Pancreas Transplantation With Grafts From Donors Deceased After Circulatory Death: 5 Years Single-Center Experience

Transplant surger

Bracing patients with idiopathic scoliosis: Design of the Dutch randomized controlled treatment trial

Background. The effectiveness of bracing patients with IS has not yet been convincingly established due to a lack of RCTs. Some authors suggest that their results confirm that bracing is effective; others conclude that the effectiveness of bracing is doubtful or recommend a RCT. The aim of this study was to establish whether bracing patients with idiopathic scoliosis (IS) in an early stage will result in at least 5 degrees less mean progression of the curvature compared to the control group after two years of follow-up. Methods. A randomized controlled trial was designed. Eligible patients are girls and boys in the age group 8-15 years whose diagnosis of IS has been established by an orthopedic surgeon, who have not yet been treated by bracing or surgery, and for whom further growth of physical height is still expected based on medical examination and maturation characteristics (Risser ? 2). The Cobb angle of the eligible patient should either be minimally 22 and maximally 29 degrees with established progression of more than 5 degrees, or should be minimally 30 and maximally 35 degrees; established progression for the latter is not necessary. A total of 100 patients will be included in this trial. The intervention group will be treated with full-time Boston brace wear; the control group will not be braced. Every four months, each patient will have a physical and an X-ray examination. The main outcomes will be the Cobb angle two years after inclusion and health-related quality of life. Discussion. The results of this trial will be of great importance for the discussion on early treatment for scoliosis. Furthermore, the result will also be important for screening for scoliosis policies. Trial registration. Nederlands Trialregister ISRCTN36964733

Microbiome dynamics of human epidermis following skin barrier disruption

Background - Recent advances in sequencing technologies have enabled metagenomic analyses of many human body sites. Several studies have catalogued the composition of bacterial communities of the surface of human skin, mostly under static conditions in healthy volunteers. Skin injury will disturb the cutaneous homeostasis of the host tissue and its commensal microbiota, but the dynamics of this process have not been studied before. Here we analyzed the microbiota of the surface layer and the deeper layers of the stratum corneum of normal skin, and we investigated the dynamics of recolonization of skin microbiota following skin barrier disruption by tape stripping as a model of superficial injury. Results - We observed gender differences in microbiota composition and showed that bacteria are not uniformly distributed in the stratum corneum. Phylogenetic distance analysis was employed to follow microbiota development during recolonization of injured skin. Surprisingly, the developing neo-microbiome at day 14 was more similar to that of the deeper stratum corneum layers than to the initial surface microbiome. In addition, we also observed variation in the host response towards superficial injury as assessed by the induction of antimicrobial protein expression in epidermal keratinocytes. Conclusions - We suggest that the microbiome of the deeper layers, rather than that of the superficial skin layer, may be regarded as the host indigenous microbiome. Characterization of the skin microbiome under dynamic conditions, and the ensuing response of the microbial community and host tissue, will shed further light on the complex interaction between resident bacteria and epidermi

Innate immunity in the skin: Schnitzler’s syndrome and pattern recognition receptors

Contains fulltext : 139134.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 6 maart 2015Promotores : Schalkwijk, J., Meer, J.W.M. van der Co-promotores : Simon, A., Zeeuwen, P.L.J.M

Two adjacent nodules on the leg.

Contains fulltext : 87592.pdf (publisher's version ) (Open Access)Poroma is a rare benign neoplasm (derived from the intraepidermal part of the eccrine or apocrine duct), which may clinically mimic malignant tumors such as (amelanotic) malignant melanoma and porocarcinoma. Histopathological examination is the key to the correct diagnosis, which is illustrated in the present case, in which a pigmented basal cell carcinoma and a poroma are in close proximity to each other. Despite a clinical differential diagnosis of melanoma, histopathology showed the typical characteristics of a poroma, a rare but much more favorable tumor. Histopathological features of poroma are discussed

Pattern recognition receptors in infectious skin diseases

Item does not contain fulltextDuring the last decade, multiple pattern recognition receptors (PRRs) have been identified. These are involved in the innate immune response against a plethora of pathogens. However, PRR functioning can also be detrimental, even during infections. This review discusses the current knowledge on PRRs that recognize dermatotropic pathogens, and potential therapeutical implications

Comment on: Schnitzlers syndrome--exacerbation after anti-TNF treatment.

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Interleukine-1-remming in cryopyrinegeassocieerd periodiek syndroom (CAPS) en schnitzlersyndroom

Item does not contain fulltextCryopyrin-associated periodic syndrome (CAPS) is a hereditary autoinflammatory disorder. Patients suffer from chronic systemic inflammation involving the skin (urticaria), joints arthritis) and in some cases also peritoneum (peritonitis) and meninges (meningitis). Recently, a causative mutation was found in the NLRP3 gene, which results in overactivation of the potent proinflammatory cytokine interleukin-1 beta (IL-1β). Targeted therapies including the IL-1 receptor antagonist (IL-1Ra) anakinra, the IL-1R-Fc fusion protein rilonacept and the monoclonal anti-IL-1β antibody canakinumab are very effective. Schnitzler syndrome is a rare, chronic autoinflammatory disease, characterized by chronic urticaria, paraproteinemia and systemic inflammation. In view of phenotypical similarities to CAPS, anakinra was tried and appeared to be highly effective in Schnitzler syndrome. There are indications that canakinumab is also effective. However, the exact pathophysiology of Schnitzler syndrome remains to be elucidated

Successful canakinumab treatment identifies IL-1beta as a pivotal mediator in Schnitzler syndrome.

Contains fulltext : 98374.pdf (publisher's version ) (Closed access)1 december 201