An international comparison of diagnostic and management strategies for vestibular schwannoma

Abstract

Objective

To compare international diagnostic and management strategies for vestibular schwannoma (VS).

Methods

A web-based questionnaire was sent to 130 otolaryngologists, mainly identified through the European Skull Base Society. It contained questions on general information including guideline usage as well as questions on diagnosis (focussing on selection of patients for MRI) and management of VS, including case scenarios. Descriptive statistics were reported.

Results

Thirty-six otolaryngologists working in 11 different countries completed the questionnaire (response rate: 28%). Guidelines for diagnosis and management of VS are used by 44% and 42% of respondents, respectively. In the diagnostic strategy for VS, different types and combinations of audiovestibular function tests are used when deciding whether a patient should undergo an MRI. Respondents apply 18 different definitions of asymmetrical hearing loss. Variation was also apparent from reported considerations on management of VS. Most respondents (84%) prefer a wait-and-scan strategy in case of a small intrameatal VS (Koos 1). Variety in management strategies increases for patients with a medium to large sized VS (Koos 2, 3 and 4). The details of each management strategy (wait-and-scan, microsurgery, stereotactic radiosurgery and fractionated radiotherapy) also differ among respondents.

Conclusions

A large variation in diagnostic and management strategies for VS was identified between respondents. More evidence and/or consensus seem warranted to reduce uncertainties for patients, and differences in outcome and costs that might result from the variety of strategies currently being applied.

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An international comparison of diagnostic and management strategies for vestibular schwannoma

Abstract

Objective

To compare international diagnostic and management strategies for vestibular schwannoma (VS).

Methods

A web-based questionnaire was sent to 130 otolaryngologists, mainly identified through the European Skull Base Society. It contained questions on general information including guideline usage as well as questions on diagnosis (focussing on selection of patients for MRI) and management of VS, including case scenarios. Descriptive statistics were reported.

Results

Thirty-six otolaryngologists working in 11 different countries completed the questionnaire (response rate: 28%). Guidelines for diagnosis and management of VS are used by 44% and 42% of respondents, respectively. In the diagnostic strategy for VS, different types and combinations of audiovestibular function tests are used when deciding whether a patient should undergo an MRI. Respondents apply 18 different definitions of asymmetrical hearing loss. Variation was also apparent from reported considerations on management of VS. Most respondents (84%) prefer a wait-and-scan strategy in case of a small intrameatal VS (Koos 1). Variety in management strategies increases for patients with a medium to large sized VS (Koos 2, 3 and 4). The details of each management strategy (wait-and-scan, microsurgery, stereotactic radiosurgery and fractionated radiotherapy) also differ among respondents.

Conclusions

A large variation in diagnostic and management strategies for VS was identified between respondents. More evidence and/or consensus seem warranted to reduce uncertainties for patients, and differences in outcome and costs that might result from the variety of strategies currently being applied.

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Schistosoma mansoni Infection-Induced Transcriptional Changes in Hepatic Macrophage Metabolism Correlate With an Athero-Protective Phenotype

Diana Cortes-Selva, Andrew F. Elvington, Andrew Ready, Bartek Rajwa, Edward J. Pearce, Gwendalyn J. Randolph, Keke C. Fairfax (Source: Frontiers in Immunology)

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Advances in Designing and Developing Vaccines, Drugs and Therapeutic Approaches to Counter Human Papilloma Virus

Maryam Dadar, Sandip Chakraborty, Kuldeep Dhama, Minakshi Prasad, Rekha Khandia, Sameer Hassan, Ashok Munjal, Ruchi Tiwari, Kumaragurubaran Karthik, Deepak Kumar, Hafiz M. N. Iqbal, Wanpen Chaicumpa (Source: Frontiers in Immunology)

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Natural Killer Cells Adapt to Cytomegalovirus Along a Functionally Static Phenotypic Spectrum in Human Immunodeficiency Virus Infection

Kayla A. Holder, Julie Lajoie, Michael D. Grant (Source: Frontiers in Immunology)

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Single-Cell Transcriptomics in Cancer Immunobiology: The Future of Precision Oncology

Fatima Valdes-Mora, Kristina Handler, Andrew M. K. Law, Robert Salomon, Samantha R. Oakes, Christopher J. Ormandy, David Gallego-Ortega (Source: Frontiers in Immunology)

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Extracellular Vesicles in Joint Disease and Therapy

Janneke Boere, Jos Malda, Chris H. A. van de Lest, P. Ren é van Weeren, Marca H. M. Wauben (Source: Frontiers in Immunology)

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Crispr/Cas Mediated Deletion of PTPN22 in Jurkat T Cells Enhances TCR Signaling and Production of IL-2

Cara Bray, David Wright, Sonja Haupt, Sharyn Thomas, Hans Stauss, Rose Zamoyska (Source: Frontiers in Immunology)

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In vitro and in vivo Effects of Lactate on Metabolism and Cytokine Production of Human Primary PBMCs and Monocytes

Jacqueline M. Ratter, Hanne M. M. Rooijackers, Guido J. Hooiveld, Anneke G. M. Hijmans, Bastiaan E. de Galan, Cees J. Tack, Rinke Stienstra (Source: Frontiers in Immunology)

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Inflammasome-Independent Role of NLRP3 Mediates Mitochondrial Regulation in Renal Injury

Su-Mi Kim, Yang Gyun Kim, Dong-Jin Kim, Seon Hwa Park, Kyung-Hwan Jeong, Yu Ho Lee, Sung Jig Lim, Sang-Ho Lee, Ju-Young Moon (Source: Frontiers in Immunology)

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Immunoproteomics and Surfaceomics of the Adult Tapeworm Hymenolepis diminuta

Daniel M łocicki, Anna Sulima, Justyna Bień, Anu Näreaho, Anna Zawistowska-Deniziak, Katarzyna Basałaj, Rusłan Sałamatin, David Bruce Conn, Kirsi Savijoki (Source: Frontiers in Immunology)

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Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

ConclusionsHealth services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact. (Source: World Allergy Organization Journal)

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Schistosoma mansoni Infection-Induced Transcriptional Changes in Hepatic Macrophage Metabolism Correlate With an Athero-Protective Phenotype

Diana Cortes-Selva, Andrew F. Elvington, Andrew Ready, Bartek Rajwa, Edward J. Pearce, Gwendalyn J. Randolph, Keke C. Fairfax (Source: Frontiers in Immunology)

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Advances in Designing and Developing Vaccines, Drugs and Therapeutic Approaches to Counter Human Papilloma Virus

Maryam Dadar, Sandip Chakraborty, Kuldeep Dhama, Minakshi Prasad, Rekha Khandia, Sameer Hassan, Ashok Munjal, Ruchi Tiwari, Kumaragurubaran Karthik, Deepak Kumar, Hafiz M. N. Iqbal, Wanpen Chaicumpa (Source: Frontiers in Immunology)

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Natural Killer Cells Adapt to Cytomegalovirus Along a Functionally Static Phenotypic Spectrum in Human Immunodeficiency Virus Infection

Kayla A. Holder, Julie Lajoie, Michael D. Grant (Source: Frontiers in Immunology)

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Single-Cell Transcriptomics in Cancer Immunobiology: The Future of Precision Oncology

Fatima Valdes-Mora, Kristina Handler, Andrew M. K. Law, Robert Salomon, Samantha R. Oakes, Christopher J. Ormandy, David Gallego-Ortega (Source: Frontiers in Immunology)

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Extracellular Vesicles in Joint Disease and Therapy

Janneke Boere, Jos Malda, Chris H. A. van de Lest, P. Ren é van Weeren, Marca H. M. Wauben (Source: Frontiers in Immunology)

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Crispr/Cas Mediated Deletion of PTPN22 in Jurkat T Cells Enhances TCR Signaling and Production of IL-2

Cara Bray, David Wright, Sonja Haupt, Sharyn Thomas, Hans Stauss, Rose Zamoyska (Source: Frontiers in Immunology)

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In vitro and in vivo Effects of Lactate on Metabolism and Cytokine Production of Human Primary PBMCs and Monocytes

Jacqueline M. Ratter, Hanne M. M. Rooijackers, Guido J. Hooiveld, Anneke G. M. Hijmans, Bastiaan E. de Galan, Cees J. Tack, Rinke Stienstra (Source: Frontiers in Immunology)

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Inflammasome-Independent Role of NLRP3 Mediates Mitochondrial Regulation in Renal Injury

Su-Mi Kim, Yang Gyun Kim, Dong-Jin Kim, Seon Hwa Park, Kyung-Hwan Jeong, Yu Ho Lee, Sung Jig Lim, Sang-Ho Lee, Ju-Young Moon (Source: Frontiers in Immunology)

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Immunoproteomics and Surfaceomics of the Adult Tapeworm Hymenolepis diminuta

Daniel M łocicki, Anna Sulima, Justyna Bień, Anu Näreaho, Anna Zawistowska-Deniziak, Katarzyna Basałaj, Rusłan Sałamatin, David Bruce Conn, Kirsi Savijoki (Source: Frontiers in Immunology)

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Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

ConclusionsHealth services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact. (Source: World Allergy Organization Journal)

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Diagnosis of osteoporotic vertebral fractures in children

Abstract

Osteoporosis is a generalised disorder of the skeleton with reduced bone density and abnormal bone architecture. It increases bone fragility and renders the individual susceptible to fractures. Fractures of the vertebrae are common osteoporotic fractures. Vertebral fractures may result in scoliosis or kyphosis and, because they may be clinically silent, it is imperative that vertebral fractures are diagnosed in children accurately and at an early stage, so the necessary medical care can be implemented. Traditionally, diagnosis of osteoporotic vertebral fractures has been from lateral spine radiographs; however, a small number of studies have shown that dual energy x-ray absorptiometry is comparable to radiographs for identifying vertebral fractures in children, while allowing reduced radiation exposure. The diagnosis of vertebral fractures from dual energy x-ray absorptiometry is termed vertebral fracture assessment. Existing scoring systems for vertebral fracture assessment in adults have been assessed for use in children, but there is no standardisation and observer reliability is variable. This literature review suggests the need for a semiautomated tool that (compared to the subjective and semiquantitative methods available) will allow more reliable and precise detection of vertebral fractures in children.

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Diagnosis of osteoporotic vertebral fractures in children

Abstract

Osteoporosis is a generalised disorder of the skeleton with reduced bone density and abnormal bone architecture. It increases bone fragility and renders the individual susceptible to fractures. Fractures of the vertebrae are common osteoporotic fractures. Vertebral fractures may result in scoliosis or kyphosis and, because they may be clinically silent, it is imperative that vertebral fractures are diagnosed in children accurately and at an early stage, so the necessary medical care can be implemented. Traditionally, diagnosis of osteoporotic vertebral fractures has been from lateral spine radiographs; however, a small number of studies have shown that dual energy x-ray absorptiometry is comparable to radiographs for identifying vertebral fractures in children, while allowing reduced radiation exposure. The diagnosis of vertebral fractures from dual energy x-ray absorptiometry is termed vertebral fracture assessment. Existing scoring systems for vertebral fracture assessment in adults have been assessed for use in children, but there is no standardisation and observer reliability is variable. This literature review suggests the need for a semiautomated tool that (compared to the subjective and semiquantitative methods available) will allow more reliable and precise detection of vertebral fractures in children.

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Cancer Biology: a Primer for Perioperative Clinicians

Abstract

Purpose of Review

Cancer biology is a field that has grown exponentially in the last several decades. Elucidating the mechanisms involved in tumor development, while broadening our understanding, continues to reveal unexplained phenomena. Attempting to understand cancer biology requires a framework from which to start; two landmark reviews from 2000 and 2011 by Hanahan and Weinberg present such a framework. With advances in cancer therapeutics, an appreciation of the underlying tumor biology is necessary to optimally care for patients in the perioperative period.

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Cancer Biology: a Primer for Perioperative Clinicians

Abstract

Purpose of Review

Cancer biology is a field that has grown exponentially in the last several decades. Elucidating the mechanisms involved in tumor development, while broadening our understanding, continues to reveal unexplained phenomena. Attempting to understand cancer biology requires a framework from which to start; two landmark reviews from 2000 and 2011 by Hanahan and Weinberg present such a framework. With advances in cancer therapeutics, an appreciation of the underlying tumor biology is necessary to optimally care for patients in the perioperative period.

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Probiotics as treatment for food allergies among pediatric patients: a meta-analysis

ConclusionAnalysis of available evidence shows moderate certainty that the use of probiotics can relieve symptoms of children with cow 's milk allergy. The reduction in certainty is due to imprecise results. Moreover, there is low certainty that probiotics can induce tolerance among children with cow's milk allergy, due to problems of imprecision and attrition bias. In the subgroup analysis,Lactobacillus rhamnosus GG administration likely results in inducing tolerance among infants with suspected cow 's milk allergy. Only studies on CMA were analyzed since no studies were found on probiotics as treatment for other types of food allergy among children. (Source: World Allergy Organization Journal)

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Probiotics as treatment for food allergies among pediatric patients: a meta-analysis

ConclusionAnalysis of available evidence shows moderate certainty that the use of probiotics can relieve symptoms of children with cow 's milk allergy. The reduction in certainty is due to imprecise results. Moreover, there is low certainty that probiotics can induce tolerance among children with cow's milk allergy, due to problems of imprecision and attrition bias. In the subgroup analysis,Lactobacillus rhamnosus GG administration likely results in inducing tolerance among infants with suspected cow 's milk allergy. Only studies on CMA were analyzed since no studies were found on probiotics as treatment for other types of food allergy among children. (Source: World Allergy Organization Journal)

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SOCS3 as a future target to treat metabolic disorders.

Authors: Pedroso JAB, Ramos-Lobo AM, Donato J Abstract The suppressors of cytokine signaling (SOCS) are a group of eight proteins responsible for preventing excessive cytokine signaling. Among this protein family, SOCS3 has received special attention. SOCS3 expression is important to control certain allergy autoimmune diseases. Furthermore, SOCS3 expression is elevated in obesity and it is involved in the inhibition of leptin and insulin signaling, two important hormones involved in the control of energy metabolism. Therefore, increased SOCS3 expression in obese individuals is associated with several metabolic disorders, including reduced energy expenditure, increased food intake and adiposity, and insulin and leptin resistance. In addition, recent studies found that SOCS3 expressi...

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SOCS3 as a future target to treat metabolic disorders.

Authors: Pedroso JAB, Ramos-Lobo AM, Donato J Abstract The suppressors of cytokine signaling (SOCS) are a group of eight proteins responsible for preventing excessive cytokine signaling. Among this protein family, SOCS3 has received special attention. SOCS3 expression is important to control certain allergy autoimmune diseases. Furthermore, SOCS3 expression is elevated in obesity and it is involved in the inhibition of leptin and insulin signaling, two important hormones involved in the control of energy metabolism. Therefore, increased SOCS3 expression in obese individuals is associated with several metabolic disorders, including reduced energy expenditure, increased food intake and adiposity, and insulin and leptin resistance. In addition, recent studies found that SOCS3 expressi...

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An application of reflectance spectroscopy to differentiate of entomopathogenic fungi species

Publication date: Available online 10 November 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Jan Piekarczyk, Henryk Ratajkiewicz, Jarosław Jasiewicz, Danuta Sosnowska, Andrzej WójtowiczAbstractFourier Transform Infrared Spectroscopy (FTIR) methods are the most commonly used spectroscopic techniques for differentiation of fungi species, however reflectance spectroscopy as a non-invasive technique can also be used. The aim of the study was to develop a method to rapidly differentiate fungi by means of reflectance spectroscopy using visible-infrared spectrum. Spectral measurements were conducted on six entomopathogenic fungi: Beauveria bassiana, Isaria fumosorosea, I. farinosa, I. tenuipes, Lecanicillium lecanii, L. muscarium cultured on Petri-dishes. The Field...

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Noun –verb naming dissociation in neurosurgical patients

. (Source: Aphasiology)

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An application of reflectance spectroscopy to differentiate of entomopathogenic fungi species

Publication date: Available online 10 November 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Jan Piekarczyk, Henryk Ratajkiewicz, Jarosław Jasiewicz, Danuta Sosnowska, Andrzej WójtowiczAbstractFourier Transform Infrared Spectroscopy (FTIR) methods are the most commonly used spectroscopic techniques for differentiation of fungi species, however reflectance spectroscopy as a non-invasive technique can also be used. The aim of the study was to develop a method to rapidly differentiate fungi by means of reflectance spectroscopy using visible-infrared spectrum. Spectral measurements were conducted on six entomopathogenic fungi: Beauveria bassiana, Isaria fumosorosea, I. farinosa, I. tenuipes, Lecanicillium lecanii, L. muscarium cultured on Petri-dishes. The Field...

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Noun –verb naming dissociation in neurosurgical patients

. (Source: Aphasiology)

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Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Abstract

Background

Asthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia.

Methods

This study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics.

Results

A total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134), $482 (1506), $1061 (1983), $2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%).

Conclusions

Health services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact.

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Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Abstract

Background

Asthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia.

Methods

This study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics.

Results

A total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134), $482 (1506), $1061 (1983), $2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%).

Conclusions

Health services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact.

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Genetic Tests Help Patients Avoid Unneeded Thyroid Surgery

Genetic Tests Help Patients Avoid Unneeded Thyroid Surgery  NorthcentralPa.comFull coverage

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Genetic Tests Help Patients Avoid Unneeded Thyroid Surgery

Genetic Tests Help Patients Avoid Unneeded Thyroid Surgery  NorthcentralPa.comFull coverage

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Skin xenotransplantation: Historical review and clinical potential

Publication date: November 2018Source: Burns, Volume 44, Issue 7Author(s): Takayuki Yamamoto, Hayato Iwase, Timothy W. King, Hidetaka Hara, David K.C. CooperAbstractHalf a million patients in the USA alone require treatment for burns annually. Following an extensive burn, it may not be possible to provide sufficient autografts in a single setting. Pig skin xenografts may provide temporary coverage. However, preformed xenoreactive antibodies in the human recipient activate complement, and thus result in rapid rejection of the graft. Because burn patients usually have some degree of immune dysfunction and are therefore at increased risk of infection, immunosuppressive therapy is undesirable. Genetic engineering of the pig has increased the survival of pig heart, kidney, islet, and corneal gr...

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Skin xenotransplantation: Historical review and clinical potential

Publication date: November 2018Source: Burns, Volume 44, Issue 7Author(s): Takayuki Yamamoto, Hayato Iwase, Timothy W. King, Hidetaka Hara, David K.C. CooperAbstractHalf a million patients in the USA alone require treatment for burns annually. Following an extensive burn, it may not be possible to provide sufficient autografts in a single setting. Pig skin xenografts may provide temporary coverage. However, preformed xenoreactive antibodies in the human recipient activate complement, and thus result in rapid rejection of the graft. Because burn patients usually have some degree of immune dysfunction and are therefore at increased risk of infection, immunosuppressive therapy is undesirable. Genetic engineering of the pig has increased the survival of pig heart, kidney, islet, and corneal gr...

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Association between asthma and depression: A National Cohort Study

ConclusionA bidirectional association between asthma and depression was observed in this study. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Efficacy, safety, and quality of life in a multi-center, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in peanut allergic children

We examined the efficacy, safety, immunological parameters, quality of life (QoL) and burden of treatment (BoT) of low-dose peanut- OIT in a multicenter, double-blind, randomized placebo-controlled trial.Methods62 children aged 3-17 years with IgE-mediated, challenge-proven peanut allergy were randomized (1:1) to receive peanut-OIT with a maintenance dose of 125-250 mg peanut protein or placebo. The primary outcome was the proportion of children tolerating ≥300 mg peanut protein at oral food challenge (OFC) after 16 months of OIT. We measured occurrence of adverse events (AEs), immunological changes, QoL prior and post OIT and BoT during OIT.Results23/31 (74.2%) children of the active group tolerated at least 300 mg peanut protein at final OFC compared to 5 /31 (16.1%) in the placebo gro...

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Traffic ‐related air pollution induces non‐allergic eosinophilic airway inflammation and cough hypersensitivity in guinea pigs

Conclusions& Clinical RelevanceTRAP exposures induced cough hypersensitivity and non ‐allergic eosinophilic inflammation of airways in guinea pigs. This study highlights the potential mechanisms of eosinophilia‐related chronic cough that can be induced by traffic‐related air pollution.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Antihistamine ‐resistant chronic spontaneous urticaria: 1‐year data from the AWARE study

Conclusions& Clinical RelevanceThis study highlights a significant discrepancy between recommendations for managing CSU in international guidelines, and in real ‐world clinical practice in Germany.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Dividing neutrophils in subsets, reveals a significant role for activated neutrophils in the development of airway hyperreactivity

Conclusions& Clinical RelevanceThe present study introduces a new concept regarding the role of neutrophils and defines a novel direct link between a specific activated neutrophil subset and airway smooth muscle, establishing neutrophils as important players in the development of asthmatic airway hyperactivity.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Variability of blood eosinophils in patients in a clinic for severe asthma

ConclusionIn an urban clinic for patients referred for uncontrolled asthma, blood measures of eosinophils were variable and showed differing patterns of variability. These data reinforce the need to perform repeated eosinophil blood measures for appropriate designation for therapeutic intervention.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Association between asthma and depression: A National Cohort Study

ConclusionA bidirectional association between asthma and depression was observed in this study. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Efficacy, safety, and quality of life in a multi-center, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in peanut allergic children

We examined the efficacy, safety, immunological parameters, quality of life (QoL) and burden of treatment (BoT) of low-dose peanut- OIT in a multicenter, double-blind, randomized placebo-controlled trial.Methods62 children aged 3-17 years with IgE-mediated, challenge-proven peanut allergy were randomized (1:1) to receive peanut-OIT with a maintenance dose of 125-250 mg peanut protein or placebo. The primary outcome was the proportion of children tolerating ≥300 mg peanut protein at oral food challenge (OFC) after 16 months of OIT. We measured occurrence of adverse events (AEs), immunological changes, QoL prior and post OIT and BoT during OIT.Results23/31 (74.2%) children of the active group tolerated at least 300 mg peanut protein at final OFC compared to 5 /31 (16.1%) in the placebo gro...

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Traffic ‐related air pollution induces non‐allergic eosinophilic airway inflammation and cough hypersensitivity in guinea pigs

Conclusions& Clinical RelevanceTRAP exposures induced cough hypersensitivity and non ‐allergic eosinophilic inflammation of airways in guinea pigs. This study highlights the potential mechanisms of eosinophilia‐related chronic cough that can be induced by traffic‐related air pollution.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Antihistamine ‐resistant chronic spontaneous urticaria: 1‐year data from the AWARE study

Conclusions& Clinical RelevanceThis study highlights a significant discrepancy between recommendations for managing CSU in international guidelines, and in real ‐world clinical practice in Germany.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Dividing neutrophils in subsets, reveals a significant role for activated neutrophils in the development of airway hyperreactivity

Conclusions& Clinical RelevanceThe present study introduces a new concept regarding the role of neutrophils and defines a novel direct link between a specific activated neutrophil subset and airway smooth muscle, establishing neutrophils as important players in the development of asthmatic airway hyperactivity.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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Variability of blood eosinophils in patients in a clinic for severe asthma

ConclusionIn an urban clinic for patients referred for uncontrolled asthma, blood measures of eosinophils were variable and showed differing patterns of variability. These data reinforce the need to perform repeated eosinophil blood measures for appropriate designation for therapeutic intervention.This article is protected by copyright. All rights reserved. (Source: Clinical and Experimental Allergy)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DxrTf7

Immunomodulatory effects of antipsychotic treatment on gene expression in first-episode psychosis

In conclusion, risperidone possessed strong immunomodulatory properties affecting mainly innate immune response in FEP patients, whereas the observed effects of quetiapine and olanzapine were only marginal. Our results further emphasize the importance of understanding the immunomodulatory mechanisms of antipsychotic treatment, especially in terms of specific compounds, doses and duration of medication in patients with severe mental illness. Future studies should evaluate the response pre- and post-treatment, and the possible role of this inflammatory activation for the progression of psychiatric and metabolic symptoms. (Source: Journal of Psychiatric Research)

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Characterization and functional analysis of a novel gC1qR in the swimming crab Portunus trituberculatus

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Junhao Ning, Yuan Liu, Fengtao Gao, Hourong Liu, Zhaoxia CuiAbstractThe receptor for the globular head of complement component C1q, gC1qR, is a multifunctional and multiligand binding protein with a crucial role in host defense. In the present study, a full-length cDNA sequence of a gC1qR homolog (PtgC1qR) in Portunus trituberculatus was identified. PtgC1qR was a 268-amino-acid polypeptide with a conserved MAM33 domain and a mitochondrial targeting sequence in the first 56 amino acids. The transcripts of PtgC1qR were detected in all examined tissues with the highest level detected in the hepatopancreas. Compared with other early embryonic stages, PtgC1qR was highly expressed in the fertilized eggs and em...

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Oral yeast-based DNA vaccine confers effective protection from Aeromonas hydrophila infection on Carassius auratus

In conclusion, our work provided a framework for the further development of oral yeast-based fishery vaccines. (Source: Fish and Shellfish Immunology)

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Cloning, expression prolife, and immune characterization of a novel stat family member (stat5bl) in Chinese tongue sole (Cynoglossus semilaevis)

This study would enlarge our understanding of stat5bl in fish immunity. (Source: Fish and Shellfish Immunology)

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Influence of CD4-1+, CD4-2+ and CD8+ T lymphocytes subpopulations on the immune response of B lymphocytes in flounder (Paralichthys olivaceus) immunized with thymus-dependent or thymus-independent antigen

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Jing Xing, Keke Luo, Yue'e Xiao, Xiaoqian Tang, Wenbin ZhanAbstractIn order to elucidate the influence of T lymphocytes subpopulations on B lymphocytes immune response, in this paper, CD4-1+, CD4-2+, CD8+ T lymphocytes and B lymphocytes responses to thymus-independent (TI) or thymus-dependent (TD) antigen plus immunosuppressant were investigated in flounder (Paralichthys olivaceus). The results showed that in LPS-immunized group, the percentages of CD4-1+, CD4-2+, CD8β+ T (PCD4-1+ T, PCD4-2+ T and PCD8β+ T) lymphocytes in peripheral blood leucocytes (PBLs) had no significant variations, the percentages of IgM+ B (PIgM+ B) lymphocytes and LPS-specific antibodies (LA) significantly increased and peaked a...

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Adipose tissue contributes to hepatic pro-inflammatory response when dietary fish oil is replaced by vegetable oil in large yellow croaker (Larimichthys crocea): An ex vivo study

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Peng Tan, Xueshan Li, Xiaojun Xiang, Xiaojing Dong, Songlin Li, Kangsen Mai, Qinghui AiAbstractThe shortage of fish oil (FO) leads to the extensive use of vegetable oil (VO) in marine fish diets. High replacement percentage of dietary FO by VO induced pro-inflammatory response of adipose tissue (AT) and liver tissue (LT) in large yellow croaker (Larimichthys crocea). Mammalian studies showed that the secretion of cytokines by AT affected the immune response of LT. To investigate whether or not the inflammation response of LT is related to AT in large yellow croaker, LT and AT cells from fish fed FO diet (FOL and FOA) and VO diet (VOL and VOA) were co-cultured in a trans-well system, which resulted in an ...

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Replacement of fish meal with Bacillus pumillus SE5 and Pseudozyma aphidis ZR1 fermented soybean meal in diets for Japanese seabass (Lateolabrax japonicus)

This study examined the effects of replacing fish meal (FM) with three different types of soybean meal (SM) including untreated SM, Bacillus pumillus SE5 (BP) fermented SM (BPFSM) and Pseudozyma aphidis ZR1 (PA) fermented SM (PAFSM) in diets for Japanese seabass (Lateolabrax japonicus). A basal diet was formulated using FM (FM diet), and six other diets were produced by substituting 40 or 80% of FM with SM, BPFSM or PAFSM (SM40, SM80, BPFSM40, BPFSM80, PAFSM40 and PAFSM80 diets). Each diet was fed to triplicate groups of fish (7.14 ± 0.05 g) twice daily for eight weeks. Replacing 40% of FM with SM sources did not significantly influence growth (P > 0.05), while increasing the substitution level to 80% led to reduced growth rates (P < 0.05). The groups received SM80 and P...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DeQjcg

Immunomodulatory effects of antipsychotic treatment on gene expression in first-episode psychosis

In conclusion, risperidone possessed strong immunomodulatory properties affecting mainly innate immune response in FEP patients, whereas the observed effects of quetiapine and olanzapine were only marginal. Our results further emphasize the importance of understanding the immunomodulatory mechanisms of antipsychotic treatment, especially in terms of specific compounds, doses and duration of medication in patients with severe mental illness. Future studies should evaluate the response pre- and post-treatment, and the possible role of this inflammatory activation for the progression of psychiatric and metabolic symptoms. (Source: Journal of Psychiatric Research)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DdKprY

Characterization and functional analysis of a novel gC1qR in the swimming crab Portunus trituberculatus

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Junhao Ning, Yuan Liu, Fengtao Gao, Hourong Liu, Zhaoxia CuiAbstractThe receptor for the globular head of complement component C1q, gC1qR, is a multifunctional and multiligand binding protein with a crucial role in host defense. In the present study, a full-length cDNA sequence of a gC1qR homolog (PtgC1qR) in Portunus trituberculatus was identified. PtgC1qR was a 268-amino-acid polypeptide with a conserved MAM33 domain and a mitochondrial targeting sequence in the first 56 amino acids. The transcripts of PtgC1qR were detected in all examined tissues with the highest level detected in the hepatopancreas. Compared with other early embryonic stages, PtgC1qR was highly expressed in the fertilized eggs and em...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PNm03d

Oral yeast-based DNA vaccine confers effective protection from Aeromonas hydrophila infection on Carassius auratus

In conclusion, our work provided a framework for the further development of oral yeast-based fishery vaccines. (Source: Fish and Shellfish Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DgZGID

Cloning, expression prolife, and immune characterization of a novel stat family member (stat5bl) in Chinese tongue sole (Cynoglossus semilaevis)

This study would enlarge our understanding of stat5bl in fish immunity. (Source: Fish and Shellfish Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PQMjFr

Influence of CD4-1+, CD4-2+ and CD8+ T lymphocytes subpopulations on the immune response of B lymphocytes in flounder (Paralichthys olivaceus) immunized with thymus-dependent or thymus-independent antigen

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Jing Xing, Keke Luo, Yue'e Xiao, Xiaoqian Tang, Wenbin ZhanAbstractIn order to elucidate the influence of T lymphocytes subpopulations on B lymphocytes immune response, in this paper, CD4-1+, CD4-2+, CD8+ T lymphocytes and B lymphocytes responses to thymus-independent (TI) or thymus-dependent (TD) antigen plus immunosuppressant were investigated in flounder (Paralichthys olivaceus). The results showed that in LPS-immunized group, the percentages of CD4-1+, CD4-2+, CD8β+ T (PCD4-1+ T, PCD4-2+ T and PCD8β+ T) lymphocytes in peripheral blood leucocytes (PBLs) had no significant variations, the percentages of IgM+ B (PIgM+ B) lymphocytes and LPS-specific antibodies (LA) significantly increased and peaked a...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DhezdF

Adipose tissue contributes to hepatic pro-inflammatory response when dietary fish oil is replaced by vegetable oil in large yellow croaker (Larimichthys crocea): An ex vivo study

Publication date: January 2019Source: Fish & Shellfish Immunology, Volume 84Author(s): Peng Tan, Xueshan Li, Xiaojun Xiang, Xiaojing Dong, Songlin Li, Kangsen Mai, Qinghui AiAbstractThe shortage of fish oil (FO) leads to the extensive use of vegetable oil (VO) in marine fish diets. High replacement percentage of dietary FO by VO induced pro-inflammatory response of adipose tissue (AT) and liver tissue (LT) in large yellow croaker (Larimichthys crocea). Mammalian studies showed that the secretion of cytokines by AT affected the immune response of LT. To investigate whether or not the inflammation response of LT is related to AT in large yellow croaker, LT and AT cells from fish fed FO diet (FOL and FOA) and VO diet (VOL and VOA) were co-cultured in a trans-well system, which resulted in an ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PMDs83

Replacement of fish meal with Bacillus pumillus SE5 and Pseudozyma aphidis ZR1 fermented soybean meal in diets for Japanese seabass (Lateolabrax japonicus)

This study examined the effects of replacing fish meal (FM) with three different types of soybean meal (SM) including untreated SM, Bacillus pumillus SE5 (BP) fermented SM (BPFSM) and Pseudozyma aphidis ZR1 (PA) fermented SM (PAFSM) in diets for Japanese seabass (Lateolabrax japonicus). A basal diet was formulated using FM (FM diet), and six other diets were produced by substituting 40 or 80% of FM with SM, BPFSM or PAFSM (SM40, SM80, BPFSM40, BPFSM80, PAFSM40 and PAFSM80 diets). Each diet was fed to triplicate groups of fish (7.14 ± 0.05 g) twice daily for eight weeks. Replacing 40% of FM with SM sources did not significantly influence growth (P > 0.05), while increasing the substitution level to 80% led to reduced growth rates (P < 0.05). The groups received SM80 and P...

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Preseptal Upper Eyelid Lipoma

Superficial subcutaneous lipomas are benign, slow-growing neoplasms comprised mature adipose cells that may be surrounded by a fibrous tissue capsule. While found commonly on the body, simple lipomas are rarely described in the eyelids. Reports of two eyelid lipomas in the literature describe the anatomy to be posterior to the orbital septum. The presenting authors report the case of a simple lipoma of the eyelid found fully in the preseptal plane. Lipomas can occur anterior to the orbital septum and should be considered in the differential when presented with a painless, slow-growing eyelid mass in adults. Accepted for publication September 25, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Michael Kazim, M.D., 635 W 165 Street, New York, NY 10032. E-mail: mk48@cumc.columbia.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Preseptal Upper Eyelid Lipoma

Superficial subcutaneous lipomas are benign, slow-growing neoplasms comprised mature adipose cells that may be surrounded by a fibrous tissue capsule. While found commonly on the body, simple lipomas are rarely described in the eyelids. Reports of two eyelid lipomas in the literature describe the anatomy to be posterior to the orbital septum. The presenting authors report the case of a simple lipoma of the eyelid found fully in the preseptal plane. Lipomas can occur anterior to the orbital septum and should be considered in the differential when presented with a painless, slow-growing eyelid mass in adults. Accepted for publication September 25, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Michael Kazim, M.D., 635 W 165 Street, New York, NY 10032. E-mail: mk48@cumc.columbia.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Differential effect of sex on pain severity and smoking behavior and processes

Publication date: Available online 10 November 2018

Source: Addictive Behaviors

Author(s): Tanya Smit, Lorra Garey, Kirsten J. Langdon, Joseph W. Ditre, Andrew H. Rogers, Michael F. Orr, Michael J. Zvolensky

Abstract

Scientific evidence suggests that pain contributes to the maintenance of tobacco cigarette smoking among individuals with varying levels of pain. Yet, little is understood about factors that may moderate relations between pain severity and smoking processes. Considering that women are more likely to experience deleterious pain- and smoking-related outcomes, female smokers may be a particularly vulnerable group when considering pain in the maintenance of maladaptive smoking behavior. Thus, it is important to investigate the role of sex in pain-smoking relations. The current cross-sectional study examined sex differences in the relation between reported levels of pain and cessation-relevant smoking processes (i.e. cigarette dependence, barriers for cessation, and past cessation-related problems). Participants included 100 adult daily cigarette smokers (M_age = 32.57 years, SD = 13.58; 33% female). Results indicated that greater pain was significantly associated with greater cigarette dependence, greater perceived barriers to cessation, and greater cessation-related problems among female, but not male, smokers. The current findings identify sex as a potentially important moderator of complex associations between pain and tobacco smoking and suggests that women may constitute a group that is especially vulnerable to the effects of pain in the maintenance of tobacco dependence. Based on the present data, integrated pain-smoking treatments may be especially useful for female, versus male, smokers.

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Differential effect of sex on pain severity and smoking behavior and processes

Publication date: Available online 10 November 2018

Source: Addictive Behaviors

Author(s): Tanya Smit, Lorra Garey, Kirsten J. Langdon, Joseph W. Ditre, Andrew H. Rogers, Michael F. Orr, Michael J. Zvolensky

Abstract

Scientific evidence suggests that pain contributes to the maintenance of tobacco cigarette smoking among individuals with varying levels of pain. Yet, little is understood about factors that may moderate relations between pain severity and smoking processes. Considering that women are more likely to experience deleterious pain- and smoking-related outcomes, female smokers may be a particularly vulnerable group when considering pain in the maintenance of maladaptive smoking behavior. Thus, it is important to investigate the role of sex in pain-smoking relations. The current cross-sectional study examined sex differences in the relation between reported levels of pain and cessation-relevant smoking processes (i.e. cigarette dependence, barriers for cessation, and past cessation-related problems). Participants included 100 adult daily cigarette smokers (M_age = 32.57 years, SD = 13.58; 33% female). Results indicated that greater pain was significantly associated with greater cigarette dependence, greater perceived barriers to cessation, and greater cessation-related problems among female, but not male, smokers. The current findings identify sex as a potentially important moderator of complex associations between pain and tobacco smoking and suggests that women may constitute a group that is especially vulnerable to the effects of pain in the maintenance of tobacco dependence. Based on the present data, integrated pain-smoking treatments may be especially useful for female, versus male, smokers.

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HOPE in Action Trial of HIV+ Deceased Donor Liver Transplants for HIV+ Recipients

Condition:   Hiv Intervention:   Other: HIVD+/R+ Sponsors:   Johns Hopkins University;   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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Eczema Reminder and Accountability Program

Conditions:   Atopic Dermatitis;   Eczema Intervention:   Behavioral: Patient reminders and accountability questionnaires Sponsors:   McMaster University;   Hamilton Allergy Recruiting (Source: ClinicalTrials.gov)

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Evaluating the Safety and Pharmacokinetics of VRC-HIVMAB075-00-AB (VRC07-523LS) in the Sera and Mucosae of Healthy, HIV-Uninfected Adult Participants

Condition:   HIV Infections Intervention:   Biological: VRC07-523LS Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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PREVAIL VIII: A CoHOrt Clinical, Viral, and ImmuNOlogic Monitoring Study of People Living With Retroviral Infection in Liberia (HONOR)

Condition:   HIV Intervention:   Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Pragmatic Assessment Study Influenza Vaccine Effectiveness in DoD

Conditions:   Influenza;   Influenza-like Illness Interventions:   Biological: Egg based influenza vaccines;   Biological: Recombinant influenza vaccines;   Biological: Cell-culture based influenza vaccines Sponsors:   Henry M. Jackson Foundation for the Advancement of Military Medicine;   National Institute of Allergy and Infectious Diseases (NIAID);   Food and Drug Administration (FDA);   Defense Health Agency Immunization Healthcare Branch;   Armed Forces Health Surveillance Branch;   Naval He alth Research Center;   United States Air Force School of Aerospace Medicine;   Uniformed Services University of the Health Sciences Not yet recruiting (Source: ClinicalTrials.gov)

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Safety and Efficacy of Abatacept for Treating Chronic Cytopenia in Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Haploinsufficiency

Conditions:   CTLA4 Haplonisufficiency;   Chronic Cytopernia Interventions:   Drug: Orencia (abatacept);   Other: Placebo Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Effects of Exercise and Yogurt on Bone Mineral Density and Immunological Factors in Human Milk: The MEEMA Study

Conditions:   Lactational Amenorrhea;   Body Weight Changes;   Bone Loss Intervention:   Other: Exercise and dietary Sponsor:   North Carolina Agriculture& Technical State University Not yet recruiting (Source: ClinicalTrials.gov)

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Quality of Life in Systemic Nickel Allergy Syndrome

Conditions:   Systemic Nickel Allergy Syndrome;   Quality of Life Intervention:   Biological: Nickel oral hyposensitization treatment Sponsor:   Catholic University of the Sacred Heart Recruiting (Source: ClinicalTrials.gov)

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the Efficacy and Safety of Sugammadex in Children 0-2 Years Old

Conditions:   Anesthesia;   Pediatric Cancer;   Pediatric Tumor;   Pediatric Hepatoblastoma;   Beta-Thalassemia;   Hepatic Metastases Intervention:   Drug: Sugammadex Sponsor:   Federal Research Institute of Pediatric Hematology, Oncology and Immunology Not yet recruiting (Source: ClinicalTrials.gov)

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Immunological Tolerance After Frequent Rabies Booster Vaccinations

Condition:   Rabies Intervention:   Biological: Blood drawn after rabies vaccine booster vaccination Sponsor:   Queen Saovabha Memorial Institute Not yet recruiting (Source: ClinicalTrials.gov)

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HOPE in Action Trial of HIV+ Deceased Donor Liver Transplants for HIV+ Recipients

Condition:   Hiv Intervention:   Other: HIVD+/R+ Sponsors:   Johns Hopkins University;   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zJ04Mt

Eczema Reminder and Accountability Program

Conditions:   Atopic Dermatitis;   Eczema Intervention:   Behavioral: Patient reminders and accountability questionnaires Sponsors:   McMaster University;   Hamilton Allergy Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T6vLIi

Evaluating the Safety and Pharmacokinetics of VRC-HIVMAB075-00-AB (VRC07-523LS) in the Sera and Mucosae of Healthy, HIV-Uninfected Adult Participants

Condition:   HIV Infections Intervention:   Biological: VRC07-523LS Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zIZVbT

PREVAIL VIII: A CoHOrt Clinical, Viral, and ImmuNOlogic Monitoring Study of People Living With Retroviral Infection in Liberia (HONOR)

Condition:   HIV Intervention:   Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T2ui61

Pragmatic Assessment Study Influenza Vaccine Effectiveness in DoD

Conditions:   Influenza;   Influenza-like Illness Interventions:   Biological: Egg based influenza vaccines;   Biological: Recombinant influenza vaccines;   Biological: Cell-culture based influenza vaccines Sponsors:   Henry M. Jackson Foundation for the Advancement of Military Medicine;   National Institute of Allergy and Infectious Diseases (NIAID);   Food and Drug Administration (FDA);   Defense Health Agency Immunization Healthcare Branch;   Armed Forces Health Surveillance Branch;   Naval He alth Research Center;   United States Air Force School of Aerospace Medicine;   Uniformed Services University of the Health Sciences Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zIVNsy

Safety and Efficacy of Abatacept for Treating Chronic Cytopenia in Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Haploinsufficiency

Conditions:   CTLA4 Haplonisufficiency;   Chronic Cytopernia Interventions:   Drug: Orencia (abatacept);   Other: Placebo Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T1TOs1

Effects of Exercise and Yogurt on Bone Mineral Density and Immunological Factors in Human Milk: The MEEMA Study

Conditions:   Lactational Amenorrhea;   Body Weight Changes;   Bone Loss Intervention:   Other: Exercise and dietary Sponsor:   North Carolina Agriculture& Technical State University Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zN3nlF

Quality of Life in Systemic Nickel Allergy Syndrome

Conditions:   Systemic Nickel Allergy Syndrome;   Quality of Life Intervention:   Biological: Nickel oral hyposensitization treatment Sponsor:   Catholic University of the Sacred Heart Recruiting (Source: ClinicalTrials.gov)

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the Efficacy and Safety of Sugammadex in Children 0-2 Years Old

Conditions:   Anesthesia;   Pediatric Cancer;   Pediatric Tumor;   Pediatric Hepatoblastoma;   Beta-Thalassemia;   Hepatic Metastases Intervention:   Drug: Sugammadex Sponsor:   Federal Research Institute of Pediatric Hematology, Oncology and Immunology Not yet recruiting (Source: ClinicalTrials.gov)

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Immunological Tolerance After Frequent Rabies Booster Vaccinations

Condition:   Rabies Intervention:   Biological: Blood drawn after rabies vaccine booster vaccination Sponsor:   Queen Saovabha Memorial Institute Not yet recruiting (Source: ClinicalTrials.gov)

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Prevalence of human papillomavirus in oral rinse samples from healthy individuals in northern Thailand

Abstract

Background

The incidence of oral cancers associated with human papillomavirus (HPV) has been increasing in recent years. Therefore, it is necessary to elucidate HPV prevalence in oral cells and exposure to risk factors in various age groups.

Methods

Oral rinse samples from healthy individuals in northern Thailand were investigated for HPV prevalence and genotyped using the polymerase chain reaction (GP5+/6+ primers) and DNA sequencing of the PCR products.

Results

Samples were collected from 594 participants between 4 and 60 years of age. HPV was detected in 3.7% of samples: there was no gender difference. The prevalence of HPV positive cases was 8.6% in the 31 ‐50 age group. HPV prevalence increased with age and was the highest (9.2%) in the 41‐50 age group, but decreased (to 3%) in the 51‐60 age group. Risk factors significantly associated with HPV‐positive cases included alcohol consumption, coffee drinking, sexual activity and having children. HPV 16 and 18 were common genotypes, especially in the 31‐50 age group, and were associated with having sexual activity [odds ratio 19.0 (95% CI: 2.5‐142.5)]. At follow‐up of some individuals in the 4‐10 age group, a 9‐year‐old child was found to be positive for HPV18.

Conclusions

These results suggest that HPV can be acquired at a young age and the prevalence peaks in the middle age class among healthy individuals in northern Thailand, especially in the 31‐50 age group.

This article is protected by copyright. All rights reserved.

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Prevalence of human papillomavirus in oral rinse samples from healthy individuals in northern Thailand

Abstract

Background

The incidence of oral cancers associated with human papillomavirus (HPV) has been increasing in recent years. Therefore, it is necessary to elucidate HPV prevalence in oral cells and exposure to risk factors in various age groups.

Methods

Oral rinse samples from healthy individuals in northern Thailand were investigated for HPV prevalence and genotyped using the polymerase chain reaction (GP5+/6+ primers) and DNA sequencing of the PCR products.

Results

Samples were collected from 594 participants between 4 and 60 years of age. HPV was detected in 3.7% of samples: there was no gender difference. The prevalence of HPV positive cases was 8.6% in the 31 ‐50 age group. HPV prevalence increased with age and was the highest (9.2%) in the 41‐50 age group, but decreased (to 3%) in the 51‐60 age group. Risk factors significantly associated with HPV‐positive cases included alcohol consumption, coffee drinking, sexual activity and having children. HPV 16 and 18 were common genotypes, especially in the 31‐50 age group, and were associated with having sexual activity [odds ratio 19.0 (95% CI: 2.5‐142.5)]. At follow‐up of some individuals in the 4‐10 age group, a 9‐year‐old child was found to be positive for HPV18.

Conclusions

These results suggest that HPV can be acquired at a young age and the prevalence peaks in the middle age class among healthy individuals in northern Thailand, especially in the 31‐50 age group.

This article is protected by copyright. All rights reserved.

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Effects of chronic γ-irradiation on growth and sexual maturation of the Tohoku hynobiid salamander, Hynobius lichenatus

Publication date: January 2019

Source: Journal of Environmental Radioactivity, Volume 196

Author(s): Shoichi Fuma, Haruhi Soeda, Sadao Ihara, Kumi Matsui, Isao Kawaguchi, Takahiro Ishikawa, Yoshihisa Kubota, Yoshito Watanabe, Tatsuo Aono

Abstract

There are still considerable gaps in knowledge regarding the biological effects of chronic ionising radiation exposure in amphibians. To fill these gaps, Tohoku hynobiid salamanders, Hynobius lichenatus (Amphibia, Caudata), were chronically irradiated with ¹³⁷Cs γ-rays from embryonic to adult stages over 1954 days, and the effects on their growth and sexual maturation were examined under laboratory conditions. Irradiation at a dose rate of 33 μGy h⁻¹ had some stimulatory effects on growth (body weight increase) of H. lichenatus, while growth was temporarily or permanently suppressed at 150 or 510 μGy h⁻¹, respectively. On day 1802, secondary sexual characteristics (a tubercle at the anterior angle of the cloacal vent for males and ovisac development for females) were observed in 91% of the salamanders irradiated at 33 μGy h⁻¹, and in a similar percentage of non-irradiated controls. At 150 and 510 μGy h⁻¹, secondary sexual characteristics were not observed in any individuals. These results suggest that the derived consideration reference level (DCRL) of the International Commission on Radiological Protection (ICRP) for Reference Frog, i.e. 40–400 μGy h⁻¹, is applicable for the protection of H. lichenatus, and that growth and sexual maturation of this salamander may not have been adversely affected even in the most severely contaminated area in Fukushima, where the highest dose rate to salamanders was estimated to be 50 μGy h⁻¹. However, observations in the contaminated area are required to confirm this conclusion, considering the possible confounding factors which may make this salamander more sensitive to radiation in the natural environment than under laboratory conditions.

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Measurement of ambient dose equivalent rates by walk survey around Fukushima Dai-ichi Nuclear Power Plant using KURAMA-II until 2016

Publication date: Available online 10 November 2018

Source: Journal of Environmental Radioactivity

Author(s): Masaki Andoh, Hideaki Yamamoto, Takashi Kanno, Kimiaki Saito

Abstract

Ambient dose equivalent rates in various environments related to human lives were measured by walk surveys using the KURAMA-II systems from 2013 to 2016 within an 80-km radius of the Fukushima Dai-ichi Nuclear Power Plant. The dose rate of the locations where the walk survey was performed decreased to about 38% of its initial value in the 42 months from June 2013 to the December 2016, which was beyond that attributable to the physical decay of radiocaesium. The ecological half-life of the slow decreasing component was evaluated to be 4.1 ± 0.2 y. The air dose rates decreased depending on the level of the evacuation areas, and the decrease in the dose rates was slightly larger in populated areas where humans are active. The dose rates as measured by walk surveys exhibited a good correlation with those by car-borne surveys, suggesting that car-borne survey data are reflecting the air dose rates in living environments surrounding roads. The comparison of walk survey data with car-borne survey data indicated that the air dose rate varies largely even within a 100 m square area, and the variation is enhanced by human activities. The dose rates measured by the walk surveys were estimated to be medial of those along roads and those of undisturbed flat ground, and they were found to be decreasing quickly compared with the air dose rate from the flat ground fixed-point measurements.

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Effects of chronic γ-irradiation on growth and sexual maturation of the Tohoku hynobiid salamander, Hynobius lichenatus

Publication date: January 2019

Source: Journal of Environmental Radioactivity, Volume 196

Author(s): Shoichi Fuma, Haruhi Soeda, Sadao Ihara, Kumi Matsui, Isao Kawaguchi, Takahiro Ishikawa, Yoshihisa Kubota, Yoshito Watanabe, Tatsuo Aono

Abstract

There are still considerable gaps in knowledge regarding the biological effects of chronic ionising radiation exposure in amphibians. To fill these gaps, Tohoku hynobiid salamanders, Hynobius lichenatus (Amphibia, Caudata), were chronically irradiated with ¹³⁷Cs γ-rays from embryonic to adult stages over 1954 days, and the effects on their growth and sexual maturation were examined under laboratory conditions. Irradiation at a dose rate of 33 μGy h⁻¹ had some stimulatory effects on growth (body weight increase) of H. lichenatus, while growth was temporarily or permanently suppressed at 150 or 510 μGy h⁻¹, respectively. On day 1802, secondary sexual characteristics (a tubercle at the anterior angle of the cloacal vent for males and ovisac development for females) were observed in 91% of the salamanders irradiated at 33 μGy h⁻¹, and in a similar percentage of non-irradiated controls. At 150 and 510 μGy h⁻¹, secondary sexual characteristics were not observed in any individuals. These results suggest that the derived consideration reference level (DCRL) of the International Commission on Radiological Protection (ICRP) for Reference Frog, i.e. 40–400 μGy h⁻¹, is applicable for the protection of H. lichenatus, and that growth and sexual maturation of this salamander may not have been adversely affected even in the most severely contaminated area in Fukushima, where the highest dose rate to salamanders was estimated to be 50 μGy h⁻¹. However, observations in the contaminated area are required to confirm this conclusion, considering the possible confounding factors which may make this salamander more sensitive to radiation in the natural environment than under laboratory conditions.

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Measurement of ambient dose equivalent rates by walk survey around Fukushima Dai-ichi Nuclear Power Plant using KURAMA-II until 2016

Publication date: Available online 10 November 2018

Source: Journal of Environmental Radioactivity

Author(s): Masaki Andoh, Hideaki Yamamoto, Takashi Kanno, Kimiaki Saito

Abstract

Ambient dose equivalent rates in various environments related to human lives were measured by walk surveys using the KURAMA-II systems from 2013 to 2016 within an 80-km radius of the Fukushima Dai-ichi Nuclear Power Plant. The dose rate of the locations where the walk survey was performed decreased to about 38% of its initial value in the 42 months from June 2013 to the December 2016, which was beyond that attributable to the physical decay of radiocaesium. The ecological half-life of the slow decreasing component was evaluated to be 4.1 ± 0.2 y. The air dose rates decreased depending on the level of the evacuation areas, and the decrease in the dose rates was slightly larger in populated areas where humans are active. The dose rates as measured by walk surveys exhibited a good correlation with those by car-borne surveys, suggesting that car-borne survey data are reflecting the air dose rates in living environments surrounding roads. The comparison of walk survey data with car-borne survey data indicated that the air dose rate varies largely even within a 100 m square area, and the variation is enhanced by human activities. The dose rates measured by the walk surveys were estimated to be medial of those along roads and those of undisturbed flat ground, and they were found to be decreasing quickly compared with the air dose rate from the flat ground fixed-point measurements.

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Dividing neutrophils in subsets, reveals a significant role for activated neutrophils in the development of airway hyperreactivity

Abstract

Background

Previous research has emphasized the importance of eosinophils in allergic asthma, while paying less attention to neutrophils. The known functionality of neutrophils in the inflammatory process has recently changed and knowledge about subsets of neutrophils, as characterized by their expression of CD16 and CD62L, has surfaced. Their specific roles in asthma are still unknown.

Objective

To study the functional differences between subsets of neutrophils by characterising the impact of individual subsets on airway smooth muscle reactivity.

Methods

The direct effect of neutrophils on airway hyper‐responsiveness was assessed by co‐culturing different subsets of neutrophils (produced by LPS in vitro stimulation) with human isolated small airways or murine tracheae with subsequent evaluation of smooth muscle reactivity to bradykinin in myographs. Supernatants and tissue were saved for ELISA and immunohistochemistry.

Results

The CD16^highCD62L^dim neutrophils were found to enhance the response to bradykinin in both human isolated small airways and murine tracheae. No such effects were obtained for the other subsets. The response is due to an upregulation of bradykinin receptor 2 through release of TNFα from the neutrophil.

Conclusions & Clinical Relevance

The present study introduces a new concept regarding the role of neutrophils and defines a novel direct link between a specific activated neutrophil subset and airway smooth muscle, establishing neutrophils as important players in the development of asthmatic airway hyperactivity.

This article is protected by copyright. All rights reserved.

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Variability of blood eosinophils in patients in a clinic for severe asthma

Abstract

Background

Blood eosinophils are used to determine eligibility for agents targeting IL‐5 in patients with uncontrolled asthma. However, little is known about the variability of blood eosinophil measures in these patients before treatment initiation.

Objective

To characterize variability and patterns of variability of blood eosinophil levels in a real‐world clinic for severe asthmatics.

Methods

Retrospective review of blood eosinophils measured over a 5‐year period in patients enrolled in an urban clinic. Repeated measures of blood eosinophil levels in individuals were evaluated and cluster analysis was performed to characterize patients by eosinophil patterns. Clinical characteristics associated with eosinophil levels and patterns of variability were analyzed.

Results

Patients treated in the Bellevue Hospital Asthma Clinic within a 3‐month period were identified (n = 219). Blood eosinophil measures were obtained over the previous 5 years. Only 6% (n= 13) of patients had levels that were consistently above 300 cells/μL. Nearly 50% (n = 104) had eosinophil levels that traversed the threshold of 300 cells/μL. In contrast, 102 (46%) had levels that never reached the threshold of 300 cells/μL. Cluster analyses revealed three clusters with differing patterns of levels and variability. There was a suggestion of decreased clinical control and increased atopy in the cluster with the greatest variability in blood eosinophil measures.

Conclusion

In an urban clinic for patients referred for uncontrolled asthma, blood measures of eosinophils were variable and showed differing patterns of variability. These data reinforce the need to perform repeated eosinophil blood measures for appropriate designation for therapeutic intervention.

This article is protected by copyright. All rights reserved.

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Traffic‐related air pollution induces non‐allergic eosinophilic airway inflammation and cough hypersensitivity in guinea pigs

Abstract

Background

The pathogenesis and pathophysiology of eosinophilia‐related chronic cough such as non‐asthmatic eosinophilic bronchitis and cough variant asthma are still not clear.

Objective

This study is to examine the potential role of traffic‐related air pollution (TRAP) in eosinophilic inflammation and cough responses.

Methods

Non‐sensitized guinea pigs were exposed to TRAP in an urban traffic tunnel or kept in a filtered air environment for 7 or 14 days. Reflexive cough was measured using citric acid and allyl isothiocyanate (AITC) challenges, respectively. Spontaneous cough counting was determined using audio recording and a waveform analysis. Airway inflammation was evaluated using differential cells in bronchoalveolar lavage fluid (BALF) and lung histopathology. To further elucidate the relationship between airway inflammation and cough hypersensitivity, a subgroup of those exposed for 14 days received a dexamethasone treatment.

Results

Compared to reflexive cough count (mean (95% confidence interval) in 10 min) provoked by the AITC challenge for the unexposed animals (3.1 (1.7‐4.5)), those were increased significantly following both the 7‐day (12.0 (6.8‐17.2), p<0.01) and the 14‐day (12.0 (6.4‐17.6), p<0.01) TRAP exposure. The effect provoked by the citric acid challenge was more profound following the 14‐day exposure (26.0 (19.5‐32.5) vs. 3.8 (1.5‐6.0) for the control, p<0.001). TRAP exposures enhanced spontaneous cough events, caused a significant increase of eosinophils and neutrophils in BALF, and resulted in a dramatic eosinophilic infiltration in submucosal layer of trachea and bronchus, which can be inhibited significantly by dexamethasone treatment.

Conclusions & Clinical Relevance

TRAP exposures induced cough hypersensitivity and non‐allergic eosinophilic inflammation of airways in guinea pigs. This study highlights the potential mechanisms of eosinophilia‐related chronic cough that can be induced by traffic‐related air pollution.

This article is protected by copyright. All rights reserved.

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Antihistamine‐resistant chronic spontaneous urticaria: 1‐year data from the AWARE study

Abstract

Background

Previous reports indicate that patients with chronic spontaneous urticaria (CSU) are undertreated and that physicians show poor adherence to guideline recommendations. Awareness of CSU has improved in recent years, but it remains unclear if this has improved the management of these patients in clinical practice.

Objective

To describe disease burden, quality of life (QoL), and treatment patterns of patients with H₁‐antihistamine‐refractory CSU in Germany.

Method

AWARE (A World‐wide Antihistamine‐Refractory chronic urticaria patient Evaluation) is a global prospective, non‐interventional study of chronic urticaria in the real‐world setting, supported by the manufacturer of omalizumab. Patients (18–75 years) were included who had H₁‐antihistamine‐refractory CSU for ≥2 months. Disease characteristics, pharmacological treatments, and QoL (dermatology life quality index [DLQI], chronic urticaria QoL questionnaire, and angioedema QoL questionnaire) are reported for patients enrolled in Germany.

Results

After 1 year in AWARE, CSU remained uncontrolled (urticaria control test [UCT] score <12) in 432 of 1032 (42.2%) patients. QoL impairment remained high after one year, with 28.2% of patients reporting that CSU had a moderate/very large/extremely large effect on the DLQI. Most patients did not receive guideline‐recommended treatments at the end of the one‐year observation period. Changes in treatments were most evident at the first patient visit, with an increase in patients receiving omalizumab vs. prior therapy from 8.5% to 21.4%, and a decrease in those receiving no treatment from 29.9% to 12.8%. These changes were associated with reduced hives, angioedema, UCT scores, and QoL scores at Month 3, but only modest improvements thereafter. Of 528 patients with uncontrolled CSU and who were eligible for treatment escalation, only 3% received up‐dosing of H₁‐antihistamines and only 5% were initiated on omalizumab during one year of treatment.

Conclusions & Clinical Relevance

This study highlights a significant discrepancy between recommendations for managing CSU in international guidelines, and in real‐world clinical practice in Germany.

This article is protected by copyright. All rights reserved.

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Dividing neutrophils in subsets, reveals a significant role for activated neutrophils in the development of airway hyperreactivity

Abstract

Background

Previous research has emphasized the importance of eosinophils in allergic asthma, while paying less attention to neutrophils. The known functionality of neutrophils in the inflammatory process has recently changed and knowledge about subsets of neutrophils, as characterized by their expression of CD16 and CD62L, has surfaced. Their specific roles in asthma are still unknown.

Objective

To study the functional differences between subsets of neutrophils by characterising the impact of individual subsets on airway smooth muscle reactivity.

Methods

The direct effect of neutrophils on airway hyper‐responsiveness was assessed by co‐culturing different subsets of neutrophils (produced by LPS in vitro stimulation) with human isolated small airways or murine tracheae with subsequent evaluation of smooth muscle reactivity to bradykinin in myographs. Supernatants and tissue were saved for ELISA and immunohistochemistry.

Results

The CD16^highCD62L^dim neutrophils were found to enhance the response to bradykinin in both human isolated small airways and murine tracheae. No such effects were obtained for the other subsets. The response is due to an upregulation of bradykinin receptor 2 through release of TNFα from the neutrophil.

Conclusions & Clinical Relevance

The present study introduces a new concept regarding the role of neutrophils and defines a novel direct link between a specific activated neutrophil subset and airway smooth muscle, establishing neutrophils as important players in the development of asthmatic airway hyperactivity.

This article is protected by copyright. All rights reserved.

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Variability of blood eosinophils in patients in a clinic for severe asthma

Abstract

Background

Blood eosinophils are used to determine eligibility for agents targeting IL‐5 in patients with uncontrolled asthma. However, little is known about the variability of blood eosinophil measures in these patients before treatment initiation.

Objective

To characterize variability and patterns of variability of blood eosinophil levels in a real‐world clinic for severe asthmatics.

Methods

Retrospective review of blood eosinophils measured over a 5‐year period in patients enrolled in an urban clinic. Repeated measures of blood eosinophil levels in individuals were evaluated and cluster analysis was performed to characterize patients by eosinophil patterns. Clinical characteristics associated with eosinophil levels and patterns of variability were analyzed.

Results

Patients treated in the Bellevue Hospital Asthma Clinic within a 3‐month period were identified (n = 219). Blood eosinophil measures were obtained over the previous 5 years. Only 6% (n= 13) of patients had levels that were consistently above 300 cells/μL. Nearly 50% (n = 104) had eosinophil levels that traversed the threshold of 300 cells/μL. In contrast, 102 (46%) had levels that never reached the threshold of 300 cells/μL. Cluster analyses revealed three clusters with differing patterns of levels and variability. There was a suggestion of decreased clinical control and increased atopy in the cluster with the greatest variability in blood eosinophil measures.

Conclusion

In an urban clinic for patients referred for uncontrolled asthma, blood measures of eosinophils were variable and showed differing patterns of variability. These data reinforce the need to perform repeated eosinophil blood measures for appropriate designation for therapeutic intervention.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DznsjI

Traffic‐related air pollution induces non‐allergic eosinophilic airway inflammation and cough hypersensitivity in guinea pigs

Abstract

Background

The pathogenesis and pathophysiology of eosinophilia‐related chronic cough such as non‐asthmatic eosinophilic bronchitis and cough variant asthma are still not clear.

Objective

This study is to examine the potential role of traffic‐related air pollution (TRAP) in eosinophilic inflammation and cough responses.

Methods

Non‐sensitized guinea pigs were exposed to TRAP in an urban traffic tunnel or kept in a filtered air environment for 7 or 14 days. Reflexive cough was measured using citric acid and allyl isothiocyanate (AITC) challenges, respectively. Spontaneous cough counting was determined using audio recording and a waveform analysis. Airway inflammation was evaluated using differential cells in bronchoalveolar lavage fluid (BALF) and lung histopathology. To further elucidate the relationship between airway inflammation and cough hypersensitivity, a subgroup of those exposed for 14 days received a dexamethasone treatment.

Results

Compared to reflexive cough count (mean (95% confidence interval) in 10 min) provoked by the AITC challenge for the unexposed animals (3.1 (1.7‐4.5)), those were increased significantly following both the 7‐day (12.0 (6.8‐17.2), p<0.01) and the 14‐day (12.0 (6.4‐17.6), p<0.01) TRAP exposure. The effect provoked by the citric acid challenge was more profound following the 14‐day exposure (26.0 (19.5‐32.5) vs. 3.8 (1.5‐6.0) for the control, p<0.001). TRAP exposures enhanced spontaneous cough events, caused a significant increase of eosinophils and neutrophils in BALF, and resulted in a dramatic eosinophilic infiltration in submucosal layer of trachea and bronchus, which can be inhibited significantly by dexamethasone treatment.

Conclusions & Clinical Relevance

TRAP exposures induced cough hypersensitivity and non‐allergic eosinophilic inflammation of airways in guinea pigs. This study highlights the potential mechanisms of eosinophilia‐related chronic cough that can be induced by traffic‐related air pollution.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2RNmuDH

Antihistamine‐resistant chronic spontaneous urticaria: 1‐year data from the AWARE study

Abstract

Background

Previous reports indicate that patients with chronic spontaneous urticaria (CSU) are undertreated and that physicians show poor adherence to guideline recommendations. Awareness of CSU has improved in recent years, but it remains unclear if this has improved the management of these patients in clinical practice.

Objective

To describe disease burden, quality of life (QoL), and treatment patterns of patients with H₁‐antihistamine‐refractory CSU in Germany.

Method

AWARE (A World‐wide Antihistamine‐Refractory chronic urticaria patient Evaluation) is a global prospective, non‐interventional study of chronic urticaria in the real‐world setting, supported by the manufacturer of omalizumab. Patients (18–75 years) were included who had H₁‐antihistamine‐refractory CSU for ≥2 months. Disease characteristics, pharmacological treatments, and QoL (dermatology life quality index [DLQI], chronic urticaria QoL questionnaire, and angioedema QoL questionnaire) are reported for patients enrolled in Germany.

Results

After 1 year in AWARE, CSU remained uncontrolled (urticaria control test [UCT] score <12) in 432 of 1032 (42.2%) patients. QoL impairment remained high after one year, with 28.2% of patients reporting that CSU had a moderate/very large/extremely large effect on the DLQI. Most patients did not receive guideline‐recommended treatments at the end of the one‐year observation period. Changes in treatments were most evident at the first patient visit, with an increase in patients receiving omalizumab vs. prior therapy from 8.5% to 21.4%, and a decrease in those receiving no treatment from 29.9% to 12.8%. These changes were associated with reduced hives, angioedema, UCT scores, and QoL scores at Month 3, but only modest improvements thereafter. Of 528 patients with uncontrolled CSU and who were eligible for treatment escalation, only 3% received up‐dosing of H₁‐antihistamines and only 5% were initiated on omalizumab during one year of treatment.

Conclusions & Clinical Relevance

This study highlights a significant discrepancy between recommendations for managing CSU in international guidelines, and in real‐world clinical practice in Germany.

This article is protected by copyright. All rights reserved.

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Diagnostic Accuracy of CT for Prediction of Bladder Cancer Treatment Response with and without Computerized Decision Support

Publication date: Available online 10 November 2018

Source: Academic Radiology

Author(s): Kenny H. Cha, Lubomir M. Hadjiiski, PhD, Richard H. Cohan, MD, Heang-Ping Chan, PhD, Elaine M. Caoili, MD, Matthew Davenport, MD, Ravi K. Samala, PhD, Alon Z. Weizer, MD, Ajjai Alva, MD, Galina Kirova-Nedyalkova, MD, PhD, Kimberly Shampain, MD, Nathaniel Meyer, MD, Daniel Barkmeier, MD, PhD, Sean Woolen, MD, Prasad R. Shankar, MD, Isaac R. Francis, MD, Phillip Palmbos, MD

Rationale and Objectives

To evaluate whether a computed tomography (CT)-based computerized decision-support system for muscle-invasive bladder cancer treatment response assessment (CDSS-T) can improve identification of patients who have responded completely to neoadjuvant chemotherapy.

Materials and Methods

Following Institutional Review Board approval, pre-chemotherapy and post-chemotherapy CT scans of 123 subjects with 157 muscle-invasive bladder cancer foci were collected retrospectively. CT data were analyzed with a CDSS-T that uses a combination of deep-learning convolutional neural network and radiomic features to distinguish muscle-invasive bladder cancers that have fully responded to neoadjuvant treatment from those that have not. Leave-one-case-out cross-validation was used to minimize overfitting. Five attending abdominal radiologists, four diagnostic radiology residents, two attending oncologists, and one attending urologist estimated the likelihood of pathologic T0 disease (complete response) by viewing paired pre/post-treatment CT scans placed side-by-side on an internally-developed graphical user interface. The observers provided an estimate without use of CDSS-T and then were permitted to revise their estimate after a CDSS-T-derived likelihood score was displayed. Observer estimates were analyzed with multi-reader, multi-case receiver operating characteristic methodology. The area under the curve (AUC) and the statistical significance of the difference were estimated.

Results

The mean AUCs for assessment of pathologic T0 disease were 0.80 for CDSS-T alone, 0.74 for physicians not using CDSS-T, and 0.77 for physicians using CDSS-T. The increase in the physicians' performance was statistically significant (P < .05).

Conclusion

CDSS-T improves physician performance for identifying complete response of muscle-invasive bladder cancer to neoadjuvant chemotherapy.

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Texture Analysis Based on Preoperative Magnetic Resonance Imaging (MRI) and Conventional MRI Features for Predicting the Early Recurrence of Single Hepatocellular Carcinoma after Hepatectomy

Publication date: Available online 10 November 2018

Source: Academic Radiology

Author(s): Jing Zhang, Xinjie Liu, Haiping Zhang, Xiaojing He, Yangyang Liu, Jun Zhou, Dajing Guo

Rationale and Objectives

To investigate the value of texture analysis and conventional magnetic resonance imaging (MRI) features for predicting the early recurrence (ER) of single hepatocellular carcinoma (HCC) after hepatectomy.

Materials and Methods

A total of 100 HCC patients were first divided into group A (tumor diameter ≤3 cm) and group B (tumor diameter >3 cm) and then classified into two subgroups with ER or nonearly recurrence. Textural parameters (skewness, kurtosis, uniformity, energy, entropy, and correlation) based on MR images and conventional MRI features were compared between the ER and nonearly recurrence subgroups. Predictive factors for ER were further assessed with multivariate logistic regression analysis. Receiver operating characteristic curve was performed to assess the predictive power.

Results

There were 53 patients in group A and 47 patients in group B. On arterial phase analysis, tumors with ER displayed significantly lower uniformity and higher entropy in group A, and higher skewness and entropy in group B. On portal venous phase analysis, tumors with ER had significantly lower kurtosis and energy in group A, and higher entropy in group B. Irregular margin in groups A and B, and arterial peritumoral enhancement and capsule presence in group B were associated with ER. In multivariate logistic regression analysis, uniformity and entropy based on arterial phase images and irregular margin in group A, and skewness and entropy based on arterial phase images and arterial peritumoral enhancement in group B were independent predictors for ER. Entropy displayed higher predictive power for ER.

Conclusion

Texture analysis based on preoperative MRI are potential quantitative predictors of ER in HCC patients after hepatectomy, and may provide more information for preoperative treatment decision-making and follow up.

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Implementing universal newborn hearing screening in the French Rhône-Alpes region. State of affairs in 2016 and the 1st half of 2017

Publication date: Available online 10 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Lorène Bouillot, Maurice Vercherat, Catherine Durand

ABSTRACT

Introduction

Universal newborn hearing screening (UNHS) started as public health policy in 2015 in the French Rhône-Alpes region, aiming to screen for unilateral and bilateral hearing loss. After a first and second screening (retest) in the maternity hospital, the diagnostic process occurred at a limited number of specialist centers. A deferred preliminary screening (T3) was proposed before the age of 1 month. The aims of this study were to assess implementation of the program, impact of T3, and present the incidence of hearing loss in this population.

Materials and methods

The retrospective observational study was based on data transmitted routinely by the 51 maternities to the regional organization responsible for newborn screening, in 2016 and first half of 2017.

Results

All the facilities implemented the UNHS protocol, with 47 out of 51 using the recommended techniques. 99.7% of the 115,435 newborns were screened (excluding 0.2% of parental refusals). A retest was required for 10.2% of the babies. Among babies who didn't pass retest, 7.7% were lost to follow-up. 2.2% of the newborns were referred to diagnostic centers. The rate of T3 was 31.3% of newborns who did not pass retest. 88.6% of the infants passed T3. In the perinatal network making extensive use of T3 (75.8 % versus 14.9% elsewhere), 0.6 % of the infants were referred to a diagnostic center, versus 2.9% in the rest of the region (2016, p<0.001). For 2016, the outcomes at 6 months revealed an overall hearing loss rate of 1.7‰ (4.7‰ for neonatal care unit babies), and bilateral hearing loss in 1.2‰.

Conclusion

In Rhône-Alpes, the national and regional objectives for UNHS were exceeded, although limiting the number of infants lost to follow-up remains essential. Repeating an automated test around 2-4 weeks after birth improves the program by decreasing the false positives of the screening. It considerably limits the number of infants referred to specialist centers, without increasing the number of patients lost to follow-up.

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A 3-Dimensional Bioprinted Tracheal Segment Implant Pilot Study: Rabbit Tracheal Resection with Graft Implantation

Publication date: Available online 10 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Rachel Kaye, Todd Goldstein, Daniel A. Grande, David Zeltsman, Lee P. Smith

Abstract

Objectives

Surgical reconstruction of tracheal disease has expanded to include bioengineering and three dimensional (3D) printing. This pilot study investigates the viability of introducing a living functional tracheal replacement graft in a rabbit animal model.

Methods

Seven New Zealand White rabbits were enrolled and six completed participation (one intraoperative mortality). Tracheal replacement grafts were created by impregnating 3D printed biodegradable polycaprolactone (PCL) tracheal scaffolds with rabbit tracheal hyaline chondrocytes. 2cm of native trachea was resected and the tracheal replacement graft implanted. Subjects were divided into two equal groups (n=3) that differed in their time of harvest following implantation (three or six weeks). Tracheal specimens were analyzed with intraluminal telescopic visualization and histopathology.

Results

The two groups did not significantly differ in histopathology or intraluminal diameter. All sections wherein the implant telescoped over native trachea (anastomotic ends) contained adequate hyaline cartilage formation (i.e. chondrocytes within lacuna, surrounding extracellular matrix, and strong Safranin O staining). Furthermore, the PCL scaffold was surrounded by a thin layer of fibrous tissue. All areas without membranous coverage contained inadequate or immature cartilage formation with inflammation. The average intraluminal stenosis was 83.4% (range 34.2-95%).

Conclusions

We report normal cartilage growth in a tracheal replacement graft when chondrocytes are separated from the tracheal lumen by an intervening membrane. When no such membrane exists there is a propensity for inflammation and stenosis. These findings are important for future construction and implantation of tracheal replacement grafts.

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