Head and Neck Diseases by Alexandros G.Sfakianakis: 02/14/17

Τρίτη 14 Φεβρουαρίου 2017

Editorial Board

Publication date: February 2017
Source:Clinical Immunology, Volume 175

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Editorial Board

Publication date: February 2017
Source:Clinical Immunology, Volume 175

http://ift.tt/2l6X6cQ

Intramammary 1,25-dihydroxyvitamin D3 treatment increases expression of host-defense genes in mammary immune cells of lactating dairy cattle.

Publication date: Available online 14 February 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Kathryn E. Merriman, Michael B. Poindexter, Mercedes F. Kweh, Jose E.P. Santos, Corwin D. Nelson
Bacterial infection of the mammary gland activates an intracrine vitamin D pathway in macrophages of dairy cows. The active hormone of the vitamin D pathway, 1,25-dihydroxyvitamin D3 (1,25D), stimulates nitric oxide and β-defensin responses in bovine monocyte cultures, but the effect of 1,25D on innate immune genes in the mammary gland remained unknown. Therefore, the objective of this study was to determine the effects intramammary 1,25D treatment on expression of vitamin D associated host-defenses of the bovine mammary gland. Intramammary treatment of normal, healthy mammary glands of lactating dairy cows (n=14) with 10μg 1,25D increased inducible nitric oxide synthase (iNOS) and β-defensin 7 (DEFB7) gene expression in total milk somatic cells more than two-fold relative to placebo-treated glands within 8h after treatment. The vitamin D 24-hydroxylase gene (CYP24A1) also was increased nearly 100-fold in 1,25D-treated glands within 4h after treatment but was not affected in placebo-treated glands. Both macrophages and neutrophils isolated from milk had increased CYP24A1 expression in response to 1,25D treatment but only macrophages had increased iNOS expression. Repeated intramammary 1,25D treatment, every 12h for 48h, of infected mammary glands of cows diagnosed with subclinical mastitis resulted in increased expression of CYP24A1, DEFB4, DEFB7 and iNOS genes compared to placebo-treated glands. The 1,25D treatment resulted in elevated serum 1,25D concentrations (55 vs 33pg/mL) compared to placebo but it did not change serum calcium concentrations or bacteria counts in milk of infected mammary glands. In conclusion, 1,25D upregulates iNOS and β-defensin genes in vivo in cattle and affirms earlier reports that vitamin D supports innate immune functions of cattle.

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HMBA is a putative HSP70 activator stimulating HEXIM1 expression that is down-regulated by estrogen

Publication date: Available online 14 February 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Rati Lama, Chunfang Gan, Nethrie Idippily, Viharika Bobba, David Danielpour, Monica Montano, Bin Su
Hexamethylene bis-acetamide inducible protein 1 (HEXIM1) is identified as a novel inhibitor of estrogen stimulated breast cell growth, and it suppresses estrogen receptor-α transcriptional activity. HEXIM1 protein level has been found to be downregulated by estrogens. Recently, HEXIM1 has been found to inhibit androgen receptor transcriptional activity as well. Researchers have used Hexamethylene bis-acetamide (HMBA) for decades to stimulate HEXIM1 expression, which also inhibit estrogen stimulated breast cancer cell gene activation and androgen stimulated prostate cancer gene activation. However, the direct molecular targets of HMBA that modulate the induction of HEXIM1 expression in mammalian cells have not been identified. Based on HMBA and its more potent analog 4a1, we designed molecular probes to pull down the binding proteins of these compounds. Via proteomic approach and biological assays, we demonstrate that HMBA and 4a1 are actually heat shock protein 70 (HSP70) binders. The known HSP70 activator showed similar activity as HMBA and 4a1 to induce HEXIM1 expression, suggesting that HMBA and 4a1 might be putative HSP70 activators. Molecular target identification of HMBA and 4a1 could lead to further structural optimization of the parental compound to generate more potent derivatives to stimulate HEXIM1 expression, which could be a novel approach for hormone dependent breast cancer and prostate cancer treatment.

Graphical abstract

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Biomarkers in diagnosis and therapy of oral squamous cell carcinoma: A review of the literature

Oral squamous cell carcinoma (OSCC) represents the sixth most common cancer, accounting for 2-4% of all malignancies worldwide. The overall survival rate of less than 60% remains generally poor, with prognosis heavily relying on the TNM staging system. Tumor size as well as the presence and extent of lymph node metastases are widely recognized as the most important predictors. However, the underlying mechanisms that lead to an aggressive phenotype are not yet fully understood. Therefore, possible biomarkers are much in need to predict prognosis, to help individualize therapy approaches, and to overcome possible resistance mechanisms.

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Simulation-Guided Navigation for Vector Control in Pediatric Mandibular Distraction Osteogenesis

Navigation technology has given surgeons the capacity to know precisely where their instruments are during surgery, and simulation-guided navigation is a surgical method which is based on the use of navigation technology linked to 3D virtual surgery simulation. The aim of the present study was to evaluate the absolute accuracy of simulation-guided navigation as an aid to reproduce the planned position of the distraction device vector in pediatric mandibular distraction osteogenesis.

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Lipophagic Panniculitis of Childhood: A Case Report and Comprehensive Review of the Literature.

Lipophagic panniculitis of childhood is a rare condition notable clinically for an inflammatory panniculitis followed by the development of permanent lipoatrophy. In this regard, the term lipoatrophic panniculitis has been used synonymously with lipophagic panniculitis. Additional designations include lipophagic lipoatrophic panniculitis and annular lipoatrophic panniculitis of the ankles. Although lipophagic panniculitis has been associated with a number of autoimmune phenomena, a paucity of reports and limited pathological analyses to date renders this disease an elusive one whose pathogenesis is not yet established. We describe the clinical, histopathologic, and immunohistochemical findings in a case of lipophagic panniculitis of childhood in a 7-year-old boy and present it in the context of a comprehensive review of the literature. Furthermore, we offer a hypothesis regarding the pathogenetic basis of lipophagic panniculitis of childhood, suggesting cellular immunity targeting the adipocyte at the crux of its pathogenesis. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Hypocalcemia: low incidence in flares of pustular and chronic plaque psoriasis

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Perineal nodular induration: a report of three cases in France

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Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients

Abstract

Background

Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies.

Methods

The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of São Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1.

Results

The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease.

Conclusions

The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study.

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Cutaneous Cryptococcus albidus infection

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Transformation of porokeratosis ptychotropica into invasive squamous cell carcinoma

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Vulvar infections: beyond sexually transmitted infections

Abstract

The vulva is an under-studied area of the female genitourinary tract which is prone to maceration, overgrowth of organisms, and atypical presentations of common dermatologic conditions. In current practice, dermatologists must recognize and manage vulvar infections and infestations beyond the more commonly recognized sexually transmitted infections. Herein, this article reviews the literature on a selection of under-recognized viral, bacterial, fungal, and parasitic vulvar infections and infestations.

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Standardized methods for photography in procedural dermatology using simple equipment

Abstract

Photography is an important tool in dermatology. Reproducing the settings of before photos after interventions allows more accurate evaluation of treatment outcomes. In this article, we describe standardized methods and tips to obtain photographs, both for clinical practice and research procedural dermatology, using common equipment. Standards for the studio, cameras, photographer, patients, and framing are presented in this article.

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Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis

Abstract

The objective is to determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve after transpalatal advancement pharyngoplasty (TPAP) with obstructive sleep apnea (OSA) in adults, using a systematic review and meta-analysis. Nine databases, including PubMed/MEDLINE, were searched through April 1, 2016. All studies that included patients who underwent TPAP alone were included in this analysis. Fifty-six studies were potentially relevant, 37 were downloaded and five studies met criteria with 199 patients (age: 42.5 ± 9.7 years and body mass index: 29.0 ± 4.0 kg/m²). The grand mean (M) and standard deviation (SD) for AHI (199 patients) pre and post-TPAP decreased from 54.6 ± 23.0 [95 % CI 51.4, 57.8] to 19.2 ± 16.8 [95 % CI 16.9, 21.5] events/h (relative reduction: 64.8 %). Random effects modeling demonstrated a mean difference (MD) of −36.3 [95 % CI −48.5, −24.1], overall effect Z = 5.8 (p < 0.00001), and I ² = 85 % (significant inconsistency). The standardized mean difference (SMD) for TPAP demonstrated a large magnitude of effect for AHI −1.76 [95 % CI −2.4, −1.1]. For LSAT (70 patients), the pre and post-TPAP M ± SD improved from 81.9 ± 8.1 [95 % CI 80.0, 83.8] to 85.4 ± 6.9 [95 % CI 83.8, 87.0], with a MD of 3.55, overall effect Z = 1.79 (p = 0.07). Thus far, few studies have evaluated transpalatal advancement pharyngoplasty; therefore, we recommend additional studies, especially prospective studies. Research comparing TPAP to pharyngoplasty procedures without palatal advancement would help determine the optimal role for this procedure.

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The impact of dizziness on quality-of-life in the elderly

Abstract

Dizziness is a common medical condition that has been related to falls in the elderly, and it is, therefore, considered a severe social health problem. Particularly in the elderly, the impact of dizziness may be relevant, as it has been linked to several conditions, such as isolation, depression, reduced self autonomy, and self control. The social, functional, and psychological well-being of those affected can be hampered significantly, thus reducing the quality-of-life (QoL) perception. In addition, due to the aging of the population in the developed world, dizziness is becoming a growing public health problem; an optimal management of this condition includes, nowadays, the improvement of rehabilitative programs, as well as the evaluation of QoL status and its management. The aim of this paper is to evaluate the impact of dizziness on the QoL in the elderly, also analyzing the instruments available, nowadays, to evaluate QoL of dizzy patients.

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Necrotising fasciitis of the paranasal sinuses

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Chronic rhinosinusitis with nasal polyps is associated with chronic otitis media in the elderly

Abstract

Chronic rhinosinusitis (CRS) and chronic otitis media (COM) are common diseases in the otorhinolaryngology field. Although clinicians frequently encounter patients presenting both diseases simultaneously, a few studies have shown relationships between them. We examined whether CRS was associated with COM in adults who participated in the Korea National Health and Nutrition Examination Survey from 2009 to 2012. A total of 27,492 participants were examined in this cross-sectional epidemiological study. Regression analyses was performed and adjusted for socio-demographics, general health behavior, and other comorbidities. All analyses used complex sampling designs; subgroup analyses were performed according to age, hearing loss, and the presence of cholesteatoma or nasal polyps. The weighted prevalence of COM and CRS was 3.6 ± 0.2 and 6.0 ± 0.2%, respectively. COM prevalence was significantly higher in subjects with CRS (5.1%) than in those without (3.5%). In the multivariate analysis, COM was more prevalent in subjects with CRS (adjusted odds ratio = 1.738; P = 0.038) after adjusting for other factors. The subgroup analysis showed that this association was significant only in older subjects (≥50 years) with nasal polyps. Non-serviceable hearing and cholesteatoma were not significantly associated with CRS. Our findings demonstrated that CRS with nasal polyps might be associated with COM in older patients.

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Effects of polymer-based, silver nanoparticle-coated silicone splints on the nasal mucosa of rats

Abstract

Infection is a serious complication after nasal packing that otolaryngologists seek to avoid. The aim of this study is to investigate the use of silver (Ag) nanoparticle, which serves as antimicrobial agents, with nasal tampons. The study design is an experimental animal model and the setting is tertiary referral center. Twenty-four rats were randomized into the following four groups: (1) control group (n = 6); (2) silicone nasal splint (SNS) group (n = 6); (3) polypropylene-grafted polyethylene glycol (PP-g-PEG) amphiphilic graft copolymer-coated SNS group (n = 6); and (4) Ag nanoparticle-embedded PP-g-PEG (Ag-PP-g-PEG) amphiphilic graft copolymer-coated SNS group (n = 6). These tampons were applied to rats for 48 h, after which they were removed in a sterile manner, and the rats were sacrificed. The nasal septa of the rats were excised, and assessments of tissue changes in the nasal mucosa were compared among the groups. The removed tampons were microbiologically examined, and quantitative analyses were made. When the groups were compared microbiologically, there were no significant differences in bacterial colonization rates of coagulase-negative Staphylococcus spp. among the three groups (p = 0.519), but there was a statistically significant difference among bacterial colonization rates of Heamophilus parainfluenzae and Corynebacterium spp. (p = 0.018, p = 0.004). We found that H. parainfluenzae grew less robustly in the Ag-PP-g-PEG than the PP-g-PEG group (p = 0.017). However, we found no significant difference between the Ag-PP-g-PEG and SNS groups, or between the SNS and PP-g-PEG groups. The growth of Corynebacterium spp. did not differ significantly between the Ag-PP-g-PEG and SNS groups (p = 1.000). When Group 4 was compared with Group 2, the former showed less inflammation. Compared with other tampons, Ag-PP-g-PEG amphiphilic graft copolymer-coated silicone nasal tampons caused less microbiological colonization and inflammation. Therefore, the use of these tampons may prevent secondary infections and reduce the risk of developing complications by minimizing tissue damage.

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Chronological changes in microbial profiles in external and middle ear diseases: a 20-year study in Korea

Abstract

Microbial infection is one of the most significant causes of ear diseases, but microbial profiles are very diverse according to the diseases and change over time. The purpose of the study was to clarify differences and chronological changes in causative pathogens among infectious ear diseases over the last 20 years, and to identify antibiotic resistance. In total, 1191 isolates were included from patients diagnosed with chronic otitis media without cholesteatoma (COM), cholesteatomatous otitis media (Chole), middle ear effusion (MEE), including acute otitis media and otitis media with effusion, and external otitis (EO). Data were collected periodically for the years 1995, 2000, 2004, 2009, and 2013. Culture results and antibiotic resistance were assessed. The most common microorganism identified was S. aureus. The microbial profiles differed significant among the COM, Chole, and MEE groups (p < 0.001). In contrast, there was no distinct difference between COM and EO (p = 0.332). COM, Chole, and MEE also showed significant chronological changes in microbial profiles over time. The frequency of CNS increased markedly in COM and Chole (p = 0.029 and 0.028, respectively); however, S. pneumoniae infection decreased significantly in MEE (p = 0.016). Methicillin-resistant S. aureus (MRSA) demonstrated a constant trend (p = 0.564), whereas ciprofloxacin-resistant P. aeruginosa increased over time (p < 0.001). Microbial profiles have changed over a 20-year period. Increases in the frequency of coagulase-negative Staphylococcus (CNS) and bacterial resistance to ciprofloxacin, used widely in treating ear infections, are noteworthy.

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Classification of congenital nasal deformities: a proposal to amend the existing classification

Abstract

Congenital nasal anomalies are rare malformations with a broad spectrum of defects. The only existing classification strictly relating to nasal anomalies was presented by Losee et al. (Plast Reconstr Surg 113(2):676–689, 2004). The aim of this paper is to propose some suggestions, based on our current knowledge and experience gained by treating our patients in the clinic, in creating a specification of patients with congenital nasal anomalies. All patients with congenital nose defects treated in our health center were selected for this study. The research was retrospective and included years from 1995 to 2015. Nasal anomaly associated with cleft lip and palate was excluded. Patients were classified into four categories of congenital nasal anomalies, according to Losee et al. classification. In the period of 20 years, 191 patients with congenital nasal anomalies were treated in our health center. Type 1 defects were found in 124 patients, type 2 in 15, type 3 in 32 and type 4 in 20 patients. The nasal defect accompanying craniofacial syndrome is the most common type of nose malformation. The nose cleft is not always a part of craniofacial clefts; isolated forms of such malformations can occur. Vascular anomalies, due to different etiology, categorization and treatment, should not be recognized as nasal malformation.

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The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility

Abstract

Vagus nerve stimulation (VNS) is a useful tool for drug-resistant epilepsy, but it induces known laryngeal side effects, with a significant role on patients' quality of life. VNS patients may show persistent left vocal fold (LVF) palsy at rest and/or recurrent LVF adduction during stimulation. This study aims at electromyographically evaluating laryngeal muscles abnormalities in VNS patients. We compared endoscopic laryngeal evaluation data in six VNS patients with laryngeal muscle electromyography (LMEMG) carried out on the thyroarytenoid, cricothyroid, posterior cricoarytenoid, and cricopharyngeal muscles. Endoscopy showed LVF palsy at rest in 3/6 patients in whom LMEMG documented a tonic spastic activity with reduced phasic modulation. In four out of six patients with recurrent LVF adduction during VNS activation, LMEMG showed a compound muscle action potential persisting for the whole stimulation. This is the first LMEMG report of VNS-induced motor unit activation via recurrent laryngeal nerve and upper laryngeal nerve stimulation. LMEMG data were could, therefore, be considered consistent with the endoscopic laryngeal examination in all patient.

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Reply to the letter ‘Linguistic validation of the “FACE-Q Rhinoplasty Module” in Italian’

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Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis

Abstract

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Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions

Abstract

The aim of this study was to: (1) find out whether laryngomalacia (LM) types are related to clinical course; (2) which patients with LM are at higher risk of other airway malacia [tracheomalacia (TM) and/or bronchomalacia (BM)]; and (3) evaluate the prevalence of LM in our region. Patients with established LM diagnosis and complete clinical and endoscopy records were enrolled. They were classified into different LM types according to classification based on the side of supraglottic obstruction. One hundred ten children were included. The most common LM appearance was type I—58 children, followed by combine types (I + II and I + III)—38. The other airway malacia were found in 47 patients: TM in 31, BM in 10, and TM with BM in 6. Other comorbidities (cardiac, neurological, and genetic disorders) were identified in 30 children. Patients with combine types of LM differ from those with single type of LM in terms of prematurity (13 vs 31 %, p = 0.04) and higher weight on the examination day (p = 0.006). Patients with other airway malacia differ from children with isolated LM in terms of prematurity (40 vs 13 %, p = 0.008), comorbidities (38 vs 19 %, p = 0.024), and lower weight on the examination day (p = 0.014). The prevalence of clinically relevant LM was one in 2600–3100 newborns. Clinical course of LM cannot be anticipated on the basis of solely endoscopic evaluation of the larynx. Comorbidities and prematurity increase the risk of other airway malacia. The prevalence of LM is relatively high in the middle-south part of Poland.

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The impact of dizziness on quality-of-life in the elderly

Abstract

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Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods

Abstract

Limited olfactory improvement after topical steroid therapy in chronic rhinosinusitis (CRS) patients might result from restricted drug access to the olfactory cleft. The aim of our study was to investigate the difference between two methods to topically administer steroids with respect to olfaction: (1) conventional nasal spray and (2) a device using pressure and vibration to distribute steroid aerosol endonasally. A prospective study was performed in patients with olfactory impairment due to chronic rhinosinusitis with and without nasal polyps. While the first group used the conventional dexamethasone nasal spray, the second group used the device over a period of 12 days. Olfactory testing was done at 0, 2, and 8 weeks using Sniffin' Sticks test. A significant olfactory improvement was found after 2 weeks of treatment with either steroid (p = 0.005). However, there was no significant difference between the different methods of steroid application. There is a significant olfactory improvement in CRS patients following topical dexamethasone therapy, but no obvious superiority of one of the two ways to administer the steroid.

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Necrotising fasciitis of the paranasal sinuses

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Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful?

Abstract

The aim of this study is to present our management protocol of sphenopalatine artery bleeding, demonstrating that nasoendoscopic cautery (NC) was a more effective method than the nasal packing, in terms of shorter inpatient stay and reduced complications rate. We present ten posterior epistaxis not resolved by nasal packing. Tabotamp^® was placed in the area of sphenopalatine foramen and/or in those parts of the posterior nasal cavity, where it was suspected that bleeding origins. In two cases, the bleeding was resolved in this way, instead eight cases needed of subperiosteal cauterization of sphenopalatine artery by Dessi bipolar forceps (MicroFrance^®). 4 of these 8 patients evidenced a remarkable bleeding removing nasal packing (Hb before-nasal packing = 15 ± 0.69 versus Hb after-nasal packing = 13.3 ± 0.81; t student = 2.94; p value = 0.025). These four patients showed a deviation of the nasal septum ipsilateral to epistaxis, and according our experience, a traumatism of sphenopalatine area can be caused by Merocel^® nasal packing in this condition. During follow-up, no recurrences of nasal bleeding have been observed in such patients. Nasal packing must be considered if posterior epistaxis is severe, but always taking into account the specific anatomy of patient and in particular septal spurs that can further compromise sphenopalatine artery. In our experience, the endoscopic endonasal cauterization of the sphenopalatine branches represented a safe and effective procedure.

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Chronic rhinosinusitis with nasal polyps is associated with chronic otitis media in the elderly

Abstract

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Associations between the probabilities of frequency-specific hearing loss and unaided APHAB scores

Abstract

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHAB_u) to determine whether the APHAB_u could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20–75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHAB_u subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHAB_u subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHAB_u score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHAB_u subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert's evaluation of the subject's hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry.

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Effects of polymer-based, silver nanoparticle-coated silicone splints on the nasal mucosa of rats

Abstract

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Incidence of IP and risk of malignant transformation in the Swedish population 1960–2010

Abstract

The true incidence of inverted papilloma (IP) is not yet known. From hospital-based studies, its incidence has been estimated to approximately 0.5/100,000 person years. Earlier hospital case studies have shown that IP can undergo a malignant transformation in 1–53 %. The frequency of its malignant transformation on a population basis is unknown. To our knowledge, no standardised incidence ratio (SIR) has been reported for malignancies among IPs. This study aims to investigate these incidences on a population basis. Using the data from the Swedish Cancer Registry (SCR), we have identified patients with IP and patients with Squamous Cell Carcinoma (SCC) diagnosed between 1960 and 2010 in Sweden. Incidence of IP and incidence of SCC among patients with IP and SIR were analyzed. Eight hundred and fourteen patients with IP were identified. The incidence of IPs reported to the SCR increased from 1960 to 2010. In this cohort, SCC was overrepresented, as compared with the general population. The incidence of IP in the Swedish population seems to have increased.

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Chronological changes in microbial profiles in external and middle ear diseases: a 20-year study in Korea

Abstract

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Untreated head and neck cancer in Korea: a national cohort study

Abstract

Few studies have analyzed the survival of patients with untreated head and neck cancer. The objective of this study is to assess the survival rates of untreated head and neck cancer patients and to determine why the patients were not treated. Using data from a national patient sample cohort (1,025,340 cases) from the Korean Health Insurance Review and Assessment Service, 605 patients with diagnoses of head and neck cancer (lip and oral cavity, oropharynx, hypopharynx, and laryngeal cancer) between 2003 and 2013 were evaluated. Cox proportional hazards modeling and multiple logistic regression analysis were performed. Of the considered cases of head and neck cancer, 32.2% were untreated. The median survival rate of untreated groups was 9 months. The untreated group showed poorer survival than the treatment groups. Old age [adjusted odds ratio (AOR) = 1.37, 95% confidence internal (CI) 1.25–1.49, P < 0.001] and low income (AOR = 0.94, 95% CI 0.89–1.00, P = 0.028) were related to not receiving treatment. Many head and neck cancers go untreated. Clinicians should focus on untreated patients and seek to understand the reasons for their lack of treatment.

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Classification of congenital nasal deformities: a proposal to amend the existing classification

Abstract

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Rhinophototherapy in persistent allergic rhinitis

Abstract

Previous published results have revealed that Rhinolight^® intranasal phototherapy is safe and effective in intermittent allergic rhinitis. The present objective was to assess whether phototherapy is also safe and effective in persistent allergic rhinitis. Thirty-four patients with persistent allergic rhinitis were randomized into two groups; twenty-five subjects completed the study. The Rhinolight^® group was treated with a combination of UV-B, UV-A, and high-intensity visible light, while the placebo group received low-intensity visible white light intranasal phototherapy on a total of 13 occasions in 6 weeks. The assessment was based on the diary of symptoms, nasal inspiratory peak flow, quantitative smell threshold, mucociliary transport function, and ICAM-1 expression of the epithelial cells. All nasal symptom scores and nasal inspiratory peak flow measurements improved significantly in the Rhinolight^® group relative to the placebo group and this finding persisted after 4 weeks of follow-up. The smell and mucociliary functions did not change significantly in either group. The number of ICAM-1 positive cells decreased non-significantly in the Rhinolight^® group. No severe side-effects were reported during the treatment period. These results suggest that Rhinolight^® treatment is safe and effective in persistent allergic rhinitis.

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The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility

Abstract

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Laser tracheobronchoplasty: a novel technique for the treatment of symptomatic tracheobronchomalacia

Abstract

The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years. Symptoms included severe dyspnea, dry cough, recurrent pulmonary infections, and respiratory failure. Fifty percent of patients presented with wheezing refractory to traditional treatment. Tracheobronchomalacia was associated with gastroesophageal reflux disease (n = 8), obstructive sleep apnea (n = 5), and tracheal stenosis (n = 3). Only 50 % of patients presented with morbid obesity. All cases showed significant improvement of their respiratory symptoms with a mean postoperative difference of 22.3 out of a maximum impairment score of 40 (P < 0.01) on the Dyspnea Index. The mean number of procedures was 2.3 per patient with the average laser energy delivered per procedure of 1600 J. Laser tracheobronchoplasty is a safe, easy to adopt, and effective technique for the treatment of membranous tracheobronchomalacia. It presents a simple alternative to the commonly used procedures like endoluminal stenting and open tracheobronchoplasty.

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Reply to the letter ‘Linguistic validation of the “FACE-Q Rhinoplasty Module” in Italian’

http://ift.tt/2l62A7E

Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions

Abstract

http://ift.tt/2leKiDV

Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods

Abstract

http://ift.tt/2l5TU1c

Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful?

Abstract

http://ift.tt/2leLTcE

Associations between the probabilities of frequency-specific hearing loss and unaided APHAB scores

Abstract

http://ift.tt/2l5TRT4

Incidence of IP and risk of malignant transformation in the Swedish population 1960–2010

Abstract

http://ift.tt/2lerR20

Untreated head and neck cancer in Korea: a national cohort study

Abstract

http://ift.tt/2leLQO0

Rhinophototherapy in persistent allergic rhinitis

Abstract

http://ift.tt/2l622Ps

Laser tracheobronchoplasty: a novel technique for the treatment of symptomatic tracheobronchomalacia

Abstract

http://ift.tt/2leNS0H

Allergic asthmatic subjects have elevated levels of IgE+B-cells in the airways

http://ift.tt/2l6OvXV

The histopathology of cutaneous polyarteritis nodosa and its relationship with lymphocytic thrombophilic arteritis

http://ift.tt/2kRkc8Q

Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow

Publication date: Available online 30 January 2017
Source:Brachytherapy
Author(s): P. Blanchard, C. Ménard, S.J. Frank
MRI produces better soft tissue contrast than does ultrasonography or computed tomography for visualizing male pelvic anatomy and prostate cancer. Better visualization of the tumor and organs at risk could allow better conformation of the dose to the target volumes while at the same time minimizing the dose to critical structures and the associated toxicity. Although the use of MRI for prostate brachytherapy would theoretically result in an improved therapeutic ratio, its implementation been slow, mostly because of technical challenges. In this review, we describe the potential role of MRI at different steps in the treatment workflow for prostate brachytherapy: for patient selection, treatment planning, in the operating room, or for postimplant assessment. We further present the current clinical experience with MRI-guided prostate brachytherapy, both for permanent seed implantation and high–dose-rate brachytherapy.

http://ift.tt/2l6ToA6

Risk factors for secondary post-tonsillectomy haemorrhage following tonsillectomy with bipolar scissors: four-year retrospective cohort study.

Risk factors for secondary post-tonsillectomy haemorrhage following tonsillectomy with bipolar scissors: four-year retrospective cohort study.

J Laryngol Otol. 2017 Feb;131(2):155-161

Authors: Harju T, Numminen J

Abstract
OBJECTIVE: To analyse risk factors associated with secondary post-operative bleeding when only one technique, namely bipolar scissors, is used.
METHODS: The medical records of all consecutive patients aged six years or older who underwent tonsillectomy or adenotonsillectomy between 1 December 2010 and 30 November 2014 were retrospectively analysed.
RESULTS: A total of 1734 patients were included in the study. A secondary haemorrhage occurred in 208 patients (12 per cent). Patients aged 15 years or older were 4.5 times (95 per cent confidence interval = 2.6-7.9; p < 0.001) more likely to experience secondary haemorrhage. In cases of acute quinsy, patients aged 15 years or older had an 8.1-fold (95 per cent confidence interval = 1.1-59.6; p = 0.02) increased likelihood of experiencing secondary haemorrhage.
CONCLUSION: Patients aged 15 years or older have a higher risk for bleeding regardless of the primary indication for the tonsillectomy. The risk for secondary haemorrhage does not seem to depend on the primary indication itself.

PMID: 28031063 [PubMed - indexed for MEDLINE]

http://ift.tt/2ioVmwH

Iranian Voice Quality of Life Profile (IVQLP): Factor Analysis.

Iranian Voice Quality of Life Profile (IVQLP): Factor Analysis.

J Voice. 2017 Feb 09;:

Authors: Dehqan A, Yadegari F, Scherer RC, Asgari A, Dabirmoghadam P

Abstract
OBJECTIVES: An important domain in health-related quality of life evaluations is quality of life perceptions due to having a voice disorder. The objective of this study was to examine the factor structure of the Iranian Voice Quality of Life Profile (IVQLP) based on Exploratory Factor Analysis and confirmatory factor analysis.
METHODS: The study sample consisted of 280 patients (174 males and 106 females) diagnosed with MTD, benign organic disorders such as polyps and nodules, and unilateral vocal fold paralysis and cancer. To evaluate the different dimensions of the IVQLP, a principal component analysis (PCA) was conducted. Confirmatory factor analysis (CFA) was used to investigate the fitting of extracted dimensions and construct validity of the IVQLP.
RESULTS: The results showed that the IVQLP has a 4-factor structure. The first factor has 17 items and refers to Emotions. The second factor has 12 items and refers to Individual/Social Relations. The third factor with 6 items refers to Occupation, and the forth with 5 items relates to Psychosomatic characteristics.
CONCLUSIONS: The conclusion of this study is that the concept of quality of life in Iranian patients with voice disorders is somewhat different from that of Western patients. This difference can be seen in. the large number of items related to an Emotional factor and the identification of a Psychosomatic factor.

PMID: 28190663 [PubMed - as supplied by publisher]

http://ift.tt/2leRBuK

A novel missense mutation in the SLC26A4 gene causes nonsyndromic hearing loss and enlarged vestibular aqueduct

We aimed to investigate the genetic causes of hearing loss in a Chinese proband with nonsyndromic hearing loss and enlarged vestibular aqueduct syndrome.

http://ift.tt/2lOCbL5

Refractory sleep-disordered breathing due to unilateral lingual tonsillar hypertrophy in a child with Proteus Syndrome

Proteus Syndrome (PS) is a rare congenital overgrowth disease affecting bones, skin, adipose and the central nervous system. The result is asymmetric, disfiguring hypertrophy which can manifest as craniofacial dysmorphia and aerodigestive tract abnormalities. We report the case of obstructive lingual tonsillar hypertrophy resulting in residual sleep disordered breathing after adenotonsillectomy in a child with PS, a previously unrecognized manifestation of the disease. Endoscopic treatment with coblation effectively and safely treated the obstructive symptoms.

http://ift.tt/2lJcgbF

Pediatric post-tonsillectomy hemorrhage in the setting of post-transplantation immunosuppression

Long-term immunosuppressants form an integral part of therapy for post-transplantation patients. Immunosuppressants may also have an anticoagulant effect, and little is known about their effects on bleeding risk after adenotonsillectomy. Our objective was to investigate whether there is an increased observed rate of post-tonsillectomy hemorrhage in a population of pediatric patients on long-term immunosuppressants after solid organ transplantation, compared to healthy controls.

http://ift.tt/2lOCd5y

Teratoma of the Neonatal Head and Neck: A 41-Year Experience

To review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population.

http://ift.tt/2lO4ny8

Cystic cervical teratoma: A diagnostic and management challenge

Cervical teratomas are relatively rare congenital tumors pathologically defined by their three germ cell layer composition. Classically they manifest as solid or mixed solid-cystic lesions. Purely cystic teratomas pose a diagnostic challenge due to their clinical and radiologic similarity to lymphatic vascular malformations. Sclerotherapy, rather than operative excision, may be offered as therapy. We present an unusual cystic neck mass to highlight this dilemma.

http://ift.tt/2lO5pKP

Retrieval of tracheobronchial foreign bodies by short flexible endoscopy in children

Flexible endoscopy (FE) is frequently used to diagnose tracheobronchial foreign bodies (TBFB). However, it is still controversial for retrieval of TBFB in pediatric field. This study aims at reporting and evaluating our experiences of using short-length FE with a non-invasive ventilation (NIV) technique and intensive care unit (ICU) support in retrieving pediatric TBFB.

http://ift.tt/2kosTsU

Update on Biomarkers to Predict Responders to Allergen Immunotherapy

Opinion statement

Most investigations aiming to identify biomarkers (BMKs) have focused on immunological changes reflecting our understanding of allergen-specific immunotherapy (AIT) mechanisms of action. The upregulation of allergen-specific regulatory CD4⁺ T cells, the downregulation or anergy of Th2 cells, the induction of specific "blocking" IgG4s, and the decrease of basophil activation are all thought to contribute to AIT efficacy. To this date, however, none of these immunological alterations can be used to predict AIT efficacy. Changes in the blood at the level of dendritic cells (DCs) reflecting the induction of regulatory DCs concomitantly with a downregulation of pro-allergic DC2s are the only parameters which have been correlated at an individual patient level with AIT efficacy. In this context, the search for BMKs should be extended beyond currently existing boundaries.

To this aim, the combined use of "Omics" technologies, encompassing comprehensive genome, transcriptome and proteome-wide analyses, is being implemented to compare biological samples obtained from clinical responders and non-responders. Such a non-hypothesis driven approach, referred to as the "panorOmic" view, will lead to the discovery of completely novel molecules. In order to predict the patient's specific response to AIT, future BMKs will likely emerge as algorithms combining information on the patient's disease, as well as his/her immune status and exposome.

http://ift.tt/2li2mMQ

Does selective pleural irradiation of malignant pleural mesothelioma allow radiation dose escalation?

Abstract

Background

After lung-sparing radiotherapy for malignant pleural mesothelioma (MPM), local failure at sites of previous gross disease represents the dominant form of failure. Our aim is to investigate if selective irradiation of the gross pleural disease only can allow dose escalation.

Materials and methods

In all, 12 consecutive stage I–IV MPM patients (6 left-sided and 6 right-sided) were retrospectively identified and included. A magnetic resonance imaging-based pleural gross tumor volume (GTV) was contoured. Two sets of planning target volumes (PTV) were generated for each patient: (1) a "selective" PTV (S-PTV), originating from a 5-mm isotropic expansion from the GTV and (2) an "elective" PTV (E-PTV), originating from a 5-mm isotropic expansion from the whole ipsilateral pleural space. Two sets of volumetric modulated arc therapy (VMAT) treatment plans were generated: a "selective" pleural irradiation plan (SPI plan) and an "elective" pleural irradiation plan (EPI plan, planned with a simultaneous integrated boost technique [SIB]).

Results

In the SPI plans, the average median dose to the S‑PTV was 53.6 Gy (range 41–63.6 Gy). In 4 of 12 patients, it was possible to escalate the dose to the S‑PTV to >58 Gy. In the EPI plans, the average median doses to the E‑PTV and to the S‑PTV were 48.6 Gy (range 38.5–58.7) and 49 Gy (range 38.6–59.5 Gy), respectively. No significant dose escalation was achievable.

Conclusion

The omission of the elective irradiation of the whole ipsilateral pleural space allowed dose escalation from 49 Gy to more than 58 Gy in 4 of 12 chemonaive MPM patients. This strategy may form the basis for nonsurgical radical combined modality treatment of MPM.

http://ift.tt/2kvMFxL

Prefraction displacement and intrafraction drift of the prostate due to perineal ultrasound probe pressure

Abstract

Objective

In image-guided EBRT of the prostate, transperineal ultrasound (US) probes exert pressure on the perineum both during planning and treatment. Through tissue deformation and relaxation, this causes target and risk organ displacement and drift. In this study, prefraction shift and intrafraction drift of the prostate are quantified during robotic transperineal 4DUS.

Methods

The position of the prostate was recorded for different positions of the probe before treatment in 10 patients (16 series of measurements). During treatment (15 patients, 273 fractions), intrafraction motion of the prostate was tracked (total of 27 h and 24 min) with the transperineal probe in place.

Results

Per 1 mm shift of the US probe in the cranial direction, a displacement of the prostate by 0.42 ± 0.09 mm in the cranial direction was detected. The relationship was found to be linear (R² = 0.97) and highly significant (p < 0.0001). After initial contact of the probe and the perineum (no pressure), a shift of the probe of about 5–10 mm was typically necessary to achieve good image quality, corresponding to a shift of the prostate of about 2–4 mm in the cranial direction. Tissue compression and prostate displacement were well visible. During treatment, the prostate drifted at an average rate of 0.075 mm/min in the cranial direction (p = 0.0014).

Conclusion

The pressure applied by a perineal US probe has a quantitatively similar impact on prostate displacement as transabdominal pressure. Shifts are predominantly in the cranial direction (typically 2–4 mm) with some component in the anterior direction (typically <1 mm). Slight probe pressure can improve image quality, but excessive probe pressure can distort the surrounding anatomy and potentially move risk organs closer to the high-dose area.

http://ift.tt/2li48xy

Temozolomide during radiotherapy of glioblastoma multiforme

Abstract

Background

Temozolomide-(TMZ)-based chemoradiotherapy defines the current gold standard for the treatment of newly diagnosed glioblastoma. Data regarding the influence of TMZ dose density during chemoradiotherapy are currently not available. We retrospectively compared outcomes in patients receiving no TMZ, TMZ during radiotherapy on radiotherapy days only, and TMZ constantly 7 days a week.

Patients and methods

From 2002–2012, a total of 432 patients with newly diagnosed glioblastoma received radiotherapy in our department: 118 patients had radiotherapy alone, 210 had chemoradiotherapy with TMZ (75 mg/m²) daily (7/7), and 104 with TMZ only on radiotherapy days (5/7). Radiotherapy was applied to a total dose of 60 Gy.

Results

Median survival after radiotherapy alone was 9.1 months, compared to 12.6 months with 5/7-TMZ and to 15.7 months with 7/7-TMZ. The 1‑year survival rates were 33, 52, and 64%, respectively. Kaplan–Meier analysis showed a significant improvement of TMZ-7/7 vs. 5/7 (p = 0.01 by the log-rank test), while 5/7-TMZ was still superior to no TMZ at all (p = 0.02). Multivariate Cox regression showed a significant influence of TMZ regimen (p = 0.009) on hazard rate (+58% between groups) even in the presence of confounding factors age, sex, resection status, and radiotherapy dose concept.

Conclusion

Our results confirm the findings of the EORTC/NCIC trial. It seems that also a reduced TMZ scheme can at first prolong the survival of glioblastoma patients, but not as much as the daily administration.

http://ift.tt/2kvWo7h

Oncogenic growth factor signaling mediating tumor escape from cellular immunity

Publication date: April 2017
Source:Current Opinion in Immunology, Volume 45
Author(s): Fernando Concha-Benavente, Robert L Ferris
Unrestrained growth factor signals can promote carcinogenesis, as well as other hallmarks of cancer such as immune evasion. Our understanding of the function and complex regulation of HER family of receptors has led to the development of targeted therapeutic agents that suppress tumor growth. However, these receptors also mediate escape from recognition by the host immune system. We discuss how HER family of oncogenic receptors downregulate tumor antigen presentation and upregulate suppressive membrane-bound or soluble secreted inhibitory molecules that ultimately lead to impaired cellular immunity mediated by cytotoxic T lymphocyte (CTL) recognition. Implementing this knowledge into new therapeutic strategies to enhance tumor immunogenicity may restore effector cell mediated immune clearance of tumors and clinical efficacy of tumor-targeted immunotherapy against HER receptor overexpression.

http://ift.tt/2lJ4sGJ

Perceptions and Practices regarding Women's Vaginal Health following Radiation Therapy: A Survey of Radiation Oncologists Practicing in the USA

Publication date: Available online 14 February 2017
Source:Practical Radiation Oncology
Author(s): L.A. Kachnic, D.W. Bruner, M.M. Qureshi, G.A. Russo
Purpose/ObjectivesVaginal stenosis (VS) is a recognized complication of pelvic and vaginal radiation therapy (RT).Materials/MethodsA 26-item survey assessing the signs/symptoms, risk factors, diagnosis, prevention, treatment and impact of VS on women's sexual health was distributed. Descriptive statistics were calculated. Chi-square tests examined differences in categorical responses.Results233 (10.5%) completed the entire survey. Twelve%, 21%, and 68% report treating only gynecologic (GYN) tumors, only non-GYN pelvic tumors, or both, respectively. Regarding risk factors, 78% feel that VS can be caused by pelvic RT alone, 91% by vaginal brachytherapy (VB) alone, and 98% by combined pelvic RT and VB. Approximately half of respondents felt that being post-menopausal and having a hysterectomy prior to radiation therapy were risk factors for VS, while the other half felt that these were not risk factors. All respondents agree that VS is a clinical diagnosis. Reported VS symptoms include dyspareunia, vaginal pain, dryness, and/or bleeding (100%, 90%, 85% and 72%, respectively); 65% indicate all four. The most commonly recommended treatment for VS is vaginal dilator (VD) use Radiation oncologists who treat only GYN vs. non-GYN cancers are more likely to perform a vaginal exam, to distribute written instructions regarding VD use (p=0.002), to have vaginal bleeding reported after RT (p=0.001), and to refer patients to a sexual counselor (p=0.007). Most providers (73%) expressed willingness to participate in prospective research on the diagnosis and treatment of VS.ConclusionsThis is the first large-scale survey of radiation oncologists' perceptions and practices regarding VS. There is agreement among providers regarding the signs/symptoms of VS, and strategies for the prevention/treatment using vaginal dilators. Further prospective and observational research is needed. This survey shows a willingness on the part of providers to take part in prospective research regarding the diagnosis, impact, and treatment of VS on women's sexual health.

http://ift.tt/2kopz0K

Corrigendum to “Chondroitin sulfate is involved in the hypercalcification of the organic matrix of bovine peritubular dentin” [Archives of Oral Biology 62 (2016) 93–100]

Publication date: April 2017
Source:Archives of Oral Biology, Volume 76
Author(s): Jason R. Dorvee, Lauren Gerkowicz, Sara Bahmanyar, Alix Deymier-Black, Arthur Veis

http://ift.tt/2lfCDVW

Aims & Scope/Editorial board

Publication date: April 2017
Source:Archives of Oral Biology, Volume 76

http://ift.tt/2kIjJ6J

Review of flavonoids: A diverse group of natural compounds with anti-Candida albicans activity in vitro

1-s2.0-S0003996917X00022-cov150h.gif

Publication date: April 2017
Source:Archives of Oral Biology, Volume 76
Author(s): Dalia Seleem, Vanessa Pardi, Ramiro Mendonça Murata
Flavonoids are a subdivision of polyphenols, a versatile class of natural compounds that represent secondary metabolites from higher plants and are abundant in human diet. Various protective effects of flavonoids have been reported, including antimicrobial and antifungal activities. Due to the nature of oral candidiasis and the increased use of antifungal agents, several drug-resistant strains have emerged making it impractical to rely on one standard therapeutic regime. The aim of this review is to summarize the antifungal activity of some examples of the major subclasses of flavonoids in pure extract forms against C. albicans in vitro, as reported in literature over the past 10 years (2004–2015). In addition, this review outlines the potential mechanism of actions of flavonoids studied in vitro, which may contribute to a better understanding of flavonoids as multi-targets agents in the treatment and/or prevention of oral candidiasis in clinical settings.

http://ift.tt/2lfrtjL

Breathing parameters associated to two different external nasal dilator strips in endurance athletes

Publication date: Available online 30 January 2017
Source:Auris Nasus Larynx
Author(s): Giancarlo Ottaviano, Andrea Ermolao, Ennio Nardello, Flavio Muci, Vittorio Favero, Marco Zaccaria, Lorenzo Favero
ObjectiveThe aim of the study was to investigate and compare the effects of two different external nasal dilator strips (ENDS) on nasal respiratory flow, maximal oxygen uptake (VO2max), nasal VO2max, time to exhaustion and subjective nasal obstruction in adult triathletes participating in exhaustive, controlled physical exercise tests.MethodsThirteen healthy triathletes without nasal symptoms were recruited and randomly tested in three different conditions: without ENDS, wearing the Breathe Right^® dilator strip and wearing the Master-aid Roll-flex^® strip. We investigated the variations in the peak nasal inspiratory flow (PNIF) and the Nasal Obstruction Symptom Evaluation questionnaire before and after an exhaustive treadmill test. VO2max, nasal VO2max, time to exhaustion, total time of nasal respiration values were also registered and compared.ResultsPost-exercise PNIF was higher than the pre-exercise PNIF. Pre-exercise PNIF was higher in athletes wearing the Master-aid Roll-Flex^® than in those wearing the Breathe Right^® strips; no differences in post-exercise PNIF values were found in the three different conditions. Nasal VO2max value was higher when both types of ENDS were worn. Nasal respiration time to exhaustion was longer when the athletes were wearing either type of ENDS. Both ENDS gave a better sensation of nasal airflow passage after physical exercise.ConclusionENDS had similar effects, improving the subjective sensation of nasal patency, the nasal respiration time, and the nasal VO2max, anyway Master-aid Roll-flex^® is more economic than the Breathe Right^® and it can be cut to fit the nasal anatomy.As ENDS affect the cross-sectional area, especially at the level of the nasal valve, in future studies should be conducted also by means of acoustic rhinometry in order to evaluate if any difference could be find at this level when wearing either one of the two ENDS.

http://ift.tt/2kvJ2b4

Coronary Artery Stent Evaluation with Model-based Iterative Reconstruction at Coronary CT Angiography

Publication date: Available online 14 February 2017
Source:Academic Radiology
Author(s): Fuminari Tatsugami, Toru Higaki, Hiroaki Sakane, Wataru Fukumoto, Yoko Kaichi, Makoto Iida, Yasutaka Baba, Masao Kiguchi, Yasuki Kihara, So Tsushima, Kazuo Awai
Rationale and ObjectivesThis study aims to compare the image quality of coronary artery stent scans on computed tomography images reconstructed with forward projected model-based iterative reconstruction solution (FIRST) and adaptive iterative dose reduction 3D (AIDR 3D).Materials and MethodsCoronary computed tomography angiography scans of 23 patients with 32 coronary stents were used. The images were reconstructed with AIDR 3D and FIRST. We generated computed tomography attenuation profiles across the stents and measured the width of the edge rise distance and the edge rise slope (ERS). We also calculated the stent lumen attenuation increase ratio (SAIR) and measured visible stent lumen diameters. Two radiologists visually evaluated the image quality of the stents using a 4-point scale (1 = poor, 4 = excellent).ResultsThere was no significant difference in the edge rise distance between the two reconstruction methods (P = 0.36). The ERS on FIRST images was greater than the ERS on AIDR 3D images (325.2 HU/mm vs 224.4 HU/mm; P < 0.01). The rate of the visible stent lumen diameter compared to the true diameter on FIRST images was higher than that on AIDR 3D images (51.4% vs 47.3%, P < 0.01). The SAIR on FIRST images was lower than the SAIR on AIDR 3D images (0.19 vs 0.30, P < 0.01). The mean image quality scores for AIDR 3D and FIRST images were 3.18 and 3.63, respectively; the difference was also significant (P < 0.01).ConclusionThe image quality of coronary artery stent scans is better on FIRST than on AIDR 3D images.

http://ift.tt/2lfvrZS

Automated Breast Density Computation in Digital Mammography and Digital Breast Tomosynthesis

Publication date: Available online 14 February 2017
Source:Academic Radiology
Author(s): Maria Castillo-García, Margarita Chevalier, Julia Garayoa, Alejandro Rodriguez-Ruiz, Diego García-Pinto, Julio Valverde
Rationale and ObjectivesThe study aimed to compare the breast density estimates from two algorithms on full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) and to analyze the clinical implications.Materials and MethodsWe selected 561 FFDM and DBT examinations from patients without breast pathologies. Two versions of a commercial software (Quantra 2D and Quantra 3D) calculated the volumetric breast density automatically in FFDM and DBT, respectively. Other parameters such as area breast density and total breast volume were evaluated. We compared the results from both algorithms using the Mann-Whitney U non-parametric test and the Spearman's rank coefficient for data correlation analysis. Mean glandular dose (MGD) was calculated following the methodology proposed by Dance et al.ResultsMeasurements with both algorithms are well correlated (r ≥ 0.77). However, there are statistically significant differences between the medians (P < 0.05) of most parameters. The volumetric and area breast density median values from FFDM are, respectively, 8% and 77% higher than DBT estimations. Both algorithms classify 35% and 55% of breasts into BIRADS (Breast Imaging-Reporting and Data System) b and c categories, respectively. There are no significant differences between the MGD calculated using the breast density from each algorithm. DBT delivers higher MGD than FFDM, with a lower difference (5%) for breasts in the BIRADS d category. MGD is, on average, 6% higher than values obtained with the breast glandularity proposed by Dance et al.ConclusionsBreast density measurements from both algorithms lead to equivalent BIRADS classification and MGD values, hence showing no difference in clinical outcomes. The median MGD values of FFDM and DBT examinations are similar for dense breasts (BIRADS d category).

http://ift.tt/2kvLNsJ

Impact of Filling Gas on Subharmonic Emissions of Phospholipid Ultrasound Contrast Agents

Publication date: Available online 14 February 2017
Source:Ultrasound in Medicine & Biology
Author(s): Emma Kanbar, Damien Fouan, Charles A. Sennoga, Alexander A. Doinikov, Ayache Bouakaz
Subharmonic signals backscattered from gas-filled lipid-shelled microbubbles have generated significant research interest because they can improve the detection and sensitivity of contrast-enhanced ultrasound imaging. However, the emission of subharmonic signals is strongly characterized by a temporal dependence, the origins of which have not been sufficiently elucidated. The features that influence subharmonic emissions need to be identified not only to better develop next-generation microbubble contrast agents, but also to develop more efficient subharmonic imaging (SHI) modes and therapeutic strategies. We examined the effect of microbubble filling gas on subharmonic emissions. Phospholipid shelled-microbubbles with different gaseous compositions such as sulfur hexafluoride (SF6), octafluoropropane (C3F8) or decafluorobutane (C4F10), nitrogen (N2)/C4F10 or air were insonated using a driving frequency of 10 MHz and peak negative pressure of 450 kPa, and their acoustic responses were tracked by monitoring both second harmonic and subharmonic emissions. Microbubbles were first acoustically characterized with their original gas and then re-characterized after substitution of the original gas with air, SF6 or C4F10. A measureable change in intensity of the subharmonic emissions with a 20- to 40-min delayed onset and increasing subharmonic emissions of the order 12–18 dB was recorded for microbubbles filled with C4F10. Substitution of C4F10 with air eliminated the earlier observed delay in subharmonic emissions. Significantly, substitution of SF6 for C4F10 successfully triggered a delay in the subharmonic emissions of the resultant agents, whereas substitution of C4F10 for SF6 eliminated the earlier observed suppression of subharmonic emissions, clearly suggesting that the type of filling gas contained in the microbubble agent influences subharmonic emissions in a time-dependent manner. Because our agents were dispersed in air-stabilized phosphate-buffered saline, these results suggest that the diffusivity of the gas from the agent to the surrounding medium is correlated with the time-dependent evolution of subharmonic emissions.

http://ift.tt/2koqLkN

Holistic Processing of Static and Moving Faces.

Author: Zhao, Mintao; Bulthoff, Isabelle

DOI: 10.1037/xlm0000368

Publication Date: POST AUTHOR CORRECTIONS, 13 February 2017

http://ift.tt/2kvE4Lz

Rule-Based Reasoning Is Fast and Belief-Based Reasoning Can Be Slow: Challenging Current Explanations of Belief-Bias and Base-Rate Neglect.

Author: Newman, Ian R.; Gibb, Maia; Thompson, Valerie A.

DOI: 10.1037/xlm0000372

Publication Date: POST AUTHOR CORRECTIONS, 13 February 2017

http://ift.tt/2lhVgIo

Metformin and thyroid disease

An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studies in vitro and in vivo have demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF-1 and mTOR pathways. Besides, metformin treatment was associated with a decrease in the levels of serum thyroid stimulating hormone (TSH) in diabetic patients possibly by enhancing the effects of thyroid hormones in the pituitary and activating the adenosine monophosphate-activated protein kinase (AMPK). Based on these evidences, metformin appears to be a promising therapeutic tool in patients with thyroid disease. More clinical studies are necessary to evaluate the clinical significance of metformin for the treatment of thyroid diseases.

http://ift.tt/2lIRUPG

It's Out of My Hands! Grasping Capacity May Not Influence Perceived Object Size.

Author: Collier, Elizabeth S.; Lawson, Rebecca

DOI: 10.1037/xhp0000331

Publication Date: POST AUTHOR CORRECTIONS, 13 February 2017

http://ift.tt/2lfkl79

Histological and immunohistochemical characteristics of undifferentiated small round cell sarcomas associated with CIC-DUX4 and BCOR-CCNB3 fusion genes

Abstract

CIC-DUX4 and BCOR-CCNB3 fusion-gene-associated small round cell sarcomas account for a proportion of pediatric small round cell sarcomas, but their pathological features have not been sufficiently clarified. We reviewed a large number of soft tissue tumors registered at our institution, retrieved the cases of unclassified tumors with a small round cell component, and subjected them to histopathological, immunohistochemical, and gene profile analysis. We reviewed 164 cases of unclassified tumors with a small round cell component and analyzed them by RT-PCR and FISH. Tumors positive for a specific fusion-gene were also subjected to histopathological and immunohistochemical examinations. We identified 16 cases of BCOR-CCNB3/CIC-associated (CIC-DUX4 or CIC gene rearrangement-positive) sarcomas. These included seven BCOR-CCNB3 sarcomas and nine CIC-associated sarcomas. Heterogeneous elements included a myxoid spindle cell component in three BCOR-CCNB3 sarcomas and an epithelioid cell component in two CIC-associated sarcomas (one CIC-DUX4-positive and one CIC-DUX4-negative sarcomas). Mitotic activity was low in both heterogeneous components. By immunohistochemistry, in seven BCOR-CCNB3 sarcomas expression of EMA was positive in two cases, of p63 in three, of CD56 in six, of TLE1 in seven, of NKX2.2 in two, of CCNB3 in seven, and of BCOR in six cases (one case could not be tested for BCOR). In nine cases of CIC-associated sarcoma, CD56 was expressed in five, alpha-smooth muscle actin in one, ERG in three, and CD99, WT1 and TLE1 each in eight cases. Both sarcoma types showed not only a small round cell component, but also a myxoid/epithelioid component with low mitotic activity.

http://ift.tt/2kojktX

Prevalence of minimal hearing loss in South Korea

by Ji Eun Choi, Jungmin Ahn, Hyun Woo Park, Sun-Young Baek, Seonwoo Kim, Il Joon Moon

This study evaluated the prevalence of minimal hearing loss (MHL) in South Korea based on the 2010 to 2012 Korea National Health and Nutrition Examination Survey. A total of 16,630 representative individuals (older than 12 years) who completed ear examinations and structured questionnaires were analyzed. Only participants who had normal tympanic membranes were included. MHL was categorized into the following three groups: 1) unilateral sensorineural hearing loss (USHL, pure-tone average (PTA) ≥ 15 dB in the affected ear), 2) bilateral sensorineural hearing loss (BSHL, 15 dB ≤ PTA 25 dB in either ear). To evaluate clinical symptoms, subjective hearing status, tinnitus, and quality of life of each MHL group were compared to those of normal-hearing listeners. The use of hearing aids (HAs) was also investigated in the MHL population. The prevalence of normal hearing and MHL were 58.4% and 37.4%, respectively. In univariate analyses, the prevalence of MHL increased with age. It was significantly increased in males. Regarding clinical symptoms, 13.0% and 92.1% of participants with MHL reported difficulties with hearing and annoying tinnitus, respectively. In multivariate analyses, these proportions were significantly higher in the MHL groups than in normal-hearing listeners. Participants with MHL also showed significantly lower Euro Qol-5D index scores than did normal-hearing listeners. Regarding hearing rehabilitation, among minimally hearing impaired participants with subjective hearing loss, only 0.47% of individuals used HAs. Our results reveal that MHL is common in South Korea. It is associated with significant subjective hearing loss, tinnitus, and poor quality of life. Therefore, clinicians need to pay attention to this special group and provide proper counselling and rehabilitative management.

http://ift.tt/2lMWdFq

The alpha-herpesviridae in dermatology

Abstract

This review on herpes simplex virus type I and type II (HSV‑I, HSV‑II) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSV‑I infection; HSV-related folliculitis; verrucous HSV‑I and HSV‑II lesions; the role of recurrent HSV‑I infection in burning mouth syndrome; HSV‑I and HSV‑II infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSV‑I or HSV‑II are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSV‑I and anti-HSV‑II agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSV‑I and HSV‑II infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.

http://ift.tt/2lOeP8l

Alpha-Herpesviridae in der Dermatologie

Zusammenfassung

In der vorliegenden Übersichtsarbeit zum Herpes-simplex-Virus Typ I und II (HSV-I, HSV-II) werden aktuelle Entwicklungen in Bezug auf klinische Symptome, Behandlungsmaßnahmen bei primärem und rezidivierendem Lippen- und Genitalherpes sowie Fragen zur Impfung zusammengefasst. Hinsichtlich der klinischen Manifestationen werden der Zusammenhang zwischen pyogenem Granulom und chronischer HSV-I-Infektion, die HSV-bedingte Follikulitis, verruköse HSV-I- und HSV-II-Läsionen, die Rolle der rezidivierenden HSV-I-Infektion beim „burning mouth syndrome", die HSV-I- und HSV-II-Infektion des periareolären Bereichs, die zosteriforme HSV-Infektion, das „knife-cut sign" (Messerschnittzeichen) und die bevorzugte Kolonisierung und Infektion vorbestehender Dermatosen durch HSV-I oder HSV-II erörtert. Die üblichen antiviralen Therapieschemata bei primärem und rezidivierendem Lippen- und Genitalherpes werden mit den Optionen der Kurzzeit- und der Eintagestherapie verglichen. Zu den neuen Anti-HSV-I- und Anti-HSV-II-Agenzien gehören Amenavir, Pritelivir, Brincidofovir, Valomaciclovir und FV-100. Die therapeutische oder präventive Impfung gegen HSV-I- und HSV-II-Infektionen bleibt ein sehr wünschenswertes Therapieziel, zu dem es bisher leider noch keine klinisch relevanten Anwendungen gibt.

http://ift.tt/2lIDu1N

Alpha-Herpesviridae in der Dermatologie

Zusammenfassung

Der zweite Teil der vorliegenden Übersichtsarbeit befasst sich mit dem Varicella-Zoster-Virus (VZV) und bietet einen Überblick über neue, seltene und atypische klinische Symptome: fotolokalisierte Varizellen (an lichtexponierten Stellen), hämorrhagische Bullae während der Varizelleninfektion, die Bedeutung des VZV bei Immunglobulin-A-Vaskulitis, VZV-bedingte Alopezie, ulcerative Varizellen-Hautläsionen, kindlicher Herpes zoster (HZ), anhaltende Prodromalschmerzen, rezidivierender HZ, Bedeutung des VZV beim „burning mouth syndrome", warzenähnliche VZV-Läsionen, Bedeutung von Satellitenläsionen bei HZ und neurologische oder internistische Spätkomplikationen des HZ. Darüber hinaus werden bestimmte Zusammenhänge zwischen dem Auftreten des HZ und nachfolgenden internistischen Erkrankungen, Risikofaktoren für HZ und neue Entwicklungen bei der Impfung gegen HZ dargestellt.

http://ift.tt/2lOoPOy

The alpha-herpesviridae in dermatology

Abstract

The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.

http://ift.tt/2lIJVCh

Innovative Formen der spezifischen Immuntherapie

Zusammenfassung

Der Erfolg allergenspezifischer Immuntherapie hängt von ihrer toleranzinduzierenden Immunogenität ab und ist derzeit limitiert durch therapieassoziierte unerwünschte Wirkungen. Ein wichtiges Ziel innovativer Therapieansätze ist daher die Verbesserung der Verträglichkeit. Die epikutane Immuntherapie (EPIT), bei der kommerziell verfügbare Extraktpräparate über ein Pflaster auf der Haut appliziert werden, zeichnet sich bei guter klinischer Wirksamkeit durch eine ausgezeichnete Verträglichkeit aus. Erste vielversprechende Ergebnisse mit einer epikutanen Erdnuss-Immuntherapie wurden 2016 publiziert. Die intralymphatische Immuntherapie (ILIT) fällt neben ihrer guten Verträglichkeit durch die ausgeprägte Immunogenität auf, die es, nach den Ergebnissen erster klinischer Studien zu urteilen, erlaubt, mit nur 3 Injektionen einer minimalen Dosis eines etablierten Extraktes eine dauerhafte Immuntoleranz zu erreichen. Den Aspekt der Toleranzinduktion berücksichtigen in besonderem Maße neue Entwicklungen synthetischer Allergievakzine. Diese sind, da rekombinant hergestellt, von reproduzierbarer Qualität und genau definiertem Wirkprofil. Damit soll einerseits eine ausgeprägte Immunogenität der enthaltenen antigenen Determinanten und andererseits ein optimiertes Sicherheitsprofil erreicht werden. Derzeit werden Gräser-, Birken-, Katzen- und Hausstaubmilbenpräparate in unterschiedlichen klinischen Prüfungsphasen evaluiert. Welche Produkte die Marktreife erreichen werden, ist noch unklar. Die Ergebnisse klinischer Studien mit Nahrungsmittelimmuntherapeutika erlauben bis dato aufgrund durchgehend schlechter Verträglichkeit und limitierter Wirksamkeit keine vielversprechende Perspektive.

http://ift.tt/2lOqZ0N

Headspace single drop microextraction versus dispersive liquid-liquid microextraction using magnetic ionic liquid extraction solvents

Publication date: 15 May 2017
Source:Talanta, Volume 167
Author(s): Jiwoo An, Kira L. Rahn, Jared L. Anderson
A headspace single drop microextraction (HS-SDME) method and a dispersive liquid-liquid microextraction (DLLME) method were developed using two tetrachloromanganate ([MnCl4^2-])-based magnetic ionic liquids (MIL) as extraction solvents for the determination of twelve aromatic compounds, including four polyaromatic hydrocarbons, by reversed phase high-performance liquid chromatography (HPLC). The analytical performance of the developed HS-SDME method was compared to the DLLME approach employing the same MILs. In the HS-SDME approach, the magnetic field generated by the magnet was exploited to suspend the MIL solvent from the tip of a rod magnet. The utilization of MILs in HS-SDME resulted in a highly stable microdroplet under elevated temperatures and long extraction times, overcoming a common challenge encountered in traditional SDME approaches of droplet instability. The low UV absorbance of the [MnCl4^2-]-based MILs permitted direct analysis of the analyte enriched extraction solvent by HPLC. In HS-SDME, the effects of ionic strength of the sample solution, temperature of the extraction system, extraction time, stir rate, and headspace volume on extraction efficiencies were examined. Coefficients of determination (R²) ranged from 0.994 to 0.999 and limits of detection (LODs) varied from 0.04 to 1.0μgL⁻¹ with relative recoveries from lake water ranging from 70.2% to 109.6%. For the DLLME method, parameters including disperser solvent type and volume, ionic strength of the sample solution, mass of extraction solvent, and extraction time were studied and optimized. Coefficients of determination for the DLLME method varied from 0.997 to 0.999 with LODs ranging from 0.05 to 1.0μgL⁻¹. Relative recoveries from lake water samples ranged from 68.7% to 104.5%. Overall, the DLLME approach permitted faster extraction times and higher enrichment factors for analytes with low vapor pressure whereas the HS-SDME approach exhibited better extraction efficiencies for analytes with relatively higher vapor pressure.

Graphical abstract

http://ift.tt/2lhKBx9

High sensitive detection of penicillin G residues in milk by surface-enhanced Raman scattering

Publication date: 15 May 2017
Source:Talanta, Volume 167
Author(s): Yongliang Chen, Xiuling Li, Ming Yang, Libin Yang, Xiaoxia Han, Xin Jiang, Bing Zhao
The antibiotic residue in animal source foods (milk, meat, etc.) is threatening people's health due to its abusing in livestock breeding more and more seriously. In this study, a simple and sensitive SERS method coupled with a two-step pretreatment process of sample was proposed for the residue detection of penicillin G (PENG) in real milk sample. It can be found that the two-step pretreatment process of sample is an essential procedure for the successful detection of PENG residue in milk, which can effectively avoid interference from other components in the sample and achieve the trace-level detection of PENG residue by SERS. Under the optimal test conditions, the limit of detection of PENG residue is 2.54×10⁻⁹mol/L (equal to 0.85μg/kg), which is lower than the standard of the European Union (4μg/kg). And, there is a good linear relationship (R²=0.9902) in the concentration range of 1.0×10⁻⁸~1.0×10⁻³mol/L. By this method, the recovery of PENG residue ranges from 76% to 97% with relative standard deviation between 4.8% and 2.1%. The proposed SERS method can be effectively applied for determination of PENG residue in milk.

Graphical abstract

http://ift.tt/2lhRAWX

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τρίτη 14 Φεβρουαρίου 2017

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