Gastrointestinal and Hepatic Manifestations in Patients with Generalised Pustular Psoriasis

AlexandrosSfakianakis shared this article with you from Inoreader Gastrointestinal and Hepatic Manifestations in Patients with Generalised Pustular Psoriasis via Wiley: Experimental Dermatology: Table of Contents Abstract Generalised pustular psoriasis (GPP) is a rare and severe form of pustular psoriasis. It is defined by persisting or relapsing macroscopically visible sterile primary pustules occurring on non-acral skin and not within psoriasis plaques. Due to its rarity, there is a lack of randomised controlled trials on GPP and its associated gastrointestinal (GI) and liver disorders. In this article, we present a review of the GI and hepatic disorders associated with GPP. GPP is known to be associated with extracutaneous manifestations such as neutrophilic cholangitis. Abnormal liver function tests are reported in up to 90% of patients with GPP upon diagnosis. Less commonly, pancreatitis and gastrointestinal bleeding have been attributed to GPP. While a psoriasis registry with 7.5% prevalence of pustular psoriasis reported an association with viral hepatitis B and C, the true relationship remains to be elucidated as hepatitis B is endemic in Asia where GPP prevalence is higher. Common genetic mutations between GPP and conditions such as hepatocellular carcinoma and inflammatory bowel disease have been identified, explaining their possible associations and providing answers to potential therapeutic options for these conditions. A lack of recognition of these association may result in unnecessary withdrawal of efficacious and definitive drugs for the treatment of GPP. Understanding the characteristics of the associated GI and hepatic disorders will h ave important implications for targeting the appropriate therapeutics. View on Web

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Combined proliferation and apoptosis index provides better risk stratification in breast cancer

AlexandrosSfakianakis shared this article with you from Inoreader Combined proliferation and apoptosis index provides better risk stratification in breast cancer via Histopathology Introduction Breast cancer (BC) risk stratification is critical for predicting behaviour and guiding management decision-making. Despite the well-established prognostic value of cellular proliferation in BC, the interplay between proliferation and apoptosis remains to be defined. In this study, we hypothesised that the combined proliferation and apoptosis indices can provide a more accurate in vivo growth rate measure and a precise prognostic predictor. Methods and Results Apoptotic and mitotic figures were counted in whole slide images (WSI) generated from haematoxylin and eosin-stained sections of 1545 BC cases derived from two well-defined BC cohorts. Counts were carried out visually within defined areas. There was a significant correlation between mitosis and apoptosis scores. High apoptotic counts were associated with features of aggressive behaviour including high grade, high pleomorphism score, and hormonal receptor negativity. Although the mitotic index (MI) and apoptotic index (AI) were independent prognostic indicators, the prognostic value was synergistically higher when combined. BC patients with a high combined AI and MI had the shortest survival. Replacing the mitosis score with the mitosis-apoptosis index, in the Nottingham grading system, revealed that the modified grade with the new score had a higher significant association with BC-specific survival with a higher hazard ratio. Conclusion Apoptotic figures count provides additional prognostic value in BC when combined with MI, such a combination can be implemented to assess the behaviour of BC and provides an accurate prognostic indicator. This can be considered when using artificial intelligence algorithms to assess proliferation in BC. View on Web

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Strength-based rehabilitation on clinical outcomes in patients post-partial meniscectomy: a systematic review and meta-analysis

AlexandrosSfakianakis shared this article with you from Inoreader Strength-based rehabilitation on clinical outcomes in patients post-partial meniscectomy: a systematic review and meta-analysis via American Journal of Physical Medicine & Rehabilitation - Published Ahead-of-Print Objective To determine the effect of strength-based rehabilitation programs on patients who underwent partial meniscectomy procedures Design Three databases MEDLINE, PubMed and EMBASE were searched from inception to May 9th, 2022. Data on functional outcomes such as quadriceps and hamstring strengths, as well as patient-reported outcomes such as Knee Osteoarthritis and Outcome Score (KOOS) and Visual-Analogue Scale (VAS) were recorded. Results A total of nine studies comprising 417 patients were included in this review. There were no significant differences in quadriceps or hamstring strength measures between pre and post-intervention for both groups. KOOS scores significantly increased from pre and post-intervention in both control and exercise groups. VAS scores changed from 5.0 cm to 1.4 cm in the exercise arm and 3.1 cm to 1.9 cm in the control arm. Conclusion Strength-based exercise programs for patients post-partial meniscectomy did not result in significantly different improvements in quadriceps or hamstring strength compared to control programs. However, strength-based exercise programs resulted in significantly higher KOOS scores and a greater decrease in VAS scores. Further studies, specifically well-designed systematic randomized controlled trials are necessary in order to elucidate the specifics behind what type of exercises to use in addition to load progression and frequency of training. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. View on Web

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Improving trunk postural control facilitates walking in children with cerebral palsy: a pilot study

AlexandrosSfakianakis shared this article with you from Inoreader Improving trunk postural control facilitates walking in children with cerebral palsy: a pilot study via American Journal of Physical Medicine & Rehabilitation - Published Ahead-of-Print Objective The aim of this study was to determine the effects of bilateral trunk support during walking on trunk and leg kinematics and neuromuscular responses in children with cerebral palsy (CP). Design Fourteen children with spastic CP (GMFCS level I to III) participated in this study. Children walked on a treadmill under 4 different conditions, i.e., without support (BASELINE), with bilateral support applied to the upper trunk (UTS), the lower trunk (LTS), and combined upper and lower trunk (CTS). The trunk and leg kinematics and muscle activity were recorded. Results Providing bilateral support to the trunk had a significant impact on the displacement of the pelvis and trunk (p View on Web

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Plasma Biomarkers and Positron Emission Tomography Tau Pathology in Progressive Supranuclear Palsy

AlexandrosSfakianakis shared this article with you from Inoreader Plasma Biomarkers and Positron Emission Tomography Tau Pathology in Progressive Supranuclear Palsy via Movement Disorders Plasma neurofilament light chain (NfL) is a promising biomarker of progressive supranuclear palsy (PSP) to assist in PSP diagnosis and differential diagnosis from Parkinson's disease (PD) and to monitor disease severity. Pending replication in independent cohorts, plasma glial fibrillary acidic protein (GFAP) holds promise for a PSP diagnosis and a differential diagnosis with multiple system atrophy with predominant parkinsonism (MSA-P) and for detecting brainstem atrophy and tau deposition in PSP. ABSTRACT Background Development of disease-modifying therapeutic trials of progressive supranuclear palsy (PSP) urges the need for sensitive fluid biomarkers. Objectives The objectives of this study were to explore the utility of plasma biomarkers in the diagnosis, differential diagnosis, and assessment of disease severity, brain atrophy, and tau deposition in PSP. Methods Plasma biomarkers were measured using a single-molecule array in a cohort composed of patients with PSP, Parkinson's disease (PD), multiple system atrophy with predominant parkinsonism (MSA-P), and healthy controls (HCs). Results Plasma neurofilament light chain (NfL) outperformed other plasma makers (ie, glial fibrillary acidic protein [GFAP], phosphorylated-tau 181 [p-tau181], amyloid-β 1–40, amyloid-β 1–42) in identifying PSP from HC (area under the curve [AUC] = 0.904) and from MSA-P (AUC = 0.711). Plasma GFAP aided in distinguishing PSP from HC (AUC = 0.774) and from MSA-P (AUC = 0.832). It correlated with brainstem atrophy and higher regional tau accumulation. However, plasma p-tau181 neither helped in diagnosis nor was it associated with clinical or neuroimaging measures. Conclusions Plasma NfL and GFAP showed different values in differentiating PSP from HC or controls with other forms of neurodegenerative parkinsonism and detecting disease severity, brain atrophy, or tau deposition in PSP. © 2023 International Parkinson and Movement Disorder Society. View on Web

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Temporomandibular joint meniscopexy using the juggerknot ®soft anchor system. technical note

AlexandrosSfakianakis shared this article with you from Inoreader Temporomandibular joint meniscopexy using the juggerknot ®soft anchor system. technical note via The British Journal of Oral and Maxillofacial Surgery Anterior disk displacement is one of the most frequent temporomandibular joint (TMJ) disorders. Disc displacement can incite inflammatory changes that cause osteoarthritis and progressive degenerative joint disease1. (Source: The British Journal of Oral and Maxillofacial Surgery) View on Web

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Effects of dimension reduction of hyperspectral images in skin gross pathology

AlexandrosSfakianakis shared this article with you from Inoreader Effects of dimension reduction of hyperspectral images in skin gross pathology via Wiley: Skin Research and Technology: Table of Contents Abstract Background Hyperspectral imaging (HSI) is an emerging modality for the gross pathology of the skin. Spectral signatures of HSI could discriminate malignant from benign tissue. Because of inherent redundancies in HSI and in order to facilitate the use of deep-learning models, dimension reduction is a common preprocessing step. The effects of dimension reduction choice, training scope, and number of retained dimensions have not been evaluated on skin HSI for segmentation tasks. Materials and methods An in-house dataset of HSI signatures from pigmented skin lesions was prepared and labeled with histology. Eleven different dimension reduction methods were used as preprocessing for tumor margin detection with support vector machines. Cluster-wise principal component analysis (ClusterPCA), a new variant of PCA, was proposed. The scope of application for dimension reduction was also investigated. Results The components produced by ClusterPCA show good agreement with the expected optical properties of skin chromophores. Random forest importance performed best during classification. However, all methods suffered from low sensitivity and generalization. Conclusion Investigation of more complex reduction and segmentation schemes with emphasis on the nature of HSI and optical properties of the skin is necessary. Insights on dimension reduction for skin tissue could facilitate the development of HSI-based systems for cancer margin detection at gross level. View on Web

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Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

AlexandrosSfakianakis shared this article with you from Inoreader Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches via Journal of Computer Assisted Tomography - Published Ahead-of-Print Objective This article aimed to differentiate noncalcified hamartoma from pulmonary carcinoid preoperatively using computed tomography (CT) radiomics approaches. Materials and Methods The unenhanced CT (UECT) and contrast-enhanced CT (CECT) data of noncalcified hamartoma (n = 73) and pulmonary carcinoid (n = 54; typical/atypical carcinoid = 13/41) were retrospectively analyzed. The patients were randomly divided into the training and validation sets. A total of 396 radiomics features were extracted from UECT and CECT, respectively. The features were selected by using the minimum redundancy maximum relevance and the least absolute shrinkage and selection operator to construct a radiomics model. Clinical factors and radiomics features were integrated to build a nomogram model. The performance of clinical factors, radiomics, and nomogram models on the differential diagnosis between noncalcified hamartoma and carcinoid were investigated. Diagnostic performance of radiologists was also explored. Result In regard to distinguishing noncalcified hamartoma from carcinoid, the areas under the receiver operating characteristic curves of the clinical, radiomics, and nomogram models were 0.88, 0.94, and 0.96 in the training set UECT, and were 0.85, 0.92, and 0.96 in the training set CECT, respectively. The areas under the curve of the 3 models were 0.89, 0.96, and 0.96 in the validation set UECT, and were 0.79, 0.90, and 0.94 in the validation set CECT, respectively. The nomogram model exhibited good calibration and was clinically useful by decision curve analysis. Nomogram did not show significant improvement compared with radiomics, neither for UECT nor for CECT. Diagnostic performance of radiologists was lower than both radiomics and nomogram model. Conclusions Radiomics approaches may be useful in distinguishing peripheral pulmonary noncalcified hamartoma from carcinoid. Radiomics features extracted from CECT provided no significant benefit when compared with UECT. View on Web

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Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach?

AlexandrosSfakianakis shared this article with you from Inoreader Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach? via Journal of Computer Assisted Tomography - Published Ahead-of-Print Objective Incidental gallbladder lesions are common in imaging studies, although it is not always easy to discriminate benign lesions from gallbladder cancer with conventional imaging procedures. The present study aims to assess the capacity of positron emission tomography/computed tomography (PET/CT) with 2-[18F]FDG to distinguish between benign and malignant pathology of the gallbladder, compared with conventional imaging techniques (contrast-enhanced CT or magnetic resonance imaging). Methods Positron emission tomography/CT and conventional imaging studies of 53 patients with gallbladder lesions were evaluated and visually classified as benign, malignant, or inconclusive. Agreement between PET/CT and conventional imaging was determined, and imaging findings were correlated with histology or follow-up. Positron emission tomography/CT images were also analyzed semiquantitatively (SUVmax and maximum tumor-to-liver ratio [TLRmax]). The presence of adenopathies and distant metastases was assessed and compared between both imaging procedures. Results According to histology or follow-up, 33 patients (62%) had a malignant process and 20 (38%) had benign lesions. Positron emission tomography/CT and conventional imaging showed a moderate agreement (κ = 0.59). Conventional imaging classified more studies as inconclusive compared with PET/CT (17.0% and 7.5%, respectively), although both procedures showed a similar accuracy. Malignant lesions had significantly higher SUVmax and, especially, TLRmax (0.89 and 2.38 [P = 0.00028] for benign and malignant lesions, respectively). Positron emission tomography/CT identified more pathologic adenopathies and distant metastases, and patients with regional or distant spread had higher SUVmax and TLRmax in the gallbladder. Conclusions Positron emission tomography/CT is accurate to distinguish between benign and malignant pathology of the gallbladder, with a similar performance to conventional imaging procedures but with less inconclusive results. Malignant lesions present higher SUVmax and TLRmax values. View on Web

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Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis

AlexandrosSfakianakis shared this article with you from Inoreader Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis via Wiley: Clinical Otolaryngology: Table of Contents Abstract Background Currently, the most common surgical modalities used for recurrent respiratory papillomatosis (RRP) resection are microdebrider, carbon dioxide (CO2) laser and potassium-titanyl-phosphate (KTP) laser. However, complication rates vary among different surgical modalities and have been controversial in different studies. Objective of Review This study systematically reviews the available studies which reported intra-operative and post-operative complications, aiming to compare the safety of microdebrider, CO2 laser and KTP laser. Type of Review Meta-analysis. Search Strategy Seven electronic databases (PubMed/MEDLINE, EMBASE[Ovid], Scopus, Cochrane Library and Web of Science) were searched from inception through 28 April 2022. Randomised controlled, prospective or retrospective observational studies that recorded the complications of three different surgical modalities for RRP resection were included in the meta-analysis. Evaluation Method Outcomes of interest were intra-operative and post-operative complications, and complication rate was calculated to evaluate the safety of surgical methods. Results Twenty different studies were included in quantitative synthesis. Only one study compared outcomes of those three kinds of treatment modalities simultaneously, two studies compared microdebrider and CO2 laser, and the remaining studies focussed on only one of three treatments. The weighted average complication rate for microdebrider was 0.03 (95% confidence interval [CI] 0.00–0.21), n = 6, for CO2 laser treatment was 0.16 (95% CI 0.09–0.25), n = 14 and for KTP laser treatment was 0.04 (95% CI 0.00–0.14), n = 4. Conclusion The limited evidence demonstrated that CO2 lasers in the surgical treatment of RRP may lead to more surgical complications, and microdebrider and KTP lasers may be safer. However, the heterogeneous data limit any strong comparison of outcomes of different treatment of laryngeal papillomas. Future randomised controlled trials that directly compare the safety of different surgical modalities are needed. View on Web

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