Effect of traffic restriction on reducing ambient volatile organic compounds (VOCs): Observation-based evaluation during a traffic restriction drill in Guangzhou, China

Publication date: July 2017
Source:Atmospheric Environment, Volume 161
Author(s): Xinyu Huang, Yanli Zhang, Weiqiang Yang, Zuzhao Huang, Yujun Wang, Zhou Zhang, Quanfu He, Sujun Lü, Zhonghui Huang, Xinhui Bi, Xinming Wang
Traffic restriction (TR) is a widely adopted control measure in case of heavy air pollution particularly in urban areas, yet it is hard to evaluate the effect of TR on reducing VOC emissions based on monitoring data since ambient VOC mixing ratios are influenced not only by source emissions but also by meteorological conditions and atmospheric degradation. Here we collected air samples for analysis of VOCs before, during and after a TR drill carried out in Guangzhou in September 2010 at both a roadside and a rooftop (∼50 m above the ground) site. TR measures mainly included the "odd-even license" rule and banning high-emitting "yellow label" vehicles. The mixing ratios of non-methane hydrocarbons (NMHCs) did not show significant changes at the roadside site with total NMHCs of 39.0 ± 11.8 ppbv during non-TR period and 39.1 ± 14.8 ppbv during TR period, whereas total NMHCs decreased from 30.4 ± 14.3 ppbv during the non-TR period to 22.1 ± 10.6 ppbv during the TR period at rooftop site. However, the ratios of methyl tert-butyl ether (MTBE), benzene and toluene against carbon monoxide (MTBE/CO, T/CO and B/CO) at the both sampling sites dropped significantly. The ratios of toluene to benzene (T/B) instead increased significantly. Changes in these ratios all consistently indicated reduced input from traffic emissions particularly gasoline vehicles. Source attribution by positive matrix factorization (PMF) confirmed that during the TR period gasoline vehicles contributed less VOCs in percentages while industrial sources, biomass burning and LPG shared larger percentages. Assuming that emissions from industrial sources remained unchanged during the TR and non-TR periods, we further used the PMF-retrieved contribution percentages to deduce the reduction rate of traffic-related VOC emissions, and obtained a reduction rate of 31% based on monitoring data at the roadside site and of 34% based on the monitoring data at the rooftop site. Considering VOC emissions from all sources in Guangzhou city, the TR control measures adopted could reduce VOC up to 15%.



http://ift.tt/2oWiK92

Deposition pattern and throughfall fluxes in secondary cool temperate forest, South Korea

Publication date: July 2017
Source:Atmospheric Environment, Volume 161
Author(s): Mukesh Kumar Gautam, Kwang-Sik Lee, Byeong -Yeol Song
Chemistry and deposition fluxes in the rainfall and throughfall of red pine (Pinus densiflora), black locust (Robinia pseudoacacia), and chestnut (Castanea crenata) monocultures, and mixed red pine–black locust–chestnut stands were examined in a nutrient-limited cool temperate forest of central South Korea. Throughfall was enriched in both basic and acidic constituents relative to rainfall, suggesting that both dry deposition and canopy leaching are important sources of throughfall constituents. Net throughfall fluxes (NTFs) of cations and anions significantly differed among four different stands as well as seasonally. Red pine exhibited highest fluxes (TF and NTF) for Ca²⁺, black locust for K⁺, mixed stands for Mg²⁺, and chestnut for Na⁺. In contrast, NTF of SO4^2-, NO3⁻, and NH4⁺was highest in the red pine, intermediate in the chestnut and mixed stands, and lowest in the black locust. In general, canopy uptake of H⁺ and NH4⁺ for all stands was higher in summer than in winter. Dry deposition appears to play a major role in atmospheric deposition to this cool temperate forest, especially in summer. Dry deposition for both cations and anions displayed high spatial variability, even though stands were adjacent to one another and experienced identical atmospheric deposition loads. Canopy leaching of K⁺ (95–78% of NTF), Mg²⁺ (92–23% of NTF), and Ca²⁺ (91–12% of NTF) was highest for the black locust, lowest for chestnut, and intermediate for the red pine and mixed stands. The present study documented significant changes in throughfall chemistry and NTF among different forest stands, which presumably be related with the differences in the canopy characteristics and differences in their scavenging capacity for dry deposition and canopy exchange. Difference in the canopy retention of H⁺ and base cation leaching suggests that canopy exchange was mainly driven by weak acid excretion and lesser by H⁺ exchange reaction. Our results indicate that despite a high base cation deposition, a combination of higher input of acidifying constituents, low soil pH, and total acidic deposition approaching South Korean critical loads make regional forest vulnerable to acidification.

Graphical abstract

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CMAQ simulation of atmospheric CO2 concentration in East Asia: Comparison with GOSAT observations and ground measurements

Publication date: July 2017
Source:Atmospheric Environment, Volume 160
Author(s): Rong Li, Meigen Zhang, Liangfu Chen, Xingxia Kou, Andrei Skorokhod
Satellite observations are widely used in global CO2 assimilations, but their quality for use in regional assimilation systems has not yet been thoroughly determined. Validation of satellite observations and model simulations of CO2 is crucial for carbon flux inversions. In this study, we focus on evaluating the uncertainties of model simulations and satellite observations. The atmospheric CO2 distribution in East Asia during 2012 was simulated using a regional chemical transport model (RAMS-CMAQ) and compared with both CO2 column density (XCO2) from the Gases Observing SATellite (GOSAT) and CO2 concentrations from the World Data Centre for Greenhouse Gases (WDCGG). The results indicate that simulated XCO2 is generally lower than GOSAT XCO2 by 1.19 ppm on average, and their monthly differences vary from 0.05 to 2.84 ppm, with the corresponding correlation coefficients ranging between 0.1 and 0.67. CMAQ simulations are good to capture the CO2 variation as ground-based observations, and their correlation coefficients are from 0.62 to 0.93, but the average value of CMAQ simulation is 2.4 ppm higher than ground-based observation. Thus, we inferred that the GOSAT retrievals may overestimate XCO2, which is consistent with the validation of GOSAT XCO2 using Total Carbon Column Observing Network measurements. The near-surface CO2 concentration was obviously overestimated in GOSAT XCO2. Compared with the relatively small difference between CMAQ and GOSAT XCO2, the large difference in CO2 near surface or their vertical profiles indicates more improvements are needed to reduce the uncertainties in both satellite observations and model simulations.



http://ift.tt/2oWhxOY

Development of a scoring system to predict massive postpartum transfusion in placenta previa totalis

Abstract

Purpose

It is important to predict massive postpartum hemorrhage in patients with placenta previa totalis (PPT) and a method that accurately predicts this event is needed. The present study developed a scoring system that predicts massive transfusion in patients with PPT.

Methods

This single-center retrospective cohort study comprised 238 patients with PPT who underwent caesarean section between January 2004 and December 2010. Massive transfusion was defined as the transfusion of ≥8 units of packed red blood cells within 24 h after delivery. Multivariate regression analysis was used to estimate the risks of massive transfusion. A probability score model was then constructed and tested for performance. Subsequently, the model was validated in other patients with PPT (n = 117).

Results

Thirty-one patients (13.0%) underwent massive transfusion. Ultrasound suspicion of placental adhesion, previous caesarean section, gestational age <37 weeks, sponge-like appearance of the cervix, and anterior placenta were all independent predictors of massive transfusion. The performance for the score model revealed good calibration (Hosmer–Lemeshow chi-squared 1.64; P = 0.44), and its discrimination (the area under the receiver operating characteristic for this model was 0.84) was better than when suspicion of placental adhesion was used alone (0.67; P < 0.001). In the validation set, the performance was 0.88.

Conclusion

The scoring system developed using the five independent risk factors had better performance to predict massive transfusion in patients with PPT than when suspicion of placental adhesion was used alone. However, further large-scale studies are warranted to clarify the usefulness and accuracy of this model.

http://ift.tt/2qCOkFl

Sedative effects of oral pregabalin premedication on intravenous sedation using propofol target-controlled infusion

Abstract

Purpose

The sedative effects of pregabalin during perioperative period have not been sufficiently characterized. The aim of this study was to verify the sedative effects of premedication with pregabalin on intravenous sedation (IVS) using propofol and also to assess the influences of this agent on circulation, respiration, and postanesthetic complications.

Methods

Ten healthy young volunteers underwent 1 h of IVS using propofol, three times per subject, on separate days (first time, no pregabalin; second time, pregabalin 100 mg; third time, pregabalin 200 mg). The target blood concentration (C _T) of propofol was increased in a stepwise fashion based on the bispectral index (BIS) value. Ramsay's sedation score (RSS) was determined at each propofol C _T. Propofol C _T was analyzed at each sedation level. Circulation and respiration during IVS and complications were also verified.

Results

Propofol C _T was reduced at BIS values of 60 and 70 in both premedicated groups (100 mg: p = 0.043 and 0.041; 200 mg: p = 0.004 and 0.016, respectively) and at a BIS value of 80 in the pregabalin 200 mg group (p < 0.001). Propofol C _T was decreased at RSS 4–6 in the pregabalin 100 mg group (RSS 4: p = 0.047; RSS 5: p = 0.007; RSS 6: p = 0.014), and at RSS 3–6 in the pregabalin 200 mg group (RSS 3–5: p < 0.001; RSS 6: p = 0.002).

Conclusion

We conclude that oral premedication with pregabalin reduces the amount of propofol required to obtain an acceptable and adequate sedation level.

http://ift.tt/2pX2HIj

MEP monitoring during aortic surgery: what we truly know

http://ift.tt/2qCYLZs

Liquid biopsy: unlocking the potentials of cell-free DNA

Abstract

Circulating tumor DNA (ctDNA) has garnered much excitement over the past few years for its potential clinical utility as a surrogate for tumor biopsies in early cancer detection and prognosis. Numerous studies have demonstrated that ctDNA is shed into the circulation and is elevated in disease states such as cancer. Despite the low levels of ctDNA in the "sea" of normal DNA, advances in next generation sequencing (NGS) and digital polymerase chain reaction (PCR) technologies have led to dramatic improvements in variant detection sensitivity and specificity. These technologies allow the quantification of ctDNA, providing both prognostic and predictive information. Here, we review the history of cell-free DNA and different technologies for the detection of ctDNA in cancer and describe the different modalities for using ctDNA in clinical oncology.

http://ift.tt/2qwPin7

The Greek Version of the Ohkuma Questionnaire for Dysphagia Screening

http://otorhinolaryngology-crete.blogspot.gr/2017/05/the-greek-version-of-ohkuma.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Is levothyroxine requirement the same for tablet and soft gel formulations?

http://ift.tt/2p4arDj

The relationship of 19 functional polymorphisms in iodothyronine deiodinase and psychological well-being in hypothyroid patients

Abstract

Purpose

Levothyroxine supplementation is insufficient for the management of one tenth of patients with hypothyroidism. Iodothyronine deiodinases have been suggested to play a role in residual hypothyroid symptoms of these patients by controlling local thyroid hormone homeostasis. Previous research has suggested a relationship between commonly inherited variations in type 2 iodothyronine deiodinase and impaired well-being. We evaluated the prevalence of iodothyronine deiodinase genotypes and their association with psychological well-being in the Korean hypothyroid population.

Methods

A prospective observational study. We enrolled 196 hypothyroid subjects (136 chronic autoimmune thyroiditis and 60 thyroid cancer) and assessed baseline well-being using six validated questionnaires. Genotyping was conducted for 19 single nucleotide polymorphisms in type 1, 2, and 3 iodothyronine deiodinase using Sequenom MassARRAY matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in all patients.

Results

Frequencies of iodothyronine deiodinase genotypes and well-being scores were not different in hypothyroid subjects according to their disease types. Minor genotypes of a few iodothyronine deiodinase 1 variants (rs11206244, rs2294512, and rs4926616) were associated with reduced psychological well-being. However, iodothyronine deiodinase 2 and 3 variants had no effect on baseline well-being.

Conclusion

Minor variations in iodothyronine deiodinase 1 were associated with decreased well-being in the Korean hypothyroid population, whereas iodothyronine deiodinase 2 and 3 were not. Due to controversial results among different ethnicities, further studies to clarify the effects of iodothyronine deiodinase polymorphisms on psychological well-being are warranted in hypothyroid individuals.

http://ift.tt/2pGEiFC

Trunk rotation,Cervical induced horizontal nystagmus,“neck torsion test” (NTT),There is a “cervicotonic provocation nystagmus” in response to objective reaction to cervical straining with a static trunk excursion.

http://otorhinolaryngology-crete.blogspot.gr/2017/05/cervico-vestibular-muscle-afferents.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Prolonged endotracheal intubation is the main indication of tracheostomy, performed after two weeks of intubation. Although there were no major early complications, laryngotracheal stenosis is still a challenging sequel for tracheostomy that needs to be investigated to be prevented.

http://otorhinolaryngology-crete.blogspot.com/2017/05/prolonged-endotracheal-intubation-is.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Sialendoscopy Training

http://otorhinolaryngology-crete.blogspot.gr/2017/05/sialendoscopy.html

Introduction

Several surgical training simulators have been created for residents and young surgeons to gain experience with surgical procedures. Laboratory training is fundamental for acquiring familiarity with the techniques of surgery and skill in handing instruments.

Objective

The aim of this study is to present a novel simulator for training sialendoscopy.

Method

This realistic simulator was built with a synthetic thermo-retractile, thermosensible rubber which, when combined with different polymers, producesmore than 30 different formulas. These formulas present textures, consistencies, and mechanical resistance are similar to many human tissues.

Results

The authors present a training model to practice sialendoscopy. All aspects of the procedure are simulated: month opening, dilatation of papillae, insert of the scope, visualization of stones, extraction of these stones with grasping or baskets, and finally, stone fragmentation with holmium laser.

Conclusion

This anatomical model for sialendoscopy training should be considerably useful to abbreviate the learning curve during the qualification of young surgeons while minimizing the consequences of technical errors.

Keywords : salivary glands; learning; medical education.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

The angle of mandible was found to be the most accurate landmark for identifying the cervical level, which corresponded to C2 and C2–C3 disc space. The hyoid bone, thyroid cartilage, and cricoid cartilage were not reliable to predict the cervical levels : The lateral flexion and extension radiographs of cervical spine in standing position : Anterior Cervical Surgical Landmarks (the hyoid bone, thyroid cartilage, and cricoid cartilage).The main corresponding cervical levels for the mandibular angle were C2 on both of the flexion and extension films, for the hyoid bone were the C3–C4 interspace on flexion film and C3 on extension film, for the thyroid cartilage C5 on both of flexion and extension films, and for the cricoid cartilage C6 on flexion film and C5–C6 interspace on extension film, respectively.

http://otorhinolaryngology-crete.blogspot.com/2017/05/the-angle-of-mandible-was-found-to-be.html

Radiographic Evaluation of the Reliability of Neck Anatomic Structures as Anterior Cervical Surgical Landmarks

στο World Neurosurgery

Μετάφραση άρθρου

Publication date: July 2017

Source:World Neurosurgery, Volume 103

Author(s): Jia-Ming Liu, Liu-Xue Du, Xu Xiong, Xuan-Yin Chen, Yang Zhou, Xin-Hua Long, Shan-Hu Huang, Zhi-Li Liu

BackgroundAccurate location of the skin incision is helpful to decrease the technical difficulty and save the operative time in anterior cervical spine surgery. Spine surgeons usually use the traditional neck anatomic structures (the hyoid bone, thyroid cartilage, and cricoid cartilage) as landmarks during the surgery. However, the reliability of these landmarks has not been validated in actual practice.ObjectiveTo find out which landmark is the most accurate for identifying the cervical levels in anterior cervical spine surgery.MethodsThe lateral flexion and extension radiographs of cervical spine in standing position from 30 consecutive patients from January 2015 to February 2015 were obtained. The cervical vertebral bodies from C2 to C7 were divided equally into 2 segments. The cervical segments corresponding to each of the surface landmarks were recorded on the flexion and extension radiographs, respectively, and the displacement of corresponding cervical segments from the flexion to extension radiographs for each landmark was calculated.ResultsBased on the measurements, the main corresponding cervical levels for the mandibular angle were C2 on both of the flexion and extension films, for the hyoid bone were the C3–C4 interspace on flexion film and C3 on extension film, for the thyroid cartilage C5 on both of flexion and extension films, and for the cricoid cartilage C6 on flexion film and C5–C6 interspace on extension film, respectively. The ratios of displacement within 2 segments from flexion to extension were 83.3% (25/30) for mandibular angle, 56.7% (17/30) for hyoid bone, 66.7% (20/30) for thyroid cartilage, and 56.7% (17/30) for cricoid cartilage, respectively. The mean displacement from flexion to extension films were significantly less than 2 cervical segments for the mandibular angle but greater than 2 segments for the other landmarks. Significant differences were found between mandibular angle and the other 3 landmarks for the displacement from flexion to extension.ConclusionsThe angle of mandible was found to be the most accurate landmark for identifying the cervical level, which corresponded to C2 and C2–C3 disc space. The hyoid bone, thyroid cartilage, and cricoid cartilage were not reliable to predict the cervical levels.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Variable expressivity of TCTEX1D2 mutations and a possible pathogenic link of molar-incisor malformation to ciliary dysfunction

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Johannes Zschocke, Anna Schossig, Dieter D. Bosshardt, Daniela Karall, Rudolf Glueckert, Ines Kapferer-Seebacher
ObjectiveClarification of the molecular basis of a ciliopathy associated with molar-incisor malformation in a consanguineous Turkish family.DesignFull dental and clinical examinations, histologic analysis, comprehensive genetic analyses including exome sequencing, ciliary function tests and transmission electron microscopy of ciliary biopsies in the surviving patient.ResultsTwo siblings had situs inversus and complex heart defects suggestive of ciliary dysfunction. The affected girl who died in utero showed severe chest abnormalities compatible with Jeune syndrome which were not present in the affected boy. Dental investigations in the boy showed typical signs of molar-incisor-malformation. Exome sequencing identified a homozygous intragenic deletion in TCTEX1D2 which is predicted to completely remove protein function. Ciliary function tests and electron microscopy showed mild irregularities of motile cilia such as compound cilia and loss of membranes.ConclusionsOur findings support the suggestion that TCTEX1D2 mutations have variable expressivity and may be associated with disturbances of embryonic development caused by both, ciliary signaling and motile dysfunction. The presence of molar-incisor-malformation in the living patient raises the possibility of a pathogenetic link of this rare dental anomaly to ciliary dysfunction during tooth development at least in some individuals.



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Expression of cancer cell-derived IgG and extra domain A-containing fibronectin in salivary adenoid cystic carcinoma

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Wan-Qi Lv, Jing Peng, Hai-Cheng Wang, De-ping Chen, Yue Yang, Yang Zhao, Xiao-yan Qiu, Jiu-Hui Jiang, Cui-Ying Li
ObjectiveCancer-IgG is a newly-discovered molecule, mainly derived from epithelial carcinoma cells and is significantly correlated with differentiation, metastasis, local invasion, and poor prognosis of many cancers. In our previous study we detected IgG expression in oral epithelial carcinoma, including salivary adenoid cystic carcinoma (SACC), using an IgG-specific commercial antibody. Here, we explored the correlation between cancer-IgG and clinicopathological features of SACC.DesignA total of 68 human SACC tissue specimens and 2 siRNAs were used to analyze the correlation between cancer-IgG and extra domain A (EDA⁺)-containing fibronectin using the cancer-IgG-specific monoclonal antibody, RP215.ResultsWe found an unexpected correlation between cancer-IgG and EDA⁺ fibronectin, both of which showed aberrant expression in SACC tissue samples. Both were highly expressed in SACC with nerve invasion. In our previous study, EDA⁺ fibronectin overexpression in SACC cells decreased N-cadherin expression. In the present study, we used SACC-83 cells, wherein EDA⁺ fibronectin is overexpressed and cancer-IgG is knocked down. EDA⁺ fibronectin expression was reduced with cancer-IgG knockdown, while cancer-IgG expression did not affect EDA⁺ fibronectin overexpression. Furthermore, knockdown of non-B cell-derived IgG in SACC cells decreased cellular motility (P<0.05) as well as increased E-cadherin and alpha-smooth muscle actin levels.ConclusionThe results suggest that cancer IgG potentially regulates EDA⁺ fibronectin expression, thereby suggesting possible new therapeutic approaches for SACC.



http://ift.tt/2pWqR5u

Effect of preparation method and storage period on the stability of saliva DNA

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Maribasappa Karched, Radhika G. Bhardwaj, Eunice M. Pauline, Swapna George, Sirkka Asikainen
Saliva is an attractive source for oral microbial detection and quantification since sampling is non-invasive and rapid.ObjectivesTo determine whether different saliva preparation methods or preservation time periods affect DNA stability.MethodsSaliva samples from 4 healthy adult volunteers were processed to obtain 3 different preparations: whole saliva, and after centrifugation pellet and supernatant. Purified DNA (MasterPure™) from each sample was divided into 4 aliquots, one for immediate analysis and 3 (stored at −80°C) for later analyses after 1 week and 2 and 6 months. DNA concentrations and qPCR based quantities of Porphyromonas gingivalis, Prevotella intermedia, Parvimonas micra, Fusobacterium nucleatum, Filifactor alocis and Streptococcus mutans were determined.ResultsDNA concentration did not decrease (P>0.05) during the 6-month period in any sample. Mean (SE) DNA concentrations (ng/μl) in whole saliva were 152.2 (51.2) and 147.8 (50) at day 0 and 6 months, respectively. Similarly, the values for pellet were 134.9 (42.5) and 133.6 (42.9), and for supernatant, 11 (1.9) and 8.9 (2.3), the difference being significant (P<0.001) between supernatant and whole saliva or pellet. The quantities of most bacterial species found at day 0 remained stable over the 6-month period in all saliva preparations. In supernatant, species quantities were lower (P<0.05) than in whole saliva or pellet.ConclusionsDNA concentrations were comparable between whole saliva and pellet, suggesting that either of them can be used for DNA-based analyses. Our results also demonstrated that DNA extracted from saliva can be preserved at −80°C for at least 6 months without decrease in DNA concentration.



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Measurement of root surface area of permanent teeth in a Chinese population

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Y. Gu, Q. Zhu, Y. Tang, Y. Zhang, X. Feng
ObjectivesThe aim of this study was to investigate the relation between the remaining area of periodontal attachment and the attachment levels for each type of permanent teeth in a Chinese population by using micro-computed tomography (micro-CT) scans.DesignA total of 440 extracted permanent teeth (including each tooth type except for the third molars) were collected from a Chinese population and scanned using a micro-CT. The CT data were input into Mimics 15.01 to generate 3D tooth models. To simulate various attachment levels, the roots were virtually cut at 0, 2, 4, 6, 8, and 10mm from the cemonto-enamel junction (CEJ). The net and percent remaining root surface area (RSA) were measured and calculated, and the data corresponding to attachment level were fitted to a linear function.ResultsA Linear function can perfectly fit in relating the simulated attachment level to the net and percent remaining RSA (R²>0.99, and p<0.001 for each tooth type). For net remaining RSA, the slope of the linear function was steepest for maxillary first molars (b1=−39.32) and least steep for mandibular central incisor (b1=−13.08); whereas for the percentage of remaining RSA, the slopes (b1) were relatively within a narrow range, from −7.40 (maxillary canine) to −9.64 (maxillary first molars).ConclusionMicro-CT offers simple and precise technique for quantitative analysis of the RSA. The total amount and vertical distribution of the RSA varied by tooth type. Linear formulas can perfectly describe the relation between the attachment level and the net and percent remaining RSA.



http://ift.tt/2pWy1XD

Impact of wear and diet on molar row geometry and topography in the house mouse

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Sabrina Renaud, Ronan Ledevin
ObjectivesDental evolution affects the geometry of the tooth, but the adaptive relevance of these changes is related to tooth sharpness, complexity, and relief (topography). On a set of laboratory mice, we assessed how wear related to age and food consistency affected molar geometry and topography.DesignThree groups of laboratory inbred mice (C57BL/6J strain) were considered: Four week old mice close to weaning, six month old mice fed on regular rodent pellets, and six month old mice fed on rodent pellets that were powdered and served as jelly. Their upper and lower molar rows were imaged in 3D. The geometry of the surfaces was quantified using a template describing the whole surface of the rows. Topographic indices were estimated on the same surfaces.ResultsThe geometry of the molar rows was heavily affected by age-related wear. Food consistency affected mostly the upper molar row, which was more worn and less helical in soft food eaters. Tooth sharpness and relief decreased with age-related wear. Tooth relief was lower in soft food eaters, but only on the upper molar row. Tooth complexity was insensitive to wear.ConclusionThe primary factor affecting tooth geometry and topography is age-related wear, as wear erodes the molar surfaces. Tooth complexity, however, appears to be insensitive to wear, making this index relevant for comparison of tooth morphology among wild mice of unknown age. Soft food eaters displayed more worn teeth, with less helical molar row occlusal surface, possibly because behavior and jaw morphology were disturbed due to this unusual food resource.



http://ift.tt/2qCyxGs

Exposure to Porphyromonas gingivalis LPS during macrophage polarisation leads to diminished inflammatory cytokine production

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Louise A. Belfield, Jon H. Bennett, Wondwossen Abate, Simon K. Jackson
ObjectiveThe objective of the present study was to determine the effects of concurrent LPS and cytokine priming, reflective of the in vivo milieu, on macrophage production of key periodontitis associated cytokines TNF, IL-1β and IL-6.DesignTHP-1 cells were pre-treated with combinations of Porphyromonas gingivalis and Escherichia coli lipopolysaccharide (LPS), concurrently with polarising cytokines IFNγ and IL-4, or PMA as a non-polarised control. Production of key periodontitis associated cytokines in response to subsequent LPS challenge were measured by enzyme − linked immunosorbent assay.ResultsCompared with cells incubated with IFNγ or IL-4 alone in the "polarisation" phase, macrophages that were incubated with LPS during the first 24h displayed a down-regulation of TNF and IL-1β production upon secondary LPS treatment in the "activation" phase. In all three macrophage populations (M0, M1 and M2), pre-treatment with P. gingivalis LPS during the polarisation process led to a significant decrease in TNF production in response to subsequent activation by LPS (p=0.007, p=0.002 and p=0.004, respectively). Pre-treatment with E. coli LPS also led to a significant down-regulation in TNF production in all three macrophage populations (p<0.001). Furthermore, the presence of E. coli LPS during polarisation also led to the down-regulation of IL-1β in the M1 population (p<0.001), whereas there was no measurable effect on IL-1β production in M0 or M2 macrophages. There was no significant effect on IL-6 production.ConclusionsMacrophages become refractory to further LPS challenge, whereby production of key periodontitis associated cytokines TNF and IL-1β is reduced after exposure to LPS during the polarisation phase, even in the presence of inflammatory polarising cytokines. This diminished cytokine response may lead to the reduced ability to clear infection and transition to chronic inflammation seen in periodontitis.



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Epithelial to mesenchymal transition in Cyclosporine A-induced rat gingival overgrowth

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Fei Yang, Jing Lu, Youcheng Yu, Yiming Gong
Background and objectiveEpithelial-mesenchymal transition (EMT) has been proved to occur in drug-induced gingival overgrowth. However, the specific pathogenic mechanism remains uncertain. The aim of this study is to examine the expression of EMT markers in cyclosporine A (CsA)-induced gingival overgrowth in rat models.Material and methodsThirty-six rats were randomly divided into two groups. The experimental group received CsA therapy subcutaneously in a daily dose of 10mg/kg, and the other group was used as a control. Six rats per group were sacrificed at 20, 40 and 60days, and the gingivae were obtained. The expression of TGF-β1, E-Cadherin, ZEB1, ZEB2, and Snail1 were examined by quantitative real time PCR (qRT-PCR), western blotting, and immunohistochemistry. In addition, a group of microRNAs associated with EMT and fibrosis were also detected in gingival tissue by qRT-PCR.ResultsThe mRNA and protein levels of TGF-β1, ZEB1, and ZEB2 in gingivae were significantly upregulated after 40 and 60days of CsA administration. Conversely, the levels of E-cadherin were significantly downregulated in overgrowth sample at day 40 and 60. Intense immunohistochemmical staining for TGF-β1 were observed in the samples from CsA group at day 40 and 60. Concomitantly, the densities of E-cadherin were gradually decreased in the basal layers of epithelium with time. Three members of miR–200s (miR-200a, miR-200b and miR-200c) were significantly downregulated in CsA-treated rats at 40 and 60days, while miR-9, miR-23a and miR-155 were significantly upregulated when compared with those of the control group.ConclusionsThe process of EMT in CsA-induced rat gingival overgrowth is associated with increased expression of TGF-β1, ZEB1, and ZEB2, and decreased expression of E-cadherin.



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Molecular Pathology of Anaplastic Thyroid Carcinomas: A Retrospective Study of 144 Cases

Thyroid May 2017, Vol. 27, No. 5: 682-692.


http://ift.tt/2qqDllV

Glycyrrhizin, a Direct HMGB1 Antagonist, Ameliorates Inflammatory Infiltration in a Model of Autoimmune Thyroiditis via Inhibition of TLR2-HMGB1 Signaling

Thyroid May 2017, Vol. 27, No. 5: 722-731.


http://ift.tt/2qqydxQ

Glycyrrhizin, a Direct HMGB1 Antagonist, Ameliorates Inflammatory Infiltration in a Model of Autoimmune Thyroiditis via Inhibition of TLR2-HMGB1 Signaling

Thyroid May 2017, Vol. 27, No. 5: 722-731.


http://ift.tt/2qqydxQ

Molecular Pathology of Anaplastic Thyroid Carcinomas: A Retrospective Study of 144 Cases

Thyroid May 2017, Vol. 27, No. 5: 682-692.


http://ift.tt/2qqDllV

International Archives of Otorhinolaryngology: 20 Years of Excellence!

http://ift.tt/2pE65EH

Efficacy of Carbon Microcoils in Relieving Cervicogenic Dizziness

Abstract Introduction Cervical pain contributes to postural deviations and imbalance. Nanotechnology may be used for the treatment of neck pain by fixing to the skin small rounds silicone patches containing double spiral carbon nanotubes arranged in the form of a coil (Helical), which would then relieve dizziness caused by muscular contraction. Objective The objective of this study is to Evaluate pain and dizziness scores before and after Helical patches effect on cervicogenic dizziness treatment. Methods The selected patients should have neck pain arising from muscle contraction with loss of balance or instability lasting more than 90 days and normal electrooculography. Treatment consisted of placing 10 Helical patches distributed as follows: two in the upper cervical area, two in the lower cervical area (near the 5th and 6th vertebrae), two in the upper trapezius muscle area (between neck and shoulder), and four in the tender point area (as reported by the patient). Using a Visual Analogue Scale (VAS), we matched pain and dizziness scores from Day 1 to those from Day 15 and Day 30 using Mann-Whitney test. Results There was a significant difference between pain score reported on Day 1 and Day 15 (Z = 2.43, U = 5, p = 0.01). We also found significant differences between dizziness scores reportedondays1 and15 (Z = 2.62, U = 3.5, p = 0.01) and days 1 and 30 (Z = 2.36, U = 5.5, p = 0.01). Conclusion The Helical patches seem to be an effective treatment for cervicogenic dizziness.

http://ift.tt/2qqDgyp

Neck Dissection Technique Commonality and Variance: A Survey on Neck Dissection Technique Preferences among Head and Neck Oncologic Surgeons in the American Head and Neck Society

Abstract Introduction Neck dissection (ND) technique preferences are not well reported. Objective The objective of this study is to educate practitioners and trainees about surgical technique commonality and variance used by head and neck oncologic surgeons when performing a ND. Methods Online survey of surgeon members of the American Head and Neck Society (AHNS). Survey investigated respondents' demographic information, degree of surgical experience, ND technique preferences. Results In our study, 283 out of 1,010 (28%) AHNS surgeon members with a mean age of 50.3 years (range 32-77 years) completed surveys from 41 states and 24 countries. We found that 205 (72.4%) had completed a fellowship in head and neck surgical oncology. Also, 225 (79.5%) respondents reported completing more than 25 NDs per year. ND technique commonalities (>66% respondents) included: preserving level 5 (unless with suspicious lymph nodes (LN)), only excising the portion of sternocleidomastoid muscle involved with tumor, resecting lymphatic tissue en bloc, preservation of cervical sensory rootlets, not performing submandibular gland (SMG) transfer, placing one drain for unilateral selective NDs, and performing a ND after parotidectomy and thyroidectomy and before transcervical approaches to upper aerodigestive tract primary site. Variability existed in the sequence of LN levels excised, instrument preferences, criteria for drain removal, the timing of a ND with transoral upper aerodigestive tract primary site resections, and submandibular gland preservation. Results showed that 122 (43.1%) surgeons reported that they preserve the submandibular gland during the level 1b portion of a ND. Conclusions The commonalities and variances reported for the ND technique may help put individual preferences into context.

http://ift.tt/2pDWwWu

Sialendoscopy Training: Presentation of a Realistic Model

Abstract Introduction Several surgical training simulators have been created for residents and young surgeons to gain experience with surgical procedures. Laboratory training is fundamental for acquiring familiarity with the techniques of surgery and skill in handing instruments. Objective The aim of this study is to present a novel simulator for training sialendoscopy. Method This realistic simulator was built with a synthetic thermo-retractile, thermosensible rubber which, when combined with different polymers, producesmore than 30 different formulas. These formulas present textures, consistencies, and mechanical resistance are similar to many human tissues. Results The authors present a training model to practice sialendoscopy. All aspects of the procedure are simulated: month opening, dilatation of papillae, insert of the scope, visualization of stones, extraction of these stones with grasping or baskets, and finally, stone fragmentation with holmium laser. Conclusion This anatomical model for sialendoscopy training should be considerably useful to abbreviate the learning curve during the qualification of young surgeons while minimizing the consequences of technical errors.

http://ift.tt/2qqReAr

Role of Monocyte Count and Neutrophil-to- Lymphocyte Ratio in Survival of Oral Cancer Patients

Abstract Introduction Inflammation seems to play a critical role in the development and progression of numerous cancers. Peripheral blood leukocyte count is an easily assessable parameter of systemic inflammatory response. Objective The aim of this study was to investigate whether the pretreatment leukocyte counts can predict the prognosis of patients with oral cavity cancer. Methods Medical records of 471 oral cavity cancer patients diagnosed between January 2007 and December 2008 were retrospectively analyzed. Receiver operating characteristic curve analysis and Cox proportional hazards analyses were applied to evaluate the associations of leukocyte counts with overall survival. Results The overall five year's survival of the cohort was found to be 49.4%. On univariate analysis, elevated monocyte count (≥500/mm3) and neutrophil-to-lymphocyte ratio (NLR) (>2.38) were associated with poor overall survival (OS) (p = 0.001 and 0.000, respectively). Multivariate Cox proportional hazard analysis showed that higher monocyte and NLR levels were significant independent predictors of worse OS (HR = 1.385, 95% CI = 1.049 - 1.829; p < 0.05 and HR = 1.392, 95% CI = 1.045 - 1.855; p < 0.05, respectively). The advanced overall stage and lymph nodal involvement were also independent indicators for poor OS. Conclusions Higher pretreatment monocyte and NLR levels are independent predictors of poor prognosis for patients with oral cavity cancer. Thus, these easily accessed variables can serve as a potent marker to predict the outcomes of oral cancer patients.

http://ift.tt/2pDABPi

Emotional Stress Evaluation of Patients with Moderate and Severe Sleep Apnea Syndrome

Abstract Introduction The scientific literature has shown that the damage caused by sleep fragmentation in people affected by Obstructive Sleep Apnea (OSA) can reflect emotionally, generating not only physical symptoms such as drowsiness and tiredness, but also psychical symptoms, such as stress. Objective This study aimed at comparing symptoms of stress in patients with moderate or severe OSA, before and after twomonths of treatment (clinical or surgical). Method This is an Individual, prospective, longitudinal, and interventional study. All patients underwent polysomnography before treatment.We collected data through the application of Stress Symptoms Inventory for Adults Lipp (ISSL) before and after two months of medical or surgical treatment for moderate or severe OSA. Results The sample consisted of 18 patients (72.2% male) with a mean age of 51.83 years. We found that 77.8% (n = 14) of patients had stress in the first evaluation. In the second evaluation (after treatment), this reduced to 16.7% (n = 3). The average stress symptoms decreased from the first to the second evaluation (M = 13.78 andM = 6.17, respectively), being statistically significant (z = -3.53; p < 0.000). Conclusions We found that moderate and severe apnea patients have significant stress index and that, after two months of medical or surgical treatment, there is a significant reduction of the symptom. In addition, the patients with severe OSA had a better outcome regarding the reduction of stress index than patients with moderate OSA.

http://ift.tt/2qqxDjE

Tracheostomy in the Intensive Care Unit: a University Hospital in a Developing Country Study

Abstract Introduction Tracheostomy is the commonest surgical procedure in intensive care units (ICUs). It not only provides stable airway and facilitates pulmonary toilet and ventilator weaning, but also decreases the direct laryngeal injury of endotracheal intubation, and improves patient comfort and daily living activity. Objective The objective of this study is to assess the incidence, indications, timing, complications (early and late), and the outcome of tracheostomy on patients in the intensive care units (ICU) at a university hospital in a developing country. Methods This study is an observational prospective study. It was performed at the otolaryngology department and ICU new surgery hospital on 124 ICU admitted patients. We collected patients' demographic records, cause of admission, indications of tracheostomy, mechanical ventilation, and duration of ICU stay. We also gathered patientś tracheostomy records including the incidence, timing, technique, type, early and late complications, and outcome. All tracheostomized patients received follow-up for 12 months. Results The indication for tracheostomy in ICU patients was mostly prolonged intubation (80.5%), followed by diaphragmatic paralysis (19.5%). All tracheostomies were done by the open approach technique. Tracheostomy for prolonged intubation was done within 17 to 26 days after intubation with a mean of 19.4 ± 2.07 days. Complications after tracheostomy were 13.9% tracheal stenosis and 25% subglottic stenosis. Conclusion Prolonged endotracheal intubation is theman indication of tracheostomy, performed after two weeks of intubation. Although there were no major early complications, laryngotracheal stenosis is still a challenging sequel for tracheostomy that needs to be investigated to be prevented.

http://ift.tt/2pDLFf4

Thyroid Carcinoma Pattern Presentation According to Age

Abstract Introduction Patients with thyroid cancer in different age groups present with different prognosis. Objective The objective of this study is to analyze the clinicopathological pattern of thyroid carcinoma presentation according to age groups. Methods This is a retrospective study. From 2000 to 2010, 623 patients underwent thyroidectomy for cancer in our institution, with 596 enrolled. Patients were divided into groups of 10 years and then in four age subgroups (≤ 24, 25-44, 45-64, and ≥65 years) for statistical analysis. We compared age, gender, and histopathological characteristics between groups. Results Individuals belonging to the earlier age group presented with a highest prevalence of neuro-vascular invasion, capsular invasion and lymph node metastasis. Together with individuals of advanced age, that group also had larger tumor diameter and higher prevalence of extra-glandular disease. Even when analyzed only cases with well-differentiated carcinoma, younger individuals remain with a highest prevalence of lymph node metastasis, neuro-vascular invasion and larger tumor diameter. Conclusion We observed a distinct pattern of clinicopathological manifestation of thyroid cancer according to age. Individuals belonging to age extremes resemble in several pathological features, and young people usually present with more aggressive disease characteristics.

http://ift.tt/2qqNYFa

Is There A Systemıc Inflammatory Effect of Cholesteatoma?

Abstract Introduction Inflammation causes squamous epithelial transformation of the mucosa in the middle ear cavity and plays a role in the onset, growth, spread, and recurrence of cholesteatoma. Objectives The objective of this study is to investigate the systemic inflammatory effect in chronic otitis with cholesteatoma. Methods The study included a total of 311 patients comprising 156 patients with a pathology diagnosis of cholesteatoma and a control group of 155 with no active inflammation. The Neutrophil-to-lymphocyte Ratio (NLR) was calculated by dividing the neutrophil value by the lymphocyte value. Results The mean NLR was 1.94 ± 0.91 in the patients with cholesteatoma and 1.94 ± 0.85 in the control group. We determined no statistically significant difference between the groups in respect of NLR (p = 0.983). We calculated the NLR as 2.01 ± 1.00 in patients with ossicle erosion and 1.82 ± 0.69 in those without ossicle erosion, 1.86 ± 0.85 in patients with bone erosion and 1.98 ± 0.95 in those without bone erosion. We determined no statistical difference between these values (p = 0.175). Conclusion The results of this study showed that NLR had no predictive value in respect of bone erosions and associated complications in patients with cholesteatoma. The inflammatory effect of cholesteatoma is not systemic but remains more local.

http://ift.tt/2pDMEvF

Tonic Investigation Concept of Cervico-vestibular Muscle Afferents

Abstract Introduction Interdisciplinary research has contributed greatly to an improved understanding of the vestibular system. To date, however, very little research has focused on the vestibular system's somatosensory afferents. To ensure the diagnostic quality of vestibular somatosensory afferent data, especially the extra cranial afferents, stimulation of the vestibular balance system has to be precluded. Objective Sophisticated movements require intra- and extra cranial vestibular receptors. The study's objective is to evaluate an investigation concept for cervico-vestibular afferents with respect to clinical feasibility. Methods A dedicated chair was constructed, permitting three-dimensional trunk excursions, during which the volunteer's head remains fixed. Whether or not a cervicotonic provocation nystagmus (c-PN) can be induced with static trunk excursion is to be evaluated and if this can be influenced by cervical monophasic transcutaneous electrical nerve stimulation (c-TENS) with a randomized test group. 3D-video-oculography (VOG) was used to record any change in cervico-ocular examination parameters. The occurring nystagmuses were evaluated visually due to the small caliber of nystagmus amplitudes in healthy volunteers. Results The results demonstrate: no influence of placebo-controlled c-TENS on the spontaneous nystagmus; a significant increase of the vertical nystagmus on the 3Dtrunk- excursion chair in static trunk flexion with cervical provocation in all young healthy volunteers (n = 49); and a significant difference between vertical and horizontal nystagmuses during static trunk excursion after placebo-controlled c-TENS, except for the horizontal nystagmus during trunk torsion. Conclusion We hope this cervicotonic investigation concept on the 3D trunk-excursion chair will contribute to new diagnostic and therapeutic perspectives on cervical pathologies in vestibular head-to-trunk alignment.

http://ift.tt/2qqmNKM

Adaptation and Assessment of Reliability and Validity of the Greek Version of the Ohkuma Questionnaire for Dysphagia Screening

Abstract Introduction The Ohkuma questionnaire is a validated screening tool originally used to detect dysphagia among patients hospitalized in Japanese nursing facilities. Objective The purpose of this study is to evaluate the reliability and validity of the adapted Greek version of the Ohkuma questionnaire. Methods Following the steps for cross-cultural adaptation, we delivered the validated Ohkuma questionnaire to 70 patients (53 men, 17 women) who were either suffering from dysphagia or not. All of them completed the questionnaire a second time within a month. For all of them, we performed a bedside and VFSS study of dysphagia and asked participants to undergo a second VFSS screening, with the exception of nine individuals. Statistical analysis included measurement of internal consistency with Cronbach's α coefficient, reliability with Cohen's Kappa, Pearson's correlation coefficient and construct validity with categorical components, and One-Way Anova test. Results According to Cronbach's α coefficient (0.976) for total score, there was high internal consistency for the Ohkuma Dysphagia questionnaire. Test-retest reliability (Cohen's Kappa) ranged from 0.586 to 1.00, exhibiting acceptable stability. We also estimated the Pearson's correlation coefficient for the test-retest total score, which reached high levels (0.952; p = 0.000). The One-Way Anova test in the two measurement times showed statistically significant correlation in bothmeasurements (p = 0.02 and p = 0.016). Conclusion The adapted Greek version of the questionnaire is valid and reliable and can be used for the screening of dysphagia in the Greek-speaking patients.

http://ift.tt/2pDT7ad

Tinnitus in Elderly Individuals: Discomfort and Impact in the Quality of Life

Abstract Introduction Tinnitus is a symptom that affects mainly the elderly and can negatively influence their quality of life. Objective The objective of our study is to evaluate the existence of a relationship between the quality of life and the impact caused by tinnitus in elderly individuals, considering the age and gender variables. Method We conducted a cross-sectional study in elderly people of both genders who participate in the extension activities at the university. The evaluation was composed of anamnesis and WHOQOL-OLD instruments, to evaluate the quality of life, and Tinnitus Handicap Inventory (THI) for the evaluation of the tinnitus impact. Result We evaluated 36 elderly individuals with an average age of 68.6 ± 6.8 years old, 72.2 % of them were women. We verified that most of the subjects classified their tinnitus as weak (44.4%) ormedium (36.1%). The score average in the THI was 20 points, with predominant classification of tinnitus impact as negligible (41.7%) or mild (30.6%). In the WHOQOL-OLD, the average score was 15.6 ± 1.6 points (total score). The negative correlation between the THI score and the WHOQOL-OLD score was found in the sensory domain operation and total score. Conclusion The results obtained in the study prove that the quality of life of the elderly individuals evaluated is related to a discomfort caused by the tinnitus.

http://ift.tt/2qqXs38

Auditory Processing Assessment in Children with Attention Deficit Hyperactivity Disorder: An Open Study Examining Methylphenidate Effects

Abstract Introduction Children with Attention Deficit Hyperactivity Disorder can present Auditory Processing (AP) Disorder. Objective The study examined the AP in ADHD children compared with non-ADHD children, and before and after 3 and 6 months of methylphenidate (MPH) treatment in ADHD children. Methods Drug-naive children diagnosed with ADHD combined subtype aging between 7 and 11 years, coming from public and private outpatient service or public and private school, and age-gender-matched non-ADHD children, participated in an open, non-randomized study from February 2013 to December 2013. They were submitted to a behavioral battery of AP tests comprising Speech with white Noise, Dichotic Digits (DD), and Pitch Pattern Sequence (PPS) and were compared with non-ADHD children. They were followed for 3 and 6 months of MPH treatment (0.5 mg/kg/day). Results ADHD children presented larger number of errors in DD (p < 0.01), and less correct responses in the PPS (p < 0.0001) and in the SN (p < 0.05) tests when compared with non-ADHD children. The treatment with MPH, especially along 6 months, significantly decreased the mean errors in the DD (p < 0.01) and increased the correct response in the PPS (p < 0.001) and SN (p < 0.01) tests when compared with the performance before MPH treatment. Conclusions ADHD children show inefficient AP in selected behavioral auditory battery suggesting impaired in auditory closure, binaural integration, and temporal ordering. Treatment with MPH gradually improved these deficiencies and completely reversed them by reaching a performance similar to non-ADHD children at 6 months of treatment.

http://ift.tt/2pDQR2u

Otoneurological Abnormalities in Patients with Friedreich's Ataxia

Abstract Introduction Friedreich's ataxia is a neurodegenerative disease and progressive by nature. It has autosomal recessive inheritance and early onset inmost cases. Nystagmus and hearing loss (in some cases) make up some of the common symptoms seen in this disorder. Objective The objective of this study is to examine vestibular disorders in patientswith Friedreich ataxia. Methods We conducted a retrospective cross-sectional study. We evaluated 30 patients with ages ranging from six to 72 years (mean age of 38.6 ( 14.7). The patients underwent the following procedures: anamnesis, ENT, and vestibular evaluations. Results Clinically, the patients commonly had symptoms of incoordination of movement (66.7%), gait disturbances (56.7%), and dizziness (50%). In vestibular testing, alterations were predominantly evident under caloric testing (73.4%), gaze nystagmus testing (50.1%), rotational chair testing (36.7%), and optokinetic nystagmus testing (33.4%). The presence of alterations occurred under examination in 90% of subjects, with the majority occurring in those with central vestibular dysfunction (70% of the examinations). Conclusion The most evident neurotological symptoms were incoordination of movement, gait disturbances, and dizziness. Alterations in vestibular examinations occurred in 90% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction.

http://ift.tt/2qqud0u

Auditory Alterations in Children Infected by Human Immunodeficiency Virus Verified Through Auditory Processing Test

Abstract Introduction The auditory system of HIV-positive children may have deficits at various levels, such as the high incidence of problems in the middle ear that can cause hearing loss. Objective The objective of this study is to characterize the development of children infected by the Human Immunodeficiency Virus (HIV) in the Simplified Auditory Processing Test (SAPT) and the Staggered Spondaic Word Test. Methods We performed behavioral tests composed of the Simplified Auditory Processing Test and the Portuguese version of the Staggered SpondaicWord Test (SSW). The participants were 15 children infected by HIV, all using antiretroviral medication. Results The children had abnormal auditory processing verified by Simplified Auditory Processing Test and the Portuguese version of SSW. In the Simplified Auditory Processing Test, 60% of the children presented hearing impairment. In the SAPT, the memory test for verbal sounds showed more errors (53.33%); whereas in SSW, 86.67% of the children showed deficiencies indicating deficit in figure-ground, attention, and memory auditory skills. Furthermore, there aremore errors in conditions of background noise in both age groups, where most errors were in the left ear in the Group of 8-yearolds, with similar results for the group aged 9 years. Conclusion The high incidence of hearing loss in children with HIV and comorbidity with several biological and environmental factors indicate the need for: 1) familiar and professional awareness of the impact on auditory alteration on the developing and learning of the children withHIV, and 2) access to educational plans and follow-up with multidisciplinary teams as early as possible to minimize the damage caused by auditory deficits.

http://ift.tt/2pE0TRv

Satisfaction of Elderly Hearing Aid Users

Abstract Introduction The impact of auditory sensory deprivation in the life of an individual is enormous because it not only affects one's ability to properly understand auditory information, but also the way people relate to their environment and their culture. The monitoring of adult and elderly subjects with hearing loss is intended to minimize the difficulties and handicaps that occur as a consequence of this pathology. Objective To evaluate the level of user satisfaction with hearing aids. Methods A clinical and experimental study involving 91 elderly hearing aid users. We used the questionnaire Satisfaction with Amplification in Daily Life to determine the degree of the satisfaction provided by hearing aids. We evaluated mean global score, subscales, as well as the variables time to use, age, and degree of hearing loss. Results Mean global score was 4.73, the score for Positive Effects 5.45, Negative Factors 3.2, demonstrating that they were satisfied; Services and Costs 5.98: very satisfied ; 3.65 Personal Image: dissatisfied. We observed statistically significant difference for the time of hearing aid use, age, and degree of hearing loss. Conclusion The SADL is a tool, simple and easy to apply and in this study we can demonstrate the high degree of satisfaction with the hearing aids by themajority of the sample collected, increasing with time of use and a greater degree of hearing loss.

http://ift.tt/2qqx9tS

Rhinoplasty Complications and Reoperations: Systematic Review

Abstract Introduction This article is related to complications of rhinoplasty and its main causes of reoperations. Objectives The objective of this study is to perform a systematic review of literature on complications in rhinoplasty. Data Synthesis The authors conducted a survey of articles related to key terms in the literature by using three important databases within 11 years, between January 2002 and January 2013. We found 1,271 abstracts and selected 49 articles to this review. Conclusion Themain results showed that the number of primary open rhinoplasty was 7902 (89%) and 765 closed (11%) and the percentage of reoperations in primary open complete rhinoplasties was 2.73% and closed complete was 1.56%. The statistical analysis revealed a value of p = 0.071. The standardization of terms can improve the quality of scientific publications about rhinoplasty. There is no difference between primary open or closed rhinoplasty techniques in relation to reoperations.

http://ift.tt/2pDAzHa

Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases

Abstract Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions Themiddle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

http://ift.tt/2qqGp1f

Asymptomatic Brain Edema after Hemodialysis Initiation in a Patient with Severe Uremia

A 66-year-old man with severe renal insufficiency presented with mild confusion associated with uremia. Cranial magnetic resonance imaging (MRI) showed no remarkable changes. The patient was placed on short-duration hemodialysis (2 hours) with smaller surface area and low blood flow (100 mL/min) to avoid dialysis disequilibrium syndrome (DDS). His consciousness gradually improved and he did not develop apparent DDS symptoms. However, T2-weighted FLAIR MRI showed increased signal intensities bilaterally in the cortical and subcortical areas of the occipital lobe on day 15. In other words, cranial MRI showed cerebral edema, indicating asymptomatic DDS. On day 29, cranial MRI showed a return to findings on admission. In this case, because the patient did not have apparent DDS symptoms despite MRI changes, we diagnosed asymptomatic cerebral edema. The patient was discharged on regular intermittent HD without any neurological deficits. No further neurological disturbances were noted during 1-year follow-up. MRI findings in ESKD patients without DDS symptoms help to clarify the diagnosis of cerebral edema. In this case, the patient did not have apparent DDS symptoms and was therefore diagnosed with asymptomatic cerebral edema.

http://ift.tt/2qwNric

Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016

The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.

http://ift.tt/2oVGQ3w

Clinical guidelines: How can we improve adherence and implementation?

No abstract available

http://ift.tt/2oVDSvT

Ultrasound Guided Regional Anaesthesia; 2nd edition

No abstract available

http://ift.tt/2p6UNYB

Late rebound of dabigatran levels after idarucizumab reversal in two patients with severe renal failure

No abstract available

http://ift.tt/2p6VaCx

European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness

No abstract available

http://ift.tt/2p6I87R

Use of anaesthetics in young children: Consensus statement of the European Society of Anaesthesiology, the European Society of Paediatric Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology and the European Safe Tots Anaesthesia Research Initiative

No abstract available

http://ift.tt/2p6UOf7

Is the central venous pressure an obsolescent model or a valuable puzzle stone in haemodynamic monitoring?

No abstract available

http://ift.tt/2oVL3V0

Reply to: European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness

No abstract available

http://ift.tt/2p6SIM8

Reply to: is the central venous pressure an obsolescent model or a valuable puzzle stone in haemodynamic monitoring?

No abstract available

http://ift.tt/2oVDQUN

Late rebound of dabigatran levels after idarucizumab reversal in two patients with severe renal failure

No abstract available

http://ift.tt/2p6VaCx

Clinical guidelines: How can we improve adherence and implementation?

No abstract available

http://ift.tt/2oVDSvT

Reply to: is the central venous pressure an obsolescent model or a valuable puzzle stone in haemodynamic monitoring?

No abstract available

http://ift.tt/2oVDQUN

European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness

No abstract available

http://ift.tt/2p6I87R

Ultrasound Guided Regional Anaesthesia; 2nd edition

No abstract available

http://ift.tt/2p6UNYB

Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016

The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.

http://ift.tt/2oVGQ3w

Use of anaesthetics in young children: Consensus statement of the European Society of Anaesthesiology, the European Society of Paediatric Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology and the European Safe Tots Anaesthesia Research Initiative

No abstract available

http://ift.tt/2p6UOf7

Is the central venous pressure an obsolescent model or a valuable puzzle stone in haemodynamic monitoring?

No abstract available

http://ift.tt/2oVL3V0

Reply to: European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness

No abstract available

http://ift.tt/2p6SIM8

Intrathecal baclofen pump infection treated by adjunct intrareservoir teicoplanin instillation.

Related Articles

Intrathecal baclofen pump infection treated by adjunct intrareservoir teicoplanin instillation.

Surg Neurol Int. 2017;8:38

Authors: Aristedis R, Dimitrios P, Nikolaos P, Alexandros B

Abstract
BACKGROUND: The delivery of intrathecal baclofen via pumps is gaining increasing use in the management of intractable spasticity. One of the rare but devastating complications of this method is infection. In the majority of cases, removal of the device is required, despite appropriate intravenous antibiotic therapy. We report a case that highlights the use of intrareservoir teicoplanin to achieve sterilization of the infected pump system in a patient in whom removal of the pump was not an easy option.
CASE DESCRIPTION: We describe our experience on a patient with cerebral palsy in whom Staphylococcus epidermidis pump infection developed due to contamination of the infusion reservoir during refilling procedure, which was successfully sterilized in situ by the combined use of systemic antibiotics and intrareservoir coadministration of baclofen with teicoplanin. The infection was eradicated and baclofen therapy was continued uninterrupted.
CONCLUSIONS: Removal of intrathecal baclofen pump is not necessary as the first measure in cases with mild clinical symptomatology. In view of the fact that pumps for intrathecal drug delivery are very costly, salvage of the device may be attempted in selected cases, although it is not generally recommended. Combined infusion of baclofen and an antibiotic through the pump makes it possible to maintain treatment for spasticity, sterilize the pump reservoir and flow tubes, and effectively treat infections that develop during the use of these systems.

PMID: 28458952 [PubMed - in process]

http://ift.tt/2puETK1

Midline depressed skull fracture presenting with quadriplegia: A rare phenomenon.

Related Articles

Midline depressed skull fracture presenting with quadriplegia: A rare phenomenon.

Surg Neurol Int. 2017;8:39

Authors: Mathew MJ, Pruthi N, Savardekar AR, Tiwari S, Rao MB

Abstract
BACKGROUND: Midline depressed skull fractures (MDSFs) deserve a special mention among skull fractures and should always be treated with caution. Here, an extremely unusual clinical presentation of a case of MDSF is highlighted along with its successful surgical management.
CASE DESCRIPTION: A 26-year-old male presented with quadriplegia following assault on the head with sharp weapons. The patient had multiple lacerated wounds on the scalp with underlying cranial fractures. On evaluation, computerized tomography (CT) of the brain showed a midline depressed skull fracture compressing the superior sagittal sinus (SSS) causing bilateral frontoparietal venous infarction. CT venogram showed a filling defect of the SSS due to the penetrating bone fragment. He underwent elevation of the depressed fracture and repair of the sinus with pericranial graft. Patient improved neurologically, and follow-up magnetic resonance venogram showed a patent SS.
CONCLUSION: MDSF can present with quadriparesis/quadriplegia due to middle one-third SSS obstruction/thrombosis leading to bilateral motor cortical venous infarction. Such MDSFs may require emergent surgical elevation of the depressed bone fragment for restoration of the patency of the sinus.

PMID: 28458953 [PubMed - in process]

http://ift.tt/2puyI95

Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties.

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Cost-effectiveness of short-term neurosurgical missions relative to other surgical specialties.

Surg Neurol Int. 2017;8:37

Authors: Punchak M, Lazareff JA

Abstract
BACKGROUND: Short-term surgical relief efforts have helped close some gaps in the provision of surgical care in remote settings. We reviewed the published literature on short-term surgical missions to compare their cost-effectiveness across subspecialties.
METHODS: PubMed was searched using the algorithm ["cost-effectiveness" AND "surgery" AND ("mission" OR "volunteer")]. Articles detailing the cost-effectiveness of short-term surgical missions in low and middle-income countries (LMIC) were included. Only direct mission costs were considered, and all costs were converted into 2014 USD.
RESULTS: Eight articles, representing 27 missions in 9 LMIC countries during 2006-2014, met our inclusion criteria. Latin America was the most frequently visited region. Per capita costs ranged from $259 for cleft lip/cleft palate (CL/CP) missions to $2900 for a neurosurgery mission. Mission effectiveness ranged from 3 disability adjusted life years (DALYs) averted per patient for orthopedic surgery missions to 8.12 DALYs averted per patient for a neurosurgery mission. CL/CP and general surgery missions were the most cost-effective, averaging $80/DALY and $87/DALY, respectively. The neurosurgical, orthopedic, and hand surgery missions averaged the highest costs/DALY averted, with the cost-effectiveness being $357/DALY, $435/DALY, and $445/DALY, respectively. All analyzed missions were very cost effective.
CONCLUSION: To date, this is the first study to assess the cost-effectiveness of short-term surgical missions across surgical specialties. Neurosurgical missions avert the largest number of healthy life years compared to other specialties, and thus, could yield a greater long-term benefit to resource-poor communities. We recommend that further studies be carried out to assess the impact of surgical missions in low-resource settings.

PMID: 28458951 [PubMed - in process]

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Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils.

Related Articles

Carotid cavernous fistula after percutaneous balloon compression for trigeminal neuralgia: Endovascular treatment with coils.

Surg Neurol Int. 2017;8:36

Authors: Gatto LAM, Tacla R, Koppe GL, Junior ZD

Abstract
BACKGROUND: Percutaneous ganglyolysis treatment of trigeminal neuralgia is rarely associated with vascular complications, such as hematoma, subarachnoid hemorrhage, and stroke. Internal carotid artery injury may also occur after misguided needle placement, particularly far posteriorly or medially, resulting in carotid cavernous fistula. Anatomical variations of the foramen ovale can predispose those complications.
CASE DESCRIPTION: A young woman diagnosed with trigeminal neuralgia during 11 years was submitted to a balloon rhizotomy by percutaneous approach to the trigeminal ganglion, with severe intraoperative bleeding. Cavernous syndrome developed few hours later. Magnetic resonance imaging and digital subtraction angiography confirmed an indirect carotid cavernous sinus fistula, which was treated by one session of endovascular procedure using coils, achieving total occlusion of the fistula and total recovery of the symptoms.
CONCLUSIONS: Embolization with coils is a minimally invasive, safe, and effective procedure for the treatment of carotid cavernous fistulas, including those related to iatrogenic causes.

PMID: 28458950 [PubMed - in process]

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Low cost quality initiatives for management of neurosurgical patients in developing nations: Perspective from a tertiary care centre in Pakistan.

Related Articles

Low cost quality initiatives for management of neurosurgical patients in developing nations: Perspective from a tertiary care centre in Pakistan.

Surg Neurol Int. 2017;8:35

Authors: Rai HH, Waqas M, Shamim MS

Abstract
BACKGROUND: Targeting resources on cost-effective care strategies is pertinent for developing nations, specifically for already burdened specialties such as neurosurgery, where without state support and insurance companies, expenses are borne by the patient themselves.
METHODS: This was a descriptive review of literary work published by the section of neurosurgery at Aga Khan University Hospital, Pakistan. We searched PubMed and CiNAHL databases to identify articles, which were then critically analyzed and discussed from a perspective of low-cost quality care.
RESULTS: We demonstrate the cost effectiveness of three initiatives, namely, blood ordering protocol for elective spine arthrodesis, nonoperative management being superior to surgical stabilization in spine injury patients with complete neurological deficits, and early tracheostomy in patients with isolated severe traumatic brain injury.
CONCLUSION: Initiation and implementation of such cost-effective strategies without compromising quality health standards must be emphasized by neurosurgical centers throughout the developing world for smart allocation and utilization of funds.

PMID: 28458949 [PubMed - in process]

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Primary atypical teratoid rhabdoid tumor in the adult spine.

Related Articles

Primary atypical teratoid rhabdoid tumor in the adult spine.

Surg Neurol Int. 2017;8:34

Authors: McGinity M, Siddiqui H, Singh G, Tio F, Shakir A

Abstract
BACKGROUND: Atypical teratoid/rhabdoid tumor (ATRT) is a highly aggressive tumor of the central nervous system (WHO grade IV), which is most frequently found intracranially in young children and infants. Only three prior cases of primary ATRT involving the adult spine were found following a literature review, and the average survival for these patients was only 20 postoperative months.
CASE DESCRIPTION: A 43 year-old female presented with an acute exacerbation of chronic neck pain. While awaiting magnetic resonance (MR) studies of the cervical spine, she was found pulseless in her room. Although cardiopulmonary resuscitation was successful, she was found to be quadriplegic. The subsequent cervical MR imaging revealed a C1-3 intradural, extramedullary ventrolateral mass, markedly compressing the upper cervical spinal cord. Following successful surgical resection of the lesion, which proved pathologically to be an ATRT, she was treated with a full course of fractionated radiation therapy. Over the successive 6-month period, her neurological examination continued to improve to 4-/5 functional strength in her upper extremities, however, remained with 2/5 nonfunctional strength in her legs.
CONCLUSIONS: ATRT involving the adult spine are rare and may often be misdiagnosed. This study points out that aggressive surgery followed by radiation therapy may improve outcome.

PMID: 28458948 [PubMed - in process]

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Suboccipital osteoblastoma: Microsurgical resection of a rare entity.

Related Articles

Suboccipital osteoblastoma: Microsurgical resection of a rare entity.

Surg Neurol Int. 2017;8:33

Authors: Choque-Velasquez J, Colasanti R, Piippo A, Niemelä M

Abstract
BACKGROUND: Osteoblastomas are rare lesions comprising 1% of all bone tumors. The occipital bone is one of the rarest affected bone, with only 11 cases reported during the last 40 years.
CASE DESCRIPTION: Here, we describe the clinical presentation and the radiological features of a suboccipital osteoblastoma that was successfully resected in a 30-year-old man. A short video shows the microsurgical removal of the lesion. There was no recurrence during a 12-month follow-up.
CONCLUSIONS: Even if osteoblastomas are benign tumors, a complete removal has to be achieved to reduce the risk of recurrences. This makes necessary an appropriate monitoring of the patient.

PMID: 28458947 [PubMed - in process]

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Serum endocan levels before and after surgery on low-grade gliomas.

Related Articles

Serum endocan levels before and after surgery on low-grade gliomas.

Surg Neurol Int. 2017;8:32

Authors: Tanriverdi T, Kemerdere R, Inal BB, Yuksel O, Emre HO, Ahmedov M, Baran O, Ates S

Abstract
BACKGROUND: Endocan has been shown to be a marker for several cancers and may show degree of malignancy. The aim of this study is to assess serum levels of endocan before and after surgery on low-grade gliomas (LGGs).
METHODS: Endocan was assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits in a total of 19 patients and 12 controls. Serial serum samples were obtained before and after surgery (1(st) day, 1(st) week, and 1(st) month of surgery). Control samples were collected from cord blood during cesarean section. The results were compared with control brain tissues.
RESULTS: Controls showed significantly lower serum endocan levels compared to before and after surgery (P < 0.05). There is a trend of increase in mean serum levels from before surgery and during the very early period after surgery (during first week); however, in the first month, mean serum levels became lower.
CONCLUSION: Endocan, a vital molecule for angiogenesis, is highly expressed before and after surgery in LGGs, but long-term data is needed. Furthermore, future studies should include high-grade gliomas to discuss whether endocan is associated with recurrence and response to treatment.

PMID: 28458946 [PubMed - in process]

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Radiosurgery vs radiation therapy for brain metastases: A waning controversy.

Related Articles

Radiosurgery vs radiation therapy for brain metastases: A waning controversy.

Surg Neurol Int. 2017;8:31

Authors: Lunsford LD

PMID: 28458945 [PubMed - in process]

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Phase I Dose-Escalation Study of Ramucirumab in Chinese Patients with Advanced Solid Tumors

Trial Information.

ClinicalTrials.gov Identifier: NCT01682135

Sponsor(s): Eli Lilly and Company

Principal Investigator: Jin Li

IRB Approved: Yes

Lessons Learned.

Ramucirumab was well tolerated in Chinese patients with advanced solid tumors, and adverse events were manageable in this study.

Pharmacokinetics characteristics in Chinese patients were similar to those in other populations. Immunogenicity was not detected.

No efficacy conclusion could be drawn, and further randomized studies are warranted.

Background.

This single-arm, nonrandomized, open-label, dose-escalation, phase I study was designed to evaluate the safety, tolerability, and pharmacokinetics (PK) of ramucirumab in Chinese patients with advanced solid tumors that were resistant to standard therapy or no standard therapy was available.

Methods.

Dose escalation was a 3 + 3 design, with expansion in Cohorts 2 and 3 for PK. Ramucirumab was given intravenously at three different dosages: 6 mg/kg every 2 weeks, 10 mg/kg every 3 weeks, and 8 mg/kg every 2 weeks. Safety analyses included all patients. PK, immunogenicity, and antitumor activity were also assessed.

Results.

Among 28 patients treated, 2 experienced dose-limiting toxicity, possibly related to ramucirumab. No maximum tolerated dose was determined. All patients experienced at least one treatment-emergent adverse event. Grade ≥3 adverse event was reported for 53.6% (n = 15) of patients. PK analyses indicated that ramucirumab had low clearance, small volume of distribution, and long half-life in Chinese patients, as in other populations. Immunogenicity was not detected. No patient had complete/partial response, and 64.3% (n = 18) had stable disease with a median duration of 5.55 months (95% confidence interval: 3.38–7.13 months).

Conclusion.

Ramucirumab appeared to be well tolerated in Chinese patients with advanced solid tumors. PK characteristics in Chinese patients were similar to those in other populations. The Oncologist 2017;22:1–9

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DNA Polymerase {varepsilon} Deficiency Leading to an Ultramutator Phenotype: A Novel Clinically Relevant Entity

Deficiencies in DNA repair due to mutations in the exonuclease domain of DNA polymerase have recently been described in a subset of cancers characterized by an ultramutated and microsatellite stable (MSS) phenotype. This alteration in DNA repair is distinct from the better-known mismatch repair deficiencies which lead to microsatellite instability (MSI) and an increased tumor mutation burden. Instead, mutations in POLE lead to impaired proofreading intrinsic to Pol during DNA replication resulting in a dramatically increased mutation rate. Somatic mutations of Pol have been found most frequently in endometrial and colorectal cancers (CRC) and can lead to a unique familial syndrome in the case of germline mutations. While other key genomic abnormalities, such as MSI, have known prognostic and treatment implications, in this case it is less clear. As molecular genotyping of tumors becomes routine in the care of cancer patients, less common, but potentially actionable findings such as these POLE mutations could be overlooked unless appropriate algorithms are in place. We present two cases of metastatic CRC with a POLE mutation, both of which are ultramutated and MSS. The basic biochemical mechanisms leading to a unique phenotype in POLE deficiency as well as challenges faced with interpreting the genomic profiling of tumors in this important subset of patients and the potential clinical implications will be discussed here. The Oncologist 2017;22:1–6

Key Points

Clinicians should recognize that tumors with high tumor mutation burden and that are microsatellite stable may harbor a POLE mutation, which is associated with an ultramutated phenotype.

Work-up for POLE deficiency should indeed become part of the routine molecular testing paradigm for patients with colorectal cancer.

This subset of patients may benefit from clinical trials where the higher number of mutation-associated neoantigens and defect in DNA repair may be exploited therapeutically.

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Apoptosis in Vocal Fold Polyps

To examine the degree of apoptosis and its role in the pathogenesis of polyps of the vocal folds.

http://ift.tt/2p3Cu5I

Potential Causative Factors for Saccular Disorders: Association with Smoking and Other Laryngeal Pathologies

To describe risk factors, clinical presentation, and outcome of patients with saccular disorders.

http://ift.tt/2pGeFEU

The Edinburgh modification of the minimal access zygomatic osteotomy, used for the correction of zygomatic orbital hypoplasia

Zygomatic hypoplasia can be an exceedingly difficult proposition for the surgeon treating facial deformity. The classical approach would be a coronal access, which is time-consuming, leaves a long scar on the scalp that shows in patients with balding patterns, and carries the risk of permanent facial weakness. The Edinburgh technique presents a minimal access approach to the zygomatic osteotomy. This is performed through local incisions and a bone cut made using hand-held diamond-coated wire that mobilizes the entire zygoma.

http://ift.tt/2qwfy0S

Bioresorbable versus titanium space-maintaining mesh in maxillary sinus floor elevation: a split-mouth study

Maxillary sinus pneumatization limits implant placement in the edentulous posterior maxilla. Grafted sinus floor augmentation through Schneiderian membrane elevation and space obliteration with autogenous bone grafts, bone substitutes, or a combination of the two has often been used to resolve this problem. More recently, non-grafted sinus floor elevation has been established. This is based on the concept of membrane elevation and support either by tenting technique or using space-maintaining mesh.

http://ift.tt/2puP5Cl

Team Approach Helps Patient Survive High-voltage Electric Burn

Summary: A 20-year-old man was subjected to high-voltage electric burn, which was occupational. The patient was admitted to AlGalaa Military Medical Complex almost 2 weeks after the accident had happened. According to Lund and Browder's chart, the patient had a 40% total body surface area burn involving the upper limbs, anterior and posterior trunks, and the left thigh (third- and fourth-degree burns). The aim of this study was to stabilize the patient by conducting lifesaving operations in multiple scheduled sessions, bilateral below-elbow amputations, escharotomies, and excision of affected ribs and cartilages. A left latissimus dorsi flap used to cover the left side of the anterior chest wall. Skin grafting (split thickness, meshed 1:3) was done to cover the raw areas. Multiple aggressive operations by a multidisciplinary team saved the patient's life. The victim suffered a major injury and was handicapped, but he survived. It was not necessary to replace the excised ribs with prosthesis because of the preserved sternum. An electric burn poses a burden on many people in addition to the patients themselves.

http://ift.tt/2niiK2o

Penile Squamous Cell Carcinoma Masquerading as Giant Condyloma

No abstract available

http://ift.tt/2oOOrx5

Editorial board members

Publication date: 1 May 2017
Source:European Journal of Pharmaceutical Sciences, Volume 102





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Pharmacokinetic drug-drug interaction between erlotinib and paracetamol: A potential risk for clinical practice

Publication date: 1 May 2017
Source:European Journal of Pharmaceutical Sciences, Volume 102
Author(s): Agnieszka Karbownik, Edyta Szałek, Katarzyna Sobańska, Tomasz Grabowski, Anna Wolc, Edmund Grześkowiak
BackgroundErlotinib is a tyrosine kinase inhibitor available for the treatment of non-small cell lung cancer. Paracetamol is an analgesic agent, commonly used in cancer patients. Because these drugs are often co-administered, there is an increasing issue of interaction between them.ObjectiveThe aim of the study was to investigate the effect of paracetamol on the pharmacokinetic parameters of erlotinib, as well as the influence of erlotinib on the pharmacokinetics of paracetamol.MethodsThe rabbits were divided into three groups: the rabbits receiving erlotinib (IER), the group receiving paracetamol (IIPR), and the rabbits receiving erlotinib+paracetamol (IIIER+PR). A single dose of erlotinib was administered orally (25mg) and was administered intravenously (35mg/kg). Plasma concentrations of erlotinib, its metabolite (OSI420), paracetamol and its metabolites – glucuronide and sulphate were measured with the validated method.ResultsDuring paracetamol co-administration we observed increased erlotinib maximum concentration (Cmax) and area under the plasma concentration-time curve from time zero to infinity (AUC0-∞) by 87.7% and 31.1%, respectively. In turn, erlotinib lead to decreased paracetamol AUC0-∞ by 35.5% and Cmax by 18.9%. The mean values of paracetamol glucuronide/paracetamol ratios for Cmax were 32.2% higher, whereas paracetamol sulphate/paracetamol ratios for Cmax and AUC0-∞ were 37.1% and 57.1% lower in the IIPR group, when compared to the IIIER+PR group.ConclusionsParacetamol had significant effect on the enhanced plasma exposure of erlotinib. Additionally, erlotinib contributed to the lower concentrations of paracetamol. Decreased glucuronidation and increased sulphation of paracetamol after co-administration of erlotinib were also observed.



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Structural characterization and dissolution profile of mycophenolic acid cocrystals

Publication date: 1 May 2017
Source:European Journal of Pharmaceutical Sciences, Volume 102
Author(s): Qing-Zhu Zeng, Jian Ouyang, Shuo Zhang, Lei Zhang
Three novel cocrystals of mycophenolic acid (MPA) with isonicotinamide (MPA-ISO), minoxidil (MPA-MIN) and 2,2′-dipyridylamine (MPA-DPA) as coformers have been prepared successfully by both slow evaporation and liquid-assisted grinding. The structures of these cocrystals show that all the three coformers form hydrogen bonds with the carboxylic acid group of MPA. The cocrystal MPA-ISO possesses remarkably improved solubility and dissolution rate, while two other cocrystals exhibit the opposite characteristics. The solids in the slurry with pH6.8 phosphate buffer and cocrystals remain as the incipient cocrystal after 24h. However, evidence of slight polymerization was shown in the slurry of pH6.8 phosphate buffer with MPA and MPA-ISO cocrystal.

Graphical abstract

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Studies on Photoresponse and LPG sensitivity of transparent Al doped ZnO thin films prepared by thermal evaporation technique

Publication date: September 2017
Source:Materials Research Bulletin, Volume 93
Author(s): N.H. Sheeba, Sunil C. Vattappalam, G.S Okram, Vikash Sharma, P.V. Sreenivasan, Sunny Mathew, Rachel ReenaPhilip
Undoped and Al doped ZnO thin films are prepared by thermal oxidation of vacuum coated Zn and Zn:Al metallic films at different concentrations of Al. The effect of Al doping on structural, optical and photoconducting properties of the films is studied by XRD, UV–vis spectroscopy and photoconductivity measurements. Both undoped and doped films possess polycrystalline hexagonal wurtzite structure with preferential orientation along (002) plane. The films are transparent (70%–90%) andpossess band gaps in the range 3.01eV–3.29eV. Enhanced electrical conductivity and improved photoconductivity are observed with increase in Al concentration,whereas the heavily doped ZnO samples show no appreciablesensitivity towards UV and visible light. The thermopower studies show the samples to be n-type conducting. Moreover, the Al doped ZnO exhibit improved gas sensitivity and response time to LPG detection, with that doped at 3 at% showing the best response time of ∼40s.

Graphical abstract

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DNA interaction, antioxidant and in vitro cytotoxic activities of some mononuclear metal(II) complexes of a bishydrazone ligand

Publication date: 1 September 2017
Source:Materials Science and Engineering: C, Volume 78
Author(s): Chellaian Justin Dhanaraj, Jijo Johnson
A tridentate ONO donor bishydrazone ligand, 3-(((3-oxoindolin-2-ylidene)hydrazono) methyl)quinoxalin-2(1H)-one (L) was synthesized. Using the ligand, mononuclear metal complexes of the type [M(L)(OAc)] (M=Co(II), Ni(II), Cu(II) and Zn(II), OAc=–OCOCH3) were synthesized. The newly synthesized compounds were thoroughly characterized by various analytical and spectral techniques. Tetrahedral geometry was proposed for Co(II), Ni(II) and Zn(II) complexes, while square planar geometry has been assigned to the Cu(II) complex. The in vitro antibacterial, antifungal and antioxidant studies reveal that the Cu(II) complex of the bishydrazone ligand possess higher activities. DNA binding studies suggest that the present compounds interact with CT DNA through intercalation. This was further supported by molecular docking. Gel electrophoresis studies substantiated the involvement of free radicals in the cleavage of pUC18 DNA. In vitro cytotoxicity of the compounds against MCF-7 cell line was also examined. The molecular modeling studies reveal that the compounds strongly interact with VEGFR-2 kinase receptor through hydrogen bonding, π-π, π-cation and sigma-π interactions. The bioavailability and bioactivity determination of the compounds suggest that the present compounds may be utilized as drug candidates.

Graphical abstract

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Electronic structure and half-metallicity in new Heusler alloys CoYO2 (Y=Sc, Ti, V, Cr, Mn, Fe, Ni, Cu, and Zn)

Publication date: 15 September 2017
Source:Journal of Magnetism and Magnetic Materials, Volume 438
Author(s): S. Esteki, F. Ahmadian
First-principles calculations based on density functional theory (DFT) using the self-consistent full-potential linearized augmented plane wave (FPLAPW) method were applied to study the electronic structures and magnetic properties of new Heusler alloys CoYO2 (Y=Sc, Ti, V, Cr, Mn, Fe, Ni, Cu, and Zn). The calculated formation energies of these compounds were negative, therefore, they can be synthesized experimentally. All compounds were stable in ferromagnetic AlCu2Mn-type structure. In AlCu2Mn-type structure, CoScO2, CoFeO2, and CoNiO2 compounds were HM ferromagnets, CoCuO2 was a nearly half-metal, CoZnO2 was a spin gapless semiconductor, and other compounds were conventional ferromagnets. In CuHg2Ti-type structure, CoTiO2 compound had a nearly HM characteristic, CoVO2 was a spin gapless semiconductor, and other compounds were conventional ferromagnets. The origin of the half-metallic band gap for CoScO2 alloy Heusler alloy was well understood. The total magnetic moments of the three HM compounds obeyed Slater-Pauling rules (Mtot=22-Ztot and Mtot=32-Ztot). CoScO2 had the widest region of half-metallicity between the three half-metals indicating its high robustness of half-metallicity with respect to the variation of lattice constants.



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Screening of Passiflora L. mineral content using principal component analysis and Kohonen self-organizing maps

Publication date: 15 October 2017
Source:Food Chemistry, Volume 233
Author(s): Cleber Galvão Novaes, Ivana Lago da Silva Romão, Berlane Gomes Santos, Jéssica Palhares Ribeiro, Marcos Almeida Bezerra, Erik Galvão Paranhos da Silva
A method using digestion with diluted nitric acid and inductively coupled plasma optical emission spectrometry was applied to determine metal ions in the peel, pulp, and seed of Passiflora edulis f. flavicarpa and Passiflora cincinnata cultivated in the Bahia state, Brazil. Plasma parameters (radio frequency power and argon flow rates) were optimized. The quantification limits (µg g⁻¹) were: Ca (43.0); Co (1.3); Cu (10.0); Fe (10.0); K (20.0); Mg (26.6); Mn (0.33); Na (56.6) and Zn (10.0). The accuracy of the method was evaluated by the analysis of certified reference materials (NIST 1567a Wheat Flour and NIST 1577b Bovine Liver). Recovery studies were carried out and values found were between 89 and 120%. PCA and Kohonen self-organizing maps showed the formation of groups, corresponding to the fruit parts. Thus, passion fruit has great importance and biological potential, due to its high content of K and low Na.



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Enhancement of electric and magnetic properties by tuning Co cluster in ZnO films via high magnetic field

Publication date: 15 September 2017
Source:Applied Surface Science, Volume 416
Author(s): Yang Gao, Guojian Li, Zhao Wang, Shan Liu, Qiang Wang
To reveal the origin of magnetic coupling in dilute magnetic semiconductors (DMSs), this article utilized high magnetic field (HMF) in the process of oxidizing Co/Zn bilayers to study the influence of Co clusters and oxygen vacancy (Vo) content control on magnetic and electrical properties of Co doped ZnO (Co-ZnO) films. Results indicated that HMF can suppress the diffusion of Co and remain the content of Co clusters compared with oxidation growth in the absence of HMF. Moreover, HMF promoted the oxidation of Zn, improved the crystallinity in the films, and lowered the content of Vo. Consequently, the resistivity of the films oxidized in HMF was decreased by 50%, while both the saturation magnetization and coercivity were increased by 100%. This indicates that contribution of more Co clusters to the magnetic properties of the films is greater than that of Vo.



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Relationships between degree of milling and loss of Vitamin B, minerals, and change in amino acid composition of brown rice

Publication date: 1 September 2017
Source:LWT - Food Science and Technology, Volume 82
Author(s): Kun-lun Liu, Jia-bao Zheng, Fu-sheng Chen
The effects of the degree of milling (DOM) on amino acid composition, thiamine, riboflavin, phytic acid (PA), and mineral (Mg, Fe, Zn, Mn, Cu, Ca, Se, and Pb) contents of japonica Xinfeng 2 and indica T-You 15 brown rice were investigated. Almost all amino acids slightly decreased as DOM increased. Quadratic and linear relationships were observed between DOM and milling time at 0–30 s and 30–100 s, respectively. Thiamine and riboflavin content decreased linearly as DOM increased. Approximately 57.6–65.4% of thiamine and 40.3–45.7% of riboflavin were removed after 30 s of milling (DOM = ca. 9%). Considerable losses were observed for PA, Mg, Mn, Fe, and Pb during milling (DOM = ca. 9%), whereas the losses of Ca, Cu, Zn, and Se were relatively lower. In addition, the linear correlations of Mg, Mn, Pb, and Fe levels with PA concentration were revealed. These results indicate that DOM should be supervised to improve nutrient utilization and appropriately control toxic metal contamination.

Graphical abstract

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