Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


Contact Dermatitis : Improved metal allergen reactivity of artificial skin models by integration of TLR4‐positive cells Contact Dermatitis, Volume 0, Issue ja, -Not available-. Cutaneous adverse drug reaction induced by oral dexamethasone with possible cross‐reactivity to Group 1 corticosteroids confirmed by patch testing and intradermal testing Contact Dermatitis, Volume 0, Issue ja, -Not available-. New positive patch test reactions on day 7—The additional value of the day 7 patch test reading Contact Dermatitis, EarlyView. Two cases of contact allergic reactions to Finn Chamber AQUA test chambers Contact Dermatitis, EarlyView. Patch test reactivity to aluminium chambers Contact Dermatitis, EarlyView. Systemic allergic dermatitis after patch testing with cinchocaine (dibucaine) and topical corticosteroids Contact Dermatitis, EarlyView. Textile‐induced vulvar and perianal dermatitis Contact Dermatitis, Volume 81, Issue 1, Page 66-67, July 2019. Allergic contact dermatitis probably caused by latanoprost during treatment for alopecia areata Contact Dermatitis, Volume 81, Issue 1, Page 67-68, July 2019. Bullous irritant contact dermatitis caused by an alcoholic extract from Juglans regia leaves Contact Dermatitis, Volume 81, Issue 1, Page 73-74, July 2019. Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication Contact Dermatitis, Volume 81, Issue 1, Page 74-76, July 2019.
Early ViewOnline Version of Record before inclusion in an issueCONTACT POINTSAllergic contact dermatitis caused by ethylhexyl salicylate with possible cross‐reactivity with benzyl salicylateAnne‐Catherine Dens An Goossens Jeroen Darcis Sara Huygens Charlotte LambrechtLiesbeth GilissenVersion of Record online:11 June 2019Full text PDF ReferencesRequest permissionsORIGINAL ARTICLESCausative exposures and temporal development of cobalt allergy in Denmark between 2002 and 2017Farzad Alinaghi Claus…

Αλέξανδρος Γ. Σφακιανάκης

2m

Contact urticaria (CU): frequency, elicitors and cofactors in three cohorts (Information Network of…
Contact urticaria (CU): frequency, elicitors and cofactors in three cohorts (Information Network of Departments of Dermatology (IVDK); Network of Anaphylaxis and Dept. of Dermatology University Hospital Erlangen, Germany)Helene Süß Sabine Dölle‐Bierke Johannes Geier Burkhard Kreft Eva Oppel Claudia Pföhler Christoph Skudlik Margitta Worm Vera MahlerFirst published: 07 June 2019 https://doi.org/10.1111/cod.13331This article has been accepted for publication and undergone full peer review but…

Αλέξανδρος Γ. Σφακιανάκης

5m

Fibreglass dermatitis in a caravan manufacturer manifesting as prurigo nodularisErick Bravo Claire M….
Fibreglass dermatitis in a caravan manufacturer manifesting as prurigo nodularisErick Bravo Claire M. Felmingham Rosemary L. NixonFirst Published: 08 June 2019First Page PDF

Αλέξανδρος Γ. Σφακιανάκης

5m

Adding sorbitan sesquioleate to the European baseline series: necessary, reasonable, or unavoidable?…
Adding sorbitan sesquioleate to the European baseline series: necessary, reasonable, or unavoidable?Anton de Groot Liesbeth Gilissen Johannes Geier David Orton An GoossensFirst published: 08 June 2019 https://doi.org/10.1111/cod.13332This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this…

Αλέξανδρος Γ. Σφακιανάκης

6m

Cutaneous adverse drug reaction induced by oral dexamethasone with possible cross‐reactivity to Group…
Cutaneous adverse drug reaction induced by oral dexamethasone with possible cross‐reactivity to Group 1 corticosteroids confirmed by patch testing and intradermal testingTimothy J. Watts David Thursfield Rubaiyat HaqueFirst Published: 13 June 2019First Page PDF

Αλέξανδρος Γ. Σφακιανάκης

6m

Improved metal allergen reactivity of artificial skin models by integration of TLR4‐positive cells Verena…
Improved metal allergen reactivity of artificial skin models by integration of TLR4‐positive cellsVerena G. Frings Damaris Müller Gabriel Storz Angela Rossi Helga Sennefelder Christian Adam Matthias Goebeler Florian K. Groeber‐Becker Marc SchmidtFirst published: 14 June 2019 https://doi.org/10.1111/cod.13336This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead…

Αλέξανδρος Γ. Σφακιανάκης

7m

Mycobacteriology
Risk factors associated with unsuppressed viral load in HIV-1 infected patients at the first antiretroviral therapy in MoroccoTitou Hicham, Elkassimi Ilyas, Hanafi Tarik, Baba Noureddine, Boudi Omar, Frikh Rachid, Hjira Naoufal, Boui MohammedInternational Journal of Mycobacteriology 2019 8(2):113-117Background: Nonsuppression of viral load (VL) in HIV-infected patients on antiretroviral therapy (ART) is associated with increased HIV transmission and poor survival. The objective of this work was to…

Αλέξανδρος Γ. Σφακιανάκης

9m

Industrial Psychiatry
Violence: The scourge of Indian industryKalpana Srivastava, Suprakash Chaudhury, PS Bhat, Jyoti PrakashIndustrial Psychiatry Journal 2018 27(2):159-162Pharmacotherapy for relapse prevention of alcohol use disorder in the Indian setting: A systematic reviewBalaji Bharadwaj, Nivedhitha Selvakumar, Pooja Patnaik KuppiliIndustrial Psychiatry Journal 2018 27(2):163-171Alcohol use disorders (AUDs) is an important public health concern as estimates of the prevalence of AUD range at 4%–6% in the Indian population….

Αλέξανδρος Γ. Σφακιανάκης

10m


Hot Topics in Otolaryngology
Management of Benign Vocal Fold Lesions: Current Perspectives On The Role For Voice TherapyCurrent Opinion In Otolaryngology Read More Sudden Sensorineural Hearing Loss in Children: Clinical Characteristics, Etiology, Treatment Outcomes, and Prognostic Factors Otology & NeurotologyOfficial Journal of the American Otological Society, American Neurotology Society, European Academy of Otology & Neurotology,Politzer Society, Japan Otological Society, Korean Otologic Society, and ADANO Read…

Αλέξανδρος Γ. Σφακιανάκης

10m


Molecular and Cellular Endocrinology
Altered miR-186 and miR-135a contribute to granulosa cell dysfunction by targeting ESR2: A possible role in polycystic ovary syndromePublication date: 20 August 2019Source: Molecular and Cellular Endocrinology, Volume 494Author(s): Yuxia Song, Guo Yu, Yungai Xiang, Yan Li, Lijing Wan, Li TanAbstractMicroRNAs (miRNAs) are a group of negative regulators of gene expression that function at the posttranscriptional level. Dysregulation of miRNAs is involved in many pathophysiological processes, including…

Αλέξανδρος Γ. Σφακιανάκης

11m

Addictive Behaviors
Nicotine or expectancies? Using the balanced-placebo design to test immediate outcomes of vapingPublication date: October 2019Source: Addictive Behaviors, Volume 97Author(s): Amanda M. Palmer, Thomas H. BrandonAbstractIntroductionElectronic (e-)cigarette use has increased in popularity, especially among those attempting to quit smoking. Previous studies evaluating the therapeutic efficacy of e-cigarettes have suggested that non-pharmacologic factors, such as expectancies about nicotine effects, may…

Αλέξανδρος Γ. Σφακιανάκης

12m

Otolaryngology
https://www.sciencedirect.com/journal/american-journal-of-otolaryngology/articles-in-pressResearch articleAbstract onlyFungus ball of the maxillary sinus: Retrospective study of 48 patients and review of the literatureFabio Costa, Enzo Emanuelli, Leonardo Franz, Alessandro Tel, … Massimo RobionyIn Press, Accepted Manuscript, Available online 15 June 2019Purchase PDFArticle previewAbstractAbstractBackgroundMaxillary fungus ball (FB) is the most frequent paranasal localization.ObjectiveTo review…

Αλέξανδρος Γ. Σφακιανάκης

13m

Symbiosis
Evidence against mutualism in an aeolid nudibranch associated with Symbiodiniaceae dinoflagellatesAbstractThe symbiotic association with Symbiodiniaceae dinoflagellates has been more investigated for reef-building corals than for other metazoan taxa. Nudibranchs are relevant hosts as they present a wide variety of relationships with Symbiodiniaceae that range from predation to mutualistic association. The aeolid Berghia stephanieae is perhaps the best model for ecological studies in the mollusk-dinoflagellate…

Αλέξανδρος Γ. Σφακιανάκης

14m

Odontology
Correction to: Internal and marginal adaptation of high-viscosity bulk-fill composites in class II cavities placed with different adhesive strategiesIn the original publication of the article the paragraph “The four resin-based composites…” appearing below the “Materials and methods” section is incomplete. The correct paragraph is provided in this correction below.ADAM28 dramatically regulates the biological features of human gingival fibroblastsAbstractThis study was to explore the effects of a…

Αλέξανδρος Γ. Σφακιανάκης

15m

Orthopaedics
Correction to: Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a meta-analysis of forty-two thousand forty-six hipsThe author name “Muhammad Shawqi” was incorrectly presented as “Muhammad Shawq”.Correction to: Prior arthroscopic treatment for femoro-acetabular impingement does not compromise hip arthroplasty outcomes: a matched-controlled study with minimum two-year follow-upThe original version of this article was revised: The…

Αλέξανδρος Γ. Σφακιανάκης

16m

Extremophiles
Eukaryotic organisms of continental hydrothermal systemsAbstractContinental hydrothermal systems are a dynamic component of global thermal and geochemical cycles, exerting a pronounced impact on water chemistry and heat storage. As such, these environments are commonly classified by temperature, thermal fluid ionic concentration, and pH. Terrestrial hydrothermal systems are a refuge for extremophilic organisms, as extremes in temperature, metal concentration, and pH profoundly impact microorganism…

Αλέξανδρος Γ. Σφακιανάκης

17m

Mindfulness
Cross-Lagged Analyses Between Life Meaning, Self-Compassion, and Subjective Well-being Among Gifted AdultsAbstractObjectivesHighly intellectually gifted adults seem to be at a higher risk for existential crisis. However, not much is known about what contributes to their life meaning and/or well-being. This study examined if self-compassion may be a resource leading to a happy and/or meaningful life, or vice versa.MethodsCross-lagged associations between meaningfulness, subjective well-being, and…

Αλέξανδρος Γ. Σφακιανάκης

17m

Virology
Correction to: Intratype variants of the E2 protein from human papillomavirus type 18 induce different gene expression profiles associated with apoptosis and cell proliferationThe Given names of the author Alma Mariana Fuentes-González was incorrectly tagged in original publication and corrected here. The original article has been corrected.Molecular characterization and detection of two carlaviruses infecting cactusAbstractTwo large contigs with sequence similarities to different carlaviruses were…

Αλέξανδρος Γ. Σφακιανάκης

19m

Douleurs post-radiques après radiothérapie pour cancer des voies aérodigestives superieures : traitement…
Douleurs post-radiques après radiothérapie pour cancer des voies aérodigestives superieures : traitement par injections de toxine botulique APublication date: July 2019Source: Cancer/Radiothérapie, Volume 23, Issue 4Author(s): M. Mailly, S. Benzakin, A. Chauvin, D. Brasnu, D. AyacheRésuméObjectif de l’étudeAnalyser l’efficacité de l’injection de toxine botulique A dans les douleurs cervico-faciales post-radiques.Matériel et MéthodesÉtude rétrospective incluant tous les patients traités dans notre…

Αλέξανδρος Γ. Σφακιανάκης

19m

Stereotactic radiotherapy in targeted therapy treated oligo-metastatic oncogene-addicted (non-small-cell)…
Stereotactic radiotherapy in targeted therapy treated oligo-metastatic oncogene-addicted (non-small-cell) lung cancerPublication date: July 2019Source: Cancer/Radiothérapie, Volume 23, Issue 4Author(s): N. Giraud, S. Abdiche, R. TrouetteAbstractWhile the prognosis of metastatic non-small-cell lung cancer has shown significant progress these last years, notably with the discovery of oncogen-driven subtypes and the development of targeted therapies, significant improvements are still needed. More recently,…

Αλέξανδρος Γ. Σφακιανάκης

19m

Radiothérapie en conditions stéréotaxiques : étude prospective évaluant la fatigue et la qualité…
Radiothérapie en conditions stéréotaxiques : étude prospective évaluant la fatigue et la qualité de viePublication date: July 2019Source: Cancer/Radiothérapie, Volume 23, Issue 4Author(s): L.M. Abbassi, M. Laurans, A. Gasnier, A. Smulevici, H. Tournat, J.-E. Bibault, A. Huertas, E. Jouglar, A. Suissa, S. Kreps, P. Giraud, C. DurduxRésuméObjectif de l’étudeÉvaluer la fatigue et la qualité de vie chez les patients traités par irradiation en conditions stéréotaxiques et en déterminer les facteurs prédictifs.Matériel…

Αλέξανδρος Γ. Σφακιανάκης

20m

Radiothérapie
Douleurs post-radiques après radiothérapie pour cancer des voies aérodigestives superieures : traitement par injections de toxine botulique APublication date: July 2019Source: Cancer/Radiothérapie, Volume 23, Issue 4Author(s): M. Mailly, S. Benzakin, A. Chauvin, D. Brasnu, D. AyacheRésuméObjectif de l’étudeAnalyser l’efficacité de l’injection de toxine botulique A dans les douleurs cervico-faciales post-radiques.Matériel et MéthodesÉtude rétrospective incluant tous les patients traités dans notre…

Αλέξανδρος Γ. Σφακιανάκης

20m


Cytokine & Growth Factor
Interplay of deubiquitinating enzymes and cytokinesPublication date: Available online 8 June 2019Source: Cytokine & Growth Factor ReviewsAuthor(s): Bean Woo, Kwang-Hyun BaekAbstractDeubiquitinating enzymes (DUBs) are cysteine protease proteins that reverse the ubiquitination by removing ubiquitins from the target protein. With over 100 DUBs identified and categorized into at least 7 families, many DUBs interact with one or more cytokines, influencing cellular processes, such as antiviral responses,…

Αλέξανδρος Γ. Σφακιανάκης

21m

Medicine & Science in Sports & Exercise
Community-Level Sports Group Participation and the Risk of Cognitive ImpairmentPurpose Community-level group participation is a structural aspect of social capital that may have a contextual influence on individual health. We investigated the contextual effect of community-level prevalence of sports group participation on the risk of cognitive impairment among older individuals. Methods We analyzed prospective cohort data from the Japan Gerontological Evaluation Study (JAGES), a nationwide survey…

Αλέξανδρος Γ. Σφακιανάκης

22m

Physical Medicine & Rehabilitation
Not Always as it Seems: A Case of Ascending ParalysisNo abstract availableEvaluation of Service Delivery Effectiveness through Patient Reported Outcome MeasuresObjective To report the demographic characteristics and functional mobility for individuals accessing an academic medical center mobility device clinic, and to compare functional mobility data across demographic characteristics and mobility device type. Design This study utilized a retrospective, cross-sectional design. Demographic, mobility…

Αλέξανδρος Γ. Σφακιανάκης

25m

Clinical Characteristics and Microsurgery Treatment of Anterior Cranial Fossa Dural Arteriovenous Fistula…
Clinical Characteristics and Microsurgery Treatment of Anterior Cranial Fossa Dural Arteriovenous FistulaAnterior cranial fossa dural arteriovenous fistulas (DAVFs) represent 6% of all intracranial DAVFs and have a high risk of intracranial hemorrhage. To analyze the clinical characteristics and microsurgery treatment of anterior cranial fossa DAVFs, a retrospective review of 21 patients with anterior cranial fossa DAVFs undergoing microsurgery was performed, including 8 bleeding patients and 13…

Αλέξανδρος Γ. Σφακιανάκης

27m

Scalp Arteriovenous Malformation Resection With Novel Technique of Endovascular and Surgical Devascularization…
Scalp Arteriovenous Malformation Resection With Novel Technique of Endovascular and Surgical DevascularizationA 26-year-old female patient referred to our emergency service with complaint of increase headache and swelling of the left upper eye led. External examination of the head revealed left frontal scalp and left eye led swelling, which was soft and pulsatile. Brain computed tomography (CT) scan and magnetic resonance imaging showed left frontal soft tissue and left periorbital swelling with…

Αλέξανδρος Γ. Σφακιανάκης

34m

Composite Nasoseptal Flap for Palate Reconstruction Palatal fistulae represent a pathological connection…
Composite Nasoseptal Flap for Palate ReconstructionPalatal fistulae represent a pathological connection from the oral cavity through the hard or soft palate to the nasal cavity and can present a significant reconstructive dilemma. Surgical correction of palatal fistulae is often limited by prior treatment, including ablative procedures and radiotherapy, or previous reconstructive attempts. In light of these challenges, the nasoseptal flap represents an excellent adjacent source of vascularized tissue…

Αλέξανδρος Γ. Σφακιανάκης

36m

Pediatric Blood Management Protocol in Cranial Vault Surgery Background: Cranial vault surgeries are…
Pediatric Blood Management Protocol in Cranial Vault SurgeryBackground: Cranial vault surgeries are invasive, extensive procedures with blood transfusions being frequently required. Previous interventions have been described to attempt to decrease the transfusion burden. The objective of this study is to determine if a Pediatric Blood Management (PBM) team can reduce transfusion requirements in children undergoing cranial vault surgery. Methods: A protocol was developed which involved preoperative…

Αλέξανδρος Γ. Σφακιανάκης

36m

Dermal-Fat Graft for Facial Contouring in Patients With Craniofacial Microsomia Craniofacial microsomia…
Dermal-Fat Graft for Facial Contouring in Patients With Craniofacial MicrosomiaCraniofacial microsomia (CFM) is a variable craniofacial malformation, related to the development of the structures originated from the first and second brachial arches, affecting skeletal tissue, soft tissue, and neuromuscular components. In the situation of subcutaneous tissue and chewing muscles hypoplasia, free tissue transfer is a treatment option. Dermal-fat graft allows easy modeling during surgery, volumetric gain…

Αλέξανδρος Γ. Σφακιανάκης

36m

Craniofacial Surgery
Pediatric Blood Management Protocol in Cranial Vault SurgeryBackground: Cranial vault surgeries are invasive, extensive procedures with blood transfusions being frequently required. Previous interventions have been described to attempt to decrease the transfusion burden. The objective of this study is to determine if a Pediatric Blood Management (PBM) team can reduce transfusion requirements in children undergoing cranial vault surgery. Methods: A protocol was developed which involved preoperative…

Αλέξανδρος Γ. Σφακιανάκης

37m

Trauma and Acute Care Surgery
Optimizing Energy Expenditure and Oxygenation Toward Ventilator Tolerance is Associated with Lower Ventilator and ICU DaysIntroduction We hypothesize that if both energy expenditure and oxygenation are optimized (EEOO) towards ventilator tolerance; this would provide patients with the best condition to be liberated from the ventilator. We defined ventilator tolerance as having a RQ value between 0.7 and 1.0, while maintaining saturations above 98% with FiO2 70% or less and a normal respiratory rate…

Αλέξανδρος Γ. Σφακιανάκης

39m

Thyroid Cancer Bone Metastasis: Survival and Genomic Characteristics of a Large Tertiary Care Cohort…
Thyroid Cancer Bone Metastasis: Survival and Genomic Characteristics of a Large Tertiary Care CohortPurpose Bone metastasis (BM) in differentiated thyroid cancer (DTC) is the second most common site of metastasis after lung. Bone metastases are associated with worse prognosis in DTC. In this study, we examined risk factors for overall survival in patients with BM and for the first time explore the pattern of genomic alterations in DTC BM. Patients and Methods A Health Insurance Portability and Accountability…

Αλέξανδρος Γ. Σφακιανάκης

40m

Clinical Nuclear Medicine
Thyroid Cancer Bone Metastasis: Survival and Genomic Characteristics of a Large Tertiary Care CohortPurpose Bone metastasis (BM) in differentiated thyroid cancer (DTC) is the second most common site of metastasis after lung. Bone metastases are associated with worse prognosis in DTC. In this study, we examined risk factors for overall survival in patients with BM and for the first time explore the pattern of genomic alterations in DTC BM. Patients and Methods A Health Insurance Portability and Accountability…

Αλέξανδρος Γ. Σφακιανάκης

40m


Dengue infection complicated by hemophagocytic lymphohistiocytosis: Experiences from 180 severe dengue…
Dengue infection complicated by hemophagocytic lymphohistiocytosis: Experiences from 180 severe dengue patients Foong Kee Kan, MD, MRCP (UK) Cheng Cheng Tan, MBBS, MMedTatiana von Bahr Greenwood, MD Khairil E Khalid, MBBS, MRCPPremaa Supramaniam, BSc Ida Hed Myrberg, BScLian Huat Tan, MD, MMed Jan-Inge Henter, MD, PhDClinical Infectious Diseases, ciz499,https://doi.org/10.1093/cid/ciz499Published: 12 June 2019 Article historyPDF Split ViewCitePermissions Icon Permissions Share AbstractBackgroundGlobally…

Αλέξανδρος Γ. Σφακιανάκης

43m

Timing of HPV16-E6 antibody seroconversion before OPSCC: findings from the HPVC3 consortium A R Kreimer …
Timing of HPV16-E6 antibody seroconversion before OPSCC: findings from the HPVC3 consortiumA R Kreimer A Ferreiro-Iglesias M Nygard N Bender L Schroeder A Hildesheim H A Robbins M Pawlita H Langseth N F Schlecht … Show moreAnnals of Oncology, mdz138, https://doi.org/10.1093/annonc/mdz138Published: 11 June 2019 pdfPDF Split View CitePermissions Icon Permissions ShareBackgroundHuman papillomavirus type 16 (HPV16)-E6 antibodies are detectable in peripheral blood before diagnosis in the majority…

Αλέξανδρος Γ. Σφακιανάκης

44m

Microbial Ecology
Phenotyping Thermal Responses of Yeasts and Yeast-like Microorganisms at the Individual and Population Levels: Proof-of-Concept, Development and Application of an Experimental Framework to a Plant PathogenAbstractDeciphering the responses of microbial populations to spatiotemporal changes in their thermal environment is instrumental in improving our understanding of their eco-evolutionary dynamics. Recent studies have shown that current phenotyping protocols do not adequately address all dimensions…

Αλέξανδρος Γ. Σφακιανάκης

46m

Diabetologia
Correction to: Bone marrow pericyte dysfunction in individuals with type 2 diabetesUnfortunately, three errors were made in the conversion of HbA1c to per cent values.The Integrated Islet Distribution Program answers the call for improved human islet phenotyping and reporting of human islet characteristics in research articlesSoluble receptor for AGE in diabetic nephropathy and its progression in Finnish individuals with type 1 diabetesAbstractAims/hypothesisActivation of the receptor for AGE (RAGE)…

Αλέξανδρος Γ. Σφακιανάκης

49m

Mental Health
Individualised or Standardised Outcome Measures: A Co-habitation?AbstractMental health outcome measurement is conflicted between two different schools of thought which underlie the division between standardised (nomothetic) and individualised or patient-generated (idiographic) measures. The underpinning philosophies of both approaches have very different starting points in terms of how we understand the world. And yet the strengths of both may contribute something useful for patients and mental health…

Αλέξανδρος Γ. Σφακιανάκης

51m

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Transplantation
Clostridium difficile: a frequent infection in children after intestinal transplantationBackground: Organ transplantation is a risk factor for Clostridium difficile infection (CDI). After intestinal transplantation (ITx), few data are available on the impact of this graft infection and the possible induction of rejection. Methods: We included retrospectively all children after ITx in our unit, with at least one year of graft survival. All samples positive for Clostridium difficile and its toxin were…

Αλέξανδρος Γ. Σφακιανάκης

52m

Sex Roles
Pursuing Medicina [Medicine]: Latina Physicians and Parental Messages on Gendered Career ChoicesAbstractPrior research underscores that college-educated Latinas are hyper-segregated into highly feminized occupations and that Latino parents socialize their daughters to seek out these careers. Despite this trend, a small and growing number of Latinas are steadily entering prestigious non-traditional careers in medicine. Drawing on in-depth interviews with 20 Latina physicians of various generational…

Αλέξανδρος Γ. Σφακιανάκης

54m

Familial
Pediatric craniopharyngioma in association with familial adenomatous polyposisAbstractFamilial adenomatous polyposis (FAP) is a cancer predisposition syndrome driven by germline loss-of-function of the APC gene and phenotypically manifests with intestinal polyposis and a variety of extra-intestinal bone and soft tissue tumors. Craniopharyngioma is not a well-described FAP-associated tumor, however, six cases have been reported in adults, all demonstrating ectopic location and adamantinomatous histology….

Αλέξανδρος Γ. Σφακιανάκης

1h

Ophthalmology
"Graefe’s Archive" is a distinguished international journal that presents original clinical reports and clinically relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, "Graefe’s Archive" provides…

Αλέξανδρος Γ. Σφακιανάκης

1h

Abdominal Radiology
Bare area signThese four signs (the diaphragm sign, the displaced crus sign, the interface sign, and the bare area sign) are reliable when only one abnormal fluid collection is present.Ascites or pleural effusion? CT and ultrasound differentiation. – NCBIhttps://www.ncbi.nlm.nih.gov/pubmed/3536306The stalk-of-corn sign of ureterReply to letter to the editor: "clinical evaluation of ureteral pseudodiverticulosis"Clinical evaluation of ureteral pseudodiverticulosisThimble bladderThe "hot air balloon"…

Αλέξανδρος Γ. Σφακιανάκης

1h

Behavior Analysis
Why WIBA?AbstractHistorically, men have dominated the field of behavior analysis; however, recent trends have indicated increased participation by women. As a result of these recent changes to the field of behavior analysis, the inaugural Women in Behavior Analysis Conference (WIBA) was hosted in 2017. WIBA was initially established to highlight the accomplishments of women in the field of behavior analysis, to provide opportunities for early career behavior analysts to obtain mentorship, and to…

Αλέξανδρος Γ. Σφακιανάκης

1h

Der Chirurg
Laparoskopische Enukleation von InsulinomenHypertherme intraperitoneale ChemotherapieZusammenfassungZytoreduktive Chirurgie (CRS) und hypertherme intraperitoneale Chemotherapie (HIPEC) sind fester Bestandteil der Therapie peritonealer Malignome. Eine vollständige makroskopische Zytoreduktion ist die Grundlage einer erfolgreichen multimodalen Therapie. Der Stellenwert der intraperitonealen Chemotherapie ist weiterhin unklar. Diese Übersichtsarbeit erklärt die Prinzipien und die Bedeutung der HIPEC…

Αλέξανδρος Γ. Σφακιανάκης

1h

Genes & Genomics
Pre-labelled oligo probe-FISH karyotype analyses of four Araliaceae species using rDNA and telomeric repeatAbstractBackgroundThe family Araliaceae contains many medicinal species including ginseng of which the whole genome sequencing analyses have been going on these days.ObjectiveTo characterize the chromosomal distribution of 5S and 45S rDNAs and telomeric repeat in four ginseng related species of Aralia elata (Miq.) Seem., Dendropanax morbiferus H. Lév., Eleutherococcus sessiliflorus (Rupr. Et…

Αλέξανδρος Γ. Σφακιανάκης

1h

Heart Failure
Experimental models of cardiac physiology and pathologyAbstractExperimental models of cardiac disease play a key role in understanding the pathophysiology of the disease and developing new therapies. The features of the experimental models should reflect the clinical phenotype, which can have a wide spectrum of underlying mechanisms. We review characteristics of commonly used experimental models of cardiac physiology and pathophysiology in all translational steps including in vitro, small animal,…

Αλέξανδρος Γ. Σφακιανάκης

1h


Gastro
Mehr Screening in den HCV-RisikogruppenMit nur einer Tablette am Tag ist es heute meist möglich, die chronische Hepatitis-C-Virus(HCV)-Infektion binnen zwölf Wochen zu heilen. Bis zur endgültigen HCV-Eliminierung sind jedoch noch etliche Hürden zu überwinden. Seit Einführung der direkt antiviral wirksamen Therapie, etwa mit Sofosbuvir/Velpatasvir (SOF/VEL, Epclusa®) und SOF/VEL/Voxilaprevir (Vosevi®), haben HCV-Patienten heute eine hohe Chance auf Heilung. Dennoch ist die aktuelle Versorgungssituation…

Αλέξανδρος Γ. Σφακιανάκης

1h

Onkologie
MerkelzellkarzinomZusammenfassungDas Merkelzellkarzinom ist ein seltener, hoch aggressiver Hauttumor des älteren Menschen. Er besitzt neuroendokrine Eigenschaften. Die Pathogenese ist mit chronischer UV-Licht-Exposition und dem Merkelzell-Polyomavirus assoziiert. Klinisch fällt das Merkelzellkarzinom durch einen solitären, kutan oder subkutan gelegenen, roten bis bläulichen Knoten auf. Da der Tumor frühzeitig lymphogen metastasiert, sind zum Zeitpunkt der Diagnosestellung in etwa 30 % der Fälle bereits…

Αλέξανδρος Γ. Σφακιανάκης

1h

Endocrine and Metabolic Disorders
Correction to: Statins, metformin, proprotein-convertase-subtilisin-kexin type-9 (PCSK9) inhibitors and sex hormones: Immunomodulatory properties?The authors would like to note that several errors had occurred, especially in Table 2, Tables 5, 6 and 7, Figure 13, and in the legend of Figure 23.Nutritional and non-nutritional agents that stimulate white adipose tissue browningAbstractObesity is a public health problem present in both developed and developing countries. The white adipose tissue (WAT)…

Αλέξανδρος Γ. Σφακιανάκης

1h

Forum
Out of Africa: Exploring the Ethiopian Sentencing GuidelinesAbstractTo date, the literature on sentencing reform has largely focused on western jurisdictions, particularly the United States and Europe. Developments in other parts of the world, particularly on the African continent, have been overlooked. This article explores sentencing in a lesser-known African jurisdiction: Ethiopia. The focus of the essay is upon the issue of structured sentencing. Sentencing in Ethiopia, like most jurisdictions,…

Αλέξανδρος Γ. Σφακιανάκης

1h

Ethics
Surviving a Crisis: How Crisis Type and Psychological Distance Can Inform Corporate Crisis ResponsesAbstractThis research examines how one’s construal level of a crisis differs by crisis type, and how the interplay of crisis type (self-threatening vs. society-threatening) and apology appeal type (emotional vs. informational) impacts the effectiveness of apology messages in a corporate crisis context. Findings indicate that one’s mental construal toward a crisis varies by crisis type, with a self-threatening…

Αλέξανδρος Γ. Σφακιανάκης

1h

Medicine
Erratum to: Irreversible phenotypic perturbation and functional impairment of B cells during HIV-1 infectionThe original version of this article unfortunately contained a mistake. One of the authors of this article has been misspelled. Xiaoyang Zhang should be Xiaoyan Zhang. The update is also provided here.Cytokines and inflammation in adipogenesis: an updated reviewAbstractThe biological relevance of cytokines is known for more than 20 years. Evidence suggests that adipogenesis is one of the biological…

Αλέξανδρος Γ. Σφακιανάκης

1h


Cultural Heritage
Calcium oxalate films on works of art: A reviewPublication date: Available online 14 June 2019Source: Journal of Cultural HeritageAuthor(s): Laura RampazziAbstractThis work presents a review of the findings of calcium oxalate films, a widespread decay phenomenon recovered on stone and other substrates (mortars, wall and easel paintings, written materials, glass). The specific attention given to the issue in the 1990s has decreased, although articles have documented films until the present day. The…

Αλέξανδρος Γ. Σφακιανάκης

1h

Urologie und Urogynäkologie/Österreich
Chronische ZystitisKindliche Urolithiasis – ein Fallbericht und aktuelle StrategieZusammenfassungEtwa 1 % aller Fälle der symptomatischen Urolithiasis in Deutschland betreffen Kinder und Jugendliche unter 18 Jahren. Wir präsentieren den Fall eines 5 Jahre alten Mädchens mit symptomatischer Nephrolithiasis, welche in unserer Klinik per ESWL behandelt und im weiteren Verlauf mit allen notwendigen Folgeeingriffen betreut wurde. Basierend auf den aktuellen Leitlinien folgt im Anschluss daran eine Darstellung…

Αλέξανδρος Γ. Σφακιανάκης

1h

Allergo
Atopic eczema score of emotional consequences—a questionnaire to assess emotional consequences of atopic eczemaAbstractPurposeAtopic eczema (AE, atopic dermatitis), one of the most common chronic skin diseases worldwide, can dramatically influence the lives of affected patients as well as the lives of their families. Despite the availability of several questionnaires for assessing the impairment of quality of life, so far the emotional consequences of AE have received limited attention. The purpose…

Αλέξανδρος Γ. Σφακιανάκης

1h


Antibacterial and antidiarrheal activity of Butea Monospermea bark extract against waterborne enterobacter Cloacae in…
Antibacterial and antidiarrheal activity of Butea Monospermea bark extract against waterborne enterobacter Cloacae in rodents: In-vitro, Ex-vivo and In-Vivo evidencesPublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Divya Sharma, Saraswati Patel, Kanika Verma, Shiva Gudlawar, Dipjyoti Chakraborty, Sarvesh Paliwal, Jaya Dwivedi, Swapnil SharmaAbstractEthnopharmacological relevanceButea monosperma (Lam.) Taub. (family Leguminosae), popularly known as ‘Palash’…

Αλέξανδρος Γ. Σφακιανάκης

2h


Neoline is the active ingredient of processed aconite root against murine peripheral neuropathic pain…
Neoline is the active ingredient of processed aconite root against murine peripheral neuropathic pain model, and its pharmacokinetics in ratsPublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Yohei Tanimura, Masato Yoshida, Kan’ichiro Ishiuchi, Masahiro Ohsawa, Toshiaki MakinoAbstractEthnopharmacological relevanceProcessed aconite root (PA), the root of Aconitum carmichaeli (Ranunculaceae), is a crude drug used in traditional Chinese or Japanese kampo medicine…

Αλέξανδρος Γ. Σφακιανάκης

2h

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Anti-aggregant effect of butanolic extract of Rubia tinctorum L on platelets in vitro and ex vivo Publication…
Anti-aggregant effect of butanolic extract of Rubia tinctorum L on platelets in vitro and ex vivoPublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Fatima Zahra Marhoume, Mehdi Ait Laaradia, Younes Zaid, Jawad Laadraoui, Sara Oufquir, Rachida Aboufatima, Abderrahmane Chait, Abdallah BagriGraphical abstract

Αλέξανδρος Γ. Σφακιανάκης

2h


The contribution of beta-2 adrenergic, muscarinic and histamine (H1) receptors, calcium and potassium…
The contribution of beta-2 adrenergic, muscarinic and histamine (H1) receptors, calcium and potassium channels and cyclooxygenase pathway in the relaxant effect of Allium cepa L. on the tracheal smooth musclePublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Arghavan Memarzia, Fatemeh Amin, Saeideh Saadat, Mehrdad Jalali, Zahra Ghasemi, Mohammad Hossein BoskabadyAbstractEthnopharmacological relevanceThere are report regarding therapeutic effects for Allium…

Αλέξανδρος Γ. Σφακιανάκης

3h


A lipid-soluble extract of Pinellia pedatisecta Schott enhances antitumor T cell responses by restoring…
A lipid-soluble extract of Pinellia pedatisecta Schott enhances antitumor T cell responses by restoring tumor-associated dendritic cell activation and maturationPublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Yumeng Wang, Haixia Huang, Sheng Yao, Guiling Li, Congjian Xu, Yang Ye, Suiqi GuiAbstractEthnopharmacological relevancePinellia pedatisecta Schott (PPS)is a traditional Chinese medicine functioning as reducing swelling and drying dampness. Pinellia…

Αλέξανδρος Γ. Σφακιανάκης

3h


Binding of the polysaccharide from Acanthopanax giraldii Harms to toll-like receptor 4 activates macrophages…
Binding of the polysaccharide from Acanthopanax giraldii Harms to toll-like receptor 4 activates macrophagesPublication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Qingqing Li, Zhiting Chen, Zhilu Xu, Shaoyun Han, Huihui Hao, Jiang Wu, Fengxiang Sun, Xiaoyan Fu, Ruyue Li, Birong Zheng, Xiaoxiao Guo, Tongtong Zhang, Yong ChenAbstractEthnopharmacological relevanceThe traditional Chinese medicine, Acanthopanax giraldii Harms, is commonly used to treat arthralgia…

Αλέξανδρος Γ. Σφακιανάκης

3h


Ethnopharmacology
Toxicological findings about an anticancer fraction with casearins described by traditional and alternative techniques as support to the Brazilian Unified Health System (SUS)Publication date: 15 September 2019Source: Journal of Ethnopharmacology, Volume 241Author(s): Paulo Michel Pinheiro Ferreira, Denise Barbosa Santos, Jurandy do Nascimento Silva, Amanda Freitas Goudinho, Carla Lorena Silva Ramos, Patrícia Canteri de Souza, Ricardo Sérgio Couto de Almeida, Diego Sousa Moura, Rhaul de Oliveira,…

Αλέξανδρος Γ. Σφακιανάκης

3h

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Sex Roles

Pursuing Medicina [Medicine]: Latina Physicians and Parental Messages on Gendered Career Choices

Abstract

Prior research underscores that college-educated Latinas are hyper-segregated into highly feminized occupations and that Latino parents socialize their daughters to seek out these careers. Despite this trend, a small and growing number of Latinas are steadily entering prestigious non-traditional careers in medicine. Drawing on in-depth interviews with 20 Latina physicians of various generational backgrounds in California, I examine how Latina doctors explain the role parental messages played in their occupational trajectories. I document the fluid and often contradicting gendered expectations Latina physicians received from parents and identify three primary patterns in these messages, including: (a) fathers’ contradictory gendered expectations for their wives versus their U.S. born/raised daughters, (b) fathers and mothers’ differing messages about procuring financial and social independence from men, and (c) parental messages about sexuality. The messages that young Latinas receive vary and reflect tensions between gendered expectations for women in the immigrant parents’ home country and those available in the United States. The messages of support and resistance that Latina physicians receive from their parents regarding the pursuit of a career in medicine show how changing structural contexts—such as access and entry into prestigious non-traditional fields—rearranges gendered dynamics within Latino families.

The Impact of Gendered Stereotypes on Perceptions of Violence: A Commentary

Abstract

The present commentary explores the impact of gender role stereotypes on perceptions of both intimate partner violence (IPV) and sexual violence. Two papers published in this issue of Sex Roles explored the influence of gender stereotypes on both IPV (Bates et al. 2019) and rape myths (Klement et al. 2019). An overarching theme of these papers is how gender stereotypes may influence incorrect beliefs in how we view and approach interventions to these two types of violence. Reflecting on this convergence, we have come together as authors to consider how influential and damaging these stereotypes can be to victims of both partner violence and sexual violence. Our paper considers the nature of these stereotypes, who is harmed by them considering both gender and sexuality, and also the impact they have in societal and service responses to violence, as well as policy and practice development.

Reducing a Male Bias in Language? Establishing the Efficiency of Three Different Gender-Fair Language Strategies

Abstract

Different strategies of gender-fair language have been applied to reduce a male bias, which means the implicit belief that a word describing an undefined person describes a man. This male bias might be caused by the words themselves in terms of generic masculine or masculine forms or by androcentrism (the conflation of men with humanity). In two experiments, we tested how different gender-fair strategies used as labels of an unknown social target (an applicant in a recruitment situation) could eliminate the male bias. The three types of gender-fair strategies tested were: (a) paired forms (he/she), (b) traditional neutral words (e.g., singular they, “the applicant”), or (c) gender-neutral third-person pronouns actively created to challenge the binary gender system (ze, Swedish hen). The two experiments were performed in Swedish with 417 undergraduates in Sweden and in English with 411 U.S. participants recruited online. In Swedish, the third-person gender-neutral pronoun singular (hen) was used. In English, several forms of such gender-neutral pronouns have been suggested (e.g., ze). In both experiments, results indicated that paired forms and actively created gender-neutral pronouns eliminated the male bias, whereas traditional neutral words contained a male bias. Thus, gender-fair language strategies should avoid using traditional words. Consequences of using paired forms and creating new gender-neutral words are discussed. We argue that an actively created gender-neutral pronoun is of highest value because it is more inclusive.

When Seeing Is Not Believing: An Examination of the Mechanisms Accounting for the Protective Effect of Media Literacy on Body Image

Abstract

The present study aimed to explore the moderating role of three dimensions of media literacy on the relationship between media exposure and body dissatisfaction, mediated by thin-ideal internalization and appearance comparison among early female adolescents. A sample of 284 Australian female adolescents in single-sex schools (Mage = 13.15 years, range 11–16) reported on their media exposure, thin-ideal internalization, appearance comparison, body dissatisfaction, and three dimensions of media literacy: realism scepticism (scepticism regarding the extent to which media images portray reality, similarity scepticism (scepticism regarding the extent to which images portray a reality that is compatible with one’s personal experience), and critical thinking (with regard to the intention of the message, its meaning, and influence). Moderated mediation analyses were conducted. Findings revealed different patterns of relationships for the different dimensions of media literacy, with similarity scepticism moderating the mediated relationship between media exposure and body dissatisfaction via both thin-ideal internalization and appearance comparison. In contrast, reality scepticism and critical thinking revealed negative associations with body dissatisfaction but were not found to serve as moderators. Findings suggest that the mechanisms of action may vary for different dimensions of media literacy, and they highlight the importance of targeting media literacy in intervention and prevention efforts.

Body Surveillance Predicts Men’s and Women’s Perceived Loneliness: A Serial Mediation Model

Abstract

Previous research on self-objectification mainly focuses on its influences on intrapersonal psychological distress whereas our study examined whether self-objectification would influence interpersonal distress (i.e., loneliness) and its corresponding mechanisms in a sample of American women and men recruited with MTurk. Participants’ self-objectification was indexed by their level of body surveillance, and we proposed that body surveillance would increase women’s and men’s tendency to experience shame about their body and decrease their general self-esteem, which would in turn predict their level of loneliness. A total of 373 Americans (235 women; Mdnage = 33 years-old, range = 18–77) participated in the present study, and the results provided support for the proposed theoretical model. Specifically, we found that body surveillance positively predicted people’s body shame, and body shame negatively predicted self-esteem, which in turn predicted people’s loneliness. Moreover, this mediational model was not different between men and women. These results expand the scope of investigation by incorporating male samples, and they suggest that in addition to intrapersonal consequences, self-objectification can also influence people’s interpersonal well-being. Implications were discussed.

Accusers Lie and Other Myths: Rape Myth Acceptance Predicts Judgments Made About Accusers and Accused Perpetrators in a Rape Case

Abstract

Previous research results have yielded a consistent link between rape myth acceptance and sexual assault victim blaming: Individuals reporting higher levels of rape myth acceptance also report higher levels of victim blaming. In four studies we explored whether the presentation of rape-myth confirming information or rape-myth debunking information might moderate these tendencies. In these studies, U.S. undergraduates (97 in Study 1, 84 in Study 2, 98 in Study 3, and 116 in Study 4) read scenarios of a heterosexual sexual assault case and were randomly assigned to a control condition, a rape myth confirmation condition, or a rape myth debunking condition; they also reported the extent to which they endorsed or accepted rape myths. Rape myth acceptance robustly correlated with judgments made about accusers and accused rapists regardless whether the accuser/accused pairing was female/male (Studies 1 and 2) or male/female (Studies 3 and 4). For example, those who most strongly endorsed rape myths were also likely to disbelieve accusers. There were few instances indicating that the presentation of rape myth confirming information or rape myth debunking information moderated these effects. This lack of moderation occurred regardless of whether the information came from trial lawyers or from expert witnesses in the case. The relative impotence of the information presentations could be due to several factors (e.g., entrenched nature of rape myth acceptance, psychological reactance, timing and strength of manipulation), and we suggest ideas for how to overcome this relative impotence in future research.

Do Women in the Newsroom Make a Difference? Coverage Sentiment toward Women and Men as a Function of Newsroom Composition

Abstract

Positive or negative media coverage may have important consequences for individuals’ lives and ability to succeed. One potential factor that may affect the tone of coverage, in particular for women, is the gender of newsroom managers. Some scholars have suggested that women in key editorial and managerial roles should have a positive effect on the overall coverage of issues in the news, and specifically on the coverage of women. We used fixed effects regression to analyze panel data on the coverage sentiment of 212 U.S. newspapers from various cities and states between 2004 and 2009 to examine the effects of the gendered composition of newsrooms on coverage tone for both men and women. Our results showed that individuals with female names receive more positive coverage than those with male names do in every section of the newspaper. We also found that increases in female representation on newspapers’ editorial boards resulted in coverage for women that is moderately more positive. However, there is no evidence that under female executive editorship coverage sentiment favors women. Our findings are consistent with the work of gender sociologists and media scholars who have highlighted the media’s rigid gender structures and their resistance to change.

How Societal Changes Have Influenced German Children’s Gender Representations as Expressed in Human Figure Drawings in 1977 and 2015

Abstract

We investigated German first graders’ gender representations in human figure drawings done in 1977 and 2015. We hypothesized that increasing gender-status equality in society as well as growing gender differentiation in childcare and marketing are reflected in depictions of the human figure. Drawings were collected from a total of 376 children between 5 years 10 months and 8 years of age. Overall, the results are in accordance with the hypotheses: In contrast to 1977, the proportion of male and female figures was more balanced in 2015. In 2015, more girls drew a figure of their own gender and the femininity of female figures was higher than in 1977. Unexpectedly, the masculinity of male figures did not increase over this time. These results provide some insight into dynamic changes of children’s view of gender roles reflecting societal conditions. Drawings as a nonverbal approach to children’s gender representations proved sensitive in research but may also serve as a starting point in social and pedagogical work addressing gender issues. Considering gender status equality and gender specification as independent aspects of gender representations contributes to a better understanding by researchers as well as by practice professionals.

What about the Male Victims? Exploring the Impact of Gender Stereotyping on Implicit Attitudes and Behavioural Intentions Associated with Intimate Partner Violence

Abstract

Although intimate partner violence (IPV) is considered stereotypically as a gendered phenomenon, empirical evidence contradicts such gender asymmetry in reported rates of victimisation and perpetration. The current research explored the impact of stereotype priming on implicit attitudes associated with IPV victimisation (Study 1) and perpetration (Study 2), and further examined behavioural intentions associated with hypothetical gendered scenarios of IPV. Participants recruited in the United Kingdom were primed with either stereotype congruent, incongruent or no information about IPV victimisation (Study 1, n = 122) or perpetration rates (Study 2, n = 101). They then completed an Implicit Association Test and reported their subjective norms, self-efficacy, behavioural intentions, and outcome expectancies pertaining to different scenarios depicting gendered IPV. Findings indicate that priming an incongruent stereotype did not impact significantly on implicit or explicit attitudes toward IPV. Gendered scenarios were found to be influential on explicit attitudes, with IPV less likely to be identified toward male victims and considered more acceptable compared to when the victim was female. Moreover, individuals reported feeling more capable and likely to intervene in an act of IPV when the victim was female compared to male, were more likely to report such an incident, and anticipated greater outcomes. These findings highlight the need for an inclusive research approach that recognises men’s victimisation.

Does Traditional Stereotyping of Career as Male Affect College Women’s, but Not College Men’s, Career Decision Self-Efficacy and Ultimately Their Career Adaptability?

Abstract

In South Korea, strong beliefs about traditional gender roles in accordance with Confucian and patriarchic atmosphere still strongly influence daily life and the career development process. Cultural and contextual factors impact the development of gender role socialization, which influences an individual’s career decision self-efficacy (CDSE) and adaptability to manage the challenging career decision-making process. In our study, we recruited 291 South Korean undergraduate students (138 women, 153 men) and investigated how an implicit gender-career stereotyping impacts career adaptability via CDSE and whether there is a gender difference on the direct and indirect effects of implicit gender-career stereotyping on career adaptability. The Implicit Association Test (IAT) was implemented to measure implicit gender-career stereotyping. By testing a moderated mediation model, we found a mediated effect of CDSE in the link between implicit gender-career stereotyping and career adaptability in the female students. Moreover, the direct relationship between implicit gender-career stereotyping and CDSE was significant only for female students. Given the findings, practitioners and educators who work with South Korean women need to explore the degree of clients’ traditional gender role stereotyping and provide tailored interventions to increase their level of career adaptability by minimizing the negative impacts of gender role stereotyping and by increasing CDSE.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Sex Roles

Familial

Pediatric craniopharyngioma in association with familial adenomatous polyposis

Abstract

Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome driven by germline loss-of-function of the APC gene and phenotypically manifests with intestinal polyposis and a variety of extra-intestinal bone and soft tissue tumors. Craniopharyngioma is not a well-described FAP-associated tumor, however, six cases have been reported in adults, all demonstrating ectopic location and adamantinomatous histology. We report the first case of craniopharyngioma associated with FAP in a pediatric patient. A seven-year-old girl who presented with headache and vomiting was found on magnetic resonance imaging to have a suprasellar mass with cystic extension to the pre-pontine space. The tumor represented an adamantinomatous craniopharyngioma (aCP) with nuclear β-catenin expression. Whole exome sequencing confirmed a CTNNB1 activating point mutation and a germline APC frameshift variant. This case represents the first FAP-associated craniopharyngioma in childhood…. expanding our understanding of the molecular underpinnings driving tumorigenesis in this unique patient.

Phenotypic confirmation of oligodontia, colorectal polyposis and cancer in a family carrying an exon 7 nonsense variant in the AXIN2 gene

Abstract

The AXIN2 gene, like APC, plays a role in the Wnt signalling pathway involved in colorectal tumour formation. Heterozygous mutations in AXIN2 have been shown to cause ectodermal dysplasia (including tooth agenesis, or more specifically, oligodontia), and, in some carriers, colorectal cancer and/or adenomatous polyposis develops. There is a paucity of published AXIN2 families making genotype-phenotype (polyposis, colorectal cancer and oligodontia) correlations challenging. In this case report we describe a family with c.1972delA, p.Ser658Alafs*31 nonsense variant in AXIN2 where the three confirmed carriers presented with both oligodontia and colorectal adenomatous polyposis; mean number of teeth missing in carriers was 16.5 (range 11–22) and mean number of polyps in carriers was 49 (range 5->100, polyps were predominantly adenomatous). This highlights the importance of confirming phenotypic information in familial polyposis, to guide appropriate genetic investigations, as well as providing additional phenotypic and penetrance data to aid in clinical risk management recommendations. Our experience supports the inclusion of AXIN2 on panels for testing of patients with polyposis.

Endoscopic full thickness resection for early colon cancer in Lynch syndrome

Abstract

Subtotal colectomy is usually the therapy of choice in Lynch syndrome patients diagnosed with colon cancer. In patients who develop cancer after the age of 50–60 years, segmental colectomy is considered a good alternative. Although the endoscopic treatment of early colorectal cancer in non-Lynch patients has increased in the last decades, almost all patients with a Lynch syndrome-associated colorectal malignancy undergo surgery, even if the tumour is diagnosed in a (very) early stage. One of the endoscopic treatment options for early colorectal cancer is an endoscopic full thickness resection (eFTR). This treatment modality allows optimal pathological examination of the resection specimen, as a transmural resection is performed with optimal T-staging of the tumour. We report a case of a 62 year old man, diagnosed with MSH2-Lynch syndrome, who underwent successful eFTR treatment of an early (pT1) colon cancer located in the ascending colon, with no signs of recurrence 12 months after treatment. We discuss the pros and cons of endoscopic resection of early colorectal carcinoma in Lynch syndrome patients.

Progress report: familial pancreatic cancer

Abstract

A hereditary predisposition to pancreatic ductal adenocarcinoma (PDAC) is reported in approximately 5% of patients. Familial pancreatic cancer (FPC) accounts for the vast majority of hereditary PDAC cases. FPC defines families with two or more affected first-degree relatives with PDAC that do not fulfil the criteria of any other inherited tumor syndrome or families with PDAC in three or more relatives of any degree. The current progress report focuses on the knowledge of FPC with regard to molecular pathogenesis, clinical and molecular diagnosis, surveillance and novel treatment options reported in the last 5 years.

Genetic counseling referral for ovarian cancer patients: a call to action

Abstract

The hereditary contribution to ovarian cancer has been increasingly recognized over the past decade, with a 2014 Society of Gynecologic Oncology (SGO) recommendation for all women with epithelial ovarian cancer to be considered for genetic testing. The objective of the study was to determine if disparities exist in genetic referrals and characterize referral patterns over time. A retrospective cohort study included all women diagnosed with invasive epithelial ovarian cancer at the University of Virginia from 2004 to 2015. Clinicopathologic data were abstracted from the electronic medical record and analyzed for association with genetic referral and testing. We identified 696 cases, with a median age of 62 years and a median follow up of 25.2 months (range 1–115). Thirty-four percent were referred for genetic counseling with an 80% genetic testing rate in those women. Referrals increased from a rate of 8% in 2004 to 68% in 2015. On multivariable analysis, papillary serous histology (OR 1.6, 95% CI 1.0–2.6), stage III disease (OR 3.4, 95% CI 1.6–7.5), ovarian cancer family history (OR 2.6, 95% CI 1.5–4.6), breast cancer family history (OR 1.7, 95% CI 1.1–2.5), and diagnosis after 2014 (OR 2.3, 95% CI 1.3–4.1) remained significantly associated with genetics referral. Older age and living > 100 miles away were associated with decreased referral (OR 0.97, 95% CI 0.95–0.99 per year and OR 0.49, 95% CI 0.28–0.86). As only 68% of women with epithelial ovarian cancer were referred in 2015 innovative strategies such as Medicare coverage for counseling are still needed to universalize testing.

The incidence of consecutive manifestations in Von Hippel-Lindau disease

Abstract

Von Hippel-Lindau (VHL) disease is an autosomal dominant rare tumor syndrome characterized by high penetrance. VHL mutation carriers develop numerous manifestations in multiple organs during life. The natural course of development of new and growth of existing VHL-related manifestations is still unclear. In this study we aimed to gain insight into the development of subsequent manifestations in VHL disease. We retrospectively scored each new VHL-related manifestation as detected by standard follow-up (retina, central nervous system, kidneys and pancreas, excluding adrenal and endolymfatic sac manifestations) in 75 VHL mutation carriers. The Kaplan–Meier method was used to plot the cumulative proportions of all consecutive manifestations in each organ against age. The cumulative average number of manifestations in all organs during life was calculated by summating these cumulative proportions. Poisson model parameters were used to calculate average time to the detection of consecutive VHL manifestations in each organ. Consecutive VHL-related kidney and retina manifestations during life occur linearly according to Poisson distribution model. The total number of VHL manifestations rises linearly, with an average of seven VHL-related lesions at age 60 years. The incidence of consecutive VHL-related manifestations is constant during life in VHL mutation carriers. Our data is consistent with the notion that somatic inactivation of the remaining allele (Knudson’s “two-hit” hypothesis) is the determining factor in developing new VHL-related manifestations.

Moving into the mainstream: healthcare professionals’ views of implementing treatment focussed genetic testing in breast cancer care

Abstract

A proportion of breast cancers are attributable to BRCA1 or BRCA2 mutations. Technological advances has meant that mutation testing in newly diagnosed cancer patients can be used to inform treatment plans. Although oncologists increasingly deliver treatment-focused genetic testing (TFGT) as part of mainstream ovarian cancer care, we know little about non-genetics specialists’ views about offering genetic testing to newly diagnosed breast cancer patients. This study sought to determine genetics and non-genetics specialists’ views of a proposal to mainstream BRCA1 and 2 testing in newly diagnosed breast cancer patients. Qualitative interview study. Nineteen healthcare professionals currently responsible for offering TFGT in a standard (triage + referral) pathway (breast surgeons + clinical genetics team) and oncologists preparing to offer TFGT to breast cancer patients in a mainstreamed pathway participated in in-depth interviews. Genetics and non-genetics professionals’ perceptions of mainstreaming are influenced by their views of: their clinical roles and responsibilities, the impact of TFGT on their workload and the patient pathway and the perceived relevance of genetic testing for patient care in the short-term. Perceived barriers to mainstreaming may be overcome by: more effective communication between specialities, clearer guidelines/patient pathways and the recruitment of mainstreaming champions.

Hereditary gastric cancer: what’s new? Update 2013–2018

Abstract

Around 10–20% of gastric cancer patients have relatives with a diagnosis of GC and in 1–3% of patients a genetic cause can be confirmed. Histopathologically, GC is classified into intestinal-type, with glandular growth, and diffuse-type with poorly cohesive growth pattern often with signet ring cells. Familial or hereditary GC is classified into hereditary diffuse GC (HDGC), familial intestinal GC (FIGC) and polyposis forms. This review focuses on recent research findings and new concepts of hereditary GC.

Implementation of a Systematic Tumor Screening Program for Lynch Syndrome in an Integrated Health Care Setting

Abstract

A subset of colorectal cancer (CRC) cases are attributable to Lynch syndrome (LS), a hereditary form of CRC. Effective evaluation for LS can be done on CRC tumors to guide diagnostic testing. Increased diagnosis of LS allows for surveillance and risk reduction, which can mitigate CRC-related burden and prevent cancer-related deaths. We evaluated participation in LS screening among newly diagnosed adult CRC patients. Some cases were referred for genetics evaluation prior to study recruitment (selective screening). Those not referred directly were randomized to the intervention or control (usual care) arms. Control cases were observed for one year, then given information about LS screening. Patients who declined participation were followed through the medical record. Of 601 cases of CRC, 194 (32%) enrolled in our study and were offered LS screening, 43 (7%) were followed as a control group, 148 (25%) declined participation and 216 (36%) were ineligible [63 (10%) of which received prior selective screening]. Six and nine cases of LS were identified through the intervention and selective screening groups, respectively. Overall, a higher proportion of PMS2 variants were identified in the intervention (3/6, 50%) versus selective screening groups (2/9, 22%) (not statistically significant). Eighty-eight percent and 23% of intervention and control patients, respectively, received LS screening. No control patients were found to have LS. Systems-based approaches are needed to ensure we fully identify LS cases. The proportion of LS cases from this program was 4% of newly diagnosed cases of CRC, similar to other programs.

Implication of DNA repair genes in Lynch-like syndrome

Abstract

Many colorectal cancers (CRCs) that exhibit microsatellite instability (MSI) are not explained by MLH1 promoter methylation or germline mutations in mismatch repair (MMR) genes, which cause Lynch syndrome (LS). Instead, these Lynch-like syndrome (LLS) patients have somatic mutations in MMR genes. However, many of these patients are young and have relatives with cancer, suggesting a hereditary entity. We performed germline sequence analysis in LLS patients and determined their tumor’s mutational profiles using FFPE DNA. Six hundred and fifty-four consecutive CRC patients were screened for suspected LS using MSI and absence of MLH1methylation. Suspected LS cases were exome sequenced to identify germline and somatic mutations. Single nucleotide variants were used to characterize mutational signatures. We identified 23 suspected LS cases. Germline sequence analysis of 16 available samples identified five cases with LS mutations and 11 cases without LS mutations, LLS. Most LLS tumors had a combination of somatic MMR gene mutation and loss of heterozygosity. LLS patients were relatively young and had excess first-degree relatives with cancer. Four of the 11 LLS patients had rare likely pathogenic variants in genes that maintain genome integrity. Moreover, tumors from this group had a distinct mutational signature compared to tumors from LLS patients lacking germline mutations in these genes. In summary, more than a third of the LLS patients studied had germline mutations in genes that maintain genome integrity and their tumors had a distinct mutational signature. The possibility of hereditary factors in LLS warrants further studies so counseling can be properly informed.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Familial

Ophthalmology

"Graefe’s Archive" is a distinguished international journal that presents original clinical reports and clinically relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, "Graefe’s Archive" provides rapid dissemination of clinical and clinically related experimental information.

Correction to: Intravitreal bevacizumab injections combined with laser photocoagulation for adult-onset Coats’ disease
The IRB number of the published article was A-2015-016 (page 1512, 1st paragraph of the method section).
Transcaruncular laser-assisted StopLoss Lester Jones tube surgery for lacrimal canalicular obstructions
Optical coherence tomography angiography analysis of the choriocapillary layer in treatment-naïve diabetic eyes

Abstract

Purpose

To evaluate the capillary flow density (CFD) of choriocapillary (CC) microvasculature using optical coherence tomography angiography (OCT-A) in diabetic eyes and the association of CFD and systemic and metabolic factors.

Methods

Cross-sectional study. This study enrolled 282 eyes of 146 subjects, including 43 healthy control eyes, 56 diabetic eyes without diabetic retinopathy (DR), 43 eyes with mild nonproliferative DR (NPDR), 54 eyes with moderate NPDR, 38 eyes with severe NPDR, and 48 eyes with proliferative DR (PDR). CFD was measured in the CC layer. Clinical data were collected. Multiple linear regression analyses were performed to identify associated clinical variables.

Results

CFD in the CC layer presented a downward trend with DR progression. Comparisons of CFD in the CC layer between adjacent stages of DR revealed significant differences between severe NPDR and PDR using both 3-mm and 6-mm scan patterns (P = 0.003, P = 0.001). CFD in the CC layer in DR with diabetic macular edema (DME) was less than that in DR without DME using both 3-mm and 6-mm scan patterns (P < 0.001, P < 0.001). Coronary artery disease and atherosclerosis in other locations, estimated glomerular filtration rate, and increased HbA1c were associated with CFD in the CC layer using both 3-mm and 6-mm scan patterns (all P values < 0.05).

Conclusions

OCT-A revealed decreased CFD in the CC layer in the PDR stage and the presence of DME. Diabetic patients with apparently decreased CFD should be assessed carefully under general conditions.

Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients

Abstract

Purpose

To assess the real-world 5-year treatment outcomes of ranibizumab therapy in Japanese patients with neovascular age-related macular degeneration (AMD).

Methods

This was a retrospective, observational, and open-label effectiveness study that included 295 eyes. The participants were patients with treatment-naïve neovascular AMD who received intravitreal ranibizumab (IVR) monthly injection at least three times as the loading phase, followed by further injections as needed (pro re nata (PRN)) and follow-up assessments for 5 years. Outcomes were determined at least 5 years after the first ranibizumab injection.

Results

Mean logMAR best-corrected visual acuity (BCVA) at baseline was 0.52. The mean BCVA significantly improved after three loading injections; however, it declined gradually. The BCVA at 1 year was significantly better than the baseline BCVA, whereas the 3-year, 4-year, and 5-year BCVA values were significantly lower than the baseline values. The average central foveal thickness improved significantly from 366 ± 125 μm to 268 ± 134 μm (p < 0.0001). Macular atrophy was significantly more likely to occur in cases with classic choroidal neovascularization (CNV) than in cases with other AMD (p = 0.01).

Conclusions

IVR is well tolerated in eyes with AMD. However, a PRN regimen for AMD may have limited real-world effectiveness for long-term maintenance of improved visual acuity. Macular atrophy may occur more frequently in classic CNV. To maintain good vision, IVR treatment should be started earlier and performed continuously.

Patient characteristics of untreated chronic central serous chorioretinopathy patients with focal versus diffuse leakage

Abstract

Purpose

To describe the characteristics and potential differences between focal and diffuse phenotypes of untreated chronic central serous chorioretinopathy (cCSC).

Methods

For this study, patients were divided in two groups. Focal leakage was defined as 1 “hot spot” of leakage, whereas diffuse leakage was defined as either > 1 hot spot or a larger area of widespread leakage on FA. Clinical characteristics were assessed at presentation. After Bonferroni correction, P values < 0.00125 were deemed statistically significant.

Results

The focal leakage group included 68 eyes (53 males), and the diffuse leakage group included 105 eyes (88 males). Mean best-corrected visual acuity (BCVA) was 77.1 ± 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the focal group and 76.0 ± 9.6 ETDRS letters in the diffuse group (p = 0.440). In the focal group, mean age was 46.9 ± 8.8 years, whereas this was 49.7 ± 8.3 years in the diffuse group (p = 0.033). Mean central foveal thickness was 107.1 ± 21.3 μm in the focal group and 106.2 ± 27.3 μm in the diffuse group (p = 0.818). Mean choroidal thickness was 407.5 ± 114.8 μm in the focal group and 419.1 ± 113.9 μm in the diffuse group (p = 0.578). In the focal group, subretinal fluid was present in the fellow eye in 16% of the patients, as compared to 29% in the diffuse group (p = 0.067).

Conclusions

In untreated cCSC patients with focal or diffuse leakage on FA, no marked differences in clinical characteristics were found. Extensive choroidal abnormalities may be present in both groups, which are presumed to lie at the basis of the development of cCSC.

Protein kinase C-mediated insulin receptor phosphorylation in diabetic rat retina

Abstract

Purpose

Diabetic retinopathy (DR) involves a proliferation of vascular endothelial cells and loss of pericytes. There is a link among the action of protein kinase C (PKC) and insulin signaling. Thus, we investigated the differences between these cells in insulin receptor (IR) phosphorylation in DR.

Methods

Retinas were removed from streptozotocin-induced diabetic or healthy rats, and IR expression levels were compared by immunoblot and immunohistochemistry. In vitro assays also were performed in order to determine the expressions of phosphorylated IR in both cells cultured under 5.5 or 25 mM glucose by immunoblot. Cell viability was determined in both cells cultured under different concentrations of phorbol myristate acetate (PMA), a PKC activator. To determine the involvement of the PI3 kinase pathway of IR, PMA with or without wortmannin-induced changes in Akt was also analyzed.

Results

Immunoreactivity to the IR was decreased in diabetic retina. High glucose (25 mM) increased phosphorylated IR levels in endothelial cells but not in pericytes. PMA (1 nM or higher) induced death of pericytes, while endothelial cells were increased. PMA increased phosphorylated Akt in endothelial cells and decreased in pericytes. Wortmannin suppressed the PMA-induced phosphorylation of Akt in endothelial cells.

Conclusions

The different responses to 25 mM glucose and PMA were observed between retinal endothelial cells and pericytes. Thus, IR phosphorylation is likely important for retinal vascular cells to survive in diabetic retina.

Elevation of the vitreous body concentrations of oxidative stress-responsive apoptosis-inducing protein (ORAIP) in proliferative diabetic retinopathy

Abstract

Purpose

Oxidative stress has been implicated in the pathogenesis of various disorders, including diabetic retinopathy (DR). Oxidative stress-responsive apoptosis-inducing protein (ORAIP; a tyrosine-sulfated secreted form of eukaryotic translation initiation factor 5A [eIF5A]) is a recently discovered pro-apoptotic ligand that is secreted from cells in response to oxidative stress and induces apoptosis in an autocrine fashion. This study aimed to determine if ORAIP plays a role in DR.

Methods

To investigate the role of ORAIP in DR, we analyzed the levels of ORAIP in the vitreous body and their relationship with the extent of proliferative diabetic retinopathy (PDR). Enzyme-linked immunosorbent assay was used to quantify the levels of ORAIP, vascular endothelial growth factor (VEGF), C–C motif chemokine ligand 2 (CCL2), interleukin-6 (IL-6), and IL-8 in the vitreous body of 40 eyes from 28 patients with PDR and 11 patients with non-PDR (NPDR). We also analyzed the expression of ORAIP in insoluble proliferative tissues from vitreous body samples by immunofluorescent staining.

Results

The vitreous body concentration of ORAIP was significantly (P = 0.0433) higher in the PDR group (52.26 ± 8.68 [mean ± SE] ng/mL, n = 29) than in the NPDR group (28.21 ± 7.30 ng/mL, n = 11). However, there were no significant correlations between the concentration of ORAIP and those of VEGF, IL-6, CCL2, or IL-8. ORAIP expression was observed in the insoluble proliferative tissues in vitreous body samples of most patients in the PDR group, whereas almost no expression of ORAIP was observed in patients in the NPDR group.

Conclusions

Our findings strongly suggest that ORAIP plays a role in oxidative stress-induced retinal injury and may be a sensitive diagnostic marker and a promising therapeutic target for oxidative stress-induced cytotoxicity.

Ocular alterations, molecular findings, and three novel pathological mutations in a series of NF2 patients

Abstract

Purpose

To evaluate ophthalmological and molecular findings in eight patients with a clinical diagnosis of neurofibromatosis type 2 (NF2). New pathological mutations are described and variability in the ophthalmic phenotype and NF2 allelic heterogeneity are discussed.

Methods

Eye examination was performed in eight NF2 patients, and it included the measurement of the visual acuity, biomicroscopy, dilated fundus examination, color fundus photography, infrared photography, and spectral domain optical coherence tomography (SD-OCT). Molecular analysis was performed with whole-exome sequencing using DNA derived from peripheral blood mononuclear cells from each individual.

Results

Ophthalmological features were present in all patients, ranging from subtle retinal alterations identified only using SD-OCT to severe ocular damage present at birth. Six mutations were observed: two patients with stop codon mutation as shown on table 1 and result section, three patients with frameshift mutation as shown on table 1 and result section. Three novel mutations were found among them.

Conclusions

It is a descriptive study of a rare disease, with poor previous literature. Clinical and genetic data are shown, reviving the need to further studies to clarify the genotype-phenotype correlations in NF2.

Usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy

Abstract

Purpose

To evaluate the clinical usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy.

Methods

One hundred thirty-five lacrimal views of endoscopic dacryocystorhinostomy (DCR) with a single surgeon for primary nasolacrimal duct obstruction (PANDO) were included. These were assigned into three groups according to the type of dacryoscintigraphy. Group 1 was a pre-sac obstruction pattern. Group 2 was an intra-sac obstruction pattern. Group 3 was post-sac obstruction pattern. Each group was evaluated for an anatomical and functional surgical success, presence of complications including granuloma, synechiae, and tube-induced inflammation at least 12 months after the surgery.

Results

Both anatomical and functional success rate showed no significant difference among the three groups (P = .297 and .472 linear by linear association). Functional failure rate (functional failure/total failure) also showed no clinically significant differences between groups. Logistic regression analysis was performed to determine the factors associated with functional success. There were no statistically significant factors in age, sex, scintigraphy type, pre-operative endoscopic grade, post-operative granuloma, and synechiae.

Conclusion

In patients with nasolacrimal duct obstruction, preoperative evaluation of obstruction level using dacryoscintigraphy may be not useful for predicting the functional success of the endoscopic dacryocystorhinostomy.

Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up

Abstract

Background

Phakic intraocular lens (pIOL) models have indicated an association between cataract formation and inadequate vaulting. In this study, the efficacy and safety of low-vault posterior chamber pIOLs in the correction of myopia were examined over 3 years.

Methods

From 316 patients undergoing surgery, 14 eyes with a low vault (≤ 150 μm) were examined from 14 patients. After implanting the Visian Implantable Collamer pIOL for the correction of myopia (moderate and high), the pIOL vault, endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected DVA (CDVA), and detrimental events were examined over 3 years.

Results

Based on the findings, the mean spherical equivalent reduced from − 8.15 ± 3.29 before surgery to − 1.02 ± 0.75 diopters 3 years after the surgery. In terms of visual outcomes, the mean UDVA (Log MAR) significantly increased from 0.95 ± 037 to 0.27 ± 0.28, and the mean CDVA also increased from 0.99 ± 0.11 to 0.06 ± 0.08 (P < 0.05). The mean indices of safety and efficacy were respectively 1.075 and 0.748. The eyes lost not more than two visual acuity lines. Based on the findings, 82% achieved 0.80 or better CDVA, while the total endothelial cell loss was 7.96% during 3 years. Overall, vision-threatening conditions were not reported.

Conclusion

The introduced pIOL can be considered a safe and efficient method for myopia at moderate to high levels.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Ophthalmology

Medicine

Erratum to: Irreversible phenotypic perturbation and functional impairment of B cells during HIV-1 infection
The original version of this article unfortunately contained a mistake. One of the authors of this article has been misspelled. Xiaoyang Zhang should be Xiaoyan Zhang. The update is also provided here.
Cytokines and inflammation in adipogenesis: an updated review

Abstract

The biological relevance of cytokines is known for more than 20 years. Evidence suggests that adipogenesis is one of the biological events involved in the regulation of cytokines, and pro-inflammatory cytokines (e.g., TNFα and IL-1β) inhibit adipogenesis through various pathways. This inhibitory effect can constrain the hyperplastic expandability of adipose tissues. Meanwhile, chronic low-grade inflammation is commonly observed in obese populations. In some individuals, the impaired ability of adipose tissues to recruit new adipocytes to adipose depots during overnutrition results in adipocyte hypertrophy, ectopic lipid accumulation, and insulin resistance. Intervention studies showed that pro-inflammatory cytokine antagonists improve metabolism in patients with metabolic syndrome. This review focuses on the cytokines currently known to regulate adipogenesis under physiological and pathophysiological circumstances. Recent studies on how inhibited adipogenesis leads to metabolic disorders were summarized. Although the interplay of cytokines and lipid metabolism is yet incompletely understood, cytokines represent a class of potential therapeutic targets in the treatment of metabolic disorders.

Overexpressed long noncoding RNA CRNDE with distinct alternatively spliced isoforms in multiple cancers

Abstract

Alternative splicing is a tightly regulated process that contributes to cancer development. CRNDE is a long noncoding RNA with alternative splicing and is implicated in the pathogenesis of several cancers. However, whether deregulated expression of CRNDE is common and which isoforms are mainly involved in cancers remain unclear. In this study, we report that CRNDE is aberrantly expressed in the majority of solid and hematopoietic malignancies. The investigation of CRNDE expression in normal samples revealed that CRNDE was expressed in a tissue- and cell-specific manner. Further comparison of CRNDE expression in 2938 patient samples from 15 solid and hematopoietic tumors showed that CRNDE was significantly overexpressed in 11 malignancies, including 3 reported and 8 unreported, and also implicated that the overexpressed isoforms differed in various cancer types. Furthermore, anti-cancer drugs could efficiently repress CRNDE overexpression in cancer cell lines and primary samples, and even had different impacts on the expression of CRNDE isoforms. Finally, experimental profiles of 12 alternatively spliced isoforms demonstrated that the spliced variant CRNDE-g was the most highly expressed isoform in multiple cancer types. Collectively, our results emphasize the cancer-associated feature of CRNDE and its spliced isoforms, and may provide promising targets for cancer diagnosis and therapy.

Histone variants: critical determinants in tumour heterogeneity

Abstract

Malignant cell transformation could be considered as a series of cell reprogramming events driven by oncogenic transcription factors and upstream signalling pathways. Chromatin plasticity and dynamics are critical determinants in the control of cell reprograming. An increase in chromatin dynamics could therefore constitute an essential step in driving oncogenesis and in generating tumour cell heterogeneity, which is indispensable for the selection of aggressive properties, including the ability of cells to disseminate and acquire resistance to treatments. Histone supply and dosage, as well as histone variants, are the best-known regulators of chromatin dynamics. By facilitating cell reprogramming, histone under-dosage and histone variants should also be crucial in cell transformation and tumour metastasis. Here we summarize and discuss our knowledge of the role of histone supply and histone variants in chromatin dynamics and their ability to enhance oncogenic cell reprogramming and tumour heterogeneity.

Four-year follow-up of patients with imatinib-resistant or intolerant chronic myeloid leukemia receiving dasatinib: efficacy and safety

Abstract

Dasatinib is a highly effective second-generation tyrosine kinase inhibitor used to treat chronic myeloid leukemia (CML). In 2007, a pivotal phase-2 study of dasatinib as second-line treatment was initiated in 140 Chinese CML patients. This report from the 4-year follow-up revealed that 73% of 59 patients in chronic phase (CML-CP) and 32% of 25 patients in accelerated phase (CML-AP) remained under treatment. The initial dosage of dasatinib for CML-CP and CML-AP patients were 100 mg once daily and 70 mg twice daily (total = 140 mg/ day), respectively. The cumulative major cytogenetic response (MCyR) rate among patients with CML-CP was 66.1% (versus 50.8% at 18 months), and the median time to MCyR was 12.7 weeks. All CML-CP patients who achieved MCyR after a 4-year follow-up also achieved a complete cytogenetic response. The cumulative complete hematological response (CHR) rate among patients with CML-AP was 64% (16/25), with three CML-AP patients achieving CHR between 18 months and 4 years of follow-up; the median time to CHR was 16.4 weeks. The adverse event (AE) profile of dasatinib at 4 years was similar to that at 6 and 18 months. The most frequently reported AEs (any grade) included pleural effusion, headache, and myelosuppression. These long-term follow-up data continue to support dasatinib as a second-line treatment for Chinese patients with CML.

Homoharringtonine is a safe and effective substitute for anthracyclines in children younger than 2 years old with acute myeloid leukemia

Abstract

Homoharringtonine (HHT), a plant alkaloid from Cephalotaxus harringtonia, exhibits a unique anticancer mechanism and has been widely used in China to treat patients with acute myeloid leukemia (AML) since the 1970s. Trial SCMC-AML-2009 presented herein was a randomized clinical study designed based on our previous findings that pediatric AML patients younger than two years old may benefit from HHT-containing chemotherapy regimens. Patients randomized to arm A were treated with a standard chemotherapy regimen comprising mainly of anthracyclines and cytarabine (Ara-C), whereas patients in arm B were treated with HHT-containing regimens in which anthracyclines in all but the initial induction therapy were replaced by HHT. From February 2009 to November 2015, 59 patients less than 2 years old with de novo AML (other than acute promyelocytic leukemia) were recruited. A total of 42 patients achieved a morphologic complete remission (CR) after the first course, with similar rates in both arms (70.6% vs.72.0%). At the end of the follow-up period, 40 patients remained in CR and 5 patients underwent hematopoietic stem cell transplantation in CR, which could not be considered as events but censors. The 5-year event-free survival (EFS) was 60.2%±9.6% for arm A and 88.0%±6.5% for arm B (P= 0.024). Patients in arm B experienced shorter durations of leukopenia, neutropenia, and thrombocytopenia and had a lower risk of infection during consolidation chemotherapy with high-dosage Ara-C. Consequently, the homoharringtonine-based regimen achieved excellent EFS and alleviated hematologic toxicity for children aged younger than 2 years with de novo AML compared with the anthracycline-based regimen.

Minimal residual disease-directed immunotherapy for high-risk myelodysplastic syndrome after allogeneic hematopoietic stem cell transplantation

Abstract

The efficacy of minimal residual disease (MRD)-directed immunotherapy, including interferon-α (IFN- α) treatment and chemotherapy plus granulocyte colony-stimulating factor-primed donor leukocyte infusion (chemo-DLI), was investigated in patients with high-risk myelodysplastic syndrome (MDS) who were MRD-positive after allogeneic hematopoietic stem cell transplantation (allo-HSCT). High-risk MDS patients who received non-T-cell-depleted allo-HSCT at the Peking University Institute of Hematology and were MRD-positive after allo-HSCT were studied (n = 47). The MRD-positive status was considered if leukemia-associated aberrant immune phenotypes or Wilms’ tumor gene 1 expression is present in a single bone marrow sample. The cumulative incidence of the relapse and non-relapse mortality 2 years after immunotherapy were 14.5% and 21.4% (P = 0.377) and 9.1% and 0.0% (P = 0.985) for patients in the IFN-α and chemo-DLI groups, respectively. The probability of disease-free and overall survival 2 years after immunotherapy were 76.4% and 78.6% (P = 0.891) and 84.3% and 84.6% (P = 0.972) for patients in the IFN-α and chemo-DLI groups, respectively. Persistent MRD after immunotherapy was associated with poor survival. Thus, the MRD-directed immunotherapy was effective for patients with high-risk MDS who were MRD-positive after allo-HSCT, and the efficacy was comparable between chemo-DLI and IFN-α treatment.

Homoharringtonine synergy with oridonin in treatment of t(8; 21) acute myeloid leukemia

Abstract

Collaboration of c-KIT mutations with AML1–ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.

HLA and lung transplantation

Abstract

Lung transplantation is increasingly practiced for patients with end-stage lung disease. The successful outcome of solid organ transplantation today is severely impeded by the production of alloantibodies, mainly directed against the protein products of the HLA complex of the organ donor. While the association between antibody mediated rejection and allograft damage has been well established in renal and heart transplantation, it has not yet been well characterized in lung transplantation. This review addresses the question of HLA matching in lung transplantation and current knowledge of the allogenicity of different HLA class I and II antigens. The role of the antibody mediated immune response is discussed as well as the importance of pre-transplant or de novo post-transplant circulating antibodies. Finally, potential mechanisms, which may act individually or in combination, of antibody mediated damage to solid organ transplants are considered.

Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy: China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study

Abstract

Invasive fungal disease (IFD) is a major infectious complication in patients with hematological malignancies. In this study, we examined 4889 courses of chemotherapy in patients with hematological diseases to establish a training dataset (n = 3500) by simple random sampling to develop a weighted risk score for proven or probable IFD through multivariate regression, which included the following variables: male patients, induction chemotherapy for newly diagnosed or relapsed disease, neutropenia, neutropenia longer than 10 days, hypoalbuminemia, central-venous catheter, and history of IFD. The patients were classified into three groups, which had low (0–10, ~1.2%), intermediate (11–15, 6.4%), and high risk ( > 15, 17.5%) of IFD. In the validation set (n = 1389), the IFD incidences of the groups were ~1.4%, 5.0%, and 21.4%. In addition, we demonstrated that antifungal prophylaxis offered no benefits in low-risk patients, whereas benefits were documented in intermediate (2.1% vs. 6.6%, P = 0.007) and high-risk patients (8.4% vs. 23.3%, P = 0.007). To make the risk score applicable for clinical settings, a pre-chemo risk score that deleted all unpredictable factors before chemotherapy was established, and it confirmed that anti-fungal prophylaxis was beneficial in patients with intermediate and high risk of IFD. In conclusion, an objective, weighted risk score for IFD was developed, and it may be useful in guiding antifungal prophylaxis.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Medicine

Cultural Heritage

Calcium oxalate films on works of art: A review
Publication date: Available online 14 June 2019

Source: Journal of Cultural Heritage

Author(s): Laura Rampazzi

Abstract

This work presents a review of the findings of calcium oxalate films, a widespread decay phenomenon recovered on stone and other substrates (mortars, wall and easel paintings, written materials, glass). The specific attention given to the issue in the 1990s has decreased, although articles have documented films until the present day. The review provides critical insights into the literature, focusing on the general properties of films, numerous case studies, the instrumental techniques used to characterise and date films, insights into the possible origin of the decay phenomenon, and an evaluation of the protective role of calcium oxalate layers. The practice of creating artificial films on stone surfaces for protective purposes is also considered. An evaluation of the literature over the last few decades shows various open issues. The origin is still up for debate, and the issue is still of major concern to conservation scientists, conservators, and restorers. The scientific community tends to attribute a biological origin to these films, however further studies are needed to study exactly how they form, focusing for example on simulation tests of the chemical and atmospheric pathway. How these films protect the artwork in terms of the mechanical properties of the surface underneath deserves more study. This would also help restorers to reproduce the calcium oxalate. The bibliography highlights the prevalence of calcium oxalate findings in the Mediterranean Basin and the formation of the least stable form, i.e. weddellite, which has yet to be explained.

Virtual reality in maritime archaeology legacy data for a virtual diving on the shipwreck of the Mercurio (1812)
Publication date: Available online 14 June 2019

Source: Journal of Cultural Heritage

Author(s): Massimiliano Secci, Carlo Beltrame, Stefania Manfio, Francesco Guerra

Abstract

Virtual Reality is becoming a complete and original way to leverage the enormous potential of the underwater cultural heritage world. In this paper, we illustrate how we used this tool and other 3D reconstruction to create a virtual experience on the Mercurio shipwreck. The brig Mercurio, sunk during the Battle of Grado (1812), currently lies at a depth of 17 m in the northern Adriatic Sea. Artifacts recovered during investigations made by the Università Ca’ Foscari are now exposed in the Museum of the Sea in Caorle where a multimedia station has been installed. In order to create the virtual dive on this site, it was necessary to process legacy data from the photogrammetry surveys made during the excavation campaigns carried out when VR was unknown in archaeology. The paper presents this original way to create a virtual dive on an ancient shipwreck from archival and heterogeneous data.

Microstructure imaging of Florentine stuccoes through X-ray tomography: A new insight on ancient plaster-making techniques
Publication date: Available online 11 June 2019

Source: Journal of Cultural Heritage

Author(s): Florian Beaugnon, Gianluca Gariani, Emmanuelle Gouillart, Anne Bouquillon, Marc Bormand, Gilles Wallez

Abstract

Gypsum-based plasters or stuccoes, in spite of their importance and diffusion, received little attention in cultural heritage materials studies. This work introduces a new, non-destructive methodology, using micro-tomography to measure the water/plaster ratio and the morphology of the hemihydrate powder used to make plasters on < 1 mm3 samples. This methodology give insight in both the raw material (and ultimately provenance) and the technique used to make plaster. The methodology was tested first on mock-up samples of known composition, then in a case study on 13 low-relief cast plaster sculptures from 15th century Florentine artists. Preliminary conclusions on this limited corpus show relative uniformity across most reliefs in terms of raw materials and techniques. The casts of one model (Nativity, attributed to Donatello and B. Bellano) were made with a different raw material, in line with prior geochemical analyses; these results support the previous attribution to a North Italian rather than Florentine origin. The casts of a second model (Virgin and Child, type of Saint Petersburg, attributed to Antonio Rossellino) were prepared with a different technique. This surprising result was not expected from Art History or previous studies.

Application of imaging polarimeters to enhanced detection of stone carving
Publication date: Available online 11 June 2019

Source: Journal of Cultural Heritage

Author(s): Haifeng Wang, Yongquan Luo, Caidan An, Songnan Chu, Zhixue Shen, Lixian Huang, Dayong Zhang

Abstract

The enhanced detection and identification of stone carvings is significant for the remote sensing and digital museum project of cultural relic. In addition, imaging polarimeters have the potential to be efficient detectors owing to their superiority in terms of their capability of recognizing object contours and surface roughness. In this paper, the polarization changes of stone materials with different angles and varying degrees of roughness are theoretically analyzed and detected by a high-precision imaging polarimeter based on the liquid crystal variable retarder (LCVR) innovatively. It is observed that the detection of carving characteristics is enhanced in polarized imaging owing to the depressed background and enhanced contrast. The experimental finding indicates that polarized imaging has an exciting function in the remote sensing of stone carvings and enhanced detecting of the fuzzy inscriptions. This kind of specialized photography complements other, equally important recording techniques in the quest for comprehensive documentation of faint carvings.

The pigments of the frigidarium in the Sarno Baths, Pompeii: Identification, stratigraphy and weathering
Publication date: Available online 11 June 2019

Source: Journal of Cultural Heritage

Author(s): Ivana Angelini, Yotam Asscher, Michele Secco, Matteo Parisatto, Gilberto Artioli

Abstract

In the present research is used a multi-analytical approach to study the wall paintings from the Sarno Baths, located in the southern part of Pompeii. In particular the investigation is focused on the frescos of the frigidarium, though a few samples from other rooms were also analysed. Twenty wall paintings fragments were analysed by laser scanning confocal microscopy (LSCM), optical microscopy (OM), μ-Raman, scanning electron microscope with energy dispersive spectrometry (SEM-EDS), portable X-ray fluorescence spectrometry (p-XRF) and X-ray powder diffraction (XRPD). The XRPD data were used for the mineralogical semi-quantitative phase analyses (SQPA) and the estimation of the hematite crystals size. The obtained data allow the identification of the pigments and the techniques used, and address new question such as whether talc and aragonite were used routinely in the formulation of pigments. The chemical composition of red and yellow pigments is also discussed and compared with data available from the recent literature. The wall paintings are badly preserved and weathering products occur on the pictorial surface. Eight samples of efflorescence salts and patinas were analysed by XRPD: all the samples are composed mainly by alkali sulphates. The systematic difference between the salts present on the northern and the western walls is likely related to the materials inserted during the 19th century restauration.

The deposition from the Cross in the church of Saint-Germain-en-Laye (France): A masterpiece of Romanesque sculpture? Materials characterization to solve a 20th c. mystery
Publication date: Available online 10 June 2019

Source: Journal of Cultural Heritage

Author(s): Alessia Coccato, Luciana Mantovani, Romano Ferrari, Danilo Bersani, Mario Tribaudino, Pier Paolo Lottici

Abstract

Dating and authenticating stone-sculpted works of art is a challenging aspect of cultural heritage studies. In fact, it is often possible to provenance the rock, by comparison of petrological, mineralogical and geochemical data, but no dating of the sculpture can be obtained. Also, stylistic observations need to be considered with care. However, in the case of mastic incrustation sculptures, the applied polychromy can support dating studies, based on pigments and binders. In the church of Saint-Germain-en-Laye, a haut-relief representing the Deposition from the Cross is exposed. The calcareous slab is decorated with red and black mastics. It resembles closely the Deposition from the Cross in the transept of Parma Cathedral, dated 1178 and “signed” by Benedictus Antelami. However, the St-Germain Deposition appeared in 1994, when it was donated to the parish by the descendants of Julien Auguste Duperrier, marble worker and collector of Italian antiquities. His last trip to Italy took place in 1924. No information is available on his deal, neither on the transport means arranged, nor on the sculpture itself (author, contractor, date, etc.). Art historical and historical considerations propose either a 12th or 19th–20th c. context for the creation of the sculpture. Chemical analyses of the pigments and binders are therefore proposed to clarify the dating the work of art. Microscopic samples are characterized by a multi-analytical approach: vibrational spectroscopies and X-ray powder diffraction are used to characterize the rock and the polychrome mastic. The rock is identified as a micritic limestone, and shows sulphation issues. Through Raman scattering measurements, the pigments were identified: carbon in the black mastic, and a mixture of red lead and a modern synthetic pigment (PR49:1) in the red areas. This information sheds new light on the chronology and manufacture of the Deposition from the Cross of Saint-Germain-en-Laye. These results allow for a better definition of further lines of research, and to finally propose an authorship for the sculpture.

Erratum to “Investigation of cellulose nitrate and cellulose acetate plastics in museum collections using ion chromatography and size exclusion chromatography” [J. Cult. Herit. (2019) 263–70]
Publication date: Available online 10 June 2019

Source: Journal of Cultural Heritage

Author(s): Joy Mazurek, Anna Laganà, Vincent Dion, Suzanna Etyemez, Carolyn Carta, Michael R. Schilling

Mitigating salt damage in building materials by the use of crystallization modifiers – a review and outlook
Publication date: Available online 5 June 2019

Source: Journal of Cultural Heritage

Author(s): Sanne J.C. Granneman, Barbara Lubelli, Rob P.J. van Hees

Abstract

Salt crystallization damage in porous building materials is a widespread phenomenon. Several solutions to prevent, or mitigate, salt damage in building materials, prolonging thereby their service-life have been proposed. One of the latest approaches is the use of crystallization modifiers, aiming at reducing the crystallization pressure and/or favouring the crystallization of salts at the surface (efflorescence) instead of in the pores of the materials (crypto-florescence1). This paper summarizes the working mechanisms of crystallization modifiers and critically reviews the available literature on their use in building materials; finally, it provides an outlook on the potentials of modifiers for the mitigation of salt crystallization damage in building materials.

Visual information retrieval from historical document images
Publication date: Available online 4 June 2019

Source: Journal of Cultural Heritage

Author(s): Sara Zhalehpour, Ehsan Arabnejad, Chad Wellmon, Andrew Piper, Mohamed Cheriet

Abstract

Information retrieval from documentary heritage is considered a challenging issue because of the documents’ unique structures and level of degradation. Text characters in printed documents historically are accompanied by typographical objects. Retrieving and pursuing these visual typographical elements, which inform the content of historical manuscripts can help us better understand our documentary cultural heritage. Extracting these visual objects aids us in understanding and conveying more information about different practices of representation in historical documents and their effects on the current trends of publishing. Two important typographical objects related to the history of knowledge and information are footnotes and tables; the former are one of the critical elements that demonstrate authority and link the manuscript to its sources, and the latter summarize information in a compact and organized manner essential to the growth of scientific knowledge. To the best of our knowledge, there is currently no work that considers in depth the automated detection of these two typographical objects from the large collections of historical documents that would allow further historical study. This article focuses on the problem of detecting the presence of these two visual elements from historical printed documents and establishes two frameworks. The footnote detection framework uses a set of layout-based methods to extract some features regarding the font and appearance, and the table detection framework extracts spectral-based features from the images. These frameworks are tested on a large collection of 18th-century printed documents with more than 32 million images, and the results show their effectiveness and generalization power.

Changes in biodeterioration patterns of mural paintings: Multi-temporal mapping for a preventive conservation strategy in the Crypt of the Original Sin (Matera, Italy)
Publication date: Available online 2 June 2019

Source: Journal of Cultural Heritage

Author(s): Giulia Caneva, Flavia Bartoli, Martina Fontani, Doretta Mazzeschi, Paolo Visca

Abstract

Multi-temporal investigation of biodeterioration patterns (BPs) in cultural heritage sites is crucial for the development of effective management plans. Here, microscopy and biomolecular methods were employed to analyze the BPs, which took place in the Crypt of the Original Sin (Italy) over a wide temporal scale, i.e., from 2001 to 2017. Before restoration interventions, performed in 2002–2003, a variety of BPs was observed, including green patinas (Chlorophyceae), brown-black patinas (Cyanobacteria), rosy discolorations (Actinobacteria) and some colonization by lichens, mosses and ferns. Restoration included biocide treatments as well as structural interventions causing environmental modifications of the site. To interpret the ecological relationships between environmental factors and temporal changes, we combined the analysis of ecological information on the various BPs with the results of a multivariate statistical analysis. Using BPs as bioindicators, humidity maps of the plasters were generated and water infiltration paths reconstructed. Several years after biocide application, a significant reduction of BPs was observed, together with limited colonization by dematiaceous and meristematic fungi. Our observations demonstrate the usefulness of combining structural and environmental interventions for an effective restoration strategy; these interventions reduced the moisture levels of the walls, consequently reducing biological colonization. Moreover, our findings suggest that monitoring BPs during time can be of guidance in the long-term maintenance of cultural heritage, and provide an evidence-based model for preventive interventions and biocide treatments.

Graphical abstract

Graphical abstract for this article

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Cultural Heritage

Urologie und Urogynäkologie/Österreich

Chronische Zystitis
Kindliche Urolithiasis – ein Fallbericht und aktuelle Strategie

Zusammenfassung

Etwa 1 % aller Fälle der symptomatischen Urolithiasis in Deutschland betreffen Kinder und Jugendliche unter 18 Jahren. Wir präsentieren den Fall eines 5 Jahre alten Mädchens mit symptomatischer Nephrolithiasis, welche in unserer Klinik per ESWL behandelt und im weiteren Verlauf mit allen notwendigen Folgeeingriffen betreut wurde. Basierend auf den aktuellen Leitlinien folgt im Anschluss daran eine Darstellung der Abklärungs- und Behandlungs- Strategie der kindlichen Urolithiasis.

Transurethrale Resektion der Prostata unter Verwendung einer suprapubischen Absaugvorrichtung

Zusammenfassung

Auch wenn die transurethrale Resektion der Prostata (TURP) den Goldstandard in der chirurgischen Behandlung der symptomatischen Prostatahyperplasie bei kleinen Prostatadrüsen darstellt, werden derzeit bei Prostatavolumina >70–80 cm3 aufgrund des höheren Risikoprofils invasivere oder kostspieligere Interventionen empfohlen. In dieser kombiniert retro- und prospektiven Studie evaluierten wir die perioperativen Komplikationen und postoperativen Langzeitergebnisse von Patienten mit einem Prostatavolumen <70 cm3 und >70 cm3 nach TURP unter der Verwendung einer suprapubischen Absaugvorrichtung. Hinsichtlich Komplikationen und funktionellen Ergebnissen fanden sich keine signifikanten Unterschiede zwischen den beiden Gruppen. Die Modalität der monopolaren TURP bewährte sich damit auch bei Prostatavolumina >70 cm3als ein sicheres und effektives Verfahren.

Prostatakarzinom-Highlights vom ASCO-GU
Vaginale Manifestation eines Urothelkarzinoms – Metastase oder Primärtumor?

Zusammenfassung

Das Urothelkarzinom der Harnblase (auch Transitionalzellkarzinom [TCC]) zählt weltweit zu den häufigsten Malignomen der Frau. Es metastasiert bevorzugt in Knochen, Leber, Gehirn und Peritoneum. Vaginale Manifestationen dieser Tumorentität gelten jedoch als untypisch und sind extrem selten. Die Entstehung solcher vaginalen Manifestationen ist noch ungeklärt und derzeit Gegenstand intensiver Forschungen. Wir berichten den seltenen Fall einer 72-jährigen Patientin mit einem vaginalen Rezidiv eines Urothelkarzinoms bei primär nicht muskelinvasivem niedriggradigem Karzinom der Harnblase. Hierbei sollen wichtige klinische und therapeutische Aspekte hervorgehoben werden.

Urogynäkologie und Hormone
Kindliche Obstipation und M. Hirschsprung

Zusammenfassung

Einleitung

Die Obstipation stellt eine der häufigsten chronischen Erkrankungen im Kindesalter dar, sodass diese ca. 3–5 % der ambulanten pädiatrischen bzw. bis zu 25 % der pädiatrisch-gastroenterologischen Besuche ausmacht. Zusätzlich kann Obstipation die Lebensqualität der Betroffenen bis zum Erwachsenenalter stark beeinträchtigen.

Material und Methoden

In ca. 95 % der Betroffenen liegt eine funktionelle Obstipation vor. In der Regel sind die Kinder am häufigsten zur Zeit der Umstellung auf solides Essen, beim sog. Sauberwerden sowie vor Schulbeginn betroffen, wobei die Kinder wegen schmerzhafter Defäkation den Stuhl zurückhalten. Konsekutiv können sie im weiteren Verlauf aufgrund des Überlaufstuhls eine Pseudoinkontinenz entwickeln. Davon sind ca. 1–4 % der Schulkinder betroffen, wobei die Pseudoinkontinenz oft als Diarrhö fehlgedeutet wird. Die Kinder mit Pseudoinkontinenz und jene unter 4 Jahren haben eine schlechtere Prognose. Die Erfolgsrate nach einer 1‑jährigen Therapiedauer beträgt lediglich 60 %. Insgesamt begünstigt ein früher Therapiebeginn das Outcome. Die konservative Therapie kann aus Diätberatung, Verhaltensmodifikation sowie medikamentöser Therapie bestehen.

Im Gegensatz liegen bei ca. 5 % der Betroffenen organische Ursachen für die Obstipation vor – am häufigsten ein M. Hirschsprung (MH). Bereits während der Erstuntersuchung sollte auf mögliche Warnhinweise für MH geachtet werden: verzögerter Mekoniumabgang, Gedeihstörung, distendiertes Abdomen, erhöhter Sphinktertonus und Ausbleiben des Erfolgs der konservativen Therapie. Extrem wichtig ist eine rasche Diagnostik, andernfalls droht eine lebensbedrohliche Enterokolitis mit Fieber, abdominaler Distension, Lethargie, bakterieller Überwucherung und explosiver blutiger Diarrhö. Nach gesicherter Diagnose eines MH mittels Rektummanometrie, Kontrastmitteldarstellung und Biopsien erfolgt die endgültige operative Sanierung: Der aganglionäre Anteil des Dickdarms wird reseziert und der normoganglionäre unter Erhaltung des analen Sphinkters zum Anus durchgezogen – ein Eingriff, der Zentren mit Expertise vorbehalten sein muss. Die teilweise vermeidbaren Komplikationen sind die postoperative Obstipation, Inkontinenz und Strikturen gehören hingegen zu den vermeidbaren. Trotz korrekter Operation kann sich die dementsprechend die nichtvermeidbare Komplikation einer Enterokolitis entwickeln. Für das postoperative Management und zur rechtzeitigen Erkennung von Komplikationen bedarf es einer langfristigen Betreuung.

Schlussfolgerungen

Eine große Zahl der Betroffenen mit funktioneller Obstipation benötigt eine Langzeittherapie, da sie häufig Rezidive aufweisen. Beim Vorliegen von Warnhinweisen, die auf M. Hirschsprung hindeuten, sollten die Menschen an Zentren mit hoher Expertise in der operativen Technik und der langfristigen postoperativen Betreuung weitergeleitet werden, auch im Interesse der Lebensqualität im Erwachsenenalter.

Operative Therapie der benignen Prostatahyperplasie – Versorgungsrealität und Outcome

Zusammenfassung

Zielsetzung

Die TUR-P gilt nach wie vor als Referenzverfahren in der Behandlung der gutartigen Prostataobstruktion (BPO); die Grünlicht-Laser-Vaporisation (PVP) und die Thulium-Laser-Vapoenukleation (ThuVEP) sind inzwischen ebenfalls etablierte Therapieverfahren. Ziel dieser prospektiven Untersuchung ist der Vergleich dieser Verfahren in der täglichen Routine anhand eines ungefilterten großen Patientenkollektivs.

Methoden

Diese prospektive multizentrische Datenerhebung untersucht die Morbidität, den perioperativen Verlauf und das postoperative Follow-up nach transurethraler Intervention zur Therapie des BPO an einem konsekutiven Patientenkollektiv, das zwischen 2011 und 2014 in der Metropolregion Hamburg mit TUR-P, PVP oder ThuVEP behandelt wurde. Der postoperative Verlauf wurde durch das Versenden von Fragebögen an die Patienten ermittelt („patient-related outcome measurement“ [PROM]).

Ergebnisse

Im erfassten Zeitraum wurden 2648 Patienten behandelt. Mit allen Verfahren wurde die sofortige Verbesserung der Miktionsparameter erreicht. Die multivariate Analyse bestätigte eine Verkürzung der Liegezeit durch den Einsatz von Laserverfahren (p < 0,001). Patienten unter fortgesetzter gerinnungsbeeinflussender Medikation hatten eine verlängerte Verweildauer (p < 0,001). Perioperative Komplikationen und Reinterventionen (Clavien 3b) waren in der PVP-Gruppe am seltensten (p = 0,016; p < 0,001). Das durchschnittliche Follow-up betrug 3,2 Jahre. Die Rücklaufquote der Fragebögen betrug 60,7 %. Der IPSS fiel in der TUR-P-, PVP- und ThuLEP-Gruppe auf 7,6; 7,1 und 5,9 ab. Die IPSS-Reduktion war in der ThuVEP-Gruppe am stärksten ausgeprägt (p < 0,001). In der TUR-P- und in der PVP-Gruppe verbesserte sich die QoL auf 1,72 bzw. 1,66, in der ThuVEP-Gruppe auf 1,3. Auch dieser Unterschied ist signifikant (p < 0,001).

Schlussfolgerung

Die transurethrale abladierende Therapie der BPO ist bei allen untersuchten Verfahren sicher und effektiv möglich. Die Volumenreduktion ist bei der ThuVEP am größten. Die PVP hat die niedrigste Komplikationsrate. Die Laserverfahren führen zu einer verkürzten Krankenhausverweildauer. Die hohe Rücklaufquote macht PROM zu einem zuverlässigen Instrument. IPSS und QoL wurden durch alle Verfahren signifikant verbessert. Die ThuVEP erzielte den stärksten Effekt.

Editorial
Urotherapie im interdisziplinären Team

Zusammenfassung

Nach der Definition der „International Children’s Continence Society“ (ICCS) bezeichnet Urotherapie die konservative Therapie von Funktionsstörungen der unteren Harnwege. Ursprünglich aus dem nordeuropäischen Raum stammend gehört Urotherapie im deutschsprachigen Raum seit Jahren zum Standard in der Behandlung der funktionellen kindlichen Blasenstörung. In den letzten Jahren wurde das Behandlungsspektrum erweitert und gewann durch wissenschaftliche Forschung und Professionalisierung weiter an Bedeutung. Urotherapie richtet sich an Menschen, die eine funktionell oder neurologisch bedingte Störung der Blasen- und/oder Darmentleerung haben. Betroffene benötigen eine fachgerechte Ermittlung ihrer Störung und eine entsprechende problem- und lösungsorientierte Behandlung, die ihrer persönlichen Lebenssituation und ihren Fähigkeiten entspricht. Ziele der Urotherapie sind die Entmystifizierung, die Förderung der Kontinenz, die Unterstützung der Betroffenen zum Selbstmanagement sowie die Begleitung der Angehörigen. Urotherapeuten, Mediziner unterschiedlicher Fachbereiche, Psychologen und Physiotherapeuten stellen meist das Team des individuell ausgerichteten Behandlungsprogramms. Um Urotherapie anbieten zu können, bedarf es umfangreichen Wissens zu Theorie und Praxis. Ein fachlich strukturiertes Vorgehen bei Diagnostik, Therapie und interdisziplinärer Teamarbeit ist notwendig, was eine professionelle Ausbildung erfordert. Die Arbeitsgruppe Konsensusgruppe Kontinenzschulung – KgKS e. V. kümmert sich um die Standardisierung von Diagnostik und Therapie der funktionellen kindlichen Harninkontinenz und um die Fort- und Weiterbildung zum Kontinenztrainer. Die interdisziplinär ausgerichtete Weiterbildung zum Urotherapeuten in Bremen eröffnet das professionelle Arbeitsfeld der Urotherapie auch für den Erwachsenenbereich.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480
alsfakia

Urologie und Urogynäkologie/Österreich