Source:Trends in Cell Biology, Volume 27, Issue 8
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Πέμπτη 20 Ιουλίου 2017
Editorial Board and Contents
Source:Trends in Cell Biology, Volume 27, Issue 8
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Concurrent Chondrodysplasia Punctata Type 2 (Conradi–Hunermann–Happle Syndrome) and Ichthyosis Vulgaris in Teenaged Twin Girls
Abstract
We present concurrent X-linked chondrodysplasia punctata and ichthyosis vulgaris in adolescent fraternal twin girls, notable for initial presentation with dry skin in adolescence, characterized by dark-brown scale typical of ichthyosis vulgaris and blaschkolinear, atrophic, scaly plaques. This constellation of findings prompted further genetic investigation. Using a multigene approach to examine 39 genes associated with congenital ichthyosis, next-generation sequencing revealed a novel heterozygous missense mutation at a mutational hotspot in the EBP gene c.439C>T (p.R147C) in conjunction with a single nonsense mutation in the FLG gene (p.R501X) in both sisters. These individuals highlight the clinical variability of Conradi–Hunermann–Happle syndrome, illustrate the possibility of co-occurrence of rare and common forms of ichthyosis, and demonstrate the utility of multigene analysis.
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Methotrexate for Severe Childhood Atopic Dermatitis: Clinical Experience in a Tertiary Center
Abstract
Background/Objectives
Atopic dermatitis (AD) affects up to 20% of children. Although the majority of patients are adequately controlled using emollients, topical corticosteroids, topical calcineurin inhibitors, or phototherapy, children with moderate to severe AD may require systemic treatment for control. The objective of the current study was to evaluate the efficacy and safety of methotrexate in children with severe AD attending a tertiary referral center.
Methods
A retrospective chart review was undertaken of all children who received methotrexate for severe AD at our tertiary referral center from November 2010 to August 2015.
Results
Forty-seven children were started on methotrexate for AD during this period. The mean Investigator Global Assessment (IGA) at the 3- to 5-month follow-up improved from 4.25 to 2.8, with further improvement to 1.9 in the patients that continued therapy beyond 10 months. Changes in the Children's Dermatology Life Quality Index (CDLQI) mirrored changes in the IGA, with improvement in the mean CDLQI from 14.4 at the start of the treatment to 7.5 at the 3- to 5-month follow-up. Further improvement in the CDLQI to 6.6 in patients who continued methotrexate beyond 10 months confirmed continued improvement in disease control beyond medium-term therapy. The treatment was well tolerated.
Conclusions
Methotrexate appears to be an effective, safe treatment for severe pediatric AD. Its therapeutic effects continue beyond the medium-term treatment period, as reflected by further improvement in IGA and CDLQI scores in patients who continued methotrexate therapy beyond 10 months.
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Autoimmunity and its association with regulatory T cells and B cell subsets in patients with common variable immunodeficiency
Publication date: Available online 20 July 2017
Source:Allergologia et Immunopathologia
Author(s): G. Azizi, H. Abolhassani, F. Kiaee, N. Tavakolinia, H. Rafiemanesh, R. Yazdani, SA. Mahdaviani, S. Mohammadikhajehdehi, M. Tavakol, V. Ziaee, B. Negahdari, J. Mohammadi, A. Mirshafiey, A. Aghamohammadi
BackgroundCommon variable immunodeficiency (CVID) is one of the most prevalent symptomatic primary immunodeficiencies (PIDs), which manifests a wide clinical variability such as autoimmunity, as well as T cell and B cell abnormalities.MethodsA total of 72 patients with CVID were enrolled in this study. Patients were evaluated for clinical manifestations and classified according to the presence or absence of autoimmune disease. We measured regulatory T cells (Tregs) and B-cell subsets using flow cytometry, as well as specific antibody response (SAR) to pneumococcal vaccine, autoantibodies and anti-IgA in patients.ResultsTwenty-nine patients (40.3%) have shown at least one autoimmune manifestation. Autoimmune cytopenias and autoimmune gastrointestinal diseases were the most common. A significant association was detected between autoimmunity and presence of hepatomegaly and splenomegaly. Among CVID patients, 38.5% and 79.3% presented a defect in Tregs and switched memory B-cells, respectively, whereas 69.0% presented CD21low B cell expansion. Among patients with a defect in Treg, switched memory and CD21low B cell, the frequency of autoimmunity was 80.0%, 52.2% and 55.0%, respectively. A negative correlation was observed between the frequency of Tregs and CD21low B cell population. 82.2% of patients had a defective SAR which was associated with the lack of autoantibodies.ConclusionsAutoimmunity may be the first clinical manifestation of CVID, thus routine screening of immunoglobulins is suggested for patients with autoimmunity. Lack of SAR in CVID is associated with the lack of specific autoantibodies in patients with autoimmunity. It is suggested that physicians use alternative diagnostic procedures.
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Contralateral regional recurrence after elective unilateral neck irradiation in oropharyngeal carcinoma: A literature-based critical review
Source:Cancer Treatment Reviews
Author(s): Abrahim Al-Mamgani, Erik van Werkhoven, Arash Navran, Baris Karakullukcu, Olga Hamming-Vrieze, Melanie Machiels, Lilly-Ann van der Velden, Wouter V. Vogel, W. Martin Klop
Background: The head and neck region has rich regional lymphatic network, with a theoretical risk on contralateral metastasis from oropharyngeal cancer (OPC). There is a long-standing convention to irradiate the great majority of these tumors electively to both sides of the neck to reduce the risk of contralateral regional failure (cRF), but this can induce significant toxicity. We aimed to identify patient groups where elective contralateral irradiation may safely be omitted.Methods: PubMed and EMBASE were searched for original full-text articles in English with a combination of search terms related to the end points: cRF in OPC primarily treated by radiotherapy only to the ipsilateral neck and identifying predictive factors for increased incidence of cRF. The data from the identified studies were pooled, the incidence of cRF was calculated and the correlation with different predictive factors was investigated.Results: Eleven full-text articles met the inclusion criteria. In these studies, 1116 patients were treated to the ipsilateral neck alone. The mean incidence of cRF was 2.42% (range 0-5.9%, 95% CI 1.6-3.5%). The incidence of cRF correlated only with T-stage (p=0.008), and involvement of midline (p=0.001). However, the significant correlation with T-stage can be explained by the very low incidence of cRF among T1 (0.77%), and disappeared when the incidence of cRF was compared between T2, T3,and T4 (p=0.344).Conclusion: The incidence of cRF in patients with OPC is very low, with involvement of midline providing the most significant prognosticator. These results call for trials on unilateral elective irradiation in selected groups.
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Structural characterisation of galacto-oligosaccharides (VITAGOS™) sythesized by transgalactosylation of lactose
Publication date: Available online 21 July 2017
Source:Bioactive Carbohydrates and Dietary Fibre
Author(s): Qingbin Guo, H. Douglas Goff, Steve W. Cui
A galacto-oligosaccharide product (VITAGOS™) was prepared by glycoside hydrolases (β-galactosidase from Aspergillus oryzae and Kluyveromyces lactis) using lactose as substrate. Monosaccharide composition analysis indicated that VITAGOS™ contained 40.3% (w/w, dry basis) glucose and 51.1% (w/w, dry basis) galactose. According to high performance size exclusion chromatography (HPSEC) analysis, VITAGOS™ was a sugar mixture with degree of polymerisation (DP) ranging from 1 to 7, with DP2 and DP3 as the dominant fractions (32% and 33%, w/w). In addition, more than three fractions were observed for each DP pool indicated by the oligosaccharides profiles obtained from high performance anion exchange chromatography (HPAEC) analysis. Six sub-fractions (F1-F6, corresponding to DP1 to DP6 rich fraction, respectively) were then collected using biogel P-2 column, followed by structural characterisation through methylation analysis combined with 1D & 2D NMR spectroscopy. The detailed molecular structures of VITAGOS™ with DP up to 4 are provided.
Graphical abstract
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Multiple Drug Allergy
Opinion statement
The tendency to develop multiple drug hypersensitivity (MDH), defined as a hypersensitivity to two or more structurally unrelated drugs, occurs in up to 10% of people who have a severe and proven immune-mediated drug hypersensitivity reaction (DHR). There are two subtypes of MDH: in the first type, MDH develops if different drugs are administered simultaneously; in the second, MDH develops if different drugs are administered sequentially, sometimes years apart. MDH presents clinically as immediate and/or non-immediate reactions. The main drugs responsible for MDH are antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), antiepileptics, hypnotics, antidepressants, corticosteroids, and local anesthetics. There are two pathogenic mechanisms of developing MDH: the first is T cell mediated and the second is IgE mediated. Activated T cells are directed against the culprit drug or its metabolites. MDH can be proven by positive responses to patch tests and/or delayed-reading intradermal tests as well as a positive lymphocyte transformation test. During the first DHR, the immune stimulation may lower the threshold of T cell reactivity to that drug and facilitate the immune response to the second drug, similar to viral infections. The drug-reactive T cells in patients with MDH display an enhanced state of activation. Less frequently, the pathogenic mechanism is IgE mediated. This can be proven by positive responses to an immediate-reading intradermal test and provocation test, as well as with positive specific IgE to culprit drug and a basophil activation test (BAT). A T cell-mediated reaction might be built on the IgE-mediated reaction. It is well-known that the tolerance mechanism to small molecular compounds fails in MDH patients, although the pathogenic mechanisms of this syndrome are still unknown.
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Occurrence and distribution of six selected endocrine disrupting compounds in surface- and groundwaters of the Romagna area (North Italy)
Abstract
Endocrine disrupting compounds (EDCs) are a wide group of contaminants of emerging concern known to be harmful for organisms. The aim of the study was to assess the occurrence and distribution of six EDCs (estrone—E1, ß-estradiol—E2, 17α-ethinylestradiol—EE2, bisphenol A—BPA, perfluooctanoic acid—PFOA, perfluorooctane sulfonate—PFOS) in the Apenninic rivers and groundwaters of the Romagna area (North of Italy). Groundwaters were unaffected by EDC contamination, while all classes of compounds were detected at concentrations above the method quantification limit (MQL) in the majority of the river bodies. In detail, PFOA and PFOS concentrations varied between <MQL and 17.7 ng/l (PFOA) and between <MQL and 5.5 ng/l (PFOS), and their occurrence in the aquatic compartment was related to the discharge of wastewater treatment plant effluents. Concerning estrogens, EE2 was below the MQL in all samples, whereas E1 and E2 reached concentrations up to 39.7 ng/l (E2) and 28 ng/l (E1) in surface waters. The highest estrogen values were registered in those areas where livestock and farming are the main activities, indicating a close relation between these activities and estrogen release into the aquatic compartment. BPA (<MQL–171.3 ng/l) distribution in river waters did not show any correlation with a specific anthropic activity; a mixture of sources of contamination (e.g., industries of food packaging and plastic production) is rather responsible for its detection in river bodies. Overall, the northern part of the Romagna area showed a higher contamination by EDCs, in contrast with the southern part, which was almost unaffected by this kind of microcontamination.
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Fatty Acid Composition of Plasma Phosphatidylcholine Determines Body Fat Parameters in Subjects with Metabolic Syndrome-Related Traits
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
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Hidradenitis Suppurativa in Children Treated with Finasteride—A Case Series
Abstract
Background
Hidradenitis suppurativa (HS) is rare in childhood, with only 2% of cases in patients younger than 11 years. It is a chronic, recurrent, debilitating condition for which no universally effective treatment has been developed. We present five cases of children with HS diagnosed between the ages of 6 and 11 years.
Methods
Patients were treated with oral finasteride 1 to 5 mg/day. All had entered puberty at the time of treatment initiation. All had normal laboratory results before starting treatment. The maximum duration of treatment was 24 months.
Results
Four patients were female. Two were overweight. Three had been previously treated with oral antibiotics, and two of these with oral isotretinoin, with partial or no improvement. Overall improvement of the disease was observed in all patients, with a reduction of the frequency and intensity of the flares. No adverse effects were observed or reported during treatment.
Conclusion
Treatment of HS can be challenging. The options available include antimicrobials, immunosuppressants, hormonal therapies, lasers, and surgery. The authors report the largest series of children with HS treated with finasteride. The results support the use of finasteride as monotherapy for the treatment of this disease in children. Further studies are necessary to fully understand the role of this drug in the management of this disease.
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EACMFS Prizes and Awards
The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments.
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Precision based guidelines for sub-maximal normalisation task selection for trunk extensor EMG
Publication date: Available online 20 July 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Jennie A. Jackson, Svend Erik Mathiassen, Jack P. Callaghan, Patrick G. Dempsey
AimThe object of this study was to quantify the contribution of sub-maximal normalisation to the overall variance of exposure parameters describing erector spinae (ES) activity, and to provide guidelines for task selection which minimize methodological variance.MethodsES EMG was measured from three locations (T9, L1 and L5 levels) on fifteen men performing a manual materials handling task in the laboratory on three separate days. Four repeats of each of eleven sub-maximal normalisation tasks (eight static, three dynamic) were collected, work data were normalised to each task and repeat, and exposure parameters calculated. The unique contribution of normalisation to the overall variance was determined for each task and exposure parameter using variance component analyses. Normalisation tasks were scored according to their relative contributions to the overall variance and coefficients of variation.ResultsA prone task, similar to the Biering-Sørensen test posture, was the most repeatable for all electrode locations and across all exposure parameters. Thoracic level normalisation typically showed poorer repeatability than lumbar normalisation.Discussion: To maximize measurement precision, we recommend that future ES EMG studies employing sub-maximal normalisation utilise said prone task. An alternate normalisation task specific to thoracic level ES muscles may be warranted.
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CD8+ T cell programming by cytomegalovirus vectors: applications in prophylactic and therapeutic vaccination
Klaus Früh | Louis Picker
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Cancer immunotherapy: moving forward with peptide T cell vaccines
Takumi Kumai | Aaron Fan | Yasuaki Harabuchi | Esteban Celis
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Turbocharging vaccines: emerging adjuvants for dendritic cell based therapeutic cancer vaccines
Mansi Saxena | Nina Bhardwaj
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No pain no gain? Adjuvant effects of alum and monophosphoryl lipid A in pertussis and HPV vaccines
Thomas C Mitchell | Carolyn R Casella
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Immunological tolerance as a barrier to protective HIV humoral immunity
Kristin MS Schroeder | Amanda Agazio | Raul M Torres
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Editorial overview: Molecular neuroscience 2017
Source:Current Opinion in Neurobiology
Author(s): Susumu Tomita, Brenda L Bloodgood
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The buried dermal pennant stitch for the correction of symmastia following breast reduction
Abstract
Symmastia is a difficult surgical problem to correct. Symmastia has various etiologies and can occur following reduction mammoplasty. Techniques previously described have been criticized for their limited success due to temporary results, inadequate correction, or creation of secondary deformities. In this study, we present a novel approach to correct symmastia in a patient who developed the deformity following reduction mammoplasty. The technique described uses a buried dermal pennant suture, local advancement flaps, and liposuction to correct the symmastia and improve medial breast contour. We believe this technique provides adequate and long-term correction of symmastia in the breast reduction patient and avoids the shortcomings of previously described approaches.
Level of Evidence: Level V, therapeutic study
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Research progress on osteoarthritis treatment mechanisms
Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Yun-Yao Gu, Jian Chen, Zhu-Long Meng, Wan-Yu Ge, Yang-Yang Bian, Shao-Wen Cheng, Chen-Kun Xing, Jiang-Ling Yao, Jian Fu, Lei Peng
Osteoarthritis is a common disease and is frequently encountered in the older population; the incidence rises sharply with age. It is estimated that more than 360 million people suffer from OA. However, the pathogenesis of osteoarthritis remains unclear, and we cannot effectively prevent the progression of OA. The aim of this review was to explore the molecular markers and signaling pathways that induce chondrocyte apoptosis in OA. We searched, using the key words osteoarthritis, chondrocyte apoptosis, autophagy, endoplasmic reticulum stress, molecular targets, and biomarkers, in PubMed, Web of Science, and Google Scholar from 1994 to 2017. We also reviewed the signaling pathways and molecular markers associated with chondrocyte apoptosis and approaches aimed at inhibiting the apoptosis-inducing mechanism to at least delay the progression of cartilage degeneration in OA. This article provides an overview of targeted therapies and the related signaling pathways in OA.
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Dissolving microneedles for transdermal drug delivery: Advances and challenges
Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Kevin Ita
Over the last number of years, a significant body of evidence has shown the benefit of using dissolving microneedles (DMNs) for transdermal drug delivery. These devices are prepared from a wide range of materials such as sugars and polymers. DMNs are mainly fabricated by micromolding, photopolymerization, drawing lithography and droplet-airborne blowing. In this review, we have focused on the advances made in the field in recent years using a representative set of studies. Although the list of studies is not exhaustive, they highlight the challenges encountered such as the need to increase mechanical strength as well as medication dose while ensuring fast release of the active ingredient. DMNs can be used to delivery low molecular drugs as well as peptides, proteins and other high molecular weight compounds.
Graphical abstract
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Acquired External Auditory Canal Atresia: A Comparison of Acellular Dermal Matrix and Split-thickness Skin Grafting Techniques.
Objective: To describe the use of acellular dermal matrix (ADM) in the repair of acquired external auditory canal atresia (AEACA), and compare surgical results to AEACA repair by split-thickness skin grafting (STSG). Study Design: Retrospective chart review. Setting: Neurotology clinical practice. Patients and Intervention: From 2007 to 2015, 25 AEACA surgeries (8 ADM and 17 STSG) were identified meeting inclusion and exclusion criteria. Pre- and postoperative audiometric data with clinical follow-up were examined. Outcome Measures: Rate of external auditory canal restenosis, improvement of conductive hearing loss, and resolution of otorrhea. Results: Both surgical groups had similar preoperative air bone gaps (ABG). Mean follow-up was 24 months. There was no significant difference in restenosis rates between the ADM (13%, n = 1/8) and STSG (12%, n = 2/17) groups. ABG improved from 28 dB to 11 dB in the ADM group and from 24 dB to 9 dB in the STSG group. ABG closure with surgery was statistically significant (p
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Visual Processing Recruits the Auditory Cortices in Prelingually Deaf Children and Influences Cochlear Implant Outcomes.
Objective: Although visual processing recruitment of the auditory cortices has been reported previously in prelingually deaf children who have a rapidly developing brain and no auditory processing, the visual processing recruitment of auditory cortices might be different in processing different visual stimuli and may affect cochlear implant (CI) outcomes. Methods: Ten prelingually deaf children, 4 to 6 years old, were recruited for the study. Twenty prelingually deaf subjects, 4 to 6 years old with CIs for 1 year, were also recruited; 10 with well-performing CIs, 10 with poorly performing CIs. Ten age and sex-matched normal-hearing children were recruited as controls. Visual ("sound" photo [photograph with imaginative sound] and "nonsound" photo [photograph without imaginative sound]) evoked potentials were measured in all subjects. P1 at Oz and N1 at the bilateral temporal-frontal areas (FC3 and FC4) were compared. Results: N1 amplitudes were strongest in the deaf children, followed by those with poorly performing CIs, controls and those with well-performing CIs. There was no significant difference between controls and those with well-performing CIs. "Sound" photo stimuli evoked a stronger N1 than "nonsound" photo stimuli. Further analysis showed that only at FC4 in deaf subjects and those with poorly performing CIs were the N1 responses to "sound" photo stimuli stronger than those to "nonsound" photo stimuli. No significant difference was found for the FC3 and FC4 areas. No significant difference was found in N1 latencies and P1 amplitudes or latencies. Conclusion: The results indicate enhanced visual recruitment of the auditory cortices in prelingually deaf children. Additionally, the decrement in visual recruitment of auditory cortices was related to good CI outcomes. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Surgical Emphysema Following Canalplasty for Aural Exostoses.
Objective: To describe the presentation and management of surgical emphysema involving the temporomandibular joint and deep neck following exostoses removal. Patient: A 60-year-old male surfer presented with hearing loss and recurrent infections in the right ear. An examination revealed obstructing bony exostoses in the right external auditory canal. He underwent right canalplasty using a postauricular approach. At 5 weeks after surgery, he presented with right otalgia, swelling of the right face and neck, and complaints of a squeaking noise in the right ear with mandibular excursions. An otomicroscopic examination demonstrated a focal area of prolapsing soft tissue along the anterior bony external auditory canal with mandibular movement. The examination also revealed palpable crepitus of the right face and neck. Computed tomography was obtained of the temporal bones and neck confirming a focal anterior canal wall defect allowing communication between the glenoid fossa and external auditory canal with subcutaneous emphysema tracking around the temporomandibular joint into the masticator, parotid, and parapharyngeal spaces. Intervention: Maxillomandibular fixation for 2 weeks with revision canalplasty using a split tragal cartilage graft. Results: At 6 weeks after revision surgery, the patient reported complete resolution of all symptoms. Repeat imaging demonstrated complete resolution of subcutaneous and deep neck emphysema, and the otomicroscopic examination revealed a fully epithelialized external auditory canal with no further evidence of soft tissue prolapse. Conclusion: Maxillomandibular fixation with autologous cartilage graft is an effective management strategy for complications of canalplasty resulting in exposure of the temporomandibular joint capsule and surgical emphysema. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Is DNA ploidy related to smoking?
Abstract
Background
In the oral cavity, genomic instability is caused by long-term exposure to carcinogens. The aim of the present study was to evaluate the relationship between smoking and DNA ploidy
Methods
Cytological material was obtained from patients participating in the Outpatient Smoking Treatment Program of the Heart Institute (INCOR-HCFMUSP), and of the Discipline of Oral Medicine (ICT-UNESP). The inclusion criteria for all groups were the absence of a history of malignant tumors, absence of clinical signs of changes in the selected area, and alcohol consumption of less than 3 units per week. Group 1: 30 smokers before smoking cessation treatment; Group 2: 30 non-smokers; Group 3: 30 ex-smokers abstinent for at least one year. Cytological smears were collected from the floor of the mouth and border of the tongue and stained by Feulgen. Aneuploidy was evaluated using the ACIS® III system
Results
The Kruskal-Wallis test showed no statistically significant difference (p = 0.4383) between the groups studied. No association between tobacco consumption and aneuploidy was observed in group 1 (p = 1) or group 2 (p = 0.68) (Fisher's exact test)
Conclusion
Smoking was not associated with changes in DNA content or the incidence of aneuploidy in normal oral mucosa.
This article is protected by copyright. All rights reserved.
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Speech fluency profile on different tasks for individuals with Parkinson’s disease
RESUMO Objetivo Caracterizar o perfil da fluência da fala de indivíduos com Doença de Parkinson em diferentes tarefas de fala. Método Participaram do estudo 40 indivíduos, de 40 a 80 anos de idade, de ambos os gêneros, divididos em 2 grupos: GP (grupo pesquisa - 20 indivíduos com diagnóstico de Doença de Parkinson); GC (grupo controle - 20 indivíduos sem qualquer alteração de comunicação e/ou neurológica). Para todos os participantes, foram coletadas três amostras de fala envolvendo diferentes tarefas: monólogo, leitura individual e fala automática. Resultados O GP apresentou um número significativamente maior de rupturas, tanto comuns quanto gagas, e maiores porcentagens de descontinuidade de fala e disfluências gagas nas tarefas de monólogo e leitura quando comparado ao GC. Nas tarefas de fala automática, ambos os grupos apresentaram número reduzido de rupturas comuns e gagas, não apresentando diferença significante entre os grupos para esta tarefa. Em relação à velocidade de fala, tanto em palavras quanto em sílabas por minuto, os indivíduos com Doença de Parkinson apresentaram velocidade reduzida em relação ao grupo controle em todas as tarefas de fala. Conclusão O GP apresentou alteração em todos os parâmetros da fluência avaliados no presente estudo quando comparado ao grupo controle, porém esta alteração da fluência não se configura como um quadro de gagueira.
ABSTRACT Purpose To characterize the speech fluency profile of patients with Parkinson's disease. Methods Study participants were 40 individuals of both genders aged 40 to 80 years divided into 2 groups: Research Group - RG (20 individuals with diagnosis of Parkinson's disease) and Control Group - CG (20 individuals with no communication or neurological disorders). For all of the participants, three speech samples involving different tasks were collected: monologue, individual reading, and automatic speech. Results The RG presented a significant larger number of speech disruptions, both stuttering-like and typical dysfluencies, and higher percentage of speech discontinuity in the monologue and individual reading tasks compared with the CG. Both groups presented reduced number of speech disruptions (stuttering-like and typical dysfluencies) in the automatic speech task; the groups presented similar performance in this task. Regarding speech rate, individuals in the RG presented lower number of words and syllables per minute compared with those in the CG in all speech tasks. Conclusion Participants of the RG presented altered parameters of speech fluency compared with those of the CG; however, this change in fluency cannot be considered a stuttering disorder.
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Elaboration of an instrument to investigate the acquisition of minimal contrast perception in the Brazilian sign language
RESUMO Objetivo Elaborar um instrumento para verificar a percepção dos contrastes mínimos, mediante a utilização de pares de sinais, os quais apresentam oposições em relação a um dos parâmetros: configuração de mão, locação de mão, movimento de mão e orientação de mão. Método Realizou-se um levantamento dos pares mínimos e foram confeccionadas figuras por um profissional das artes visuais, essas foram dispostas em três colunas, podendo ser iguais ou diferentes. Realizou-se a gravação de um vídeo contendo uma intérprete que realizava dois sinais por vez, para que o sujeito que fosse avaliado pudesse visualizá-los e apontar, nas figuras, quais sinais foram solicitados. Os julgadores analisaram os pares, referindo se estavam adequados, podendo realizar modificações ou solicitar que o par mínimo fosse retirado. Os julgadores verificaram ainda se as figuras estavam claras e se eram do vocabulário de crianças. Resultados A análise de concordância realizada entre os avaliadores mostrou resultado significativo para o critério julgado como 'não é par mínimo'. Foram retirados do instrumento 13 itens, pois variavam em mais de um parâmetro, configurando, dessa forma, pares análogos e não pares mínimos. Foram modificados 16 pares e acrescentados sete que variavam quanto ao parâmetro orientação, configurando um total de 35 pares mínimos na versão final do instrumento. Conclusão O objetivo de elaborar um instrumento de percepção de contrastes mínimos foi alcançado, sendo realizados alguns ajustes necessários durante a avaliação de seu conteúdo pelos juízes. O instrumento final foi composto por 35 pares, os quais diferem em somente um parâmetro.
ABSTRACT Purpose To design an instrument to check the perception of minimal contrasts by through pairs of signs, which differ in one the following parameters: handshape, hand location, hand movement and hand orientation. Methods An inventory of minimal pairs was made and some pictures were drawn by a visual artist. These pictures were organized into three columns, which could be equal or different from each other in the pair. A video file with an interpreter making two signs at a time was played to the individual taking the test and this was expected to watch the signs and point to the pictures that corresponded to them. Raters analyzed the pairs and decided whether or not they were accurate. They could modify the pairs or ask for particular pairs to be removed; they also checked if the pictures were clear and if they were part of the children's vocabulary. Results The analysis of agreement among raters had a significant result for the criterion rated as 'not a minimal pair'. Thus, 13 items were removed from the instrument because they differed as to more than one parameter, and were considered either analogous or not minimal pairs. Additionally, 16 pairs were modified, and seven pairs which differed in orientation, were added. As a consequence, there was a total of 35 minimal pairs in the final version of the instrument. Conclusion The purpose of designing an instrument for evaluation of the perception of minimal contrasts was achieved. Some adjustments were made during the assessment of the content of the instrument as suggested by raters. The final instrument was composed of 35 pairs which differ from each other in only one parameter.
http://ift.tt/2tkIfPx
Orofacial characteristics of functionally independent elders
RESUMO Objetivo conhecer as características orofaciais de idosos funcionalmente independentes e analisar a associação com a idade, gênero, nível socioeconômico e estado dentário. Método estudo observacional, transversal de caráter analítico com amostra não probabilística. Foi aplicado o instrumento validado "Protocolo de Avaliação Miofuncional Orofacial com Escalas para Idoso" em sujeitos funcionalmente independentes com idade igual ou acima de 60 anos, em boas condições de saúde segundo avaliação geriátrica padronizada, intitulada Protocolo de Avaliação Multidimensional do Idoso. Resultados os idosos apresentaram padrões de normalidade acima de 60% nos parâmetros de aspecto e mobilidade das estruturas. As alterações significantes foram: sulco nasolabial acentuado; bochechas flácidas ou arqueadas; vedamento labial com tensão ou ausência de vedamento e comissuras labiais deprimidas. As alterações de mobilidade foram pequenas, entre 20,6% e 33,8%, com maior prevalência na elevação da língua e lateralização do ar em bochechas infladas e da mandíbula. Não houve relação destes achados perante a progressão da idade e as classes socioeconômicas. As mulheres apresentaram maior chance de exibirem aspecto normal dos lábios e alguma alteração da mobilidade. O número de dentes associou-se com o volume e a configuração dos lábios e a mobilidade da mandíbula. Além disso, o uso de prótese dentária associou-se significativamente com o aspecto do sulco nasolabial e a tensão/configuração das bochechas. Conclusão este trabalho sugere que o sistema oromiofacial encontra-se dentro dos padrões de normalidade na maioria dos idosos funcionalmente independentes. O que ampara a atuação multiprofissional na prevenção, promoção e tratamento da saúde oromiofuncional dos idosos.
ABSTRACT Purpose to understand the main orofacial characteristics of functionally independent elderly individuals and to investigate their association with age, gender, socioeconomic level, and dental status. Methods an observational, cross-sectional, and analytical study was carried out with a non-probabilistic sample. Inclusion criteria: minimum age of 60 years, individual in good health conditions according to a pre-established protocol published by the health care service. In order to collect the data, we used the validated Orofacial Myofunctional Evaluation with Scores for Aged Protocol. Results The elderly individuals presented normal patterns in more than 60% of the appearance and mobility parameters. Significant alterations observed were: pronounced nasolabial sulcus; flaccid or arched cheeks; labial sealing with tension or absence of sealing; and depressed labial commissures. Alterations in mobility were few, between 20.6% and 33.8%, with higher prevalence of alterations when raising the tongue, lateralizing air inflated in cheeks and jaw. There was no relationship between these findings and the progression of age and socioeconomic classes. Women were more likely to show normal appearance of lips and some alterations in lips mobility. The number of teeth was associated with the volume and shape of lips and with jaw mobility. In addition, the use of dental prosthesis was shown to be significantly related to the nasolabial sulcus aspect and the configuration/tension of cheeks. Conclusion This study suggests normal patterns of oromyofacial system in most functionally independent elderly individuals. It supports multidisciplinary action for prevention, promotion, and treatment of the elderly population's oral functions.
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Differential Connectivity of Gene Regulatory Networks Distinguishes Corticosteroid Response in Asthma
Almost half of asthmatic patients do not respond well to standard treatment. We proposed a network approach to identify key transcription factors and their target genes that may determine differential drug response in asthmatic patients.
http://ift.tt/2ufkVUz
Atopy as a risk factor for subclinical hypothyroidism development in children
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
http://ift.tt/2ufrNRE
Update on Allergen Immunotherapy for Allergic Rhinitis: Drops, Tablets, or Shots?
Abstract
Purpose of Review
Allergen immunotherapy (AIT) is the only disease-modifying treatment available for allergic rhinitis (AR). Dosing considerations, efficacy, and safety of subcutaneous (SCIT), sublingual (SLIT), and intralymphatic (ILIT) immunotherapy are discussed.
Recent Findings
Patients with AR who cannot tolerate or do not wish to continue indefinite pharmacotherapy may be candidates for AIT. SCIT is the gold standard formulation but requires repeat injections over several years and may place the patient at risk for systemic allergic reactions such as anaphylaxis. SLIT has been developed as an alternative formulation by which the patient can avoid multiple injections and physician visits as it is dosed at home. SLIT has been proven to be very safe but still requires prolonged treatment, and efficacy compared to SCIT has been questioned. ILIT is currently being developed with the goal of shortening length of treatment while maintaining the efficacy and safety of SCIT and SLIT.
Summary
SCIT and SLIT are current options for patients wishing to undergo AIT. Further studies are required to determine if ILIT may become an effective option for patients who do not wish to undergo long-term treatments.
http://ift.tt/2udyXYn
Re: Wrong tooth extraction: an examination of ‘Never Event’ data
After the "never" event framework was introduced, a core list of examples was drawn up in 2009 that included operations on the wrong site,1 and a further revision after April 2015 included extraction of the wrong tooth.2,3 We read with interest the article by Pemberton et al3 who found that extraction of the wrong tooth accounted for about a quarter of all procedures at the wrong site, and up to 10% of "never" events in total, all in hospital. As most dental extractions were done in primary care, this raises questions because, as far as we are aware, no data are available from this sector.
http://ift.tt/2tLkz65
Re: Endoscopically-assisted extracapsular dissection of pleomorphic adenoma of the parotid gland through a postauricular sulcus approach in young patients
I read with interest the recent paper by Chen et al1 and commend them on their original work. However, I would like to raise some important points.
http://ift.tt/2uNOz6k
Use of cyanoacrylate tissue adhesive to orientate histopathological specimens
The correct orientation of specimens is important for histopathological diagnosis. Occasionally, after a resected specimen has been inspected, it may be necessary to remove a further section because of concern about involved margins. It is important to orient the second sample correctly with the first, or the potential for error is increased. The use of sutures to bind the specimens can cause artefacts, which can compromise histopathological evaluation. We describe a method to help orientate these specimens accurately.
http://ift.tt/2tLqVTf
Management of upper and lower molars that are displaced into the neighbouring spaces
Our aim was to describe our experience of retrieval of accidental displacements of upper and lower molars into neighbouring anatomical spaces. Thirteen patients were evaluated retrospectively in terms of age, sex, affected side, jaw (mandible or maxilla), surgeon's experience, whether the extracted teeth had erupted, which portion of the tooth or teeth was displaced, the anatomical space into which the fragment was displaced, postoperative complaints, timing of the retrieval, type of anaesthesia, and surgical approach.
http://ift.tt/2uO6Q3u
Free flap reconstruction for patients aged 85 years and over with head and neck cancer: clinical considerations for comprehensive care
We aimed to identify and evaluate the clinical challenges involved in microvascular flap reconstructions of defects caused by resection of head and neck cancer among patients aged 85 and over. We designed a retrospective study of patients who were treated in the head and neck department of a tertiary referral centre from 2005 to 2015, and all patients aged 85 years and over who had reconstructions with microvascular flaps for head and neck cancer were entered into the study. A total of 24 patients fulfilled the criteria, of whom 15 were men and nine were women.
http://ift.tt/2tLaVAo
Intraosseous spindle cell lipoma of the mandible: case report
We describe what is to our knowledge the first reported intraosseous spindle cell lipoma of the mandible. It is the first spindle cell lipoma we have seen that shows dental resorption, and the largest that we have seen published (60×30×20mm).
http://ift.tt/2uO0np9
Severe distortion of an orbital titanium mesh implant after recurrent facial trauma: a potential threat to the orbital contents?
Titanium mesh implants have proved their effectiveness in the reconstruction of fractures of the orbital wall, and their compromise between stiffness and elasticity allows for optimal support of the orbital contents. However, after recurrent orbital trauma, these implants (even when properly positioned) can become a potential "penetrating object" that threatens the critical adjacent anatomical structures. We report the case of a patient with recurrent facial trauma whose orbit had previously been reconstructed with a titanium implant, and which resulted in severe deformation.
http://ift.tt/2tLF7f3
Minimally-invasive removal of a screw in the mandibular condyle using computer-assisted navigation
A sagittal fracture of the mandibular condyle is routinely fixed with screws because they can provide stability, functional restoration, and anatomical reduction.1,2 Plates and screws (and other materials used for osteosynthesis) are not routinely removed unless the patients has particular symptoms or complications,3 but it is a common procedure in the craniomaxillofacial region.3,4 When larger devices are removed we often reopen the original incisions, but because screws are so small it is better to use a different, minimal incision.
http://ift.tt/2uNOqQk
Prevalence of chromosomal aberrations in Argentinean agricultural workers
Abstract
Little is known about biosecurity measures and toxic effects during pesticide application in the province of Jujuy, Argentina, particularly concerning the protective measures and mixture of pesticides used by rural workers. We carried out an observational study of agricultural workers from Jujuy (76 exposed subjects and 53 controls) to investigate the prevalence of chromosomal aberrations (CAs) in human lymphocytes as well as the activity level of acetylcholinesterase (AChE) in red blood cell erythrocytes. Whole blood samples (5 mL) were collected in heparinized Vacutainer tubes for cytogenetic analysis and erythrocyte cholinesterase activity determination according to Ellman's method. Cytogenetic results showed a significant CA increase in pesticide-exposed individuals as compared with controls (4.20 ± 0.15 vs. 1.00 ± 0.05, respectively; p < 0.001), suggesting that pesticides are clastogenic agents causing DNA damage. Erythrocyte cholinesterase activity was significantly lower in exposed individuals, evidencing the possible occurrence of perturbations in blood as well as neurotoxicity in pesticide sprayers. These results suggest the need for periodic biomonitoring of these biomarkers together with education and training of occupational workers for the safe application of potentially harmful pesticides.
http://ift.tt/2uEIxon
Delayed stinging insect reactions
Systemic allergic reactions to stinging insects occur in approximately 1% of children and 3% of adults.1 Immunoglobulin E (IgE)-mediated reactions can present as systemic reactions or large local reactions.1 Systemic reactions present with symptoms related to urticaria, angioedema, airway obstruction, and hypotension (and sometimes abdominal pain, bronchospasm, or cardiac abnormalities) within 5 to 30 minutes after an insect sting.2 Large local reactions present as swelling of at least 10 cm in diameter that is contiguous with the sting site, increases in size for 1 to 2 days, and resolves over 5 to 10 days.
http://ift.tt/2voZJf2
Posterior canal wall reposition for management of cholesteatoma: Technique and results
Publication date: Available online 20 July 2017
Source:Auris Nasus Larynx
Author(s): Mohammad Kamal Mobashir, Waleed M. Basha, Abd ElRaof Said Mohamed, Mohammed Elsayed Elmaghawry
ObjectiveThe main goal of surgery in acquired middle ear cholesteatomas is the complete eradication of the disease with an ear free of discharge. This can be performed either by open or closed techniques with their benefits and drawbacks. We present the technique of reposition of the posterior canal wall for the management of cholesteatoma cases and its results and outcome.Patients and methodsThis study included 31 patients with primary acquired middle ear cholesteatoma. The surgical technique included complete cortical mastoidectomy, wide posterior tympanotomy, dividing the bony posterior meatal wall with a micro-sagittal saw and its removal, dissection and eradication of cholesteatoma, and repositioning the canal wall segment in its anatomical site.ResultsNo significant intraoperative complication occurred. An injury to the dura occurred in one patient. Damage of the bony posterior canal wall occurred in two patients during saw cutting. Residual cholesteatoma was found in two patients. No dislocation or necrosis of the reconstructed posterior canal wall was noted and the new reconstructed external ear canal appeared to be of near normal size, shape, and contour.ConclusionThis technique provides optimal surgical exposure and access to areas that are difficult to reach by CWU approach, allows removal of the cholesteatoma without intraoperative complications, decreases the rate of residual cholesteatoma, restores near-normal anatomy of the external auditory canal, and avoids the sequelae of the open mastoid cavity. Therefore, it would be a feasible alternative to the standard CWU and CWD procedures.
http://ift.tt/2tkrqEe
Treatment of pharyngotympanic tube dysfunction
Publication date: Available online 19 July 2017
Source:Auris Nasus Larynx
Author(s): Holger H. Sudhoff, Stefan Mueller
Eustachian tube dysfuntion intends to describe a variety of signs, symptoms, and physical findings that result from the impairment of ET function. A large variety of methods have been employed to assess ET function in the literature. Due to the lack of high level evidence, it is difficult to draw conclusions on the effectiveness of medical and surgical treatments. There are various medical and surgical interventions available for chronic obstructive ET dysfunction including balloon Eustachian tuboplasty (BET) and laser or microdebrider tuboplasty. Consensus on diagnostic criteria for ETD is required to define inclusion criteria of future trials. There is however emerging work with reassuring, but preliminary, results that suggest evidence for safety in the surgical management of ETD. Like many newly introduced techniques the current data remains limited to non-controlled case-series, with heterogeneous data collection methods and lacking substantial long-term outcomes. Nevertheless, short-term data provide favorable results. Current treatment options comprising BET and patulous ET surgery may be offered as a treatment possibility to selected patients.
http://ift.tt/2voOLWF
Three-dimensional volumetric changes in the upper airway after maxillomandibular advancement in obstructive sleep apnoea patients and the impact on quality of life
Obstructive sleep apnoea (OSA) is a sleep-related breathing disorder, characterized by repetitive airway obstructions, causing disruptive snoring and daytime sleepiness. Maxillomandibular advancement (MMA), which enlarges the upper airway, is a therapeutic surgical approach. However, no study has performed an upper airway sub-region analysis using validated three-dimensional (3D) anatomical and technical limits on cone beam computed tomography (CBCT). Hence, this prospective, observational trial was performed to evaluate 3D volumetric changes in the upper airway according to validated 3D cephalometric landmarks, before and after MMA, for all patients with a polysomnography diagnosis of OSA (apnoea–hypopnoea index (AHI) ≥5).
http://ift.tt/2vGuECE
Central nervous system anomalies in craniofacial microsomia: a systematic review
Extracraniofacial anomalies, including central nervous system (CNS) anomalies, may occur in craniofacial microsomia (CFM). This systematic review was performed to provide an overview of the literature on the prevalence and types of CNS anomalies and developmental disorders in CFM, in order to improve the recognition and possible treatment of these anomalies. A systematic search was conducted and data on the number of patients, patient characteristics, type and prevalence of CNS anomalies or developmental delay, and correlations between CFM and CNS anomalies were extracted.
http://ift.tt/2vGwlAg
Corrigendum to “Multifactorial sleep disturbance in Parkinson's disease” [Sleep Med 35 (2017) 41–48]
The authors regret that an error was present within the reference list – the names of the authors and the year of publication were incorrectly listed for reference number 68. The corrected reference is shown below:
http://ift.tt/2uH21rQ
Posterior canal wall reposition for management of cholesteatoma: Technique and results
The main goal of surgery in acquired middle ear cholesteatomas is the complete eradication of the disease with an ear free of discharge. This can be performed either by open or closed techniques with their benefits and drawbacks. We present the technique of reposition of the posterior canal wall for the management of cholesteatoma cases and its results and outcome.
http://ift.tt/2uH8uTM
Gender comparisons in children with ASD entering early intervention
Source:Research in Developmental Disabilities, Volume 68
Author(s): Alexandra M. Fulton, Jessica M. Paynter, David Trembath
BackgroundMales are diagnosed with Autism Spectrum Disorder (ASD) approximately four times as often as females. This has led to interest in recent years of potential under-diagnosis of females, as well as negative consequences for females with ASD due to under-identification. A number of potential explanations for gender bias in diagnosis are discussed including that females and males may present differently despite showing the same core symptoms. Previous research has shown inconsistent findings in comparisons between genders in young children with ASD for whom early intervention is vital. Thus, the aim of the present study was to investigate the social, communication, and cognitive functioning, as well as level of ASD symptoms, in a cohort of children who presented for early intervention to inform understanding of gender differences in this population, as well as to inform understanding of the mechanisms by which gender bias may occur.MethodParticipants included 254 children (42 females) aged 29–74 months who completed measures of cognition, communication skills, adaptive behaviour, and ASD symptoms on entry to early intervention.ResultsConsistent with hypotheses, no significant gender differences were found both overall, and when split by functioning level. However, a similar ratio of males and females was found in both high- and low-functioning groups contrary to predictions.ConclusionsThese results are consistent with some of the previous research that suggests gender differences may not be apparent in clinical samples at this young age. We highlight a need for further research that may use universal screening or longitudinal methods to understand the trajectory of development for females with ASD specifically. Such research could better inform timely and tailored intervention from the preschool years onwards.
http://ift.tt/2vp5Lw6
Longitudinal assessment of gait quality in children with bilateral cerebral palsy following repeated lower limb intramuscular Botulinum toxin-A injections
Source:Research in Developmental Disabilities, Volume 68
Author(s): Felicity A. Read, Roslyn N. Boyd, Lee A. Barber
BackgroundSerial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS).AimTo determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures.Methods and proceduresSeventeen children with BCP and dynamic equinus (8 females and 9 males, age mean (SD), 4.0 (2.2) years, GMFCS I=2 and II=15) were included in the study after a retrospective audit of the records of the Queensland Children's Gait Laboratory (QCGL), Children's Health Queensland, Brisbane. The medical records of children who attended the QCGL between January 2001 and January 2016 were searched for eligibility. Children who had undertaken pre- and post-treatment 2DVGA for the first three lower limb BoNT-A treatment cycles (6 assessments) were reviewed using the EVGS. BoNT-A treatments were administered 7.7 (2.3) months apart and post-BoNT-A reviews occurred 12.6 (6.7) weeks after injection. Mixed-effects linear regression assessed the change from baseline to each subsequent assessment (p<0.05).Outcomes and resultsEVGS reduced significantly by a mean of 2.4 points from pre- to post-BoNT-A in the first treatment cycle (p=0.001). Compared to baseline, mean total EVGS reduced significantly during the second (pre-BoNT-A −1.7 (p=0.020), post BoNT-A −2.8 (p<0.001)) and third (pre-BoNT-A −2.6 (p=0.001), post BoNT-A −2.4 (p=0.002)) treatment cycles. There was no difference in EVGS between post-BoNT-A in the first treatment cycle and scores for the second and third treatment cycles.Conclusions and implicationsImprovements in gait quality were statistically significant, but did not reach the EVGS smallest real difference value of 4 points. Repeated lower limb intramuscular BoNT-A injections to improve gait quality in children with BCP should be reconsidered.
http://ift.tt/2gOEdNn
Spectrum of lesions derived from branchial arches occurring in the thyroid: from solid cell nests to tumors
Abstract
There is a group of lesions in the head and neck region derived from branchial arches and related structures which, when inflamed, are characterized by the formation of cysts lined by squamous or glandular epithelium and surrounded by a heavy inflammatory infiltrate rich in germinal centers. In the thyroid, the main source of various structures which may cause diagnostic dilemma is the ultimobranchial body. To investigate the spectrum of such thyroid lesions, the consultation files were reviewed for thyroid samples containing pathological structures regarded to arise from the ultimobranchial body. Positive reaction with antibodies against CK5/6, p63, galectin 3, and CEA, and negative reaction with antibodies against thyroglobulin, TTF-1, and calcitonin were used to confirm the diagnosis. The specific subtype of the ultimobranchial body-derived lesion was then determined based on histological examination of H&E-stained slides. Twenty-one cases of ultimobranchial body-derived lesions were retrieved from the consultation files, 20 of them along with clinical information (M/F = 6/14, mean age 55 years, range 36–68 years). Lesions derived from the ultimobranchial body were classified as follows: (hyperplastic) solid cell nests (nine cases), solid cell nests with focal cystic change (five cases), cystic solid cell nests (two cases), branchial cleft-like cyst (four cases), and finally a peculiar Warthin tumor-like lesion (one case). We suggest that the common denominator of these structures is that they all arise due to activation of inflammatory cells around the vestigial structures, which leads to cystic dilatation and proliferation of the epithelial component.
http://ift.tt/2ufUS1d
Fast carotid artery MR angiography with compressed sensing based three-dimensional time-of-fight sequence
Source:Magnetic Resonance Imaging
Author(s): Bo Li, Hao Li, Li Dong, Guofu Huang
ObjectiveIn this study, we sought to investigate the feasibility of fast carotid artery MR angiography (MRA) by combining three-dimensional time-of-flight (3D TOF) with compressed sensing method (CS-3D TOF).Materials and methodsA pseudo-sequential phase encoding order was developed for CS-3D TOF to generate hyper-intense vessel and suppress background tissues in under-sampled 3D k-space. Seven healthy volunteers and one patient with carotid artery stenosis were recruited for this study. Five sequential CS-3D TOF scans were implemented at 1, 2, 3, 4 and 5-fold acceleration factors for carotid artery MRA. Blood signal-to-tissue ratio (BTR) values for fully-sampled and under-sampled acquisitions were calculated and compared in seven subjects. Blood area (BA) was measured and compared between fully sampled acquisition and each under-sampled one.ResultsThere were no significant differences between the fully-sampled dataset and each under-sampled in BTR comparisons (P>0.05 for all comparisons). The carotid vessel BA measured from the images of CS-3D TOF sequences with 2, 3, 4 and 5-fold acceleration scans were all highly correlated with that of the fully-sampled acquisition. The contrast between blood vessels and background tissues of the images of 2 to 5-fold acceleration is comparable to that of fully sampled images. The images at 2× to 5× exhibit the comparable lumen definition to the corresponding images at 1×.ConclusionBy combining pseudo-sequential phase encoding order, CS reconstruction, and 3D TOF sequence, this technique provides excellent visualizations for carotid vessel and calcifications in a short scan time. It has the potential to be integrated into current multiple blood contrast imaging protocol.
http://ift.tt/2uECIHx
Assessment of MRI issues for a new cerebral spinal fluid shunt, gravitational valve (GV)
Source:Magnetic Resonance Imaging
Author(s): Daniel Moghtader, Hans-Joachim Crawack, Christoph Miethke, Zinah Dörlemann, Frank G. Shellock
PurposeA gravitational valve (GV) may be used to treat hydrocephalus, offering possible advantages that include avoidance of over drainage and long-term complications. Because a GV is made from metal, there are potential safety and other problems related to the use of MRI. The objective of this investigation was to evaluate MRI-related issues (i.e., magnetic field interactions, heating, and artifacts) for a newly developed, metallic GV.MethodsTests were performed on the GV (GAV 2.0) using well-accepted techniques to assess magnetic field interactions (translational attraction and torque, 3-Tesla), MRI-related heating (1.5-T/64-MH and 3-T/128-MHz, whole body averaged SAR, 2.7-W/kg and 2.9-W/kg, respectively), artifacts (3-Tesla; gradient echo and T1-weighted, spin echo sequences), and possible functional changes related to exposures to different MRI conditions (exposing six samples each to eight different pulse sequences at 1.5-T/64-MHz and 3-T/128-MHz).ResultsMagnetic field interactions were not substantial (deflection angle 2°, no torque) and heating was minor (highest temperature rise, ≥1.9°C, highest background temperature rise, ≥1.7°C). Artifacts on the gradient echo pulse sequence extended approximately 10mm from the size and shape of the GV. The different exposures to 1.5-T/64-MHz and 3-T/128-MHz conditions did not alter or damage the operational aspects of the GV samples.ConclusionsThe findings demonstrated that MRI can be safely used in patients with this GV and, thus, this metallic implant is deemed acceptable or "MR Conditional" (i.e., using current labeling terminology), according to the conditions used in this study.
http://ift.tt/2voYKeQ
Predicting the nodal status in gastric cancers: The role of apparent diffusion coefficient histogram characteristic analysis
Source:Magnetic Resonance Imaging
Author(s): Song Liu, Yujuan Zhang, Jie Xia, Ling Chen, Wenxian Guan, Yue Guan, Yun Ge, Jian He, Zhengyang Zhou
PurposeTo explore the application of histogram analysis in preoperative T and N staging of gastric cancers, with a focus on characteristic parameters of apparent diffusion coefficient (ADC) maps.Materials and methodsEighty-seven patients with gastric cancers underwent diffusion weighted magnetic resonance imaging (b=0, 1000s/mm2), which generated ADC maps. Whole-volume histogram analysis was performed on ADC maps and 7 characteristic parameters were obtained. All those patients underwent surgery and postoperative pathologic T and N stages were determined.ResultsFour parameters, including skew, kurtosis, s-sDav and sample number, showed significant differences among gastric cancers at different T and N stages. Most parameters correlated with T and N stages significantly and worked in differentiating gastric cancers at different T or N stages. Especially skew yielded a sensitivity of 0.758, a specificity of 0.810, and an area under the curve (AUC) of 0.802 for differentiating gastric cancers with and without lymph node metastasis (P<0.001). All the parameters, except AUClow, showed good or excellent inter-observer agreement with intra-class correlation coefficients ranging from 0.710 to 0.991.ConclusionCharacteristic parameters derived from whole-volume ADC histogram analysis could help assessing preoperative T and N stages of gastric cancers.
http://ift.tt/2uDUWsI
Monitoring of Free Flaps with Combined Tissue Spectrophotometry and Laser Doppler Flowmetry in an Animal Experimental Model
J reconstr Microsurg
DOI: 10.1055/s-0037-1603735
Background When mobilizing free flaps, postoperative monitoring of perfusion is crucial to detect ischemia. Continuous monitoring may be feasible by applying a combination of tissue spectrophotometry and laser Doppler flowmetry (oxygen-2-see [O2C]). Material and Methods On 10 pigs, two symmetrical myocutaneous flaps were mobilized on each side of the abdomen based on the deep inferior epigastric vessels. Flaps were randomized to clamp either the artery or the vein and measurements using O2C were performed before, during, and after the intervention yielding information on blood flow, saturation (sat), and relative tissue hemoglobin (rHgb) concentration. Results Baseline values were similar in all groups. Introduction of ischemia caused a rapid decline in arterial ischemic flaps which all reached threshold levels in 3 minutes, whereas that was only the case for three of six venous ischemic flaps. Venous clamping resulted in a decline in sat, while the response to arterial clamping was an initial decline followed by an increase in sat. In all arterial ischemic flaps, rHgb concentration either decreased or remained at baseline levels but increased in all venous ischemic flaps. The median time to a 30% rise was 1 minute at an 8-mm depth. The rate of decreasing flow along with the rHgb measurements made it possible to distinguish the arterial ischemia (AI) from the venous ischemia (VI) within the first few minutes. Conclusion In this animal experimental model, O2C measurements of blood flow reliably detected ischemia. By adding information about rHgb, it was possible to distinguish between AI and VI.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 225-262
DOI: 10.1055/s-0037-1603726
Noise levels are truly continuous in relatively few occupations, with some degree of intermittency the most common condition. The sound levels of intermittent noise are often referred to as non-Gaussian in that they are not normally distributed in the time domain. In some conditions, intermittent noise affects the ear differently from continuous noise, and it is this assumption that underlies the selection of the 5-dB exchange rate (ER). The scientific and professional communities have debated this assumption over recent decades. This monograph explores the effect of non-Gaussian noise on the auditory system. It begins by summarizing an earlier report by the same author concentrating on the subject of the ER. The conclusions of the earlier report supported the more conservative 3-dB ER with possible adjustments to the permissible exposure limit for certain working conditions. The current document has expanded on the earlier report in light of the relevant research accomplished in the intervening decades. Although some of the animal research has supported the mitigating effect of intermittency, a closer look at many of these studies reveals certain weaknesses, along with the fact that these noise exposures were not usually representative of the conditions under which people actually work. The more recent animal research on complex noise shows that intermittencies do not protect the cochlea and that many of the previous assumptions about the ameliorative effect of intermittencies are no longer valid, lending further support to the 3-dB ER. The neurologic effects of noise on hearing have gained increasing attention in recent years because of improvements in microscopy and immunostaining techniques. Animal experiments showing damage to auditory synapses from noise exposures previously considered harmless may signify the need for a more conservative approach to the assessment of noise-induced hearing loss and consequently the practice of hearing conservation programs.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study
Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1604426
The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4–6 weeks and 12–14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained. Forty patients were included in the final analysis. Emotional distress was present in nine participants and five participants satisfied the TSQ criteria for a diagnosis of stress disorder. Anxiety and depression were observed in 10 and 4 patients, respectively. Characteristics associated with abnormal high scores included substance abuse, low education and income levels, facial scars, and complications needing additional intervention. These findings reveal the abnormal psychological response to maxillofacial trauma in immediate and follow-up periods. The use of such screening tools can be considered by the maxillofacial surgeon for early identification of psychological symptoms and referral to the psychiatrist.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2uH7WNt
Differential Connectivity of Gene Regulatory Networks Distinguishes Corticosteroid Response in Asthma
Publication date: Available online 20 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Weiliang Qiu, Feng Guo, Kimberly Glass, Guo Cheng Yuan, John Quackenbush, Xiaobo Zhou, Kelan G. Tantisira
BackgroundVariations in drug response between individuals have prevented us from achieving high drug efficacy in treating many complex diseases, including asthma. Genetics plays an important role in accounting for such inter-individual variations in drug response. However, systematic approaches for addressing how genetic factors and their regulators determine variations in drug response in asthma treatment are lacking.MethodsWe used PANDA (Passing Attributes between Networks for Data Assimilations) to construct the gene regulatory networks associated with good responders and poor responders to inhaled corticosteroids based on a subset of 145 Caucasian asthmatic children who participated in the Childhood Asthma Management Cohort (CAMP). PANDA utilizes gene expression profiles and published relationships among genes, transcription factors (TFs), and proteins to construct the directed networks of TFs and genes. We assessed the differential connectivity between the gene regulatory network of good responders vs. that of poor responders.ResultsWhen compared to poor responders, the network of good responders has differential connectivity and distinct ontologies (e.g., pro-apoptosis enriched in network of good responders and anti-apoptosis enriched in network of poor responders). Many of the key hubs identified in conjunction with clinical response are also cellular response hubs. Functional validation demonstrated abrogation of differences in corticosteroid treated cell viability following siRNA knockdown of two TFs and differential downstream expression between good-responders and poor-responders.ConclusionsWe have identified and validated multiple transcription factors influencing asthma treatment response. Our results show that differential connectivity analysis can provide new insights into the heterogeneity of drug treatment effects.
Teaser
Almost half of asthmatic patients do not respond well to standard treatment. We proposed a network approach to identify key transcription factors and their target genes that may determine differential drug response in asthmatic patients.http://ift.tt/2gOFBzy
An Enlarging Neck Mass
A man in his 50s presented with sudden onset of neck swelling, pain, respiratory distress, and jaw pain; his neck was diffusely swollen without palpable fluctuance, induration, or a discrete mass, and imaging showed a large hyperdense mass. What is your diagnosis?
http://ift.tt/2pdiej3
http://ift.tt/2pdiej3
Health Literacy in Patients With Head and Neck Cancer
This Viewpoint discusses the impact of health literacy on treatment compliance and outcomes in a number of medical conditions, focusing on a general measure and a cancer-specific measure of health literacy.
http://ift.tt/2pCbTgB
http://ift.tt/2pCbTgB
Health Literacy in Patients With Head and Neck Cancer
This Viewpoint discusses the impact of health literacy on treatment compliance and outcomes in a number of medical conditions, focusing on a general measure and a cancer-specific measure of health literacy.
http://ift.tt/2pCbTgB
http://ift.tt/2pCbTgB
Exclusion of Eligible Indeterminate Thyroid Nodules in Estimates of Negative Predictive Value for the Gene Expression Classifier—Reply
In Reply We appreciate all scientific efforts to improve care for patients with indeterminate nodules. The Afirma assay has been an excellent addition to this endeavor, and our study helpful in understanding test characteristics in a unique patient population.
http://ift.tt/2p8bOUD
http://ift.tt/2p8bOUD
Exclusion of Eligible Indeterminate Thyroid Nodules in Estimates of Negative Predictive Value for the Gene Expression Classifier—Reply
In Reply We appreciate all scientific efforts to improve care for patients with indeterminate nodules. The Afirma assay has been an excellent addition to this endeavor, and our study helpful in understanding test characteristics in a unique patient population.
http://ift.tt/2p8bOUD
http://ift.tt/2p8bOUD
Cost as a Barrier for Hearing Aid Adoption
This Viewpoint explores the broader barriers audiologists face in providing services and technologies to those with reduced hearing ability and why cost is not the main barrier for patients.
http://ift.tt/2rvEVQn
http://ift.tt/2rvEVQn
Addressing Estimated Hearing Loss in Adults in 2060
This population epidemiology study uses data from the NHANES to estimate the number of adults expected to have hearing loss in the next 43 years.
http://ift.tt/2libQJc
http://ift.tt/2libQJc
Posttonsillectomy Hemorrhage in the Ibuprofen Era
The perioperative treatment of children undergoing tonsillectomy with or without adenoidectomy has changed considerably since the publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation "Clinical Practice Guideline: Tonsillectomy in Children" in 2011. Intraoperative dexamethasone has been advocated, perioperative antibiotics have been discouraged, and the previously commonly used combination of acetaminophen and narcotics (codeine or oxycodone hydrochloride) for postoperative pain management has been replaced by the alternative combination of acetaminophen and nonsteroidal anti-inflammatory drugs, principally ibuprofen. The latter recommendation is based principally on the following 3 factors: the comparative effectiveness of ibuprofen to narcotics for posttonsillectomy pain control; the absence of evidence in systematic review that the use of nonsteroidal anti-inflammatory drugs after tonsillectomy is associated with an increased risk for bleeding or clinical intervention owing to bleeding; and concerns regarding the ultrarapid metabolism of codeine and, to a lesser degree, oxycodone in specific individuals, resulting in significantly higher plasma concentrations of morphine compared with normal metabolizers. Indeed, documentation from 1969 to 2012 of multiple cases of death or overdose after tonsillectomy in pediatric patients who had taken codeine postoperatively prompted the US Food and Drug Administration to issue a black box warning in 2013 stating that codeine use was contraindicated in children for this indication.
http://ift.tt/2pK9VMw
http://ift.tt/2pK9VMw
Addressing Estimated Hearing Loss in Adults in 2060
This population epidemiology study uses data from the NHANES to estimate the number of adults expected to have hearing loss in the next 43 years.
http://ift.tt/2libQJc
http://ift.tt/2libQJc
Association Between Ibuprofen Use and Surgically Managed Posttonsillectomy Hemorrhage
This cohort study evaluates the association between ibuprofen use and severity of posttonsillectomy hemorrhage using transfusion events as a marker of severity in pediatric patients undergoing tonsillectomy.
http://ift.tt/2pDilH3
http://ift.tt/2pDilH3
Superior Canal Dehiscence Syndrome Affecting 3 Families
This case series describes the features of superior canal dehiscence syndrome in the multiple affected members of 3 families and explores the prospect of a genetic origin.
http://ift.tt/2o1zOGQ
http://ift.tt/2o1zOGQ
Posttonsillectomy Hemorrhage in the Ibuprofen Era
The perioperative treatment of children undergoing tonsillectomy with or without adenoidectomy has changed considerably since the publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation "Clinical Practice Guideline: Tonsillectomy in Children" in 2011. Intraoperative dexamethasone has been advocated, perioperative antibiotics have been discouraged, and the previously commonly used combination of acetaminophen and narcotics (codeine or oxycodone hydrochloride) for postoperative pain management has been replaced by the alternative combination of acetaminophen and nonsteroidal anti-inflammatory drugs, principally ibuprofen. The latter recommendation is based principally on the following 3 factors: the comparative effectiveness of ibuprofen to narcotics for posttonsillectomy pain control; the absence of evidence in systematic review that the use of nonsteroidal anti-inflammatory drugs after tonsillectomy is associated with an increased risk for bleeding or clinical intervention owing to bleeding; and concerns regarding the ultrarapid metabolism of codeine and, to a lesser degree, oxycodone in specific individuals, resulting in significantly higher plasma concentrations of morphine compared with normal metabolizers. Indeed, documentation from 1969 to 2012 of multiple cases of death or overdose after tonsillectomy in pediatric patients who had taken codeine postoperatively prompted the US Food and Drug Administration to issue a black box warning in 2013 stating that codeine use was contraindicated in children for this indication.
http://ift.tt/2pK9VMw
http://ift.tt/2pK9VMw
Sphenoid Sinus and Petrous Apex Mass
A man had worsening blurry vision, gait instability, headache, and nasal congestion; examination revealed bilateral visual acuity of 20/100 with intact visual fields and a well-circumscribed expansile mass occupying the left petrous apex and sphenoid sinus. What is your diagnosis?
http://ift.tt/2i5PLbG
http://ift.tt/2i5PLbG
Bilateral Hearing and Vestibular Loss in a Patient With Untreated CML
This case study describes a man in his 40s with uncontrolled chronic myeloid leukemia who presented with sudden-onset positional vertigo and profound sensorineural hearing loss.
http://ift.tt/2rZkKuc
http://ift.tt/2rZkKuc
Experience of US Patients Who Self-identified Overdiagnosed Thyroid Cancer
This qualitative study describes the experience of US patients who independently self-identify as having an overdiagnosed cancer and elect not to intervene.
http://ift.tt/2m7dauU
http://ift.tt/2m7dauU
Oral Cavity and Oropharyngeal Cancer Biomarkers in Surgical Drain Fluid
This cohort study determines whether there is an association between biomarker levels in surgical drain fluid of patients with head and neck cancer and disease-free survival and cancer recurrence.
http://ift.tt/2obUZo3
http://ift.tt/2obUZo3
Risks and Harms of Management of Incidental Thyroid Nodules
This review assesses the clinical dilemma of the incidental thyroid nodule, the risk for missing a significant cancer, and the potential harms of examination and reviews management recommendations for patients with these findings.
http://ift.tt/2pH9ipJ
http://ift.tt/2pH9ipJ
Bilateral Hearing and Vestibular Loss in a Patient With Untreated CML
This case study describes a man in his 40s with uncontrolled chronic myeloid leukemia who presented with sudden-onset positional vertigo and profound sensorineural hearing loss.
http://ift.tt/2rZkKuc
http://ift.tt/2rZkKuc
Unilateral Hearing Loss and Otorrhea
A man in his 70s had painless left-sided otorrhea, aural fullness, and hearing loss; temporal bone computed tomography demonstrated near-complete opacification of the left mastoid air cells and middle ear. What is your diagnosis?
http://ift.tt/2pHfeit
http://ift.tt/2pHfeit
Experience of US Patients Who Self-identified Overdiagnosed Thyroid Cancer
This qualitative study describes the experience of US patients who independently self-identify as having an overdiagnosed cancer and elect not to intervene.
http://ift.tt/2m7dauU
http://ift.tt/2m7dauU
Survival After Salvage Surgery for Recurrent Oral Cavity Cancer
This cohort study evaluates overall survival in patients who undergo salvage surgery for recurrent oral cavity squamous cell cancer.
http://ift.tt/2oNl1y8
http://ift.tt/2oNl1y8
Oral Cavity and Oropharyngeal Cancer Biomarkers in Surgical Drain Fluid
This cohort study determines whether there is an association between biomarker levels in surgical drain fluid of patients with head and neck cancer and disease-free survival and cancer recurrence.
http://ift.tt/2obUZo3
http://ift.tt/2obUZo3
Surgery and Radiotherapy vs Chemoradiotherapy for Oral Cavity Cancer
This study compares the differences in survival between patients with locally advanced oral cavity squamous cell carcinoma treated with surgery followed by postoperative radiotherapy vs chemoradiotherapy.
http://ift.tt/2pWmrY6
http://ift.tt/2pWmrY6
Risks and Harms of Management of Incidental Thyroid Nodules
This review assesses the clinical dilemma of the incidental thyroid nodule, the risk for missing a significant cancer, and the potential harms of examination and reviews management recommendations for patients with these findings.
http://ift.tt/2pH9ipJ
http://ift.tt/2pH9ipJ
Preoperative Calcium and Calcitriol and Hypocalcemia After Thyroidectomy
This cohort study compares the incidence of symptomatic hypocalcemia following administration of calcium and calcitriol supplementation given preoperatively and postoperatively vs postoperative therapy alone in patients undergoing total thyroidectomy.
http://ift.tt/2paZQdG
http://ift.tt/2paZQdG
Unilateral Hearing Loss and Otorrhea
A man in his 70s had painless left-sided otorrhea, aural fullness, and hearing loss; temporal bone computed tomography demonstrated near-complete opacification of the left mastoid air cells and middle ear. What is your diagnosis?
http://ift.tt/2pHfeit
http://ift.tt/2pHfeit
Survival After Salvage Surgery for Recurrent Oral Cavity Cancer
This cohort study evaluates overall survival in patients who undergo salvage surgery for recurrent oral cavity squamous cell cancer.
http://ift.tt/2oNl1y8
http://ift.tt/2oNl1y8
Frontal Sinus Lesion
A woman with allergic rhinitis experienced progressive periorbital edema and proptosis of the left eye, with nasal congestion, altered sense of smell, supraorbital pain, proptosis, and periorbital edema; a CT scan revealed extensive thickening of the left frontal bone. What is your diagnosis?
http://ift.tt/2p85NY9
http://ift.tt/2p85NY9
Surgery and Radiotherapy vs Chemoradiotherapy for Oral Cavity Cancer
This study compares the differences in survival between patients with locally advanced oral cavity squamous cell carcinoma treated with surgery followed by postoperative radiotherapy vs chemoradiotherapy.
http://ift.tt/2pWmrY6
http://ift.tt/2pWmrY6
To coil or not to coil: application practices, perception and efficacy of mosquito coils in a malaria-endemic community in Ghana
Abstract
Although evidence of mosquito coils' impact on disease epidemiology is limited, they are popularized as mosquito-borne disease prevention devices. Their usage affects the environment, human and mosquito health. This study investigated the perception, usage pattern and efficacy of coils in a predominantly poor malaria-endemic Ghanaian peri-urban area. Information on protection methods, perception and usage pattern was garnered using questionnaires. The efficacy of commonly used coils in the area was then assessed on the malaria vector, Anopheles gambiae, in a glass chamber. Sole or co-application of mosquito control methods and risky usage practices were reported. Coils were deemed harmful to humans and mosquitoes, and their perceived effectiveness varied, with several factors influencing their purchase. High d-allethrin concentration coils induced quicker mosquito knockdown; however, mortality was less than 85%. The coil usage pattern compromises users' health and can enhance mosquito tolerance to d-allethrin. The coils were ineffective against the vector, outlining a dichotomy between the users' perception of efficacy and the observed efficacy. Hence, the usage of other safer and more effective vector control methods should be encouraged to protect households.
http://ift.tt/2tkHaXO
Functional connectivity and cognitive impairment in migraine with and without aura
Several fMRI studies in migraine assessed resting state functional connectivity in different networks suggesting that this neurological condition was associated with brain functional alteration. The aim of pre...
http://ift.tt/2tLco9O
Therapeutical approaches to paroxysmal hemicrania, hemicrania continua and short lasting unilateral neuralgiform headache attacks: a critical appraisal
Hemicrania continua (HC), paroxysmal hemicrania (PH) and short lasting neuralgiform headache attacks (SUNCT and SUNA) are rare syndromes with a difficult therapeutic approach. The aim of this review is to summ...
http://ift.tt/2uExZFt
The Myth of the Internal Nasal Valve
This Viewpoint examines misunderstandings of flow mechanisms through the nasal gateway.
http://ift.tt/2nIgNaD
http://ift.tt/2nIgNaD
Analysis of the Trend Toward Fuller Lips Among Fashion Models
This study examined 50 years of facial images of fashion models to determine a trend toward fuller lips.
http://ift.tt/2jIV70L
http://ift.tt/2jIV70L
Analysis of Rhytidectomy Malpractice Litigation Cases
This analysis describes the factors associated with medical malpractice litigation and resolution related to rhytidectomy.
http://ift.tt/2kTt3YA
http://ift.tt/2kTt3YA
Modern Management of Nasal Hemangiomas
This article discusses the current options available for treatment of infantile hemangiomas of the nose.
http://ift.tt/2pBZJ7d
http://ift.tt/2pBZJ7d
Body Dysmorphic Disorder in Facial Plastic Surgery Clinics
This prospective cohort study attempts to establish the prevalence of body dysmorphic disorder across facial plastic and oculoplastic surgery practice settings and to estimate the ability of surgeons to screen for it.
http://ift.tt/2h1MTOU
http://ift.tt/2h1MTOU
Photographic Standards for Patients With Facial Palsy
This literature search reviews the use of facial photography in the management of patients with facial palsy, and a cross-sectional survey of the Sir Charles Bell Society members examines their use of photography in documenting facial nerve function.
http://ift.tt/2jjlnu0
http://ift.tt/2jjlnu0
Incorrect Type of Online Review Cited
In the article titled "Negative and Positive Online Patient Reviews of Physicians—1 vs 5 Stars," an incorrect type of online review cited has been corrected. In the Results section, "33 of 152 comments (21.7%) accompanied 5-star reviews based on how honest the physician seemed to be" has been changed to "33 of 152 comments (21.7%) accompanied 5-star reviews based on how knowledgeable the physician seemed to be." This article has been corrected online.
http://ift.tt/2lvwsfE
http://ift.tt/2lvwsfE
Tissue Expander Effect in Surgical Management of Infantile Hemangiomas
This case series describes use of the tissue expansion effect in surgical intervention for young children with focal infantile hemangiomas.
http://ift.tt/2kuHF0b
http://ift.tt/2kuHF0b
Association of Increasing Nasal Tip Projection With Lip Position
This case series evaluates the association of increasing nasal tip projection with lip position patients undergoing primary rhinoplasty.
http://ift.tt/2ovUnwU
http://ift.tt/2ovUnwU
Use of Spreader Flaps Without Dorsal Hump Reduction and Nasal Function
This medical record review evaluates whether spreader flaps are equivalent to spreader grafts in correcting internal nasal valve collapse in the absence of simultaneous dorsal hump reduction in a series of patients undergoing open septorhinoplasty.
http://ift.tt/2lvvlg0
http://ift.tt/2lvvlg0
Defining the Perfect Mouth
Solidifying the aesthetic definition of beautiful lips has been a prominent and timely quest in light of the rapid expansion in popularity of injectable fillers. Our ability to contour and define the perioral region has led to an ever-younger population seeking not only rejuvenation but also reshaping of natural anatomy. Led by celebrity experience and social media discussion, requests are routinely made for injectables to shape the appearance of named celebrities' lips. Consumer demand has led to an increasing body of literature, seeking to quantify a uniform scale for assessment of lip fullness. Moving beyond the ability to describe the volumetric improvements, we next seek to identify and describe what ideal outcome we want to achieve.
http://ift.tt/2lPJBS2
http://ift.tt/2lPJBS2
Association of Upper Eyelid Ptosis Repair and Blepharoplasty With Headache-Related QOL
This cohort study evaluates the changes in headache-related quality of life in patients who underwent upper eyelid ptosis repair or blepharoplasty.
http://ift.tt/2meqIb1
http://ift.tt/2meqIb1
Costal Cartilage Harvest Technique
This Surgical Pearl describes a technique to reduce surgical time and patient pain and risk in costal cartilage harvest.
http://ift.tt/2mLmxnO
http://ift.tt/2mLmxnO
Biomechanics of Fractures Associated With Orbital Floor Fractures
This cadaver study defines the biomechanical factors associated with orbital floor fractures using a drop tower with an accelerometer to measure impact force on the globe and rim of cadaver heads affixed with strain gauges.
http://ift.tt/2mLylpT
http://ift.tt/2mLylpT
Italian Linguistic Validation of the FACE-Q Instrument
Linguistic validation is essential in translating patient-reported outcomes.
http://ift.tt/2mKsiyY
http://ift.tt/2mKsiyY
Outcomes of radioembolization for unresectable hepatocellular carcinoma in patients with marginal functional hepatic reserve
Publication date: Available online 20 July 2017
Source:Clinical Imaging
Author(s): Derek M. Biederman, Raghuram Posham, Raisa J. Durrani, Joseph J. Titano, Rahul S. Patel, Nora E. Tabori, Francis S. Nowakowski, Aaron M. Fischman, Robert A. Lookstein, Edward Kim
PurposeTo evaluate the outcomes of radioembolization (RE) as a therapy for unresectable hepatocellular carcinoma (HCC) in patients with marginal functional hepatic reserve.MethodsA retrospective review of 471 patients (1/2010–7/2015) treated with RE (Therasphere, BTG, UK) was performed. A total of 36 patients (mean age: 66.1±9.3, male: 86.1%) underwent therapy for HCC with a MELD≥15 (median: 16, range: 15–22). Baseline demographics of the study cohort were as follows: etiology (HCV: 26, 72.2%), cirrhosis (n=32, 88.9%), ECOG 0 (n=16, 44.4%), Child-Pugh class (A=15, B=19, C=2), unilobar distribution (n=27, 75%), AFP>200 (n=11, 30.6%), portal vein thrombosis (PVT, n=7, 19.4%), metastasis (n=3, 8.3%). Outcomes analyzed included CTCAEv4.03 laboratory toxicities (120-day), imaging response (mRECIST), progression-free survival (PFS), and overall survival (OS).ResultsA total of 42 treatments were performed with mean dose of 2.02±1.23GBq. The cumulative grade 3/4 toxicity was 28% overall and 21% for bilirubin at 120-days. The objective response and disease control rates were 48.3% (14/29) and 69% (20/29) respectively. The median (95% CI) PFS was 5.9 (4.4–7.7) months. Ten (27.8%) patients received additional locoregional therapy at a median (IQR) of 138 (102–243) days post RE. The mean (95% CI) OS was 21.9 (14.8–29.0) months. The absence of PVT was associated with improved OS (p=0.005) Disease control at 90-days was also associated with an OS benefit (p=0.037).ConclusionsPatients with unresectable HCC and marginal functional hepatic reserve treated with RE had favorable objective response and disease control rates, both predictive of overall survival.
http://ift.tt/2tktnk0
Role of Toluidine Blue Staining in Suspicious Lesions of Oral Cavity and Oropharynx
Abstract
Oral cancer; the sixth most common malignancy in the world has one of the lowest 5 year survival rates. This can be attributed mainly to the delay in diagnosis. The purpose of this study was to evaluate the efficacy of vital staining with toluidine blue dye as an adjunct to standard clinical examination to facilitate early detection of malignant lesions of oral cavity and oropharynx. A hospital based diagnostic test accuracy study was carried out on 55 subjects with oral mucosal disorders that included clinically suspicious premalignant or malignant lesions, in the Department of ENT, Academy of Medical Sciences, Pariyaram, Kannur, Kerala over a period of 2 years. All lesions were subjected to detailed clinical examination and toluidine blue staining; and dye retention was recorded with photographs. The results of staining were compared with findings on histopathological examination. The Sensitivity and specificity of toluidine blue test for the detection of malignancy was 92.6 and 67.9% respectively; and the overall diagnostic accuracy was 80%. The result was highly significant with a 'p value' <0.001. The results indicate that toluidine blue staining is a simple, non-invasive technique which can be a valuable adjunct in the diagnostic process of oral and oropharyngeal cancers.
http://ift.tt/2uf8kCw
Role of Toluidine Blue Staining in Suspicious Lesions of Oral Cavity and Oropharynx
Abstract
Oral cancer; the sixth most common malignancy in the world has one of the lowest 5 year survival rates. This can be attributed mainly to the delay in diagnosis. The purpose of this study was to evaluate the efficacy of vital staining with toluidine blue dye as an adjunct to standard clinical examination to facilitate early detection of malignant lesions of oral cavity and oropharynx. A hospital based diagnostic test accuracy study was carried out on 55 subjects with oral mucosal disorders that included clinically suspicious premalignant or malignant lesions, in the Department of ENT, Academy of Medical Sciences, Pariyaram, Kannur, Kerala over a period of 2 years. All lesions were subjected to detailed clinical examination and toluidine blue staining; and dye retention was recorded with photographs. The results of staining were compared with findings on histopathological examination. The Sensitivity and specificity of toluidine blue test for the detection of malignancy was 92.6 and 67.9% respectively; and the overall diagnostic accuracy was 80%. The result was highly significant with a 'p value' <0.001. The results indicate that toluidine blue staining is a simple, non-invasive technique which can be a valuable adjunct in the diagnostic process of oral and oropharyngeal cancers.
http://ift.tt/2uf8kCw
Cd, Pb, and Zn mobility and (bio)availability in contaminated soils from a former smelting site amended with biochar
Abstract
Biochar is a potential candidate for the remediation of metal(loid)-contaminated soils. However, the mechanisms of contaminant-biochar retention and release depend on the amount of soil contaminants and physicochemical characteristics, as well as the durability of the biochar contaminant complex, which may be related to the pyrolysis process parameters. The objective of the present study was to evaluate, in a former contaminated smelting site, the impact of two doses of wood biochar (2 and 5% w/w) on metal immobilization and/or phytoavailability and their effectiveness in promoting plant growth in mesocosm experiments. Different soil mixtures were investigated. The main physicochemical parameters and the Cd, Pb, and Zn contents were determined in soil and in soil pore water. Additionally, the growth, dry weight, and metal concentrations were analyzed in the different dwarf bean plant (Phaseolus vulgaris L.) organs tested. Results showed that the addition of biochar at two doses (2 and 5%) improved soil conditions by increasing soil pH, electrical conductivity, and water holding capacity. Furthermore, the application of biochar (5%) to metal-contaminated soil reduced Cd, Pb, and Zn mobility and availability, and hence their accumulation in the different P. vulgaris L. organs. In conclusion, the data clearly demonstrated that biochar application can be effectively used for Cd, Pb, and Zn immobilization, thereby reducing their bioavailability and phytotoxicity.
http://ift.tt/2gO6xPT
Serum Bupivacaine Concentration After Periarticular Injection With a Mixture of Liposomal Bupivacaine and Bupivacaine HCl During Total Knee Arthroplasty.
Background and Objectives: A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks. Methods: A total of 40 subjects scheduled for primary unilateral total knee arthroplasty with intraoperative periarticular injection of the liposomal bupivacaine and bupivacaine HCl mixture were included. Total serum bupivacaine concentrations were measured after the last injection at selected time points and calculated by gas chromatography. Quantile regression techniques were used to analyze the data over time. This study is registered with ClinicalTrials.gov (ID NCT02626559). Results: Peak serum concentration ranged from 0.17 to 1.2 [mu]g/mL and occurred from 10 minutes to 48 hours. Across all time points, the 48-hour interval had the highest mean concentration of total serum bupivacaine at 0.55 [mu]g/mL (SD, 0.27). Quantile regression showed total serum bupivacaine concentrations increased over the 48 hours measured. None of the participants demonstrated signs or symptoms of local anesthetic toxicity. Conclusions: Total serum concentrations of bupivacaine after periarticular administration of liposomal bupivacaine mixed with bupivacaine HCl remained below the described toxicity threshold (2.5 [mu]g/mL) within the first 48 hours, and no patients demonstrated signs or symptoms of toxicity. However, peak serum concentration time was not achieved within the 48-hour interval. Additional studies are needed to describe the course of serum bupivacaine levels after 48 hours and to ascertain the risk of toxicity when combining this method of periarticular injection with peripheral nerve blocks. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.
http://ift.tt/2vouOQ4
http://ift.tt/2vouOQ4
Thoracic Epidural Catheter Placement in a Preoperative Block Area Improves Operating Room Efficiency and Decreases Epidural Failure Rate.
Background and Objectives: The primary aim of this study was to review the impact of inserting thoracic epidural catheters in a preoperative block room setting on operating room efficiency. Methods: We conducted a retrospective preintervention/postintervention review of thoracic epidurals inserted over a 12-month period. The review included 6 months of data prior to implementation of the regional anesthesia block room and 6 months of data following implementation. The primary outcome measure was anesthesia-controlled operating room time, defined as time from patient arrival to the operating room to time of surgical site sterile preparation. Secondary measures included operating room waiting time for the patient arrival, thoracic epidural failure rate, and number of epidural insertion attempts. Results: Data from thoracic epidurals for 112 patients of preblock room and 142 patients of postblock room implementation were collected. Anesthesia-controlled operating room time was reduced by an average of 22.9 minutes per patient (95% confidence interval, 19.3-26.3 minutes; P
http://ift.tt/2tushpV
http://ift.tt/2tushpV
Central line–associated bloodstream infection rate elevation: Attributable to National Healthcare Safety Network surveillance definition changes, ongoing opportunities for infection prevention, or both?
Source:American Journal of Infection Control
Author(s): Andrew Corley, Maggie Cantara, Julia Gardner, Polly Trexler, Clare Rock, Lisa L. Maragakis
Calendar year 2015 intensive care unit (ICU) central line–associated bloodstream infections (CLABSIs) from 1 hospital were reviewed using 2014 CLABSI surveillance definitions to assess the relative impact of definition changes and infection control practices on CLABSI rates. Increased ICU primary CLABSI rates were found to be a result of both surveillance definition changes and infection control practices.
http://ift.tt/2uDJCfP
Additive effects of sensory-enhanced satiety and memory for recent eating on appetite
Source:Appetite, Volume 117
Author(s): Martin R. Yeomans, Millie Ruder Milton, Lucy Chambers
The sensory characteristics of a product have been shown to interact with actual nutrient content to generate satiety. Separately, cued recall of recent eating has also been shown to reduce food intake. Here we explore for the first time how these two effects interact, with the hypothesis that sensory enhancement of satiety might be mediated by more vivid memory of the earlier consumed item. On each of two test sessions, 119 women volunteers consumed a control drink (lemonade) on one morning and then one of two test drinks on the next day 30 min before an ad libitum lunch. The test drinks were equicaloric but one was noticeably thicker and creamier, and expected to generate stronger satiety. Just prior to the test lunch, participants were asked to recall either the test drink (test recall) or the drink from the previous day (control recall). Overall, lunch intake was significantly lower after the thicker and creamier (enhanced sensory ES) than thinner (low sensory: LS) test drink (p < 0.001, η2 = 0.11) regardless of recall condition (p = 0.65, η2 < 0.01), but was significantly lower after the test than control recall condition (p < 0.001, η2 = 0.14). Rated hunger was lower after consuming the ES than LS drink both immediately after consumption (p < 0.001, η2 = 0.11) and prior to the test lunch (p = 0.007, η2 = 0.06), while rated hunger just before lunch tended to be lower after recalling the test than control drink (p = 0.052, η2 = 0.03) regardless of the sensory characteristics (p = 0.27, η2 = 0.01). Overall these data further demonstrate the power of 'sensory-enhanced satiety' and cued recall of earlier eating as methods to reduce acute food intake, but suggest these effects operate independently.
http://ift.tt/2tu8siI
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