Radiotherapy skin marking with lancets versus electric marking pen - Comfort, satisfaction, effectiveness and cosmesis results from the randomized, double-blind COMFORTATTOO trial.

INTRODUCTION: Set-up skin markings are performed, in several centers, for radiotherapy (RT) treatments. This study aimed to compare two permanent methods: lancets and an electric marking pen, the Comfort Marker 2.0® (CM). METHODS: This was a prospective, unicentric, randomized study. Patients aged 18 years or older referred to our department to receive RT were recruited. Patients were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. The markings arrangement followed our departmental protocols. The coprimary endpoints were patients' comfort and effectiveness. Secondary endpoints included radiation therapists (RTTs) satisfaction and cosmesis. RESULTS: Between October 2021 and January 2022, 100 patients were enrolled (50 received lancets and 50 CM) and assessed for the comfort and satisfaction outcomes. CM was significantly less painful than the lancets, with 44% and 16% of the patients, respectively, considering the tattooing process painless (RR = 2.75; 95% IC: 1.36 - 5.58). On the RTT-reported satisfaction, CM had significantly easier processes than lancets (98.0% vs. 78.0%, respectively; RR = 1.26; 95% CI: 1.08 - 1.46). For effectiveness and cosmesis assessment, 98 patients were analyzed (48 received lancets and 50 CM). Patients receiving CM had a significantly higher proportion of markings graded as good and excellent compared to those receiving lancets (98.0% and 50.0%, respectively, had ≥75% of the tattoos assessed as good/excellent, RR = 1.96; 95% CI: 1.47 - 2.61). On the cosmetic evaluation, patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs. 3.5 for lancets, p <0.001). CONCLUSION: The trial results demonstrated that tattooing with the CM is significantly less painful, more effective, easier to apply, and cosmetically superior to tattooing with lancets. IMPLICATIONS FOR PRACTICE: Tattooing with CM allows for better results regarding pain, quality, ease and cosmesis.

Glycosphingolipids and Infection. Potential New Therapeutic Avenues.

Glycosphingolipids (GSLs), the main topic of this review, are a subclass of sphingolipids. With their glycans exposed to the extracellular space, glycosphingolipids are ubiquitous components of the plasma membrane of cells. GSLs are implicated in a variety of biological processes including specific infections. Several pathogens use GSLs at the surface of host cells as binding receptors. In addition, lipid-rafts in the plasma membrane of host cells may act as platform for signaling the presence of pathogens. Relatively common in man are inherited deficiencies in lysosomal glycosidases involved in the turnover of GSLs. The associated storage disorders (glycosphingolipidoses) show lysosomal accumulation of substrate(s) of the deficient enzyme. In recent years compounds have been identified that allow modulation of GSLs levels in cells. Some of these agents are well tolerated and already used to treat lysosomal glycosphingolipidoses. This review summarizes present knowledge on the role of GSLs in infection and subsequent immune response. It concludes with the thought to apply glycosphingolipid-lowering agents to prevent and/or combat infections.

Simultaneous quantitation of sphingoid bases by UPLC-ESI-MS/MS with identical 13C-encoded internal standards.

Free sphingoid bases (lysosphingolipids) of primary storage sphingolipids are increased in tissues and plasma of several sphingolipidoses. As shown earlier by us, sphingoid bases can be accurately quantified using UPLC-ESI-MS/MS, particularly in combination with identical 13C-encoded internal standards. The feasibility of simultaneous quantitation of sphingoid bases in plasma specimens spiked with a mixture of such standards is here described. The sensitivity and linearity of detection is excellent for all examined sphingoid bases (sphingosine, sphinganine, hexosyl-sphingosine (glucosylsphingosine), hexosyl2-sphingosine (lactosylsphingosine), hexosyl3-sphingosine (globotriaosylsphingosine), phosphorylcholine-sphingosine) in the relevant concentration range and the measurements show very acceptable intra- and inter-assay variation (<10% average). Plasma samples of a series of male and female Gaucher Disease and Fabry Disease patients were analyzed with the multiplex assay. The obtained data compare well to those earlier determined for plasma globotriaosylsphingosine and glucosylsphingosine in GD and FD patients. The same approach can be also applied to measure sphingolipids in the same sample. Following extraction of sphingolipids from the same sample these can be converted to sphingoid bases by microwave exposure and subsequently quantified using 13C-encoded internal standards.

Neurophysiological, behavioral and morphological abnormalities in the Fabry knockout mice.

Fabry disease (OMIM 301500) is a rare X-linked recessive disorder caused by mutations in the alpha-galactosidase gene (GLA). Loss of alpha-galactosidase (alpha-Gal) activity leads to the abnormal accumulation of glycosphingolipids in lysosomes predominantly of vascular endothelial cells. Clinically the disorder presents with angiokeratomas, clouding of the cornea, and renal, cardiac, and cerebrovascular complications. In addition, there is an increased incidence of neuropathic pain in Fabry patients. In this study, we investigated the implications of loss of alpha-galactosidase A activity on sensorimotor function and peripheral nervous system. Similar to the described in Fabry disease patients, the sensorimotor assessment of Fabry mice revealed diminished locomotor activity and warm hypoalgesia as assessed in the hot-plate. Moreover Fabry mice displayed alterations both in balance and co-ordination. By histological analysis, the cyto-architecture of Fabry mice sciatic nerves showed an increase in mean cross-sectional area accompanied by a decrease in the density of non-myelinated fibers as well as a trend for a decreased number of small myelinated fibers, a well established feature of Fabry disease. A relative preservation of large myelinated fibers and nerve conduction velocity measurements was observed. Our findings demonstrate for the first time that Fabry knockout mice have Gb3 accumulation in the peripheral nervous system, alterations in sensorimotor function, hypoalgesia and no impairment of motor nerve conduction.

Evaluación electromiográfica de los músculos masticadores durante la fuerza máxima de mordedura / Electromyography Evaluations of the masticator muscles during the maximum bite force

La actividad de los músculos masetero y de la porción anterior temporalde ambos lados, derecho e izquierdo, respectivamente, durante la fuerza máximade mordedura fue estudiada en voluntarios sanos. El estudio incluyó a 17 voluntariosadultos de ambos sexos, edad promedia de 25 años, que no evidenciaban ningúnindicio de disfunción temporomandibular y eran relacionados con la Facultadde Odontología de Piracicaba. Se registraron los datos electromiográficos en amboslados de la cara del masetero y de la porción anterior de los músculos temporal ysuprahioideo en las posiciones postural e isométrica. Se utilizaron electrodos de superficiepasivos para niños, de Ag/AgCl, con forma circular y descargables de Meditrace® Kendall-LTP, modelo Chicopee MA01. Éstos se conectaron a un preamplificadorcon una ganancia de 20x que formaba un circuito de diferenciales. Se captaron losregistros de las señales eléctricas utilizando un equipo EMG-8OOC de EMG Systemof Brazil, Ltd., de ocho canales, a una frecuencia de 2 KHz con 16 bitios de resolucióny un filtro digital con un paso de banda de 20 a 500Hz. Se utilizó también untransductor de presión que consistía en un tubo de goma con un sensor de presión(MPX 5700)* (Motorola SPS, Austin, TX, EE.UU.) para registrar la fuerza máxima demordedura. El análisis estadístico incluyó la correlación lineal, la prueba t emparejaday el análisis de la varianza. Se consideró estadísticamente significativa una probabilidadde p<0,05. Los resultados pusieron en evidencia cierto grado de asimetríamuscular para el masetero y la porción anterior del músculo temporal que variabaen relación con la tarea realizada y la intensidad de la contracción. El índice deasimetría fue menor en la posición postural que en la de fuerza máxima de mordedura(AU)

Healthy individuals were examined in terms of the patternof activity of the masseter and temporal muscles in their anteriorportion of both right and left sides, respectively, with the maximumbite force. The study consisted in seventeen adult volunteers withno sign of apparent temporomandibular dysfunction, of both genders,connected to the School of Dentistry of Piracicaba, with averageage of 25 years old. The electromyography data were obtained,bilaterally, of the masseter, anterior portion of temporal andsuprahyoid muscles in the postural and isometric positions. Wereutilized surface passive electrodes for kids of Ag/AgCl, of circularformat and dischargeable of Meditrace® Kendall-LTP, modelChicopee MA01, attached to a pre-amplifier with gain of 20 timesforming a differential circuit. The records of the electrical signs werecaptured by the equipment EMG-8OOC of EMG System of BrazilLtd. of eight channels, with frequency of 2 KHz and 16 bits ofresolution, digital filter with band pass of 20 to 500Hz. It was utilizedalso a pressurized transductor which consists of a pressurized rubbertube connected to a sensor element (MPX 5700) to obtain themaximum bite force. The statistic tests used were linear correlation,test t in pair and analysis of variance. Probability of p<0, 05 weresignificant considered statistically. The results showed a certaindegree of muscular asymmetry for the masseter and anterior portionof temporal muscles that depended on the task performed orcontraction level. The index of asymmetry was lower in the posturalposition than in the maximum bite force(AU)