Head and Neck Diseases by Alexandros G.Sfakianakis: 06/11/17

Κυριακή 11 Ιουνίου 2017

Ponto 3 SuperPower, New Treatment Option to BAHS Patients

An overview of Ponto 3 superpower bone anchored hearing system, patient benefits, outcomes with its directionality system, and fitting aspects for professionals.

http://ift.tt/2r9GlQo

20Q: EMA Methodology - Research Findings and Clinical Potential

an overview of Ecological Momentary Assessment (EMA), its relevance to audiology research and practice, a review of key studies using this methodology, and a look at potential future applications.

http://ift.tt/2r9IjQU

Data Logging - Hearing Aid Behavior in the Real World

This course will examine the information available in the Starkey Inspire Data Log and applications for using that information to enhance the patient's journey with amplification.

http://ift.tt/2r9db4h

Transnasal endoscopic ultrasound-guided reduction of maxillary sinus wall fracture

Abstract

Surgical morbidity from open reduction and internal fixation (ORIF) of maxillary sinus wall fracture often surpasses the benefits of ORIF. Hence, the authors devised transnasal endoscopic-assisted reduction of maxillary sinus wall fracture (TERM) without internal fixation as a minimally invasive surgery for maxillary sinus wall fracture. The purpose of this study was to investigate the feasibility of TERM in cadavers and patients. Six cadavers were dissected to evaluate the feasibility of TERM. In addition, 20 patients with maxillary sinus wall fractures who underwent TERM in a tertiary hospital from August of 2013 to December of 2015 were enrolled in this study. Demographic factors, type of anesthesia, computed tomography (CT) scans, clinical characteristics of patients, and patient satisfaction with surgery were analyzed. Cadaveric study showed that endoscopic inferior meatus antrostomy is a feasible method of approaching the maxillary sinus wall in cadavers. In addition, counterforce could be applied to the maxillary sinus wall by pushing packed Vaseline-soaked gauze or using a zygomatic process approach via a Gillies incision. Clinical experience revealed that patients experienced good facial contour restoration postoperatively. The extent of fractured bony segments was reduced on postoperative CT without complications. Patient satisfaction with TERM was greater than that with ORIF (p = 0.031). TERM showed its feasibility in both cadaveric study and clinical study. TERM can be a good alternative to ORIF, especially in patients who are reluctant to undergo a facial incision.

http://ift.tt/2rh3DYN

Transnasal endoscopic ultrasound-guided reduction of maxillary sinus wall fracture

Abstract

http://ift.tt/2rh3DYN

A study on the oil-based drilling cutting pyrolysis residue resource utilization by the exploration and development of shale gas

Abstract

Based on the requirement of national energy conservation and environmental protection, attention has been given to building an environment-friendly and resource-saving society. Shale gas oil-based drilling cutting pyrolysis residues (ODPRs) have been used as the main research object to developing new technology which can convert the residues into a harmless and recyclable material. Using the test data of ODPR, we analyze the development prospect in the building material industry and provide a scheme to utilize this particular solid-waste efficiently. Theoretically speaking, the ODPR resource utilization such as admixture of cement, making sintered brick, and non-fired brick, by the exploration and development of Fuling shale gas is feasible.

http://ift.tt/2r9CyTm

Research on nutrient pollution load in Lake Taihu, China

Abstract

The eutrophication of Lake Taihu is the joint result of internal and external pollution. Research on the sources and flux loads of total nitrogen (TN) and total phosphorus (TP) has great significance for the control and management of the eutrophication issues facing Lake Taihu. We used hydrologic and water quality surveys of the surrounding rivers, precipitation investigations, and an experimental simulation of suspended sediment to analyze the sources of TN and TP to Lake Taihu and to estimate the flux loads of TN and TP. Our results indicate that (1) surrounding rivers, atmospheric deposition, and sediment suspension were the three main sources of TN and TP, with annual flux loads of 29.6 thousand t and 2.8 thousand t, respectively; (2) for the flux load of TN, influxes from surrounding rivers accounted for 61.1%, while atmospheric deposition contributed 23.5%, with both of these sources varying seasonally. Total nitrogen released from sediments contributed 15.4% of the TN load of Lake Taihu; (3) for TP flux load, surrounding rivers accounted for 42.8% and also showed seasonal variation. Atmospheric deposition and sediment release accounted for 17.9 and 39.3% with no significant seasonal variation. This article quantitatively analyzed the sources and loads of TN and TP and provided a basis for pollution control in Lake Taihu.

http://ift.tt/2ssEgD9

Perioperative goal-directed therapy with uncalibrated pulse contour methods: impact on fluid management and postoperative outcome

Abstract

Previous meta-analyses suggest that perioperative goal-directed therapy (GDT) is useful to decrease postoperative morbidity. Most GDT studies analysed were done with pulmonary artery catheters, oesophageal Doppler and calibrated pulse contour methods. Uncalibrated pulse contour (uPC) techniques are an appealing alternative but their accuracy has been questioned. The effects of GDT on fluid management (volumes and volume variability) remain unclear. We performed a meta-analysis of randomized controlled trials investigating the effects of GDT with uPC methods on postoperative outcome. The primary endpoint was postoperative morbidity. Fluid volumes and fluid volume variability (standard deviation/mean) over the GDT period were also studied. Nineteen studies met the inclusion criteria (2159 patients). Postoperative morbidity was reduced with GDT (OR 0.46, 95% CI 0.30–0.70, P<0.001). The volume of colloids was higher [weighted mean difference (WMD) +345 ml, 95% CI 148–541 ml, P<0.001] and the volume of crystalloids was lower (WMD –429 ml, 95% CI –634 to –224 ml, P<0.01) in the GDT group than in the control group. However, the total volume of fluid (WMD –220 ml, 95% CI –590 to 150 ml, P=0.25) and the variability of fluid volume (34% vs 33%, P=0.98) were not affected by GDT. The use of GDT with uPC techniques was associated with a decrease in postoperative morbidity. It was not associated with an increase in total fluid volume nor with a decrease in fluid volume variability.

http://ift.tt/2r9IpZ1

Perioperative goal-directed therapy with uncalibrated pulse contour methods: impact on fluid management and postoperative outcome

Abstract

Modified Frailty Index Score and Perioperative Risk in Laryngectomy : The 11 Variables Included in Modified Frailty Index Assessment : History of diabetes Functional status (not independent at baseline) History of pneumonia or chronic obstructive pulmonary disease History of congestive cardiac failure History of myocardial infarction History of percutaneous coronary intervention, stent placement, or angina History of hypertension (requiring medical treatment) History of peripheral vascular disease or ischemic rest pain History of impaired sensorium History of transient ischemic attack or cerebrovascular accident History of cerebrovascular accident with neurologic deficit

http://orlhealth.blogspot.com/2017/06/modified-frailty-index-score-and.html

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

6948891480

alsfakia@gmail.com

Barking Cough

https://youtu.be/IgZuVo81298?t=33

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

6948891480

alsfakia@gmail.com

Bovine cough

http://orlhealth.blogspot.com/2017/06/hoarse-voice-and-bovine-cough.html

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

6948891480

alsfakia@gmail.com

Hyperspectral X-ray transmission imaging................................3D chemical imaging

http://orlhealth.blogspot.com/2017/06/hyperspectral-x-ray-transmission.html

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

6948891480

alsfakia@gmail.com

Technique: Sizing up tumours with Tuba-seq

http://ift.tt/2sdfEho

Network propagation: a universal amplifier of genetic associations

Network propagation is based on the principle that genes underlying similar phenotypes are more likely to interact with each other. It is proving to be a powerful approach for extracting biological information from molecular networks that is relevant to human disease.

http://ift.tt/2tbfeFi

Persistent lesion hyperintensity on brain diffusion-weighted MRI

http://orlhealth.blogspot.com/2017/06/persistent-lesion-hyperintensity-on.html

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

6948891480

alsfakia@gmail.com

Nausea, vomiting, loss of appetite and oliguria : haemoglobin =12.7 g/dL, indirect bilirubin =2.0 mg/dL, haptoglobin ≤6 mg/dL, platelet count =121 000/μL and schistocytes on peripheral smear.

http://orlhealth.blogspot.com/2017/06/nausea-vomiting-loss-of-appetite-and.html

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

6948891480

alsfakia@gmail.com

Estimation of distal arm joint angles from EMG and shoulder orientation for transhumeral prostheses

Publication date: Available online 11 June 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Aadeel Akhtar, Navid Aghasadeghi, Levi Hargrove, Timothy Bretl
In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R2=0.72) and mirrored bilateral (R2=0.72) reaches and of forearm pronation/supination during unilateral (R2=0.77) and mirrored bilateral (R2=0.70) reaches. We also show that adding forearm EMG further improves the prediction of forearm pronation/supination during unilateral (R2=0.82) and mirrored bilateral (R2=0.75) reaches. In principle, these results provide the basis for choosing inputs for control of transhumeral prostheses, both by subjects with targeted motor reinnervation (when forearm EMG is available) and by subjects without target motor reinnervation (when forearm EMG is not available). In particular, we confirm that shoulder orientation and upper-arm EMG together best predict elbow flexion/extension (R2=0.72) for three subjects with unilateral transhumeral amputations and targeted motor reinnervation. However, shoulder orientation alone best predicts forearm pronation/supination (R2=0.88) for these subjects, a contradictory result that merits further study.

http://ift.tt/2r9b2Fo

PRELIM II(EDI BOARD)

Publication date: June 2017
Source:Neuroscience Research, Volume 119

http://ift.tt/2sRTqzm

True lab-in-a-syringe technology for bioassays

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Lenka Hárendarčíková, Daniel Baron, Andrea Šebestová, Jan Rozsypal, Jan Petr
In our work, we introduced a novel concept of the lab-in-a-syringe tests. We solved the problem of detection in already published LIS tests by putting all the reaction and detection pads directly into the syringe barrel. We also used more layers to make the results visible for users. Two detection layouts: (i) with using rounded pads-based detection, and (ii) with using rectangular detection pads, were studied. As the proof of concept, we studied the determination of Ni(II) using dimethylglyoxime as the reagent and blocking of the interference of Fe(II). The calibrations for Ni(II) at the optimal conditions has excellent R² of 0.998 with production costs of 0.2 USD per one test.

Graphical abstract

http://ift.tt/2rflLm9

Publication date: July–August 2017
Source:Clinical Imaging, Volume 44

http://ift.tt/2rPJR5h

Prevalence and clinical significance of incidental extra-mammary findings in breast magnetic resonance imaging: A retrospective study of 1070 patients

Publication date: Available online 10 June 2017
Source:Clinical Imaging
Author(s): Wieland Staab, Jan Menke, Christian Sohns, Susanne Wienbeck, Lukas Bauer, Johannes Tammo Kowallick, Frank Konietschke, Thorsten Derlin, Joachim Lotz, Jan Martin Sohns
PurposeThe purpose of this study was to analyze the prevalence of extra-mammary findings in magnetic resonance imaging (MRI).Materials and methodsData from 1070 consecutive breast MRI studies was analyzed. MR-BI-RADS (Breast Imaging Reporting and Data System) was used to classify the risk category.ResultsAccording to MR-BI-RADS, 915 (85.5%) of 1070 women were classified into MR-BI-RADS categories 1–3, and 155 (14.5%) into MR-BI-RADS categories 4–5. MR-BI-RADS categories 4–5 had a 10-times higher risk for major extra-mammary findings (odds ratio 10.1, P<0.01).ConclusionExtra-mammary findings are common and may have important clinical consequences.

http://ift.tt/2rkRjSx

Spinal epidural involvement in Erdheim-Chester disease: 18F-FDG PET/CT findings

Publication date: Available online 11 June 2017
Source:Revista Española de Medicina Nuclear e Imagen Molecular
Author(s): A. Biyi, H. Ennouali, S.N. Oueriagli, S.E. Moussaoui, M. Rabhi, A. Doudouh

http://ift.tt/2ta46IV

Error-prone bypass of O6-methylguanine by DNA polymerase of Pseudomonas aeruginosa phage PaP1

Publication date: Available online 10 June 2017
Source:DNA Repair
Author(s): Shiling Gu, Jingyuan Xiong, Ying Shi, Jia You, Zhenyu Zou, Xiaoying Liu, Huidong Zhang
O⁶-Methylguanine (O⁶-MeG) is highly mutagenic and is commonly found in DNA exposed to methylating agents, generally leads to G:C to A:T mutagenesis. To study DNA replication encountering O⁶-MeG by the DNA polymerase (gp90) of P. aeruginosa phage PaP1, we analyzed steady-state and pre-steady-state kinetics of nucleotide incorporation opposite O⁶-MeG by gp90 exo⁻. O⁶-MeG partially inhibited full-length extension by gp90 exo⁻. O⁶-MeG greatly reduces dNTP incorporation efficiency, resulting in 67-fold preferential error-prone incorporation of dTTP than dCTP. Gp90 exo⁻ extends beyond T:O⁶-MeG 2-fold more efficiently than C:O⁶-MeG. Incorporation of dCTP opposite G and incorporation of dCTP or dTTP opposite O⁶-MeG show fast burst phases. The pre-steady-state incorporation efficiency (kpol/Kd,dNTP) is decreased in the order of dCTP:G > dTTP:O⁶-MeG > dCTP:O⁶-MeG. The presence of O⁶-MeG at template does not affect the binding affinity of polymerase to DNA but it weakened their binding in the presence of dCTP and Mg²⁺. Misincorporation of dTTP opposite O⁶-MeG further weakens the binding affinity of polymerase to DNA. The priority of dTTP incorporation opposite O⁶-MeG is originated from the fact that dTTP can induce a faster conformational change step and a faster chemical step than dCTP. This study reveals that gp90 bypasses O⁶-MeG in an error-prone manner and provides further understanding in DNA replication encountering mutagenic alkylation DNA damage for P. aeruginosa phage PaP1.

http://ift.tt/2t9Lx7B

MFHAS1 suppresses TLR4 signaling pathway via induction of PP2A C subunit cytoplasm translocation and inhibition of c-Jun dephosphorylation at Thr239

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Qiqing Shi, Bo Xiong, Jing Zhong, Huihui Wang, Duan Ma, Changhong Miao
TLR4, an important Toll-like receptor in innate immunity, can be activated by LPS and induce proinflammatory cytokines to resist invasion of pathogenic microorganism, but excessive inflammation can trigger tissue injury. Many genes negatively regulate TLR4 signaling pathway. Recent studies found that malignant fibrous histiocytoma amplified sequence 1 (MFHAS1) suppressed the expression of cytokine IL6 in Raw264.7 cells stimulated by LPS, but the mechanisms remained unclear. This study investigated the role of MFHAS1 in TLR4 signaling pathway and the possible mechanisms implicated. The results indicated that the expression of MFHAS1 was significantly increased in cells stimulated with LPS. Up-regulation of MFHAS1 effectively suppressed inflammatory cytokine expression in cells exposed to LPS, whereas down-regulation of MFHAS1 markedly increased inflammatory cytokines expression. Co-immunoprecipitation, pull-down and immunofluorescence tests demonstrated that MFHAS1 combined with the B and C subunits of PP2A and induced cytoplasm translocation of the C subunit, leading to decrease dephosphorylation of c-Jun at Thr239 and increase degradation of c-Jun. Reduction of c-Jun protein results in decreased AP-1 activity, which is independent of inhibition of JNK or p38MAPK phosphorylation. Taken together, these results indicate that MFHAS1 suppresses TLR4 signaling pathway through induction of PP2A C subunit cytoplasm translocation and subsequent c-Jun degradation, leading finally to decrease AP-1 activity and cytokines expression.

http://ift.tt/2s0fKXm

MFHAS1 suppresses TLR4 signaling pathway via induction of PP2A C subunit cytoplasm translocation and inhibition of c-Jun dephosphorylation at Thr239

Enhancing data visualisation to capture the simulator sickness phenomenon: On the usefulness of radar charts

Publication date: August 2017
Source:Data in Brief, Volume 13
Author(s): Romain Chaumillon, Thomas Romeas, Charles Paillard, Delphine Bernardin, Guillaume Giraudet, Jean-François Bouchard, Jocelyn Faubert
The data presented in this article are related to the research article entitled "The use of transdermal scopolamine to solve methodological issues raised by gender differences in susceptibility to simulator sickness" (Chaumillon et al., 2017) [1]. In an outstanding first demonstration, Kennedy et al. [2] showed that the Simulator Sickness Questionnaire (SSQ) is an appropriate tool to suit the purposes of characterizing motion sickness experienced in virtual environments. This questionnaire has since been used in many scientific studies. Recently, Balk et al. [3] suggested that the proposed segregation of SSQ scores into three subclasses of symptoms might limit the accuracy of simulator sickness assessment. These authors performed a factor analysis based on SSQ scores obtained from nine studies on driving simulators. Although their factor analysis resulted in the same three orthogonal classes of symptoms as Kennedy et al. [2], unlike this pioneering study, no items were attributed to more than one factor and five items were not attributed to any class of symptoms. As a result, they claimed that an exploration of each item score should give additional cues on individual profiles. To gain a better characterization of such item-by-item exploration, data utilised in this research are shown using a radar chart visualisation.

http://ift.tt/2t9wIBR

Residual Stress Distribution Analysis of Heat Treated APS TBC Using Image Based Modelling

Publication date: Available online 11 June 2017
Source:Data in Brief
Author(s): Chun Li, Xun Zhang, Ying Chen, James Carr, Simon Jacques, Julia Behnsen, Marco di Michiel, Ping Xiao, Robert Cernik
We carried out a residual stress distribution analysis in a APS TBC throughout the depth of the coatings. The samples were heat treated at 1150°C for 190h and the data analysis used image based modelling based on the real 3D images measured by Computed Tomography (CT). The stress distribution in several 2D slices from the 3D model is included in this paper as well as the stress distribution along several paths shown on the slices. Our analysis can explain the occurrence of the "jump" features near the interface between the top coat and the bond coat. These features in the residual stress distribution trend were measured (as a function of depth) by high-energy synchrotron XRD (as shown in our related research article entitled 'Understanding the Residual Stress Distribution through the Thickness of Atmosphere Plasma Sprayed (APS) Thermal Barrier Coatings (TBCs) by high energy Synchrotron XRD; Digital Image Correlation (DIC) and Image Based Modelling') [1].

http://ift.tt/2sbNWS5

Experiments on deformation behaviour of functionally graded NiTi structures

Publication date: Available online 10 June 2017
Source:Data in Brief
Author(s): Bashir S. Shariat, Qinglin Meng, Abdus S. Mahmud, Zhigang Wu, Reza Bakhtiari, Junsong Zhang, Fakhrodin Motazedian, Hong Yang, Gerard Rio, Tae-hyun Nam, Yinong Liu
Functionally graded NiTi structures benefit from the combination of the smart properties of NiTi and those of functionally graded structures. This article provides experimental data for thermomechanical deformation behaviour of microstructurally graded, compositionally graded and geometrically graded NiTi alloy components, related to the research article entitled "Functionally graded shape memory alloys: design, fabrication and experimental evaluation" (Shariat et al., 2017) [1]. Stress-strain variation of microstructurally graded NiTi wires is presented at different heat treatment conditions and testing temperatures. The complex 4-way shape memory behaviour of a compositionally graded NiTi strip during one complete thermal cycle is demonstrated. The effects of geometrical design on pseudoelastic behaviour of geometrically graded NiTi plates over tensile loading cycles are presented on the stress-strain diagrams.

http://ift.tt/2t9THge

Transoral thyroidectomy and parathyroidectomy – A North American series of robotic and endoscopic transoral approaches to the central neck

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Jonathon O. Russell, James Clark, Salem I. Noureldine, Angkoon Anuwong, Mai G. Al Khademh, Hoon Yub Kim, Vaninder K. Dhillon, Gianlorenzo Dionigi, Ralph P. Tufano, Jeremy D. Richmon
ObjectiveMost thyroid surgery in North America is completed via a cervical incision, which leaves a permanent scar. Approaches without cutaneous incisions offer aesthetic advantages. This series represents the largest series of transoral vestibular approaches to the central neck in North America, and the first published reports of robotic transoral vestibular thyroidectomy for thyroid carcinoma.Materials and methodsData was prospectively collected for patients that underwent transoral vestibular approach thyroidectomy and/or parathyroidectomy between April 2016 and February 2017.ResultsFifteen patients underwent the procedure for removal of the thyroid (n=12), parathyroid (n=2) or both thyroid and parathyroid glands (n=1). The first case was converted to an open procedure. Fourteen were completed through these remote access incisions, including patients with a body mass index as high as 44. There were no permanent complications. The postoperative median Dermatology Life Quality Index score was 3, which indicates a small effect on quality of life.ConclusionThe transoral vestibular approach to the central neck is a promising technique for patients who desire to optimize aesthetics.

http://ift.tt/2siaZvc

Prognostic value of the eighth edition AJCC TNM classification for differentiated thyroid carcinoma

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Tae Hyuk Kim, Young Nam Kim, Hye In Kim, So Young Park, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim, Young Lyun Oh, Soo Yeon Hahn, Jung Hee Shin, Kyunga Kim, Jong Gill Jeong, Sun Wook Kim, Jae Hoon Chung
BackgroundThe prognostic value of the proposed eighth edition of the American Joint Committee on Cancer (AJCC) tumor, node, and metastasis (TNM) classification is currently unclear. The aim of the study was to evaluate the prognostic value of the eighth edition of the AJCC TNM classification.MethodsWe retrospectively assessed 3176 patients with differentiated thyroid carcinoma (DTC) who underwent thyroidectomy at a tertiary Korean hospital from 1996 to 2005. Cancer-specific survival (CSS) was analyzed using the Kaplan–Meier method and compared using the log-rank test. Performance of the eighth edition TNM with respect to prediction of CSS was assessed against the current seventh edition.ResultsUpon reclassification according to the eighth edition, 37.6% of patients were down-staged. The proportions of stage I and II tumors increased from 61.9% to 81.1% and from 1.7% to 16.0%, respectively, whereas those of stage III and IVB (formerly IVC in the seventh edition) decreased from 27.6% to 2.3% and 0.8% to 0.5%, respectively. The proportions of variance explained (PVEs) for the ability of the eighth and the seventh edition to predict CSS were 3.9% and 2.9%, respectively. The C-index values were 0.765 (95% confidence interval 0.764–0.766) for the eighth edition and 0.736 (0.735–0.737) for the seventh edition.ConclusionOur results demonstrate that the eighth edition TNM more accurately predicts CSS for patients with DTC than does the seventh edition.

http://ift.tt/2sRiaHP

Dose-dependent enhancement of T-lymphocyte priming and CTL lysis following ionizing radiation in an engineered model of oral cancer

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Megan Morisada, Ellen C. Moore, Rachel Hodge, Jay Friedman, Harrison A. Cash, James W. Hodge, James B. Mitchell, Clint T. Allen
ObjectivesDetermine if direct tumor cell cytotoxicity, antigen release, and susceptibility to T-lymphocyte killing following radiation treatment is dose-dependent.Materials and methodsMouse oral cancer cells were engineered to express full-length ovalbumin as a model antigen. Tumor antigen release with uptake and cross presentation of antigen by antigen presenting cells with subsequent priming and expansion of antigen-specific T-lymphocytes following radiation was modeled in vitro and in vivo. T-lymphocyte mediated killing was measured following radiation treatment using a novel impedance-based cytotoxicity assay.ResultsRadiation treatment induced dose-dependent induction of executioner caspase activity and apoptosis in MOC1 cells. In vitro modeling of antigen release and T-lymphocyte priming demonstrated enhanced proliferation of OT-1 T-lymphocytes with 8Gy treatment of MOC1ova cells compared to 2Gy. This was validated in vivo following treatment of established MOC1ova tumors and adoptive transfer of antigen-specific T-lymphocytes. Using a novel impedance–based cytotoxicity assay, 8Gy enhanced tumor cell susceptibility to T-lymphocyte killing to a greater degree than 2Gy.ConclusionIn the context of using clinically-relevant doses of radiation treatment as an adjuvant for immunotherapy, 8Gy is superior to 2Gy for induction of antigen-specific immune responses and enhancing tumor cell susceptibility to T-lymphocyte killing. These findings have significant implications for the design of trials combining radiation and immunotherapy.

http://ift.tt/2shFJfP

The impact of a head and neck microvascular fellowship program on otolaryngology resident training

Objective

To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience.

Study Design

Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey.

Methods

A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship. An electronic survey was distributed to senior residents at all U.S. otolaryngology residency programs to determine residents' perceptions of a H&N fellow's impact on their surgical experience. An electronic survey was distributed to senior medical students applying to surgical residencies to explore the perceived impact that a fellowship has on the desirability of a residency program.

Results

The average number of each postgraduate year (PGY)5's H&N KIC before and after the addition of the fellowship were: parotidectomy, 19 versus 17.8; neck dissection, 33.2 versus 40.6; oral cavity resection, 15.3 versus 12.6; thyroid/parathyroid, 45.5 versus 45.6; and flaps/grafts, 56.7 versus 42. PGY5 participation as first assistant in free flaps dropped from 78% to 17%; however, residents still participated in some aspect of 45% of the cases. Seventy percent of senior residents reported a positive perception of the H&N fellow on their H&N operative experience. Eighty-nine percent of senior medical student respondents reported a nonnegative perception of a fellowship in their applied field.

Conclusion

The addition of a H&N fellowship did not decrease senior residents' H&N KIC, and most senior residents at programs with fellowships report that the fellow has a positive impact on their H&N operative experience.

Level of Evidence

4. Laryngoscope, 2017

http://ift.tt/2rkx2g0

The impact of a head and neck microvascular fellowship program on otolaryngology resident training

Objective

To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience.

Study Design

Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey.

Methods

Results

Conclusion

Level of Evidence

4. Laryngoscope, 2017

http://ift.tt/2rkx2g0

Automatic segmentation of the lumen region in intravascular images of the coronary artery

Publication date: Available online 10 June 2017
Source:Medical Image Analysis
Author(s): Danilo Samuel Jodas, Aledir Silveira Pereira, João Manuel R.S. Tavares
Image assessment of the arterial system plays an important role in the diagnosis of cardiovascular diseases. The segmentation of the lumen and media-adventitia in intravascular (IVUS) images of the coronary artery is the first step towards the evaluation of the morphology of the vessel under analysis and the identification of possible atherosclerotic lesions. In this study, a fully automatic method for the segmentation of the lumen in IVUS images of the coronary artery is presented. The proposed method relies on the K-means algorithm and the mean roundness to identify the region corresponding to the potential lumen. An approach to identify and eliminate side branches on bifurcations is also proposed to delimit the area with the potential lumen regions. Additionally, an active contour model is applied to refine the contour of the lumen region. In order to evaluate the segmentation accuracy, the results of the proposed method were compared against manual delineations made by two experts in 326 IVUS images of the coronary artery. The average values of the Jaccard measure, Hausdorff distance, percentage of area difference and Dice coefficient were 0.88 ± 0.06, 0.29 ± 0.17 mm, 0.09 ± 0.07 and 0.94 ± 0.04, respectively, in 324 IVUS images successfully segmented. Additionally, a comparison with the studies found in the literature showed that the proposed method is slight better than the majority of the related methods that have been proposed. Hence, the new automatic segmentation method is shown to be effective in detecting the lumen in IVUS images without using complex solutions and user interaction.

Graphical abstract

http://ift.tt/2rfaoKU

Decreased expression of the ATM gene linked to poor prognosis for gastric cancer of different nationalities in Xinjiang

Publication date: Available online 10 June 2017
Source:Pathology - Research and Practice
Author(s): Mei Han, Lanying Ma, Yanli Qu, Yong Tang
ObjectiveTo explore the clinicopathological significance of ATM gene in the occurrence and prognosis of gastric cancer (GC) from different nationalities in Xinjiang.MethodThe expression of ATM in 385 patients with GC (including 98 Uygurs, 231 Hans and 56 Kazaks) and its corresponding adjacent tissues were examined by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry assay to, analyze its correlations with clinicopathological features and prognosis of GC.ResultsThe ATM expression in GC tissues was significantly decreased when compared to that in adjacent normal tissues of Uygur, Han and Kazak patients in Xinjiang, while Uygurs and Kazaks were much lower than Hans in the ATM expression of GC tissues (all P <0.05). Kaplan-Meier analysis showed that Uygur and Kazak patients with ATM-negative tumors had a markedly lower survival rate than patients in Hans (P=0.028), and GC patients with ATM negative expression presented more unfavorable overall survival rate than those with positive expression among the three different nationalities (all P <0.05). Multivariate Cox regression analysis revealed that nationality, ATM expression, TNM staging, depth of invasion, and lymph node metastasis were independent factors affecting the prognosis of GC patients in Xinjiang (all P < 0.05).ConclusionATM was downregulated in GC patients in Xinjiang, especially for Uygurs and Kazaks, which suggested ATM to be an independent indicator of prognosis for GC therapy.

http://ift.tt/2sbtOQ0

An Atypical Presentation of Paget’s Disease of the Breast without Nipple Involvement: Case Report and Review of the Literature

Publication date: Available online 10 June 2017
Source:Pathology - Research and Practice
Author(s): Justine S. Broecker, Charles W. Sewell, Bahig M. Shehata, Bahar Memis, Nazmi V. Adsay, Toncred M. Styblo
We present a case of a 63 year-old Caucasian female who developed a right breast skin lesion discrete from the nipple that was subsequently diagnosed as Paget's Disease of the breast (PDB). Imaging did not reveal an underlying breast cancer or involvement of the nipple. The patient underwent a segmental mastectomy preserving the nipple and final pathology demonstrated residual Paget's disease of the skin and did not reveal any additional underlying breast carcinoma. To our knowledge, this case represents the first reported diagnosed case of isolated PDB without nipple involvement.

http://ift.tt/2t9AvPR

Combined primary hepatic neuroendocrine carcinoma and hepatocellular carcinoma with aggressive biological behavior (adverse clinical course): A case report

Publication date: Available online 10 June 2017
Source:Pathology - Research and Practice
Author(s): Yukihiko Okumura, Kenichi Kohashi, Huanlin Wang, Masaki Kato, Yoshihiko Maehara, Yoshihiro Ogawa, Yoshinao Oda
Combined primary hepatic neuroendocrine carcinoma (PHNEC) and hepatocellular carcinoma (HCC) is a very rare malignant hepatic tumor. Its prognosis and histological features are uncertain. Here we report the case of such a tumor in a 70-year-old male Japanese patient with adverse prognosis. The patient underwent a right hepatic lobectomy for a tumor mass that measured 11×10cm in diameter located in the right lobe of the liver, treated with transcatheter arterial chemoembolization (TACE) and percutaneous transhepatic portal vein embolization (PTPE) therapy five weeks before the operation. Histologically, the hepatic tumor was composed of predominantly HCC and admixed with a small part of neuroendocrine carcinoma (NEC). The NEC component was distributed as a collision-type tumor separated by fibrous bands from HCC and the combined-type tumor, focally intermingling with HCC. One month after the surgery, metastasis to abdominal lymph nodes and the lumbar vertebra was detected. Although the additional treatments of systematic chemotherapy and radiation therapy were performed, the patient died 3 months after the initial surgery.

http://ift.tt/2sbF4vH

Nuclear β-catenin positivity as a predictive marker of long-term survival in advanced epithelial ovarian cancer

Publication date: Available online 10 June 2017
Source:Pathology - Research and Practice
Author(s): Bence Nagy, László Tóth, Péter Molnár, Gábor Méhes, László Thurzó, Róbert Póka, Zoltán Hernádi

http://ift.tt/2t9mQs7

A polymethoxyflavone mixture extracted from orange peels, mainly containing nobiletin, 3,3’,4’,5,6,7,8-heptamethoxyflavone and tangeretin, suppresses melanogenesis through the acidification of cell organelles, including melanosomes

Publication date: Available online 10 June 2017
Source:Journal of Dermatological Science
Author(s): Norihiro Yoshizaki, Ron Hashizume, Hitoshi Masaki
BackgroundSkin color is determined by melanin contents and its distribution. Melanin is synthesized in melanosomes of melanocytes, catalyzed by tyrosinase, melanogenic enzymes. Regarding the process of melanin synthesis, melanosomal pH is considered to play an important role, because it has been reported to differ between Caucasian and Black melanocytes.ObjectiveAlthough polymethoxyflavone (PMF) has many beneficial effects, it has not been reported which PMF suppresses melanogenesis. In this study, we identified the mechanism underlying the effect of PMF on melanogenesisMethodsWe determined the effects of a PMF mixture extracted from orange peels on melanogenesis, on tyrosinase expression, on the localization of tyrosinase and on the acidification of organelles, including melanosomes, in HM3KO human melanoma cells.Results treatmentwith the PMF mixture elicited the suppression of melanogenesis, the degradation of tyrosinase in lysosomes and the mislocalization of tyrosinase associated with the acidification of intracellular organelles, including melanosomes. The neutralization of cell organelle pH by ammonium chloride restored melanogenesis and the correct localization of tyrosinase to melanosomes, which had been suppressed by the PMF mixture.ConclusionThese results suggest that the PMF mixture suppresses the localization of tyrosinase to melanosomes and consequently inhibits melanogenesis due to the acidification of cell organelles, including melanosomes.

http://ift.tt/2sbuIMz

Induction of skin-pathogenic Th22 cells by epicutaneous allergen exposure

Publication date: Available online 9 June 2017
Source:Journal of Dermatological Science
Author(s): Ivana Glocova, Jürgen Brück, Julia Geisel, Eva Müller-Hermelink, Katja Widmaier, Amir. S. Yazdi, Martin Röcken, Kamran Ghoreschi
BackgroundAtopic dermatitis (AD) is a common inflammatory skin disease with dysfunction of the skin barrier, an abnormal immune response and frequent allergies to environmental antigens like food antigens. Clinical observations suggest that certain diets can influence the course of AD.ObjectiveHere we compared the phenotype of food allergen-specific T cells activated through skin or gut allergen exposure to transfer skin inflammation into naïve recipients upon epicutaenous allergen challenge.MethodsOvalbumin (OVA) TCR-transgenic mice were treated epicutaneously with OVA or were fed OVA. CD4⁺ T cells from skin lymph nodes or mesenteric lymph nodes were transferred into naïve BALB/c mice, which were challenged with OVA epicutaneously. Skin inflammation was determined by histological parameters. In addition, we analyzed the phenotype of the immune response in lymphoid tissues and in skin tissue.ResultsTCR-transgenic T cells activated through epicutaneous or oral OVA exposure both migrate to skin lymph nodes after adoptive transfer and epicutaenous OVA exposure. AD-like skin inflammation could only be induced by the transfer of epicutaneously primed OVA T cells. Analysis of the immune phenotype demonstrated an IL-22/IL-17A-dominated immune phenotype of skin-pathogenic T cells.ConclusionIL-22 seems to be the critical cytokine for the development of AD and is induced in this model by epicutaneous sensitization with OVA.

http://ift.tt/2t9baFE

PLACK syndrome resulting from a new homozygous insertion mutation in CAST

Publication date: Available online 9 June 2017
Source:Journal of Dermatological Science
Author(s): Azzam Alkhalifah, Christine Chiaverini, Pascal Del Giudice, Chavalit Supsrisunjai, Chao-Kai Hsu, Lu Liu, Alexandra Charlesworth, John A. McGrath, Jean-Philippe Lacour

http://ift.tt/2sbc6fA

Keratinocytes as sensors and central players in the immune defense against Staphylococcus aureus in the skin

Publication date: Available online 10 June 2017
Source:Journal of Dermatological Science
Author(s): Katharina Bitschar, Christiane Wolz, Bernhard Krismer, Andreas Peschel, Birgit Schittek
Healthy human skin provides an effective mechanical as well as immunologic barrier against pathogenic microorganisms with keratinocytes as the main cell type in the epidermis actively participating and orchestrating the innate immune response of the skin. As constituent of the outermost layer encountering potential pathogens they have to sense signals from the environment and must be able to initiate a differential immune response to harmless commensals and harmful pathogens. Staphylococci are among the most abundant colonizers of the skin: Whereas Staphylococcus epidermidis is part of the skin microbiota and ubiquitously colonizes human skin, Staphylococcus aureus is only rarely found on healthy human skin, but frequently colonizes the skin of atopic dermatitis (AD) patients. This review highlights recent advances in understanding how keratinocytes as sessile innate immune cells orchestrate an effective defense against S. aureus in healthy skin and the mechanisms leading to an impaired keratinocyte function in AD patients.

http://ift.tt/2t901Vd

Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2)

Publication date: November 2017
Source:Addictive Behaviors, Volume 74
Author(s): Quyen Q. Tiet, Yani E. Leyva, Rudolf H. Moos, Brandy Smith
ObjectiveDrug use is prevalent and costly to society, but individuals with drug use disorders (DUDs) are under-diagnosed and under-treated, particularly in primary care (PC) settings. Drug screening instruments have been developed to identify patients with DUDs and facilitate treatment. The Drug Abuse Screening Test (DAST) is one of the most well-known drug screening instruments. However, similar to many such instruments, it is too long for routine use in busy PC settings. This study developed and validated a briefer and more practical DAST for busy PC settings.MethodWe recruited 1300 PC patients in two Department of Veterans Affairs (VA) clinics. Participants responded to a structured diagnostic interview. We randomly selected half of the sample to develop and the other half to validate the new instrument. We employed signal detection techniques to select the best DAST items to identify DUDs (based on the MINI) and negative consequences of drug use (measured by the Inventory of Drug Use Consequences). Performance indicators were calculated.ResultsThe two-item DAST (DAST-2) was 97% sensitive and 91% specific for DUDs in the development sample and 95% sensitive and 89% specific in the validation sample. It was highly sensitive and specific for DUD and negative consequences of drug use in subgroups of patients, including gender, age, race/ethnicity, marital status, educational level, and posttraumatic stress disorder status.ConclusionsThe DAST-2 is an appropriate drug screening instrument for routine use in PC settings in the VA and may be applicable in broader range of PC clinics.

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A rural/urban comparison of privacy and confidentiality concerns associated with providing sensitive location information in epidemiologic research involving persons who use drugs

Publication date: November 2017
Source:Addictive Behaviors, Volume 74
Author(s): Abby E. Rudolph, April M. Young, Jennifer R. Havens
BackgroundAnalyses that link contextual factors with individual-level data can improve our understanding of the "risk environment"; however, the accuracy of information provided by participants about locations where illegal/stigmatized behaviors occur may be influenced by privacy/confidentiality concerns that may vary by setting and/or data collection approach.MethodsWe recruited thirty-five persons who use drugs from a rural Appalachian town and a Mid-Atlantic city to participate in in-depth interviews. Through thematic analyses, we identified and compared privacy/confidentiality concerns associated with two survey methods that (1) collect self-reported addresses/cross-streets and (2) use an interactive web-based map to find/confirm locations in rural and urban settings.ResultsConcerns differed more by setting than between methods. For example, (1) rural participants valued interviewer rapport and protections provided by the Certificate of Confidentiality more; (2) locations considered to be sensitive differed in rural (i.e., others' homes) and urban (i.e., where drugs were used) settings; and (3) urban participants were more likely to view providing cross-streets as an acceptable alternative to providing exact addresses for sensitive locations and to prefer the web-based map approach.ConclusionRural-urban differences in privacy/confidentiality concerns reflect contextual differences (i.e., where drugs are used/purchased, population density, and prior drug-related arrests). Strategies to alleviate concerns include: (1) obtain a Certificate of Confidentiality, (2) collect geographic data at the scale necessary for proposed analyses, and (3) permit participants to provide intersections/landmarks in close proximity to actual locations rather than exact addresses or to skip questions where providing an intersection/landmark would not obfuscate the actual address.

http://ift.tt/2rOCtHu

Ischemic stroke complicating thrombolytic therapy with tenecteplase for ST elevation myocardial infarction: two case reports

Hemorrhagic complications are quite common in the rare cases where thrombolysis is performed. Ischemic stroke in the aftermath of thrombolysis for a ST elevation myocardial infarction is a very rare and parado...

http://ift.tt/2reAr4T

Elements and inorganic ions as source tracers in recent Greenland snow

Publication date: September 2017
Source:Atmospheric Environment, Volume 164
Author(s): Alexandra M. Lai, Martin M. Shafer, Jack E. Dibb, Chris M. Polashenski, James J. Schauer
Atmospheric transport of aerosols leads to deposition of impurities in snow, even in areas of the Arctic as remote as Greenland. Major ions (e.g. Na⁺, Ca²⁺, NH4⁺, K⁺, SO4²⁻) are frequently used as tracers for common aerosol sources (e.g. sea spray, dust, biomass burning, anthropogenic emissions). Trace element data can supplement tracer ion data by providing additional information about sources. Although many studies have considered either trace elements or major ions, few have reported both. This study determined total and water-soluble concentrations of 31 elements (Al, As, Ca, Cd, Ce, Co, Cr, Dy, Eu, Fe, Gd, K, La, Mg, Mn, Na, Nb, Nd, Pb, Pr, S, Sb, Si, Sm, Sn, Sr, Ti, V, U, Y, Zn) in shallow snow pits at 22 sampling sites in Greenland, along a transect from Summit Station to sites in the northwest. Black carbon (BC) and inorganic ions were measured in colocated samples. Sodium, which is typically used as a tracer of sea spray, did not appear to have any non-marine sources. The rare earth elements, alkaline earth elements (Mg, Ca, Sr), and other crustal elements (Fe, Si, Ti, V) were not enriched above crustal abundances relative to Al, indicating that these elements are primarily dust sourced. Calculated ratios of non-sea salt Ca (nssCa) to estimated dust mass affirm the use of nssCa as a dust tracer, but suggest up to 50% uncertainty in that estimate in the absence of other crustal element data. Crustal enrichment factors indicated that As, Cd, Pb, non-sea-salt S, Sb, Sn, and Zn were enriched in these samples, likely by anthropogenic sources. Principal component analysis indicated more than one crustal factor, and a variety of factors related to anthropogenically enriched elements. Analysis of trace elements alongside major tracer ions does not change interpretation of ion-based source attribution for sources that are well-characterized by ions, but is valuable for assessing uncertainty in source attribution and identifying sources not represented by major ions.

http://ift.tt/2rZvWIj

Ischemic stroke complicating thrombolytic therapy with tenecteplase for ST elevation myocardial infarction: two case reports

Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis.

Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis.

Laryngoscope. 2017 Jun 10;:

Authors: Mehlum CS, Rosenberg T, Dyrvig AK, Groentved AM, Kjaergaard T, Godballe C

Abstract
OBJECTIVES: The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non-neoplasia. We aimed to evaluate the ability of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia.
DATA SOURCES: PubMed, Embase, Cochrane, and Scopus databases.
REVIEW METHODS: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We systematically searched for publications from 2011 until 2016. All retrieved studies were reviewed and qualitatively assessed. The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created.
RESULTS: The combined sensitivity of five studies (n = 687) with Ni type IV-V defined as test-positive was 0.89 (95% confidence interval [CI]: 0.76-0.95), and specificity was 0.82 (95% CI: 0.72-0.89). The equivalent combined sensitivity of four studies (n = 624) with Ni type V defined as test-positive was 0.82 (95% CI: 0.75-0.87), and specificity was 0.93 (95% CI: 0.82-0.97).
CONCLUSIONS: The diagnostic accuracy of the Ni classification in predicting neoplasia was high, without significant difference between the two analyzed cutoff values. Implementation of the proposed ELS classification of vascular changes seems reasonable from a clinical perspective, with comparable accuracy. Attention must be drawn to the accompanying risk of exposing patients to unnecessary surgery. Laryngoscope, 2017.

PMID: 28600823 [PubMed - as supplied by publisher]

http://ift.tt/2sQksa4

Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo).

Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo).

BMJ Open. 2017 Jun 08;7(6):e016505

Authors: Maret-Ouda J, Wahlin K, Artama M, Brusselaers N, Färkkilä M, Lynge E, Mattsson F, Pukkala E, Romundstad P, Tryggvadóttir L, Euler-Chelpin MV, Lagergren J

Abstract
PURPOSE: To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk of cancers, other diseases and mortality.
PARTICIPANTS: Included were individuals with a GORD diagnosis recorded in any of the nationwide patient registries in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1964-2014 (with various start and end years in different countries). Data regarding cancer, other diseases and mortality were retrieved from the nationwide registries for cancer, patients and causes of death, respectively.
FINDINGS TO DATE: The NordASCo includes 945 153 individuals with a diagnosis of GORD. Of these, 48 433 (5.1%) have undergone primary antireflux surgery. Median age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries.
FUTURE PLANS: The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents.

PMID: 28600380 [PubMed - in process]

http://ift.tt/2r7mMbL

Effects of thiopentone, propofol and alfaxalone on laryngeal motion during oral laryngoscopy in healthy dogs.

Effects of thiopentone, propofol and alfaxalone on laryngeal motion during oral laryngoscopy in healthy dogs.

Vet Anaesth Analg. 2017 Mar 03;:

Authors: Smalle TM, Hartman MJ, Bester L, Buck RK, Fosgate GT, Zeiler GE

Abstract
OBJECTIVE: To compare the effects of thiopentone, propofol and alfaxalone on arytenoid cartilage motion and establish the dose rates to achieve a consistent oral laryngoscopy examination.
STUDY DESIGN: Randomised crossover study.
ANIMALS: Six healthy adult Beagle dogs.
METHODS: Each dog was randomly administered three induction agents with a 1-week washout period between treatments. Thiopentone (7.5 mg kg(-1)), propofol (3 mg kg(-1)) or alfaxalone (1.5 mg kg(-1)) was administered over 1 minute for induction of anaesthesia. If the dog was deemed inadequately anaesthetised, then supplemental boluses of 1.8, 0.75 and 0.4 mg kg(-1) were administered, respectively. Continual examination of the larynx, using a laryngoscope, commenced once an adequate anaesthetic depth was reached until examination end point. The number of arytenoid motions and vital breaths were counted during three time periods and compared over time and among treatments. Data were analysed using Friedman and Mann-Whitney U tests, Spearman rho and a linear mixed model with post hoc pairwise comparison with Tukey correction.
RESULTS: The median (range) induction and examination times were 2.8 (2.0-3.0), 2.7 (2.0-3.3) and 2.5 (1.7-3.3) minutes (p = 0.727); and 14.1 (8.0-41.8), 5.4 (3.3-14.8) and 8.5 (3.8-31.6) minutes (p = 0.016) for thiopentone, propofol and alfaxalone, respectively. The median dose rates required to achieve an adequate anaesthetic depth were 6.3 (6.0-6.6), 2.4 (2.4-2.4) and 1.2 (1.2-1.2) mg kg(-1) minute(-1), respectively. There was no significant difference for the total number of arytenoid motions (p = 0.662) or vital breaths (p = 0.789) among induction agents.
CONCLUSION AND CLINICAL RELEVANCE: The number of arytenoid motions were similar among the induction agents. However, at the dose rates used in this study, propofol provided adequate conditions for evaluation of the larynx with a shorter examination time which may be advantageous during laryngoscopy in dogs.

PMID: 28599889 [PubMed - as supplied by publisher]

http://ift.tt/2r7Kc0y

Expressions of TRPVs in the cholesteatoma epithelium.

Expressions of TRPVs in the cholesteatoma epithelium.

Acta Otolaryngol. 2017 Jun 09;:1-7

Authors: Do BH, Koizumi H, Ohbuchi T, Kawaguchi R, Suzuki H

Abstract
OBJECTIVE: We have recently proposed a hypothesis that acid leakage through the cholesteatoma epithelium mediates bone resorption in middle ear cholesteatoma. In the present study, we investigated the expressions of transient receptor potential vanilloid (TRPV) channels, which have been shown to play roles in the regulation of epidermal barrier function, in the cholesteatoma epithelium in comparison with the normal skin.
METHODS: Cholesteatoma epithelium and postauricular skin were collected from 17 patients with primary acquired middle ear cholesteatoma who underwent tympanomastoidectomy. Expressions of TRPV1, TRPV3, TRPV4, and TRPV6 were explored by fluorescence immunohistochemistry and quantitative reverse transcription-polymerase chain reaction (qRT-PCR).
RESULTS: TRPV1, TRPV3, TRPV4, and TRPV6 mRNAs were all detected by qRT-PCR both in the skin and cholesteatoma tissue. Immunohistochemical staining showed that TRPV1 and TRPV3 were positive in the viable cell layers of the epidermis of the skin, and only TRPV3 was positive in those of the cholesteatoma epithelium. The immunoreactivity for TRPV3 was significantly weaker in cholesteatoma than in the skin.
CONCLUSIONS: The lower expression of TRPV3 in cholesteatoma may be one of the mechanisms underlying the increased permeability of this tissue. On the other hand, TRPV1, TRPV4, and TRPV6 are unlikely to be involved in the regulation of epithelial permeability in cholesteatoma.

PMID: 28599589 [PubMed - as supplied by publisher]

http://ift.tt/2sgBcdE

Direct Versus Indirect Bypass for Moyamoya Disease.

Direct Versus Indirect Bypass for Moyamoya Disease.

Neurosurg Clin N Am. 2017 Jul;28(3):361-374

Authors: Liu JJ, Steinberg GK

Abstract
Moyamoya disease is a progressive occlusive vasculopathy that involves the supraclinoid internal carotid arteries and Circle of Willis, and results in the formation of collateral vessels at the skull base. The progressive nature of this disease leads to cerebral ischemia and sometimes intracerebral hemorrhage. The treatment of moyamoya disease is mainly surgical revascularization, using revascularization techniques that include direct, indirect, and combined strategies. Here we discuss the available options for revascularization as well as our opinions regarding the surgical management of patients with moyamoya disease.

PMID: 28600011 [PubMed - in process]

http://ift.tt/2t93CCK

Phase I Trial of Cediranib in combination with cisplatin and pemetrexed in chemo naive patients with unresectable malignant pleural mesothelioma (SWOG S0905).

Phase I Trial of Cediranib in combination with cisplatin and pemetrexed in chemo naive patients with unresectable malignant pleural mesothelioma (SWOG S0905).

J Thorac Oncol. 2017 Jun 06;:

Authors: Tsao AS, Moon J, Wistuba II, Vogelzang NJ, Kalemkerian GP, Redman MW, Gandara DR, Kelly K

Abstract
BACKGROUND: In malignant pleural mesothelioma (MPM), targeting angiogenesis, with cediranib, a vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor (PDGFR) inhibitor, may have therapeutic potential.
METHODS: S0905 phase I combined cediranib (2 dose cohorts 30 mg and 20 mg daily) with cisplatin-pemetrexed for 6 cycles followed by maintenance cediranib in unresectable chemo-naïve MPM patients of any histologic subtype. The primary endpoint established the MTD in combination with cisplatin-pemetrexed in a dose de-escalation schema.
RESULTS: A total of 20 patients (7 to cohort 30 mg, 13 to cohort 20 mg) were enrolled. In the cediranib 30 mg dose cohort, 2 of the initial 6 patients reported DLTs and the dose was deemed too toxic to continue. In the next cohort, 2 patients experienced DLTs and thus the MTD was established as cediranib at 20 mg. During the 6 cycles of cisplatin-pemetrexed-cediranib 20 mg, there were grade 3 toxicities (neutropenia, gastrointestinal) and grade 4 thrombocytopenia. No patients had any significant episodes of bleeding. By RECIST (n=17), the median PFS was 12.8 months (95% CI: 6.9 - 17.2); by modified RECIST (n=19), the median PFS was 8.6 months (95% CI: 6.1-10.9). For all patients, the disease control rate at 6 weeks was 90% and median OS was 16.2 months (95% CI: 10.5 - 28.7).
CONCLUSIONS: Cediranib combined with cisplatin-pemetrexed has a reasonable toxicity profile and preliminary promising efficacy. The phase II S0905 trial will evaluate the efficacy of the triplet regimen compared to the current standard of care cisplatin-pemetrexed.

PMID: 28599887 [PubMed - as supplied by publisher]

http://ift.tt/2sgO8QQ

Functions of the subregions of the infraspinatus during lateral rotation.

Functions of the subregions of the infraspinatus during lateral rotation.

Surg Radiol Anat. 2017 Jun 09;:

Authors: Kuwahara Y, Yuri T, Fujii H, Kiyoshige Y

Abstract
PURPOSE: Although recent morphological studies have revealed that the infraspinatus muscle is subdivided, the functions of the subregions remain unknown. The aim of this study is to investigate the functions of the infraspinatus subregions during lateral rotation using real-time tissue elastography (RTE).
METHODS: Ten young male volunteers participated in the study. In addition to the infraspinatus subregions, the teres minor and two of six subregions of the supraspinatus determined by Kim were examined. The muscle stiffness of these subregions was measured in six conditions during lateral rotation, i.e., at rest and during manual muscle testing (MMT) 3 contraction at 0°, 35°, and 70° of lateral rotation.
RESULTS: The middle and inferior subregions of the infraspinatus, teres minor, and the posterior deep supraspinatus acted as a lateral rotator. The inferior subregion of the infraspinatus was somewhat an abductor. The superior subregion of the infraspinatus was an abductor but did not contribute to the lateral rotational motion at 35° and 70° of rotation. The anterior superficial supraspinatus played an abduction role at neutral rotation but this role gradually decreased with an increasing lateral rotational angle.
CONCLUSIONS: Three subregions of the infraspinatus are functionally distinct. The superior subregion contributes to abduction, the middle subregion acts as a lateral rotator, and the inferior subregion has both functions.

PMID: 28600654 [PubMed - as supplied by publisher]

http://ift.tt/2rjdvMM

Ruptured Distal Anterior Choroidal Artery Aneurysm Treated with Superselective Provocative Testing and Coil Embolization: report of a case.

Ruptured Distal Anterior Choroidal Artery Aneurysm Treated with Superselective Provocative Testing and Coil Embolization: report of a case.

World Neurosurg. 2017 Jun 06;:

Authors: Schmalz PGR, Alturki A, Ogilvy CS, Thomas AJ

Abstract
BACKGROUND: and Importance: Aneurysms of the anterior choroidal artery are uncommon, and distal anterior choroidal artery aneurysms are even rarer, with only 34 cases reported in the medical literature. These lesions have been most commonly reported in association with moyamoya disease or arteriovenous malformations. Most published experience with these aneurysms involves open surgical approaches. Reports of endovascular treatment have been in patients with lesions distal to the plexal point and have employed vessel occlusion with liquid embolic agents in preference to coil embolization.
CLINICAL PRESENTATION: We present a case of a ruptured distal anterior choroidal artery aneurysm located on the cisternal segment of the artery. This lesion was successfully treated with endovascular coil embolization. Additionally, the patient underwent pre-embolization superselective provocative testing with amobarbital to assess the safety of parent vessel occlusion.
CONCLUSION: Endovascular coil embolization for distal anterior choroidal artery aneurysms is technically feasible and may be preferable to embolization with liquid embolic agents for lesions proximal to the plexal point. This case illustrates the utility of provocative testing and efficacy of endovascular coil embolization for lesions in this unique location.

PMID: 28599910 [PubMed - as supplied by publisher]

http://ift.tt/2sqPUyw

Anterior transthoracic surgery with motor evoked potential monitoring for high-risk thoracic disc herniations: technique and results.

Anterior transthoracic surgery with motor evoked potential monitoring for high-risk thoracic disc herniations: technique and results.

World Neurosurg. 2017 Jun 06;:

Authors: Cornips E, Habets J, van Kranen-Mastenbroek V, Bos H, Bergs P, Postma A

Abstract
OBJECTIVE: We present our experience with anterior transthoracic surgery for high-risk thoracic disc herniations (TDHs) using motor evoked potential monitoring (MEPm).
METHODS: We estimated surgical risk based on clinical and radiological characteristics, including antero-posterior (AP) spinal canal occupation (SCO), AP spinal cord compression (SCC), residual AP spinal cord diameter (RSCD), and intramedullary signal changes (ISC). We analyzed Anand, ASIA, and Nurick scores, anesthesiological, neurophysiological, and surgical reports. We considered >50% MEP signal deterioration significant.
RESULTS: Out of 435 anterior transthoracic procedures, 77 concerned high-risk TDH(s): 69 single-level (SL), 8 multi-level (ML), 61 with clinical myelopathy, 6 with merely ISC. Mean SCO and SCC were 55.4% and 54.0% for SL, 31.8% and 33.9% for ML cases. ISC were present in 64% of SL and 50% of ML cases, calcifications in 87% of SL and 84% of ML TDHs. We initially performed 23 mini-transthoracic approaches (mini-TTAs) and 24 thoracoscopic microdiscectomies (TMDs), more recently 29 TMDs (23 giant TDHs) and one transaxillary mini-TTA. Overall, 72 patients had reliable MEP signals. Isolated lower extremity MEP signal deteriorations (n=21) correlated with maximal TDH AP diameter, SCO, SCC, and ISC. ASIA and Nurick scores improved in 45% and 66% respectively. One patient became paraplegic. MEP signal deterioration had 100% sensitivity, 75% specificity, 19% positive predictive value during and 44% at end of surgery.
CONCLUSIONS: Maximal TDH AP diameter, SCO, SCC, (sub)total calcification, and ISC correlate with lower extremity MEP signal deterioration. In experienced hands, TMD with MEPm support is a safe, efficient procedure for high-risk TDHs.

PMID: 28599909 [PubMed - as supplied by publisher]

http://ift.tt/2sqFxL1

Fluorescein angiography in intracranial aneurysm surgery - a helpful method to evaluate the security of clipping and to observe blood flow.

Fluorescein angiography in intracranial aneurysm surgery - a helpful method to evaluate the security of clipping and to observe blood flow.

World Neurosurg. 2017 Jun 06;:

Authors: Kakucs C, Florian IA, Ungureanu G, Florian IS

Abstract
OBJECTIVE: In cerebral aneurysm surgery, a number of tools are employed to evaluate blood flow, such as Doppler ultrasonography, conventional cerebral angiography, and electrophysiological monitoring. Fluorescein and indocyanine green are widely used in vascular and central nervous system tumor neurosurgery. Nevertheless, their routine utilization in aneurysmal surgery is uncommon, despite the fact that they allow direct visualization of blood flow after an aneurysmal sac occlusion, enabling the observation of vessel permeability and the effectiveness of aneurysmal obliteration. We report our initial experience using fluorescein videoangiography as a control measure for proper clip placement and control of blood flow in aneurysm surgery and review the relevant literature.
MATERIAL AND METHODS: This pilot study presents an initial experience, having enrolled ten patients harboring a total of 12 cerebral aneurysms that underwent surgery via clipping and subsequent fluorescence videoangiography control. The intravenous injection was performed to demonstrate the patency of the arteries adjacent of the aneurysm.
RESULTS: Following intravenous injection, fluorescein sodium remains in the cerebral vasculature for around 3 minutes, providing ample time to evaluate the patency of the vessels and whether clip repositioning is necessary. None of the patients presented complications during intravenous injection of fluorescein sodium and the patency of the surrounding vessels was demonstrated in all of the cases.
CONCLUSIONS: Fluorescein injection in itself does not present any risks of complications, it is simple to use and offers a clear image of the cerebral vasculature. Therefore, this method is useful in determining vessel patency and degree of aneurysmal occlusion.

PMID: 28599908 [PubMed - as supplied by publisher]

http://ift.tt/2sqvKod

Association of plasminogen activator inhibitor 1 (SERPINE1 gene) polymorphisms and aneurysmal subarachnoid hemorrhage.

Association of plasminogen activator inhibitor 1 (SERPINE1 gene) polymorphisms and aneurysmal subarachnoid hemorrhage.

World Neurosurg. 2017 Jun 06;:

Authors: Hendrix P, Foreman PM, Harrigan MR, Fisher WS, Vyas NA, Lipsky RH, Lin M, Walters BC, Tubbs RS, Shoja MM, Pittet JF, Mathru M, Griessenauer CJ

Abstract
OBJECTIVE: Genetic variations of the SERPINE1 gene, which encodes plasminogen activator inhibitor 1 (PAI-1), correlate with serum levels of its product and are associated with thrombophilia and coronary atherosclerosis. Various SERPINE1 gene polymorphisms have been identified. Only the functional 5G/4G polymorphism, however, has been assessed in the context of aneurysmal subarachnoid hemorrhage (aSAH). Here, we assessed associations of 6 SERPINE1 polymorphisms with the clinical sequelae of aSAH.
METHODS: From 2012 to 2015, patients with aSAH were prospectively enrolled into the CARAS (Cerebral Aneurysm Renin Angiotensin System) study at two major academic institutions. Blood samples were used to evaluate 6 common SERPINE1 single nucleotide polymorphisms (SNPs) via 5'exonuclease (Taqman) genotyping assays.
RESULTS: There was an association of the AA genotype of rs2227631 with the 4G/4G genotype and of the GG genotype of rs7242 with the AA genotype of rs2227684. In multivariable analysis, patients with the AA genotype of rs2227631 and 4G/4G genotype had an increased risk for developing DCI. Additionally, patients with the GG genotype of rs7242 and AA genotype of rs2227684 had a decreased risk for a poor functional outcome.
CONCLUSIONS: SERPINE1 gene polymorphisms were associated with delayed cerebral ischemia and functional outcome following aSAH. These associations may arise from alterations of PAI-1 levels.

PMID: 28599907 [PubMed - as supplied by publisher]

http://ift.tt/2sqJUWt

Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-laboratory.

Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-laboratory.

World Neurosurg. 2017 Jun 06;:

Authors: Chung SB, Ryu J, Chung Y, Lee SH, Choi SK

Abstract
OBJECTIVE: Based on our experience, this report provides detailed information about how to realize a self-laboratory including cost-effective microsurgical instruments especially for the novice trainee.
METHODS: Our training model was designed to allow microsurgical practice to be performed in a cost-effective way. A used stereoscopic microscope was prepared for microsurgical training. A sufficient working distance for microsurgical practice was obtained by attaching an auxiliary objective lens. The minimum instrument list included two jeweler's forceps, iris scissors, and alligator clips. The iris scissors and alligator clip were used as good alternatives for micro-scissors and a microvascular clamp.
RESULTS: The training model allowed daily practice since it did not require a long time to set up the microscope and suture the gauze with micro-forceps. It took about 15 minutes to suture 10 neighboring fibers of the gauze with 10-0 Nylon; thus, we can easily complete the training within a short amount of time.
CONCLUSION: We established an inexpensive and efficient micro-anastomosis training system using a stereoscopic microscope and minimal micro-instruments. Especially for novice trainee, our detailed experience provides high accessibility for a microsurgical training.

PMID: 28599906 [PubMed - as supplied by publisher]

http://ift.tt/2sr0Lsh

Potential of new generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque ∼ A preliminary result using OFDI analysis ∼.

Potential of new generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque ∼ A preliminary result using OFDI analysis ∼.

World Neurosurg. 2017 Jun 06;:

Authors: Yamada K, Yoshimura S, Miura M, Kanamaru T, Shindo S, Uchida K, Shirakawa M, Shibuya M, Imanaka T, Ishihara M, Masuyama T, Ishikura R, Kawasaki M

Abstract
BACKGROUND: One of the disadvantages of carotid artery stenting (CAS) is high incidence of distal embolism (DE) during or after the procedure. It has been reported that unstable plaque cases are at high risk of DE and plaque protrusion (PP) after stent placement which will become a cause of post procedural ischemic complications.
OBJECTIVE: The purpose of this study was to compare the rate and size of PP between CASPER stent which is a new generation double-layer micromesh stent and conventional stents detected by optical frequency domain imaging (OFDI) and to evaluate the efficacy of CAS with CASPER stent for cases with unstable plaque.
METHODS: Forty-six consecutive patients with unstable plaque defined as magnetic resonance imaging undergoing CAS with OFDI image acquisition were enrolled in this study. Cross-sectional OFDI images within the stented segments were evaluated at 0.125mm intervals and compared the rate and size of PP between CASPER stent and conventional stents.
RESULTS: CASPER stent was used in 9 patients. No procedural complications occurred. With OFDI analysis, presence of PP was apparently lower in CASPER stent group than conventional stents group (44% vs 88%, p=0.022). Also, mean PP area was significantly smaller in CASPER stent group than conventional stents group (Mean PP area: 0.013 ± 0.034 mm(2) vs 0.057 ± 0.09 mm(2), p=0.006).
CONCLUSION: Using OFDI evaluation after CAS, the degree of PP was significantly smaller in CASPER stent than conventional stents. This result indicates new insights of CAS for the treatment of carotid artery stenosis with unstable plaque.

PMID: 28599905 [PubMed - as supplied by publisher]

http://ift.tt/2sqVT6f

YouTube as a Source of Information on Neurosurgery.

YouTube as a Source of Information on Neurosurgery.

World Neurosurg. 2017 Jun 06;:

Authors: Samuel N, Alotaibi NM, Lozano AM

Abstract
BACKGROUND: The importance of videos in social media communications in the context of healthcare and neurosurgery is becoming increasingly recognized. However, to date, there has not yet been a systematic analysis of these neurosurgery-related communications. Accordingly, this study was aimed at characterizing the online video content pertaining to neurosurgery.
METHODS: Neurosurgery-related videos uploaded on YouTube were collected using a comprehensive search strategy. The following metrics were extracted for each video: number of views, likes, dislikes, comments, shares, date of upload and geographical region of origin where specified. A quantitative and qualitative evaluation was performed on all videos included in the study.
RESULTS: A total of 713 non-duplicate videos met the inclusion criteria. The overall number of views for all videos was 90,545,164. Videos were most frequently uploaded in 2016 (n=348), with a 200% increase in uploads compared to the previous year. Of the videos that were directly relevant to clinical neurosurgery, the most frequent video categories were: 'Educational Videos' (25%), followed by 'Surgical and Procedure Overview' (20%), 'Promotional Videos' (17%), and 'Patient Experience' (16%). The remainder of the videos consisted primarily of unrealistic simulations of cranial surgery for entertainment purposes (20%).
CONCLUSIONS: The findings from this study highlight the increasing use of video communications related to neurosurgery and demonstrate that institutions, neurosurgeons and patients are utilizing YouTube as an educational and promotional platform. As online communications continue to evolve, it will be important to harness this tool to advance patient-oriented communication and knowledge dissemination in the field of neurosurgery.

PMID: 28599904 [PubMed - as supplied by publisher]

http://ift.tt/2reIazI

The ModA2 Phasevarion of nontypeable Haemophilus influenzae Regulates Resistance to Oxidative Stress and Killing by Human Neutrophils.

The ModA2 Phasevarion of nontypeable Haemophilus influenzae Regulates Resistance to Oxidative Stress and Killing by Human Neutrophils.

Sci Rep. 2017 Jun 09;7(1):3161

Authors: Brockman KL, Branstool MT, Atack JM, Robledo-Avila F, Partida-Sanchez S, Jennings MP, Bakaletz LO

Abstract
Nontypeable Haemophilus influenzae (NTHI) is the causative agent of multiple respiratory tract infections. Several human pathogens, including NTHI, possess a novel genetic system, termed the phasevarion, which mediates a rapid and reversible change in the expression of many genes throughout the chromosome. This occurs by phase variation of a single gene (modA) that encodes a DNA methyltransferase and results in two phenotypically distinct subpopulations, ON and OFF. NTHI encounters many pressures within the various microenvironments of its human host as the disease course evolves from one of asymptomatic nasopharyngeal carriage to overt disease. These include oxidative stresses, which are present throughout the respiratory tract. To persist in the human nasopharynx and as a pathogen throughout the airways, NTHI must be able to mitigate toxic levels of oxidative stress. Here we show that expression of ModA2, modA2 ON status, resulted in increased sensitivity to oxidative stress. Furthermore, the modA2 ON status resulted in decreased resistance to neutrophil-mediated killing, which resulted in selection for the modA2 OFF subpopulation in an ex vivo survival assay. These findings highlight the importance of the ModA2 phasevarion in adaptation to innate host defences and reveal an additional microenvironmental pressure that selected for a specific ModA2 subpopulation.

PMID: 28600561 [PubMed - in process]

http://ift.tt/2rebp5S

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis.

Seasonality of acquisition of respiratory bacterial pathogens in young children with cystic fibrosis.

BMC Infect Dis. 2017 Jun 09;17(1):411

Authors: Psoter KJ, De Roos AJ, Wakefield J, Mayer JD, Rosenfeld M

Abstract
BACKGROUND: Seasonal variations are often observed for respiratory tract infections; however, limited information is available regarding seasonal patterns of acquisition of common cystic fibrosis (CF)-related respiratory pathogens. We previously reported differential seasonal acquisition of Pseudomonas aeruginosa in young children with CF and no such variation for methicillin-susceptible Staphylococcus aureus acquisition. The purpose of this study was to describe and compare the seasonal incidence of acquisition of other respiratory bacterial pathogens in young children with CF.
METHODS: We conducted a retrospective study to describe and compare the seasonal incidence of methicillin-resistant Staphylococcus aureus (MRSA), Stenotrophomonas maltophilia, Achromobacter xylosoxidans, and Haemophilus influenzae acquisition in young CF patients residing in the U.S. using the Cystic Fibrosis Foundation National Patient Registry, 2003-2009. Log-linear overdispersed Poisson regression was used to evaluate seasonal acquisition of each of these pathogens.
RESULTS: A total of 4552 children met inclusion criteria. During follow-up 910 (20%), 1161 (26%), 228 (5%), and 2148 (47%) children acquired MRSA, S. maltophilia, A. xylosoxidans and H. influenzae, respectively. Compared to winter season, MRSA was less frequently acquired in spring (Incidence Rate Ratio [IRR]: 0.79; 95% Confidence Interval [CI]: 0.65, 0.96) and summer (IRR: 0.69; 95% CI: 0.57, 0.84) seasons. Similarly, a lower rate of A. xylosoxidans acquisition was observed in spring (IRR: 0.59; 95% CI: 0.39, 0.89). For H. influenzae, summer (IRR: 0.88; 95% CI: 0.78, 0.99) and autumn (IRR: 0.78; 95% CI: 0.69, 0.88) seasons were associated with lower acquisition rates compared to winter. No seasonal variation was observed for S. maltophilia acquisition.
CONCLUSION: Acquisition of CF-related respiratory pathogens displays seasonal variation in young children with CF, with the highest rate of acquisition for most pathogens occurring in the winter. Investigation of factors underlying these observed associations may contribute to our understanding of the aetiology of these infections and guide future infection control strategies.

PMID: 28599639 [PubMed - in process]

http://ift.tt/2shcvhb

Composite breast reconstruction: Implant-based breast reconstruction with adjunctive lipofilling.

Composite breast reconstruction: Implant-based breast reconstruction with adjunctive lipofilling.

J Plast Reconstr Aesthet Surg. 2017 May 22;:

Authors: Sommeling CE, Van Landuyt K, Depypere H, Van den Broecke R, Monstrey S, Blondeel PN, Morrison WA, Stillaert FB

Abstract
INTRODUCTION: Options for breast reconstructions enclose autologous tissue transfers or implants. Fat grafting is gaining more interest in this specific field of breast surgery. This study concentrates on the technique and aesthetic results of breast reconstruction with fat grafts combined with implants, in women who have undergone total mastectomy.
METHODS: Breast reconstructions (n = 23) was performed using a protocol of intratissular expansion with serial deflation-lipofilling. In order to achieve the best aesthetic outcome, an additional small implant was placed. A retrospective data analysis was performed. In all patients a tissue expander was placed at the time of mastectomy or after removal of a previous breast reconstruction. The mean of lipoaspirate material for the reconstruction was 333 mL (range 120-715 mL). To create an adequate volume of the reconstructed breast, a supplementary small implant was placed, with a mean volume of 222 mL (range 125-375 mL). The mean follow-up was 33 months (range 19-50 months).
RESULTS: A MRI analysis was performed in eight patients at least 9 months after the last lipofilling procedure, demonstrating a mean of 171 mL (range 64-538 mL) of transferred fat, a mean fat survival of 53% and a volume ratio of fat graft/implant of 0.97 (range 0,3-3,8).
CONCLUSION: This composite technique of using autologous fat tissue and implants shows aesthetic pleasant results and must be considered as a valid alternative in a subset of patients. Further investigations to optimize the fat graft take must be encouraged.

PMID: 28599842 [PubMed - as supplied by publisher]

http://ift.tt/2san3hh

25 (OH) D3 levels, incidence and recurrence of different clinical forms of BPPV

Publication date: Available online 11 June 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Sinisa Maslovara, Silva Butkovic Soldo, Anamarija Sestak, Katarina Milinkovic, Jasna Rogic-Namacinski, Anamarija Soldo
IntroductionBenign Paroxysmal Positional Vertigo (BPPV) is the most common cause of dizziness in the general population. It is a condition with potential impact of reduced levels of vitamin D on its recurrent attacks.ObjectivesThe aim of this study was to measure the serum levels of 25-hydroxyvitamin D3 (25-OH D3) in patients with BPPV and determine whether there is a difference in the serum levels of vitamin D3 between patients with and without recurrence, as well as between the different clinical forms of BPPV.MethodsThe study included 40 patients who came to the regular medical examination, diagnosed with PC-BPPV based on the positive Dix-Hallpike's test. All patients underwent Epley manoeuvre after the diagnosis. Patients were classified according to current guidelines for levels of vitamin D3 in the serum in three groups: the deficiency, insufficiency and adequate level.ResultsThe average serum level of 25-OH D3 among respondents was 20.78ng/mL, indicating a lack or insufficiency of the aforementioned 25-OH D3. According to the levels of 25-OH D3, most patients suffer from deficiency (47.5%). 7 (17.5%) respondents had adequate blood level of 25-OH D3, and 14 (35%) respondents suffer from insufficiency. A significant difference was not found in the serum level of 25-OH D3 between patients with and without BPPV recurrence. There was a significant difference in the serum levels of 25-OH D3 in comparison to the clinical form of the disease. Lower 25-OH D3 values were found in patients with canalithiasis compared to those with cupulolithiasis.ConclusionsThere were no significant differences in the vitamin D3 serum level in patients with and without recurrence. The study showed a low level of serum vitamin D3 in most patients, indicating the need for supplemental therapy.

http://ift.tt/2r7JIaw

Pattern of care and impact of prognostic factors in the outcome of ameloblastic carcinoma: a systematic review and individual patient data analysis of 199 cases.

Pattern of care and impact of prognostic factors in the outcome of ameloblastic carcinoma: a systematic review and individual patient data analysis of 199 cases.

Eur Arch Otorhinolaryngol. 2017 Jun 09;:

Authors: Giridhar P, Mallick S, Upadhyay AD, Rath GK

Abstract
Ameloblastic carcinoma is a rare locally aggressive odontogenic neoplasm. These tumors are most commonly found to arise from mandible. Because of rarity, there is limited information about the clinical behaviour of such patients. We intended to perform this review of published literature to assess the demographic profile, pattern of care and assess survival outcomes. Two authors independently searched PubMed, Google search, and Cochrane library for eligible studies from 1950 until July 1 2016 published in English language. Data of 199 patients were retrieved from 94 publications for statistical analysis. Median age of the entire cohort was 49 years (range 7-91 years). The analysis revealed that a clear twofold higher incidence in male with male-to-female ratio was 2.4:1 (140:57). Mandible was found to be the commonest tumor location in 66.7% (n = 132) cases followed by maxilla (31.8%) (n = 64). The present analysis revealed that median PFS of 57 months (95% CI 39-120 months) with 5- and 10-year PFS was found to be 47.88 and 29.48%, respectively. Median OS for the entire cohort which was 122 months (95% CI 96-153 months) with 2- and 5-year OS for the entire cohort was 87.16 and 69.08%, respectively. In univariate analysis, patients with an R0 resection were found to have a favourable survival. In addition, patients with localized disease and younger age were found to have a better survival. Adjuvant radiation did not confer any survival advantage. The present analysis revealed excellent outcome for patients treated with an R0 resection. Older patients with high-risk factor may benefit from adjuvant radiation. Role of chemotherapy needs to be evaluated.

PMID: 28600599 [PubMed - as supplied by publisher]

http://ift.tt/2reJgLQ

Clinical Development of Anti-mitotic Drugs in Cancer.

Clinical Development of Anti-mitotic Drugs in Cancer.

Adv Exp Med Biol. 2017;1002:125-152

Authors: Olziersky AM, Labidi-Galy SI

Abstract
Mitosis is one of the most fundamental processes of life by which a mammalian cell divides into two daughter cells. Mitosis has been an attractive target for anticancer therapies since fast proliferation was identified as one of the hallmarks of cancer cells. Despite efforts into developing specific inhibitors for mitotic kinases and kinesins, very few drugs have shown the efficiency of microtubule targeting-agents in cancer cells with paclitaxel being the most successful. A deeper translational research accompanying clinical trials of anti-mitotic drugs will help in identifying potent biomarkers predictive for response. Here, we review the current knowledge of mitosis targeting agents that have been tested so far in the clinics.

PMID: 28600785 [PubMed - in process]

http://ift.tt/2saR5lf

Synthesis and biological evaluation of novel steroidal 5α,8α-endoperoxide derivatives with aliphatic side-chain as potential anticancer agents.

Synthesis and biological evaluation of novel steroidal 5α,8α-endoperoxide derivatives with aliphatic side-chain as potential anticancer agents.

Steroids. 2017 Jun 06;:

Authors: Bu M, Cao T, Li H, Guo M, Yang BB, Zhou Y, Zhang N, Zeng C, Hu L

Abstract
By inspiration of significant anti-cancer activity of our previously screened natural ergosterol peroxide (EP), a series of novel steroidal 5α,8α-endoperoxide derivatives 5a-d and 14a-f were designed, synthesized, and biologically evaluated for their in vitro anti-proliferative inhibitory and cytotoxic activity. The results revealed that most of these compounds showed moderate-to-excellent anti-proliferative effects against the tested cancer cell lines (i.e. HepG2, SK-Hep1, MDA-MB-231 and MCF-7). Among them, compound 5b and 14d exhibited preferable inhibitory activities (IC50 of 5b and 14d are 8.07 and 9.50 μM against HepG2, respectively). The structure-activity relationships indicated that incorporation the peroxidic bridge to the steroid scaffolds at C-5 and C-8 positions together with the aliphatic side-chain at the C-17 position would provide synergistic effect for the bioactivity.

PMID: 28600221 [PubMed - as supplied by publisher]

http://ift.tt/2saNL9y

Continuous oral cyclophosphamide as salvage or maintenance therapy in ovarian, primary peritoneal, and fallopian tube cancers: A retrospective, single institute study.

Continuous oral cyclophosphamide as salvage or maintenance therapy in ovarian, primary peritoneal, and fallopian tube cancers: A retrospective, single institute study.

Taiwan J Obstet Gynecol. 2017 Jun;56(3):302-305

Authors: Wong CN, Wong CN, Liu FS

Abstract
OBJECTIVE: Most patients with recurrent ovarian cancer are treated with multiple regimens of intravenous salvage chemotherapy. These anticancer agents often cause severe toxicities and offset their therapeutic effects. The present study assessed the experience of a single institute regarding the safety and treatment outcomes of continuous oral cyclophosphamide in patients with ovarian, primary peritoneal, and fallopian tube cancers.
MATERIALS AND METHODS: A retrospective review was conducted on patients who received oral cyclophosphamide as salvage or maintenance therapy. All the patients had received platinum plus paclitaxel as the front line chemotherapy before being enrolled in the study. Oral cyclophosphamide 50 or 100 mg daily was administered. The response rate, progression-free survival, and side effects were evaluated.
RESULTS: Twenty patients were eligible for analysis, and 18 patients (90%) initially had FIGO stage IIIC disease. Most patients were heavily pretreated with the median number of previous chemotherapy regimens being 4 (range 1-8). Seventeen patients received oral cyclophosphamide as salvage therapy. Complete and partial responses were obtained in 3 and 2 patients, respectively. Five patients were classified as having stable disease. The median progression-free survival was 15 weeks (range 5-60 weeks). Three patients received oral cyclophosphamide as maintenance therapy in the remission status. The remission duration was maintained for 18, 28, and 67 weeks. Grade 2-3 myelosuppression was the only side effect.
CONCLUSION: Continuous oral cyclophosphamide can be used as an alternative salvage therapy in recurrent ovarian cancer with an acceptable response rate and toxicity. Additional clinical trials are required to evaluate its efficacy as maintenance therapy.

PMID: 28600037 [PubMed - in process]

http://ift.tt/2saImPO

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 11 Ιουνίου 2017

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