Τετάρτη 1 Νοεμβρίου 2017

Endosomal signaling of the receptor for calcitonin gene-related peptide mediates pain transmission.

Endosomal signaling of the receptor for calcitonin gene-related peptide mediates pain transmission.

Proc Natl Acad Sci U S A. 2017 Oct 30;:

Authors: Yarwood RE, Imlach WL, Lieu T, Veldhuis NA, Jensen DD, Klein Herenbrink C, Aurelio L, Cai Z, Christie MJ, Poole DP, Porter CJH, McLean P, Hicks GA, Geppetti P, Halls ML, Canals M, Bunnett NW

Abstract
G protein-coupled receptors (GPCRs) are considered to function primarily at the plasma membrane, where they interact with extracellular ligands and couple to G proteins that transmit intracellular signals. Consequently, therapeutic drugs are designed to target GPCRs at the plasma membrane. Activated GPCRs undergo clathrin-dependent endocytosis. Whether GPCRs in endosomes control pathophysiological processes in vivo and are therapeutic targets remains uncertain. We investigated the contribution of endosomal signaling of the calcitonin receptor-like receptor (CLR) to pain transmission. Calcitonin gene-related peptide (CGRP) stimulated CLR endocytosis and activated protein kinase C (PKC) in the cytosol and extracellular signal regulated kinase (ERK) in the cytosol and nucleus. Inhibitors of clathrin and dynamin prevented CLR endocytosis and activation of cytosolic PKC and nuclear ERK, which derive from endosomal CLR. A cholestanol-conjugated antagonist, CGRP8-37, accumulated in CLR-containing endosomes and selectively inhibited CLR signaling in endosomes. CGRP caused sustained excitation of neurons in slices of rat spinal cord. Inhibitors of dynamin, ERK, and PKC suppressed persistent neuronal excitation. CGRP8-37-cholestanol, but not unconjugated CGRP8-37, prevented sustained neuronal excitation. When injected intrathecally to mice, CGRP8-37-cholestanol inhibited nociceptive responses to intraplantar injection of capsaicin, formalin, or complete Freund's adjuvant more effectively than unconjugated CGRP8-37 Our results show that CLR signals from endosomes to control pain transmission and identify CLR in endosomes as a therapeutic target for pain. Thus, GPCRs function not only at the plasma membrane but also in endosomes to control complex processes in vivo. Endosomal GPCRs are a drug target that deserve further attention.

PMID: 29087309 [PubMed - as supplied by publisher]



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The pathogenesis of cutaneous squamous cell carcinoma in organ transplant recipients.

The pathogenesis of cutaneous squamous cell carcinoma in organ transplant recipients.

Br J Dermatol. 2017 Oct 30;:

Authors: Harwood CA, Toland AE, Proby CM, Euvrard S, Hofbauer GFL, Tommasino M, Bouwes Bavinck JN, KeraCon Consortium

Abstract
The pathogenesis of keratinocyte carcinoma following organ transplantation is multifactorial, and recent evidence suggests a complex and often synergistic interplay between the carcinogenic effects of ultraviolet radiation, compromised immune surveillance, direct pro- and anticarcinogenic effects of drugs, oncogenic viruses (in particular, beta-genus human papillomaviruses) and host genetic susceptibility factors. We present an overview of those factors for which there is currently the most convincing evidence and highlight important gaps in our knowledge. In particular, a clear understanding of the interdependence and relative contributions of these co-factors is currently lacking, yet has important implications for rational development of clinically relevant biomarkers and targeted strategies for treatment and prevention of post-transplant keratinocyte cancers.

PMID: 29086420 [PubMed - as supplied by publisher]



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Synergistic effect of photodynamic therapy and alendronate on alveolar bone loss in rats with ligature-induced periodontitis.

Synergistic effect of photodynamic therapy and alendronate on alveolar bone loss in rats with ligature-induced periodontitis.

J Periodontal Res. 2017 Oct 31;:

Authors: Camacho-Alonso F, Davia-Peña RS, Vilaplana-Vivo C, Tudela-Mulero MR, Merino JJ, Martínez-Beneyto Y

Abstract
BACKGROUND AND OBJECTIVE: Photodynamic therapy (PDT) and antiresorptive drugs, such as alendronate (ALN), have been shown to reduce alveolar bone loss. The aim of this study was to evaluate the possible synergic effects of combining PDT and ALN on bone loss in periodontitis in rats.
MATERIAL AND METHODS: Periodontitis was induced by ligature in 60 Wistar rats randomized into the following groups: control (Group 1); PDT (Group 2); ALN 0.01 mg/kg (Group 3); ALN 0.25 mg/kg (Group 4); PDT + ALN 0.01 mg/kg (Group 5); and PDT + ALN 0.25 mg/kg (Group 6). The rats were killed on day 12 and the mandibles were processed for macroscopic morphometric analysis, micro-computed tomography to analyze bone mineral density (BMD) and histological analysis. Gingival samples were collected to evaluate myeloperoxidase (MPO) and malonaldehyde (MDA) levels.
RESULTS: Bone loss and inflammatory activity in histological studies, from the greatest to least was: control > ALN 0.01 mg/kg > PDT > ALN 0.25 mg/kg > PDT + ALN 0.01 mg/kg > PDT + ALN 0.25 mg/kg, while the order from least to greatest BMD was: control < ALN 0.01 mg/kg < PDT < ALN 0.25 mg/kg < PDT + ALN 0.01 mg/kg < PDT + ALN 0.25 mg/kg. The order of MPO and MDA activity from greatest to least was: control > ALN 0.01 mg/kg > PDT > ALN 0.25 mg/kg > PDT + ALN 0.01 mg/kg > PDT + ALN 0.25 mg/kg. The positive results obtained in the group treated with PDT + ALN 0.25 mg/kg showed statistically significant differences (P ≤ .05) compared with the other 5 groups for BMD, MPO and MDA.
CONCLUSION: Combined approach therapy of PDT + ALN 0.25 mg/kg demonstrated a protective effect on alveolar bone loss.

PMID: 29086417 [PubMed - as supplied by publisher]



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Combination of Anti-miRNAs Oligonucleotides with Low Amounts of Chemotherapeutic Agents for Pancreatic Cancer Therapy.

Combination of Anti-miRNAs Oligonucleotides with Low Amounts of Chemotherapeutic Agents for Pancreatic Cancer Therapy.

Methods Mol Biol. 2018;1699:135-154

Authors: Passadouro M, Faneca H

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is the most predominant type of pancreatic cancer and presents one of the highest mortality rates when compared with other carcinomas. The absence of efficient treatment options for PDAC prompted us to investigate whether microRNA inhibition, combined or not with chemotherapeutic agents, would constitute a promising therapeutic approach for this disease. In this chapter, we describe several methods and procedures that can be used to evaluate the potential of new therapeutic strategies involving oligonucleotides against overexpressed microRNAs, in PDAC, either alone or in combination with low amounts of chemotherapeutic drugs.

PMID: 29086375 [PubMed - in process]



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Noncoding RNAs in DNA Damage Response: Opportunities for Cancer Therapeutics.

Noncoding RNAs in DNA Damage Response: Opportunities for Cancer Therapeutics.

Methods Mol Biol. 2018;1699:3-21

Authors: Arjumand W, Asiaf A, Ahmad ST

Abstract
DNA repair machinery preserves genomic integrity, which is frequently challenged through endogenous and exogenous toxic insults, and any sort of repair machinery malfunctioning ultimately manifests in the form of several types of terrible human diseases such as cancers (Hoeijmakers, Nature 411(6835): 366-374, 2001). Noncoding RNAs (ncRNAs) are crucial players of DNA repair machinery in a cell and play a vital role in maintaining genomic stability, which is essential for its survival and normal functioning thus preventing tumorigenesis. To preserve the integrity of the genome, cells initiate a specific cellular response, recognized as DNA damage response (DDR), which includes several distinct DNA repair pathways. These repair pathways permit normal cells to repair DNA damage or induce apoptosis and cell cycle arrest in case the damage is irreparable. Disruption of these pathways in cancer leads to an increase in genomic instability and mutagenesis. Recently, emerging evidence suggests that ncRNAs play a critical role in the regulation of DDR. There is an extensive crosstalk between ncRNAs and the canonical DDR signaling pathway. DDR-induced expression of ncRNAs can provide a regulatory mechanism to accurately control the expression of DNA damage responsive genes in a spatio-temporal manner. DNA damage alters expression of a variety of ncRNAs at multiple levels including transcriptional regulation, post-transcriptional regulation, and RNA degradation and vice versa, wherein ncRNAs can directly regulate cellular processes involved in DDR by altering expression of their targeting genes, with a particular emphasis on microRNAs (miRNAs) and long noncoding RNAs (lncRNAs). Relationship between the defects in the DDR and deregulation of related ncRNAs in human cancers is one of the established, which is growing stronger with the advent of high-throughput sequencing techniques such as next-generation sequencing. Understanding of the mechanisms that explain the association between ncRNAs and DDR/DNA repair pathways will definitely increase our understanding on human tumor biology and on different responses to diverse drugs. Different ncRNAs interact with distinct DDR components and are promising targets for improving the effects to overcome the resistance to conventional chemotherapeutic agents. In this chapter, we will focus the role of ncRNAs in the DNA damage, repair, and cancer.

PMID: 29086365 [PubMed - in process]



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In vitro antagonistic and indifferent activity of combination of 3-deoxyanthocyanidins against Toxoplasma gondii.

In vitro antagonistic and indifferent activity of combination of 3-deoxyanthocyanidins against Toxoplasma gondii.

Parasitol Res. 2017 Oct 30;:

Authors: Abugri DA, Witola WH, Jaynes JM

Abstract
Toxoplasma gondii is a ubiquitous intracellular zoonotic parasite estimated to affect about 30-90% of the world's human population. The most affected are immunocompromised individuals such as HIV-AIDS and cancer patients, organ and tissue transplant recipients, and congenitally infected children. No effective and safe drugs and vaccines are available against all forms of the parasite. We report here the antagonistic and indifferent activity of the combination of five different formulations of pure synthetic 3-deoxyanthocyaninidin (3-DA) chloride compounds against T. gondii tachyzoites and the synergistic and additive interaction against a human foreskin fibroblast (HFF) cell line in vitro using fluorescence microscopy, trypan blue assay, and fractional inhibitory concentration index. The individual and the combined pure 3-DA compounds were observed to have effective inhibition against T. gondii parasites with less cytotoxic effect in a ratio of 1:1. The IC50 values for parasite inhibition ranged from 1.88 μg/mL (1.51-2.32 μg/mL) for luteolinindin plus 7-methoxyapigeninindin (LU/7-MAP) and 2.23 μg/mL (1.66-2.97 μg/mL) for apigeninindin plus 7-methoxyapigeninindin (AP/7-MAP) combinations at 95% confidence interval (CI) after 48 h of culture. We found LU/7-MAP to be antagonistic and AP/7-MAP to be indifferent in interaction against T. gondii growth. Both individual and combination 3-DA compounds not only depicted very strong inhibitory activity against T. gondii, but also had synergistic and additive cytotoxic effects against HFF cells. These synthetic 3-DAs have potential as antiparasitic agents for the treatment of human toxoplasmosis.

PMID: 29086004 [PubMed - as supplied by publisher]



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A drug-self-gated and tumor microenvironment-responsive mesoporous silica vehicle: "four-in-one" versatile nanomedicine for targeted multidrug-resistant cancer therapy.

A drug-self-gated and tumor microenvironment-responsive mesoporous silica vehicle: "four-in-one" versatile nanomedicine for targeted multidrug-resistant cancer therapy.

Nanoscale. 2017 Oct 31;:

Authors: Cheng W, Liang C, Wang X, Tsai HI, Liu G, Peng Y, Nie J, Huang L, Mei L, Zeng X

Abstract
The design of multifunctional nanocarriers for the co-delivery of anticancer drugs and genetic agents offers an effective and promising strategy to combat multidrug-resistant cancer. Herein, we developed a simple and facile method to fabricate a drug-self-gated and pH-sensitive mesoporous silica vehicle as a "four-in-one" versatile co-delivery system, which possesses targeted chemo and gene therapy capability against multidrug-resistant cancer. P-gp siRNA molecules were loaded into the channels of mesoporous silica nanoparticles. A chemotherapeutic drug (DOX) was employed as a gatekeeper via a pH-sensitive benzoic-imine covalent bond. Folic acid conjugation onto the surface endowed this system with an excellent tumor-targeting effect, which was demonstrated by the cellular and tumor targeting assay. The effective downregulation of P-gp protein by the co-delivered P-gp siRNA was observed by western blotting. Both the in vitro cell viability study and in vivo tumor inhibition assay showed a synergistic effect in suppressing cancer cell proliferation. Therefore, this drug-self-gated nanosystem exhibited great potential for improved multidrug-resistant cancer treatment without any further potential risks of capping agents.

PMID: 29085938 [PubMed - as supplied by publisher]



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Anti-mycobacterium tuberculosis activity of polyherbal medicines used for the treatment of tuberculosis in Eastern Cape, South Africa.

Anti-mycobacterium tuberculosis activity of polyherbal medicines used for the treatment of tuberculosis in Eastern Cape, South Africa.

Afr Health Sci. 2017 Sep;17(3):780-789

Authors: Famewo EB, Clarke AM, Wiid I, Ngwane A, van Helden P, Afolayan AJ

Abstract
BACKGROUND: The emergence of drug-resistant strains of Mycobacterium tuberculosis has become a global public health problem. Polyherbal medicines offer great hope for developing alternative drugs for the treatment of tuberculosis.
OBJECTIVE: To evaluate the anti-tubercular activity of polyherbal medicines used for the treatment of tuberculosis.
METHODS: The remedies were screened against Mycobacterium tuberculosis H37Rv using Middlebrook 7H9 media and MGIT BACTEC 960 system. They were liquid preparations from King Williams Town site A (KWTa), King Williams Town site B (KWTb), King Williams Town site C (KWTc), Hogsback first site (HBfs), Hogsback second site (HBss), Hogsback third site (HBts), East London (EL), Alice (AL) and Fort Beaufort (FB).
RESULTS: The susceptibility testing revealed that all the remedies contain anti-tubercular activity with KWTa, KWTb, KWTc, HBfs, HBts, AL and FB exhibiting more activity at a concentration below 25 µl/ml. Furthermore, MIC values exhibited inhibitory activity with the most active remedies from KWTa, HBfs and HBts at 1.562 µg/ml. However, isoniazid showed more inhibitory activity against M. tuberculosis at 0.05 µg/ml when compare to the polyherbal remedies.
CONCLUSION: This study has indicated that these remedies could be potential sources of new anti-mycobacterial agents against M. tuberculosis. However, the activity of these preparations and their active principles still require in vivo study in order to assess their future as new anti-tuberculosis agents.

PMID: 29085406 [PubMed - in process]



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Angiotensin II-derived constrained peptides with antiplasmodial activity and suppressed vasoconstriction.

Angiotensin II-derived constrained peptides with antiplasmodial activity and suppressed vasoconstriction.

Sci Rep. 2017 Oct 30;7(1):14326

Authors: Silva AF, Torres MT, Silva LS, Alves FL, de Sá Pinheiro AA, Miranda A, Capurro ML, de la Fuente-Nunez C, Oliveira VX

Abstract
Angiotensin II (Ang II) is a natural mammalian hormone that has been described to exhibit antiplasmodial activity therefore constituting a promising alternative for the treatment of malaria. Despite its promise, the development of Ang II as an antimalarial is limited by its potent induction of vasoconstriction and its rapid degradation within minutes. Here, we used peptide design to perform targeted chemical modifications to Ang II to generate conformationally restricted (disulfide-crosslinked) peptide derivatives with suppressed vasoconstrictor activity and increased stability. Designed constrained peptides were synthesized chemically and then tested for antiplasmodial activity. Two lead constrained peptides were identified (i.e., peptides 1 and 2), each composed of 10 amino acid residues. These peptides exhibited very promising activity in both our Plasmodium gallinaceum (>80%) and Plasmodium falciparum (>40%) models, an activity that was equivalent to that of Ang II, and led to complete suppression of vasoconstriction. In addition, peptide 5 exhibited selective activity towards the pre-erythrocytic stage (98% of activity against P. gallinaceum), thus suggesting that it may be possible to design peptides that target specific stages of the malaria life cycle. The Ang II derived stable scaffolds presented here may provide the basis for development of a new generation of peptide-based drugs for the treatment of malaria.

PMID: 29085013 [PubMed - in process]



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Common and cell-type specific responses to anti-cancer drugs revealed by high throughput transcript profiling.

Common and cell-type specific responses to anti-cancer drugs revealed by high throughput transcript profiling.

Nat Commun. 2017 Oct 30;8(1):1186

Authors: Niepel M, Hafner M, Duan Q, Wang Z, Paull EO, Chung M, Lu X, Stuart JM, Golub TR, Subramanian A, Ma'ayan A, Sorger PK

Abstract
More effective use of targeted anti-cancer drugs depends on elucidating the connection between the molecular states induced by drug treatment and the cellular phenotypes controlled by these states, such as cytostasis and death. This is particularly true when mutation of a single gene is inadequate as a predictor of drug response. The current paper describes a data set of ~600 drug cell line pairs collected as part of the NIH LINCS Program ( http://ift.tt/1LdKiq5 ) in which molecular data (reduced dimensionality transcript L1000 profiles) were recorded across dose and time in parallel with phenotypic data on cellular cytostasis and cytotoxicity. We report that transcriptional and phenotypic responses correlate with each other in general, but whereas inhibitors of chaperones and cell cycle kinases induce similar transcriptional changes across cell lines, changes induced by drugs that inhibit intra-cellular signaling kinases are cell-type specific. In some drug/cell line pairs significant changes in transcription are observed without a change in cell growth or survival; analysis of such pairs identifies drug equivalence classes and, in one case, synergistic drug interactions. In this case, synergy involves cell-type specific suppression of an adaptive drug response.

PMID: 29084964 [PubMed - in process]



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Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden.

Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden.

BMJ Open. 2017 Oct 30;7(10):e017739

Authors: Brusselaers N, Wahlin K, Engstrand L, Lagergren J

Abstract
OBJECTIVE: Proton pump inhibitors (PPIs) are among the most commonly prescribed drugs. Concerns have been raised about a potentially increased risk of gastric cancer following long-term use. Our aim is to assess the risk of gastric cancer associated with PPI use, taking into account underlying indications.
DESIGN: This is a population-based cohort study. Standardised incidence ratios (SIRs) and 95% CIs were calculated to compare the risk of gastric cancer among long-term PPI users with the corresponding background population, while taking confounding by indication into account.
SETTING: Population-based study in Sweden (2005-2012).
PARTICIPANTS: This study included virtually all adults residing in Sweden exposed to maintenance therapy with PPIs.
EXPOSURE/INTERVENTION: Maintenance use of PPIs, defined as at least 180 days during the study period. Maintenance use of histamine 2 receptor antagonist was evaluated for comparison reasons.
OUTCOME MEASURES: Gastric cancer (cardia and non-cardia), and subgroup analysis for gastric adenocarcinoma, as defined by the Swedish Cancer Registry.
RESULTS: Among 797 067 individuals on maintenance PPI therapy, the SIR of gastric cancer was over threefold increased (SIR=3.38, 95% CI 3.23 to 3.53). Increased SIRs were found in both sexes and all age groups, but were especially increased among PPI users younger than 40 years (SIR=22.76, 95% CI 15.94 to 31.52). Increased SIRs were found for each indication studied, including those without an association with gastric cancer, for example, gastro-oesophageal reflux (SIR=3.04, 95% CI 2.80 to 3.31), and those with a supposedly decreased risk, for example, aspirin users (SIR=1.93, 95% CI 1.70 to 2.18). The association was similar for cardia and non-cardia gastric cancer. Analyses restricted to adenocarcinoma showed similar results to those for all gastric cancers. Long-term users of histamine 2 receptor antagonists, which have the same indications as PPIs, were not at any increased risk.
CONCLUSIONS: Long-term PPI use might be an independent risk factor for gastric cancer. This challenges broad maintenance PPI therapy, particularly if the indication is weak.

PMID: 29084798 [PubMed - in process]



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Effect of Anesthetics on Efficiency of Remote Ischemic Preconditioning.

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Effect of Anesthetics on Efficiency of Remote Ischemic Preconditioning.

Biochemistry (Mosc). 2017 Sep;82(9):1006-1016

Authors: Silachev DN, Usatikova EA, Pevzner IB, Zorova LD, Babenko VA, Gulyaev MV, Pirogov YA, Plotnikov EY, Zorov DB

Abstract
Remote ischemic preconditioning of hind limbs (RIPC) is an effective method for preventing brain injury resulting from ischemia. However, in numerous studies RIPC has been used on the background of administered anesthetics, which also could exhibit neuroprotective properties. Therefore, investigation of the signaling pathways triggered by RIPC and the effect of anesthetics is important. In this study, we explored the effect of anesthetics (chloral hydrate and Zoletil) on the ability of RIPC to protect the brain from injury caused by ischemia and reperfusion. We found that RIPC without anesthesia resulted in statistically significant decrease in neurological deficit 24 h after ischemia, but did not affect the volume of brain injury. Administration of chloral hydrate or Zoletil one day prior to brain ischemia produced a preconditioning effect by their own, decreasing the degree of neurological deficit and lowering the volume of infarct with the use of Zoletil. The protective effects observed after RIPC with chloral hydrate or Zoletil were similar to those observed when only the respective anesthetic was used. RIPC was accompanied by significant increase in the level of brain proteins associated with the induction of ischemic tolerance such as pGSK-3β, BDNF, and HSP70. However, Zoletil did not affect the level of these proteins 24 h after injection, and chloral hydrate caused increase of only pGSK-3β. We conclude that RIPC, chloral hydrate, and Zoletil produce a significant neuroprotective effect, but the simultaneous use of anesthetics with RIPC does not enhance the degree of neuroprotection.

PMID: 28988529 [PubMed - indexed for MEDLINE]



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Encapsulation of ropivacaine in a combined (donor-acceptor, ionic-gradient) liposomal system promotes extended anesthesia time.

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Encapsulation of ropivacaine in a combined (donor-acceptor, ionic-gradient) liposomal system promotes extended anesthesia time.

PLoS One. 2017;12(10):e0185828

Authors: da Silva CMG, Franz-Montan M, Limia CEG, Ribeiro LNM, Braga MA, Guilherme VA, da Silva CB, Casadei BR, Cereda CMS, de Paula E

Abstract
Ropivacaine is a local anesthetic with similar potency but lower systemic toxicity than bupivacaine, the most commonly used spinal anesthetic. The present study concerns the development of a combined drug delivery system for ropivacaine, comprised of two types of liposomes: donor multivesicular vesicles containing 250 mM (NH4)2SO4 plus the anesthetic, and acceptor large unilamellar vesicles with internal pH of 5.5. Both kinds of liposomes were composed of hydrogenated soy-phosphatidylcholine:cholesterol (2:1 mol%) and were prepared at pH 7.4. Dynamic light scattering, transmission electron microscopy and electron paramagnetic resonance techniques were used to characterize the average particle size, polydispersity, zeta potential, morphology and fluidity of the liposomes. In vitro dialysis experiments showed that the combined liposomal system provided significantly longer (72 h) release of ropivacaine, compared to conventional liposomes (~45 h), or plain ropivacaine (~4 h) (p <0.05). The pre-formulations tested were significantly less toxic to 3T3 cells, with toxicity increasing in the order: combined system < ropivacaine in donor or acceptor liposomes < ropivacaine in conventional liposomes < plain ropivacaine. The combined formulation, containing 2% ropivacaine, increased the anesthesia duration up to 9 h after subcutaneous infiltration in mice. In conclusion, a promising drug delivery system for ropivacaine was described, which can be loaded with large amounts of the anesthetic (2%), with reduced in vitro cytotoxicity and extended anesthesia time.

PMID: 28982145 [PubMed - indexed for MEDLINE]



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Comparative role of neem seed extract, moringa leaf extract and imidacloprid in the management of wheat aphids in relation to yield losses in Pakistan.

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Comparative role of neem seed extract, moringa leaf extract and imidacloprid in the management of wheat aphids in relation to yield losses in Pakistan.

PLoS One. 2017;12(9):e0184639

Authors: Shah FM, Razaq M, Ali A, Han P, Chen J

Abstract
Wheat being staple food of Pakistan is constantly attacked by major wheat aphid species, Schizaphis graminum (R.), Rhopalosiphum padi (L.) and Sitobion avenae (F.). Due to concern on synthetic chemical use in wheat, it is imperative to search for alternative environment- and human- friendly control measures such as botanical pesticides. In the present study, we evaluated the comparative role of neem seed extract (NSE), moringa leaf extract (MLE) and imidacloprid (I) in the management of the aphid as well as the yield losses parameters in late planted wheat fields. Imidacloprid reduced significantly aphids infestation compared to the other treatments, hence resulting in higher yield, particularly when applied with MLE. The percentages of yield increase in I+MLE treated plots over the control were 19.15-81.89% for grains per spike, 5.33-37.62% for thousand grain weight and 27.59-61.12% for yield kg/ha. NSE was the second most effective control measure in suppressing aphid population, but the yield protected by NSE treatment over the control was comparable to that by imidacloprid. Population densities of coccinellids and syrphids in the plots treated with NSE-2 were higher than those treated with imidacloprid in two out of three experiments during 2013-14. Low predator density in imidacloprid-treated plots was attributed to the lower availability of prey aphids. The efficacy of NSE against aphids varied depending on degree of synchronization among the application timing, the activity of aphids, crop variety and environmental conditions. Despite that, we suggested NSE to be a promising alternative botanical insecticide compared to the most commonly recommended imidiacloprid. Further studies should consider the side effects of biopesticides on non-target organisms in order to provide better management practices in the field.

PMID: 28953894 [PubMed - indexed for MEDLINE]



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Uniform neural tissue models produced on synthetic hydrogels using standard culture techniques.

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Uniform neural tissue models produced on synthetic hydrogels using standard culture techniques.

Exp Biol Med (Maywood). 2017 Nov;242(17):1679-1689

Authors: Barry C, Schmitz MT, Propson NE, Hou Z, Zhang J, Nguyen BK, Bolin JM, Jiang P, McIntosh BE, Probasco MD, Swanson S, Stewart R, Thomson JA, Schwartz MP, Murphy WL

Abstract
The aim of the present study was to test sample reproducibility for model neural tissues formed on synthetic hydrogels. Human embryonic stem (ES) cell-derived precursor cells were cultured on synthetic poly(ethylene glycol) (PEG) hydrogels to promote differentiation and self-organization into model neural tissue constructs. Neural progenitor, vascular, and microglial precursor cells were combined on PEG hydrogels to mimic developmental timing, which produced multicomponent neural constructs with 3D neuronal and glial organization, organized vascular networks, and microglia with ramified morphologies. Spearman's rank correlation analysis of global gene expression profiles and a comparison of coefficient of variation for expressed genes demonstrated that replicate neural constructs were highly uniform to at least day 21 for samples from independent experiments. We also demonstrate that model neural tissues formed on PEG hydrogels using a simplified neural differentiation protocol correlated more strongly to in vivo brain development than samples cultured on tissue culture polystyrene surfaces alone. These results provide a proof-of-concept demonstration that 3D cellular models that mimic aspects of human brain development can be produced from human pluripotent stem cells with high sample uniformity between experiments by using standard culture techniques, cryopreserved cell stocks, and a synthetic extracellular matrix. Impact statement Pluripotent stem (PS) cells have been characterized by an inherent ability to self-organize into 3D "organoids" resembling stomach, intestine, liver, kidney, and brain tissues, offering a potentially powerful tool for modeling human development and disease. However, organoid formation must be quantitatively reproducible for applications such as drug and toxicity screening. Here, we report a strategy to produce uniform neural tissue constructs with reproducible global gene expression profiles for replicate samples from multiple experiments.

PMID: 28599598 [PubMed - indexed for MEDLINE]



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Prospective bacterial quorum sensing inhibitors from Indian medicinal plant extracts.

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Prospective bacterial quorum sensing inhibitors from Indian medicinal plant extracts.

Lett Appl Microbiol. 2017 Jul;65(1):2-10

Authors: Tiwary BK, Ghosh R, Moktan S, Ranjan VK, Dey P, Choudhury D, Dutta S, Deb D, Das AP, Chakraborty R

Abstract
As virulence of many pathogenic bacteria is regulated by the phenomenon of quorum sensing (QS), the present study aimed to find the QS-inhibiting (QS-I) property (if any) in 61 Indian medicinal plants. The presence of QS-I compound in the leaf extract was evaluated by its ability to inhibit production of pigment in Chromobacterium violaceum MTCC 2656 (violacein) and Pseudomonas aeruginosa MTCC 2297 (pyocyanin) or swarming of P. aeruginosa MTCC 2297. Extracts of three plants, Astilbe rivularis, Fragaria nubicola and Osbeckia nepalensis, have shown a dose-dependent inhibition of violacein production with no negative effect on bacterial growth. Inhibition of pyocyanin pigment production and swarming motility in P. aeruginosa MTCC 2297 was also shown. Based on the results obtained by gas chromatography-mass spectroscopy (GC-MS) and thin-layer chromatography-direct bioautography (TLC-DB), it was concluded that triterpenes and flavonoid compounds found in the three plant extracts could have QS-I activity.
SIGNIFICANCE AND IMPACT OF THE STUDY: A novel alternative prospect to prevent bacterial infections without inhibiting the growth is to apply chemicals that inhibit quorum sensing mechanism of the pathogens. Antiquorum property of 61 medicinal plants was evaluated by the ability of their leaf extract(s) to inhibit production of pigment (violacein in Chromobacterium violaceum MTCC 2656, pyocyanin in Pseudomonas aeruginosa MTCC 2297) or swarming in P. aeruginosa MTCC 2297. The most prospective plants (for the development of quorum sensing inhibitor), showing inhibition of violacein production without affecting bacterial growth, were Astilbe rivularis, Fragaria nubicola and Osbeckia nepalensis.

PMID: 28421612 [PubMed - indexed for MEDLINE]



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The 150 most important questions in cancer research and clinical oncology series: questions 15-24 : Edited by Chinese Journal of Cancer.

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The 150 most important questions in cancer research and clinical oncology series: questions 15-24 : Edited by Chinese Journal of Cancer.

Chin J Cancer. 2017 Apr 05;36(1):39

Authors: Chinese Journal of Cancer

Abstract
To accelerate our endeavors to overcome cancer, Chinese Journal of Cancer has launched a program of publishing 150 most important questions in cancer research and clinical oncology. In this article, 10 more questions are presented as follows. Question 15: Can tumor-induced erythrogenesis provide qualified red blood cells for carrying oxygen to distant organs? Question 16: Can we overcome tumor resistance to platinum-containing antineoplastic drugs by activating the sensitivity factors in the tumor? Question 17: How can a cancer cell stay dormant for years? Question 18: Why do cancer cells use distinct transcriptomic and proteomic programs to reach the same metastatic phenotype? Question 19: Why do some cancers regress spontaneously? Question 20: What are the regulatory mechanisms occurring in donor cells that determine selective sorting of biological content into vesicles and their biological consequences in recipient cells? Are the genetic transfer and exchange of biological messages between cells transient? Is the phenotypic manipulation of recipient cells temporary or prolonged and persistent? If extracellular vesicles possess immune-modulatory potential, how could they be exploited for immune interventions and cancer immunotherapy? Presumably the cargo of extracellular vesicles reflects the cells of their origin and can be used for cancer diagnosis, how could the uniform/stringent capture criteria be met universally for applying EVs in point-of-care diagnostics for cancer patients? Question 21: Can we use self-sampling technologies to monitor the tumor genetic alterations for more precise targeted therapy? Can we cure a heterogeneous tumor by sequentially targeting the driver molecules? Question 22: Can we postpone the onset of non-infection-related cancers? Question 23: How many types of cells can jointly form the tumor vasculature to provide blood supply for tumor progression? Question 24: How tumor cells transmit their epigenetic features to daughter cells and maintain the malignant phenotype?

PMID: 28381242 [PubMed - indexed for MEDLINE]



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Alternating Rabacfosadine/Doxorubicin: Efficacy and Tolerability in Naïve Canine Multicentric Lymphoma.

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Alternating Rabacfosadine/Doxorubicin: Efficacy and Tolerability in Naïve Canine Multicentric Lymphoma.

J Vet Intern Med. 2017 May;31(3):872-878

Authors: Thamm DH, Vail DM, Post GS, Fan TM, Phillips BS, Axiak-Bechtel S, Elmslie RS, Klein MK, Ruslander DA

Abstract
BACKGROUND: Standard of care treatment for multicentric lymphoma in dogs remains doxorubicin (DOX)-based combination chemotherapy, but owners may hesitate to commit the time and financial resources to complete such a protocol, typically requiring 12-16 visits. Rabacfosadine (RAB), a double prodrug of the nucleotide analog 9-(2-phosphonylmethoxyethyl) guanine, has substantial single-agent activity in dogs with lymphoma, and a different mechanism of action than DOX.
HYPOTHESIS/OBJECTIVES: Our objective was to evaluate the efficacy and adverse effect (AE) profile of alternating doses of RAB and DOX in dogs with naïve multicentric lymphoma.
ANIMALS: Fifty-four dogs with previously untreated lymphoma.
METHODS: Open-label, multicenter prospective clinical trial. Dogs received alternating RAB (1.0 mg/kg IV weeks 0, 6, 12) and DOX (30 mg/m(2) IV weeks 3, 9, 15). Dogs that achieved complete response (CR) were followed by monthly evaluations. Complete clinicopathological evaluation and assessment of remission and AEs were performed every 21 days.
RESULTS: The overall response rate was 84% (68%; CR; 16%; partial response [PR)]. The overall median progression-free interval (PFI) was 194 days (216 for CR and 63 for PR). Most AEs were mild and self-limiting: gastrointestinal and hematologic AEs were most common. Thirteen dogs experienced dermatologic AEs, and 2 dogs developed grade 5 pulmonary fibrosis.
CONCLUSIONS AND CLINICAL IMPORTANCE: Alternating RAB/DOX generally was well tolerated and resulted in PFIs comparable to standard DOX-based multi-agent protocols, with fewer treatment visits. Most adverse events were mild or moderate and self-limiting. Further studies are warranted to explore long-term outcome and other RAB chemotherapy combinations.

PMID: 28370378 [PubMed - indexed for MEDLINE]



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Drug involvement during and after college: Estimates of opportunity and use given opportunity.

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Drug involvement during and after college: Estimates of opportunity and use given opportunity.

Drug Alcohol Depend. 2017 May 01;174:150-157

Authors: Allen HK, Caldeira KM, Bugbee BA, Vincent KB, O'Grady KE, Arria AM

Abstract
BACKGROUND: College students perceive widespread availability of drugs and prescription medications for non-medical use on campus, but less is known about the relationship between opportunity to use, use, and use given opportunity of these drugs during and after college. The current study describes annual trends in (1) opportunity to use, (2) use, and (3) use given opportunity of eight drugs and three prescription medications used non-medically over seven years.
METHODS: Data were derived from a longitudinal cohort study of 1253 first-year college students (52% female, 72% non-Hispanic white) at one large, public university. Annually, past-year opportunity to use and use were assessed for marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine, heroin, and non-medical use of prescription stimulants, analgesics, and tranquilizers. Binary variables were created to represent opportunity to use, use, and use given opportunity for each drug.
RESULTS: Participants had the greatest opportunity to use marijuana compared with other drugs during the study period, but there was a significant decline in the opportunity to use marijuana over time. Notably, opportunity for both drugs other than marijuana and prescription medications used non-medically consistently declined, while use given opportunity remained relatively stable over time.
CONCLUSIONS: These findings suggest that changes in drug use are driven by changes in opportunity to use, even during the post-college years. Greater opportunity to use and use of all drugs during the college years in comparison with the post-college years confirms the high-risk nature of the college environment.

PMID: 28329719 [PubMed - indexed for MEDLINE]



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Giant juvenile fibroadenoma of the breast: a clinical case.

Giant juvenile fibroadenoma of the breast: a clinical case.

Arch Argent Pediatr. 2017 Dec 01;115(6):e428-e431

Authors: Celik SU, Besli Celik D, Yetiskin E, Ergun E, Percinel S, Demirer S

Abstract
Juvenile giant fibroadenoma is a benign breast tumor and rare variant of the fibroadenomas. Clinical presentation is usually a painless, solitary and unilateral breast mass. It accounts for 0.5%-2% of all fibroadenomas and exact etiology is not known; however, hormonal influences are thought to be contributing factors. We present a case of a 20 cm diameter giant juvenile fibroadenoma of the breast in a 14-year-old girl. The patient was suffering from a painless, progressively enlarging mass for 1 year. Ultrasound revealed fibroadenoma and total surgical excision was performed. The patient is doing well in ten months of follow up.

PMID: 29087128 [PubMed - in process]



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Epithelial-Myoepithelial Carcinoma of the Base of Tongue with Possible Lung Metastases.

Epithelial-Myoepithelial Carcinoma of the Base of Tongue with Possible Lung Metastases.

Case Rep Otolaryngol. 2017;2017:4973573

Authors: Chen MY, Vyas V, Sommerville R

Abstract
BACKGROUND: Epithelial-myoepithelial carcinomas are rare neoplasms usually arising from the salivary glands. There is limited evidence in the literature on their prognosis in the base of the tongue but other cases have resolved without recurrence.
METHODS: The patient underwent biopsies demonstrating the diagnosis of epithelial-myoepithelial carcinoma of the base of tongue and a PET scan showed multiple bilateral rounded pulmonary nodules.
RESULTS: The patient declined chemotherapy and radiotherapy to maximise his quality of life and passed away under management from palliative care several months later.
DISCUSSION: This is the only case in the literature of this type of carcinoma in the base of the tongue resulting in metastases and a poor prognosis. The case highlights the importance of checking for metastases in such lesions and their potentially serious outcomes if left untreated.

PMID: 29085691 [PubMed]



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Uterine Tumors Resembling Ovarian Sex Cord Tumors: Case Report of Rare Pathological and Clinical Entity.

Uterine Tumors Resembling Ovarian Sex Cord Tumors: Case Report of Rare Pathological and Clinical Entity.

Case Rep Obstet Gynecol. 2017;2017:2736710

Authors: Sadeh R, Segev Y, Schmidt M, Schendler J, Baruch T, Lavie O

Abstract
Uterine tumors resembling ovarian sex cord tumors (UTROSCT) are rare uterine neoplasms. These tumors are usually benign, displaying a nodular or polypoid growth pattern; common occurrence is observed at the 4th to 6th decade of life. This entity is divided according to clinical behavior and pathological typical findings including different immunohistochemical staining. Traditionally type I tumors show a predominant endometrial stromal pattern with less than 50% ovarian sex cord component. This type has been shown to behave more aggressively with a decreased disease free survival period. Type II tumors, the classical UTROSCT, are less invasive but have the tendency to recur. We report a case of a 57-year-old patient presenting with postmenopausal bleeding. Hysteroscopic polypectomy showed the diagnosis of UTROSCT. This case presents a less morbid minimally invasive treatment plan and exemplifies that in patients where low malignant potential exists and their will is taken into consideration such management is both crucial and correct.

PMID: 29085684 [PubMed]



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Human herpes virus 8-unrelated primary effusion lymphoma-like lymphoma presenting with cardiac tamponade: A case report.

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Human herpes virus 8-unrelated primary effusion lymphoma-like lymphoma presenting with cardiac tamponade: A case report.

Medicine (Baltimore). 2017 Oct;96(43):e8010

Authors: Kim HJ, Lee K, Yoon CH, Bang SM

Abstract
RATIONALE: Primary effusion lymphoma (PEL) is a rare disease of lymphomatous effusion in the body cavities in the absence of detectable mass and lymphadenopathy. PEL is predominantly related to the immunosuppressed patients infected with human herpes virus 8 (HHV-8). PEL-like lymphoma is negative for HHV-8 and human immunodeficiency virus (HIV) unlike PEL. The pathogenesis and prognosis of PEL-like lymphoma are unclear and there is no established treatment yet.
PATIENT CONCERNS: A 73-year-old male patient was admitted for evaluation of dyspnea on exertion with 1-week duration. His relevant examinations were completed.
DIAGNOSES: PEL-like lymphoma was diagnosed.
INTERVENTIONS: The patient received chemotherapy including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), and palliative whole-brain radiotherapy, sequentially.
OUTCOMES: He died 3 months after the diagnosis.
LESSON: Although the prognosis of PEL-like lymphoma may be better than PEL, our case showed poor disease course despite chemotherapy.

PMID: 29068981 [PubMed - indexed for MEDLINE]



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Treatment, prognostic markers, and survival in thymic neuroendocrine tumors: A single center experience of 41 patients.

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Treatment, prognostic markers, and survival in thymic neuroendocrine tumors: A single center experience of 41 patients.

Medicine (Baltimore). 2017 Oct;96(43):e7842

Authors: Ma K, Liu Y, Xue Z, Chu X

Abstract
Neuroendocrine tumors of the thymus (NETTs) are rare but aggressive, and lead to poor overall survival. This retrospective study was designed to analyze factors that correlate with the prognosis of patients with NETTs.From 1999 to 2015, 41 ongoing patients with NETTs were enrolled in this study. The clinical data and outcome were compiled. Overall survival (OS) rate was analyzed using the Kaplan-Meier method in univariate analysis and the Cox-model was used in multivariate analysis.Of the 41 NETTs patients analyzed (31 male and 10 female), 12 were typical carcinoma, 14 were atypical carcinoma, 14 were small-cell carcinoma and, 1 was large-cell carcinoma. The median follow-up time was 29 months (range, 9.0-69.0). In total, 25 patients died of cancer-related disease by the last follow-up. The 3- and 5-year survival rates for all patients were 42.7% and 23.4%, respectively. Among the prognostic factors analyzed by multivariate analysis, low tumor grade, complete resection, and a negative chromogranin A (CgA) expression were positively correlated with survival.The surgical treatment of NETTs, CgA negative, and low grade of NETTs were associated with a statistically significant better prognosis. However, large, multicenter studies are required to fully validate these prognostic factors.

PMID: 29068978 [PubMed - indexed for MEDLINE]



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An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx: A case report.

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An atypical lipomatous tumor mimicking a giant fibrovascular polyp of the hypopharynx: A case report.

Medicine (Baltimore). 2017 Oct;96(43):e6927

Authors: Ioanidis KE, MacNeil SD, Tay KY, Wehrli B

Abstract
RATIONALE: Giant fibrovascular polyps (GFVPs) found in the hypopharynx are exceedingly rare. These are benign tumors which are identified by CT or MRI and usually treated based on symptoms. Even more rarely, pathology may identify one of these masses as an atypical lipomatous tumor (ALT). This paper will present a case of an ALT of the hypopharynx that was originally classified as a GFVP, highlighting the difficulty in distinguishing between them and the importance of making the correct diagnosis.
PATIENT CONCERNS: An 84-year-old man presented to the emergency department with a 6-month history of a pedunculated hypopharyngeal growth, dysphagia, and intermittent dyspnea.
DIAGNOSES: The mass was characterized as a GFVP by barium swallow and MRI.
INTERVENTIONS: The hypopharyngeal mass was resected for obstructive symptoms and to confirm the diagnosis. Final pathology found the mass to be more consistent with an atypical lipomatous tumor (ALT).
OUTCOMES: The patient's dysphagia and dyspnea resolved. He was free of recurrence at 22 months postoperative.
LESSONS: Both GFVPs and ALTs are very rarely found in the hypopharynx but can be easily misclassified as one another. Imaging is useful to initially characterize the mass, but to definitively differentiate between them, pathological analysis is necessary. Although they are rare, it is important to consider both possibilities on the differential for hypopharyngeal masses. Further, accurate analysis is essential to distinguish between them because their definitive management and follow-up is different.

PMID: 29068974 [PubMed - indexed for MEDLINE]



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A myeloid sarcoma involving the small intestine, kidneys, mesentery, and mesenteric lymph nodes: A case report and literature review.

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A myeloid sarcoma involving the small intestine, kidneys, mesentery, and mesenteric lymph nodes: A case report and literature review.

Medicine (Baltimore). 2017 Oct;96(42):e7934

Authors: Wang P, Li Q, Zhang L, Ji H, Zhang CZ, Wang B

Abstract
RATIONALE: Myeloid sarcomas (MSs) are rare malignant hematological tumors. They most commonly occur in patients with acute or chronic myeloid leukemia. A de novo MS with no evidence of blood system disease is rare, but may represent the first sign of a systemic illness that precedes a full-blown disease. Herein, we report the computed tomography (CT) findings of an extremely rare case of a nonleukemic MS that progressed to acute myelogenous leukemia (AML) and simultaneously involved the small intestine, kidneys, mesentery, and mesenteric lymph nodes. Moreover, we provide CT findings before and after AML chemotherapy, which have not been reported previously.
PATIENT CONCERNS: A 25-year-old man with intermittent upper abdominal pain for 6 months was admitted to the hospital on November 28, 2015. Initial CT showed concentric wall thickening of the jejunum with an adjacent mesenteric soft tissue mass and mesenteric lymph nodes enlargement. Both kidneys were involved as indicated by the presence of well-defined mildly dilated lesions. During the laparoscopic surgery, the small intestinal tumor, mesenteric soft tissue mass, and mesenteric lymph nodes were removed.
DIAGNOSES: The pathological diagnosis was an MS.
INTERVENTIONS: The patient refused systemic chemotherapy and was rehospitalized with persistently aggravated abdominal distension on February 17, 2016. Follow-up CT showed diffuse small bowel wall thickening, widespread infiltration of the peritoneum, omentum, and mesentery, mesenteric lymph node enlargement, and large amounts of ascites fluid. The lesions in both kidneys were substantially larger and more numerous than on initial CT. Then the patient was treated with conventional AML chemotherapy.
OUTCOMES: The patient achieved complete hematological remission on bone marrow examination. Follow-up CT in September 4, 2016, showed none of the abnormalities seen on initial CT. Currently, the patient is in complete remission.
LESSONS: If the radiological examination shows lesions at multiple sites, and these lesions are soft tissue masses with homogenous enhancement, MS should be considered in the differential diagnosis, and an aspiration biopsy should be performed to provide a definitive pathological diagnosis. If MS is diagnosed, systemic chemotherapy is crucial to recovery; otherwise, the disease may progress rapidly. Medical imaging is helpful for diagnosing MS and for monitoring treatment response.

PMID: 29049187 [PubMed - indexed for MEDLINE]



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The diagnosis of a metastatic breast tumor from ovarian cancer by the succession of a p53 mutation: a case report.

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The diagnosis of a metastatic breast tumor from ovarian cancer by the succession of a p53 mutation: a case report.

World J Surg Oncol. 2017 Jun 29;15(1):117

Authors: Mori R, Futamura M, Morimitsu K, Saigo C, Miyazaki T, Yoshida K

Abstract
BACKGROUND: Metastatic breast tumors from other organs are very rare. We herein describe the case of a patient with a metastatic breast tumor due to ovarian cancer who was diagnosed by the succession of a p53 mutation.
CASE PRESENTATION: The patient was a 59-year-old woman with sigmoid colon stenosis. Diagnostic imaging revealed a pelvic mass, multiple liver tumors, ascites, and multiple swollen para-aortic lymph nodes, suggesting an advanced ovarian tumor. Transverse loop colostomy and partial resection of the greater omentum was performed followed by six cycles of paclitaxel with carboplatin chemotherapy (TC therapy). Her cancer almost disappeared, with the exception of a small tumor in her pelvis. Simple hysterectomy with bilateral salpingo-oophorectomy was performed. Two years and 5 months after the second surgery, a mass was detected in her right breast and simple mastectomy was performed. A histological examination of the tumors from the first surgery revealed infiltrating papillary adenocarcinoma and the solid nest proliferation of atypical cells with comedo necrosis and psammoma bodies. The findings of an immunohistochemical analysis were as follows: cancer antigen 125 (CA125 (+)), cytokeratin 7 (CK7 (+)), cytokeratin 20 (CK20 (-)), p53 (+) and CDX2 (-), estrogen receptor (ER (slightly +)), progesterone receptor (PR (slightly +)), and human epidermal growth factor receptor 2 (HER2 (1+)). The breast tumors presented similar morphological features (ER (-), PR (-), HER2 (-), CA125 (+), CK7 (+), CK20 (-), p53 (+), mammaglobin (-), and GCDFP15 (-)), which were not characteristic of breast cancer. A direct sequencing analysis of p53 revealed a p.V173M mutation in exon 5 in both the breast tumor and the ovarian cancer. It was not detected in normal tissue, suggesting that the breast tumors were metastatic serous adenocarcinomas from ovarian cancer.
CONCLUSIONS: A direct sequencing mutation analysis of p53 was useful for distinguishing the primary tumor from the metastatic tumor. We should resect metastatic breast tumors to the extent that is possible because the prognosis of such patients is relatively good.

PMID: 28662703 [PubMed - indexed for MEDLINE]



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Focal necrosis mimicking breast cancer following coronary bypass grafting.

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Focal necrosis mimicking breast cancer following coronary bypass grafting.

World J Surg Oncol. 2017 May 30;15(1):111

Authors: Coufal O, Ostřížek T, Krsička P, Lžičařová E, Nenutil R, Procházková M, Bencsiková B, Grell P, Šefr R

Abstract
BACKGROUND: Breast cancer can be diagnosed easily in most cases. However, occasionally, we are faced with some conditions that can mimic it. These may include inflammations, benign tumors, cysts, hematomas, or, more rarely, focal necrosis.
CASE PRESENTATION: This report presents a case of focal breast necrosis following myocardial revascularization with the left internal mammary artery, which is a very rare condition, with only few cases described in the literature. The necrosis becomes usually apparent a few days or weeks after the surgery and is often coincidental with the dehiscence of sternotomy with necrosis of wound edges. As it mostly affects the skin, it can be easily recognized. Also, our patient developed a dehisced sternotomy shortly after the surgery but there were no obvious objective changes on the breast. The condition was first dominated only by non-specific subjective symptom-pain. Later, a lump in the breast occurred, when the sternotomy had already healed. Moreover, an enlarged lymph node was palpable in the axilla. Because of non-typical symptoms, the condition was suggestive of breast cancer for a relatively long time. The patient had suffered from a very strong pain until she was treated by mastectomy with a good clinical result.
CONCLUSIONS: Mammary necrosis following the coronary artery bypass is rare. In most cases, it manifests on the skin shortly after the surgery concurrently with dehisced sternotomy, so it can be easily diagnosed. However, in sporadic cases, the symptoms may occur later and may mimic breast cancer. Our objective is to raise awareness of this rare condition.

PMID: 28558811 [PubMed - indexed for MEDLINE]



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Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report.

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Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report.

World J Surg Oncol. 2017 May 30;15(1):109

Authors: Ban LK, Tseng AH, Huang SH, Lee HH

Abstract
BACKGROUND: Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor that has a tendency to grow in the deep soft tissue of the trunk and extremities. Despite its benign appearance, the tumor has a high recurrence rate and metastatic potential. LGFMS in the perineal space is rare, and only a few cases have been reported. We present the first case of LGFMS to be located at the external anal sphincter.
CASE PRESENTATION: A 27-year-old male patient admitted to our Surgical Department with perianal pain and swollen for a year. The digital rectal examination revealed a perianal mass. Oral metronidazole and analgesia were prescribed on suspicion of perianal abscess failed to alleviate the symptom; hence, the patient was scheduled for surgery. Intraoperative diagnosis revealed an encapsulated tumor in the external anal sphincter that extended from the perianal region orally to the pararectal space. The results of immunohistochemistry (MUC4 staining) and FUS gene rearrangement by fluorescence in situ hybridization confirmed the diagnosis of LGFMS.
CONCLUSIONS: This case is unique in terms of the location of the rare soft tissue tumor. Although LGFMS is considered low grade, its unpredictable behavior necessitates a long-term follow-up.

PMID: 28558780 [PubMed - indexed for MEDLINE]



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Clinical case series of pediatric hepatic angiosarcoma.

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Clinical case series of pediatric hepatic angiosarcoma.

Pediatr Blood Cancer. 2017 Nov;64(11):

Authors: Grassia KL, Peterman CM, Iacobas I, Margolin JF, Bien E, Padhye B, Meyers RL, Adams DM

Abstract
Hepatic angiosarcoma is a rare, aggressive, malignant neoplasm with fewer than 50 cases reported in children. Prognosis is poor, with a minority surviving beyond 2 years after diagnosis. We report eight cases of pediatric hepatic angiosarcoma, diagnosed at a mean age of 3 years. Seven were initially diagnosed with an infantile hepatic hemangioendothelioma (IHHE) or hemangioma and the eighth with a "vascular tumor." Two patients, who received liver transplant, survived. We suggest hepatic hemangiomas can rarely transform into angiosarcomas and a subset of IHHEs (Type II) are actually a low-grade form of angiosarcoma rather than a benign lesion.

PMID: 28521077 [PubMed - indexed for MEDLINE]



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Morbidity and oncologic outcome after saphenous vein-sparing inguinal lymphadenectomy in melanoma patients.

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Morbidity and oncologic outcome after saphenous vein-sparing inguinal lymphadenectomy in melanoma patients.

World J Surg Oncol. 2017 May 11;15(1):99

Authors: Baur J, Mathe K, Gesierich A, Weyandt G, Wiegering A, Germer CT, Gasser M, Pelz JOW

Abstract
BACKGROUND: Inguinal lymph node dissection (LND) is a surgical procedure with a high morbidity rate. Variations in surgical procedure, such as sparing of the saphenous vein, have been proposed to reduce surgical morbidity. While sparing of the saphenous vein has shown promising results in earlier studies, data for this procedure in melanoma patients are rare. In this retrospective study, we report 10-year findings on the effects of saphenous vein-sparing LND on surgical morbidity and oncologic outcomes in melanoma patients.
METHODS: A retrospective analysis of melanoma patients receiving inguinal LND in our facility between 2003 and 2013 was performed. Patients were divided into two groups: the saphenous vein resection group and the vein sparing group. Surgical morbidity, including wound infection, lymphatic fistula, severe bleeding, neurological complications, and chronic lymphedema, as well as regional recurrence-free survival were investigated.
RESULTS: A total of 106 patients were included in this study; of these, the saphenous vein was spared in 41 patients (38.7%). The rate of lymphatic fistula was 51.6 vs. 48.8%, wound infection occurred in 31.3 vs. 24.4%, and patients suffered from chronic lymphedema in 30.0 vs. 26.5% in V. saphena magna resection vs. sparing group. Differences observed, however, were not significant. No difference in regional recurrence-free survival between the two study groups was detected.
CONCLUSIONS: The results of our retrospective analysis could not confirm the promising results reported in earlier studies. Thus, sparing of the saphenous vein appears to be optional.

PMID: 28490340 [PubMed - indexed for MEDLINE]



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Renal medullary carcinoma: A national analysis of 159 patients.

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Renal medullary carcinoma: A national analysis of 159 patients.

Pediatr Blood Cancer. 2017 Nov;64(11):

Authors: Ezekian B, Englum B, Gilmore BF, Nag UP, Kim J, Leraas HJ, Routh JC, Rice HE, Tracy ET

Abstract
BACKGROUND: Renal medullary carcinoma (RMC) is an aggressive malignancy seen predominantly in young males with sickle cell trait. RMC is poorly understood, with fewer than 220 cases described in the medical literature to date. We used a large national registry to define the typical presentation, treatments, and outcomes of this rare tumor.
METHODS: The National Cancer Database was queried for patients under 40 years of age diagnosed with RMC from 1998 to 2011. An analysis of patient and tumor characteristics, treatment details, and overall survival (OS) was undertaken, and factors associated with mortality were identified using multivariable regression analysis.
RESULTS: In total, 159 patients with RMC were identified, of whom a majority were male (71%), African American (87%), and had metastatic disease (71%). Median tumor size was 6 cm and median survival was 7.7 months. Most patients underwent surgery (60%) and chemotherapy (65%). Few patients received radiation (12%). Patients with metastatic disease had a significantly worse median survival (4.7 vs. 17.8 months, P < 0.001) and were less likely to receive surgery (42% vs. 91%, P < 0.001). Age and tumor size did not appear to impact OS.
CONCLUSION: In the largest cohort to date of patients with RMC, we found a dismal median survival of less than 8 months. Age and tumor size were not associated with OS. Metastatic disease at presentation was the main negative prognostic indicator in RMC and was present in a majority of patients at the time of diagnosis.

PMID: 28485059 [PubMed - indexed for MEDLINE]



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Giant low-grade primary myofibroblastic sarcoma of the posterior chest wall.

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Giant low-grade primary myofibroblastic sarcoma of the posterior chest wall.

World J Surg Oncol. 2017 May 03;15(1):96

Authors: Katalinic D, Santek F

Abstract
Primary myofibroblastic sarcoma is an extremely rare, highly malignant neoplasm, and only few cases had been reported in the literature worldwide. In the present study, we report an unusual case of a low-grade myofibroblastic sarcoma located in the posterior chest wall with intrathoracic propagation and discuss its clinical and pathological features.

PMID: 28468630 [PubMed - indexed for MEDLINE]



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Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological analysis of 52 cases.

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Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological analysis of 52 cases.

World J Surg Oncol. 2017 May 02;15(1):92

Authors: Sun T, Wang L, Guo C, Zhang G, Hu W

Abstract
BACKGROUND: Malignant tumors in the proximal fibula are rare but life-threatening; however, biopsy is not routine due to the high risk of peroneal nerve injury. Our aim was to determine preoperative clinical indicators of malignancy.
METHODS: Between 2004 and 2016, 52 consecutive patients with proximal fibular tumors were retrospectively reviewed. Details of the clinicopathological characteristics including age, gender, location of tumors, the presenting symptoms, the duration of symptoms, and pathological diagnosis were collected. Descriptive statistics were calculated, and univariate and multivariate regression were performed.
RESULTS: Of these 52 patients, 84.6% had benign tumors and 15.4% malignant tumors. The most common benign tumors were osteochondromas (46.2%), followed by enchondromas (13.5%) and giant cell tumors (13.5%). The most common malignancy was osteosarcomas (11.5%). The most common presenting symptoms were a palpable mass (52.0%) and pain (46.2%). Pain was the most sensitive (100%) and fourth specific (64%); both high skin temperature and peroneal nerve compression had the highest specificity (98%) and third sensitivity (64%); change in symptoms had the second highest specificity (89%) while 50% sensitivity. Using multivariate regression, palpable pain, high skin temperature, and peroneal nerve compression symptoms were predictors of malignancy.
CONCLUSIONS: Most tumors in the proximal fibula are benign, and the malignancy is rare. Palpable pain, peroneal nerve compression symptoms, and high skin temperature were specific in predicting malignancy.

PMID: 28464896 [PubMed - indexed for MEDLINE]



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Clear cell sarcoma of kidney involving a horseshoe kidney and harboring EGFR internal tandem duplication.

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Clear cell sarcoma of kidney involving a horseshoe kidney and harboring EGFR internal tandem duplication.

Pediatr Blood Cancer. 2017 Nov;64(11):

Authors: Santiago T, Clay MR, Azzato E, Newman S, Fernandez-Pineda I, Nichols KE, Zhang J, Downing JR, Davidoff A, Brennan RC, Ellison DW

Abstract
Clear cell sarcoma of kidney (CCSK) is a rare renal malignancy, previously unreported in horseshoe kidney (HSK). B-cell lymphoma 6 corepressor (BCOR) gene internal tandem duplication (ITD) was identified as a recurrent somatic alteration in approximately 85% of CCSKs. This and the YWHAE-NUTM2B/E fusion, the second most common recurrent molecular alteration in CCSK (10%), are considered to be mutually exclusive. However, there is a subset of CCSKs that do not harbor either the BCOR-ITD or YWHAE-NUTM2 translocation and lack known molecular alterations. Herein, we report the first case of CCSK arising in HSK and harboring epidermal growth factor receptor ITD.

PMID: 28440018 [PubMed - indexed for MEDLINE]



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Comparative study of single-center patients with thyroid metastases from colorectal cancer and previously reported cases in the literature.

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Comparative study of single-center patients with thyroid metastases from colorectal cancer and previously reported cases in the literature.

World J Surg Oncol. 2017 Apr 20;15(1):88

Authors: Keranmu A, Zheng H, Wu Y, Zhao J, Xu X, Liu F, Cai S, Wang Y, Xu Y

Abstract
BACKGROUND: Thyroid metastases from colorectal cancer (CRC) are rare, both in clinical practice and in the literature; hence, their diagnosis, appropriate treatment, and prognostic factors require further investigations.
METHODS: A retrospective analysis was performed for four cases of thyroid metastases from CRC, treated in our center between January 2005 and December 2015, and the relevant literature was searched using PubMed, resulting in the identification of 17 patients with detailed information available. The clinical data and follow-up information of our patients and the previously reported cases were collected and compared.
RESULTS: The median age of the 21 patients was 59 years (44.5 and 66 years for our patients and the previously reported cases, respectively). Fifteen (71.4%) primary tumors were distributed throughout the distal colon or rectum (75% [3/4] in our center and 70.5% [12/17] in the previously reported cases). According to our analysis, we found that 81.0% of patients (17/21) showed concomitant lung metastasis. Among them, all four patients in our center showed lung metastasis, and 75% (3/4) developed thyroid metastases after the lung metastasis. In the previously reported cases, the corresponding proportions were 76.5 and 76.5% (13/17) of patients, respectively. The median time after primary tumor diagnosis to thyroid metastasis development was 28 months (26 months in our center and 35 months in the previously reported cases). One patient with advanced CRC in our center died 5 months after the thyroid metastasis was identified, while the remaining three patients are currently alive (longest follow-up time, 27 months). The median survival time after thyroid metastasis during 3 years of follow-up of the previously reported 17 patients was 12 months. There was no difference in the overall survival between patients treated non-surgically (8/21) and patients undergoing thyroidectomy alone or thyroidectomy with adjuvant therapy (13/21) (p = 0.388). In addition, we found that the overall survival of the patients whose other metastases were treated with radical treatment was superior to that in those treated with palliative treatment (p = 0.022).
CONCLUSIONS: Thyroid metastases from CRC are rare in clinical practice and are a manifestation of advanced CRC. The prognosis of patients with thyroid metastases from CRC is related to various factors, including the grade of malignancy of the primary lesion, the presence of other metastases, and whether the metastases are timely diagnosed and a radical treatment strategy is employed.

PMID: 28427420 [PubMed - indexed for MEDLINE]



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Medical treatment of mammary desmoid-type fibromatosis: which benefit?

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Medical treatment of mammary desmoid-type fibromatosis: which benefit?

World J Surg Oncol. 2017 Apr 18;15(1):86

Authors: Scheer L, Lodi M, Molière S, Kurtz JE, Mathelin C

Abstract
BACKGROUND: Breast fibromatosis is a rare disease characterized by monoclonal fibroblast proliferation. It has no ability to metastasize but has a high local recurrence rate and often infiltrates surrounding tissues. Surgical treatment is the reference, but recently, new targeted therapies have emerged. We report an original case of a patient with breast fibromatosis who received exclusive medical treatment. Our aim was to analyze these treatments based on the clinical and radiological outcome, iatrogenic effects, and pharmacological action.
CASE PRESENTATION: We report the case of a 19-year-old woman who developed a desmoid-type fibromatosis of the lower inner quadrant of the right breast, measuring 50 × 25 mm (i.e., a volume of 27.4 cm(3)). Initial surgery was not possible because of potential esthetic and functional prejudice. Thus, she had an exclusive medical treatment including several lines: NSAIDs with tamoxifen and triptorelin, followed by sorafenib, then interferon α2b, and finally sunitinib. With tyrosine-kinase inhibitors (TKIs) (sunitinib), a significant partial response was observed (57% reduction of the maximal tumoral volume). For each treatment, we provided the clinical and radiological outcome in association with known pharmacological action.
CONCLUSIONS: TKI had been an interesting alternative option to initial surgery, providing at least a partial response and potentially allowing less mutilating surgery. However, no pharmacological mechanism can unequivocally explain TKI efficacy. In general, breast fibromatosis should be treated along with oncologist and interventional radiologists in a trans-disciplinary modality, thus offering an adapted treatment for this particular desmoid-type fibromatosis localization.

PMID: 28420393 [PubMed - indexed for MEDLINE]



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Orchitis reveals an extragonadal primary mediastinal thymic seminoma: a coincidence or not?

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Orchitis reveals an extragonadal primary mediastinal thymic seminoma: a coincidence or not?

World J Surg Oncol. 2017 Apr 13;15(1):85

Authors: Tampakis A, Tampaki EC, Damaskos C, Feretis T, Thymara I, Kontzoglou K, Tomos P, Kouraklis G

Abstract
BACKGROUND: Mediastinal thymic seminomas are rare male germ cell tumors with extragonadal origin that appear predominately with a cystic appearance.
CASE PRESENTATION: A 22-year-old male was referred to our department for further investigation of a mediastinal mass discovered incidentally during routine chest X-ray. The patient has denied any symptoms including dyspnea, chest pain, cough, fever, dysphagia, hemoptysis, weight loss, and weakness. His past medical history was remarkable for orchitis, for which he had undergone a bilateral testicular biopsy, without the latter however, indicating the presence of a germ cell tumor or a premalignant lesion. Contrast-enhanced chest computed tomography revealed a lobulated and well-marginated cystic lesion in the anterior mediastinum. Differential diagnosis included mostly a multilocular thymic cyst, a lymphoma, a seminoma, or a soft tissue tumor. Resection of the mass revealed a primary thymic seminoma.
CONCLUSIONS: A surgical approach for the management of these tumors might be reasonable considering that an extensive sampling is mandatory to gain an appropriate biopsy preoperatively in order to securely confirm or refute the presence of a mediastinal extragonadal tumor. Orchitis might be a sign of a general disorder of the germ cells which might transform in time.

PMID: 28407803 [PubMed - indexed for MEDLINE]



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Fibroma of tendon sheath on the medial side of the knee: a case report.

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Fibroma of tendon sheath on the medial side of the knee: a case report.

J Med Invest. 2017;64(1.2):173-176

Authors: Toki S, Nishisho T, Takao S, Miyagi R, Tezuka F, Nagamachi A, Sairyo K

Abstract
Fibroma of tendon sheath, which is a benign soft tissue tumor, primarily affects the finger, hand, or wrist. It rarely involves the knee and only a few cases appear in the literature. Here, we report a case of fibroma of tendon sheath on the medial side of the knee, in a previously hardly reported location, and provide detailed imaging and histological findings. A 54-year-old man presented with his right knee pain and a palpable mass that had developed 3 months earlier. Magnetic resonance imaging showed isointensity in the soft tissue tumor on T1-weighted images, variable intensity on T2-weighted images, and contrast enhancement. The specimen obtained by needle biopsy showed no histological findings of malignancy. Marginal resection was performed and the microscopic diagnosis was fibroma of tendon sheath. Since fibroma of tendon sheath is relatively rare, the radiological feature is not specific, and a rate of local recurrence following excision is high, careful diagnosis, surgical treatment and long-term follow-up are necessary. J. Med. Invest. 64: 173-176, February, 2017.

PMID: 28373618 [PubMed - indexed for MEDLINE]



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A Case Series of the Probability Density and Cumulative Distribution of Laryngeal Disease in a Tertiary Care Voice Center.

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A Case Series of the Probability Density and Cumulative Distribution of Laryngeal Disease in a Tertiary Care Voice Center.

Ann Otol Rhinol Laryngol. 2017 Nov;126(11):748-754

Authors: de la Fuente J, Garrett CG, Ossoff R, Vinson K, Francis DO, Gelbard A

Abstract
OBJECTIVE: To examine the distribution of clinic and operative pathology in a tertiary care laryngology practice.
METHODS: Probability density and cumulative distribution analyses (Pareto analysis) was used to rank order laryngeal conditions seen in an outpatient tertiary care laryngology practice and those requiring surgical intervention during a 3-year period.
RESULTS: Among 3783 new clinic consultations and 1380 operative procedures, voice disorders were the most common primary diagnostic category seen in clinic (n = 3223), followed by airway (n = 374) and swallowing (n = 186) disorders. Within the voice strata, the most common primary ICD-9 code used was dysphonia (41%), followed by unilateral vocal fold paralysis (UVFP) (9%) and cough (7%). Among new voice patients, 45% were found to have a structural abnormality. The most common surgical indications were laryngotracheal stenosis (37%), followed by recurrent respiratory papillomatosis (18%) and UVFP (17%).
CONCLUSIONS: Nearly 55% of patients presenting to a tertiary referral laryngology practice did not have an identifiable structural abnormality in the larynx on direct or indirect examination. The distribution of ICD-9 codes requiring surgical intervention was disparate from that seen in clinic. Application of the Pareto principle may improve resource allocation in laryngology, but these initial results require confirmation across multiple institutions.

PMID: 28949246 [PubMed - indexed for MEDLINE]



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The direct basal ganglia pathway is hyperfunctional in focal dystonia.

The direct basal ganglia pathway is hyperfunctional in focal dystonia.

Brain. 2017 Oct 26;:

Authors: Simonyan K, Cho H, Hamzehei Sichani A, Rubien-Thomas E, Hallett M

Abstract
Focal dystonias are the most common type of isolated dystonia. Although their causative pathophysiology remains unclear, it is thought to involve abnormal functioning of the basal ganglia-thalamo-cortical circuitry. We used high-resolution research tomography with the radioligand 11C-NNC-112 to examine striatal dopamine D1 receptor function in two independent groups of patients, writer's cramp and laryngeal dystonia, compared to healthy controls. We found that availability of dopamine D1 receptors was significantly increased in bilateral putamen by 19.6-22.5% in writer's cramp and in right putamen and caudate nucleus by 24.6-26.8% in laryngeal dystonia (all P ≤ 0.009). This suggests hyperactivity of the direct basal ganglia pathway in focal dystonia. Our findings paralleled abnormally decreased dopaminergic function via the indirect basal ganglia pathway and decreased symptom-induced phasic striatal dopamine release in writer's cramp and laryngeal dystonia. When examining topological distribution of dopamine D1 and D2 receptor abnormalities in these forms of dystonia, we found abnormal separation of direct and indirect pathways within the striatum, with negligible, if any, overlap between the two pathways and with the regions of phasic dopamine release. However, despite topological disorganization of dopaminergic function, alterations of dopamine D1 and D2 receptors were somatotopically localized within the striatal hand and larynx representations in writer's cramp and laryngeal dystonia, respectively. This finding points to their direct relevance to disorder-characteristic clinical features. Increased D1 receptor availability showed significant negative correlations with dystonia duration but not its severity, likely representing a developmental endophenotype of this disorder. In conclusion, a comprehensive pathophysiological mechanism of abnormal basal ganglia function in focal dystonia is built upon upregulated dopamine D1 receptors that abnormally increase excitation of the direct pathway, downregulated dopamine D2 receptors that abnormally decrease inhibition within the indirect pathway, and weakened nigro-striatal phasic dopamine release during symptomatic task performance. Collectively, these aberrations of striatal dopaminergic function underlie imbalance between direct and indirect basal ganglia pathways and lead to abnormal thalamo-motor-cortical hyperexcitability in dystonia.

PMID: 29087445 [PubMed - as supplied by publisher]



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MRSA chronic bacterial laryngitis: A growing problem.

MRSA chronic bacterial laryngitis: A growing problem.

Laryngoscope. 2017 Oct 31;:

Authors: Carpenter PS, Kendall KA

Abstract
OBJECTIVES: Chronic bacterial infection of the larynx is characterized by long-standing hoarseness and exudative laryngitis. Prolonged antibiotic therapy is required to clear the infection, and methicillin-resistant staphylococcus aureus (MRSA) may be the responsible pathogen. The objective of this study was to describe the presentation, comorbidities, treatment response, and underlying etiology- including the incidence of MRSA-in our patient population with chronic bacterial laryngitis.
METHODS: A review of patients with a diagnosis of chronic bacterial laryngitis from 2012 to 2016 was performed. Diagnosis of chronic bacterial laryngitis was based on clinical history and findings on flexible laryngoscopy. In selected cases, the diagnosis of bacterial laryngitis was confirmed by operative biopsy. Information regarding clinical presentation and course was collected.
RESULTS: Twenty-eight patients were included in the study. Twenty-three were treated empirically with Amoxicillin-clavulonic acid for a minimum of 21 days. Twelve of the 23 (52%) had recurrence or nonresolution of infection. Seven of the 12 nonresponders (58%) were found to have MRSA by laryngeal tissue culture. Five patients were treated initially with Sulfamethoxazole and trimethoprim, and all resolved the infection without the need for further treatment. There was a nonstatistically significant increase in smoking and reflux in the MRSA population compared to the non-MRSA group.
CONCLUSION: MRSA infection was documented in 30% of patients overall with chronic bacterial laryngitis. Based on the results of the study, a treatment algorithm for management of this unusual patient population is suggested.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 29086424 [PubMed - as supplied by publisher]



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Contemporary management of advanced laryngeal cancer.

Contemporary management of advanced laryngeal cancer.

Laryngoscope Investig Otolaryngol. 2017 Oct;2(5):307-309

Authors: Britt CJ, Gourin CG

Abstract
The treatment of advanced laryngeal cancer has undergone a paradigm shift in recent years, with an increase in chemoradiation for organ preservation and a decrease in primary surgery. This review will summarize the contemporary management of advanced laryngeal cancer and discuss treatment-related toxicity and strategies to improve outcomes.
LEVEL OF EVIDENCE: NA.

PMID: 29085911 [PubMed]



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[About a case of laryngeal location of SAPHO].

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[About a case of laryngeal location of SAPHO].

Rev Med Interne. 2017 Oct;38(10):700-703

Authors: Vatin L, Jean E, Rivière D, Montava M, Giovanni A, Dessi P, Lagier A

Abstract
INTRODUCTION: Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) is a syndrome that combines dermatological, articular and osseous inflammatory manifestations. Bilateral laryngeal immobility relative to cricoarytenoid joint origin is very uncommon. This article presents a case of bilateral cricoarytenoid joint ankylosis in a SAPHO syndrome context.
CASE REPORT: A 53-year-old patient presenting with a two year history of intermittent bouts of dyspnea. A SAPHO syndrome was discussed on repeated thoracic CT-scan. The link between dyspnea and SAPHO syndrome had not been made immediately given the absence of any known anteriority. However, having ruled out other etiologies and after having had to perform a tracheotomy due a worsening of the respiratory condition, this diagnosis was considered. Treatment by corticosteroids and infliximab permitted a clinical improvement of the patient.
CONCLUSION: This clinical case report should increase awareness of possible cricoarytenoid joint involvement in SAPHO.

PMID: 28320544 [PubMed - indexed for MEDLINE]



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What is propensity score modelling?

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What is propensity score modelling?

Emerg Med J. 2017 Mar;34(3):129-131

Authors: Campbell MJ

Abstract
Propensity score methodology is being increasingly used to try and make inferences about treatments when randomised trials are either impossible or not conducted and the only data are from observational studies. This paper reviews the basis of propensity scores and the current state of knowledge about them. It uses and critiques a current paper in the Emergency Medicine Journal to illustrate the methodology.

PMID: 28143814 [PubMed - indexed for MEDLINE]



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Effect of cricoid pressure on laryngeal view during prehospital tracheal intubation: a propensity-based analysis.

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Effect of cricoid pressure on laryngeal view during prehospital tracheal intubation: a propensity-based analysis.

Emerg Med J. 2017 Mar;34(3):132-137

Authors: Caruana E, Chevret S, Pirracchio R

Abstract
BACKGROUND: The benefit of cricoid pressure during tracheal intubation is still debated and, due to its potential negative impact on laryngeal views, its routine use is questioned. The goal of this study was to estimate its impact on laryngeal view.
METHODS: All patients intubated in the prehospital setting were included. Three different propensity score (PS) models were used and compared in terms of the balance achieved between those patients who received cricoid pressure and those who did not. The PS model that optimised the balance was retained in order to estimate the relationship between cricoid pressure and the following outcomes: difficult laryngoscopy, intubation-related complications and difficult intubation.
RESULTS: Among the 1195 patients included, 499 (41.7%) received cricoid pressure. The optimal PS included seven variables (cardiac arrest, altered neurological status, shock, respiratory distress, gender, obesity, patient's position). After PS matching, no significant risk difference (RD) in the rate of difficult laryngoscopy was found between the patients who received cricoid pressure and those who did not (RD=0.001, 95% CI -0.07 to 0.08, p=0.50). No significant difference was found in terms of difficult intubation (RD=0.06, 95% CI -0.13 to 0.25, p=0.28) and in terms of prevalence of complications, except for airway trauma that were more frequent in cricoid pressure group (RD=0.03, 95% CI 0.002 to 0.05, p=0.01).
CONCLUSIONS: No significant relationship was found between the use of cricoid pressure for prehospital intubation and difficult laryngoscopy. Cricoid pressure was found to be associated with more airway trauma. This finding could question its routine use.

PMID: 27694275 [PubMed - indexed for MEDLINE]



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Effects of Career Duration, Concussion History, and Playing Position on White Matter Microstructure and Functional Neural Recruitment in Former College and Professional Football Athletes.

Effects of Career Duration, Concussion History, and Playing Position on White Matter Microstructure and Functional Neural Recruitment in Former College and Professional Football Athletes.

Radiology. 2017 Oct 31;:170539

Authors: Clark MD, Varangis EML, Champagne AA, Giovanello KS, Shi F, Kerr ZY, Smith JK, Guskiewicz KM

Abstract
Purpose To better understand the relationship between exposure to concussive and subconcussive head impacts, white matter integrity, and functional task-related neural activity in former U.S. football athletes. Materials and Methods Between 2011 and 2013, 61 cognitively unimpaired former collegiate and professional football players (age range, 52-65 years) provided informed consent to participate in this cross-sectional study. Participants were stratified across three crossed factors: career duration, concussion history, and primary playing position. Fractional anisotropy (FA) and blood oxygen level-dependent (BOLD) percent signal change (PSC) were measured with diffusion-weighted and task-related functional magnetic resonance imaging, respectively. Analyses of variance of FA and BOLD PSC were used to determine main or interaction effects of the three factors. Results A significant interaction between career duration and concussion history was observed; former college players with more than three concussions had lower FA in a broadly distributed area of white matter compared with those with zero to one concussion (t29 = 2.774; adjusted P = .037), and the opposite was observed for former professional players (t29 = 3.883; adjusted P = .001). A separate interaction between concussion history and position was observed: Nonspeed players with more than three concussions had lower FA in frontal white matter compared with those with zero to one concussion (t25 = 3.861; adjusted P = .002). Analysis of working memory-task BOLD PSC revealed a similar interaction between concussion history and position (all adjusted P < .004). Overall, former players with lower FA tended to have lower BOLD PSC across three levels of a working memory task. Conclusion Career duration and primary playing position seem to modify the effects of concussion history on white matter structure and neural recruitment. The differences in brain structure and function were observed in the absence of clinical impairment, which suggested that multimodal imaging may provide early markers of onset of traumatic neurodegenerative disease. (©) RSNA, 2017 Online supplemental material is available for this article.

PMID: 29087238 [PubMed - as supplied by publisher]



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