Symmetry of fMRI activation in the primary sensorimotor cortex during unilateral chewing

Abstract

Objective

Functional magnetic resonance imaging (fMRI) is one of the most advanced techniques to analyze the cerebral effects on many behavior aspects of the oral system such as chewing and mastication. Studies on imaging of the cerebral representation of chewing demonstrated differential results with respect to cortical lateralization during unilateral chewing. The aim of our study is to clarify the effects of cerebral responses during unilateral chewing.

Material and methods

We used fMRI to compare brain activities during occlusal function in centric occlusion on natural teeth and chewing on a gum located on the right or the left teeth in 15 healthy subjects. Group data were performed by Talairach normalization and in addition by an assignment of activation maxima to individual anatomical landmarks in order to avoid possible loss of spatial preciseness of activation sites by normalization procedures.

Results

Evaluation of group data by Talairach normalization revealed representation sites for occlusal movements in bilateral primary (S1) and secondary (S2) somatosensory cortices, primary motor (M1) and premotor cortices, supplementary motor area (SMA) and medial cingulate gyrus, bilateral anterior cerebellar hemispheres and vermis, insula, orbitofrontal cortex, thalamus, and left pallidum. Right-sided chewing showed no differential activation to left-sided chewing, and both showed activation in areas also involved in bilateral occlusion. Both techniques, the one based on group normalization and the one based on an individual evaluation method, revealed remarkable low differences in activation maximum location in the primary motor, the primary and secondary somatosensory cortices, and the anterior cerebellar lobe. All chewing movements tested involved bilateral sensorimotor activation without a significant lateralization of activation intensities.

Conclusion

Overall, a general lateralization of occlusion movements to the dominant side could not be verified in the present study. Chewing on the left or on the right side of teeth makes no difference for brain representation of chewing.

Clinical relevance

The results describe the basic effects of what we can expect by evaluation of cerebral effects of chewing and mastication. Based on these results, clinical fMRI studies can be performed in different patient groups.

http://ift.tt/2pKlhm4

Transmitted irradiance through ceramics: effect on the mechanical properties of a luting resin cement

Abstract

Objectives

The study aims to characterise the curing behaviour of a light-curing luting composite (Variolink® Aesthetic LC, Ivoclar Vivadent) polymerised at different exposure times (10 s, 20 s) through different ceramics (IPS Empress CAD and IPS e.max CAD, Ivoclar Vivadent) and ceramic thicknesses (no ceramic, 0.5, 1, 1.5 and 2 mm).

Material and method

Curing units' (Bluephase Style, Ivoclar Vivadent) variation in irradiance delivered up to 10-mm exposure distance as well as the incident and transmitted irradiance and radiant exposure up to 6-mm ceramic thickness were assessed on a laboratory-grade spectrometer. A total of 216 (18 groups, n = 12) thin and flat luting composite specimens of 500-μm thickness were prepared and stored after curing in a saturated vapour atmosphere for 24 h at 37 °C. Micro-mechanical properties (Vickers hardness, HV and indentation modulus, Y_HU) were determined by means of an automatic micro-hardness indenter.

Results

Within the study design, the radiant exposure received by the luting composite varied from 2.56 to 24.75 J/cm², showing a high impact on the measured properties. Comparing the effect of the parameters exposure time, ceramic thickness and type, the highest influence on the micro-mechanical parameters was identified for exposure time, while this influence was stronger on HV (p < 0.001, η _P² = 0.452) than on Y_HU (p < 0.001, η _P² = 0.178). The influence of ceramic type was significant but low (η _P² = 0.161 on HV and 0.113 on Y_HU), while the influence of ceramic thickness was the lowest (η _P² = 0.04 and 0.05, respectively).

Conclusions

Slightly higher irradiance values were transmitted through Empress CAD up to a ceramic thickness of 3 mm (p < 0.001), while being comparable with e.max for thicker slices. Differences in translucency between ceramics were reflected in the micro-mechanical properties of the luting composite.

Clinical relevance

The radiant exposure reaching the luting composite is determined by the incident irradiance, exposure time, ceramic type and ceramic thickness. At the analysed incident irradiance, exposure time was the most consistent parameter affecting the micro-mechanical properties of the luting composite, and this effect was strongly reflected in the more translucent ceramic Empress CAD. Within the curing conditions, an exposure time of 20 s is recommended.

http://ift.tt/2oXhWxl

In vivo determination of tooth mobility after fixed orthodontic appliance therapy with a novel intraoral measurement device

Abstract

Objective

Valid measurement systems recording tooth mobility upon displacement within the subtle range of physiological strains are missing. Here, we introduce a novel in vivo measurement device and demonstrate a first clinical application by monitoring tooth mobility changes during retention after fixed multibracket appliance therapy.

Materials and methods

Tooth mobility was measured in vivo on 21 patients (11 female, 10 male; mean age 16.1 ± 3.1 years) by displacing the upper first incisor 0.2 mm lingually for 0.2, 0.5, 1, 2, 5, and 10 s with the novel intraoral device. Measurements were recorded directly after, as much as 2, 7, and 14 days and up to 6 months after appliance debonding.

Results

Device performance was precise and valid in clinical use. Data revealed significant interindividual varying tooth mobility, which was very high during the first 2 days after appliance removal. After 1 week, mobility values decreased, but were generally higher upon short loadings compared to long ones. After 3 months, tooth mobility was significantly lower than directly after debonding. Interestingly, males exhibited significantly less mobility than females.

Conclusions

Our work is the first using an in vivo measurement device capable of performing and recording tooth displacements within this delicate range and in such precision. Furthermore, our findings elucidate tooth mobility changes after multibracket treatment, giving important information for retention periods.

Clinical relevance

Establishment of this novel measurement device in clinical use is an important improvement when approaching the complexity of tooth mobility in vivo regarding different issues like orthodontics, periodontal disease, or bruxism.

http://ift.tt/2pKn4rl

Skin entrance dose with and without lead apron in digital panoramic radiography for selected sensitive body regions

Abstract

Purpose

The aim of this study was to compare the dose at skin level at five significant anatomical regions for panoramic radiography devices with and without lead apron by means of a highly sensitive dosimeter.

Materials and methods

A female RANDO-phantom was exposed in five different digital panoramic radiography systems, and the dose at skin level was assessed tenfold for each measurement region by means of a highly sensitive solid-state-dosimeter. The five measurement regions selected were the thyroid, both female breasts, the gonads, and a central region in the back of the phantom. For each panoramic machine, the measurements were performed in two modes: with and without a commercial lead apron specifically designed for panoramic radiography. Reproducibility of the measurements was expressed by absolute differences and the coefficient of variation. Values between shielded and unshielded doses were pooled for each region and compared by means of the paired Wilcoxon tests (p ≤ 0.05).

Results

Reproducibility as represented by the mean CV was 22 ± 52 % (median 2.3 %) with larger variations for small dose values. Doses at skin level ranged between 0.00 μGy at the gonads and 85.39 μGy at the unshielded thyroid (mean ± SD 15 ± 24 μGy). Except for the gonads, the dose in all the other regions was significantly lower (p < 0.001) when a lead apron was applied. Unshielded doses were between 1.02-fold (thyroid) and 112-fold (at the right breast) higher than those with lead apron shielding (mean: 14-fold ± 18-fold).

Conclusion

Although the doses were entirely very low, we observed a significant increase in dose in the radiation-sensitive female breast region when no lead apron was used. Future discussions on shielding requirements for panoramic radiography should focus on these differences in the light of the linear non-threshold (LNT) theory which is generally adopted in medical imaging.

http://ift.tt/2oXdJJV

A comparison of lower canine retraction and loss of anchorage between conventional and self-ligating brackets: a single-center randomized split-mouth controlled trial

Abstract

Objective

To evaluate the rate of lower canine retraction, anchorage loss, and changes on lower canines and first molars axial inclination using self-ligating and conventional brackets.

Materials and methods

Twenty-five adult patients with a treatment plan involving extractions of four first premolars were selected for this split-mouth trial and had either conventional or self-ligating brackets bonded to lower canines in a block randomization. Retraction was accomplished using 100-g nickel titanium closed-coil springs, which were reactivated each 4 weeks. Oblique radiographs were taken before and after total canine retraction and the cephalograms were superimposed on stable structures of the mandible. Cephalometric points were digitized twice by a single-blinded operator for error control and the average of the points were used to determine the following variables: canine cusp horizontal changes, molar cusp horizontal changes, and angulation changes in canines and molars. Paired t tests were used to analyze the blinded data for group differences.

Results

All patients reached final phase without bracket debonds. No differences were found between the two groups for all variables tested. No serious harm was observed.

Conclusion

Both brackets showed the same rate of canine retraction and loss of anteroposterior anchorage of the molars. No changes were found between brackets regarding the inclination of canines and first molars.

Clinical Relevance

Using self-ligating brackets to retract lower canines will not increase the velocity of tooth movement, does not increase anchorage, and does not decrease tipping.

http://ift.tt/2pKf2Pv

Impact of combined CO 2 laser irradiation and fluoride on enamel and dentin biofilm-induced mineral loss

Abstract

Objectives

The caries-protective effects of CO₂ laser irradiation on dental enamel have been demonstrated using chemical demineralization models. We compared the effect of CO₂ laser irradiation, sodium fluoride, or both on biofilm-induced mineral loss (∆Z) and Streptococcus mutans adhesion to enamel and dentin in vitro.

Materials and methods

Ground, polished bovine enamel, and dentin samples were allocated to four groups (n = 12/group): no treatment (C); single 22,600-ppm fluoride (F) varnish (5 % NaF) application; single CO₂ laser treatment (L) with short pulses (5 μs/λ = 10.6 μm); and laser and subsequent fluoride treatment (LF). Samples were sterilized and submitted to an automated mono-species S. mutans biofilm model. Brain heart infusion plus 5 % sucrose medium was provided eight times daily, followed by rinses with artificial saliva. After 10 days, bacterial numbers in biofilms were enumerated as colony-forming units/ml (CFU/ml) (n = 7/group). ∆Z was assessed using transversal microradiography (n = 12/group). Univariate ANOVA with post hoc Tukey honestly-significant-difference test was used for statistical analysis.

Results

Bacterial numbers were significantly higher on dentin than enamel (p < 0.01/ANOVA). On dentin, LF yielded significantly lower CFUs than other groups (p = 0.03/Tukey), while no differences between groups were found for enamel. The lowest ∆Z in enamel was observed for L (mean/SD 2036/1353 vol%×μm), which was not only significantly lower than C (9642/2452 vol%×μm) and F (7713/1489 vol%×μm) (p < 0.05) but also not significantly different from LF (3135/2628 vol%×μm) (p > 0.05). In dentin, only LF (163/227) significantly reduced ∆Z (p < 0.05).

Conclusion/clinical relevance

CO₂ laser irradiation did not increase adhesion of S. mutans in vitro. Laser treatment alone protected enamel against biofilm-induced demineralization, while a combined laser-fluoride application was required to protect dentin.

http://ift.tt/2oXfA1q

Prologue: Reading Comprehension Is Not a Single Ability

Purpose

In this initial article of the clinical forum on reading comprehension, we argue that reading comprehension is not a single ability that can be assessed by one or more general reading measures or taught by a small set of strategies or approaches.

Method

We present evidence for a multidimensional view of reading comprehension that demonstrates how it varies as a function of reader ability, text, and task. The implications of this view for instruction of reading comprehension are considered.

Conclusion

Reading comprehension is best conceptualized with a multidimensional model. The multidimensionality of reading comprehension means that instruction will be more effective when tailored to student performance with specific texts and tasks.

http://ift.tt/2orlKIP

An Interactive View of Reading Comprehension: Implications for Assessment

Purpose

This clinical focus article explores further the multidimensional view of reading comprehension put forward by Catts and Kamhi (2017) in this clinical forum and its implications for reading assessment.

Method

It is argued that a multidimensional or interactive view of reading predicts variability in student performance on reading assessments as a function of the interaction among reader, text, and task factors.

Result

Student performance on any given reading assessment should be interpreted in relation to the specific reading demands of the assessment, rather than as a fixed ability that generalizes to any given reading situation.

Conclusion

This view implies a different approach to the use of both summative and classroom assessment than is currently common practice.

http://ift.tt/2orczbs

Epilogue: Reading Comprehension Is Not a Single Ability—Implications for Assessment and Instruction

Purpose

In this epilogue, we review the 4 response articles and highlight the implications of a multidimensional view of reading for the assessment and instruction of reading comprehension.

Method

We reiterate the problems with standardized tests of reading comprehension and discuss the advantages and disadvantages of recently developed authentic tests of reading comprehension. In the "Instruction" section, we review the benefits and limitations of strategy instruction and highlight suggestions from the response articles to improve content and language knowledge.

Conclusions

We argue that the only compelling reason to administer a standardized test of reading comprehension is when these tests are necessary to qualify students for special education services. Instruction should be focused on content knowledge, language knowledge, and specific task and learning requirements. This instruction may entail the use of comprehension strategies, particularly those that are specific to the task and focus on integrating new knowledge with prior knowledge.

http://ift.tt/2orlLwm

Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying Adequate Progress and Successful Learning Patterns

Purpose

The goal of this study was to provide guidance to clinicians on early benchmarks of successful word learning in an interactive book reading treatment and to examine how encoding and memory evolution during treatment contribute to word learning outcomes by kindergarten children with specific language impairment (SLI).

Method

Twenty-seven kindergarten children with SLI participated in a preliminary clinical trial using interactive book reading to teach 30 new words. Word learning was assessed at 4 points during treatment through a picture naming test.

Results

The results indicate that the following performance during treatment was cause for concern, indicating a need to modify the treatment: naming 0–1 treated words correctly at Naming Test 1; naming 0–2 treated words correctly at Naming Test 2; naming 0–3 treated words correctly at Naming Test 3. In addition, the results showed that encoding was the primary limiting factor in word learning, but rmemory evolution also contributed (albeit to a lesser degree) to word learning success.

Conclusion

Case illustrations demonstrate how a clinician's understanding of a child's word learning strengths and weaknesses develop over the course of treatment, substantiating the importance of regular data collection and clinical decision-making to ensure the best possible outcomes for each individual child.

http://ift.tt/2pPHmwg

Commentary on “Reading Comprehension Is Not a Single Ability”: Implications for Child Language Intervention

Purpose

This commentary responds to the implications for child language intervention of Catts and Kamhi's (2017) call to move from viewing reading comprehension as a single ability to recognizing it as a complex constellation of reader, text, and activity.

Method

Reading comprehension, as Catts and Kamhi explain, is very complicated. In this commentary, I consider how comprehension has been taught and the directions in which it is moving. I consider how speech-language pathologists (SLPs), with their distinctive expertise and resources, can contribute to effective reading comprehension instruction. I build from Catts and Kamhi's emphasis on the importance of context and knowledge, using the approaches of staying on topic, close reading, and incorporating quality features of intervention. I consider whether and how SLPs should treat language skills and comprehension strategies to achieve noticeable changes in their students' reading comprehension.

Conclusion

Within this multidimensional view of reading comprehension, SLPs can make strategic, meaningful contributions to improving the reading comprehension of students with language impairments.

http://ift.tt/2o0KQvb

Reading Comprehension Deficits in Adolescents: Addressing Underlying Language Abilities

Purpose

The purpose of this article is to discuss reading comprehension deficits in adolescents in relation to their word reading skills and lexical and syntactic development. Although reading comprehension strategies (e.g., "Find the main idea") are often recommended, it is argued that before these can be effective, students' underlying language deficits should be addressed.

Method

Data from a longitudinal study are analyzed to determine the relationship between reading comprehension, word reading, and lexical and syntactic development in adolescents.

Results

The findings indicate that poor reading comprehension in adolescents is predicted by concurrent deficits in word reading ability, lexical development, and syntactic development.

Conclusion

When poor comprehension is accompanied by deficits in word reading ability and/or lexical and syntactic development, intervention should target the underlying areas of deficiency. Studies designed to improve reading comprehension in adolescents are needed.

http://ift.tt/2oY5Pib

Masthead

http://ift.tt/2p1QrVE

Beyond Comprehension Strategy Instruction: What's Next?

Purpose

In this article, we respond to Catts and Kamhi's (2017) argument that reading comprehension is not a single ability.

Method

We provide a brief review of the impact of strategy instruction, the importance of knowledge in reading comprehension, and possible avenues for future research and practice.

Results

We agree with Catts and Kamhi's argument that reading comprehension is a complex endeavor and that current recommended practices do not reflect the complexity of the construct. Knowledge building, despite its important role in comprehension, has been relegated to a back seat in reading comprehension instruction. In the final section of the article, we outline possible avenues for research and practice (e.g., generative language instruction, dialogic approaches to knowledge building, analogical reasoning and disciplinary literacy, the use of graphics and media, inference instruction) for improving reading-comprehension outcomes.

Conclusions

Reading comprehension is a complex ability, and comprehension instruction should reflect this complexity. If we want to have an impact on long-term growth in reading comprehension, we will need to expand our current repertoire of instructional methods to include approaches that support the acquisition and integration of knowledge across a variety of texts and topics.

http://ift.tt/2o0sBWY

Introduction to the Clinical Forum: Reading Comprehension Is Not a Single Ability

Purpose

In this introduction to the clinical forum on reading comprehension, the Editor-in-Chief of Language, Speech, and Hearing Services in Schools provides data on our national reading comprehension problem, resources for increasing our understanding of reading comprehension, and a call to action for speech-language pathologists to work with educational teams to address poor reading comprehension in school-age children.

http://ift.tt/2o0KPHD

Comprehending Comprehension: Selected Possibilities for Clinical Practice Within a Multidimensional Model

Purpose

In this discussion as part of a response to Catts and Kamhi's "Prologue: Reading Comprehension Is Not a Single Activity" (2017), the authors provide selected examples from 4th-, 5th-, and 6th-grade texts to demonstrate, in agreement with Catts and Kamhi, that reading comprehension is a multifaceted and complex ability. The authors were asked to provide readers with evidence-based practices that lend support to applications of a multidimensional model of comprehension.

Method

We present examples from the reading comprehension literature that support the notion that reading is a complex set of abilities that include a reader's ability, especially background knowledge; the type of text the reader is being asked to comprehend; and the task or technique used in assessment or intervention paradigms. An intervention session from 6th grade serves to demonstrate how background knowledge, a text's demands, and tasks may come together in the real world as clinicians and educators aim to help students comprehend complex material.

Conclusions

The authors agree with the conceptual framework proposed by Catts and Kamhi that clinicians and educators should consider the multidimensional nature of reading comprehension (an interaction of reader, text, and task) when creating assessment and intervention programs. The authors might depart slightly by considering, more closely, those reading comprehension strategies that might facilitate comprehension across texts and tasks with an understanding of students' individual needs at different points in time

http://ift.tt/2orcAMy

US antibiotic stewardship and penicillin allergy.

Purpose of review: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. Recent findings: Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. Summary: Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics. This permits use of narrower-spectrum antibiotics and saves money. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2oWfGXi

Steroid Resistance of Airway Type 2 Innate Lymphoid Cells (ILC2s) from Severe Asthma: The Role of Thymic Stromal cell Lymphopoietin (TSLP)

Publication date: Available online 20 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Sucai Liu, Mukesh Verma, Lidia Michalec, Weimin Liu, Anand Sripada, Donald Rollins, James Good, Yoko Ito, HongWei Chu, Magdalena M. Gorska, Richard J. Martin, Rafeul Alam
BackgroundILC2s represent an important type 2 immune cell. Glucocorticoid regulation of human ILC2s is largely unknown.ObjectiveTo assess steroid resistance of human blood and airway ILC2s from asthmatic patients and examine its mechanism of induction.MethodsWe studied human blood and lung ILC2s from asthmatic and control subjects by flow cytometry and ELISA.ResultsDexamethasone (Dex) inhibited (P=0.04) CRTH2 and type 2 cytokine expression by blood ILC2s stimulated with IL25 and IL33. However, it failed to do so when ILC2s were stimulated with IL7 and TSLP, two ligands of IL7Rα. Unlike blood ILC2s, BAL ILC2s from asthmatic patients were resistant to Dex. BAL from the asthmatic patients had elevated TSLP but not IL7. The BAL TSLP level correlated (r=0.74) with steroid resistance of ILC2s. TSLP was synergistically induced in epithelial cells by IL13 and human rhinovirus. Mechanistically, Dex upregulated ILC2 expression of IL7Rα , which augmented and sustained STAT5 signaling by TSLP. TSLP induced MEK, c-Fos, ID3, pSTAT3 and pSTAT5—molecules linked to steroid resistance. Dex inhibited c-Fos, ID3 and pSTAT3, but not pSTAT5 and MEK. The MEK inhibitor Trametinib, the JAK-STAT inhibitor Tofacitinib and the STAT5 inhibitor Pimozide reversed steroid resistance of BAL ILC2s.ConclusionsDex inhibited type 2 cytokine production by blood ILC2s. IL7 and TSLP abrogated this inhibition and induced steroid resistance of ILC2s in a MEK and STAT5-dependent manner. BAL ILC2s from asthmatic patients with elevated TSLP were steroid resistant, which was reversed by clinically available inhibitors of MEK and STAT5.

Teaser

Dexamethasone inhibited CRTH2 and IL5 but promoted IL7Rα expression by ILC2s, which led to the development of steroid resistance This steroid resistance was reversed by MEK and STAT5 inhibitors.


http://ift.tt/2oaDBow

Type 3 innate lymphoid cells induce proliferation of CD94+ NK cells

Publication date: Available online 20 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Shuo Li, Hideaki Morita, Beate Rückert, tadech boonpiyathad, Avidan Neumann, Cezmi Akdis




http://ift.tt/2osHwcp

Direct monitoring of basophil degranulation by using avidin-based probes

Publication date: Available online 20 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Régis Joulia, Claire Mailhol, Salvatore Valitutti, Alain Didier, Eric Espinosa

Teaser

We show that fluorescent avidin binds to basophil cell surface upon degranulation and can be used to set up a new basophil activation test (BAT). This new assay provides results comparable to those provided by the CD63 exposure-based BAT, but has the advantage to directly monitor granule exteriorization.


http://ift.tt/2oax2lQ

Asthma: the past, the future, the environment, and the costs

Publication date: Available online 20 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Eyal Shemesh, Lawrence C. Kleinman




http://ift.tt/2p1Pts6

Vitamin D downregulates the IL-23 receptor pathway in human mucosal ILC3

Publication date: Available online 20 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Viktoria Konya, Paulo Czarnewski, Marianne Forkel, Anna Rao, Efthymia Kokkinou, Eduardo J. Villablanca, Sven Almer, Ulrik Lindforss, Danielle Friberg, Charlotte Höög, Peter Bergman, Jenny Mjösberg
BackgroundVitamin D deficiency is a risk factor for inflammatory bowel disease (IBD). The IL-23-driven tissue-resident ILC3 play essential roles in intestinal immunity, and targeting IL-23/12 is a promising approach in IBD therapy.ObjectiveWe set out to define the role of 1α,25-dihydroxy vitamin D3 (1,25D) in regulating functional responses of human mucosal ILC3 to IL-23 plus IL-1β stimulation.MethodsTranscriptomes of sorted tonsil ILC3 were assessed by microarray analysis. ILC3 cytokine production, proliferation and differentiation were determined by flow cytometry, ELISA and multiplex immunoassay. Intestinal cell suspensions and ILC3 sorted from gut biopsies of IBD patients were also analyzed along with plasma 25-hydroxy vitamin D3 (25D) detection.ResultsILC3 stimulated with IL-23 plus IL-1β upregulated the vitamin D receptor (VDR) and responded to 1,25D with downregulation of the IL-23 receptor (IL-23R) pathway. Consequently, 1,25D suppressed the IL-22, IL-17F and GM-CSF production from tonsil and gut ILC3. In parallel, 1,25D upregulated genes linked to the IL-1β signaling pathway as well as the IL-1β-inducible cytokines IL-6, IL-8 and MIP-1α/β. The 1,25D-triggered skewing in ILC3 function was not accompanied or caused by changes in viability, proliferation or phenotype. Finally, we confirmed low 25D plasma levels in IBD patients with active inflammation.ConclusionIn the light of the beneficial targeting of IL-23/12 in IBD, 1,25D appears as an interesting therapeutic agent that inhibits the IL-23R pathway, providing a novel mechanism for how ILC3 could be manipulated to regulate intestinal inflammation.

Teaser

We have unraveled the detailed mechanisms behind how vitamin D efficiently suppresses IL-23 receptor signaling in gut innate lymphoid cells, providing incitement for vitamin D supplementation as a therapeutic approach in IBD.


http://ift.tt/2oXfuqG

Follistatin and the Breast Implant Capsule

Background: Breast capsular contracture remains an elusive problem faced by plastic surgeons and is the leading long-term complication after breast implantation. Follistatin (Fst) is a protein with known anti-inflammatory and antifibrotic properties and has the potential to limit the severity of diseases associated with inflammation and fibrosis such as capsular contracture. The aim of this study was to examine the effect of Fst288 on capsular fibrosis around silicone implants in a mouse model. Methods: BALB/c mice were implanted subcutaneously with untreated silicone implants (baseline control). In the experimental group, immediately after silicone implant insertion, the implant pocket received either a single injection of 1 µg Fst288 or normal saline (internal control). The animals were killed at 3, 5, 7, 14, 28, and 90 days after surgery, and serum, implants, and the surrounding tissue were removed for histological and immunohistochemical analyses. Results: Fst288 treatment resulted in significant decreases in capsule thickness at 28 days (P

http://ift.tt/2o2CIeH

Segmental Humeral Reconstruction with a Pedicled Radius Bone Flap in Congenital Amyoplasia

The clinical case of a patient with a segmental humeral defect, in the context of an arthrogryposis congenita multiplex and morbid obesity, reconstructed with a pedicled segmental radial bone flap is reported. The use of the pedicled vascularized diaphyseal radial bone flap may be a useful technique for humerus reconstruction in patients with contraindication for microvascular bone transfers and an already injured or severely handicapped upper limb.

http://ift.tt/2o2JaSS

Allergens involved in the cross-reactivity of Aedes aegypti with other arthropods

Publication date: Available online 20 April 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jose Fernando Cantillo, Leonardo Puerta, Sylvie Lafosse-Marin, Jose Luis Subiza, Luis Caraballo, Enrique Fernandez-Caldas
BackgroundCross-reactivity between Aedes aegypti and mites, cockroaches, and shrimp has been previously suggested, but the involved molecular components have not been fully described.ObjectiveTo evaluate the cross-reactivity between A aegypti and other arthropods.MethodsThirty-four serum samples from patients with asthma and/or allergic rhinitis were selected, and specific IgE to A aegypti, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, Periplaneta americana. and Litopenaeus vannamei was measured by enzyme-linked immunosorbent assay. Cross-reactivity was investigated using pooled serum samples from allergic patients, allergenic extracts, and the recombinant tropomyosins (Aed a 10.0201, Der p 10, Blo t 10, Lit v 1, and Per a 7). Four IgE reactive bands were further characterized by matrix-assisted laser desorption/ionization tandem time of flight.ResultsFrequency of positive IgE reactivity was 82.35% to at least one mite species, 64.7% to A aegypti, 29.4% to P americana, and 23.5% to L vannamei. The highest IgE cross-reactivity was seen between A aegypti and D pteronyssinus (96.6%) followed by L vannamei (95.4%), B tropicalis (84.4%), and P americana (75.4%). Recombinant tropomyosins from mites, cockroach, or shrimp inhibited the IgE reactivity to the mosquito at a lower extent than the extracts from these arthropods. Several bands of A aegypti cross-reacted with arthropod extracts, and 4 of them were identified as odorant binding protein, mitochondrial cytochrome C, peptidyl-prolyl cis-trans isomerase, and protein with hypothetical magnesium ion binding function.ConclusionWe identified 4 novel cross-reactive allergens in A aegypti allergenic extract. These molecules could influence the manifestation of allergy to environmental allergens in the tropics.



http://ift.tt/2oXgJ96

An Innovative Cooling Jacket to Combat Heat Intolerance in Children with Anhidrosis

Abstract

Hyperthermia and heat intolerance are distressing symptoms in patients with anhidrosis. Body cooling devices are an integral part of management of these patients. A cooling jacket made from easily available materials has been invented for a girl with congenital insensitivity to pain and anhidrosis with severe heat intolerance. This innovative cooling jacket may be helpful for anhidrotic children in resource-poor situations.

http://ift.tt/2oX2Ojn

In situ Hearing Tests for the Purpose of a Self-Fit Hearing Aid

This study investigated the potential and limitations of a self-fit hearing aid. This can be used in the "developing" world or in countries with large distances between the hearing-impaired subjects and the professional. It contains an on-board tone generator for in situ user-controlled, automated audiometry, and other tests for hearing aid fitting. Twenty subjects with mild hearing losses were involved. In situ audiometry showed a test-retest reliability (SD Audiol Neurotol 2017;22:15-23

http://ift.tt/2pJTzTJ

Resveratrol improves mitochondrial function in the remnant kidney from 5/6 nephrectomized rats

Publication date: Available online 20 April 2017
Source:Acta Histochemica
Author(s): Yan Hui, Miaomiao Lu, Yarong Han, Hongli Zhou, Wei Liu, Lijing Li, Ruixia Jin
Mitochondrial dysfunction is involved in the pathogenesis of chronic kidney disease (CKD). Resveratrol has been demonstrated to be beneficial for the recovery of kidney diseases. In this study, the 5/6 nephrectomized rat was used as a CKD model and the TGF-β1-exposed mouse mesangial cells were used as an in vitro model. Pathological examination showed that resveratrol treatment attenuated glomerular injury in the remnant kidney of 5/6 nephrectomized rat. Additionally, resveratrol improved mitochondrial function in vivo and in vitro, as evidenced by increasing mitochondrial membrane potential, increasing ATP, decreasing reactive oxygen species production and enhancing activities of complex I and III. Furthermore, the dysregulated expressions of electron transport chain proteins and fission/fusion proteins in the kidney of 5/6 nephrectomize rats and TGF-β1-exposed mesangial cells were restored by resveratrol. Finally, upregulated sirt1 and PGC-1α deacetylation were found after treatment with resveratrol in vivo and in vitro, which may contribute to the mitochondrial protective effects of resveratrol. The results demonstrate that resveratrol protects the mitochondria of kidney in 5/6 nephrectomized rats and TGF-β1 induced mesangial cells. The study provides new insights into the renoprotective mechanisms of resveratrol.



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Management of a case of myopic foveoschisis with phakic intraocular lens (pIOL) in situ: intraoperative challenges

We describe the case of a 30-year-old man with pathological myopia with a phakic intraocular lens (IOL) (Visian ICL V4c model; STAAR, Monrovia, California, USA) in situ having complaints of metamorphopsia in the left eye with documented myopic foveoschisis on swept-source optical coherence tomography (DRI OCT Triton; Topcon, Tokyo, Japan). The patient underwent pars plana vitrectomy with internal limiting membrane peeling. This report discusses the intraoperative challenges occurring as a result of increased optical aberrations in the presence of a phakic IOL.

http://ift.tt/2pJziOf

Exogenous Cushing's syndrome due to a Chinese herbalists prescription of ointment containing dexamethasone

Eczema in children is a chronic disabling condition. The impact of this condition on the lives of families is often underestimated by conventional physicians. As a consequence parents may investigate complementary treatment options. Close monitoring by a paediatrician is essential, considering that a variety of adverse effects can occur during the use of complementary treatment. We present a 5-year-old girl with eczema. She visited a Chinese herbalist who prescribed an ointment. The parents noticed that the eczema resolved fast, itching decreased and she was finally sleeping well. However, her behaviour changed and appetite increased. Undetectable levels of serum cortisol were found, which was indicative of exogenous Cushing's syndrome. Analysis of the ointment revealed the presence of dexamethasone. Hydrocortisone substitution and subsequently a reduction schedule were implemented, after which endogenous cortisol production recovered after 4 months. Physicians should be aware that unregistered herbal medicine can contain potent drugs such as glucocorticoids.

http://ift.tt/2p1w1Me

Efficacy of proportional condylectomy in a treatment protocol for unilateral condylar hyperplasia: A review of 73 cases

Unilateral condylar hyperplasia (UCH) is characterized by an excessive growth of a mandibular condyle, resulting in facial, and occlusal deformities. Scintigraphic hyperactivity usually triggers the need of condylectomy. Delaire has presented a protocol for the treatment of active or non-active UCH using systematically a proportional condylectomy, which could solve both aetiology and adaptive deformities. The aim of this study was to evaluate this protocol by clinical and radiographical analysis.

http://ift.tt/2pJKD0D

Prospective comparison of perioperative antibiotic management protocols in oncological head and neck surgery

The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients.

http://ift.tt/2pkVpgP

The orbit first! A novel surgical treatment protocol for secondary orbitozygomatic reconstruction

A novel surgical treatment sequence for secondary orbitozygomatic complex (OZC) reconstruction is described. Orbital reconstruction is performed before OZC repositioning. A surgical plan is made: the affected OZC is virtually osteotomized and aligned with a mirrored model of the unaffected OZC. A patient-specific implant (PSI) is designed for orbital reconstruction. Screw holes from the primary reconstruction are used for fixation. Primary screw hole positions at the repositioned OZC are embedded in the design, to guide OZC repositioning.

http://ift.tt/2pJeVRf

Infant feeding and child fussy eating: The Generation R Study

Publication date: 1 July 2017
Source:Appetite, Volume 114
Author(s): Lisanne M. de Barse, Pauline W. Jansen, Lisa R. Edelson-Fries, Vincent W.V. Jaddoe, Oscar H. Franco, Henning Tiemeier, Jolien Steenweg-de Graaff
Fussy/picky eating – i.e. consistently avoiding certain foods – is common in childhood and can be worrisome for parents. Repeated exposure to various flavors as occurs in breastmilk and early exposure to complementary feeding may increase food acceptance and thereby decrease fussy eating. This study examines the associations between infant feeding and child fussy eating in 4779 participants of Generation R, a Dutch population-based cohort. Breastfeeding initiation and continuation, and timing of complementary feeding were assessed by questionnaires at 2, 6, and 12 months. The food fussiness scale of the Children's Eating Behaviour Questionnaire was administered at 4 years. Linear regression analyses were performed, adjusted for confounders. Children who were never breastfed did not differ in fussy eating frequency from children breastfed for 6 months or longer. However, children who were breastfed for less than 2 months had a 0.70 points higher food fussiness sum-score (95%CI:0.27; 1.12) than children breastfed for 6 months or longer. An earlier introduction of vegetables was associated with less fussy eating behavior (p-for-trend:0.005). Particularly children who were introduced to vegetables between 4 and 5 months had a 0.60 point lower food fussiness score (95%CI: 1.06;-0.15) than children introduced to vegetables after 6 months. An early introduction to fruits or any solids was not significantly related to fussy eating, although the effect estimates were in the same direction as for introducing vegetables early. Results suggest that breastfeeding does not predict fussy eating. However, introducing vegetables into a child's diet before 5 months might be protective against fussy eating, although future research should account for parents' own fussy eating.



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Sir Charles Bell: Unheralded laryngologist

Sir Charles Bell is renowned and revered as an outstanding surgeon, anatomist, clinician and teacher and his many contributions to various medical fields have been amply described. What are less well-known are his contributions to the field of laryngology.

http://ift.tt/2osp0AZ

Primary mucosal melanoma of the palatine tonsil: Report of a case and review of the literature

Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment.

http://ift.tt/2oakhbi

The effectiveness of earmuffs on the physiologic and behavioral stability in preterm infants

The use of earmuffs can protect preterm infants against negative effects of high noise levels in the neonatal intensive care unit. This study was aimed at assessing the effectiveness of the earmuffs on the physiologic and behavioral responses in preterm infants.

http://ift.tt/2p1SQiR

Foreign body aspiration in children: A study of children who lived or died following aspiration

Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999 - 2014. Children were either managed with bronchoscopy for removal of the foreign body or died due to FBA. A total of 103 children were seen due to FBA including 27 deaths. The majority of children were boys and were less than 3 years old. Most aspirated foreign bodies were food-related, mainly peanuts.

http://ift.tt/2pXKGFo

Paediatric tracheomalacia - a review of clinical features and comparison of diagnostic imaging techniques

Tracheomalacia is the excessive collapse of the tracheal wall during respiration [1]. In children, it can be classified as primary or secondary in origin. Primary tracheomalacia is due to impaired maturation or deficiency in cartilaginous rings and/or decreased tone of the trachealis muscle. In a healthy child, the tracheal cartilage extends for approximately 320 degrees. In patients with primary tracheomalacia, cartilage may be small or fragmented leading to anterior collapse and the membranous portion of the trachea can account for up to 50% of the circumference.

http://ift.tt/2p1BDWT

Outcomes and Limitations of Hospital-Based Newborn Hearing Screening

Globally, newborn hearing screening (NHS) is variably incorporated into national healthcare systems. The authors reviewed the set-up and evolution process of a hospital-based NHS program in South Korea, where screening costs for low-income families are paid by the National Health Authority.

http://ift.tt/2pXG2r1

Sir Charles Bell: Unheralded laryngologist

Sir Charles Bell is renowned and revered as an outstanding surgeon, anatomist, clinician and teacher and his many contributions to various medical fields have been amply described. What are less well-known are his contributions to the field of laryngology.

http://ift.tt/2osp0AZ

Primary mucosal melanoma of the palatine tonsil: Report of a case and review of the literature

Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment.

http://ift.tt/2oakhbi

Epidemiological Evidences for the Association of Obesity and Metabolic Disorders with Oral Diseases

Abstract

Purpose of Review

Obesity is the underlying cause of many chronic diseases and affects overall health. Obesity and obesity-related metabolic disorders, particularly, metabolic syndrome and diabetes, have been recognized to be associated with oral diseases. This review describes the recent evidence from epidemiological studies investigating the effect of obesity and metabolic disorders on oral diseases, including dental caries and periodontal disease in adults.

Recent Findings

Longitudinal studies indicate the direction of association that obesity and diabetes affect periodontal disease. Interpretation of causal relationships between metabolic syndrome and periodontal disease remains limited because of the small number of prospective evidence. Longitudinal studies investigating dental caries have not been performed.

Summary

Further exploration of the effect of metabolic syndrome on periodontal disease, and that of obesity and metabolic disorders on dental caries in longitudinal studies, is warranted.

http://ift.tt/2p1y4jB

Restoration of the Worn Dentition: Basic Prosthodontic Principles and Current Rehabilitation Techniques

Abstract

Purpose of Review

Dental wear is an existing and increasing problem. This review aims to describe the prosthodontic principles as well as the current trends in materials and techniques for the rehabilitation of patients with worn dentition.

Recent Findings

The current literature includes a lot of information in relation to clinical and laboratory procedures for the restoration of the worn dentition. Also, recent in vitro and in vivo studies address the clinical success, properties, and wear behavior of current materials.

Summary

A plethora of materials are currently used to restore dental wear including, direct/indirect composite resin, and all-ceramic restorations. Minimally invasive procedures are based on adhesive cementation of restorations, and in many situations, patients are restored with partial coverage restorations. Long-term success of the rehabilitation is dependent on careful material selection, based on current evidence, careful execution of well-established rehabilitation techniques, and a patient-based individualized maintenance program.

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A Novel Recombinant Canine Adenovirus Type 1 Detected from Acute Lethal Cases of Infectious Canine Hepatitis

Viral Immunology , Vol. 0, No. 0.


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Asthma: the past, the future, the environment, and the costs

http://ift.tt/2owkrF1

Brodie abscess of the femoral capital epiphysis in a 2-year-old child caused by Kingella kingae

We report the case of a Brodie abscess of the femoral capital epiphysis from which Kingella kingae was isolated. This is to the best of our knowledge the first report of a Brodie abscess of the femoral capital epiphysis from which K. kingae was isolated.

http://ift.tt/2oamKlY

Direct monitoring of basophil degranulation by using avidin-based probes

We show that fluorescent avidin binds to basophil cell surface upon degranulation and can be used to set up a new basophil activation test (BAT). This new assay provides results comparable to those provided by the CD63 exposure-based BAT, but has the advantage to directly monitor granule exteriorization.

http://ift.tt/2owhTXz

Steroid Resistance of Airway Type 2 Innate Lymphoid Cells (ILC2s) from Severe Asthma: The Role of Thymic Stromal cell Lymphopoietin (TSLP)

Dexamethasone inhibited CRTH2 and IL5 but promoted IL7Rα expression by ILC2s, which led to the development of steroid resistance This steroid resistance was reversed by MEK and STAT5 inhibitors.

http://ift.tt/2pK3Z8J

Vitamin D downregulates the IL-23 receptor pathway in human mucosal ILC3

We have unraveled the detailed mechanisms behind how vitamin D efficiently suppresses IL-23 receptor signaling in gut innate lymphoid cells, providing incitement for vitamin D supplementation as a therapeutic approach in IBD.

http://ift.tt/2pK9nZH

Type 3 innate lymphoid cells induce proliferation of CD94+ NK cells

http://ift.tt/2owsxxr

Delayed LGI1 seropositivity in voltage-gated potassium channel (VGKC)-complex antibody limbic encephalitis

We utilise a clinical case to highlight why exclusion of voltage-gated potassium channel (VGKC)-complex autoantibody testing in serological evaluation of patients may delay or miss the diagnosis. A 68-year-old man presented with increasing involuntary movements consistent with faciobrachial dystonic seizures (FBDS). Initial evaluation demonstrated VGKC antibody seropositivity with leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) seronegativity. Aggressive immunotherapy with methylprednisolone and plasmapheresis was started early in the course of his presentation. Following treatment with immunotherapy, the patient demonstrated clinical improvement. Repeat serum evaluation 4 months posthospitalisation remained seropositive for VGKC-complex antibodies, with development of LGI1 autoantibody seropositivity. VGKC-complex and LGI1 antibodies remained positive 12 months posthospitalisation. Our findings suggest that clinical symptoms can predate the detection of the antibody. We conclude that when suspicion for autoimmune encephalitis is high in the setting of VGKC autoantibody positivity, regardless of LGI1 or CASPR2 seropositivity, early immunotherapy and repeat testing should be considered.

http://ift.tt/2osA6Gd

Syndrome of inappropriate antidiuretic hormone accompanied by bilateral hypothalamic and anterior thalamic lesions with serum antiaquaporin 4 antibody

We described a rare case of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and severe unconsciousness accompanied by bilateral hypothalamic and anterior thalamic lesions with positive serum antiaquaporin 4 (AQP4) antibody. A 29-year-old man was admitted to our hospital due to the subacute progression of an unconscious state. He was observed to be hyponatraemic secondary to SIADH. Brain MRI showed bilateral hypothalamic and anterior thalamic lesions. Anti-AQP4 antibody was detected in his serum. After the administration of intravenous methylprednisolone pulse therapy, his symptoms improved with complete recovery from SIADH and regression of the hypothalamic and anterior thalamic lesions. The patient was transferred to another hospital for rehabilitation with 20 mg/day of oral prednisolone 127 days after admission. This case highlights the importance of testing for anti-AQP4 antibody in patients with unexplainable SIADH, subacute progressive unconsciousness and bilateral hypothalamic and anterior thalamic lesions.

http://ift.tt/2oajiI5

Transoesophageal three-dimensional echocardiographic diagnosis of Barlows disease

Description

A 67-year-old man with a year history of palpitations and dyspnoea presented to the physician's office. His blood pressure was 140/80 mm Hg and pulse was 80 beats/min. Heart auscultation revealed a loud systolic click followed by a holosystolic murmur. The ECG showed sinus rhythm, P wave +/– in V1 and P wave duration 140 ms in DII. The Holter monitoring showed atrial extrasystoles and an episode of atrial tachycardia (figure 1A).

Figure 1

(A) The Holter monitoring showed atrial extrasystoles and an episode of atrial tachycardia. (B) M-mode echocardiogram showed late systolic sagging of the mitral valve. (C) Transoesophageal echocardiogram showed clearly the prolapsing mitral leaflets and severe mitral regurgitation. (D,E) Three-dimensional echocardiographic imaging demonstrated bileaflet prolapse. Mitral model showed prolapse of the P1, P2, P3 and A1, A2, A3.

The transthoracic echocardiogram M-mode showed late systolic sagging of the mitral...

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A review of mouthguards: effectiveness, types, characteristics and indications for use

http://ift.tt/2oadwWY

Dental patients: Self-diagnosis

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Non-surgical management of tooth hypersensitivity

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Dental research: Collaboration needed

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Gently moving teeth into the ideal position

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Pharmacology: Sea change of indications

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The oral health of individuals with dental phobia: a multivariate analysis of the Adult Dental Health Survey, 2009

http://ift.tt/2oabq9z

Water fluoridation: There is no evidence

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Special offers at the one stop shop this spring

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Synthesis and cytotoxic activity of new artemisinin hybrid molecules against human leukemia cells

Publication date: Available online 20 April 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Antonios S. Letis, Ean-Jeong Seo, Sotiris S. Nikolaropoulos, Thomas Efferth, Athanassios Giannis, Manolis A. Fousteris
A series of new artemisinin-derived hybrids which incorporate cholic acid moieties have been synthesized and evaluated for their antileukemic activity against sensitive CCRF-CEM and multidrug-resistant CEM/ADR5000 cells. The new hybrids 20–28 showed IC50 values in the range of 0.019 µM to 0.192 µM against CCRF-CEM cells and between 0.345 µM and 7.159 µM against CEM/ADR5000 cells. Amide hybrid 25 proved the most active compound against both CCRF-CEM and CEM/ADR5000 cells with IC50 value of 0.019 ± 0.001 µM and 0.345 ± 0.031 µM, respectively. A relatively low cross resistance to hybrids 20–28 in the range of 5.7-fold to 46.1-fold was measured. CEM/ADR5000 cells showed higher resistance than CCRF-CEM to all the tested compounds. Interestingly, the lowest cross resistance to 23 was observed (5.7-fold), whereas hybrid 25 showed 18.2-fold cross-resistant to CEM/ADR5000 cells. Hybrid 25 which proved even more potent than clinically used doxorubicin against CEM/ADR5000 cells may serve as a promising antileukemic agent against both sensitive and multidrug-resistant cells.

Graphical abstract

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Endorsed effectiveness

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Chemical composition of Ocimum sanctum by LC-ESI–MS/MS analysis and its protective effects against smoke induced lung and neuronal tissue damage in rats

Publication date: July 2017
Source:Biomedicine & Pharmacotherapy, Volume 91
Author(s): M.P. Venuprasad, Hemanth Kumar Kandikattu, Sakina Razack, Narayanappa Amruta, Farhath Khanum
Smoke induced oxidative stress is known to cause various cancers and associated health problems including lung cancer. Herbal extracts have been reported as antioxidant supplements which attenuate free radical induced oxidative damage of tissues, among which Ocimum sanctum has been reported as the elixir of life due to its innumerable health benefits. In the present study, we investigated the protective effect of O. sanctum against cracker smoke induced lung and brain tissue damage. The results of the study demonstrate that O. sanctum regulates the hematological and serum biochemical parameters such as RBC, WBC, blood urea nitrogen and creatinine kinase. O. sanctum supplementation inhibited oxidative stress as analyzed by SOD, CAT enzyme levels and i-NOS, HSP-70 protein expression. O. sanctum administration also regulated neurotransmitter levels, such as serotonin, dopamine, and regulated acetylcholine esterase levels which play a vital role in neuronal function. Further O. sanctum treatment also preserved the morphology of lung and brain tissues of smoke stress induced rats as observed by histopathology and transmission electron microscope analysis. The biodistribution of O. sanctum was showed its accumulation in key tissues such as kidney, liver, lungs and heart. The LC-ESI–MS/MS analysis of O. sanctum showed the presence of polyphenols, flavonoids and fatty acids which might be responsible for the observed anti-stress effects.

Graphical abstract

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Style, comfort and fuctionality

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Orthodontics: Link with obesity

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Effect of hypnosis during administration of local anesthesia in six- to 16-year-old children

http://ift.tt/2oa3xRg

Fitness to practise: A question of reputation

http://ift.tt/2oWHOcB

Investigation of the erosive potential of sour novelty sweets

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OMFS: GA rights

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Improve implant care

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Charles Tomes lecture addresses the 'trauma of trauma'

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Educational webinars with free verifiable CPD

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Joy Harrild Award for Young Dentists launched

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High prevalence of restless legs syndrome/Willis Ekbom Disease (RLS/WED) among people living at high altitude in the Indian Himalaya

At high altitude, prevalence of restless legs syndrome has been found to be greater than expected in small population-based studies, which did not use validated tools for identification of RLS. However, it is not known as to whether this increased prevalence is associated with altitude or increased risk factors for RLS in these populations or errors in identification of RLS.

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Chronic Candidiasis in Children

Abstract

Purpose of Review

Healthy children may develop candidal infections as the result of exposure to antibiotics or corticosteroids, but chronic candidiasis in children after the newborn period is unusual. Chronic mucocutaneous candidiasis (CMC) refers to a group of conditions characterized by recurrent or persistent infections with Candida species, particularly Candida albicans. CMC is a phenotype observed in a spectrum of immunologic disorders, some with endocrinologic and autoimmune features.

Recent Findings

CMC can arise secondary to inherited or acquired T cell deficiencies, but in children is largely due to inborn errors impairing the dectin pathway and IL-17 immunity. We review the current understanding of the pathogenesis of chronic mucocutaneous candidiasis and discuss the immunologic pathways by which the immune system handles Candida. We highlight the historical and recent knowledge of CMC in children, emphasizing recent insights into basic science aspects of the dectin pathway, IL-17 signaling, consequences of AIRE gene defects, and clinical aspects of inheritance, and features that distinguish the different syndromes.

Summary

The clinical phenotype of CMC has many underlying genetic causes. Genetic testing is required for definitive diagnosis.

http://ift.tt/2oVrjgV

Emerging Approaches to Food Desensitization in Children

Abstract

Purpose of Review

The purpose of this review is to highlight the recent advances in food desensitization in children with food allergy.

Recent Findings

Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities.

Summary

Food allergy prevalence in children is estimated to be up to 8%. These children are at risk of significant allergic reactions and anaphylaxis. Food avoidance and use of antihistamines or epinephrine has been the standard of care for these patients. This approach also has a significant socioeconomic effects on patients and their families. Recent advancements in understanding food allergy have allowed for exploring new methods of treatment. There is an increasing interest in oral immunotherapy, epicutaneous immunotherapy, or sublingual immunotherapy for food allergy. There have been also innovative approaches to immunotherapy by modification of food allergens (to make them less allergenic while maintain their immunogenicity) or adding adjunctive treatments (probiotics, anti-IgE, etc.) to increase efficacy or safety.

http://ift.tt/2pIyBrf

Blocked transcription through KvDMR1 results in absence of methylation and gene silencing resembling Beckwith-Wiedemann syndrome [RESEARCH ARTICLE]

Vir B. Singh, Sirinapa Sribenja, Kayla E. Wilson, Kristopher M. Attwood, Joanna C. Hillman, Shilpa Pathak, and Michael J. Higgins

The maternally methylated KvDMR1 ICR regulates imprinted expression of a cluster of maternally-expressed genes on human chromosome 11p15.5. Disruption of imprinting leads to Beckwith-Wiedemann syndrome (BWS), an overgrowth and cancer predisposition condition. In the majority of BWS patients, maternal-specific methylation at KvDMR1 is absent and genes under its control are repressed. We analyzed a mouse model carrying a poly(A) truncation cassette inserted to prevent RNA transcripts from elongation through KvDMR1. Maternal inheritance of this mutation resulted in absence of DNA methylation at KvDMR1, which led to biallelic expression of Kcnq1ot1 and suppression of maternally expressed genes. This study provides further evidence that transcription is required for establishment of methylation at maternal gametic DMRs. More importantly, this mouse model recapitulates the molecular phenotypic characteristics of the most common form of BWS including loss of methylation at KvDMR1 and biallelic repression of Cdkn1c, suggesting deficiency of maternal transcription through KvDMR1 may be an underlying cause of some BWS cases.

http://ift.tt/2pJlgfI

PARP inhibitors alone and in combination with other biological agents in homologous recombination deficient epithelial ovarian cancer: from the basic research to the clinic

Publication date: Available online 20 April 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Angiolo Gadducci, Maria Elena Guerrieri
Hereditary epithelial ovarian cancer [EOC] in germline BRCA mutation (gBRCAm) carriers has a distinct clinical behavior characterized by younger age, high- grade serous histology, advanced stage, visceral distribution of disease, high response to platinum and other non-platinum agents and better clinical outcome. Sporadic EOC with homologous recombination deficiency [HDR] but no gBRCAm has the same biological and clinical behavior as EOC in gBRCAm carriers ("BRCAness"phenotype). Biomarkers are in development to enable an accurate definition of molecular features of BRCAness phenotype, and trials are warranted to determine whether such HDR signature will predict sensitivity to PARP inhibitors in sporadic EOC. Moreover, the link between PARP inhibition and angiogenesis suppression, the immunologic properties of EOC in gBRCAm carriers, the HRD induced by PI3K inhibition in EOC cells in vitro strongly support novel clinical trials testing the combination of PARP inhibitors with other biological agents.



http://ift.tt/2pHrKhL

Second-line chemotherapy for advanced pancreatic cancer: Which is the best option?

Publication date: Available online 20 April 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Giuseppe Aprile, Francesca V. Negri, Francesco Giuliani, Elisa De Carlo, Davide Melisi, Francesca Simionato, Nicola Silvestris, Oronzo Brunetti, Francesco Leone, Donatella Marino, Daniele Santini, Emanuela Dell'Aquila, Tea Zeppola, Marco Puzzoni, Mario Scartozzi
Despite recent biological insight and therapeutic advances, the prognosis of advanced pancreatic cancer still remains poor. For more than 15 years, gemcitabine monotherapy has been the cornerstone of first-line treatment. Recently, prospective randomized trials have shown that novel upfront combination regimens tested in prospective randomized trials have resulted in improved patients' outcome increasing the proportion of putative candidate to second-line therapy. There is no definite standard of care after disease progression. A novel formulation in which irinotecan is encapsulated into liposomal-based nanoparticles may increase the efficacy of the drug without incrementing its toxicity. NAPOLI-1 was the first randomized trial to compare nanoliposomal irinotecan and fluorouracil-leucovorin (5-FU/LV) to 5-FU/LV alone after a gemcitabine-based chemotherapy. This review focuses on the current data for the management of second-line treatment for metastatic pancreatic adenocarcinoma, presents the most interesting ongoing clinical trials and illustrates the biologically-driven future options beyond disease progression.



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How Accurate are Environmental Classifiers in Hearing Aids?

All modern hearing aids with any kind of automatic functionality use analysis of the acoustic environment. The most basic is the compression system, which uses level detectors to determine how much gain should be applied to the input signal according to the amplification scheme. However, when speaking of environmental classification, what we usually mean is the system by which the hearing aid decides what sort of listening situation it is in.

http://ift.tt/2pJ2dC7

Improving blend content uniformity via dry particle coating of micronized drug powders

Publication date: Available online 20 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Zhonghui Huang, Wannan Xiong, Kuriakose Kunnath, Sayani Bhaumik, Rajesh N. Davé
Content uniformity of low dose blends with fine active pharmaceutical ingredients (API) is adversely impacted due to API agglomeration caused by high powder cohesion. Dry coating using high-intensity vibratory mixing is employed to reduce API cohesion and granular Bond number as well as agglomeration as predicted by contact models, hence improve blend content uniformity (CU). Micronized acetaminophen (mAPAP) (~10μm), a model API, was dry coated with nano-silica R972P (20nm), and mixed with Avicel 102. The amount of silica was varied from 0 to 2.74wt%, corresponding to theoretical surface area coverage (SAC) from 0 to 100% respectively. Bulk density, unconfined yield strength, and dispersive surface energy results indicated dry coating with 0.27 to 1.0wt% silica was adequate for API property enhancement; further corroborated by improved CU for 5wt% API blends. Excellent CU was achieved for 3, 5 and 10wt% API loaded blends, where 30min of mixing was found to be acceptable for all three. The CU with dry coated mAPAP was significantly lower and within the acceptable range as compared to control blends without silica, as well as those with silica added during blending. Sieving of mAPAP illustrated the reduction in mAPAP agglomeration, necessary for improved CU after dry coating, corroborating model based predictions. Compared to theoretical predictions, actual CU was higher unless API agglomerate size distribution obtained via sieving was taken into account. Overall, cohesion reduction by dry coating is shown as a promising approach for improving content uniformity of cohesive API blends.

Graphical abstract

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Preformulation studies of ceftriaxone for pediatric non-parenteral administration as an alternative to existing injectable formulations

Publication date: Available online 20 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Tina Kauss, Mathieu Marchivie, Thida Phoeung, Alexandra Gaubert, Amélie Désiré, Giovanni Tonelli, Chantal Boyer, Marie-Hélène Langlois, Anthony Cartwright, Melba Gomes, Nicholas White, Karen Gaudin
Ceftriaxone, a third generation cephalosporin, has a wide antibacterial spectrum that has good CNS penetration, which makes it potentially suitable for initial treatment of severe neonatal pediatric infections providing suitable formulation. We evaluated its physicochemical and technical characteristics to assess its potential for development as a non-parenteral dosage form. As ceftriaxone is marked only for injectable use, these data are not available. Using HPLC and Karl Fischer titration, sensitivity of ceftriaxone to water, feasibility and impact of pharmaceutical processes and compatibility with common pharmaceutical excipients were assessed. X-ray diffraction studies gave deeper insight into the mechanisms involved in degradation. Chemometrical analysis of near infrared spectra enabled classification of ceftriaxone powder according to exposure conditions or processes applied. The results showed that ceftriaxone was not highly hygroscopic, could be processed in all climatic zones, but should be packaged protected against humidity. Controlling water presence in formulation was shown critical, as ceftriaxone degraded in the presence of water content above 2.4% w/w. To improve flowability, a critical parameter for dry dosage form development, granulation (wet and dry techniques, providing complete drying and moderate force compaction respectively) was shown feasible. Compression with moderate forces was possible, but grinding and high compression forces significantly affected long term ceftriaxone stability and should be avoided. Based on these results, development of ceftriaxone non-parenteral solid or liquid non-aqueous forms appears feasible.

Graphical abstract

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Novel sulphur-containing imatinib metabolites found by untargeted LC-HRMS analysis

Publication date: Available online 20 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Ivo Vrobel, David Friedecký, Edgar Faber, Lukáš Najdekr, Kateřina Mičová, Radana Karlíková, Tomáš Adam
Untargeted metabolite profiling using high-resolution mass spectrometry coupled with liquid chromatography (LC-HRMS), followed by data analysis with the Compound Discoverer 2.0™ software, was used to study the metabolism of imatinib in humans with chronic myeloid leukemia. Plasma samples from control (drug-free) and patient (treated with imatinib) groups were analyzed in full-scan mode and the unknown ions occurring only in the patient group were then, as potential imatinib metabolites, subjected to multi-stage fragmentation in order to elucidate their structure. The application of an untargeted approach, as described in this study, enabled the detection of 24 novel structurally unexpected metabolites. Several sulphur-containing compounds, probably originating after the reaction of reactive intermediates of imatinib with endogenous glutathione, were found and annotated as cysteine and cystine adducts. In the proposed mechanism, the cysteine adducts were formed after the rearrangement of piperazine moiety to imidazoline. On the contrary, in vivo S-N exchange occurred in the case of the cystine adducts. In addition, N-O exchange was observed in the collision cell in the course of the fragmentation of the cystine adducts. The presence of sulphur in the cysteine and cystine conjugates was proved by means of ultra-high resolution measurements using Orbitrap Elite. The detection of metabolites derived from glutathione might improve knowledge about the disposition of imatinib towards bioactivation and help to improve understanding of the mechanism of its hepatotoxicity or nephrotoxicity in humans.

Graphical abstract

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Development of oral lyophilisates containing meloxicam nanocrystals using QbD approach

Publication date: Available online 20 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Sonia Iurian, Cătălina Bogdan, Ioan Tomuță, Piroska Szabó-Révész, Anita Chvatal, Sorin E. Leucuța, Mirela Moldovan, Rita Ambrus
The aim of this study was to develop oral lyophilisates with improved meloxicam (MEL) dissolution, optimizing each step of the preparation by design of experiments. First, meloxicam nanosuspensions were prepared by high-pressure homogenization (HPH), using PVP, Poloxamer or PEG as stabilizers and were subjected to freeze-drying using mannitol as cryoprotectant. The effects of the stabilizers and cryoprotectant were assessed and an optimal formulation was generated within the Design Space where the particle sizes and the PDIs are at their lowest values. The optimal formulation was used at the preparation of oral lyophilisates. Sodium alginate (SA) and croscarmellose sodium (CCS) were tested as matrix forming agents and three different freezing regimes were applied. The formulation was optimized, choosing the polymer that yielded both high mechanical strength and fast MEL dissolution. Poloxamer led to particle size reduction down to 10.27% of the initial size, meaning 477.6±7.5nm, with a slight increase during freeze-drying process. PEG showed lower nanonizing capacity during HPH, but freeze-drying produced further diminution of the particle size. Since Poloxamer provided advanced size reduction while preserving MEL crystallinity, it was used for the optimized formulation containing 1% Poloxamer and 5% mannitol added before freeze-drying. SA showed good structural properties when compared to CCS and allowed fast MEL dissolution at low ratios. The optimal formulation contained 1.157% of SA was subjected to thermal treatment during freeze-drying. It disintegrated in 3.33s and released 77.14% of the MEL after 2min. The quality by design (QbD) approach for the development of pharmaceutical products ensured high quality of the dosage form and good understanding of the preparation process.

Graphical abstract

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In response to stomal maturation does not increase the rate of tracheocutaneous fistulas

http://ift.tt/2oWurcm

In response to stomal maturation does not increase the rate of tracheocutaneous fistulas

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Hepatic lipid accumulation: cause and consequence of dysregulated glucoregulatory hormones

Fatty liver can be diet, endocrine, genetic, viral, or drug induced. Independent of cause, hepatic lipid accumulation promotes systemic metabolic dysfunction. By acting as peroxisome proliferator activated receptor (PPAR) ligands, hepatic non-esterified fatty acids upregulate expression of gluconeogenic, beta-oxidative, lipogenic, and ketogenic genes, promoting hyperglycemia, hyperlipidemia, and ketosis. The typical hormonal environment in fatty liver disease consists of hyperinsulinemia, hyperglucagonemia, hypercortisolemia, growth hormone deficiency, and elevated sympathetic tone. These endocrine and metabolic changes further encourage hepatic steatosis by regulating adipose tissue lipolysis, liver lipid uptake, de novo lipogenesis (DNL), beta-oxidation, ketogenesis, and lipid export. Hepatic lipid accumulation may be induced through 4 separate mechanisms: 1) increased hepatic uptake of circulating fatty acids, 2) increased hepatic de novo fatty acid synthesis, 3) decreased hepatic beta-oxidation, and 4) decreased hepatic lipid export. This review will discuss the hormonal regulation of each mechanism comparing multiple physiological models of hepatic lipid accumulation. Nonalcoholic fatty liver disease (NAFLD) is typified by increased hepatic lipid uptake, synthesis, oxidation, and export. Chronic hepatic lipid signaling through PPARgamma results in gene expression changes that allow concurrent activity of DNL and beta-oxidation. The importance of hepatic steatosis in driving systemic metabolic dysfunction is highlighted by the common endocrine and metabolic disturbances across many conditions that result in fatty liver. Understanding the mechanisms underlying the metabolic dysfunction that develops as a consequence of hepatic lipid accumulation is critical to identifying points of intervention in this increasingly prevalent disease state.

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PHLPP: a putative cellular target during insulin resistance and type 2 diabetes

Progressive research in the past decade converges to the impact of PHLPP (Pleckstrin homology domain and leucine rich repeat protein phosphatase) in regulating the cellular metabolism through PI3K/Akt inhibition. Defects in the PKB/Akt signaling coordinates with impaired insulin secretion and insulin resistance, identified during T2D, obesity and cardiovascular disorders which brings in the relevance of PHLPPs in the metabolic paradigm. In this review, we discuss the impact of PHLPP isoforms in insulin signaling and its associated cellular events including mitochondrial dysfunction, DNA damage, autophagy and cell death. The article highlights the plausible molecular targets that share the role during insulin resistant states, whose understandings can be extended into treatment responses to facilitate targeted drug discovery for T2D and allied metabolic syndromes.

http://ift.tt/2os1u7b

Role of oestrogen receptor signaling in skeletal response to leptin in female ob/ob mice

Leptin, critical in regulation of energy metabolism, is also important for normal bone growth, maturation and turnover. Compared to wild type (WT) mice, bone mass is lower in leptin-deficient ob/ob mice; osteopenia in growing ob/ob mice is due to decreased bone accrual, and is associated with reduced longitudinal bone growth, impaired cancellous bone maturation and increased marrow adipose tissue (MAT). However, leptin deficiency also results in gonadal dysfunction, disrupting production of gonadal hormones which regulate bone growth and turnover. The present study evaluated the role of increased oestrogen in mediating the effects of leptin on bone in ob/ob mice. Three-month-old female ob/ob mice were randomized into one of 3 groups: (1) ob/ob+vehicle (veh), (2) ob/ob+leptin (leptin), or (3) ob/ob+leptin and the potent oestrogen receptor antagonist ICI 182,780 (leptin+ICI). Age-matched WT mice received vehicle. Leptin (40 µg/mouse, daily) and ICI (10 µg/mouse, 2x/w) were administered by sc injection for 1 month and bone analyzed by x-ray absorptiometry, microcomputed tomography, and static and dynamic histomorphometry. Uterine weight did not differ between ob/ob mice and ob/ob mice receiving leptin+ICI, indicating that ICI successfully blocked the uterine response to leptin-induced increases in oestrogen levels. Compared to leptin-treated ob/ob mice, ob/ob mice receiving leptin+ICI had lower uterine weight, did not differ in weight loss, MAT, or bone formation rate, and had higher longitudinal bone growth rate and cancellous bone volume fraction. We conclude that increased oestrogen signaling following leptin treatment is dispensable for the positive actions of leptin on bone and may attenuate leptin-induced bone growth.

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A note from Editor’s desk

Publication date: March 2017
Source:Arab Journal of Gastroenterology, Volume 18, Issue 1
Author(s): Abdel Meguid Kassem




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Editorial Board

Publication date: March 2017
Source:Arab Journal of Gastroenterology, Volume 18, Issue 1





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Effect of non-coherent infrared light (LED, λ 945 ± 20 nm) on bone repair in diabetic rats—morphometric and spectral analyses

Abstract

Phototherapy using coherent light (lasers) and non-coherent light (light-emitting diodes (LEDs)) has been investigated for the purpose of biomodulation in biological tissues. Several effects can be expected, including pain moderation, biostimulation of cellular tropism, anti-inflammatory effects, regular circulatory stimulation, and tissue repair. The aim of this study was to evaluate the effect of LED (λ945 ± 20 nm, 48 mW) therapy on the regeneration process in femoral lesions of rats (Wistar). Seven irradiation sessions were held, with a 48-h interval between sessions. The animals were euthanised 14, 21, and 28 days after surgery. Bone samples were analysed by histomorphometry, micro X-ray fluorescence spectroscopy, scanning electron microscopy, and optical densitometry. The results demonstrated the effective positive influence of low-intensity LED therapy using the near-infrared region on the tissue repair process in diabetic animals, especially in the early stages of repair (14 and 21 days after surgery). It can be concluded that LED therapy positively influences bone formation in the early stages of the bone repair process in non-diabetic and diabetic animals, without causing changes in the optical density and volume of tissue in the final stages. No influence of LED therapy was observed on the percentage of calcium, percentage of phosphorus, Ca/P ratio, or optical mineral density in non-diabetic animals. However, increased mineral concentration was evident in the diabetic animals treated with the LED during the repair process.

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Photoinactivation effect of eosin methylene blue and chlorophyllin sodium-copper against Staphylococcus aureus and Escherichia coli

Abstract

The use of eosin methylene blue according to Giemsa as photosensitizer is presented for the first time in this paper. The present study evaluated the potential application of chlorophyllin sodium copper salt (CuChlNa) and eosin methylene blue according to Giemsa (EMB) as antimicrobial photosensitizers (aPS) for photodynamic inactivation (PDI) of Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacteria. The experiments were performed using S. aureus stain ATCC 25923 and E. coli ATCC 25922 in which five aPS concentrations (0.0, 1.0, 2.5, 5.0, 10.0, and 20.0 μM for S. aureus and 0.0, 5.0, 10.0, 20.0, 40.0, and 50.0 μM for E. coli) were prepared and added in 2 mL of a saline solution containing the bacterial inoculum. After aPS incubation, the samples were divided into two groups, one kept in the dark and another submitted to the illumination. Then, the bacterial inactivation was determined 18 h after the incubation at 37 °C by counting the colony-forming units (CFU). The results revealed that both EMB and CuChlNa can be used as aPS for the photoinactivation of S. aureus, while only EMB was able to photoinactivate E. coli. Nevertheless, a more complex experimental setup was needed for photoinactivation of E. coli. The data showed that EMB and CuChlNa presented similar photoinactivation effects on S. aureus, in which bacterial growth was completely inhibited at photosensitizer (PS) concentrations over 5 μM, when samples were previously incubated for 30 min and irradiated by a light dose of 30 J cm⁻² as a result of an illumination of 1 h at 8.3 mW cm⁻² by using a red light at 625 nm with a 1 cm beam diameter and output power of 6.5 mW. In the case of E. coli, bacterial growth was completely inhibited only when combining a PS incubation period of 120 min with concentrations over 20 μM.

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Melanogenesis inhibition in mice using a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser: a pilot study

Abstract

A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser, or laser toning, has yielded favorable outcomes in various benign pigmented disorders. However, the exact mechanism of action of laser toning has not been fully elucidated. We sought to determine the inhibitory effect of laser toning on melanogenesis and to assess how laser passes influence the outcomes. To produce perceptible pigmentation, nine HRM-2 melanin-possessing hairless mice were treated with ultraviolet (UV) B radiation on the dorsal skin. This was followed by zero, two, four, or six passes of laser toning twice in 2 weeks on each designated quadrant. The spectrophotometric values and pigmentation-related protein expressions were measured. Pigment changes were found in the mice skin using the Fontana-Masson stain for histopathological analysis. Four- and six-pass laser toning significantly improved the lightness compared to that in the unirradiated control (p < 0.002). The Fontana-Masson stain showed that melanin was considerably decreased in laser-irradiated skin. As the number of laser passes increased, the expression of tyrosinase decreased (p < 0.008). The following parameters also decreased in proportion to the number of laser passes: MITF, TRP-1, TRP-2, p-ERK, and p-Akt. In contrast, TGF-β increased in proportion to the number of laser passes. However, the changes in these six proteins were not statistically significant. Our study demonstrates that laser toning improves skin pigmentation with increased number of passes in a dose-dependent manner. This effect is mediated by tyrosinase inhibition.

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Optimizing Outcomes in Free Flap Breast Reconstruction in the Community Hospitals Setting: A Stepwise Approach to DIEP/SIEA Flap Procedures with Banking a Hemiabdominal Flap

J reconstr Microsurg
DOI: 10.1055/s-0037-1602588

Background Free flap breast reconstruction is a conventional procedure in many countries; however, microvascular compromise remains a devastating outcome. Given the morbidity of total necrosis, optimizing free flap salvage stands out as an important area for research, especially among surgeons to overcome the learning curve period and in resource constrained scenario such as community hospitals. To ensure free deep inferior epigastric perforator (DIEP)/superficial inferior epigastric artery (SIEA) flap breast reconstruction, the authors present a technique involving raising a hemiabdominal flap as a free flap, and banking the remaining flap to be utilized if needed in a subsequent procedure. Methods A retrospective review was performed on all free flap breast reconstructions. In this period, 84 patients (mean age: 50.1 ± 8 years) were included. Results In this study, 65.5% patients underwent immediate reconstruction, and 51.2% received DIEP reconstruction; 9.52% patients were returned to the operating room, and salvage reconstruction using the banked flap was performed in all patients. No differences were observed regarding early complications and age, body mass index, American Society of Anesthesiologists status, diabetes, smoking history, chemotherapy, radiotherapy, and type of flap used (p > 0.05). Hypertension was significantly associated with early complications (p < 0.05). Donor-site complications were associated with RT (p < 0.05). Conclusion The banked flap is a reliable method for ensuring DIEP/SIEA flap survival and should be considered in higher risk reconstructions and community hospitals. We believe that the present technique can be a good addition to the arsenal of plastic surgeons dealing with free flap breast reconstructions in selected patients.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Allergens involved in the cross-reactivity of Aedes aegypti with other arthropods

Cross-reactivity between Aedes aegypti and mites, cockroaches, and shrimp has been previously suggested, but the involved molecular components have not been fully described.

http://ift.tt/2orPjXV

Allergens involved in the cross-reactivity of Aedes aegypti with other arthropods

Cross-reactivity between Aedes aegypti and mites, cockroaches, and shrimp has been previously suggested, but the involved molecular components have not been fully described.

http://ift.tt/2orPjXV

US antibiotic stewardship and penicillin allergy.

Purpose of review: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. Recent findings: Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. Summary: Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics. This permits use of narrower-spectrum antibiotics and saves money. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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US antibiotic stewardship and penicillin allergy.

Purpose of review: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. Recent findings: Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. Summary: Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics. This permits use of narrower-spectrum antibiotics and saves money. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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MuPeXI: prediction of neo-epitopes from tumor sequencing data

Abstract

Personalization of immunotherapies such as cancer vaccines and adoptive T cell therapy depends on identification of patient-specific neo-epitopes that can be specifically targeted. MuPeXI, the mutant peptide extractor and informer, is a program to identify tumor-specific peptides and assess their potential to be neo-epitopes. The program input is a file with somatic mutation calls, a list of HLA types, and optionally a gene expression profile. The output is a table with all tumor-specific peptides derived from nucleotide substitutions, insertions, and deletions, along with comprehensive annotation, including HLA binding and similarity to normal peptides. The peptides are sorted according to a priority score which is intended to roughly predict immunogenicity. We applied MuPeXI to three tumors for which predicted MHC-binding peptides had been screened for T cell reactivity, and found that MuPeXI was able to prioritize immunogenic peptides with an area under the curve of 0.63. Compared to other available tools, MuPeXI provides more information and is easier to use. MuPeXI is available as stand-alone software and as a web server at http://ift.tt/2pIfAoY.

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Evaluation of tinnitus retraining therapy for patients with normal audiograms versus patients with hearing loss

A few chronic tinnitus patients show normal hearing thresholds in the pure tone audiometry from 125Hz to 8000Hz (≤20dB). We report the characteristics of the course of those patients underwent tinnitus retraining therapy (TRT) compared with other patients suffering from chronic and severe tinnitus.

http://ift.tt/2p0PpJw

Evaluation of tinnitus retraining therapy for patients with normal audiograms versus patients with hearing loss

A few chronic tinnitus patients show normal hearing thresholds in the pure tone audiometry from 125Hz to 8000Hz (≤20dB). We report the characteristics of the course of those patients underwent tinnitus retraining therapy (TRT) compared with other patients suffering from chronic and severe tinnitus.

http://ift.tt/2p0PpJw

Zinc and platinum co-doped ceria for WGS and CO oxidation

Publication date: 15 August 2017
Source:Applied Catalysis B: Environmental, Volume 211
Author(s): Ravikiran Mandapaka, Giridhar Madras
This study presents the synthesis and application of zinc and platinum co-doped ceria for CO oxidation and water gas shift reaction (WGS). To synthesize the catalyst, novel combustion synthesis procedure at pH=10 has been employed, yielding the catalyst in single step without further purification procedures. The catalyst was found to be active under high temperature conditions (>350°C) thus asserting the functionality of the catalyst as single stage WGS catalyst. In this study, we have also developed a dual site redox mechanism to understand the intrinsic kinetics of WGS reaction. For the proposed mechanism, a plausible microkinetic model has been developed for WGS and CO oxidation reactions, respectively. In line with the application of reaction route (RR) analysis to the microkinetic models developed for single site pathway for WGS. In this study, we have extended the RR approach to dual site redox mechanism. From the above analysis, the surface dissociation of OH surface species was found to be rate determining step of the mechanism. The rate expression developed using RR analysis was validated through isothermal plug flow reactor (PFR) model. The PFR simulations predicted the experimental trend for wider range of temperature conditions thus portraying the significance of the microkinetic model developed in this study.

Graphical abstract

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Pollution characteristics and human health risks of potentially (eco)toxic elements (PTEs) in road dust from metropolitan area of Hefei, China

Publication date: August 2017
Source:Chemosphere, Volume 181
Author(s): Muhammad Ubaid Ali, Guijian Liu, Balal Yousaf, Qumber Abbas, Habib Ullah, Mehr Ahmed Mujtaba Munir, Biao Fu
This study aims to investigate the pollution characteristics of road dust and their associated health risks of potentially toxic elements (PTEs) to humans using array-based risk assessment models described by United States Environmental Protection Agency (USEPA) in a metropolitan area of Hefei, China. Geoaccumulation index (Igeo) was used to describe pollution characteristics of roadside dust in urban, periurban and industrial areas. Results indicate that industrial roadside dust was contaminated with Fe, Ni, Cu, Ti, V, Pb, Ba, Sb, Cr, Sn, Pb, As and Ga showing Igeo value (log2 (x)) between Igeo class 3 to 4. In other hand, urban roadside dust contamination with Cu, Zn, Sb and Ga ranged between Igeo classes 2 to 3 and with As and Pb ranged between Igeo classes 4 to 5. Furthermore, health risk assessment revealed negligible non-cancerous health hazard in all sites including urban, periurban and industrial areas. The hazard quotient (HQ) and hazard Index (HI) values for all exposure routes (ingestion, inhalation, and dermal contact) were <1 except for chromium with HI value of 1.06E+00 in industrial areas. Moreover, the most prominent exposure route was ingestion (HQing) and the non-carcinogenic health risks were found to be high in case of children compared to the adults. The cancer risk from As, Co, Cr, Ni, and Pb was found to be in safe levels as the RI (carcinogenic risks) values were below the limits for carcinogens (1.00E-6 to 1.00E-4).

Graphical abstract

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Photoelectric properties of ZnS/Au/ZnS transparent conductive tri-layer films

Publication date: 1 September 2017
Source:Optics & Laser Technology, Volume 94
Author(s): Caifeng Wang, Bo Hu
ZnS/Au/ZnS tri-layer films are deposited on quartz glass by pulsed laser deposition (PLD) at room temperature, and have been annealed in air at different temperatures. The effect of annealing temperature on the optical and electrical properties of ZnS/Au/ZnS tri-layer films is investigated. X-ray diffraction (XRD) patterns show that the increase in annealing temperature improves the crystallinity of the structures. Scanning electron microscope (SEM) images of the samples show that the particle size becomes larger as the annealing temperature increases. Moreover, with the increase of annealing temperature, sheet resistance of the tri-layer films decreases initially, and increases further by increasing the annealing temperature to 300°C. High quality ZnS/Au/ZnS tri-layer films with the sheet resistance of 27Ω/sq and the maximum optical transmittance of 86.2% in the visible light region (400–800nm) are obtained when the sample is annealed at 200°C. The figure of merit is calculated to evaluate the performance of ZnS/Au/ZnS tri-layer films.



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Innovations in Federal Statistics: Combining Data Sources While Protecting Privacy.

Federal government statistics provide critical information to the country and serve a key role in a democracy. For decades, sample surveys with instruments carefully designed for particular data needs have been one of the primary methods for collecting data for federal statistics. However, the costs of conducting such surveys have been increasing while response rates have been declining, and many surveys are not able to fulfill growing demands for more timely information and for more detailed information at state and local levels.

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Medical Expenditure Panel Survey Statistical Briefs [Internet].

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JAMA Otolaryngology–Head & Neck Surgery Peer Reviewers in 2016

http://ift.tt/2k7NHVd

Unilateral Neck Swelling in a Pediatric Patient

A young child had persistent unilateral neck swelling; examination revealed a firm, immobile, and nontender mass fixed to the underlying right mandible with cortical destruction, extending into the submandibular and sublingual spaces. What is your diagnosis?

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March 2017 Issue Highlights

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Association Between Laryngeal Cancer and Asbestos Exposure

This systematic review assesses the literature to determine whether an association exists between laryngeal cancer and asbestos exposure.

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Lymph Node Biopsy in Patients With Papillary Thyroid Cancer

To the Editor Recently Cabrera et al published a prospective study on 37 patients with papillary thyroid cancer (PTC) who underwent radioguided sentinel lymph node biopsy (SLNB), aimed to correlate the presence of lymph node metastasis with patient and tumor characteristics. The authors stated that this is the first study in which that evaluation has been performed. However, in the largest prospective study of 345 patients with PTC who underwent SLNB with 3-year follow-up, we have already demonstrated that the presence of multifocal or infiltrating PTC was associated with increased nodal metastases.

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JAMA Otolaryngology–Head & Neck Surgery —The Year in Review, 2016

As I complete my first year as Editor of JAMA Otolaryngology–Head & Neck Surgery, I would like to take this opportunity to thank our authors, editors, staff, reviewers, and readers for the many substantial contributions they made to the journal. Without our authors producing the research and sharing their thoughts, experiences, and observations, we would not have the content to create our fine journal. I thank my Deputy Editors, Neal Futran and Sukgi Choi, and Associate Editors, Timothy Smith and Timothy Hullar. I also owe much thanks to Karen Dodson, Editorial Manager, for her wonderful organizational skills and professional support during this past year. And finally, I acknowledge the support of the superb JAMA Network publication staff in Chicago.

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Additional Data for Figures

In the Original Investigation titled "Association of Extracapsular Spread With Survival According to Human Papillomavirus Status in Oropharynx Squamous Cell Carcinoma and Carcinoma of Unknown Primary Site," published in the July 2106 issue of JAMA Otolaryngology–Head & Neck Surgery,¹ Figures 1 through 4 were missing the number of patients at risk for the Kaplan-Meier curves. The numbers at risk have now been added. This article was corrected online.

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Individualized Bioselection Treatment Methods in Laryngeal Cancer

This cohort study evaluates the association between individualized bioselection treatment decision criteria and survival of patients with laryngeal cancer.

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Ciprofloxacin Plus Fluocinolone in Otitis Media With Tympanostomy Tubes

This randomized clinical trial evaluates the efficacy and safety of topical ciprofloxacin plus fluocinolone acetonide otic solution vs ciprofloxacin otic solution alone and fluocinolone acetonide otic solution alone for acute otitis media in children with tympanostomy tubes.

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The Changing Cochlear Implant Center

This Viewpoint summarizes the origins, challenges, and future of the cochlear implant center.

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Complications of Bilateral Neck Dissection in Thyroid Cancer

This study delineates the specific complications arising from bilateral neck dissection for thyroid cancers at a single high-volume center.

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Slowly Growing Neck Mass With Progressive Dysphagia

A man with history of smoking and alcohol use had neck tenderness and dysphagia; computed tomography revealed a heterogeneously enhancing mass in the right side of the neck. What is your diagnosis?

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Identifying Intraoperative Nerve Monitoring in Thyroid Surgery

To the Editor I read with interest the article titled "Analysis of Variations in the Use of Intraoperative Nerve Monitoring in Thyroid Surgery" by Al-Qurayshi et al. This was a cross-sectional study on the impact of patient demographic factors and surgeon and hospital thyroidectomy volume on the use of intraoperative nerve monitoring (IONM), using the State Inpatient Database for Florida, New York, and Washington. They found that IONM was used in only 8.3% of thyroidectomies. White patients were more likely to undergo IONM than racial minority patients. They also found that use of IONM was higher in thyroidectomies performed by low-volume surgeons, and in low-volume hospitals.

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Association of Iron Deficiency Anemia With Hearing Loss

This population-based cohort study examines the association between iron deficiency anemia and sensorineural, conductive, or combined hearing loss in young to elderly adults.

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Individualized Treatment of Laryngeal Cancer

In this issue of JAMA Otolaryngology–Head & Neck Surgery, Wolf et al describe very high survival rates in an unselected cohort of 247 patients with advanced laryngeal cancer. These patients were treated with a program of individualized bioselection. All of us invested in the care of patients with advanced laryngeal cancer must breathe a deep sigh of relief. Only 10 years ago, Hoffman et al, in a landmark review of the national cancer database, evaluated the outcome of 158 426 patients with laryngeal cancer. Between the years of 1985 and 2001, the survival rate had gone down. So what has changed?

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Distant Metastases Following Postoperative Intensity-Modulated Radiotherapy

This study examines the characteristics and risk factors of distant metastases following postoperative intensity-modulated radiotherapy in oral squamous cell carcinoma and the clinicopathological characteristics that could be associated with distant-only failure.

http://ift.tt/2ht1oIi