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Objectives: There is little research on the rate and risk factors for revision tonsillectomy after primary intracapsular tonsillectomy. Our study aimed to determine the revision rate following intracapsular tonsillectomy, identify patient characteristics that may increase the probability of revision surgery, and report the tonsillar hemorrhage rate after revision. Study Design: Level III, retrospective case-control study. Setting: A tertiary care pediatric center (Alfred I. duPont Hospital for Children, Wilmington, Delaware). Methods: A case-control study of pediatric patients who underwent intracapsular tonsillectomy between January 1, 2004, and December 31, 2018, was performed. Patients aged 2 to 20 years were analyzed and compared with matched controls who underwent intracapsular tonsillectomy within 7 days of the same surgeon's case. In total, 169 revision procedures were included with 169 matched controls. Results: A 1.39% revision rate was observed among a total of 12,145 intracapsular tonsillectomies. Among the 169 patients who underwent a revision procedure, the mean time between cases was 3.5 years. Tonsillitis was the most common diagnosis prompting revision tonsillectomy. Four (2.4%) patients underwent operative control of a postoperative tonsillar hemorrhage after revision surgery. Younger patients (P <.001) and patients with a history of gastroesophageal reflux disease (P =.006) were more likely to undergo revision tonsillectomy. Conclusion: Patients below age 4 years and patients with gastroesophageal reflux disease may be at increased risk of undergoing revision tonsillectomy after primary intracapsular tonsillectomy. These factors should be considered when selecting an intracapsular technique for primary tonsillectomy in pediatric patients. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the acute changes in muscle swelling (as assessed by muscle thickness and echo intensity) and muscle blood flow associated with an acute bout of low‐load blood flow restriction (LLBFR) and low‐load non‐blood flow restriction (LL) exercise. Twenty women (mean ± SD; 22 ± 2years) volunteered to perform an acute exercise bout that consisted of 75 (1 × 30, 3 × 15) isokinetic, reciprocal, concentric‐only, submaximal (30% of peak torque), forearm flexion and extension muscle actions. Pretest, immediately after (posttest), and 5‐min after (recovery) completing the 75 repetitions, muscle thickness and echo intensity were assessed from the biceps brachii and triceps brachii muscles and muscle blood flow was assessed from the brachial artery. There were no between group differences for any of the dependent variables, but there were significant simple and main effects for muscle and time. Biceps and triceps brachii muscle thickness increased from pretest (2.13 ± 0.39 cm and 1.88 ± 0.40 cm, respectively) to posttest (2.58 ± 0.49 cm and 2.17 ± 0.43 cm, respectively) for both muscles and remained elevated for the biceps brachii (2.53 ± 0.43 cm), but partially returned to pretest levels for the triceps brachii (2.06 ± 0.41 cm). Echo intensity and muscle blood flow increased from pretest (98.0 ± 13.6 Au and 94.5 ± 31.6 ml min−1, respectively) to posttest (109.2 ± 16.9 Au and 312.2 ± 106.5 ml min−1, respectively) and pretest to recovery (110.1 ± 18.3 Au and 206.7 ± 92.9 ml min−1, respectively) and remained elevated for echo intensity, but partially returned to pretest levels for muscle blood flow. The findings of the present study indicated that LLBFR and LL elicited comparable acute responses as a result of reciprocal, concentric‐only, forearm flexion and extension muscle actions. [ABSTRACT FROM AUTHOR]

This review focuses on contact dermatitis as an adverse effect of a selection of topically used herbal medicinal products for which the European Medicines Agency has completed an evaluation up to the end of November 2013 and for which a Community herbal monograph - now (since 2014) called a ' European Union herbal monograph' - has been produced. The present part 4 addresses species from Solidago virgaurea L. to Vitis vinifera L. [ABSTRACT FROM AUTHOR]

Introduction: The onsets of the electromyographic (EMG) signal, mechanomyographic (MMG) signal, and force production were used to identify voluntary electromechanical delay (EMD) during maximal and submaximal leg extensions.Methods: Twelve men performed 30% 1-repetition-maximum concentric, dynamic constant external resistance leg extensions to failure. The time periods for the onsets of EMG to MMG (EMDE-M ), MMG to force (EMDM-F ), and EMG to force (EMDE-F ) were assessed before, during, and after testing.Results: Pretest vs. posttest assessments indicated approximately equal contributions from excitation-contraction coupling (EMDE-M ) and series elastic component (EMDM-F ) to the overall EMDE-F . During the workbout, excitation-contraction coupling failure and increases in the compliance of the series elastic component began at 40% and 30% of the repetitions to failure, respectively, and continued to failure.Conclusions: Increases in the series elastic component (EMDM-F ) began to affect EMDE-F before excitation-contraction coupling failure (EMDE-M ), and both contributed to EMDE-F throughout the remainder of the fatiguing workbout. Muscle Nerve 56: 315-320, 2017. [ABSTRACT FROM AUTHOR]

This review focuses on contact dermatitis as an adverse effect of a selection of topically used herbal medicinal products for which the European Medicines Agency has completed an evaluation up to the end of November 2013 and for which a Community herbal monograph - now (since 2015)† called a European Union herbal monograph - has been produced. Part 3: Mentha × piperita L. - Solanum dulcamara L. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: We compared absolute and normalized values for peak torque (PT), mean power (MP), rate of velocity development, and electromyography (EMG) amplitude during maximal isometric and concentric isokinetic leg extension muscle actions, as well as the %decrease in PT and %increase in MP from 1.05 to 3.14 rad·s−1 in younger versus older men. Methods: Measurements were performed twice for reliability. Isokinetic measurements were normalized to the isometric muscle actions. Results: Absolute isometric PT, isokinetic PT and MP, and EMG amplitudes at 1.05 and 3.14 rad·s−1 were greater in the younger men, although normalizing to isometric PT eliminated the age differences. The older men exhibited greater %decrease in PT (37.2% vs. 31.3%) and lower %increase in MP (87.6% vs. 126.4%) regardless of normalization. Conclusions: Normalization eliminated absolute differences in isokinetic strength and power, but the relative differences from slow to fast velocities may reflect dynapenia characterized by age-related decreases in fast-twitch fiber function. Muscle Nerve 52: 120-130, 2015 [ABSTRACT FROM AUTHOR]

This review focuses on contact dermatitis as an adverse effect of a selection of topically used herbal medicinal products for which the European Medicines Agency has completed an evaluation up to the end of November 2013 and for which a Community herbal monograph has been produced. Part 2: Echinacea purpurea Moench- Lavandula angustifolia Mill. [ABSTRACT FROM AUTHOR]

This review focuses on contact dermatitis as an adverse effect of a selection of topically used herbal medicinal products for which the European Medicines Agency has completed an evaluation up to the end of November 2013 and for which a Community herbal monograph has been produced. Part 1: Achillea millefolium L.- Curcuma longa L. [ABSTRACT FROM AUTHOR]

Introduction We compared peak and submaximal mean values for neuromuscular and metabolic parameters between ramp (15 W·min−1) and step (30 W increments every 2 min) incremental cycle ergometer tests. Methods Thirteen healthy adults (7 men and 6 women; mean ± SD age = 23.4 ± 3.3 years) performed randomly ordered ramp or step incremental tests. Two-way repeated measures analyses of variance were used to analyze the data. Results The ramp incremental test resulted in lower mean EMG amplitude, O2, and HR values at the common power outputs, with no differences for MMG amplitude values. Conclusions It is possible that the cumulative effect of producing an increased amount of work during the step (total work = 75.83 kJ) vs. ramp (total work = 65.60 kJ) incremental cycle ergometer tests at the common power outputs may have contributed to the greater fatigue-induced increase in muscle recruitment and/or firing rate, oxygen consumption, and heart rate. Muscle Nerve, 2013 [ABSTRACT FROM AUTHOR]

Abstract: An interdisciplinary, proactive perspective allows providers to engage in productive, long-term collaborative relationships with corporations, while 1) maintaining patient care improvements; 2) maintaining legality; 3) enhancing technical and clinical innovation; and 4) providing fair compensation for work done. The case study approach is used to demonstrate an effective approach to compliant behavior. [Copyright &y& Elsevier]

Conservative management of complicated esophageal perforations has gained favor in recent years. However, there are limited data concerning the applicability of this approach in the pediatric population. We describe the care and outcome of a 14-year-old girl who sustained an esophageal perforation after accidental ingestion of a shard of glass. The patient was treated using ultrasound-guided drainage catheter placement with simultaneous esophagoscopy and postoperative antibiotics. She was discharged within 1 week of presentation and enjoyed an uncomplicated recovery. We believe that selected cases of pediatric esophageal perforation may be safely and effectively treated using a conservative approach. [ABSTRACT FROM AUTHOR]

Objective: We sought to confirm the finding of pepsin/pepsinogen in the middle ear fluid of children with otitis media in a larger sample size using a sensitive and specific pepsin assay. Study Design and Setting: We evaluated 152 children (225 ear samples) in a prospective study at a tertiary care children’s hospital. The presence of pepsin in middle ear aspirates was determined using enzymatic assay. Results: Of the patients, 14.4 percent (22 of 152) had detectable pepsin activity in one or both of the ear samples with no pepsin activity detected in control serum. Average pepsin concentration in the samples was 96.6 ± 170.8 ng/ml, ranging from 13 to 687 ng/ml. Pepsin concentration in the middle ear of children younger than 1.0 year was significantly higher than in older age groups. Conclusion and Significance: Results indicate that pepsin/pepsinogen is present in the middle ears of children with otitis media, although not at the high rate previously reported. Gastric reflux may be one causative factor in the pathogenesis of otitis media. [Copyright &y& Elsevier]

In order to provide a new reference point in the dermatological literature from which the naming of florists' chrysanthemums may be regularised and standardised, the case is presented for the use of the generic name Dendranthema together with a cultivar name in place of a specific epithet. A review of cultivar specificity in chrysanthemum dermatitis is also presented. [ABSTRACT FROM AUTHOR]

The skin irritant properties of both the juice expressed from the ripe berries and the slimy mucilage present in the rhizomes of black bryony (Tamus communis L.) were investigated. The dermatitis produced on human skin after gently rubbing in either the berry juice or the rhizome mucilage was found in both cases to be a result of mechanical irritation, being produced by penetration of the skin by minute needle-like crystals of calcium oxalate. Scanning electron micrographs supporting this conclusion are presented. Chemical investigation of the rhizome mucilage confirmed the presence of histamine. The role of histamine in the production of skin irritation following contact with the rhizome mucilage is discussed. [ABSTRACT FROM AUTHOR]

The simulation of multiphase and multicomponent fluid flows often requires large coupled systems of nonlinear partial differential equations. These equations are convection-dominated, with important local diffusive effects. An operator splitting technique is used to address these different phenomena. Adaptive local grid refinement methods are then presented to resolve the moving internal boundary layers which arise and often govern the mass transfer between the phases. Owing to the large size of many applications, efficiency in computation is critical. Concepts of domain decomposition for dynamic adaptive grid refinement are presented. Techniques for dividing the problems into pieces for parallel computation on separate processors are also discussed. [ABSTRACT FROM AUTHOR]

Provides information on the super-nettles plants that harbor ants. Incitement of aggressive response from ant inhabitants; Skin reaction to the sting from ants; Nature of the ants; Characteristics of the super-nettles.

This article presents information related to the super-nettles. A widely distributed, well-defined, but not extensively studied group of higher plants comprises the stinging nettles. The most primitive ants in evolutionary terms are equipped with an extendable, unbarbed sting enclosed in a sheath (which may be barbed) and connected to a venom gland. The super-nettles are myrmecophilous plants but are often described as ant plants or myrmecophytes. Myrmecotrophic plants simply provided food for ants, most commonly in the form of nectar from floral or extra-floral nectaries.

A letter to the editor in response to the article about the generation of free radicals and the antioxidant concept of prohapten activation is presented.

Euphorbia helioscapia is a common herbaceous weed found in the British Isles and parts of Europe. It has been responsible for poisoning of livestock resulting in severe inflammation particularly of mucous membranes and the eyes. Four esters of 12-deoxyphorbol were isolated from the fresh aerial parts of the plant and their irritant doses 50% (I.D.[sub50]) ascertained using female L.A.C.A. mice. l2-Deoxyphorbol-43-phenylacetate-20-acetate was found to be the major component of the toxic fraction and occurred in yields of 0.0012% w/w. This compound was also the most irritant substance isolated and exhibited an I.D.[sub50] of 0.038μg, and is accordingly considered to be responsible for the major part of the toxicity of E. helioscopia. A high molecular weight aliphatic ester, 12-deoxyphorbol-13-dodecdienoate-20-acetate, was also obtained in low yields. This compound exhibited an I.D.[sub50] of 0.12μg. The final two esters obtained from the toxic fraction of the plant were the low molecular weight homologues, 12-deoxyphorbol -13-[2-methyl-cis-2-butenoate]-20-acetate and 12-deoxyphorbol-13-[2-methyl-cis-2-butenoate]. These compounds exhibited I.D.[sub50] of 3.09 and 0.72 μg, respectively and were the least irritant of the series of compounds isolated. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about mild heat shock therapy of allergic contact reaction.

A case of delayed contact sensitivity to black bryony berries in 66 year old bronchitic and spondyloarthritic male, who used these berries as a counter-irritant application to his forearm is discussed. All extracts of the fresh or lyophilized berries with organic solvents have produced no reaction in patch and scratch tests, whilst these berries themselves and aqueous extracts produced a delayed vesicular eczematous reaction lasting more than 120 hours. Spanish berries produced a more intense reaction. These reactions produced were, on macroscopic criteria, a typical delayed immune response.

The article presents an experiment conducted by researchers in Cardiff, Wales to diagnose chrysanthemum dermatitis by patch testing with feverfew. When patch tests are carried out with plant material selected randomly from unidentified chrysanthemum cultivars to be found within hospitals, individual patients react differently to various plant parts tested. Lack of sensitivity to certain sample of plant materials could result in misdiagnosis. Researchers tested patients of chrysanthemum dermatitis with the extract of feverfew leaves and applied in ethanolic solution. All patients reacted to feverfew extract suggesting that feverfew could provide a valuable confirmatory reaction in cases of chrysanthemum allergy.

Presents a letter to the editor about contact dermatitis from tosyl chloride.