“Reporting Time Horizons in Randomized Controlled Trials in Plastic Surgery: A Systematic Review.”

Background: Current guidelines for randomized controlled trial (RCT) reporting do not require authors to justify their choice of time horizon. This is concerning, as the time horizon when an outcome is assessed has important implications for the interpretation of study results, and resources allocated to an investigation. Therefore, this study seeks to examine the standards of time horizon reporting in the plastic surgery literature. Methods: This is a systematic review of plastic surgery RCTs published within the last 4 years. The MEDLINE database was searched to yield relevant studies. All studies included were English language, prospective, non-pharmaceutical RCTs, comparing two plastic surgical interventions. Studies were classified into plastic surgery domains, and information regarding study population, time horizon reporting, and justification of chosen time horizons, was extracted. Results: The search retrieved 720 articles, of which 103 were eligible for inclusion. Time horizons were reported as either a standardized time point at which all patients were assessed, a follow-up duration range, or were not reported at all. Although most studies (85.4%) reported a standardized time horizon, the majority (85.4%) failed to provide a valid justification to support their selection of time horizons. Conclusion: Clinical investigators failed to justify their choice of time horizons in the majority of published RCTs. To limit heterogeneity, time horizons for given interventions should be standardized to improve validity of outcome assessments, enable future pooling of results, and increase research efficiency. The authors have no financial interests to declare. Corresponding Author: Achilleas Thoma, MD, MSc, 101-206 James Street South, Hamilton, ON L8P 3A9, Canada. athoma@mcmaster.ca, ©2018American Society of Plastic Surgeons

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Compact and Economical Microsurgical Training made possible with Virtual Reality

No abstract available

https://ift.tt/2pd3dQ1

Understanding platelet function in microsurgical arterial anastomosis: the Charing Cross Clamp Technique

No abstract available

https://ift.tt/2Ol9K5O

Improvement of ternary fuel combustion with various injection pressure strategies in a toroidal re-entrant combustion chamber

Abstract

The present experimental work focuses on the influence injection pressure and toroidal re-entrant combustion chamber in a single cylinder diesel engine fuelled with ternary fuel (diesel-biodiesel-ethanol) blend. Ternary fuel (TF) is prepared by blending 70% diesel, 20% biodiesel, and 10% ethanol blends and its fuel properties were investigated and compared with diesel fuel. Since the physic-chemical properties of TF are well behind the diesel fuel, it is proposed to be blended with 20 ppm alumina nano additives which act as an ignition enhancer and catalytic oxidizer. The resulting fuel mixture (TF + 20 ppm alumina additive) is named as high performance fuel (HPF). Experimentations were conducted on HPF subjected to various injection pressures of 18 MPa, 20 MPa, 22 MPa, and 24 MPa respectively and are operated in toroidal re-entrant chamber geometry (TG) at an injection timing of 22 ^obTDC. From experimentation, it was identified that, for TG-HPF, higher injection pressure of 22 MPa ensued highest BTE (Brake Thermal Efficiency) of 35.5% and lowest BSEC (Brake Specific Fuel Consumption) of 10.13 MJ/kWh owing to the pooled effect of higher swirl formation, improved atomization enhanced evaporation rate, and better air-fuel mixing. Emission wise TG-HPF operated at 22 MPa lowered the HC (hydrocarbon), CO (carbon monoxide), and smoke emissions by 18.88%, 7.19%, and 5.02%, but with marginally improved NOx (oxides of nitrogen) and CO₂ (carbon dioxide) emissions by 3.92% and 3.89% respectively. In combustion point of view, it is observed that injection pressure increased the cylinder pressure, heat release rate (HRR), and cumulative heat release rate (CHRR) by 5.35%, 5.08%, and 3.38% respectively indicating improved combustion rate as a result of enhanced atomization, evaporation, and high turbulence inducement. Overall, it is concluded that operating the ternary fuel at 22 MPa injection pressure at toroidal re-entrant combustion chamber results in improved performance and minimized emissions.

https://ift.tt/2NMuSou

Help-Seeking Behaviors and Intimate Partner Violence-Related Traumatic Brain Injury

Violence and Gender, Ahead of Print.


https://ift.tt/2p5kAC3

Intensity-Modulated Radiation Therapy With or Without Concurrent Chemotherapy in Nonanaplastic Thyroid Cancer with Unresectable or Gross Residual Disease

Thyroid, Volume 28, Issue 9, Page 1180-1189, September 2018.


https://ift.tt/2Mwnnxi

Radioiodine Refractory Differentiated Thyroid Cancer: Time to Update the Classifications

Thyroid, Volume 28, Issue 9, Page 1083-1093, September 2018.


https://ift.tt/2Nakasx

Effect of Buparlisib, a Pan-Class I PI3K Inhibitor, in Refractory Follicular and Poorly Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 9, Page 1174-1179, September 2018.


https://ift.tt/2MwLrAa

Das Myxödemherz: The Myxedema Heart Herman Zondek 1887–1979

Thyroid, Volume 28, Issue 9, Page 1079-1080, September 2018.


https://ift.tt/2N82jm5

South Korean Thyroid Cancer Trends: Good News and Bad

Thyroid, Volume 28, Issue 9, Page 1081-1082, September 2018.


https://ift.tt/2Mw9KOO

Future Meetings

Thyroid, Volume 28, Issue 9, Page 1224-1225, September 2018.


https://ift.tt/2NesHuv

Sonographically Estimated Risks of Malignancy for Thyroid Nodules Computed with Five Standard Classification Systems: Changes over Time and Their Relation to Malignancy

Thyroid, Volume 28, Issue 9, Page 1190-1197, September 2018.


https://ift.tt/2MrmWUZ

Novel variant of reversed midgut rotation – retro-arterial proximal jejunum and transverse colon: a case report and review of the literature

Reversed rotation of the midgut is the rarest variation of midgut malrotations, which are congenital disorders that result from aberrant rotation and fixation of the midgut during embryological development. Co...

https://ift.tt/2xaLBZo

Fifth Euro‐Asian Congress of Dermatovenereologists, Riga, Latvia

Dermatologic Therapy, EarlyView.


https://ift.tt/2x97V5s

First case of secukinumab successful therapy in a very elderly psoriatic patient

Dermatologic Therapy, EarlyView.


https://ift.tt/2CRYCfq

Fifth Euro‐Asian Congress of Dermatovenereologists, Riga, Latvia

Dermatologic Therapy, EarlyView.


https://ift.tt/2x97V5s

First case of secukinumab successful therapy in a very elderly psoriatic patient

Dermatologic Therapy, EarlyView.


https://ift.tt/2CRYCfq

Emotional eating and weight regulation: a qualitative study of compensatory behaviors and concerns

Abstract

Background

Emotional eating, or overeating in response to negative emotions, is a behavior endorsed by both normal weight and people with overweight/obesity. For some individuals, emotional eating contributes to weight gain and difficulties losing weight. However, there are also many who engage in emotional eating who maintain a normal weight. Little is known about the mechanisms by which these individuals are able to regulate their weight.

Methods

The present study seeks to gain insight into the behaviors of individuals of normal weight who engage in emotional eating through a series of one-on-one, 1-h long, qualitative interviews. Interviews were semi-structured and guided by questions pertaining to participants' compensatory behaviors used to regulate weight and concerns regarding their emotional eating. All interviews were transcribed and then objected to a thematic analysis of their content.

Results

The results of this analysis showed that participants endorsed using physical activity, controlling their eating behaviors, and engaging in alternative stress reduction and coping strategies to mitigate the effects of their emotional eating. They reported concern over the effects of emotional eating on their weight, body image, and health and saw this behavior as an unhealthy coping mechanism that was difficult to control.

Conclusions

These results suggest that programs promoting exercise, mindful eating, emotion regulation, and positive body image could have a positive effect on emotional eaters who struggle to maintain a healthy weight.

https://ift.tt/2xag0XH

Inhibition of return for body images in individuals with shape/weight based self-worth

Abstract

Background

Attentional biases for body shape and weight information have been found in people with eating disorders, indicating disorder-specific changes in the way this information is processed. To date, the literature has focused on the initial capture of attention, with little research on the maintenance of attention to shape/weight-related information. The current study aims to investigate the occurrence of attentional maintenance through the use of an Inhibition of Return task to shape and weight stimuli in those with and without an eating disorder.

Method

Three groups of female participants between the ages of 16–30 years undertook an Inhibition of Return task with target images of female bodies and control images of animals. The groups were an eating disorder group (n = 20), a High shape/weight based self-worth group (n = 23), and a Low shape/weight based self-worth group (n = 26).

Results

The results indicated differential patterns of Inhibition of Return between the High and Low shape/weight based self-worth groups. The High group displayed increased inhibition of return for the shape/weight stimuli relative to control stimuli, while the Low group displayed reduced inhibition of return for the shape/weight stimuli compared to control stimuli. The ED group displayed a similar pattern of results to the High group, but this did not reach significance.

Conclusion

The current findings indicate that young women without an eating disorder who base their self-worth on shape/weight display a pattern of avoidance of shape/weight stimuli that is in direct contrast to those at low risk of developing eating disorders. The possible implications of these specific patterns of inhibition of return across those at varying levels of risk for an eating disorder are discussed along with their implications for intervention approaches.

https://ift.tt/2Oh85yh

Environmental hazards associated with open-beach breaking of end-of-life ships: a review

Abstract

End-of-life (EOL) ships contribute significantly to the flow of recycled industrial Fe and non-Fe metal materials in resource-poor developing countries. The ship scrapping (breaking) and recycling industry (SBRI) recycles 90–95% of the total weight of EOL ships and is currently concentrated in Bangladesh, India, Pakistan, Turkey, and China, due to the high demand for recyclable and reusable materials there, an abundance of low-cost labor, and lenient environmental regulations. However, the SBRI has long been criticized for non-compliance with standards relating to occupational health, labor safety, and to the management of hazardous materials. Among the different EOL recycling options, Bangladesh, India, and Pakistan use open beaching, a technique that exposes all spheres of the environment to the release of hazardous materials from EOL ships. This article summarizes the current state of knowledge on the environmental exposure of hazardous materials from SBRI, to judge the risks associated with the dismantling of EOL ships on open beaches. Our work includes an overview of the industry and its recent growth, compares available ship-breaking methods, provides an inventory of hazardous releases from EOL ships, and reviews their movement into different spheres of the environment. The economic dynamics behind open beaching, and apportionment of responsibility for hazards related to it, are discussed, in order to generate policy and legal recommendations to mitigate the environmental harm stemming from this industry.

https://ift.tt/2NdSm6I

Determination of azole fungal residues in soils and detection of Aspergillus fumigatus -resistant strains in market gardens of Eastern France

Abstract

Medical azole antifungals are major compounds used to prevent and to treat invasive aspergillosis (IA). Azole fungicides, called DMI (14-alpha demethylase inhibitors), are also widely used for crop protection and have been reported to be linked to azole-resistant A. fumigatus (aR-Af) development in the environment. The aim of this study was to determine whether or not market gardens that spray DMIs in Eastern France are also affected by the presence of aR-Af. Forty aR-Afs were detected in soils in only two of the four market gardens using DMIs, with 23% (7/30) and 10% (3/30) of soils containing aR-Af. A total of 87.5% of these isolates had the TR34/L98H mutation and 22.5% the TR46/Y121F/T289A mutation on the cyp51A gene. Analyses of residual azole concentrations in soils showed the presence of difenoconazole for up to 2 years after spraying, but only in soils of market gardens where aR-Af was detected. It is very important to identify professional activities that could lead to aR-Af development and to develop preventive measures for at-risk patients living near professional activities using DMIs. We have to better understand why, in some cases, the use of DMI is not linked to aR-Af. Measures should be taken to avoid the use of DMI conferring cross-resistance to preserve the efficiency of human therapeutics.

https://ift.tt/2xhQDCG

Use of carbon-based composites to enhance performance of TiO 2 for the simultaneous removal of nitrates and organics from aqueous environments

Abstract

The simultaneous photocatalytic removal of nitrate from aqueous environment in presence of organic hole scavenger using TiO₂ has long been explored. However, the use of unmodified TiO₂ in such reaction resulted in non-performance or release of significant amount of undesirable reaction products in the process, a problem that triggered surface modification of TiO₂ for enhanced photocatalytic performance. Previous studies focused on decreasing rate of charge carrier recombination and absorption of light in the visible region. Yet, increasing active sites and adsorption capacity by combining TiO₂ with a high surface area adsorbent such as activated carbon (AC) remains unexploited. This study reports the potential of such modification in simultaneous removal of nitrates and oxalic acid in aqueous environment. The adsorptive behaviour of nitrate and oxalic acid on TiO₂ and TiO₂/AC composites were studied. The Langmuir adsorption coefficient for nitrate was four times greater than that of oxalic acid. However, the amount of oxalic acid adsorbed was about 10 times greater than the amount of nitrate taken up. Despite this advantage, the materials did not appear to produce more active photocatalysts for the simultaneous degradation of nitrate and oxalic acid. The photocatalytic activity of TiO₂ and its carbon-based composites was improved by combination with Cu₂O particles. Consequently, 2.5 Cu₂O/TiO₂ exhibited the maximum photocatalytic performance with 57.6 and 99.8% removal of nitrate and oxalic acid, respectively, while selectivity stood at 45.7, 12.4 and 41.9% for NH₄⁺, NO₂⁻ and N₂, respectively. For the carbon based, 2.5 Cu₂O/TiO₂-20AC showed removal of 12.7% nitrate and 80.3% oxalic acid and achieved 21.6, 0 and 78.4% selectivity for NH₄⁺, NO₂⁻ and N₂, respectively. Using the optimal AC loading (20 wt%) resulted in significant decrease in the selectivity for NH₄⁺ with no formation of NO₂⁻, which unveils that selectivity for N₂ and low/no selectivity for undesirable products can be manipulated by controlling the rate of consumption of oxalic acid. In contract, no nitrate reduction was observed with Cu₂O promoted TiO₂-T and its TiO₂-(T)-20AC, which may be connected to amorphous nature of TiO₂-T and perhaps served as charge carrier trapping sites that impeded activity.

https://ift.tt/2x8uTcT

Inflammasome, interleukine 1, maladies auto-inflammatoires et dermatoses neutrophiliques

Publication date: Available online 13 September 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): M.-S. Doutre

https://ift.tt/2CTucJN

Is Improved Insurance Coverage a Fleeting Opportunity?

The data from the Surveillance, Epidemiology, and End Results (SEER) database analyzed by Cannon et al in this issue of JAMA Otolaryngology–Head & Neck Surgery are highly relevant as the future of the Patient Protection and Affordable Care Act (ACA) becomes progressively more fragile. The authors provide objective data on improved rates of health care coverage after implementation of the ACA among patients with head and neck cancer. Reviewing the evolving payer mix is an important metric when assessing access to care. The decline in uninsured patients with head and neck cancer from 6.2% in 2013 to 3.0% in 2014 is a significant improvement. This finding does not mean that increased coverage is inexpensive, uniformly successful, or synonymous with improved patient adherence to treatment and healthier living. Although SEER survival outcomes data are not yet available for comparison of the periods before and after implementation of the ACA, this article is an important catalyst in our specialty for future study of the influence that major health policy change has on patients with head and neck cancer.

https://ift.tt/2p2D9Xw

A Parathyroid Hemangioma of the Retropharynx

This case report describes a man in his 30s who presented with cluster headaches and migraines and was subsequently diagnosed with retropharyngeal parathyroid hemangioma.

https://ift.tt/2CR7sdu

FDG PET–CT in the Detection of Oropharyngeal Cancer Recurrence

This cohort study compares the accuracies of the initial posttreatment positron emission tomography and computed tomography between primary treatment groups and attempts to define indicators of false-positive findings in patients treated for oropharyngeal cancer.

https://ift.tt/2CRPV4R

Ultrasonographic Evaluation of Upper Airway Structures in Children With Obstructive Sleep Apnea

This single-center, observational study of children with sleep-disordered breathing measures the upper airway structures using head and neck ultrasonography and evaluates the association between these measurements and severity of obstructive sleep apnea seen on polysomnography.

https://ift.tt/2p6tuPM

Pediatric Laryngeal Expression and Surgical Treatment of IgG4-Related Disease

This case report describes a previously healthy female child who presented with several months of hoarseness, globus sensation, and dysphagia and was subsequently diagnosed with a rare form of IgG4-related disease.

https://ift.tt/2CRPM1j

Atypical Infraglottic Lesion

A cigarette smoker in his 50s with a history of hypertension, chronic kidney disease, colon adenocarcinoma, and hyperuricemia presented with an asymptomatic right vocal fold mass found incidentally during esophagogastroduodenoscopy; he denied fevers or weight loss. What is your diagnosis?

https://ift.tt/2p3ZtjF

Evidence for Multiparametric Magnetic Resonance Imaging as a Biomarker for Prostate Cancer Screening

This Viewpoint addresses whether there is sufficient evidence to support routine use of multiparametric magnetic resonance imaging as an adjunctive test for men with elevated prostate-specific antigen level and considers the practical implications of its widespread implementation.

https://ift.tt/2MqwnEg

Oral Contraceptive Use and Increases in Breast, Ovarian, and Endometrial Cancers—Reply

In Reply We thank Dr Grant for the interest in our work. The associations between oral contraceptive (OC) use and the cancers on which we report have been established with extensive research; the protective effect of OC use on endometrial and ovarian cancer risk is well documented. Thus, the goal of our study was to evaluate the consistency of OC use–cancer risk associations across modifiable risk factors. The points raised about our article include potential confounding by (1) menopausal hormone therapy (MHT) use and (2) hysterectomy.

https://ift.tt/2MrBmVa

Fatal Toxic Effects Associated With Immune Checkpoint Inhibitors

This systematic review and meta-analysis analyzes the incidence of regimen-specific fatal toxic effects associated with the use of immune checkpoint inhibitors for cancer treatment.

https://ift.tt/2NcqZK0

Oral Contraceptive Use and Increases in Breast, Ovarian, and Endometrial Cancers

To the Editor Michels and colleagues claim that long past oral contraceptive (OC) use reduces the risk of ovarian and endometrial cancer. Carcinogenic effects of more recent exposures to menopausal progestin and/or estrogen hormone therapy (HT) are ignored. Among the entire sample of women aged 50 to 71 years (median age, 60 years), 118 144 (60%) formed a control reference group that included both never users and women who had taken OCs for less than 1 year. Only 10% of women took OCs for at least 10 years. A follow-up 11 years later found that 18 199 women had cancer: 61% breast cancer, 19% colorectal cancer, 13% endometrial cancer, and 7% ovarian cancer.

https://ift.tt/2QxCTfQ

Atezolizumab Therapy for Patients With Metastatic Triple-Negative Breast Cancer

This phase 1 study evaluates the safety, clinical activity, and biomarkers associated with the use of single-agent atezolizumab in women with metastatic triple-negative breast cancer.

https://ift.tt/2Mv0z1f

A Lesion on the Scalp

A 67-year-old man presented with a rapidly enlarging, itchy scalp lesion without generalized pruritus first noticed 3 months earlier as a pimple. What is your diagnosis?

https://ift.tt/2QxCx90

Incorrect Author Surname

In the Brief Report titled "Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins," published online July 12, 2018, in JAMA Oncology,¹ the surname of one of the authors was incorrect. In the Article Information section, in the list of authors taking responsibility for the study as part of the Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) Consortium for Early Detection of Lung Cancer, the full name of the author listed as Elisabete Weiderpass Vainio, MD, PhD, should have been given as Elisabete Weiderpass, MD, PhD. In addition, her affiliations should have been identified with the surname Weiderpass instead of Vainio (4 places), and her surname under "Critical revision of the manuscript for important intellectual content" in the Author Contributions section should have been listed as Weiderpass instead of Weiderpass Vainio. This article was corrected online.

https://ift.tt/2MsqDKj

Vitamin D deficiency are associated with subjective disease severity in Chinese patients with chronic rhinosinusitis with nasal polyps

Publication date: Available online 13 September 2018

Source: American Journal of Otolaryngology

Author(s): Feng Wang, Yang Yang, Haihong Chen

Abstract

Objective

To evaluate the serum vitamin D level in patients with chronic rhinosinusitis with nasal polyps and its correlation with the disease severity.

Setting

Hospital of Zhejiang University.

Study design

Retrospective analysis of collected data.

Subjects and methods

Patients with chronic rhinosinusitis with or without nasal polyps who underwent endoscopic sinus surgery were recruited. Demographic information including age, gender, body mass index, smoke history, atopic status and asthma was collected. Disease severity was measured by the Lund-Mackay CT score and Sino-Nasal Outcome Test-22 score. Serum 25-hydroxyvitamin D3 was measured by enzyme-linked immunosorbent assay preoperatively.

Results

Serum 25-hydroxyvitamin D3 levels were significantly lower in patients with nasal polyps (CRSwNP, 38.2 ± 9.1 nmol/L; CRSsNP, 48.94 ± 12.1 nmol/L; control, 54.1 ± 17.1 nmol/L. p < 0.001), and the levels were significantly associated with the preoperative Sino-Nasal Outcome Test-22 score (p = 0.013), but not with the Lund-Mackay score (p = 0.126). Furthermore, serum 25-hydroxyvitamin D3 levels were associated with the subjective improvement six months postoperatively (p < 0.001),

Conclusion

Serum 25-hydroxyvitamin D3 levels are lower in Chinese CRSwNP patients. These 25-hydroxyvitamin D3 levels are associated with SNOT-22 score. Preoperative 25-hydroxyvitamin D3 level may impact on the symptom improvement after surgery.

https://ift.tt/2xkEUTV

Ultrasound guided superior laryngeal nerve block as an adjuvant to generalanesthesia during endoscopic laryngeal surgery: A prospective, randomized, double-blind trial

Publication date: Available online 13 September 2018

Source: American Journal of Otolaryngology

Author(s): Rupavath Ramkumar, Suman Arora, Nidhi Bhatia, Sandeep Bansal

Abstract

Introduction

Blindly administered bilateral (B/L) superior laryngeal nerve (SLN) blocks, have been used to decrease the perioperative stress response of endoscopic laryngosurgeries. Use of ultrasound (USG) for giving these blocks is more likely to be successful, with fewer complications. We evaluated the efficacy of USG guided B/L SLN block in decreasing perioperative cough, sore-throat and hoarseness of voice.

Material and methods

This study was conducted on forty patients undergoing endoscopic laryngosurgery under GA. Patients were randomized into two groups of 20 patients each. Patients in group C received GA, whereas those in group L received USG-guided SLN block bilaterally with 2.5 ml of 2% lignocaine, along with GA. Postoperative cough, sore throat and hoarseness of voice was measured at 30 min, 2 h, 4 h and 24 h following transfer to post-anesthesia care unit.

Results

Patients receiving SLN block had significantly lower incidence of perioperative cough (20% in group L vs 90% in group C; p value - 0.0001) as well as sore throat (5% in group L vs 95% in group C; p value - 0.0001). In these patients, severity of hoarseness of voice was greater in the early postoperative period (100% in group L vs 70% in group C; p value - 0.027), while it decreased significantly at 24 h postoperatively(0.0% in group L vs 30% in group C; p value - 0.027).

Conclusion

USG guided SLN block as an adjuvant to GA resulted in better recovery profile of the patients with significant reduction in postoperative cough, sore throat and hoarseness of voice.

https://ift.tt/2NbcA0T

Differential effects of postoperative oral corticosteroid on eosinophilic vs. non-eosinophilic CRSwNP subtypes

Publication date: Available online 13 September 2018

Source: American Journal of Otolaryngology

Author(s): Kuang-Hsuan Shen, Yu-Hsuan Wang, Ting-Wei Hsu, Li-Chun Hsieh, Fang-Ju Sun, Ying-Piao Wang

Abstract

Purpose

The efficacy of postoperative oral corticosteroids on surgical outcomes in chronic rhinosinusitis with nasal polyps (CRSwNP) patients following endoscopic sinus surgery (ESS) remains controversial. This study evaluated the potential benefits of postoperative oral corticosteroids on surgical outcomes in CRSwNP patients and investigated the differential effects on eosinophilic CRSwNP (ECRSwNP) and noneosinophilic CRSwNP (NECRSwNP).

Materials and methods

Patients with bilateral CRSwNP who underwent ESS were enrolled and randomized to receive either oral prednisolone (30 mg/day) or placebo for 2 weeks after surgery. Visual analog scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22) scores were chosen as the subjective outcomes, evaluated at preoperative baseline and 1, 3, and 6 months postoperatively. Lund-Kennedy Endoscopic Scores (LKESs) were used as the objective outcome, evaluated at preoperative baseline and at 2 weeks and 2, 3, and 6 months postoperatively.

Results

In total, 100 patients with bilateral CRSwNP were enrolled, of whom only 82 completed the 6-month follow-up. The subjective outcomes showed no significant difference at each follow-up points. Of the objective outcomes, the corticosteroid group reporting a trend of improvement in LKESs at 6 months postoperatively (p = 0.05). After stratification by tissue eosinophils, only patients with NECRSwNP (<10 eosinophils/HPF) demonstrated a significant improvement in LKESs at 3 months postoperatively (p = 0.03).

Conclusions

Postoperative oral corticosteroids did not provide additional improvements in VAS and SNOT-22 scores; nevertheless, a trend of LKES improvement was noted at 6 months postoperatively. After stratification by tissue eosinophils, this effect was significant only among NECRSwNP patients at 3 months follow-up.

https://ift.tt/2NdNfUd

Anterior Canal benign paroxysmal positional Vertigo following surgical Management of superior canal dehiscence

Publication date: Available online 12 September 2018

Source: American Journal of Otolaryngology

Author(s): Richard A. Roberts, Alejandro Rivas, Kathryn F. Makowiec

Abstract

Objective

Benign paroxysmal positional vertigo (BPPV) is a common post-surgical finding in patients managed for superior semicircular canal dehiscence (SSCD). The posterior semicircular canal has been reported as the involved canal in the majority of cases of post-surgical BPPV, with only two cases reported of lateral canal involvement. The objective of this report is to present a case in which an anterior semicircular canal BPPV response was identified in a patient following surgical management for SSCD.

Method

This case report presents an adult with residual dizziness following surgical management of SSCD and vestibular rehabilitation therapy (VRT). During subsequent evaluation of vestibular function, a transient and torsional, down-beating nystagmus was provoked along with vertigo during Dix-Hallpike positioning to the right. This was consistent with BPPV affecting the left superior (anterior) semicircular canal.

Results

The patient was treated with a repositioning maneuver to manage anterior semicircular canal BPPV and no nystagmus response was recorded with post-repositioning Dix-Hallpike test. Review of radiographic images, obtained prior to vestibular function testing, showed a hyperintensity in the area of the left anterior semicircular canal ampulla. It was felt this was likely a bone chip from the SSCD repair that was pushing against the ampulla with further mobile debris within the canal.

Conclusion

It is reported that BPPV is a common complication in patients surgically managed for SSCD. Posterior semicircular canal BPPV is reported most often, with a couple of cases of lateral semicircular canal BPPV also reported. As far as we are aware, the current case represents the first report of anterior semicircular canal BPPV in this type of patient.

https://ift.tt/2xgjOGe

Sialendoscopy under conscious sedation versus general anesthesia. A comparative study

Publication date: Available online 12 September 2018

Source: American Journal of Otolaryngology

Author(s): Naif Bawazeer, Jean Carvalho, Idir Djennaoui, Anne Charpiot

Abstract

Objective

Sialendoscopy is a minimally invasive emerging approach, the general surgical technique has been published but many essential questions still need to be addressed with the aim of improving outcomes. For instance, should we systematically perform sialendoscopy under conscious sedation (CS) or general anesthesia (GA)? What are the limitations of CS? The objective of this study is to compare these two modalities.

Methodology

A retrospective study of 70 patients who had undergone a sialendoscopy between 2014 and 2016 (34 under GA and 36 under CS). Comparisons were made between these two groups in term of operative time, stone size and location, tolerability, operative success and post-operative pain.

Result

The patients' mean age was 45.33 years. The operative success rate among the GA group was 79.4% vs. 88.9% in the CS group (P = 0.276), while complications for both groups were comparable. All patients considered the intervention under CS to be tolerable.

Conclusion

Sialendoscopy under CS or GA demonstrated the ability to access large and distal stones among the different salivary glands with an excellent tolerability. Anesthesia type should be based on surgeon and patient preference Nevertheless, patient reassurance and surgeon experience are important to producing a good result with CS.

https://ift.tt/2NeCa5i

Honey can help in herpes simplex gingivostomatitis in children: Prospective randomized double blind placebo controlled clinical trial

Publication date: Available online 12 September 2018

Source: American Journal of Otolaryngology

Author(s): Osama G. Abdel-Naby Awad, Abdel-Monem H. Hamad

Abstract

Purpose

Herpes simplex gingivostomatitis (HSGS) in children is a common painful infectious disease. This study aims to examine the combined efficacy of honey with acyclovir suspension compared to acyclovir alone for treating HSGS in young children.

Material and methods

This Randomized double blind placebo controlled study was conducted from June 2015 to September 2017 in a tertiary referral hospital. One hundred children aged 2–8 years with HSGS were randomly classified into 2 groups; study group: treated with honey plus oral acyclovir and control group: treated with oral acyclovir alone. Severity of oral lesions, Fever, eating and drinking ability, pain scores and need for analgesics were compared between 2 groups on day 3, 5 and 7 after starting treatment.

Results

Children receiving honey plus acyclovir (i.e. study group) had significantly earlier disappearance of herpetic oral lesions; median 3 days vs. 6 days in control group (P = 0.022), drooling; 2 days vs. 4 days (P = 0.030) and eating difficulty; 3 days vs. 8 days (P = 0.001). Study group also had significantly lower pain scores, better eating and drinking ability and significantly less need for analgesics at 3 time-points of assessment. Fever disappeared in both groups with no statistically significant difference.

Conclusions

The combined use of honey with oral acyclovir can produce favorable outcome than acyclovir alone in children with Primary herpetic gingivostomatitis.

https://ift.tt/2xaRxRm

Laryngopharyngeal reflux in obstructive sleep apnoea patients: Literature review and meta-analysis

Publication date: Available online 12 September 2018

Source: American Journal of Otolaryngology

Author(s): Giuseppe Magliulo, Giannicola Iannella, Antonella Polimeni, Marco De Vincentiis, Giuseppe Meccariello, Giampiero Gulotta, Benedetta Pasquariello, Filippo Montevecchi, Andrea De Vito, Giovanni D'agostino, Riccardo Gobbi, Giovanni Cammaroto, Claudio Vicini

Abstract

Purpose

Laryngopharyngeal reflux (LPR) is a frequent condition in Obstructive Sleep Apnoea (OSA) patients and different studies have been published in the last years about this topic. A review of the published literature regarding LPR in OSA patients has been reported. A meta-analysis to evaluate the incidence of LPR in OSA patients and correlate LPR positivity with OSA patients' characteristics has been performed.

Methods

A comprehensive review of the English language literature about LPR in OSA patients was performed using the most important electronic databases (PubMed, EMBASE, the Cochrane Library etc.). A total of 10 papers studying LPR in OSA were assessed and considered eligible for the meta-analysis.

Results

The data analysis regarding 870 identified OSA patients showed that 394 patients were LPR +, while 476 were LPR-. The meta-analysis showed no statistical difference regarding the AHI value between LPR + patients and LPR- patients (p = 0,3). Mean BMI was more higher in LPR + patients than in the patients without LPR, showing a significant statistical difference (p = 0.001).

Conclusion

Current international literature demonstrates a high incidence of LPR (45.2%) in OSA patients. The severity of AHI in OSA patients would not seem to correlate with the presence of laryngopharyngeal reflux. The OSA patients with LPR showed a higher BMI compared with LPR- patients.

https://ift.tt/2N7fpQq

Temperature and depth evaluation of the in vitro effects of femtosecond laser on oral soft tissue, with or without air-cooling

Abstract

Femtosecond laser is an effective and safe tool in many surgeries, but the studies of its effect on oral soft tissue ablation are insufficient. This study aimed to investigate the effect of soft tissue ablation with a 1030-nm femtosecond laser on temperature and depth. Twenty Sprague–Dawley rat tongue specimens were obtained and flat-mounted. The 1030-nm femtosecond laser was controlled by a computer system, with a set distance of 4.7 mm between the laser aperture and soft tissue surfaces. Ten specimens were ablated for > 1 min with or without air-cooling for temperature measurement, while the other 10 specimens were ablated for depth measurements, using the following parameters: (i) 3 W, 2000 mm/s; (ii) 3 W, 4000 mm/s; (iii) 5 W, 2000 mm/s; (iv) 5 W, 4000 mm/s; (v) 8 W, 2000 mm/s; (vi) 8 W, 4000 mm/s. Temperature changes were measured using a type-K thermocouple. The depth attained using different power and scanning speed settings was measured by a three-dimensional morphology measurement laser microscope. Laser power, scanning speed, and air-cooling effects were determined. Higher energy and lower speed induced higher temperatures (p < 0.05), which were significantly decreased by air-cooling (p < 0.05). The lowest ablation depth was obtained at 3 W and 4000 mm/s (72.63 ± 6.47 μm) (p < 0.05). The greatest incision depth was achieved at 8 W and 2000 mm/s (696.19 ± 35.37 μm), or 4000 mm/s (681.16 ± 55.65 μm) (p < 0.05). The 1030-nm femtosecond laser application demonstrates clinically acceptable ablation efficiency, without marked temperature damage, in a controlled manner.

https://ift.tt/2N6MzQh

Er,Cr:YSGG laser associated with acidulated phosphate fluoride gel (1.23% F) for prevention and control of dentin erosion progression

Abstract

To evaluate the effect of Er,Cr:YSGG laser, associated with fluoride application, on the prevention/control of dentin erosion. Dentin slabs were embedded in acrylic resin, flattened, and polished. Half of the specimens were previously eroded (10 min immersion in 1% citric acid solution) and half were kept sound. The specimens (n = 10 each substrate) were randomly allocated into the experimental groups, according to the following treatments: control (no treatment); APF gel (1.23% F, 1 min); Er,Cr:YSGG laser irradiation (P1: 0.25 W, 20 Hz, 2.8 J/cm², tip S75, beam diameter of 750 μm, 1 mm away from the surface); Er,Cr:YSGG laser irradiation (P2: 0.50 W, 20 Hz, 5.7 J/cm², tip S75, beam diameter of 750 μm, 1 mm away from the surface); APF gel + Er,Cr:YSGG laser P1 and; APF gel + Er,Cr:YSGG laser P2. Afterwards, the specimens underwent an erosion-remineralization cycling, consisting of a 5-min immersion into 0.3% citric acid, followed by 60-min exposure to artificial saliva. This procedure was repeated 4×/day, for 5 days. Surface loss (SL, in μm) was determined by optical profilometry. Specimens from each group were analyzed by environmental scanning electron microscopy (n = 3). Data were statistically analyzed (α = 0.05). For the eroded specimens, APF gel presented the lowest SL, being different from the control. For the sound specimens, none of the groups differed from the control, except for Er,Cr:YSGG laser P2, which presented the highest SL. When substrates were compared, only the eroded specimens of the control and APF + Er,Cr:YSGG laser P1 Groups showed higher SL. Selective structure removal was observed for the laser-treated groups. None of the Er,Cr:YSGG laser parameters were effective in the prevention/control dentin erosion. The laser was also unable to enhance the protection of fluoride against dentin erosion.

https://ift.tt/2Oi3tYP

Evaluation of theranostic perspective of gold-silica nanoshell for cancer nano-medicine: a numerical parametric study

Abstract

Using gold-silica nanoshell as a reference nano-agent, this work has performed preliminary numerical parametric study to investigate the feasibility and if feasible the efficiency of using a single nano-agent to achieve theranostic goals. In total, seven generics of gold-silica nanoshells have been tested including the R[50,10] (radius of the silica core is 50 nm and thickness of the gold shell is 10 nm), R[40,15], R[55,25], R[40,40], R[75,40], R[104,23], and R[154,24] nanoshells. A planar tissue model has been constructed as the platform for parametric study. For mathematical modeling, radiant transport equation (RTE) has been applied to describe the interactions among laser lights, the hosting tissue, and the hosted nanoshells and Penne's bio-heat equation has been applied to describe the hyperthermia induced by such interactions. Effects of different nanoshell generics on the diffuse reflectance signal and hyperthermia temperature transition have been simulated, basing on which the potential of a certain nanoshell generic as theranostic nano-agent has been evaluated. It has been found that it is highly feasible for gold-silica nanoshells to be engineered for theranostic purpose and nanoshell generics that are preferentially scattering should be explored for good theranostic candidates. On the condition that nanoshell generic with the right optical properties has been located, a moderate nanoshell retention in the target tissue site is already sufficient to induce effective theranostic effects, which indicates that theranostic nano-medicine might not have a stringent requirement for the delivery technique. Among nanoshells that have been tested, the R[55,25] nanoshell seems to be a promising candidate as theranostic nano-agent. Further testing on it is highly recommended. Nanoshells that are preferentially absorbing such as the R[50,10] and R[40,15] nanoshells are efficient photothermal agent and could be used for therapeutic purpose only. However, it is not recommended that preferentially absorbing nanoshells being used for theranostic purpose due to possible negative effects such nanoshells might bring to the diffuse reflectance signal.

https://ift.tt/2N8xMV7

Hörgeräteversorgung im Kindesalter

Zusammenfassung

Die Hörgeräteversorgung im Kindesalter stellt eine Herausforderung für alle Fachdisziplinen dar. Nach den Qualitätsvereinbarungen ist eine vergleichende Anpassung und Erprobung vor der Verordnung zwingend erforderlich. Auch die regelmäßigen Überprüfungen der Hörgeräteeinstellungen mittels In-situ- oder RECD(„real ear to coupler difference")-Messung und Einstellungsoptimierung sind als Standard in der Kinderversorgung anzustreben. HNO-Ärzte, Phoniater und Pädaudiologen, Pädakustiker (Kinderhörgeräteakustiker), Schwerhörigen- und Sonderpädagogen sollten dabei interdisziplinär zusammenarbeiten.

https://ift.tt/2xfJnXE

Intralymphatic allergen immunotherapy against pollen allergy: A 3-year open follow-up study of 10 patients

Publication date: Available online 13 September 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Lars Ahlbeck, Emelie Ahlberg, Ulla Nyström, Janne Björkander, Maria C. Jenmalm

https://ift.tt/2MqFNjf

Food-induced anaphylaxis in infants and children

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Waheeda Samady, Jennifer Trainor, Bridget Smith, Ruchi Gupta

Abstract

Background

Recent recommendations to introduce peanut products to infants for peanut allergy prevention requires a focused assessment of infant anaphylaxis.

Objective

This study describes the symptomatology of food-induced anaphylaxis (FIA) in infants (<12 months) compared with older pediatric cohorts.

Methods

Retrospective review between June 2015 and June 2017 of children presenting with FIA at a large urban children's hospital emergency department (ED).

Results

A total of 357 cases of FIA were evaluated: 47 in infants (<12 months), 43 in toddlers (12-24 months), 96 in young children (2-6 years), and 171 in school-aged children (>6 years). Infants presented with gastrointestinal (GI) involvement more frequently than any other age group (89% vs 63% [P = .003], 60% [P < .001], and 58% [P < .001]). Additionally, infants and young children presented with skin involvement more frequently than school-aged children (94% and 91% vs 62% [P < .001]). Respiratory symptoms were more common in older cohorts (17% in infants vs 44% in young children [P < .001] and 54% in school-aged children [P < .001]). Egg and cow's milk were more common causes of FIA in infants compared with school-aged children (egg, 38% vs 1% [P < .001]; milk, 17% vs 7% [P = .03]). Only 21% of infants with FIA had eczema, and 36% had a history of food allergy.

Conclusion

Infants with FIA primarily presented with GI and skin manifestations. Egg was the most common food trigger in infants. Most infants with FIA did not have eczema or a history of food allergy.

https://ift.tt/2N9ZUal

Hepatitis B vaccine nonresponders: Possible mechanisms and solutions

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Tara Vinyette Saco, Alexandra T. Strauss, Dennis K. Ledford

Abstract

Objective

Hepatitis B (HBV) is a viral illness that chronically infects 240 million people worldwide, leads to liver disease, and increases risk of hepatocellular carcinoma. The HBV vaccine has decreased HBV infection, and it and the human papilloma virus vaccine are the only vaccines that prevent cancer. Despite the effectiveness of the HBV vaccine, some populations do not develop protective responses. The risk groups for poor response include those with immunosuppression or dialysis-dependent, end-stage renal disease. Five percent of normal people do not have a response. These subjects are deemed HBV "nonresponders." Multiple strategies to improve the immunogenicity of the HBV vaccine are currently being pursued, including vaccine adjuvants, recombinant vaccines, and immune enhancement via up-regulation of dendritic cells.

Data Sources

PubMed was searched for peer-reviewed publications published from January 1980 to September 2017.

Study Selections

Studies retrieved for inclusion summarized potential mechanisms behind HBV vaccine nonresponsiveness and potential solutions.

Results

The mechanisms behind HBV vaccine nonresponsiveness vary between each subject population. Many current and future strategies may provide protective immunity against HBV in each of these populations.

Conclusion

This review provides a background on the immunology of HBV infection, the possible immunologic mechanisms to explain HBV vaccine nonresponsiveness, current research aimed at improving vaccine effectiveness, and possible future approaches for providing nonresponders protection from HBV.

https://ift.tt/2MqFGUR

Hidden allergens in food allergy

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Mary Grace Baker, Sarah Saf, Angela Tsuang, Anna Nowak-Wegrzyn

https://ift.tt/2N85RVo

New diagnostic criteria for eosinophilic esophagitis: Will they influence our practice?

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Mirna Chehade

https://ift.tt/2MseVPz

Life in the FAST lane

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Matthew Greenhawt, John J. Oppenheimer

https://ift.tt/2N7yJx4

Allergen immunotherapy

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): John Oppenheimer, Gailen D. Marshall

https://ift.tt/2MqFuF7

Editorial Board

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s):

https://ift.tt/2Nc7GAw

Information for Authors

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s):

https://ift.tt/2MseEMx

Table of Contents

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s):

https://ift.tt/2Nc7vVS

Information for Readers

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s):

https://ift.tt/2Msercd

Diane E. Schuller, MD (1943–2018)

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Joseph A. Bellanti

https://ift.tt/2Nb8Ufp

Pilot study of the CAPS (Clinical extent, Area, Pruritus, Sleep) measure for atopic dermatitis severity

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Aaron M. Drucker, Natalie H. Matthews, Jennie Muglia, Abrar A. Qureshi

Keywords

Eczema; Atopic dermatitis; Outcome measures; Severity; Symptoms; Itch

Abbreviations: AD, atopic dermatitis; BSA, body surface area; CAPS, Clinical extent, Area, Pruritus, Sleep; DLQI, Dermatology Life Quality Index; EASI, Eczema Area and Severity Index; IGA, Investigator Global Assessment; POEM, Patient-Oriented Eczema Measure

https://ift.tt/2MqEZuJ

Development of food protein–induced enterocolitis syndrome (FPIES) to egg after immunoglobulin E–mediated egg allergy

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s): Hannah Duffey, Maureen Egan

https://ift.tt/2N8V3qe

Erratum

Publication date: September 2018

Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 3

Author(s):

https://ift.tt/2MqEReJ

A Randomized Phase 2 Study of Cemiplimab ± ISA101b in HPV16-Positive OPC

Conditions:   Squamous Cell Carcinoma of the Oropharynx;   HPV16 Positive
Interventions:   Biological: ISA101b;   Drug: Cemiplimab;   Other: Placebo
Sponsors:   ISA Pharmaceuticals;   Regeneron Pharmaceuticals
Not yet recruiting

https://ift.tt/2x6QAu7

Pilot Study of Somatostatin Receptor Imaging in Nasopharyngeal Cancer

Condition:   Nasopharyngeal Carcinoma
Intervention:  
Sponsors:   National Cancer Centre, Singapore;   Singapore General Hospital;   A*Star
Recruiting

https://ift.tt/2D49jfl

To Study the Impact of Radiation Treatment After Surgery in Patient With Locally Advanced Thyroid Cancer.

Conditions:   Thyroid Cancer Stage IV;   Radiation Toxicity
Interventions:   Radiation: Intensity Modulated Radiotherapy;   Procedure: Surgery alone
Sponsors:   Tata Memorial Hospital;   Department of Atomic Energy
Recruiting

https://ift.tt/2x9VruB

Reduced-dose Radiotherapy for Low-risk Stage III Patients With Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Carcinoma
Interventions:   Radiation: Intensity-modulated radiation therapy;   Drug: Paclitaxel liposome;   Drug: Cisplatin;   Drug: 5-Fluorouracil
Sponsor:   Sun Yat-sen University
Not yet recruiting

https://ift.tt/2CPY4Hd

A Randomized Phase 2 Study of Cemiplimab ± ISA101b in HPV16-Positive OPC

Conditions:   Squamous Cell Carcinoma of the Oropharynx;   HPV16 Positive
Interventions:   Biological: ISA101b;   Drug: Cemiplimab;   Other: Placebo
Sponsors:   ISA Pharmaceuticals;   Regeneron Pharmaceuticals
Not yet recruiting

https://ift.tt/2x6QAu7

Pilot Study of Somatostatin Receptor Imaging in Nasopharyngeal Cancer

Condition:   Nasopharyngeal Carcinoma
Intervention:  
Sponsors:   National Cancer Centre, Singapore;   Singapore General Hospital;   A*Star
Recruiting

https://ift.tt/2D49jfl

To Study the Impact of Radiation Treatment After Surgery in Patient With Locally Advanced Thyroid Cancer.

Conditions:   Thyroid Cancer Stage IV;   Radiation Toxicity
Interventions:   Radiation: Intensity Modulated Radiotherapy;   Procedure: Surgery alone
Sponsors:   Tata Memorial Hospital;   Department of Atomic Energy
Recruiting

https://ift.tt/2x9VruB

Reduced-dose Radiotherapy for Low-risk Stage III Patients With Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Carcinoma
Interventions:   Radiation: Intensity-modulated radiation therapy;   Drug: Paclitaxel liposome;   Drug: Cisplatin;   Drug: 5-Fluorouracil
Sponsor:   Sun Yat-sen University
Not yet recruiting

https://ift.tt/2CPY4Hd

Cabozantinib beim fortgeschrittenen hepatozellulären Karzinom

https://ift.tt/2QmvrUy

Loss of transforming growth factor-β1 in epithelium cells affects enamel formation in mice

Publication date: Available online 12 September 2018

Source: Archives of Oral Biology

Author(s): Wenying Song, Yanli Wang, Qing Chu, Congcong Qi, Yuehua Gao, Yan Gao, Lili Xiang, Xu Zhenzhen, Yuguang Gao

Abstract

Objectives

In order to understand the specific in vivo function of transforming growth factor-beta1 (TGF-β1), we successfully established aTGF-β1 deficient mouse model using a conditional knockout method. In the present study, we aimed to further understand the potential role of TGF-β1 in enamel formation.

Design

Transgenic mice withoutTGF-β1 in epithelial cells were generated. Scanning electron microscopy and micro-computed tomography analysis were used to detect the dental appearance, enamel microstructure and tooth density. Histological analysis was used to examine the residual organic matrix of enamel. Quantitative real-time polymerase chain reaction was used to analyze the expressions of enamel matrix proteins at the mRNA level.

Results

The enamel of mandibular molars and incisors inTGF-β1 conditional knockout mice displayed severe attrition and lower density compared with the wild-type littermates. A slender microstructure of enamel rod was observed, and enamel matrix proteins were retained in the enamel space at the maturation stage in conditional knockout mice. Moreover, the expressions of enamel matrix protein-encoding genes, such as amelogenin (Amelx), ameloblastin (Ambn), Enamelin (Enam) and matrix metalloproteinase-20 (Mmp-20), were increased in enamel organs of conditional knockout mice. On the other hand, the expressions of Amelotin (Amtn), kallikrein-related peptidase-4 (Klk4), C4orf26 and WD repeat-containing protein 72 (Wdr72) were dramatically decreased at the transition and maturation stages.

Conclusions

TGF-β1 played an important role in enamel mineralization through decreasing synthesis ofAmelx, Ambn and Enam and increasing synthesis of Klk4, Amtn, Corf26 and Wdr72.

https://ift.tt/2CR946Z

Masticatory hypofunction effects induced by BTXA injection of hippocampal neurons in developing rats

Publication date: Available online 12 September 2018

Source: Archives of Oral Biology

Author(s): Chi-Yang Tsai, Hsin-Ping Lee, Hung-Ming Chang, Fang-Chun Wu

Abstract

Background and objective

In clinical practice, malocclusion is often encountered during the period of growth and development of individuals. In addition to nutritional imbalance, some studies have found that mastication affects learning and memory ability. Tooth loss and masticatory hypofunction have been suggested as risk factors of Alzheimer disease. However, relatively little research has been done in developing animals. The present study evaluated the relationship between masticatory hypofunction and neuropathological changes of the hippocampus in developing rats.

Design

Four-week-old Wistar rats were randomly divided into saline-injected and botulinum toxin type A (BTXA)-injected groups. After an experiment period of 4 weeks, the rats were sacrificed for evaluation of neuropathological changes in the hippocampus through Nissl staining and phosphorylated cyclic AMP (cAMP) response element binding protein (CREB) immunohistochemistry.

Results

Nissl staining revealed a significant reduction in the density of neurons in the BTXA-injected rats. The BTXA-injected rats exhibited a decreased level of CREB phosphorylation. The degree of p-CREB immunoreactivity differed significantly between the two groups.

Conclusion

The BTXA-injected rats exhibited a reduction in neuron density and phosphorylated CREB, indicating that mastication might influence the learning and memory ability during the growth period. Therefore, it is strongly suggested that malocclusion be corrected as soon as possible during growth and development.

https://ift.tt/2x9yebD

Effectiveness and acid/tooth brushing resistance of in-office desensitizing treatments—A hydraulic conductance study

Publication date: Available online 12 September 2018

Source: Archives of Oral Biology

Author(s): Samira Helena João-Souza, Alana Cristina Machado, Raquel Mariana Lopes, Denise Maria Zezell, Tais Scaramucci, Ana Cecília Corrêa Aranha

Abstract

Objective

To evaluate dentin permeability and tubule occlusion of in-office desensitizing treatments, and to analyze their resistance to erosive/abrasive challenges.

Design

Ninety-one 1mm-thick dentin discs were immersed in EDTA solution for 5 min. After analyzing the maximum dentin permeability, the specimens were randomly allocated into 7 experimental groups (n = 10): Control (no treatment); Er,Cr:YSGG laser; Nd:YAG laser; Gluma Desensitizer ; Duraphat; Pro-Argin toothpaste; Calcium Sodium Phosphosilicate (CSP) paste. The post-treatment permeability was assessed and then the specimens were subjected to a 5-day erosion-abrasion cycling protocol: 4x/day of immersion in citric acid solution (5 min;0.3%), followed by exposure to clarified human saliva (60 min). After the first and last acid challenges, specimens were brushed for 15 s, with exposure to the toothpaste slurry for total time of 2 min. Dentin permeability was re-measured (post-cycling). Percentage of dentin permeability for each experimental time was calculated in relation to the maximum permeability (%Lp). Data were analyzed with 2-way repeated measures ANOVA and Tukey tests (α = 0.05). Surface modifications were analyzed by scanning electron microscopy.

Results

In both experimental time CSP paste and Gluma Desensitizer did not differ from each other (p = 0.0874), and were the only groups that presented significantly lower %Lp than the Control (p = 0.026 and p = 0.022, respectively). After treatment, they were able to reduce dentin permeability in 82% and 72%, respectively. The %Lp post-cycling was higher than post-treatment value for all groups (p = 0.008). Dentin permeability increased 21% for CSP paste and 12% for Gluma, but they remained significant different from Control. Deposits on the surface were observed for CSP paste; and for Gluma, tubule diameters were shown to be smaller.

Conclusions

CSP paste and Gluma Desensitizer were the only treatments able to decrease dentin permeability post-treatment and to sustain low permeability post-cycling.

https://ift.tt/2CSvwg8

Th17 and Treg lymphocytes in obesity and Type 2 diabetic patients

Publication date: Available online 13 September 2018

Source: Clinical Immunology

Author(s): Mei Wang, Fuqiong Chen, Jingli Wang, Zhixuan Zeng, Qin Yang, Shiying Shao

Abstract

Assumption that the pathogenesis of obesity-associated type 2 diabetes (T2DM) encompasses inflammation and autoimmune aspects is increasingly recognized. In the state of obesity and T2DM, the imbalance of T helper 17 (Th17) cells and regulatory T (Treg) cells are observed. These alterations reflect a loss of T cell homeostasis, which may contribute to tissue and systemic inflammation and immunity in T2DM. In this review we will discuss the accumulating data supporting the concept that Th17/Treg mediated immune responses are present in obesity-related T2DM pathogenesis, and provide evidences that restoration of Th17/Treg imbalance may be a possible therapeutic avenue for the prevention and treatment of T2DM and its complications.

https://ift.tt/2Ojrqie

Reproductive Guidance Through Prenatal Diagnosis and Genetic Counseling for Recessive Hereditary Hearing Loss in High-risk Families

Publication date: Available online 12 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Deng Yuyuan, Sang Shushan, Wen Jie, Liu Yalan, Ling Jie, Chen Hongsheng, Cai Xinzhang, Mei Lingyun, Chen Xiaoya, Li Meng, Li Wu, Li Taoxi, He Chufeng, Feng Yong

Abstract

Objective

To evaluate the accuracy and validity of our protocol for prenatal diagnosis and genetic counseling in high-risk families at a clinic.

Methods

Fifteen unrelated families with recessive nonsyndromic hearing loss (NSHL) in their family history and a positive attitude towards prenatal diagnosis were recruited in the present study. According to genetic information for each family, Sanger sequencing, fluorescence polymerase chain reaction (PCR)-based congenital deafness gene detection kit and multiple PCR-based target gene capture and high-throughput sequencing were used. Genetic counseling was offered to all participating families by genetic counselors and otologists. Prenatal diagnosis was provided to families with detected pathogenic mutations and who were expected to participate in subsequent prenatal diagnosis.

Results

In this study, confirmed pathogenic mutations were detected in eight families, who were defined as high-risk families. These families all participated in prenatal diagnosis with positive attitudes. One novel variant (c.1687dupA) in the SLC264 gene was detected in a family. Through genetic counseling, the recurrence probability of NSHL in fetuses was 25% in six families, 0% in one family, and 50% in one family. The results of fetal DNA detection showed that one fetal variant was wild type, three were heterozygous mutations in SLC26A4, and one was a compound heterozygous mutation in SLC26A4. Two variants were heterozygous mutations in GJB2, and one was a homozygous mutation in GJB2. According to the test results for fetal DNA, prenatal diagnosis found that six fetuses had normal hearing, whereas two fetuses suffered from NSHL. After birth, six infants predicted to have normal hearing passed a newborn hearing screening test and two infants predicted to have NSHL were diagnosed with NSHL and received cochlear implants.

Conclusion

Our protocol for prenatal diagnosis and genetic counseling provides detailed information that can assist couples in high-risk families in preparing for infant arrival and future family planning. For the affected neonates, prenatal diagnosis and genetic counseling achieve an "early screening, early diagnosis, early intervention" strategy.

https://ift.tt/2MuincR

Overhauser DNP FFC study of block copolymer diluted solution

Publication date: Available online 12 September 2018

Source: Magnetic Resonance Imaging

Author(s): Bulat Gizatullin, Carlos Mattea, Siegfried Stapf

Abstract

Overhauser dynamic nuclear polarization (DNP) is the dominating hyperpolarization technique to increasing the nuclear magnetic resonance signal in liquids and diluted systems. The enhancement obtained depends on the overall mobility of the radical-carrying molecule but also on its specific interaction with the host molecules. Information about the nature of molecular and radical dynamics can be identified from determining the nuclear T₁ as a function of Larmor frequency by Fast Field Cycling (FFC) relaxometry. In this work, DNP and FFC methods were combined for a detailed study of ¹H Overhauser DNP enhancements at 340 mT (X-band) and 73 mT (S-band) for diluted solutions of a block-copolymer with and without the addition of TEMPO radicals. NMR relaxation dispersions of these solutions are measured at thermal polarization and DNP conditions in the X-band, and the obtained DNP data were analyzed by a model of electron-nucleus interactions modulated by translational diffusion. The coupling factors for the two different blocks of the copolymer are obtained independently from DNP and NMRD experiments. An additional contribution from scalar interactions was found for polystyrene blocks.

https://ift.tt/2NF0tbD

State of the art: Rehabilitation of speech and swallowing after total laryngectomy

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Joseph Zenga, Tessa Goldsmith, Glenn Bunting, Daniel G. Deschler

Abstract

Despite the development and expansion of non-surgical organ preservation therapy, total laryngectomy continues to be the optimal therapy for far-advanced local disease and the only curative option for radiotherapy failures not amenable to partial laryngeal procedures. Laryngectomy, however, remains a life-altering operation with profound effects on swallowing and speech. In the nearly 150 years since the first total laryngectomy was performed, few ablative aspects have changed, but reconstructive techniques have undergone radical evolution. This review will trace the origins of laryngeal rehabilitation for voice and swallowing, the current state of the art with attention to pre-treatment considerations and post-operative management, current surgical management techniques, and the future of functional laryngeal reconstruction.

https://ift.tt/2xa2tzc

Modification of the eight-edition tumor-node-metastasis staging system with N1b for papillary thyroid carcinoma: A multi-institutional cohort study

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Mijin Kim, Hee Kyung Kim, Hye In Kim, Eun Heui Kim, Min Ji Jeon, Hyon-Seung Yi, Eun Sook Kim, Hosu Kim, Tae Hyuk Kim, Bo Hyun Kim, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Jae Hoon Chung, Young Kee Shong, Sun Wook Kim, Won Gu Kim

Abstract

Objectives

Based on the tumor-node-metastasis staging system, eighth edition (TNM-8), N1b is no longer used as a variable to determine final stage in papillary thyroid carcinoma (PTC). We aimed to evaluate the predictability of a simple modification of the TNM staging with N1b classification in a large multicenter thyroid cancer cohort.

Materials and methods

This study included 7717 patients with PTC who underwent thyroid surgery between 1996 and 2005 from six tertiary hospitals. We classified patients with stage II into stage IIA and IIB with modified-TNM: older patients with N1b disease were classified as stage IIB, while remaining patients were classified as stage IIA.

Results

The mean age was 46.2 years, and 24% were aged ≥55 years. In older patients, the 10-year disease-specific survival (DSS) rate of N1b disease (86.3%) was approximately 10% lower than that of N1a disease, and patients with N1b had significantly poorer DSS than those with N1a (HR = 3.3, p < 0.001). When the modified-TNM was applied, DSS curves between stage groups significantly differed (p < 0.001), and the relative risk of DSS in stage IIB patients was 2.3 times higher than in stage IIA patients (p < 0.001). The proportion of variation explained value of the modified-TNM was 4.9% and that of the TNM-8 was 4.7%.

Conclusion

This multicenter study reveals that the presence of lateral lymph node metastasis affects disease mortality in PTC, especially in older patients. The sub-classification of stage II in older patients improves DSS predictability. This simple modification of TNM-8 provides better prognostic information for patients with PTC.

https://ift.tt/2CSiCig

A Very Rare Complication of Hepatitis A Infection: Acute Myocarditis—A Case Report with Literature Review

Hepatitis A is a common viral infection with a benign course but in rare cases can progress to acute liver failure. It usually presents with abdominal pain, nausea, vomiting, diarrhea, jaundice, anorexia, or asymptomatically, but it can also present atypically with relapsing hepatitis and prolonged cholestasis. In addition, extrahepatic manifestations have been reported, including urticarial and maculopapular rash, acute kidney injury, autoimmune hemolytic anemia, aplastic anemia, acute pancreatitis, mononeuritis, reactive arthritis, glomerulonephritis, cryoglobulinemia, Guillain–Barre syndrome, and pleural or pericardial effusion. A rare manifestation of hepatitis A is acute myocarditis. We report a case of a young woman who presented with "flu-like symptoms" and was found to have severe elevation of liver enzymes due to acute hepatitis A infection. On her 3rd day of admission, the patient developed chest pain and nonspecific electrocardiographic changes. Her troponins rose to 16.4  ng/mL, and a transthoracic echocardiogram revealed global hypokinesis and a depressed ejection fraction at 30%. A CT angiography showed no evidence of significant coronary artery disease. The patient was managed supportively, and symptoms and laboratory findings slowly improved over the next 7 days. Her chest pain resolved and a follow-up echocardiogram showed improved ejection fraction to 45%.

https://ift.tt/2xa73Nb

IL-17A is functionally relevant and a potential therapeutic target in bullous pemphigoid

Publication date: Available online 13 September 2018

Source: Journal of Autoimmunity

Author(s): Lenche Chakievska, Maike M. Holtsche, Axel Künstner, Stephanie Goletz, Britt-Sabina Petersen, Diamant Thaci, Saleh M. Ibrahim, Ralf J. Ludwig, Andre Franke, Christian D. Sadik, Detlef Zillikens, Christoph Hölscher, Hauke Busch, Enno Schmidt

Abstract

IL-17A has been identified as key regulatory molecule in several autoimmune and chronic inflammatory diseases followed by the successful use of anti-IL-17 therapy, e.g. in ankylosing spondylitis and psoriasis. Bullous pemphigoid (BP) is the most frequent autoimmune blistering disease with a high need for more specific, effective and safe treatment options. The aim of this study was to clarify the pathophysiological importance of IL-17A in BP. We found elevated numbers of IL-17A⁺ CD4⁺ lymphocytes in the peripheral blood of BP patients and identified CD3⁺ cells as major source of IL-17A in early BP skin lesions. IL17A and related genes were upregulated in BP skin and exome sequencing of 51 BP patients revealed mutations in twelve IL-17-related genes in 18 patients. We have subsequently found several lines of evidence suggesting a significant role of IL-17A in the BP pathogenesis: (i) IL-17A activated human neutrophils in vitro, (ii) inhibition of dermal-epidermal separation in cryosections of human skin incubated with anti-BP180 IgG and subsequently with anti-IL-17A IgG-treated leukocytes, (iii) close correlation of serum IL-17A levels and diseases activity in a mouse model of BP, (iv) IL17A-deficient mice were protected against autoantibody-induced BP, and (v) pharmacological inhibition of lL-17A reduced the induction of BP in mice. Our data give evidence for a pivotal role of IL-17A in the pathophysiology of BP and advocate IL-17A inhibition as potential novel treatment for this disease.

https://ift.tt/2OjbTyT

Autophagy: A new concept in autoimmunity regulation and a novel therapeutic option

Publication date: Available online 13 September 2018

Source: Journal of Autoimmunity

Author(s): Srinivasa Reddy Bonam, Fengjuan Wang, Sylviane Muller

Abstract

Nowadays, pharmacologic treatments of autoinflammatory diseases are largely palliative rather than curative. Most of them result in non-specific immunosuppression, which can be associated with broad disruption of natural and induced immunity with significant and sometimes serious unwanted injuries. Among the novel strategies that are under development, tools that modulate the immune system to restore normal tolerance mechanisms are central. In these approaches, peptide therapeutics constitute a class of agents that display many physicochemical advantages. Within this class of potent drugs, the phosphopeptide P140 is very promising for treating patients with lupus, and likely also patients with other chronic inflammatory diseases. We discovered that P140 targets autophagy, a finely orchestrated catabolic process, involved in the regulation of inflammation and in the biology of immune cells. In vitro, P140 acts directly on a particular form of autophagy called chaperone-mediated autophagy, which seems to be hyperactivated in certain subsets of lymphocytes in lupus and in other autoinflammatory settings. In lupus, the "correcting" effect of P140 on autophagy results in a weaker signaling of autoreactive T cells, leading to a significant improvement of pathophysiological status of treated mice. These findings also demonstrated ex vivo in human cells, open novel avenues of therapeutic intervention in pathological conditions, in which specific and not general targeting is highly pursued in the context of the new action plans for personalized medicines.

https://ift.tt/2NdfDpv

Synchronous Multiple Pituitary Neuroendocrine Tumors of Different Cell Lineages

Abstract

We report clinicopathological features of a large series of synchronous multiple pituitary neuroendocrine tumors (PitNETs) of different cell lineages. Retrospective review of pathology records from 2001 to 2016 identified 13 synchronous multiple PitNETs from 1055 PitNETs classified using pituitary cell-lineage transcription factors, adenohypohyseal hormones, and other biomarkers. Clinical, radiological, and histopathological features of these tumors were reviewed. The series included seven females and six males. Mean age at diagnosis was 55.23 years (range 36–73). Imaging was unavailable for four patients; among the other nine, mean tumor size was 2.23 cm (range 0.9–3.9). Five patients had acromegaly, four had Cushing disease, and four had clinically non-functional tumors. Twelve had double PitNETs; one had a triple PitNET. The most common tumor type was corticotroph (n = 8; six densely and one sparsely granulated and one Crooke cell; three densely and one sparsely granulated were clinically silent), gonadotroph tumors (n = 8), and somatotroph tumors (n = 5; four sparsely granulated and one densely granulated somatotroph) were followed by lactotroph tumors (n = 4; all sparsely granulated), poorly differentiated Pit-1 lineage tumor (n = 1), and unusual plurihormonal tumor (n = 1). A 54-year-old man with Cushing disease had MEN1-driven Crooke cell and gonadotroph tumors. The triple pitNET consisted of a multilineage plurihormonal tumor associated with a gonadotroph and a sparsely granulated lactotroph tumor. The Ki67 (available from 10 specimens) ranged from 1 to 5% in individual tumors. Radiological and biochemical follow-up was available for 10 and 11 patients, respectively. Radiological tumor persistence/recurrence was identified in three patients with double PitNETs consisting of sparsely granulated lactotroph and gonadotroph tumors (n = 1), sparsely granulated somatotroph and silent corticotroph tumors (n = 1), and gonadotroph and silent corticotroph tumors (n = 1) with cavernous sinus invasion. Biochemical persistence was noted in four patients with double PitNETs consisting of sparsely granulated somatotroph and silent corticotroph tumors (n = 2), gonadotroph and Crooke cell tumors (n = 1), and densely granulated somatotroph and silent corticotroph tumors (n = 1). Multiple PitNETs represent about 1% of PitNETs and usually have hormone excess due to at least one tumor component. Clinical manifestations may be due to the minor component, especially in patients with Cushing disease. Invasive growth and aggressive histological subtypes predicted disease persistence/recurrence. This series also highlights the importance of routine application of pituitary cell lineage transcription factors along with hormones to distinguish and subtype multiple synchronous PitNETs.

https://ift.tt/2NaLuae

The Telomerase and Alternative Lengthening of Telomeres Mechanisms Regulate Laryngeal Cancer Cell Apoptosis via the PI3K/Akt Pathway

Purpose: To investigate the possible telomerase and alternative lengthening of telomeres (ALT) mechanisms influencing the apoptosis of laryngeal squamous cells. Materials and Methods: The effects of the telomerase mechanism were observed by knockdown of human telomerase reverse transcriptase (hTERT). The ALT mechanism was induced by silencing related genes including TRF2, RAD51, and NBS1. Effects of telomerase and ALT mechanisms on tumor development were confirmed by xenograft tumors model. Tumor cell apoptosis was investigated by flow cytometry and Hoechst staining. Caspase-3 activity assay and Western blot were performed to investigate the possible mechanisms. Results: After silencing ALT- and telomerase mechanism-related genes, Bax and Bcl-2 were increased, and nuclear factor (NF)-κB translocation and PI3K/Akt phosphorylation were inhibited. Conclusions: The inhibition of telomere-related genes inhibited the growth of laryngeal squamous cell carcinoma by promoting cell apoptosis via the PI3K/Akt pathway.
ORL

https://ift.tt/2xjO0QP

Functional recovery after surgical stabilization and postoperative radiotherapy due to metastases of long bones

Abstract

Purpose

To reinvestigate the functional recovery after combined treatment with surgery and postoperative irradiation of complete or impending pathologic fractures of long bones.

Methods

We retrospectively evaluated the results of external beam radiation therapy (EBRT) carried out after 68 orthopedic stabilization procedures (femur, n = 55, 80.8%; humerus, n = 13, 19.2%) for actual or impending pathological fracture of long bone in 61 patients with skeletal metastases. The mean normalized total dose was 34.7 ± 7.8 Gy. Endpoints were patient's functional status (FS; 1 = normal pain free status; 2 = normal use with pain; 3 = significantly limited used; 4 = nonfunctional status), a need for a secondary procedure to the same site and overall survival following surgery.

Results

Overall, 75% of patients achieved normal functional status (FS 1–2) within 12 weeks after surgery. Functional recovery in surviving patients reached 93%. Median survival was 17 months (95% confidence interval 13.7–20.2). Secondary surgical intervention at the same location was necessary in 3 patients (4.4%). On multivariate analysis, only general status (p = 0.011) and growing potential of primary tumor (p = 0.049) were associated with achieving normal functional status within 12 weeks after surgery and radiotherapy. The applied radiation schemes demonstrated a comparable impact on functional recovery.

Conclusions

Our results confirm the effectiveness of stabilizing surgery and fractionated postoperative radiotherapy in terms of functional recovery, supporting prior results assessing postsurgical radiotherapy versus follow-up. The patient's general status is a strong prognostic factor for functional recovery. Rapidly growing tumors may hinder achievement of a normal functional status.

https://ift.tt/2x9XptX

Aflatoxin M 1 in cow, sheep, and donkey milk produced in Sicily, Southern Italy

Abstract

Samples (n = 485) of raw (n = 394) or heat-treated (n = 91) milk of three different species (cow, n = 170; sheep, n = 133; donkey, n = 84), collected 2013–2016 in Western Sicily (Southern Italy), were analyzed for aflatoxin M₁ (AFM₁) by enzyme-linked immunosorbent assay (ELISA). Positive ELISA results were further analyzed by HPLC with fluorescence detection. Both methods had a detection limit for AFM₁ in milk of 7 ng kg⁻¹. ELISA yielded 12.9 and 5% positives in cows and sheep milk, respectively, all samples of donkey milk were negative. Levels of AFM₁ were in most cases at 0.007–< 0.05 μg kg⁻¹, only two samples (sheep milk) slightly exceeded the European Union maximum level of 0.05 μg kg⁻¹. Only 6% of the samples were positive for AFM₁ in a concentration range of 0.008–0.15 μg kg⁻¹. Only milk samples collected directly from farms were positive. Overall, the levels were much lower than previously reported for Southern Italy cow and sheep milk samples purchased in retail stores. The results of this work indicate a continuous improvement of the feeding techniques on dairy farms of Southern Italy, which is essential to ensure consumers' protection.

https://ift.tt/2x7IvoZ

Versorgungsforschung in der Dermatologie 2018 – Kraft des Faktischen

Zusammenfassung

In der in Deutschland praktizierten Dermatologie ist Versorgungsforschung eine etablierte und hoch differenzierte Disziplin. In vielen universitären dermatologischen Einrichtungen und niedergelassenen Praxen werden Studien zu Vorgängen der gesundheitlichen Versorgung bei Hautkrankheiten durchgeführt. Unter dem Dach der Deutschen Dermatologischen Gesellschaft und des Berufsverbandes der Deutschen Dermatologen wird ein wesentlicher Teil der Studien und Projekte des Competenzzentrums Versorgungsforschung in der Dermatologie (CVderm) als bundesweites Referenzzentrum getragen. Wichtige Projekte sind Implementierung von Patientenregistern, Umsetzung nationaler Versorgungsstudien, Forschung mit Sekundärdaten sowie Durchführung methodischer Studien zur Weiterentwicklung wissenschaftlicher Fragestellungen. Wichtige Ergebnisse sind die nationalen Versorgungskonferenzen für Psoriasis, Hautkrebs, Wunden und Neurodermitis, die regionalen Versorgungsnetze sowie Projekte und Kooperationen mit Krankenkassen, Selbstverwaltung und öffentlichen Trägern. Im Interesse der verbesserten Patientenversorgung werden wichtige Faktoren der Versorgung laufend verbessert. Zukünftige dermatologische Versorgungsforschung wird in noch effizienterer Weise zur besseren Versorgungsplanung und -lenkung beitragen. Patientenregister werden den Transfer von Innovationen in die Versorgung erleichtern und dazu beitragen, dass neue Therapieverfahren angewendet werden können. Register unterstützen auch die Optimierung der Therapieansätze, die inzwischen beispielsweise bei Psoriasis wegen der Fülle an zur Verfügung stehenden Arzneimitteln nicht mehr allein auf der Basis klinischer Studien durchgeführt werden kann. Im Zeitalter der digitalen Medizin kommt der Versorgungsforschung eine noch wichtigere Funktion zu.

https://ift.tt/2MrhRw3

„Schuppenflechte“ oder „Psoriasis“?

https://ift.tt/2p3AAV3

Biologic Therapy as a First-Line Treatment in Patients with Psoriasis: An Unstudied Population

O. Baniandrés Rodríguez
Actas Dermosifiliogr 2018;109:579

Full Text - PDF

https://ift.tt/2NErc8d

Teledermatology Implementation: The Importance of a Clear Objective

I. García-Doval
Actas Dermosifiliogr 2018;109:580

Full Text - PDF

https://ift.tt/2MqLyNQ

Role of Color Doppler Ultrasound in the Diagnosis of Idiopathic Facial Aseptic Granuloma

X. Wortsman
Actas Dermosifiliogr 2018;109:581

Full Text - PDF

https://ift.tt/2NHeEwW

Ertapenem for the treatment of Hidradenitis suppurativa: how much do we need it?

P. Mendes-Bastos, A. Martorell, S. Magina
Actas Dermosifiliogr 2018;109:582-3

Full Text - PDF

https://ift.tt/2Mn1gJO

Prevention and treatment of tuberculosis infection in candidates for biologic therapy: A multidisciplinary consensus statement adapted to the dermatology patient

P. Rodríguez-Jiménez, I. Mir-Viladrich, P. Chicharro, G. Solano-López, F.J. López-Longo, C. Taxonera, P. Sánchez-Martínez, X. Martínez-Lacasa, M. García-Gasalla, J. Dorca, M. Arias-Guillén, J.M. García-García, E. Dauden
Actas Dermosifiliogr 2018;109:584-601

Abstract - Full Text - PDF

https://ift.tt/2NAeTdl

Allergic Contact Dermatitis Due to Paraphenylenediamine: An Update

B. Encabo Durán, D. Romero-Pérez, J.F. Silvestre Salvador
Actas Dermosifiliogr 2018;109:602-9

Abstract - Full Text - PDF

https://ift.tt/2Mr4hsk

The First Year of the AEVD Primary Cutaneous Lymphoma Registry

Y. Peñate, O. Servitje, S. Machan, R. Fernández-de-Misa, M.T. Estrach, E. Acebo, J. Mitxelena, M.D. Ramón, A. Flórez, M. Blanes, M. Morillo, S. Medina, J. Bassas, A. Zayas, P. Espinosa, A. Pérez, N. Gónzalez-Romero, J.D. Domínguez, C. Muniesa, J. López Robles, A. Combalia, I. Yanguas, H. Suh, I. Polo-Rodríguez, I. Bielsa, A. Mateu, B. Ferrer, M.A. Descalzo, I. García-Doval, P.L. Ortiz-Romero
Actas Dermosifiliogr 2018;109:610-6

Abstract - Full Text - PDF

https://ift.tt/2NDY69i

Description of Patients Treated with Biologic Drugs as First-Line Systemic Therapy in the BIOBADADERM Registry Between 2008 and 2016

G. Carretero Hernández, C. Ferrándiz, R. Rivera Díaz, E. Daudén Tello, P. de la Cueva-Dobao, F.J. Gómez-García, E. Herrera-Ceballos, I. Belinchón Romero, J.L. López-Estebaranz, M. Alsina Gibert, J.L. Sánchez-Carazo, M. Ferrán Farrés, A. González Quesada, J.M. Carrascosa Carrillo, M. Llamas-Velasco, M.V. Mendiola Fernández, D. Ruiz Genao, C. Muñoz Santos, I. García-Doval, M.A. Descalzo
Actas Dermosifiliogr 2018;109:617-23

Abstract - Full Text - PDF

https://ift.tt/2Mn0EE0

Practice Models in Teledermatology in Spain: Longitudinal Study, 2009-2014

G. Romero, D. de Argila, L. Ferrandiz, M.P. Sánchez, S. Vañó, R. Taberner, P. Pasquali, C. de la Torre, F. Alfageme, J. Malvehy, D. Moreno-Ramírez
Actas Dermosifiliogr 2018;109:624-30

Abstract - Full Text - PDF

https://ift.tt/2NCv6yK

Management of Moderate to Severe Psoriasis in Routine Clinical Practice in Spanish Hospitals

J.L. López-Estebaranz, P. de la Cueva-Dobao, C. de la Torre Fraga, M. Galán Gutiérrez, E. González Guerra, J. Mollet Sánchez, I. Belinchón Romero
Actas Dermosifiliogr 2018;109:631-42

Abstract - Full Text - PDF

https://ift.tt/2Mwno4E

Idiopathic Facial Aseptic Granuloma: Clinical and Ultrasound Findings in 3 Cases

A.I. Rodríguez-Bandera, M. Feito-Rodríguez, R. Maseda-Pedrero, R. de Lucas-Laguna
Actas Dermosifiliogr 2018;109:e1-5

Abstract - Full Text - PDF

https://ift.tt/2NHRJS8

Pityriasis Lichenoides et Varioliformis Acuta Associated With Human Herpesvirus 7

M. Costa-Silva, A. Calistru, J. Sobrinho-Simões, C. Lisboa, F. Azevedo
Actas Dermosifiliogr 2018;109:e6-e10

Abstract - Full Text - PDF

https://ift.tt/2MtedBQ

Ulcerated Penile Lesion

E.R. Martínez Lorenzo, B. Moreno Torres, A.I. Sánchez Moya
Actas Dermosifiliogr 2018;109:643-4

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https://ift.tt/2NDdouL

Máculas evanescentes en tronco y extremidades

M.Á. Flores-Terry, M. Franco-Muñóz, J.A. Garrido-Martín, N. Villasanti-Rivas
Actas Dermosifiliogr 2018;109:645-6

Full Text - PDF

https://ift.tt/2Mr9FvN

Tumor Collision Over Sebaceous Nevus: Clues for Dermoscopic Diagnosis

A. Lobato-Berezo, P. Aguilera-Peiró, R.M. Pujol
Actas Dermosifiliogr 2018;109:647-8

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https://ift.tt/2NJjCcu

Quality of Life in Nonmelanoma Skin Cancer

P. García-Montero, M.V. de Gálvez-Aranda, M. de Troya Martín
Actas Dermosifiliogr 2018;109:649-50

Full Text - PDF

https://ift.tt/2Mr9z7p

Rare Tongue Compromising of Mucocutaneous Leishmaniasis by Leishmania Subgenus Viannia

R. Bueno-Filho, S. Vernal, C.M. Gomes, A.M. Roselino
Actas Dermosifiliogr 2018;109:651

Full Text - PDF

https://ift.tt/2NGNaHY

Cervical Cellulitis of Odontogenic Origin

P. García-Montero, G. González-Pérez, N. Blázquez-Sánchez
Actas Dermosifiliogr 2018;109:652

Full Text - PDF

https://ift.tt/2MqhuBO

Agminated Dermal Melanocytosis in the Territory of Ota's Nevus

L. Diluvio, M. Mazzeo, L. Bianchi, E. Campione
Actas Dermosifiliogr 2018;109:653-5

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https://ift.tt/2NGhtOR

Enfermedad de Rosai-Dorfman cutánea: una nueva presentación clínica

J.M. Conde, A.Y. Kim, R. de Miguel, C.H. Nousari
Actas Dermosifiliogr 2018;109:655-7

Full Text - PDF

https://ift.tt/2MpNIxf

Ultrasound Guidance for Implantation of Hypoglossal Nerve Stimulator in a Breast Implant Patient

The Laryngoscope, EarlyView.


https://ift.tt/2NFiLtl

Transoral robotic surgery versus upper airway stimulation in select obstructive sleep apnea patients

The Laryngoscope, EarlyView.


https://ift.tt/2MomPJP

Endoscopic resection of a chorda tympani schwannoma: A novel approach for an exceedingly rare entity

The Laryngoscope, EarlyView.


https://ift.tt/2NLcvk9

Narrow Band Imaging Endoscopy of the Nasopharynx for Malignancy: An Inter‐ and Intraobserver Study

The Laryngoscope, EarlyView.


https://ift.tt/2Ms5506

Facial Palsy‐Specific Quality of Life in 920 Patients: Correlation With Clinician‐Graded Severity and Predicting Factors

The Laryngoscope, EarlyView.


https://ift.tt/2NGg7Uh

Longitudinal Pure‐Tone Threshold Changes in the Same Subjects: Analysis of Factors Affecting Hearing

The Laryngoscope, EarlyView.


https://ift.tt/2Msr8Ur

Laser Soldering of Cartilage Graft Interposed Into a Tracheal Incision in a Porcine Model

The Laryngoscope, EarlyView.


https://ift.tt/2NDM3Zn

Radiation and Second Primary Thyroid Cancer Following Index Head and Neck Cancer

The Laryngoscope, EarlyView.


https://ift.tt/2MtUpOC

The Otolaryngology Match: A Bibliometric Analysis of 222 First‐Year Residents

The Laryngoscope, EarlyView.


https://ift.tt/2NH86yr

Does Medical Therapy Improve SinoNasal Outcomes Test–22 Domain Scores? An Analysis of Clinically Important Differences

The Laryngoscope, EarlyView.


https://ift.tt/2Msr6vN

Anatomical Course of the Thyroarytenoid Branch of the Recurrent Laryngeal Nerve

The Laryngoscope, EarlyView.


https://ift.tt/2NCbFGc

What Is the Utility of Fine‐Needle Aspiration in Parotid Gland Neoplasms?

The Laryngoscope, EarlyView.


https://ift.tt/2MwlNvG

Development of a survival animal model for subglottic stenosis

The Laryngoscope, EarlyView.


https://ift.tt/2NKHY60

Endoscopic Resection Followed by Proton Therapy With Pencil Beam Scanning for Skull Base Tumors

The Laryngoscope, EarlyView.


https://ift.tt/2MqeLZ6

Comparing Upper Airway Stimulation to Transoral Robotic Base of Tongue Resection for Treatment of Obstructive Sleep Apnea

The Laryngoscope, EarlyView.


https://ift.tt/2NKHXyY

Granulomas of the membranous vocal fold after intubation and other airway instrumentation

The Laryngoscope, EarlyView.


https://ift.tt/2MqeNjG

Does Delaying Endoscopic Sinus Surgery Adversely Impact Quality‐of‐Life Outcomes?

The Laryngoscope, EarlyView.


https://ift.tt/2NCRLL8

Histone Variants as Stem Cell Biomarkers for Long‐Term Injection Medialization Laryngoplasty

The Laryngoscope, EarlyView.


https://ift.tt/2MqeN3a

Sudden hearing loss after cialis (tadalafil) use: A unique case of cochlear hydrops

The Laryngoscope, EarlyView.


https://ift.tt/2NCRCay

Endoscopic Posterior Cricoid Split With Graft in an Adult With Posterior Cricoid Fracture

The Laryngoscope, EarlyView.


https://ift.tt/2MtUlym

Nichtkleinzelliges Lungenkarzinom – Pathologie und Biologie

Zusammenfassung

Hintergrund

Nichtkleinzellige Lungenkarzinome (NSCLC) machen ca. 75 % der malignen epithelialen Lungentumoren aus. In den vergangenen Jahren konnten profunde Erkenntnisse über molekulare Mechanismen der Krebsentstehung der Lunge gewonnen werden und in der Folge zielgerichtete Substanzen („targeted drugs") und immuntherapeutisch wirksame Medikamente entwickelt werden. Diese Fortschritte haben den Ablauf der pathologischen Diagnostik maßgeblich beeinflusst.

Ziel

Der vorliegende Artikel soll einen Überblick über die häufigsten histologischen Subtypen der NSCLC, ihre morphologischen, immunhistochemischen und molekularpathologischen Charakteristika geben.

Material und Methoden

Eine selektive Literaturrecherche der Datenbank Pubmed wurde durchgeführt.

Ergebnisse und Diskussion

Adenokarzinome, Plattenepithelkarzinome und großzellige Karzinome sind die häufigsten histologischen Subtypen. Durch die in der pathologischen Routine verfügbaren Zusatzuntersuchungen lassen sich in der Regel auch gering differenzierte Tumoren gut zuordnen. NSCLC zeigen eine Reihe genetischer Veränderungen, therapeutisch nutzbar sind Alterationen von EGFR, MET, ALK1 und ROS1.

https://ift.tt/2p1qbt4

Micro-edaphic factors affect intra-specific variations in trace element profiles of Noccaea praecox on ultramafic soils

Abstract

The aim of this study was to compare trace element profiles of Noccaea praecox (Wulfen) F. K. Mey. growing on ultramafic soils in different habitat types and to observe differences in uptake and translocation of trace elements. Physico-chemical characteristics of the soil and concentrations of P₂O₅, K₂O, Ca, Fe, Mn, Zn, Cu, Ni, Cr, Pb, Cd, and Co in plant samples were presented. Biological concentration, accumulation, and translocation factors were calculated to estimate accumulation potential of different N. praecox accessions. All of the studied accessions were Ni hyperaccumulators (with shoot concentrations up to 14,593 mg kg⁻¹), but with notable differences in accumulation and translocation rates. Significant differences in accumulation and translocation patterns of trace elements were observed among accessions from habitats characterized as serpentine steppes on dry, shallow soils in contrast to the accessions from habitats with higher soil moisture, and higher content of organic matter.

https://ift.tt/2xeh8Zq

Levels, distribution, and sources of organophosphate flame retardants and plasticizers in urban soils of Shenyang, China

Abstract

Seventy-four soil samples from the road greenbelts, residential areas, drylands, waste grasslands, education lands, industrial areas, city parks, and rural homesteads of Shenyang city, China, were collected and analyzed for 13 organophosphate esters (OPEs). OPEs were detected in all analyzed soil samples, which indicate that OPEs are ubiquitously environmental contaminants. The ∑₁₃OPEs concentrations ranged from 0.039 to 0.95 mg/kg dry weight (dw), with the mean and median concentrations of 0.23 and 0.16 mg/kg dw, respectively. The pollution levels of OPEs in different land use types were different; the concentrations of OPEs in dryland soils were maximum and in city park soils were minimum. Of 13 OPEs, tri-iso-butyl phosphate (TiBP), tris-(1-chloro-2-propyl) phosphate (TCPP), tri-butoxyethyl phosphate (TBEP), and tris[2-chloro-1-(chloromethyl) ethyl] phosphate (TDCP) were the most abundant OPEs, contributing 42.0 ± 12.8, 12.4 ± 2.32, 6.31 ± 1.88, and 5.76 ± 1.86% of ∑₁₃OPEs, respectively. Principal component analysis (PCA) and absolute principal component score-multiple linear regression (APCS-MLR) suggested that OPE pollution in soils may be derived from atmospheric deposition, road runoff and vehicular traffic emission, and wastewater/reclaimed water irrigation and sludge application, their contributions were accounting for 62.4, 17.6, and 20.0%, respectively. As compared to the results from other studies, the pollution of OPEs in the urban soils of Shenyang is relatively serious.

https://ift.tt/2x9y18m

Response to “Letter to the editor re: Cheng YH, Chou WC, Yang YF, et al. Environ Sci Pollut Res (2018). https://doi.org/10.107/s11356-017-0875-4”

https://ift.tt/2x6QbqC

Langerhans cells express human β‐defensin 3: relevance for immunity during skin ageing

British Journal of Dermatology, EarlyView.


https://ift.tt/2x5rQCo

Variation in daily ultraviolet light exposure and sun protection behaviours of melanoma survivors: an observational single‐arm pilot study with a wearable sensor

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2CQeKhz

GM‐CSF as a therapeutic target in psoriasis: randomised, controlled investigation using namilumab – a specific, human anti‐GM‐CSF monoclonal antibody

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2x5Bogu

Efficacy of a thermally treated single file compared with rotary systems in endodontic retreatment of curved canals: a micro-CT study

Abstract

Objectives

This study aimed to compare WaveOne Gold with ProTaper and RaCe systems regarding remaining filling material, apical transportation (AT), and working time (WT) after (i) filling removal and (ii) shaping of curved canals.

Methods

Thirty mesiobuccal canals of maxillary molars were prepared and filled. After 30 days, they were randomly assigned into three groups (n = 10), according to the instruments used for filling removal and shaping, respectively: WOG—WaveOne Gold Primary and Medium; PTG—ProTaper Retreatment and ProTaper Next; RCG—D-RaCe and RaCe. Micro-CT analysis assessed the residual filling material and AT. WT was recorded. Data were statistically analyzed (α = .05).

Results

There was no significant difference between groups in the amount of filling material at any evaluated moment (P > .05). All groups presented low AT values. The WT was similar in all groups in filling removal (P > .05), and in shaping step WOG was faster than PTG and RCG (P < .05).

Conclusions

Neither system could completely remove the filling material. The instruments evaluated were safe and the reciprocating system was faster than the rotary systems in shaping the canals.

Clinical relevance

This study provided consistent information on filling material removal capacity of WaveOne Gold. Considering that all tested systems were safe, WaveOne Gold may be an alternative with cost-effectiveness and shorter learning curve for endodontic retreatment.

https://ift.tt/2CPZrFz

Langerhans cells express human β‐defensin 3: relevance for immunity during skin ageing

British Journal of Dermatology, EarlyView.


https://ift.tt/2x5rQCo

Variation in daily ultraviolet light exposure and sun protection behaviours of melanoma survivors: an observational single‐arm pilot study with a wearable sensor

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2CQeKhz

GM‐CSF as a therapeutic target in psoriasis: randomised, controlled investigation using namilumab – a specific, human anti‐GM‐CSF monoclonal antibody

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2x5Bogu

Impact of Helicobacter pylori and/or Helicobacter pylori‐related metabolic syndrome on gastroesophageal reflux disease‐ Barrett's esophagus‐ esophageal adenocarcinoma sequence

Helicobacter, EarlyView.


https://ift.tt/2xc9sXN

Impact of Helicobacter pylori and/or Helicobacter pylori‐related metabolic syndrome on gastroesophageal reflux disease‐ Barrett's esophagus‐ esophageal adenocarcinoma sequence

Helicobacter, EarlyView.


https://ift.tt/2xc9sXN