Glucocorticoids: the mode of action in bullous pemphigoid

Abstract

Bullous pemphigoid (BP) is the most common of pemphigoid diseases caused by autoantibodies against the structures of dermoepidermal junction followed by complement activation, innate immune cell infiltration, neutrophil proteinase secretion and subepidermal blister formation. The first line treatment of BP is topical and systemic glucocorticoids (GC).

Regulation of the immune system and inflammatory cells is the main target of GC actions. GCs act through genomic and non-genomic mechanisms. The human glucocorticoid receptor (GR) mediates most of the biologic effects of glucocorticoids: cytosolic GR binds GCs and is capable to bind to glucocorticoid response elements in DNA and either transactivate or transrepress genes depending on the tissue and cell-type. In addition, GR exerts rapid, non-genomic effects possibly mediated by membrane-localized receptors or by translocation to mitochondria. GCs can also interact directly with several enzymes and cytokines.

As a target treatment for BP, the production of autoantibodies should be discontinued. GCs, in spite of their wide immunosuppressive actions, are weak to stop immunoglobulin G (IgG) autoantibody formation. However, both systemic and topical GCs are able to reduce the clinical symptoms of BP. GCs are used to inhibit the secondary inflammation and symptoms, such as blistering and pruritus, and it is shown that GC treatment will gradually decrease also the autoantibody formation. Our review article analyzes the mode of action of GC treatment in BP, as far it is possible due to paucity of modern immunological studies.

This article is protected by copyright. All rights reserved.

http://ift.tt/2faiMWH

Synthesis of grafted natural pozzolan with 3-aminopropyltriethoxysilane: preparation, characterization, and application for removal of Brilliant Green 1 and Reactive Black 5 from aqueous solutions

Abstract

Natural pozzolan is an amorphous silicate-based material of volcanic origin. In this work, the natural pozzolan was modified by using 3-aminopropyltriethoxysilane (APTES) as a grafting agent. This material was characterized by pH_pzc, N₂ adsorption/desorption curves, FTIR, TGA/DTG, DRUV, SEM, and elementary analysis. The functionalized materials were used for the removal of Reactive Black 5 (RB-5) and Brilliant Green 1 (BG-1) dyes from aqueous solutions using batch-contact adsorption. The characterization of modified pozzolan by FTIR, TGA/DTG, BET, and DRUV–vis revealed the effectiveness of grafting of amine functional group on pozzolan structure. The kinetic adsorption data were better fitted with general order for both dyes while for equilibrium models were better fitted by the Liu isotherm model. The maximum sorption capacities Q _max (at 50 °C) obtained with the modified pozzolan were 350.6 and 300.9 mg g⁻¹ for BG-1 and RB-5, at pH 9.0 and 2.0, respectively. The thermodynamic parameters show that the removal of dyes was spontaneous and endothermic. The modified material was also tested for the treatment of simulated dye house effluents showing very high efficiency.

http://ift.tt/2w8V0ya

The Role of Charge in Protein Targeting Evolution

Publication date: Available online 2 August 2017
Source:Trends in Cell Biology
Author(s): Sriram G. Garg, Sven B. Gould




http://ift.tt/2vkCNQI

Hepatitis due to EBV-reactivation under infliximab in a psoriasis patient

http://ift.tt/2hpK1x7

Hepatitis due to EBV-reactivation under infliximab in a psoriasis patient

http://ift.tt/2hpK1x7

Validation of a Simple Scoring System to Predict Sorafenib Effectiveness in Patients with Hepatocellular Carcinoma

Abstract

Background

Sorafenib is recommended for the treatment of advanced-stage hepatocellular carcinoma (HCC). Nonetheless, it is expensive, effective in few patients, and may cause significant adverse effects. Therefore, accurate selection of patients is needed. In a previous study, we constructed a simple scoring system to predict patients' outcomes based on the occurrence of sorafenib adverse effects.

Objective

The present study aimed to validate this scoring system in a real-life cohort of HCC patients.

Patients and Methods

Clinical records of 279 outpatients treated with sorafenib in eight Italian centers were retrospectively analyzed. Adverse effects considered to calculate the score were skin toxicity, diarrhea, and arterial hypertension, occurring during the first month of therapy. For each adverse effect, 1 point was assigned if present; and 0 points if absent (resulting in a total score between 0 and 3).

Results

Median overall survival (OS) was 10.8 months and median time to progression (TTP) was 5.1 months. At multivariate analysis, performance status, α-fetoprotein (AFP), and Child-Pugh score were independently associated with TTP and OS. A progressive increase of OS and TTP was observed in patients with scores from 0 to 3 (p < 0.001). Six-, 12-, and 24-month survival probabilities were 55.1, 24.5, and 7.9% in score 0 patients, and 100, 80.9, and 46.2% in score 3 patients, respectively. Complete response was observed in one patient (0.4%), partial responses in 41 (15.2%), and stable disease in 117 (43.5%). The disease control rate in patients with scores of 0, 1, 2, and 3 was 34.3, 51.6, 80.9, and 96.3%, respectively (p < 0.001). Complete or partial responses were not observed in score 0 patients.

Conclusions

We have validated a useful scoring system to predict outcomes in sorafenib-treated HCC patients. This score is easy to calculate and suitable for implementation in daily clinical practice.

http://ift.tt/2u5Nk2G

Editorial Board

Publication date: September 2017
Source:Annals of Anatomy - Anatomischer Anzeiger, Volume 213





http://ift.tt/2uYtchJ

OBC

Publication date: September 2017
Source:Annals of Anatomy - Anatomischer Anzeiger, Volume 213





http://ift.tt/2w8xP7v

SpectraCam®: A new polarized hyperspectral imaging system for repeatable and reproducible in vivo skin quantification of melanin, total hemoglobin, and oxygen saturation

Abstract

Background

An accurate way to determine skin pigmentation is to acquire the spectral reflectance of a skin sample and to quantify chromophores by reverse calculation from physical models of light propagation. Therefore, we tested a new hyperspectral imaging device and software suite, the SpectraCam^® system, and evaluated its accuracy to quantify skin chromophores.

Methods

Validation of the SpectraCam^® system was performed by, firstly, comparing the known and the acquired reflectance spectra of color phantoms. Repeatability and reproducibility were then evaluated by two operators who performed acquisitions at different time points and compared the acquired reflectance spectra. The specificity of the system was tested by quantitative analysis of single chromophore variation models: lentigo and pressure relief. Finally, we tested the ability of the SpectraCam^® system to detect variations in chromophore in the eye region due to the daily application of a new anti-dark circle cosmetic product.

Results

The SpectraCam^® system faithfully acquires the reflectance spectra of color phantoms (r²>0.90). The skin reflectance spectra acquired by different operators at different times are highly repeatable (r²>0.94) and reproducible (r²>0.99). The SpectraCam^® system can also produce qualitative maps that reveal local variations in skin chromophore or underlying structures such as blood vessels. The system is precise enough to detect melanin variation in lentigo or total hemoglobin and oxygen saturation variations upon pressure relief. It is also sensitive enough to detect a decrease in melanin in the eye region due to the application of an anti-dark circle cosmetic product.

Conclusion

The SpectraCam^® system proves to be rapid and produces high-resolution data encompassing a large field of view. It is a robust hyperspectral imaging system that quantifies melanin, total hemoglobin, and oxygen saturation and is well adapted to cosmetic research.

http://ift.tt/2vkX6h8

Pathogen-mimicking nanocomplexes: self-stimulating oxidative stress in tumor microenvironment for chemo-immunotherapy

Publication date: Available online 2 August 2017
Source:Materials Today
Author(s): Kai Dong, Zhenhua Li, Hanjun Sun, Enguo Ju, Jinsong Ren, Xiaogang Qu
A novel drug-loaded pathogen-mimicking nanocomplex has been constructed for synergistic chemo-immunotherapy using detoxified lipopolysaccharide coated mesoporous silica nanoparticle. Detoxified lipopolysaccharide behaves as a dual-purpose entity that not only effectively mimics the function of the natural pathogen for triggering immune responses but also acts as a lid for inhibiting premature chemical drug release. In this approach, a knock-on effect would be observed at site of tumor: firstly, pathogen-mimicries elicited the elevated production of ROS; secondly, excessive production of ROS in turn oxidized the arylboronic ester to realize controlled chemotherapy; thirdly, in addition to inducing ROS generation, the nanocomplex would self-stimulate macrophages activation which subsequently activated cytotoxic T cells. Importantly, chemotherapy and immunotherapy were acting in a synergistic manner to inhibit solid tumor growth. Moreover, chemotherapeutic agents could be effectively released upon exposure to self-stimulating oxidative stress in which external addition of ROS was avoided. This proof of concept might open the door to a new generation of carrier materials in the field of cancer therapy.



http://ift.tt/2wnWHr5

Corrigendum to “Measuring satisfaction with appearance: Validation of the FACE-Q scales for double-eyelid blepharoplasty with minor incision in young Asians- retrospective study of 200 cases” [J Plast Reconstr Aesthet Surg 70 (2017) 1129–1135]

The authors regret that the authorship of the original article was incorrect and should be cited as per the authorship of this corrigendum. To confirm, the order of authors should be as follows: Baoguo Chen, Huifeng Song, Quanwen Gao, Minghuo Xu, Jue Wang, Fang Wang, Shuai Chen, Jiang Wu, Huichao Li.

http://ift.tt/2u2rnNL

Frequency of self-reported drug allergy

Patients reporting drug allergy are treated with second-line therapies, with possible negative clinical and health consequences.

http://ift.tt/2hqahY8

Cutaneous Small-Vessel Vasculitis in Two Children with Inflammatory Bowel Disease: Case Series and Review of the Literature

Abstract

Cutaneous small-vessel vasculitis (CSVV) is an infrequent manifestation of pediatric inflammatory bowel disease (IBD). We report two cases of CSVV associated with ulcerative colitis, review the literature, and discuss the diagnostic evaluation of children who present with CSVV and abdominal pain. After excluding more common causes of CSVV and abdominal pain in children, including immunoglobulin A vasculitis (previously Henoch–Schönlein purpura), infectious colitis, and drug-induced vasculitis, alternative diagnoses such as CSVV secondary to IBD or systemic vasculitis with gastrointestinal involvement must be considered.

http://ift.tt/2wnTyay

Palmar Eccrine Hidradenitis Secondary to Trauma from Computer Gaming in an Adolescent After Bone Marrow Transplantation

Abstract

A 14-year-old boy who had undergone a matched sibling bone marrow transplant for acute lymphoblastic leukemia presented with painful nodules on his palms after prolonged gaming on his computer and mobile phone. Histology showed a neutrophilic inflammatory infiltrate surrounding the acrosyringium and eccrine sweat coils in the deep dermis. The lesions resolved spontaneously with conservative management.

http://ift.tt/2vuY4YB

Idiopathic Calcinosis Cutis Universalis Treated Successfully with Oral Diltiazem—A Case Report

Abstract

Idiopathic calcinosis cutis is very rare and difficult to treat. Various medical modalities of treatment described with inconsistent results include chelating agents, colchicine, and probenecid. Calcium channel blockers are known to work by inhibiting intracellular entry of calcium. We successfully treated a case of idiopathic calcinosis cutis using oral diltiazem.

http://ift.tt/2vr0AOR

Tuberous Sclerosis Complex in 29 Children: Clinical and Genetic Analysis and Facial Angiofibroma Responses to Topical Sirolimus

Abstract

Background/Objectives

Tuberous sclerosis complex (TSC) is a genetic disorder and facial angiofibromas are disfiguring facial lesions. The aim of this study was to analyze the clinical and genetic features of TSC and to assess the treatment of facial angiofibromas using topical sirolimus in Chinese children.

Methods

Information was collected on 29 patients with TSC. Genetic analyses were performed in 12 children and their parents. Children were treated with 0.1% sirolimus ointment for 36 weeks. Clinical efficacy and plasma sirolimus concentrations were evaluated at baseline and 12, 24, and 36 weeks.

Results

Twenty-seven (93%) of the 29 patients had hypomelanotic macules and 15 (52%) had shagreen patch; 11 of the 12 (92%) who underwent genetic analysis had gene mutations in the TSC1 or TSC2 gene. Twenty-four children completed 36 weeks of treatment with topical sirolimus; facial angiofibromas were clinically undetectable in four (17%). The mean decrease in the Facial Angiofibroma Severity Index (FASI) score at 36 weeks was 47.6 ± 30.4%. There was no significant difference in the FASI score between weeks 24 and 36 (F = 1.00, p = 0.33). There was no detectable systemic absorption of sirolimus.

Conclusion

Hypomelanotic macules are often the first sign of TSC. Genetic testing has a high detection rate in patients with a clinical diagnosis of TSC. Topical sirolimus appears to be both effective and well-tolerated as a treatment of facial angiofibromas in children with TSC. The response typically plateaus after 12 to 24 weeks of treatment.

http://ift.tt/2u21ca3

Can You See Me Now? Video Supplementation for Pediatric Teledermatology Cases

Abstract

Background/Objectives

Digital video is widely available and is used sporadically in clinical settings to evaluate patients, but whether it helps improve clinical management has not been determined. The aim of this study was to assess whether recorded video in addition to still images can improve residents' diagnostic and management accuracy and confidence with pediatric teledermatology cases.

Methods

Dermatology residents from three programs were assigned alternately to an online survey with 15 pediatric teledermatology cases presented with still images only (still) or still images plus recorded video (mixed). Participants provided free-text diagnoses and management recommendations and rated their confidence and image quality. Responses were scored using a modified script concordance grading key based on reference panelists' responses.

Results

Thirty-one residents participated (response rate 57%). Participants in the mixed group scored significantly higher on management accuracy (87.6 ± 12.9 vs 71.7 ± 14.2; p = 0.003). Both groups performed better on more common conditions than less common conditions. The mixed group outperformed the still group on less common conditions with respect to management recommendations.

Conclusion

This novel study suggests that supplemental recorded video may improve the management accuracy of pediatric teledermatology consultations, particularly for complex cases. Residents may benefit from training in recording and interpreting video.

http://ift.tt/2vuYLRx

See One, Do One, Teach One: No More

Anatomic dissection prior to examining and treating a living person dates back to Alexandria, Greece in the third century bc.1 For Otolaryngologist-Head and Neck Surgeons, anatomic dissections, the original "simulators," have served to prepare them for open approaches to the face, head, and neck, for temporal bone surgery, and for paranasal sinus procedures. But, as with diagnostic and surgical methods and tools, simulation tools and techniques have evolved, most rapidly over the past several years.

http://ift.tt/2hpweXr

See One, Do One, Teach One: No More

Anatomic dissection prior to examining and treating a living person dates back to Alexandria, Greece in the third century bc.1 For Otolaryngologist-Head and Neck Surgeons, anatomic dissections, the original "simulators," have served to prepare them for open approaches to the face, head, and neck, for temporal bone surgery, and for paranasal sinus procedures. But, as with diagnostic and surgical methods and tools, simulation tools and techniques have evolved, most rapidly over the past several years.

http://ift.tt/2hpweXr

Simulation in Otolaryngology

At present, simulation is widely accepted as a means of providing surgical education outside of the clinical environment. Recent advances in simulation technology and medical education reform coupled with political and societal demands have provided the impetus toward the exponential growth of this field. Research in this area supports the use of simulation to train and assess individuals in both psychomotor and team-based skills. Further benefits include translation of these improved skills to patient care practices with better patient outcomes and reduced health care costs.

http://ift.tt/2f9Nz66

Pain during topical photodynamic therapy - comparing methyl aminolevulinate (Metvix®) to aminolaevulinic acid (Ameluz®); an intra-individual clinical study

Publication date: Available online 2 August 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Shiva Yazdanyar, Kian Zarchi, Gregor B.E. Jemec
BackgroundActinic keratoses are often treated by photodynamic therapy. However, the main side effects of this treatment is pain during and short after illumination.ObjectivesTo evaluate, in an intra-individual study, whether the pain response differ in treatment of actinic keratoses in scalp and forhead, using branded methyl aminolevulinate (MAL) and aminolaevulinic acid (ALA).Materials and methods Patients with mild to moderate actinic keratoses on forehead and scalp were treated with methyl aminolaevulinate (MAL)-PDT and aminolaevulinic acid (ALA)-PDT on two similar areas of forehead and scalp. The pain response were measured using visual analogue scale ranging from 0 to 10 during the illumination and 30minutes after the treatment.ResultsFourteen patients completed treatment to MAL and ALA-PDT. We found no significant difference in pain intensity between MAL and ALA-PDT, neither during the treatment (p-value=1) nor 30minutes after the treatment (p-value of 0.19).ConclusionsThis intra-individual study demonstrate no significant difference between the pain response during PDT using methyl aminolevulinate and aminolaevulinic acid.



http://ift.tt/2u1OTub

TCRαβ+ and CD19+ cell depleted Haploidentical and Mismatched Hematopoietic Stem Cell Transplantation in Primary Immune Deficiency

CD3+TCRαβ+ and CD19+ cell depleted haploidentical or mMUD HSCT has reproducible outcomes in children with a range of PIDs resulting in good immune reconstitution. Viral infections before or after HSCT are major contributors to mortality and morbidity.

http://ift.tt/2vraLCX

Response

We appreciate the cautious optimism offered in the two letters responding to our editorial. Our criticism of self-reported sleep duration in epidemiology is not new (references 2-5 in our editorial1). In fact, the recent AASM consensus statement2 regarding healthy sleep duration (NB: consensus is the lowest form of evidence) notes the limitations of self-reporting in detail, and specifically anticipates "opportunities for accurate, reliable, scalable objective sleep duration assessment in large epidemiological studies."

http://ift.tt/2v19Aro

Split-Hand Malformation in a 4-Year-Old Child

Split-hand deformity is one of the milder manifestations of a congenital disorder called split-hand/split-foot malformation. We present a case of a 4-year-old child with split-hand malformation in his left hand since birth. A median cleft was present in the affected hand with absence of the 3rd and 4th digits, giving rise to a characteristic lobster-claw appearance. Functionality of the affected hand was modestly impaired. As none of the close family members of the patient had similar limb malformations, the deformity was postulated to arise most likely from a de novo mutation. The patient was discharged after the parents were provided with genetic counseling.

http://ift.tt/2vr25wp

Periodic characterization of alkyl-naphthalenes in stack gas and ambient air around a medical waste incinerator

Abstract

Due to the subtle occurrence of environmental polycyclic aromatic hydrocarbon (PAHs) pollution from incinerators, it is seldom considered a significant source of PAH pollution. However, considering the recent build-up of toxics in urban air, this may be a serious concern around the incinerator vicinity due to the potential consequences of PAHs on human health. Hence, this study determined 11 alkyl-naphthalene contributions from a hospital waste incinerator (HWI_0) into ambient air receptor points (HWI_1 to HWI_5) for a 1-year period: June 2014–May 2015. The HWI_0 and ambient gases were sampled using filter-sorbent sampling system and polyurethane foam (PUF) passive samplers, respectively, and all alkyl-naphthalenes were determined using GC-MS. Results showed that the source concentrations were in the range of 0–14.0 ng/m³ and generally higher than the receptor points. The receptor point concentration trends were mainly HWI_1 > HWI_2 ≥ HWI_3 ≥ HWI_5 ≥ HWI_4. Multivariate receptor model analysis suggested high correlations between source and the receptor points though there might be some significant contributions from other emission sources. The average monthly concentrations (∑alkyl-naphthalene) at HWI_0 and the receptors HWI_1, HWI_2, HWI_3, HWI_4 and HWI_5 were 67.4 ± 24.3, 57.9 ± 20.1, 42.8 ± 16.9, 39.7 ± 12.2, 36.5 ± 22.2 and 37.8 ± 15.4 ng/m³, respectively. Though these concentrations were lower than the estimated minimal risk level (MRL) for chronic inhalation exposure to naphthalene and its derivatives 0.003 mg/m³, continuous exposure to these pollutants might result in chronic effects. Finally, this study may be used to evaluate the environmental contribution of alkyl-naphthalenes from typical medical waste incinerator in Nigeria.

http://ift.tt/2wnlkEe

Mushrooms: from nutrition to mycoremediation

Abstract

Mushrooms are well known as important food items. The uses of mushrooms in the cuisine are manifolds and are being utilized for thousands of years in both Oriental and Occidental cultures. Medicinal properties of mushrooms show an immense potential as drugs for the treatment of various diseases as they are rich in a great variety of phytochemicals. In this review, we attempted to encompass the recent knowledge and scientific advancement about mushrooms and their utilization as food or curative properties, along with their natural ability to accumulate (heavy) metals/radionuclides, which leads to an important aspect of bioremediation. However, accumulation of heavy metals and radionuclides from natural or anthropogenic sources also involves potential nutritional hazards upon consumption. These hazards have been pointed out in this review incorporating a selection of the most recently published literature.

http://ift.tt/2vv1rin

Adsorption mechanism of chromium(III) using biosorbents of Jatropha curcas L.

Abstract

The removal of Cr³⁺ from water solutions by biosorbents from the rind, endosperm, and endosperm + episperm of the Jatropha curcas was evaluated. Adsorption tests were performed in batch systems for evaluating the influence of the solution's pH, adsorbent mass, contact time, initial Cr³⁺ concentrations, and solution temperature during the adsorption process. Kinetic, adsorption isotherm, and thermodynamic studies were performed to investigate the mechanisms that control adsorption. Ideal conditions for the adsorption process included pH of the solution of 5.5 and 8 g L⁻¹ adsorbent mass, within 60 min time contact between adsorbent and adsorbate. Maximum adsorption capacities by Langmuir model for rind, endosperm, and endosperm + episperm of the J. curcas were, respectively, 22.11, 18.20, and 22.88 mg g⁻¹, with the occurrence of chemosorption in mono and multilayers. Results show that the biosorbents obtained from J. curcas have a high potential to recuperate Cr³⁺ from contaminated water sources.

http://ift.tt/2wnyUY9

Canalicular adenoma: a systematic review

Canalicular adenoma (CA) is an uncommon but unique benign tumor of salivary gland origin. It is the third most common benign tumor of minor salivary glands, representing less than 1% of all salivary neoplasms. A systematic review is presented of reported cases of CA, to determine trends in presentation, diagnostic features, treatment, and patient outcome.

http://ift.tt/2vv7cwm

Aesthetic facial perception and need for intervention in laterognathism in women of different ethnicities

This study compared the perception of facial pleasantness and the need for intervention, as assessed by orthodontists, oral and maxillofacial (OMF) surgeons, and laypersons, in people of different ethnicities showing varying degrees of simulated laterognathism. Facial photographs were modified to simulate deviations in the lower face of women of African, Asian and Caucasian descent, ascending in two-degree steps from zero to eight degrees of deviation. Three groups of 20 individuals each (OMF surgeons, orthodontists, and laypersons) assessed the images and rated facial pleasantness on a numerical scale ranging from 0 to 10.

http://ift.tt/2hpGRtq

A customised digitally engineered solution for fixed dental rehabilitation in severe bone deficiency: A new innovative line extension in implant dentistry

In the 1940s, Dahl first introduced and described subperiosteal implants that were placed onto the alveolar ridge without rigid fixation (Dahl, 1943), but due to high complication rates, including implant loss, exposure, and flap dehiscence, subperiosteal implants have not been recommended for decades. However, the principle of subperiosteal implant placement onto the alveolar ridge rather than drilling implants into the bone might prove to be both simple and innovative, and could be a potential strategy for avoiding soft tissue complications leading to peri-implantitis, and bone and implant loss in complex cases (Lin et al., 2013).

http://ift.tt/2vrnzJm

In vitro studies to evaluate the effect of varying culture conditions and IPL fluencies on tenocyte activities

Abstract

Tendons are dense, fibrous connective tissues which carry out the essential physiological role of transmitting mechanical forces from skeletal muscle to bone. From a clinical perspective, tendinopathy is very common, both within the sporting arena and amongst the sedentary population. Studies have shown that light therapy may stimulate tendon healing, and more recently, intense pulsed light (IPL) has attracted attention as a potential treatment modality for tendinopathy; however, its mechanism of action and effect on the tendon cells (tenocytes) is poorly understood. The present study therefore investigates the influence of IPL on an in vitro bovine tendon model. Tenocytes were irradiated with IPL at different devise settings and under variable culture conditions (e.g. utilising cell culture media with or without the pH indicator dye phenol red), and changes in tenocyte viability and migration were subsequently investigated using Alamar blue and scratch assays, respectively. Our data demonstrated that IPL fluencies of up to 15.9 J/cm² proved harmless to the tenocyte cultures (this was the case using culture media with or without phenol red) and resulted in a significant increase in cell viability under certain culture conditions. Furthermore, IPL treatment of tenocytes did not affect the rate of cell migration. This study demonstrates that irradiation with IPL is not detrimental to the tenocytes and may increase their viability under certain conditions, thus validating our in vitro model. Further studies are required to elucidate the effects of IPL application in the clinical situation.

http://ift.tt/2u1KmYZ

Editorial board

Publication date: October 2017
Source:Biomaterials, Volume 142





http://ift.tt/2wnDci6

Tetherless near-infrared control of brain activity in behaving animals using fully implantable upconversion microdevices

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Ying Wang, Xudong Lin, Xi Chen, Xian Chen, Zhen Xu, Wenchong Zhang, Qinghai Liao, Xin Duan, Xin Wang, Ming Liu, Feng Wang, Jufang He, Peng Shi
Many nanomaterials can be used as sensors or transducers in biomedical research and they form the essential components of transformative novel biotechnologies. In this study, we present an all-optical method for tetherless remote control of neural activity using fully implantable micro-devices based on upconversion technology. Upconversion nanoparticles (UCNPs) were used as transducers to convert near-infrared (NIR) energy to visible light in order to stimulate neurons expressing different opsin proteins. In our setup, UCNPs were packaged in a glass micro-optrode to form an implantable device with superb long-term biocompatibility. We showed that remotely applied NIR illumination is able to reliably trigger spiking activity in rat brains. In combination with a robotic laser projection system, the upconversion-based tetherless neural stimulation technique was implemented to modulate brain activity in various regions, including the striatum, ventral tegmental area, and visual cortex. Using this system, we were able to achieve behavioral conditioning in freely moving animals. Notably, our microscale device was at least one order of magnitude smaller in size (∼100 μm in diameter) and two orders of magnitude lighter in weight (less than 1 mg) than existing wireless optogenetic devices based on light-emitting diodes. This feature allows simultaneous implantation of multiple UCNP-optrodes to achieve modulation of brain function to control complex animal behavior. We believe that this technology not only represents a novel practical application of upconversion nanomaterials, but also opens up new possibilities for remote control of neural activity in the brains of behaving animals.



http://ift.tt/2wntlsI

Cancer cell membrane-coated biomimetic platform for tumor targeted photodynamic therapy and hypoxia-amplified bioreductive therapy

Publication date: October 2017
Source:Biomaterials, Volume 142
Author(s): Shi-Ying Li, Hong Cheng, Wen-Xiu Qiu, Lu Zhang, Shuang-Shuang Wan, Jing-Yue Zeng, Xian-Zheng Zhang
Modulating tumor microenvironment to amplify the therapeutic efficiency would be a novel strategy for effective cancer treatment. In this work, based on the TPZ-loaded porphyrinic metal organic framework PCN-224 (PCN stands for porous coordination network), a cancer cell membrane-coated nanoplatform (TPZ@PCN@Mem) was fabricated for tumor targeted PDT and the successively resulting hypoxia-amplified bioreductive therapy. After administration, TPZ@PCN@Mem exhibited the selective accumulation and long-term retention at tumor tissue due to the immune escape and homologous targeting endowed by the cancer membrane coating. Upon light irradiation, PCN-224-mediated toxic reactive oxygen species (ROS) were generated for PDT, and the resulting local hypoxia microenvironment would further accelerate the activation of TPZ for enhanced chemotherapy in 4T1 orthotopic tumor. The cascade synergistic therapeutic effects of TPZ@PCN@Mem could significantly suppress the primary tumor growth, and also inhibit its distal metastasis with minimal side effects. The study indicated an overwhelming superiority of utilizing this bioinspired strategy for tumor targeted PDT and hypoxia-activated bioreductive therapy, which provided a new insight for precise and effective tumor treatment.



http://ift.tt/2vv3fYy

Cognitive and Contextual Correlates of Spontaneous and Deliberate Mind-Wandering.

Author: Robison, Matthew K.; Unsworth, Nash

DOI: 10.1037/xlm0000444

Publication Date: POST AUTHOR CORRECTIONS, 31 July 2017

http://ift.tt/2u5prZ7

The Articulatory In-Out Effect Resists Oral Motor Interference.

Author: Lindau, Berit; Topolinski, Sascha

DOI: 10.1037/xlm0000443

Publication Date: POST AUTHOR CORRECTIONS, 31 July 2017

http://ift.tt/2ulFYmA

Near-Independent Capacities and Highly Constrained Output Orders in the Simultaneous Free Recall of Auditory-Verbal and Visuo-Spatial Stimuli.

Author: Cortis Mack, Cathleen; Dent, Kevin; Ward, Geoff

DOI: 10.1037/xlm0000439

Publication Date: POST AUTHOR CORRECTIONS, 31 July 2017

http://ift.tt/2u5yY2j

Reading Dilemmas in a Foreign Language Reduces Both Deontological and Utilitarian Response Tendencies.

Author: Muda, Rafal; Niszczota, Pawel; Bialek, Michal; Conway, Paul

DOI: 10.1037/xlm0000447

Publication Date: POST AUTHOR CORRECTIONS, 31 July 2017

http://ift.tt/2ultQCe

The Acquisition of Simple Associations as Observed in Color-Word Contingency Learning.

Author: Lin, Olivia Y.-H.; MacLeod, Colin M.

DOI: 10.1037/xlm0000436

Publication Date: POST AUTHOR CORRECTIONS, 31 July 2017

http://ift.tt/2u64k8K

Seasonal variations of natural radionuclides, minor and trace elements in lake sediments and water in a lignite mining area of North-Western Greece

Abstract

The radiological and chemical pollution of a cluster of four lakes in a lignite mining area of North-Western Greece was investigated using a variety of analytical techniques. Alpha spectrometry was applied to measure the activity concentrations of the uranium radioisotopes (U-234, U-235, and U-238) in waters. The mass activities of U-238, Th-232, and K-40 in sediments were measured by high-resolution gamma spectrometry. Furthermore, the determination of the minor and trace elements was carried out by instrumental neutron activation analysis (INAA) in both water and sediments samples, respectively. Pollution levels were also evaluated by calculating enrichment factors (EFs), contamination factors (CFs) and pollution load index (PLI). The data were discussed taking into account several parameters such as the distance from the pollution source, temperature, and location and showed that the environmental impact in this region could not be considered as negligible. The deviation of the isotopic ratio of U-234/U-238 from the equilibrium value indicated waters with intensive dissolution of uranium. The activity values in both waters and sediments found to be low in cool periods and increased in warm periods. Moreover, the concentrations of the elements U, Zn, and Fe were raised in water samples indicating possible pollution as well as the CFs and PLI denoted accumulation in the sediments and moderate to severe contamination for Zn and Cr in some cases.

http://ift.tt/2ulkZk1

The psychological and physical health of fathers of children with Autism Spectrum Disorder compared to fathers of children with long-term disabilities and fathers of children without disabilities

Publication date: October 2017
Source:Research in Developmental Disabilities, Volume 69
Author(s): Monique Seymour, Rebecca Giallo, Catherine E. Wood
BackgroundThe psychological and physical health of fathers of children with Autism Spectrum Disorder (ASD) is under-researched. Due to the unique parenting demands, fathers of children with ASD may be at increased risk of experiencing psychological and physical health difficulties compared to fathers of children without disabilities (W/OD) and fathers of children with other long-term disabilities (LTD). What little research there is on fathers of children with ASD is often conducted on small clinical samples, or embeds the experiences of fathers within other groups.AimThe current study aimed to explore the extent to which fathers of children with ASD experience psychological distress and physical health issues (e.g., general health, smoking, chronic pain) compared to fathers of children W/OD and fathers of children with a LTD.MethodFrom a large, nationally representative sample of children, 159 fathers of children with ASD were identified, along with 45 fathers of children with a LTD and 6578 fathers of children W/OD.ResultsThe majority of fathers were experiencing good psychological and physical health. Approximately 1 in 6 fathers of children with ASD were experiencing elevated levels of psychological distress and poor global health, and were at significantly greater risk than fathers of children W/OD; although these differences were not found compared to fathers of children with a LTD.ConclusionsSome fathers of children with ASD may require additional support which not only focuses on their psychological wellbeing but also fathers' physical health. The current findings encourage health services to check-in with, or reach-out to fathers as they too may require additional support.



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Repair of Large Segmental Bone Defect using Vascularized Small Corticocancellous Bone in Rabbit Femur

J reconstr Microsurg
DOI: 10.1055/s-0037-1604437

Background Although free-vascularized long-bone transfer is useful for reconstruction of a large segmental bone defect, it is limited by availability of transplantable bone, meticulous microsurgical technique, and donor-site morbidities. Hence, easier, readily available, and safer surgical procedures are warranted. This study evaluated the effects of vascularized small corticocancellous bone grafting for reconstruction of a large segmental rabbit femur defect. Methods A 1.5 cm defect was created in the femurs of 40 New Zealand white rabbits and divided into a control group (n = 10, bone defect without graft), group A (n = 10, bone defect filled with morselized autogenous bone), group B (n = 10, bone defect grafted with a vascularized small corticocancellous bone and morselized autogenous bone), and group C (n = 10, bone defect grafted with a vascularized small corticocancellous bone). Simple radiographs were taken postoperatively, and bone healing ability was scored using Taira's radiologic scale. Histologic examinations were scored using Emery's histologic scale. The expression of osteogenesis-related growth factors (BMP-2, -4, and -7, VEGF, and RANKL) was analyzed. Results Radiologically, group B showed superior biological efficacy in bone formation and consolidation over the other groups. Histologically, the defect in group B was filled with more abundant mature bone than the other groups. Group B showed higher gene expression of BMP-2, -4, and -7, and VEGF. Conclusions The grafting of the morselized autogenous bone (MSB) combined with the vascularized small corticocancellous bone is more effective than that of the MSB alone for repairing a large segmental bone defect.
[...]

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Table of contents  |  Abstract  |  Full text

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Effects of anaesthesia and analgesia on long-term outcome after total knee replacement: A prospective, observational, multicentre study.

BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery. INTERVENTION(S): Personal data (age, sex, BMI and ASA class), preoperative pain assessed by numerical rating scale (NRS) score, and risk factors for PPSP were registered preoperatively. Data on anaesthetic and analgesic techniques were collected. Postoperative pain (NRS), analgesic consumption, major complications and patient satisfaction were registered up to the time of discharge. PPSP was assessed by a blinded investigator during a phone call after 1, 3 and 6 months, together with patient satisfaction, quality of life (QOL) and walking ability. MAIN OUTCOME MEASURES: Experience of PPSP according to the type of peri-operative analgesia. RESULTS: Five hundred sixty-three patients completed the follow-up. At 6 months, 21.6% of patients experienced PPSP, whereas autonomy was improved only in 56.3%; QOL was worsened or unchanged in 30.7% of patients and improved in 69.3%. Patients receiving continuous regional anaesthesia (epidural or peripheral nerve block) showed a lower NRS through the whole peri-operative period up to 1 month compared with both single shot peripheral nerve block and those who did not receive any type of regional anaesthesia. No difference was found between these latter two groups. Differences in PPSP at 3 or 6 months were not significantly affected by the type of anaesthesia or postoperative analgesia. A higher NRS score at 1 month, younger age, history of anxiety or depression, pro-inflammatory status, higher BMI and a lower ASA physical status were associated with a higher incidence of PPSP and worsened QOL at 6 months. CONCLUSION: Continuous regional anaesthesia provides analgesic benefit for up to 1 month after surgery, but did not influence PPSP at 6 months. Better pain control at 1 month was associated with reduced PPSP. Patients with higher expectations from surgery, enhanced basal inflammation and a pessimistic outlook are more prone to develop PPSP. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02147730 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://ift.tt/OBJ4xP (C) 2017 European Society of Anaesthesiology

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Indicadores de calidad del Programa de Detección Precoz de Hipoacusia Permanente del Hospital Padre Hurtado

Introducción: La detección precoz de hipoacusia permanente en lactantes beneficia el desarrollo integral del paciente. Los programas cuyo objetivo es la identificación universal de hipoacusia debieran tener como meta determinados criterios de calidad en su ejecución. Objetivo: El objetivo del presente trabajo es comunicar los resultados del Programa de Detección Precoz de Hipoacusia en el Hospital Padre Hurtado. Material y método: Se incluyen los recién nacidos entre el 1 de enero de 2014 y el 31 de agosto de 2016. Los pacientes sin factores de riesgo para hipoacusia congénita se evalúan con examen de emisiones otoacústicas, y los pacientes con factores de riesgo con potenciales auditivos automatizados de tronco encefálico. Refieren aquellos pacientes con exámenes alterados en forma uní o bilateral. La etapa diagnóstica incluye potenciales auditivos evocados con tono, impedanciometría de alta frecuencia y audiometría de refuerzo visual. Los pacientes con diagnóstico de hipoacusia permanente son amplificados e inician proceso de habilitación. Resultados: En el período de estudio el universo a evaluar fue de 12.313 recién nacidos. Se completó la etapa de pesquisa en 98.4% con una tasa de referencia de 0.6%. 79 pacientes pasaron a etapa diagnóstica, completaron su evaluación antes de 3 meses en 95% de los casos. Se confirmó hipoacusia sensorioneural en 7 casos, con una tasa de 0.56 por 1.000 recién nacidos vivos. En 57% de los pacientes se amplificaron antes de los seis meses de vida. Conclusiones: El Programa de Hipoacusia Congénita del Hospital Padre Hurtado cumple con los indicadores de calidad recomendados en los ítemes de pesquisa y diagnóstico. En la etapa de habilitación con audffonos esto se realiza antes de los seis meses de vida sólo en 57% de los casos.

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Introduction: Quality indicators of the newborn hearing screening program in Hospital Padre Hurtado. Aim: Asses the accomplishment of quality indicators of the newborn hearing screening program in Hospital Padre Hurtado, Chile, as proposed by the Joint Committee on Infant Hearing Loss (JCIH). Material and method: Two stage screening protocol: otoacoustic emissions for babies in the well-infant nursery and automated auditory brainstem responses for those in the intensive care unit orwith risk factors. If they fail one or both ears they proceed to a comprehensive audiological assessment. Results: 12.313 live births between 01/01/2014 and 108/31/16, 12.103 were screened before discharge (98.4%). 79 cases proceeded to diagnostic assessment, referral rate 0.6%. 95% infants completed audiological evaluation before three months, seven cases were diagnose with permanent sensorineural hearing loss for a prevalence of 0.56 per 1000 live births. Amplification was provided before 6 months of age in 57% of deaf children. Conclusions: Quality indicators of the JCIH are met by our newborn hearing screening program with the exception of adequate timing for the provision of hearing aids: 57% before six months of age.

http://ift.tt/2v0IFMs

Detección temprana de la hipoacusia con emisiones acústicas

Introducción: La hipoacusia neonatal es considerada un problema de salud pública. Su diagnóstico precoz y rehabilitación adecuada previenen la consecuencia más importante de la hipoacusia infantil: crecer sin un lenguaje. Objetivo: Analizar los resultados obtenidos en el Programa Universal de Detección Precoz de la Hipoacusia Infantil implementado en el Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria desde enero de 2007 hasta diciembre de 2013. Material y método: Se estudiaron 44.597 recién nacidos, mediante otoemisiones acústicas en ambas fases del programa. La fase diagnóstica es llevada cabo en la Unidad de Hipoacusia del Servicio de Otorrinolaringología. Resultados: Desde enero de 2007 y diciembre de 2013 nacieron 46.587 niños, se le practicaron el screening a 44.597, de los cuales, 41.621 presentan OEA positivas, 1.233 tienen OEA ausentes. En la segunda fase 8.193 presentaron otoemisiones positivas en ambos oídos, 649 no pasaron la segunda fase. Presentaron factores de riesgo para hipoacusia un total de 9.581 niños. La media de derivación a la fase diagnóstica fue de 5.69%, alcanzó una cobertura del 95,73%. 32 niños fueron diagnosticados entre los 6 y 8 meses ingresaron al Programa de Implantes Cocleares siendo intervenidos quirúrgicamente entre los 9 y 16 meses. Conclusión: El programa es adecuado a nuestro funcionamiento, alcanzando el mismo un porcentaje de cobertura superiordel 95% valor ampliamente satisfactorio teniendo en cuenta las recomendaciones de la CODEPEH.

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Introduction: Neonatal hearing loss is a public health problem early diagnosis and (re) habilitation adequate prevent the most important consequence of infant hearing loss: growing up without a language. Aim: To analyze the results obtained in the Universal Program for Early Detection of Infant Hearing Loss implemented in the Complejo Hospitalario Universitario Insular Materno Infantil, in Las Palmas de Gran Canaria, from January 2007 to December 2013. Material and method: We studied otoacoustic emissions in both phases ofthe program for 44 597 newborns. The diagnostic phase was carried out at the Hearing Loss Unit, Department of Otorhinolaryngology. Results: Between January 2007 and December 2013, 46,587 children were born, 44,597 underwent screening, of which 41,621 have positive otoacustic emissions and in 1233 these are absent. In 8,193 the secondphase gave positive otoacustic emissions in both ears and 649 failed the second phase. 9,581 newborns presented risk factors associated with hearing loss. The average referral to diagnostic phase was 5.69%, the program reacheda coverage of 95.73%. 32 children diagnosedbetween 6and8months entered the Cochlear Implant Program being operated on between 9 and 16 months. Conclusion: The Program in our hospital has proved adequate, achieving a coverage rate above 95%, highly satisfactory value considering the recommendations of the CODEPEH.

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Análisis de tiempos de espera en pacientes con cáncer de cabeza y cuello en el Hospital San Juan de Dios

Introducción: Los cánceres de cabeza y cuello (CCyC) son reconocibles precozmente mediante la cínica y exámenes poco invasivo, sin embargo, existe importante demora entre las primeras molestias del paciente y el tratamiento. Objetivo: Describir los tiempos involucrados entre los primeros síntomas y el tratamiento. Material y método: Estudio descriptivo retrospectivo, mediante evaluación de fichas de pacientes diagnosticados y tratados por CCyC en otorrinolaringología del Hospital San Juan de Dios durante 18 meses. Resultados: Fueron elegibles 33 casos. El 93,7% correspondieron a carcinomas escamosos. Fueron comprometidos principalmente laringe (45,4%) y orofaringe (24,2%). El 90,2% se diagnosticó en estadio avanzado. Los pacientes demoraron 17 semanas en consultar desde sus primeros síntomas. Pasó una semana para ser evaluados por el especialista. Este tardó una semana en obtener una biopsia. El resultado histológico tomó tres semanas y el tratamiento se realizó a las cinco semanas. Quienes recibieron cirugía como primer tratamiento tardaron cuatro semanas en recibirla. Quienes fueron a quimiorradioterapia como coadyuvancia esperaron 11,5 semanas. Mientras, quienes recibieron quimiorradioterapia como único tratamiento, tardaron 8 semanas. Conclusión: Los principales retrasos en el manejo de estos pacientes son: la demora del paciente en consultar, el informe histológico y el acceso al tratamiento al conocerse el diagnóstico, especialmente cuando el tratamiento es la radio-quimioterapia.

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Introduction: Head and neck cancers (HNC) are recognizable by clinical and early minimally invasive tests, however, there is significant delay between the first symptoms and treatment. Aim: To describe the times involved between the first symptoms and treatment. Material and method: Descriptive and retrospective study, by evaluating records of patients diagnosed and treated for HNC in otolaryngology at the Hospital San Juan de Dios, for 18 months. Results: 33 cases were eligible. 937% corresponded to squamous cell carcinoma. The sites most committed were larynx (45.4%) and (24.2%); the diagnosis was made in advanced stages in 90.2% of the cases. The patients took 17 weeks to consult since their first symptoms. It took 1 week to be evaluated by the specialist. It took 1 week to get a biopsy. The histological result took 3 weeks and treatment was performed at 5 weeks. Who received surgery as first treatment took 4 weeks to receive it. Who went to chemo-radiotherapy as co-adjuvant waited 11.5 weeks. Those receiving chemo-radiotherapy as the only treatment, 8 weeks. Conclusion: The major delays are the patient delay in consulting, the time delay in the histological report and access to treatment when knowing the diagnosis, especially when treatment is radio-chemotherapy.

http://ift.tt/2v10xH5

Pólipo bilateral de cuerda vocal: Presentación de un caso clínico

Los pólipos de cuerda vocal son lesiones laríngeas benignas. Se asocian a micro-traumatismos por mal uso vocal que generan remodelación de la lámina propia y el epitelio. Es más frecuente en hombres entre los veinte y cuarenta años. En la gran mayoría de los casos se presenta de manera unilateral. Si bien estas lesiones están bien documentadas en la literatura, es raro encontrar presentaciones bilaterales, por lo que su enfrentamiento y manejo puede ser discutible. Se presenta el caso de una paciente de sexo femenino de 41 años, fumadora, que consulta por disfonía de larga data. Se diagnostican pólipos bilaterales de cuerda vocal, realizando una intervención quirúrgica en un tiempo, con un resultado favorable.

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Vocal cord polyps are benign Iaryngeal lesions. They are associated to micro traumatisms because ofvocal misuse, generating a remodelation of the lamina propria and the epithelium. It is more common in men between twenty and forty years of age. In the vast majority of cases it unilaterally occurs. While these are well documented injuries in the literature, it is rare to find bilateral presentations, so their confrontation and management may be debatable. We present the case of a female patient, smoker, who consulted for chronic dysphonia. Bilateral vocal cord polyps were diagnosed, performing a bilateral resection with a positive outcome.

http://ift.tt/2vk2KQv

Presentación inusual de fracturas laríngeas: Reporte de dos casos de fracturas laríngeas no traumáticas

Las fracturas laríngeas se producen principalmente en el contexto de traumas cervicales, ahorcamiento o estrangulamiento. Las fracturas laríngeas no traumáticas son excepcionales, existiendo escasos reportes en la literatura. A continuación, presentamos dos casos de fracturas laríngeas no traumáticas evaluadas en nuestro servicio.

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Laryngeal fractures occur mainly in the context of cervical trauma, hanging or strangulation. Nontraumatic laryngeal fractures are rare and there are fewreports in the literature. We present two cases of nontraumatic laryngeal fractures evaluated in our service.

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Linfoma T/NK extraganglionar tipo nasal: Caso clínico

El linfoma T/NK extraganglionar tipo nasal es un linfoma extraganglionar, habitualmente expresa el fenotipo NK y VEB positivo. Cursa ocasionando necrosis y angioinvasión afectando de manera preferente estructuras mediofaciales. Característicamente es muy agresivo. Presentamos un caso con una sobrevida de siete meses a partir de los primeros síntomas y realizamos revisión de la literatura.

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Extranodal NK/T-cell lymphoma nasal type, is an extranodal lymphoma, usually with an NK-cell phenotype and EBV possitive. It causes necrosis and angioinvasion, and it is most commonly presenting in the midfacial area. Characteristically it is very aggressive. A case with survival of seven months from the first symptoms is reported and a review of the literature is made.

http://ift.tt/2vjSGXI

Cierre de fístula oroantral con injerto de hueso vómer

Presentamos un caso de fístula oroantral y rinosinusitis maxilar, resuelto por abordaje combinado endoscópico, nasal e intraoral en el cual se utilizó colgajo de mucosa palatina y hueso vómer para el cierre de la misma. Describimos el caso de una paciente femenina de 66 años de edad, que consultó por presentar cacosmia, algia facial izquierda y rinorrea posterior purulenta, 3 semanas posterior a extracción de segundo molar superior izquierdo, la tomograffa axial computarizada (TC) de senos paranasales evidenció velamiento total maxilar izquierdo, parcial etmoidal izquierdo y defecto óseo en reborde alveolar superior izquierdo. Se realizó toma de fragmento de hueso vómer. Seguidamente abordaje de cavidad antral izquierda por vía endoscópica; e intraoral, se concluyó disección, cierre óseo y mucoso de la fístula.

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We report a case of an oroantral fistula and maxillary rhinosinusitis, that was resolved by combined approach, in which palatal mucosa flap and vomer bone was used for its closure. We describe the case of a female patient of 66 years old, who consulted for having cacosmia, left facial pain and purulent rhinorrhea, after left second molar extraction. CT-scan sinus showed the total left maxillary sinus, partial left ethmoid opacity and bone defect in left alveolar ridge. A vomer bone graft was taken from the nasal septum; left maxillary sinus surgerywas done by endoscopic approach and intraoral closure of bony and mucosa fístula was concluded.

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Uso de probióticos en otorrinolaringología

En los humanos las infecciones más frecuentes son las respiratorias, siendo la principal indicación de antibióticos en niños. El uso indiscriminado de antibióticos lleva a la aparición de gérmenes multirresistentes. Uno de los objetivos actuales en salud es la prevención de las enfermedades infecciosas para disminuir el uso de antibióticos. Una estrategia postulada recientemente para prevenir infecciones respiratorias es el uso de probióticos.

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In humans, the most frequent infections are respiratory, being the main indication of antibiotics in children. The indiscriminate use of antibiotics leads to the emergence of multi-resistant germs. One of the current health objectives is the prevention of infectious diseases so we can reduce the use of antibiotics. A potential strategy for preventing respiratory infections is the use of probiotics.

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Title Page

Publication date: July–August 2017
Source:Current Problems in Cancer, Volume 41, Issue 4





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Information for Readers

Publication date: July–August 2017
Source:Current Problems in Cancer, Volume 41, Issue 4





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Table of Contents

Publication date: July–August 2017
Source:Current Problems in Cancer, Volume 41, Issue 4





http://ift.tt/2hpqGMP

Indicadores de calidad del Programa de Detección Precoz de Hipoacusia Permanente del Hospital Padre Hurtado

Introducción: La detección precoz de hipoacusia permanente en lactantes beneficia el desarrollo integral del paciente. Los programas cuyo objetivo es la identificación universal de hipoacusia debieran tener como meta determinados criterios de calidad en su ejecución. Objetivo: El objetivo del presente trabajo es comunicar los resultados del Programa de Detección Precoz de Hipoacusia en el Hospital Padre Hurtado. Material y método: Se incluyen los recién nacidos entre el 1 de enero de 2014 y el 31 de agosto de 2016. Los pacientes sin factores de riesgo para hipoacusia congénita se evalúan con examen de emisiones otoacústicas, y los pacientes con factores de riesgo con potenciales auditivos automatizados de tronco encefálico. Refieren aquellos pacientes con exámenes alterados en forma uní o bilateral. La etapa diagnóstica incluye potenciales auditivos evocados con tono, impedanciometría de alta frecuencia y audiometría de refuerzo visual. Los pacientes con diagnóstico de hipoacusia permanente son amplificados e inician proceso de habilitación. Resultados: En el período de estudio el universo a evaluar fue de 12.313 recién nacidos. Se completó la etapa de pesquisa en 98.4% con una tasa de referencia de 0.6%. 79 pacientes pasaron a etapa diagnóstica, completaron su evaluación antes de 3 meses en 95% de los casos. Se confirmó hipoacusia sensorioneural en 7 casos, con una tasa de 0.56 por 1.000 recién nacidos vivos. En 57% de los pacientes se amplificaron antes de los seis meses de vida. Conclusiones: El Programa de Hipoacusia Congénita del Hospital Padre Hurtado cumple con los indicadores de calidad recomendados en los ítemes de pesquisa y diagnóstico. En la etapa de habilitación con audffonos esto se realiza antes de los seis meses de vida sólo en 57% de los casos.

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Introduction: Quality indicators of the newborn hearing screening program in Hospital Padre Hurtado. Aim: Asses the accomplishment of quality indicators of the newborn hearing screening program in Hospital Padre Hurtado, Chile, as proposed by the Joint Committee on Infant Hearing Loss (JCIH). Material and method: Two stage screening protocol: otoacoustic emissions for babies in the well-infant nursery and automated auditory brainstem responses for those in the intensive care unit orwith risk factors. If they fail one or both ears they proceed to a comprehensive audiological assessment. Results: 12.313 live births between 01/01/2014 and 108/31/16, 12.103 were screened before discharge (98.4%). 79 cases proceeded to diagnostic assessment, referral rate 0.6%. 95% infants completed audiological evaluation before three months, seven cases were diagnose with permanent sensorineural hearing loss for a prevalence of 0.56 per 1000 live births. Amplification was provided before 6 months of age in 57% of deaf children. Conclusions: Quality indicators of the JCIH are met by our newborn hearing screening program with the exception of adequate timing for the provision of hearing aids: 57% before six months of age.

http://ift.tt/2v0IFMs

Estimación de la incidencia del cáncer de laringe en Chile según la aplicación de un formulario de registro digital

Introducción: El cáncer de laringe es una neoplasia frecuente en otorrinolaringología. Actualmente la incidencia ajustada por edad en Chile de cáncer laríngeo se proyecta en base al Registro Poblacional de Cáncer de la provincia de Los Lagos (International Agency for Research on Cancer - WHO), siendo ésta de 1,3 x100.000 habitantes. Objetivo: Estimar la incidencia del cáncer de laringe en Chile medida mediante un formulario de registro digital en hospitales y clínicas del país que realizan diagnóstico y tratamiento a esta patología, entre septiembre de 2015 y septiembre de 2016. Material y metodo: Estudio descriptivo prospectivo. Se utilizó un formulario de registro digital. Se incluyeron pacientes con diagnóstico histológico de cáncer de laringe entre septiembre de 2015 y septiembre de 2016. Resultados: Se registraron un total de 134 carcinomas escamosos de laringe. 15 (11%) de sexo femenino y 119 (89%) de sexo masculino. La incidencia fue de 2,13 casos por cada 100.000 habitantes, al estandarizarla por edad fue de 2,12 por cada 100.000 habitantes. Conclusión: La estimación del presente estudio es más alta que la reportada en los registros nacionales. Es necesario crear un registro poblacional más representativo de la realidad nacional, y así conocer la magnitud real de los casos de cáncer en el país.

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Introduction: The squamous cell carcinoma of the larynx is a frequent neoplasms within otorhinolaryngology Currently the age standardized incidence of Chile for laryngeal cancer is based on the cancerpopulation registration of the province of Los Lagos (International Agency for Research on Cancer - WHO), which is 1.3 x 100,000 inhabitants. Aim: To estimate the incidence of laryngeal cancer in Chile using a digital registry form in hospitals and clinics of the country that diagnose and treat this condition between September 2015 and September 2016. Material and method: A descriptive prospective study was conducted. We use a digital registration form. We included patients with clinical diagnosis of laryngeal cancer between September 2015 and September 2016. Data was analyzed with descriptive statistics. Results: A total of 134 squamous cell carcinomas of the larynx were registered. 15 (11%) were female and 119 (89%) were male, with a mean age of65years. The incidence was of 2.13 cases per 100,000 inhabitants, and the age-standardized incidence was of 2.12 per 100,000 inhabitants. Conclusion: In this study the incidence is greater than the one reported in other registrations. It is necessary a more representative population registration of the national reality in order to estimate accurately the cancer cases in the country.

http://ift.tt/2vjkZFW

Angiomiolipoma de cavidad nasal: Reporte de un caso y revisión de la literatura

El angiomiolipoma de cavidad nasal es un tumor hamartomatoso extremadamente infrecuente compuesto por adipocitos maduros, espacios vasculares con escaso tejido elástico y la presencia de haces de células musculares lisas maduras. Se manifiesta principalmente por obstrucción nasal unilateral y epistaxis recurrente. Se presenta el caso de una paciente de 73 años con historia crónica de obstrucción nasal y epistaxis recurrente izquierda asociada a rinorrea y descarga posterior intermitente. La tomografía computarizada (TC) y resonancia nuclear magnética (RNM) demuestran una lesión vascular circunscrita en fosa nasal izquierda. La angiografía demostró irrigación exclusiva de la arteria esfenopalatina izquierda. Se realizó extirpación de la lesión por abordaje endonasal endoscópico previa embolización arterial. La revisión de la literatura mundial muestra que es el duodécimo caso de angiomiolipoma de cavidad nasal reportado.

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Angiomyolipoma of nasal cavity is an extremely rare hamartoma tumor composed of mature adipocytes, vascular spaces with lack of elastic tissue, and the presence of bundles of mature smooth muscle cells. It manifests itself mainly by unilateral nasal obstruction and recurrent epistaxis. We present the case of a 73-years-old woman with chronic history of left-sided nasal obstruction and recurrent epistaxis associated with rhinorrhea and intermittent post nasal drip. Computed tomography and magnetic resonance imaging demonstrate a vascular lesion inside the left nasal cavity. Angiography showed irrigation exclusively by the left sphenopalatine artery Surgical excision was performed by endoscopic endonasal approach after arterial embolization. World literature review showed that this is the twelfth reported case of angiomyolipoma of the nasal cavity.

http://ift.tt/2vkc2Mj

Pólipo bilateral de cuerda vocal: Presentación de un caso clínico

Los pólipos de cuerda vocal son lesiones laríngeas benignas. Se asocian a micro-traumatismos por mal uso vocal que generan remodelación de la lámina propia y el epitelio. Es más frecuente en hombres entre los veinte y cuarenta años. En la gran mayoría de los casos se presenta de manera unilateral. Si bien estas lesiones están bien documentadas en la literatura, es raro encontrar presentaciones bilaterales, por lo que su enfrentamiento y manejo puede ser discutible. Se presenta el caso de una paciente de sexo femenino de 41 años, fumadora, que consulta por disfonía de larga data. Se diagnostican pólipos bilaterales de cuerda vocal, realizando una intervención quirúrgica en un tiempo, con un resultado favorable.

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Vocal cord polyps are benign Iaryngeal lesions. They are associated to micro traumatisms because ofvocal misuse, generating a remodelation of the lamina propria and the epithelium. It is more common in men between twenty and forty years of age. In the vast majority of cases it unilaterally occurs. While these are well documented injuries in the literature, it is rare to find bilateral presentations, so their confrontation and management may be debatable. We present the case of a female patient, smoker, who consulted for chronic dysphonia. Bilateral vocal cord polyps were diagnosed, performing a bilateral resection with a positive outcome.

http://ift.tt/2vk2KQv

Biopsia endoscópica de osteocondroma de fosa infratemporal

Presentamos el caso de una mujer de 13 años con un gran tumor de características óseas en la fosa infratemporal derecha, el cual fue biopsiado mediante un abordaje endoscópico transeptal transpterigoídeo. La biospia mostró un osteocondroma. Describimos el caso y discutimos sus aspectos relevantes.

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We report the case of a 13-year-old woman with a large tumor with osseous appearance in her right infratemporal fossa, which was biopsied through an endoscopic transpterygoid approach. The biopsy showed an osteocondroma. We described the case and discuss its relevant aspects.

http://ift.tt/2vk14GA

Condrosarcoma de la laringe: Reporte de un caso y revisión de la literatura

El cáncer de laringe es un tumor relativamente raro en Ecuador (0,5/100000 varones). Las lesiones neoplásicas de laringe son usualmente epiteliales y el tipo histológico más frecuente es el carcinoma escamocelular. El tumor mesenquimal más común es el condrosarcoma. En los 31 años de existencia del Registro Nacional de Tumores de Ecuador éste es el primer caso de condrosarcoma de laringe registrado. Por este motivo, hemos decidido reportar el manejo diagnóstico y terapéutico de este caso.

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Laryngeal cancer is a relatively uncommon tumor en Ecuador (0,5/100000 males). These neoplastic lesions usually epithelial and the most frequent histological type is squamous cell carcinoma. The most common mesenchymal tumor is chondrosarcoma. No case of this type of laryngeal tumor has been registered since the foundation of the National Cancer Registry of Ecuador thirty-one years ago. For this reason, we have decided to report the diagnostic and therapeutic management of his case.

http://ift.tt/2vkp8JE

Estenosis de la apertura piriforme y síndrome de incisivo central único: Casos clínicos

El síndrome incisivo central único es un trastorno que involucra anomalías de la línea media. Se puede presentar con dificultad respiratoria poniendo en peligro la vida del recién nacido, debido a malformaciones nasales. Estas malformaciones incluyen atresia de coanas y la estenosis de la apertura del orificio piriforme. Debe pensarse en esta última en todo recién nacido con estridor y dificultad respiratoria de grado variable, asociado a la dificultad de pasar una sonda a través de la región anterior de las fosas nasales. El diagnóstico se confirma por tomografía computarizada del macizo craneofacial y el examen nasofibroscópico. La conducta terapéutica dependerá de la gravedad de los síntomas, pero en general si es que no hay compromiso respiratorio severo, se prefiere una conducta expectante, y esperar el crecimiento craneofacial del niño, para aumentar permeabilidad nasal. Presentamos dos casos clínicos.

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Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities. It may present with life threatening respiratory distress in the neonate secondary to nasal malformations. These include choanal atresia and pyriform aperture stenosis. The last to be thought in any newborn with stridor and respiratory distress associated with the difficulty of passing a tube through the anterior region of the nostrils. The diagnosis is confirmed by craniofacial CT scan and nasolaryngoscope evaluation. The therapeutic approach depends on the severity of symptoms.

http://ift.tt/2vk2Ibl

Presentación inusual de fracturas laríngeas: Reporte de dos casos de fracturas laríngeas no traumáticas

Las fracturas laríngeas se producen principalmente en el contexto de traumas cervicales, ahorcamiento o estrangulamiento. Las fracturas laríngeas no traumáticas son excepcionales, existiendo escasos reportes en la literatura. A continuación, presentamos dos casos de fracturas laríngeas no traumáticas evaluadas en nuestro servicio.

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Laryngeal fractures occur mainly in the context of cervical trauma, hanging or strangulation. Nontraumatic laryngeal fractures are rare and there are fewreports in the literature. We present two cases of nontraumatic laryngeal fractures evaluated in our service.

http://ift.tt/2vk3N2I

Utilidad de imagen de banda estrecha en un caso de melanoma mucoso de septum nasal

En los últimos años, se está utilizando la fibrolaringoscopía con imagen de banda estrecha (NBI) como técnica novedosa para observar el patrón específico de microvas-cularización de una lesión concreta a evaluar. Es conocida por su utilidad en el diagnóstico de otras lesiones de vías aerodigestivas superiores, fundamentalmente laríngea y digestiva. Los melanomas mucosos son tumores infrecuentes, que suelen localizarse a nivel del área rinosinusaly que comportan un manejo y pronóstico distinto con respecto a los melanomas cutáneos. Se presenta el caso clínico de una paciente mujer con anamnesis, exploración y fibrolaringoscopía con imagen de banda estrecha, compatible con melanoma mucoso de fosa nasal izquierda. El tratamiento realizado fue quirúrgico, sin necesidad de tratamiento coadyuvante, y no presenta evidencia de enfermedad al año postseguimiento.

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In recent years, it is being used fibrolaryngoscopy with narrowband image (NBI) as a novel technique to observe the specific pattern of microvasculature of a particular lesion. NBI is known for its usefulness in the diagnosis of other lesions of the upper aerodigestive tract, (primarily laryngeal and digestive lesions). Mucosal melanomas are rare tumors, which are usually located at the level of rhino-sinusal area and involving a different prognosis and management regarding cutaneous melanomas. We report a female patient case with anamnesis, clinical examination and NBI compatible with mucosal melanoma of left nostril. Surgical treatmentwas performed without adjuvant therapy, and there is no evidence of disease at one year post-monitoring.

http://ift.tt/2vkfbvG

Linfoma T/NK extraganglionar tipo nasal: Caso clínico

El linfoma T/NK extraganglionar tipo nasal es un linfoma extraganglionar, habitualmente expresa el fenotipo NK y VEB positivo. Cursa ocasionando necrosis y angioinvasión afectando de manera preferente estructuras mediofaciales. Característicamente es muy agresivo. Presentamos un caso con una sobrevida de siete meses a partir de los primeros síntomas y realizamos revisión de la literatura.

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Extranodal NK/T-cell lymphoma nasal type, is an extranodal lymphoma, usually with an NK-cell phenotype and EBV possitive. It causes necrosis and angioinvasion, and it is most commonly presenting in the midfacial area. Characteristically it is very aggressive. A case with survival of seven months from the first symptoms is reported and a review of the literature is made.

http://ift.tt/2vjSGXI

Cierre de fístula oroantral con injerto de hueso vómer

Presentamos un caso de fístula oroantral y rinosinusitis maxilar, resuelto por abordaje combinado endoscópico, nasal e intraoral en el cual se utilizó colgajo de mucosa palatina y hueso vómer para el cierre de la misma. Describimos el caso de una paciente femenina de 66 años de edad, que consultó por presentar cacosmia, algia facial izquierda y rinorrea posterior purulenta, 3 semanas posterior a extracción de segundo molar superior izquierdo, la tomograffa axial computarizada (TC) de senos paranasales evidenció velamiento total maxilar izquierdo, parcial etmoidal izquierdo y defecto óseo en reborde alveolar superior izquierdo. Se realizó toma de fragmento de hueso vómer. Seguidamente abordaje de cavidad antral izquierda por vía endoscópica; e intraoral, se concluyó disección, cierre óseo y mucoso de la fístula.

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We report a case of an oroantral fistula and maxillary rhinosinusitis, that was resolved by combined approach, in which palatal mucosa flap and vomer bone was used for its closure. We describe the case of a female patient of 66 years old, who consulted for having cacosmia, left facial pain and purulent rhinorrhea, after left second molar extraction. CT-scan sinus showed the total left maxillary sinus, partial left ethmoid opacity and bone defect in left alveolar ridge. A vomer bone graft was taken from the nasal septum; left maxillary sinus surgerywas done by endoscopic approach and intraoral closure of bony and mucosa fístula was concluded.

http://ift.tt/2vkvwk9

Carcinoma familiar de tiroides no medular: Reporte de un caso clínico y revisión de la literatura

El carcinoma tiroideo familiar no medular (CFTNM) representa aproximadamente entre el 3,2% y 9,6% de todos los cánceres de tiroides, y se define por la presencia de cáncer diferenciado de tiroides en 2 o más familiares, en ausencia de otros síndromes familiares conocidos o exposición a radiación. Si bien su fisiopatología es aún incierta, algunos investigadores postulan un patrón de herencia dominante con penetrancia incompleta, no habiendo aún un gen específico responsable. Esta entidad suele presentarse a una menor edad y con características más agresivas que en su forma esporádica. Dado el interés por conocer la presentación de esta enfermedad y las recomendaciones para su manejo, se presenta el caso de una paciente diagnosticada con cáncer papilar de tiroides con el antecedente de 4 familiares con la misma patología. Actualmente el tamizaje mediante ecografía cervical y biopsia por punción aspiración con aguja fina de los nódulos tiroideos es el examen de elección ante la presencia del antecedente de CFTNM, ya que aún no hay estudios genéticos disponibles. La tiroidectomía total más disección ganglionar es el tratamiento de elección. Debido al comportamiento más agresivo y peor pronóstico del CFTNM, es necesaria un alto índice de sospecha y una investigación completa en la presencia de un componente familiar.

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The non-familial medullary thyroid carcinoma (FNMTC) represents approximately between 3.2 and 9.6% of all thyroid cancers, and is defined by the presence of differentiated thyroid cancer in 2 or more families in the absence of other known familial syndromes or radiation exposure. Although the pathophysiology is still uncertain, some investigators posit a dominant pattern of inheritance with incomplete penetrance, but still there is no specific gene responsible. It occurs at a younger age and with more aggressive characteristics than the sporadic form. Because of the interest in learning about the presentation of this disease and its recommendations, we present the case of a patient diagnosed with papillary thyroid cancer with a history of 4 family with the same pathology. Actually cervical screening by ultrasound and the fine needle aspiration biopsy (FNAB) of thyroid nodules is the examination of choice in the presence of a history of FNMTC, since no genetic studies yet available. Total thyroidectomy with lymph node dissection is the treatment of choice. Because the more aggressive behavior and poor prognosis of FNMTC, a high index of suspicion and a full investigation is required in the presence of a familial component.

http://ift.tt/2vk2EZ9

Uso de probióticos en otorrinolaringología

En los humanos las infecciones más frecuentes son las respiratorias, siendo la principal indicación de antibióticos en niños. El uso indiscriminado de antibióticos lleva a la aparición de gérmenes multirresistentes. Uno de los objetivos actuales en salud es la prevención de las enfermedades infecciosas para disminuir el uso de antibióticos. Una estrategia postulada recientemente para prevenir infecciones respiratorias es el uso de probióticos.

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In humans, the most frequent infections are respiratory, being the main indication of antibiotics in children. The indiscriminate use of antibiotics leads to the emergence of multi-resistant germs. One of the current health objectives is the prevention of infectious diseases so we can reduce the use of antibiotics. A potential strategy for preventing respiratory infections is the use of probiotics.

http://ift.tt/2vke13s

Superviviencia en cáncer de laringe: A propósito de un artículo

En los humanos las infecciones más frecuentes son las respiratorias, siendo la principal indicación de antibióticos en niños. El uso indiscriminado de antibióticos lleva a la aparición de gérmenes multirresistentes. Uno de los objetivos actuales en salud es la prevención de las enfermedades infecciosas para disminuir el uso de antibióticos. Una estrategia postulada recientemente para prevenir infecciones respiratorias es el uso de probióticos.

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In humans, the most frequent infections are respiratory, being the main indication of antibiotics in children. The indiscriminate use of antibiotics leads to the emergence of multi-resistant germs. One of the current health objectives is the prevention of infectious diseases so we can reduce the use of antibiotics. A potential strategy for preventing respiratory infections is the use of probiotics.

http://ift.tt/2v0DzzP

A Cost Comparison for Telehealth Utilization in the Kidney Transplant Waitlist Evaluation Process.

Background: There have been limited publications on telehealth utilization in transplantation with no prior reports of telehealth-related costs for pretransplant evaluations. The aim of this study is to compare costs throughout the evaluation process for those patients assessed initially by telehealth to those seen in-person. Methods: All patients approved for kidney transplant waitlist evaluation at our center from March 2013 thru May 2016 with decisions were included in this study. Patients approved for evaluation were scheduled for either an initial telehealth or in-person visit, partly based on patient factors. Clinically-related and travel-related costs were calculated. Time estimates for patient time needed to complete visit, time from application approval to initial visit, and time from application approval to decision were obtained. Comparisons were made using t tests. Results: Thirty-nine months were included for 302 patients. All categories of clinically or travel-related costs were significantly less for the telehealth cohort (p

http://ift.tt/2u5Eou2

Refractory Vascular Rejection in a Hand Allograft in the Presence of Antibodies Against Angiotensin II (Type 1) Receptor.

No abstract available

http://ift.tt/2ulzWmh

Gender equity in Transplantation: A Report from the Women in Transplantation Workshop of the Transplantation Society of Australia and New Zealand.

The exponential growth of young talented females choosing science and medicine as their professional career over the past decade is substantial. Currently, more than half of the Australian medical doctoral graduates and early career researchers are comprised of women, but less than 20% of all academic professorial staff are female. The loss of female talent in the hierarchical ladder of Australian academia is a considerable waste of government investment, productivity and scientific innovation. Gender disparity in the professional workforce composition is even more striking within the field of transplantation. Women are grossly under-represented in leadership roles, with currently no female Heads of Unit in any of the Australian and New Zealand Transplanting centres. At the same time, there is also gender segregation with a greater concentration of women in lower-status academic position compared to their male counterparts. Given the extent and magnitude of the disparity, the Women In Transplantation Committee, a subcommittee of the Transplantation Society of Australia and New Zealand established a workshop comprising 8 female clinicians/scientists in transplantation. The key objectives were to i) identify potential gender equity issues within the transplantation workforce, ii) devise and implement potential strategies and interventions to address some of these challenges at a societal level, iii) set realistic and achievable goals to enhance and facility gender equality, equity and diversity in transplantation. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2u5HVIN

Disabling Central Paroxysmal Positioning Upbeat Nystagmus and Vertigo Associated With the Presence of Anti-Glutamic Acid Decarboxylase Antibodies.

An immune attack by anti-glutamic acid decarboxylase (GAD) antibodies is believed to cause a deficiency in gamma-aminobutyric acid-mediated neurotransmission in the cerebellum. This, in turn, leads to several eye movement disorders, including spontaneous downbeat (DBN) and periodic alternating nystagmus. We describe a 68-year-old diabetic woman with disabling paroxysmal positioning upbeat nystagmus (UBN) exclusively in the supine position, associated with asymptomatic spontaneous DBN, alternating skew deviation and hyperactive vestibulo-ocular reflex responses on head impulse testing, in whom high titers of anti-GAD antibodies were detected. After treatment with intravenous immunoglobulin, a complete resolution of positioning UBN and spontaneous DBN occurred, along with a decrease in anti-GAD antibody titers. Positioning UBN in this case may reflect a transient disinhibition of the central vestibular pathways carrying posterior semicircular canal signals, due to lack of normal inhibitory input from the cerebellar nodulus/uvula. Immunoglobulin restored cerebellar inhibitory output, possibly by improving gamma-aminobutyric acid neurotransmission. (C) 2017 by North American Neuro-Ophthalmology Society

http://ift.tt/2vqcloI

Antibiotika-Therapien erhöhen das Risiko für eine chronische Rhinosinusitis

Laryngo-Rhino-Otol 2017; 96: 436-437
DOI: 10.1055/s-0043-105200

© Georg Thieme Verlag KG Stuttgart · New York

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Singultus – Diagnostik und Therapie

Laryngo-Rhino-Otol 2017; 96: 446-455
DOI: 10.1055/s-0043-104086

Der Schluckauf (Singultus) ist ein reflektorischer Bewegungsablauf mit diffus im Thorax verteilten Afferenzen und Efferenzen und kontrovers diskutierter funktioneller Relevanz. In seiner physiologischen Form handelt es sich um eine meist spontan sistierende Bagatellbeschwerde, die nur selten zum Arztkontakt führt. Ein anhaltender quälender Singultus kann jedoch zu einer erheblichen Beeinträchtigung der Lebensqualtiät führen. Ein solcher chronischer Singultus wird im Allgemeinen durch eine Dauer von mehr als 48 h definiert. Häufigste zugrundeliegende Erkrankung ist der gastroösophageale Reflux. Die weiteren Ursachen für einen chronischen Singultus sind vielfältig und betreffen multiple Organsysteme mit zum Teil schwerwiegenden Grunderkrankungen. In einigen Fällen können sich auch neurologische Erkrankungen mit einem Schluckauf präsentieren, zum Teil ist er sogar das einzige Symptom im Rahmen der Erstmanifestation. In der zerebralen Bildgebung findet sich dann häufig eine Läsion der Medulla oblongata. Eine Neuromyelitis optica und ein ischämischer Hirninfarkt mit Wallenbergsyndrom sind 2 häufigere zugrundeliegende neurologische Erkrankungen, aber auch andere entzündliche und vaskuläre Erkrankungen und Tumorerkrankungen des zentralen Nervensystems sind beschrieben. Für ein optimales evidenzbasiertes Management der Diagnostik und Therapie des chronischen Singultus gibt es keine hinreichenden Daten. Die Suche nach der Grunderkrankung erfordert oft ein interdisziplinäres Vorgehen von Internisten, Neurologen und HNO-Ärzten. Bereits vor Abschluss der Diagnostik oder bei nicht behebbarer Ursache kann eine symptomatische Therapie erforderlich sein. Der anhaltende Schluckauf stellt auch ein häufiges Problem in der onkologischen Palliativversorgung dar. Die medikamentöse Therapie des Singultus ist oft diffizil. Protonenpumpenhemmer oder Prokinetika bei gastroösophagealer Ursache bzw. Baclofen mit oder ohne Gabapentin bei anderer Ursache gehören dabei zu den Mitteln der ersten Wahl. Weitere Alternativen sind andere Antikonvulsiva, Neuroleptika, Antidepressiva und Kalziumantagonisten. Für den therapierefraktären Verlauf stehen grundsätzlich auch invasive Verfahren wie z. B. die selektive Phrenicusblockade zur Verfügung. Insgesamt wären mehr Studien zum Singultus wünschenswert, um der therapeutischen und diagnostischen Herausforderung gerecht zu werden, die dieses Symptom für Neurologen darstellen kann.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Leserbrief von Prof. Dr. med. Dr. med. dent. Dr. h. c. Ralf Siegert

Laryngo-Rhino-Otol 2017; 96: 440-441
DOI: 10.1055/s-0043-103502

© Georg Thieme Verlag KG Stuttgart · New York

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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2017; 96: 497-498
DOI: 10.1055/s-0043-104095

© Georg Thieme Verlag KG Stuttgart · New York

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Spontanes retropharyngeales Hämatom mit letalem Ausgang

Laryngo-Rhino-Otol 2017; 96: 473-475
DOI: 10.1055/s-0043-112162

© Georg Thieme Verlag KG Stuttgart · New York

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Einlage eines tracheobronchialen Bifurkationsstents zur Behandlung ­malignombedingter tracheobronchialer Stenosen und Fisteln

Laryngo-Rhino-Otol 2017; 96: 443-444
DOI: 10.1055/s-0043-104092

© Georg Thieme Verlag KG Stuttgart · New York

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Chirurgie der inneren Nase

Laryngo-Rhino-Otol 2017; 96: 499-502
DOI: 10.1055/s-0043-104090

© Georg Thieme Verlag KG Stuttgart · New York

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2017; 96: 433-434
DOI: 10.1055/s-0043-104084

Liebe Leserinnen und Leser,genau, Sie lesen richtig: Ich bin der Neue.Nach mehreren Jahren sehr erfolgreicher Schriftleitungstätigkeit durch meinen hochgeschätzten, lieben Kollegen Orlando Guntinas-Lichius habe ich jetzt mit diesem Juli-Heft die federführende Schriftleitung innerhalb unseres aus Stefan Dazert, Orlando Guntinas-Lichius, Gerd Rasp und mir bestehenden Schriftleitungsteams übernommen. Ich möchte bei dieser Gelegenheit Orlando Guntinas-Lichius im Namen der gesamten Schriftleitung meinen herzlichen Dank für die ausgezeichnete Arbeit der letzten Jahre aussprechen.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Antibiotika-Therapien erhöhen das Risiko für eine chronische Rhinosinusitis

Laryngo-Rhino-Otol 2017; 96: 436-437
DOI: 10.1055/s-0043-105200

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

http://ift.tt/2u1jpog

Singultus – Diagnostik und Therapie

Laryngo-Rhino-Otol 2017; 96: 446-455
DOI: 10.1055/s-0043-104086

Der Schluckauf (Singultus) ist ein reflektorischer Bewegungsablauf mit diffus im Thorax verteilten Afferenzen und Efferenzen und kontrovers diskutierter funktioneller Relevanz. In seiner physiologischen Form handelt es sich um eine meist spontan sistierende Bagatellbeschwerde, die nur selten zum Arztkontakt führt. Ein anhaltender quälender Singultus kann jedoch zu einer erheblichen Beeinträchtigung der Lebensqualtiät führen. Ein solcher chronischer Singultus wird im Allgemeinen durch eine Dauer von mehr als 48 h definiert. Häufigste zugrundeliegende Erkrankung ist der gastroösophageale Reflux. Die weiteren Ursachen für einen chronischen Singultus sind vielfältig und betreffen multiple Organsysteme mit zum Teil schwerwiegenden Grunderkrankungen. In einigen Fällen können sich auch neurologische Erkrankungen mit einem Schluckauf präsentieren, zum Teil ist er sogar das einzige Symptom im Rahmen der Erstmanifestation. In der zerebralen Bildgebung findet sich dann häufig eine Läsion der Medulla oblongata. Eine Neuromyelitis optica und ein ischämischer Hirninfarkt mit Wallenbergsyndrom sind 2 häufigere zugrundeliegende neurologische Erkrankungen, aber auch andere entzündliche und vaskuläre Erkrankungen und Tumorerkrankungen des zentralen Nervensystems sind beschrieben. Für ein optimales evidenzbasiertes Management der Diagnostik und Therapie des chronischen Singultus gibt es keine hinreichenden Daten. Die Suche nach der Grunderkrankung erfordert oft ein interdisziplinäres Vorgehen von Internisten, Neurologen und HNO-Ärzten. Bereits vor Abschluss der Diagnostik oder bei nicht behebbarer Ursache kann eine symptomatische Therapie erforderlich sein. Der anhaltende Schluckauf stellt auch ein häufiges Problem in der onkologischen Palliativversorgung dar. Die medikamentöse Therapie des Singultus ist oft diffizil. Protonenpumpenhemmer oder Prokinetika bei gastroösophagealer Ursache bzw. Baclofen mit oder ohne Gabapentin bei anderer Ursache gehören dabei zu den Mitteln der ersten Wahl. Weitere Alternativen sind andere Antikonvulsiva, Neuroleptika, Antidepressiva und Kalziumantagonisten. Für den therapierefraktären Verlauf stehen grundsätzlich auch invasive Verfahren wie z. B. die selektive Phrenicusblockade zur Verfügung. Insgesamt wären mehr Studien zum Singultus wünschenswert, um der therapeutischen und diagnostischen Herausforderung gerecht zu werden, die dieses Symptom für Neurologen darstellen kann.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Leserbrief von Prof. Dr. med. Dr. med. dent. Dr. h. c. Ralf Siegert

Laryngo-Rhino-Otol 2017; 96: 440-441
DOI: 10.1055/s-0043-103502

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

http://ift.tt/2u1FTFk

Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2017; 96: 497-498
DOI: 10.1055/s-0043-104095

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Antwort auf den Leserbrief

Laryngo-Rhino-Otol 2017; 96: 441-442
DOI: 10.1055/s-0037-1606176

© Georg Thieme Verlag KG Stuttgart · New York

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http://ift.tt/2u1bQ0B

Spontanes retropharyngeales Hämatom mit letalem Ausgang

Laryngo-Rhino-Otol 2017; 96: 473-475
DOI: 10.1055/s-0043-112162

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

http://ift.tt/2vqvPcQ

Einlage eines tracheobronchialen Bifurkationsstents zur Behandlung ­malignombedingter tracheobronchialer Stenosen und Fisteln

Laryngo-Rhino-Otol 2017; 96: 443-444
DOI: 10.1055/s-0043-104092

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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http://ift.tt/2u1jmZC

Laryngopharyngeale Refluxerkrankung (LPRD) bei Kindern

Laryngo-Rhino-Otol 2017; 96: 485-496
DOI: 10.1055/s-0043-109188

Zwischen 5 und 20 % aller Kinder leiden an einer gastroösophagealen Refluxerkrankung (GERD), die zu Erosionen, Ulzera und Metaplasien der Ösophagusschleimhaut führen kann. Überwindet der Mageninhalt in pathologischer Häufigkeit und Intensität auch den kindlichen oberen Ösophagussphinkter, liegt eine laryngopharyngeale Refluxerkrankung (LPRD) vor. Die mit einer kindlichen LPRD assoziierten Symptome und Folgeerkrankungen sind äußerst vielfältig.LPRD in children is characterized by symptoms, clinical findings, and sequelae caused by the reflux of gastric acid, bile acid or refluxate containing pepsin beyond the esophagus. For diagnostic procedures and therapy of gastroesophageal reflux disease (GERD) in children and adults widely accepted guidelines have been established. However, diagnosis and therapy of LPRD in children remains a continuous issue of inter- and intradisciplinary discussions. Although both GERD and LPRD in children are reflux-induced diseases, these two entities are different in symptoms, cause, diagnostic procedures, and therapy. Thus, the terms GERD and LPRD are not eligible to be used as synonyms.Otorhinolaryngologists are becoming more and more involved in the management of children with suspicious LPRD. With flexible transnasal laryngopharyngoscopy being one of the most important diagnostic tools for LPRD detection, otorhinolaryngologists play an important role in the interdisciplinary diagnostic network of physicians treating children with suspected LPRD. The present article highlights age-dependent clinical symptoms, diagnostic tools, differential diagnoses, and adequate therapy for pediatric LPRD.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Chirurgie der inneren Nase

Laryngo-Rhino-Otol 2017; 96: 499-502
DOI: 10.1055/s-0043-104090

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2017; 96: 433-434
DOI: 10.1055/s-0043-104084

Liebe Leserinnen und Leser,genau, Sie lesen richtig: Ich bin der Neue.Nach mehreren Jahren sehr erfolgreicher Schriftleitungstätigkeit durch meinen hochgeschätzten, lieben Kollegen Orlando Guntinas-Lichius habe ich jetzt mit diesem Juli-Heft die federführende Schriftleitung innerhalb unseres aus Stefan Dazert, Orlando Guntinas-Lichius, Gerd Rasp und mir bestehenden Schriftleitungsteams übernommen. Ich möchte bei dieser Gelegenheit Orlando Guntinas-Lichius im Namen der gesamten Schriftleitung meinen herzlichen Dank für die ausgezeichnete Arbeit der letzten Jahre aussprechen.
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“Malignant Pleural Mesothelioma: Diagnosis, Staging, Pitfalls and Follow-up”

Publication date: Available online 2 August 2017
Source:Seminars in Ultrasound, CT and MRI
Author(s): Erika G. Odisio, Edith M. Marom, Girish S. Shroff, Carol C. Wu, Ana Paula A. Benveniste, Mylene T. Truong, Marcelo F. Benveniste
Malignant Pleural Mesothelioma (MPM) is the most common primary neoplasm of the pleura. Imaging evaluation is essential in diagnosis, staging and assessment of treatment response in MPM. Computed tomography is the most commonly used modality for tumor staging. Assessment of tumor extension and lymph node involvement is essential in imaging evaluation as locally advanced tumors are amenable to resection. Knowledge of the full imaging spectrum of this rare disease, differential diagnosis, staging classification and the current guidelines for diagnostic evaluation and follow-up are essential in accurate interpretation to optimize patient management.



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