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The purpose of the presents study was to analyze the levels of indoor allergens in dust from the homes of asthmatic children in three climatic zones of Sweden, and to assess the importance of some conditions, including humidity and ventilation in the homes, that could influence the allergen levels in house dust. From September to December 1989, 390 house-dust samples were collected from 130 homes of children with moderately severe perennial asthma. The patients were selected on the basis of medication scores. All patients were on medication throughout the year.

Carpet and floor dust samples were collected in four different seasons, from 39 Swedish homes of babies with a family history of allergy. Houseadust mite (Der p .1, Derf 1) and cat (Fel d 1) allergen contents were determined by mab ELISA, and the levels were related to various environmental factors. Both mite and cat antigens were detected in 94 % of the samples and in all homes, but the levels were low (Der p 1, range 15 ng-1944 ng/g fine dust; Der f 1, range 14 ng-264 ng/g of fine dust; Fel d 1, range 16 ng-3 120 ng/g fine dust). Mite-allergen levels were significantly higher (P< 0.001) in floor dust than in carpets, and D. pteronyssinus predominated. In contrast, the levels of cat antigen were significantly (P< 0.05) higher in carpets than in floor dust. There was no clear relation between mite-allergen levels and type of house, except that the higher values were found in homes with dampness problems. Cat-allergen levels were higher than total mite-allergen content, and the highest Levels were found in homes with a cat (P<0.05). Rather high concentrations of cat allergen were also found in homes without a cat, which may explain why cat sensitization is so common in Sweden. As the prevalence of house-dust mite sensitivity is increasing in Swedish children, and as the individual patient threshold for eliciting symptoms varies, we suggest that sensitization may possibly occur at a lower exposure level than generally accepted as risk level for sensitization (2 μg/g dust). [ABSTRACT FROM AUTHOR]

Seasonal variations in IgE antibody synthesis in vitro were studied in cultures of blood mononuclear cells (MNC) from 11 pollen allergic individuals. The IgE levels were significantly higher in two summer seasons than in the winter and spring between them. Net synthesis was confined to the summer in all but one of the patients. All the IgE in the cultures outside the pollen season represented preformed IgE which was present mainly (59%) in the moncyte fraction. Thus, preformed IgE seems to persist in moncytes at times when there is little de novo synthesis of IgE. [ABSTRACT FROM AUTHOR]

In order to screen for mould allergy, extracts of five common atmospheric moulds (Cladosporium, Alternaria, Penicillium, Aspergillus and Mucor) from various manufacturers were investigated in 150 patients (5-60 years old) with clinical symptoms indicating possible mould allergy. The patients were screened by skin prick test (SPT) and radio- allergosorbent test (RAST). SPT seemed to be more sensitive than RAST as a diagnostic screening procedure (80% positive reactions to one or more species compared to 50%). With a partially purified, standardized preparation of Cladosporium herbarum more positive reactions were obtained than with crude extracts without evidence of any unspecific reactions. The difference between commercial and standardized extracts is most probably a result of a variation of both the biological potency of allergenic determinants and the allergenic composition. A considerable number of negative RAST reactions with standard discs were found in patients with positive skin reactions to partially purified Cladosporium, but RAST seemed to be more sensitive than SPT with the other commercial mould extracts. Based on the screening, a very convincing tendency to IgE-reactivity to other moulds was found in patients reacting to Cladosporium, the most common cause of mould allergy. The results confirm the inadequacy of most mould extracts used in diagnostic procedures and strengthen the value of using standardized extracts. [ABSTRACT FROM AUTHOR]

Deals with the therapeutic benefits of hydrolised cow's milk formulae for immunoglobulin E-mediated cow's milk protein allergy (CMA) among children. Genetic characteristics of atopic individuals; Methods of measuring the allergenicity of hydrolysate cow's milk formulae; Guidelines for the administration of hydrolysed formulae in CMA infants.

Introduction: Epigenetic alterations of DNA methylation are known to be associated with the clinical presentation of midgut carcinoids. Aim{s): To assess global and gene-specific promoter methylation for selected previously implicated tumor suppressors or frequently deleted loci in relation to clinical and genetic characteristics, as well as mRNA levels of the corresponding genes. Materials and methods: In total, 41 tumors and six normal tissues were analyzed by Pyrosequencing for CpG methylation of RASSFIA, CTNNB1, HIC1, P14, P16, WIF1, APC, NKX2-3, CXCL14, SMAD2, SMAD4, CDH1, CDH3, LAMA1 and LINE1. Results: Hypermetylation > 10% was observed for WIF 1, RASSF 1A, CTNNB1, NKX2-3, CXCL14, CDH1, P16 and LAMA1. Among these RASSFIA was associated with female gender (p=0.003) and alterations of the SDHD locus (p=0.002), and CTNNB1 was associated with patient outcome (p=0.01). Global LINE1 methylation was reduced in 31/40 cases especially in female cases (p=0.002) and tumors with deletion of chromosome 18 (p=0.02). Hypermethylation was associated with reduced gene expression in 83% (25/30) for WIF1 and 76% (13/17) for CTNNB1, and CTNNB1 expression was significantly increased in metastatic samples (p=0.01). Conclusion: Global hypomethylation and promoter hypermethylation were frequently observed in midgut carcinoids. Alterations affecting the CTNNB 1 gene showed effects on patient outcome. [ABSTRACT FROM AUTHOR]

Papillary thyroid cancer is associated with lymph node metastasis and tumor recurrence that need repeated surgery, entailing surgical challenges with a high risk of complications such as nerve damage and bleeding. Magseed is a metal coil used to detect non-palpable lesions and is an established modality in breast cancer surgery. In this case series, we explore the feasibility of Magseed in metastasis surgery of papillary thyroid cancer. Under the guidance of ultrasonography, Magseed is injected into the target tissue and intraoperatively detected with a handheld magnetometer probe, Sentimag®. Five patients with recurrence of papillary thyroid cancer were operated on with focused Magseed-guided localization. All patients had repeated surgery and radioiodine treatments. Four of the patients had lymph node metastasis hidden in the fibrosis, and one patient had recurrent tumor tissue on the left side of the larynx. Magseed was easy to use, safe, and precise in detecting the target tissue., Competing Interests: Declaration of competing interest All authors do not have any financial and personal relationships with other people or organizations that could inappropriately influence (bias) this work., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Recently developed prismatic loupes may mitigate the high physical workload and risk of neck disorders associated with traditional surgical loupes among surgeons. However, research in this area, particularly among surgeons, is sparse. This study examines the impact of prismatic loupes on surgeons' physical workload, musculoskeletal discomfort, and performance during simulated surgical tasks., Materials and Methods: Nineteen out of twenty recruited surgeons performed three tasks in a fixed-order with their own loupes and both low-tilt (LT) and high-tilt (HT) prismatic loupes, in a randomized order. The primary outcomes were the median inclination angles and velocities of the head, trunk, and upper arms, along with the median muscle activity of the cervical erector spinae (CES), upper trapezius (UT), and lumbar erector spinae (LES) for each pair of loupes. The secondary outcomes included performance (completion time and errors), perceived body-part discomfort, and subjective evaluation of the three pairs of loupes., Results: Using prismatic loupes, either LT or HT, compared with the surgeons' own loupes yielded lower head inclinations (all p  < 0.001), lower neck muscle activity (all p  < 0.05), and lower neck discomfort in indirect comparisons ( p  < 0.01) with no significant difference in surgical errors ( p  = 0.628). However, HT loupes resulted in a longer task completion time in two tasks ( p  < 0.001). Most surgeons preferred LT loupes ( N  = 12) for their comfort and visual functions., Discussion: The results indicate that prismatic loupes can reduce physical workload in the neck during simulated surgical task, with no significant difference in surgical errors. Future studies are needed to investigate the long-term effects of prismatic loupes among surgeons., Competing Interests: The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fan, Yang, Young, Kaner, Kjellman and Forsman.)

Practical training for new surgeons differs between institutions, and standards are mostly lacking. The largest problems seem to occur during the first years, when novices begin their specialty training, (specialisttjänstgöring in Swedish). A large number of scientific publications are available, but the they are usually limited to one specific procedure or one surgical specialty, and the results are rarely applied in practice. Scientifically validated and systematic methods for basic training outside the operating room have been called for over the last decade, but the main part of the training still takes place during surgery on patients. In order to evaluate the practising of manual skills among doctors doing their training within surgical specialties, a survey with fourteen questions was carried out. The results show shortcomings that seem easy to remedy in the short term, but long term studies on the subject are required to better understand and systematize surgical training.

Abnormalities of the insulin‑like growth factor 2 (IGF2)‑H19 locus with the overexpression of IGF2 are frequent findings in adrenocortical carcinoma (ACC). The present study assessed the expression of RNAs and microRNAs (miRNAs/miRs) from the IGF2‑H19 locus using PCR‑based methods in ACC and adrenocortical adenoma (ACA). The results were associated with proteomics data. IGF2 was overexpressed in ACC, and its expression correlated with that of miR‑483‑3p and miR‑483‑5p hosted by IGF2 . The downregulated expression of H19 in ACC compared to ACA correlated with miR‑675 expression hosted by H19 . Several proteins exhibited an inverse correlation in expression and were predicted as targets of miR‑483‑3p , miR‑483‑5p or miR‑675 . Subsets of these proteins were differentially expressed between ACC and ACA. These included several proteins involved in mitochondrial metabolism. Among the mitochondrial respiratory complexes, complex I and IV were significantly decreased in ACC compared to ACA. The protein expression of NADH:ubiquinone oxidoreductase subunit C1 (NDUFC1), a subunit of mitochondrial respiratory complex I, was further validated as being lower in ACC compared to ACA and normal adrenals. The silencing of miR‑483‑5p increased NDUFC1 protein expression and reduced both oxygen consumption and glycolysis rates. On the whole, the findings of the present study reveal the dysregulation of the IGF2‑H19 locus and mitochondrial respiration in ACC. These findings may provide a basis for the further understanding of the pathogenesis of ACC and may have potential values for diagnostics and treatment.

Background: Musculoskeletal disorders (MSDs) are common among surgeons, and its prevalence varies among surgical modalities. There are conflicting results concerning the correlation between adverse work exposures and MSD prevalence in different surgical modalities. The progress of rationalization in health care may lead to job intensification for surgeons, but the literature is scarce regarding to what extent such intensification influences the physical workload in surgery. The objectives of this study were to quantify the physical workload in open surgery and compare it to that in (1) nonsurgical tasks and (2) two surgeon roles in robot-assisted surgery (RAS)., Methods: The physical workload of 22 surgeons (12 performing open surgery and 10 RAS) was measured during surgical workdays, which includes trapezius muscle activity from electromyography, and posture and movement of the head, upper arms and trunk from inertial measurement units. The physical workload of surgeons in open surgery was compared to that in nonsurgical tasks, and to the chief and assistant surgeons in RAS, and to the corresponding proposed action levels. Mixed-effects models were used to analyze the differences., Results: Open surgery constituted more than half of a surgical workday. It was associated with more awkward postures of the head and trunk than nonsurgical tasks. It was also associated with higher trapezius muscle activity levels, less muscle rest time and a higher proportion of sustained low muscle activity than nonsurgical tasks and the two roles in RAS. The head inclination and trapezius activity in open surgery exceeded the proposed action levels., Conclusions: The physical workload of surgeons in open surgery, which exceeded the proposed action levels, was higher than that in RAS and that in nonsurgical tasks. Demands of increased operation time may result in higher physical workload for open surgeons, which poses an increased risk of MSDs. Risk-reducing measures are, therefore, needed., (© 2022. The Author(s).)

There is an unmet need for novel biomarkers to diagnose and monitor patients with neuroendocrine neoplasms. The EXPLAIN study explores a multi-plasma protein and supervised machine learning strategy to improve the diagnosis of pancreatic neuroendocrine tumors (PanNET) and differentiate them from small intestinal neuroendocrine tumors (SI-NET). At time of diagnosis, blood samples were collected and analyzed from 39 patients with PanNET, 135 with SI-NET (World Health Organization Grade 1-2) and 144 controls. Exclusion criteria were other malignant diseases, chronic inflammatory diseases, reduced kidney or liver function. Prosed Oncology-II (i.e., OLink) was used to measure 92 cancer related plasma proteins. Chromogranin A was analyzed separately. Median age in all groups was 65-67 years and with a similar sex distribution (females: PanNET, 51%; SI-NET, 42%; controls, 42%). Tumor grade (G1/G2): PanNET, 39/61%; SI-NET, 46/54%. Patients with liver metastases: PanNET, 78%; SI-NET, 63%. The classification model of PanNET versus controls provided a sensitivity (SEN) of 0.84, specificity (SPE) 0.98, positive predictive value (PPV) of 0.92 and negative predictive value (NPV) of 0.95, and area under the receiver operating characteristic curve (AUROC) of 0.99; the model for the discrimination of PanNET versus SI-NET providing a SEN 0.61, SPE 0.96, PPV 0.83, NPV 0.90 and AUROC 0.98. These results suggest that a multi-plasma protein strategy can significantly improve diagnostic accuracy of PanNET and SI-NET., (© 2022 Ipsen. Journal of Neuroendocrinology published by John Wiley & Sons Ltd on behalf of British Society for Neuroendocrinology.)