidence and determinants of survival of patients with verrucous carcinoma of the sinonasal tract between the years of 1973 to 2014 using the Surveillance, Epidemiology, and End Results (SEER) database.
METHODS: The SEER registry was utilized to calculate survival trends for patients with verrucous carcinoma of the sinonasal tract between 1973 and 2014. Patient data then was analyzed with respect to age, sex, race, and treatment modalities (surgery and radiation therapy). Overall survival (OS) and disease-specific survival (DSS) were calculated.
RESULTS: A total of 86 cases of VC of the sinonasal tract were identified. The cohort was comprised of 69.8% males. The mean age at diagnosis was 67.4 years. The nasal cavity was the most common primary site (51.2%), followed by the maxillary sinus (40.7%) and nasopharynx (5.8%). The median OS was 97.6 months. 89.5% of cases underwent surgery and 20.9% received both surgery and radiation therapy. Overall survival at 2, 5, and 10 years was 73%, 59%, and 36%, respectively. On multivariate analysis, advanced age (P < 0.05) and primary site (P < 0.05) were associated with worse OS and DSS, respectively. Primary nasopharyngeal tumor site was associated with reduced DSS (P < 0.05). Surgery improved OS (P < 0.001) and DSS (P < 0.001).
CONCLUSION: Verrucous carcinoma of the sinonasal tract is associated with a generally favorable prognosis. Age, primary site, and surgical therapy are independent predictors of OS and DSS, respectively. We present the first population-based analysis of sinonasal VC, thus clarifying the prognosis and reinforcing the management of this malignancy.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 28865078 [PubMed - as supplied by publisher]

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Prospective experience of percutaneous endoscopic gastrostomy tubes placed by otorhinolaryngologist-head and neck surgeons: safe and efficacious.

Related Articles

Prospective experience of percutaneous endoscopic gastrostomy tubes placed by otorhinolaryngologist-head and neck surgeons: safe and efficacious.

Eur Arch Otorhinolaryngol. 2017 Sep 01;:

Authors: Ruohoalho J, Aro K, Mäkitie AA, Atula T, Haapaniemi A, Keski-Säntti H, Kylänpää L, Takala A, Bäck LJ

Abstract
Percutaneous endoscopic gastrostomy (PEG) is often the treatment of choice in head and neck cancer (HNC) patients needing long-term nutritional support. Prospective studies on PEG tube placement in an otorhinolaryngologist service are lacking. At our hospital, otolaryngologist-head and neck (ORL-HN) surgeons-have performed PEG insertions for HNC patients since 2008. We prospectively analyzed 127 consecutive HNC patients who received their PEG tubes at the Department of Otorhinolaryngology-head and neck surgery, and evaluated the outcome of PEG tube insertions performed by ORL-HN surgeons. To compare time delays before and after, PEG placement service was transferred from gastrointestinal surgeons to ORL-HN surgeons, and we retrospectively analyzed a separate group of 110 HNC patients who had earlier received PEG tubes at the Department of Gastrointestinal Surgery. ORL-HN surgeons' success rate in PEG insertion was 97.6%, leading to a final prospective study group of 124 patients. Major complications occurred in four (3.2%): two buried bumper syndromes, one subcutaneous hemorrhage leading to an abscess in the abdominal wall, and one metastasis at the PEG site. The most common minor complication was peristomal granulomatous tissue affecting 23 (18.5%) patients. After the change in practice, median time delay before PEG insertion decreased from 13 to 10 days (P < 0.005). The proportion of early PEG placements within 0-3 days increased from 3.6 to 14.6% (P < 0.005). PEG tube insertion seems to be a safe procedure in the hands of an ORL-HN surgeon. Independence from gastrointestinal surgeons' services reduced the time delay and improved the availability of urgent PEG insertions.

PMID: 28865046 [PubMed - as supplied by publisher]

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Transoral robotic-assisted surgery for the approach to anterior cervical spine lesions.

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Transoral robotic-assisted surgery for the approach to anterior cervical spine lesions.

Eur Arch Otorhinolaryngol. 2017 Sep 01;:

Authors: Molteni G, Greco MG, Presutti L

Abstract
The Da Vinci robotic surgical system is increasingly being used by head and neck surgeons in transoral approaches for head and neck cancer. Our experience using the Da Vinci system for transoral robotic-assisted surgery (TORS) is presented. The feasibility of TORS for lesions involving the anterior portion of C1-C2 and the cranio-cervical junction has been evaluated from an anatomical viewpoint in a cadaveric laboratory. Two patients treated using the Da Vinci system to reach C1-C2 benign lesions are presented. The anatomical cadaveric study showed that this approach is safe and feasible. The first two cases which we describe confirmed the advantages of the Da Vinci system in the anterior approach to the cervical spine and allowed the limitations of this procedure to be assessed. TORS may be useful to reach anterior lesions of the cervical spine localized at the level of C1 and C2: first, for removal of small benign and well-delineated lesions; and second, for diagnostic purposes with biopsy of large lesions. Further studies and new instruments are needed to confirm the safety and results of this approach in terms of morbidity.

PMID: 28864959 [PubMed - as supplied by publisher]

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The Impact of Research on the Future of Dental Education: How Research and Innovation Shape Dental Education and the Dental Profession.

Related Articles

The Impact of Research on the Future of Dental Education: How Research and Innovation Shape Dental Education and the Dental Profession.

J Dent Educ. 2017 Sep;81(9):eS108-eS127

Authors: Slavkin HC

Abstract
Scientific inquiry and discovery are the fuel for education, research, technology, and health care in all the health professions: dentistry, medicine, nursing, pharmacy, and allied health sciences. The progression of discoveries from basic or fundamental to clinical research is followed by the progression from clinical to implementation and improved health outcomes and processes. Generally, implementation science is the scientific study of methods to promote the systematic uptake of research findings (e.g., basic, translational, behavioral, socioeconomic, and clinical) as well as other related evidence-based practices into standards of care, thereby improving the quality, effectiveness, and cost benefits of health care services. There is little doubt that science has and will continue to provide the essential fuel for innovations that lead to new and improved technologies for risk assessment, prevention, diagnosis, treatments and therapeutics, and implementation for addressing oral and craniofacial diseases and disorders. The history of the U.S. dental profession reviewed in this article gives testimony to the continued need for investments in scientific inquiry that accelerate progress in comprehensive health care for all people. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

PMID: 28864811 [PubMed - in process]

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Venous Complications in One Versus Two Vein Anastomoses in Head and Neck Free Flaps.

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Venous Complications in One Versus Two Vein Anastomoses in Head and Neck Free Flaps.

Ann Otol Rhinol Laryngol. 2017 Sep 01;:3489417728089

Authors: Khaja SF, Rubin N, Bayon R

Abstract
OBJECTIVE: The purpose of this study was to compare rates of reexploration and flap failure in patients with 1- and 2-vein anastomoses in free flap reconstructions.
METHODS: Retrospective chart review of 300 patients undergoing free flap reconstruction to head and neck defects from 2010 to 2014.
RESULTS: One venous anastomosis was performed in 229 patients, and 2 venous anastomoses were performed in 71 patients. The 1-vein group had significantly more reexplorations in the operating room (36/229, 15.7%) compared with the 2-vein group (4/71, 5.6%; P = .028), even when controlling for flap type ( P = .022). This finding remained true among radial forearm flaps (17/81, 21% vs 3/53, 5.7%; P = .024). The number of venous anastomoses was not significantly associated with flap failure, though patients with flap failure did have a significantly greater proportion of venous issues ( P < .001).
CONCLUSIONS: Two-vein anastomoses do not appear to reduce rates of flap failure or postoperative venous thrombosis but are associated with a lower number of reexplorations in the operating room even after accounting for differences in flap types and surgeons.

PMID: 28863728 [PubMed - as supplied by publisher]

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A PET/CT-based strategy is a stronger predictor of survival than a standard imaging strategy in patients with head and neck squamous cell carcinoma.

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A PET/CT-based strategy is a stronger predictor of survival than a standard imaging strategy in patients with head and neck squamous cell carcinoma.

J Nucl Med. 2017 Sep 01;:

Authors: Rohde M, Nielsen AL, Pareek M, Johansen J, Sørensen JA, Diaz A, Nielsen MK, Christiansen JM, Asmussen JT, Nguyen N, Gerke O, Thomassen A, Alavi A, Høilund-Carlsen PF, Godballe C

Abstract
Purpose: To examine whether tumor staging by upfront (18)F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) leads to improved discrimination of survival, when compared with traditionally used imaging strategies based on chest X-ray + head and neck magnetic resonance imaging (CXR/MRI) or chest computed tomography + head and neck MRI (CCT/MRI) in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Blinded prospective cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were recruited at Odense University Hospital from September 2013 to March 2016. All included patients underwent CXR/MRI, CCT/MRI, and PET/CT on the same day. Tumors were categorized as localized (stages I-II), locally advanced (stages III-IVB), or metastatic (stage IVC) disease. Discriminative abilities for each imaging modality with respect to HNSCC staging were compared using Kaplan-Meier analysis, Cox proportional-hazards regression with Harrell's C-index, and net reclassification improvement (NRI). Results: A total of 307 patients with histologically verified HNSCC were included. Use of PET/CT resulted in significantly altered stratification of tumor stage, when compared to either CXR/MRI or CCT/MRI (χ(2): P < 0.001 for both). Cancer stages based on PET/CT, but not CXR/MRI or CCT/MRI, were associated with significant differences in mortality risk in Kaplan-Meier analyses (P ≤ 0.002 for all PET/CT-based comparisons). Furthermore, overall discriminative ability was significantly greater for PET/CT (C-index: 0.712) than CXR/MRI (C-index: 0.675, P = 0.04 for difference) and CCT/MRI (C-index: 0.657, P = 0.02 for difference). Finally, PET/CT was significantly associated with a positive NRI when compared with CXR/MRI (0.184, P = 0.03), but not CCT/MRI (0.094%, P = 0.31). Conclusion: Tumor stages determined by PET/CT were associated with more distinct prognostic properties in terms of survival than those determined by standard imaging strategies.

PMID: 28864630 [PubMed - as supplied by publisher]

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Epiphycan is specifically expressed in cochlear supporting cells and is necessary for normal hearing.

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Epiphycan is specifically expressed in cochlear supporting cells and is necessary for normal hearing.

Biochem Biophys Res Commun. 2017 Aug 29;:

Authors: Hanada Y, Nakamura Y, Ishida Y, Takimoto Y, Taniguchi M, Ozono Y, Koyama Y, Morihana T, Imai T, Ota Y, Sato T, Inohara H, Shimada S

Abstract
The study of inner ear specific transcripts has revealed novel information about hereditary hearing loss and a mechanism of normal hearing. In this study, by analyzing a published cDNA library, we focused on Epiphycan (Epyc), a member of the small leucine-rich repeat proteoglycan family, whose transcript is enriched in the inner ear. Epyc mRNA was expressed abundantly and specifically in adult mice cochleae and was localized in supporting cells within the organ of Corti of both neonatal and adult mice. To examine the function of Epyc, we generated Epyc knockout (KO) mice using the CRISPR/Cas9 system. Epyc KO mice cochleae exhibited normal morphology. However, measurement of the auditory brain-stem response in Epyc KO mice revealed an elevated hearing threshold above 16 kHz frequency. This study suggests that Epyc is necessary for normal auditory function.

PMID: 28864419 [PubMed - as supplied by publisher]

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Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score-Weighted Analysis.

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Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score-Weighted Analysis.

Int J Radiat Oncol Biol Phys. 2017 Jun 27;:

Authors: Bibault JE, Dussart S, Pommier P, Morelle M, Huguet M, Boisselier P, Coche-Dequeant B, Alfonsi M, Bardet E, Rives M, Calugaru V, Chajon E, Noel G, Mecellem H, Servagi Vernat S, Perrier L, Giraud P

Abstract
PURPOSE: The Advanced Radiotherapy Oto-Rhino-Laryngologie (ART-ORL) study (NCT02024035) was performed to prospectively evaluate the clinical and economic aspects of helical TomoTherapy and volumetric modulated arc therapy (RapidArc, Varian Medical Systems, Palo Alto, CA) for patients with head and neck cancer.
METHODS AND MATERIALS: Fourteen centers participated in this prospective comparative study. Randomization was not possible based on the availability of equipment. Patients with epidermoid or undifferentiated nasopharyngeal carcinoma or epidermoid carcinoma of the oropharynx and oral cavity (T1-T4, M0, N0-N3) were included between February 2010 and February 2012. Only the results of the clinical study are presented in this report, as the results of the economic assessment have been published previously. Inverse probability of treatment weighting using the propensity score analysis was undertaken in an effort to adjust for potential bias due to nonrandomization. Locoregional control, cancer-specific survival, and overall survival assessed 18 months after treatment, as well as long-term toxicity and salivary function, were evaluated.
RESULTS: The analysis included 166 patients. The following results are given after inverse probability of treatment weighting adjustment. The locoregional control rate at 18 months was significantly better in the TomoTherapy group: 83.3% (95% confidence interval [CI], 72.5%-90.2%) versus 72.7% (95% CI, 62.1%-80.8%) in the RapidArc group (P=.025). The cancer-specific survival rate was better in the TomoTherapy group: 97.2% (95% CI, 89.3%-99.3%) versus 85.5% (95% CI, 75.8%-91.5%) in the RapidArc group (P=.014). No significant difference was shown in progression-free or overall survival. TomoTherapy induced fewer acute salivary disorders (P=.012). Posttreatment salivary function degradation was worse in the RapidArc group (P=.012).
CONCLUSIONS: TomoTherapy provided better locoregional control and cancer-specific survival than RapidArc treatment, with fewer salivary disorders. No significant difference was shown in progression-free and overall survival. These results should be explored in a randomized trial.

PMID: 28864403 [PubMed - as supplied by publisher]

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Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review.

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Transtympanic pseudoaneurysm of the internal carotid artery complicating a myringotomy in a four-year old child: Case report and literature review.

Am J Otolaryngol. 2017 Aug 24;:

Authors: Bonnard D, de Monès E, Sagardoy T, Franco-Vidal V, Darrouzet V, Fierens S

Abstract
We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

PMID: 28864273 [PubMed - as supplied by publisher]

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Langerhans Cell Histiocytosis Mimicking Periapical Pathology in a 39-Year-Old Man.

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Langerhans Cell Histiocytosis Mimicking Periapical Pathology in a 39-Year-Old Man.

J Endod. 2017 Aug 29;:

Authors: Peters SM, Pastagia J, Yoon AJ, Philipone EM

Abstract
Langerhans cell histiocytosis (LCH) is a clonal neoplastic proliferation of Langerhans-type dendritic cells, with more than 50% of cases of LCH seen in children younger than 15 years of age. The most common clinical presentation of LCH is solitary or multiple bony lesions. The jaws are affected in approximately 10%-20% of cases, with a strong predilection for the mandible. The maxilla is involved in only 1% of head and neck cases. When the jaws are involved, lesions of LCH may mimic periapical pathology as seen in patients requiring endodontic therapy or bone loss as seen in periodontal disease. We report the case of a 39-year-old man with LCH involving the posterior maxilla. This is a rare presentation of LCH with respect to both location and patient age. Clinicians should consider LCH when developing a differential diagnosis of an apical radiolucency of vital teeth or teeth that fail to respond to endodontic therapy and be aware of its clinical and radiographic mimics.

PMID: 28864216 [PubMed - as supplied by publisher]

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Sentinel lymph node biopsy for oral squamous cell carcinoma. Where are we now?

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Sentinel lymph node biopsy for oral squamous cell carcinoma. Where are we now?

Br J Oral Maxillofac Surg. 2017 Aug 29;:

Authors: Schilling C, Shaw R, Schache A, McMahon J, Chegini S, Kerawala C, McGurk M

Abstract
Recent data have confirmed that elective surgical management of the cN0 neck improves survival in patients with early (T1-T2) oral squamous cell carcinoma (SCC), and is better than watchful waiting. However, elective neck dissection (END) may not always be necessary. Sentinel node biopsy (SNB), which is a reliable staging test for patients with early disease and a radiologically N0 neck, can detect occult metastases with a sensitivity of 86%-94%. Patients with no sign of metastases on SNB could avoid neck dissection, and individual treatment should reduce both morbidity and cost. Currently, SNB for oral SCC is available at a limited number of centres in the UK, but this is likely to change as national guidelines have recommended that it is incorporated into the standard treatment pathway. It is therefore important to understand the current evidence that supports its use, its limitations and related controversies, and to plan for a validated training programme.

PMID: 28864148 [PubMed - as supplied by publisher]

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[Radiotherapy for head and neck squamous cell carcinoma: State of the art and future directions].

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[Radiotherapy for head and neck squamous cell carcinoma: State of the art and future directions].

Cancer Radiother. 2017 Aug 29;:

Authors: Schick U, Huguet F, Pointreau Y, Pradier O

Abstract
Therapeutic principles of radiation therapy in head and neck carcinomas will be discussed in this review. Intensity-modulated radiotherapy with concomitant cisplatin should be standard. In case of contraindication to chemotherapy, cetuximab is an option, while hyperfractionation should be considered in patients unfit for concomitant treatment. Concomitant chemotherapy should be administered in the presence of extracapsular extensions and positive margins in the postoperative setting. Current research areas such as desescalation in human papillomavirus-positive tumours, adaptive radiotherapy, radiomics and immunotherapy will also be addressed.

PMID: 28864046 [PubMed - as supplied by publisher]

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Grafting materials for alveolar cleft reconstruction: a systematic review and best-evidence synthesis.

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Grafting materials for alveolar cleft reconstruction: a systematic review and best-evidence synthesis.

Int J Oral Maxillofac Surg. 2017 Aug 29;:

Authors: Wu C, Pan W, Feng C, Su Z, Duan Z, Zheng Q, Hua C, Li C

Abstract
The purpose of this study was to compare the efficacy of alveolar bone reconstruction for alveolar cleft patients performed with the traditional iliac graft or alternative/supplementary bone grafting materials. Electronic databases, relevant journals, and reference lists of the included studies were searched to the end of June 2016. A best-evidence synthesis was performed to draw conclusions. A total of 38 studies were included, which provided 25 pieces of evidence: seven of moderate evidence and 18 of insufficient evidence. The seven pieces of moderate evidence indicated that (1) bone morphogenetic protein 2 bound to absorbable collagen sponge shares similar cleft repair efficacy to the iliac graft; (2) covering the iliac graft with an acellular dermis matrix membrane may increase bone retention for unilateral cleft patients; (3) mixing iliac graft with platelet-rich plasma may increase bone retention for skeletally mature patients, but (4) does not achieve the same result for younger patients; and compared with the iliac graft, (5) the mandible graft is more effective, whereas (6) the cranium graft and (7) rib graft are less effective for alveolar cleft reconstruction. The efficacy of the remaining grafting materials was supported by insufficient evidence. More well-designed controlled studies are needed to ascertain the long-term clinical results of alveolar cleft reconstruction.

PMID: 28863859 [PubMed - as supplied by publisher]

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A change in the study evaluation paradigm reveals that larynx preservation compromises survival in T4 laryngeal cancer patients.

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A change in the study evaluation paradigm reveals that larynx preservation compromises survival in T4 laryngeal cancer patients.

BMC Cancer. 2017 Sep 01;17(1):609

Authors: Dyckhoff G, Plinkert PK, Ramroth H

Abstract
BACKGROUND: Larynx preservation (LP) is recommended for up to low-volume T4 laryngeal cancer as an evidence-based treatment option that does not compromise survival. However, a reevaluation of the current literature raises questions regarding whether there is indeed reliable evidence to support larynx preservation for T4 tumor patients.
METHODS: In an observational cohort study of 810 laryngeal cancer patients, we evaluated the outcomes of all T4 tumor patients treated with primary chemo-radiotherapy (CRT) or primary radiotherapy alone (RT) compared with upfront total laryngectomy followed by adjuvant (chemo)radiotherapy (TL + a[C]RT). Additionally, we reevaluated the studies that form the evidence base for the recommendation of LP for patients with up to T4 tumors (Pfister et al., J Clin Oncol 24:3693-704, 2006).
RESULTS: The evaluation of all 288 stage III and IV patients together did not show a significant difference in overall survival (OS) between CRT-LP and TL + a(C)RT (hazard ratio (HR) 1.23; 95% confidence interval (CI): 0.82-1.86; p = 0.31) using a multivariate proportional hazard model. However, a subgroup analysis of T4 tumor patients alone (N = 107; 13.9%) revealed significantly worse OS after CRT compared with TL + a(C)RT (HR 2.0; 95% CI: 1.04-3.7; p = 0.0369). A reevaluation of the subgroup of T4 patients in the 5 LP studies that led to the ASCO clinical practice guidelines revealed that only 21-45 T4 patients had differential data on survival outcome. These data, however, showed a markedly worse outcome for T4 patients after LP.
CONCLUSIONS: T4 laryngeal cancer patients who reject TL as a treatment option should be informed that their chance of organ preservation with primary conservative treatment is likely to result in a significantly worse outcome in terms of OS. Significant loss of survival in T4 patients after LP is also confirmed in recent literature.

PMID: 28863776 [PubMed - in process]

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Soluble Endoglin (CD105) Serum Level as a Potential Marker in the Management of Head and Neck Paragangliomas.

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Soluble Endoglin (CD105) Serum Level as a Potential Marker in the Management of Head and Neck Paragangliomas.

Ann Otol Rhinol Laryngol. 2017 Sep 01;:3489417727548

Authors: Litwiniuk M, Niemczyk K, Niderla-Bielińska J, Łukawska-Popieluch I, Grzela T

Abstract
OBJECTIVES: To assess the expression of endoglin in head and neck paragangliomas and the soluble endoglin level in serum of paraganglioma patients.
METHODS: Seven tumor samples of patients operated for cervical paraganglioma were assessed, as well as serum samples collected preoperatively, on days 4 and 28 postoperation. Serum level of endoglin in healthy controls was also determined. Tumor samples were subjected to immunofluorescent staining and examined with confocal microscope. The level of soluble endoglin in serum samples was examined using the immunoenzymatic assay (ELISA).
RESULTS: Endoglin was highly expressed in all tumor samples. The level of soluble endoglin was significantly higher in paraganglioma patients compared to healthy controls and correlated with the tumor size. The serum level of s-endoglin was reduced after surgical excision of the tumor and remained stable after 4 weeks in all patients with complete resection of the tumor.
CONCLUSION: Endoglin is an important factor in the pathophysiology of head and neck paragangliomas and may be a potential diagnostic and prognostic marker in these types of tumors.

PMID: 28863727 [PubMed - as supplied by publisher]

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Book Review: Head and Neck Ultrasonography: Essential and Extended Applications Orloff Lisa A. Head and Neck Ultrasonography: Essential and Extended Applications , 2nd ed. San Diego, CA : Plural Publishing ; 2017 . Hard cover, illustrated, 544 pages, $299.95 .

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Book Review: Head and Neck Ultrasonography: Essential and Extended Applications Orloff Lisa A. Head and Neck Ultrasonography: Essential and Extended Applications , 2nd ed. San Diego, CA : Plural Publishing ; 2017 . Hard cover, illustrated, 544 pages, $299.95 .

Ann Otol Rhinol Laryngol. 2017 Sep 01;:3489417727525

Authors: Ahmed YC

PMID: 28863716 [PubMed - as supplied by publisher]

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Esophagus foreign body in the thyroid gland

Publication date: Available online 2 September 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Sílvia Miguéis Picado Petrarolha, Rogério Aparecido Dedivitis, Fabíola Garcia Perruccio, Ingrid de Andrade Quirino




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Self-help organisations as patient representatives in health care and policy decision-making

Publication date: Available online 2 September 2017
Source:Health Policy
Author(s): Daniela Rojatz, Rudolf Forster
A crucial question about participation is who is legitimised, willing and capable of representing particular collectives. Social insurance health care systems tend to focus on representation by patient organisations. Self-help organisations (SHOs), as one type of 'health consumer and patient organisation' often take over this role. Research findings indicate that participation by SHOs is accompanied by high expectations, but also by concerns about the risks of instrumental abuse, overload and professionalisation. However, there is a dearth of in-depth knowledge about both potential and risks of participating for the SHO. To tackle this research gap, a qualitative study design was used to investigate fifteen SHOs in Austria. Data were generated by expert interviews with SHO representatives and documentary analysis of SHO websites. Content analysis was applied.SHOs in Austria advocate for patients' interests, participate in invited spaces and have various forms of cooperative relations with the health care system. Thereby, they draw on the experiential knowledge of their members without, however, systematising it. Experiences with professionalisation and instrumental use are ambiguous, whereas overload is prevalent.SHOs need resources for reflection in order to define their position visà- vis the health system and to realise their potential as patient representatives. Deepening co-operation with the health care system might lead to new participatory practices acknowledging differences in culture and the resources of both sides.



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Pathogens, Vol. 6, Pages 40: HPV16 E6 and E7 Upregulate Interferon-Induced Antiviral Response Genes ISG15 and IFIT1 in Human Trophoblast Cells

Pathogens, Vol. 6, Pages 40: HPV16 E6 and E7 Upregulate Interferon-Induced Antiviral Response Genes ISG15 and IFIT1 in Human Trophoblast Cells

Pathogens doi: 10.3390/pathogens6030040

Authors: Lea M.M. Ambühl Annemarie B. Villadsen Ulrik Baandrup Karen Dybkær Suzette Sørensen

Human papillomavirus (HPV) is suggested to infect trophoblasts in the placenta, and HPV infections are reported to be more prevalent in pregnancies with adverse outcomes. Results are however controversial, and studies investigating the molecular consequences of placental HPV infections are lacking. We studied HPV DNA localization in the placenta in cases of spontaneous abortion/spontaneous preterm delivery as well as in elective abortion/normal full-term delivery. Using in vitro assays, we investigated downstream effects of HPV16 E6 and E7 expression in trophoblast cells at the gene expression level in order to gain increased biological insight into the interaction between HPV and the cellular host. Fluorescent in situ hybridization (FISH), combined with fluorescent immunohistochemistry (FIHC) to target the trophoblast marker CK7 clearly showed, that HPV DNA resides within syncytiotrophoblast cells in the placenta. In vitro HPV16 E6 and E7-transfected trophoblasts were analyzed by RNA sequencing, and results were validated by reverse transcription real time polymerase chain reaction (RT-qPCR) for selected genes in cell lines, as well as in patient material. We show that HPV16 E6 and E7 upregulate interferon-induced antiviral response genes ISG15 and IFIT1 in a human trophoblast cell line two-days post-transfection. This is a response that is not observed when assessing the gene expression levels of the same genes in HPV16-positive placenta samples. Investigations on viral activity find that HPV16 E6 and E7 are not transcribed in patients, possibly suggesting that HPV16 syncytiotrophoblast infection may be latent. We conclude that HPV localizes to syncytiotrophoblast cells of the placenta, and that active expression of HPV16 E6 and E7 induce an immediate interferon-induced antiviral response in trophoblast cells, which is not present in HPV-positive placenta samples, suggesting latent infection.

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Paving the future of rhinosinusitis care.

Paving the future of rhinosinusitis care.

Rhinology. 2017 Sep 02;:

Authors: Hellings PW

Abstract
Novel insights into the pathophysiology of chronic rhinosinsusitis (CRS) will lead to endo-type driven treatment and reduce oral corticosteroid treatment.

PMID: 28865115 [PubMed - as supplied by publisher]

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IJERPH, Vol. 14, Pages 1008: Fine-Scale Spatial Variability of Pedestrian-Level Particulate Matters in Compact Urban Commercial Districts in Hong Kong

IJERPH, Vol. 14, Pages 1008: Fine-Scale Spatial Variability of Pedestrian-Level Particulate Matters in Compact Urban Commercial Districts in Hong Kong

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14091008

Authors: Yuan Shi Edward Ng

Particulate matters (PM) at the pedestrian level significantly raises the health impacts in the compact urban environment of Hong Kong. A detailed investigation of the fine-scale spatial variation of pedestrian-level PM is necessary to assess the health risk to pedestrians in the outdoor environment. However, the collection of PM data is difficult in the compact urban environment of Hong Kong due to the limited amount of roadside monitoring stations and the complicated urban context. In this study, we measured the fine-scale spatial variability of the PM in three of the most representative commercial districts of Hong Kong using a backpack outdoor environmental measuring unit. Based on the measurement data, 13 types of geospatial interpolation methods were examined for the spatial mapping of PM2.5 and PM10 with a group of building geometrical covariates. Geostatistical modelling was adopted as the basis of spatial interpolation of the PM. The results show that the original cokriging with the exponential kernel function provides the best performance in the PM mapping. Using the fine-scale building geometrical features as covariates slightly improves the interpolation performance. The study results also imply that the fine-scale, localized pollution emission sources heavily influence pedestrian exposure to PM.

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IJMS, Vol. 18, Pages 1895: Modulation of Immunogenicity and Conformation of HA1 Subunit of Influenza A Virus H1/N1 Hemagglutinin in Tubular Immunostimulating Complexes

IJMS, Vol. 18, Pages 1895: Modulation of Immunogenicity and Conformation of HA1 Subunit of Influenza A Virus H1/N1 Hemagglutinin in Tubular Immunostimulating Complexes

International Journal of Molecular Sciences doi: 10.3390/ijms18091895

Authors: Nina Sanina Ludmila Davydova Natalia Chopenko Eduard Kostetsky Valery Shnyrov

The HA1 subunit of the influenza virus hemagglutinin (HA) is a valuable antigen for the development of vaccines against flu due to the availability of most antigenic sites which are conformational. Therefore, a novel adjuvanted antigen delivery system, tubular immunostimulating complexes (TI-complexes) comprising monogalactosyldiacylglycerol (MGDG) from different marine macrophytes as a lipid matrix for an antigen, was applied to enhance the immunogenicity of recombinant HA1 of influenza A H1N1 and to study the relation between its immunogenicity and conformation. The content of anti-HA1 antibodies and cytokines was estimated by ELISA after the immunization of mice with HA1 alone, and HA1 was incorporated in TI-complexes based on different MGDGs isolated from green algae Ulva lactuca, brown algae Sargassum pallidum, and seagrass Zostera marina. Conformational changes of HA1 were estimated by differential scanning calorimetry and intrinsic fluorescence. It was shown that the adjuvant activity of TI-complexes depends on the microviscosity of MGDGs, which differently influence the conformation of HA1. The highest production of anti-HA1 antibodies (compared with the control) was induced by HA1 incorporated in a TI-complex based on MGDG from S. pallidum, which provided the relaxation of the spatial structure and, likely, the proper presentation of the antigen to immunocompetent cells.

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Effects of age and gender on the serum levels of clozapine, olanzapine, risperidone, and quetiapine.

Effects of age and gender on the serum levels of clozapine, olanzapine, risperidone, and quetiapine.

Acta Psychiatr Scand. 2017 Sep 02;:

Authors: Castberg I, Westin AA, Skogvoll E, Spigset O

Abstract
OBJECTIVE: To investigate serum concentrations of second-generation antipsychotics in relation to age and gender in a population ranging from 18 to 100 years.
METHOD: Results from a routine therapeutic drug monitoring database were retrieved, and 43 079 samples from 11 968 patients were included (17 249 samples for clozapine, 16 171 samples for olanzapine, 5343 samples for risperidone, and 4316 samples for quetiapine). The dose-adjusted concentration was used as the primary target variable. A linear mixed model was used to allow the inclusion of multiple samples from each patient.
RESULTS: Age had a significant impact on the concentrations of all four drugs. At the age of 80, the dose-adjusted concentrations were up to twice those of the age of 40. At the age of 90, dose-adjusted concentrations were two- to three-fold higher. Age-related increases were largest for clozapine (+108% at 80 years; +197% at 90 years) and smallest for olanzapine (+28% at 80 years; +106% at 90 years). Females generally had dose-adjusted concentrations 20-30% higher than males.
CONCLUSION: The effect of age on the serum concentrations of the antipsychotics studied becomes pronounced with advanced age. The patient population aged above 70 should be subdivided according to exact age, and considerable dose reductions are recommended.

PMID: 28865402 [PubMed - as supplied by publisher]

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Clinical measures of balance in people with type two diabetes: A systematic literature review.

Clinical measures of balance in people with type two diabetes: A systematic literature review.

Gait Posture. 2017 Aug 24;58:325-332

Authors: Dixon CJ, Knight T, Binns E, Ihaka B, O'Brien D

Abstract
Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM.

PMID: 28865394 [PubMed - as supplied by publisher]

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Metabolomic study for monitoring of biomarkers in mouse plasma with asthma by gas chromatography-mass spectrometry.

Metabolomic study for monitoring of biomarkers in mouse plasma with asthma by gas chromatography-mass spectrometry.

J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Aug 30;1063:156-162

Authors: Seo C, Hwang YH, Lee HS, Kim Y, Shin TH, Lee G, Son YJ, Kim H, Yee ST, Park AK, Paik MJ

Abstract
Asthma is a multifaceted chronic disease caused by an alteration of various genetic and environmental factors that is increasing in incidence worldwide. However, the biochemical mechanisms regarding asthma are not completely understood. Thus, we performed of metabolomic study for understanding of the biochemical events by monitoring of altered metabolism and biomarkers in asthma. In mice plasma, 27 amino acids(AAs), 24 fatty acids(FAs) and 17 organic acids(OAs) were determined by ethoxycarbonyl(EOC)/methoxime(MO)/tert-butyldimethylsilyl(TBDMS) derivatives with GC-MS. Their percentage composition normalized to the corresponding mean levels of control group. They then plotted as star symbol patterns for visual monitoring of altered metabolism, which were characteristic and readily distinguishable in control and asthma groups. The Mann-Whitney test revealed 25 metabolites, including eight AAs, nine FAs and eight OAs, which were significantly different (p<0.05), and orthogonal partial least-squares-discriminant analysis revealed a clear separation of the two groups. In classification analysis, palmitic acid and methionine were the main metabolites for discrimination between asthma and the control followed by pipecolic, lactic, α-ketoglutaric, and linoleic acids for high classification accuracy as potential biomarkers. These explain the metabolic disturbance in asthma for AAs and FAs including intermediate OAs related to the energy metabolism in the TCA cycle.

PMID: 28865332 [PubMed - as supplied by publisher]

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Increased diabetes risk and interaction with social and medical events in patients upon stroke: Two nationwide studies.

Increased diabetes risk and interaction with social and medical events in patients upon stroke: Two nationwide studies.

Atherosclerosis. 2017 Aug 22;265:87-92

Authors: Chu LM, Liu CC, Yeh CC, Chang YC, Hu CJ, Shih CC, Cherng YG, Chen TL, Liao CC

Abstract
BACKGROUND & AIMS: The relationship between stroke and diabetes is not completely understood. This study evaluated diabetes risk and post-diabetes adverse events in patients with stroke.
METHODS: We identified 10,255 adults, newly diagnosed with stroke from 2000 to 2005, using the Taiwan's National Health Insurance Research Database. A comparison cohort of 41,020 adults without stroke was randomly selected from the same dataset, frequency matched by age and sex. Diabetes events from 2000 to 2013 were ascertained from medical claims. Adjusted hazard ratios (HRs) and 95% CIs were calculated for diabetes associated with stroke. A nested cohort study of 33,437 patients with inpatient care for diabetes between 2008 and 2013 was conducted to calculate the adjusted odds ratios (ORs) and 95% CIs for adverse events after diabetes, in patients with and without stroke.
RESULTS: During 489,561 person-years of follow-up, there were 10,742 newly diagnosed diabetes cases. The incidence of diabetes for people with and without stroke was 43.9 and 17.8 per 1000 person-years, respectively (p < 0.0001). Compared to that for people without stroke, the adjusted HR for diabetes was 2.69 (95% CI 2.56-2.82) for stroke patients. The ORs of post-diabetes pneumonia, urinary tract infection, and mortality associated with stroke were 1.35 (95% CI 1.17-1.55), 1.52 (95% CI 1.36-1.70), and 1.71 (95% CI 1.27-2.29), respectively.
CONCLUSIONS: We provide evidence that the consequences of stroke are not limited to the neurological defect, but evoke diabetes and a plethora of associated medical, psychological and social impacts the physician must be strongly aware of if evaluating and treating stroke patients.

PMID: 28865327 [PubMed - as supplied by publisher]

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The impact of APOA5, APOB, APOC3 and ABCA1 gene polymorphisms on ischemic stroke: Evidence from a meta-analysis.

The impact of APOA5, APOB, APOC3 and ABCA1 gene polymorphisms on ischemic stroke: Evidence from a meta-analysis.

Atherosclerosis. 2017 Aug 19;265:60-70

Authors: Au A, Griffiths LR, Irene L, Kooi CW, Wei LK

Abstract
BACKGROUND AND AIMS: Genetic studies have been reported on the association between APOA5, APOB, APOC3 and ABCA1 gene polymorphisms and ischemic stroke, but results remain controversial. Hence, this meta-analysis aimed to infer the causal relationships of APOA5 (rs662799, rs3135506), APOB (rs693, rs1042031, rs1801701), APOC3 (rs4520, rs5128, rs2854116, rs2854117) and ABCA1 rs2230806 with ischemic stroke risk.
METHODS: A systematic review was performed for all the articles retrieved from multiple databases, up until March 2017. Data were extracted from all eligible studies, and meta-analysis was carried out using RevMan 5.3 and R package 3.2.1. The strength of association between each studied polymorphism and ischemic stroke risk was measured as odds ratios (ORs) and 95% confidence intervals (CIs), under fixed- and random-effect models.
RESULTS: A total of 79 studies reporting on the association between the studied polymorphisms and ischemic stroke risk were identified. The pooled data indicated that all genetic models of APOA5 rs662799 (ORs = 1.23-1.43), allelic and over-dominant models of APOA5 rs3135506 (ORs = 1.77-1.97), APOB rs1801701 (ORs = 1.72-2.13) and APOB rs1042031 (ORs = 1.66-1.88) as well as dominant model of ABCA1 rs2230806 (OR = 1.31) were significantly associated with higher risk of ischemic stroke. However, no significant associations were observed between ischemic stroke and the other five polymorphisms, namely ApoB (rs693) and APOC3 (rs4520, rs5128, rs2854116 and rs2854117), under any genetic model.
CONCLUSIONS: The present meta-analysis confirmed a significant association of APOA5 rs662799 CC, APOA5 rs3135506 CG, APOB rs1801701 GA, APOB rs1042031 GA and ABCA1 rs2230806 GG with increased risk of ischemic stroke.

PMID: 28865324 [PubMed - as supplied by publisher]

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Thermal effects on arsenic emissions during coal combustion process.

Thermal effects on arsenic emissions during coal combustion process.

Sci Total Environ. 2017 Aug 30;612:582-589

Authors: Zhang W, Sun Q, Yang X

Abstract
In this study, the rate of emission of arsenic during the burning process of different kinds of coal is examined in order to study the volatile characteristics of arsenic during coal combustion which have negative effects on the ecological environment and human health. The results show that the emission rate of arsenic gradually increases with increased burning temperature, with a threshold of approximately 700°C to 800°C in the process of temperature increase. Then, the relationships among the arsenic emission rate and combustion environment, original arsenic content, combustion time, burning temperature, air flow and amount of arsenic fixing agent are discussed, and it is found that except for the original arsenic content, the rest of the factors have a nonlinear relationship with the emission rate of arsenic. That is, up to a certain level, they all contribute to the release of arsenic, and then their impact is minimal. The original arsenic content in coal is proportional to the arsenic emission rate. Therefore, taking into consideration the nonlinear relationships between factors that affect the arsenic emission rate can reduce contamination from arsenic.

PMID: 28865274 [PubMed - as supplied by publisher]

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Societal challenges of precision medicine: Bringing order to chaos.

Societal challenges of precision medicine: Bringing order to chaos.

Eur J Cancer. 2017 Aug 30;84:325-334

Authors: Salgado R, Moore H, Martens JWM, Lively T, Malik S, McDermott U, Michiels S, Moscow JA, Tejpar S, McKee T, Lacombe D, IBCD-Faculty

Abstract
The increasing number of drugs targeting specific proteins implicated in tumourigenesis and the commercial promotion of relatively affordable genome-wide analyses has led to an increasing expectation among patients with cancer that they can now receive effective personalised treatment based on the often complex genomic signature of their tumour. For such approaches to work in routine practice, the development of correspondingly complex biomarker assays through an appropriate and rigorous regulatory framework will be required. It is becoming increasingly evident that a re-engineering of clinical research is necessary so that regulatory considerations and procedures facilitate the efficient translation of these required biomarker assays from the discovery setting through to clinical application. This article discusses the practical requirements and challenges of developing such new precision medicine strategies, based on leveraging complex genomic profiles, as discussed at the Innovation and Biomarkers in Cancer Drug Development meeting (8th-9th September 2016, Brussels, Belgium).

PMID: 28865260 [PubMed - as supplied by publisher]

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Hyaluronic acid-Hydroxyapatite Nanocomposite Hydrogels for Enhanced Biophysical and Biological Performance in a Dermal Matrix.

Hyaluronic acid-Hydroxyapatite Nanocomposite Hydrogels for Enhanced Biophysical and Biological Performance in a Dermal Matrix.

J Biomed Mater Res A. 2017 Sep 02;:

Authors: Jeong SH, Fan Y, Cheon KH, Baek J, Kim S, Kim HE

Abstract
A hyaluronic acid (HAc) - hydroxyapatite (HAp) nanocomposite (HAc-nanoHAp) hydrogel was fabricated through an in situ precipitation process for mechanical and biological enhancement as a soft tissue augmentation product. In this study, these composite hydrogel fillers were analyzed from three different perspectives and compared with pure HAc hydrogel for soft tissue augmentation application: 1) rheological behaviors, 2) in vivo lateral diffusion under mouse skin, and 3) wrinkle improvement in a photo-aged mouse model. HAc-nanoHAp provided great improvement to wrinkles because of its higher stiffness and gel cohesiveness in comparison with that of pure HAc. HAc-nanoHAp also presented great enhancement in strengthening the dermal matrix by stimulating the synthesis of collagen and elastin. Thus, HAc-nanoHAp filler has great potential as a soft tissue augmentation product, improving the biophysical and biological performance in skin tissue. This article is protected by copyright. All rights reserved.

PMID: 28865186 [PubMed - as supplied by publisher]

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Effects of Moxonidine and Low-Calorie Diet: Cardiometabolic Benefits from Combination of Both Therapies.

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Effects of Moxonidine and Low-Calorie Diet: Cardiometabolic Benefits from Combination of Both Therapies.

Obesity (Silver Spring). 2017 Sep 02;:

Authors: Lambert EA, Sari CI, Eikelis N, Phillips SE, Grima M, Straznicky NE, Dixon JB, Esler M, Schlaich MP, Head GA, Lambert GW

Abstract
OBJECTIVE: Because sympathetic nervous system activity plays a detrimental role in metabolic and cardiovascular health, this study compared the effects of a centrally acting sympatholytic agent, the effects of a weight loss (WL) program using a low-calorie diet, and the effects of a combination of both.
METHODS: Young (18-30 years) male subjects with overweight (BMI > 25 kg/m(2) ) were allocated to a WL program (n = 10), a moxonidine treatment course (M; n = 10, 0.4 mg/d), a combination of both (WL + M; n = 11), or to a control (C) group (n = 6) for 6 months. Muscle sympathetic nerve activity (MSNA), endothelial function, renal function (Cockcroft-Gault formula), and the metabolic profile were assessed before and after intervention.
RESULTS: WL occurred in the WL and WL + M groups (-7.6 ± 1.9 kg, P < 0.001 in both). MSNA and systolic blood pressure decreased similarly in the WL, M, and WL + M groups (by ∼10 bursts/min, P < 0.001, and by ∼9 mm Hg, P < 0.05). All other parameters for the WL, C, and M groups remained unchanged. In the WL + M group, decreased total cholesterol (-0.78 ± 0.23 mmol/L, P < 0.001), decreased low-density lipoprotein cholesterol (-0.49 ± 0.16 mmol/L, P < 0.01), decreased insulin (-6.5 ± 2.8 mmol/L, P < 0.05), and attenuated glomerular hyperfiltration (-19 ± 5 mL/min, P < 0.01) occurred.
CONCLUSIONS: The combination of moxonidine with a WL program has beneficial effects on aspects of the metabolic profile and end organ damage in young males with overweight.

PMID: 28865109 [PubMed - as supplied by publisher]

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The Roles of Relative Linguistic Proficiency and Modality Switching in Language Switch Cost: Evidence from Chinese Visual Unimodal and Bimodal Bilinguals.

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The Roles of Relative Linguistic Proficiency and Modality Switching in Language Switch Cost: Evidence from Chinese Visual Unimodal and Bimodal Bilinguals.

J Psycholinguist Res. 2017 Sep 01;:

Authors: Lu A, Wang L, Guo Y, Zeng J, Zheng D, Wang X, Shao Y, Wang R

Abstract
The current study investigated the mechanism of language switching in unbalanced visual unimodal bilinguals as well as balanced and unbalanced bimodal bilinguals during a picture naming task. All three groups exhibited significant switch costs across two languages, with symmetrical switch cost in balanced bimodal bilinguals and asymmetrical switch cost in unbalanced unimodal bilinguals and bimodal bilinguals. Moreover, the relative proficiency of the two languages but not their absolute proficiency had an effect on language switch cost. For the bimodal bilinguals the language switch cost also arose from modality switching. These findings suggest that the language switch cost might originate from multiple sources from both outside (e.g., modality switching) and inside (e.g., the relative proficiency of the two languages) the linguistic lexicon.

PMID: 28865039 [PubMed - as supplied by publisher]

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The presence of anaemia negatively influences survival in patients with POLG disease.

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The presence of anaemia negatively influences survival in patients with POLG disease.

J Inherit Metab Dis. 2017 Sep 01;:

Authors: Hikmat O, Charalampos T, Klingenberg C, Rasmussen M, Tallaksen CME, Brodtkorb E, Fiskerstrand T, McFarland R, Rahman S, Bindoff LA

Abstract
BACKGROUND: Mitochondria play an important role in iron metabolism and haematopoietic cell homeostasis. Recent studies in mice showed that a mutation in the catalytic subunit of polymerase gamma (POLG) was associated with haematopoietic dysfunction including anaemia. The aim of this study was to analyse the frequency of anaemia in a large cohort of patients with POLG related disease.
METHODS: We conducted a multi-national, retrospective study of 61 patients with confirmed, pathogenic biallelic POLG mutations from six centres, four in Norway and two in the United Kingdom. Clinical, laboratory and genetic data were collected using a structured questionnaire. Anaemia was defined as an abnormally low haemoglobin value adjusted for age and sex. Univariate survival analysis was performed using log-rank test to compare differences in survival time between categories.
RESULTS: Anaemia occurred in 67% (41/61) of patients and in 23% (14/61) it was already present at clinical presentation. The frequency of anaemia in patients with early onset disease including Alpers syndrome and myocerebrohepatopathy spectrum (MCHS) was high (72%) and 35% (8/23) of these had anaemia at presentation. Survival analysis showed that the presence of anaemia was associated with a significantly worse survival (P = 0.004).
CONCLUSION: Our study reveals that anaemia can be a feature of POLG-related disease. Further, we show that its presence is associated with significantly worse prognosis either because anaemia itself is impacting survival or because it reflects the presence of more serious disease. In either case, our data suggests anaemia is a marker for negative prognosis.

PMID: 28865037 [PubMed - as supplied by publisher]

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Genome Characterization of Oleaginous Aspergillus oryzae BCC7051: A Potential Fungal-Based Platform for Lipid Production.

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Genome Characterization of Oleaginous Aspergillus oryzae BCC7051: A Potential Fungal-Based Platform for Lipid Production.

Curr Microbiol. 2017 Sep 01;:

Authors: Thammarongtham C, Nookaew I, Vorapreeda T, Srisuk T, Land ML, Jeennor S, Laoteng K

Abstract
The selected robust fungus, Aspergillus oryzae strain BCC7051 is of interest for biotechnological production of lipid-derived products due to its capability to accumulate high amount of intracellular lipids using various sugars and agro-industrial substrates. Here, we report the genome sequence of the oleaginous A. oryzae BCC7051. The obtained reads were de novo assembled into 25 scaffolds spanning of 38,550,958 bps with predicted 11,456 protein-coding genes. By synteny mapping, a large rearrangement was found in two scaffolds of A. oryzae BCC7051 as compared to the reference RIB40 strain. The genetic relationship between BCC7051 and other strains of A. oryzae in terms of aflatoxin production was investigated, indicating that the A. oryzae BCC7051 was categorized into group 2 nonaflatoxin-producing strain. Moreover, a comparative analysis of the structural genes focusing on the involvement in lipid metabolism among oleaginous yeast and fungi revealed the presence of multiple isoforms of metabolic enzymes responsible for fatty acid synthesis in BCC7051. The alternative routes of acetyl-CoA generation as oleaginous features and malate/citrate/pyruvate shuttle were also identified in this A. oryzae strain. The genome sequence generated in this work is a dedicated resource for expanding genome-wide study of microbial lipids at systems level, and developing the fungal-based platform for production of diversified lipids with commercial relevance.

PMID: 28865010 [PubMed - as supplied by publisher]

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Epigenetic Influences During the Periconception Period and Assisted Reproduction.

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Epigenetic Influences During the Periconception Period and Assisted Reproduction.

Adv Exp Med Biol. 2017;1014:15-39

Authors: Amoako AA, Nafee TM, Ola B

Abstract
The periconception period starts 6 months before conception and lasts until the tenth week of gestation. In this chapter, we will focus on epigenetic modifications to DNA and gene expression within this period and during assisted reproduction. There are two critical times during the periconception window when significant epigenetic 'reprogramming' occur: one during gametogenesis and another during the pre-implantation embryonic stage. Furthermore, assisted conception treatments, laboratory protocols and culture media can affect the embryo development and birth weights in laboratory animals. There is, however, an ongoing debate as to whether epigenetic changes in humans, causing embryo mal-development, placenta dysfunction and birth defects, result from assisted reproductive technologies or are consequences of pre-existing medical and/or genetic conditions in the parents. The periconception period starts from ovarian folliculogenesis, through resumption of oogenesis, fertilisation, peri-implantation embryo development, embryogenesis until the end of organogenesis. In men, it is the period from spermatogenesis to epididymal sperm storage and fertilisation. Gametes and developing embryos are sensitive to environmental factors during this period, and epigenetic modifications can occur in response to adverse lifestyles and environmental factors. We now know that lifestyle factors such as advanced parentage age, obesity or undernutrition, smoking, excessive alcohol and caffeine intake and recreational drugs used during gamete production and embryogenesis could induce epigenetic alterations, which could impact adversely on pregnancy outcomes and health of the offspring. Furthermore, these can also result in a permanent and irreversible effect in a dose-dependent manner, which can be passed on to the future generations.

PMID: 28864983 [PubMed - in process]

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Physical Activity and Nutrition INfluences In ageing (PANINI): consortium mission statement.

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Physical Activity and Nutrition INfluences In ageing (PANINI): consortium mission statement.

Aging Clin Exp Res. 2017 Sep 01;:

Authors: Whittaker AC, Delledonne M, Finni T, Garagnani P, Greig C, Kallen V, Kokko K, Lord J, Maier AB, Meskers CGM, Santos NC, Sipila S, Thompson JL, van Riel N

PMID: 28864957 [PubMed - as supplied by publisher]

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Antibiotic resistance genes in an urban river as impacted by bacterial community and physicochemical parameters.

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Antibiotic resistance genes in an urban river as impacted by bacterial community and physicochemical parameters.

Environ Sci Pollut Res Int. 2017 Sep 01;:

Authors: Zhou ZC, Zheng J, Wei YY, Chen T, Dahlgren RA, Shang X, Chen H

Abstract
Antibiotic resistance genes (ARGs) in urban rivers are a serious public health concern in regions with poorly planned, rapid development. To gain insights into the predominant factors affecting the fate of ARGs in a highly polluted urban river in eastern China, a total of 285 ARGs, microbial communities, and 20 physicochemical parameters were analyzed for 17 sites. A total of 258 unique ARGs were detected using high-throughput qPCR, and the absolute abundance of total ARGs was positively correlated with total organic carbon and total dissolved nitrogen concentrations (P < 0.01). ARG abundance and diversity were greatly altered by microbial community structure. Variation partitioning analysis showed that the combined effects of multiple factors contributed to the profile and dissemination of ARGs, and variation of microbial communities was the major factor affecting the distribution of ARGs. The disparate distribution of some bacteria, including Bacteroides from mammalian gastrointestinal flora, Burkholderia from zoonotic infectious diseases, and Zoogloea from wastewater treatment, indicates that the urban river was strongly influenced by point-source pollution. Results imply that microbial community shifts caused by changes in water quality may lead to the spread of ARGs, and point-source pollution in urban rivers requires greater attention to control the transfer of ARGs between environmental bacteria and pathogens.

PMID: 28864929 [PubMed - as supplied by publisher]

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Essential oils of aromatic Egyptian plants repel nymphs of the tick Ixodes ricinus (Acari: Ixodidae).

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Essential oils of aromatic Egyptian plants repel nymphs of the tick Ixodes ricinus (Acari: Ixodidae).

Exp Appl Acarol. 2017 Sep 01;:

Authors: El-Seedi HR, Azeem M, Khalil NS, Sakr HH, Khalifa SAM, Awang K, Saeed A, Farag MA, AlAjmi MF, Pålsson K, Borg-Karlson AK

Abstract
Due to the role of Ixodes ricinus (L.) (Acari: Ixodidae) in the transmission of many serious pathogens, personal protection against bites of this tick is essential. In the present study the essential oils from 11 aromatic Egyptian plants were isolated and their repellent activity against I. ricinus nymphs was evaluated Three oils (i.e. Conyza dioscoridis L., Artemisia herba-alba Asso and Calendula officinalis L.) elicited high repellent activity in vitro of 94, 84.2 and 82%, respectively. The most active essential oil (C. dioscoridis) was applied in the field at a concentration of 6.5 µg/cm(2) and elicited a significant repellent activity against I. ricinus nymphs by 61.1%. The most repellent plants C. dioscoridis, C. officinalis and A. herba-alba yielded essential oils by 0.17, 0.11 and 0.14%, respectively. These oils were further investigated using gas chromatography-mass spectrometry analysis. α-Cadinol (10.7%) and hexadecanoic acid (10.5%) were the major components of C. dioscoridis whereas in C. officinalis, α-cadinol (21.2%) and carvone (18.2%) were major components. Artemisia herba-alba contained piperitone (26.5%), ethyl cinnamate (9.5%), camphor (7.7%) and hexadecanoic acid (6.9%). Essential oils of these three plants have a potential to be used for personal protection against tick bites.

PMID: 28864886 [PubMed - as supplied by publisher]

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The Use of Decision-Analytic Models in Atopic Eczema: A Systematic Review and Critical Appraisal.

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The Use of Decision-Analytic Models in Atopic Eczema: A Systematic Review and Critical Appraisal.

Pharmacoeconomics. 2017 Sep 01;:

Authors: McManus E, Sach T, Levell N

Abstract
OBJECTIVE: The objective of this systematic review was to identify and assess the quality of published economic decision-analytic models within atopic eczema against best practice guidelines, with the intention of informing future decision-analytic models within this condition.
METHODS: A systematic search of the following online databases was performed: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, NHS Economic Evaluation Database, EconLit, Scopus, Health Technology Assessment, Cost-Effectiveness Analysis Registry and Web of Science. Papers were eligible for inclusion if they described a decision-analytic model evaluating both the costs and benefits associated with an intervention or prevention for atopic eczema. Data were extracted using a standardised form by two independent reviewers, whilst quality was assessed using the model-specific Philips criteria.
RESULTS: Twenty-four models were identified, evaluating either preventions (n = 12) or interventions (n = 12): 14 reported using a Markov modelling approach, four utilised decision trees and one a discrete event simulation, whilst five did not specify the approach. The majority, 22 studies, reported that the intervention was dominant or cost effective, given the assumptions and analytical perspective taken. Notably, the models tended to be short-term (16 used a time horizon of ≤1 year), often providing little justification for the limited time horizon chosen. The methodological and reporting quality of the studies was generally weak, with only seven studies fulfilling more than 50% of their applicable Philips criteria.
CONCLUSIONS: This is the first systematic review of decision models in eczema. Whilst the majority of models reported favourable outcomes in terms of the cost effectiveness of the new intervention, the usefulness of these findings for decision-making is questionable. In particular, there is considerable scope for increasing the range of interventions evaluated, for improving modelling structures and reporting quality.

PMID: 28864846 [PubMed - as supplied by publisher]

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