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Karger Kompass
   Full-text available via subscription Subscription journal
     ISSN (Print) 2296-0368 - ISSN (Online) 2296-0317
     Published by Karger Homepage  [104 journals]
  • Dermoscopic Findings in Radiation-Induced Alopecia after Angioembolization
    • Abstract: Background: Cases of non-scarring alopecia after endovascular brain surgery have been reported, but dermoscopic findings of these lesions have rarely been published. Objective: To report the dermoscopic findings for alopecic skin lesions that developed after radiation exposure during angioembolization. Methods: Dermoscopic examination was used to evaluate alopecic skin lesions in 10 patients who presented with post-angioembolization alopecia. Results: The male to female ratio was 1:4, mean age 55.0 ± 12.3 years and mean duration to lesion development 3.4 ± 2.5 weeks. The rectangular-shaped lesions mostly occurred at the occiput and temple areas. Both yellow and black dots were the predominant dermoscopic findings in 60% (6/10) of patients, followed by short vellus hair (50%), peripilar sign (20%), broken hair (10%), coiled hair (10%) and white dots (10%). Conclusions: Alopecic skin lesions induced by radiation exposure during angioembolization share characteristic dermoscopy findings with alopecia areata. They may be misdiagnosed if a precise history is not obtained. © 2014 S. Karger AG, Basel
  • Do Stress Markers and Anesthetic Technique Predict Delirium in the
    • Abstract: Background: Postoperative delirium (PD) is a prevalent complication of elderly surgical patients, which predisposes to worsened cognitive recovery and dementia. Risk of PD has been associated with increasing magnitude of the hypothalamic-pituitary-adrenal stress response (serum cortisol, epinephrine and norepinephrine) to surgery. Anesthetics suppress this response; however, some (total intravenous anesthesia, TIVA) more than others (anesthetic gases). Prior comparisons of anesthetics have been equivocal but have not included stress markers. We hypothesized that TIVA would decrease serum stress markers and the incidence of PD. Methods: We performed a prospective cohort study of 76 elderly major surgical patients. Patients received TIVA or sevoflurane gas, and blood was drawn for serum markers pre-, intra-, and postoperatively. PD was assessed with the Confusion Assessment Method. We compared stress markers and PD between patients who received TIVA versus sevoflurane, and then modeled PD including stress and anesthetic. Results: The group that received TIVA during surgery demonstrated lower levels of all stress markers compared to the gas group, but no difference in PD. However, across groups, the postoperative norepinephrine level was much higher in patients who developed PD. Other markers and other times had no effect. Conclusion: The development of PD depends more on postoperative stress than intraoperative stress or anesthetic. © 2014 S. Karger AG, Basel
      Dement Geriatr Cogn Disord 2014;38:366-374
  • Human Natural Killer Cells: Origin, Receptors, Function, and Clinical
    • Abstract: Natural killer (NK) cells are important effectors playing a relevant role in innate immunity, primarily in tumor surveillance and in defenses against viruses. Human NK cells recognize HLA class I molecules through surface receptors (KIR and NKG2A) that inhibit NK cell function and kill target cells that have lost (or underexpress) HLA class I molecules as it occurs in tumors or virus-infected cells. NK cell activation is mediated by an array of activating receptors and co-receptors that recognize ligands expressed primarily on tumors or virus-infected cells. In vivo anti-tumor NK cell activity may be suppressed by tumor or tumor-associated cells. Alloreactive NK cells (i.e. those that are not inhibited by the HLA class I alleles of the patient) derived from HSC of haploidentical donors play a major role in the cure of high-risk leukemia, by killing leukemia blasts and patient's DC, thus preventing tumor relapses and graft-versus-host disease. The expression of the HLA-C2-specific activating KIR2DS1 may also contribute to NK alloreactivity in patients expressing C2 alleles. A clear correlation has been proven between the size of the alloreactive NK cell population and the clinical outcome. Recently, haplo-HSCT has been further improved with the direct infusion, together with HSC, of donor-derived, mature alloreactive NK cells and TCRγδ+ T cells - both contributing to a prompt anti-leukemia effect together with an efficient defense against pathogens during the 6- to 8-week interval required for the generation of alloreactive NK cells from HSC. © 2014 S. Karger AG, Basel
      Int Arch Allergy Immunol 2014;164:253-264
  • Rate, Triggers, Severity and Management of Anaphylaxis in Adults Treated
           in a Canadian Emergency Department
    • Abstract: Background: The Cross-Canada Anaphylaxis Registry (C-CARE) assesses the triggers and management of anaphylaxis and identifies predictors of the development of severe allergic reactions and of epinephrine use. Here, we present data from an urban adult tertiary care emergency department (ED) in Montreal, Canada. Methods: Potential anaphylaxis cases were identified using ICD-10 codes related to anaphylaxis or allergic reactions. Putative cases underwent chart review to ensure they met anaphylaxis diagnostic criteria. Demographic, clinical and management data were collected. Multivariate logistic regressions were conducted to assess the effect of demographic characteristics, triggers, and comorbidities on severity and management of reactions. Results: Among 37,730 ED visits, 0.26% (95% CI 0.21, 0.32) fulfilled the definition of anaphylaxis. Food was the suspected trigger in almost 60% of cases. Epinephrine was not administered in almost half of moderate-to-severe cases, and similar numbers of individuals with moderate-to-severe reactions were not prescribed an epinephrine autoinjector. Reaction to shellfish was associated with more severe reactions (OR 13.9; 95% CI 2.2, 89.4). Older individuals and those not receiving steroids were more likely managed without epinephrine (OR 1.04; 95% CI 1.01, 1.07 and OR 2.97; 95% CI 1.05, 8.39, respectively). Conclusions: Anaphylaxis accounted for a substantial number of ED visits in adults, and the most common trigger was food. There is non-adherence to guidelines recommending epinephrine use for all cases of anaphylaxis. We postulate that this may be related to concerns regarding the side effects of epinephrine in adults. © 2014 S. Karger AG, Basel
      Int Arch Allergy Immunol 2014;164:246-252
  • Breslow Thickness, Clark Index and Ulceration Are Associated with Sentinel
           Lymph Node Metastasis in Melanoma Patients: A Cohort Analysis of 612
    • Abstract: Background: Sentinel lymph node biopsy (SLNB) is the most sensitive procedure for assessing nodal status in patients with primary melanoma. Objective: To evaluate the predictive ability of usual primary melanoma prognosis factors of detecting sentinel lymph node (SLN) metastasis in patients with melanoma. Patients and Methods: A cohort of 612 consecutive patients presenting with primary skin melanoma who underwent a SLNB was evaluated. Assessment of the determinants of SLN metastasis was based on general linear model analysis. The model performance was studied using the concordance statistic and the net reclassification index. The calibration was estimated using the Hosmer-Lemeshow test. Results: The discrimination ability did not differ significantly between Breslow thickness (0.57), Clark index (0.61), ulceration (0.57) and histological subtype (0.55). Clark index, ulceration and Breslow thickness were all significant and independent determinants of SLN metastasis. The predictive ability of the final model was 0.657. Conclusion: Breslow thickness, Clark index and ulceration are independent predictors of a SLN metastasis. © 2014 S. Karger AG, Basel
  • β-Caryophyllene Ameliorates the Alzheimer-Like Phenotype in APP/PS1
           Mice through CB2 Receptor Activation and the PPARγ Pathway
    • Abstract: Background/Aims: The activation of cannabinoid receptor 2 (CB2) has the beneficial effect of reducing neuroinflammatory response in the treatment of Alzheimer's disease (AD) and is suggested to trigger the peroxisome proliferator-activated receptor-γ (PPARγ) pathway; agonists of both receptors improve AD. Recently, the plant metabolite β-caryophyllene was shown to selectively bind to CB2 receptor and act as a full agonist. Methods: In this study, we examined the anti-inflammatory effect of β-caryophyllene in a transgenic APP/PS1 AD model and analyzed whether this effect was mediated by CB2 and PPARγ. Results: β-Caryophyllene, given orally, prevented cognitive impairment in APP/PS1 mice, and this positive cognitive effect was associated with reduced β-amyloid burden in both the hippocampus and the cerebral cortex. Moreover, β-caryophyllene reduced astrogliosis and microglial activation as well as the levels of COX-2 protein and the mRNA levels of the proinflammatory cytokines tumor necrosis factor-α and interleukin-1β in the cerebral cortex. The use of the CB2 antagonist AM630 or the PPARγ antagonist GW9662 significantly reversed the protective effects of β-caryophyllene on APP/PS1 mice. Conclusion: These results demonstrate that the anti-inflammatory effect of the sesquiterpene β-caryophyllene involves CB2 receptor activation and the PPARγ pathway and suggest β-caryophyllene as an attractive molecule for the development of new drugs with therapeutic potential for the treatment of AD. © 2014 S. Karger AG, Basel
      Pharmacology 2014;94:1-12
  • Compound Astragalus and
           Salvia miltiorrhiza Extract
           Suppresses Rabbits' Hypertrophic Scars by Modulating the TGF-β/Smad
    • Abstract: Background: Hypertrophic scars is a fibro-proliferative disease. Our previous studies demonstrated that compound Astragalus and Salvia miltiorrhiza extract (CASE) inhibits proliferation and invasion in keloid fibroblasts. Objective: To investigate the effects of CASE on hypertrophic scars. Methods: Rabbits were divided into a control, a model and three dosage groups of CASE (30, 60 and 120 mg/kg). An animal model of hypertrophic scars were established and rats were treated with CASE ointment or ointment base. Histopathological detection by H&E and Masson's trichrome staining as well as protein expression of scars by Western blot were performed. Results: The hydroxyproline content was decreased under CASE treatment. Transforming growth factor beta 1 (TGF-β1) protein expression increased in the model group while it decreased under CASE treatment. The elevated expression of Smad4 protein was decreased under CASE treatment. Additionally, CASE promoted Smad7 protein expression. Conclusion: CASE could inhibit formation of hypertrophic scars by TGF-β/Smad signal and may be useful for the treatment of hyperplastic scars. © 2014 S. Karger AG, Basel
  • The Longitudinal Evolution of Cerebral Blood Flow Regulation after Acute
           Ischaemic Stroke
    • Abstract: Background: Acute stroke is known to impair cerebral blood flow (CBF) regulation, but the longitudinal changes of these effects have been poorly reported. The main CBF regulatory mechanisms [cerebral autoregulation (CA) and neurovascular coupling (NVC)] were assessed over 3 months after acute ischaemic stroke. Methods: Recordings of CBF velocity (CBFv), blood pressure (BP), and end-tidal CO2 were performed during 5 min baseline and 1 min passive movement of the elbow. Stroke patients were assessed
  • Effect of Intravitreal Bevacizumab Injection before Ahmed Glaucoma Valve
           Implantation in Neovascular Glaucoma
    • Abstract: Ophthalmologica 2013;229:94–100
  • Long-Term Outcome of Polymyositis Treated with High Single-Dose
           Alternate-Day Prednisolone Therapy
    • Abstract: Eur Neurol 2012;68:117–121
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