Head and Neck Diseases by Alexandros G.Sfakianakis: 06/25/18

Δευτέρα 25 Ιουνίου 2018

Immune checkpoint blockade therapy of mesothelioma: a clinical and radiological challenge

Abstract

Treatment of malignant pleural mesothelioma (MPM) represents a highly unmet medical need. Here, we discuss the results and therapeutic potential of first- and second-generation immunomodulatory antibodies targeting distinct immune checkpoints for the treatment of MPM, as well as their prospective therapeutic role in combination strategies. We also discuss the role of appropriate radiological criteria of response for MPM and the potential need of ad hoc criteria of disease evaluation in MPM patients undergoing treatment with immunotherapeutic agents.

https://ift.tt/2Kk4HE9

Atopic Dermatitis: Five Promising Targeted Therapies

Finally, patients with atopic dermatitis will have a range of treatment options.
Medscape Dermatology

https://ift.tt/2KoIWzX

Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats

Molecular Oral Microbiology, EarlyView.

https://ift.tt/2MYct53

Organelle dynamics and viral infections: at cross roads

Publication date: Available online 25 June 2018
Source:Microbes and Infection
Author(s): Sahaya Glingston R, Rachayeeta Deb, Sachin Kumar, Shirisha Nagotu
Viruses are obligate intracellular parasites of the host cells. A commonly accepted view is the requirement of internal membranous structures for various aspects of viral life cycle. Organelles enable favourable intracellular environment for several viruses. However, studies reporting organelle dynamics upon viral infections are scant. In this review, we aim to summarize and highlight modulations caused to various organelles upon viral infection or expression of its proteins.

https://ift.tt/2KngpdX

Attitudes to local anaesthesia in radiofrequency thermotherapy sleep surgery: Our experience in a single centre with 42 adult patients

Clinical Otolaryngology, EarlyView.

https://ift.tt/2yIy0LZ

Three UTHealth Medical Students Invited to Present at Triological Society Meeting

Medical students José Ting, Margaret Engelhardt, and Brandon Esianor, BS, were invited to present the results of their research at...

https://ift.tt/2KoYFP9

5th Pediatric Allergy and Asthma Meeting (PAAM)

https://ift.tt/2Mj0jCs

Effects of Bacillus subtilis and nanohydroxyapatite on the metal accumulation and microbial diversity of rapeseed ( Brassica campestris L.) for the remediation of cadmium-contaminated soil

Abstract

This study investigated the effects of the co-application of Bacillus subtilis and nanohydroxyapatite (NHAP) on plant growth, soil cadmium (Cd) dynamics, and the microbiological characteristics (such as enzyme activity and bacterial species richness) of the rhizosphere soil. Rapeseed was used as a model plant in pot experiments. Different concentrations of B. subtilis and 0.5% NHAP were applied alone and in combination to Cd-contaminated soil. The Cd contents in soils and plants as well as the rhizospheric microorganism diversity were assessed. The addition of B. subtilis or NHAP alone increased the soil Cd content and decreased the plant Cd content, while their co-application more effectively increased the soil and plant Cd contents than either treatment alone. B. subtilis and NHAP reduced the plant Cd content by 43.15–57.04% compared with that in the control. Rhizosphere community richness and bacterial diversity were significantly increased after co-application of B. subtilis and NHAP. Co-application of B. subtilis and NHAP effectively promoted rapeseed growth and improved Cd-contaminated soil remediation.

https://ift.tt/2lxGeNv

Hydrophilic modification and anti-fouling properties of PVDF membrane via in situ nano-particle blending

Abstract

Two hydrophilic poly-vinylidene fluoride (PVDF) ultrafiltration membranes were prepared via in situ embedment of nanoparticles (NP), i.e., TiO₂ and Al₂O₃, respectively, and their anti-organic-fouling and anti-biofouling were comprehensively investigated. Characterization of modified PVDF-NP membranes by XRD and FTIR exhibited that nanoparticles were embedded successfully. Series of fast filtration tests demonstrated that in contrary to virgin PVDF membrane, PVDF-NP membranes have high permeability and anti-organic-fouling ability by decreasing the possibility of organic matters deposition and accumulation. Co-existed Ca²⁺ in feed solution deteriorated the organic fouling in virgin PVDF and PVDF-NP membranes, which was mainly caused by gelation of macromolecular foulants. PVDF-NP membranes were used to form MBR modules for domestic wastewater treatment, and the long-term monitoring evidenced that hydrophilic modified membranes achieved stably high COD and \( {\mathrm{NH}}_4^{+}-\mathrm{N} \) rejection efficiencies, and better organic rejection capability than mAO process. PVDF-NP membranes possessed consistently high anti-biofouling ability to maintain stable membrane permeability.

https://ift.tt/2yIn9ld

The burden of chronic rhinosinusitis and its effect on quality of life among patients re-attending an otolaryngology clinic in south western Uganda

Worldwide, the burden of chronic rhinosinusitis (CRS) is variable, but not known in Uganda. CRS has significant negative impact on quality of life (QOL) and as such QOL scores should guide adjustments in treat...

https://ift.tt/2IrAa25

MicroRNA-204-3p Attenuates High Glucose-Induced MPC5 Podocytes Apoptosis by Targeting Braykinin B2 Receptor

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0630-0173

Background Previous study has been reported that braykinin B2 receptor (Bdkrb2) involves in high glucose-induced renal and podocytes injuries. However, there have been some studies with contradictory results that Bdkrb2 has a protective effect on hyperglycemia-induced injuries in vivo and in vitro. The purpose of the present study was carried out to further investigate the post-transcriptional regulatory mechanism of microRNA (miR) in high glucose-treated podocytes by targeting Bdkrb2 signaling in vitro. Methods The CCK-8 and flow cytometry were performed to measure the cell viability and apoptosis. Gene and protein expression were assayed by RT-qPCR and western blotting, respectively. Results High glucose treatment decreased cell viability and induced membrane and DNA damage, as well as apoptosis in podocytes. High glucose treatment also increased the expression of Bdkrb2, which was blocked by miR-204-3p mimics transfection in podocytes. Bioinformatics and luciferase reporter activity showed that miR-204-3p was directly targeted to the 3′-untranslated region (3′-UTR) of Bdkrb2. High glucose-induced apoptosis and dysfunction in podocytes were reserved by miR-204-3p mimics transfection, while the effects of miR-204-3p mimics in high glucose-treated podocytes were neutralized by overexpressed Bdkrb2. Conclusions These findings suggested that miR-204-3p may play a protective role in high glucose-induced apoptosis and dysfunction in podocytes through down-regulation of Bdkrb2.
[...]

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

https://ift.tt/2yIkUhJ

Giant Prolactinomas: Outcomes of Multimodal Treatments for 42 Cases with Long-Term Follow-Up

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0597-8877

Giant prolactinomas represent a rare entity of pituitary tumors so that the management of these patients is still a prevalent challenge at present. Paying special attention to the treatment strategy and outcomes, we presented a large series of 42 cases looking forward to share our understanding and experience in management of these patients. Male patients accounted for 71.4% of this series and were relatively younger (35.70±2.42 vs. 52.00±3.55 years, p=0.0011) and harbored bigger tumors (14.57 vs. 7.74 cm3, p=0.0179) compared to females. Almost all of these tumors showed suprasellar extension (97.6%) and cavernous sinus invasion (92.9%). Dopamine agonist represented an efficient method to control PRL concentrations (98.8%) and reduce tumor burdens (81.2 %). PRL normalization was detected in 13 out of the 27 patients initially treated with bromocriptine (BRC) whereas none of the 14 patients with first-line operation gained a normalization of PRL concentration after surgery. Although there was no reliable predictor of tumor response, First PRL reduction was a predictive criterion for the nadir PRL level during the long-time period of follow-up for first-line bromocriptine treatment. In conclusion, patients with giant prolactinomas did not gain more benefits from initial surgery. Dopamine agonist (BRC) should be first-line treatment for giant prolactinomas whereas operation merely served as a remedy for acute compression symptoms and dopamine agonist resistance. Consecutive monitoring of serum PRL levels in the early stage of initial BRC treatment is useful for evaluation of therapeutic effect and further therapeutic decision.
[...]

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

https://ift.tt/2trDs0S

Designing a modified electrode based on graphene quantum dot-chitosan application to electrochemical detection of epinephrine

Publication date: Available online 25 June 2018
Source:Journal of Molecular Liquids
Author(s): Javad Tashkhourian, Sayedeh Fatemeh Nami-Ana, Mojtaba Shamsipur
Graphene quantum dots were used for constructing modified carbon paste electrode in a simple way using chitosan as a stabilizing agent. Since these dots are soluble in aqueous solution, chitosan is used to keep the quantum dot into the paste. A triple mixture nanocomposite including graphene quantum dots surrounded by chitosan on the plane of graphite was formed. The graphene quantum dots have plenty of carboxyl groups with the negative charges, which can have a strong electrostatic interaction with amine functional groups in chitosan. This characteristic besides having conjugated π-π bonding makes a stable and an excellent electrochemical platform for epinephrine detection. Electrochemical impedance spectroscopy and cyclic voltammetry showed that the prepared graphene quantum dots-chitosan modified carbon paste electrode possesses a fast electron transfer compared with the bare electrode and a noticeable electrocatalytic activity toward electrooxidation of epinephrine. Under optimized experimental conditions, the modified electrode revealed a linear relationship between the peak current and concentrations of epinephrine over a wide range from 0.36 to 380 μM with the limit of detection of 0.3 nM (3Sb/m). The modified electrode, proposed as a new promising nanoplatform is suitable for designing of electrochemical sensors.

Graphical abstract

https://ift.tt/2KnqU42

UTHealth Medical Students Make Presentations at International SENTAC Meeting

Nine posters were presented by medical students and residents from the McGovern Medical School Department of Otorhinolaryngology-Head and Neck Surgery...

https://ift.tt/2lycn7G

Posttraumatic stress disorder and positive memories: Clinical considerations

Publication date: Available online 25 June 2018
Source:Journal of Anxiety Disorders
Author(s): Ateka A. Contractor, Lily A. Brown, Stephanie V. Caldas, Anne N. Banducci, Daniel Taylor, Cherie Armour, M. Tracie Shea
Encoding and retrieval difficulties, and avoidance of both traumatic and positive memories, are associated with posttraumatic stress disorder (PTSD) symptoms. However, most PTSD research and clinical work has solely examined the role of traumatic memories in the maintenance/resolution of PTSD symptoms. Our current review provides a comprehensive discussion of the literature on positive memories and PTSD. First, we review theories and empirical evidence on the relations between trauma, PTSD, and memory processes (particularly positive memories). Next, we propose a conceptual model that integrates empirical evidence from experimental and positive/memory-based intervention research and highlights hypothesized mechanisms underlying the potential effectiveness of targeting positive memories in PTSD interventions. Specifically, we discuss how targeting positive memories could (1) increase positive affect and reduce negative affect, (2) correct negative cognitions, (3) increase specificity of retrieving autobiographical memories, and (4) be effectively integrated/sequenced with and enhance the effects of trauma-focused interventions. Lastly, we suggest clinical research avenues for investigating the relationship between positive memories and PTSD to possibly alter the current PTSD intervention paradigm focused only on traumatic memories. Overall, our proposed model drawing from experimental and intervention research and outlining potential effects of targeting positive memories to reduce PTSD severity needs further empirical investigation.

https://ift.tt/2tsOxyw

Mercury, cadmium, and lead content in demersal sharks from the Macaronesian islands

Abstract

The overexploitation of shark and ray fishing as well as anthropogenic pollution in the sea has led to a large decline in their population, and because sharks occupy a high trophic position in the ecosystem, they could have high concentrations of heavy metals such as Hg, Pb, and Cd. This study is based on seven species of demersal sharks which were caught in the Macaronesian archipelagos (Tenerife, Gran Canaria, and the Azores Archipelago). Hg and Pb concentrations were found in the present study to be below those reported in other comparative studies, with the highest reported values of Hg and Pb being 281,738 μg/kg for Pb in Deania profundorum (Smith & Radcliffe, 1912) and 264,30 μg/kg for Hg in Centrophorus uyato, Rafinesque, 1810. As for Cd, the values found here are higher than those in the literature, the highest reported concentration being 120.36 μg/kg in Centrophorus squamosus (Bonnaterre, 1788).

https://ift.tt/2MXt09a

Precision medicine

https://ift.tt/2tEK6jg

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.

https://ift.tt/2MVfbrU

Effects of distractors on upright balance performance in school-aged children with attention deficit hyperactivity disorder, preliminary study,

Abstract Introduction: Attention deficit hyperactivity disorder is a common impairing neuropsychiatric disorder with onset in early childhood. Almost half of the children with attention deficit hyperactivity disorder also experience a variety of motor-related dysfunctions ranging from fine/gross motor control problems to difficulties in maintaining balance. Objectives: The main purpose of this study was to investigate the effects of distractors two different auditory distractors namely, relaxing music and white noise on upright balance performance in children with attention deficit hyperactivity disorder. Methods: We compared upright balance performance and the involvement of different sensory systems in the presence of auditory distractors between school-aged children with attention deficit hyperactivity disorder (n = 26) and typically developing controls (n = 20). Neurocom SMART Balance Master Dynamic Posturography device was used for the sensory organization test. Sensory organization test was repeated three times for each participant in three different test environments. Results: The balance scores in the silence environment were lower in the attention deficit hyperactivity disorder group but the differences were not statistically significant. In addition to lower balance scores the visual and vestibular ratios were also lower. Auditory distractors affected the general balance performance positively for both groups. More challenging conditions, using an unstable platform with distorted somatosensory signals were more affected. Relaxing music was more effective in the control group, and white noise was more effective in the attention deficit hyperactivity disorder group and the positive effects of white noise became more apparent in challenging conditions. Conclusion: To the best of our knowledge, this is the first study evaluating balance performance in children with attention deficit hyperactivity disorder under the effects of auditory distractors. Although more studies are needed, our results indicate that auditory distractors may have enhancing effects on upright balance performance in children with attention deficit hyperactivity disorder.

Resumo Introdução: O transtorno do déficit de atenção e hiperatividade é um distúrbio neuropsiquiátrico comum que causa comprometimentos, com início na primeira infância. Quase metade das crianças com transtorno do déficit de atenção e hiperatividade também experimenta uma variedade de distúrbios relacionados às habilidades motoras, desde problemas de controle de habilidades motoras finas/grossas até dificuldades na manutenção do equilíbrio. Objetivos: O principal objetivo deste estudo foi investigar os efeitos de distrações, especificamente duas distrações auditivas diferentes, música relaxante e ruído branco, sobre o desempenho do equilíbrio vertical em crianças com transtorno de déficit de atenção e hiperatividade. Método: Comparamos o desempenho do equilíbrio vertical e o envolvimento de diferentes sistemas sensoriais na presença de distração auditiva entre crianças em idade escolar com transtorno do déficit de atenção e hiperatividade (n = 26) e controles com desenvolvimento típico (n = 20). O dispositivo Neurocom Smart Balance Master Dynamic Posturography foi utilizado para o teste de organização sensorial. O teste de organização sensorial foi repetido três vezes para cada participante em três ambientes de teste diferentes. Resultados: Os escores de equilíbrio no ambiente em silêncio foram menores no grupo com transtorno do déficit de atenção e hiperatividade, mas as diferenças não foram estatisticamente significativas. Além dos escores de equilíbrio mais baixos, as razões vestibulares e visuais também foram menores. As distrações auditivas afetaram positivamente o desempenho do equilíbrio geral para ambos os grupos. Condições mais desafiadoras, usando uma plataforma instável com sinais somatossensoriais distorcidos, foram mais afetados. Música relaxante foi mais eficaz no grupo de controle, e ruído branco foi mais eficaz no grupo de hiperatividade com déficit de atenção e os efeitos positivos do ruído branco se tornaram mais evidentes em condições desafiadoras. Conclusão: Que seja de nosso conhecimento, este é o primeiro estudo que avalia o desempenho do equilíbrio em crianças com transtorno do déficit de atenção e hiperatividade sob os efeitos de distrações auditivas. Embora mais estudos sejam necessários, os nossos resultados indicam que as distrações auditivas podem ter efeitos de aumento no desempenho do equilíbrio vertical em crianças com transtorno de déficit de atenção e hiperatividade.

https://ift.tt/2tK2tDR

Breaking paradigms in severe epistaxis: the importance of looking for the S-point

Abstract Introduction: Since the introduction of nasal endoscopy into the field of Otorhinolaryngology, the treatment paradigm for cases of severe epistaxis has shifted toward early and precise identification of the bleeding site. Although severe epistaxis is usually considered to arise from posterior bleeding, an arterial vascular pedicle in the superior portion of the nasal septum, around the axilla projection of the middle turbinate, posterior to the septal body, frequently has been observed. That vascular pedicle was named the Stamm's S-point. Objective: The aim of this study was to describe the S-point and report cases of severe epistaxis originating from it. Methods: A retrospective case series study was conducted. Nine patients with spontaneous severe epistaxis, where the S-point was identified as the source of bleeding, were treated between March 2016 and March 2017. Results: Male predominance (77.8%) with age average of 59.3 years old were reported. Most cases presented comorbidities (88.9%) and were not taking acetylsalicylic acid (66.7%). A predominance of left sided involvement (55.6%) and anteroposterior bleeding being the principal initial presentation (77.8%) was seen. Six patients (66.7%) presented with hemoglobin levels below 10 g/dL, and four (44.4%) required blood transfusion. Cauterization of S-point was performed in all patients, with complete resolution of bleeding. No patient experienced recurrence of severe epistaxis. Conclusion: The Stamm's S-point, a novel source of spontaneous severe epistaxis, is reported, and its cauterization was effective and safe. Otolaryngologists must actively seek this site of bleeding in cases of severe epistaxis.

Resumo Introdução: Desde a introdução da endoscopia nasal no campo de otorrinolaringologia, o paradigma de tratamento para casos graves de epistaxe voltou-se para a identificação precoce e correta do local de sangramento. Embora a epistaxe grave seja geralmente considerada uma hemorragia posterior, um pedículo vascular arterial tem sido frequentemente observado na porção superior do septo nasal, ao redor da projeção da axila da concha média, posterior ao tubérculo septal. Esse pedículo vascular foi chamado de Stamm's S-point. Objetivo: Descrever o S-point e relatar casos graves de epistaxe que se originam nesse local. Método: Um estudo retrospectivo de série de casos foi conduzido. Nove pacientes com epistaxe grave espontânea, na qual o S-point foi identificado como a fonte do sangramento, foram tratados de março de 2016 a março de 2017. Resultados: Houve predominância do sexo masculino (77,8%) com média de 59,3 anos. A maioria dos casos apresentava comorbidades (88,9%), mas sem uso de ácido acetilsalicílico (66,7%). Observou-se predominância do lado esquerdo (55,6%) com sangramento anteroposterior como a principal apresentação inicial (77,8%). Seis pacientes (66,7%) apresentaram níveis de hemoglobina inferiores a 10 g/dL e quatro (44,4%) necessitaram de transfusão sanguínea. Cauterização do S-point foi feita em todos os pacientes, com resolução completa do sangramento. Nenhum paciente apresentou recorrência de epistaxe grave. Conclusão: O Stamm's S-point é relatado como uma nova região de origem de epistaxe grave espontânea e o tratamento feito com cauterização foi eficaz e seguro. Os otorrinolaringologistas devem buscar ativamente esse local de sangramento em casos de epistaxe grave.

https://ift.tt/2MVGSAR

Obstructive sleep apnea is associated with increased QT corrected interval dispersion: the effects of continuous positive airway pressure

Abstract Introduction: Severe obstructive sleep apnea is associated with increased QT corrected interval dispersion and continuous positive airway pressure is thought to improve this arrhythmogenic marker. Objective: The aim of the study was to determine the decrease of ratio of cardiovascular risk in patients with obstructive sleep apnea. Methods: The study included 65 patients with severe obstructive sleep apnea who had an apnea-hypopnea index score of >30. Each patient underwent 12-channel electrocardiogram monitoring and polysomnography. Patients with an apnea-hypopnea index score of <5 were used as the control group. The control group also underwent electrocardiogram monitoring and polysomnography testing. The QT corrected interval dispersion levels of both groups were calculated. Three months after continuous positive airway pressure treatment, electrocardiogram recordings were obtained from the 65 patients with severe obstructive sleep apnea again, and their QT corrected interval dispersion values were calculated. Results: There were 44 male and 21 female patients with severe obstructive sleep apnea syndrome. The age, gender, body mass index, initial saturation, minimum saturation, average saturation, and desaturation index were determined in both groups. The QT corrected intervals of the obstructive sleep apnea patients (62.48 ± 16.29 ms) were significantly higher (p = 0.001) than those of the control group (29.72 ± 6.30 ms). There were statistically significant differences between the QT corrected values before and after the continuous positive airway pressure treatment, with pretreatment QT corrected intervals of 62.48 ± 16.29 ms and 3-month post-treatment values of 41.42 ± 16.96 ms (p = 0.001). There was a positive and significant correlation between QT corrected interval dispersion periods and the apnea-hypopnea index and hypopnea index in obstructive sleep apnea patients (p = 0.001; r = 0.71; p = 0.001; r = 0.679, respectively). Conclusion: Continuous positive airway pressure treatment reduced the QT corrected interval dispersion in patients with severe obstructive sleep apnea. In addition, shortening the QT corrected interval dispersion periods in patients with severe obstructive sleep apnea may reduce their risk of arrhythmias and cardiovascular disease.

Resumo Introdução: A apneia obstrutiva do sono grave está associada a uma maior dispersão do intervalo QT corrigido e acredita-se que a pressão positiva contínua nas vias aéreas melhore esse marcador arritmogênico. Objetivo: Determinar a diminuição da razão de risco cardiovascular em pacientes com apneia obstrutiva do sono. Método: O estudo incluiu 65 pacientes com apneia obstrutiva do sono grave que apresentavam índice de apneia-hipopneia > 30. Cada paciente foi submetido à monitoração por eletrocardiograma de 12 derivações e polissonografia. Os pacientes com escore de índice de apneia-hipopneia < 5 foram utilizados como o grupo de controle. O grupo de controle também foi submetido à monitoração por eletrocardiograma e teste de polissonografia. Os níveis de dispersão do intervalo QT corrigido dos dois grupos foram calculados. Três meses após o tratamento com pressão positiva contínua nas vias aéreas, os registros de eletrocardiograma foram novamente obtidos dos 65 pacientes com apneia obstrutiva do sono grave e seus valores de dispersão do intervalo QT corrigido foram calculados. Resultados: Havia 44 pacientes do sexo masculino e 21 do feminino com síndrome de apneia obstrutiva do sono grave. Idade, sexo, índice de massa corporal, saturação inicial, saturação mínima, saturação média e índice de dessaturação foram determinados em ambos os grupos. Os intervalos QT corrigido dos pacientes com apneia obstrutiva do sono (62,48 ± 16,29 ms) foram significativamente maiores (p = 0,001) do que os do grupo controle (29,72 ± 6,30 ms). Houve diferenças estatisticamente significativas entre os valores de QT corrigido antes e após o tratamento com pressão positiva contínua nas vias aéreas, com intervalos QT corrigido pré-tratamento de 62,48 ± 16,29 ms e três meses pós-tratamento, de 41,42 ± 16,96 ms (p = 0,001). Houve uma correlação positiva e significativa entre os períodos de dispersão do intervalo QT corrigido e o índice de apneia-hipopneia e índice de hipopneia em pacientes com apneia obstrutiva do sono (p = 0,001; r = 0,71; p = 0,001; r = 0,679, respectivamente). Conclusão: O tratamento com pressão positiva contínua nas vias aéreas reduziu a dispersão do intervalo QT corrigido em pacientes com apneia obstrutiva do sono grave. Além disso, o encurtamento de dispersão do intervalo QT corrigido em pacientes com apneia obstrutiva do sono grave pode reduzir o risco de arritmias e doenças cardiovasculares.

https://ift.tt/2tK2cRl

Peritonsillar and deep neck infections: a review of 330 cases

Abstract Introduction: Deep neck infections are defined as suppurative infectious processes of deep visceral spaces of the neck. Objective: The aim of this study is to review different factors that may influence peritonsillar and deep neck infections and may play a role as bad prognosis predictors. Methods: We present a retrospective study of 330 patients with deep neck infections and peritonsillar infections who were admitted between January 2005 and December 2015 in a tertiary referral hospital. Statistical analysis of comorbidities, diagnostic and therapeutic aspects was performed with Excel and SPSS. Results: There has been an increase in incidence of peritonsilar and deep neck infections. Systemic comorbidities such as diabetes or hepatopathy are bad prognosis factors. The most common pathogen was S. viridans (32.1% of positive cultures). 100% of the patients received antibiotics and corticosteroids, 74.24% needed surgical treatment. The most common complications were mediastinitis (1.2%) and airway obstruction (0.9%). Conclusion: Systemic comorbidities are bad prognosis predictors. Nowadays mortality has decreased thanks to multidisciplinary attention and improvements in diagnosis and treatment.

Resumo Introdução: Infecções cervicais profundas são definidas como processos infecciosos supurativos dos espaços viscerais profundos do pescoço. Objetivo: Analisar diferentes fatores que podem influenciar as infecções peritonsilares e cervicais profundas que podem desempenhar um papel como preditores de mau prognóstico. Método: Apresentamos um estudo retrospectivo de 330 pacientes portadores de infecções cervicais profundas e de infecções peritonsilares admitidos entre janeiro de 2005 e dezembro de 2015 em um hospital terciário de referência. A análise estatística de comorbidades, aspectos diagnósticos e terapêuticos foi realizada utilizando-se os programas Excel e o SPSS. Resultados: Houve um aumento na incidência de infecções peritonsilares e infecções cervicais profundas. Comorbidades sistêmicas como diabetes ou doença hepática são fatores de mau prognóstico. O patógeno mais comum foi S. viridans (32,1% das culturas positivas). 100% dos pacientes receberam antibióticos e corticosteroides, e 74,24% necessitaram de tratamento cirúrgico. As complicações mais comuns foram mediastinite (1,2%) e obstrução das vias aéreas (0,9%). Conclusão: Comorbidades sistêmicas são preditores de mau prognóstico. Atualmente, a mortalidade diminuiu graças ao cuidado multidisciplinar e melhorias no diagnóstico e tratamento.

https://ift.tt/2trV1xO

Nasal mucociliary transportability of male and female smokers

Abstract Introduction: Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers. Objective: To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function. Methods: The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values. Results: There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF25-75% (women non-smokers) on saccharin transit time values. Conclusion: Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Resumo Introdução: Mulheres tabagistas apresentam maior susceptibilidade à diversas doenças quando comparadas ao sexo masculino. No entanto, não há estudos mostrando diferenças no comportamento do transporte mucociliar nasal entre tabagistas do sexo masculino e feminino. Objetivo: Comparar a transportabilidade mucociliar nasal em homens e mulheres fumantes e não fumantes, levando em consideração idade, dados antropométricos, carga tabágica e função pulmonar. Método: A análise incluiu 139 indivíduos (33 homens e 37 mulheres fumantes e 32 homens e 37 mulheres não fumantes). Todos os participantes responderam a uma entrevista inicial para a obtenção de dados pessoais e a carga tabágica. Dados antropométricos e monóxido de carbono no ar expirado foram avaliados. Os indivíduos também fizeram teste de função pulmonar e o teste de trânsito de sacarina. Para comparar os valores do teste de trânsito de sacarina entre homens e mulheres, fumantes e não fumantes, foi feita a estratificação de todas as variáveis independentes (variáveis sociodemográficas, tabágicas e respiratórias) em duas categorias: abaixo e acima dos valores médios. Resultados: Não houve diferenças entre homens e mulheres, fumantes e não fumantes, em relação à transportabilidade mucociliar nasal. Diferenças significativas foram observadas apenas entre não fumantes. Entre os que apresentaram valores menores de capacidade vital forçada (< 97,37% do previsto), as mulheres apresentaram transporte mucociliar mais rápido do que os homens. Além disso, observou-se influência do IMC e COex (mulheres fumantes), CVF e VEF1 (homens não fumantes) e FEF25%-75% (mulheres não fumantes) sobre os valores do teste de trânsito de sacarina. Conclusão: Com base nos achados deste estudo, o transporte mucociliar nasal em tabagistas masculinos e femininos adultos, aparentemente saudáveis, são semelhantes.

https://ift.tt/2tHODlo

Comparison between clinical and audiological results of tympanoplasty with modified sandwich technique and underlay technique

Abstract Introduction: Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane. Objective: To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty. Methods: A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results. Results: Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB while in Group B; it was 22.5 ± 3.5 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant. Conclusion: Double layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.

Resumo Introdução: O reparo cirúrgico da membrana timpânica, denominado timpanoplastia tipo 1, é uma modalidade de tratamento já bem estabelecida. As técnicas overlay ou underlay de timpanoplastia são comuns. A timpanoplastia "sanduíche" é a técnica de enxerto de membrana timpânica overlay e underlay combinadas. Objetivo: Descrever e avaliar a timpanoplastia com a técnica "sanduíche" modificada (timpanoplastia mediolateral) utilizando fáscia temporal e fáscia aureolar. Comparar o desfecho clínico e audiológico da timpanoplastia com a técnica "sanduíche" modificada com o da timpanoplastia com a técnica underlay. Método: Foram estudados 88 pacientes com otite média crônica, 48 (Grupo A) foram submetidos à timpanoplastia tipo 1 com enxerto "sanduíche" modificado. A fáscia temporal foi utilizada na técnica underlay e a fáscia areolar na técnica overlay. 48 pacientes (Grupo B) foram submetidos à timpanoplastia tipo 1 com a técnica underlay. Foram avaliados os resultados da cicatrização e da audição. Resultados: O sucesso do enxerto ocorreu em 47 pacientes (97,9%) no Grupo A e em 40 (83,3%) do Grupo B. O fechamento médio do gap aéreo-ósseo no Grupo A foi de 24,4 ± 1,7 dB, enquanto no Grupo B foi de 22,5 ± 3,5 dB. Houve diferença estatisticamente significativa na taxa de cicatrização do enxerto. A diferença na melhora auditiva não foi estatisticamente significante. Conclusão: O enxerto de camada dupla e o tímpano-martelo posicionados como o "recheio" do sanduíche mantém um equilíbrio perfeito entre a estabilidade necessária e adequada sensibilidade acústica.

https://ift.tt/2MZd8Dq

Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit

Abstract Introduction: The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision. Objective: To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids. Methods: This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0 = none; Grade 1 = erythema; Grade 2 = erythema and discharge; Grade 3 = granulation tissue; and Grade 4 = inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit. Results: A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p = 0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications. Conclusion: Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of patients with bone-anchored hearing aids.

Resumo Introdução: A prótese auditiva óssea (BAHA, do inglês Bone-Anchored Hearing Aid) é uma forma eficaz de reabilitação auditiva. Devido à natureza do implante, as complicações mais comuns são relacionadas à pele. Várias técnicas opcionais de implantação cirúrgica têm sido usadas para reduzir a frequência e a gravidade das complicações cutâneas, inclusive o enxerto em forma de U e a incisão linear. Objetivo: Avaliar as complicações cutâneas e sua associação com a técnica cirúrgica, qualidade de vida e benefício audiológico em pacientes com BAHAs. Método: Estudo retrospectivo feito em um centro terciário de referência em Bogotá, Colômbia. Os pacientes que receberam um implante de BAHA (unilateral ou bilateralmente) durante pelo menos seis meses foram incluídos no estudo. A classificação de Holgers foi usada para classificar as complicações cutâneas (Grau 0 = nenhuma, Grau 1 = eritema, Grau 2 = eritema e secreção, Grau 3 = tecido de granulação e Grau 4 = inflamação/infecção, resultou na remoção da estrutura de apoio). O questionário Glasgow Benefit Inventory (GBI) foi usado para determinar a qualidade de vida e o questionário Abbreviated Profile of Hearing Aid Benefit (APHAB) foi usado para determinar o benefício audiológico subjetivo. Resultados: Foram incluídos 37 pacientes (30 com implantes unilaterais e sete com implantes bilaterais). Dos 44 implantes avaliados, 31 (70,3%) foram associados às complicações cutâneas (sete [15,9%] Grau 1; quatro [9,1%] Grau 2; 15 [34,1%] Grau 3 e cinco [11,4%] Grau 4). O enxerto em forma de U foi estatisticamente associado a complicações maiores (Graus 3 e 4) em comparação com a técnica de incisão linear (p = 0,045). Não foram encontradas diferenças estatisticamente significativas entre os escores APHAB e gravidade das complicações. Do mesmo modo, não foram encontradas diferenças entre as questões de saúde física pelo questionário GBI e complicações cutâneas. Conclusão: Apesar da alta frequência, as complicações cutâneas não parecem afetar a qualidade de vida ou os benefícios audiológicos subjetivos de pacientes com BAHAs.

https://ift.tt/2yDxmPM

Ototoxicity of boric acid powder in a rat animal model

Abstract Introduction: Boric acid, which has antiseptic and acidic properties, is used to treat external and middle ear infections. However, we have not found any literature about the effect of boric acid powder on middle ear mucosa and inner ear. Objective: The purpose of this study is to investigate possible ototoxic effects of boric acid powder on cochlear outer hair cell function and histological changes in middle ear mucosa in a rat animal model. Methods: Twenty healthy, mature Wistar albino rats were used in this study. The rats were divided into two groups, Group A and Group B, each of which consisted of 10 rats. Initially, the animals in each group underwent distortion product otoacoustic emissions testing of their right and left ears. After the first distortion product otoacoustic emissions test, a surgical microscope was used to make a small perforation in both ears of the rats in each group, and a second distortion product otoacoustic emissions test was used to measure both ears in all of the rats. Boric acid powder was applied to the right middle ear of the rats using tympanic membrane perforation, and the distortion product otoacoustic emissions were measured immediately after the boric acid powder application. The histological changes and distortion product otoacoustic emissions were evaluated three days later in Group A and 40 days later in Group B. Results: No significant differences were found at all of the distortion product otoacoustic emissions frequencies. In Group A, mild inflammation of the middle ear mucosa was found on the third day after boric acid powder application. In Group B, boric acid powder caused mild inflammatory changes on the 40th day, which declined over time. Those changes did not lead to significant fibrosis within the mucosa. Conclusion: In rats, boric acid powder causes mild inflammation in middle ear mucosa and it has no ototoxic effects on cochlear outer hair cell function in the inner ear of rats.

Resumo Introdução: O ácido bórico, que tem propriedades antissépticas e ácidas, é usado para tratar infecções de orelha externa e média. No entanto, não encontramos literatura sobre o efeito do ácido bórico em pó sobre a mucosa da orelha interna e da orelha média. Objetivo: Investigar possíveis efeitos ototóxicos do ácido bórico em pó sobre a função das células ciliadas externas cocleares e alterações histológicas na mucosa da orelha média em um modelo animal de rato. Método: Vinte ratos Wistar albinos maduros e saudáveis foram usados neste estudo. Os ratos foram divididos em dois grupos, Grupo A e Grupo B, cada um dos quais com 10 ratos. Inicialmente, os animais de cada grupo foram submetidos a testes de emissões otoacústicas - produto de distorção, nas orelhas direita e esquerda. Após o primeiro teste de emissões otoacústicas - produto de distorção, utilizou-se um microscópio cirúrgico para fazer uma pequena perfuração em ambas as orelhas dos ratos em cada grupo, e um segundo teste de emissões otoacústicas - produto de distorção foi utilizado para medir e avaliar as orelhas em todos os ratos. O ácido bórico em pó foi aplicado na orelha média direita dos ratos utilizando perfuração da membrana timpânica e as emissões otoacústicas - produto de distorção foram medidas imediatamente após a aplicação de ácido bórico em pó. As alterações histológicas e emissões otoacústicas - produto de distorção foram avaliadas três dias depois no Grupo A e 40 dias depois no Grupo B. Resultados: Não foram encontradas diferenças significativas em todas as frequências da emissões otoacústicas - produto de distorção. No Grupo A, foi observada uma ligeira inflamação da mucosa da orelha média no terceiro dia após a aplicação de ácido bórico em pó. No Grupo B, o ácido bórico em pó causou leves alterações inflamatórias após 40 dias, que diminuíram ao longo do tempo. Essas alterações não levaram à fibrose significativa da mucosa. Conclusão: Em ratos, o ácido bórico em pó causa inflamação leve na mucosa da orelha média e não tem efeitos ototóxicos na função das células ciliadas externas da cóclea na orelha interna.

https://ift.tt/2tvhdH9

The analysis of expression of p16 protein in group of 53 patients treated for sinonasal inverted papilloma

Abstract Introduction: Sinonasal inverted papilloma constitute relevant therapeutic problem due to destructive character of growth, tendency to recur and the possibility of malignant transformation. Therefore, many attempts to identify risk factors for inverted papilloma occurrence have been undertaken, as well as research to find markers that would allow for the earlier detection of tumors and the application of adequate therapy. A widely known risk factor of inverted papilloma is HPV infection. One of the markers of HPV infection and the ongoing effect of this change (although arousing some controversy) is the expression of the p16 protein. Objective: The aim of the study was to analyze the correlation between the expression of p16 as a surrogate of HPV infection in analyzed histopathological material and epidemiological variables, recurrences or malignant transformation. Methods: The retrospective study includes a group of 53 patients (18 women and 35 men) undergoing treatment for sinonasal inverted papilloma in the period of 2002-2012. The intensity of the p16 protein in histopathological material was scored as: 0 - no expression, 1 - diffuse expression (borderline) and 2 - positive expression; or 0 - no expression/diffuse expression (borderline); 1 - positive expression. The Ethics Committee agreement was obtained (1089/12; 245/13). Results and conclusion: There was no statistically significant relationship between the expression of p16 and the age of patients, cigarette smoking, tumor location, tumor staging according to the Krouse and Cannady classification, the presence of dysplasia or the occurrence of relapse.

Resumo Introdução: Papiloma invertido nasossinusal constitui um problema terapêutico relevante devido ao caráter destrutivo do crescimento, a tendência à recorrência e a possibilidade de transformação maligna. Assim, muitas tentativas têm sido realizadas para identificar fatores de risco para ocorrência de papiloma invertido, bem como pesquisas para encontrar marcadores que permitam a detecção precoce de tumores e a utilização de terapia adequada. Um fator de risco amplamente conhecido de papiloma invertido é a infecção pelo HPV. Um dos marcadores da infecção por HPV e do efeito contínuo dessa alteração (embora suscite alguma controvérsia) é a expressão da proteína p16. Objetivo: Analisar a correlação entre a expressão de p16 como um substituto da infecção pelo HPV no material histopatológico analisado e as variáveis epidemiológicas, recorrências ou transformação maligna. Método: O estudo retrospectivo inclui um grupo de 53 pacientes (18 mulheres e 35 homens) submetidos a tratamento para papiloma invertido nasossinusal de 2002 a 2012. A intensidade da expressão da proteína p16 no material histopatológico foi pontuada como: 0 - sem expressão, 1 - expressão difusa (limite) e 2 - expressão positiva; ou 0 - sem expressão/expressão difusa (limite); 1 - expressão positiva. O Comitê de Ética aprovou o estudo (1.089/12; 245/13). Resultados e conclusão: Não houve relação estatisticamente significante entre a expressão de p16 e a idade dos pacientes, o tabagismo, a localização tumoral e o estadiamento tumoral de acordo com a classificação de Krouse e Cannady, presença de displasia ou ocorrência de recidiva.

https://ift.tt/2yEziHG

Translation and adaptation of the Radiotherapy Edema Rating Scale to Brazilian Portuguese

Abstract Introduction: Internal lymphedema is one of the sequelae of head and neck cancer treatment that can lead to varying degrees of swallowing, speech, and respiration alterations. The Radiotherapy Edema Rating Scale, developed by Patterson et al., is a tool used to evaluate pharyngeal and laryngeal edema. Objective: To translate into Brazilian Portuguese, to culturally adapt and test this scale in patients undergoing treatment for head and neck cancer. Methods: The process followed the international guidelines and translation steps by two head and neck surgeons and back-translation performed independently by two North-American natives. The final version of the test was evaluated based on the assessment of 18 patients by two head and neck surgeons and two speech therapists using the scales in Brazilian Portuguese. Results: The translation and cultural adaptation were satisfactorily performed by the members of the committee in charge. Conclusion: The translation and adaptation into Brazilian Portuguese of the Radiotherapy Edema Rating Scale was successfully performed and showed to be easy to apply.

Resumo Introdução: O linfedema interno é uma das sequelas do tratamento para o câncer de cabeça e pescoço, pode levar a alterações de grau variado na deglutição, voz e respiração. A Escala do Edema da Radioterapia (Radiotherapy Edema Rating Scale), elaborada por Patterson et al., é uma ferramenta de avaliação do edema de faringe e laringe. Objetivo: Traduzir, para o português brasileiro, adaptar culturalmente e testar essa escala em pacientes submetidos ao tratamento para o câncer de cabeça e pescoço. Método: O processo seguiu as diretrizes internacionais e as etapas de tradução por dois cirurgiões de cabeça e pescoço e a retrotradução de forma independente por dois nativos norte-americanos. O teste da versão final para avaliação foi realizado a partir da avaliação de 18 pacientes por dois médicos cirurgiões de cabeça e pescoço e duas fonoaudiólogas por meio da aplicação das escalas em português. Resultados: A tradução e a adaptação cultural foram executadas satisfatoriamente pelos membros do comitê responsável. Conclusão: A tradução e adaptação da Escala do Edema da Radioterapia para o português foi bem-sucedida e de fácil aplicação.

https://ift.tt/2MZuCQ6

Evaluation of pre- and post-pyriform plasty nasal airflow

Abstract Introduction: Nasal obstruction is a frequent complaint in otorhinolaryngology outpatient clinics, and nasal valve incompetence is the cause in most cases. Scientific publications describing surgical techniques on the upper and lower lateral cartilages to improve the nasal valve are also quite frequent. Relatively few authors currently describe surgical procedures in the piriform aperture for nasal valve augmentation. We describe the surgical technique called pyriform plasty and evaluate its effectiveness subjectively through the NOSE questionnaire and objectively through the rhinomanometry evaluation. Objective: To compare pre- and post-pyriform plasty nasal airflow variations using rhinomanometry and the NOSE questionnaire. Methods: Eight patients submitted to pyriform surgery were studied. These patients were screened in the otorhinolaryngology outpatient clinic among those who complained of nasal obstruction, and who had a positive response to Cottle maneuver. They answered the NOSE questionnaire and were submitted to preoperative rhinomanometry. After 90 days, they were reassessed through the NOSE questionnaire and the postoperative rhinomanometry. The results of these two parameters were compared pre- and postoperatively. Results: Regarding the subjective measure, the NOSE questionnaire, seven patients reported improvement, of which two reported marked improvement, and one patient reported an unchanged obstructive condition. Regarding the rhinomanometry assessment, of 96 comparative measurements between the preoperative and postoperative periods, we obtained 68 measurements with an increase in nasal airflow in the postoperative period, 26 negative results, and two cases that remained unaltered between the preoperative and postoperative periods. Conclusion: When analyzing the results obtained in this study, we can conclude that the piriform plasty surgical procedure resulted in nasal airflow improvement in most of the obtained measurements.

Resumo Introdução: A obstrução nasal é queixa frequente nos ambulatórios de otorrinolaringologia, e a incompetência da válvula nasal é responsável em grande parte dos casos. São bastante frequente também as publicações de trabalhos científicos descrevendo técnicas cirúrgicas sobre as cartilagens laterais superiores e inferiores para melhorar a válvula nasal. Relativamente poucos autores descrevem atualmente procedimentos cirúrgicos na abertura piriforme para incremento da válvula nasal. Descrevemos a técnica cirúrgica chamada piriformeplastia e avaliamos a sua eficácia de forma subjetiva através do questionário NOSE e de forma objetiva através do exame rinomanometria. Objetivo: Comparar as variações do fluxo aéreo nasal pré e pós-piriformeplastia através da rinomanometria e do questionário NOSE. Método: Foram estudados 8 pacientes submetidos à piriformeplastia. Estes pacientes foram triados no ambulatório de otorrinolaringologia, pacientes estes que se queixavam de obstrução nasal, e que apresentavam resposta positiva a manobra de Cottle. Responderam ao questionário NOSE e foram submetidos a rinomanometria no pré-operatório. Após 90 dias foram reavaliados pelo questionário NOSE e pela rinomanometria pós-operatória. Os resultados desses dois parâmetros foram comparados pré e pós-operatoriamente. Resultados: Em relação a medida subjetiva, questionário NOSE, sete pacientes referiram melhora, sendo que dois deles referiram melhora acentuada, e um paciente referiu quadro obstrutivo inalterado. Em relação ao exame rinomanometria, de 96 medidas comparativas entre o pré e o pós-operatório, obtivemos 68 medidas com incremento ao fluxo aéreo nasal no pós-operatório, 26 resultados negativos, e dois casos inalterados entre pré e pós-operatório. Conclusão: O procedimento cirúrgico piriformeplastia conferiu melhoria do fluxo aéreo nasal na maioria das medidas obtidas.

https://ift.tt/2yH6Yo6

Hearing in Noise Test, HINT-Brazil, in normal-hearing children

Abstract Introduction: The auditory processing is related to certain skills such as speech recognition in noise. The HINT-Brazil test allows the measurement of the Speech/Noise ratio however there are no studies in the national literature that establish parameters for the child population. Objective: To analyze the performance of normal-hearing subjects aged 8-10 years old in tasks for speech recognition in noise using HINT test. Methods: Sixty schoolchildren were evaluated. They were between 8 and 10 years of age, of both genders, and had no auditory and school complaints, with results ranking within normality for the Basic Audiological Assessment and the Dichotic Digits Test. HINT-Brazil test was applied with headphones, with the Speech/Noise ratio in conditions of frontal noise, noise to the right, and noise to the left being investigated. The software calculated the Composite Noise, which corresponds to the weighted mean of the tested conditions. Results: There was no statistically significant difference between the ears, nor between the genders. There was a statistically significant difference for age ranges of 8 and 10 years, in situations with noise, and for Composite Noise. The age group of 10 years showed better performance than the age group of 8; the age group of 9 years did not show statistically significant difference regarding the other age ranges. We suggest the values of mean and standard deviation of the Speech/Noise ratio, considering the age ranges of: 8 years - Frontal Noise: −2.09 (±1.09); Right Noise: −7.64 (±1.72); Left Noise: −7.53 (±2.80); Composite Noise: −4.86 (±1.31); 9 years - Frontal Noise: −2.82 (±0.74); Right Noise: −8.49 (±2.24); Left Noise: −8.41 (±1.75); Composite Noise: −5.63 (±1.02); 10 years - Frontal Noise: −3.01 (±0.95); Right Noise: −9.47 (±1.43); Left Noise: −9.16 (±1.65); Composite Noise: −6.16 (±0.91). Conclusion: HINT-Brazil test is a simple and fast test, and is not difficult to performed with normal-hearing children. The results confirm that it is an efficient test to be used with the age range evaluated.

Resumo Introdução: O processamento auditivo está relacionado a determinadas habilidades, como o reconhecimento de fala no ruído. O teste HINT-Brasil permite a mensuração da relação Fala/Ruído, porém, não há na literatura nacional estudos que estabeleçam parâmetros para a população infantil. Objetivo: Analisar o desempenho de normo-ouvintes, de 8 a 10 anos, nas tarefas de reconhecimento de fala no ruído, por meio do teste HINT. Método: Avaliados 60 escolares, entre 8 e 10 anos, de ambos os gêneros, sem queixas auditivas e escolares, e com resultados dentro da normalidade para a Avaliação Audiológica Básica e o Teste Dicótico de Dígitos. O teste HINT-Brasil foi aplicado com fones de ouvido, sendo pesquisada a relação Fala/Ruído nas condições Ruído Frontal, Ruído à Direita e Ruído à Esquerda. O software calculou o Ruído Composto, que corresponde à média ponderada das condições testadas. Resultados: Não houve diferença estatisticamente significante entre as orelhas, nem entre os gêneros. Houve diferença estatisticamente significante para as faixas de 8 e 10 anos, nas situações com ruído e para o Ruído Composto. A faixa etária de 10 anos apresentou desempenho melhor do que a faixa etária de 8; a faixa etária de 9 anos não apresentou diferença estatisticamente significante com relação as outras faixas etárias. Sugerimos os valores de Média e Desvio Padrão da relação F/R, considerando as faixas: 8 anos - RF: -2,09 (± 1,09); RD: -7,64 (± 1,72); RE: -7,53 (± 2,80); RC: -4,86 (± 1,31); 9 anos - RF: -2,82 (± 0,74); RD: -8,49 (± 2,24); RE: -8,41 (± 1,75); RC: -5,63 (± 1,02); 10 anos - RF: -3,01 (± 0,95); RD: -9,47 (± 1,43); RE: -9,16 (± 1,65); RC: -6,16 (± 0,91). Conclusão: O teste HINT-Brasil é um teste simples e rápido e não oferece dificuldades em seu uso com crianças normo-ouvintes; os resultados mostram se tratar de um teste eficaz para ser utilizado com a faixa etária avaliada.

https://ift.tt/2tvgNAz

Effect of antioxidant supplementation on the auditory threshold in sensorineural hearing loss: a meta-analysis

Abstract Introduction: Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at different stages of life; during pregnancy or childbirth, in childhood, adulthood or old age. It should be noted that aging is the most common cause of sensorineural hearing loss followed by noise-induced hearing loss, and both are closely related to the formation of reactive oxygen species. Dietary antioxidant supplementation has been employed as a therapeutic strategy to prevent and/or delay the risks of major human diseases. Objective: To assess randomized clinical trials to determine the effect of antioxidant supplementation on the auditory thresholds in patients of different age groups with sensorineural hearing loss. Methods: This systematic review consisted of a search in the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to the intervention (antioxidant supplementation), primary outcome (sensorineural hearing loss), as well as terms related to randomized clinical trials to improve search sensitivity. Results: Based on 977 potentially relevant records identified through the search in the databases, ten full-text publications were retrieved for further evaluation. The increase in threshold at the 4 kHz frequency was statistically higher in the control group (1.89 [1.01-2.78], p < 0.0001) when compared to the NAC group and the ginseng group, whereas at 6 kHz, the threshold increase was higher in the control group (1.42 [−1.14-3.97], p = 0.28), but no statistically significant differences were found between groups. Conclusion: Ginseng was the antioxidant agent that showed the best effect in preventing auditory threshold worsening at the frequency of 4 kHz, but not at 6 kHz in patients with sensorineural hearing loss caused by exposure to high sound pressure levels. There was no improvement in the thresholds with vitamin E supplementation.

Resumo Introdução: A perda auditiva é conceituada como qualquer diminuição da capacidade de ouvir e/ou detectar sons da fala ou do ambiente, independentemente da causa, tipo ou grau e pode ocorrer em diversos estágios da vida, durante a gestação ou parto, na infância, vida adulta ou na terceira idade. Convém destacar que o envelhecimento é a primeira causa de perda auditiva do tipo sensorioneural e em segundo lugar a perda auditiva induzida pelo ruído, ambas estão intimamente relacionadas com a formação de espécies reativas de oxigênio. Evidências têm sido acumuladas indicando que a suplementação com antioxidantes via alimentação tornou-se estratégia terapêutica para prevenir e/ou retardar os riscos das principais doenças humanas. Objetivo: Avaliar ensaios clínicos aleatórios para determinar qual o efeito da suplementação com antioxidantes sobre o limiar auditivo na perda auditiva sensorioneural em pacientes de diversas faixas etárias. Método: A formulação desta revisão sistemática consistiu na busca dos estudos nas seguintes bases de dados: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO e ClinicalTrials.gov. Adicionalmente, a literatura cinzenta também foi pesquisada. A estratégia de busca incluiu termos relacionados à intervenção (suplementação de antioxidantes), o desfecho primário (perda auditiva sensorioneural), bem como termos relacionados aos ensaios clínicos randomizados para melhorar e a sensibilidade da busca. Resultados: A partir de 977 registros potencialmente relevantes identificados através da busca nas bases de dados, dez publicações em texto completo foram recuperadas para avaliação mais aprofundada. O aumento no limiar na frequência de 4 kHz foi estatisticamente maior no Grupo Controle (1,89 [1,01-2,78], p < 0,0001) quando comparados com o Grupo NAC e o Grupo Ginseng, já na frequência de 6 kHz o aumento no limiar foi maior no Grupo Controle (1,42 [-1,14-3,97], p = 0,28), porém, não foram encontradas diferenças estatisticamente significativas entre grupos. Conclusão: O Ginseng foi o antioxidante que evitou a piora do limiar auditivo na frequência de 4 kHz, mas não em 6 kHz, em pacientes com perda auditiva sensorioneural causada por exposição a elevados níveis de pressão sonora. Não foi observada melhora nos limiares com a suplementação com Vitamina E.

https://ift.tt/2tHNIBs

Effect of caffeine on vestibular evoked myogenic potential: a systematic review with meta-analysis

Abstract Introduction: Caffeine can be considered the most consumed drug by adults worldwide, and can be found in several foods, such as chocolate, coffee, tea, soda and others. Overall, caffeine in moderate doses, results in increased physical and intellectual productivity, increases the capacity of concentration and reduces the time of reaction to sensory stimuli. On the other hand, high doses can cause noticeable signs of mental confusion and error induction in intellectual tasks, anxiety, restlessness, muscle tremors, tachycardia, labyrinthine changes, and tinnitus. Objective: Considering that the vestibular evoked myogenic potential is a clinical test that evaluates the muscular response of high intensity auditory stimulation, the present systematic review aimed to analyze the effects of caffeine on vestibular evoked myogenic potential. Methods: This study consisted of the search of the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to intervention (caffeine or coffee consumption) and the primary outcome (vestibular evoked myogenic potential). Results: Based on the 253 potentially relevant articles identified through the database search, only two full-text publications were retrieved for further evaluation, which were maintained for qualitative analysis. Conclusion: Analyzing the articles found, caffeine has no effect on vestibular evoked myogenic potential in normal individuals.

Resumo Introdução: A cafeína pode ser considerada a droga mais consumida por adultos em nível mundial, podendo ser encontrada em inúmeros alimentos, como no chocolate, café, chá, refrigerante e outros. Em geral, a cafeína em doses moderadas, produz ótimos rendimentos físico e intelectual, aumenta a capacidade de concentração e diminui o tempo de reação aos estímulos sensoriais. Por outro lado, doses elevadas podem causar sinais perceptíveis de confusão mental e indução de erros em tarefas intelectuais, ansiedade, nervosismo, tremores musculares, taquicardia, alterações labirínticas e zumbido. Objetivo: Considerando que o potencial evocado miogênico vestibular é um teste clínico que avalia a resposta muscular decorrente de estimulação auditiva de alta intensidade, a presente revisão sistemática objetivou analisar o efeito da cafeína sobre o potencial evocado miogênico vestibular. Método: A formulação deste trabalho consistiu na busca dos estudos nas seguintes bases de dados: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO e Clinical-Trials.gov. Adicionalmente, a literatura cinzenta também foi pesquisada. A estratégia de busca incluiu termos relacionados à intervenção (consumo de cafeína ou café) e ao desfecho primário (potencial evocado miogênico vestibular). Resultados: A partir de 253 registros potencialmente relevantes identificados através da busca nas bases de dados, apenas duas publicações em texto completo foram recuperadas para avaliação mais aprofundada, sendo estas mantidas para a análise qualitativa. Conclusão: Diante dos artigos encontrados a cafeína não tem efeito sobre o potencial evocado miogênico vestibular em sujeitos normais.

https://ift.tt/2tvgANN

Undifferentiated high-grade pleomorphic sarcoma of ethmoid sinus: a case report and literature review

Genomic profile of a squamous cell carcinoma ex pleomorphic adenoma compared to a head and neck squamous cell carcinoma

Unusual coexisting thyroglossal duct cyst and second branchial cleft fistula in an adult

Two cases of extranasopharyngeal angiofibroma mimicking choanal polyp in patients with chronic paranasal sinusitis

Extranasopharyngeal angiofibroma (ENA) is an angiofibroma that occurs in the extranasopharynx. It shows pathologic findings, such as juvenile angiofibroma (JNA), which accounts for 0.5% of head and neck mass. However, compared with JNA, the prevalence, affected site, and clinical characteristics are completely different, which leads some physicians to classify ENA as a disease different from JNA. ENA of the nasal turbinate origin are rarely reported in the literature. In addition, choanal polyp originating from the posterior part of the nasal turbinate is uncommonly reported.

https://ift.tt/2MXliMp

Binaural sensitivity to temporal fine structure and lateralization ability in children with suspected (central) auditory processing disorder

Previous studies have shown that a subgroup of children with suspected (central) auditory processing disorder (SusCAPD) have insufficient ability to use binaural cues to benefit from spatial processing. Thus, they experience considerable listening difficulties in challenging auditory environments, such as classrooms. Some researchers have also indicated the probable role of binaural temporal fine structure (TFS) in the perceptual segregation of target signal from noise and hence in speech perception in noise.

https://ift.tt/2Mqy459

Matricaria genus as a source of antimicrobial agents: From Farm to Pharmacy and Food Applications

Publication date: Available online 25 June 2018
Source:Microbiological Research
Author(s): Mehdi Sharifi-Rad, Jolanta Nazaruk, Letizia Polito, Maria Flaviana Bezerra Morais-Braga, Janaína Esmeraldo Rocha, Henrique Douglas Melo Coutinho, Bahare Salehi, Giulia Tabanelli, Chiara Montanari, María del Mar Contreras, Zubaida Yousaf, William N. Setzer, Deepa R. Verma, Miquel Martorell, Antoni Sureda, Javad Sharifi-Rad
Matricaria is a widespread genus of flowering plants of the family Asteraceae that grow in temperate regions of Europe, Asia, America and Africa. Some of the species are also naturalized in Australia. Some species of this genus such as Chamomiles are recognized medicinal plants and cultivated in several countries for commercial purposes: to obtain its blue essence, as herbal tea, and for pharmaceutical or cosmeceutical uses. The phytochemical composition of Matricaria spp. includes volatile terpenoids (e.g., α-bisabolol, bisabolol oxide A and B, β-trans-farnesene and chamazulene), sesquiterpene lactones such as matricin, and phenolic compounds (flavonoids, coumarins and phenolic acids). Their essential oil is obtained from the fresh or dried inflorescences by steam distillation, and additionally cohobation of the remaining water. The volatile composition of the essential oil, especially the content of the valuable components α-bisabolol and chamazulene, depends on the plant part, origin and quality of the source, genetic, and environmental factors. Moreover, other parameters, such as season of harvest and methods of extraction, can affect the extraction yield of the essential oils/extracts, their composition and, therefore, their bioactivity. Due to the importance of this genus and particularly M. recutita (M. chamomilla), this review focus on its cultivation, factor affecting essential oils' composition and their role in traditional medicine, as antibacterial agents and finally as food preservatives.

https://ift.tt/2trKUsQ

Bacteria and bacterial products: Foe and friends to Caenorhabditis elegans

Publication date: Available online 25 June 2018
Source:Microbiological Research
Author(s): Fazlurrahman Khan, Saurabh Jain, Sandra Folarin Oloketuyi
Caenorhabditis elegans is a model organism for the study of different molecular, biochemical, microbial and immunity-related mechanisms. In its natural habitat, C. elegans survives by feeding microorganisms (mainly bacteria), though majorly on Escherichia coli OP50 when grown in the laboratory. Numerous bacteria are shown to influence the lifespan, behavioural responses and innate immunity of C. elegans. The secondary metabolites produced by bacteria have shown to play key role in C. elegans longevity. This behaviour provides insights for potential development of new strategies for the treatment of diseases in other species, including humans. This review explains the concept of C. elegans microbiome, different mechanisms employed in its longevity and resistance against bacterial pathogens and the effects of various bacteria (both beneficial and harmful) as well as their products on the life cycle of C. elegans.

https://ift.tt/2MlfNGi

Volume change in the rectus abdominis muscle after deep inferior epigastric perforator flap harvest

Deep inferior epigastric perforator flap has less donor site morbidity than that of transverse rectus abdominis myocutaneous flap. However, abdominal muscle atrophy and donor site complications caused by denervation during pedicle dissection cannot be avoided. This retrospective study investigated the change in rectus abdominis muscle volume after deep inferior epigastric perforator flap harvest. Of 395 patients who underwent unilateral deep inferior epigastric perforator flap breast reconstruction between August 2007 and July 2017, 25 patients with >2-year postoperative abdominal computed tomography data were evaluated.

https://ift.tt/2tuvKTC

Abnormal soft palate movements in patients with microtia

Microtia is a congenital malformation of the auricle, ranging in severity. It can be isolated or associated with (craniofacial) anomalies. Most of these anomalies together are described as being part of the oculo-auriculo-vertebral spectrum (OAVS). Velar abnormalities have been described to occur in patients with OAVS, however the incidence in patients with microtia without OAVS is largely unknown. The primary purpose of this study was to examine the prevalence of velar palsy in patients with isolated microtia, and in patients with microtia and signs of OAVS.

https://ift.tt/2yEoEkc

Comparing Transversus Abdominus Release and Anterior Component Separation Techniques in Reconstructing Midline Hernias – A Cadaveric Study

Midline hernias result in abdominal wall defects that can be reconstructed with autologous tissue utilizing component separation of the abdominal wall. The first technique described was anterior component separation described by Ramirez et al1 where the release of the external oblique aponeurosis allowed advancement of the rectus abdominus medially to the midline, thus allowing closure of ventral midline defects with autologous tissue. The technique, however, involved dissection of the subcutaneous tissues laterally which often created devascularized skin flaps and increased the risk of poor wound healing with the risk of skin necrosis.

https://ift.tt/2MXhkDm

Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial

Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid -resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively).

https://ift.tt/2tDmsUF

Heat-induced necrosis after bronchial thermoplasty: a new concern?

Bronchial thermoplasty (BT) is an endoscopic procedure for the treatment of severe refractory asthma, based on the local airways delivery of radio-frequency at 65 °C. Several controlled clinical studies demons...

https://ift.tt/2Ir782B

Growth, physiological adaptation, and NHX gene expression analysis of Iris halophila under salt stress

Abstract

This study investigated the growth, physiological changes, and the transcript levels of NHX1 gene of Iris halophila in response to low NaCl concentration (50 mM) and high NaCl concentration (150 mM). Our results showed that both 50 and 150 mM NaCl had no obvious negative effects on plant growth; what is more, low NaCl concentration (50 mM) increased root length, root fresh weight, and the ratio of root length to leaf length compared with the control group. The malondialdehyde (MDA) contents in leaves and roots of I. halophila had no obvious difference as compared with control. Proline levels of I. halophila exhibited basically an enhancement under salt stress conditions. Particularly at 4 days, the proline contents in leaves reached 1.85 to 2.31-fold higher and the contents in roots reached 1.27 to 1.62-fold higher than that of control at 50 and 150 mM NaCl, respectively. The contents of the soluble sugar in leaves and roots of I. halophila under 150 mM NaCl at 7 days were 32.4 and 98.7% higher than that of control, respectively. The increase rate of K⁺ contents with the increasing concentration of salt was less than that of Na⁺ contents, but K⁺ contents in the seedlings under NaCl stress was still higher than Na⁺ contents and the ratio of K⁺ to Na⁺ was also greater than 1. The transcript levels of IhNHX1 in leaves of I. halophila at 4 and 7 days under 150 mM NaCl were higher than that of control; however, the transcript levels of IhNHX1 in roots had no significant difference compared with the control under low and high salt stress at 1, 4, and 7 days. Therefore, salt tolerance in I. halophila could be partially due to higher proline, soluble sugar, and K⁺ accumulation.

https://ift.tt/2MpeENI

Ultrastructural changes of Trichophyton rubrum in tinea unguium after itraconazole therapy in vivo observed using scanning electron microscopy

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2yK1zwI

Ultrastructural changes of Trichophyton rubrum in tinea unguium after itraconazole therapy in vivo observed using scanning electron microscopy

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2yK1zwI

Utility of a minimal skin incision laparotomy technique for removing uterine leiomyomas at a regional core hospital: a retrospective study

We present a minimal skin wound abdominal myomectomy performed in our hospital and attempt to identify the optimal range of this technique by considering the characteristics of target leiomyomas. In this proce...

https://ift.tt/2IpU1Pn

Osteolytic lesions (brown tumors) of primary hyperparathyroidism misdiagnosed as multifocal giant cell tumor of the distal ulna and radius: a case report

Brown tumors represent a rare clinical manifestation reported in approximately 3% of patients with primary hyperparathyroidism and correspond to radiologically osteolytic lesions with well-defined borders in d...

https://ift.tt/2lxUplK

Issue Information ‐ TOC

Allergy, Volume 73, Issue 7, Page 1357-1358, July 2018.

https://ift.tt/2tuUSth

Issue Information ‐ Cover and Editorial Board

Allergy, Volume 73, Issue 7, Page 1355-1355, July 2018.

https://ift.tt/2Kmt1SB

The influence of ‘moral disengagement’ on conflict of interest: insights for dermatology from social psychology and qualitative research

British Journal of Dermatology, EarlyView.

https://ift.tt/2K85mJF

Detection of anti‐BP180 NC16A autoantibodies after the onset of dipeptidyl peptidase‐IV inhibitor‐associated bullous pemphigoid: a report of three patients

British Journal of Dermatology, EarlyView.

https://ift.tt/2MVZxNb

The influence of ‘moral disengagement’ on conflict of interest: insights for dermatology from social psychology and qualitative research

British Journal of Dermatology, EarlyView.

https://ift.tt/2K85mJF

Detection of anti‐BP180 NC16A autoantibodies after the onset of dipeptidyl peptidase‐IV inhibitor‐associated bullous pemphigoid: a report of three patients

British Journal of Dermatology, EarlyView.

https://ift.tt/2MVZxNb

Elevated serum interleukin‐29 levels in patients with Henoch–Schönlein purpura

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2Ml0pd0

Elevated serum interleukin‐29 levels in patients with Henoch–Schönlein purpura

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2Ml0pd0

Scleroderma‐like cutaneous lesions during treatment with paclitaxel and gemcitabine in a patient with pancreatic adenocarcinoma. Review of literature

International Journal of Dermatology, EarlyView.

https://ift.tt/2Mjsotx

Primary extramammary Paget's disease of the skin: treatment and survival

International Journal of Dermatology, EarlyView.

https://ift.tt/2tr1TeS

A pigmented nodule on the neck

International Journal of Dermatology, EarlyView.

https://ift.tt/2KorpYg

Topical 5‐fluorouracil in dermatologic disease

International Journal of Dermatology, EarlyView.

https://ift.tt/2ttGfGC

Difficult to diagnose small cutaneous melanoma metastases mimicking angiomas: utility of dermoscopy

International Journal of Dermatology, EarlyView.

https://ift.tt/2KlOZoT

Efficacy of PUVA in Russian patients with mastocytosis: a case series and review of literature

International Journal of Dermatology, EarlyView.

https://ift.tt/2ttG3qS

A case of melanocytic matricoma with prominent mitotic activity and melanocytic hyperplasia

International Journal of Dermatology, EarlyView.

https://ift.tt/2MpfQkl

Skin fragility, woolly hair syndrome with a desmoplakin mutation – a case from India

International Journal of Dermatology, EarlyView.

https://ift.tt/2MVjOSK

Anti-Inflammatory Effects on Atherosclerotic Lesions Induced by CXCR4-Directed Endoradiotherapy

https://ift.tt/2tE9B4k

CRISPRed Cardiomyocytes to Decrypt Variants of Uncertain Significance

https://ift.tt/2yHhFXS

Pre-Eclampsia: A Twilight Zone Between Health and Cardiovascular Disease?

https://ift.tt/2tzQ6uP

Digital Defenses for Hacked Hearts: Why Software Patching Can Save Lives

https://ift.tt/2tBoPal

Risk of Myocardial Infarction in Anticoagulated Patients With Atrial Fibrillation

AbstractBackground

Evidence is conflicting as to the efficacy of direct oral anticoagulation (DOAC) and vitamin K antagonist (VKA) for prevention of myocardial infarction (MI).

Objectives

This study aimed to investigate the risk of MI associated with the use of apixaban, dabigatran, rivaroxaban, and VKA in patients with atrial fibrillation.

Methods

Patients with atrial fibrillation were identified using Danish health care registers and stratified by initial oral anticoagulant treatment. Standardized absolute 1-year risks were estimated based on Cox regression for hazard rates of MI hospitalizations and mortality. Reported were absolute risks separately for the oral anticoagulation treatments and standardized to the characteristics of the study population.

Results

Of the 31,739 patients included (median age, 74 years; 47% females), the standardized 1-year risk of MI for VKA was 1.6% (95% confidence interval [CI]: 1.3 to 1.8), apixaban was 1.2% (95% CI: 0.9 to 1.4), dabigatran was 1.2% (95% CI: 1.0 to 1.5), and rivaroxaban was 1.1% (95% CI: 0.8 to 1.3). No significant risk differences were observed in the standardized 1-year risks of MI among the DOACs: dabigatran versus apixaban (0.04%; 95% CI: –0.3 to 0.4), rivaroxaban versus apixaban (0.1%; 95% CI: –0.4 to 0.3), and rivaroxaban versus dabigatran (–0.1%; 95% CI: –0.5 to 0.2). The risk differences for DOACs versus VKA were all significant: –0.4% (95% CI: –0.7 to –0.1) for apixaban, –0.4% (95% CI: –0.7 to –0.03) for dabigatran, and –0.5% (95% CI: –0.8 to –0.2) for rivaroxaban.

Conclusions

No significant risk differences of MI were found in the direct comparisons of DOACs, and DOACs were all associated with a significant risk reduction of MI compared with VKA.

https://ift.tt/2twO2Tk

The Role of Nutraceuticals in Statin Intolerant Patients

Abstract

Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non–lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction.

https://ift.tt/2tBloAE

JACC Instructions for Authors

https://ift.tt/2MUUYT8

Reference for Serum Digoxin Concentration Should Be Redefined Now

https://ift.tt/2tAaUBx

Direct Oral Anticoagulants and Myocardial Infarction: The Dust Is Settling

https://ift.tt/2yNldIm

Acute Cardiac Effects of Severe Pre-Eclampsia

AbstractBackground

Pre-eclampsia with severe features (PEC) is a pregnancy-specific syndrome characterized by severe hypertension and end-organ dysfunction, and is associated with short-term adverse cardiovascular events, including heart failure, pulmonary edema, and stroke.

Objectives

The authors aimed to characterize the short-term echocardiographic, clinical, and laboratory changes in women with PEC, focusing on right ventricular (RV) systolic pressure (RVSP) and echocardiographic-derived diastolic, systolic, and speckle tracking parameters.

Methods

In this prospective observational study, the authors recruited 63 women with PEC and 36 pregnant control patients.

Results

The PEC cohort had higher RVSP (31.0 ± 7.9 mm Hg vs. 22.5 ± 6.1 mm Hg; p < 0.001) and decreased global RV longitudinal systolic strain (RVLSS) (–19.6 ± 3.2% vs. –23.8 ± 2.9% [p < 0.0001]) when compared with the control cohort. For left-sided cardiac parameters, there were differences (p < 0.001) in mitral septal e' velocity (9.6 ± 2.4 cm/s vs. 11.6 ± 1.9 cm/s), septal E/e' ratio (10.8 ± 2.8 vs. 7.4 ± 1.6), left atrial area size (20.1 ± 3.8 cm² vs. 17.3 ± 2.9 cm²), and posterior and septal wall thickness (median [interquartile range]: 1.0 cm [0.9 to 1.1 cm] vs. 0.8 cm [0.7 to 0.9 cm], and 1.0 cm [0.8 to 1.2 cm] vs. 0.8 cm [0.7 to 0.9 cm]). Eight women (12.7%) with PEC had grade II diastolic dysfunction, and 6 women (9.5%) had peripartum pulmonary edema.

Conclusions

Women with PEC have higher RVSP, higher rates of abnormal diastolic function, decreased global RVLSS, increased left-sided chamber remodeling, and higher rates of peripartum pulmonary edema, when compared with healthy pregnant women.

https://ift.tt/2twOa5g

Myocardial Injury and Cardiac Reserve in Patients With Heart Failure and Preserved Ejection Fraction

AbstractBackground

Cardiac reserve is depressed in patients with heart failure and preserved ejection fraction (HFpEF). The mechanisms causing this are poorly understood.

Objectives

The authors hypothesized that myocardial injury might contribute to the hemodynamic derangements and cardiac reserve limitations that are present in HFpEF. Markers of cardiomyocyte injury, central hemodynamics, ventricular function, and determinants of cardiac oxygen supply–demand balance were measured.

Methods

Subjects with HFpEF (n = 38) and control subjects without heart failure (n = 20) underwent cardiac catheterization, echocardiography, and expired gas analysis at rest and during exercise. Central venous blood was sampled to measure plasma high-sensitivity troponin T levels as an index of cardiomyocyte injury.

Results

Compared with control subjects, troponins were more than 2-fold higher in subjects with HFpEF at rest and during exercise (p < 0.0001). Troponin levels were directly correlated with left ventricular (LV) filling pressures (r = 0.52; p < 0.0001) and diastolic dysfunction (r = –0.43; p = 0.002). Although myocardial oxygen demand was similar, myocardial oxygen supply was depressed in HFpEF, particularly during exercise (coronary perfusion pressure–time integral; 44 ± 9 mm Hg x s x min^–1 x l x dl^–1 vs. 30 ± 9 mm Hg x s x min^–1 x l x dl^–1; p < 0.0001), and reduced indices of supply were correlated with greater myocyte injury during exercise (r = –0.44; p = 0.0008). Elevation in troponin with exercise was directly correlated with an inability to augment LV diastolic (r = –0.40; p = 0.02) and systolic reserve (r = –0.57; p = 0.0003), greater increases in LV filling pressures (r = 0.55; p < 0.0001), blunted cardiac output response (r = –0.44; p = 0.002), and more severely depressed aerobic capacity in HFpEF.

Conclusions

Limitations in LV functional reserve and the hemodynamic derangements that develop secondary to these limitations during exercise in HFpEF are correlated with the severity of cardiac injury, assessed by plasma levels of troponin T. Further study is warranted to determine the mechanisms causing myocyte injury in HFpEF and the potential role of ischemia, and to identify and test novel interventions targeted to these mechanisms. (EXEC [Study of Exercise and Heart Function in Patients With Heart Failure and Pulmonary Vascular Disease]; NCT01418248)

https://ift.tt/2MZEVU3

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Δευτέρα 25 Ιουνίου 2018

Abstract

Abstract

Abstract

Graphical abstract

Abstract

Abstract

Αρχειοθήκη ιστολογίου