Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Παρασκευή 20 Οκτωβρίου 2017

Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

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Publication date: Available online 20 October 2017
Source:Acta Otorrinolaringológica Española
Author(s): Ricardo Bartel, Xavier Gonzalez-Compta, Enric Cisa, Francesc Cruellas, Alberto Torres, Aleix Rovira, Manel Manos
Introduction and objectivesOlfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/−adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature.MethodsA retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution.Results9 patients were included. Mean follow-up of 52.5 months (range 10–107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%.ConclusionNeoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications.



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Anticancer Agents; +198 new citations

198 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

Anticancer Agents

These pubmed results were generated on 2017/10/20

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.



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Concurrent Neoadjuvant Chemotherapy and Radiation Therapy in Locally Advanced Breast Cancer

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Brackstone, Muriel, MD, PhD; Palma, David, MD, PhD; Tuck, Alan B., MD, PhD;...
Summary This prospective phase 2 trial recruited 32 patients with locally advanced breast cancer to receive neoadjuvant radiosensitizing chemotherapy with concurrent radiation. Patients were matched to a concurrent cohort treated with neoadjuvant ...

http://ift.tt/2xV2gh0

Online Adaptive Radiation Therapy

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Lim-Reinders, Stephanie, BSc; Keller, Brian M., PhD; Al-Ward, Shahad, MSc;...
Introduction Technological improvements such as multileaf collimation (MLCacrnm1) (1) , in-room daily imaging (2, 3) , and robotic shift correction (4) have allowed radiation treatment targeting accuracy to improve. Intensity modulated radiation t...

http://ift.tt/2yE7NME

Radiation-Induced Large Vessel Cerebral Vasculopathy in Pediatric Patients With Brain Tumors Treated With Proton Radiation Therapy

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Kralik, Stephen F., MD; Watson, Gordon A., MD; Shih, Chie-Schin, MD;...
Summary This is the largest study to report radiation-induced large vessel cerebral vasculopathy in pediatric patients with primary brain tumors treated with proton radiation therapy. This adverse event can lead to stroke and associated permanent ...

http://ift.tt/2xUVtE0

Conditional Plasminogen Activator Inhibitor Type 1 Deletion in the Endothelial Compartment Has No Beneficial Effect on Radiation-Induced Whole-Lung Damage in Mice

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Lavigne, Jérémy; Soysouvanh, Frédéric; Buard, Valérie;...
Summary Plasminogen activators inhibitor type 1 (PAI-1acrnm1) has been demonstrated as an interesting target against radiation-induced lung damage. Mice specifically invalidated for * Plasminogen activator inhibitor type 1 * in the endothelium wer...

http://ift.tt/2yDRob1

Multicenter, Phase 1, Dose Escalation Study of Hypofractionated Stereotactic Radiation Therapy With Bevacizumab for Recurrent Glioblastoma and Anaplastic Astrocytoma

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Clarke, Jennifer, MD; Neil, Elizabeth, MD; Terziev, Robert, MD;...
Summary Contemporary RT techniques allow for highly accurate targeting of infiltrating tumor and more aggressive dosing regimens. Recent trials have explored the safety and feasibility of hypofractionated stereotactic reirradiation for recurrent g...

http://ift.tt/2xURuHo

Implementing Radiation Dose-Volume Liver Response in Biomechanical Deformable Image Registration

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Polan, Daniel F., MSE; Feng, Mary, MD; Lawrence, Theodore S., MD, PhD;...
Summary Deformable image registration (DIRacrnm1) of the liver after radiation therapy is challenging because of the complex radiation dose–dependent volume response of normal hepatic tissue. A modified biomechanical modeling method for hepatic ti...

http://ift.tt/2yE8u8x

Prospective, Randomized Study of Radiation Dose Escalation With Combined Proton-Photon Therapy for Benign Meningiomas

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Sanford, Nina N., MD; Yeap, Beow Y., ScD; Larvie, Mykol, MD, PhD;...
Summary Fractionated radiation therapy is commonly used to treat recurrent or subtotally resected benign meningiomas. This randomized, controlled trial evaluates the role of dose escalation for benign meningiomas and does not support a benefit wit...

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Toxicity and Outcomes in Patients With and Without Esophageal Stents in Locally Advanced Esophageal Cancer

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Francis, Samual R., MD; Orton, Andrew, MD; Thorpe, Cameron, BS;...
Summary The use of esophageal stents to relieve dysphagia is increasing in patients with locally advanced esophageal cancer; however, the effects on toxicity and outcomes are unclear. We retrospectively analyzed our cohort of curatively treated es...

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Adjuvant Intensity Modulated Whole-Abdominal Radiation Therapy for High-Risk Patients With Ovarian Cancer (International Federation of Gynecology and Obstetrics Stage III): First Results of a Prospective Phase 2 Study

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Arians, Nathalie, MD; Kieser, Meinhard, PhD; Benner, Laura;...
Summary Patients with advanced-stage ovarian cancer have a poor prognosis, with intraperitoneal disease recurrence being a common pattern of relapse. This prospective, multicenter, phase 2 study tested treatment tolerability of whole-abdominal rad...

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Panitumumab in Combination With Preoperative Radiation Therapy in Patients With Locally Advanced RAS Wild-type Rectal Cancer: Results of the Multicenter Explorative Single-Arm Phase 2 Study NEORIT

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Merx, Kirsten, MD; Martens, Uwe M., MD; Kripp, Melanie, MD;...
Summary We report the results of a phase 2 study investigating single-agent panitumumab in combination with radiation therapy as neoadjuvant treatment in 54 patients with RAS wild-type locally advanced rectal cancer. This combination therapy showe...

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Performance of Knowledge-Based Radiation Therapy Planning for the Glioblastoma Disease Site

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Chatterjee, Avishek, PhD; Serban, Monica, MSc; Abdulkarim, Bassam, MD, PhD;...
Summary A knowledge-based radiation therapy planning model for glioblastoma was created using RapidPlan. Eighty-two patients treated with 60 Gy to the target in 30 fractions were used to train the model. The model was validated on an independent s...

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Effect of Brain Tumor Presence During Radiation on Tissue Toxicity: Transcriptomic and Metabolic Changes

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Zawaski, Janice A., PhD; Sabek, Omaima M., PhD; Voicu, Horatiu, PhD;...
Summary An allograft brain tumor model was irradiated to isolate the effect of the tumor on damage to surrounding tissue after irradiation. Comparison of radiation+tumor implant versus radiation+sham implant groups allowed isolation of the tumor e...

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Online Adaptive Hyperthermia Treatment Planning During Locoregional Heating to Suppress Treatment-Limiting Hot Spots

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Kok, H. Petra, PhD; Korshuize- van Straten, Linda; Bakker, Akke, MSc;...
Summary Hyperthermia is the clinical application of heat to increase the therapeutic efficacy of radiation therapy, chemotherapy, or both. This study demonstrates that online application of hyperthermia treatment planning can help to reduce undesi...

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Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma: Influence of Gonadal Hormone Exposure

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Krul, Inge M., MSc; Opstal–van Winden, Annemieke W.J., PhD; Aleman, Berthe M.P., MD, PhD;...
Summary It is unknown whether gonadal hormone exposure affects the risk of radiation-associated breast cancer in female survivors of Hodgkin lymphoma. We performed a nested case-control study to assess the separate and joint effects of radiation d...

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Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score–Weighted Analysis

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Bibault, Jean-Emmanuel, MD, MSc; Dussart, Sophie, MD; Pommier, Pascal, MD, PhD;...
Summary Helical TomoTherapy (Accuray) and volumetric modulated arc therapy (RapidArc) are 2 different intensity modulated radiation therapy techniques used to treat patients with head and neck cancer. In this study we have prospectively compared t...

http://ift.tt/2xUGcmv

Evidence-based Review on the Use of Proton Therapy in Lymphoma From the Particle Therapy Cooperative Group (PTCOG) Lymphoma Subcommittee

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Tseng, Yolanda D., MD; Cutter, David J., MD, DPhil, FRCR; Plastaras, John P., MD, PhD;...
Introduction Proton therapy was first suggested in the management of lymphoma in 1974 as a way to spare the bone marrow when treating total nodal fields (1) . However, interest in its use in lymphoma has grown only recently with the global growth ...

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Multicenter Evaluation of Biochemical Relapse–Free Survival Outcomes for Intraoperatively Planned Prostate Brachytherapy Using an Automated Delivery System

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Martell, Kevin, MD; Husain, Siraj, MD; Taussky, Daniel, MD;...
Summary This multicenter analysis shows evidence for efficacy in brachytherapy treatments for prostate cancer when delivered using an automated delivery system. Results with this technique do not seem to be inferior to other published series on pr...

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SABR Given Thoughtfully

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Slotman, Berend J., MD, PhD; Senan, Suresh, PhD, MRCP, FRCR
The patient (1) has had a histologically proven lung metastasis excised 12 months previously, and the site and pattern of the new findings are consistent with progressive lung metastases. A local metastasis–directed therapy is one of the treatment...

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Let “Whitmore's Principle” be the Guide

International Journal of Radiation Oncology, Biology, Physics, Volume 99, Issue 4, 2017 Nov 15 | Tyldesley, Scott, MD, FRCPC; Schellenberg, Devin, MD, FRCPC
As we try to balance what we can do versus what we should do for this patient (1) , several of Willet Whitmore's quotes come to mind (2) . "Is cure possible only when it is not necessary"; or in this context "is control possible only…." Does ...

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Cutaneous atypical papular CD8+ lymphoproliferative disorder at acral sites in a renal transplant patient

Summary

A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.



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Cutaneous atypical papular CD8+ lymphoproliferative disorder at acral sites in a renal transplant patient

Summary

A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.



http://ift.tt/2ywjx4v

Association of Mannose-Binding Lectin rs1800450 and Tumor Necrotic Factor-α rs1800620 Polymorphism with Helicobacter pylori in Type II Diabetes Mellitus

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 236-241.


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Anti-hLCN6 Monoclonal Antibody

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 242-242.


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A new endoscopic technique to close big nasal septal perforations: prospective evaluation of the double meat hook technique in 19 consecutive cases

Abstract

Despite the variety of surgical techniques available to close big symptomatic septum perforations, closure rates of 30 to 70% indicate the difficulty of obtaining a good end result.

The double meat hook technique is a new endoscopically assisted technique that delivers excellent visualization and control of mucosal flap elevation, extension and suturing.

Mucosa from the nasal floor, lateral nasal wall and inferior turbinate bone are valuable donor site extensions.

There is no need for additional incisions into the nasal septal mucosa in order to perform a tension-free closure. Preservation of the structural integrity and blood supply of the mucosal flaps, possibly contributes to a high closure rate and delivers a physiological result.

This article is protected by copyright. All rights reserved.



http://ift.tt/2gwvwb8

A new endoscopic technique to close big nasal septal perforations: prospective evaluation of the double meat hook technique in 19 consecutive cases

Abstract

Despite the variety of surgical techniques available to close big symptomatic septum perforations, closure rates of 30 to 70% indicate the difficulty of obtaining a good end result.

The double meat hook technique is a new endoscopically assisted technique that delivers excellent visualization and control of mucosal flap elevation, extension and suturing.

Mucosa from the nasal floor, lateral nasal wall and inferior turbinate bone are valuable donor site extensions.

There is no need for additional incisions into the nasal septal mucosa in order to perform a tension-free closure. Preservation of the structural integrity and blood supply of the mucosal flaps, possibly contributes to a high closure rate and delivers a physiological result.

This article is protected by copyright. All rights reserved.



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Is There a Need for Scientific Education in the Aging Field?

Rejuvenation Research Oct 2017, Vol. 20, No. 5: 365-366.


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Response to Milholland et al. (Rejuvenation Res. 2017;20:437–440)

Rejuvenation Research Oct 2017, Vol. 20, No. 5: 440-441.


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“Best-Guess” MRAD Provides Robust Evidence for a Limit to Human Lifespan: Reply to de Grey (Rejuvenation Res. 2017;20:261–262)

Rejuvenation Research Oct 2017, Vol. 20, No. 5: 437-440.


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Epigenetic Drift Is a Determinant of Mammalian Lifespan

Rejuvenation Research Oct 2017, Vol. 20, No. 5: 430-436.


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The rich photonic world of plasmonic nanoparticle arrays

Publication date: Available online 20 October 2017
Source:Materials Today
Author(s): Weijia Wang, Mohammad Ramezani, Aaro I. Väkeväinen, Päivi Törmä, Jaime Gómez Rivas, Teri W. Odom
Metal nanoparticle arrays that support surface lattice resonances have emerged as an exciting platform for manipulating light–matter interactions at the nanoscale and enabling a diverse range of applications. Their recent prominence can be attributed to a combination of desirable photonic and plasmonic attributes: high electromagnetic field enhancements extended over large volumes with long-lived lifetimes. This Review will describe the design rules for achieving high-quality optical responses from metal nanoparticle arrays, nanofabrication advances that have enabled their production, and the theory that inspired their experimental realization. Rich fundamental insights will focus on weak and strong coupling with molecular excitons, as well as semiconductor excitons and the lattice resonances. Applications related to nanoscale lasing, solid-state lighting, and optical devices will be discussed. Finally, prospects and future open questions will be described.

Graphical abstract

image


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Effect of Laser Etching on Glass Fiber Posts Cemented with Different Adhesive Systems

Photomedicine and Laser Surgery , Vol. 0, No. 0.


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Photobiomodulation Therapy Alleviates Tissue Fibroses Associated with Chronic Graft-Versus-Host Disease: Two Case Reports and Putative Anti-Fibrotic Roles of TGF-β

Photomedicine and Laser Surgery , Vol. 0, No. 0.


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High throughput analysis of solute effects on the mechanical behavior and slip activity of beta titanium alloys

Publication date: 5 January 2018
Source:Materials & Design, Volume 137
Author(s): C.Y. Wang, L.W. Yang, Y.-W. Cui, M.T. Pérez-Prado
The high-throughput technique of diffusion multiples has been utilized to unveil the effect of solutes on the mechanical properties (yield strength, elastic modulus, hardness), as well as on slip activity, in β (bcc) quaternary Ti alloys. Using this methodology, libraries of [134] Ti-Al-Cr-Mo and [113] Ti-Al-V-Mo single crystals with gradient compositions were generated over distances spanning a few hundred microns and their mechanical properties were probed at room temperature by compression of micropillars milled at selected compositions. Our results evidence that Cr is a more potent strengthener than Mo in Ti-Al-Cr-Mo alloys, and that Mo is very effective in strengthening Ti-Al-V-Mo alloys. Slip activity was measured by observation of slip traces. In all single crystals investigated, irrespective of orientation and composition, plastic strain was accommodated by cross slip between different {110} planes. The specific combination of {110} slip systems that act cooperatively to accommodate strain, as well as the amount of strain accommodated by each slip system, however, is dependent on orientation and on composition. Anomalous {110} slip was observed in the Ti-Al-V-Mo alloys. The incidence of this mechanism was found to increase with increasing Mo. This study highlights the efficiency of diffusion multiples for non-trivial materials' discovery and design.

Graphical abstract

image


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Current Use of Baseline Medical Treatment in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Abstract

Objectives

According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes.

Design and setting

Case-control study in a secondary care setting.

Methods

Participant-reported study-specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of CRS and its management.

Particpants

Patients with both without (CRSsNPs) and with polyps (CRSwNPs).

Main outcome measures

Reported use of CRS-related and non-related medications.

Results

Within a total of 1243 CRS participants, current INCS usage was low (18% in CRSwNPs, 12% in CRSsNPs); ND was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in CRSwNPs participants (p < 0.0001). Antidepressants use was significantly higher in CRSsNPs (14% versus 7%, p < 0.0002). There were no significant regional variations in rates of INCS use, nor any significant influence of social deprivation.

Conclusions

The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.

This article is protected by copyright. All rights reserved.



http://ift.tt/2zqFvTt

Current Use of Baseline Medical Treatment in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Abstract

Objectives

According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes.

Design and setting

Case-control study in a secondary care setting.

Methods

Participant-reported study-specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of CRS and its management.

Particpants

Patients with both without (CRSsNPs) and with polyps (CRSwNPs).

Main outcome measures

Reported use of CRS-related and non-related medications.

Results

Within a total of 1243 CRS participants, current INCS usage was low (18% in CRSwNPs, 12% in CRSsNPs); ND was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in CRSwNPs participants (p < 0.0001). Antidepressants use was significantly higher in CRSsNPs (14% versus 7%, p < 0.0002). There were no significant regional variations in rates of INCS use, nor any significant influence of social deprivation.

Conclusions

The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.

This article is protected by copyright. All rights reserved.



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Mimics of acute appendicitis—Alternative diagnoses at sonography, CT, and MRI; specific imaging findings that can help in differential diagnosis

Publication date: March–April 2018
Source:Clinical Imaging, Volume 48
Author(s): Huseyin Toprak, Temel Fatih Yilmaz, Seyma Yildiz, Ihsan Turkmen, Serpil Kurtcan




http://ift.tt/2hUKYL9

The effect of without using anisodamine during CT enterography on image quality, diagnostic performance and latent side effects

Publication date: March–April 2018
Source:Clinical Imaging, Volume 48
Author(s): Didi Wen, Jian Xu, Ying Liu, Rui An, Jian Li, Hongliang Zhao, Minwen Zheng
ObjectiveTo examine whether no anisodamine injection before CTE was feasible without impairing image quality and diagnostic performance.MaterialsThe change of mural thickness and luminal diameter were compared between using and no using anisodamine. The diagnostic performance of small-bowel disease was analyzed and compared.ResultsNo motion artifact was detected in two groups. There was no significant difference regarding the change of luminal diameter and mural thickness (all P>0.05). The diagnostic accuracy of small-bowel disease was no significant difference (P=0.63).ConclusionLack of anisodamine injection before CTE did not impair image quality and diagnostic performance compared with CTEs performed with anisodamine injection.



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Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Abstract

Background

Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood.

Methods

We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA.

Results

The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration.

Conclusions

In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response.

This article is protected by copyright. All rights reserved.



http://ift.tt/2gVjxki

Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Abstract

Background

Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood.

Methods

We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA.

Results

The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration.

Conclusions

In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response.

This article is protected by copyright. All rights reserved.



http://ift.tt/2gVjxki

Lenalidomide-Associated Thyroid-Related Eyelid Retraction.

Several antineoplastic treatments have been responsible for thyroid dysfunction and thyroid eye disease. Min, Vaidya, and Becker (2011) reported a case of euthyroid Graves orbitopathy after treatment with ipilimumab with the patient displaying proptosis and myositis in the setting of normal thyroid function tests and elevated thyroid antibodies. The authors report a case of a 76-year-old woman who developed right upper lid retraction and proptosis after 2.5 years of treatment with lenalidomide for multiple myeloma. Thyroid function tests were normal: thyroid-stimulating hormone 0.808 mIU/mL, total T3 102 ng/dL, free T4 1.48 ng/dL. Thyroid antibodies were elevated: thyrotropin receptor antibody 2.26 IU/L, thyroglobulin antibody 1043.1 IU/mL, and thyroid peroxidase antibody 38 IU/mL. A nuclear medicine thyroid scan was normal. Given the possible thyroid effects from lenalidomide, patients who receive this medication should be periodically evaluated for thyroid dysfunction and thyroid eye disease. (C) 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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ATA Announces Recipients of 2017 Special Awards

American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

The post ATA Announces Recipients of 2017 Special Awards appeared first on American Thyroid Association.



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American Thyroid Association’s 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

haymart-2017.png

American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

The ATA announced the Van Meter Award recipient

 October 19, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Van Meter Award recipient is Megan R. Haymart, MD, Megan R. Haymart, MDAssistant Professor of Medicine at the University of Michigan, Ann Arbor. The Van Meter Award recognizes outstanding contributions to research on the thyroid gland or related subjects by an investigator who is age 45 or under. At the ATA annual meeting in Victoria, British Columbia, Dr. Haymart will deliver the Van Meter Lecture at 8:05 am on October 19, 2017. Her lecture is titled "Implications of Diagnosing  Low-Risk Thyroid Cancer." The award winner is kept secret until the time of the lecture.

Dr. Haymart received her MD from the Johns Hopkins University School of Medicine. She completed an internship in Internal Medicine at Johns Hopkins Hospital and a fellowship in Endocrinology, Diabetes, and Metabolism at the University of Wisconsin.

Since joining the ATA in 2007, Dr. Haymart has donated a great deal of time and enthusiasm to the ATA, serving on the Public Health Committee (2010−12) and the Finance and Audit Committee (2012−18), which she now chairs.  She participated in Strategic Planning for the ATA in 2012; and has attended every annual meeting since 2006.   She serves on the editorial boards of Thyroid and Journal of Clinical Endocrinology and Metabolism (JCEM) and is an associate editor of VideoEndocrinology.  She is currently a candidate for the ATA Board of Directors.  In addition, she is a member of the Endocrine Society's Annual Meeting Steering Committee.

In the eight years since she began her independent career at the University of Michigan, Dr. Haymart has earned a reputation as one of the national leaders in thyroid clinical research. She has recently secured two major research grants, one to study the role of patient and physician perceptions in treatment decision-making in thyroid cancer care, and the other to study incidental thyroid cancer discovery and strategies to minimize over-diagnosis and over-treatment. Both are critical issues for the field.

She has published many important papers in high-profile journals. Dr. Haymart's CV lists 46 peer-reviewed publications, of which she is the first author of 17. These papers offer important new insights into thyroid cancer care and identify directions for future health services research.

Dr. Haymart's expertise also is recognized by frequent invitations to speak at national conferences—including the 2009, 2013, and 2016 ATA annual meetings and the 2011 and 2016 Endocrine Society annual meetings—and to give presentations, such as those at the University of Wisconsin (2012, 2014), the Washington Hospital Center (2014), and Johns Hopkins (2016).

Dr. Haymart's accomplishments, their impact on the field of thyroid cancer, and her contributions to thyroidology make her an ideal recipient of the Van Meter Award.  The Van Meter is supported by an endowment gift from the estate of long-time member, Dr. Jacob Robbins; and by an annual contribution from Mary Ann Liebert, Inc., publishers.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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American Thyroid Association’s 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

haymart-2017.png

American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

The ATA announced the Van Meter Award recipient

 October 19, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Van Meter Award recipient is Megan R. Haymart, MD, Megan R. Haymart, MDAssistant Professor of Medicine at the University of Michigan, Ann Arbor. The Van Meter Award recognizes outstanding contributions to research on the thyroid gland or related subjects by an investigator who is age 45 or under. At the ATA annual meeting in Victoria, British Columbia, Dr. Haymart will deliver the Van Meter Lecture at 8:05 am on October 19, 2017. Her lecture is titled "Implications of Diagnosing  Low-Risk Thyroid Cancer." The award winner is kept secret until the time of the lecture.

Dr. Haymart received her MD from the Johns Hopkins University School of Medicine. She completed an internship in Internal Medicine at Johns Hopkins Hospital and a fellowship in Endocrinology, Diabetes, and Metabolism at the University of Wisconsin.

Since joining the ATA in 2007, Dr. Haymart has donated a great deal of time and enthusiasm to the ATA, serving on the Public Health Committee (2010−12) and the Finance and Audit Committee (2012−18), which she now chairs.  She participated in Strategic Planning for the ATA in 2012; and has attended every annual meeting since 2006.   She serves on the editorial boards of Thyroid and Journal of Clinical Endocrinology and Metabolism (JCEM) and is an associate editor of VideoEndocrinology.  She is currently a candidate for the ATA Board of Directors.  In addition, she is a member of the Endocrine Society's Annual Meeting Steering Committee.

In the eight years since she began her independent career at the University of Michigan, Dr. Haymart has earned a reputation as one of the national leaders in thyroid clinical research. She has recently secured two major research grants, one to study the role of patient and physician perceptions in treatment decision-making in thyroid cancer care, and the other to study incidental thyroid cancer discovery and strategies to minimize over-diagnosis and over-treatment. Both are critical issues for the field.

She has published many important papers in high-profile journals. Dr. Haymart's CV lists 46 peer-reviewed publications, of which she is the first author of 17. These papers offer important new insights into thyroid cancer care and identify directions for future health services research.

Dr. Haymart's expertise also is recognized by frequent invitations to speak at national conferences—including the 2009, 2013, and 2016 ATA annual meetings and the 2011 and 2016 Endocrine Society annual meetings—and to give presentations, such as those at the University of Wisconsin (2012, 2014), the Washington Hospital Center (2014), and Johns Hopkins (2016).

Dr. Haymart's accomplishments, their impact on the field of thyroid cancer, and her contributions to thyroidology make her an ideal recipient of the Van Meter Award.  The Van Meter is supported by an endowment gift from the estate of long-time member, Dr. Jacob Robbins; and by an annual contribution from Mary Ann Liebert, Inc., publishers.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

The post American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD appeared first on American Thyroid Association.



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Comparison of Moderate and High Energy of a Nano-Fractional Radiofrequency Treatment on a Photoaging Hairless Mice Model.

BACKGROUND: Fractional radiofrequency (FRF) has been widely used in skin rejuvenation. To explore optimal settings, it is important to compare different treatment parameters. OBJECTIVE: This study was designed to compare the effect of moderate-energy and high-energy FRF treatment on a hairless mice model. METHODS: Fifteen photoaged hairless mice were assigned to 3 groups: control, moderate energy, and high energy. Two treatment sessions (T x 1 and T x 2) were performed at 1-month interval. Transepidermal water loss was measured at baseline, immediately, 1, 2, and 4 weeks after T x 1. Skin samples were harvested before each treatment, 1 and 2 months after T x 2. Neocollagenesis was evaluated by hematoxylin and eosin staining, Masson staining, and immunohistochemistry analysis. RESULTS: Transepidermal water loss of high-energy group was significantly higher than the moderate-energy group (p = .008) immediately after T x 1. Remarkable fibroblast proliferation was observed at 1 month after T x 1, followed by significant dermal thickening, and increase of Type I collagen and Type III collagen. There was no significant difference between 2 energy groups in fibroblast proliferation, dermal thickness, and collagen density. CONCLUSION: The effect of moderate-energy treatment was comparable with that of high energy in neocollagenesis, whereas moderate energy yielded less damage to skin barrier function. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2gWStBi

Use of a Single Anatomic Donor Site for Harvesting a Full-Thickness Skin Graft and a Free Cartilage Graft for Nasal Defects.

No abstract available

http://ift.tt/2zriy2h

Histologic Status of Squamous Cell Carcinoma In Situ After Diagnostic Biopsy in Immunocompetent and Immunosuppressed Patients.

BACKGROUND: The histologic status of squamous cell carcinoma in situ (SCC-IS) after diagnostic biopsy has not been well described or compared between immunocompetent and immunosuppressed patients. Expression of immunohistochemical (IHC) markers of aggressive SCC has not been compared between SCC-IS that clears or becomes invasive after biopsy. OBJECTIVE: To determine the histologic status of SCC-IS after diagnostic biopsy in these populations. METHODS: Retrospective analysis of 129 patients with SCC-IS treated with excision and 55 patients treated with Mohs surgery. Histologic features of SCC in excised tissue after biopsy were recorded. Known SCC markers were evaluated using IHC. RESULTS: Invasive SCC was found in 3% to 16% of residual SCC-IS depending on surgical treatment modality. The history of skin cancer increased the odds of having invasive SCC in SCC-IS excisions (odds ratio 7.1, p

http://ift.tt/2gUofyP

ATX-101 (Deoxycholic Acid Injection) for Paradoxical Adipose Hyperplasia Secondary to Cryolipolysis.

No abstract available

http://ift.tt/2zriqQl

Thermal Ultra Short Photodynamic Therapy: Heating Fibroblasts During Sub-30-Minute Incubation of 5-Aminolevulinic Acid Increases Photodynamic Therapy-Induced Cell Death.

BACKGROUND: Actinic keratoses (AKs) prevalence was estimated at 39.5 million Americans in 2004, and the cost to treat AKs that year was approximately 1 billion dollars. Photodynamic therapy (PDT) is an FDA-approved therapy for the treatment of AK. Recent studies have focused on reducing PDT treatment time while maintaining efficacy. OBJECTIVE: To investigate the use of thermal modulation to improve the efficacy of ultra short aminolevulinic acid (ALA) incubation PDT. MATERIALS AND METHODS: Human dermal fibroblasts (HDFs) were incubated for 10, 15, or 20 minutes with 0.5-mM ALA at various temperatures (21, 24, 27, 30, 33, 36, 39, and 42[degrees]C). After ALA incubation, samples were treated for 1,000 seconds with blue light (417 +/- 5 nm) resulting in a fluence of 10 J/cm2. Samples were collected and stained for apoptosis/necrosis with annexin-V and 7-aminoactinomycin D (7-AAD), then analyzed by flow cytometry. RESULTS: Human dermal fibroblast treated with 10-minute ALA-PDT had no statistically significant changes in apoptosis at all temperatures. Human dermal fibroblast treated with 15- or 20-minute ALA-PDT had statistically significant increases in apoptosis at 39 and 42[degrees]C (p

http://ift.tt/2gWSk0I

Management of Incompletely Excised Skin Tumors: Our Experience.

BACKGROUND: Current British Association of Dermatologists guidelines recommend that Mohs micrographic surgery should be considered for incompletely excised basal cell carcinomas and squamous cell carcinomas. Units that perform Mohs surgery are limited. In Teesside, the skin cancer multidisciplinary team discusses all incompletely excised skin tumors, considers all treatment options, provides recommendations, and initiates the agreed management plan. OBJECTIVE: To assess the outcome and appropriateness of local surgical macroexcision for incompletely excised skin tumors. METHODS: The authors performed a retrospective analysis of the local skin multidisciplinary team notes from July 2010 to July 2012 identifying all incompletely excised skin cancers. A total of 46 basal cell carcinomas and 27 squamous cell carcinomas were incompletely excised. Case note and pathology report review was used to identify the recommended management option and subsequent outcome. RESULTS: Fifty-four of the 73 incompletely excised tumor identified underwent further surgical excision locally. Fifty-one of 54 patients (94.4%) had successful completion of excision with a single procedure. The remaining 3 patients' required further surgery, performed locally, to completely excise their tumor. Average follow-up was 35 months with 1 (1.9%) recurrence. CONCLUSION: In the authors' region, local surgical management of incompletely excised skin tumors has yielded results comparable to Mohs surgery. Mohs surgery remains a viable option in specific cases. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System

imageSummary: Establishing anatomic reduction of an edentulous mandible fracture is a frequently acknowledged challenge in craniomaxillofacial trauma surgery. In this study, we report a novel method for the reduction of the edentulous mandible fracture, via fabrication of modified Gunning splints using existing dentures and SMARTLock hybrid arch bars. This technique dramatically simplifies the application of an arch bar to dentures, obviates the need for the fabrication of impressions and custom splints, and eliminates the lag time associated with the creation of splints. Furthermore, this method may be used with or without adjunctive rigid internal fixation. The technique described herein of creating Gunning splints with SMARTLock hybrid arch bars provides surgeons with a simple, rapid, single-stage solution for reduction of mandibular fractures in the edentulous patient.

http://ift.tt/2xWsjcA

Immediate Nipple-Areolar Complex Reconstruction for Patients Undergoing Implant-Based Reconstruction or Therapeutic Mammoplasty

imageBackground: We report a technique of immediate nipple-areolar complex (NAC) reconstruction for patients undergoing skin-sparing mastectomy and implant-based breast reconstruction or therapeutic mammoplasty with central excision. Methods: Immediate nipple reconstruction is performed using a modified C-V flap planned along the edge of the incision. The areola is reconstructed using a full-thickness skin graft taken from skin usually discarded during the procedure. Immediate NAC reconstruction using this technique was performed on 32 breasts in 21 patients. This included 19 risk-reducing mastectomies, 9 therapeutic mastectomies, and 2 major revisions to existing implant reconstruction. Reconstruction was direct to implant in 29 breasts and by expander in 1 breast. The device was placed in a pre- or post-pectoral plane utilizing dermal sling and/or acellular dermal matrix as determined on a case-by-case basis. Immediate NAC reconstruction was also performed on 2 patients undergoing therapeutic mammoplasty with central excision. Results: Mean follow-up is 12 months (5–27 months), and cosmetic results have been good. There have been no significant complications, and no revisional surgery has been required. Conclusion: The application of simple techniques for NAC reconstruction in the primary procedure allows reconstruction of the whole breast in a single stage. There is an immediate focal point to the reconstruction to improve cosmesis, patient satisfaction, and psychosocial function without delay.

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Is Immunohistochemical Screening of Cutaneous Leiomyomas for the Early Detection of Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome Justified?.

No abstract available

http://ift.tt/2xU0bly

Painful Skin Nodule on the Finger of a 59 Year Old.

No abstract available

http://ift.tt/2yDxxsy

Induction of Desmoplastic Trichoepithelioma in a Dermatofibroma.

Induction of follicular germinative structures above a dermatofibroma (DF) is a common finding. Rarely, induction of a trichoblastoma in a DF has been observed. Here, we report the case of a desmoplastic trichoepithelioma induced by a DF. The lesion with clinical and histological appearance of a DF situated on the left dorsal foot showed an associated adnexal proliferation that fulfilled histopathological criteria of desmoplastic trichoepithelioma. Immunohistochemistry (Ber-EP4, Bcl-2, CK17, CK20, CK7, EMA, and Ki67) helped to confirm the diagnosis and to exclude possible differential diagnoses. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Surveying the Literature: Synopsis of Recent Key Publications

No abstract available

http://ift.tt/2gyd4yQ

Effect of Stellate Ganglion Block on the Regional Hemodynamics of the Upper Extremity: A Randomized Controlled Trial

BACKGROUND: BACKGROUND:The success of stellate ganglion block (SGB) is traditionally determined on the basis of findings such as Horner's syndrome, temperature rise in the face, hyperemia of the tympanic membrane, and nasal congestion. However, decreases in vascular resistance and increases in blood flow in the arm may be more meaningful findings. To date, the effect of SGB on the regional hemodynamics of the arm has not been evaluated using pulsed-wave Doppler ultrasound. METHODS: METHODS:A total of 52 patients who were to undergo orthopedic surgery of the forearm were randomly assigned to either the mepivacaine group (SGB with 5 mL of 0.5% mepivacaine) or the saline group (SGB with 5 mL of normal saline). Before surgery, a single anesthesiologist performed a SGB under ultrasound guidance. The temperature of the upper extremity and the resistance index and blood flow in the brachial artery were measured before SGB, 15 and 30 minutes after SGB, and 1 hour after surgery. The severity of pain, requirement for rescue analgesics, and side effects of the local anesthetic agent were all documented. RESULTS: RESULTS:After SGB, the resistance index decreased significantly and the blood flow increased significantly in the brachial artery of members of the mepivacaine group (15 minutes: P = .004 and P

http://ift.tt/2ywupPZ

Postoperative Outcomes in Obstructive Sleep Apnea Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis of Comparative Studies

BACKGROUND: BACKGROUND:Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: METHODS:A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed. The search was constrained to studies in adult cardiac surgical patients with diagnosed or suspected OSA. All included studies must report at least 1 postoperative complication. The primary outcome is major adverse cardiac or cerebrovascular events (MACCEs) up to 30 days after surgery, which includes death from all-cause mortality, myocardial infarction, myocardial injury, nonfatal cardiac arrest, revascularization process, pulmonary embolism, deep venous thrombosis, newly documented postoperative atrial fibrillation (POAF), stroke, and congestive heart failure. Secondary outcome is newly documented POAF. The other exploratory outcomes include the following: (1) postoperative tracheal intubation and mechanical ventilation; (2) infection and/or sepsis; (3) unplanned intensive care unit (ICU) admission; and (4) duration of stay in hospital and ICU. Meta-analysis and meta-regression were conducted using Cochrane Review Manager 5.3 (Cochrane, London, UK) and OpenBUGS v3.0, respectively. RESULTS: RESULTS:Eleven comparative studies were included (n = 1801 patients; OSA versus non-OSA: 688 vs 1113, respectively). MACCEs were 33.3% higher odds in OSA versus non-OSA patients (OSA versus non-OSA: 31% vs 10.6%; odds ratio [OR], 2.4; 95% confidence interval [CI], 1.38–4.2; P = .002). The odds of newly documented POAF (OSA versus non-OSA: 31% vs 21%; OR, 1.94; 95% CI, 1.13–3.33; P = .02) was higher in OSA compared to non-OSA. Even though the postoperative tracheal intubation and mechanical ventilation (OSA versus non-OSA: 13% vs 5.4%; OR, 2.67; 95% CI, 1.03–6.89; P = .04) were significantly higher in OSA patients, the length of ICU stay and hospital stay were not significantly prolonged in patients with OSA compared to non-OSA. The majority of OSA patients were not treated with continuous positive airway pressure therapy. Meta-regression and sensitivity analysis of the subgroups did not impact the OR of postoperative complications for OSA versus non-OSA groups. CONCLUSIONS: CONCLUSIONS:Our meta-analysis demonstrates that after cardiac surgery, MACCEs and newly documented POAF were 33.3% and 18.1% higher odds in OSA versus non-OSA patients, respectively. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Accepted for publication August 16, 2017. Funding: The STOP-Bang tool is proprietary to University Health Network. This study is supported by University Health Network Foundation, and Department of Anesthesiology, University Health Network, University of Toronto. Conflicts of Interest: See Disclosures at the end of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Frances Chung, MD, FRCPC, Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, 399 Bathurst St, Toronto, Ontario, M5T 2S8, Canada. Address e-mail to frances.chung@uhn.ca. © 2017 International Anesthesia Research Society

http://ift.tt/2yxYcrs

Noninfectious Fever in the Near-Term Pregnant Rat Induces Fetal Brain Inflammation: A Model for the Consequences of Epidural-Associated Maternal Fever

BACKGROUND: BACKGROUND:Women laboring with epidural analgesia experience fever much more frequently than do women who chose other forms of analgesia, and maternal intrapartum fever is associated with numerous adverse consequences, including brain injury in the fetus. We developed a model of noninfectious inflammatory fever in the near-term pregnant rat to simulate the pathophysiology of epidural-associated fever and hypothesized that it would produce fetal brain inflammation. METHODS: METHODS:Twenty-four pregnant Sprague-Dawley rats were studied at 20 days gestation (term: 22 days). Dams were treated by injection of rat recombinant interleukin (IL)-6 or vehicle at 90-minute intervals, and temperature was monitored every 30 minutes. Eight hours after the first treatment, dams were delivered of fetuses and then killed. Maternal IL-6 was measured at delivery. Fetal brains (n = 24) were processed and stained for ED-1/CD68, a marker for activated microglia, and cell counts in the lateral septal and hippocampal brain regions were measured. Fetal brains were also stained for cyclooxygenase-2 (COX-2), a downstream marker of neuroinflammation. Eight fetal brains were further analyzed for quantitative forebrain COX-2 by Western blotting compared to a β-actin standard. Maternal temperature and IL-6 levels were compared between treatments, as were cell counts, COX-2 staining, and COX-2 levels by Mann-Whitney U test, repeated-measures analysis of variance, or Fisher exact test, as appropriate. RESULTS: RESULTS:Injection of rat IL-6 at 90-minute intervals produced an elevation of maternal temperature compared to vehicle (P

http://ift.tt/2yvR6nj

Multisensory modulation of experimentally evoked perceptual distortion of the face

Abstract

Background

Chronic orofacial pain patients often perceive the painful face area as 'swollen' without clinical signs, i.e., a perceptual distortion (PD). Local anesthetic (LA) injections in healthy participants are also associated with PD

Objective

The aim was to explore whether PD evoked by LA into the infraorbital region of could be modulated by adding mechanical stimulation (MS) to the affected area

Methods

MS was given with a brush and a 128 mN von Frey filament. First, sixty healthy participants were randomly divided into three groups: 1) LA control, 2) LA with MS, 3) Isotonic solution (ISO) with MS as an additional control condition. To further examine the role of a multisensory modulation an additional experiment was conducted. Twenty participants received LA with MS (filament) in addition to visual feedback of their distorted face. The results of the two experiments are presented together

Results

All three LA groups experienced PD, per contra PD was not reported in the ISO group. MS alone did not change the magnitude of PD: brush (p = 0.089), filament (p = 0.203). However, when the filament stimulation was combined with additional visual information of a distorted face there was observable decrease in PD (p = 0.002)

Conclusion

The findings indicate the importance of multisensory integration for PD, and represent a significant step forward in the understanding of the factors that may influence this common condition. Future studies are encouraged to investigate further the cortical processing for possible implications for PD in pain management.

This article is protected by copyright. All rights reserved.



http://ift.tt/2hTzbwp

Nuances in component nasal hump reduction

Nasal hump reduction is a frequent manoeuver in rhinoplasty. Over the last years, composite hump reduction has been advocated in favour of component hump reduction. The latter allows a more controlled and stepwise approach in reducing the nasal dorsum by deprojecting the cartilaginous dorsum separately from the bony dorsum. This approach also preserves the upper lateral cartilages (ULCs) and their mucosa.

http://ift.tt/2yXoTX2

Anthropometric growth study of the ear in a chinese population

A large number of anthropometric studies of the auricle have been reported in different nations, but little data are available in the Chinese population. The aim of this study was to analyze growth changes in the ear by measuring the width and length of ears in a Chinese population.

http://ift.tt/2hTZfrl

Mammaplasty in patients with large areola: reducing the nipple-areola complex using intra-areolar incisions

Minimal incision breast reduction techniques resulting in periareolar scars are widely used. However, this technique is less suitable for patients with large areola diameters and relatively small breasts, requiring a modest reduction or lift only. As a result of the large nipple-areola-complex larger amounts of skin must be removed in order to resect the complete peripheral areola, increasing the risk of high-riding nipples, breast flattening and incomplete areola resection resulting in a rest on the vertical scar.

http://ift.tt/2yXfsHb

Post-operative care of VRAM flaps for perineal reconstruction: results of a UK practice survey and literature review

The trans-pelvic vertical rectus abdominis myocutaneous (VRAM) flap has shown considerable utility in the reconstruction of pelvic defects following abdomino-perineal excision (APE) or total pelvic exenteration (TPE) for pelvic malignancy. These patients are often nursed post-operatively on colorectal wards, or even in outlying hospitals in those Plastics units operating on a hub-and-spoke basis. Protocols for the post-operative care of free flap reconstruction patients are well established and have been shown to reduce major complications1,2.

http://ift.tt/2hTZ27q

The scrotal free flap: first successful clinical application of a free Super-Thin External Pudendal Artery (STEPA) flap for reconstruction of a foot defect

Dear Editor,

http://ift.tt/2yXoQdO

American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

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American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

October 19, 2017—The American Thyroid Association (ATA) announces with pleasure the election of Charles H. Emerson, MD, as president of its Board of Directors. All terms begin at the close of the Annual Meeting, taking place October 18‒22 in Victoria, British Columbia.

Additional new board members include:

Elizabeth Pearce, MD, MSc, President-Elect
Julie Ann Sosa, MD, MA, FACS, Treasurer
Douglas Forrest, PhD, Research Director
Megan Haymart, MD, Clinician Director
Thomas Giordano, MD, PhD, Pathology Director

Charles H. Emerson, MD, President

Dr. Emerson is Professor Emeritus of Medicine at the University of Massachusetts Medical School (UMASSMED). He received his MD degree from the University of Virginia and completed his internship and residency in internal medicine at the Hospital of the University of Pennsylvania (Penn) in Philadelphia. After a year of endocrine fellowship at the same institution, he served as Chief of Endocrinology at the US Army Medical Center in Augusta, GA. Following military service, he returned to Penn and completed his endocrine fellowship, where he worked on purifying thyroid stimulating antigen, the kinetics of thyrotropin releasing hormone (TRH), inappropriate TSH secretion, and the effects of lithium and stable iodine on thyroid function.

After six years as Assistant Professor of Medicine at the University of Illinois, Dr. Emerson was recruited to UMASSMED by Lewis E. Braverman, MD. The two collaborated on a study of thyroid hormone metabolism in the chorion and placenta of various species, sparked by the finding that, in experimental models of hypothyroidism, reverse T3 in amniotic fluid was derived from the mother rather than the fetus. Among the other areas of Dr. Emerson's research are the effects of recombinant TSH in humans and rats, the relationship between age and the thyrotroph response to primary hypothyroidism and, working with Dr. Ronald Lechan, the mechanism of fasting-induced suppression of ProTRH mRNA in the hypothalamic paraventricular nucleus.

Dr. Emerson has served on the VA Merit Review Board and as an ad hoc member of NIH study sections. He is a member of the Endocrine Society, the American Association of Clinical Endocrinologists, the European Thyroid Association and, since 1976, the ATA. He has served on the ATA Program, Awards, and Development Committees, and as Chair of the Membership and Bylaws Committees. He was a member of the ATA Board from 2003 to 2007 and Treasurer from 2004 to 2007.

From 2008 through 2012 he was Editor-in-Chief of the journal Thyroid. He is currently Associate Editor of Clinical Thyroidology and Associated Editor of Endocrine Practice. Dr. Emerson was awarded the ATA's Distinguished Service Award in 2010.

He writes, "My vision of the ideal ATA is that it should be an intellectual home and voice for both individuals and groups, for original groundbreaking research and education of health care workers and the public, for scholarly work by one or two people and collective synthesis of the literature by groups. Revolutionary insights are generally formulated by individuals or close collaborations between two or three investigators. These in turn are integrated into the mainstream by groups, ideally in an erudite fashion. I will strive for an agenda and allocation of resources and time that is inclusive of these outwardly competing values."

Dr. Emerson has served a year on the board as President-Elect. He will now serve a one-year term as President, followed by a one-year term as Past-President.

Elizabeth Pearce, MD, MSc, President-Elect

Dr. Pearce is Associate Professor of Medicine in the Endocrinology, Diabetes, and Nutrition Section at Boston University School of Medicine. She received her undergraduate and medical degrees from Harvard and a masters' degree in epidemiology from the Boston University School of Public Health. She completed her residency in internal medicine at Beth Israel Deaconess Medical Center, and her fellowship in endocrinology at Boston University under the mentorship of Dr. Lewis Braverman. Her research interests include the sufficiency of dietary iodine in the U.S. and globally; thyroid function in pregnancy; thyroidal effects of exposure to environmental endocrine disruptors; and the cardiovascular effects of subclinical thyroid dysfunction. She has been part of the leadership of the Iodine Global Network (IGN; formerly ICCIDD) since 2009. She is a member of the AACE Thyroid Scientific Committee and serves as faculty for the Endocrine Society's annual board review course. She has served on multiple editorial boards, including those for Endocrine Practice, Journal of Clinical Endocrinology and Metabolism, Clinical Endocrinology, European Journal of Clinical Nutrition, and Lancet Diabetes & Endocrinology.

Dr. Pearce has been a member of the American Thyroid Association since 2000. She has chaired both the ATA's Publications and Public Health Committees. She co-chaired the 2012 Annual Meeting Program Committee and the 2009 and 2016 Spring Symposia, and was a member of the Program Committee for the 2015 International Thyroid Congress. She has served as a member of the ATA Finance Committee, and currently is a member of the Guidelines Policy Task Force. She was one of the leaders of the effort to establish the ATA's Braverman Lectureship and co-chaired the task force for the 2017 Pregnancy Guidelines. She is Associate Editor for both Thyroid and Clinical Thyroidology journals. She served as a member of the Board of Directors from 2009­ to 2013. Dr. Pearce was the 2011 recipient of the ATA Van Meter Award for outstanding contributions to research on the thyroid gland.

Julie Ann Sosa, MD, MA, FACS, Treasurer

After a year as Treasurer-Elect, Dr. Sosa will now become Treasurer. She is Professor of Surgery and Medicine in Oncology at Duke University, where she serves as Chief of Endocrine Surgery and Director of the Surgical Center for Outcomes Research, as well as Leader of the Endocrine Neoplasia Diseases Group at the Duke Cancer Institute and the Duke Clinical Research Institute, a large transdisciplinary group of clinicians and researchers. She received her AB at Princeton, her MA at Oxford, and her MD at Johns Hopkins, where she also completed the Halsted residency and a fellowship. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is an NIH-funded investigator and author of more than 230 peer-reviewed publications and 50 book chapters, largely focused on outcomes research and thyroid cancer, including clinical trials.

Dr. Sosa is also this year's Lewis E. Braverman Distinguished Award recipient. The Braverman Award recognizes an individual who: demonstrates excellence and passion for mentoring fellows, students, and junior faculty; has a long history of productive thyroid research; and is devoted to the ATA. At the Annual Meeting, she will present the Braverman lecture, titled "Retelling the Story of Thyroid Cancer—Rising Incidence, Mortality, and Maybe an Explanation."

In addition to Board liaison to the ATA Finance and Audit Committee and Internet Communications Committee, Dr. Sosa is a past Chair of the Program Committee and has served on the Nominating Committee and Patient Affairs and Education Committee, as well as guidelines committees for the management of thyroid nodules and differentiated thyroid cancer (2015) and hyperthyroidism/thyrotoxicosis (2011, 2016). She was vice president of the American Association of Endocrine Surgeons and serves on the Board of Directors of the International Thyroid Oncology Group as well as the Executive Council of the Society for Surgical Oncology. She is a member of the National Comprehensive Cancer Network (NCCN) Practice Guidelines Committee for Neuroendocrine Tumors. She is deputy editor of JAMA-Surgery and associate editor for World Journal of Surgery, Journal of Surgical Research, and Current Opinion in Oncology. She is on the editorial boards of the Annals of Surgical Oncology, Annals of Surgery, Hormones and Cancer, Endocrine, and Surgery. She has mentored more than 50 students, residents, and fellows.

Douglas Forrest, PhD, Research Director

Dr. Forrest is Senior Investigator in the Laboratory of Endocrinology and Receptor Biology at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) at the National Institutes of Health (NIH). He received his PhD at Glasgow University for studies on feline leukemia virus. His life-long interest in thyroid hormone was first sparked during training at the European Molecular Biology Laboratory in Heidelberg and the Karolinska Institute in Stockholm.

In the United States, Dr. Forrest previously held faculty appointments as Assistant Professor, then Associate Professor at the Department of Human Genetics at Mount Sinai School of Medicine. His experience includes teaching and obtaining NIH and international grants. He has served on grant study sections and on the editorial boards of Thyroid, Endocrinology, Molecular Endocrinology, and Frontiers in Endocrinology. He has mentored trainees who have pursued careers in independent research, clinical practice, industry, and scientific administration.

Dr. Forrest's research interests concern thyroid hormone functions in mammalian development and disease with emphasis on basic and translational studies of thyroid hormone receptors and deiodinase enzymes. His contributions have been recognized with the ATA Van Meter Award and the Merck Prize of the European Thyroid Association. He has presented the Shizume Lecture of the Japanese Thyroid Association and the Pitt-Rivers Lecture of the British Endocrine Society.

A member of the ATA since 1999, Dr. Forrest has served on the Annual Meeting Program Committee, the Awards Committee, the Planning Committee for the Spring Summit on "The thyroid in pregnancy and development," and the Basic Research Guidelines Task Force. He co-authored the "ATA Guide to investigating thyroid hormone economy and action in rodent and cell models." He was co-chair with Elizabeth Pearce of the 82nd Annual Meeting in Quebec City. He currently serves on the Trainee Career and Advancement Committee as chair of the Basic Track and is a keen advocate for all trainees in the thyroid field.

Megan Haymart, MD, Clinician Director

Dr. Haymart is Associate Professor of Medicine in the Division of Metabolism, Endocrinology, and Diabetes and Hematology/Oncology at the University of Michigan. She received her MD degree from Johns Hopkins Medical School. She completed her internal medicine residency at Johns Hopkins Hospital and her endocrinology fellowship at the University of Wisconsin.

Dr. Haymart's clinical focus is thyroid cancer and thyroid nodules, working with a multidisciplinary endocrine oncology team at the University of Michigan. Her research focus is on variation in the management of thyroid disorders, with an emphasis on the role of patients, providers, and health systems in treatment decision-making. With R01 funding from the National Cancer Institute (NCI) of the National Institutes of Health (NIH), she is currently evaluating treatment decision-making in low-risk thyroid cancer. With R01 funding from the Agency for Healthcare Research and Quality (AHRQ), she is investigating the role of imaging in the over-diagnosis of low-risk thyroid cancer.

In addition to her clinical efforts and research endeavors, Dr. Haymart is involved in creating the National Comprehensive Cancer Network (NCCN) thyroid carcinoma guidelines. She is the recent recipient of the University of Michigan's Jerome Conn Award for Research Excellence. She currently serves as chair of the ATA Finance and Audit Committee and is on the Endocrine Society's Annual Meeting Steering Committee. She served on the editorial board of the Journal of Clinical Endocrinology and Metabolism (JCEM) from 2013 to 2016 and currently serves on the editorial boards of Thyroid (since 2013) and Endocrine Today (since 2017). She is also Associate Editor for VideoEndocrinology (2014‒present).

Thomas Giordano, MD, PhD, Pathology Director

Dr. Giordano is the Henry Clay Bryant Professor of Pathology in the Department of Pathology, University of Michigan Medical School, and holds a joint appointment in the Metabolism and Endocrinology Division of the school's Department of Internal Medicine. After receiving his BA from Johns Hopkins University, Dr. Giordano earned his MD and PhD in a combined program at the Rutgers University and UMDNJ's Robert Wood Johnson Medical School. His graduate studies in the Department of Microbiology involved the regulation of gene expression. He completed residency training in anatomic pathology at the National Cancer Institute (NCI) and fellowship training in oncologic pathology at Memorial Sloan-Kettering Cancer Center. Both residency and fellowship training permitted extensive exposure to endocrine pathology. He then joined the faculty at the University of Michigan Medical School.

Dr. Giordano is an endocrine and molecular pathologist with long-standing interests in thyroid and adrenocortical neoplasia. His specific academic interests in thyroid cancer include molecular and genomic profiling and tumor classification. He served as co-chair of The Cancer Genome Atlas's (TCGA's) Papillary Thyroid Carcinoma project, which he led from its initiation to publication in Cell in 2014. He also was instrumental in convincing the TCGA leadership to conduct their Adrenal Cortical Carcinoma project and served as co-chair of this study until its publication in Cancer Cell in 2016. He also served on the Analysis Working group for the TCGA Pheochromocytoma project, published in Cancer Cell in 2017. He currently serves on
the TCGA Steering Committee for the PanCancerAtlas project, the goal of which is to collectively evaluate the genomics of all tumors studied by TCGA.

Dr. Giordano regularly attends the ATA Annual Meeting and has participated on their Tumor Board for the last two years. He is a member of the ATA Laboratory Services Committee and ATA Anaplastic Thyroid Cancer (ATC) Guidelines Task Force.

Nominating Process

The ATA thanks this year's nominating committee, chaired by David Steward, and is extremely grateful to all who are willing to stand for election and to serve on the Board of Directors. Special thanks to those who will retire from the Board this year: Anthony Hollenberg, MD, Jacqueline Jonklaas, MD, outgoing Past-President Anthony Bianco, MD, PhD, and outgoing Treasurer David H. Sarne, who has served for six years in that position. Additional thanks to current President John Morris, MD, who now continues to serve as Past-President of the Board.

###

 

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

 

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

 

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

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American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

October 19, 2017—The American Thyroid Association (ATA) announces with pleasure the election of Charles H. Emerson, MD, as president of its Board of Directors. All terms begin at the close of the Annual Meeting, taking place October 18‒22 in Victoria, British Columbia.

Additional new board members include:

Elizabeth Pearce, MD, MSc, President-Elect
Julie Ann Sosa, MD, MA, FACS, Treasurer
Douglas Forrest, PhD, Research Director
Megan Haymart, MD, Clinician Director
Thomas Giordano, MD, PhD, Pathology Director

Charles H. Emerson, MD, President

Dr. Emerson is Professor Emeritus of Medicine at the University of Massachusetts Medical School (UMASSMED). He received his MD degree from the University of Virginia and completed his internship and residency in internal medicine at the Hospital of the University of Pennsylvania (Penn) in Philadelphia. After a year of endocrine fellowship at the same institution, he served as Chief of Endocrinology at the US Army Medical Center in Augusta, GA. Following military service, he returned to Penn and completed his endocrine fellowship, where he worked on purifying thyroid stimulating antigen, the kinetics of thyrotropin releasing hormone (TRH), inappropriate TSH secretion, and the effects of lithium and stable iodine on thyroid function.

After six years as Assistant Professor of Medicine at the University of Illinois, Dr. Emerson was recruited to UMASSMED by Lewis E. Braverman, MD. The two collaborated on a study of thyroid hormone metabolism in the chorion and placenta of various species, sparked by the finding that, in experimental models of hypothyroidism, reverse T3 in amniotic fluid was derived from the mother rather than the fetus. Among the other areas of Dr. Emerson's research are the effects of recombinant TSH in humans and rats, the relationship between age and the thyrotroph response to primary hypothyroidism and, working with Dr. Ronald Lechan, the mechanism of fasting-induced suppression of ProTRH mRNA in the hypothalamic paraventricular nucleus.

Dr. Emerson has served on the VA Merit Review Board and as an ad hoc member of NIH study sections. He is a member of the Endocrine Society, the American Association of Clinical Endocrinologists, the European Thyroid Association and, since 1976, the ATA. He has served on the ATA Program, Awards, and Development Committees, and as Chair of the Membership and Bylaws Committees. He was a member of the ATA Board from 2003 to 2007 and Treasurer from 2004 to 2007.

From 2008 through 2012 he was Editor-in-Chief of the journal Thyroid. He is currently Associate Editor of Clinical Thyroidology and Associated Editor of Endocrine Practice. Dr. Emerson was awarded the ATA's Distinguished Service Award in 2010.

He writes, "My vision of the ideal ATA is that it should be an intellectual home and voice for both individuals and groups, for original groundbreaking research and education of health care workers and the public, for scholarly work by one or two people and collective synthesis of the literature by groups. Revolutionary insights are generally formulated by individuals or close collaborations between two or three investigators. These in turn are integrated into the mainstream by groups, ideally in an erudite fashion. I will strive for an agenda and allocation of resources and time that is inclusive of these outwardly competing values."

Dr. Emerson has served a year on the board as President-Elect. He will now serve a one-year term as President, followed by a one-year term as Past-President.

Elizabeth Pearce, MD, MSc, President-Elect

Dr. Pearce is Associate Professor of Medicine in the Endocrinology, Diabetes, and Nutrition Section at Boston University School of Medicine. She received her undergraduate and medical degrees from Harvard and a masters' degree in epidemiology from the Boston University School of Public Health. She completed her residency in internal medicine at Beth Israel Deaconess Medical Center, and her fellowship in endocrinology at Boston University under the mentorship of Dr. Lewis Braverman. Her research interests include the sufficiency of dietary iodine in the U.S. and globally; thyroid function in pregnancy; thyroidal effects of exposure to environmental endocrine disruptors; and the cardiovascular effects of subclinical thyroid dysfunction. She has been part of the leadership of the Iodine Global Network (IGN; formerly ICCIDD) since 2009. She is a member of the AACE Thyroid Scientific Committee and serves as faculty for the Endocrine Society's annual board review course. She has served on multiple editorial boards, including those for Endocrine Practice, Journal of Clinical Endocrinology and Metabolism, Clinical Endocrinology, European Journal of Clinical Nutrition, and Lancet Diabetes & Endocrinology.

Dr. Pearce has been a member of the American Thyroid Association since 2000. She has chaired both the ATA's Publications and Public Health Committees. She co-chaired the 2012 Annual Meeting Program Committee and the 2009 and 2016 Spring Symposia, and was a member of the Program Committee for the 2015 International Thyroid Congress. She has served as a member of the ATA Finance Committee, and currently is a member of the Guidelines Policy Task Force. She was one of the leaders of the effort to establish the ATA's Braverman Lectureship and co-chaired the task force for the 2017 Pregnancy Guidelines. She is Associate Editor for both Thyroid and Clinical Thyroidology journals. She served as a member of the Board of Directors from 2009­ to 2013. Dr. Pearce was the 2011 recipient of the ATA Van Meter Award for outstanding contributions to research on the thyroid gland.

Julie Ann Sosa, MD, MA, FACS, Treasurer

After a year as Treasurer-Elect, Dr. Sosa will now become Treasurer. She is Professor of Surgery and Medicine in Oncology at Duke University, where she serves as Chief of Endocrine Surgery and Director of the Surgical Center for Outcomes Research, as well as Leader of the Endocrine Neoplasia Diseases Group at the Duke Cancer Institute and the Duke Clinical Research Institute, a large transdisciplinary group of clinicians and researchers. She received her AB at Princeton, her MA at Oxford, and her MD at Johns Hopkins, where she also completed the Halsted residency and a fellowship. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is an NIH-funded investigator and author of more than 230 peer-reviewed publications and 50 book chapters, largely focused on outcomes research and thyroid cancer, including clinical trials.

Dr. Sosa is also this year's Lewis E. Braverman Distinguished Award recipient. The Braverman Award recognizes an individual who: demonstrates excellence and passion for mentoring fellows, students, and junior faculty; has a long history of productive thyroid research; and is devoted to the ATA. At the Annual Meeting, she will present the Braverman lecture, titled "Retelling the Story of Thyroid Cancer—Rising Incidence, Mortality, and Maybe an Explanation."

In addition to Board liaison to the ATA Finance and Audit Committee and Internet Communications Committee, Dr. Sosa is a past Chair of the Program Committee and has served on the Nominating Committee and Patient Affairs and Education Committee, as well as guidelines committees for the management of thyroid nodules and differentiated thyroid cancer (2015) and hyperthyroidism/thyrotoxicosis (2011, 2016). She was vice president of the American Association of Endocrine Surgeons and serves on the Board of Directors of the International Thyroid Oncology Group as well as the Executive Council of the Society for Surgical Oncology. She is a member of the National Comprehensive Cancer Network (NCCN) Practice Guidelines Committee for Neuroendocrine Tumors. She is deputy editor of JAMA-Surgery and associate editor for World Journal of Surgery, Journal of Surgical Research, and Current Opinion in Oncology. She is on the editorial boards of the Annals of Surgical Oncology, Annals of Surgery, Hormones and Cancer, Endocrine, and Surgery. She has mentored more than 50 students, residents, and fellows.

Douglas Forrest, PhD, Research Director

Dr. Forrest is Senior Investigator in the Laboratory of Endocrinology and Receptor Biology at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) at the National Institutes of Health (NIH). He received his PhD at Glasgow University for studies on feline leukemia virus. His life-long interest in thyroid hormone was first sparked during training at the European Molecular Biology Laboratory in Heidelberg and the Karolinska Institute in Stockholm.

In the United States, Dr. Forrest previously held faculty appointments as Assistant Professor, then Associate Professor at the Department of Human Genetics at Mount Sinai School of Medicine. His experience includes teaching and obtaining NIH and international grants. He has served on grant study sections and on the editorial boards of Thyroid, Endocrinology, Molecular Endocrinology, and Frontiers in Endocrinology. He has mentored trainees who have pursued careers in independent research, clinical practice, industry, and scientific administration.

Dr. Forrest's research interests concern thyroid hormone functions in mammalian development and disease with emphasis on basic and translational studies of thyroid hormone receptors and deiodinase enzymes. His contributions have been recognized with the ATA Van Meter Award and the Merck Prize of the European Thyroid Association. He has presented the Shizume Lecture of the Japanese Thyroid Association and the Pitt-Rivers Lecture of the British Endocrine Society.

A member of the ATA since 1999, Dr. Forrest has served on the Annual Meeting Program Committee, the Awards Committee, the Planning Committee for the Spring Summit on "The thyroid in pregnancy and development," and the Basic Research Guidelines Task Force. He co-authored the "ATA Guide to investigating thyroid hormone economy and action in rodent and cell models." He was co-chair with Elizabeth Pearce of the 82nd Annual Meeting in Quebec City. He currently serves on the Trainee Career and Advancement Committee as chair of the Basic Track and is a keen advocate for all trainees in the thyroid field.

Megan Haymart, MD, Clinician Director

Dr. Haymart is Associate Professor of Medicine in the Division of Metabolism, Endocrinology, and Diabetes and Hematology/Oncology at the University of Michigan. She received her MD degree from Johns Hopkins Medical School. She completed her internal medicine residency at Johns Hopkins Hospital and her endocrinology fellowship at the University of Wisconsin.

Dr. Haymart's clinical focus is thyroid cancer and thyroid nodules, working with a multidisciplinary endocrine oncology team at the University of Michigan. Her research focus is on variation in the management of thyroid disorders, with an emphasis on the role of patients, providers, and health systems in treatment decision-making. With R01 funding from the National Cancer Institute (NCI) of the National Institutes of Health (NIH), she is currently evaluating treatment decision-making in low-risk thyroid cancer. With R01 funding from the Agency for Healthcare Research and Quality (AHRQ), she is investigating the role of imaging in the over-diagnosis of low-risk thyroid cancer.

In addition to her clinical efforts and research endeavors, Dr. Haymart is involved in creating the National Comprehensive Cancer Network (NCCN) thyroid carcinoma guidelines. She is the recent recipient of the University of Michigan's Jerome Conn Award for Research Excellence. She currently serves as chair of the ATA Finance and Audit Committee and is on the Endocrine Society's Annual Meeting Steering Committee. She served on the editorial board of the Journal of Clinical Endocrinology and Metabolism (JCEM) from 2013 to 2016 and currently serves on the editorial boards of Thyroid (since 2013) and Endocrine Today (since 2017). She is also Associate Editor for VideoEndocrinology (2014‒present).

Thomas Giordano, MD, PhD, Pathology Director

Dr. Giordano is the Henry Clay Bryant Professor of Pathology in the Department of Pathology, University of Michigan Medical School, and holds a joint appointment in the Metabolism and Endocrinology Division of the school's Department of Internal Medicine. After receiving his BA from Johns Hopkins University, Dr. Giordano earned his MD and PhD in a combined program at the Rutgers University and UMDNJ's Robert Wood Johnson Medical School. His graduate studies in the Department of Microbiology involved the regulation of gene expression. He completed residency training in anatomic pathology at the National Cancer Institute (NCI) and fellowship training in oncologic pathology at Memorial Sloan-Kettering Cancer Center. Both residency and fellowship training permitted extensive exposure to endocrine pathology. He then joined the faculty at the University of Michigan Medical School.

Dr. Giordano is an endocrine and molecular pathologist with long-standing interests in thyroid and adrenocortical neoplasia. His specific academic interests in thyroid cancer include molecular and genomic profiling and tumor classification. He served as co-chair of The Cancer Genome Atlas's (TCGA's) Papillary Thyroid Carcinoma project, which he led from its initiation to publication in Cell in 2014. He also was instrumental in convincing the TCGA leadership to conduct their Adrenal Cortical Carcinoma project and served as co-chair of this study until its publication in Cancer Cell in 2016. He also served on the Analysis Working group for the TCGA Pheochromocytoma project, published in Cancer Cell in 2017. He currently serves on
the TCGA Steering Committee for the PanCancerAtlas project, the goal of which is to collectively evaluate the genomics of all tumors studied by TCGA.

Dr. Giordano regularly attends the ATA Annual Meeting and has participated on their Tumor Board for the last two years. He is a member of the ATA Laboratory Services Committee and ATA Anaplastic Thyroid Cancer (ATC) Guidelines Task Force.

Nominating Process

The ATA thanks this year's nominating committee, chaired by David Steward, and is extremely grateful to all who are willing to stand for election and to serve on the Board of Directors. Special thanks to those who will retire from the Board this year: Anthony Hollenberg, MD, Jacqueline Jonklaas, MD, outgoing Past-President Anthony Bianco, MD, PhD, and outgoing Treasurer David H. Sarne, who has served for six years in that position. Additional thanks to current President John Morris, MD, who now continues to serve as Past-President of the Board.

###

 

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

 

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

 

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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ATA selects Sidney H. Ingbar Distinguished Award recipient

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American Thyroid Association's 2017 Sidney H. Ingbar Distinguished Award Lecture Delivered by Yuri Nikiforov, MD, PhD

ATA selects Sidney H. Ingbar Distinguished Award recipient

Yuri Nikiforov, MD, PhDOctober 16, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Sidney H. Ingbar Distinguished Award will be received by Yuri Nikiforov, MD, PhD, who is Vice Chair and Director of the Division of Molecular and Genomic Pathology, Department of Pathology, University of Pittsburgh School of Medicine (UPMC).

The Sidney H. Ingbar Distinguished Lectureship Award, en dowed by contributions to honor the memory of Sidney H. Ingbar, recognizes outstanding academic achievements in thyroidology, in keeping with the innovation and vision that epitomized Dr. Ingbar's brilliant investigative career. The Ingbar award is conferred upon an established investigator who has made major contributions to thyroid-related research over many years. At the ATA annual meeting in Victoria, British Columbia, Dr. Nikiforov will deliver the Ingbar Lecture at 1:00 pm on October 21, 2017. His lecture title is "Genomic Evolution of Thyroid Nodules and Cancer – New Answers to Old Questions."

Dr. Nikiforov received his MD with Honors from Minsk Medical Institute in Belarus and his PhD from the same Institute's Laboratory of Experimental Pathology. He then spent 15 years in postdoctoral research, in both pathology and endocrinology, first at the Minsk City Hospital, then at the Rhode Island City Hospital/Brown University, the Cedars-Sinai Medical Center/UCLA School of Medicine in Los Angeles, and the University of Cincinnati College of Medicine. He is certified in Anatomic Pathology by the American Board of Pathology.

With his colleagues, Dr. Nikiforov documented the genetic changes to the thyroid that occur in the setting of radiation injury, resulting in malignant transformation. His patients for this study were children who had been exposed to radiation by the Chernobyl nuclear plant accident. This and other basic science discoveries over the years are combined with his work in thyroid cancer diagnosis (introducing mutational markers, enabling highly accurate diagnoses in thyroid nodules, and more) and with developing a method for molecular testing to identify thyroid cancers, thereby reducing the number of surgeries.

In addition to many academic honors and awards, both national and international, Dr. Nikiforov currently serves on the editorial boards of three journals—Endocrine PathologyHuman Pathology, and Thyroid Research—and has served on the boards of two additional journals in the past.

Dr. Nikiforov joined the ATA in 2000 and has served and contributed to the Research and Program Committees, Guidelines for Management of Anaplastic Thyroid Cancer; and, Differentiated Thyroid Cancer; as well as, annual meeting faculty over many years.

Lectures and seminars on thyroid health, pathology, research, clinical care, and molecular genetics have called Dr. Nikiforov to universities, symposia, conferences, and annual meetings around the world. He has published substantial numbers of peer-reviewed articles (his CV lists 158 in which he has taken part), additional articles (25), books (2), book chapters (10), and several other publications.

As Dr. Sally Carty, Chief of the Division of Endocrine Surgery at UPMC, states in her award nomination letter, "Dr. Nikiforov humbly, ably, and outstandingly embodies" the qualities required for the Ingbar Award. She continues, he is "a pluripotent thyroidologist, scientist, mentor, and instigator of change of behalf of patients."

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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