Head and Neck Diseases by Alexandros G.Sfakianakis: 02/02/19

Σάββατο 2 Φεβρουαρίου 2019

Asthma and Allergy Mobile Apps in 2018

Abstract

Purpose of Review

This paper offers a comprehensive review of interactive mobile allergy and asthma smartphone applications available within the USA in 2018, with an emphasis on interactive asthma apps.

Recent Findings

Primary care and specialty clinicians interested in introducing digital health apps into their practices will soon have more choices, for Apple® and major electronic medical record software companies are investing heavily in the mobile medical marketplace, guaranteeing personal health information and access to care will always be immediately available in one's digital hand.

Summary

Interactive mobile asthma applications are valuable assets for patients and caregivers alike, for they offer immediate communications between patients and those responsible for providing for their needs.

http://bit.ly/2GmD8r8

Primary Prevention of Food Allergy

Abstract

Purpose of Review

The goal of this review is to present an updated summary of the various approaches to prevent childhood food allergies and report recent advances in potential prevention trials for food allergy.

Recent Findings

Several approaches related to maternal dietary supplementation as well as infant GI-based supplementation have been tried and are the subject of ongoing clinical investigation.

Summary

The prevalence of food allergy appears to be increasing but several, varied approaches to prevention are being actively pursued such that an effective strategy may not be too far in the future.

http://bit.ly/2Ts4Jv0

Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

Abstract

Purpose of Review

The advent of endoscopic sinus surgery (ESS) has enabled the development of minimally invasive surgical procedures in Rhinology. However, proficiency with ESS techniques can still be hampered by poorly controlled bleeding limiting visibility of the surgical field (VSF). This can lead to increased operating time and, more importantly, increased risk of major and minor complications. To optimize the VSF and mitigate the risk of complications, many strategies have been explored.

Recent Findings

This is a narrative review of the relative risks and benefits of pre- and intra-operative interventions aimed at optimizing intraoperative conditions during ESS. The value of these interventions is determined based on their impact on intraoperative blood loss, time of surgery, and the VSF, and weighed against their adverse event profile.

Summary

This review provides a comprehensive overview of the evidence relating to the safety and efficacy of interventions used to improve intraoperative conditions during ESS.

http://bit.ly/2BipHFx

Alports syndrome and intracranial aneurysm: mere coincidence or undiscovered causal relationship

Subhasish Bose Jan 29, 2019; 12:e228175-e228175 

http://bit.ly/2WzvEXE

Spontaneous spinal subdural haematoma in a patient on apixaban

Ahmad Mchaourab Jan 22, 2019; 12:e227311-e227311 

http://bit.ly/2WzvFuG

Hypocalcaemia and hyponatraemia masquerading the diagnosis of Gitelman syndrome

Bhargav Gopinath Jan 28, 2019; 12:bcr-2018-227886-bcr-2018-227886 

http://bit.ly/2RAlimC

Rare case of bladder chondroma causing lower urinary tract symptoms

Simeon Ngweso Jan 18, 2019; 12:bcr-2018-227006-bcr-2018-227006 

http://bit.ly/2RzMxhd

Misdiagnosis: Acute Chest Syndrome That Evolved into Acute Respiratory Distress Syndrome in a Patient without a Documented History of Hemoglobinopathy

Acute chest syndrome (ACS) is a feared complication of sickle cell disease. Here is a case of a patient who presented with symptoms suggestive of acute chest syndrome yet had a delayed diagnosis presumably due to the lack of documented history of sickle cell disease of the patient, consequently evolving into acute respiratory distress syndrome (ARDS). He was subsequently diagnosed with heterozygous sickle cell SC disease on hemoglobin electrophoresis. After appropriate management with mechanical ventilator, broad-spectrum empiric intravenous antibiotics, exchange transfusion, and intravenous fluid resuscitation, the patient was medically optimized and safely discharged home, with significant improvement noted on successive follow-up visits.

http://bit.ly/2GhAPpq

Congenital adrenal hyperplasia with salt-wasting crisis and arrhythmia: a case study

Johnny Figueroa Canlas Jan 29, 2019; 12:e227565-e227565 

http://bit.ly/2Ry5m4s

Persistent sciatic artery resembles a soft-tissue sarcoma in presentation

Hana Kamal Almadani Jan 29, 2019; 12:e227250-e227250 

http://bit.ly/2G7ImHZ

Disseminated intestinal basidiobolomycosis with mycotic aneurysm mimicking obstructing colon cancer

Arwa Omar Takrouni Jan 29, 2019; 12:e225054-e225054 

http://bit.ly/2Rx6qFv

Diabetes cataract in a 10-year-old girl with new-onset type 1 diabetes mellitus

Jose Bernardo Quintos Jan 29, 2019; 12:e227437-e227437 

http://bit.ly/2WDfgp9

Peroneal artery entrapment syndrome (PRAES): a rare cause of ischaemic toes

Alfred Bingchao Tan Jan 28, 2019; 12:bcr-2018-227353-bcr-2018-227353 

http://bit.ly/2WxBSaB

Real-time MRI guidance for intra-arterial drug delivery in a patient with a brain tumor: technical note

Michal Zawadzki Jan 27, 2019; 12:bcr-2018-014469-bcr-2018-014469 

http://bit.ly/2RAGc5g

Pancoast tumour presenting as shoulder pain with Horners syndrome

Nimlan Shanmugathas Jan 24, 2019; 12:bcr-2018-227873-bcr-2018-227873 

http://bit.ly/2WEVl95

Correction: Exclusively plant, whole-food diet for polypharmacy due to persistent atrial fibrillation, ischaemic cardiomyopathy, hyperlipidaemia and hypertension in an octogenarian

Jan 22, 2019; 12:e227059corr1-e227059corr1 

http://bit.ly/2RxHoGo

Rare cutaneous myiasis of the face due to Lunds fly (Cordylobia rodhaini) in a British traveller returning from Uganda

Nicola Wade Jan 22, 2019; 12:e228070-e228070 

http://bit.ly/2RxfYAp

Inguinal hernia containing a native orthotopic kidney

Douglas J Cassidy Jan 18, 2019; 12:bcr-2018-227645-bcr-2018-227645 

http://bit.ly/2WvPcvY

Spontaneous anterior dislocation of lens in a case of ectopia lentis et pupillae: a rare entity treated by a novel technique of microscope integrated optical coherence tomography (MIOCT) guided intralenticular lens aspiration

Pranita Sahay Jan 18, 2019; 12:bcr-2018-227047-bcr-2018-227047 

http://bit.ly/2RAx0NZ

Focal myositis and contracture secondary to amiodarone extravasation from a peripheral cannula

David Ledingham Jan 18, 2019; 12:bcr-2018-227725-bcr-2018-227725 

http://bit.ly/2WDijxq

Urothelial carcinoma with villoglandular differentiation (UCVGD) with small cell neuroendocrine carcinoma of urinary bladder

Shilpy Jha Jan 18, 2019; 12:bcr-2018-228017-bcr-2018-228017 

http://bit.ly/2RC7WWU

Hypokalaemic metabolic alkalosis, hypertension and diabetes: what is the link

Marius Vögelin
Jan 18, 2019; 12:bcr-2018-227068-bcr-2018-227068

http://bit.ly/2WDeb0r

Monocytopenia in clozapine-induced agranulocytosis: insights into pathophysiology and treatment

Rajvi Patel Jan 18, 2019; 12:bcr-2018-226016-bcr-2018-226016 

http://bit.ly/2WDalED

Prognostic Value of Adjuvant Chemotherapy Following Pancreaticoduodenectomy in Elderly Patients With Pancreatic Cancer

Background/Aim: The aim of this study was to investigate the relationship between age and long-term survival among patients who underwent pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). Patients and Methods: A total of 916 patients who underwent PD for curative resection of PDAC were included in this study. Patients were divided into younger (n=726, <70 years) and older (n=190, ≥70 years), and the overall survival (OS) between the two groups was compared. Results: Median OS was significantly longer in the younger group (p<0.001). However, the survival advantage among younger patients was not significant when analyzing only patients who received adjuvant chemotherapy (p=0.548). Among patients who did not receive adjuvant chemotherapy, OS was significantly longer in the younger group (p=0.003). Among patients who received neither adjuvant chemotherapy nor treatment for recurrence, survival was not significantly different between the groups (p=0.629). Conclusion: Adjuvant chemotherapy should be recommended, and additional treatment for recurrence is effective even among elderly who have not received adjuvant chemotherapy.

http://bit.ly/2MMl0bz

Radiation Therapy for Extrapelvic Lymph Node Recurrence After Curative Treatment for Cervical Cancer

Background/Aim: To investigate outcomes of patients with cervical cancer who received radiation therapy for extrapelvic lymph node recurrence after initial pelvic radiotherapy. Patients and Methods: The treatment charts of 20 patients were retrospectively reviewed, and factors influencing patient's prognosis were statistically analyzed. Results: The three-year in-field tumor control rate was 55% and overall survival (OS) at 2, 3, and 5 years was 55%, 45%, and 37.5%, respectively. The rate of the three-year OS in patients with recurrence within and after 9 months was 20% and 70%, respectively (p=0.016). None of the 4 patients who were diagnosed with supraclavicular lymph node recurrence alone at more than 9 months after initial treatment experienced further recurrence. Five-year survival of the remaining 16 patients was only 21% (p=0.021). Conclusion: Time to recurrence significantly influenced survival in patients with cervical cancer who received radiotherapy for extra-pelvic lymph node recurrence. Supraclavicular lymph node recurrence alone had a favorable impact on patient's prognosis.

http://bit.ly/2DPS0wB

The Role of KRAS in Endometrial Cancer: A Mini-Review

Endometrial cancer (EC) is the most common cancer of the female genital tract, resulting annually in 76,000 related deaths worldwide. EC originates either from oestrogen-related proliferative endometrium (type I, endometrioid), or from atrophic endometrium (type II, non-endometrioid). Each type of EC is characterized by different molecular profile alterations. The Kirsten rat sarcoma viral oncogene homolog (KRAS) gene encodes a signalling protein which moderates response to various extracellular signals via down-regulation of the mitogen-activated protein kinase (MAPK) or phosphoinositide-3-kinase/v-akt murine thymoma viral oncogene (PI3K/AKT) pathways. This article reviews the role of KRAS in predicting transition from hyperplastic endometrium to early-stage well-differentiated EC, as well as further invasive proliferation of the tumour to advanced-stage disease. KRAS seems to be directly associated with type I EC, and most studies support its early involvement in carcinogenesis. Current evidence correlates KRAS mutations with increased cell proliferation and apoptosis, as well as up-regulation of endometrial cell oestrogen receptors. Tumours positive for KRAS mutation can harbour hypermethylation-related changes in genome expression, and this can be the cause of concurrent loss of DNA repair proteins. Despite some evidence that KRAS mutation status affects cancer progression, a consensus is yet to be reached. Based on the available evidence, we suggest that screening for KRAS mutations in patients with hyperplastic endometrium or early-stage type I EC, may provide important information for prognosis stratification, and further provision of personalised treatment options.

http://bit.ly/2MNXR8u

Crypts With Corrupted Shapes in Non-polypoid Adenomas

Background: Colonic crypts with normal epithelial lining exhibiting corrupted shapes (NECS) have been previously found beneath the adenomatous tissue of polypoid conventional adenomas, in both rats and humans. Aim: To assess the frequency of NECS in non-polypoid colonic flat adenomas (FAs) and lateral-spreading adenomas (LSAs). Materials and Methods: Histological hematoxylin and eosin-stained sections from 51 non-polypoid colonic adenomas were scrutinized over a 10-mm field of vision (FOV). FAs were regarded lesions encompassed within the FOV and LSAs as those surpassing that limit. The NECS/mm ratio was calculated in individual lesions as the number of NECS beneath the adenomatous tissue, divided by the length (mm) of the FA and LSA. Results: Out of the 51 non-polypoid adenomas, 27 were FAs and the remaining 24 LSAs. All 51 non-polypoid lesions were tubular adenomas. The mean number of NECS in FAs was 6.29 (range=2-10) and in LSAs was 15.29 (range=7-41) (p<0.05). On the other hand, the mean NECS/mm ratio in FAs was 0.94 (range=0.50-2.00) and in LSAs was 0.92 (range=0.40-2.93). Thus, no essential differences in the number of NECS/mm was found between FA and LSA. Conclusion: The accretion of NECS below the neoplastic canopy of FA and LSA contrasts with the rare occurrence of NECS in normal colonic mucosa. This finding emerges as a previously unaddressed major event, an event that might play an important role in the histogenesis of non-polypoid adenomas of the colon.

http://bit.ly/2DRyrnU

Integrin as a Molecular Target for Anti-cancer Approaches in Lung Cancer

Integrins are cell-matrix adhesion molecules providing both mechanical engagement of cell to extracellular matrix, and generation of cellular signals that are implicated in cancer malignancies. The concept that integrins play important roles in cell survival, proliferation, motility, differentiation, and ensuring appropriate cell localization, leads to the hypothesis that inhibition of certain integrins would benefit cancer therapy. In lung cancer, integrins αv, α5, β1, β3, and β5 have been shown to augment survival and metastatic potential of cancer cells. This review presents data suggesting integrins as molecular targets for anti-cancer approaches, and the mechanisms through which integrins confer resistance of lung cancer to chemotherapeutics and metastasis. The better understanding of these key molecules may benefit the discovery of anti-cancer drugs and strategies.

http://bit.ly/2MJuMuW

County Median Family Income Is an Independent Prognostic Factor for Stage IV Anaplastic Thyroid Cancer

Background/Aim: Advanced anaplastic thyroid cancer (ATC) is a rare, but highly aggressive malignancy, and its prognostic factors need to be further explored. We examined socioeconomic factors' predictive effect for survival performance in stage IV ATC patients. Materials and Methods: Using the Surveillance, Epidemiology, and End Results database, we collected 1,048 cases with stage IV anaplastic thyroid cancer (ATC) from 2004 to 2015. Demographic, clinical, and socioeconomic factors were evaluated using univariate and multivariate analyses. Results: Median family income showed a significant effect on overall survival (OS) and cancer-specific survival (CSS) in univariate analysis. Median family income level was found to be an independent prognostic factor for OS after multivariate adjustment Multivariate analysis for CSS showed similar results. Conclusion: Family income level is an independent prognostic factor for stage IV ATC.

http://bit.ly/2DP76Tl

A Potent CD1d-binding Glycolipid for iNKT-Cell-based Therapy Against Human Breast Cancer

Background/Aim: Invariant natural killer T-cells (iNKT) stimulated by CD1d-binding glycolipids have been shown to exert antitumor effects by a number of studies in a mouse model. Breast cancer is a devastating disease, with different types of breast cancer recurring locally or distant as metastatic/advanced disease following initial treatment. The aim of this study was to examine the tumoricidal effect of a CD1d-binding glycolipid, called 7DW8-5, against a highly invasive human breast cancer cell line both in vitro and in vivo. Materials and Methods: Parental MDA-MB-231 cells and MDA-MB-231 cells transduced with human CD1d were labeled with carboxyfluorescein diacetate succinimidyl ester (CFSE), followed by loading with glycolipids. After co-culturing with human iNKT cells, the cells were permeabilized and stained with Alexa Flour 647-conjugated antibody to active caspase-3, and analyzed using a BD LSR II. For the in vivo tumoricidal effect, MDA-MB-231 cells transduced with human CD1d and luciferase genes were injected into the mammary fat pad of female NOD/SCID/IL2rnull (NSG) mice, followed by the injection of human iNKT cells with or without 7DW8-5, and the levels of luminescence were analyzed with whole-body imaging. Results: Human iNKT cells could kill CD1d-expressing human breast cancer cells in vitro in the presence of 7DW8-5, but not α-GalCer. As for in vivo, the adoptive transfer of human iNKT cells into tumor-challenged NSG mice significantly inhibited the growth of CD1d+ MDA-MB-231 human breast cancer cells in the presence of 7DW8-5. Conclusion: CD1d-binding, glycolipid-based iNKT-cell therapy is suggested as a potent and effective treatment against breast cancer in humans.

http://bit.ly/2ML4NDy

Clinical Outcomes of 42 Renal Cell Carcinoma Patients With Metastases Solely to the Lung Who Received Sorafenib as Second-line Systemic Therapy

Background/Aim: In renal cell carcinoma (RCC), sorafenib was the first targeted agent demonstrating a definitive benefit in a large phase III clinical trial. The objective of this study was to assess the clinical outcomes of 42 consecutive RCC patients with metastases solely to the lung who received sorafenib as a second-line systemic agent. Patients and Methods: Of the 42 patients, 14 (33.3%) and 28 (66.7%) received cytokine therapy and sunitinib, respectively, prior to treatment with sorafenib. In this series, all patients initially received 400 mg of sorafenib twice daily on a continuous dosing schedule. The efficacy and safety of second-line sorafenib in these 42 patients were retrospectively evaluated. Results: As the best response to sorafenib, 2 (4.8%), 14 (33.3%), 22 (52.4%) and 4 (9.5%) patients were judged to show a complete response, partial response, stable disease and progressive disease, respectively. The median progression-free survival (PFS) and overall survival (OS) after the introduction of sorafenib was 10.6 and 30.2 months, respectively. Multivariate analyses of several parameters identified the following independent prognostic predictors: C-reactive protein (CRP) level for PFS, and International Renal Cell Carcinoma Database Consortium classification and CRP level for OS. The common adverse events associated with sorafenib were hand-foot syndrome, hypertension and diarrhea, which developed in 22 (52.4%), 17 (40.5%) and 13 (31.0%), respectively; however, any AEs corresponding to ≥grade 3 occurred in only 16 (38.1%). Conclusion: Favorable disease control with acceptable tolerability might be expected by introducing sorafenib as second-line therapy for RCC patients with metastases solely to the lung; therefore, sorafenib could be the optimal option for this category of patients.

http://bit.ly/2DSe0Hv

High miR-3687 Expression Affects Migratory and Invasive Ability of Oesophageal Carcinoma

Background/Aim: Basaloid squamous cell carcinoma of the oesophagus (BSCCE) is a variant of oesophageal squamous cell carcinoma (ESCC), that has a more aggressive biological behaviour than that of typical ESCC. miR-3687 has been previously identified to be highly expressed in BSCCE. This study aimed to evaluate the prognostic impact of miR-3687 in ESCC and determine the role of miR-3687 in ESCC motility. Materials and Methods: miR-3687 expression in human ESCC cell lines and in primary tumour samples obtained from patients with ESCC who underwent esophagectomy were analyzed via real-time polymerase chain reaction (PCR). Knockdown and over-expression experiments were conducted with miR-3687 siRNA and miRNA mimic, and the effect on cell proliferation, migration, and invasion was analyzed. Results: A total of 92 samples were analyzed. High miR-3687 expression was correlated with poor prognosis. miR-3687 upregulation promoted cell migration and invasion. Conclusion: miR-3687 expression negatively impacts the prognosis of patients with ESCC.

http://bit.ly/2MKIZYB

Age Adjusted Charlson Comorbidity Index Strongly Influences Survival, Irrespective of Performance Status and Age, in Patients With Advanced Prostatic Cancer Treated With Enzalutamide

Background/Aim: Enzalutamide is prescribed for advanced prostatic cancer patients, regardless of physical comorbidity. We hypothesized that comorbidity negatively affects survival regardless of age, performance status and prostate-specific antigen (PSA) response. Patients and Methods: All patients (n=106) treated at the ADRZ Medical Center with enzalutamide in the period 2015-2018 and who had undergone at least one PSA response evaluation were included in a multivariate analysis to test which variables independently affected Time to PSA progression (TPSAP) and/or overall survival (OS). Results: A poorer performance status appeared to relate to a two times increased risk of dying (HR=2.032, 95%CI=1.078-3.830). An older age did not appear to influence OS, whereas an ACCI of more than 9 points appeared to relate to a more than three times increased risk of dying (HR=3.538, 95%CI=1.466-8.538). Conclusion: Survival appeared to be strongly affected by comorbidity, irrespective of age and performance status in patients treated with enzalutamide.

http://bit.ly/2DQfCBq

Association of CD31 and p53 With Survival of Ovarian Cancer Patients

Background/Aim: New markers for ovarian cancer are needed. This study aimed to examine the expression of tumour cell p53 and endothelial cell CD31 proteins and correlate them to clinicopathological factors. Patients and Methods: Expression of proteins was immunohistochemically assessed using tissue sections from 585-599 ovarian cancer patients from the Danish MALOVA study. Results: High CD31 expression was found in poorly differentiated tumours (p=0.0006), and high p53 expression was found in poorly differentiated cancers (p<0.0001), high clinical stage (p<0.0001), non-radical surgery (p<0.0001) and high serum CA-125 values (p<0.0001). CD31 expression showed no prognostic survival value, but high hazard ratios were found for patients with high p53 expression (HR=2.313, p<0.0001). An interaction was found between p53 and stage of cancer, suggesting a prognostic impact of p53 in low-stage, but not in advanced-stage cancer. Conclusion: More than 5% of p53 tissue expression may predict shorter survival of ovarian cancer patients and may be useful for predicting the risk of disease progression in low-stage patients following primary surgery. CD31 has no strong prognostic value.

http://bit.ly/2MQD84c

Diagnostic Utility of Third-Look, Contrast-Enhanced Sonography Followed by Needle Biopsy for MRI, But Not Ultrasonography Breast Lesions

Background/Aim: To clarify the diagnostic utility of third-look, contrast-enhanced ultrasonography (CEUS) for MRI-detected breast lesions undetectable by unenhanced, second-look ultrasonography (MRI+/US– lesions). Patients and Methods: Clinical stage 0–IIA breast cancer patients who underwent CEUS for incidental MRI+/US– lesions (n=27; cohort 1) and patients with breast lesions detected only by MRI, to be examined by CEUS (n=15; cohort 2), were retrospectively analyzed. Results: Of the 42 MRI+/US– lesions, 23 (55%) were detected by CEUS and then examined by needle biopsy. Pathological examination showed that 10 of these 23 lesions were malignant. None of the 19 lesions undetected by CEUS were found to be histologically malignant or developed malignancy with a median follow-up of 18.5 months. The accuracy, sensitivity, and specificity of CEUS plus needle biopsy were 98%, 91%, and 100%, respectively. Conclusion: Third-look CEUS followed by needle biopsy is useful in the initial diagnosis of MRI+/US– lesions.

http://bit.ly/2DSTSor

Oligodendrocytes Up-regulate the Invasive Activity of Glioblastoma Cells via the Angiopoietin-2 Signaling Pathway

Background/Aim: Glioblastoma (GBM) is one of the most lethal solid cancers due to its highly invasive nature. The malignant potential of GBM cells might be partially regulated by surrounding normal cells, such as oligodendrocytes or fibroblasts. The aim of this study was to examine the interaction between stromal cells and GBM cells. Materials and Methods: Two GBM cell lines were used. The effect of stromal cells, oligodendrocytes or fibroblasts, on the invasive ability of GBM cells was examined by wound-healing assay and invasion assay. Results: Oligodendrocytes, in contrast to fibroblasts, significantly increased the migration and invasive ability of GBM cells. Angiopoietin-2 levels were high in the conditioned medium obtained from oligodendrocytes. Angiopoietin-2 significantly increased the motility of GBM, and the motility-stimulating activity of the oligodendrocytes-derived conditioned medium was significantly decreased by anti-angiopoietin-2-neutralizing antibody. Conclusion: Glioma stromal cells, oligodendrocytes, might up-regulate the invasiveness of GBM cells via angiopoietin-2 signaling.

http://bit.ly/2MNUNt9

Postoperative Pneumonia After Esophagectomy and Systemic Inflammatory Response Syndrome

Background/Aim: The aim of this study was to determine the association between post-esophagectomy pneumonia and the presence of pathogenic organisms in the sputum or pharynx and postoperative systemic inflammatory response syndrome (SIRS). Materials and Methods: This retrospective study included 98 patients diagnosed with esophageal cancer who had undergone esophagectomy. Results: Postoperative pneumonia was observed in 24 patients (24.5%). Of the total 98 patients, 45 (45.9%) were tested positive for pathogenic organisms preoperatively, and 16 of those (35.6%) developed postoperative pneumonia; postoperative pneumonia occurred at a higher rate in these patients compared to pathogenic organism-negative patients (p=0.019). Postoperative SIRS was observed in 62 patients (63.3%), and 21 of these (33.9%) developed postoperative pneumonia, a significantly higher rate compared to patients without SIRS (p=0.007). Conclusion: Postoperative pneumonia was significantly associated with the presence of pathogenic organisms in the sputum or pharynx and postoperative SIRS.

http://bit.ly/2DQ3gZV

Cytoplasmic Keap1 Expression Is Associated With Poor Prognosis in Endometrial Cancer

Background/Aim: Oxidative stress is involved in several carcinogenic pathways. Nuclear factor erythroid 2-related factor (Nrf2), Kelch-like ECH-associated protein 1 (Keap1) and Park7 (DJ-1) are the main regulators of antioxidant enzymes eliminating reactive oxidative species (ROS). The roles of these proteins were studied as potential prognostic factors in endometrial cancer. Materials and Methods: Nrf2, Keap1 and DJ-1 expression in endometrial carcinomas was analyzed immunohistochemically. Correlations between staining patterns and clinical prognostic variables were evaluated. Results: Extensive cytoplasmic Keap1 staining correlated to several factors associated with poor prognosis of endometrial cancer including advanced stage, poor histological differentiation, lymphovascular invasion, pelvic lymph node metastasis and deep myometrial invasion. In multivariate analysis, cytoplasmic Keap1 was a stronger predictor of poor progression-free survival than grade. Nuclear Nrf2 staining was seen in all patients with lymph node metastasis while DJ-1 staining was associated with clinically favourable disease types. Conclusion: Cytoplasmic Keap1 expression indicates poor prognosis in endometrial cancer.

http://bit.ly/2MLdVrK

Leptomeningeal Gliomatosis: A Single Institution Study of 31 Patients

Background/Aim: Secondary leptomeningeal gliomatosis (LG) is a rare and severe progression pattern of glioma. Our objective was to evaluate the characteristics and outcome of patients with LG. Patients and Methods: We retrospectively reviewed 31 patients diagnosed with secondary LG. At the time of LG diagnosis, the median age of patients was 45 years. The histological grade was IV in 20 patients and II to III in 11 patients. As a first-line of therapy for LG, 22 patients received an oncological treatment: i) BCNU-temozolomide (TMZ) (n=15), ii) other type of chemotherapy (n=7), and iii) no treatment (supportive care) (n=9). Results: Following LG diagnosis, the median progression-free survival (PFS) and overall survival (OS) were 1.8 months [95% confidence interval (CI)=0.9-2.7] and 2.1 months (95%CI=1.3-3), respectively. The univariate analyses showed an improved OS with age of less than 45 years (p<0.001), a prolonged interval from the initial glioma diagnosis (IGD) to LG diagnosis (p=0.003), BCNU–TMZ as the preferred first-line treatment for LG out of the three options (p=0.008), and Karnofsky performance status (KPS) ≥70 (p=0.012). Prolonged interval from IGD to LG diagnosis (HR=5.839) and BCNU–TMZ as the chosen first-line treatment for LG (HR=6.635) remained significant in the multivariate analyses as well. Among the 22 treated patients, the median OS was significantly higher (p=0.008) with the BCNU–TMZ treatment (5.7 months; 95%CI=4.2-7.1), compared to other types of treatment offered (2 months; 95%CI=1.1-2.9). Conclusion: The time interval from the IGD to the LG diagnosis is a potential prognostic factor for LG. BCNU–TMZ may be a therapeutic option in the present setting.

http://bit.ly/2DQKbHi

Isothiocyanate-induced Cell Cycle Arrest in a Novel In Vitro Exposure Protocol of Human Malignant Melanoma (A375) Cells

Background/Aim: Several studies have documented the effects of isothiocyanates (ITCs) on cancer prevention by inducing oxidative stress, activating apoptosis, affecting cell-cycle regulation, etc. Previously, we have shown that ITCs, administered at low concentrations by the means of double-bolus are capable of potentiating cytotoxicity in human malignant melanoma (A375) cells by inducing apoptosis. The aim of the present study was to further investigate the effect of the treatment of A375 cells with ITCs on cell-cycle progression and the levels of various cell cycle regulators. Materials and Methods: Cell-cycle analysis was performed by means of flow cytometry whereas western immunoblotting was used to determine the expression levels of these protein regulators. Results: Our data showed an increase in the number of cells in the G₂/M phase accompanied by a decrease in the G₀/G₁ phase, while several cell-cycle regulators were shown to be differentially expressed upon exposure to ITCs. Conclusion: ITCs induced cell-cycle arrest in A375 cells.

http://bit.ly/2MK63qz

MicroRNA-based Targeted Therapeutics in Pancreatic Cancer

The discovery during the last decade of microRNAs (miRs, miRNA) and their role in regulating normal physiological processes as well as in the pathogenesis of human tumors has been a revolutionary development in molecular oncology. miRNAs activating or inhibiting oncogenic molecular pathways that are involved in tumorigenesis, cell progression, invasion, angiogenesis and metastasis are now considered of major impact in many cancer types. miRNA-based therapeutics that inhibit the levels of oncogenic miRNAs (oncomiRs) or elevate tumor suppressor miRs have enormous potential as molecular therapeutic targets. Thus, the development of new targeted cancer therapies based on miRNAs promise to revolutionize cancer treatment due to their increased efficacy compared to conventional chemoradiation-based therapies and hopefully to lower levels of adverse effects.

http://bit.ly/2DQW1ku

Basic Gene Expression Characteristics of Glioma Stem Cells and Human Glioblastoma

Background: Glioma stem cells (GSCs) play important roles in the tumorigenesis of glioblastoma multiforme (GBM). Using a novel cellular bioinformatics pipeline, we aimed to characterize the differences in gene-expression profiles among GSCs, U251 (glioma cell line), and a human GBM tissue sample. Materials and Methods: Total RNA was extracted from GSCs, U251 and GBM and microarray analysis was performed; the data were then applied to the bioinformatics pipeline consisting of a principal component analysis (PCA) with factor loadings, an intracellular pathway analysis, and an immunopathway analysis. Results: The PCA clearly distinguished the three groups. The factor loadings of the PCA suggested that v-myc avian myelocytomatosis viral oncogene neuroblastoma derived homolog (MYCN), dipeptidyl-peptidase 4 (DPP4), and macrophage migration-inhibitory factor (MIF) contribute to the stemness of GSCs. The intracellular pathway and immunopathway analyses provided relevant information about the functions of representative genes in GSCs. Conclusion: The newly-developed cellular bioinformatics pipeline was a useful method to clarify the similarities and differences among samples.

http://bit.ly/2MT8tmV

Genetic Analysis Using a Gene Panel in 87 Caucasian Patients With Colorectal Cancer: Own Results and Review of Literature

Background/Aim: Colorectal cancer (CRC) is the third most common cancer worldwide. The prognosis between left- and right-sided CRC differs, partly due to baseline differences as vascular supply. The purpose of the present study was to investigate whether there are genetic differences between left- and right-sided CRC. Patients and Methods: Eighty-seven patients with CRC (mean age: 61 years) were retrospectively included in the study. Blood samples were used for genetic analysis, by applying the sequencing research panel Ion AmpliSeq Colon and Lung Cancer Research Panel V2. Statistical analyses included Chi-square tests, Kaplan-Meier survival curves, and univariate/multivariate Cox-regression analyses. Results: By testing the sequence of 22 genes included in the panel, a significant difference was detected between left- and right-sided CRC regarding the expression of BRAF and DDR2 genes, with mutations occurring more often in the right-sided CRC. In the multivariate setting, left-sided CRC only turned out as a significant positive prognostic parameter regarding progression-free survival, irrespective of the type of chemotherapy or BRAF and NRAS mutations. Conclusion: Tumour location was the only parameter proven to be an independent prognostic factor for CRC in the present study.

http://bit.ly/2DPM8Ue

Asthma Status and Risks among Lesbian, Gay, and Bisexual Adults in the United States: A Scoping Review

Asthma is uncontrolled in up to 71% of adolescents and adults,1 resulting in higher healthcare costs, more school and work absences, and higher mortality.1,2 Sexual minority adults (SM; e.g., people who identify as lesbian, gay, or bisexual, or who have same-sex partners) have higher rates of asthma than heterosexual counterparts.3,4 However, it is unclear whether rates and risk factors differ by sexual identity. To address this critical knowledge gap, we conducted a scoping review to systematically search relevant literature following current guidelines.

http://bit.ly/2t1Xka7

Cartilage conduction as the third pathway for sound transmission

It has been long considered that air and bone are the two major mediators that conduct sounds to the inner ear. In 2004, Hosoi found that vibration of aural cartilage, generated by placing gently a transducer on it, could create audible sound with the same level of clarity as air- and bone-conduction sound. He thus proposed the term "cartilage conduction" for this concept. This research identified a third mediator for sound conduction to the inner ear. Hosoi also proposed the development of novel communication devices, such as hearing aids, telephones, etc.

http://bit.ly/2Rwm1Fu

Dendritic pattern: Unique onychoscopic feature in endonyx

http://bit.ly/2REcxrW

Factors associated with the utilization of Mohs surgery in the treatment of microcystic adnexal carcinoma

http://bit.ly/2WD3PxF

Issue Information

http://bit.ly/2D3azMl

Evidence of non-DDD pathway in the anaerobic degradation of DDT in tropical soil

Abstract

DDT transformation to DDD in soil is the most commonly reported pathway under anaerobic conditions. A few instances of DDT conversion to products other than DDD/DDE have been reported under aerobic conditions and hardly any under anaerobic conditions. In particular, few reports exist on the anaerobic degradation of DDT in African tropical soils, despite DDT contamination arising from obsolete pesticide stockpiles in the continent as well as new contamination from DDT use for mosquito and tsetse fly control. Moreover, the development of possible remediation strategies for contaminated sites demands adequate understanding of different soil processes and their effect on DDT persistence, hence necessitating the study. The aim of this work was to study the effect of simulated anaerobic conditions and slow-release carbon sources (compost) on the dissipation of DDT in two tropical clay soils (paddy soil and field soil) amenable to periodic flooding. The results showed faster DDT dissipation in the field soil but higher metabolite formation in the paddy soil. To explain this paradox, the levels of dissolved organic carbon and carbon mineralization (CH₄ and CO₂) were correlated with p,p-DDT and p,p-DDD concentrations. It was concluded that DDT underwent reductive degradation (DDD pathway) in the paddy soil and both reductive (DDD pathway) and oxidative degradation (non-DDD pathway) in the field soil.

http://bit.ly/2S75Cwo

Socioeconomic status of the population – a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print

http://bit.ly/2UDctuq

Physical growth and development characteristics of children with Williams syndrome aged 0–24 months in Zhejiang Province

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print

http://bit.ly/2S3lUX4

Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print

http://bit.ly/2UBpEvw

Recycling of crushed waste rock as backfilling material in coal mine: effects of particle size on compaction behaviours

Abstract

Crushed waste rocks can be used as materials for backfilling goafs, so as to achieve the simultaneous goals of processing solid waste and controlling surface subsidence; however, particle size distribution directly affects the compaction of crushed waste rocks. Therefore, by employing a self-designed bidirectional loading test system for granular materials, this study tested compaction characteristics of crushed waste rocks with four different particle size distributions. Moreover, this research tested the changes of parameters in lateral and axial loading of crushed waste rocks and analysed the influence of particle size distribution on lateral strain, axial strain, porosity, lateral stress, and lateral pressure coefficient during compaction. The test results show that (1) particle size distribution affects porosity, strain, and lateral pressure coefficient of crushed waste rocks under lateral and axial loading. (2) For the samples under particle size distribution ranging from 0 to 10 mm, the initial porosity is low and deformations are small under axial loading, so that particles can make contact and bear effective stress in grain-grain contact. Therefore, more stress is transferred to the lateral direction. (3) After compaction, the curves of the samples of crushed waste rocks under four particle size distributions all shift upwards in comparison with those before compaction, indicating that particles are crushed and the proportion of small particles constantly increases. (4) A reasonable particle size distribution can significantly improve stress characteristics, reduce crushing of particles in the samples, and increase the stiffness of the samples, so as to achieve better compaction effects.

http://bit.ly/2t3Ugu6

Severe deviated nose treatment: importance of preserving the dorsal septal remnant

Abstract

Purpose

To compare the surgical outcomes of modified extracorporeal septoplasty and anterior septal reconstruction for the management of the severe deviated nose.

Methods

In a prospective cohort study, we selected 86 patients referred for septorhinoplasty to a tertiary center in May 2015–April 2017 with a primary complaint of nasal obstruction and deformity. They had moderate-to-severe septal deviation and severely deviated noses, particularly in the dorsum. Forty-three patients underwent each procedure. The cohorts were age- and sex-matched, and were operated at a similar time point. Surgical outcome was assessed and compared using anthropometric measurement of photographs, acoustic rhinometry, and The Nasal Obstruction Septoplasty Effectiveness questionnaire (including a visual analog scale).

Results

In all patients, MCA1 (initial minimum cross-sectional area) and MCA2 (minimum cross-sectional area after topical decongestion of the nasal mucosa), anthropometric angles (nasolabial, nasofacial and tip projection), and The Nasal Obstruction Septoplasty Effectiveness questionnaire significantly improved after surgery in both groups (p = 0001), with no significant difference in improvement between two groups. However, anthropometric angles and minimal cross-sectional area were better in anterior septal reconstruction group.

Conclusion

Both methods are effective in patients with a severely deviated nose for correction of deviation and obstruction. Anterior septal reconstruction is the preferable method in patients with more deviation.

http://bit.ly/2Gl913t

Sulfur dioxide induces apoptosis via reactive oxygen species generation in rat cardiomyocytes

Abstract

Epidemiological evidence suggests that the incidence and mortality of cardiovascular diseases are closely related to sulfur dioxide (SO₂). In the present study, H9C2 cells were incubated with 100 μM NaHSO₃ with or without pretreatment of an antioxidant, N-acetyl-l-cysteine (NAC). The changes of apoptosis rate, mitochondrial membrane potential (MMP), ATP content, caspase-3 activity, and reactive oxygen species (ROS) were detected. Rats were inhaled 7 mg/m³ SO₂ and/or intraperitoneal injected with 50 mg/kg (bw) of NAC for 30 days. RT-PCR and Western blot were used to detect the mRNA and protein levels of apoptosis-related genes. We found that the apoptosis of H9C2 cells was induced by NaHSO₃, which decreased the content of MMP and ATP, and induced the expression of caspase-3. NAC can inhibit the apoptosis induced by NaHSO₃ treatment. SO₂ and NaHSO₃ decreased the expression of Bcl-2 and the ratio of Bcl-2/Bax, increased the expression of Bax and P53 accumulation and phosphorylation, and activated caspase-9 and caspase-3. Whereas NAC can reduce the changes of apoptosis-related proteins in rat heart. Our results suggest that SO₂ induces ROS-mediated P53 and caspase-dependent mitochondrial signaling pathways in H9C2 cells and rat hearts. Antioxidant therapy can reduce the adverse reactions of SO₂ and lead to a decline in the cardiovascular disease induced by SO₂.

http://bit.ly/2TrjQEY

Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis

Abstract

Objective

The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery.

Methods

A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured.

Results

The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm.

Conclusions

It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery.

Clinical relevance

The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

http://bit.ly/2Bh6p38

Endocrine disrupting pesticides in soil and their health risk through ingestion of vegetables grown in Pakistan

Abstract

A comprehensive study was conducted to appraise the concentrations of 30 endocrine disrupting pesticides (EDPs) in soil and vegetable samples collected from Khyber Pakhtunkhwa, Pakistan. The sum of 30 EDPs (Σ₃₀EDPs) ranged from 192 to 2148 μg kg⁻¹ in the collected soils. The selected EDP concentrations exceeded their respective limits in most of the tested soils and showed great variation from site to site. Similarly, high variations in Σ₃₀EDP concentrations were also observed in vegetables with the highest mean concentration in lettuce (28.9 μg kg⁻¹), followed by radish (26.6 μg kg⁻¹), spinach (25.7 μg kg⁻¹), onion (16.2 μg kg⁻¹), turnip (15.6 μg kg⁻¹), and garlic (14.7 μg kg⁻¹). However, EDP levels in all studied vegetables were within FAO/WHO limits. The mean bioconcentration factor values were observed < 1 for all the studied vegetables. The health risk assessment revealed that the incremental lifetime cancer risk (ILCR) of Σ₃₀EDPs associated with vegetable ingestion was below the acceptable risk level (1 × 10⁻⁶), showing no cancer risk to local inhabitants. However, exposure to endocrine disruptor and probable carcinogen heptachlor epoxide poses a potential non-cancer risk (hazard quotient (HQ > 1)) to children through vegetable consumption. The presence of banned EDPs in soils and vegetables of the study area indicates the stability of these legacy chemicals in the environment from over usage in the past or illegal current application for agricultural purposes.

Graphical abstract

http://bit.ly/2t2HMTy

Phytoextraction of heavy metals from contaminated soil, water and atmosphere using ornamental plants: mechanisms and efficiency improvement strategies

Abstract

Accumulation of heavy metals (HMs) in soil, water and air is one of the major environmental concerns worldwide, which mainly occurs due to anthropogenic activities such as industrialization, urbanization, and mining. Conventional remediation strategies involving physical or chemical techniques are not cost-effective and/or eco-friendly, reinforcing the necessity for development of novel approaches. Phytoextraction has attracted considerable attention over the past decades and generally refers to use of plants for cleaning up environmental pollutants such as HMs. Compared to other plant types such as edible crops and medicinal plants, ornamental plants (OPs) seem to be a more viable option as they offer several advantages including cleaning up the HMs pollution, beautification of the environment, by-product generation and related economic benefits, and not generally being involved in the food/feed chain or other direct human applications. Phytoextraction ability of OPs involve diverse detoxification pathways such as enzymatic and non-enzymatic (secondary metabolites) antioxidative responses, distribution and deposition of HMs in the cell walls, vacuoles and metabolically inactive tissues, and chelation of HMs by a ligand such as phytochelatins followed by the sequestration of the metal–ligand complex into the vacuoles. The phytoextraction efficiency of OPs can be improved through chemical, microbial, soil amending, and genetic approaches, which primarily target bioavailability, uptake, and sequestration of HMs. In this review, we explore the phytoextraction potential of OPs for remediation of HMs-polluted environments, underpinning mechanisms, efficiency improvement strategies, and highlight the potential future research directions.

Graphical Abstract

ᅟ

http://bit.ly/2HKcCu7

Is Day Care Tonsillectomy a Safe Procedure?

Abstract

Tonsillectomy with or without adenoidectomy is the commonest procedure performed by an otolaryngologist. It has been performed as an in-patient procedure. To present our experience of 15 years of day care tonsillectomy with or without adenoidectomy and to assess the safety of tonsillectomy as a day care procedure. Design: retrospective study. A retrospective study of all day care tonsillectomies with or without adenoidectomies operated at a Secondary care ENT Hospital from 2002 to 2016 has been carried out. In last 15 years, we have operated 1207 tonsillectomies with or without adenoidectomies as a day care procedure. Postoperatively, the patients were discharged after observing for 6 to 8 h. Out of 1207 patients, 3 patients required readmission due to bleeding and 5 due to pain. Hence the overall readmission rate following tonsillectomy was 8/1027, which equals to 0.778 percent. Two patients with postoperative bleeding within 6 h were taken up for exploration and control of hemostasis. One patient of secondary haemorrhage was managed conservatively. None of the patients required blood transfusion. Day care tonsillectomy with or without adenoidectomy is a safe procedure as long as the patients are carefully selected. It is also cost effective. Level of evidence: Level 4.

http://bit.ly/2Wx41i1

What is a pituitary adenoma? A pituitary adenoma is a fairly common benign growth that occurs in the...

What is a pituitary adenoma? A pituitary adenoma is a fairly common benign growth that occurs in the pituitary gland....

http://bit.ly/2t0T0aX

Is Day Care Tonsillectomy a Safe Procedure?

Abstract

http://bit.ly/2Wx41i1

Relationship between arsenic accumulation in tissues and hematological parameters in mullet caught in Faro Lake: a preliminary study

Abstract

The authors investigated the arsenic (As) accumulation in different tissues (muscle, gill, liver, stomach, and intestine) and the possible correlation between tissue concentration and hematological parameters in mullet (Mugil cephalus Linnaeus, 1758) caught in Faro Lake (Messina, Sicily, Italy). On all fish, hematological analyses of blood samples, measurement of biometric indices, and the removal of the muscles, gills, liver, stomach, and intestine for the determination of arsenic concentration were performed. A hemogram was performed to find effects of arsenic concentration in tissues on hematological variables. One-way analysis of variance showed significant differences of arsenic concentration in different tissues, with higher values in the gill. The correlation between hematological parameters and tissue arsenic concentration showed a statistical significance for red blood cell (RBC), hemoglobin concentration (Hb), and hematocrit (Hct) with the liver As concentration. Biometric indices (weight, length, and fork length) showed a significant correlation with As concentration of the muscle and liver also. Our results indicate the role of some hematological parameters as biomarkers useful to monitoring anthropogenic load of arsenic in water and sediment, because variations of these parameters represent one of the effects that arsenic exposure can have on fish.

http://bit.ly/2MQlmOA

Synergistic effect and degradation mechanism on Fe-Ni/CNTs for removal of 2,4-dichlorophenol in aqueous solution

Abstract

Fe-Ni bimetallic nanoparticles supported on CNTs (Fe-Ni/CNTs) were synthesized, characterized, and applied for removal of 2,4-dichlorophenol (2,4-DCP) in aqueous solution. The removal performance was enhanced drastically on Fe-Ni/CNTs with respect to monometallic Fe/CNTs. The synergistic effect between Fe-Ni nanoparticles and CNTs has been studied in detail. The research results indicated that the doping of Ni played an important role in promoting the catalytic degradation of 2,4-DCP. And the presence of CNTs not only could effectively reduce the aggregation of nanoparticles but also facilitate the mass transfer of 2,4-DCP and the formation of active atomic hydrogen during the catalytic process. In addition, the removal kinetics of 2,4-DCP by Fe-Ni/CNTs were in agreement with a pseudo-first-order model, and the rate constants were dependent on a number of factors including the initial concentration of 2,4-DCP, the dosage of Fe-Ni/CNTs, pH value of the solution, and doping amount of Ni. The degradation mechanism involved the adsorption by CNTs and catalytic reduction by Fe under the stimulating of Ni, and the preferred dechlorination followed the order of para-Cl > ortho-Cl. The study confirmed that Fe-Ni/CNTs had a potential to be a promising catalytic material for removal of chlorophenol and had a great prospect for practical application.

http://bit.ly/2DOEf17

Erratum to “Population-based cross-sectional study to assess newborn hearing screening program in Central Germany” [Int. J. Pediatr. Otorhinolaryngol., 107 (2018) 110–120]

Publication date: Available online 2 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Anke Rissmann, Andrea Koehn, Marja Loderstedt, Cornelia Schwemmle, Gerrit Goetze, Sylva Bartel, Stefan K. Plontke, Joerg Langer, Klaus Begall, Peter Matulat, Friedrich-Wilhelm Roehl, Ulrich Vorwerk

http://bit.ly/2TnVpZ6

Thank you!

Publication date: March 2019

Source: International Journal of Pediatric Otorhinolaryngology, Volume 118

Author(s):

http://bit.ly/2BiRANA

Risk of occurrence and recurrence of otitis media with effusion in children suffering from cleft palate

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Caroline Rieu-Chevreau, Nolwenn Lavagen, Cica Gbaguidi, Stéphanie Dakpé, Nathalie Klopp-Dutote, Cyril Page

http://bit.ly/2BiRxBo

Evaluation of hearing in pediatric familial Mediterranean fever patients during attack period and attack-free period

Publication date: Available online 1 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Asif Salimov, Umut Akyol, Bunyamin Cildir, Ezgi Deniz Batu, Seza Ozen

http://bit.ly/2TnVlbO

Antipsychotics Promote Metabolic Disorders Disrupting Cellular Lipid Metabolism and Trafficking

Publication date: Available online 1 February 2019

Source: Trends in Endocrinology & Metabolism

Author(s): Chiara Vantaggiato, Elena Panzeri, Andrea Citterio, Genny Orso, Marco Pozzi

Antipsychotics frequently cause obesity and related metabolic disorders that current psychopharmacological/endocrinological theories do not explain consistently. An integrative/alternative theory implies metabolic alterations happening at the cellular level. Many observations in vitro and in vivo, and pivotal observations in humans, point towards chemical properties of antipsychotics, independent of receptor binding characteristics. Being amphiphilic weak bases, antipsychotics can disrupt lysosomal function, affecting cholesterol trafficking; moreover, by chemical mimicry, antipsychotics can inhibit cholesterol biosynthesis. These two molecular adverse effects may trigger a cascade of transcriptional and biochemical events, ultimately reducing available cholesterol while increasing cholesterol precursors and fatty acids. The macroscopic manifestation of these molecular alterations includes decreased high-density lipoprotein and increased very low-density lipoprotein and triglycerides that may translate into obesity and related metabolic disorders.

http://bit.ly/2RBzhsB

Direct and antibody-dependent cell-mediated cytotoxicity of head and neck squamous cell carcinoma cells by high-affinity natural killer cells

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Jay Friedman, Michelle Padget, John Lee, Jeffrey Schlom, James Hodge, Clint Allen

Abstract

High affinity natural killer cells (haNKs) are a cell therapy product capable of mediating both direct and antibody-dependent cell-mediated cytotoxicity (ADCC). These cells may be particularly useful in tumors that escape T-cell anti-tumor immunity by harboring antigen processing and presentation defects. Here, we demonstrated that haNKs directly kill both HPV-positive and negative head and neck squamous cell carcinoma cells. Variable tumor cell sensitivity to haNK direct cytotoxicity did not correlated with MHC class I chain-related protein A or B (MICA or MICB) expression. Importantly, haNK killing was significantly enhanced via ADCC mediated by cetuximab or avelumab in cells with higher baseline EGFR or PD-L1 expression, respectively. The ability of IFNγ to induce tumor cell PD-L1 expression correlated with enhanced PD-L1-specific ADCC. IFNγ induced neither tumor cell EGFR expression nor EGFR-specific ADCC. Although a single dose of 8 Gy IR did not appear to directly enhance susceptibility to haNK killing alone, enhanced PD-L1- and EGFR-mediated ADCC after IR correlated with increased PD-L1 and EGFR expression in one of four models. This pre-clinical evidence supports the investigation of haNK cellular therapy in combination with ADCC-mediating mAbs, with or without IR, in the clinical trial setting for patients with advanced HNSCCs. Given the MHC-unrestricted nature of this treatment, it may represent an opportunity to treat patients with non-T-cell inflamed tumors.

http://bit.ly/2Rwfqux

The prevalence and impact of cervical spine pathologies in patients with nasopharyngeal carcinoma

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Colin Shing-Yat Yung, Dennis Kwok Chuen Leung, Jason Pui Yin Cheung

Abstract

Objectives

Nasopharyngeal carcinoma (NPC) and its treatment can lead to cervical spine pathologies such as metastases, osteoradionecrosis (ORN) and infection. However, the occurrence rate and relationship between timing of diagnosis and outcomes of the ever-advancing technology of radiation therapy is largely unknown. Hence, the aim of this study is to determine the prevalence and impact of cervical spine pathologies in patients with NPC.

Materials and methods

This was a cross-sectional study of all newly diagnosed cases of NPC from 2007 to 2016 at a tertiary referral oncology and spine centre with minimum 1-year post-treatment follow-up. All cervical spine pathologies, their treatment and outcomes were determined. Presentation, onset time and correlations of the cervical spine pathologies with mortality and risk factors were also analysed.

Results

Out of 605 cases of verified cases of NPC, cervical spine pathologies were seen in 8.9% of patients. New onset neck pain was seen in 5.3%, symptomatic cervical spondylosis in 4.8%, cervical spine metastases in 2.5%, local tumour invasion in 0.8%, cervical ORN in 0.7%, osteomyelitis in 0.7%, radiculopathy in 0.3%, and myelopathy in 0.3%. Cervical spine pathologies were associated with an increased risk (odds ratio: 2.73) in overall mortality. Cervical spine metastases, invasion, ORN and infection were associated with significantly higher risk of mortality (p = 0.01–0.02).

Conclusion

Cervical spine pathologies in patients with NPC are heterogenous but not uncommon. Neck pain is prevalent but is often benign. ORN and osteomyelitis of the cervical spine is uncommon but have large clinical implications including higher mortality with subtle presentations.

http://bit.ly/2WCrhLx

Prognostic value of programed death ligand-1 and ligand-2 co-expression in salivary gland carcinomas

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Takafumi Nakano, Katsumi Takizawa, Azusa Uezato, Kenichi Taguchi, Satoshi Toh, Muneyuki Masuda

Abstract

Objectives

The aim of the present study was to investigate the molecular basis for the use of immune checkpoint inhibitors to treat salivary gland carcinomas (SGC).

Materials and methods

We examined the clinical and prognostic significance of programed death ligands 1 and 2 (PD-L1 and -L2) expression using immunohistochemistry and in situ hybridization, as well as microsatellite instability (MSI) status using polymerase chain reaction, along with tumor-infiltrating lymphocytes (TILs) in 30 cases of SGC.

Results

The SGC cases studied included adenoid cystic carcinoma (AdCC, 36.7%), salivary duct carcinoma (SDC, 26.7%), mucoepidermoid carcinoma (MEC, 23.3%), and carcinoma ex pleomorphic adenoma (CxPA, 13.3%). Either PD-L1 or PD-L2 overexpression was observed in 36.7% patients. PD-L2 expression was associated with reduced disease-specific survival (DSS) and disease-free survival (DFS) (P = 0.0266 and P = 0.0209, respectively). Simultaneous PD-L1 and PD-L2 overexpression was detected in 13.3% of cases, and was correlated with reduced DSS (P = 0.0113). Among non-AdCCs, all cases that developed distant metastasis were positive for PD-L2 (P = 0.001). Cases showing low-TILs that were positive for either PD-L1 or L2 were associated with poor DFS. No MSI was detected in the SGC cases studied.

Conclusion

To our knowledge, this is the first comprehensive study examining PD-L1 and PD-L2 status, MSI status, and TILs in SGC. Our results indicate that the PD-1/PD-L1 or PD-L2 pathway, which is associated with poor clinical outcomes, may provide promising therapeutic targets against SGC in selected patients. Further experimental and clinical studies are encouraged.

http://bit.ly/2WBgJfs

Effect of prior cancer on trial eligibility and treatment outcomes in nasopharyngeal carcinoma: Implications for clinical trial accrual

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Ya-Qin Wang, Jia-Wei Lv, Ling-Long Tang, Xiao-Jing Du, Lei Chen, Wen-Fei Li, Xu Liu, Ying Guo, Ai-Hua Lin, Yan-Ping Mao, Ying Sun, Yu-Pei Chen, Jun Ma

Abstract

Objective

In cancer trials, prior cancer is a common exclusion criterion. We evaluated the characteristics of prior cancer exclusion criteria in nasopharyngeal carcinoma (NPC) trials and determined its prognostic effect on patients with NPC.

Methods

We reviewed NPC trials for prior cancer exclusion criteria. Then we estimated the effect of prior cancer among NPC patients using the Surveillance, Epidemiology, and End Results database. Propensity score-matching was used to compensate for differences in baseline characteristics between patients with and without prior cancer.

Results

There were 109 clinical trials involving 10,437 patients; 49 trials (45%) excluded patients with prior cancer. Prior cancer exclusion was more common in recent or phase III trials. We identified 10,195 NPC patients; 6.2% had prior cancer. More than 70% of these cancers were in situ/localized/regional and diagnosed relatively close to the NPC diagnosis (median 3.3 years). Patients with certain prior cancer type (prostate, breast, gynecological, hematological), time of diagnosis (>5 years ago), or stage (in situ/localized) did not have inferior survival compared with patients with no prior cancer. We tested one form of prior cancer exclusion criteria in an NPC cohort resembling a modern trial population: it did not adversely affect overall and NPC-specific survival.

Conclusions

Many NPC trials excluded patients with prior cancer, which impacts trial accrual and generalizability. Our findings suggest that broader inclusion in trials of patients with NPC with prior cancer might not affect trial outcomes. More research is needed to understand the appropriateness of this exclusion policy across cancer types and trials.

http://bit.ly/2Rwfqe1

Cervical nodal metastasis after malignant conversion of sinonasal inverted papilloma: Report of a rare case and literature review

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Daniel Sharbel, Vipawee Chat, Daniel Blumenthal, Paul Biddinger, J. Kenneth Byrd

Abstract

Malignant conversion of sinonasal inverted papilloma (SNIP) occurs in approximately ten percent of cases. These tumors are classically described as locally destructive, but without metastatic potential. Only four cases of malignant conversion with cervical nodal metastases have been described in the English literature. We present the rare case of a 61-year-old Caucasian male with a nasopharyngeal recurrence of malignant SNIP with cervical and retropharyngeal nodal metastases. The patient underwent endoscopic transpterygoid with nasoseptal flap reconstruction, followed by staged bilateral and retropharyngeal node dissection. Histopathology of the specimens demonstrated poorly differentiated invasive nonkeratinizing squamous cell carcinoma with inverted-type features. Three months after surgery, the patient suffered from C1-C2 fractures consistent with osteoradionecrosis and expired. Although the rate of malignant conversion of SNIP is low, this case highlights the need for aggressive, definitive treatment and surveillance.

http://bit.ly/2WBeJnz

Acquisition of L2 morphology by adult language learners

Publication date: Available online 2 February 2019

Source: Cortex

Author(s): Lilli Kimppa, Yury Shtyrov, Suzanne C.A. Hut, Laura Hedlund, Miika Leminen, Alina Leminen

Abstract

Learning a new language requires the acquisition of morphological units that enable the fluent use of words in different grammatical contexts. While accumulating research has elucidated the neural processing of native morphology, much less is known about how second-language (L2) learners acquire and process morphology in their L2. To address this question, we presented native speakers as well as beginning and advanced learners of Finnish with spoken (1) derived words, (2) inflected words, (3) novel derivations (novel combinations of existing stem + suffix), and (4) pseudo-suffixed words (existing stem + pseudo-suffix) in a passive listening EEG experiment. An early (60 ms after suffix deviation point) positive ERP response showed no difference between inflections and derivations, suggesting similar early parsing of these complex words. At 130 ms, derivations elicited a lexical ERP pattern of full-form memory-trace activation, present in the L2 beginners and advanced speakers to different degrees, implying a shift from lexical processing to more dual parsing and lexical activation of the complex forms with increasing proficiency. Pseudo-suffixed words produced a syntactic pattern in a later, 170-240 ms time-window, exhibiting enhanced ERPs compared to inflections, indicating second pass syntactic parsing. Overall, the L2 learners demonstrated a gradual effect of proficiency towards L1-like responses. Advanced L2 learners seem to have developed memory traces for derivations and use early parsing. This suggests that advanced learners have already developed sensitivity to morphological information, while such knowledge is weak in beginners. However, discrepancies in ERP dynamics and topographies indicate partially differing recruitment of the language network in L1 and L2. In beginners, response differences between existing and novel morphology were scarce, implying that representations for complex forms are not yet well-established. The results suggest successful development of brain mechanisms for automatic processing of L2 morphology, capable of gradually attaining L1-like functionality with increasing proficiency.

http://bit.ly/2TnM1Vc

Cartilage conduction as the third pathway for sound transmission

Publication date: Available online 2 February 2019

Source: Auris Nasus Larynx

Author(s): Hiroshi Hosoi, Tadashi Nishimura, Ryota Shimokura, Tadashi Kitahara

Abstract

For cartilage conduction, three sound pathways can be assumed. The transducer vibration may cause airborne sound which passes into the external auditory canal through the canal entrance (direct air pathway). Alternatively, the vibration at the cartilage may generate audible sound in the external auditory canal (cartilage-air pathway), or propagate directly to the inner ear through the skull bone (cartilage-bone pathway). A series of studies has illustrated that the cartilage-air pathway is dominant for hearing sensations in listeners with normal ears. The cartilage-bone pathway works for patients with bony aural atresia. A fourth pathway, the fibrotic-tissue pathway, is considered to act in the case of fibrotic aural atresia.

In this review, we summarize this series of studies and discuss the nature of cartilage conduction.

http://bit.ly/2G85PJ6

Development of conjunctivitis with a conjunctival proliferative lesion in a patient treated with dupilumab for atopic dermatitis

Publication date: Available online 2 February 2019

Source: Allergology International

Author(s): Ken Fukuda, Waka Ishida, Tatsuma Kishimoto, Atsuki Fukushima

http://bit.ly/2D2bUD7

Remerciements aux lecteurs

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s):

http://bit.ly/2SsuZIx

Thrombose post-traumatique du sinus sigmoïde par corps étranger transmastoïdien

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): G. Badidi, S. Chabrier, J.M. Prades, A. Karkas

http://bit.ly/2GiBWoO

Infection nasosinusienne à burkholderia gladioli

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): C. Zanotti, S. Munari, G. Brescia, U. Barion

Résumé

Introduction

Burkholderia gladioli est une bactérie aérobie gram-négative en bâtonnets, et non fermentaire, qui a été identifiée la première fois comme pathogène pour les plantes. La plupart des infections à B. gladioli rapportées dans la littérature concernent des adultes et des nouveau-nés immunodéprimés. Chez l'homme, B. gladioli est souvent associée à un pronostic défavorable.

Cas clinique

Nous décrivons le premier cas d'infection nasosinusienne due à B. gladioli et Staphylococcus aureus chez une patiente immunocompétente ayant fait un voyage récent au Congo.

Discussion

Comme dans les quelques autres cas rapportés impliquant des patients immunocompétents, la prise en charge adaptée pour cette infection à B. gladioli multirésistante était une combinaison de chirurgie et d'antibiotiques adaptés à l'antibiogramme.

http://bit.ly/2SnlJoT

Coloration noire récidivante de la langue et des dents

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): R. Hervochon, Q. Lisan, F. Rubin

http://bit.ly/2GiBSFA

Une masse nasale atypique

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): E. Drapier, M. Makeieff, X. Dubernard

http://bit.ly/2SjGrGi

Dacryocystocèle congénitale bilatérale

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): P.C. de Sousa, M. Neves, D. Duarte, P. Azevedo

Résumé

Introduction

Les nouveau-nés respirent exclusivement par le nez. Une obstruction nasale peut donc entraîner une cyanose et une désaturation. Malgré le fait qu'elle soit très rare, la dacryocystocèle congénitale bilatérale est une étiologie possible du syndrome de détresse respiratoire chez le nouveau-né.

Résumé du cas clinique Il s'agit d'un nouveau-né de sexe masculin présentant une détresse respiratoire due à une lésion nasale polypoïde et bleuâtre bilatérale occupant la quasi-totalité des méats inférieurs. L'imagerie a confirmé une dacryocystocèle bilatérale. Le traitement a été symptomatique et une évacuation spontanée est survenue, améliorant la détresse respiratoire.

Discussion

Le diagnostic de dacryocystocèle congénitale est clinique bien que des examens d'imagerie puissent être demandés pour le confirmer. Le traitement est controversé en raison de l'évolution spontanément variable de la maladie. Une prise en charge symptomatique initiale peut être recommandée mais, en l'absence d'amélioration spontanée de l'obstruction des voies aériennes, une prise en charge chirurgicale est obligatoire.

http://bit.ly/2GgOQDT

Une localisation épiglottique asymptomatique inattendue dans le cadre d’une maladie de Kimura

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): F. Dezoteux, R. Dubois, G. Lefèvre, J.P. Lecoutre, D. Staumont-Sallé, O. Carpentier

Résumé

Introduction

La maladie de Kimura est un syndrome lymphoprolifératif chronique d'étiologie inconnue qui affecte la peau et les ganglions lymphatiques. Il survient principalement chez les jeunes hommes d'origine asiatique. L'histoire naturelle de l'atteinte épiglottique asymptomatique n'est pas connue. Cette atteinte rare n'est souvent diagnostiquée que lorsque la croissance de la tumeur commence à obstruer les voies respiratoires supérieures.

Observation

Il s'agit d'un homme d'origine nord-africaine âgé de 34 ans présentant un tableau associant fatigue et multiples nodules cutanés fluctuants lentement progressifs dans les régions mandibulaires et rétroauriculaires droites. Un scanner cervical a confirmé une tumeur des tissus mous du corps mandibulaire droit et a également révélé un épaississement inattendu de l'épiglotte. La nasofibroscopie a confirmé les résultats de la tomodensitométrie et a montré un épaississement de l'épiglotte. Notre diagnostic de maladie de Kimura était basé sur l'examen histologique d'échantillons de biopsie prélevées sur la tumeur mandibulaire droite, un ganglion lymphatique cervical et l'épiglotte.

Discussion

La plupart des cas de maladie de Kimura avec atteinte épiglottique sont révélés par dysphonie et dysphagie. Il n'y a pas de consensus sur les examens complémentaires à effectuer. Cette observation soulève la question dépistage systématique des lésions dans des sites anatomiques inhabituels et potentiellement dangereux au cours de cette affection.

http://bit.ly/2Giybjm

Sinusalgies maxillaires radiotransparentes par agenesie de l’ostium membraneux

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): R. Jankowski, C. Rumeau, D.T. Nguyen, P. Gallet

Résumé

Introduction

L'absence d'opacité scanographique lors du bilan de douleurs faciales conduit classiquement à éliminer une étiologie sinusienne. Nous rapportons une observation qui contredit cet adage et révèle une nouvelle cause de sinusalgie.

Observation

Un homme de 16 ans présentait un tableau de « sinusites aiguës hyperalgiques » récidivantes déclenchées par les changements de pression (altitude, plongée, surf), sans opacité sinusienne au scanner. Pourtant l'exploration chirurgicale a permis de constater l'absence de tout ostium maxillaire (principal ou accessoire). Une antrostomie chirurgicale a mis fin aux douleurs.

Discussion

La physiopathologie de ce faux tableau de « sinusites aiguës récidivantes » et l'efficacité de l'antrostomie s'expliquent par la théorie évo-dévo de la formation et du rôle des sinus paranasaux. Ce cas illustre une absence d'abouchement dans l'ethmoïde du sac membranaire tapissant la cavité sinusienne, formée après dégénérescence de la moelle érythropoïétique dans l'os maxillaire. La production permanente de monoxyde d'azote par l'épithélium sinusien est éliminée par simple diffusion transmembranaire en condition environnementale stable, mais insuffisamment lors des changements pressionnels rapides, provoquant des sinusalgies parfois hyperalgiques. Cette observation ouvre la voie à de plus amples études sur le rôle des sinus dans la pathologie faciale et la physiologie respiratoire.

http://bit.ly/2ShjF1G

Fraisage et contrôle du méat auditif interne par endoscope fixé

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): X. Dubernard, J.-C. Kleiber, M. Makeieff, A. Bazin, A. Chays

Résumé

En cas de résection chirurgicale d'un schwannome vestibulaire par voie rétro sigmoïde, le contrôle des structures vestibulaires en particulier du canal semi-circulaire postérieur est impératif si l'objectif de conservation de l'audition s'ajoute à celui d'une exérèse tumorale totale. Le fraisage du méat acoustique interne (MAI) est une étape délicate au cours de laquelle les structures vestibulaires peuvent être involontairement ouvertes. L'orientation du MAI explique la formation de zone d'ombre propice à leur ouverture si le fraisage est réalisé au microscope. L'endoscopie portée expose en totalité la zone opératoire mais bloque l'une des mains du chirurgien rendant la chirurgie délicate. L'endoscopie fixée est une solution permettant de rendre au chirurgien sa liberté opératoire tout en garantissant un contrôle précis de son geste. Elle permet le repérage et le contournement des structures vestibulaires tout en étant au plus près de la tumeur. Le schwannome peut se laisser cliver en totalité, le fond du MAI étant correctement contrôlé tout en respectant le nerf facial et le nerf cochléaire.

http://bit.ly/2SjGge6

Reconstruction de la paroi antérieure du sinus frontal par prothèse en titane sur-mesure après exérèse d’un ostéome géant du sinus frontal

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): J. Fanchette, B. Faucon, F. Cartry, M. Ratajczak

Résumé

L'ostéome est une tumeur osseuse bénigne, fréquemment rencontrée au niveau naso-sinusien, le plus souvent asymptomatique. Le traitement est chirurgical et s'impose lorsque le patient devient symptomatique ou présente des complications opthalmologiques ou neurologiques. Bien que l'approche endoscopique soit de plus en plus utilisée si la localisation et/ou la taille de l'ostéome le permettent, la chirurgie par voie ouverte peut être préférable et reste encore la référence. Nous présentons dans cette note technique un cas d'ostéome géant du sinus frontal ayant nécessité une exérèse par voie bicoronale, avec reconstruction par une prothèse en titane réalisée sur-mesure.

http://bit.ly/2GnaGW6

Quelle place pour l’ambulatoire en chirurgie plastique et reconstructrice de la face et du cou en France ?

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): O. Malard, G. Michel, F. Espitalier

Résumé

Cette mise au point propose d'expliciter des grands principes qui régissent en 2018 la réalisation des soins ambulatoires dans le système de santé français, spécifiquement dans le domaine de la chirurgie plastique et esthétique de la face et du cou. Les aspects réglementaires historiques et l'évolution au cours des dernières années sont exposés, ainsi que les tendances et les attentes des autorités sanitaires pour les années à venir. L'essentiel des contraintes liées à l'exécution des actes en ambulatoire sont communs aux différentes spécialités chirurgicales. La chirurgie plastique et esthétique de la face et du cou n'y déroge pas. Parmi ces contraintes, outre les aspects purement techniques liés à l'acte chirurgical et anesthésique, il faut compter sur l'autorisation du site, l'organisation de la continuité des soins, l'environnement du patient… Dans son rapport de 2012 sur l'évaluation de la tarification des soins hospitaliers et des actes médicaux, l'IGAS, rappelle que : « La chirurgie ambulatoire devient la norme, l'hospitalisation traditionnelle est le défaut » afin de satisfaire à l'exigence « Soigner plus sans dépenser plus ». L'acte ambulatoire en chirurgie plastique et de reconstruction peut être considéré comme accessible à une majorité de patients, mais demeure un acte sous conditions.

http://bit.ly/2Sm8NQ2

Facteurs de risque de sévérité de la papillomatose respiratoire récidivante juvénile lors de la première endoscopie

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): E. Moreddu, E. Lambert, D. Kacmarynski, R. Nicollas, J.-M. Triglia, R.J. Smith

Résumé

Objectifs

L'objectif de cette étude était de définir les facteurs de risque de sévérité de la papillomatose respiratoire récidivante (PRR) juvénile lors de la première évaluation endoscopique.

Matériels et méthodes

Il d'agit d'une revue de tous les cas opérés pour PRR juvénile dans deux centres d'oto-rhino-laryngologie pédiatrique situés aux États-Unis et en France. Le nombre d'étages laryngés atteints, l'extension sous-glottique et la bilatéralité des lésions ont été analysés comme facteurs de risque de sévérité.

Résultats

Trente-deux patients ont été inclus, pour un total de 571 procédures endoscopiques. Le nombre d'endoscopies par patient était différent selon l'extension initiale de la maladie : 30,67 procédures quand les 3 étages laryngés étaient atteints, 15,57 procédures quand 2 étages étaient atteints et 14,08 quand un seul étage était atteint (p = 0,03). L'odds ratio du risque de subir plus de 14 procédures était de 20,43 (p = 0,047) quand les 3 étages étaient atteints. Les patients présentant une extension sous-glottique des lésions avaient tendance à nécessiter plus de procédures (23,67 contre 15,56, p = 0,16).

Conclusions

La sévérité de la PRRJ est corrélée à l'extension initiale des lésions papillomateuses lors de la première endoscopie. Cette observation a permis de créer une échelle d'évaluation rapide composée de 3 items, complémentaire de l'échelle de Derkay.

http://bit.ly/2GiX8eh

Ablation chirurgicale des amygdales linguales dans le traitement du syndrome d’apnées obstructives du sommeil

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): C. Mure, M. Blumen, L. Page, F. Chabolle

Résumé

Objectifs

L'espace rétro-basilingual peut être un site obstructif dans le syndrome d'apnées obstructives du sommeil (SAOS) et les amygdales linguales (AL) sont des structures anatomiques qui, quand elles sont hypertrophiées, peuvent y contribuer. L'objectif de cette étude est de mesurer l'efficacité et la tolérance de l'ablation des AL dans le SAOS.

Matériels et méthodes

Nous avons réalisé une étude rétrospective basée sur l'analyse des dossiers médicaux des patients opérés des AL. Nous avons inclus les patients porteurs d'un SAOS confirmé par un enregistrement du sommeil en échec ou refus de traitement médical. L'hypertrophie des AL était diagnostiquée par un examen clinique avec une naso-fibroscopie complété d'une IRM et d'une endoscopie sous sédation (ES). L'intervention chirurgicale était réalisée par voie endoscopique avec utilisation du laser diode ou de la coblation. Le critère de jugement principal était la baisse de l'index d'apnées-hypopnées (IAH) à 6 mois sur l'enregistrement du sommeil. Les critères secondaires étaient la diminution du ronflement, le score de somnolence diurne d'Epworth et la tolérance post-opératoire.

Résultats

Onze patients, âgés de 44,3 ± 12,6 ans, ont été inclus. Nous avons observé une baisse de l'IAH de 29,5 ± 21,7/h à 11,6 ± 9,6/h, soit une réduction de 60 % (p = 0,005). Cinq patients avaient un IAH inférieur à 10/h soit 45 % de guérison complète. Le score d'Epworth a baissé de 13 ± 3,4 à 8,1 ± 4,9 (p = 0,012). Il n'y a eu aucune complication.

Conclusion

Dans le cas d'un SAOS en échec de traitement médical avec une obstruction rétro-basilinguale, l'ablation des AL paraît être un traitement efficace.

Niveau de preuve

4.Mots clés: Amygdales linguales; Apnées du sommeil; Traitement chirurgical, Espace rétro-basilingual

http://bit.ly/2SjG7Y6

Intérêt de la vidéo-otoscopie en médecine générale

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): L. Damery, E. Lescanne, K. Reffet, C. Aussedat, D. Bakhos

Résumé

Introduction

Le rôle des omnipraticiens est primordial dans la prise en charge des pathologies otologiques. Il demeure cependant des insuffisances diagnostiques concernant les tympans pathologiques. L'objectif de ce travail était de comparer la qualité des diagnostics otoscopiques réalisés par des omnipraticiens avec l'otoscopie conventionnelle versus la vidéo-otoscopie.

Sujets et méthode

Onze généralistes ont examiné 124 patients (193 otoscopies) présentant des plaintes otologiques. Ils devaient réaliser l'examen à l'otoscope puis à la vidéo-otoscopie. Après chacun de ces examens, une grille composée de 10 critères était remplie et un diagnostic était proposé. Chaque cliché issu de la vidéo-otoscopie était relu par 2 ORL qui devaient remplir la même grille et poser un diagnostic. L'appréciation de la vidéo-otoscopie, par les médecins généralistes, était effectuée par une échelle de Likert.

Résultats

Il n'existait pas de différence significative entre les résultats des 3 groupes (otoscopie conventionnelle, vidéo-otoscopie et ORL) sur l'ensemble des examens. Concernant l'analyse des tympans pathologiques, il existait une différence significative entre les résultats des ORL et ceux des omnipraticiens utilisant un otoscope (p = 0,0032). En revanche, il n'était pas mis en évidence de différence entre les scores des omnipraticiens et des ORL dans l'interprétation des tympans issus de la vidéo-otoscopie (p = 0,0754). L'ensemble des omnipraticiens était conquis par cet outil diagnostic même s'ils n'étaient pas décidés à en faire l'acquisition.

Conclusion

La vidéo-otoscopie montre sa supériorité par rapport à l'otoscopie conventionnelle concernant l'interprétation des tympans pathologiques.

http://bit.ly/2GiThy7

Cancer du larynx d’origine professionnelle : tendances en France de 2001 à 2016

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): J. Grignoux, Q. Durand-Moreau, N. Vongmany, S. Brunel, membres du RNV3P, J.-D. Dewitte

Résumé

Objectifs

Dans le cadre du plan cancer 2014–2019 et de l'amélioration des connaissances en cancérologie professionnelle, nous avons analysé les situations professionnelles à risque de cancer du larynx recensé dans le réseau national de vigilance et de prévention des pathologies professionnelles (RNV3P) de 2001 à 2016.

Matériel et méthodes

L'étude a porté sur les cas de cancers du larynx d'origine professionnelle avec une exposition jugée par le médecin expert en lien direct avec la pathologie (imputabilité moyenne ou forte). Ont été analysés les données démographiques, les circonstances d'exposition professionnelle (nuisances, poste de travail, secteur d'activité), les facteurs de risque extraprofessionnels et l'avis pour une déclaration de maladie professionnelle.

Résultats

Entre 2001 et 2016, 244 cancers du larynx ont été enregistrés. Cent quarante-sept cas ont été conclus d'origine professionnelle dont 87 jugés avec une imputabilité moyenne ou forte. Cette population est exclusivement masculine, d'un âge médian de 59 ans. On recense 97 expositions différentes dont l'amiante pour 78 cas. Les secteurs d'activité majoritaires sont ceux des travaux de construction spécialisés (14 cas) et de la métallurgie (7 cas). Une déclaration de maladie professionnelle a été conseillée à 60 patients et l'amiante est retrouvé dans 80 % des demandes.

Conclusion

L'amiante est le facteur de risque de cancer du larynx le plus décrit dans le réseau de 2001 à 2016. Notre étude confirme l'implication de l'amiante dans la cancérogénicité du larynx, une réflexion sur la création d'un tableau de maladie professionnelle en France paraîtrait ainsi légitime à l'instar de pays voisins européens.

http://bit.ly/2SjG3aO

Évaluation de la déglutition des patients opérés d’une pharyngolaryngectomie totale circulaire. Étude multicentrique du GETTEC

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): S. Morinière, P. Gorphe, F. Espitalier, D. Blanchard, N. Fakhry, N. Saroul, C. Bach, X. Dufour, C. Fuchsmann, S. Vergez, S. Albert

Résumé

But

Les pharyngolaryngectomies totale circulaires sont réalisées pour des tumeurs évoluées du pharynx ou dans un contexte de récidive post-radique. Plusieurs procédés de reconstruction du pharynx par lambeau libres ou pédiculés sont utilisés et sont choisis selon l'opérateur. Cette étude a pour but d'évaluer les résultats fonctionnels sur la déglutition à long terme de ces patients en fonction du type de lambeau utilisé pour la reconstruction.

Matériel et méthode

Une étude rétrospective multicentrique a été menée de janvier à septembre 2016 dans le groupe Gettec. Tous les patients opérés d'une pharyngolaryngectomie totale circulaire et en rémission étaient inclus et devaient remplir le questionnaire du déglutition handicap index (DHI) et avoir une fibroscopie de déglutition. 46 patients (39 hommes 7 femmes) ont été inclus pendant cette période. Le lambeau ante-brachial tubulisé (groupe LABT) était utilisé dans 19 cas, le grand pectoral en fer à cheval (groupe LGP) dans 15 cas et le jéjunum libre (groupe LJL) dans 12 cas.

Résultats

Le DHI moyen était de 24 : 20 groupes LABT, 23 groupes LJL, 25 groupes LGP, sans différence significative ; 27 patients avaient une déglutition normale, 9 mixée, 8 liquide, 3 étaient alimentés par gastrostomie. La nasofibroscopie de la déglutition obtenait un pourcentage de patient avec une déglutition normale de salive et de yaourt significativement plus important pour les patients reconstruits avec un lambeau libre (LJL et LABT) par rapport au groupe LGP (p = 0,04).

Conclusion

Cette étude a montré que le type de lambeau de reconstruction d'une pharyngolaryngectomie totale circulaire n'a pas d'impact sur la qualité de la déglutition postopératoire évaluée par le patient par autoquestionnaire du DHI.

http://bit.ly/2GmQbct

Menaces sur le facteur d’impact ?

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s): O. Laccourreye, H. Maisonneuve

http://bit.ly/2SjFUEi

Editorial Board

Publication date: February 2019

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 136, Issue 1

Author(s):

http://bit.ly/2GgOw89

Correction to: In memory of Professor Domenico Andreani

Unfortunately, the author name and his affiliation were published in the original publication. They have now been removed.

http://bit.ly/2G4i5KJ

In vitro effect of low-level laser therapy on the proliferative, apoptosis modulation, and oxi-inflammatory markers of premature-senescent hydrogen peroxide-induced dermal fibroblasts

Abstract

Skin aging is a complex biological process induced by intrinsic and extrinsic factors which is characterized by clinical and cellular changes, especially dermal fibroblasts. It is possible that, some procedures, such as low-level laser therapy (LLLT), could decelerate this process. To test this hypothesis, this study evaluated the in vitro LLLT on dermal fibroblast cell line (HFF-1) with premature senescence H₂O₂-induced. HFF-1 cells were cultured in standardized conditions, and initially H₂O₂ exposed at different concentrations. Fibroblasts were also just exposed at different LLLT (660 nm) doses. From these curves, the lowest H₂O₂ concentration that induced indicators of premature senescence and the lowest LLLT doses that triggered fibroblast proliferation were used in all assays. Cellular mortality, proliferation, and the levels of oxidative, inflammatory cytokines, apoptotic markers, and of two growth signaling molecules (FGF-1 and KGF) were compared among treatments. The H₂O₂ at 50 μM concentration induced some fibroblast senescence markers and for LLLT, the best dose for treatment was 4 J (p < 0.001). The interaction between H₂O₂ at 50 μM and LLLT at 4 J showed partially reversion of the higher levels of DNA oxidation, CASP 3, CASP 8, IL-1B, IL-6, and INFy induced by H₂O₂ exposure. LLLT also trigger increase of IL-10 anti-inflammatory cytokine, FGF-1 and KGF levels. Cellular proliferation was also improved when fibroblasts treated with H₂O₂ were exposed to LLLT (p < 0.001). These results suggest that in fibroblast with some senescence characteristics H₂O₂-induced, the LLLT presented an important protective and proliferative action, reverting partially or totally negative effects triggering by H₂O₂.

http://bit.ly/2WCmQjG

Spontaneous remission in diffuse large cell lymphoma: a case report

Spontaneous remission in solid malignancies has been documented. However, spontaneous remission in aggressive diffuse large b cell lymphoma is exceedingly rare. Previous reports of lymphoma remission suggest t...

http://bit.ly/2WAujQq

Book Review: Biodynamic Excisional Skin Tension Lines for Cutaneous Surgery

Publication date: Available online 2 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Derek W. Nickerson

http://bit.ly/2S73CUX

REPLY to ‘Comment on “Anti-aging effects of ingenol mebutate for patients with actinic keratosis” and phenol-croton oil peelings’

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Miri Kim, Yujin Jung, Jongsic Kim, Seo-won Jeong, Yu Ri Woo, Hyun Jeong Park

http://bit.ly/2UEGhH3

Follicular mucinosis in patients with hematologic malignancies other than mycosis fungoides: A clinicopathologic study

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Shamir Geller, Christian J. Gomez, Patricia L. Myskowski, Melissa Pulitzer

Abstract

Background

Follicular mucinosis (FM), defined by mucin accumulation within follicular epithelium, may occur in mycosis fungoides (MF). FM without MF is occasionally reported in systemic hematologic malignancies, and may be diagnostically challenging.

Objective

To describe clinicopathological characteristics of FM in patients with hematologic malignancies other than MF.

Methods

Clinical data and histopathology were analyzed in patients with FM and hematologic malignancies diagnosed between 1994 and 2017.

Results

Eighteen patients with FM and systemic hematologic malignancies without cutaneous T-cell lymphoma (CTCL) were identified, nine of them were post hematopoietic stem cell transplantation (HSCT). No non-CTCL associated FM cases (n=46, 37 biopsies) developed CTCL during mean follow-up of 4.3 years. Of CTCL associated with FM (n=44, 31 biopsies) MF was the most common subtype (n=38), although other CTCLs were identified. FM in patients with non-CTCL hematologic malignancies differed clinically from MF-associated FM, presenting most frequently with erythematous papules (P < .0001), without plaques (P <.0001), without alopecia (P = .001), and without histopathologically identified epidermal exocytosis (P = .013).

Limitations

A retrospective study in a single cancer center.

Conclusions

FM can present in systemic hematologic malignancies, including post-HSCT. Papular lesional morphology and histopathology may help to distinguish these cases from MF.

http://bit.ly/2S150Iu

About “Anti-aging effects of ingenol mebutate for patients with actinic keratosis” and phenol-croton oil peelings

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Carlos Gustavo Wambier, Kachiu Cecilia Lee, Thomas Michael Bertolini, Peter P. Rullan, Flavio Luis Beltrame

http://bit.ly/2UBLuPO

Secukinumab for moderate to severe palmoplantar pustular psoriasis: Results of the 2PRECISE study

Publication date: Available online 1 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Ulrich Mrowietz, Hervé Bachelez, A. David Burden, Michael Rissler, Christian Sieder, Roberto Orsenigo, Kamel Chaouche-Teyara

Abstract

Background

Palmoplantar pustular psoriasis (PPP) is a debilitating disease of the palms and/or soles that is resistant to treatment. Secukinumab, an anti-IL-17A monoclonal antibody, is highly efficacious in the treatment of moderate to severe psoriasis.

Objective

The primary objective was ppPASI75 response with secukinumab at Week 16 vs. placebo (2.5% significance level).

Methods

2PRECISE was a phase 3b multicenter, randomized, double-blind, placebo-controlled, parallel-group study comparing secukinumab 300 mg (n=79) and 150 mg (n=80) to placebo (n=78) in subjects with moderate to severe PPP over 52 Weeks.

Results

The primary endpoint was not met. At Week 16, 26.6% of subjects with secukinumab 300 mg achieved ppPASI75 vs.. 14.1% with placebo (P=0.0411) [OR: 2.62; 95% CI: 1.04, 6.60]. At Week 52, 41.8% of subjects with secukinumab 300mg had ppPASI75. More DLQI 0/1 responses were achieved with secukinumab 300 mg (13.0%) vs. placebo (4.3%) at Week 16. At Week 52, 43.1% of subjects receiving secukinumab 300 mg had DLQI 0/1. No unexpected adverse events were observed.

Limitations

Small sample size and characteristics of PPP disease course.

Conclusion

PPP patients treated with secukinumab 300 mg showed benefit in ppPASI75 responses over 52 weeks and improved quality of life.

http://bit.ly/2S3RLHe

Autoimmunity and the Oral Cavity

Abstract

Purpose of Review

This review aims to make the oral health practitioner and researcher aware of autoimmune diseases that present in the mouth and have implications for oral health. Specifically, the autoimmune pathophysiology, examples of treatments, sequelae, and impact on oral health will be discussed. The limitations of our current knowledge and understanding of these diseases will also be highlighted.

Recent Findings

Over the past decade, it has become clear that there is a bidirectional relationship between oral health and autoimmune disease at other body sites; including diabetes and rheumatoid arthritis. Improving the oral health of patients with autoimmune diseases may reduce morbidity associated with such diseases.

Summary

Autoimmune diseases impact the oral cavity both directly and indirectly and are increasing in prevalence. As such, there is a growing need for the oral health practitioners to be aware of how autoimmune disease impacts the oral cavity. Further research is necessary to improve our understanding of the bidirectional relationship between oral health and autoimmune disease.

http://bit.ly/2sYY8wp

Issue Information

http://bit.ly/2Biyya6

Tetra‐arsenic tetra‐sulfide Ameliorates Lupus Syndromes by Inhibiting IL‐17 producing Double Negative T cells

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease of uncertain etiology that affects multiple tissues and organs. Tetra‐arsenic tetra‐sulfide (As₄S₄), a traditional Chinese medicine, is effective on acute promyelocytic leukemia with mild side effects. In our previous study, BXSB lupus‐prone mice treated with As₄S₄ has showed improved monocytosis, decreased serum interleukin‐6 (IL‐6) and suppressed skin, liver and renal lesions with well‐tolerance. In this study, we explored the effect and mechanism of As₄S₄ on the MRL/lpr mice. MRL/lpr and wild MRL/MpJ mice were divided into control and As₄S₄ treatment groups and dosed with As₄S₄ or placebo for 8 weeks. We found that As₄S₄ prevented the skin, renal and lung lesions of MRL/lpr mice. As₄S₄ significantly decreased the double negative T (DN T) cells and reduced the serum levels of IL‐17, IL‐10, and antinuclear antibodies (ANA) titer. Further results revealed that the FasL was decreased, and activated caspases elevated in DN T cells in As₄S₄ treated MRL/lpr mice. Taken together, As₄S₄ could selectively suppresses DN T cells by inducing apoptosis. It also reduced inflammatory cytokines IL‐17, which may be produced by DN T cells. As₄S₄ may represent a new therapy for SLE.

http://bit.ly/2t0qI0f

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 2 Φεβρουαρίου 2019

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