Δευτέρα 8 Ιουλίου 2019

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

S100 Negative CD1a Positive Indeterminate Cell Histiocytosis, Sima Amin BS  Jordan Jamerson MD  Ronald...
S100 Negative CD1a Positive Indeterminate Cell Histiocytosis,Sima Amin BS  Jordan Jamerson MD  Ronald G. Tee MD  Palak Parekh MDFirst published: 06 July 2019 https://doi.org/10.1111/cup.13542This 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 article as doi: 10.1111/cup.13542.ePDFPDFTOOLS...
Αλέξανδρος Γ. Σφακιανάκης
2m
Number of levels required to assess Breslow thickness in cutaneous invasive melanoma: An Observational...
Number of levels required to assess Breslow thickness in cutaneous invasive melanoma: An Observational StudyDr Jamie Bishop MBChB  Dr Ben Tallon MBChBFirst published: 03 July 2019 https://doi.org/10.1111/cup.13541This 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 article as doi: 10.1111/cup.13541.ePDFPDFTOOLS...
Αλέξανδρος Γ. Σφακιανάκης
3m
An atypical pleomorphic lipomatous tumor arising on the cheek Alan S. Boyd M.D First published: 02...
An atypical pleomorphic lipomatous tumor arising on the cheekAlan S. Boyd M.DFirst published: 02 July 2019 https://doi.org/10.1111/cup.13540This 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 article as doi: 10.1111/cup.13540.ePDFPDFTOOLS SHAREAbstractPathologists and dermatopathologists...
Αλέξανδρος Γ. Σφακιανάκης
3m
Malignant Melanoma with Metastatic Cartilaginous Transdifferentiation, a Case Report Juliett Berro ...
Malignant Melanoma with Metastatic Cartilaginous Transdifferentiation, a Case ReportJuliett Berro  Nour Abdul Halim  Chirine Khaled  Hazem I. AssiFirst published: 01 July 2019 https://doi.org/10.1111/cup.13539This 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 article as doi: 10.1111/cup.13539.ePDFPDFTOOLS...
Αλέξανδρος Γ. Σφακιανάκης
4m
Hypergranulotic dyscornification: 30 cases of a striking epithelial reaction pattern Simon F. Roy ...
Hypergranulotic dyscornification: 30 cases of a striking epithelial reaction patternSimon F. Roy  Christine J. Ko  Gilbert W. Moeckel  Jennifer M. McniffFirst published: 03 June 2019 https://doi.org/10.1111/cup.13522Funding information ASDP, Grant/Award Number: Mentorship Award to Simon F. RoyRead the full textePDFPDFTOOLS SHAREAbstractBackgroundHypergranulotic dyscornification (HD) is a rarely reported histological reaction pattern that may be observed in solitary benign keratoses.Objective and...
Αλέξανδρος Γ. Σφακιανάκης
4m
The morphologic spectrum of germline‐mutated BAP1‐inactivated melanocytic tumors includes lesions with...
The morphologic spectrum of germline‐mutated BAP1‐inactivated melanocytic tumors includes lesions with conventional nevic melanocytes: A case report and review of literatureTimothy R. Wysozan  Sihem Khelifa  Kirsten Turchan  Ahmed K. AlomariFirst published: 17 June 2019 https://doi.org/10.1111/cup.13525Read the full textePDFPDFTOOLS SHAREAbstractGermline mutations in BRCA1‐associated protein 1 (BAP1) are associated with several neoplasms, including BAP1‐inactivated melanocytic tumors (BIMTs). BIMTs...
Αλέξανδρος Γ. Σφακιανάκης
4m
Plasmacytic cutaneous pathology: A review Noreen M. Walsh  Heinz Kutzner  Luis Requena  Lorenzo...
Plasmacytic cutaneous pathology: A reviewNoreen M. Walsh Heinz Kutzner Luis Requena Lorenzo CerroniFirst published: 16 May 2019https://doi.org/10.1111/cup.13499We review the spectrum of cutaneous disorders associated with inflammatory and neoplastic plasmacytic pathology. Because plasma cells are derived from B‐lymphocytes our overview includes discussion of certain lymphoplasmacytic proliferations. It is structured along histopathological lines, addressing conditions characterized by (a) cutaneous...
Αλέξανδρος Γ. Σφακιανάκης
4m
Primary cutaneous acral CD8+ T‐cell lymphoma of the ear: A case report Emma Ormerod  Timothy Murigu ...
Primary cutaneous acral CD8+ T‐cell lymphoma of the ear: A case reportEmma Ormerod  Timothy Murigu  Joya Pawade  Matthew Beasley  Giles DunnillFirst published: 30 May 2019 https://doi.org/10.1111/cup.13517Read the full textePDFPDFTOOLS SHAREAbstractPrimary cutaneous acral CD8+ T‐cell lymphoma (TCL) is a rare, distinct type of cutaneous TCL. Despite its worrisome histological appearance it has a benign clinical course. It is therefore important to recognize this as a distinct entity from other more...
Αλέξανδρος Γ. Σφακιανάκης
5m
Pain
Non-specific Low Back Pain: Inflammatory Profiles of Patients with Acute and Chronic PainBackground: The pathogenesis of low back pain (LBP) remains unclear. However, recent studies suggest that the inflammatory response may be inherent in spinal pain. Purpose: To discern inflammatory profiles in patients with non-specific acute and chronic low back pain (LBP) in relation to those in asymptomatic subjects. Methods: Peripheral blood samples were obtained from asymptomatic subjects and patients with...
Αλέξανδρος Γ. Σφακιανάκης
6m
Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation:...
Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation: a new variant,Claudia Mestre‐Alagarda  Gema Nieto  Liria Terrádez  Carlos MonteagudoFirst published: 06 July 2019 https://doi.org/10.1111/cup.13543This 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....
Αλέξανδρος Γ. Σφακιανάκης
6m
Ethics and Professionalism Grand Rounds— Tuesday, July 23, 2019Against-Medical-Advice Discharges: What...
Ethics and ProfessionalismGrand Rounds—Tuesday, July 23, 2019Against-Medical-Advice Discharges: What They Can Teach us About Respecting Patient Rights and Preventing Patient HarmIn this live webinar, VHA healthcare professionals will learn how to manage ethical issues related to against-medical-advice, or "AMA" discharges.  Dr. David Alfandre and Dr. Virginia (Ashby) Sharpe of the National Center for Ethics in Health Care will discuss using a patient-centered approach to shared-decision making as...
Αλέξανδρος Γ. Σφακιανάκης
8m
Unfortunate Hand Positioning Yielding Inappropriate Defibrillator Shock: Another Paradigm of...
Unfortunate Hand Positioning Yielding Inappropriate Defibrillator Shock: Another Paradigm of a Guilty Association Between Patient Awareness and Occupational HazardAntoine KossaifyFirst Published July 1, 2019 Case Report https://doi.org/10.1177/1179547619861096Article information   Article InformationVolume: 12Article first published online: July 1, 2019; Issue published: January 1, 2019Received: May 12, 2019; Accepted: June 03, 2019 Antoine Kossaify1, 21Cardiology Division, Arrhythmia Unit, Holy...
Αλέξανδρος Γ. Σφακιανάκης
9m
Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn's Disease: A Case Report...
Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn's Disease: A Case ReportShow all authorsKanika Goel, Mark Bunker, Anna Balog, ...First Published July 3, 2019 Case Report https://doi.org/10.1177/1179547619858979Article information   Article InformationVolume: 12Article first published online: July 3, 2019; Issue published: January 1, 2019Received: May 10, 2019; Accepted: May 29, 2019 Kanika Goel, Mark Bunker, Anna Balog, Jan F SilvermanDepartment of Pathology, Allegheny General...
Αλέξανδρος Γ. Σφακιανάκης
10m
Mandibular Tori Limiting Treatment of Carcinoma of the Upper Aerodigestive Tract Christopher...
Mandibular Tori Limiting Treatment of Carcinoma of the Upper Aerodigestive TractChristopher M Low, Daniel L Price, Jan L KasperbauerFirst Published July 3, 2019 Case Report https://doi.org/10.1177/1179547619856599Article information   Article InformationVolume: 12Article first published online: July 3, 2019; Issue published: January 1, 2019Received: May 14, 2019; Accepted: May 20, 2019Christopher M Low, Daniel L Price, Jan L KasperbauerDepartment of Otolaryngology–Head and Neck Surgery, Mayo Clinic,...
Αλέξανδρος Γ. Σφακιανάκης
10m
Traumatic Lesion of the Brachial Artery in a Pediatric Patient: Treatment With Bioresorbable...
Traumatic Lesion of the Brachial Artery in a Pediatric Patient: Treatment With Bioresorbable Vascular ScaffoldShow all authorsFrancesca Tomei, Raffaella Berchiolli, Rosa Cervelli, ...First Published July 4, 2019 Case Report https://doi.org/10.1177/1179547619857074Article information   Article InformationVolume: 12Article first published online: July 4, 2019; Issue published: January 1, 2019Received: April 13, 2019; Accepted: May 22, 2019Francesca Tomei1, Raffaella Berchiolli1, Rosa Cervelli2, Irene...
Αλέξανδρος Γ. Σφακιανάκης
11m
Differences of FreeStyle Libre Flash Glucose Monitoring System and Finger Pricks on Clinical...
Differences of FreeStyle Libre Flash Glucose Monitoring System and Finger Pricks on Clinical Characteristics and Glucose Monitoring Satisfactions in Type 1 Diabetes Using Insulin PumpAyman A Al Hayek, Asirvatham A Robert, Mohamed A Al DawishFirst Published July 1, 2019 Research Article https://doi.org/10.1177/1179551419861102Article information   Article InformationVolume: 12Article first published online: July 1, 2019; Issue published: January 1, 2019Received: May 19, 2019; Accepted: June 07, 2019Ayman...
Αλέξανδρος Γ. Σφακιανάκης
12m
Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report...
Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of LiteratureMingyang L Gray, Catharine Kappauf, Satish GovindarajFirst Published July 1, 2019 Research Article https://doi.org/10.1177/1179550619858606Article information   Article InformationVolume: 12Article first published online: July 1, 2019; Issue published: January 1, 2019Received: May 16, 2019; Accepted: May 21, 2019 Mingyang L Gray,  Catharine Kappauf, Satish GovindarajDepartment of...
Αλέξανδρος Γ. Σφακιανάκης
12m
The Potential of Chinese Herbal Medicines in the Treatment of Cervical Cancer Show less...
The Potential of Chinese Herbal Medicines in the Treatment of Cervical CancerShow lessYi-Hsuan Hsiao, MD, PhD, Chiao-Wen Lin, PhD, Po-Hui Wang, MD, PhD, Min-Chien Hsin, PhD, Shun-Fa Yang, PhDFirst Published July 4, 2019 Review Article https://doi.org/10.1177/1534735419861693Article information   Article InformationVolume: 18Article first published online: July 4, 2019; Issue published: January 1, 2019Received: March 18, 2019; Revisions received: April 30, 2019; Accepted: June 03, 2019Yi-Hsuan Hsiao, MD,...
Αλέξανδρος Γ. Σφακιανάκης
13m
Regional Lymph Node Enlargement in Clinically Severe Cherubism Show less Yan Chen Wongworawat*, Daniel...
Regional Lymph Node Enlargement in Clinically Severe CherubismShow lessYan Chen Wongworawat*, Daniel Jack*, Jared C Inman, Fouad Abdelhalim, Camilla Cobb, Craig William Zuppan, Anwar RazaFirst Published July 4, 2019 Case Report https://doi.org/10.1177/2632010X19861107Article information   Article InformationVolume: 12Article first published online: July 4, 2019; Issue published: January 1, 2019 Yan Chen Wongworawat1*, Daniel Jack1*, Jared C Inman2, Fouad Abdelhalim3, Camilla Cobb1, Craig William...
Αλέξανδρος Γ. Σφακιανάκης
15m
Monostotic Fibrous Dysplasia of the Lumbar Spine With Secondary Features of Solid Variant Aneurysmal...
Monostotic Fibrous Dysplasia of the Lumbar Spine With Secondary Features of Solid Variant Aneurysmal Bone Cyst,Nolan Maloney and Konstantinos LinosAbstractFibrous dysplasia is a benign, mass-forming disease of bone composed of abnormal fibrous and osseous elements that can be accompanied by endocrine dysfunction, skin pigmentation, and intramuscular myxomas. It is usually encountered as a solitary lesion in the tibia or femur but can develop in any bone and can be unifocal or multifocal. Difficulty...
Αλέξανδρος Γ. Σφακιανάκης
17m
The combined effect of tranilast 8% liposomal gel on the final cosmesis of acne scarring in patients concomitantly treated by isotretinoin
: Prospective double blind split‐face studyA. Weinstein, A. Koren, E. Sprecher, E. Zur, J.N. Mehrabi, Ofir Artzi
Αλέξανδρος Γ. Σφακιανάκης
18m
British Association of Dermatologists (BAD) National Audit on Non‐Melanoma Skin Cancer Excision 2016...
British Association of Dermatologists (BAD) National Audit on Non‐Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists,D. J. Keith, A. P. Bray, A. Brain, M. F. Mohd Mustapa, H. E. Barrett, S. Lane, M. Emmerich, A. Jakes, P. D. Barrett, D. A. R. de Berker
Αλέξανδρος Γ. Σφακιανάκης
19m
Should non‐selective non‐steroidal anti‐inflammatory drugs (NSAIDs) be avoided following dermatologic surgery?
 A critically appraised topic with a proposed approach to post‐operative analgesiaT. Watson Brown, S. Nelson, T. Nelson
Αλέξανδρος Γ. Σφακιανάκης
19m
Wheat‐dependent Exercise‐induced Anaphylaxis
 in Chinese People:A Clinical Research on 33 Cases with Antigenic Analysis of Wheat ProteinsY.‐q. Zhu, D.‐q. Wang, B. Liu, Y. Hu, Y.‐y. Shen, J.‐h. Xu, H. Tang
Αλέξανδρος Γ. Σφακιανάκης
19m
Abnormal expression of the co‐stimulatory molecule B7‐H3 in lichen simplex chronicus is associated with...
Abnormal expression of the co‐stimulatory molecule B7‐H3 in lichen simplex chronicus is associated with expansion of Langerhans cells,X. Feng, M. Yang, Z. Yang, Q. Qian, E. M. Burns, W. Min
Αλέξανδρος Γ. Σφακιανάκης
20m
Male genital lichen sclerosus and filaggrin,T. N. Shim, S. J. Brown, N. D. Francis, M. Dinneen, D. Hawkins, A....
Male genital lichen sclerosus and filaggrin,T. N. Shim, S. J. Brown, N. D. Francis, M. Dinneen, D. Hawkins, A. Muneer, S. Minhas, W. H. Irwin McLean, C. B. Bunker
Αλέξανδρος Γ. Σφακιανάκης
20m
Latin American Clinical Practice Guidelines on the Systemic Treatment of Psoriasis SOLAPSO – Sociedad...
Latin American Clinical Practice Guidelines on the Systemic Treatment of Psoriasis SOLAPSO – Sociedad Latinoamericana de Psoriasis (Latin American Psoriasis Society),Nora Kogan, Nélida Raimondo, Simon E. Gusis, Ariel Izcovich, Jorge A. Abarca Duran, Lilia Barahona‐Torres, Orestes Blanco, Gerardo B. Quintana, María C. Briones, Carla Castro, Evelyn G. Castro Vargas, Juan Criniti, Juan C. Diez de Medina, Manuel Franco, Minerva Gómez, Verónica P. Levrero, Jaime E. Martínez López, Fernando Valenzuela
Αλέξανδρος Γ. Σφακιανάκης
21m
Comparison of naproxen and Gelofen for Pain relief in lower third molar surgery
: A single-blinded randomized clinical trialEhsan Aliabadi, Saeid Tavanafar, Mehdi HayatiEuropean Journal of General Dentistry 2019 8(2):41-44Objectives: Third molar surgeries are a routine procedure in oral and maxillofacial surgery and its associated pain is bothersome to patients. The purpose of this study was to compare the analgesic effect of Gelofen and naproxen in lower third molar surgery. Materials and Methods: A single-blinded randomized clinical trial was designed, and patients were randomly...
Αλέξανδρος Γ. Σφακιανάκης
22m
General Dentistry
Treatment and prevention of oral mucositis: A literature reviewParas Ahmad, Usman Akhtar, Ahmed Chaudhry, Usman Rashid, Sarmad Saif, Jawaad Ahmed AsifEuropean Journal of General Dentistry 2019 8(2):23-28Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine, hematological, gastrointestinal, cutaneous, and neurological...
Αλέξανδρος Γ. Σφακιανάκης
23m
Treatment and prevention of oral mucositis
: A literature reviewParas Ahmad, Usman Akhtar, Ahmed Chaudhry, Usman Rashid, Sarmad Saif, Jawaad Ahmed AsifEuropean Journal of General Dentistry 2019 8(2):23-28Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine, hematological, gastrointestinal, cutaneous, and neurological diseases. The intent of this review...
Αλέξανδρος Γ. Σφακιανάκης
23m
Polydioxanone sheet as a rigid framework in skull‐base repair
: Our experience in thirteen patientsMohd Afiq Mohd Slim  Hussain Jasem  Louise Melia  Gerald McGarryFirst published: 19 June 2019 https://doi.org/10.1111/coa.13391Read the full textPDFTOOLS SHARE
Αλέξανδρος Γ. Σφακιανάκης
24m
The use of freeze‐dried retronasal stimuli to assess olfactory functionPooja Pal, Daniel Shepherd, Nazimah...
The use of freeze‐dried retronasal stimuli to assess olfactory functionPooja Pal, Daniel Shepherd, Nazimah Hamid, Michael J. HautusAbstractObjectivesTo evaluate a test of olfactory perception that uses freeze‐dried stimuli developed to rapidly release aromas capable of migrating to the olfactory mucosa retronasally.DesignValidation study.SettingPsychology and Chemistry Departments.ParticipantsFirst, 15 participants provided data for psychometric functions. Second, 70 participants made perceptual...
Αλέξανδρος Γ. Σφακιανάκης
25m
Preoperative electrophysiological analysis predicts preservation of hearing and facial nerve function following vestibular schwannoma surgery with continuous intraoperative neural monitoring
: clinical outcomes of twenty‐two casesMakoto Hosoya, Naoki Oishi, Takanori Nishiyama, Masaru Noguchi, Kento Kasuya, Noriomi Suzuki, Hidemi Miyazaki, Kaoru OgawaPreoperative electrophysiological analysis predicts preservation of hearing and facial nerve function following vestibular schwannoma surgery with reinforced continuous intraoperative monitoring.Setting the lower limit of the monitoring target amplitude in accordance with preoperative ENoG was associated with the preservation of facial nerve...
Αλέξανδρος Γ. Σφακιανάκης
25m
Transoral laser microsurgery using high‐flow nasal cannula oxygenation
: Our experience of 21 casesSusanne Flach, Azza Elhoweris, Samit Majumdar, Simon Crawley, Jaiganesh ManickavasagamAbstractOptimal access and visualisation is crucial during TLM, however, airway management can be challenging.Oxygenation via HFNC provides a safe and effective way for airway management during tubeless field anaesthesia in TLM.HFNC oxygenation during TLM is well tolerated and avoids risks associated with other methods of tubeless field anaesthesia.HFNC oxygenation during TLM should only...
Αλέξανδρος Γ. Σφακιανάκης
26m
Carbohydrate Availability as a Regulator of Energy Balance with Exercise We explore the novel hypothesis...
Carbohydrate Availability as a Regulator of Energy Balance with ExerciseWe explore the novel hypothesis that carbohydrate availability is involved in the regulation of energy balance with exercise, via hormonal and neural signals. We propose that carbohydrate availability could play a direct mechanistic role and partially explain previously-documented relationships between a more active lifestyle and tighter control of energy balance. Corresponding author: Javier T. Gonzalez, Department for Health,...
Αλέξανδρος Γ. Σφακιανάκης
27m
Transcallosal Control of Bilateral Actions The corpus callosum is an important neural structure for...
Transcallosal Control of Bilateral ActionsThe corpus callosum is an important neural structure for controlling and coordinating bilateral movements of the upper limbs; however, there remains a substantial lack of knowledge regarding its association with lower limb control. We argue that transcallosal structure is an integral neural mechanism underlying control of the lower limbs and callosal degradation is a key contributor to mobility declines. Corresponding Author: Brett W. Fling, Ph.D., Assistant...
Αλέξανδρος Γ. Σφακιανάκης
27m
Rapid-Onset Psychotic Symptoms After Interferon-β-1a Treatment of Multiple Sclerosis Huang, Jing-Syuan...
Rapid-Onset Psychotic Symptoms After Interferon-β-1a Treatment of Multiple SclerosisHuang, Jing-Syuan MD1,2; Chang, Chuan-Chia MD, PhD2; Tai, Yueh-Ming MD, PhD1,2; Huang, Chien-Peng MD3; Chen, Shyi-Jou MD, PhD4; Tzeng, Nian-Sheng MD2,5American Journal of Therapeutics: June 19, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/MJT.0000000000001017Letters to the Editor: PDF OnlyBUYPAPAuthor InformationArticle MetricsCopyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
28m
Pembrolizumab for PD-L1–Positive Breast Cancer Refractory to Chemotherapy Phan, Kim DO; Charif, Mahmoud...
Pembrolizumab for PD-L1–Positive Breast Cancer Refractory to ChemotherapyPhan, Kim DO; Charif, Mahmoud MDAmerican Journal of Therapeutics: June 18, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/MJT.0000000000001015Letters to the Editor: PDF OnlyBUYPAPAuthor InformationArticle MetricsCopyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
29m
Trametinib is a cancer drug. It is a MEK inhibitor drug with anti-cancer activity. It inhibits MEK1 and MEK2. Trametinib had good results for metastatic melanoma carrying the BRAF V600E mutation in a phase III clinical trial.
Trametinib-Associated BradycardiaAlhazmi, Luai MD1; Karim, Mohammad M. MD2; Al-Sarie, Mohammad MD3; Skeel, Roland MD4; Karim, Saima DO1American Journal of Therapeutics: June 20, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/MJT.0000000000000862Letters to the Editor: PDF OnlyBUYPAPAuthor InformationArticle MetricsCopyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
29m
Adalimumab, sold under the brand name Humira among others, is a medication used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis, hidradenitis suppurativa, uveitis, and juvenile idiopathic arthritis.
Adalimumab-Associated Hemorrhagic PericarditisVyas, Rohit MD1; Adeel, Firas A. MD1; Sheikh, Taha MD1; Syed, Mubbasher MD1,2; Altorok, Nezam MD1,3American Journal of Therapeutics: June 21, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/MJT.0000000000001019Letters to the Editor: PDF OnlyBUYPAPAuthor InformationArticle MetricsCopyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
30m
Topical Nifedipine for the Treatment of Pressure Ulcer: A Randomized, Placebo-Controlled Clinical Trial...
Topical Nifedipine for the Treatment of Pressure Ulcer: A Randomized, Placebo-Controlled Clinical TrialBackground: Effect of nifedipine on pressure ulcer (PU) healing has not been evaluated in the human subjects yet. Study question: In this study, the effect of topical application of nifedipine 3% ointment on PU healing in critically ill patients was investigated. Study design: This was a randomized, double-blind, placebo-controlled clinical. Measures and outcomes: In this study, 200 patients with...
Αλέξανδρος Γ. Σφακιανάκης
32m
Turmeric-Associated Liver Injury, Turmeric is a flowering plant, Curcuma longa of the ginger family,...
Turmeric-Associated Liver Injury,Turmeric is a flowering plant, Curcuma longa of the ginger family, Zingiberaceae, the roots of which are used in cooking.Abdallah, Mohamed A. MD1; Abdalla, Abdelmohaymin MD1; Ellithi, Moataz MD1; Abdalla, Abubaker O. MD2; Cunningham, Arwyn G. DO3; Yeddi, Ahmed MD4; Rajendiran, Govarthanan MD5American Journal of Therapeutics: June 28, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/MJT.0000000000001025
Αλέξανδρος Γ. Σφακιανάκης
32m
Exercise and Sport Sciences
Amplified Neural Plasticity and Strength After StrokeFollowing stroke, sensorimotor brain networks and descending regulation are compromised but spinal interlimb neural connections remain morphologically intact. After cross-education strength and locomotion training, amplified neural plasticity and functional responses are observed in chronic stroke compared to neurologically intact participants. We hypothesize that post-stroke neuroplasticity is amplified because of the involvement of interlimb...
Αλέξανδρος Γ. Σφακιανάκης
33m
Propofol Infusion and Acute Pancreatitis: A ReviewBackground: Propofol is a short-acting anesthetic...
Propofol Infusion and Acute Pancreatitis: A ReviewBackground: Propofol is a short-acting anesthetic used to induce sedation in various ambulatory and inpatient surgical procedures. It is a US Food and Drug Administration approved lipid-based intravenous hypnotic agent, which has been used clinically for the induction and maintenance of anesthesia for over 3 decades. In addition to general anesthesia, it is used to sedate patients undergoing mechanical ventilation or short procedures such as endoscopy,...
Αλέξανδρος Γ. Σφακιανάκης
34m
Therapeutics
Propofol Infusion and Acute Pancreatitis: A ReviewBackground: Propofol is a short-acting anesthetic used to induce sedation in various ambulatory and inpatient surgical procedures. It is a US Food and Drug Administration approved lipid-based intravenous hypnotic agent, which has been used clinically for the induction and maintenance of anesthesia for over 3 decades. In addition to general anesthesia, it is used to sedate patients undergoing mechanical ventilation or short procedures such as endoscopy,...
Αλέξανδρος Γ. Σφακιανάκης
34m

Pain

Non-specific Low Back Pain: Inflammatory Profiles of Patients with Acute and Chronic Pain
Background: The pathogenesis of low back pain (LBP) remains unclear. However, recent studies suggest that the inflammatory response may be inherent in spinal pain. Purpose: To discern inflammatory profiles in patients with non-specific acute and chronic low back pain (LBP) in relation to those in asymptomatic subjects. Methods: Peripheral blood samples were obtained from asymptomatic subjects and patients with non-specific acute and chronic LBP reporting a minimum pain score of 3 on a 10-point visual analogue scale (VAS). The levels of in vitro production of pro-inflammatory (TNFα, IL-1β, IL-6, IL-2, IFN[Latin Small Letter Gamma]) and anti-inflammatory (IL-1 RA, sTNFR2 and IL-10) mediators were determined by specific immunoassays. Results: The mean VAS scores were comparable between the acute and chronic LBP patient groups. Compared to asymptomatic subjects, the production of TNFα, IL-1β, IL-6 and their ratios to IL-10 levels were significantly elevated in both patient groups (P=0.0001-0.003). In acute LBP group, the ratio of IL-2: IL-10 was also significantly increased (P=0.02). In contrast, the production of IFN[Latin Small Letter Gamma] was significantly reduced compared with the other study groups (P=0.005-0.01), nevertheless, it was positively correlated (P=0.006) with pain scores. In chronic LBP patients, the production of TNFα, IL-1RA and sTNFR2 was significantly increased (P=0.001-0.03) in comparison with the control and acute LBP groups, and TNFα and IL-1β levels were positively correlated (P<0.001) with VAS scores. Conclusion: The inflammatory profiles of patients with acute and chronic LBP are distinct. Nonetheless, in both patient groups, an imbalance between pro- and anti-inflammatory mediator levels favors the production of pro-inflammatory components. ACKNOWLEDGMENTS: We wish to express our appreciation and gratitude to Dr. A. Teitelbaum for performing phlebotomy. The excellent technical assistance of Ms. A. Corless is deeply appreciated. Conflict of Interest and Source of Funding: All authors declare that they have no conflict of interest to disclose regarding this manuscript. The study was supported by funds from Canadian Memorial Chiropractic College. Reprints: H. Stephen Injeyan, PhD, DC, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada (e-mail: sinjeyan@cmcc.ca). Received December 27, 2018 Received in revised form May 15, 2019 Accepted June 14, 2019 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Validity of the Budapest Criteria for Post-stroke Complex Regional Pain Syndrome
Objectives: Complex regional pain syndrome-1 (CRPS-1) is a chronic neuropathic disorder, and post-stroke CRPS (PS-CRPS) is not a rare complication. There is a lack of study implementing the Budapest criteria for PS-CRPS diagnosis. Thus, the present study investigated the validity of the Budapest criteria for PS-CRPS diagnosis and assessed the PS-CRPS-related factors in stroke patients with an affected upper extremity. Methods: The study included 72 patients with first-ever stroke resulting in hemiplegia. The prevalence of PS-CRPS and diagnostic validity were compared among the Budapest clinical criteria, Budapest research criteria, modified Budapest criteria (removal of the motor factor from the motor/trophic category), and International Association for the Study of Pain (IASP) criteria in patients diagnosed with PS-CRPS according to the Budapest clinical criteria. Results: PS-CRPS was diagnosed in 6 (8.3%), 1 (1.4%), 6 (8.3%), and 11 patients (15.3%) according to the Budapest clinical criteria, Budapest research criteria, modified Budapest criteria, and IASP criteria, respectively. The Budapest criteria and IASP criteria had sensitivities of 0.99 and 1.00, respectively, and specificities of 0.68 and 0.41, respectively, for PS-CRPS diagnosis. There were no differences in risk factors between PS-CRPS patients and non-PS-CRPS patients when the diagnosis was based on the Budapest clinical criteria. However, there were differences in muscle strength and Brunnstrom stage between PS-CRPS patients and non-PS-CRPS patients when the diagnosis was based on the IASP criteria. Discussion: Our findings indicate that the diagnostic validity of the current Budapest clinical criteria for PS-CRPS is low. Thus, the current Budapest criteria might not be appropriate for PS-CRPS diagnosis. Acknowledgments: We would like to thank Editage (http://www.editage.co.kr) for English language editing. There are no conflicts of interest. Conflicts of Interest and Source of Funding: We would like to thank Editage (http://www.editage.co.kr) for English language editing. Reprints: Joon-Ho Shin, MD, MS, Department of Rehabilitation Medicine, National Rehabilitation Center, 58, Samgaksan-ro, Gangbuk-gu, Seoul, 01022, Republic of Korea (e-mail: asfreelyas@gmail.com). Received January 17, 2019 Accepted June 17, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Mandatory Pain Assessment in a Pediatric Emergency Department: Failure or Success? A Retrospective Study
Objective: Pain control is a priority in patient evaluation. Despite the proliferation of guidelines, pain is still under assessed and undertreated, especially in children. To improve efficiency and to adhere to best medical practice, our triage software was upgraded; it included mandatory pain scoring for the admission of a child to the pediatric emergency service, thereby limiting the chances of overlooking a child experiencing pain. We conducted this study to verify the effect of routine versus mandatory pain scoring on pain management under the hypothesis that mandatory pain assessment would improve re-evaluation and pain treatment. Methods: This retrospective case-control study was conducted in our Pediatric Emergency Department. We collected data regarding pain assessment and reassessment at triage and during the entire stay in the ED, as well as the drugs eventually administered. We reviewed the charts of 1274 patients admitted with the older triage software and of 1262 patients admitted with the newer triage software (intervention group). Results: Pain was evaluated significantly more frequently in the intervention group at triage, during medical evaluation, and at discharge. In the intervention group, a smaller percentage of patients were treated for pain at both triage and during their stay in the ED (P=0.078 and P=0.048). Pain re-assessment resulted worse in the intervention group (P<<0.001). Discussion: Mandatory pain assessment improved the pain evaluation rate. This did not, however, translate into better treatment and management of pain in the pediatric emergency setting. No funding sources were provided for this study. DISCLOSURE: The authors declare no conflict of interest. Reprints: Federico Marzona, MD, University of Udine, Department of Medicine (DAME), "S. Maria della Misericordia" Academic Hospital, 33100, Udine, Italy (e-mail: federico.marzona@asuiud.sanita.fvg.it). Received December 11, 2018 Received in revised form June 4, 2019 Accepted June 24, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Patient and Disease Characteristics Associates With Sensory Testing Results in Chronic Pancreatitis
Background: Abdominal pain is the most common symptom in chronic pancreatitis and has extensive impact on patients' lives. Quantitative sensory testing (QST) provides information on sensitivity to pain and mechanisms which can help quantify pain and guide treatment. The aims of this study were (1) to explore sensitivity to pain in patients with chronic pancreatitis using QST, and (2) to associate patient- and disease characteristics with QST results. Methods: Ninety-one patients with painful chronic pancreatitis and 28 healthy control subjects completed a QST paradigm using static tests (muscle pressure stimulation and electrical skin stimulations) to unravel segmental and widespread hyperalgesia as a consequence of visceral pain. A dynamic conditioned pain modulation (CPM) paradigm was used as proxy of pain modulation from brainstem to inhibit incoming nociceptive barrage, and questionnaires were used to gather information on pain experience and quality of life. Results: Patients had impaired conditioned pain modulation compared to controls (18.0±29.3% vs. 30.9±29.3%, P=0.04) and were hypersensitive to pressure stimulation, specifically in the pancreatic (Th10) dermatome (P<0.001). The capacity of CPM was associated with clinical pain intensity (P=0.01) and (in univariate analysis only) the use of opioids was associated with hyperalgesia to pressure stimulation (P<0.05). Conclusion: Sensitivity to pain in chronic pancreatitis patients can be characterized by a simple bedside QST. Severe clinical pain in chronic pancreatitis was associated with reduced CPM function and should be targeted in management. Funding sources: None declared. Disclosures: The authors have nothing to disclose. Conflict of interest: None declared. Reprints: Asbjørn Mohr Drewes, MD, PhD, DMSc, Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, Denmark (e-mail: amd@rn.dk). Received January 23, 2019 Received in revised form June 4, 2019 Accepted June 14, 2019 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Insomnia Increases Symptom Severity and Health Care Utilization in Patients with Fibromyalgia: A Population-based Study
Objective: This study aimed to determine whether comorbid insomnia is associated with increased use of fibromyalgia-related medications and health resources in fibromyalgia patients. Methods: We analyzed data retrieved from the Longitudinal Health Insurance Database 2010, which contains claims data of 1 million beneficiaries randomly selected from Taiwan's National Health Insurance program. Patients treated for fibromyalgia (n=17, 920) on two separate visits between 2000 and 2001 were selected and subsequently divided into two groups: patients with and without comorbid insomnia (n=5466 and 12, 454, respectively). Insomnia was identified through diagnosis on two separate visits after the index fibromyalgia date. Fibromyalgia-related pharmacotherapies and ambulatory care visits were tracked from the index date to the end of 2013. Results: Insomnia was associated with increased likelihood of future use of antidepressants (adjusted odds ratio (OR)=3.84, P<0.001), gabapentin (adjusted OR=1.67, P<0.001), pregabalin (adjusted OR=1.79, P=0.046), muscle relaxants (adjusted OR=3.05, P<0.001), and opioids and tramadol (adjusted OR=1.59, P<0.001) among fibromyalgia patients compared with fibromyalgia patients without insomnia. In addition, a diagnosis of insomnia was associated with an increased frequency of visits to ambulatory care services for both fibromyalgia (β=1.79, 95% CI=1.57–2.02, P<0.001) and other conditions (β=108.51, 95% CI=103.14–113.89, P<0.001). Discussion: This study demonstrates the substantial burden of comorbid insomnia in patients with fibromyalgia. CJ Huang and CL Huang contributed equally to the paper. Author contribution: Pei-Shan Tsai contributed to the conception of the idea, the study design, and to acquisition, analysis and interpretation of data; drafted and revised the manuscript; gave final approval; and agreed to be accountable for all aspects of work ensuring integrity and accuracy. Chun-Jen Huang and Chin-Liang Huang contributed to the conception of the idea, analysis and interpretation of results; drafted and revised the manuscript; gave final approval; and agreed to be accountable for all aspects of work ensuring integrity and accuracy. Yen-Chun Fan and Ting-Yu Chen were involved in the analysis and interpretation of data, drafting and revising the manuscript; gave final approval; and agreed to be accountable for all aspects of work ensuring integrity and accuracy. Conflicts of interest and source of funding: Chun-Jen Huang, Chin-Liang Huang; Yen-Chun Fan, Ting-Yu Chen and Pei-Shan Tsai declare that there is no conflict of interest regarding the publication of this paper. This study was supported by grants from Taiwan Ministry of Science and Technology (MOST #105-2314-B038-052-MY3 & MOST #107-2314-B038-023-MY3). Reprints: Pei-Shan Tsai, PhD, Taipei Medical University, 250 Wuxing St. Taipei 11031, Taiwan (e-mail: ptsai@tmu.edu.tw). Received January 29, 2019 Received in revised form April 28, 2019 Accepted June 4, 2019 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Effects of Conditioned Pain Modulation on the Nociceptive Flexion Reflex in Healthy People: A Systematic Review
Objectives: The nociceptive flexion reflex (NFR) is a spinal reflex induced by painful stimuli resulting in a withdrawal response. Research has shown that the NFR is inhibited through endogenous pain inhibitory mechanisms, which can be assessed by conditioned pain modulation (CPM) paradigms. Although accumulating research suggests that the NFR can be affected by CPM, no clear overview of the current evidence exists. Therefore, the present review aimed at providing such a synthesis of the literature. In addition, the influence of personal factors on the CPM of the NFR was investigated. Materials and Methods: A systematic review was performed and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases were searched to identify relevant articles. Retrieved articles were screened on eligibility using predefined inclusion criteria. Risk of bias was investigated according to the modified Newcastle-Ottawa Scale. Levels of evidence and strength of conclusion were assigned following the guidelines of the Dutch Institute for Healthcare Improvement. Results: Forty articles were included. There is some evidence that CPM produced by thermal or mechanical stimuli induces inhibitory effects on the NFR. However, inconclusive evidence exists with regard to the effect of electrical conditioning stimuli. While several personal factors do not affect CPM of the NFR, increased cognitive interference is associated with reduced NFR inhibition. Discussion: The present review demonstrates that certain types of nociceptive conditioning stimuli have the potential to depress, at the spinal level, nociceptive stimuli elicited from distant body regions. Although CPM of the NFR seems to be robust to the influence of several personal factors, it can be affected by cognitive influences. J.V.O. is a postdoctoral research fellow funded by the Research Foundation—Flanders (FWO) (12L5616N) Brussels, Belgium. S.V.O. is a PhD researcher supported by a research project grant from the Research Foundation—Flanders (FWO) received by L.D. and J.V.O. (G0B3718N). I.C. is a postdoctoral researcher funded by the Research Foundation—Flanders (FWO) (G007217N) and the Agency for Innovation by Science and Technology (IWT)—Applied Biomedical Research Program (TBM) (150180), Brussels, Belgium. The remaining author declare no conflict of interest. Reprints: Jessica Van Oosterwijck, PhD, Department of Rehabilitation Sciences, SPINE Research Unit Ghent, Ghent University, Campus UZ Ghent, Corneel Heymanslaan 10, B3, Ghent 9000, Belgium (e-mail: jessica.vanoosterwijck@ugent.be). Received February 4, 2019 Received in revised form March 22, 2019 Accepted April 8, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Effect of Adding Dexmedetomidine to Local Anesthetic Agents for Transversus Abdominis Plane Block: A Meta-analysis
Background: Dexmedetomidine (Dex) has been used adjuvant in Transversus abdominis plane (TAP) blocks. This meta-analysis was aimed at evaluating the effect of Dex in TAP blocks. Objectives: Outcome measures were total opiate consumption in 24-hours after surgery, time to systemic rescue analgesia, pain scores after surgery, and adverse events. Materials and methods: Randomized controlled trials (RCTs) comparing Dex with local anesthetics (LAs) to LAs alone for analgesia after abdominal surgeries were searched included. Standardized mean difference (SMD) and mean difference (MD) were used for continuous variables, and odds ratio for frequency data. Results: Analysis of data from 9 RCTs (598 patients) showed that addition of Dex to LAs decreased opiate use in 24 hours after surgery (SMD −3.07, 95% CI: −4.78, −1.35), increased time to rescue analgesia (171.8▒min, 95% CI: 112.34, 231.26), and decreased pain scores (scale of 0-10) at 4 hours (MD −0.36, 95% CI: −0.65, −0.07) and 8 hours (MD −0.17, 95% CI: −0.29, −0.04) after surgery. Frequency of adverse events was similar between the two groups (OR 1, 95% CI: 0.61-1.63). The estimates for pain scores were prone to sensitivity analysis. The estimates for post-op opiate use, time to rescue analgesia and pain scores at 8 hours had significant heterogeneity. Conclusions: Addition of Dex to LAs in TAP block for analgesia after abdominal surgeries decreased 24 hour opiate use and increased the overall time to rescue analgesia including certain subgroups without increasing adverse events. Its effect on post-op pain scores was not as definitive. Disclosures: None. Source of funding: None. Conflicts of Interest: None. Reprints: Prannal Bansal, MD, 4301 W. Markham St., Little Rock, AR-72205 (e-mail: pbansal@uams.edu). Received September 14, 2018 Received in revised form June 12, 2019 Accepted June 18, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Individualization of Migraine Prevention: A Randomized Controlled Trial of Psychophysical Based Prediction of Duloxetine Efficacy
Objective: Finding an effective preventive agent for the individual migraineur is often long and frustrating. An individual-specific, efficacy-predicting tool, would be invaluable in directing, shortening, and improving this process. As the serotonin norepinephrine reuptake inhibitors (SNRI) duloxetine is a pain modulator, we hypothesized that pro-nociceptivity will directly predict drug efficacy, so that the more pro-nociceptive the patient is, the more efficacious the drug. Therefore, we used psychophysical pain measures to predict duloxetine efficacy in migraine prevention. Methods: Fifty-five migraineurs participated; 27 received duloxetine and 28 non-active placebo. Responses to painful stimuli, conditioned pain modulation and temporal summation of pain were measured before treatment. Treatment outcome-measures included changes in attack-frequency, migraine-days, pain levels and a reported self-estimate of migraine-improvement at weeks four and five. To examine treatment effects, outcome-measures were compared to pre-treatment levels. Treatment by psychophysical-predictor effect on treatment-outcome were examined in separate regression models. Results: Duloxetine was more efficacious than placebo in migraine prevention as indicated by the patient's estimation of migraine-improvement (duloxetine: 52.3±30.4%; placebo: 26.0±27.3%; P=0.001). Further, this measure, in the duloxetine group, was predicted by higher pre-treatment pain ratings for tonic heat pain (P=0.012); greater pain-sensitivity at baseline predicted greater percent of migraine-improvement in duloxetine, (r=0.47; P=0.013) but not in placebo (r=−0.36; P=0.060). Discussion: Our results suggest how personalized medicine can be applied to designing appropriate migraine prevention treatment. Psychophysical testing can reveal and characterize pro-nociceptive migraineurs, who seem to be more likely than non pro-nociceptive ones to benefit from migraine prevention with SNRIs. ClinicalTrials.gov identifier: NCT01470339 Acknowledgments: This study was financially supported by the United States–Israel Binational Science Foundation grant number 2009097. Conflict of Interest: Dr. Kisler has nothing to disclose; Dr. Granovsky, Prof. Coghill, Prof. Yarnitsky and Dr. Weissman-Fogel report grant from United States–Israel Binational Science Foundation, during the conduct of the study; Dr. Granovsky also has a patent Thermal stimulation probe and method issued; Prof. Yarnitsky also holds equity in BrainsGateLtd. and Theranica Ltd. Dr. Sprecher has nothing to disclose; Reprints: Yelena Granovsky, PhD, Department of Neurology, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa, 3109601, Israel (e-mail: y_granovsky@rambam.health.gov.il). Received October 8, 2018 Received in revised form June 1, 2019 Accepted June 6, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Improving Distress and Behaviors for Parents of Adolescents with Chronic Pain Enrolled in an Intensive Interdisciplinary Pain Program
Objectives: Intensive interdisciplinary treatment is emerging as an effective treatment of chronic pain in youth. These programs often include a parental component with the belief that targeting parental distress and responses to a child's pain will improve outcomes. However, few studies have evaluated the impact of a parental intervention in the interdisciplinary treatment of pediatric chronic pain. The present study consists of a nonrandomized pre-post design to evaluate change in psychological and behavioral functioning of parents who participated in intensive parent programming that utilized Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), delivered within the context of an interdisciplinary intensive 3-week pain treatment program for youth with chronic pain. Methods: Two hundred and twelve parents and their children participated in the study, with 116 participants completing 3-month follow-up measures. Parents completed measures of depressive symptoms, pain catastrophizing, protective responses, and psychological flexibility at admission, discharge, and 3-months after the program. Child functional disability was assessed at the same time points. We examined change in parent factors over time, while controlling for change in child distress. Results: Parents reported significant improvements in all areas of functioning from admission to discharge and improvements were maintained at 3-month follow-up. Discussion: This study provides evidence suggesting parent interventions can be effective in reducing parent distress and behaviors known to be associated with child outcomes. Note: there are no sources of support for acknowledgement. The authors declare no conflict of interest. Reprints: Karen Weiss, PhD, 4800 Sand Point Way NE, Seattle WA, 98105. Mail MB.11.500.3 PO Box 5371 (e-mail: karen.weiss@seattlechildrens.org). Received October 30, 2018 Received in revised form May 29, 2019 Accepted May 29, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Comparing Post-operative Analgesic Effect of Dexmedetomidine or Dexamethasone Added to Lidocaine Through Infraclavicular Block in Forearm Surgery
Objective: To compare the analgesic efficacy of the dexamethasone versus dexmedetomidine added to lidocaine using infraclavicular block in patients undergoing forearm fracture surgery. Method: Seventy-five patients 20-60 years old were recruited for a prospective, double-blinded, randomized clinical trial. Ultrasound-guided infraclavicular brachial plexus block was performed in three groups by injecting with 28▒mL lidocaine plus2▒mL distilled water (Lido), 28▒mL lidocaine plus2▒mL (8▒mg) dexamethasone (Dexa), and 28▒mL lidocaineplus2▒mL (1▒µg/kg) dexmedetomidine (Dexm).Sensory and motor block onset time and the duration, hemodynamic variables, the time for the first analgesic request, and the total analgesic agents consumed within 6 hours after infraclavicular block were assessed. Results: Sensory block duration in dexmedetomidine group was significantly greater than Lido (P=0.019) and Dexa (P=0.046) groups. The mean motor block duration in dexmedetomidine group showed to be significantly longer than Lido group (P=0.009). Pain intensity within 4 hours after block significantly increased in Lido group compared to those of Dexa and Dexm groups (P=0.001). Analgesic consumption during 6 hours after the procedure was higher in group Lido when compared to other two groups (P=0.001). The dexamedetomidine group showed the highest reduction in the mean arterial pressure (P=0.006) and heart rate (P=0.001) between the three groups. Conclusions: There was no significant difference in postoperative pain intensity between the dexamethasone and dexmedetomidine groups, although, dexmedetomidine demonstrated a longer sensory block duration in comparison with dexamethasone as a lidocaine adjuvant in infraclavicular block. Registration number: IRCT2016011423473N2. Contribution to Authorship: Siamak Yaghoobi was the co-author who suggested the topic and the conceptual framework for this research. Hoda Shahamat was in charge of data acquisition and drafting the manuscript. Ali Alizadeh was another co-author who contributed to finalizing the title of the study and also participated in the preparation of final conceptual framework design. Marzieh Beigom Khezri was the co-author who actively helped towards the final maturation of the initial idea and the concept of the study, data interpretation, and critically reviewing the manuscript. Conflicts of interest statement: The authors of this paper have not declared any conflict of interest. Reprints: Marzieh Beigom Khezri, Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran (e-mail: mkhezri@qums.ac.ir). Received September 2, 2018 Received in revised form May 2, 2019 Accepted May 23, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
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General Dentistry

Treatment and prevention of oral mucositis: A literature review
Paras Ahmad, Usman Akhtar, Ahmed Chaudhry, Usman Rashid, Sarmad Saif, Jawaad Ahmed Asif

European Journal of General Dentistry 2019 8(2):23-28

Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine, hematological, gastrointestinal, cutaneous, and neurological diseases. The intent of this review is to highlight the treatment as well as prevention strategies for one of the most devastating repercussions of chemotherapy (CT) and radiotherapy (RT) on the oral cavity in the form of oral mucositis (OM). A review of literature was performed using relevant key words (&#8221;Mucositis&#8221; OR &#8220;Oral Mucositis&#8221; OR &#8220;Oral Stomatitis&#8221; AND &#8220;Treatment of Mucositis&#8221; OR &#8220;Treatment of Oral Mucositis&#8221; OR &#8220;Treatment of Oral Stomatitis&#8221; AND &#8220;Prevention of Mucositis&#8221; OR &#8220;Prevention of Oral Mucositis&#8221; OR &#8220;Prevention of Oral Stomatitis&#8221;) in prominent journals pertaining to Oncology and Dentistry (CA: A Cancer Journal for Clinicians, Cancer, Frontiers in Oncology, Journal of Clinical Oncology, and Oral Oncology). It is basically sequelae of CT, RT, and radiochemotherapy in patients suffering from malignant diseases as well as those who require hematopoietic stem cell transplants. In addition to its negative effects on the oral cavity and consequently on the overall quality of life, OM may lead to delay in cancer treatment which incriminates in a poor prognosis of the disease. 


Effect of liner on the marginal integrity of resin composite restorations after selective caries excavation: An In Vitro study
Shailaja Datta, Baranya Shrikrishna Suprabha, Ethel Suman, Ramya Shenoy, Arathi Rao, KP Nandita

European Journal of General Dentistry 2019 8(2):29-35

Aim: The aim of this study is to evaluate the effect of cavity liner on marginal adaptation and microleakage of resin composite restorations placed with and without selective caries excavation. Materials and Methods: Class II cavities were prepared in 64 extracted upper premolar teeth followed by microbiological caries induction to simulate deep carious lesions. Composite restorations were performed: Group 1A: without liner and Group 1B: with resin-modified glass ionomer liner after nonselective caries excavation; Group 2A: without liner and Group 2B: with resin-modified glass ionomer liner after selective caries excavation. Maximum gap thickness was measured using a scanning electron microscope to assess the marginal adaptation, and dye penetration method was used for microleakage assessment. Results: There was a statistically significant difference between the groups in maximum gap thickness based on the type of caries excavation (P &#60; 0.001) but not for the placement of liner. Selective caries excavation groups had higher values at all margins. Microleakage between the groups was significantly different, both at the occlusal (P &#61; 0.006) and gingival margins (P &#60; 0.001), with Groups 2A and 2B showing higher microleakage. Conclusion: Resin composite restorations performed after selective caries excavation showed decreased marginal integrity and liner application did not contribute to any significant improvement in the same. 


Bulk-fill versus conventional composite: A comparative analysis on degree of conversion
Fernanda Ferreira de Albuquerque Jasse, H&#233;lida Gomes de Oliveira Barud, Juliana Maria Capelozza Boaventura, Cristiane de Melo Alencar, Alexandre Gatti, Edson Alves de Campos

European Journal of General Dentistry 2019 8(2):36-40

Aim: This study aimed to determine the degree of conversion (DC) of two resin-based composites: a conventional nanohybrid composite and a bulk-fill flowable composite (SureFil&#174; SDR&#8482; flow). Materials and Methods: DC was evaluated at 1-, 2-, 3-, and 4-mm depths at varying irradiation times (20 and 40 s) by Fourier-transform infrared spectroscopy. Disc-shaped specimens of varying depths were prepared and photoactivated with a third-generation light-emitting diode light-curing unit. The specimens were stored for 24 h in the dark at ambient temperature and pulverized into a fine powder which was mixed with potassium bromide. After homogenization, the mixture pressed to form a pellet. All pellets were evaluated by an infrared spectrometer equipped with a triglycine sulfate detector using diffuse reflectance. The percentage of monomer conversion was determined from the ratio of the absorbance intensities of the aliphatic carbon&#8211;carbon double bonds (C &#61; C) and the internal standard before and after the curing of the composite, represented by the aromatic carbon&#8211;carbon single bonds (C-C). Results: The DC data for the bulk-fill resin showed no significant difference (P &#62; 0.05) for different irradiation depths, whereas for the conventional nanohybrid resins, statistical analyses revealed a significant result of the variables time and depth as well as the interaction between them. Conclusions: The results indicated that SDR&#8482; achieves a 4-mm depth of cure with both 20- and 40-s light exposures. 


Comparison of naproxen and Gelofen for Pain relief in lower third molar surgery: A single-blinded randomized clinical trial
Ehsan Aliabadi, Saeid Tavanafar, Mehdi Hayati

European Journal of General Dentistry 2019 8(2):41-44

Objectives: Third molar surgeries are a routine procedure in oral and maxillofacial surgery and its associated pain is bothersome to patients. The purpose of this study was to compare the analgesic effect of Gelofen and naproxen in lower third molar surgery. Materials and Methods: A single-blinded randomized clinical trial was designed, and patients were randomly allocated into four groups (n &#61; 20 cases in each group): pre-Gelofen group: 400 mg Gelofen 30 min preoperative and continuing every 6 h, Gelofen group: 400 mg Gelofen immediately postoperative and continuing every 6 h, pre-naproxen group: 500 mg naproxen 30 min preoperative and every 8 h, and naproxen group: 500 mg naproxen immediately postoperative and every 8 h. The pain intensity was recorded using the visual analog scale at 2, 6, 12, and 24 h after surgery. Results: Pain intensity decreased in a linear pattern in all groups after 2, 6, 12, and 24 h. In pre-naproxen group, pain decreased suddenly between 2 and 6 h, but after 6 h, pain relief was slower than other groups. The mean pain intensity at 2 h postoperative for the pre-naproxen group was significantly lower than Gelofen group, and at 6 h, it was less than all other groups. At 12 and 24 h after surgery, pain intensity in all groups was similar except for the Gelofen group. Conclusion: Under limitation of the present study, preoperative intake of naproxen showed more effective pain relief than other groups. 


Comparison of miller's classification of gingival recession defects with mahajan's classification of gingival recession defect: A reliability study
Ajay Mahajan, Kanwarjit Singh Asi, Deepa Rayast, Mayum Negi

European Journal of General Dentistry 2019 8(2):45-50

Background: Gingival recession is a common periodontal problem encountered in most populations. A number of classification systems are available to classify gingival recession defects (GRDs), but there has been a lack of consensus among the clinicians regarding the choice of classification system to classify GRDs. Recently, Miller&#39;s classification has been criticized owing to its inherent limitations. Mahajan&#39;s classification was proposed to eliminate the drawbacks of Miller&#39;s classification system. To the best of our knowledge, there has been no study testing or comparing the reliability of Miller&#39;s classification; therefore, the present study was done to compare the reliability of Miller&#39;s classification with Mahajan&#39;s classification. Materials and Methods: The sites selected for the study were classified for GRD according to either Miller&#39;s classification or Mahajan&#39;s classification by the two groups of four examiners. All the examiners were calibrated for the two classification systems and classified the selected sites accordingly. Kappa statistics was performed to analyze the intra- and interrater agreement among the four examiners. Results: A total of 609 gingival recession sites in 91 patients (49 males and 42 females) were classified. At the end of the study, Mahajan&#39;s classification had a higher intrarater (&#954; &#61; 0.93&#8211;0.83) and interrater reliability (&#954; &#61; 0.93) compared to Miller&#39;s classification for GRD for both intrarater (&#954; &#61; 0.57&#8211;0.68) and interrater observations (&#954; &#61; 0.66), respectively. Conclusions: Miller&#39;s classification system was less reliable than Mahajan&#39;s classification system. 


Pulp canal calcification associated with periapical lesion as dental trauma sequelae – Clinical-surgical treatment
Michelle Zardin Furich, Cristina Braga Xavier, Luis Eduardo Rilling Nova Cruz, Josu&#233 Martos

European Journal of General Dentistry 2019 8(2):51-54

The objective of this report is to describe a surgical treatment in a traumatized tooth presenting pulp canal calcification (PCC) and periapical pathology. Three months after a patient had suffered injuries by luxation in the right central mandibular incisor, complete calcification of root canals was radiographically observed in addition to a radiographic image compatible with apical periodontitis. The chosen treatment was endodontic surgery and apical root sealing with mineral trioxide aggregate endodontic cement. After 4 months, the tooth showed complete apical repair. We concluded that the endodontic surgery is a procedure specifically indicated for cases of impossibility of conventional endodontic treatment, as in teeth with PCC. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Exercise and Sport Sciences

Amplified Neural Plasticity and Strength After Stroke
Following stroke, sensorimotor brain networks and descending regulation are compromised but spinal interlimb neural connections remain morphologically intact. After cross-education strength and locomotion training, amplified neural plasticity and functional responses are observed in chronic stroke compared to neurologically intact participants. We hypothesize that post-stroke neuroplasticity is amplified because of the involvement of interlimb neural connections that persist from our quadrupedal ancestry. Corresponding Author: E. Paul Zehr, Rehabilitation Neuroscience Laboratory, PO Box 3010 STN CSC, University of Victoria, Victoria, BC Canada, V8W 3P1, pzehr@uvic.ca; 1-250-721-8379 Acknowledgments: This research was supported by funding to Dr. E. Paul Zehr from the Heart and Stroke Foundation (British Columbia and Yukon) and the Natural Sciences and Engineering Research Council (NSERC) of Canada. Declaration of Interest: The authors declare that they have no conflict of interest regarding the publication of this paper. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. © 2019 American College of Sports Medicine

Transcallosal Control of Bilateral Actions
The corpus callosum is an important neural structure for controlling and coordinating bilateral movements of the upper limbs; however, there remains a substantial lack of knowledge regarding its association with lower limb control. We argue that transcallosal structure is an integral neural mechanism underlying control of the lower limbs and callosal degradation is a key contributor to mobility declines. Corresponding Author: Brett W. Fling, Ph.D., Assistant Professor – Health and Exercise Science Department, Assistant Professor – Molecular, Cellular & Integrative Neurosciences Program, Colorado State University, (970) 491-3451; Brett.Fling@colostate.edu Disclosure of funding: This work was supported in part by funding from a National Multiple Sclerosis Society Pilot Research Grant (PP-1708-29077) and a David Mahoney Neuroimaging Grant from the Dana Foundation. Conflict of interest: The authors have no conflicts to report. © 2019 American College of Sports Medicine

Macrophage Regulation of Muscle Regrowth from Disuse in Aging
Skeletal muscle immune cells, such as macrophages, are necessary for proper regrowth following muscle disuse. We suggest that the important role of macrophages concerning muscle regrowth following disuse is divergent compared to young mice (i.e. dysregulated) during the recovery period. Modulation of macrophages may be a promising future therapeutic target to enhance the impaired muscle growth during recovery from disuse in older adults. Corresponding author: M. J. Drummond, University of Utah, Department of Physical Therapy and Athletic Training, 520 Wakara Way, Salt Lake City, UT 84108-1213, USA. Email: micah.drummond@hsc.utah.edu Funding: This work was supported by the National Institute of Aging (R01AG050781, R21AG042699), the National Center for Complementary and Integrative Health (R01AT009268) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (F32AR072481). Authors declare no conflict of interest © 2019 American College of Sports Medicine

Perspectives for Progress - Female Athlete Triad and Relative Energy Deficiency in Sport: A Focus on Scientific Rigor
We examine the scientific evidence supporting The Female Athlete Triad and Relative Energy in Sport (RED-S) syndromes. More research is necessary to advance the understanding of both syndromes; however, it is premature to consider RED-S as an evidence-based syndrome. Future research should specifically define RED-S components, determine its clinical relevance, and establish the causality of relative energy deficiency on RED-S outcomes. Address for Correspondence: Nancy I. Williams, Sc.D., FACSM, FNAK, Professor and Head, Department of Kinesiology, Co-Director, Women's Health and Exercise Laboratory, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802. Email: niw1@psu.edu; Phone: 814-863-1163 Conflicts of interest; disclosure of funding: none © 2019 American College of Sports Medicine

Carbohydrate Availability as a Regulator of Energy Balance with Exercise
We explore the novel hypothesis that carbohydrate availability is involved in the regulation of energy balance with exercise, via hormonal and neural signals. We propose that carbohydrate availability could play a direct mechanistic role and partially explain previously-documented relationships between a more active lifestyle and tighter control of energy balance. Corresponding author: Javier T. Gonzalez, Department for Health, University of Bath, BA2 7AY, United Kingdom. Tel: 0(+44) 1225 38 5518; E-mail: J.T.Gonzalez@bath.ac.uk, ORCID ID: 0000-0002-9939-0074. Funding: No funding was received for the preparation of this manuscript. Conflicts of interest: J.T.G. has received research funding and/or has acted as a consultant for Arla Foods Ingredients, Lucozade Ribena Suntory, Kenniscentrum Suiker and Voeding, and PepsiCo. J.A.B. has received research funding and/or has acted as a consultant for GlaxoSmithKline, Lucozade Ribena Suntory, Kellogg's, Nestlé and PepsiCo and is a scientific advisor to the International Life Sciences Institute (ILSI). D.T. has received funding and acted as a consultant for Unilever. © 2019 American College of Sports Medicine

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Therapeutics

Propofol Infusion and Acute Pancreatitis: A Review
Background: Propofol is a short-acting anesthetic used to induce sedation in various ambulatory and inpatient surgical procedures. It is a US Food and Drug Administration approved lipid-based intravenous hypnotic agent, which has been used clinically for the induction and maintenance of anesthesia for over 3 decades. In addition to general anesthesia, it is used to sedate patients undergoing mechanical ventilation or short procedures such as endoscopy, transesophageal echocardiogram, and abscess drainage. An infrequent but serious complication of propofol is acute pancreatitis (AP), with potentially significant morbidity and possible mortality. In this review, we will discuss the proposed mechanisms of AP secondary to propofol, a number of reported cases, studies conducted, and treatment strategies. Areas of Uncertainty: There are several case reports in the literature that have shown an association between propofol and pancreatitis. The exact mechanism behind propofol-induced pancreatitis is not fully understood, but proposed mechanisms include hypertriglyceridemia (HTG), hypersensitivity, or direct pancreatic toxicity of the drug. Although the association of propofol and pancreatitis has not been proven conclusively, clinicians should be aware of this possible rare complication to prevent the devastating consequences of AP. Data Sources: We gathered articles on previously documented case reports and up-to-date studies on propofol-induced pancreatitis by searching databases such as PubMed and Google Scholar. Results: Based on previous studies and case reports, we suggest that propofol should be added to a list of drugs having a direct association with AP. Conclusions: Although, the mechanism of propofol-induced pancreatitis is not fully understood, and the causal relationship of propofol-induced hypertriglyceridemia or idiosyncratic drug reaction has remained unproven. Clinicians should be aware of the association between propofol and pancreatitis, and any patient presenting with abdominal pain after propofol infusion should be evaluated for AP and treated promptly to avoid complications. Address for correspondence: Post-Doctoral Research Fellow, Department of Surgery, Langone Medical Center, New York University, NYU Langone Health, Science Building, 435 E. 30th St, 4th Floor, New York, NY 10016. E-mail: usmanjutt898@gmail.com The authors have no conflicts of interest to declare. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Turmeric-Associated Liver Injury
No abstract available

Antimicrobial and Antineoplastic Properties of Sertraline
No abstract available

Topical Nifedipine for the Treatment of Pressure Ulcer: A Randomized, Placebo-Controlled Clinical Trial
Background: Effect of nifedipine on pressure ulcer (PU) healing has not been evaluated in the human subjects yet. Study question: In this study, the effect of topical application of nifedipine 3% ointment on PU healing in critically ill patients was investigated. Study design: This was a randomized, double-blind, placebo-controlled clinical. Measures and outcomes: In this study, 200 patients with stage I or II PU according to 2-digit Stirling Pressure Ulcer Severity Scale were randomized to receive topical nifedipine 3% ointment or placebo twice daily for 14 days. Changes in the size and stage of the ulcers were considered as primary outcome of the study. The stage of the ulcers at baseline and on day 7 and day 14 of study was determined by using 2-digit stirling scale. In addition, the surface area of the wounds was estimated by multiplying width by length. Results: In total, 83 patients in each group completed the study. The groups were matched for the baseline stage and size of PUs. Mean decrease in the stage of PU in the nifedipine group was significantly higher than the placebo group on day 7 (−1.71 vs. −0.16, respectively, P < 0.001) and day 14 (−0.78 vs. −0.09, respectively, P < 0.001). Furthermore, the mean decrease in the surface area of PU was significantly higher in the nifedipine group compared with the placebo group on day 7 (−1.44 vs. −0.32, respectively, P < 0.001) and day 14 (−2.51 vs. −0.24, respectively, P < 0.001) of study. Conclusions: Topical application of nifedipine 3% ointment for 14 days significantly improved the healing process of stage I or II PUs in critically ill patients. Address for correspondence: Professor of Clinical Pharmacy, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran, Postal Code: 14176-14411, P O Box: 14155/6451. E-mail: Khalilih@sina.tums.ac.ir The authors have no conflicts of interest to declare. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Adalimumab-Associated Hemorrhagic Pericarditis
No abstract available

Role of Flumazenil in the Management of Hepatic Encephalopathy
No abstract available

Trametinib-Associated Bradycardia
No abstract available

Poor Response to Alirocumab in a Patient With Homozygous Familial Hypercholesterolemia
No abstract available

Rapid-Onset Psychotic Symptoms After Interferon-β-1a Treatment of Multiple Sclerosis
No abstract available

Pembrolizumab for PD-L1–Positive Breast Cancer Refractory to Chemotherapy
No abstract available

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480