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Clinical and Experimental Dermatology Oct 2023Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity,...
Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity, mostly presenting as acneiform eruptions, paronychia and xerosis. Erosive pustular dermatosis of the scalp (EPDS) is a rare cutaneous adverse reaction that develops during treatment with EGFRIs. The pathogenesis of EGFRI-induced EPDS is poorly understood. Here we present three cases of EPDS induced by EGFRIs. The proteins LTA4H (leukotriene A-4 hydrolase), METAP1 (methionine aminopeptidase 1), BID (BH3-interacting domain death agonist), SMAD1 (mothers against decapentaplegic homologue), PRKRA (interferon-inducible double-stranded RNA-dependent protein kinase activator A), YES1 (tyrosine-protein kinase Yes) and EGFL7 (epidermal growth factor-like protein 7) were significantly upregulated in EGFRI-stimulated peripheral blood mononuclear cell cultures, and validated in the lesions. All of the proteins colocalized with CD4+ and CD8+ T-cell expression. Next-generation-based human leucocyte antigen (HLA) typing showed all patients carried HLA-C*15:02, and modelling studies showed that afatinib and erlotinib bound well within the E/F binding pockets of HLA-C*15:02. Moreover, T cells were preferentially activated by EGFRIs in individuals carrying HLA-C*15:02. The case series revealed that EGFRI-induced EPDS may be mediated by drug-specific T cells.
Topics: Humans; Scalp; HLA-C Antigens; Leukocytes, Mononuclear; Skin Diseases; Exanthema; ErbB Receptors; Aminopeptidases; Calcium-Binding Proteins; EGF Family of Proteins
PubMed: 37710038
DOI: 10.1093/ced/llad282 -
Scientific Reports Nov 2022The effect of gas-entrapping polydimethylsiloxane (PDMS) microstructures on the dynamics of cavitation bubbles laser-induced next to the PDMS surface is investigated and...
The effect of gas-entrapping polydimethylsiloxane (PDMS) microstructures on the dynamics of cavitation bubbles laser-induced next to the PDMS surface is investigated and compared against the cavitation dynamics next to a flat smooth boundary. Local pressure gradients produced by a cavitation bubble cause the air pockets entrapped in the PDMS microstructures to expand and oscillate, leading to a repulsion of the cavitation bubble. The microstructures were fabricated as boxed crevices via a simple and scalable laser ablation technique on cast acrylic, allowing for testing of variable structure sizes and reusable molds. The bubble dynamics were observed using high speed photography and the surrounding flows were visualized and quantified using particle tracking velocimetry. Smaller entrapped air pockets showed an enhanced ability to withstand deactivation at three stand-off distances and over 50 subsequent cavitation events. This investigation provides insight into the potential to direct the collapse of a cavitation bubble away from a surface to mitigate erosion or to enhance microfluidic mixing in low Reynolds number flows.
PubMed: 36437305
DOI: 10.1038/s41598-022-24746-w -
Journal of Veterinary Dentistry 2011Stabilizing or reducing periodontal pocket depth can have a positive influence on the retention of teeth in dogs. A topical 2% clindamycin hydrochloride gel (CHgel) was... (Randomized Controlled Trial)
Randomized Controlled Trial
Stabilizing or reducing periodontal pocket depth can have a positive influence on the retention of teeth in dogs. A topical 2% clindamycin hydrochloride gel (CHgel) was evaluated for the treatment of periodontal disease in dogs. The CHgel formulation provides for the sustained erosion of the matrix, but also flows into the periodontal pocket as a viscous liquid, and then rapidly forms a gel that has mucoadhesive properties and also may function as a physical barrier to the introduction of bacteria. A professional teeth cleaning procedure including scaling and root planing was done in dogs with one group receiving CHgel following treatment. Periodontal health was determined before and after the procedure including measurement of periodontal pocket depth, gingival index, gingival bleeding sites, and number of suppurating sites. There was a statistically significant decrease in periodontal pocket depth (19%), gingival index (16%), and the number of bleeding sites (64%) at 90-days in dogs receiving CHgel. Additionally, the number of suppurating sites was lower (93%) at 90-days for the group receiving CHgel. The addition of CHgel effectively controlled the bacterial burden (e.g, Fusobacterium nucleatum) at both day 14 and 90. Gingival cells in culture were shown to rapidly incorporate clindamycin and attain saturation in approximately 20-minutes. In summary, a professional teeth cleaning procedure including root planning and the addition of CHgel improves the gingival index and reduces periodontal pocket depth.
Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Chemistry, Pharmaceutical; Clindamycin; Dog Diseases; Dogs; Female; Gels; Male; Oral Hygiene; Periodontal Diseases; Toothpastes; Treatment Outcome
PubMed: 22416621
DOI: 10.1177/089875641102800402 -
Pacing and Clinical Electrophysiology :... Jul 1991Implantation technique for pediatric pacemaking has evolved from predominantly epicardial to predominantly endocardial. One of the potential problems with endocardial...
Implantation technique for pediatric pacemaking has evolved from predominantly epicardial to predominantly endocardial. One of the potential problems with endocardial pacing in children is their very thin subcutaneous tissue, which can result in an unpleasant cosmetic result. The superficialness of the pacemaker pulse generator also may render it more susceptible to erosion and infection. A series is presented of pediatric patients who underwent implantation of a transvenous bipolar pacing system in the pediatric catheterization laboratory. The pacemaker was implanted under the pectoralis major muscle after a muscle spreading incision was made. The lead was also introduced into the subclavian vein under the pectoralis muscle. No complications resulted, and the cosmetic result was judged to be good to excellent by the parents and physicians. No infections or erosions occurred. The subpectoral pocket is recommended as the preferred site for implantation of transvenous pacemakers in pediatric patients.
Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Humans; Infant; Methods; Pacemaker, Artificial; Pectoralis Muscles
PubMed: 1715544
DOI: 10.1111/j.1540-8159.1991.tb02838.x -
Oecologia Oct 2000One way for animals to decrease energy expenditures is to minimize the cost of movement. For animals dwelling on slopes, gravity can impart a large energetic cost to...
One way for animals to decrease energy expenditures is to minimize the cost of movement. For animals dwelling on slopes, gravity can impart a large energetic cost to movement. For this reason, animals traveling aboveground alter their movement patterns in response to the steepness of terrain (specifically hillslope angle) so as to minimize their energetic costs. Subterranean animals should also benefit from choosing optimum movement paths in relation to hillslopes but concurrently must factor the cost of excavation into their movement decisions. In cases where the excavation costs are much higher than the costs of working against gravity, excavation costs may override the consideration of gravitational costs and movement of subterranean animals may be independent of hillslope angle. To determine the response of a subterranean animal to hillslope angle, we excavated tunnels in the burrow systems of 19 pocket gophers in southern California that occupied hillslopes ranging from 2 to 30°. At each excavation we measured several characteristics of burrow geometry and used these data in a model of pocket gopher energetics to calculate the cost of tunnel construction at the various hillslope angles. We found that the cost of tunnel construction was independent of hillslope angle, and that the costs of shearing soil and pushing soil horizontally through the tunnels were 3 orders of magnitude greater than the costs of lifting the soil against the force of gravity. Accordingly, pocket gopher foraging tunnels were oriented independently of the hillslope. The decoupling of the movement patterns of subterranean animals from the effects of gravity is a distinctive feature of the subterranean habit compared to the movement of aboveground animals. Because of the important effects of tunnel construction on soil processes, this unique biological feature of subterranean animals has implications for basic physical processes, such as soil erosion. We found that the rate of soil flux generated by pocket gopher activity was invariant to hillslope. This relationship is in contrast to the most common model of soil movement generated by purely physical processes.
PubMed: 28308219
DOI: 10.1007/PL00008888 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: Investigate structural changes in the tissues of the periodontal complex under the condition of experimental lipopolysaccharide periodontitis combined with...
OBJECTIVE
The aim: Investigate structural changes in the tissues of the periodontal complex under the condition of experimental lipopolysaccharide periodontitis combined with hyper¬thyroidism.
PATIENTS AND METHODS
Materials and methods: The studies were performed on adult white male rats, which simulated periodontitis combined with hyperthyroidism. Periodontal tissues were subjected to morphological examination on the 22nd day of the experiment. Collection of material for microscopic examinations was performed according to the generally accepted method; histological specimens were studied using a light optical microscope.
RESULTS
Results: Morphological studies of the components of the periodontal complex of experimental animals with experimental periodontitis established the reorganization of its structural elements. Damage to the epithelium in the area of attachment of the circular ligament and erosive-ulcerative changes of the gums led to a deepening of the gingival sulcus with the formation of a deep periodontal pocket. Intense hyperkeratosis was observed in the area of the bottom of the periodontal pocket. In the own plate of the mucous membrane of the gums - significant edema, collagen fibers were disorganized, defragmented. There were pronounced destructive-degenerative and inflammatory changes of the epithelial and own plates of all areas of the gums and periodontium, damage to the nuclei and cytoplasm of keratinocytes, fibroblasts, and leukocytes.
CONCLUSION
Conclusions: Experimental periodontitis combined with hyperthyroidism is accompanied by pronounced signs of destructive and inflammatory changes in the soft and dense tissues of the periodontal complex, as well as disruption of stromal-vascular interactions, which progress from reversible to irreversible disruption of periodontal connective tissue.
Topics: Animals; Collagen; Hyperthyroidism; Lipopolysaccharides; Male; Periodontal Pocket; Periodontitis; Rats
PubMed: 36129078
DOI: 10.36740/WLek202208203 -
Pacing and Clinical Electrophysiology :... Dec 2013Subcutaneous implantable cardioverter defibrillator (S-ICD) systems have no components in contact with the heart and may avoid complications such as lead fracture,...
BACKGROUND
Subcutaneous implantable cardioverter defibrillator (S-ICD) systems have no components in contact with the heart and may avoid complications such as lead fracture, venous obstruction, or endocarditis that occur with transvenous leads. Concerns have been raised regarding inappropriate shocks and pocket erosion with S-ICD systems. We have compared the performance of S-ICD and transvenous ICD systems in children and teenagers.
METHODS
We studied consecutive patients <20 years of age who received an ICD over a 4-year period in two Scottish centers. Baseline characteristics, complications, and ICD therapy were recorded. The primary outcome measure was survival. The secondary outcome measure was survival-free from inappropriate ICD therapy or system revision.
RESULTS
Nine S-ICD were implanted in nine patients. Eight transvenous ICD were implanted in six patients; two were redo procedures. Baseline characteristics were well matched. Median duration of follow-up was lower for S-ICD (20 months) than for transvenous ICD (36 months, P = 0.0262). Survival was 100% in both groups. Survival free of inappropriate therapy or system revision was 89% for S-ICD and 25% for transvenous ICD systems (log-rank test, P = 0.0237). No S-ICD were extracted, but three transvenous ICD were extracted due to infection (n = 1) and lead failure (n = 2).
CONCLUSIONS
In real-world use in children and teenagers, S-ICD may offer similar survival benefit to transvenous ICD, with a lower incidence of complications requiring reoperation. In the absence of randomized trials, S-ICD should be compared prospectively with transvenous ICD in large multicenter registries with comparable periods of follow-up.
Topics: Adolescent; Arrhythmias, Cardiac; Child; Child, Preschool; Defibrillators, Implantable; Female; Heart Failure; Humans; Longitudinal Studies; Male; Risk Assessment; Scotland; Survival; Treatment Outcome
PubMed: 24033753
DOI: 10.1111/pace.12233 -
Annales de Cardiologie Et D'angeiologie Jan 2005Life expectancy of patients implanted with cardiac pacemakers has largely increased, so that generator replacement is becoming an important part of the activity in most... (Review)
Review
Life expectancy of patients implanted with cardiac pacemakers has largely increased, so that generator replacement is becoming an important part of the activity in most of the implanting centers. In more than 70% of the cases, the indication for pacemaker replacement is normal battery depletion. Since the new devices are more and more sophisticated and smaller, longevity optimization becomes a real challenge. The main determinant of pacemaker longevity is the output programmed for the pulse generator. It mainly depends on the output voltage and duration settings. The pacing impedance and the percentage of time with pacing are other major determinants of pacemaker longevity. Each manufacturer provides specific policy but the battery voltage and internal impedance are the more accurate and easy-to-obtain battery depletion parameters. The magnet rate is still frequently used but is less valuable since it can drop abruptly at the end of battery life. The complication rate of pacemaker replacement is three-fold higher than the one of first implant. Infections, skin erosions and lead related complications are not uncommon. The replacement should be systematically preceded by the checking of several points including the patient's pacemaker dependency, the necessity to replace or extract one or several leads, the venous system status, the compatibility between the new generator and the leads and the necessity to upgrade the pacing system or to change the pacemaker pocket.
Topics: Device Removal; Electric Power Supplies; Equipment Design; Equipment Failure; Humans; Pacemaker, Artificial
PubMed: 15702908
DOI: 10.1016/j.ancard.2004.11.003 -
Cureus Feb 2022Introduction Implantation of cardiac implantable electronic devices (CIEDs) is an art of science. As the volume of implantation has increased worldwide, so has the rate...
Introduction Implantation of cardiac implantable electronic devices (CIEDs) is an art of science. As the volume of implantation has increased worldwide, so has the rate of complications. Infection, fibrosis, lead and device erosion, lead displacement, right ventricle perforation, lead fracture, and insulation break are the common complications in the implantation process. This exposes the patient for reopening and threatens the implantation for further complication due to infection, fibrosis of veins, failure to retrieve the implanted wire, and failure to re-implant the device on the same site. We slightly changed our implantation technique to preserve the implantation site for future implantation and reduce the rate of complication in the index implantation. Methods This randomized control trial was conducted from January 2016 to September 2019 at Hayatabad Medical Complex Peshawar, Pakistan. A consecutive sampling technique was used to obtain a sample size of 602 patients keeping a 95% confidence interval and a 5% margin error. We adopted a strategy to take prick, for implantation of devices, inside the pocket, which reduces the number of sutures, hastens the procedure, prevents erosion, and minimizes the chance of subclavian crush syndrome and insulation break. We also selected the minimum possible length of leads. This will possibly decrease the chances of cumbersome fibrosis around the lead and device and will make future implantation convenient. Results There was a total of 602 procedures in the study period. About 253 (42%) procedures were done in the newly adopted strategy and 349 (58%) were performed in the conventional way. Our complication rate grossly reduces in the novel way of implantation in which we took our prick inside the pocket. Conclusion A slight modification in the implantation of CIEDs not only prevents the rate of complication in the index implantation but will also possibly preserve the site for future implantation.
PubMed: 35350505
DOI: 10.7759/cureus.22259 -
The Science of the Total Environment Jan 2023Procida Island, located in the Gulf of Naples (southern Italy), is characterized by steep cliffed coasts, articulated in a succession of headlands and small embayments...
Procida Island, located in the Gulf of Naples (southern Italy), is characterized by steep cliffed coasts, articulated in a succession of headlands and small embayments with narrow pocket beaches, such as Ciraccio and Chiaia, often characterized by instability. In this study, a methodology for coastal cliff susceptibility assessment has been conceived based on hydraulic and geomorphological characteristics, which supported the construction of a Cliff Stability Index (CSI). The geomorphological characteristics are related to the whole cliff face, the cliff material resistance, and the cliff failure mechanisms. The hydraulic actions on the cliff are related to the wave impact which is exerted by the breaking waves once the wave run-up distance exceeds the beach width. The index takes into account the slope of the cliff, the rock strength, the wave energy at the cliff base produced by the broken wave and the presence of defence structures at the cliff base. The resulting index classification, obtained by addition of the partial sub-indices, has been compared with the observed coastal cliff evolution from 1954 to 2021.
Topics: Italy; Conservation of Natural Resources
PubMed: 36122713
DOI: 10.1016/j.scitotenv.2022.158759