Head and Neck Diseases by Alexandros G.Sfakianakis: 03/28/17

Τρίτη 28 Μαρτίου 2017

Systematic review and meta-analysis of venous thromboembolism in otolaryngology–head and neck surgery

Abstract

Background

The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology–head and neck surgery (OHNS).

Methods

PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups.

Results

A total of 23 studies were included with a total of 618,264 patients. Incidence of VTE was 0.4%. The incidence of bleeding complications was 0.9%. The addition of chemoprophylaxis did not result in a decreased VTE incidence (odds ratio [OR], 0.86), but produced an increased risk of bleeding (OR, 3.78). The overall OR for VTE in SCC/free flap cases was 6.28.

Conclusion

http://ift.tt/2ntWnDW

Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic

Abstract

Background

Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC).

Methods

A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic.

Results

Fifty-two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5-year disease-specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease-specific survival.

Conclusion

http://ift.tt/2o5qZOO

Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection

Abstract

Background

Head and neck Merkel cell carcinoma (MCC) is commonly treated with surgery and adjuvant radiotherapy (RT) for high-risk features. The optimal radiation dose is unknown.

Methods

One thousand six hundred twenty-five eligible patients with head and neck MCC were identified in the National Cancer Data Base (NCDB). Radiation dose was divided into 3 groups: 30 to <50 Gray (Gy), 50-55 Gy, and >55-70 Gy. Cox regression was used to compare overall survival (OS) between groups, accounting for age, sex, stage, surgery type, margin status, comorbidities, and use of chemotherapy.

Results

With a median follow-up of 33.5 months, 3-year OS was 48.9%, 70.3%, and 58.7% for 30 to <50 Gy, 50-55 Gy, and >55-70 Gy, respectively (P < .001). Compared to 50-55 Gy, doses between 30 to <50 Gy (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.17-1.99; P = .002) and >55-70 Gy (adjusted HR 1.21; 95% CI 1.0-1.46; P = .06) were associated with worse survival.

Conclusion

Adjuvant radiation doses within 50-55 Gy may be optimal for head and neck MCC.

http://ift.tt/2ntQKFy

Endocavitary sonography of early oral cavity malignant tumors

Abstract

Background

Preoperative staging is crucial for oral cancer management. The purpose of this study was to assess the tumor thickness using ultrasound and to correlate the level of histological infiltration with the tumor superficial extension and lesion thickness.

Methods

Thirty-two subjects affected by oral cavity carcinoma were prospectively evaluated with intraoral ultrasound. The ultrasound sensitivity, the correlation between the ultrasound level of infiltration, and lesion diameters and thickness were assessed.

Results

A 91% ultrasound sensitivity was found with no significant correlation between tumor diameter and level of histological infiltration (P >.05). A thickness of <2 mm was associated to tumor extension to the lamina propria, a value of >6 mm to muscular layer infiltration. Lymph adenopathies were identified in 21% of cases, associated to muscular layer infiltration in all cases.

Conclusion

In the study of early oral cavity tumors, ultrasound is accurate for demonstrating the level of tumor infiltration and contributes to the therapeutic choice.

http://ift.tt/2o5vrwU

Developing a risk stratification tool for audit of outcome after surgery for head and neck squamous cell carcinoma

Abstract

Background

Patients treated surgically for head and neck squamous cell carcinoma (HNSCC) represent a heterogeneous group. Adjusting for patient case mix and complexity of surgery is essential if reporting outcomes represent surgical performance and quality of care.

Methods

A case note audit totaling 1075 patients receiving 1218 operations done for HNSCC in 4 cancer networks was completed. Logistic regression, decision tree analysis, an artificial neural network, and Naïve Bayes Classifier were used to adjust for patient case-mix using pertinent preoperative variables.

Results

Thirty-day complication rates varied widely (34%-51%; P < .015) between units. The predictive models allowed risk stratification. The artificial neural network demonstrated the best predictive performance (area under the curve [AUC] 0.85).

Conclusion

Early postoperative complications are a measurable outcome that can be used to benchmark surgical performance and quality of care. Surgical outcome reporting in national clinical audits should be taking account of the patient case mix.

http://ift.tt/2ntKLRp

Narrow-band imaging in transoral laser surgery for early glottic cancer in relation to clinical outcome

Abstract

Background

The purpose of this study was to validate the prognostic value of adding narrow-band imaging (NBI) during transoral laser surgery (TLS) for early glottic cancer.

Methods

In 84 patients, 93 transoral laser resections were performed for carcinoma in situ (Tcis), T1, or T2 glottic cancer. TLS was preceded by intraoperative evaluation using traditional white-light imaging (WLI) in 51 cases. In 42 cases, NBI was used in addition to WLI. Local recurrence rate and recurrence-free survival were retrospectively compared between both groups.

Results

Local recurrences developed in 14% of the 93 cases: 12 of 51 patients (24%) were treated by TLS based on WLI alone, and in 1 of 42 patients (2%) in the NBI group (P < .01). Two-year recurrence-free survival was 82% in the WLI group and 98% in the NBI group (P < .05).

Conclusion

Additional use of NBI during TLS for early glottic cancer significantly improves clinical outcome.

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Preoperative vitamin D level as predictor of post-thyroidectomy hypocalcemia in patients sustaining transient parathyroid injury

Abstract

Background

Several studies have sought to identify predictors of postoperative hypocalcemia after total thyroidectomy; however, there have been conflicting results regarding the impact of preoperative vitamin D deficiency.

Methods

The medical records of patients undergoing total thyroidectomy were retrospectively reviewed. The number of parathyroid glands identified or reimplanted at the time of surgery was used as a marker of transient parathyroid gland damage.

Results

Sixty-seven patients were included in the study. Vitamin D deficiency was a significant predictor of hypocalcemia in patients in whom ≥3 parathyroid glands were identified, but not in patients in whom 0-2 parathyroid glands were identified intraoperatively (odds ratio [OR] 5.8; P = .036).

Conclusion

Vitamin D deficiency is a significant predictor of postoperative hypocalcemia in patients in whom ≥3 parathyroid glands are identified intraoperatively, but not in patients who sustain minimal transient damage to the parathyroid glands.

http://ift.tt/2ntOmPg

Systematic review and meta-analysis of venous thromboembolism in otolaryngology–head and neck surgery

Abstract

Background

Methods

Results

Conclusion

http://ift.tt/2ntWnDW

Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic

Abstract

Background

Methods

Results

Conclusion

http://ift.tt/2o5qZOO

Impact of total radiotherapy dose on survival for head and neck Merkel cell carcinoma after resection

Abstract

Background

Head and neck Merkel cell carcinoma (MCC) is commonly treated with surgery and adjuvant radiotherapy (RT) for high-risk features. The optimal radiation dose is unknown.

Methods

Results

Conclusion

Adjuvant radiation doses within 50-55 Gy may be optimal for head and neck MCC.

http://ift.tt/2ntQKFy

Endocavitary sonography of early oral cavity malignant tumors

Abstract

Background

Methods

Results

Conclusion

In the study of early oral cavity tumors, ultrasound is accurate for demonstrating the level of tumor infiltration and contributes to the therapeutic choice.

http://ift.tt/2o5vrwU

Developing a risk stratification tool for audit of outcome after surgery for head and neck squamous cell carcinoma

Abstract

Background

Methods

Results

Conclusion

http://ift.tt/2ntKLRp

Narrow-band imaging in transoral laser surgery for early glottic cancer in relation to clinical outcome

Abstract

Background

The purpose of this study was to validate the prognostic value of adding narrow-band imaging (NBI) during transoral laser surgery (TLS) for early glottic cancer.

Methods

Results

Conclusion

Additional use of NBI during TLS for early glottic cancer significantly improves clinical outcome.

http://ift.tt/2o5o7Bj

Preoperative vitamin D level as predictor of post-thyroidectomy hypocalcemia in patients sustaining transient parathyroid injury

Abstract

Background

Methods

Results

Conclusion

http://ift.tt/2ntOmPg

Interaction of Treatment and Biomarker in Advanced Non-small Cell Lung Cancer

Purpose: There has been a long-standing interest in the investigation of interactions in science. The objective of the study is to evaluate interaction between Epidermal Growth Factor Receptor (EGFR) mutation and treatment from randomized, phase II study of chemotherapy versus chemotherapy plus erlotinib in patients with progressive Non-Small Cell Lung Cancer (NSCLC) following clinical benefit from erlotinib. Materials and Methods: Forty-six patients with advanced stage NSCLC and progression from erlotinib were randomized to receive chemotherapy (pemetrexed or docetaxel) or chemotherapy plus erlotinib between 2008 and 2012. Patient characteristics at baseline including age, gender, tumor stage, race, smoking history and EGFR mutation status along with the clinical outcomes, namely response, Progression- Free Survival (PFS) and Overall Survival (OS) were obtained. The effects of treatment, EGFR mutation and interaction between the two on survival outcomes were evaluated using Cox proportional hazards model with first-order interaction. Results: For PFS, there was a significant interaction between treatment (arm B) and EGFR mutation (mutant EGFR+) (p = 0.018), although the main effects of treatment (arm B vs. arm A) and EGFR mutation (mutant vs. wild-type EGFR) were statistically significant (with p = 0.03 and p = 0.088, respectively) favoring arm B and mutant EGFR+. Thus when taking the interaction between treatment and EGFR into account, the hazard ratio comparing arm B to arm A when EGFR is positive was 1.49 (95% CI: 0.72, 3.11); and the hazard ratio comparing arm B to arm A when EGFR is negative was 0.17 (95% CI: 0.04 - 0.84). Similarly, for OS, there was a significant interaction between treatment and EGFR mutation (p = 0.02), with significant main effects of treatment and EGFR favoring arm B and mutant EFGR+. Taking together, the hazard ratio comparing arm B to arm A when EGFR is positive was 1.61 (95% CI: 0.68 - 3.82); and the hazard ratio comparing arm B to arm A when EGFR is negative was 0.16 (95% CI: 0.03 - 0.9). Conclusion: The interaction identified by Cox model shows there was an antagonistic effect between chemotherapy + erlotinib and EGFR mutation, a situation that the whole is less than the sum of the parts, despite the prolonging-survival main effect of each factor from Cox model. As a result, the continuing erlotinib beyond progression adds no benefit in survival outcomes but leads to an increase in adverse events. 

http://ift.tt/2n8UtrC

Genotype- or Phenotype-Targeting Anticancer Therapies? Lessons from Tumor Evolutionary Biology

Despite the efficacy of most cancer therapies, drug resistance remains a major problem in the clinic. The eradication of the entire tumor and the cure of the patient by chemotherapy alone are rare, in particular for advanced disease. From an evolutionary perspective, the selective pressure exerted by chemotherapy leads to the emergence of resistant clones where resistance can be associated with many different functional mechanisms at the single cell level or can involve changes in the tumor micro-environment. In the last decade, tumor genomics has contributed to the improvement of our understanding of tumorigenesis and has led to the identification of numerous cellular targets for the development of novel therapies. However, since tumors are by nature extremely heterogeneous, the drug efficacy and economical sustainability of this approach is now debatable. Importantly, tumor cell heterogeneity depends not only on genetic modifications but also on non-genetic processes involving either stochastic events or epigenetic modifications making genetic biomarkers of uncertain utility. In this review, we wish to highlight how evolutionary biology can impact our understanding of carcinogenesis and resistance to therapies. We will discuss new approaches based on applied ecology and evolution dynamics that can be used to convert the cancer into a chronic disease where the drugs would control tumor growth. Finally, we will discuss the way metabolic dysfunction or phenotypic changes can help developing new delivery systems or phenotypetargeted drugs and how exploring new sources of active compounds can conduct to the development of drugs with original mechanisms of action.

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Osteophyte induced lung fibrosis prevalence and osteophyte qualities predicting disease

Publication date: July–August 2017
Source:Clinical Imaging, Volume 44
Author(s): Mary Salvatore, Claudia I. Henschke, Rowena Yip, Sukhdeep Kaur, Kunwei Li, Maria Padilla, David Yankelevitz
ObjectiveTo determine the prevalence of osteophyte induced lung fibrosis (OIF) and its relationship to osteophyte size, location, and surrounding fat.Methods94 CT scans of the chest were reviewed, size of the largest osteophyte and the presence of fibrosis were recorded.ResultsPresence of fibrosis was higher among patient with large (>10 mm) osteophytes compared to those with small (1–10mm) osteophytes. Age and presence of periosteophyte fat were significantly associated with presence of fibrosis.ConclusionsAs the size of an osteophyte increases, there is a greater likelihood of lung fibrosis. Subpleural fat protects the lung from OIF.

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Insight into anti-diabetic effect of low dose of stevioside

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Vladimirka Ilić, Saša Vukmirović, Nebojša Stilinović, Ivan Čapo, Milan Arsenović, Boris Milijašević
Diabetes mellitus is a chronic disease characterized by abnormal carbohydrate, lipid and protein metabolism due to a lack of insulin or reduced target cell sensitivity to insulin. Stevia rebaudiana is an important source of biochemically active substances with proven anti-diabetic effect. The aim of this study was to determine anti-diabetic effects of the low dose of stevioside in NMRI Haan mice. Aqueous stevioside solution (20mg/kg body weight) was administered by oral route of administration. Anti-diabetic effect of stevioside was estimated by oral glucose tolerance test, adrenaline test after a 10day stevioside treatment, and alloxan induced hyperglycaemia in mice (two experimental groups, 10day stevioside treatment before and after alloxan administration). Aqueous stevioside solution prevented significant increase in glycaemia in oral glucose tolerance test (9.22±1.13 to 9.85±1.32mmol/l, P<0.05), and not in adrenaline test. Significant difference in glycaemia was detected in mice pre-treated with saline and stevioside in alloxan induced hyperglycaemia (saline 23.32±2.14, stevioside 14.70±4.95mmol/l, P<0.05). In mice pre-treated with stevioside, smallest β cells loss was found compared to other alloxan treated groups. Preserved normal cytoarchitectonic arrangement in islets was detected. Based on the given results we presume there exist a potential therapeutic use of low dose stevioside in diabetes.

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A review of the role of orexin system in pain modulation

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Bibi Marjan Razavi, Hossein Hosseinzadeh
The roles of orexinergic system (orexin-A, orexin-B) and their receptors (orexin receptor type-1, orexin receptor type-2) in various physiological processes such as arousal, reward seeking behavior, energy homeostasis, sensory modulation, stress processing, cognition, endocrine functions, visceral functions and pain modulation have been established. This review summarizes the studies investigating orexin antinociceptive effects and their cellular mechanisms in various types of pain including neuropathic pain, migraine and cluster headache, visceral and orofacial pains. Moreover, the role of orexins in stress induced analgesia and on the development of morphine analgesic tolerance has been discussed. The antinociceptive effects of orexins have been shown in several pain models including thermal, mechanical and chemical induced nociception. Orexins modulate pain perception at both spinal and supraspinal levels. The periaqueductal gray (PAG) is one important supraspinal sites of orexin pain modulation. A possible involvement of endocannabinoids in supraspinal orexin-induced analgesia has been proposed. This review suggests a potential role of orexins in the management of pain.

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Glucocorticoid-induced leucine zipper may play an important role in icariin by suppressing osteogenesis inhibition induced by glucocorticoids in osteoblasts

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Zhong Lin, Zheng Li Jiang, Li Hua Chen, Yuan Sun, Sai Zhen Chen, Peng Zhou, Ai Xiao Xia, Hui Jin, Yan Wu Zhu, Dan Yang Chen
Background and purposeIcariin is a potent stimulator of osteogenic differentiation; however, the mechanism underlying its osteogenic effect remains unclear. The osteogenic effect of icariin is related to the upstream glucocorticoid-induced leucine zipper (GILZ) signaling pathway, and antagonism with dexamethasone-induced osteoblast inhibition was noted.MethodsMC3T3-E1 cells were cultured in induced medium treated with icariin with or without dexamethasone. After short interfering RNA (siRNA) were used to silence GILZ expression, the degree of mineralization, proliferation, and GILZ expression as well as the levels of osteogenic (OPG, RANKL, ALP, OC and RUNX2) markers were tested.ResultsDexamethasone inhibited, while icariin increased, osteogenic activity, as indicated by ALP activity and calcium nodules. Meanwhile, dexamethasone dose-dependently (10⁻⁶M–10⁻⁴M) increased GILZ and RANKL expression and reduced ALP, OPG and OC, but the pattern of mRNA expression was reversed when icariin was added. Furthermore, GILZ (dexamethasone-induced) inhibition caused by icariin or moderately silenced by GILZ siRNA abolished the osteogenesis inhibition effect of dexamethasone, as indicated by the changes in the GILZ, ALP, OPG and RANKL expression levels; ALP activity; and calcium nodule.ConclusionsThese results indicate that the GILZ-mediated osteogenic signal pathway is involved in the osteogenic effect induced by icariin.

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Gut microbiota and renal transplant outcome

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Mohammadreza Ardalan, Sepideh Zununi Vahed
Gaining long-term graft function and patient survival remain a critical challenge following kidney transplantation. Genetic and environmental factors do not completely account for the individual's graft outcome. Recently, it is reported that gut microbial community (microbiota) is associated with complications in kidney allograft recipients, as well. Commensal microbiota plays a significant role in the immunomodulation of transplant recipient responses. Different factors can disrupt the reciprocal interaction between microbiota and the host immune responses and lead to infection and rejection complications in the organ recipient. In this review, we address the relation between microbiota and immune system along with their possible roles in renal graft outcome. We next highlight the beneficial effects of probiotics on the management of kidney diseases and solid organ transplantation. Finally, we reflect on the potential impacts of probiotics on host physiology. Hopefully, a deeper understanding of the function and composition of microbiota can help clinics develop strategies to restore the normal microbiota and facilitate the clinical management of grafts in the forthcoming future.

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Hepatoprotective activity of Rhus oxyacantha root cortex extract against DDT-induced liver injury in rats

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Hanène Ben Miled, Zaineb Ben Barka, Dorsaf Hallègue, Karima Lahbib, Mohamed Ladjimi, Mounira Tlili, Mohsen Sakly, Khémais Ben Rhouma, Riadh Ksouri, Olfa Tebourbi
The present investigation aimed to study the antioxidant activity and hepatoprotective effects of ethyl acetate extract of R. oxyacantha root cortex (RE) against DDT-induced liver injury in male rats.The RE exhibited high total phenolic, flavonoid and condensed tannins contents. The antioxidant activity in vitro systems showed a significant potent free radical scavenging activity of the extract. The HPLC finger print of R. oxyacantha active extract showed the presence of five phenolic compounds with higher amounts of catechol and gallic acid. The in vivo results showed that a single intraperitoneal administration of DDT enhanced levels of hepatic markers (ALT, AST and LDH) in serum of experimental animals. It also increased the oxidative stress markers resulting in increased levels of the lipid peroxidation with a significant induction of SOD and GPx, metallothioneins (MTs) and a concomitant decrease of non protein thiols (NPSH) in liver. However, pretreatment of rats with RE at a dose of 150 and 300mg/kg body weight significantly lowered serum transaminases and LDH in treated rats. A significant reduction in hepatic thiobarbituric reactive substances and a decrease in antioxidant enzymes activities and hepatic MTs levels by treatment with plant extract against DDT, were observed. These biochemical changes were consistent with histopathological observations, suggesting marked hepatoprotective effect of RE with the two doses used. These results strongly suggest that treatment with ethyl acetate extract normalizes various biochemical parameters and protects the liver against DDT-induced oxidative damage in rats and thus help in evaluation of traditional claim on this plant.

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Emodin targets mitochondrial cyclophilin D to induce apoptosis in HepG2 cells

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Ling Zhang, Dian He, Kun Li, Hongli Liu, Baitao Wang, Lifang Zheng, Jiazhong Li
Emodin has demonstrated potent anticancer activity in human hepatocarcinoma cells and animal models, however, the cellular targets of emodin have not been fully defined. Here we report that emodin induces the dysfunction of mitochondria and the apoptosis in HepG2 cells through an enrichment in mitochondria. Specifically, A mitochondrial matrix protein (cyclophilin D, CyPD) is involved in emodin-induced apoptosis, and the inhibitor of CyPD (cyclosporin A) could almost completely suppressing the apoptosis; Moreover, as the expression of CyPD could be effectively inhibited by antioxidant N-acetyl-l-cysteine and epidermal growth factor (the activator of ERK), reactive oxygen species and ERK might be involved in the relevant role of CyPD. A further molecule-docking discloses the existence of three hydrogen-bonds in CyPD-emodin complex. Thus, target localization and CyPD in mitochondria provides an insight into the action of emodin in the treatment of liver cancer.

Graphical abstract

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Anti-coagulative and gastrointestinal motility regulative activities of Fructus Aurantii Immaturus and its effective fractions

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Wangxiao Tan, Ye Li, Yu Wang, Zhaojian Zhang, Ting Wang, Qian Zhou, Xiaoying Wang
ObjectiveFructus Aurantii Immaturus (FAI) has been used in the treatment of gastrointestinal disorders (GIDs) in traditional Chinese medicine (TCM) for thousands of years, which also has been found to have effects on cardiovascular diseases (CVDs) in recent years. The current study aimed at investigating the anti-coagulative and gastrointestinal motility regulative activities of different fractions isolated from FAI, which may have both effects on gastrointestinal and cardiovascular systems, in the manners of network pharmacology analysis and experiments in vivo and in vitro.MethodsWe obtained water decoction, volatile oils, alkaloids and flavonoids from FAI, which were identified by gas chromatography-mass spectrometry (GC–MS) and high performance liquid chromatography (HPLC). Network pharmacological analysis was used to explore the relationship between the various types of chemical constituents, gene target and biological pathways of FAI. Then, the effective fractions in terms of anti-coagulative and gastrointestinal motility regulative activities were investigated by the experiment of rabbit intestinal smooth muscles contraction, mice small intestine propulsion rate and blood-clotting time, and verified by the blood stasis model.ResultsFrom the Network pharmacological analysis, the flavonoids were predicted to be the main active ingredients on gastrointestinal and cardiovascular systems. Experimental results also showed that flavonoids could significantly increase the small intestine propulsion rate and extend the blood-clotting time of mice. The Flavonoids could alleviate the increased fractional shortening (FS), left ventricular outflow, hematocrit and fibrinogen, and ameliorate the pathological changes of myocardial tissues caused by blood stasis.ConclusionThese findings indicated that flavonoids in FAI might be the main effective fractions on gastrointestinal motility and anti-coagulation.

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Assessment of Olea europaea L. fruit extracts: Phytochemical characterization and anticancer pathway investigation

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Amina Maalej, Zouhaier Bouallagui, Fatma Hadrich, Hiroko Isoda, Sami Sayadi
Olea europaea L. has been widely used as an advantageous rich source of bioactive compounds of high economic value leading to its use in pharmaceutical, cosmetic, and agriculture industries. Ethanolic extracts of olive fruits from three different cultivars (OFE) were studied for their phytochemical contents and were investigated for antioxidant activities and anticancer potential. Major polyphenols detected in these extracts were tyrosol, hydroxytyrosol, oleuropein, rutin, quercetin and glucoside forms of luteolin and apigenin. All these compounds have shown to significantly contribute to the antioxidant activity of OFE, which was evaluated by DPPH and ABTS assays. Proliferation of hepatic and colon cancer cells, HepG2 and Caco-2, were shown to be sensitive to OFE with IC50 less than 1.6mg/ml for all tested extracts. Moreover, flow cytometry analysis showed that OFE induced cell cycle arrest in the S-phase within both HepG2 and Caco-2 cells. This has triggered a cell death mechanism as shown by DNA fragmentation, expression of p53 and phosphorylation level of Akt and Erk proteins. Interestingly, these extracts could be further used as a potential source of natural compounds with both antioxidant and anticancer effects.

Graphical abstract

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Radiological morphology variances of transient osteoporosis of the hip.

http:--linkinghub.elsevier.com-ihub-imag

Radiological morphology variances of transient osteoporosis of the hip.

J Orthop Sci. 2017 Mar 20;:

Authors: Yamaguchi R, Yamamoto T, Motomura G, Ikemura S, Iwasaki K, Zhao G, Iwamoto Y

Abstract
BACKGROUND: Although several morphological abnormalities or variances of the hip joint have been proposed to be associated with hip joint degeneration, few studies have investigated any radiological features in patients with transient osteoporosis of the hip (TOH). The purpose of this study is to evaluate the morphological variances of the hip joint in TOH patients radiographically.
METHODS: The TOH group consisted of 31 hips in 31 patients. Age- and gender-matched asymptomatic hips in patients with unilateral osteonecrosis of the femoral head were served as controls. Radiographs and MRI were utilized to examine the following parameters: acetabular dysplasia, acetabular overcoverage, acetabular retroversion, and asphericity of the femoral head-neck junction. Also, localization of the main bone marrow edema (BME) lesion was investigated.
RESULTS: TOH patients had a significantly higher incidence of acetabular retroversion (52% with a positive cross-over sign and 29% with posterior wall deficiency) than the controls (13%, P = 0.0023; 6%, P = 0.043, respectively), which was also confirmed by smaller acetabular anteversion angles on axial MRI. In addition, TOH patients tended to show asphericity of the anterior femoral head-neck junction compared to controls (39% vs. 13%, P = 0.040). In 90% of the TOH patients, the main BME lesion was located in the subchondral area of the superior portion of the femoral head, and 77% of the lesion were recognized as a band-like pattern in MRI.
CONCLUSIONS: Acetabular retroversion and asphericity of the femoral head-neck junction were more commonly observed in TOH patients compared to controls. The main BME lesion was most frequently located in the superior portion of the femoral head.

PMID: 28336192 [PubMed - as supplied by publisher]

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"Genet Mol Res"[jour]; +19 new citations

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International recognition of the Chronic Otitis Media Questionnaire 12.

International recognition of the Chronic Otitis Media Questionnaire 12.

J Laryngol Otol. 2017 Mar 27;:1-4

Authors: Kosyakov SI, Minavnina JV, Phillips JS, Yung MW

Abstract
OBJECTIVE: The Chronic Otitis Media Questionnaire 12 was developed initially in the UK to assess patient-reported health-related quality of life associated with chronic otitis media. This study aimed to determine whether this tool is applicable to the Russian population, which has a materially different healthcare system.
METHOD: A total of 108 patients with different forms of chronic otitis media completed the Russian Chronic Otitis Media Questionnaire 12.
RESULTS: The average Russian Chronic Otitis Media Questionnaire 12 score was 19.4 (standard deviation = 8.3). The internal consistency of the Russian Chronic Otitis Media Questionnaire 12 was high, with a Cronbach's alpha value of 0.860.
CONCLUSION: The Russian version of the Chronic Otitis Media Questionnaire 12 was found to be a reliable tool for the assessment of health-related quality of life in patients with chronic otitis media. This sets the scene for international collaboration, using this tool to assess the effectiveness of surgical treatments even amongst countries with different healthcare systems.

PMID: 28345505 [PubMed - as supplied by publisher]

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Pulmonary metastatic angiosarcoma from scalp with fatal complication: A case report.

Pulmonary metastatic angiosarcoma from scalp with fatal complication: A case report.

Int J Surg Case Rep. 2017 Feb 20;34:36-39

Authors: Cheng YS, Chen TM, Tsai WC, Huang TW

Abstract
INTRODUCTION: Angiosarcoma is a rare malignant neoplasm with poor prognosis. Angiosarcoma of the scalp is frequently recurs locally, and metastasizes early despite various treatments. The common sites of metastatic are lung, liver, and lymph nodes. Pulmonary metastasis with hemoptysis and pneumothorax is rare but threatening.
PRESENTATION OF CASE: A 77-year-old male had recurrent angiosarcoma of the scalp even with post operation radiotherapy. At the same time, recurrent pneumothorax was noted, thus he underwent wedge resection of the right upper lobe of the lung plus pleural biopsy. The final pathologic report of cystic lesions showed metastatic Angiosarcoma. He received intravenous paclitaxel and the lung lesions dramatically diminished subsequently.
DISCUSSION: Pulmonary metastasis from soft tissue sarcoma had fatal complications and poor prognosis. Metastases of AS to the lung have a well-described morphology on CT scan, but appear to be hypometabolic on PET scan and are easily misinterpreted as benign cysts.
CONCLUSION: Angiosarcoma is a rare but highly vascular invasive endothelial tumor that generally metastasizes to the lung. It could cause repeated hemoptysis pneumothorax and pleural effusion. Preoperative chest CT may be recommended routinely. Aggressive treatment resulted in not only symptoms control but also good prognosis.

PMID: 28343002 [PubMed - as supplied by publisher]

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Giant leiomyosarcoma of the rectum with lymph node metastasis: A case report and review of the literature.

Giant leiomyosarcoma of the rectum with lymph node metastasis: A case report and review of the literature.

Int J Surg Case Rep. 2017 Mar 08;34:27-31

Authors: Anzai H, Nozawa H, Tanaka J, Yasuda K, Otani K, Nishikawa T, Tanaka T, Kiyomatsu T, Hata K, Kawai K, Ushiku T, Ishihara S, Takano T, Fukayama M, Watanabe T

Abstract
INTRODUCTION: Leiomyosarcoma of the gastrointestinal tract is very rare, with a reported frequency of less than 0.1% of all malignancies of the colorectum. It is important to diagnose leiomyosarcoma definitively by immunohistochemical profiling of smooth muscle actin, desmin, and CD34. True leiomyosarcoma of the colorectum diagnosed by immunnohistochemical profiling is extremely rare that only 13 reports have been published in reviews of resected gastrointestinal mesenchymal tumors after 1998. In addition, lymph node involvement is rare in patients with leiomyosarcoma. Herein we report an aggressive case of LMS in a rectosigmoid lesion with lymph node metastasis.
CASE PRESENTATION: A 76-year-old woman visited our hospital complaining of intermittent anal bleeding that had lasted 5 months. Image studies aiming at examining the cause of her anal bleeding revealed a tumor located between the right ovary, uterus, and the rectosigmoid. Histopathology of biopsied materials from the colonoscopy suggested a malignant tumor of mesenchymal origin. Surgical resection was performed with curative intent. The tumor was diagnosed as leiomyosarcoma by pathological examination. Moreover, one of the 31 regional lymph nodes retrieved was metastasized by leiomyosarcoma. Eight months later, follow-up CT scans revealed multiple recurrent lesions in the liver and peritoneum. Despite systematic chemotherapy, she deceased 12 months after the surgery.
CONCLUSION: It is crucial to diagnose leioyosarcoma precisely based on immunohistochemistry, and thereby distinguish it from GIST. Although lymph node metastasis is rare, lymphadenectomy appears to be important for high-risk LMSs to perform R0 resection. Further investigation on leiomyosarcoma cases so far is required to establish standard treatment strategies.

PMID: 28342361 [PubMed - as supplied by publisher]

http://ift.tt/2owzorf

The clinical features and prognosis of mumps-associated hearing loss: a retrospective, multi-institutional investigation in Japan.

The clinical features and prognosis of mumps-associated hearing loss: a retrospective, multi-institutional investigation in Japan.

Acta Otolaryngol. 2017 Mar 24;:1-4

Authors: Morita S, Fujiwara K, Fukuda A, Fukuda S, Nishio SY, Kitoh R, Hato N, Ikezono T, Ishikawa K, Kaga K, Matsubara A, Matsunaga T, Murata T, Naito Y, Nishizaki K, Ogawa K, Sano H, Sato H, Sone M, Suzuki M, Takahashi H, Tono T, Yamashita H, Yamasoba T, Usami SI

Abstract
CONCLUSIONS: The majority of hearing loss due to mumps presents as unilateral profound sensorineural hearing loss, which is refractory to treatment. In rare cases of bilateral total deafness, cochlear implants were beneficial for speech perception. Vaccination against mumps is recommended to prevent mumps-associated hearing loss.
OBJECTIVE: The objective of this study is to investigate the clinical characteristics of hearing loss due to mumps and to evaluate hearing outcomes.
SUBJECTS AND METHODS: The clinical parameters were analyzed under a retrospective multi-institutional study design in patients diagnosed with hearing loss due to mumps at the Otolaryngology departments of 19 hospitals between 1987 and 2016.
RESULTS: Sixty-seven patients with hearing loss due to mumps were enrolled. The study population consisted of 35 males and 32 females, ranging in age from 1 to 54, with a median age of 9.5 years. Sixty-three patients presented with unilateral, and 4 with bilateral hearing loss. Profound hearing loss was observed in 65 ears. Only one ear with severe hearing loss showed complete recovery. Four patients with bilateral hearing loss received cochlear implant surgery. Most of the patients with hearing loss due to mumps had no history of vaccination.

PMID: 28338374 [PubMed - as supplied by publisher]

http://ift.tt/2owjDQM

The modified temporalis muscle flap in reconstruction of palate and temporal deformity.

The modified temporalis muscle flap in reconstruction of palate and temporal deformity.

Acta Otolaryngol. 2017 Mar 24;:1-4

Authors: Liu W, Chen X, Ni X

Abstract
PURPOSE: The purpose of this article was to introduce a modified temporalis muscle flap (TMF) which was used to reconstruct palate and temporal deformity.
PATIENT AND METHODS: This was a retrospective review of the use of the modified TMF in reconstruction of palate and temporal deformity. We evaluated the result which included operative time, bleeding, necrosis, infection, facial nerve deficit, and cosmetic deformity.
RESULTS: All the 16 patients accepted the modified TMF surgery successfully. There were no complications. All of them were satisfied with the postoperative appearance.
CONCLUSIONS: The modified TMF was a reliable and safe flap that can be used to reconstruct the surgical defect of plate and fill the temporal fossa.

PMID: 28338372 [PubMed - as supplied by publisher]

http://ift.tt/2o53C7Q

Indications, risk of lower airway infection, and complications to pediatric tracheotomy: report from a tertiary referral center.

Indications, risk of lower airway infection, and complications to pediatric tracheotomy: report from a tertiary referral center.

Acta Otolaryngol. 2017 Mar 24;:1-4

Authors: Grønhøj C, Charabi B, Buchwald CV, Hjuler T

Abstract
BACKGROUND: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center.
METHODS: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008-2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI.
RESULTS: At a median age of 8 years (range: 4 months to 17 years), a total of 69 tracheotomies were performed. Neuromuscular disease (n = 21) was the most common cause for tracheotomy. The postoperative complication rate was 22%; early complications (<30 days) occurred in four patients, and nine patients encountered late complications such as wound granulation and tracheocutaneous fistula. Children without LAI prior to tracheotomy were at increased risk of LAI from the initial 30-days following surgery (OR: 2.91, 95% CI: 1.17-7.21; p = .02). Fifty-three percent (10/19) of all LAIs following tracheotomy were caused by Staphylococcus aureus (p < .01).
CONCLUSIONS: Pediatric tracheotomy was associated with considerable rates of minor early and late complications and high risk of short-term LAI. The main cause leading to tracheotomy was neuromuscular disease.

PMID: 28338364 [PubMed - as supplied by publisher]

http://ift.tt/2oeSv9I

Heterotopic Ossification in a Newborn: A Case Report.

Heterotopic Ossification in a Newborn: A Case Report.

Eplasty. 2016;16:e37

Authors: Murrad K, Rand A, Abdulaziz J, Amir Mrad M

Abstract
Introduction: Heterotopic ossification is defined as the formation of trabecular bone that forms outside the normal sites of the skeletal structure, materializing in soft tissue where it does not usually exist. Methods/Case Report: This is a case report of a 27-day-old baby with a diagnosis of DiGeorge syndrome who developed heterotopic ossification on the dorsum of his right hand. Discussion: Heterotopic ossification in the pediatric population is a rare finding. Very few cases were published in the literature, and we find it important to increase the knowledge on such cases and discuss possible causes with the treatment used with our patient. Results: General treatments of heterotopic ossification include ruling out superimposed infection, physiotherapy to prevent joint involvement, warm compressors during the active phase of development of heterotopic ossification. If the swelling persists to the point that it interferes significantly with the functional capacity of the patient or becomes a cosmetic concern, the only treatment option remaining would be surgery.

PMID: 28344729 [PubMed - in process]

http://ift.tt/2o5a7aU

Evidence of binaural integration benefits following ARIA training for children and adolescents diagnosed with amblyaudia.

Evidence of binaural integration benefits following ARIA training for children and adolescents diagnosed with amblyaudia.

Int J Audiol. 2017 Mar 27;:1-9

Authors: Moncrieff D, Keith W, Abramson M, Swann A

Abstract
OBJECTIVE: The purpose of this study was to demonstrate the efficacy of Auditory Rehabilitation for Interaural Asymmetry (ARIA) to improve dichotic listening scores in children and adolescents diagnosed with amblyaudia and other binaural integration deficits.
DESIGN: The study is a field experiment without randomisation.
STUDY: Participants placed into groups based on dichotic listening test scores received four sessions of ARIA training. Baseline scores were compared to performance during the final session of training and to scores obtained 2 or more months after completion of ARIA.
SAMPLE: A total of 125 children participated at five different clinical sites.
RESULTS: Dichotic listening scores improved across all participants. Post hoc analyses demonstrated highly significant gains in non-dominant ear performance and reductions of interaural asymmetry among participants diagnosed with amblyaudia at both post-ARIA measurements. Participants in other diagnostic groups also showed significant benefits for some post-ARIA measures.
CONCLUSIONS: Results demonstrate that ARIA training is an effective method for improving binaural integration skills among children and adolescents identified with dichotic listening weaknesses during assessments for auditory processing disorder (APD), especially for those diagnosed with amblyaudia. Benefits achieved following ARIA training remain stable across several months.

PMID: 28346034 [PubMed - as supplied by publisher]

http://ift.tt/2nKzU7w

DSL prescriptive targets for bone conduction devices: adaptation and comparison to clinical fittings.

DSL prescriptive targets for bone conduction devices: adaptation and comparison to clinical fittings.

Int J Audiol. 2017 Mar 27;:1-10

Authors: Hodgetts WE, Scollie SD

Abstract
OBJECTIVE: To develop an algorithm that prescribes targets for bone conduction frequency response shape, compression, and output limiting, along with a clinical method that ensures accurate transforms between assessment and verification stages of the clinical workflow.
DESIGN: Technical report of target generation and validation.
STUDY SAMPLE: We recruited 39 adult users of unilateral percutaneous bone conduction hearing aids with a range of unilateral, bilateral, mixed and conductive hearing losses across the sample.
RESULTS: The initial algorithm over-prescribed output compared to the user's own settings in the low frequencies, but provided a good match to user settings in the high frequencies. Corrections to the targets were derived and implemented as a low-frequency cut aimed at improving acceptance of the wearer's own voice during device use.
CONCLUSIONS: The DSL-BCD prescriptive algorithm is compatible with verification of devices and fine-tuning to target for percutaneous bone conduction hearing devices that can be coupled to a skull simulator. Further study is needed to investigate the appropriateness of this prescriptive algorithm for other input levels, and for other clinical populations including those with single-sided deafness, bilateral devices, children and users of transcutaneous bone conduction hearing aids.

PMID: 28346016 [PubMed - as supplied by publisher]

http://ift.tt/2o53B3M

7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: Results of a phase 2 clinical trial.

http:--media.wiley.com-assets-7315-19-Wi

7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: Results of a phase 2 clinical trial.

Cancer. 2017 Mar 27;:

Authors: Sun B, Brooks ED, Komaki RU, Liao Z, Jeter MD, McAleer MF, Allen PK, Balter PA, Welsh JD, O'Reilly MS, Gomez D, Hahn SM, Roth JA, Mehran RJ, Heymach JV, Chang JY

Abstract
BACKGROUND: The authors evaluated the efficacy, patterns of failure, and toxicity of stereotactic ablative radiotherapy (SABR) for patients with medically inoperable, clinical stage I non-small cell lung cancer (NSCLC) in a prospective clinical trial with 7 years of follow-up. Clinical staging was performed according to the seventh edition of the American Joint Committee on Cancer TNM staging system.
METHODS: Eligible patients with histologically confirmed NSCLC of clinical stage I as determined using positron emission tomography staging were treated with SABR (50 grays in 4 fractions). The primary endpoint was progression-free survival. Patients were followed with computed tomography and/or positron emission tomography/computed tomography every 3 months for the first 2 years, every 6 months for the next 3 years, and then annually thereafter.
RESULTS: A total of 65 patients were eligible for analysis. The median age of the patients was 71 years, and the median follow-up was 7.2 years. A total of 18 patients (27.7%) developed disease recurrence at a median of 14.5 months (range, 4.3-71.5 months) after SABR. Estimated incidences of local, regional, and distant disease recurrence using competing risk analysis were 8.1%, 10.9%, and 11.0%, respectively, at 5 years and 8.1%, 13.6%, and 13.8%, respectively, at 7 years. A second primary lung carcinoma developed in 12 patients (18.5%) at a median of 35 months (range, 5-67 months) after SABR. Estimated 5-year and 7-year progression-free survival rates were 49.5% and 38.2%, respectively; the corresponding overall survival rates were 55.7% and 47.5%, respectively. Three patients (4.6%) experienced grade 3 treatment-related adverse events. No patients developed grade 4 or 5 adverse events (toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 3.0]).
CONCLUSIONS: With long-term follow-up, the results of the current prospective study demonstrated outstanding local control and low toxicity after SABR in patients with clinical stage I NSCLC. Regional disease recurrence and distant metastases were the dominant manifestations of failure. Surveillance for second primary lung carcinoma is recommended. Cancer 2017. © 2017 American Cancer Society.

PMID: 28346656 [PubMed - as supplied by publisher]

http://ift.tt/2nwvhha

Differential Diagnosis in Neuroendocrine Neoplasms of the Larynx.

http:--pt.wkhealth.com-pt-pt-core-templa

Differential Diagnosis in Neuroendocrine Neoplasms of the Larynx.

Adv Anat Pathol. 2017 Mar 23;:

Authors: Hunt JL, Ferlito A, Hellquist H, Rinaldo A, Skálová A, Slootweg PJ, Willems SM, Cardesa A

Abstract
The differential diagnosis of neuroendocrine neoplasms of the larynx is broad and includes lesions of epithelial, mesenchymal, and neuroectodermal origin. These lesions have overlapping clinical and pathologic aspects and must be carefully considered in the differential diagnosis of laryngeal neoplasms. The prognosis and treatment are also different among these tumor types, which necessitates making these distinctions clinically. The current literature was reviewed to provide updated information regarding the epithelial-derived tumors, including carcinoid, atypical carcinoid, small cell neuroendocrine carcinomas, large cell neuroendocrine carcinoma, and squamous cell carcinoma with neuroendocrine component. These tumors are compared and contrasted with non-epithelial-derived tumors such as paraganglioma and nonmucosal tumors, such as medullary thyroid carcinoma. The morphologic and cytologic features are discussed, along with helpful immunohistochemical and ancillary investigations.

PMID: 28338500 [PubMed - as supplied by publisher]

http://ift.tt/2njDqUl

Therapeutic targeting of protein kinase CK2 gene expression in feline oral squamous cell carcinoma - a naturally occurring large animal model of head and neck cancer.

Therapeutic targeting of protein kinase CK2 gene expression in feline oral squamous cell carcinoma - a naturally occurring large animal model of head and neck cancer.

Hum Gene Ther Clin Dev. 2017 Mar 23;:

Authors: Cannon C, Trembley J, Kren B, Unger G, O'Sullivan MG, Cornax I, Modiano J, Ahmed K

Abstract
Protein kinase CK2 (CK2) is a highly promising target for cancer therapy and anti-CK2 gene expression therapy has shown effectiveness in rodent models of human head and neck cancer (HNC). To date, there has been no large animal model of cancer in which to further explore anti-CK2 therapies. Feline oral squamous cell carcinoma (FOSCC) has been proposed as a large animal model for human HNC and we have previously shown that CK2 is a rational target in FOSCC. We hypothesized that a novel tenfibgen coated tumor-specific nanocapsule carrying RNAi oligonucleotides targeting feline CK2α and CK2α' (TBG-RNAi-fCK2αα') would be safe in cats with FOSCC. Assessment of target inhibition and tumor response were secondary aims. 9 cats were enrolled at 2 dose levels in a 3+3 escalation. Cats received a total of six treatments of TBG-RNAi-fCK2αα'. Pre- and post-treatment, tumor and normal oral mucosa biopsies were collected to assess CK2 expression using immunohistochemistry (IHC) preparations evaluated by light microscopy. Toxicity and tumor response were assessed using standard criteria. The most common adverse events were grade 1 or 2 weight loss and anorexia. Grade 3 tissue necrosis was seen associated with tumor response in one cat, asymptomatic grade 4 elevations in AST and CPK in one cat, and asymptomatic grade 3 hypokalemia in one cat. Of 6 cats with evaluable biopsies, 2 had reduction in CK2 IHC scores in tumors following treatment. Four cats had progressive disease during the study period, 3 had stable disease, one had partial response, and response could not be evaluated in one cat. We conclude that the drug appeared safe and there is some evidence of efficacy in FOSCC. Further investigation regarding dosing, schedule, target modulation, toxicity and efficacy in a larger group of cats is warranted and may inform future clinical studies in human head and neck cancer.

PMID: 28335614 [PubMed - as supplied by publisher]

http://ift.tt/2o5fs1N

Early and delayed evaluation of solid tumours with 64Cu-ATSM PET/CT: a pilot study on semiquantitative and computer-aided fractal geometry analysis.

Early and delayed evaluation of solid tumours with 64Cu-ATSM PET/CT: a pilot study on semiquantitative and computer-aided fractal geometry analysis.

Nucl Med Commun. 2017 Apr;38(4):340-346

Authors: Lopci E, Grizzi F, Russo C, Toschi L, Grassi I, Cicoria G, Lodi F, Mattioli S, Fanti S

Abstract
OBJECTIVE: The aim of this study was to analyse early and delayed acquisition on copper-64 diacetyl-bisN4-methylthiosemicarbazone (Cu-ATSM) PET/CT in a small cohort of patients by comparing semiquantitative and computer-aided fractal geometry analyses.
PATIENTS AND METHODS: Five cancer patients, including non-small-cell lung cancer and head and neck cancer, were investigated with Cu-ATSM PET/CT. Participants received an intravenous injection of Cu-ATSM according to body size and were imaged 60 min (early) and 16 h (delayed) later on hybrid PET/CT. Reconstructed images were visualized on advanced workstations for the definition of semiquantitative parameters: standardized uptake value (SUV)max, SUVratio-to-muscle, SUVmean, hypoxic volume (HV) and hypoxic burden (HB=HV×SUVmean). DICOM data retrieved from both scans were analysed using an ad-hoc computer program to determine the mean intensity value, SD, relative dispersion, three-dimensional histogram fractal dimension and three-dimensional fractal dimension.
RESULTS: All tumour lesions showed increased uptake of Cu-ATSM at early evaluation, with a median SUVratio-to-muscle of 4.42 (range: 1.58-5.62), a median SUVmax of 5.3 (range: 1.9-7.3), a median SUVmean of 2.8 (range: 1.5-3.9), a median HV of 41.6 cm (range: 2.8-453.7) and a median HB of 161.5 cm (range: 4.4-1112.5). All semiquantitative data obtained at 1 h were consistent with the parameters obtained on delayed imaging (P>0.05). A borderline statistically significant difference was found only for SUVmax of the muscle (P=0.045). Fractal geometry analysis on DICOM images showed that all parameters at early imaging showed no statistically significant difference with late acquisition (P>0.05).
CONCLUSION: Our findings support the consistency of Cu-ATSM PET/CT images obtained at early and delayed acquisition for the assessment of tumour lesions.

PMID: 28263239 [PubMed - indexed for MEDLINE]

http://ift.tt/2mhp8Vz

Color duplex ultrasonography versus handheld Doppler to plan anterior lateral thigh flaps.

Color duplex ultrasonography versus handheld Doppler to plan anterior lateral thigh flaps.

Microsurgery. 2017 Mar 27;:

Authors: Lethaus B, Loberg C, Kloss-Brandstätter A, Bartella AK, Steiner T, Modabber A, Hölzle F, Teichmann J

Abstract
BACKGROUND: The anterior lateral thigh flap (ALT) has become increasingly important in reconstructive surgery in the head and neck region. To cope with the problem of anatomical variability in the supplying blood vessels, preoperative evaluation is desirable. Purpose of the study is to compare the most commonly used Doppler devices Handheld Doppler (HD) and Color Doppler Ultrasonography (CDU) for their clinical reliability.
METHODS: Forty five consecutive head and neck cancer patients (mean age 66.0 ± 11.2 years) were included in the study. They all underwent a reconstruction via ALT flap for a defect in the head and neck area. Study period ranged from May 2014 to August 2015. We preoperatively conducted HD and CDU on the lateral thigh and compared the intraoperative findings by measuring presence of the perforator and distance to the estimated position.
RESULTS: There were 95 perforators identified in 45 patients. The sensitivity and positive predictive value (PPV) were calculated as 97.9% and 100% for CDU and 90.5% and 80.4% for HD, respectively. Accuracy was significantly greater with the HD compared to the CDU device (P < 0.001) and was strongly associated with body mass index (BMI) (P < 0.001). This effect was stronger in HD than in CDU (r = 0.800; P < 0.001 versus r = 0.673; P < 0.001).
CONCLUSIONS: Our results indicate CDU is more precise and reliable than HD with respect to detecting the anatomical position of perforating arteries.

PMID: 28345267 [PubMed - as supplied by publisher]

http://ift.tt/2of9kBE

Glycogen-Rich Clear Cell Squamous Cell Carcinoma Originating in the Oral Cavity.

http:--production.springer.de-OnlineReso

Glycogen-Rich Clear Cell Squamous Cell Carcinoma Originating in the Oral Cavity.

Head Neck Pathol. 2017 Mar 24;:

Authors: Khoury ZH, Bugshan A, Lubek JE, Papadimitriou JC, Basile JR, Younis RH

Abstract
Clear cell squamous cell carcinoma (CCSCC) is a rare histological subtype of squamous cell carcinoma (SCC) that was originally described in the skin. Here, we report a case of a 66-year-old female patient who presented with a fungating ulcerative mass of the left lateral tongue extending anteriorly to the floor of the mouth, and posteriorly to the left retromolar fossa and the oropharynx. The patient had a history of SCC of the left posterior tongue that was treated with partial glossectomy and adjuvant radiotherapy. Representative biopsies were obtained from the floor of the mouth, tongue and retromolar fossa. The examined biopsies showed various degrees of dysplastic surface epithelium with transition into infiltrating epithelial tumor nests and cords with clear cytoplasm and malignant cellular features. Pancytokeratin, CK5/6, and p63 were all diffusely positive. S-100, Calponin, and smooth muscle actin (SMA) were negative. PAS stain was diffusely positive and diastase labile in the tumor clear cells. Sparse areas of mucicarmine positivity were noted. Based on these findings a final diagnosis of a glycogen-rich CCSCC was given. This case represents a very rare histological variant of oral SCC, which is significant for the histological differential diagnosis of clear cell tumors of the oral cavity.

PMID: 28342060 [PubMed - as supplied by publisher]

http://ift.tt/2o563r7

[Spinal cord injuries resulting from diving accidents in the Canary Islands].

[Spinal cord injuries resulting from diving accidents in the Canary Islands].

Neurocirugia (Astur). 2017 Mar 23;:

Authors: Bárbara-Bataller E, Méndez-Suárez JL, Alemán-Sánchez C, Sánchez-Enríquez J, Sosa-Henríquez M

Abstract
OBJECTIVE: Diving accidents is one of the leading causes of spinal cord injury after falls and car accidents. The objective of this study was to determine the epidemiological and clinical characteristics of these patients in our setting to better prevent these injuries.
MATERIAL AND METHODS: We performed a retrospective, descriptive study of patients who have suffered from a traumatic spinal cord injury after a diving accident in the Canary Islands, Spain from 2000 to 2014. These patients were admitted to the Spinal Cord Unit of Hospital Universitario Insular de Gran Canaria.
RESULTS: Of the 264 patients admitted to our unit for acute traumatic spinal cord injury, 23 (8.7%) cases were due to diving. Grouping the patients into 5years periods, 56% of the injuries occurred in 2000-2005, 17% in 2006-2010 and 26% in 2011-2014. All patients were male, with a mean age of 29years. Approximately 65% were under 30years. A total of 22/23 patients had a fracture and injury most commonly occurred to the C5 vertebra. Burst fractures were the most common. A total of 86% of cases underwent surgery. All the spinal cord injuries were cervical, with C6 being the neurological level most often affected. A total of 65% of spinal cord injuries were complete injuries.
CONCLUSIONS: Spinal cord injury secondary to diving accidents is the third leading cause of traumatic spinal cord injury in our setting. It affects young males and the most common clinical presentation is a complete cervical spinal cord injury. Given the irreversible nature of the injury, prevention, aimed mainly at young people, is of great importance.

PMID: 28343903 [PubMed - as supplied by publisher]

http://ift.tt/2mOtLbo

[Rationale and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable thoracolumbar fractures: Experience in 86 consecutive patients].

[Rationale and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable thoracolumbar fractures: Experience in 86 consecutive patients].

Neurocirugia (Astur). 2017 Mar 22;:

Authors: Delgado-López PD, Rodríguez-Salazar A, Martín-Velasco V, Martín-Alonso J, Castilla-Díez JM, Galacho-Harriero A, Araús-Galdós E

Abstract
OBJECTIVES: To describe the rationale, pros and cons, and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable (TLICS>4) thoracolumbar fractures.
PATIENTS AND METHODS: Clinical and radiological data and outcomes from a cohort treated surgically via said approach were retrospectively reviewed. All patients were operated on exclusively by 5 neurosurgeons trained in spine surgery.
RESULTS: Between June 1999 and December 2015, 86 patients underwent surgery (median age 42years, most common level: L1). Approximately 32.5% presented with a preoperative neurological defect. After surgery (mean duration: 275minutes), 75.6% presented with no neurological sequelae and only one-third required blood transfusion. Median postoperative stay was 7days. Correction of kyphosis was considered adequate and suboptimal but acceptable in 91% and 9% of the patients, respectively. Complications occurred in 36 patients, the majority being transient. We observed failure of the construct in 2 cases (collapse of an expandable cage and extrusion of a locking screw). No infections, vascular or visceral lesions, permanent neurological worsening or mortality occurred during hospitalisation. One patient ultimately needed additional posterior fixation due to persistence of pain. Median follow-up was 252days (27.9% was lost to follow-up).
CONCLUSIONS: The extrapleural extraperitoneal approach provides solid anterior reconstruction, allows wide decompression of the spinal canal, and permits adequate and long-lasting correction of kyphosis. The rates of infection, construct failure, need for reoperation and vascular or visceral lesions are minimal.

PMID: 28342638 [PubMed - as supplied by publisher]

http://ift.tt/2mOoq40

Decreased access to bariatric care: an analysis of referral practices to bariatric specialists.

Decreased access to bariatric care: an analysis of referral practices to bariatric specialists.

Surg Obes Relat Dis. 2016 Nov;12(9):1725-1730

Authors: Primomo JA, Kajese T, Davis G, Davis R, Shah S, Orsak M, Morrison C

Abstract
BACKGROUND: Substantial evidence reveals tolerability and co-morbid disease resolution after bariatric surgery; however, few physicians refer morbidly obese patients for bariatric consultation.
OBJECTIVE: To evaluate morbidly obese patient access to bariatric surgical consultation.
SETTING: A multidisciplinary, private, bariatric center of excellence.
METHODS: Patient surveyed in person regarding preconsultation co-morbidities, physician discussion and support for bariatric surgery, and physician referral practices.
RESULTS: The patients' (n = 388) co-morbid profile was 27.0% diabetes, 54.1% hypertension, 30.1% hyperlipidemia, and 37.1% obstructive sleep apnea. It was reported that 71.1% of patients stated that their primary care physician did not initiate a discussion about bariatric surgery. Among this group, 59.7% of patients initiated a conversation about bariatric surgery, with 80.6% of physicians supporting the decision and 18.4% referring to a bariatric practice. Overall referring specialty profile was 14.4% primary care, 4.4% cardiology, and 3.6% endocrinology. Diabetes and obstructive sleep apnea were more likely to prompt a referral (P = .008 and P = .014, respectively).
CONCLUSION: Most primary care and subspecialists do not discuss bariatric surgical options, resulting in decreased access to bariatric care. The main barrier to referral is noncommunication by the primary care physician or subspecialist, despite the vast majority of physicians having positive attitudes about bariatric surgery. Co-morbidities of diabetes and obstructive sleep apnea are more likely to prompt a referral. Primary care physicians are most likely to refer, while endocrinologists are least likely. Improved familiarity with nationally recognized obesity management algorithms could contribute to improved referral rates.

PMID: 28341364 [PubMed - in process]

http://ift.tt/2of8nJi

Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis.

Purpose of review: Animal models published within the past 18 months on asthma, food allergy and anaphylaxis, all conditions of rising public health concern, were reviewed. Recent findings: While domestic animals spontaneously develop asthma, food allergy and anaphylaxis, in animal models, divergent sensitization and challenge routes, dosages, intervals and antigens are used to induce asthmatic, food allergic or anaphylactic phenotypes. This must be considered in the interpretation of results. Instead of model antigens, gradually relevant allergens such as house dust mite in asthma, and food allergens like peanut, apple and peach in food allergy research were used. Novel engineered mouse models such as a mouse with a T-cell receptor for house dust mite allergen Der p 1, or with transgenic human hFc[gamma]R genes, facilitated the investigation of single molecules of interest. Whole-body plethysmography has become a state-of-the-art in-vivo readout in asthma research. In food allergy and anaphylaxis research, novel techniques were developed allowing real-time monitoring of in-vivo effects following allergen challenge. Networks to share tissues were established as an effort to reduce animal experiments in allergy which cannot be replaced by in-vitro measures. Summary: Natural and artificial animal models were used to explore the pathophysiology of asthma, food allergy and anaphylaxis and to improve prophylactic and therapeutic measures. Especially the novel mouse models mimicking molecular aspects of the complex immune network in asthma, food allergy and anaphylaxis will facilitate proof-of-concept studies under controlled conditions. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2o5c2N7

Soil Cd, Cr, Cu, Ni, Pb and Zn sorption and retention models using SVM: Variable selection and competitive model

Publication date: 1 September 2017
Source:Science of The Total Environment, Volumes 593–594
Author(s): J.J. González Costa, M.J. Reigosa, J.M. Matías, E.F. Covelo
The aim of this study was to model the sorption and retention of Cd, Cu, Ni, Pb and Zn in soils. To that extent, the sorption and retention of these metals were studied and the soil characterization was performed separately.Multiple stepwise regression was used to produce multivariate models with linear techniques and with support vector machines, all of which included 15 explanatory variables characterizing soils. When the R-squared values are represented, two different groups are noticed. Cr, Cu and Pb sorption and retention show a higher R-squared; the most explanatory variables being humified organic matter, Al oxides and, in some cases, cation-exchange capacity (CEC). The other group of metals (Cd, Ni and Zn) shows a lower R-squared, and clays are the most explanatory variables, including a percentage of vermiculite and slime. In some cases, quartz, plagioclase or hematite percentages also show some explanatory capacity.Support Vector Machine (SVM) regression shows that the different models are not as regular as in multiple regression in terms of number of variables, the regression for nickel adsorption being the one with the highest number of variables in its optimal model. On the other hand, there are cases where the most explanatory variables are the same for two metals, as it happens with Cd and Cr adsorption. A similar adsorption mechanism is thus postulated.These patterns of the introduction of variables in the model allow us to create explainability sequences. Those which are the most similar to the selectivity sequences obtained by Covelo (2005) are Mn oxides in multiple regression and change capacity in SVM. Among all the variables, the only one that is explanatory for all the metals after applying the maximum parsimony principle is the percentage of sand in the retention process.In the competitive model arising from the aforementioned sequences, the most intense competitiveness for the adsorption and retention of different metals appears between Cr and Cd, Cu and Zn in multiple regression; and between Cr and Cd in SVM regression.

Graphical abstract

http://ift.tt/2o54IAH

Accumulation of toxic metals and organic micro-pollutants in sediments from tropical urban rivers, Kinshasa, Democratic Republic of the Congo

Publication date: July 2017
Source:Chemosphere, Volume 179
Author(s): Pitchouna I. Kilunga, Periyasamy Sivalingam, Amandine Laffite, Dominique Grandjean, Crispin K. Mulaji, Luiz Felippe de Alencastro, Pius T. Mpiana, John Poté
The increasing contamination of fresh water resource by toxic metals and Persistence Organic Pollutants (POPs) is a major environmental concern globally. In the present investigation, surface sediments collected from three main rivers named, Makelele, Kalamu and Nsanga, draining through the city of Kinshasa, Democratic Republic of the Congo, were characterized for grain size, organic matter, toxic metals, POPs (including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs)), and polycyclic aromatic hydrocarbons (PAHs). Furthermore, enrichment factor (EF) and geoaccumulation index (Igeo) were performed to determine metal source and pollution status. The results highlighted high concentration of toxic metals in all sediment samples, reaching the values (mg kg⁻¹) of 325 (Cu), 549 (Zn), 165 (Pb) and 1.5 (Cd). High values of PCBs and OCPs were detected in sediment samples, e.g. in Makelele river, PCB values ranged from 0.9 to 10.9 with total PCBs (∑7 PCBs × 4.3): 169.3 μg kg⁻¹; OCPs from 21.6 to 146.8 with ∑OCPs: 270.6 μg kg⁻¹. The PBDEs concentrations were higher in investigated rivers comparatively with values detected in many rivers from Sub-Saharan Africa. The ΣPAHs value ranged from 22.6 to 1011.9 μg kg⁻¹. River contamination may be explained by local intense domestic activities, urban and agricultural runoff, industrial and hospital wastewaters discharge into the rivers without prior treatment. This research provides not only a first baseline information on the extent of contamination in this tropical ecosystem but also represents useful tools incorporated to evaluate sediment quality in the river receiving systems which can be applied to similar aquatic environments.

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Is Firearm Threat in Intimate Relationships Associated with Posttraumatic Stress Disorder Symptoms Among Women?

Violence and Gender , Vol. 0, No. 0.

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A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report

Mesothelioma is a rare neoplasm which commonly develops in the pleura of people exposed to asbestos. Pericardial mesothelioma accounts for only 0.7 % of all malignant mesotheliomas and it usually presents with...

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Severe Asthma in Children

Abstract

Purpose of Review

The aim of this study is to characterize, diagnose, evaluate, and treat severe childhood asthma.

Recent Findings

Understanding the occurrence of the physiologic and clinical presentations of childhood severe asthma, the treatment and response may be predicted by biomarkers, but the patient's response is highly variable.

Summary

The onset of severe asthma occurs early and is primarily predicted by severity of viral infection and coexistence of the atopic state.

http://ift.tt/2nwvEbr

Brief alcohol intervention in alcohol involved facial fracture patients—a survey of patient attitudes to screening and intervention

Abstract

Purpose

Alcohol intoxication is an important contributor to traumatic facial injuries. The period following injuries afford clinicians a useful window of opportunity to provide alcohol screening and brief intervention (SBI) which may affect changes in patients' future drinking behaviour. Although SBI has been reported to decrease at risk drinking and potentially trauma recurrence, it is not routinely utilised in most clinical settings in the world. This study aims to assess utilisation of, as well as patients' knowledge and attitude towards SBI in the management of patients presenting with alcohol-related facial fractures.

Methods

Twenty consecutive patients who presented to Western Health with facial fractures who met selection criteria were offered an alcohol screening and survey questionnaire.

Results

Ninety percent of patients were male and 50% were aged between 19 and 34. ASSIST score showed 65% were in the moderate risk category; 75% reported this was their first admission with alcohol related trauma. Although 75% acknowledged alcohol as a main cause of injury, only 40% agreed they drink too much. Forty-four percent felt that talking to a healthcare worker might help and 33% would consider accepting help. Forty-seven percent felt reading materials would be helpful in changing future drinking habits. Whilst 63% would like to know safe drinking limit, only 45% would like to have a discussion about alcohol-related harms.

Conclusions

Most patients presented in this survey were in moderate risk category who are amenable to behavioural change with provision of SBI. However, there is resistance to implementation of this intervention due to lack of knowledge, self-awareness and willingness to change. Nonetheless, patients are prepared to accept advice from clinicians and some formats of intervention. It is important to formulate a simple screening questionnaire and intervention strategy that are easy to administer to affect positive changes in patients with harmful drinking behaviours.

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A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report

Spontaneous resolution of hypercalcemia

Primary hyperparathyroidism (PHPT) is a frequently encountered endocrine disorder due to benign neoplastic lesions or gland hyperplasia. It is often discovered incidentally when routine lab work reveals hypercalcemia.

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Spontaneous resolution of hypercalcemia

Mechanical mandible competence in rats with nutritional growth retardation

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Christian Esteban Lezón, Patricia Mabel Pintos, Clarisa Bozzini, Alan Agüero Romero, Patricia Casavalle, Silvia María Friedman, Patricia Mónica Boyer
ObjectiveIn order to provide a better understanding of the sympathetic nervous system as a negative regulator of bone status, the aim of the study was to establish the biomechanical mandible response to different doses of a β-adrenergic antagonist such as propranolol (P) in a stress-induced food restriction model of growth retardation.MethodsRats were assigned to eight groups: Control (C), C+P3.5 (CP3.5), C+P7 (CP7), C+P14 (CP14), NGR, NGR+P3.5 (NGRP3.5), NGR+P7 (NGRP7) and NGR+P14 (NGRP14). C, CP3.5, CP7 and CP14 rats were freely fed with the standard diet. NGR, NGRP3.5, NGRP7 and NGRP14 rats received, for 4 weeks (W4), 80% of the amount of controls food consumed. Propranolol 3.5, 7 and 14mg/kg/day was injected ip 5days per week in CP3.5 and NGRP3.5, CP7 and NGRP7, CP14 and NGRP14, respectively. At W4, zoometry, mandible morphometry, static histomorphometric and biomechanical competence were performed.ResultsA dose of Propranolol 7mg/kg/day induced interradicular bone volume accretion reaching a mandible stiffness according to chronological age.ConclusionThese findings evidenced that sympathetic nervous system activity is a negative regulator of mandible mechanical competence in the nutritional growth retardation model. Propranolol 7mg/kg/day, under the regimen usage, seems to be appropriate to blockade SNS activity on mandible mechanical performance in NGR rats, probably associated to an effect on bone mechanostat system ability to detect disuse mode as an error.

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For assessment of changes in intraoperative red blood cell transfusion practices over time, the pooled incidence of transfusion correlates highly with total units transfused

Multiple studies nationwide and at single hospitals have examined changes over time in the incidence of perioperative red blood cell (RBC) transfusion. However, the cost of RBC transfusions is related to the number of RBC units transfused, not to the incidence. We evaluate whether the readily available incidence of RBC transfusion can be used as a valid surrogate measure.

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Paediatric oral submucous fibrosis – The neglected pre-malignancy of childhood

Oral submucous fibrosis in children is one of the devastating consequences of arecanut addiction in children. Arecanut is the fourth commonest psychoactive agents used worldwide. However, regrettably, unlike other addictions like tobacco and alcohol, it has become socially acceptable atleast in a few countries. Consequently, children as young as two years have been noticed to be addicted to arecanuts. It has been a menace in most Asian countries and with increasing population migration, this has picked up even in the west.

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Temporal Bone Extramedullary Hematopoiesis as a Cause of Pediatric Bilateral Conductive Hearing Loss: Case Report and Review of the Literature

Extramedullary hematopoiesis occurs in children with hemoglobinopathy and chronic anemia. The liver and spleen are often affected first, but other foci can develop to support erythrocyte demand. We report a case of a nine-year-old with beta thalassemia and temporal bone extramedullary hematopoiesis causing ossicular fixation and bilateral conductive hearing loss. There is only one case in the literature describing this phenomenon in pediatric patients, and this is the first case report of bilateral hearing loss from this physiologic phenomenon.

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Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate

Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT-treatments) during childhood in a group of children with cleft lip and palate.

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Elevated levels of Soluble Human Leukocyte Antigen-G (sHLA-G) in the Airways are a Marker for a Low-inflammatory Endotype of Asthma

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Scalable fabrication of size-controlled chitosan nanoparticles for oral delivery of insulin

Publication date: June 2017
Source:Biomaterials, Volume 130
Author(s): Zhiyu He, Jose Luis Santos, Houkuan Tian, Huahua Huang, Yizong Hu, Lixin Liu, Kam W. Leong, Yongming Chen, Hai-Quan Mao
Controlled delivery of protein would find diverse therapeutic applications. Formulation of protein nanoparticles by polyelectrolyte complexation between the protein and a natural polymer such as chitosan (CS) is a popular approach. However, the current method of batch-mode mixing faces significant challenges in scaling up while maintaining size control, high uniformity, and high encapsulation efficiency. Here we report a new method, termed flash nanocomplexation (FNC), to fabricate insulin nanoparticles by infusing aqueous solutions of CS, tripolyphosphate (TPP), and insulin under rapid mixing condition (Re > 1600) in a multi-inlet vortex mixer. In comparison with the bulk-mixing method, the optimized FNC process produces CS/TPP/insulin nanoparticles with a smaller size (down to 45 nm) and narrower size distribution, higher encapsulation efficiency (up to 90%), and pH-dependent nanoparticle dissolution and insulin release. The CS/TPP/insulin nanoparticles can be lyophilized and reconstituted without loss of activity, and produced at a throughput of 5.1 g h⁻¹ when a flow rate of 50 mL min⁻¹ is used. Evaluated in a Type I diabetes rat model, the smaller nanoparticles (45 nm and 115 nm) control the blood glucose level through oral administration more effectively than the larger particles (240 nm). This efficient, reproducible and continuous FNC technique is amenable to scale-up in order to address the critical barrier of manufacturing for the translation of protein nanoparticles.

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Editorial board

Publication date: June 2017
Source:Biomaterials, Volume 129

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Has the primary care oral surgery service reduced the activity in secondary care oral and maxillofacial units?

To find out if the devolution of some dentoalveolar services into primary care in 2007 was having an effect on the workload of oral and maxillofacial units, I reviewed the workload of two units in 2011-13.

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Chemocauterization of second branchial cleft fistula using trichloroacetic acid: A preliminary report

Publication date: Available online 27 March 2017
Source:Auris Nasus Larynx
Author(s): Bo Hae Kim, Seong Keun Kwon, J.Hun Hah
ObjectiveAlthough second branchial cleft fistula (BCF) can be well treated with surgical excision, neck scarring is unavoidable. We previously reported chemocauterization with trichloroacetic acid (TCA) to close various fistulas. Here, we report chemocauterization of a second BCF without a consequent incision scar.MethodsThis procedure was applied in four pediatric patients whose parents were reluctant to undergo surgical excision for a second BCF. Under general anesthesia, a thin metal suction tip or cut down tube was inserted through the skin opening. Normal saline with or without dye was injected to identify the pharyngeal opening around the palatine tonsil, and 75% TCA solution mixed with dye was injected. Leaked TCA at the pharynx was sucked out meticulously to avoid extensive and unexpected injury to the mucosa, and the external opening was sealed with a thin adhesive film.ResultsThere were no immediate complications and recurrence of a second BCF in all patients during the median follow-up of 23 months (range, 18–88 months) with minimal neck scarring.ConclusionTCA chemocauterization of second BCF could be a simple, less invasive, and feasible treatment option in pediatric patients.

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Sialendoscopic removal of fish bone-induced sialoliths in the duct of the submandibular gland

Publication date: Available online 27 March 2017
Source:Auris Nasus Larynx
Author(s): Toshinori Iwai, Satomi Sugiyama, Yuichiro Hayashi, Senri Oguri, Makoto Hirota, Kenji Mitsudo, Iwai Tohnai
Obstructive sialadenitis of the submandibular gland is commonly caused by sialoliths, but more rarely by foreign body-induced sialoliths. Here, we report minimally invasive sialendoscopic removal of fish bone-induced sialoliths in the duct of the submandibular gland. A 43-year-old woman presented with recurrent swelling of the right submandibular gland at other hospital. Computed tomography (CT) showed an 8-mm linear calcification in the posterior part of Wharton's duct. The lesion was deemed difficult to remove and she was followed up. However, because the lesion did not resolve spontaneously within 9 months and chronic sialadenitis symptoms persisted, she was referred to our department for endoscopic removal. CT showed a linear calcification (5.6×1.2×0.8mm) connecting 2 spherical calcifications (2.3×2.1×1.9mm; 1.8×1.4×1.1mm) in the anterior part of Wharton's duct. The patient underwent endoscopic removal of the lesion using a 1.6-mm-diameter sialendoscope under local anesthesia. The specimen contained a fish bone connecting 2 sialoliths. The patient was unaware of the fish-bone injury. After removal, there was no recurrence of submandibular gland swelling during 6 months follow-up.

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The indication for endoscopic butterfly cartilage myringoplasty in children

We have reviewed the manuscript entitled "Endoscopic cartilage butterfly myringoplasty in children" by Akyigit et al. [1]. The authors evaluated the results of the graft success rate and hearing gain of children who underwent endoscopic inlay butterfly myringoplasty due to chronic otitis media. The authors concluded that endoscopic inlay butterfly tympanoplasty is a surgical technique with short duration, high graft success, effective hearing reconstruction, and high levels of postoperative patient comfort in children [1].

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Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome

The aim of this study was to investigate the potential impact of multiple preoperative and intraoperative variables on the outcome of partial cricotracheal resection and tracheal resection anastomosis (PCTR/TRA).

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The dual-pathway model of binge eating: Is there a need for modification?

Publication date: 1 July 2017
Source:Appetite, Volume 114
Author(s): Marie Sehm, Petra Warschburger
The dual-pathway model proposes that body dissatisfaction might lead to binge eating (BE) through restraint eating and negative affect. Both pathways have been confirmed longitudinally, but there is evidence that the affect-pathway might rather be found in the short-term, whereas other variables might be involved over longer periods. Research suggests that self-esteem represents a key-factor in the etiology of BE in adolescent girls and might serve as a mediator between body dissatisfaction and eating pathology. Based on these findings, the aim of this study was to investigate the original dual-pathway model across 20 months and to evaluate a modified version of the model with self-esteem instead of negative affect as a mediator in the affect-pathway.We assessed eating pathology, negative affect and self-esteem by self-report in a sample of 523 adolescent girls at two time points separated by 20 months. Data were analyzed using a cross-lagged panel design.Both, the original and the modified model provided good fit to the data, but results yielded limited support for the assumptions of the original model. Neither restraint eating nor negative affect mediated the link between body dissatisfaction and BE. The modified model fit the data slightly better and results indicated that low self-esteem mediated the relationship between body dissatisfaction and BE. Notably, our results indicated that restraint eating might even reduce the risk for BE through the enhancement of self-esteem.Results suggest that the dual-pathway model could benefit from the inclusion of a more trait-like variable such as self-esteem when evaluated across the long-term. Furthermore, our findings indicate that healthy restraint eating might have positive effects on self-esteem, thereby reducing risk for BE in adolescent girls, who are dissatisfied with their bodies.

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Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τρίτη 28 Μαρτίου 2017

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