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Friday, October 2, 2020
Medicine by Alexandros G. Sfakianakis
Anaphylaxis Refractory to intra‐muscular adrenaline during in‐hospital food challenges: a case series and proposed management: AbstractBackgroundAnaphylaxis is a severe, systemic hypersensitivity reaction, that can be potentially life threatening. Anaphylaxis during oral food challenge is not uncommon and can usually be effectively managed with intramuscular adrenaline as first line treatment. Although very rare, fatal anaphylaxis during in‐hospital food challenge has been reported.ObjectiveWe describe...
09:04
Association between childhood asthma and attention deficit hyperactivity or autism spectrum disorders: a systematic review with meta‐analysis: AbstractBackgroundChildren with asthma are at risk of depression and anxiety and growing evidence suggest they may also be at risk of attention deficit hyperreactivity disorder (ADHD) and autism spectrum disorder (ASD). Here, we conducted a systematic review with meta‐analysis of studies investigating association between asthma and ADHD or ASD in children.MethodsA...
09:03
Aberrant AICA Injury During Translabyrinthine Approach: Objective: To define a complication of the translabyrinthine surgical approach to the posterior fossa related to a rare variant of the anterior inferior cerebellar artery (AICA) that penetrated into the petrous temporal bone. Patient: A healthy 59-year-old male with a unilateral sporadic vestibular schwannoma. Intervention: The patient elected to undergo a translabyrinthine approach for resection of a vestibular schwannoma....
09:03
Predicting Recidivism for Acquired Cholesteatoma: Evaluation of a Current Staging System: Objective: Assess the utility and prognostic capabilities of the European Academy of Otology and Neurotology (EAONO) and Japanese Otological Society (JOS) cholesteatoma classification system, specifically for retraction pocket cholesteatoma. Study Design: Retrospective. Setting: Tertiary referral hospital. Patients: Adults and children with retraction pocket cholesteatoma. ...
09:02
A simple automated approach to measure mouse whole gut transit: AbstractBackgroundGastrointestinal (GI) motility is a complex physiological process that is critical for normal GI function. Disruption of GI motility frequently occurs in GI diseases or as side effects of therapeutics. Whole gut transit measurements, like carmine red leading‐edge transit, in mice form the cornerstone of in vivo preclinical GI motility studies.MethodWe have developed an easily achievable, labor‐saving method to measure...
09:02
Acute disseminated encephalomyelitis in a COVID-19 pediatric patient: AbstractThe authors present a case of acute disseminated encephalomyelitis in a COVID-19 pediatric patient with positive SARS-CoV2 markers from a nasopharyngeal swab. A previously healthy 12-year-old-girl presented with a skin rash, headache, and fever. Five days after that, she had an acute, progressive, bilateral, and symmetrical motor weakness. She evolved to respiratory failure. Magnetic resonance imaging (MRI) of the brain...
09:01
Global 3D parameter of the spine: application of Călugăreanu–White–Fuller theorem in classification of pediatric spinal deformity: AbstractSeveral classification systems of the spinal curves in adolescent idiopathic scoliosis (AIS) have been developed to guide surgical decision-making. The current classification systems are based on the spinal deformity patterns or deformity magnitudes in one or two anatomical planes. Considering the 3D nature of the spinal deformity in AIS, these classifications...
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Is variation in posterior tibial veins a risk factor for deep‐vein thrombosis?: ABSTRACTINTRODUCTIONThis study proposes variations in the posterior tibial vein as one of the risk factors for deep‐vein thrombosis. Understanding the anatomical classification of the posterior tibial vein would guide the antegrade approach of catheter‐directed thrombolysis.MATERIALS AND METHODSOne hundred thirty‐four legs from Korean and Thai cadavers were dissected. The posterior tibial veins were classified into four...
08:59
Anatomical guide for botulinum neurotoxin injection: Application to cosmetic shoulder contouring, pain syndromes, and cervical dystonia: ABSTRACTIntroductionThis study proposes an ideal botulinum toxin injection point of the trapezius muscle for shoulder line contouring, pain management and functional impairment. This study describes the intramuscular nerve branching in the trapezius muscle, providing essential information for botulinum neurotoxin injection.MethodA modified Sihler's method was performed...
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Morphological features of the lateral plantar ligament of the transverse metatarsal arch: AbstractThe aim of this study was to elucidate the morphological characteristics of the lateral Lisfranc ligament in a large sample. This investigation examined 100 legs from 50 cadavers. Each of the lower limbs was dissected to identify the plantar aspect of the transverse metatarsal arch, and morphological characteristics of the lateral plantar ligament were assessed, including the length, width, and thickness...
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SARS-CoV-2 samples may escape detection because of a single point mutation in the N geneWe found that a single nucleotide polymorphism (SNP) in the nucleoprotein gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a patient interfered with detection in a widely used commercial assay. Some 0.2% of the isolates in the EpiCoV database contain this SNP. Although SARS-CoV-2 was still detected by the other probe in the assay, this underlines the necessity of targeting two independent...
08:58
Designed Proteins Lead Therapeutics to Cancer Cells, Spare Other Cells [Techniques]Sets of modular proteins enabled targeting of cells with specific combinations of surface markers.Cancer Discovery current issueThu Oct 01, 2020 10:05In This Issue [In This Issue]Cancer Discovery current issueThu Oct 01, 2020 10:05Phase I Trial of the PARP Inhibitor Olaparib and AKT Inhibitor Capivasertib in Patients with BRCA1/2- and Non-BRCA1/2-Mutant Cancers [Research Articles]Preclinical studies have demonstrated...
08:57
A potential role for aspirin in the prevention and treatment of cholangiocarcinoma: AbstractCholangiocarcinoma is the second most common primary hepatic cancer, with a rising incidence worldwide. Owing to late diagnosis and limited treatment options, the prognosis for cholangiocarcinoma remains dismal, compelling a search for new treatments. As aspirin exhibits a well‐supported chemopreventive effect on common cancers, researchers have proposed using aspirin as a potential preventive and adjuvant...
08:56
Immunogenic characteristics of microsatellite instability‐low esophagogastric junction adenocarcinoma based on clinicopathological, molecular, immunological, and survival analyses: ABSTRACTMicrosatellite instability (MSI) is categorized by mutation frequency: high MSI (MSI‐H), low MSI (MSI‐L), and microsatellite stable (MSS). MSI‐H tumors have a distinct immunogenic phenotype, with immunotherapies using checkpoint inhibitors already approved for the treatment of MSI‐H gastroesophageal adenocarcinoma...
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Methylation markers FAM19A4 and miR124‐2 as triage strategy for primary HPV screen positive women; A large European multi‐center study: AbstractIn HPV cervical cancer screening, cytology is used as triage to counter the low specificity of HPV testing. VALID‐SCREEN is a EU‐multicentre, retrospective study conducted to evaluate the clinical performance of the FAM19A4/miR124‐2 methylation‐based molecular triage test as a substitute or addition to cytology as reflex testing of HPV screen positive women....
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A Phase I/II Study of Veliparib (ABT-888) in Combination with 5-Fluorouracil and Oxaliplatin in Patients with Metastatic Pancreatic CancerPurpose: Up to 17% of patients with pancreatic ductal adenocarcinoma (PDAC) harbor pathogenic (germline or somatic) mutations in a homologous recombination, DNA damage response and repair (HR-DDR) gene, such as BRCA1/2, or PALB2. Platinum-based chemotherapy, or treatment with PARP inhibitors are of particular benefit in these patients. However, there may be even...
08:54
A Phase Ib/II Study of the BRAF Inhibitor Encorafenib Plus the MEK Inhibitor Binimetinib in Patients with BRAFV600E/K-mutant Solid Tumors: Purpose: This open-label, dose-finding phase Ib/II study reports the safety and activity of the first combination use with BRAF inhibitor (BRAFi) encorafenib plus MEK inhibitor (MEKi) binimetinib in patients with BRAF V600E–mutant solid tumors.Patients and Methods: In phase I, the recommended phase 2 doses (RP2D) were established (primary objective). In phase...
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A Serum Protein Classifier Identifying Patients with Advanced Non-Small Cell Lung Cancer Who Derive Clinical Benefit from Treatment with Immune Checkpoint Inhibitors: Purpose: Pretreatment selection of patients with non–small cell lung cancer (NSCLC) who would derive clinical benefit from treatment with immune checkpoint inhibitors (CPIs) would fulfill an unmet clinical need by reducing unnecessary toxicities from treatment and result in substantial health care savings.Experimental Design: In...
08:52
A Phase II Trial of Tipifarnib for Patients with Previously Treated, Metastatic Urothelial Carcinoma Harboring HRAS Mutations: Purpose: To assess the antitumor activity and safety of tipifarnib, a highly potent and selective farnesyltransferase inhibitor, we performed a phase II clinical trial in patients with advanced and refractory urothelial carcinoma harboring missense HRAS mutations.Patients and Methods: A total of 245 adult patients with previously treated, advanced urothelial carcinoma...
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Circulating Tumor DNA is Prognostic and Potentially Predictive of Eryaspase Efficacy in Second-line in Patients with Advanced Pancreatic Adenocarcinoma: Purpose: Eryaspase is composed of l-asparaginase encapsulated in erythrocytes and has demonstrated significant efficacy in a randomized phase II trial. We assessed the prognostic and predictive value of circulating tumor DNA (ctDNA) in patients, plasma included in this trial.Experimental Design: Samples prospectively collected pretreatment were...
08:51
Nivolumab in Patients with Advanced Platinum-resistant Urothelial Carcinoma: Efficacy, Safety, and Biomarker Analyses with Extended Follow-up from CheckMate 275: Purpose: We report efficacy and safety with extended follow-up, and exploratory biomarker analyses from the phase II CheckMate 275 trial to identify biomarkers of response to nivolumab in platinum-resistant metastatic or unresectable urothelial carcinoma (mUC).Patients and Methods: Patients received nivolumab 3 mg/kg once every 2 weeks...
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A Phase II Study of Allogeneic GM-CSF-Transfected Pancreatic Tumor Vaccine (GVAX) with Ipilimumab as Maintenance Treatment for Metastatic Pancreatic Cancer: Purpose: This phase II study tested granulocyte-macrophage colony-stimulating factor (GM-CSF)-allogeneic pancreatic tumor cells (GVAX) and ipilimumab in metastatic pancreatic ductal adenocarcinoma (PDA) in the maintenance setting.Patients and Methods: Patients with PDA who were treated with front-line chemotherapy consisting of 5-fluorouracil,...
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A Bispecific DLL3/CD3 IgG-Like T-Cell Engaging Antibody Induces Antitumor Responses in Small Cell Lung Cancer: Purpose: Small cell lung cancer (SCLC) is the most lethal and aggressive subtype of lung carcinoma characterized by highly chemotherapy-resistant recurrence in the majority of patients. To effectively treat SCLC, we have developed a unique and novel IgG-like T-cell engaging bispecific antibody (ITE) that potently redirects T-cells to specifically lyse SCLC cells expressing Delta-like ligand...
08:49
Radical external beam re‐irradiation in the treatment of recurrent head and neck cancer: Critical review: AbstractManagement of patients with recurrent head and neck cancer remains a challenge for the surgeon as well as the treating radiation oncologist. Even in the era of modern radiotherapy, the rate of severe toxicity remains high with unsatisfactory treatment results. Intensity‐modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and heavy‐ion irradiation have all emerged...
08:49
Endoscopic transoral nasopharyngectomy: AbstractBackgroundA minimal access technique for the management of nasopharyngeal tumors extending below the palatal plane and laterally beyond the pterygoid musculature is yet to be developed. In this study we demonstrate the feasibility of endoscopic transoral nasopharyngectomy (ETON) for resection of large nasopharyngeal lesions as a natural orifice alternative to traditional approaches.MethodsETON was completed in three latex‐injected specimens. Surgical...
08:48
Multiphasic 68Ga-PSMA PET/CT in the Detection of Early Recurrence in Prostate Cancer Patients with a PSA Level of Less Than 1 ng/mL: A Prospective Study of 135 Patients: The main objective of this prospective study was to determine the impact of multiphasic acquisition of 68Ga-PSMA PET/CT in the detection of recurrent prostate cancer in the early stage of biochemical recurrence with a prostate-specific antigen (PSA) level of less than 1 ng/mL. Also, 68Ga-PSMA PET/CT positivity was correlated with...
10:35
Cerenkov Luminescence Imaging for Surgical Margins in Radical Prostatectomy: A Surgical Perspective: Cerenkov luminescence imaging: physics principles and ...www.ncbi.nlm.nih.gov › pmc › articles › PMC5346099Mar 11, 2017 - Cerenkov luminescence imaging (CLI) is a novel imaging modality to study charged particles with optical methods by detecting the Cerenkov luminescence produced in tissue. This paper first describes the physical processes that govern the production and transport in tissue of Cerenkov...
10:34
The Optimal Imaging Window for Dysplastic Colorectal Polyp Detection Using c-Met-Targeted Fluorescence Molecular Endoscopy: Fluorescence molecular endoscopy (FME) is an emerging technique that has the potential to improve the 22% colorectal polyp detection miss-rate. We determined the optimal dose-to-imaging interval and safety of FME using EMI-137, a c-Met–targeted fluorescent peptide, in a population at high risk for colorectal cancer. Methods: We performed in vivo FME and quantification of fluorescence...
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Design and Development of 99mTc-Labeled FAPI Tracers for SPECT Imaging and 188Re Therapy: Most epithelial tumors recruit fibroblasts and other nonmalignant cells and activate them into cancer-associated fibroblasts. This often leads to overexpression of the membrane serine protease fibroblast-activating protein (FAP). It has already been shown that DOTA-bearing FAP inhibitors (FAPIs) generate high-contrast images with PET/CT scans. Since SPECT is a lower-cost and more widely available alternative...
10:32
18F-FDG PET/CT Identifies Predictors of Survival in Patients with Locally Advanced Cervical Carcinoma and Paraaortic Lymph Node Involvement to Allow Intensification of Treatment: Our objective was to use 18F-FDG PET/CT to identify a high-risk subgroup requiring therapeutic intensification among patients with locally advanced cervical cancer (LACC) and paraaortic lymph node (PALN) involvement. Methods: In this retrospective multicentric study, patients with LACC and PALN involvement concurrently treated...
10:32
Clinical Evaluation of a Data-Driven Respiratory Gating Algorithm for Whole-Body PET with Continuous Bed Motion: Respiratory gating is the standard to prevent respiration effects from degrading image quality in PET. Data-driven gating (DDG) using signals derived from PET raw data is a promising alternative to gating approaches requiring additional hardware (e.g., pressure-sensitive belt gating [BG]). However, continuous-bed-motion (CBM) scans require dedicated DDG approaches for axially extended...
10:31
Performance of Digital PET Compared with High-Resolution Conventional PET in Patients with Cancer: Recently introduced PET systems using silicon photomultipliers with digital readout (dPET) have an improved timing and spatial resolution, aiming at a better image quality than conventional PET (cPET) systems. We prospectively evaluated the performance of a dPET system in patients with cancer, as compared with high-resolution (HR) cPET imaging. Methods: After a single 18F-FDG injection, 66 patients...
10:30
Interaction between childhood vocal fold nodules and allergic diseases: Publication date: November 2020Source: International Journal of Pediatric Otorhinolaryngology, Volume 138Author(s): Nazli Ercan, Ilknur Bostanci, Umut Kaygusuz, Kamercan CeylanAbstractObjectivesVocal fold nodules (VFNs) are benign lesions at the junction of the anterior and middle third of the vocal folds. Although VFNs are often a result of vocal cord trauma due to vocal abuse, childhood allergic diseases, and medications may...
10:30
Precision-optimized single protocol pre-/post-contrast modified-look locker inversion T1 mapping using composite inversion group fitting: Publication date: Available online 1 October 2020Source: Magnetic Resonance ImagingAuthor(s): Luigia D'Errico, Marshall S. Sussman, Kate Hanneman, Bernd J. WinterspergerFigures (6)Tables (5)Table 1Table 2Table 3Table 4Table 5Magnetic Resonance ImagingAvailable online 1 October 2020In Press, Journal Pre-proofWhat are Journal Pre-proof articles?Original ContributionPrecision-optimized...
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Estimation error bound for GRAPPA diffusion-weighted MRI: Publication date: Available online 1 October 2020Source: Magnetic Resonance ImagingAuthor(s): Zohir Laib, Farid Ahmed Sid, Karim Abed-Meraim, Aziz OuldaliAbstractIn recent years, diffusion weight magnetic resonance imaging (DW-MRI) has become one of the most important MRI imaging modalities. The importance of the DW-MRI grew thanks to the combination of parallel magnetic resonance imaging (pMRI) techniques with the echo-planar imaging (EPI),...
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Microcephaly with altered cortical layering in GIT1 deficiency revealed by quantitative neuroimaging
Microcephaly with altered cortical layering in GIT1 deficiency revealed by quantitative neuroimaging: Publication date: Available online 30 September 2020Source: Magnetic Resonance ImagingAuthor(s): Alexandra Badea, Robert Schmalzigaug, Woojoo Kim, Pamela Bonner, Umer Ahmed, G. Allan Johnson, Gary Cofer, Mark Foster, Robert J. Anderson, Cristian Badea, Richard T. PremontHighlights•Micro-CT revealed microcephaly, significant differences in local skull shape and Hounsfield units for GIT1-KO animals...
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PROTECTIVE EFFECT OF METHYLENE BLUE AGAINST COPPER OXIDE NANOPARTICLE-INDUCED NEUROBEHAVIORAL TOXICITY: Publication date: Available online 30 September 2020Source: Behavioural Brain ResearchAuthor(s): Amira. A. Goma, Osama. S. El Okle, Hossam. G. TohamyHighlights•Supplementation with Copper oxide nanoparticle-induced neurobehavioral alterations.•Increased copper (Cu) content in brain and oxidative stress markers.•In Cu-exposed rats, mitochondrial dehydrogenases activity decreased.•Immune positive...
10:16
Breast cancer screening in women at high risk of hereditary breast cancer: an Australian experience: Multimodality screening of younger women at high risk of hereditary breast cancer is effective, and the yield substantially exceeds the results from established breast screening programmes in older women. Magnetic resonance imaging offers incremental efficiency in detecting cancers in this high‐risk population and is a useful addition to the screening armamentarium. Co‐location of the high‐risk...
10:13
Artificial intelligence technology in surgery: part 1: AbstractArtificial intelligence (AI) is one of the disruptive technologies of the fourth Industrial Revolution that is changing our work practices. This technology is in use in highly diverse industries including health care, defence, insurance and e‐commerce. This review focuses on the relevance of AI to surgery. AI will aid surgeons with diagnostic decision‐making, patient selection for surgery as well as improve patient pre‐ and post‐operative...
10:12
Incidental small bowel malignancy in a chronic ileal stricture in a patient with Crohn's disease: an interesting case:
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How to do it: single‐dermatome single‐incision laparoscopic right hemicolectomy: We describe a novel single‐incision laparoscopy right hemicolectomy technique using a single‐dermatomal, muscle‐splitting approach through a 4‐cm incision located between the right anterior superior iliac spine and pubic tubercle. This new technique may be superior to traditional single‐incision laparoscopy colectomy with the potential benefits of less post‐operative pain, lower opioid requirements, lower risk of incisional...
10:10
Uncommon localization of amyloidosis in gallbladder ...www.medigraphic.com › pdfs › hepatoPDFAmyloid deposition is in fact fre- quent in the kidneys, the heart, the nervous system, the hepatosplenic and intestinal tract and can be present in bone marrow (40 ...by D Tirotta - 2016 - Cited by 7 - Related articlesIncidental finding of amyloidosis of the gallbladder - Pathologywww.pathologyjournal.rcpa.edu.au › article › fulltextFeb 1, 2017 - Amyloidosis may be systemic or localised, and is caused...
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Nonkeratinizing Squamous Cell Carcinoma of the Sinonasal Tract With DEK-AFF2: Further Solidifying an Emerging Entity:
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Masson Trichrome and Sulfated Alcian Blue Stains Distinguish Light Chain Deposition Disease From Amyloidosis in the Lung: Light chain deposition disease, characterized by nonamyloidogenic deposits of immunoglobulin light chains, is rare in the lung and possibly underdiagnosed due to low clinical suspicion and lack of readily accessible tests. We encountered a case of pulmonary light chain deposition disease (PLCDD) in which light chain deposits appeared crimson red with a Masson trichrome (MT) stain...
10:04
Histopathologic Characterization of Bladder Perivascular Epithelioid Cell Neoplasms (PEComa): A Series of 11 Cases With a Subset Having: TFE3: Rearrangements: Perivascular epithelioid cell neoplasms (PEComas) of the bladder are extremely rare, with ~30 case reports. A subset of PEComas contain TFE3 gene rearrangement, however, the distinct histomorphologic features of these translocation tumors has not been fully explored in bladder PEComas. In our series, 11 cases of bladder PEComas were collected,...
10:04
Molecular Profiling of Salivary Oncocytic Mucoepidermoid Carcinomas Helps to Resolve Differential Diagnostic Dilemma With Low-grade Oncocytic Lesions: Oncocytic mucoepidermoid carcinoma (OMEC) is a rare but diagnostically challenging variant of mucoepidermoid carcinoma (MEC). OMEC is notable for differential diagnostic considerations that are raised as a result of overlap with other benign and low-grade oncocytic salivary gland tumors. Diffuse and strong immunoreactivity of p63 protein may be useful...
10:03
Clear Cell Change in Reactive Angiogenesis: A Potential Diagnostic Pitfall: Reactive angiogenesis is commonplace, occurs in many circumstances, and is important in the repair of injured tissue. Histologically, it is characterized by newly formed capillaries arranged in a lobular architecture and lined by plump endothelial cells. We have encountered a form of reactive angiogenesis not well described; composed of large endothelial cells with abundant clear cytoplasm that causes diagnostic challenges....
10:02
ISH-basierte HER2-Diagnostik: ZusammenfassungFür die HER2-gerichtete Therapie ist der Nachweis einer Rezeptor-Überexpression und/oder der Genamplifikation mittels In-situ-Hybridisierung (ISH) von entscheidender Bedeutung. Im Laufe von mehr als 15 Jahren haben die Amerikanische Krebsgesellschaft (ASCO) und die Kanadisch-Amerikanische Pathologengesellschaft (CAP) mehrere Empfehlungen zur optimalen HER2-Testung verfasst. Für das Mammakarzinom wurde zuletzt 2018 eine Aktualisierung herausgegeben, wobei...
10:02
A demogenetic individual based model for the evolution of traits and genome architecture under sexual selection [NEW RESULTS]: Sexual selection has long been known to favor the evolution of mating behaviors such as mate preference and competition, and to affect their genetic architecture, for instance by favoring genetic correlation between some traits. Reciprocally, genetic architecture can affect the expression and the evolvability of traits and mating behaviors. But sexual selection is highly...
09:55
Configuration analysis of the injection position and shape of the gel spacer in gynecologic brachytherapy: Publication date: Available online 1 October 2020Source: BrachytherapyAuthor links open overlay panelKotaroIijima1NaoyaMurakami2SatoshiShieNishioka1TakahitoChiba13JunichiKuwahara4MihiroTakemori13HirokiNakayama13TairoKashihara2KaeOkuma2KanaTakahashi2KojiInaba2HiroshiIgaki2HiroyukiOkamoto1JunItami21Department of Medical Physics, National Cancer Center Hospital, Tokyo, Japan2Department of Radiation...
09:54
Topical lignocaine anaesthesia for oropharyngeal sampling for COVID-19: AbstractObjectivesTo ascertain if topical lignocaine application in oropharynx prior to swab sampling to test for COVID-19 improves a patient's comfort and to assess its effect on the swab sample taken to conduct the RT-PCR. MethodsAdult patients testing positive on the RT-PCR COVID-19 test were sampled again within 48 h after administering topical oropharyngeal anaesthesia. Patients were asked to rate their...
09:52
Patient specific 3D printed template for halo frame pin placement in post cranioplasty multiple skull bone defect patient: Rigid external distractor (RED) is used for midface advancement in craniofacial synostosis (Al-Namnam et al., 2018). Placement of halo frame is challenging especially in the patients with multiple skull defects due to previous cranioplasty procedures. Multiple skull defects remain even after successful healing of bone. RED fixation after Le Fort III osteotomy through skin itself...
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Diced Cartilage in Fibrin Glue for Dorsal Reconstruction as Part of Staged Paramedian Forehead Flap Reconstruction: The use of diced cartilage grafting is a powerful tool during rhinoplasty for dorsal augmentation; however, its application to nasal structural reconstruction has rarely been reported. Here we present a unique technique for Mohs defect reconstruction combining diced cartilage graft for dorsal augmentation and a folded paramedian forehead flap for soft tissue. A 54-year-old female presented...
09:50
Golf-Related Craniofacial Injuries in Adults: A NEISS Database Study: Introduction: Despite its popularity, there have been no reports outlining adult craniofacial trauma in the setting of golf injuries. Our main objective was to identify and describe trends in head and neck injuries incurred while participating in golf including injury type, anatomic location, and patient disposition. Methods: A retrospective cohort analysis of the National Electronic Injury Surveillance System (NEISS)...
09:50
Mandibular Chondrosarcoma Reconstructed Using Custom Implant and Radial Forearm Free Flap: We describe the case of a 40-year-old male presenting with an enlarging left facial and temporal chondrosarcoma centered on the left mandibular coronoid process resulting in pathologic fractures of the zygomatic arch and focal erosion of the temporal bone. The patient underwent surgical resection via a combined hemicoronal and parotidectomy approach. The zygomatic arch was reconstructed with a patient-specific...
09:49
Bilateral Epiphora as Only Presenting Sign of Total Paranasal Sinus Aplasia: A 20-year-old female patient was presented with a bilateral epiphora. She had no history of infection or trauma related to the sinus areas. On examination, her facial appearance was abnormal and fullness on the face was observed. The fluorescein dye disappearance test was positive in both eyes. The lacrimal system irrigation was patent nasolacrimal duct. However, the dacryoscintigraphy imaging scan demonstrated bilateral...
09:49
Three-Dimensionally-Printed Bioactive Ceramic Scaffolds—Construct Effects on Bone Regeneration: A Pilot Study: Background/Purpose: The utilization of three-dimensionally (3D)-printed bioceramic scaffolds composed of beta-tricalcium phosphate in conjunction with dipyridamole have shown to be effective in the osteogenesis of critical bone defects in both skeletally immature and mature animals. Furthermore, previous studies have proven the dura and pericranium's osteogenic capacity in the presence...
09:48
Unilateral Vision Loss Due to Isolated Onodi Cell Mucocele: Onodi cell mucocele is a rare, benign, cystic, destructive and expansive lesion. While the sphenoid sinus mucocele is 1% to 2%, onodi cell mucocele is very rare. Because of its direct mass compression effect, its proximity to the orbital apex may cause many symptoms such as loss of vision, eye movements, and exophthalmus. Imaging methods have an important priority in diagnosis. It also plays a crucial role in planning treatment quickly and...
09:47
A Keyhole Approach Centered by Anterior Squamous Suture to Hypertensive Basal Ganglia Hemorrhage: Objective: This study aimed to improve the accuracy and efficacy of the keyhole transsylvian approach to remove hypertensive basal ganglia hemorrhage. The authors presented a stable keyhole craniotomy based on anterior squamous suture to expose insular cortex and basal ganglia. Methods: Twenty-nine patients with hypertensive basal ganglia hemorrhage were treated with keyhole surgery and...
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Orbital Emphysema Secondary to Frontal Osteoma: Repeated bouts of nose blowing can at times lead to orbital emphysema due to stress fracture in the medial or the inferior wall of the orbit. Very rarely, this can result from paranasal sinus osteoma rendering the orbital wall weak. We report only the fifth case of literature to have such an association. Also, we managed our case non-surgically, as against the previous reports treated surgically. In discussion, we highlight the nuances related to principles...
09:46
The Integrity of the Substructure of the Corpus Callosum in Patients with Right Classic Trigeminal Neuralgia—A Diffusion Tensor Imaging Study: Objective: Patients with classic trigeminal neuralgia (CTN) have abnormalities in white matter integrity of the corpus callosum (CC). However, in CTN patients, it is unclear whether the CC substructure region is affected to varying degrees. Material and methods: A total of 22 patients with CTN and 22 healthy controls (HC) with matching age, gender,...
09:46
The Cardiac Injury Immune Response as a Target for Regenerative and Cellular Therapies: Publication date: Available online 1 October 2020Source: Clinical TherapeuticsAuthor(s): Robert D. Hume, James J.H. ChongAbstractPurposeDespite modern reperfusion and pharmacologic therapies, myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. Therefore, the development of further therapeutics affecting post-MI recovery poses significant benefits. This review focuses on the...
09:45
Benralizumab for Chronic Spontaneous Urticaria: New England Journal of Medicine, Volume 383, Issue 14, Page 1389-1391, October 2020. Benralizumab, an anti–interleukin-5-receptor antibody, was evaluated in a 24-week study involving 12 patients with chronic spontaneous urticaria. The disease was assessed on the basis of urticaria activity scores. After three monthly injections and 2 months without benralizumab, 5 patients had a complete response and 2 had a partial response.Η συνιστώμενη δόση μπενραλιζουμάμπης...
09:35
Atezolizumab for First-Line Treatment of PD-L1–Selected Patients with NSCLC: New England Journal of Medicine, Volume 383, Issue 14, Page 1328-1339, October 2020. AbstractBACKGROUNDThe efficacy and safety of the anti–programmed death ligand 1 (PD-L1) monoclonal antibody atezolizumab, as compared with those of platinum-based chemotherapy, as first-line treatment for patients with metastatic non–small-cell lung cancer (NSCLC) with PD-L1 expression are not known.METHODSWe conducted a randomized, open-label,...
09:29
Amoxicillin Course Length or Use in Childhood Pneumonia in Underserved Areas: New England Journal of Medicine, Volume 383, Issue 14, Page 1391-1393, October 2020. To the Editor: The trials by Ginsberg et al.1 and Jehan et al.2 (July 2 issue) question the recommended treatment of nonsevere pneumonia in children younger than 5 years of age. The trial conducted by Ginsburg et al. in Malawi showed that a 3-day course of amoxicillin was noninferior to a 5-day course, despite the former regimen having...
09:26
Evolocumab in Children with Heterozygous Familial Hypercholesterolemia: New England Journal of Medicine, Volume 383, Issue 14, Page 1385-1386, October 2020. Heterozygous familial hypercholesterolemia — in contrast to the more rare and more severe homozygous familial hypercholesterolemia — is a common genetic cholesterol disorder affecting approximately 1 in 250 persons and resulting in an increased risk of premature atherosclerotic cardiovascular disease.1 Autopsies and subclinical vascular studies...
09:25
Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8–12 years: AbstractBackground and ObjectiveObjective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among school children aged 8–12 years.MethodsThis prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8–12 years, with and...
09:23
Bacteriophage therapy against Pseudomonas aeruginosa biofilms: a review: AbstractMulti-Drug Resistant (MDR) Pseudomonas aeruginosa is one of the most important bacterial pathogens that causes infection with a high mortality rate due to resistance to different antibiotics. This bacterium prompts extensive tissue damage with varying factors of virulence, and its biofilm production causes chronic and antibiotic-resistant infections. Therefore, due to the non-applicability of antibiotics for the...
09:23
Broca's Aphasia & Stroke: MRI in this patient with acute stroke shows infarction involving superior division of Left Middle cerebral artery. As this is an infarct in the left hemisphere, associated expressive aphasia was present. FLAIR MRI sequence is shown to you and shows infarct with hyperintense signal in the distribution of superior division of left MCA.Famous Radiology Blog http://www.sumerdoc.blogspot.com TeleRad Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com
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Remembering Dr. Masaaki Ishizuka (February 4, 1938–July 16, 2020):
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Clinical classification of scoliosis patients using machine learning and markerless 3D surface trunk data: AbstractMarkerless 3D surface topography for scoliosis diagnosis and brace treatment can avoid repeated radiation known from standard X-ray analysis and possible side effects. Combined with the method of torso asymmetry analysis, curve severity and progression can be evaluated with high reliability. In the current study, a machine learning approach was utilised to classify scoliosis patients...
09:20
Prevalence of the prelacrimal recess in maxillary sinus and its medial bony wall dimensions: AbstractObjectiveTo investigate the occurrence rate of the prelacrimal recess (PLR) and its medial bony wall dimensions based on the radiological analysis to help surgeons enhance the understanding of anatomic structures for the endoscopic prelacrimal recess approach. MethodsCone-beam computed tomography images of 255 patients were evaluated retrospectively. The prevalence of the PLR...
09:20
IL-6 serum levels predict severity and response to Tocilizumab in COVID-19: an observational study: Publication date: Available online 30 September 2020Source: Journal of Allergy and Clinical ImmunologyAuthor(s): José María Galván-Román, Sebastián C. Rodríguez-García, Emilia Roy-Vallejo, Ana Marcos-Jiménez, Santiago Sánchez-Alonso, Carlos Fernández-Díaz, Ana Alcaraz-Serna, Tamara Mateu-Albero, Pablo Rodríguez-Cortes, Ildefonso Sánchez-Cerrillo, Laura Esparcia, Pedro Martínez-Fleta, Celia López-Sanz,...
09:18
Accuracy of serological testing for SARS‐CoV‐2 antibodies: first results of a large mixed‐method evaluation study: AbstractBackgroundSerological immunoassays that can identify protective immunity against SARS‐CoV‐2 are needed to adapt quarantine measures, assess vaccination responses, and evaluate donor plasma. To date, however, the utility of such immunoassays remains unclear. In a mixed‐design evaluation study, we compared the diagnostic accuracy of serological immunoassays that are based on various...
09:16
Functional orthodontics after arthroscopic disk repositioning in adolescent anterior disk displacement with mandibular retrusion: Publication date: October 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 130, Issue 4Author(s): Zhiyang Liu, Qianyang Xie, Chi Yang, Minjie Chen, Guo Bai, Pei Shen, Zhigui Ma
09:15
Anaphylaxis Refractory to intra‐muscular adrenaline during in‐hospital food challenges: a case series and proposed management: AbstractBackgroundAnaphylaxis is a severe, systemic hypersensitivity reaction, that can be potentially life threatening. Anaphylaxis during oral food challenge is not uncommon and can usually be effectively managed with intramuscular adrenaline as first line treatment. Although very rare, fatal anaphylaxis during in‐hospital food challenge has been reported.ObjectiveWe describe...
09:04
Association between childhood asthma and attention deficit hyperactivity or autism spectrum disorders: a systematic review with meta‐analysis: AbstractBackgroundChildren with asthma are at risk of depression and anxiety and growing evidence suggest they may also be at risk of attention deficit hyperreactivity disorder (ADHD) and autism spectrum disorder (ASD). Here, we conducted a systematic review with meta‐analysis of studies investigating association between asthma and ADHD or ASD in children.MethodsA...
09:03
Aberrant AICA Injury During Translabyrinthine Approach: Objective: To define a complication of the translabyrinthine surgical approach to the posterior fossa related to a rare variant of the anterior inferior cerebellar artery (AICA) that penetrated into the petrous temporal bone. Patient: A healthy 59-year-old male with a unilateral sporadic vestibular schwannoma. Intervention: The patient elected to undergo a translabyrinthine approach for resection of a vestibular schwannoma....
09:03
Predicting Recidivism for Acquired Cholesteatoma: Evaluation of a Current Staging System: Objective: Assess the utility and prognostic capabilities of the European Academy of Otology and Neurotology (EAONO) and Japanese Otological Society (JOS) cholesteatoma classification system, specifically for retraction pocket cholesteatoma. Study Design: Retrospective. Setting: Tertiary referral hospital. Patients: Adults and children with retraction pocket cholesteatoma. ...
09:02
A simple automated approach to measure mouse whole gut transit: AbstractBackgroundGastrointestinal (GI) motility is a complex physiological process that is critical for normal GI function. Disruption of GI motility frequently occurs in GI diseases or as side effects of therapeutics. Whole gut transit measurements, like carmine red leading‐edge transit, in mice form the cornerstone of in vivo preclinical GI motility studies.MethodWe have developed an easily achievable, labor‐saving method to measure...
09:02
Acute disseminated encephalomyelitis in a COVID-19 pediatric patient: AbstractThe authors present a case of acute disseminated encephalomyelitis in a COVID-19 pediatric patient with positive SARS-CoV2 markers from a nasopharyngeal swab. A previously healthy 12-year-old-girl presented with a skin rash, headache, and fever. Five days after that, she had an acute, progressive, bilateral, and symmetrical motor weakness. She evolved to respiratory failure. Magnetic resonance imaging (MRI) of the brain...
09:01
Global 3D parameter of the spine: application of Călugăreanu–White–Fuller theorem in classification of pediatric spinal deformity: AbstractSeveral classification systems of the spinal curves in adolescent idiopathic scoliosis (AIS) have been developed to guide surgical decision-making. The current classification systems are based on the spinal deformity patterns or deformity magnitudes in one or two anatomical planes. Considering the 3D nature of the spinal deformity in AIS, these classifications...
09:00
Anatomical guide for botulinum neurotoxin injection: Application to cosmetic shoulder contouring, pain syndromes, and cervical dystonia: ABSTRACTIntroductionThis study proposes an ideal botulinum toxin injection point of the trapezius muscle for shoulder line contouring, pain management and functional impairment. This study describes the intramuscular nerve branching in the trapezius muscle, providing essential information for botulinum neurotoxin injection.MethodA modified Sihler's method was performed...
08:59
Morphological features of the lateral plantar ligament of the transverse metatarsal arch: AbstractThe aim of this study was to elucidate the morphological characteristics of the lateral Lisfranc ligament in a large sample. This investigation examined 100 legs from 50 cadavers. Each of the lower limbs was dissected to identify the plantar aspect of the transverse metatarsal arch, and morphological characteristics of the lateral plantar ligament were assessed, including the length, width, and thickness...
08:59
Is variation in posterior tibial veins a risk factor for deep‐vein thrombosis?: ABSTRACTINTRODUCTIONThis study proposes variations in the posterior tibial vein as one of the risk factors for deep‐vein thrombosis. Understanding the anatomical classification of the posterior tibial vein would guide the antegrade approach of catheter‐directed thrombolysis.MATERIALS AND METHODSOne hundred thirty‐four legs from Korean and Thai cadavers were dissected. The posterior tibial veins were classified into four...
08:59
SARS-CoV-2 samples may escape detection because of a single point mutation in the N geneWe found that a single nucleotide polymorphism (SNP) in the nucleoprotein gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a patient interfered with detection in a widely used commercial assay. Some 0.2% of the isolates in the EpiCoV database contain this SNP. Although SARS-CoV-2 was still detected by the other probe in the assay, this underlines the necessity of targeting two independent...
08:58
Designed Proteins Lead Therapeutics to Cancer Cells, Spare Other Cells [Techniques]Sets of modular proteins enabled targeting of cells with specific combinations of surface markers.Cancer Discovery current issueThu Oct 01, 2020 10:05In This Issue [In This Issue]Cancer Discovery current issueThu Oct 01, 2020 10:05Phase I Trial of the PARP Inhibitor Olaparib and AKT Inhibitor Capivasertib in Patients with BRCA1/2- and Non-BRCA1/2-Mutant Cancers [Research Articles]Preclinical studies have demonstrated...
08:57
A potential role for aspirin in the prevention and treatment of cholangiocarcinoma: AbstractCholangiocarcinoma is the second most common primary hepatic cancer, with a rising incidence worldwide. Owing to late diagnosis and limited treatment options, the prognosis for cholangiocarcinoma remains dismal, compelling a search for new treatments. As aspirin exhibits a well‐supported chemopreventive effect on common cancers, researchers have proposed using aspirin as a potential preventive and adjuvant...
08:56
Immunogenic characteristics of microsatellite instability‐low esophagogastric junction adenocarcinoma based on clinicopathological, molecular, immunological, and survival analyses: ABSTRACTMicrosatellite instability (MSI) is categorized by mutation frequency: high MSI (MSI‐H), low MSI (MSI‐L), and microsatellite stable (MSS). MSI‐H tumors have a distinct immunogenic phenotype, with immunotherapies using checkpoint inhibitors already approved for the treatment of MSI‐H gastroesophageal adenocarcinoma...
08:55
Methylation markers FAM19A4 and miR124‐2 as triage strategy for primary HPV screen positive women; A large European multi‐center study: AbstractIn HPV cervical cancer screening, cytology is used as triage to counter the low specificity of HPV testing. VALID‐SCREEN is a EU‐multicentre, retrospective study conducted to evaluate the clinical performance of the FAM19A4/miR124‐2 methylation‐based molecular triage test as a substitute or addition to cytology as reflex testing of HPV screen positive women....
08:54
A Phase I/II Study of Veliparib (ABT-888) in Combination with 5-Fluorouracil and Oxaliplatin in Patients with Metastatic Pancreatic CancerPurpose: Up to 17% of patients with pancreatic ductal adenocarcinoma (PDAC) harbor pathogenic (germline or somatic) mutations in a homologous recombination, DNA damage response and repair (HR-DDR) gene, such as BRCA1/2, or PALB2. Platinum-based chemotherapy, or treatment with PARP inhibitors are of particular benefit in these patients. However, there may be even...
08:54
A Phase Ib/II Study of the BRAF Inhibitor Encorafenib Plus the MEK Inhibitor Binimetinib in Patients with BRAFV600E/K-mutant Solid Tumors: Purpose: This open-label, dose-finding phase Ib/II study reports the safety and activity of the first combination use with BRAF inhibitor (BRAFi) encorafenib plus MEK inhibitor (MEKi) binimetinib in patients with BRAF V600E–mutant solid tumors.Patients and Methods: In phase I, the recommended phase 2 doses (RP2D) were established (primary objective). In phase...
08:53
A Serum Protein Classifier Identifying Patients with Advanced Non-Small Cell Lung Cancer Who Derive Clinical Benefit from Treatment with Immune Checkpoint Inhibitors: Purpose: Pretreatment selection of patients with non–small cell lung cancer (NSCLC) who would derive clinical benefit from treatment with immune checkpoint inhibitors (CPIs) would fulfill an unmet clinical need by reducing unnecessary toxicities from treatment and result in substantial health care savings.Experimental Design: In...
08:52
A Phase II Trial of Tipifarnib for Patients with Previously Treated, Metastatic Urothelial Carcinoma Harboring HRAS Mutations: Purpose: To assess the antitumor activity and safety of tipifarnib, a highly potent and selective farnesyltransferase inhibitor, we performed a phase II clinical trial in patients with advanced and refractory urothelial carcinoma harboring missense HRAS mutations.Patients and Methods: A total of 245 adult patients with previously treated, advanced urothelial carcinoma...
08:52
Circulating Tumor DNA is Prognostic and Potentially Predictive of Eryaspase Efficacy in Second-line in Patients with Advanced Pancreatic Adenocarcinoma: Purpose: Eryaspase is composed of l-asparaginase encapsulated in erythrocytes and has demonstrated significant efficacy in a randomized phase II trial. We assessed the prognostic and predictive value of circulating tumor DNA (ctDNA) in patients, plasma included in this trial.Experimental Design: Samples prospectively collected pretreatment were...
08:51
Nivolumab in Patients with Advanced Platinum-resistant Urothelial Carcinoma: Efficacy, Safety, and Biomarker Analyses with Extended Follow-up from CheckMate 275: Purpose: We report efficacy and safety with extended follow-up, and exploratory biomarker analyses from the phase II CheckMate 275 trial to identify biomarkers of response to nivolumab in platinum-resistant metastatic or unresectable urothelial carcinoma (mUC).Patients and Methods: Patients received nivolumab 3 mg/kg once every 2 weeks...
08:50
A Phase II Study of Allogeneic GM-CSF-Transfected Pancreatic Tumor Vaccine (GVAX) with Ipilimumab as Maintenance Treatment for Metastatic Pancreatic Cancer: Purpose: This phase II study tested granulocyte-macrophage colony-stimulating factor (GM-CSF)-allogeneic pancreatic tumor cells (GVAX) and ipilimumab in metastatic pancreatic ductal adenocarcinoma (PDA) in the maintenance setting.Patients and Methods: Patients with PDA who were treated with front-line chemotherapy consisting of 5-fluorouracil,...
08:50
A Bispecific DLL3/CD3 IgG-Like T-Cell Engaging Antibody Induces Antitumor Responses in Small Cell Lung Cancer: Purpose: Small cell lung cancer (SCLC) is the most lethal and aggressive subtype of lung carcinoma characterized by highly chemotherapy-resistant recurrence in the majority of patients. To effectively treat SCLC, we have developed a unique and novel IgG-like T-cell engaging bispecific antibody (ITE) that potently redirects T-cells to specifically lyse SCLC cells expressing Delta-like ligand...
08:49
Radical external beam re‐irradiation in the treatment of recurrent head and neck cancer: Critical review: AbstractManagement of patients with recurrent head and neck cancer remains a challenge for the surgeon as well as the treating radiation oncologist. Even in the era of modern radiotherapy, the rate of severe toxicity remains high with unsatisfactory treatment results. Intensity‐modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and heavy‐ion irradiation have all emerged...
08:49
Endoscopic transoral nasopharyngectomy: AbstractBackgroundA minimal access technique for the management of nasopharyngeal tumors extending below the palatal plane and laterally beyond the pterygoid musculature is yet to be developed. In this study we demonstrate the feasibility of endoscopic transoral nasopharyngectomy (ETON) for resection of large nasopharyngeal lesions as a natural orifice alternative to traditional approaches.MethodsETON was completed in three latex‐injected specimens. Surgical...
08:48
Impact of 23‐valent pneumococcal polysaccharide vaccination on the frequency of pneumonia‐related hospitalization and survival in elderly patients with prostate cancer: A seven‐year nationwide matched cohort study: BackgroundThe 23‐valent pneumococcal polysaccharide vaccine (PPSV23) is indicated for adults who have a high risk of pneumonia; however, its effectiveness in patients with prostate cancer who are at a risk of pneumonia because of age and cancer treatments, including androgen‐deprivation...
08:48
Cognitive rehabilitation program to improve cognition of cancer patients treated with chemotherapy: A 3‐arm randomized trial: BackgroundThere is no treatment for cancer‐related cognitive impairment, an important adverse effect that negatively impacts quality of life (QOL). We conducted a 3‐arm randomized controlled trial to evaluate the impact of computer‐assisted cognitive rehabilitation (CR) on cognition, QOL, anxiety, and depression among cancer patients treated with chemotherapy.MethodsPatients...
08:47
Intraductal Lithotripsy in Sialolithiasis Using the Calculase III™ Ho:YAG Laser: First Experiences: Background and ObjectivesTo report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones.Study Design/Materials and MethodsA retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency...
08:47
Topical Delivery of Nivolumab, a Therapeutic Antibody, by Fractional Laser and Pneumatic Injection: Background and ObjectivesPD‐L1 is a tumor ligand that binds to the PD‐1 receptor on immune cells, thereby inhibiting the antitumor immune response. The antibody nivolumab is a PD‐1 inhibitor, Food and Drug Administration approved for systemic treatment of several aggressive cancer types. Topically applied nivolumab may hold potential as a future strategy to treat keratinocyte cancer, but its molecular...
08:46
The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy‐Induced Oral Mucositis: A Randomized Clinical Trial: Background and ObjectivesTo investigate pro‐ and anti‐inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol.Study...
08:46
AntibioticsAntibiotics, Vol. 9, Pages 666: Mutually Isomeric 2- and 4-(3-nitro-1,2,4-triazol-1-yl)pyrimidines Inspired by an Antimycobacterial Screening Hit: Synthesis and Biological Activity against the ESKAPE Panel of PathogensAntibiotics, Vol. 9, Pages 666: Mutually Isomeric 2- and 4-(3-nitro-1,2,4-triazol-1-yl)pyrimidines Inspired by an Antimycobacterial Screening Hit: Synthesis and Biological Activity against the ESKAPE Panel of Pathogens Antibiotics doi: 10.3390/antibiotics9100666 Authors:...
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Telephone consultation 11855 int 1193,
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This is the fourth in a series of posts based upon Jordan Peterson's book Maps of Meaning, published in 1999 after 17 years of researc...
