Purpose of review Tattoos and medallions are examples of nonstandard do-not-resuscitate (DNR) orders that some people use to convey end-of-life wishes. These DNR orders are neither universally accepted nor understood for reasons discussed within this manuscript. Recent findings Studies show both providers and patients confuse the meaning and implication of DNR orders. In the United States, out-of-hospital DNR orders are legislated at the state level. Most states standardized out-of-hospital DNR orders so caregivers can immediately recognize and accept the order and act on its behalf. These out-of-hospital orders are complicated by the need to be printed on paper that does not always accompany the individual. Oregon created an online system whereby individuals recorded their end-of-life wishes that medical personnel can access with an Internet connection. This system improved communication of end-of-life wishes in patients who selected comfort care only. Summary To improve conveyance of an individual's wishes for end-of-life care, the authors discuss nationwide adoption of Oregon's online registry where a person's account could comprehensively document end-of-life wishes, be universally available in all healthcare institutions, and be searchable by common patient identifiers. Facial recognition software could identify unconscious patients who present without identification. Correspondence to Gregory E. Holt, MD, PhD, University of Miami School of Medicine, Miami, FL 33136, USA. E-mail: gholt@miami.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Πέμπτη 6 Δεκεμβρίου 2018
Penguins extend point streak to five with win against Jets - NHL.com
Penguins extend point streak to five with win against Jets NHL.com
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Derek Grant and Zach Aston-Reese scored in the third period to help the Pittsburgh Penguins rally for a 4-3 win against the Winnipeg Jets at Bell MTS Place on ...
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Microtonal Variation in Sung Cantonese
Conclusion: Cantonese singers use microtonal contours to reflect rising contours of Cantonese linguistic tones.Phonetica (Source: Phonetica)
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A novel pro-apoptotic role of zinc octacarboxyphthalocyanine in melanoma me45 cancer cell's photodynamic therapy (PDT)
Publication date: Available online 5 December 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Joanna Nackiewicz, Marta Kliber-Jasik, Magdalena SkoniecznaAbstractZn-based phthalocyanine acts as drug or photosensitizer in photodynamic therapy (PDT) for the treatment of cancer cells. The activated zinc octacarboxyphthalocyanine (ZnPcOC) reacts with oxygen, to generate reactive oxygen species for the damage of melanoma cancer cells, Me45. This in vitro study aimed at investigating the cytotoxic effects of different concentrations of ZnPcOC activated with a diode laser (λ = 685 nm) on Me45, and normal human fibroblast cells, NHDF. To perform this study 104 cells/ml were seeded in 96-well plates and allowed to attach overnight, after which cells were treated wi...
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Protective effect of polysaccharide from Sophora japonica L. flower buds against UVB radiation in a human keratinocyte cell line (HaCaT cells)
In conclusion, PS pretreatment protected HaCaT keratinocytes from UVB irradiation-induced skin injuries effectively, and the underlying mechanism may involve MAPK signaling pathway which contribute to apoptotic cell death. However, further studies especially whose using human systems are needed to determine efficacy of PS in vivo.Graphical Abstract (Source: Journal of Photochemistry and Photobiology B: Biology)
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Lost in dictation. A cognitive approach to oral poetry: Frames, scripts and ‘unnecessary’ words in the Jebli ayyu
Publication date: January 2019Source: Language & Communication, Volume 64Author(s): Sarali GintsburgAbstractRecent interest in oral poetic traditions has centred on the possibility of applying cognitive linguistic categories in order to shed light on the nature of poetic improvisation across a range of cultures and historical periods (Boas, 2016). Frames, or topics or scenes, can be seen to be associated with particular scripts, consisting at least partly of formulaic language, which facilitates the process of poetic creation in real time. This paper focuses on the ayyu, a short improvised oral poetic genre common among the Jbala people of northern Morocco. In the first section, I examine the habitual repertoire of two singers, and show how they indeed associate particular frames (love, pi...
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Kinesio Taping Application in Dysphonic Singers
Kinesio Taping (KT) application in speech therapy has been studied in a few works about dysphonia, facial nerve palsy, sialorrhea, atypical deglutition, postsurgical recovery after thyroidectomy and laryngectomy. The aim of this study was the evaluation of the possible role of KT in supporting speech therapy in singers complaining of dysphonia using singing voice handicap index (SVHI), fundamental frequency (F0), shimmer, jitter and harmonic to noise ratio (mean H/N). (Source: Journal of Voice)
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An Investigation of Reliability of the Sunderland Tracheosophageal Voice Perceptual Scale
Conclusions: This study demonstrates good rater reliability for the majority of parameters on the SToPS scale, supporting the use of this tool within the clinical realm. However, further research is required to ascertain if any methods of increasing inter rater reliability on those parameters which did not reach good reliability can be identified.Folia Phoniatr Logop 2019;71:16 –23 (Source: Folia Phoniatrica et Logopaedica)
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Differential responses to constraints on naming agency among indigenous peoples and immigrants in Canada
This article illuminates the social structures and relations that shape agency for members of two marginalized groups in Canada and examines how individuals respond differently to constraints on their power to name themselves and their children. Constraints on spelling, structure and choice of name are framed according to the particular positions of indigenous peoples and immigrants in relation to European settler society as either 'original inhabitants' or 'recent arrivals'. These historically unequal power relations are manifest in intertwined ideologies of language, identity and nation, evident in ethnographic interviews, media reports and online commentary. Differential responses include resistance, endurance and assimilation. (Source: Language and Communication)
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Economic Analysis of a Three-Arm RCT Exploring the Delivery of Intensive, Prophylactic Swallowing Therapy to Patients with Head and Neck Cancer During (Chemo)Radiotherapy
This study investigated the clinical and patient-attributable costs of delivering an intensive, prophylactic swallowing therapy protocol via a new telepractice application "SwallowIT" as compared to clinician-directed FTF therapy and independent patient self-directed therapy. Patients (n = 79) with oropharyngeal HNC receiving definitive (C)RT were randomised to receive therapy via a: clinician-directed (n = 26), patient-directed (n = 27), orSwallowIT-assisted (n = 26) model of care. Data pertaining to health service costs (service time, consumables, therapy resources), patient-attributable costs (travel and wages) and patient-reported health-related quality of life (QoL) (AQoL-6D) were collected.SwallowIT provided a cost-efficient model of care when compared to the clin...
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Temporal aspects of self-monitoring for speech errors
We report two four-word tongue twister experiments eliciting consonantal errors and their repairs, in word initial and medial positions, testing some predictions relating to temporal aspects of self-monitoring. Main findings: (1) After internal error detection interrupting the speaking process takes more time than speech initiation of the error form. This implies that "covert repairs" are rare. (2) Word onset-to-cutoff times are longer for medial than for initial errors. This implies that scanning internal word forms for errors takes time. (3) Cutoff-to-repair times of 0 ms are overrepresented. This shows that often repairs are available at interruption. (4) Cutoff-to-repair times are longer for medial than initial consonants. This shows that repairing takes more time for medial than...
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Segmental contributions to cochlear implant speech perception
Publication date: Available online 3 December 2018Source: Speech CommunicationAuthor(s): Fei Chen, Yi HuAbstractThe present work assessed segmental contributions to speech perception by listeners who had been bilaterally fitted with cochlear implants (CIs). TIMIT sentences were edited to contain vowels (Vs) (replacing consonants with silence) or consonants (Cs) (replacing vowels with silence) and vowel-consonant (V-C) transitions, then presented to unilaterally or bilaterally fitted CI listeners for recognition. Experimental results showed that segmental interruption had a significant influence on CI speech perception. Vowels contained more perceptual information than consonants, and V-C transitions could significantly improve the intelligibility of V-only or C-only sentences. In addition,...
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A novel pro-apoptotic role of zinc octacarboxyphthalocyanine in melanoma me45 cancer cell's photodynamic therapy (PDT)
Publication date: Available online 5 December 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Joanna Nackiewicz, Marta Kliber-Jasik, Magdalena SkoniecznaAbstractZn-based phthalocyanine acts as drug or photosensitizer in photodynamic therapy (PDT) for the treatment of cancer cells. The activated zinc octacarboxyphthalocyanine (ZnPcOC) reacts with oxygen, to generate reactive oxygen species for the damage of melanoma cancer cells, Me45. This in vitro study aimed at investigating the cytotoxic effects of different concentrations of ZnPcOC activated with a diode laser (λ = 685 nm) on Me45, and normal human fibroblast cells, NHDF. To perform this study 104 cells/ml were seeded in 96-well plates and allowed to attach overnight, after which cells were treated wi...
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Sodium-glucose cotransporter-2 inhibitors: an overview and perioperative implications
Purpose of review Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new class of drugs used in the management of diabetes mellitus. This review will highlight key pharmacologic characteristics of this class of drugs; discuss their potential role in management of patients with cardiac disease; and raise several perioperative concerns for anesthesiologists caring for patients on SGLT-2 inhibitors. Recent findings Recent trials have shown a strong mortality benefit in diabetic patients on SGLT 2 inhibitors especially in patients with a high cardiovascular burden. In addition, there is a reduction in HbA1c levels, blood pressure, weight and readmissions secondary to heart failure in this patient population. However, these drugs have been also associated with an increased incidence of adverse events, such as euglycemic ketoacidosis, urinary tract infections, acute kidney injury and limb amputations. Summary SGLT 2 inhibitors are being increasingly prescribed secondary to their significant salutatory effect in patients with type II diabetes mellitus. Although there are no perioperative consensus guidelines for management of patients on SGLT2 inhibitors, they should be discontinued at least 24–48 h prior to major surgeries. Their overall management in the perioperative period should be carried out on a case-to-case basis using a multidisciplinary approach. Correspondence to Amit Bardia, MBBS, Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06515, USA. E-mail: amit.bardia@yale.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Protective effect of polysaccharide from Sophora japonica L. flower buds against UVB radiation in a human keratinocyte cell line (HaCaT cells)
In conclusion, PS pretreatment protected HaCaT keratinocytes from UVB irradiation-induced skin injuries effectively, and the underlying mechanism may involve MAPK signaling pathway which contribute to apoptotic cell death. However, further studies especially whose using human systems are needed to determine efficacy of PS in vivo.Graphical Abstract (Source: Journal of Photochemistry and Photobiology B: Biology)
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Lost in dictation. A cognitive approach to oral poetry: Frames, scripts and ‘unnecessary’ words in the Jebli ayyu
Publication date: January 2019Source: Language & Communication, Volume 64Author(s): Sarali GintsburgAbstractRecent interest in oral poetic traditions has centred on the possibility of applying cognitive linguistic categories in order to shed light on the nature of poetic improvisation across a range of cultures and historical periods (Boas, 2016). Frames, or topics or scenes, can be seen to be associated with particular scripts, consisting at least partly of formulaic language, which facilitates the process of poetic creation in real time. This paper focuses on the ayyu, a short improvised oral poetic genre common among the Jbala people of northern Morocco. In the first section, I examine the habitual repertoire of two singers, and show how they indeed associate particular frames (love, pi...
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Kinesio Taping Application in Dysphonic Singers
Kinesio Taping (KT) application in speech therapy has been studied in a few works about dysphonia, facial nerve palsy, sialorrhea, atypical deglutition, postsurgical recovery after thyroidectomy and laryngectomy. The aim of this study was the evaluation of the possible role of KT in supporting speech therapy in singers complaining of dysphonia using singing voice handicap index (SVHI), fundamental frequency (F0), shimmer, jitter and harmonic to noise ratio (mean H/N). (Source: Journal of Voice)
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Differential responses to constraints on naming agency among indigenous peoples and immigrants in Canada
This article illuminates the social structures and relations that shape agency for members of two marginalized groups in Canada and examines how individuals respond differently to constraints on their power to name themselves and their children. Constraints on spelling, structure and choice of name are framed according to the particular positions of indigenous peoples and immigrants in relation to European settler society as either 'original inhabitants' or 'recent arrivals'. These historically unequal power relations are manifest in intertwined ideologies of language, identity and nation, evident in ethnographic interviews, media reports and online commentary. Differential responses include resistance, endurance and assimilation. (Source: Language and Communication)
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Evidence for Incomplete Neutralization in Chilean Spanish
Conclusion: These results provide the first account of incomplete neutralization of plural vowel correlates in spontaneous speech in Chilean Spanish, and they offer evidence for closed syllable processes in this particular dialect, in alignment with an exemplar-theoretic approach.Phonetica (Source: Phonetica)
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Economic Analysis of a Three-Arm RCT Exploring the Delivery of Intensive, Prophylactic Swallowing Therapy to Patients with Head and Neck Cancer During (Chemo)Radiotherapy
This study investigated the clinical and patient-attributable costs of delivering an intensive, prophylactic swallowing therapy protocol via a new telepractice application "SwallowIT" as compared to clinician-directed FTF therapy and independent patient self-directed therapy. Patients (n = 79) with oropharyngeal HNC receiving definitive (C)RT were randomised to receive therapy via a: clinician-directed (n = 26), patient-directed (n = 27), orSwallowIT-assisted (n = 26) model of care. Data pertaining to health service costs (service time, consumables, therapy resources), patient-attributable costs (travel and wages) and patient-reported health-related quality of life (QoL) (AQoL-6D) were collected.SwallowIT provided a cost-efficient model of care when compared to the clin...
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Role of anesthesiologists in managing perioperative anemia
Purpose of review Anemia can contribute negatively to a patient's morbidity and mortality. Which treatment options do exist and what role do anesthesiologists play in management of perioperative anemia treatment? This review gives an overview about recent findings. Recent findings Patient Blood Management and standards for the management and treatment of anemia have been established worldwide. Various logistic settings and approaches are possible. With a special focus on cardiovascular anesthesia, intravenous iron is a therapeutic option in the preoperative setting. Autologous blood salvage is a standard procedure during surgery. Restrictive transfusion triggers in adult cardiac surgery have been shown to be beneficial in the majority of studies. Elderly patients and defined comorbidities might require higher transfusion triggers. Both, intravenous and oral iron increase hemoglobin values when given prior to surgery. Oral iron is effective when given several weeks prior to elective surgery. Erythropoietin is a treatment decision individualized to each patient. Summary Within the previous 18 months, important publications have demonstrated the established role of anesthesiologists in managing perioperative anemia. A substantial pillar for anemia treatment is the implementation of Patient Blood Management worldwide. Correspondence to Andrea U. Steinbicker, MD, MPH, Westfalische Wilhelms-Universitat Munster, Muenster; Muenster University Hospital, Albert-SChweitzer Campus 1, Building A1, 48149 Muenster, Germany. Tel: +0049 251 83 47898; e-mail: andrea.steinbicker@ukmuenster.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Evidence for Incomplete Neutralization in Chilean Spanish.
CONCLUSION: These results provide the first account of incomplete neutralization of plural vowel correlates in spontaneous speech in Chilean Spanish, and they offer evidence for closed syllable processes in this particular dialect, in alignment with an exemplar-theoretic approach. PMID: 30513527 [PubMed - as supplied by publisher] (Source: Phonetica)
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An Investigation of Reliability of the Sunderland Tracheosophageal Voice Perceptual Scale
Conclusions: This study demonstrates good rater reliability for the majority of parameters on the SToPS scale, supporting the use of this tool within the clinical realm. However, further research is required to ascertain if any methods of increasing inter rater reliability on those parameters which did not reach good reliability can be identified.Folia Phoniatr Logop 2019;71:16 –23 (Source: Folia Phoniatrica et Logopaedica)
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Preoperative rehabilitation for thoracic surgery
Purpose of review Lung resection provides the best outcome for patients with early stage lung cancer. However, lung cancer surgery carries a significant risk of perioperative complications. Patient risk may be reduced by addressing modifiable risk factors in the preoperative period. We review how this can be achieved through preoperative rehabilitation pathways. Recent findings Cardiorespiratory fitness is an independent predictor of survival for nonsmall cell cancer. Preoperative exercise programmes may improve cardiorespiratory reserve and reduce perioperative complications. Additional benefits may be achieved through interventions such as smoking cessation programmes, correction of anaemia, improvement of nutritional status and improved oral hygiene. These interventions may also have the additional benefit of enabling high-risk patients previously deemed unsuitable for surgery to be optimized to such a degree that they can undergo surgery. These interventions will achieve maximal benefit when delivered early in lung cancer pathways; this requires close collaboration amongst multidisciplinary teams. Summary Lung cancer surgery carries significant risk of postoperative pulmonary complications. Through integrating prehabilitation interventions into lung cancer pathways, there are opportunities to improve long-term outcomes for patients. Correspondence to Richard Templeton, MB.ChB, FRCA, Wythenshawe Hospital, Manchester Foundation Trust, Southmoor Road, Manchester M23 9LT, UK. Tel: +441612914514; e-mail: rtempleton7@doctors.org.uk Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Withholding or withdrawing life support versus physician-assisted death: a distinction with a difference?
Purpose of review Withholding or withdrawing life-sustaining therapy is generally differentiated from physician-assisted suicide or euthanasia based on the distinction between intention and foresight. We reviewed the literature surrounding the validity of this distinction. Recent findings Many physicians from different specialties express a perceived distinction between intention and foresight. The distinction between intention and foresight differs from the morally irrelevant distinction between doing and allowing. Intention and foresight may be distinguished by their opposing directions of fit between world and mind. Intention is held to be of greater moral significance than foresight because it guides and constrains our actions, determines the moral quality of our actions, and expresses the moral character of the agent. Opponents of the distinction argue that it undermines moral accountability for foreseen consequences of our actions and is overly concerned with the physician's state of mind rather than the patient's experience. They also argue that intentions may be vague and difficult to express or ascertain. Summary Several reasons may be given in favor of the distinction between intention and foresight. Given this distinction, the moral permissibility of withholding or withdrawing life-sustaining therapy does not necessarily entail the moral permissibility of physician-assisted suicide or euthanasia. Correspondence to Ewan C. Goligher, MD, PhD, Toronto General Hospital, 585 University Ave., Peter Munk Building, 11-192, Toronto, ON M5G 2N2, Canada. Tel: +1 416 340 4800 ext. 6810; e-mail: ewan.goligher@utoronto.ca Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Ethical lessons learned and to be learned from mass casualty events by terrorism
Purpose of review The world has seen a major upturn in international terror awareness. Medicine has had to respond. In addition to the unique physical and mental injuries caused by terror which require special clinical attention, so too terror represents a challenge for medicine from an ethics perspective. Recent findings Several responses in the literature over the past few years have attempted to reflect where the battlefront of ethical dilemmas falls. These include issues of resource allocation, triage, bioterror, the therapeutic relationship with terrorists, dual loyalty, and challenges in the role in the promotion of virtuous behavior as a physician under difficult conditions. Summary Although many challenges exist, physicians need to be prepared for ethical response to terror. With their associated unique status, providing legitimacy and specialized ability in the management and approach to terror situations, physicians are held to a higher standard and need to rise to the occasion. This is required in order to promote ethical behavior under trying conditions and ethical sensitivity of the medical profession by means of being attuned to the reality around. Correspondence to Rael D. Strous, MD, MHA, Mayanei Hayeshua Medical Center, 17 HaRav Povarski Street, Bnei Brak, Israel. Tel: +972 73 3398015; fax: +972 73 3398003; e-mail: raels@post.tau.ac.il Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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The ethics of treating family members
Purpose of review Many medical professionals receive requests from family and friends asking for medical advice and treatment. But should medics treat their family? Ethically can we treat, or refuse to treat, family members? This is a common ethical challenge that most doctors face during their career and there is limited evidence available. By examining ethical principles, we aim to answer these questions and provide a framework that will guide decision making in this area. Recent findings There is a paucity of evidence available. Many ethical systems exist and have been discussed since ancient Greece but in recent years, bioethics has become more prominent in medical thinking and debate. Summary We examine ethical systems such as virtue ethics, utilitarianism, deontology and principlism and how they relate to treating family members. We then look at cases in different contexts and describe a system for approaching such cases, allowing doctors to conform to moral standards, and consider ethical arguments, prior to embarking upon any treatment course with a relative. Correspondence to Paul C. McConnell, MB, ChB (Hons), FRCA, EDIC, FFICM, Consultant Intensive Care Medicine, Royal Alexandra Hospital, Paisley PA2 9PJ, Scotland. Tel: +0141 314 6609; e-mail: paulmcconnell@nhs.net Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Resource allocation in ICU: ethical considerations
Purpose of review Increasing scarcity of resources on the background of ever improving medical care and prolonged life expectancy has placed a burden on all aspects of health care. In this article we examine the current problems with resource allocation in intensive care and question whether we can find guidance on appropriate resource allocation through ethical models. Recent findings The problem of fair and ethical resource allocation has perpetually plagued health care. Recent work has looked at value for money, benefits of therapies and how we define futility, but these still fall victim to the same problems that classical schools of ethical thought have tried to tackle. Summary Many ethical principles provide a framework on which to allocate resources to certain cohorts of patients, however, most appear too rigid to be fully and primarily utilized for intensive care admission. We suggest a collaboration of principles be applied to achieve a moral, ethical and common sense approach to this issue. Over resourcing and under resourcing is also suggested to be problematic for patients and healthcare workers alike. Correspondence to Paul C. McConnell, MB ChB (Hons) FRCA EDIC FFICM, Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9QF, UK. Tel: +0141 314 6609; e-mail: paulmcconnell@nhs.net Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Cheaper drugs and techniques to fulfill chief executive officer perspectives – any choices?
Purpose of review Against the background of increasing healthcare costs and diminishing budgets, this review aims to present clinicians with ethically viable options to overcome budgetary restraints when seeking to introduce novel products. Recent findings Healthcare administrators and primary healthcare providers are not unlikely to have different opinions when discussing the introduction of novel products. However, rather than taking a 'no' for an answer, doctors may be able to argue for a change – even if this may seem to come at a higher cost. The recent introduction of the reversal agent sugammadex may provide a timely example for the possibility of success 'against all financial odds'. Summary Health professionals have the responsibility to deliver high-quality care while acknowledging the financial budget constraints. However, evidence (vs. perception) for outcome benefits of novel drugs or devices should stimulate a robust desire for their timely introduction. Demonstrating actual benefits understandable to administrators, seeking alliances with other medical specialties or patient groups, as well as negotiations with the healthcare industry may all represent viable options. Simply waiting for patents to expire should remain a measure of last resort. Correspondence to Professor Thomas Ledowski, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, 197 Wellington Street, Perth, Western Australia 6000, Australia. Tel: +61 8 92242244; e-mail: Thomas.ledowski@health.wa.gov.au Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Nonstandard do-not-resuscitate orders
Purpose of review Tattoos and medallions are examples of nonstandard do-not-resuscitate (DNR) orders that some people use to convey end-of-life wishes. These DNR orders are neither universally accepted nor understood for reasons discussed within this manuscript. Recent findings Studies show both providers and patients confuse the meaning and implication of DNR orders. In the United States, out-of-hospital DNR orders are legislated at the state level. Most states standardized out-of-hospital DNR orders so caregivers can immediately recognize and accept the order and act on its behalf. These out-of-hospital orders are complicated by the need to be printed on paper that does not always accompany the individual. Oregon created an online system whereby individuals recorded their end-of-life wishes that medical personnel can access with an Internet connection. This system improved communication of end-of-life wishes in patients who selected comfort care only. Summary To improve conveyance of an individual's wishes for end-of-life care, the authors discuss nationwide adoption of Oregon's online registry where a person's account could comprehensively document end-of-life wishes, be universally available in all healthcare institutions, and be searchable by common patient identifiers. Facial recognition software could identify unconscious patients who present without identification. Correspondence to Gregory E. Holt, MD, PhD, University of Miami School of Medicine, Miami, FL 33136, USA. E-mail: gholt@miami.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Preoperative rehabilitation for thoracic surgery
Purpose of review Lung resection provides the best outcome for patients with early stage lung cancer. However, lung cancer surgery carries a significant risk of perioperative complications. Patient risk may be reduced by addressing modifiable risk factors in the preoperative period. We review how this can be achieved through preoperative rehabilitation pathways. Recent findings Cardiorespiratory fitness is an independent predictor of survival for nonsmall cell cancer. Preoperative exercise programmes may improve cardiorespiratory reserve and reduce perioperative complications. Additional benefits may be achieved through interventions such as smoking cessation programmes, correction of anaemia, improvement of nutritional status and improved oral hygiene. These interventions may also have the additional benefit of enabling high-risk patients previously deemed unsuitable for surgery to be optimized to such a degree that they can undergo surgery. These interventions will achieve maximal benefit when delivered early in lung cancer pathways; this requires close collaboration amongst multidisciplinary teams. Summary Lung cancer surgery carries significant risk of postoperative pulmonary complications. Through integrating prehabilitation interventions into lung cancer pathways, there are opportunities to improve long-term outcomes for patients. Correspondence to Richard Templeton, MB.ChB, FRCA, Wythenshawe Hospital, Manchester Foundation Trust, Southmoor Road, Manchester M23 9LT, UK. Tel: +441612914514; e-mail: rtempleton7@doctors.org.uk Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Sodium-glucose cotransporter-2 inhibitors: an overview and perioperative implications
Purpose of review Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new class of drugs used in the management of diabetes mellitus. This review will highlight key pharmacologic characteristics of this class of drugs; discuss their potential role in management of patients with cardiac disease; and raise several perioperative concerns for anesthesiologists caring for patients on SGLT-2 inhibitors. Recent findings Recent trials have shown a strong mortality benefit in diabetic patients on SGLT 2 inhibitors especially in patients with a high cardiovascular burden. In addition, there is a reduction in HbA1c levels, blood pressure, weight and readmissions secondary to heart failure in this patient population. However, these drugs have been also associated with an increased incidence of adverse events, such as euglycemic ketoacidosis, urinary tract infections, acute kidney injury and limb amputations. Summary SGLT 2 inhibitors are being increasingly prescribed secondary to their significant salutatory effect in patients with type II diabetes mellitus. Although there are no perioperative consensus guidelines for management of patients on SGLT2 inhibitors, they should be discontinued at least 24–48 h prior to major surgeries. Their overall management in the perioperative period should be carried out on a case-to-case basis using a multidisciplinary approach. Correspondence to Amit Bardia, MBBS, Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06515, USA. E-mail: amit.bardia@yale.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Withholding or withdrawing life support versus physician-assisted death: a distinction with a difference?
Purpose of review Withholding or withdrawing life-sustaining therapy is generally differentiated from physician-assisted suicide or euthanasia based on the distinction between intention and foresight. We reviewed the literature surrounding the validity of this distinction. Recent findings Many physicians from different specialties express a perceived distinction between intention and foresight. The distinction between intention and foresight differs from the morally irrelevant distinction between doing and allowing. Intention and foresight may be distinguished by their opposing directions of fit between world and mind. Intention is held to be of greater moral significance than foresight because it guides and constrains our actions, determines the moral quality of our actions, and expresses the moral character of the agent. Opponents of the distinction argue that it undermines moral accountability for foreseen consequences of our actions and is overly concerned with the physician's state of mind rather than the patient's experience. They also argue that intentions may be vague and difficult to express or ascertain. Summary Several reasons may be given in favor of the distinction between intention and foresight. Given this distinction, the moral permissibility of withholding or withdrawing life-sustaining therapy does not necessarily entail the moral permissibility of physician-assisted suicide or euthanasia. Correspondence to Ewan C. Goligher, MD, PhD, Toronto General Hospital, 585 University Ave., Peter Munk Building, 11-192, Toronto, ON M5G 2N2, Canada. Tel: +1 416 340 4800 ext. 6810; e-mail: ewan.goligher@utoronto.ca Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Ethical lessons learned and to be learned from mass casualty events by terrorism
Purpose of review The world has seen a major upturn in international terror awareness. Medicine has had to respond. In addition to the unique physical and mental injuries caused by terror which require special clinical attention, so too terror represents a challenge for medicine from an ethics perspective. Recent findings Several responses in the literature over the past few years have attempted to reflect where the battlefront of ethical dilemmas falls. These include issues of resource allocation, triage, bioterror, the therapeutic relationship with terrorists, dual loyalty, and challenges in the role in the promotion of virtuous behavior as a physician under difficult conditions. Summary Although many challenges exist, physicians need to be prepared for ethical response to terror. With their associated unique status, providing legitimacy and specialized ability in the management and approach to terror situations, physicians are held to a higher standard and need to rise to the occasion. This is required in order to promote ethical behavior under trying conditions and ethical sensitivity of the medical profession by means of being attuned to the reality around. Correspondence to Rael D. Strous, MD, MHA, Mayanei Hayeshua Medical Center, 17 HaRav Povarski Street, Bnei Brak, Israel. Tel: +972 73 3398015; fax: +972 73 3398003; e-mail: raels@post.tau.ac.il Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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The ethics of treating family members
Purpose of review Many medical professionals receive requests from family and friends asking for medical advice and treatment. But should medics treat their family? Ethically can we treat, or refuse to treat, family members? This is a common ethical challenge that most doctors face during their career and there is limited evidence available. By examining ethical principles, we aim to answer these questions and provide a framework that will guide decision making in this area. Recent findings There is a paucity of evidence available. Many ethical systems exist and have been discussed since ancient Greece but in recent years, bioethics has become more prominent in medical thinking and debate. Summary We examine ethical systems such as virtue ethics, utilitarianism, deontology and principlism and how they relate to treating family members. We then look at cases in different contexts and describe a system for approaching such cases, allowing doctors to conform to moral standards, and consider ethical arguments, prior to embarking upon any treatment course with a relative. Correspondence to Paul C. McConnell, MB, ChB (Hons), FRCA, EDIC, FFICM, Consultant Intensive Care Medicine, Royal Alexandra Hospital, Paisley PA2 9PJ, Scotland. Tel: +0141 314 6609; e-mail: paulmcconnell@nhs.net Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Resource allocation in ICU: ethical considerations
Purpose of review Increasing scarcity of resources on the background of ever improving medical care and prolonged life expectancy has placed a burden on all aspects of health care. In this article we examine the current problems with resource allocation in intensive care and question whether we can find guidance on appropriate resource allocation through ethical models. Recent findings The problem of fair and ethical resource allocation has perpetually plagued health care. Recent work has looked at value for money, benefits of therapies and how we define futility, but these still fall victim to the same problems that classical schools of ethical thought have tried to tackle. Summary Many ethical principles provide a framework on which to allocate resources to certain cohorts of patients, however, most appear too rigid to be fully and primarily utilized for intensive care admission. We suggest a collaboration of principles be applied to achieve a moral, ethical and common sense approach to this issue. Over resourcing and under resourcing is also suggested to be problematic for patients and healthcare workers alike. Correspondence to Paul C. McConnell, MB ChB (Hons) FRCA EDIC FFICM, Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9QF, UK. Tel: +0141 314 6609; e-mail: paulmcconnell@nhs.net Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Cheaper drugs and techniques to fulfill chief executive officer perspectives – any choices?
Purpose of review Against the background of increasing healthcare costs and diminishing budgets, this review aims to present clinicians with ethically viable options to overcome budgetary restraints when seeking to introduce novel products. Recent findings Healthcare administrators and primary healthcare providers are not unlikely to have different opinions when discussing the introduction of novel products. However, rather than taking a 'no' for an answer, doctors may be able to argue for a change – even if this may seem to come at a higher cost. The recent introduction of the reversal agent sugammadex may provide a timely example for the possibility of success 'against all financial odds'. Summary Health professionals have the responsibility to deliver high-quality care while acknowledging the financial budget constraints. However, evidence (vs. perception) for outcome benefits of novel drugs or devices should stimulate a robust desire for their timely introduction. Demonstrating actual benefits understandable to administrators, seeking alliances with other medical specialties or patient groups, as well as negotiations with the healthcare industry may all represent viable options. Simply waiting for patents to expire should remain a measure of last resort. Correspondence to Professor Thomas Ledowski, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, 197 Wellington Street, Perth, Western Australia 6000, Australia. Tel: +61 8 92242244; e-mail: Thomas.ledowski@health.wa.gov.au Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Skin as an immune organ and clinical applications of skin-based immunotherapy
ConclusionsTaken together, the reviewed literature supports the concept that EPIT activates the natural desensitization pathway of the skin, offering a progressive, possibly sustained response. EPIT offers a potential alternative for allergen immunotherapy that is less invasive and carries a lower risk for systemic reactions than oral immunotherapy. (Source: World Allergy Organization Journal)
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Skin as an immune organ and clinical applications of skin-based immunotherapy
ConclusionsTaken together, the reviewed literature supports the concept that EPIT activates the natural desensitization pathway of the skin, offering a progressive, possibly sustained response. EPIT offers a potential alternative for allergen immunotherapy that is less invasive and carries a lower risk for systemic reactions than oral immunotherapy. (Source: World Allergy Organization Journal)
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Effect of brightness and contrast variation for detectability of root resorption lesions in digital intraoral radiographs
Abstract
Objectives
To evaluate the performance of periapical radiography assessed under different radiographic brightness and contrast variations in the detection of simulated internal (IRR) and external (ERR) root resorption lesions. Additionally, observers' preferences related to image quality for these diagnostic tasks were evaluated.
Methods
Thirty single-root teeth were divided into two groups (n = 15): IRR, in which lesions were simulated using mechanical and biochemical processes; and ERR, in which cavities standardized with drills of different sizes were performed on the root surfaces. Digital radiographs were obtained and subsequently adjusted in 4 additional combinations, resulting in 5 brightness/contrast variations (V1–V5). Five radiologists evaluated the radiographs. The observers' preference on the image quality was also recorded.
Results
For both conditions, there were no differences in the accuracy and specificity between the five brightness/contrast variations (p > 0.05), but the sensitivity for ERR was significantly lower in V4 (+ 15% brightness/−15% contrast) in the large size (p < 0.05). The observers classified V2 (− 15% brightness/+15% contrast) as the "best" image quality for IRR and ERR evaluation.
Conclusions
For IRR and ERR lesions, brightness and contrast variation does not affect the diagnostic performance of digital intraoral radiography within the tested range. The observers prefer images with a reasonable decrease in brightness and increase in contrast.
Clinical relevance
Brightness and contrast enhancement tools are commonly applied in digital radiographic assessment. The use of these tools for detection of root resorptions can be applied according to the observer preference without influence on diagnostic accuracy.
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Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review
Abstract
Background
Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is—surprisingly—still missing.
Objectives
To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use.
Materials and methods
A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature.
Results
From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29–86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects.
Conclusion
Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy.
Clinical relevance
Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.
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Effect of brightness and contrast variation for detectability of root resorption lesions in digital intraoral radiographs
Abstract
Objectives
To evaluate the performance of periapical radiography assessed under different radiographic brightness and contrast variations in the detection of simulated internal (IRR) and external (ERR) root resorption lesions. Additionally, observers' preferences related to image quality for these diagnostic tasks were evaluated.
Methods
Thirty single-root teeth were divided into two groups (n = 15): IRR, in which lesions were simulated using mechanical and biochemical processes; and ERR, in which cavities standardized with drills of different sizes were performed on the root surfaces. Digital radiographs were obtained and subsequently adjusted in 4 additional combinations, resulting in 5 brightness/contrast variations (V1–V5). Five radiologists evaluated the radiographs. The observers' preference on the image quality was also recorded.
Results
For both conditions, there were no differences in the accuracy and specificity between the five brightness/contrast variations (p > 0.05), but the sensitivity for ERR was significantly lower in V4 (+ 15% brightness/−15% contrast) in the large size (p < 0.05). The observers classified V2 (− 15% brightness/+15% contrast) as the "best" image quality for IRR and ERR evaluation.
Conclusions
For IRR and ERR lesions, brightness and contrast variation does not affect the diagnostic performance of digital intraoral radiography within the tested range. The observers prefer images with a reasonable decrease in brightness and increase in contrast.
Clinical relevance
Brightness and contrast enhancement tools are commonly applied in digital radiographic assessment. The use of these tools for detection of root resorptions can be applied according to the observer preference without influence on diagnostic accuracy.
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Patients with rare, incurable digestive tract cancers respond to new drug combination - Medical Xpress
Patients with rare, incurable digestive tract cancers respond to new drug combination Medical Xpress
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Dublin, Ireland: Patients with rare, but incurable cancers of the digestive tract have responded well to a combination of two drugs that block the MEK and BRAF ...
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Hendrix Students and Faculty Present Research at 2018 Arkansas INBRE Research Conference - Hendrix College Events and News
Hendrix Students and Faculty Present Research at 2018 Arkansas INBRE Research Conference Hendrix College Events and News
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CONWAY, Ark. (November 8, 2018) – Eleven Hendrix College students were among the 176 undergraduates who presented scientific research at the 2018 ...
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Global Thyroid Cancer Treatment Market 2018 – Baxter, Mylan, Alara, Bristol Myers, Abbott, Teva, App pharmaceuticals, Jerome Stevens - Browse Live News
Global Thyroid Cancer Treatment Market 2018 – Baxter, Mylan, Alara, Bristol Myers, Abbott, Teva, App pharmaceuticals, Jerome Stevens Browse Live News
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The report provides in-depth analysis and strategies of Global Thyroid Cancer Treatment Market delivers a comprehensive analysis of price, revenue, gross ...
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High PFAS levels found near Muskegon airport - Grand Haven Tribune
High PFAS levels found near Muskegon airport Grand Haven Tribune
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NORTON SHORES — Testing for PFAS in Muskegon County has uncovered four residences in Norton Shores with levels well above the U.S. Environmental ...
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Patients with rare, incurable digestive tract cancers respond to new drug combination - Medical Xpress
Patients with rare, incurable digestive tract cancers respond to new drug combination Medical Xpress
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Dublin, Ireland: Patients with rare, but incurable cancers of the digestive tract have responded well to a combination of two drugs that block the MEK and BRAF ...
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Innate immune crosstalk in asthmatic airways: Innate lymphoid cells coordinate polarization of lung macrophages
Recent studies have emphasized the role of innate lymphoid cells (ILCs) in the development of asthma. The involvement of group 2 innate lymphoid cells (ILC2s) in asthma is well studied: however, the participation of other types of ILCs in the development of asthma remains unclear. (Source: Journal of Allergy and Clinical Immunology)
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Innate immune crosstalk in asthmatic airways: Innate lymphoid cells coordinate polarization of lung macrophages
Recent studies have emphasized the role of innate lymphoid cells (ILCs) in the development of asthma. The involvement of group 2 innate lymphoid cells (ILC2s) in asthma is well studied: however, the participation of other types of ILCs in the development of asthma remains unclear. (Source: Journal of Allergy and Clinical Immunology)
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Short- and long-term impact of remifentanil on thermal detection and pain thresholds after cardiac surgery: A randomised controlled trial
CONCLUSION Earlier reports of increased pain sensitivity 1 year after the use of remifentanil could not be confirmed in this randomised study using Quantitative Sensory Testing. This indicates that remifentanil plays a minor role in the development of chronic thoracic pain. Still, the relatively high incidence of chronic thoracic pain and its accompanying impact on quality of life remain challenging problems. TRIAL REGISTRATION The study was registered at EudraCT (ref: 2013-000201-23) and ClinicalTrials.gov (https://ift.tt/2Mq69Sn). (Source: European Journal of Anaesthesiology)
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Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind, randomised study
CONCLUSION Bilateral suprazygomatic maxillary nerve block is an effective and safe alternative to the traditional peripheral nerve blocks for cleft lip and cleft palate surgery, in a mixed paediatric and adult population. (Source: European Journal of Anaesthesiology)
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Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta-analysis.
CONCLUSION: Sufficient evidence exists to develop perioperative guidelines for TXA use in many populations. Further studies evaluating perioperative TXA use in patients with a history of thromboembolism are warranted. PMID: 30516835 [PubMed - as supplied by publisher] (Source: Transfusion)
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Streptococcus Suis Serotype 2 Stimulates Neutrophil Extracellular Traps Formation via Activation of p38 MAPK and ERK1/2
Fang Ma, Xiaojing Chang, Guangyu Wang, Hong Zhou, Zhe Ma, Huixing Lin, Hongjie Fan (Source: Frontiers in Immunology)
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Editorial: Endothelial Dysfunction During Inflammation and Alloimmunity
Olaf Penack, Thomas Luft (Source: Frontiers in Immunology)
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Correction to: Building the Prestige of Archivum Immunologiae et Therapiae Experimentalis : From a Little Known to an Internationally Recognized Journal
According to JCR data, updated in October 2018 by Clarivate Analytics. (Source: Archivum Immunologiae et Therapiae Experimentalis)
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Role of Herpes Simplex Virus Type 1 (HSV-1) Glycoprotein K (gK) Pathogenic CD8+ T Cells in Exacerbation of Eye Disease
Ujjaldeep Jaggi, Shaohui Wang, Kati Tormanen, Harry Matundan, Alexander V. Ljubimov, Homayon Ghiasi (Source: Frontiers in Immunology)
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CD5, an Undercover Regulator of TCR Signaling
Guillaume Voisinne, Anne Gonzalez de Peredo, Romain Roncagalli (Source: Frontiers in Immunology)
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The Rough Guide to Monocytes in Malaria Infection
Amaya Ortega-Pajares, Stephen J. Rogerson (Source: Frontiers in Immunology)
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Anti-Ro60 Seropositivity Determines Anti-Ro52 Epitope Mapping in Patients With Systemic Sclerosis
Athanasios Gkoutzourelas, Christos Liaskos, Maria G. Mytilinaiou, Theodora Simopoulou, Christina Katsiari, Alexandra Tsirogianni, Dimitrios Daoussis, Thomas Scheper, Wolfgang Meyer, Dimitrios P. Bogdanos, Lazaros I. Sakkas (Source: Frontiers in Immunology)
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Integrating Experiment and Theory to Understand TCR-pMHC Dynamics
Ashley M. Buckle, Natalie A. Borg (Source: Frontiers in Immunology)
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Transcriptional and Epigenetic Regulation of Effector and Memory CD8 T Cell Differentiation
Yao Chen, Ryan Zander, Achia Khatun, David M. Schauder, Weiguo Cui (Source: Frontiers in Immunology)
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Non-specific Effects of Live Attenuated Pertussis Vaccine Against Heterologous Infectious and Inflammatory Diseases
St éphane Cauchi, Camille Locht (Source: Frontiers in Immunology)
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Neuroprotective Effects of Ginsenoside-Rg1 Against Depression-Like Behaviors via Suppressing Glial Activation, Synaptic Deficits, and Neuronal Apoptosis in Rats
Cuiqin Fan, Qiqi Song, Peng Wang, Ye Li, Mu Yang, Shu Yan Yu (Source: Frontiers in Immunology)
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Short- and long-term impact of remifentanil on thermal detection and pain thresholds after cardiac surgery: A randomised controlled trial
CONCLUSION Earlier reports of increased pain sensitivity 1 year after the use of remifentanil could not be confirmed in this randomised study using Quantitative Sensory Testing. This indicates that remifentanil plays a minor role in the development of chronic thoracic pain. Still, the relatively high incidence of chronic thoracic pain and its accompanying impact on quality of life remain challenging problems. TRIAL REGISTRATION The study was registered at EudraCT (ref: 2013-000201-23) and ClinicalTrials.gov (https://ift.tt/2Mq69Sn). (Source: European Journal of Anaesthesiology)
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Non-specific Effects of Live Attenuated Pertussis Vaccine Against Heterologous Infectious and Inflammatory Diseases
St éphane Cauchi, Camille Locht (Source: Frontiers in Immunology)
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Anti-Ro60 Seropositivity Determines Anti-Ro52 Epitope Mapping in Patients With Systemic Sclerosis
Athanasios Gkoutzourelas, Christos Liaskos, Maria G. Mytilinaiou, Theodora Simopoulou, Christina Katsiari, Alexandra Tsirogianni, Dimitrios Daoussis, Thomas Scheper, Wolfgang Meyer, Dimitrios P. Bogdanos, Lazaros I. Sakkas (Source: Frontiers in Immunology)
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Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind, randomised study
CONCLUSION Bilateral suprazygomatic maxillary nerve block is an effective and safe alternative to the traditional peripheral nerve blocks for cleft lip and cleft palate surgery, in a mixed paediatric and adult population. (Source: European Journal of Anaesthesiology)
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Editorial: Endothelial Dysfunction During Inflammation and Alloimmunity
Olaf Penack, Thomas Luft (Source: Frontiers in Immunology)
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The Rough Guide to Monocytes in Malaria Infection
Amaya Ortega-Pajares, Stephen J. Rogerson (Source: Frontiers in Immunology)
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CD5, an Undercover Regulator of TCR Signaling
Guillaume Voisinne, Anne Gonzalez de Peredo, Romain Roncagalli (Source: Frontiers in Immunology)
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Role of Herpes Simplex Virus Type 1 (HSV-1) Glycoprotein K (gK) Pathogenic CD8+ T Cells in Exacerbation of Eye Disease
Ujjaldeep Jaggi, Shaohui Wang, Kati Tormanen, Harry Matundan, Alexander V. Ljubimov, Homayon Ghiasi (Source: Frontiers in Immunology)
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Integrating Experiment and Theory to Understand TCR-pMHC Dynamics
Ashley M. Buckle, Natalie A. Borg (Source: Frontiers in Immunology)
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Neuroprotective Effects of Ginsenoside-Rg1 Against Depression-Like Behaviors via Suppressing Glial Activation, Synaptic Deficits, and Neuronal Apoptosis in Rats
Cuiqin Fan, Qiqi Song, Peng Wang, Ye Li, Mu Yang, Shu Yan Yu (Source: Frontiers in Immunology)
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Skin as an immune organ and clinical applications of skin-based immunotherapy
ConclusionsTaken together, the reviewed literature supports the concept that EPIT activates the natural desensitization pathway of the skin, offering a progressive, possibly sustained response. EPIT offers a potential alternative for allergen immunotherapy that is less invasive and carries a lower risk for systemic reactions than oral immunotherapy. (Source: World Allergy Organization Journal)
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Correction to: Building the Prestige of Archivum Immunologiae et Therapiae Experimentalis : From a Little Known to an Internationally Recognized Journal
According to JCR data, updated in October 2018 by Clarivate Analytics. (Source: Archivum Immunologiae et Therapiae Experimentalis)
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Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta-analysis.
CONCLUSION: Sufficient evidence exists to develop perioperative guidelines for TXA use in many populations. Further studies evaluating perioperative TXA use in patients with a history of thromboembolism are warranted. PMID: 30516835 [PubMed - as supplied by publisher] (Source: Transfusion)
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43RD GREAT AMERICAN SMOKEOUT HAPPENING THURSDAY - kqennewsradio.com
43RD GREAT AMERICAN SMOKEOUT HAPPENING THURSDAY kqennewsradio.com
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November 15, 2018 4:10 a.m.. The 43rd annual Great American Smokeout is happening Thursday. The theme this year is "Day 1" reflecting the event's evolution ...
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43RD GREAT AMERICAN SMOKEOUT HAPPENING THURSDAY - kqennewsradio.com
43RD GREAT AMERICAN SMOKEOUT HAPPENING THURSDAY kqennewsradio.com
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November 15, 2018 4:10 a.m.. The 43rd annual Great American Smokeout is happening Thursday. The theme this year is "Day 1" reflecting the event's evolution ...
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Head and Neck Cancer Therapeutics Market Size 2018: by Manufacturers, Countries, Type and Application - News by Sharp Reports
The Global Head and Neck Cancer Therapeutics Market 2018-2023 Renders deep perception of the Market Segment by Regions market status of the Head and ...
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Team in Australia uses 3D printed prosthetic jaw to help cancer survivor - WKRC TV Cincinnati
Australia (Reuters/Network Nine/CBS Newspath/WKRC) - In an Australian first reconstruction, a cancer survivor has been fitted with a 3D-printed jaw and teeth ...
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Vasculitis: A Link with IBD? | Medpage Today - MedPage Today
Vasculitis: A Link with IBD? | Medpage Today MedPage Today
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High rates of Crohn's disease and ulcerative colitis seen in patients with giant cell arteritis.
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Vasculitis: A Link with IBD? | Medpage Today - MedPage Today
Vasculitis: A Link with IBD? | Medpage Today MedPage Today
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High rates of Crohn's disease and ulcerative colitis seen in patients with giant cell arteritis.
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Head and Neck Cancer Therapeutics Market Size 2018: by Manufacturers, Countries, Type and Application - News by Sharp Reports
The Global Head and Neck Cancer Therapeutics Market 2018-2023 Renders deep perception of the Market Segment by Regions market status of the Head and ...
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Team in Australia uses 3D printed prosthetic jaw to help cancer survivor - WKRC TV Cincinnati
Australia (Reuters/Network Nine/CBS Newspath/WKRC) - In an Australian first reconstruction, a cancer survivor has been fitted with a 3D-printed jaw and teeth ...
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Danone North America Issues Allergy Alert and Recall for Light & Fit Greek Crunch S ’mores Flavor
Danone North America is voluntarily recalling 3,521 cases of Light& Fit ® Greek Crunch Nonfat Yogurt& Toppings S 'Mores Flavor sold in the United States with an expiration date of December 30, 2018 and UPC of 36632 03825. It was discovered that some of the toppers sold on the product contain peanuts and are improperly labeled. People who have an allergy to peanuts run the risk of serious or life-threatening allergic reaction if they consume this product. (Source: Food and Drug Administration)
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Generic drugmaker to sell alternative to EpiPen injectors
Generic drugmaker Sandoz to sell prefilled syringe alternative to EpiPen emergency allergy medication (Source: ABC News: Health)
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Generic drugmaker to sell alternative to EpiPen injectors
Generic drugmaker Sandoz to sell prefilled syringe alternative to EpiPen emergency allergy medication (Source: ABC News: Health)
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Danone North America Issues Allergy Alert and Recall for Light & Fit Greek Crunch S ’mores Flavor
Danone North America is voluntarily recalling 3,521 cases of Light& Fit ® Greek Crunch Nonfat Yogurt& Toppings S 'Mores Flavor sold in the United States with an expiration date of December 30, 2018 and UPC of 36632 03825. It was discovered that some of the toppers sold on the product contain peanuts and are improperly labeled. People who have an allergy to peanuts run the risk of serious or life-threatening allergic reaction if they consume this product. (Source: Food and Drug Administration)
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Danone North America Issues Allergy Alert and Recall for Light & Fit Greek Crunch S ’mores Flavor
Danone North America is voluntarily recalling 3,521 cases of Light& Fit ® Greek Crunch Nonfat Yogurt& Toppings S 'Mores Flavor sold in the United States with an expiration date of December 30, 2018 and UPC of 36632 03825. It was discovered that some of the toppers sold on the product contain peanuts and are improperly labeled. People who have an allergy to peanuts run the risk of serious or life-threatening allergic reaction if they consume this product. (Source: Food and Drug Administration)
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Generic drugmaker to sell alternative to EpiPen injectors
Generic drugmaker Sandoz to sell prefilled syringe alternative to EpiPen emergency allergy medication (Source: ABC News: Health)
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Generic drugmaker to sell alternative to EpiPen injectors
Generic drugmaker Sandoz to sell prefilled syringe alternative to EpiPen emergency allergy medication (Source: ABC News: Health)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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Danone North America Issues Allergy Alert and Recall for Light & Fit Greek Crunch S ’mores Flavor
Danone North America is voluntarily recalling 3,521 cases of Light& Fit ® Greek Crunch Nonfat Yogurt& Toppings S 'Mores Flavor sold in the United States with an expiration date of December 30, 2018 and UPC of 36632 03825. It was discovered that some of the toppers sold on the product contain peanuts and are improperly labeled. People who have an allergy to peanuts run the risk of serious or life-threatening allergic reaction if they consume this product. (Source: Food and Drug Administration)
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Iredell doctors blast state for cancer response | News - Mooresville Tribune
Iredell doctors blast state for cancer response | News Mooresville Tribune
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Michelle Ong has lived in the Lake Norman area for more than two decades, but it wasn't until she traveled to an international medical conference hundreds of ...
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Medical advances could soon spare patients surgery, say experts - The Guardian
Thousands of people every year could be spared surgery for cancer and worn-out joints thanks to better drugs, vaccination and advances in genomics, a report ...
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Medical advances could soon spare patients surgery, say experts - The Guardian
Thousands of people every year could be spared surgery for cancer and worn-out joints thanks to better drugs, vaccination and advances in genomics, a report ...
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Iredell doctors blast state for cancer response | News - Mooresville Tribune
Iredell doctors blast state for cancer response | News Mooresville Tribune
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Michelle Ong has lived in the Lake Norman area for more than two decades, but it wasn't until she traveled to an international medical conference hundreds of ...
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Super 16: Surging Sabres reach top five - NHL.com
Super 16: Surging Sabres reach top five NHL.com
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A 10-game winning streak is enough to vault the Buffalo Sabres to No. 4 in the Super 16 power rankings this week, but there are clearly some skeptics among ...
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Copper(I)–polymers and their photoluminescence thermochromism properties
Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00474A, Paper
DOI: 10.1039/C8PP00474A, Paper
Rong-Yan Wang, Xiao Zhang, Jie-Hui Yu, Ji-Qing Xu
The structures of four organic base-based copper(I)–polymers were reported, and the effect of rigidity/flexibility of the organic base on their fluorescence thermochromism properties was investigated.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
The structures of four organic base-based copper(I)–polymers were reported, and the effect of rigidity/flexibility of the organic base on their fluorescence thermochromism properties was investigated.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
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WWE Survivor Series: Smackdown megastar pays touching tribute to Roman Reigns - Express
JIMMY USO paid tribute to his cousin Roman Reigns shortly before he picked up Smackdown's first win at Survivor Series.
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Copper(I)–polymers and their photoluminescence thermochromism properties
Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00474A, Paper
DOI: 10.1039/C8PP00474A, Paper
Rong-Yan Wang, Xiao Zhang, Jie-Hui Yu, Ji-Qing Xu
The structures of four organic base-based copper(I)–polymers were reported, and the effect of rigidity/flexibility of the organic base on their fluorescence thermochromism properties was investigated.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
The structures of four organic base-based copper(I)–polymers were reported, and the effect of rigidity/flexibility of the organic base on their fluorescence thermochromism properties was investigated.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry
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Super 16: Surging Sabres reach top five - NHL.com
Super 16: Surging Sabres reach top five NHL.com
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A 10-game winning streak is enough to vault the Buffalo Sabres to No. 4 in the Super 16 power rankings this week, but there are clearly some skeptics among ...
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Annual incidence of head and neck cancers worldwide more than 550,000 cases - United News of India
Annual incidence of head and neck cancers worldwide more than 550,000 cases United News of India
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Kolkata, Dec 3 (UNI) The annual incidence of head and neck cancers worldwide is more than 550,000 cases with around 300,000 deaths each year. Male to ...
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WWE Survivor Series: Smackdown megastar pays touching tribute to Roman Reigns - Express
JIMMY USO paid tribute to his cousin Roman Reigns shortly before he picked up Smackdown's first win at Survivor Series.
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Burpees helping students find path to success - WKBW-TV
A burpee is an exercise that many dread doing at the gym-- and that is the exact reason why Giovanni Mion has taken on the challenge to do as many burpees ...
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Head And Neck Cancer (HNC) Market Analysis, Therapeutic Reviews and Survey Report 2016-2027 - Forest Fire News
Head And Neck Cancer (HNC) Market Analysis, Therapeutic Reviews and Survey Report 2016-2027 Forest Fire News
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Head And Neck Cancer (HNC) – Market Insights, Epidemiology and Market Forecast 2027 report provides the detailed overview of the disease and in depth ...
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Burpees helping students find path to success - WKBW-TV
A burpee is an exercise that many dread doing at the gym-- and that is the exact reason why Giovanni Mion has taken on the challenge to do as many burpees ...
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Head And Neck Cancer (HNC) Market Analysis, Therapeutic Reviews and Survey Report 2016-2027 - Forest Fire News
Head And Neck Cancer (HNC) Market Analysis, Therapeutic Reviews and Survey Report 2016-2027 Forest Fire News
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Head And Neck Cancer (HNC) – Market Insights, Epidemiology and Market Forecast 2027 report provides the detailed overview of the disease and in depth ...
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Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis [INTERVENTIONAL]
BACKGROUND:
Y-stent-assisted coiling for wide-neck intracranial aneurysms required further investigation.
PURPOSE:Our aim was to analyze outcomes after Y-stent placement in wide-neck aneurysms.
DATA SOURCES:We performed a systematic search of 3 data bases for studies published from 2000 to 2018.
STUDY SELECTION:According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we included studies reporting Y-stent-assisted coiling of wide-neck aneurysms.
DATA ANALYSIS:Random-effects meta-analysis was used to pool the following: aneurysm occlusion rate, complications, and factors influencing the studied outcomes.
DATA SYNTHESIS:We included 27 studies and 750 aneurysms treated with Y-stent placement. The immediate complete/near-complete occlusion rate was 82.2% (352/468; 95% CI, 71.4%–93%; I2 = 92%), whereas the long-term complete/near-complete occlusion rate was 95.4% (564/598; 95% CI, 93.7%–97%; I2 = 0%) (mean radiologic follow-up of 14 months). The aneurysm recanalization rate was 3% (20/496; 95% CI, 1.5%–4.5%; I2 = 0%), and half of the recanalized aneurysms required retreatment. The treatment-related complication rate was 8.9% (63/614; 95% CI, 5.8%–12.1%; I2 = 44%). Morbidity and mortality after treatment were 2.4% (18/540; 95% CI, 1.2%–3.7%; I2 = 0%) and 1.1% (5/668; 95% CI, 0.3%–1.9%; I2 = 0%), respectively. Crossing Y-stent placement was associated with a slightly lower complication rate compared with the kissing configuration (56/572 = 8.4%; 95% CI, 5%–11%; I2 = 46% versus 4/30 = 12.7%; 95% CI, 3%–24%; I2 = 0%). Occlusion rates were quite comparable among Enterprise, Neuroform, and LVIS stents, whereas the Enterprise stent was associated with lower rates of complications (8/89 = 6.5%; 95% CI, 1.6%–11%; I2 = 0%) compared with the others (20/131 = 14%; 95% CI, 5%–26%; I2 = 69% and 9/64 = 11%; 95% CI, 3%–20%; I2 = 18%).
LIMITATIONS:This was a small, retrospective series.
CONCLUSIONS:Y-stent-assisted coiling yields high rates of long-term angiographic occlusion, with a relatively low rate of treatment-related complications. Y-stent placement with a crossing configuration appears to be associated with better outcomes. Although Y-configuration can be obtained using many types of stents with comparable occlusion rates, the Enterprise stent is associated with lower complication rates.
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Solitary Parathyroid Adenoma Localization in Technetium Tc99m Sestamibi SPECT CT and Multiphase Multidetector 4D CT [HEAD & NECK]
BACKGROUND AND PURPOSE:
Minimally invasive parathyroid surgery relies critically on image guidance, but data comparing the efficacy of various imaging modalities are scarce. Our aim was to perform a blinded comparison of the localizing capability of technetium Tc99m sestamibi SPECT, multiphase multidetector 4D CT, and the combination of these 2 modalities (technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT).
MATERIALS AND METHODS:We reviewed the records of 31 (6 men, 25 women; median age, 56 years) consecutive patients diagnosed with biochemically confirmed primary hyperparathyroidism between November 2009 and March 2010 who underwent preoperative technetium Tc99m sestamibi SPECT and multiphase multidetector 4D CT performed on the same scanner with pathologic confirmation by resection of a single parathyroid adenoma. Accuracy was determined separately for localization to the correct side and quadrant using surgical localization as the standard of reference.
RESULTS:Surgical resection identified 14 left and 17 right parathyroid adenomas and 2 left inferior, 12 left superior, 11 right inferior, and 6 right superior parathyroid adenomas. For left/right localization, technetium Tc99m sestamibi SPECT achieved an accuracy of 93.5% (29 of 31), multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31). For quadrant localization, technetium Tc99m sestamibi SPECT accuracy was 67.7% (21 of 31), multiphase multidetector 4D CT accuracy was 87.1% (27 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT accuracy was 93.5% (29 of 31). Reader diagnostic confidence was consistently ranked lowest for technetium Tc99m sestamibi SPECT and highest for technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT.
CONCLUSIONS:For left/right localization of parathyroid adenomas, all modalities performed equivalently. For quadrant localization, technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT is superior to technetium Tc99m sestamibi SPECT.
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Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients [SPINE]
BACKGROUND AND PURPOSE:
Spinal epidural arteriovenous fistulas are rare vascular malformations. We present 13 patients with spinal epidural arteriovenous fistulas, noting the various presenting symptom patterns, imaging findings related to bone involvement, and outcomes.
MATERIALS AND METHODS:Among 111 patients with spinal vascular malformations in the institutional data base from 1993 to 2017, thirteen patients (11.7%) had spinal epidural arteriovenous fistulas. We evaluated presenting symptoms and imaging findings, including bone involvement and mode of treatment. To assess the treatment outcome, we compared initial and follow-up clinical status using the modified Aminoff and Logue Scale of Disability and the modified Rankin Scale.
RESULTS:The presenting symptoms were lower back pain (n = 2), radiculopathy (n = 5), and myelopathy (n = 7). There is overlap of symptoms in 1 patient (No. 11). Distribution of spinal epidural arteriovenous fistulas was cervical (n = 3), thoracic (n = 2), lumbar (n = 6), and sacral (n = 2). Intradural venous reflux was identified in 7 patients with congestive venous myelopathy. The fistulas were successfully treated in all patients who underwent treatment (endovascular embolization, n = 10; operation, n = 1) except 2 patients who refused treatment due to tolerable symptoms. Transarterial glue (n = 7) was used in nonosseous types; and transvenous coils (n = 3), in osseous type. After 19 months of median follow-up, the patients showed symptom improvement after treatment.
CONCLUSIONS:Although presenting symptoms were diverse, myelopathy caused by intradural venous reflux was the main target of treatment. Endovascular treatment was considered via an arterial approach in nonosseous types and via a venous approach in osseous types.
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Understanding Subdural Collections in Pediatric Abusive Head Trauma [REVIEW ARTICLE]
SUMMARY:
Life-threatening physical abuse of infants and toddlers is frequently correlated with head injuries. A common variant of the abusive head trauma is the shaken baby syndrome. The present review article sheds light on subdural collections in children with abusive head trauma and aims at providing a recent knowledge base for various medical disciplines involved in diagnostic procedures and legal proceedings. To this end, the different subdural collection entities are presented and illustrated. The pathophysiologic background is explained. Differential and age-diagnostic aspects are discussed and summarized by tabular and graphic overviews. Two problematic constellations frequently occurring during initial CT investigations are evaluated: A mixed-density subdural collection does not prove repeated trauma, and hypodense subdural collections are not synonymous with chronicity. The neuroradiologic analysis and assessment of subdural collections may decisively contribute to answering differential diagnostic and forensic questions. In addition to more reference data, a harmonization of terminology and methodology is urgently needed, especially with respect to age-diagnostic aspects.
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Compressed Sensing-Sensitivity Encoding (CS-SENSE) Accelerated Brain Imaging: Reduced Scan Time without Reduced Image Quality [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Compressed sensing–sensitivity encoding is a promising MR imaging acceleration technique. This study compares the image quality of compressed sensing–sensitivity encoding accelerated imaging with conventional MR imaging sequences.
MATERIALS AND METHODS:Patients with known, treated, or suspected brain tumors underwent compressed sensing–sensitivity encoding accelerated 3D T1-echo-spoiled gradient echo or 3D T2-FLAIR sequences in addition to the corresponding conventional acquisition as part of their clinical brain MR imaging. Two neuroradiologists blinded to sequence and patient information independently evaluated both the accelerated and corresponding conventional acquisitions. The sequences were evaluated on 4- or 5-point Likert scales for overall image quality, SNR, extent/severity of artifacts, and gray-white junction and lesion boundary sharpness. SNR and contrast-to-noise ratio values were compared.
RESULTS:Sixty-six patients were included in the study. For T1-echo-spoiled gradient echo, image quality in all 5 metrics was slightly better for compressed sensing–sensitivity encoding than conventional images on average, though it was not statistically significant, and the lower bounds of the 95% confidence intervals indicated that compressed sensing–sensitivity encoding image quality was within 10% of conventional imaging. For T2-FLAIR, image quality of the compressed sensing–sensitivity encoding images was within 10% of the conventional images on average for 3 of 5 metrics. The compressed sensing–sensitivity encoding images had somewhat more artifacts (P = .068) and less gray-white matter sharpness (P = .36) than the conventional images, though neither difference was significant. There was no significant difference in the SNR and contrast-to-noise ratio. There was 25% and 35% scan-time reduction with compressed sensing–sensitivity encoding for FLAIR and echo-spoiled gradient echo sequences, respectively.
CONCLUSIONS:Compressed sensing–sensitivity encoding accelerated 3D T1-echo-spoiled gradient echo and T2-FLAIR sequences of the brain show image quality similar to that of standard acquisitions with reduced scan time. Compressed sensing–sensitivity encoding may reduce scan time without sacrificing image quality.
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Absence of Disproportionately Enlarged Subarachnoid Space Hydrocephalus, a Sharp Callosal Angle, or Other Morphologic MRI Markers Should Not Be Used to Exclude Patients with Idiopathic Normal Pressure Hydrocephalus from Shunt Surgery [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Several studies have evaluated the use of MR imaging markers for the prediction of outcome after shunt surgery in idiopathic normal pressure hydrocephalus with conflicting results. Our aim was to investigate the predictive value of a number of earlier proposed morphologic MR imaging markers in a large group of patients with idiopathic normal pressure hydrocephalus.
MATERIALS AND METHODS:One hundred sixty-eight patients (mean age, 70 ± 9.3 years) with idiopathic normal pressure hydrocephalus, subjected to standardized quantification of clinical symptoms before and after shunt surgery, were included in the study. Outcome was calculated using a composite score. Preoperative T1, FLAIR, and flow-sensitive images were analyzed regarding the presence of 13 different morphologic MR imaging markers.
RESULTS:The median Evans index was 0.41 (interquartile range, 0.37–0.44). All patients had an aqueductal flow void sign present and white matter hyperintensities. The median callosal angle was 68.8° (interquartile range, 57.7°–80.8°). Dilated Sylvian fissures were found in 69%; focally dilated sulci, in 25%; and widening of the interhemispheric fissure, in 55%. Obliteration of the sulci at the convexity was found in 36%, and 36% of patients were characterized as having disproportionately enlarged subarachnoid space hydrocephalus. Sixty-eight percent of patients improved after surgery. None of the investigated MR imaging markers were significant predictors of improvement after shunt surgery.
CONCLUSIONS:Disproportionately enlarged subarachnoid space hydrocephalus, a small callosal angle, and the other MR imaging markers evaluated in this study should not be used to exclude patients from shunt surgery. These markers, though they may be indicative of idiopathic normal pressure hydrocephalus, do not seem to be a part of the mechanisms connected to the reversibility of the syndrome.
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MR Imaging-Based Radiomic Signatures of Distinct Molecular Subgroups of Medulloblastoma [FUNCTIONAL]
BACKGROUND AND PURPOSE:
Distinct molecular subgroups of pediatric medulloblastoma confer important differences in prognosis and therapy. Currently, tissue sampling is the only method to obtain information for classification. Our goal was to develop and validate radiomic and machine learning approaches for predicting molecular subgroups of pediatric medulloblastoma.
MATERIALS AND METHODS:In this multi-institutional retrospective study, we evaluated MR imaging datasets of 109 pediatric patients with medulloblastoma from 3 children's hospitals from January 2001 to January 2014. A computational framework was developed to extract MR imaging–based radiomic features from tumor segmentations, and we tested 2 predictive models: a double 10-fold cross-validation using a combined dataset consisting of all 3 patient cohorts and a 3-dataset cross-validation, in which training was performed on 2 cohorts and testing was performed on the third independent cohort. We used the Wilcoxon rank sum test for feature selection with assessment of area under the receiver operating characteristic curve to evaluate model performance.
RESULTS:Of 590 MR imaging–derived radiomic features, including intensity-based histograms, tumor edge-sharpness, Gabor features, and local area integral invariant features, extracted from imaging-derived tumor segmentations, tumor edge-sharpness was most useful for predicting sonic hedgehog and group 4 tumors. Receiver operating characteristic analysis revealed superior performance of the double 10-fold cross-validation model for predicting sonic hedgehog, group 3, and group 4 tumors when using combined T1- and T2-weighted images (area under the curve = 0.79, 0.70, and 0.83, respectively). With the independent 3-dataset cross-validation strategy, select radiomic features were predictive of sonic hedgehog (area under the curve = 0.70–0.73) and group 4 (area under the curve = 0.76–0.80) medulloblastoma.
CONCLUSIONS:This study provides proof-of-concept results for the application of radiomic and machine learning approaches to a multi-institutional dataset for the prediction of medulloblastoma subgroups.
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Disproportionate International Contributions to Subspecialties of Neuroradiology in the American Journal of Neuroradiology [LETTERS]
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