Head and Neck Diseases by Alexandros G.Sfakianakis: 04/05/17

Τετάρτη 5 Απριλίου 2017

Environmental photocatalysis and photochemistry for a sustainable world: a big challenge

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A brief review and evaluation of earthworm biomarkers in soil pollution assessment

Abstract

Earthworm biomarker response to pollutants has been widely investigated in the assessment of soil pollution. However, whether and how the earthworm biomarker-approach can be actually applied to soil pollution assessment is still a controversial issue. This review is concerned about the following points:

Despite much debate, biomarker is valuable to ecotoxicology and biomarker approach has been properly used in different fields. Earthworm biomarker might be used in different scenarios such as large-scale soil pollution survey and soil pollution risk assessment. Compared with physicochemical analysis, they can provide more comprehensive and straightforward information about soil pollution at low cost.
Although many earthworm species from different ecological categories have been tested, Eisenia fetida/andrei is commonly used. Many earthworm biomarkers have been screened from the molecular to the individual level, while only a few biomarkers, such as avoidance behavior and lysosomal membrane stability, have been focused on. Other aspects of the experimental design were critically reviewed.
More studies should focus on determining the reliability of various earthworm biomarkers in soil pollution assessment in future research. Besides, establishing a database of a basal level of each biomarker, exploring biomarker response in different region/section/part of earthworm, and other issues are also proposed.
A set of research guideline for earthworm biomarker studies was recommended, and the suitability of several earthworm biomarkers was briefly evaluated with respect to their application in soil pollution assessment.

This review will help to promote further studies and practical application of earthworm biomarker in soil pollution assessment.

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Does the use of distiller’s dried grains with solubles (DDGS) in layer diets affect the nutrients digestibility and manure pollution by nitrogen and phosphorous?

Abstract

The objective of the current study was to examine the effect of the inclusion levels of distiller's dried grains with solubles (DDGS) which partially and fully replaced soybean meal (SBM) in laying hen diets with or without enzyme or vitamin E supplementation on nutrients digestibility and excreted nitrogen and phosphorous. For these purposes, a total of 180 Hisex Brown laying hens at 22 weeks of age were randomly distributed into 15 treatment groups in a 5 × 3 factorial design experiment including five levels of DDGS (0, 5.5, 11, 16.5 and 22% replaced for the same percent of SBM which represents 0, 25, 50, 75 and 100% respectively in the diet) and three levels of feed additives (without, 250 mg enzyme/kg diet or 200 mg vitamin E/kg diet) through 22–42 weeks of age. Results revealed that digestion coefficient values of nutrients including DM, OM, CP, EE, NFE and CF were more preferable in hens fed diets involved 25% DDGS instead of SBM than that of the control diet and other treatment groups. In contrast, hens fed 100% substitution of DDGS caused significant (P ≤ 0.01) decrease in digestibility coefficients of all nutrients. The amount of daily excreted N was decreased in hens fed 25 or 50% DDGS substitution, whilst feeding 75 or 100% DDGS led to an elevation in N excretion. The proportion of excreted phosphorous was statistically (P ≤ 0.01) decreased as the level of DDGS increased. Generally, neither enzyme nor vitamin E supplementation had any significant effect on the studied parameters. It could be concluded that DDGS could be used up to 50% as a replacement of SBM (11% of the diet) without any adverse effects on nutrients digestibility. Laying hen farms using DDGS up to 25 or 50% substituted for SBM in its diets (5.5 or 11% of the diet) will have clearer environment of nitrogen and phosphorous pollution than others whose diets free of DDGS.

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A refined method for analysis of 4,4′-dicofol and 4,4′-dichlorobenzophenone

Abstract

The acaricide, dicofol, is a well-known pesticide and partly a substitute for dichlorodiphenyltrichloroethane (DDT). Only few reports on environmental occurrence and concentrations have been reported calling for improvements. Hence, an analytical method was further developed for dicofol and dichlorobenzophenone (DCBP) to enable assessments of their environmental occurrence. Concentrated sulfuric acid was used to remove lipids and to separate dicofol from DCBP. On-column injection was used as an alternative to splitless injection to protect dicofol from thermal decomposition. By the method presented herein, it is possible to quantify dicofol and DCBP in the same samples. Arctic cod (Gadus morhua) were spiked at two dose levels and the recoveries were determined. The mean recovery for dicofol was 65% at the low dose (1 ng) and 77% at the high dose (10 ng). The mean recovery for DCBP was 99% at the low dose (9.2 ng) and 146% at the high dose (46 ng). The method may be further improved by use of another lipid removal method, e.g., gel permeation chromatography. The method implies a step forward in dicofol environmental assessments.

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Quantitative study on nitrogen deposition and canopy retention in Mediterranean evergreen forests

Abstract

To assess the impact of nitrogen (N) pollutants on forest ecosystems, the role of the interactions in the canopy needs to be understood. A great number of studies have addressed this issue in heavily N-polluted regions in north and central Europe. Much less information is available for the Iberian Peninsula, and yet this region is home to mountain forests and alpine grasslands that may be at risk due to excessive N deposition. To establish the basis for ecology-based policies, there is a need to better understand the forest response to this atmospheric impact. To fill this gap, in this study, we measured N deposition (as bulk, wet, and throughfall fluxes of dissolved inorganic nitrogen) and air N gas concentrations from 2011 to 2013 at four Spanish holm oak (Quercus ilex) forests located in different pollution environments. One site was in an area of intensive agriculture, two sites were influenced by big cities (Madrid and Barcelona, respectively), and one site was in a rural mountain environment 40 km north of Barcelona. Wet deposition ranged between 0.54 and 3.8 kg N ha⁻¹ year⁻¹ for ammonium (NH₄⁺)-N and between 0.65 and 2.1 kg N ha⁻¹ year⁻¹ for nitrate (NO₃⁻)-N, with the lowest deposition at the Madrid site for both components. Dry deposition was evaluated with three different approaches: (1) a canopy budget model based in throughfall measurements, (2) a branch washing method, and (3) inferential calculations. Taking the average dry deposition from these methods, dry deposition represented 51–67% (reduced N) and 72–75% (oxidized N) of total N deposition. Canopies retained both NH₄⁺-N and NO₃-N, with a higher retention at the agricultural and rural sites (50–60%) than at sites located close to big cities (20–35%, though more uncertainty was found for the site near Madrid), thereby highlighting the role of the forest canopy in processing N pollutant emissions.

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Simulating changes in cropping practices in conventional and glyphosate-resistant maize. II. Weed impacts on crop production and biodiversity

Abstract

Overreliance on the same herbicide mode of action leads to the spread of resistant weeds, which cancels the advantages of herbicide-tolerant (HT) crops. Here, the objective was to quantify, with simulations, the impact of glyphosate-resistant (GR) weeds on crop production and weed-related wild biodiversity in HT maize-based cropping systems differing in terms of management practices. We (1) simulated current conventional and probable HT cropping systems in two European regions, Aquitaine and Catalonia, with the weed dynamics model FlorSys; (2) quantified how much the presence of GR weeds contributed to weed impacts on crop production and biodiversity; (3) determined the effect of cultural practices on the impact of GR weeds and (4) identified which species traits most influence weed-impact indicators. The simulation study showed that during the analysed 28 years, the advent of glyphosate resistance had little effect on plant biodiversity. Glyphosate-susceptible populations and species were replaced by GR ones. Including GR weeds only affected functional biodiversity (food offer for birds, bees and carabids) and weed harmfulness when weed effect was initially low; when weed effect was initially high, including GR weeds had little effect. The GR effect also depended on cultural practices, e.g. GR weeds were most detrimental for species equitability when maize was sown late. Species traits most harmful for crop production and most beneficial for biodiversity were identified, using RLQ analyses. None of the species presenting these traits belonged to a family for which glyphosate resistance was reported. An advice table was built; the effects of cultural practices on crop production and biodiversity were synthesized, explained, quantified and ranked, and the optimal choices for each management technique were identified.

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Emissions analysis on diesel engine fuelled with cashew nut shell biodiesel and pentanol blends

Abstract

The present work is intended to investigate the emission characteristics of neat cashew nut shell methyl ester (CNSME100) by adding pentanol at two different proportions and compared with the baseline diesel. CNSME100 is prepared by the conventional transesterification process. CNSME100 is chosen due to its non-edible nature. Pentanol is chosen as an additive because of its higher inbuilt oxygen content and surface to volume ratio which reduces the drawbacks of neat CNSME100. Emission characteristics were carried out in single cylinder naturally aspirated CI engine fuelled with neat cashew nut shell methyl ester (CNSME), cashew nut shell methyl ester and pentanol by 10% volume (CNSME90P10), cashew nut shell methyl ester and pentanol by 20% volume (CNSME80P20), and diesel. This work also aims to investigate the feasibility of operating an engine fuelled with neat methyl ester and alcohol blends. Experimental results showed that by blending higher alcohol to neat cashew nut shell methyl ester reduces the emissions significantly. It is also found that the emission from neat methyl ester and pentanol blends is lesser than diesel at all loads.

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A soil biotechnology system for wastewater treatment: technical, hygiene, environmental LCA and economic aspects

Abstract

Soil biotechnology (SBT) is a green engineering approach for wastewater treatment and recycling. Five SBT units located in the Mumbai region were under consideration of which holistic assessment of two SBT plants was carried out considering its technical, environmental and economic aspects and was compared with published research of other three. LCA has been done to evaluate the environmental impacts of construction and operation phase of SBT. Chemical oxygen demand (COD) and biochemical oxygen demand (BOD) removal of more than 90% can be achieved using this technology. Also, the nutrient removal proficiency (nitrate, nitrite, ammoniacal nitrogen, TKN, total nitrogen and phosphates) of this technique is good. On the other hand, SBT has low annual operation and maintenance cost, comparable to land-based systems and lower than conventional or advanced technologies. From the life cycle impact assessment, the main contributors for overall impact from the plant were identified as electricity consumption, discharges of COD, P-PO₄³⁻ and N-NH₄⁺ and disposal of sludge. The construction phase was found to have significantly more impact than the operation phase of the plant. This study suggests plant I is not relatively as efficient enough regarding sanitation. SBT provides several benefits over other conventional technologies for wastewater treatment. It is based on a bio-conversion process and is practically maintenance free. It does not produce any odorous bio-sludge and consumes the least energy.

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Electronic cigarettes: age-specific generation-resolved pulmonary doses

Abstract

Particle size-number distributions of aerosol from e-cigarettes (0 and 14 mg mL⁻¹ nicotine) were compared with conventional cigarettes. Results were used to provide age-specific (9–21 years) dosimetry estimates applying the MMPD model. After a 2-s puff, total number doses (D _Tot ) were highest for 9 years of age (6.01 × 10¹⁰–1.31 × 10¹¹ particles) and lowest for 18 years of age (4.69 × 10¹⁰–1.06 × 10¹¹ particles). Such doses represented about 19–45 and 25–100% of the relevant daily doses of not smoking individuals, respectively, in tracheobronchial (TB) and alveolar (A) regions. D _Tot for the e-cigarettes were about double that for conventional cigarette. Deposition densities and daily volume of e-cigarette liquid deposited per unit surface area were maximum at lobar bronchi, highest for 9 years and lowest for 21 years age.

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Removal of PFOA and PFOS from aqueous solutions using activated carbon produced from Vitis vinifera leaf litter

Abstract

The removal of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) from aqueous solutions using agro-waste biomass of Vitis vinifera (grape) leaf litter was studied. Activated carbons were produced from the biomass and chemical activation achieved by using phosphoric acid (H₃PO₄) and potassium hydroxide (KOH) for the modification of the carbons' surface morphology. Activated carbons were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy and Brunauer–Emmett–Teller (BET) in order to understand removal mechanisms of the contaminants by activated carbons. The effect of solution concentration, pH, adsorbent dosage, contact time and temperature was evaluated to optimize the removal efficiency of activated carbons. Adsorption isotherm models were used to analyse the equilibrium data obtained, and kinetic models were applied to study sorption mechanisms. The results fitted well into Freundlich isotherm with both AC-KOH and AC-H₃PO₄ having high K _f values. Maximum adsorption capacities for AC-H₃PO₄ were 78.90 and 75.13 mg/g for PFOA and PFOS, respectively. Equilibrium was reached before 60 min on both adsorbents, and thermodynamic studies indicated that the process was exothermic and spontaneous. Surface morphology showed the abundance of microspores (>60%) with BET total surface area of 295.488 and 158.67 m²/g for AC-H₃PO₄ and AC-KOH activated carbons, respectively. Removal efficiencies were 95 and 90% for PFOA using AC-H₃PO₄ and AC-KOH, respectively; corresponding values for PFOS were 94 and 88%. Adsorbents' removal capacities depended on the physicochemical characteristics of adsorbents.

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Association of Pre-residency Peer Reviewed Publications with Radiation Oncology Resident Choice of Academic Versus Private Practice Career

Publication date: Available online 5 April 2017
Source:Practical Radiation Oncology
Author(s): Shearwood McClelland, Charles R Thomas, Lynn D Wilson, Emma B Holliday, Jerry J Jaboin
IntroductionThe decision of radiation oncology residents to pursue academic versus private practice careers plays a central role in shaping the present and future of the field, yet factors potentially predictive of this decision are lacking. This study was performed to examine the role of several factors publicly available prior to residency on post-residency career choice, including pre-residency peer-reviewed publications (PRP) which have been associated with resident career choice in comparably competitive subspecialties such as neurosurgery.MethodsUsing a combination of internet searches, telephone interviews, and the 2015 Association of Residents in Radiation Oncology (ARRO) directory, a list of 2016 radiation oncology resident graduates was compiled along with their post-residency career choice. PRP was defined as the number of PubMed publications encompassing the end of the calendar year (2010) in which residency applications were due; this number was then correlated with career choice.Results163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs were examined. 78% were male, 22% were MD/PhD, and 79 graduates (48%) chose academic careers. 52% of graduates had at least one PRP at the time of application to radiation oncology residency; 35% had more than one PRP. Regarding career choice, the difference between 0 and 1+ PRP was statistically significant (odds ratio=3.3; p<0.01), but not between 1 and >1 PRP. Gender, PhD or non-PhD dual degree status were not associated with career choice.ConclusionRadiation oncology residency graduates with one or more peer-reviewed publications at the time of residency application were roughly two times more likely to choose an academic career as their initial career choice than graduates with no pre-residency peer-reviewed publications. This information may prove useful to medical students, medical school advisors and residency program directors, and deserves further prospective investigation.

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Association of established hypothyroidism-associated genetic variants with Hashimoto’s thyroiditis

Abstract

Purpose

Hashimoto's thyroiditis (HT) as a chronic autoimmune disease of the thyroid gland is the most common cause of hypothyroidism. Since HT and hypothyroidism are closely related, the main aim of this study was to explore the association of established hypothyroidism single-nucleotide polymorphisms (SNPs) with HT.

Methods

The case–control dataset included 200 HT cases and 304 controls. Diagnosis of HT cases was based on clinical examination, measurement of thyroid antibodies (TgAb, TPOAb), hormones (TSH and FT4) and ultrasound examination. We genotyped and analysed 11 known hypothyroidism-associated genetic variants. Case–control association analysis was performed in order to test each SNP for the association with HT using logistic regression model. Additionally, each SNP was tested for the association with thyroid-related quantitative traits (TPOAb levels, TgAb levels and thyroid volume) in HT cases only using linear regression.

Results

We identified two genetic variants nominally associated with HT rs3184504 in SH2B3 gene (P = 0.0135, OR = 0.74, 95% CI = 0.57–0.95) and rs4704397 in PDE8B gene (P = 0.0383, OR = 1.32, 95% CI = 1.01–1.74). The SH2B3 genetic variant also showed nominal association with TPOAb levels (P = 0.0163, β = −0.46) and rs4979402 inside DFNB31 gene was nominally associated with TgAb levels (P = 0.0443, β = 0.41).

Conclusions

SH2B3 gene has previously been associated with susceptibility to several autoimmune diseases, whereas PDE8B has been associated with TSH levels and suggested to modulate thyroid physiology that may influence the manifestation of thyroid disease. Identified loci are novel and biologically plausible candidates for HT development and represent good basis for further exploration of HT susceptibility.

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Fungal raw materials used to produce allergen extracts

To review the topic of fungal raw materials used for the production of allergen extracts and the associated challenges and highlight candidate areas for development before standardized fungal allergen extracts can be commercially produced.

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High exhaled nitric oxide levels correlate with nonadherence in acute asthmatic children

Nonadherence to asthma controller medication is associated with an increased number of acute exacerbations, increased asthma-related emergency department visits and childhood hospitalizations, and high health care costs.1 The average medication adherence rate in children with asthma tends to be poor (<50%). Improving patient adherence is essential to achieving optimal outcomes.2

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High exhaled nitric oxide levels correlate with nonadherence in acute asthmatic children

Preventing food allergies with tweaks to the infant diet

The increase in food allergy prevalence during the past few decades is an important public health concern, galvanizing efforts worldwide to understand and curb this trend. An area of particular interest has been the role of early feeding, particularly feeding of commonly allergenic foods, in the development of allergy. During the past several decades, infant feeding recommendations were made based on available evidence at the time. These recommendations continue to evolve as we gain insight into the multiple factors that influence the development of allergic sensitization to foods.

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Instructions for Authors

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Author's response

Motivated by the article by Zazzali et al,1 my editorial2 was intended to elaborate on the possibility of having conflicting conclusions concerning clinical significance vs statistical significance. I would like to thank the authors for their constructive letter3 in support of clinical significance of the effects of omalizumab on angioedema in patients with chronic idiopathic/spontaneous urticaria. The statistical significance of the collective primary outcome differences in patients treated with an active intervention compared with a control is often assessed in terms of the difference in the outcome means for the treatments.

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Editorial Board

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Urticarial vasculitis and associated disorders

Patients often present to allergists with urticarial eruption symptoms. In many instances, these lesions represent chronic idiopathic or spontaneous urticaria.1 Some of these patients may have a condition referred to as urticarial vasculitis (UV), including its variants normocomplementemic urticarial vasculitis (NUV), hypocomplementemic urticarial vasculitis (HUV), and hypocomplementemic urticarial vasculitis syndrome (HUVS) or Schnitzler syndrome.2,3 There are some features that set this condition apart, and in some instances, the disease may be severe enough to require systemic immunosuppressive therapies.

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A systematic review of food protein–induced enterocolitis syndrome from the last 40 years

To provide a complete, exhaustive summary of current literature relevant to food protein–induced enterocolitis syndrome (FPIES).

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Re: “Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel”

The Learning Early About Peanut Allergy (LEAP) Study has shed light on a growing prevalence of allergy to peanuts. The trial concluded that early exposure to peanuts in a child's diet decreases the frequency of developing peanut allergy.1 Based on this trial and expert opinion, the new addendum guidelines2–4 help tailor the introduction of peanut into the diet of children who are at high risk of developing allergy. Although decreasing the incidence of severe peanut allergy is of significant importance, the public has to be equally aware of the danger of allowing the ingestion of solid peanuts in children younger than 2 years because of the risk of aspiration.

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Clinical features of adolescents with chronic idiopathic or spontaneous urticaria

Adults and adolescents were included in 3 phase 3 omalizumab trials in chronic idiopathic urticaria (CIU): ASTERIA I, ASTERIA II, and GLACIAL.

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Biomarkers of oxidative stress and antioxidants in severe asthma

Bronchial airway inflammation is the hallmark of asthma, which may be driven by an imbalance between oxidative stress and antioxidant defenses. Antioxidants deficiency may play a role, but this has remained unconfirmed.

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Preventing food allergies with tweaks to the infant diet

An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period

Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few.

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Instructions for Authors

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Mammalian milk allergy: case presentation and review of prevalence, diagnosis, and treatment

A 5-year-old boy with a history of mild intermittent asthma and allergic rhinoconjunctivitis was seen for evaluation of anaphylactic reactions.

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Author's response

Live attenuated influenza vaccine use and safety in children and adults with asthma

Live attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing.

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Editorial Board

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Biomarkers of oxidative stress and antioxidants in severe asthma

Fungal raw materials used to produce allergen extracts

An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period

Case series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few.

http://ift.tt/2oLGhpm

Mammalian milk allergy: case presentation and review of prevalence, diagnosis, and treatment

A 5-year-old boy with a history of mild intermittent asthma and allergic rhinoconjunctivitis was seen for evaluation of anaphylactic reactions.

http://ift.tt/2oG1m7F

Live attenuated influenza vaccine use and safety in children and adults with asthma

Live attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing.

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Celiac disease and nonceliac gluten sensitivity

Celiac disease (CD) is an increasingly common chronic autoimmune disease caused by permanent gluten sensitivity that occurs in people carrying the HLA-DQ2 or HLA-DQ8. It causes both gastroenteropathy (demonstrated by duodenal biopsy) and extraintestinal pathologic conditions (Fig 1A and B). The disease is often diagnosed by the discovery of positive autoantibodies (anti–tissue transglutaminase [anti-tTG] IgA and anti–endomysial antibody [EMA] IgA) in a patient, which might trigger an intestinal biopsy that reveals villous atrophy.

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Re: “Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel”

Urticarial vasculitis and associated disorders

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Importance of angioedema-free days in patients with chronic idiopathic or spontaneous urticaria

We read with interest Dr Johnson's editorial1 that accompanied our analysis of data from 3 pivotal trials of omalizumab in chronic idiopathic/spontaneous urticaria (CIU/CSU).2 Dr Johnson suggested that, albeit statistically significant, the improvements in angioedema-free days might not be of clinical significance.

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Celiac disease and nonceliac gluten sensitivity

Clinical features of adolescents with chronic idiopathic or spontaneous urticaria

Adults and adolescents were included in 3 phase 3 omalizumab trials in chronic idiopathic urticaria (CIU): ASTERIA I, ASTERIA II, and GLACIAL.

http://ift.tt/2oLPrSQ

A systematic review of food protein–induced enterocolitis syndrome from the last 40 years

To provide a complete, exhaustive summary of current literature relevant to food protein–induced enterocolitis syndrome (FPIES).

http://ift.tt/2oLvPhs

Importance of angioedema-free days in patients with chronic idiopathic or spontaneous urticaria

Poncet’s disease: two case reports

One of the rare presentations of active pulmonary or even extrapulmonary tuberculosis is polyarthropathy which is the involvement of multiple large and small joints in the body; a reactive constellation known ...

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Distant metastasis as the sole initial manifestation of well-differentiated thyroid carcinoma

Abstract

Thyroid carcinoma usually presents as a neck lump. Distant metastasis as the sole initial manifestation of well-differentiated thyroid carcinoma (WDTC) is rare and little is known about these patients. The aim of this study is to characterize patients who present with distant metastasis as the sole initial manifestation of WDTC. Retrospective review of case records of WDTC seen at the National Cancer Centre Singapore from 2002 to 2015 was performed. Patients with no prior complaint of neck swelling and whose first presentation was distant metastatic WDTC were included. Patient demographics, disease characteristics, radiological imaging, histopathology, types of treatment administered, and survival outcomes were examined. Nineteen out of seven hundred and thirty-two cases fulfilled inclusion criteria. Mean age was 65.4 years. All patients presented with osseous (36.8%), pulmonary (31.6%), cerebral metastases (5.3%), or a combination of two out of three aforementioned sites (26.3%). Follicular thyroid carcinoma was most common (47.4%), followed by papillary (36.8%) and medullary (15.8%). More than two-thirds of patients had multiple metastatic foci. Thirteen out of nineteen patients (68.4%) underwent total thyroidectomy with or without neck dissection and adjuvant RAI, while the rest declined surgery. The mean length of follow-up was 40.1 ± 5.1 months and 5-year disease-specific survival was 48.0 ± 17.2%. Distant metastasis without a history of neck swelling as the initial presentation of WDTC is extremely rare. Osseous metastasis and follicular thyroid carcinoma are the most common metastatic site and etiology, respectively. Disease-specific survival at 5-year post-diagnosis is lower compared to patients with thyroid carcinoma diagnosed with distant metastasis on further work-up.

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Retrospective evaluation of concomitant cetuximab and radiotherapy tolerance for locoregional advanced head and neck squamous cell carcinoma treatment in patients unfit for platinum-based chemotherapy

Abstract

Radiotherapy associated with cetuximab (Cet-RT) is an alternative treatment to platinum-based chemoradiotherapy in locally advanced head and neck carcinoma (LAHNC). Reviews suggest that the use of cetuximab is associated with poorer tolerance in patients unfit for chemotherapy than in pivotal trial. We retrospectively studied patients first treated by Cet-RT for LAHNC presenting contraindications to chemoradiotherapy. Objectives were treated population description, acute tolerance, progression-free survival (PFS), overall survival (OS), and 3-month clinical response. Eighty-eight patients were included. Treatment was completed without delay for 43 patients. Grade 3–4 acute toxicity was described in 44.3%: mucositis (n = 20), radiodermatitis (n = 25) folliculitis (n = 10), and anaphylaxis (n = 6). Fourteen patients died during treatment. Median PFS and OS were 6.3 and 18.7 months, respectively. We confirm that Cet-RT tolerance in unfit patients is poorer than that in trials. Survival data illustrate patients' frailty and suggest that balanced use of Cet-RT is required in this population.

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Distant metastasis as the sole initial manifestation of well-differentiated thyroid carcinoma

Abstract

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Retrospective evaluation of concomitant cetuximab and radiotherapy tolerance for locoregional advanced head and neck squamous cell carcinoma treatment in patients unfit for platinum-based chemotherapy

Abstract

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Optimizing medical trips to care for those with rare genetic diseases in remote settings: lessons learned from xeroderma pigmentosum

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Issue Information - TOC

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Instructions for Authors

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4

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Editorial Board

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4

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Preventing food allergies with tweaks to the infant diet

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Julie Wang, Marion Groetch

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Information for Readers

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4

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High exhaled nitric oxide levels correlate with nonadherence in acute asthmatic children

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Yi-Giien Tsai, Hai-Lun Sun, Jien-Wen Chien, Chun-Yu Chen, Ching-Hsiung Lin, Ching-Yuang Lin

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Celiac disease and nonceliac gluten sensitivity

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Chongwei Cui, Tyler Basen, Ami Thakor Philipp, Joseph Yusin, Guha Krishnaswamy

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Urticarial vasculitis and associated disorders

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Ahmad Hamad, Warit Jithpratuck, Guha Krishnaswamy

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Fungal raw materials used to produce allergen extracts

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Robert E. Esch, Rosa Codina
ObjectiveTo review the topic of fungal raw materials used for the production of allergen extracts and the associated challenges and highlight candidate areas for development before standardized fungal allergen extracts can be commercially produced.Data SourcesA PubMed search was performed using focused keywords and combined with a review of regulatory documents and industry guidelines. Several books on mycology also were consulted.Study SelectionsThe information obtained through the literature, books, and industry was scrutinized and combined with personal experience and expertise to write this article.ResultsFungi are complex ubiquitous organisms on Earth. They are beneficial and detrimental for humans. Fungi can cause hypersensitivity reactions, including types I, III, and IV. The procurement of fungal raw materials to prepare allergen extracts for diagnosis and possible allergen immunotherapy is complex owing to the intrinsic nature of fungi and their complex genome. Allergen manufacturers produce allergen extracts with variable qualitative and quantitative compositions, which can lead to unpredictable clinical outcomes.ConclusionThe clinician should be aware of the factors responsible for the qualitative and quantitative compositions of fungal allergen extracts and the reasons that currently preclude their standardization. Scientific advances and collaboration and cooperation between allergen manufacturing companies and regulatory agencies are necessary to improve the quality and consistency of fungal extracts. Moreover, clinicians should understand the limitations of currently available fungal extracts.

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Mammalian milk allergy: case presentation and review of prevalence, diagnosis, and treatment

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Michele Ngoc Pham, Julie Wang

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Author's response

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): William D. Johnson

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A systematic review of food protein–induced enterocolitis syndrome from the last 40 years

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Sara Manti, Salvatore Leonardi, Annamaria Salpietro, Giuliana Del Campo, Carmelo Salpietro, Caterina Cuppari
ObjectiveTo provide a complete, exhaustive summary of current literature relevant to food protein–induced enterocolitis syndrome (FPIES).Data SourcesData have been extracted from PubMed and Science Direct databases.Study SelectionsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, a literature search for peer-reviewed journal articles in English through January 1975 with updates through October 2016 was conducted. Relevant publications were reviewed that included pediatric and adult populations. Information on the study design, sample, intervention, comparators, outcome, timeframe, and risk of bias were abstracted for each article.ResultsOf 135 reviewed reports, 52 were included in this systematic review. In accordance with the age at onset, clinical features, and offending foods, it is possible to distiguish different types of FPIES. An immune systemic involvement can occur in patients with FPIES. In addition to the most common causative foods (cow's milk, soy, and rice), any food can potentially cause FPIES. Although specific diagnostic tests are not available, open food challenge remains the gold standard for FPIES diagnosis. Moreover, because of the lack of randomized clinical trials and of use of different adopted methods, confounding factors might mask critical findings, leading to poor knowledge of this pleiotropic clinical entity.ConclusionMulticenter studies are needed to better develop an evidence-based approach to pathophysiology, prevalence, diagnosis, and natural history of the disease.

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Live attenuated influenza vaccine use and safety in children and adults with asthma

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Jonathan Duffy, Melissa Lewis, Theresa Harrington, Roger Baxter, Edward A. Belongia, Lisa A. Jackson, Steven J. Jacobsen, Grace M. Lee, Allison L. Naleway, James Nordin, Matthew F. Daley
BackgroundLive attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing.ObjectiveTo describe the use and assess the safety of LAIV in persons with asthma in the Vaccine Safety Datalink population.MethodsWe identified persons with asthma using diagnosis codes and medication records in 7 health care organizations over 3 influenza seasons (2008–2009 through 2010–2011) and determined their influenza vaccination rates. Using the self-controlled risk interval method, we calculated the incidence rate ratio of medically attended respiratory events in the 14 days after LAIV compared with 29 to 42 days after vaccination in persons 2 through 49 years old.ResultsIn our population of 6.3 million, asthma prevalence was 5.9%. Of persons with asthma, approximately 50% received any influenza vaccine but less than 1% received LAIV. The safety study included 12,354 LAIV doses (75% in children; 93% in those with intermittent or mild persistent asthma). The incidence rate ratio for inpatient and emergency department visits for lower respiratory events (including asthma exacerbation and wheezing) was 0.98 (95% confidence interval 0.63–1.51) and the incidence rate ratio for upper respiratory events was 0.94 (95% confidence interval 0.48–1.86). The risk of lower respiratory events was similar for intermittent and mild persistent asthma, across age groups, and for seasonal trivalent LAIV and 2009 H1N1 pandemic monovalent LAIV.ConclusionLAIV use in asthma was mostly in persons with intermittent or mild persistent asthma. LAIV was not associated with an increased risk of medically attended respiratory adverse events.

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Biomarkers of oxidative stress and antioxidants in severe asthma

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Abigail Bishopp, Ramamurthy Sathyamurthy, Sarah Manney, Craig Webbster, Mamidipudi Thirumala Krishna, Adel H. Mansur
BackgroundBronchial airway inflammation is the hallmark of asthma, which may be driven by an imbalance between oxidative stress and antioxidant defenses. Antioxidants deficiency may play a role, but this has remained unconfirmed.ObjectiveTo evaluate the oxidative stress burden and antioxidants defenses in patients with increasing asthma severity.MethodsThis prospective case-control study compared fractional exhaled nitric oxide (FeNO), exhaled breath condensate nitrite/nitrate (EBC-NOx), spirometry, and serum vitamins and trace elements among patients with and without asthma.ResultsSixty participants were recruited (30 with severe asthma number; 23 women [76.7%]; mean age, 41.4 years; mean forced expiratory volume in 1 second [FEV1], 2.2 L [72.2% predicted]; mean inhaled corticosteroid dosage, 2,540 μg/d; 18/30 [60%] receiving maintenance oral corticosteroids; 15 with mild asthma; all corticosteroids naïve; 9 women [60%]; mean age, 34.6 years; mean FEV1, 3.48 L [100.5% predicted]; 15 healthy controls; 12 women [80%]; mean age, 37.6 years; and mean FEV1, 3.53 L [111.7% predicted]). The mean FeNO levels increased significantly with increasing asthma severity (P = .01), but the EBC-NOx levels did not change significantly (P = .90). Paradoxically, vitamin A and vitamin E increased with increased disease severity, with vitamin E levels increasing significantly (P = .07 and P < .001, respectively). There was no significant difference between groups in the levels of copper (P = .37), zinc (P = .97), or selenium (P = .90).ConclusionFeNO but not EBC-NOx is increased significantly with asthma severity with no evidence of vitamins or trace elements deficiency in severe asthma. Impaired oxidative stress defenses in severe asthma may be driven by factors other than vitamins or trace elements deficiency.

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An analysis of anaphylaxis cases at a single pediatric emergency department during a 1-year period

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Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Christopher D. Wright, Mindy Longjohn, Phillip L. Lieberman, Jay Adam Lieberman
BackgroundCase series of anaphylaxis can vary regarding causes, treatments, and follow-up of patients. Unfortunately, case series that are specific to the pediatric population are few.ObjectiveTo describe confirmed cases of pediatric anaphylaxis in patients presenting to a pediatric hospital emergency department (ED).MethodsWe identified all ED visits with the International Classification of Diseases, Ninth Revision (ICD-9) codes 995.XX (allergic reactions) and 989.5 (sting or venom reaction) for 1 calendar year (January 1, 2014, through December 31, 2014). Cases were reviewed by an allergist and an emergency medicine physician to identify true anaphylaxis cases using National Institute of Health/National Institute of Allergy and Infectious Diseases criteria. Any questionable or debatable cases were evaluated and adjudicated by a second allergist.ResultsWe identified 927 unique ED visits. Of these visits, 40 were determined to definitively meet anaphylaxis criteria. Median age of the patients was 6.5 years. A total of 70% of patients were male, and 80% were African American. Causes included foods (65%), venom or insect sting (12.5%), and medications (5%), and 17.5% were idiopathic. All patients had multiorgan involvement, with 98% having skin involvement, 78% having lower respiratory tract symptoms, and 40% having gastrointestinal symptoms. There were no deaths. Only 33% of patients received epinephrine at some point in their care. Only 12 patients were referred to an allergist, and only 4 of these were actually seen by an allergist.ConclusionAt our center, foods are the most common trigger for pediatric anaphylaxis. Patients continue to be undertreated, and referral to an allergist from the ED is rare.

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Importance of angioedema-free days in patients with chronic idiopathic or spontaneous urticaria

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): James L. Zazzali, Allen Kaplan, Marcus Maurer, Karina Raimundo, Benjamin Trzaskoma, Evgeniya N. Antonova, Karin E. Rosén

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Re: “Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel”

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Faisal Zawawi, Paolo Campisi

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Clinical features of adolescents with chronic idiopathic or spontaneous urticaria

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Stanley Goldstein, Susan Gabriel, Farid Kianifard, Benjamin Ortiz, David P. Skoner
BackgroundAdults and adolescents were included in 3 phase 3 omalizumab trials in chronic idiopathic urticaria (CIU): ASTERIA I, ASTERIA II, and GLACIAL.ObjectiveTo describe the baseline clinical profile of adolescent patients with CIU enrolled in the omalizumab trials to add to the limited literature available on CIU in this population.MethodsData for patient demographics, baseline clinical disease characteristics, medical history, and previous CIU medication information (not efficacy assessments) from phase 3 omalizumab trials were pooled and descriptive statistical analyses performed for adolescent (12 to <18 years old) and adult (≥18 years old) subgroups. Inferential analysis was inappropriate, partly because of small sample size in the adolescent subgroup.ResultsThe pooled population of 975 patients with CIU included 39 adolescents (4.0%). Demographics of adolescents and adults with CIU were similar, but compared with adults, fewer adolescents had positive Chronic Urticaria Index test results. Baseline clinical disease characteristics were also similar between the subgroups, with the number of previous CIU medications slightly lower in adolescents compared with adults. Medical history and existing conditions in adolescents tended to be more allergy than cardiovascular related, and fewer experienced angioedema compared with adults.ConclusionPooled data indicate differences in baseline demographic and clinical characteristics between adult and adolescent patient subgroups. This finding helps augment our understanding of the clinical profile of CIU in adolescents, but larger-scale studies in this population are warranted.Trial RegistrationClinicalTrials.gov Identifiers: NCT01287117 (ASTERIA I), NCT01292473 (ASTERIA II), and NCT01264939 (GLACIAL).

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Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China.

Objectives: To evaluate the cost utility of cochlear implantation (CI) for severe to profound sensorineural hearing loss (SNHL) among children from rural settings in P.R. China (China). Research Design: A cost-utility analysis (CUA) was undertaken using data generated from a single-center substudy of the CochlearTM Pediatric Implanted Recipient Observational Study (Cochlear P-IROS). The data were projected over a 20-year time horizon using a decision tree model. Setting: The Chinese healthcare payer and patient perspectives were adopted. Intervention: Unilateral CI of children with a severe-to-profound SNHL compared with their preimplantation state of no treatment or amplification with hearing aids ("no CI" status). Main Outcome Measure/s: Incremental costs per quality adjusted life year (QALY) gained. Results: The mean total discounted cost of unilateral CI was CNY 252,506 (37,876 USD), compared with CNY 29,005 (4,351 USD) for the no CI status from the healthcare payer plus patient perspective. A total discounted benefit of 8.9 QALYs was estimated for CI recipients compared with 6.7 QALYs for the no CI status. From the healthcare payer plus patient perspective, incremental cost-effectiveness ratio (ICER) for unilateral CI compared with no CI was CNY 100,561 (15,084 USD) per QALY. The healthcare payer perspective yielded an ICER of CNY 40,929 (6,139 USD) per QALY. Both ICERs fell within one to three times China's gross domestic product per capita (GDP, 2011-2015), considered "cost-effective" by World Health Organization (WHO) standards. Conclusions: Treatment with unilateral CI is a cost-effective hearing solution for children with severe to profound SNHL in rural China. Increased access to mainstream education and greater opportunities for employment, are potential downstream benefits of CI that may yield further societal and economic benefits. CI may be considered favorably for broader inclusion in medical insurance schemes across China. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://ift.tt/OBJ4xP Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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A case of pulsating sternal and clavicular metastases of thyrofollicular carcinoma

DESCRIPTION

Bony metastases are not infrequently encountered with follicular carcinoma of thyroid. Rarely, papillary thyroid carcinoma spreads to bones1; however, anterior chest wall (sternal and clavicular) involvement are rare. A 54-year-old man with long-standing (~25 years) multinodular goitre presented with recent-onset rapid enlargement of the sternoclavicular area beneath the goitre. On examination, the swelling was hard, warm and pulsatile and in addition showed engorged anterior chest wall veins (figure 1). He was clinically and biochemically euthyroid. Chest X-ray (figure 2) showed huge thyroid mass with sternal and clavicular erosion confirmed by CT (figure 3). Fine-needle aspiration cytology of the goitre and bony mass confirmed follicular carcinoma. He underwent total thyroidectomy with excision of the sternal and clavicular metastases and reconstruction of the chest wall defect with Marlex mesh. Following surgery, he underwent radioiodine therapy (200 mCi) and the post-therapy scan showed multiple pulmonary macronodular...

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Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: A split face study

Summary

Background

The escalating urge for a youthful-looking skin instigates continuous innovations with minimally invasive procedures. Readymade growth factors and autologous platelet-rich plasma (PRP) represent such therapeutic interventions.

Objective

Compare the efficacy and safety of PRP to readymade growth factors in skin rejuvenation.

Patients and Methods

Twenty adult females with Fitzpatrick skin types III-IV and Glogau photoaging types II and III were enrolled in this study. They underwent a split face therapy where each side was randomly assigned to treatment by either readymade growth factors (area A) or autologous PRP (area B). All patients received six sessions at 2-weeks interval. Evaluation was carried out using Global Aesthetic Improvement Scale (GAIS) and optical coherence tomography (OCT). Patients were followed up for 6 months.

Results

Both procedures yielded significant improvement regarding both GAIS (skin turgor and overall vitality) and OCT (epidermal and dermal thickness) assessment. Significant negative correlation was detected between patients' age, sun exposure, and GAIS. Burning sensation was significantly higher in area A. Patient satisfaction was significantly higher in area B. Improvement was more sustained in area B on follow-up.

Conclusion

Platelet-rich plasma is effective and safe for skin rejuvenation, comparable to readymade growth factors with noticeable higher longevity.

http://ift.tt/2ndLb1a

Effectiveness of topical clove oil on symptomatic treatment of chronic pruritus

Summary

Background

Pruritus is a frequent symptom in the general population and in many skin and systemic diseases. Its frequency demonstrates a high burden and an impaired quality of life.

Aim

Assessment of the efficacy of topically applied clove oil alone in the treatment of chronic pruritus.

Methods

Fifty selected subjects diagnosed with chronic pruritus due to either hepatic, renal, or diabetic causes were studied and divided into two groups of 25 patients each. Group I patients were instructed to hydrate the skin and then apply topical clove oil while group II patients applied petrolatum topically by hand; this application was done on the areas of pruritus, twice daily and for 2 weeks. The severity of the itch was assessed and compared before and after the study by 5-D itch scale. The results were analyzed by SPSS. Statistical methods such as descriptive analysis, independent-samples t-test, paired-samples t-test, and chi-square were employed.

Results

There was a significant improvement regarding all studied individual parameters (5-D itch scale) for the clove oil users with no significance among petrolatum users. Comparison of 5-D itch scale total score between patients of group I and patients of group II favored the improvement following the use of clove oil than using placebo (P value>.05).

Conclusion

The topical treatment of chronic pruritus with clove oils is effective, easy to use, safe, cheap, and more acceptable for whom topical and systemic treatments tend to be irritating, contraindicated, or less well tolerated.

http://ift.tt/2p3sPN4

Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: A split face study

Summary

Background

Objective

Compare the efficacy and safety of PRP to readymade growth factors in skin rejuvenation.

Patients and Methods

Results

Conclusion

Platelet-rich plasma is effective and safe for skin rejuvenation, comparable to readymade growth factors with noticeable higher longevity.

http://ift.tt/2ndLb1a

Effectiveness of topical clove oil on symptomatic treatment of chronic pruritus

Summary

Background

Pruritus is a frequent symptom in the general population and in many skin and systemic diseases. Its frequency demonstrates a high burden and an impaired quality of life.

Aim

Assessment of the efficacy of topically applied clove oil alone in the treatment of chronic pruritus.

Methods

Results

Conclusion

http://ift.tt/2p3sPN4

Effects of tongxinluo on angiogenesis in the carotid adventitia of hyperlipidemic rabbits.

Effects of tongxinluo on angiogenesis in the carotid adventitia of hyperlipidemic rabbits.

Mol Med Rep. 2016 Oct;14(4):3832-40

Authors: Zhou J, Cao B, Ju W, Liu S, Song J, Liu L

Abstract
Atherosclerosis, as a common arterial disease with high morbidity rate, is reported to be closely associated with adventitia angiogenesis. The present study aimed to investigate the effect of tongxinluo (TXL) on angiogenesis in the carotid adventitia of hyperlipidemic rabbits and the underlying mechanism. A total of 90 experimental rabbits were randomly assigned into the following six groups (n=15 per group): Normal group, model group, low‑dose TXL group, moderate-dose TXL group, high‑dose TXL group and atorvastatin group. The normal group was fed with a standard diet. The model and treatment groups were on a high cholesterol diet for 4 weeks. The serum lipid level of the model group was significantly higher compared with the normal group. TXL serum lipid level compared with the model group. Hematoxylin and eosin, and CD31 staining demonstrated that TXL inhibited adventitia angiogenesis in a dose‑dependent manner. The dihydroethidium probe and fluorescence in situ hybridization results indicated that TXL reduced O2‑ level and positive signal of gp91phox and p22phox mRNA in adventitia. Reverse transcription‑polymerase chain reaction and western blot analysis determined that TXL treatment significantly downregulated the expression levels of the gp91phox, p22phox genes and the vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2 (VEGFR-2) proteins compared with the model group. TXL exhibited a dose‑dependent inhibitory effect on angiogenesis in the carotid adventitia of hyperlipidemic rabbits. This may be associated with the downregulation of reactive oxygen species generation in the adventitia and the suppression of VEGF/VEGFR-2 expression.

PMID: 27572484 [PubMed - indexed for MEDLINE]

http://ift.tt/2nMYged

Poncet’s disease: two case reports

Myofibroblastic activation of valvular interstitial cells is modulated by spatial variations in matrix elasticity and its organization

Publication date: July 2017
Source:Biomaterials, Volume 131
Author(s): Hao Ma, Anouk R. Killaars, Frank W. DelRio, Chun Yang, Kristi S. Anseth
Valvular interstitial cells (VICs) are key regulators of the heart valve's extracellular matrix (ECM), and upon tissue damage, quiescent VIC fibroblasts become activated to myofibroblasts. As the behavior of VICs during disease progression and wound healing is different compared to healthy tissue, we hypothesized that the organization of the matrix mechanics, which results from depositing of collagen fibers, would affect VIC phenotypic transition. Specifically, we investigated how the subcellular organization of ECM mechanical properties affects subcellular localization of Yes-associated protein (YAP), an early marker of mechanotransduction, and α-smooth muscle actin (α-SMA), a myofibroblast marker, in VICs. Photo-tunable hydrogels were used to generate substrates with different moduli and to create organized and disorganized patterns of varying elastic moduli. When porcine VICs were cultured on these matrices, YAP and α-SMA activation were significantly increased on substrates with higher elastic modulus or a higher percentage of stiff regions. Moreover, VICs cultured on substrates with a spatially disorganized elasticity had smaller focal adhesions, less nuclear localized YAP, less α-SMA organization into stress fibers and higher proliferation compared to those cultured on substrates with a regular mechanical organization. Collectively, these results suggest that disorganized spatial variations in mechanics that appear during wound healing and fibrotic disease progression may influence the maintenance of the VIC fibroblast phenotype, causing more proliferation, ECM remodeling and matrix deposition.

http://ift.tt/2p1f7Ko

Novel lipoproteoplex delivers Keap1 siRNA based gene therapy to accelerate diabetic wound healing

Publication date: July 2017
Source:Biomaterials, Volume 132
Author(s): Piul S. Rabbani, Anna Zhou, Zachary M. Borab, Joseph A. Frezzo, Nikita Srivastava, Haresh T. More, William J. Rifkin, Joshua A. David, Samuel J. Berens, Raymond Chen, Sophia Hameedi, Muhammad H. Junejo, Camille Kim, Rita A. Sartor, Che F. Liu, Pierre B. Saadeh, Jin K. Montclare, Daniel J. Ceradini
Therapeutics utilizing siRNA are currently limited by the availability of safe and effective delivery systems. Cutaneous diseases, specifically ones with significant genetic components are ideal candidates for topical siRNA based therapy but the anatomical structure of skin presents a considerable hurdle. Here, we optimized a novel liposome and protein hybrid nanoparticle delivery system for the topical treatment of diabetic wounds with severe oxidative stress. We utilized a cationic lipid nanoparticle (CLN) composed of 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP) and the edge activator sodium cholate (NaChol), in a 6:1 ratio of DOTAP:NaChol (DNC). Addition of a cationic engineered supercharged coiled-coil protein (CSP) in a 10:1:1 ratio of DNC:CSP:siRNA produced a stable lipoproteoplex (LPP) nanoparticle, with optimal siRNA complexation, minimal cytotoxicity, and increased transfection efficacy. In a humanized murine diabetic wound healing model, our optimized LPP formulation successfully delivered siRNA targeted against Keap1, key repressor of Nrf2 which is a central regulator of redox mechanisms. Application of LPP complexing siKeap1 restored Nrf2 antioxidant function, accelerated diabetic tissue regeneration, and augmented reduction-oxidation homeostasis in the wound environment. Our topical LPP delivery system can readily be translated into clinical use for the treatment of diabetic wounds and can be extended to other cutaneous diseases with genetic components.

Graphical abstract

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Editorial board

Publication date: June 2017
Source:Biomaterials, Volume 130

http://ift.tt/2oFGLjD

Biomaterials innovation for next generation ex vivo immune tissue engineering

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Publication date: June 2017
Source:Biomaterials, Volume 130
Author(s): Ankur Singh
Primary and secondary lymphoid organs are tissues that facilitate differentiation of B and T cells, leading to the induction of adaptive immune responses. These organs are present in the body from birth and are also recognized as locations where self-reactive B and T cells can be eliminated during the natural selection process. Many insights into the mechanisms that control the process of immune cell development and maturation in response to infection come from the analysis of various gene-deficient mice that lack some or all hallmark features of lymphoid tissues. The complexity of such animal models limits our ability to modulate the parameters that control the process of immune cell development, differentiation, and immunomodulation. Engineering functional, living immune tissues using biomaterials can grant researchers the ability to reproduce immunological events with tunable parameters for more rapid development of immunotherapeutics, cell-based therapy, and enhancing our understanding of fundamental biology as well as improving efforts in regenerative medicine. Here the author provides his review and perspective on the bioengineering of primary and secondary lymphoid tissues, and biomaterials innovation needed for the construction of these immune organs in tissue culture plates and on-chip.

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Biodegradable and Injectable Thermoreversible Xyloglucan Based Hydrogel for Prevention of Postoperative Adhesion

Publication date: Available online 5 April 2017
Source:Acta Biomaterialia
Author(s): Ershuai Zhang, Junjie Li, Yuhang Zhou, Pengcheng Che, Bohua Ren, Zhihui Qin, Litao Ma, Jing Cui, Hong Sun, Fanglian Yao
Peritoneal adhesion is very common after abdominal and pelvic surgery, which leads to a variety of severe complications. Although numerous pharmacological treatments and barrier-based devices have been investigated to minimize or prevent postoperative adhesion, the clinical efficacy is not very encouraging. In this work, a biodegradable and thermoreversible galactose modified xyloglucan (mXG) hydrogel was developed and the efficacy of mXG hydrogel in preventing postoperative peritoneal adhesion was investigated. The 4% (w/v) mXG solution was a free flowing sol at low temperature, but could rapidly convert into a physical hydrogel at body temperature without any extra additives or chemical reactions. In vitro cell tests showed that mXG hydrogel was non-toxic and could effectively resist the adhesion of fibroblasts. Moreover, in vitro and in vivo degradation experiments exhibited that mXG hydrogel was degradable and biocompatible. Finally, the rat model of sidewall defect-cecum abrasion was employed to evaluate the anti-adhesion efficacy of the mXG hydrogel. The results demonstrated that mXG hydrogel could effectively prevent postoperative peritoneal adhesion without side effects. The combination of suitable gel temperature, appropriate biodegradation period, and excellent postoperative anti-adhesion efficacy make mXG hydrogel a promising candidate for the prevention of postsurgical peritoneal adhesion.Statement of SignificanceDespite numerous drugs or barrier-based devices have been developed to prevent postoperative adhesion, few solutions have proven to be uniformly effective in subsequent clinical trials. In the present study, we developed a biodegradable and thermoreversible galactose modified xyloglucan (mXG) hydrogel by green enzymatic reaction without using any organic reagents. The developed physical mXG hydrogel not only showed excellent injectability, appropriate gelation time and temperature, but also exhibited excellent biocompatibility and biodegradability both in vitro and in vivo. In addition, mXG hydrogel was easy to handle and could effectively prevent postoperative adhesion without side effects in a rat model of sidewall defect-bowel abrasion. Our study provide a safe and effective postoperative anti-adhesion material which may have potential applications in clinical practice.

Graphical abstract

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Bio-orthogonal conjugation and enzymatically triggered release of proteins within multi-layered hydrogels

Publication date: Available online 5 April 2017
Source:Acta Biomaterialia
Author(s): Chen Guo, Heejae Kim, Elisa M. Ovadia, Christine M. Mourafetis, Mingrui Yang, Wilfred Chen, April M. Kloxin
Hydrogels are facile architectures for the controlled presentation of proteins with far-reaching applications, from fundamental biological studies in three-dimensional culture to new regenerative medicine and therapeutic delivery strategies. Here, we demonstrate a versatile approach for spatially-defined presentation of engineered proteins within hydrogels through i) immobilization using bio-orthogonal strain-promoted alkyne-azide click chemistry and ii) dynamic proteasedriven protein release using exogenously applied enzyme. Model fluorescent proteins were expressed using nonsense codon replacement to incorporate azide-containing unnatural amino acids in a site-specific manner toward maintaining protein activity: here, cyan fluorescent protein (AzCFP), mCherry fluorescent protein (AzmCh), and mCh decorated with a thrombin cut-site. (AzTMBmCh). Eight-arm poly(ethylene glycol) (PEG) was modified with dibenzylcyclooctyne (DBCO) groups and reacted with azide functionalized PEG in aqueous solution for rapid formation of hydrogels. Azide functionalized full-length fluorescent proteins were successfully incorporated into the hydrogel network by reaction with PEGDBCO prior to gel formation. Temporal release and removal of select proteins (AzTMBmCh) was triggered with the application of thrombin and monitored in real-time with confocal microscopy, providing a responsive handle for controlling matrix properties. Hydrogels with regions of different protein compositions were created using a layering technique with thicknesses of hundreds of micrometers, affording opportunities for the creation of complex geometries on size scales relevant for controlling cellular microenvironments.Statement of SignificanceControlling protein presentation within biomaterials is important for modulating interactions with biological systems. For example, native tissues are composed of subunits with different matrix compositions (proteins, stiffness) that dynamically interact with cells, influencing function and fate. Toward mimicking such temporally-regulated and spatially-defined microenvironments, we utilize bio-orthogonal click chemistry and protein engineering to create hydrogels with distinct regions of proteins and modify them over time. Through nonsense codon replacement, we site-specifically functionalize large proteins with i) azides for covalent conjugation and ii) an enzymatic cleavage site for user-defined release from hydrogels. Our results exemplify not only the ability to create unique bio-functionalized hydrogels with controlled mechanical properties, but also the potential for creating interesting interfaces for cell culture and tissue engineering applications.

Graphical abstract

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Rapid antidepressant effects of Yueju: A new look at the function and mechanism of an old herbal medicine

Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Li Ren, Gang Chen
Ethnopharmacological relevanceYueju is a traditional herbal medicine which consists of five herbs and formulated to treat depression-related syndromes 800 years ago. Yueju is still widely prescribed to treat conditions which include digestive dysfunction and depression. Recently, Yueju has been shown to promote a fast-onset antidepressant effect clinically and in preclinical studies. Because conventional antidepressants have a delayed onset in treating depression, the novelty of Yueju's rapid antidepressant effect and its underlying mechanism are of great significance both clinically and scientifically.Aim of the studyTo review the use of Yueju for treatment of mood-related syndromes, and particularly its use in depression. To evaluate recent evidence of Yueju rapid antidepressant actions, based on new findings at behavioral and molecular levels. To suggest direction for future studies to address further scientific issues.Materials and methodsReports regarding to the history and current use of Yueju are summarized. Recent progress on rapid antidepressant effects of Yueju, the crucial constituent, Gardenia jasminoides J.Ellis (GJ) and other herbs, are reviewed.ResultsThe medical need for rapid antidepressant actions, as well as breakthrough findings using ketamine and its limitations are introduced. Studies with Yueju using a number of acute, subacute and chronic behavioral paradigms are compared with ketamine. Findings from clinical reports also support the rapid action of Yueju. Studies examine the contribution of the constituent herb GJ, in rapid antidepressant effects. Importantly, research into the mechanism of Yueju or GJ's antidepressant response indicate the importance of up-regulation in the neural circuit responsible for antidepressant activity, and highlight common and specific molecular signaling by Yueju that may explain why this herb formula has unique antidepressant activity.ConclusionPreclinical and clinical studies demonstrate that Yueju confers rapid antidepressant effects. The common mechanisms shared both for ketamine and Yueju, as well as the novel mechanism specific to Yueju are examined. Yueju and GJ may have great clinic applicability and further more detailed studies are warranted.

Graphical abstract

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Insulin receptor substrate signaling controls cardiac energy metabolism and heart failure

The heart is an insulin-dependent and energy consuming organ in which insulin and nutritional signaling integrates to the regulation of cardiac metabolism, growth, and survival. Heart failure is highly associated with insulin resistance and heart failure patients suffer from the cardiac energy deficiency, structural and functional dysfunction. Chronic pathological conditions, such as obesity and type 2 diabetes mellitus, involve various mechanisms in promoting heart failure by remodeling metabolic pathways, modulating cardiac energetics, and impairing cardiac contractility. Recent studies demonstrated that insulin receptor substrate-1, -2 (IRS-1, -2) are major mediators of both insulin and insulin-like growth factor-1 (IGF-1) signaling responsible for myocardial energetics, structure, function, and organismal survival. Importantly, the insulin receptor substrates (IRS) play an important role in activation of the phosphatidylinositide-3 dependent kinase (PI-3K) that controls Akt and Foxo1 signaling cascade, regulating the mitochondrial function, cardiac energy metabolism, and the renin-angiotensin system. Dysregulation of this branch in signaling cascades by insulin resistance in the heart through the endocrine system promotes heart failure, providing a novel mechanism for diabetic cardiomyopathy. Therefore, targeting this branch of IRS->PI-3K->Foxo1 signaling cascade and associated pathways may provide a fundamental strategy for the therapeutic and nutritional development in control of metabolic and cardiovascular diseases. In this review, we focus on insulin signaling and resistance in the heart and the role energetics play in cardiac metabolism, structure and function.

http://ift.tt/2oFi4Ul

Hypothyroidism decreases JAK/STAT signaling pathway in lactating rat mammary gland

Publication date: Available online 5 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Fiorella Campo Verde Arboccó, Fabio Andres Persia, María Belén Hapon, Graciela A. Jahn
Thyroid pathologies have deleterious effects on lactation. Especially hypothyroidism (HypoT) induces premature mammary involution at the end of lactation and decreases milk production and quality in mid lactation. Milk synthesis is controlled by JAK2/STAT5 signaling pathway and prolactin (PRL), which activates the pathway. In this work we analyzed the effect of chronic 6-propyl-2- thiouracil (PTU)-induced HypoT on PRL signaling pathway on mammary glands from rats on lactation (L) days 2, 7 and 14. HypoT decreased prolactin receptor expression, and expression and activation of Stat5a/b protein. Expression of members of the SOCS-CIS family, inhibitors of the JAK-STAT pathway, decreased in L2 and L7, possibly as a compensatory response of the mammary cells to maintain PRL responsiveness. However, on L14, the level of these inhibitors was normal and the transcription of α-lactoalbumin (lalba), a target gene of the PRL pathway, decreased by half. HypoT altered the transcriptional capacity of the cell and decreased mRNA levels of Prlr and Stat5b on L14. Stat5b gene has functional thyroid hormone response elements in the regulatory regions, that bind thyroid hormone receptor β (TRβ) differentially and in a thyroid hormone dependent manner. The overall decrease in the PRL signaling pathway and consequently in target gene (lalba) mRNA transcription explain the profound negative impact of HypoT on mammary function through lactation.

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The effects of RAMPs upon cell signalling

Publication date: Available online 5 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Sarah J. Routledge, Graham Ladds, David R. Poyner
G protein-coupled receptors (GPCRs) play a vital role in signal transduction. It is now clear that numerous other molecules within the cell and at the cell surface interact with GPCRs to modulate their signalling properties. Receptor activity modifying proteins (RAMPs) are a group of single transmembrane domain proteins which have been predominantly demonstrated to interact with Family B GPCRs, but interactions with Family A and C receptors have recently begun to emerge. These interactions can influence cell surface expression, ligand binding preferences and G protein-coupling, thus modulating GPCR signal transduction. There is still a great deal of research to be conducted into the effects of RAMPs on GPCR signalling; their effects upon Family B GPCRs are still not fully documented, in addition to their potential interactions with Family A and C GPCRs. New interactions could have a significant impact on the development of therapeutics.

http://ift.tt/2oLbl8M

Pannexin-2-deficiency sensitizes pancreatic β-cells to cytokine-induced apoptosis in vitro and impairs glucose tolerance in vivo

Publication date: Available online 5 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Lukas A. Berchtold, Michela Miani, Thi A. Diep, Andreas N. Madsen, Valentina Cigliola, Maikel Colli, Jelena M. Krivokapic, Flemming Pociot, Decio L. Eizirik, Paolo Meda, Birgitte Holst, Nils Billestrup, Joachim Størling
Pannexins (Panx's) are membrane proteins involved in a variety of biological processes, including cell death signaling and immune functions. The role and functions of Panx's in pancreatic β-cells remain to be clarified. Here, we show Panx1 and Panx2 expression in isolated islets, primary β-cells, and β-cell lines. The expression of Panx2, but not Panx1, was downregulated by interleukin-1β (IL-1β) plus interferon-γ (IFNγ), two pro-inflammatory cytokines suggested to contribute to β-cell demise in type 1 diabetes (T1D). siRNA-mediated knockdown (KD) of Panx2 aggravated cytokine-induced apoptosis in rat INS-1E cells and primary rat β-cells, suggesting anti-apoptotic properties of Panx2. An anti-apoptotic function of Panx2 was confirmed in isolated islets from Panx2^-/- mice and in human EndoC-βH1 cells. Panx2 KD was associated with increased cytokine-induced activation of STAT3 and higher expression of inducible nitric oxide synthase (iNOS). Glucose-stimulated insulin release was impaired in Panx2^-/- islets, and Panx2^-/- mice subjected to multiple low-dose Streptozotocin (MLDS) treatment, a model of T1D, developed more severe diabetes compared to wild type mice. These data suggest that Panx2 is an important regulator of the insulin secretory capacity and apoptosis in pancreatic β-cells.

http://ift.tt/2obXeLW

Oropharyngectomie par voie transorale et transcervicale sans mandibulotomie et réparation par lambeau libre fasciocutané antébrachial dans les cancers de l’oropharynx : suites opératoires, résultats carcinologiques et fonctionnels, facteurs pronostiques

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): M. Roux, O. Dassonville, M. Ettaiche, G. Poissonnet, A. Sudaka, A. Bozec
ObjectifAnalyser les suites opératoires, les résultats carcinologiques et fonctionnels, ainsi que les facteurs pronostiques de la chirurgie des cancers l'oropharynx par voie transorale et transcervicale sans mandibulotomie avec réparation par lambeau libre fasciocutané antébrachial.Matériel et méthodesAnalyse rétrospective des dossiers informatisés de tous les patients ayant bénéficié de ce type de chirurgie entre 2004 et 2014 dans notre institution. Les facteurs prédictifs des résultats carcinologiques et fonctionnels ont été recherchés en analyses univariées et multivariées.RésultatsAu total, 44 patients (37 hommes et 7 femmes, âge moyen=62,3±9,3 ans) ont été inclus dans cette étude. À trois ans, les taux de survie globale, spécifique et sans récidive étaient respectivement de 90, 92 et 79 %. Un score fonctionnel satisfaisant (fonction normale ou légèrement perturbée) a été obtenu pour l'alimentation, l'élocution et l'ouverture buccale dans respectivement 86, 93 et 100 % des cas. Un score ASA ≥ III avait un impact péjoratif statistiquement significatif sur la survie globale (p=0,005), ainsi que sur la qualité de l'alimentation (p=0,01) et de l'élocution (p=0,01).ConclusionLa chirurgie des cancers de l'oropharynx par voie transorale et transcervicale sans mandibulotomie permet d'obtenir d'excellents résultats carcinologiques et fonctionnels et constitue une alternative avantageuse à la classique buccopharyngectomie transmandibulaire conservatrice.

http://ift.tt/2p2Zv9q

Hommage à Georges Freyss

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): P. Tran Ba Huy

http://ift.tt/2oFa6us

Kyste hydatique cervical primitif. Localisation rare et inhabituelle

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): K. Oqbani, M. Chraïbi, N. Harchichi, S. Abbaoui
IntroductionLes tuméfactions cervicales isolées d'origine parasitaire, en particulier hydatique sont rares même en pays d'endémie. Notre objectif est d'étudier les aspects épidémiologiques, cliniques et les démarches diagnostiques de l'hydatidose cervico-faciale.ObservationIl s'agit d'un garçon âgé de 3 ans, hospitalisé pour une masse latéro-cervicale gauche isolée et évoluant depuis un an. L'échographie cervicale objectivait une formation latéro-cervicale kystique hypoéchogène de 3,5cm de diamètre. L'étude histologique de la masse reséquée confirmait le diagnostic du kyste hydatique cervical (KHC).DiscussionEn pays d'endémie, toute masse cervicale kystique doit faire évoquer le diagnostic d'hydatidose. Les données épidémiologiques, cliniques, biologiques et radiologiques du kyste hydatique restent des éléments de présomption. La cytoponction permet de rectifier des diagnostics erronés. L'étude histologique permet le diagnostic de certitude devant ces localisations inhabituelles.

http://ift.tt/2p367EK

Lymphome nasal T/NK : observation dramatique

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): L. Taali, M. Abou-Elfadl, M. Fassih, M. Mahtar
IntroductionLe lymphome nasal T/NK est une entité clinicopathologique rare anciennement dénommée granulome malin centrofacial. Depuis les progrès de l'anatomopathologie et l'avènement de l'immunohistochimie en pratique courante, le diagnostic de lymphome nasal T/NK a pu être reconnu par l'OMS en 2001.ObservationNous rapportons l'observation d'une patiente âgée de 22ans, diabétique insulinodépendante, qui a présenté un placard inflammatoire médiofacial à la suite d'un traumatisme facial, et qui a été diagnostiqué et traité comme une cellulite de la face. L'évolution était rapidement progressive et fatale, avec installation d'une nécrose centrofaciale dont les examens anatomopathologiques ont conclu à un lymphome T/NK.DiscussionParmi les diagnostics différentiels du lymphome T N/K, on trouve une cellulite gangréneuse, une rhinosinusite mycosique invasive, une maladie de Wegener, une actinomycose, ou un lymphome T facial… ; sa présentation clinique est atypique d'où le retard diagnostique et thérapeutique. Le traitement repose sur la radiothérapie et la chimiothérapie mais le pronostic reste péjoratif même si le traitement est instauré rapidement.

http://ift.tt/2oFdDch

Comment réaliser une reconstruction tridimensionnelle pour une tumeur de la base du crâne ?

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): N.-X. Bonne, F. Dubrulle, M. Risoud, C. Vincent
La prise en charge chirurgicale d'une lésion de la base du crâne est délicate du fait de la complexité anatomique de cette région et des rapports étroits pouvant exister entre la lésion et les structures vasculo-nerveuses environnantes. L'évolution de cette chirurgie se fait vers des voies d'abord moins invasives respectant le plus possible le pronostic fonctionnel. La possibilité de visualiser une reconstruction tridimensionnelle tomodensitométrique (TDM) de la lésion permet au chirurgien une meilleure planification de la chirurgie grâce à une visualisation des rapports dans tous les plans (artères, veines, nerfs, oreille interne) ainsi qu'une simulation de la voie d'abord dans la position opératoire. Un angioscanner spiralé est effectué avec une optimisation de l'injection par rapport à la prise de contraste tumorale et aux vaisseaux. La définition 3D de chaque structure se fait en affectant une couleur spécifique avec seuillage automatique lorsque cela est possible (os, vaisseaux) ou manuel par contourage sur chaque coupe (tumeur, structures nerveuses, oreille interne). La présentation s'effectue généralement dans les 3 plans de l'espace (vues supérieure, frontale antérieure et sagittale) avec simulation du geste opératoire (5 à 6 vues en position opératoire avec différents niveaux en profondeur).

http://ift.tt/2p2ZsKM

Mise au point sur la technique du ganglion sentinelle dans les cancers épidermoïdes des voies aérodigestives supérieures cN0. Guide pour la pratique du GETTEC

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): R. Garrel, G. Poissonnet, S. Temam, G. Dolivet, N. Fakhry, D. de Raucourt
La fiabilité de la technique du ganglion sentinelle (GS) est établie depuis plus d'une dizaine d'années dans les carcinomes épidermoïdes T1-T2 de la cavité buccale et de l'oropharynx. Bien que la plupart des auteurs insistent sur la rigueur nécessaire à sa réalisation, il n'existe pas de référence consensuelle. De plus, d'autres indications sont décrites sur d'autres aires anatomiques des voies aérodigestives supérieures (VADS) ainsi qu'en cas d'antécédents chirurgicaux ou de radiothérapie. Les équipes expertes dans cette technique sous l'égide du GETTEC ont réalisé une mise au point sur les points clés de la réalisation de la technique des ganglions sentinelles dans les VADS à travers un guide pour la pratique, ainsi que sur les indications classiques et étendues. La fiabilité de cette technique repose sur le respect des points clés du repérage préopératoire par lymphoscintigraphie, du prélèvement peropératoire et de l'analyse anatomo-pathologique des GS. Cette technique est le meilleur moyen de diagnostiquer une atteinte ganglionnaire occulte quelle que soit la localisation de la tumeur primaire, son stade T ou les antécédents du patient.

http://ift.tt/2oFxwQq

L’articulation voméroprémaxillaire : un témoin de l’évolution des espèces

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): S. Botti, C. Rumeau, P. Gallet, R. Jankowski
ObjectifDans la théorie évo-dévo, les vomers sont des os issus du palais secondaire. La croissance des plaques palatines des maxillaires les pousse à fusionner sur la ligne médiane en arrière du palais primaire qui sert de butée à leur élévation en direction de la cloison du nez primaire, formée du cartilage septal et de la lame perpendiculaire de l'ethmoïde. Dans cette hypothèse, le bord antérieur du vomer s'articule avec la face postérieure du prémaxillaire au niveau du canal incisif (CI).Matériel et méthodeLe but de cette étude rétrospective était de mesurer l'incarcération de l'angle antéro-inférieur du vomer dans le CI sur des scanners montrant un septum nasal non déformé. Trente-deux scanners de sinus sur 506 archivés ont permis les mesures sur des coupes coronales de septums non déformés passant par le CI.RésultatsTrente et un vomers sur 32 étaient incarcérés dans le CI. Lorsque le vomer avait une forme en Y (n=26), 43 % de sa hauteur étaient incarcérés dans 41 % de la hauteur du CI. Dans les formes en I (n=6), 34 % de la hauteur du vomer étaient incarcérés dans 41 % de la hauteur du CI. Le seul vomer non incarcéré avait une forme de Y.ConclusionL'incarcération du vomer dans le CI en arrière du prémaxillaire trouve son explication dans la conception évo-dévo de la formation des fosses nasales. La description embryologique classique de formation de la cloison nasale ne permet pas quant à elle d'expliquer l'incarcération vomérienne.

http://ift.tt/2p3enVf

Endoscopie sous sommeil induit : nouvel examen de référence du SAS ? Partie II : résultats

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): M. Blumen, E. Bequignon, F. Chabolle
Les résultats de la chirurgie du syndrome d'apnée du sommeil sont très variables quels que soit la technique utilisée ou le site traité. La plupart des auteurs s'accordent à dire qu'une sélection précise des bons candidats à la chirurgie s'avère logique et nécessaire. Un examen, l'endoscopie sous sommeil induit, a été mis au point en 1991 et redécouvert de façon extensive après les années 2000. Il s'agit d'essayer de mimer le sommeil naturel et d'examiner les voies aériennes supérieures à l'aide d'une nasofibroscopie dans une situation où des obstructions peuvent survenir. Une revue de la littérature a été réalisée comprenant 2 parties. Dans la 2^e partie, nous décrivons les résultats retrouvés lors de l'endoscopie sous sommeil induit concernant les sites d'obstruction, l'impact sur l'efficacité des traitements et les indications qui en découlent.

http://ift.tt/2oFwqUZ

Polype fibroépithelial du conduit auditif externe

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): P. Thomas, P. Rai, R. Meena

http://ift.tt/2p3anEl

Exérèse d’un schwannome massétérin par voie d’abord transorale assistée par endoscopie

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): K. Endo, K. Kase, T. Yoshizaki

http://ift.tt/2oFrf7A

Lettre sur l’article « Une tumeur cervicale rare chez un enfant »

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): M. Dogan, A.S. Kahraman, İ.O. Yıldırım

http://ift.tt/2oFqjzK

Monitorage peropératoire des nerfs vagues et récurrents au cours de la chirurgie thyroïdienne et parathyroïdienne : étude prospective

Publication date: April 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 2
Author(s): N. Julien, E. Ferrary, A. Sokoloff, G. Lamas, O. Sterkers, D. Bernardeschi
ObjectifsStimuler électriquement les nerfs vagues et laryngés inférieurs pendant une chirurgie thyroïdienne ou parathyroïdienne, enregistrer les réponses musculaires, interpréter les modifications des paramètres électrophysiologiques et en déduire un pronostic sur la mobilité laryngée.Patients et méthodesIl s'agit d'une étude prospective au cours de laquelle 151 nerfs vagues et 144 nerfs laryngés inférieurs ont été monitorés chez 114 patients. Parmi eux, 7 patients (14 nerfs vagues) ont été monitorés en continu avec l'électrode APS et chez 15 patients (21 nerfs vagues), le seuil de stimulation a été étudié. La réponse musculaire a été recueillie après stimulation directe du nerf vague et/ou du nerf laryngé inférieur par une sonde monopolaire ou après stimulation directe et répétée par une électrode fixée sur le nerf vague. En cas d'altération du signal du premier côté opéré, la totalisation chirurgicale n'était pas réalisée.RésultatsLa stimulation du nerf vague permet de vérifier l'intégrité du nerf laryngé inférieur et son caractère récurrent, sans risque de faux-négatif. Le seuil minimal de stimulation avant et après la dissection du nerf vague entraînant une réponse supérieure ou égale à 100 μV variait de 0,1 à 0,8mA. La similitude des réponses à une stimulation supramaximale de 1mA, en pré- et post-dissection, d'une part et en post-dissection entre le nerf vague et le nerf laryngé inférieur, d'autre part, était corrélée à une mobilité laryngée postopératoire normale. À l'inverse, la diminution de la réponse musculaire en dessous de 100μV et l'augmentation du temps de latence témoignaient d'un risque de paralysie laryngée.ConclusionLa stimulation du nerf vague permet de suspecter ou d'éliminer une lésion bas-située sur le nerf laryngé inférieur et de détecter un nerf laryngé inférieur non récurrent. Le monitorage « intermittent » apprécie la fonction nerveuse à l'instant de la stimulation, alors que le monitorage « permanent » peut détecter les premiers signes de la souffrance nerveuse annonciateurs d'une possible paralysie récurrentielle postopératoire. En cas d'indication de thyroïdectomie totale, la perte du signal électrique du premier côté opéré doit faire reconsidérer la réalisation d'un geste chirurgical controlatéral dans le même temps.

http://ift.tt/2oFa6dW

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 5 Απριλίου 2017

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