Paclitaxel-related scleredema-like skin changes in a patient with breast cancer

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A composite of exhaled LTB4, LXA4, FeNO and FEV1 as an “asthma classification ratio” characterizes childhood asthma

Abstract

Background

Aberrant generation of eicosanoids is associated with asthma, but the evidence remains incomplete and its potential utility as biomarkers is unclear. Major eicosanoids in exhaled breath condensates (EBCs) were assessed as candidate markers for childhood asthma.

Methods

Ten exhaled eicosanoid species was evaluated using ELISA in the discovery phase, followed by prediction model-building and validation phases.

Results

Exhaled LTB₄, LTE₄, PGE₂ and LXA₄ showed significant difference between asthmatics (N=60) and controls (N=20). For validation, an expanded study population consisting of 626 subjects with asthma and 161 healthy controls were partitioned into a training subset to establish a prediction model and a test sample subset for validation. Receiver Operating Characteristic (ROC) analyses of the training subset revealed the level of exhaled LTB₄ to be the most discriminative among all parameters, including FeNO, and a composite of exhaled LTB₄, LXA₄, together with FeNO and FEV₁, distinguishing asthma with high sensitivity and specificity. Further, the Youden index (J) indicated the cut point value of 0.598 for this composite of markers as having the strongest discriminatory ability (sensitivity = 85.2% and specificity = 83.6%). The predictive algorithm as "asthma classification ratio" was further validated in an independent test sample with sensitivity and specificity being 84.4% and 84.8%, respectively.

Conclusions

In a pediatric study population in Taiwan, the levels of exhaled LTB₄, LTE₄, LXA₄ and PGE₂ in asthmatic children were significantly different from those of healthy controls, and the combination of exhaled LTB₄ and LXA₄, together with FeNO and FEV₁, best characterized childhood asthma.

This article is protected by copyright. All rights reserved.

http://ift.tt/2hqQ4lo

A composite of exhaled LTB4, LXA4, FeNO and FEV1 as an “asthma classification ratio” characterizes childhood asthma

Abstract

Background

Aberrant generation of eicosanoids is associated with asthma, but the evidence remains incomplete and its potential utility as biomarkers is unclear. Major eicosanoids in exhaled breath condensates (EBCs) were assessed as candidate markers for childhood asthma.

Methods

Ten exhaled eicosanoid species was evaluated using ELISA in the discovery phase, followed by prediction model-building and validation phases.

Results

Exhaled LTB₄, LTE₄, PGE₂ and LXA₄ showed significant difference between asthmatics (N=60) and controls (N=20). For validation, an expanded study population consisting of 626 subjects with asthma and 161 healthy controls were partitioned into a training subset to establish a prediction model and a test sample subset for validation. Receiver Operating Characteristic (ROC) analyses of the training subset revealed the level of exhaled LTB₄ to be the most discriminative among all parameters, including FeNO, and a composite of exhaled LTB₄, LXA₄, together with FeNO and FEV₁, distinguishing asthma with high sensitivity and specificity. Further, the Youden index (J) indicated the cut point value of 0.598 for this composite of markers as having the strongest discriminatory ability (sensitivity = 85.2% and specificity = 83.6%). The predictive algorithm as "asthma classification ratio" was further validated in an independent test sample with sensitivity and specificity being 84.4% and 84.8%, respectively.

Conclusions

In a pediatric study population in Taiwan, the levels of exhaled LTB₄, LTE₄, LXA₄ and PGE₂ in asthmatic children were significantly different from those of healthy controls, and the combination of exhaled LTB₄ and LXA₄, together with FeNO and FEV₁, best characterized childhood asthma.

This article is protected by copyright. All rights reserved.

http://ift.tt/2hqQ4lo

Comparative Study of New Autologous Material, Bone-Cartilage Composite Graft (BCCG), for Ossiculoplasty with Polycel® and Titanium

Abstract

Objective

Ossiculoplasty is a surgical procedure that recreates sound transmission of the middle ear in conductive hearing loss. Various materials have been used for ossicular reconstruction, but the most ideal material for ossiculoplasty remains controversial. The purpose of this study is to introduce a novel method of autologous ossiculoplasty, bone-cartilage composite graft (BCCG), and to compare its surgical results with different types of ossiculoplastic prostheses.

Study Design

A retrospective study was performed in a tertiary referral center.

Methods

Data of 275 patients who received ossiculoplasty using the three different materials of BCCG, Polycel^®, and titanium were analyzed according to type of ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP). Hearing results, complication rates, and clinical parameters including age, sex, past history, preoperative diagnosis, and surgery type were compared among different groups.

Results

Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the lowest complication rate among the three different materials. In particular, its extrusion rate was 0%.

Conclusion

We propose that the BCCG technique is a useful alternative method for ossiculoplasty, with proper patient selection.

This article is protected by copyright. All rights reserved.

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The effect of side of implantation on unilateral cochlear implant performance in patients with prelingual and postlingual sensorineural hearing loss – a systematic review

Abstract

Objective

Cerebral lateralization of language processing leads to a right ear advantage in normal hearing subjects. The aim of this study was to present a systematic overview of the effect of implantation side on postoperative cochlear implant performance in patients with symmetrical severe to profound sensorineural hearing loss.

Data sources

PubMed, Embase and The Cochrane Library databases.

Research methods

Databases were searched from database inception up to January 9^th 2017 for cochlear implant and side and all synonyms. Title, abstract and full-text of retrieved articles were screened for eligibility. Then, directness of evidence and risk of bias were assessed. For the included articles, study characteristics and outcome data (hearing and language development) were extracted.

Results

2541 unique articles were screened, of which twenty were eligible for critical appraisal. No randomized controlled trials were identified. Twelve studies with a high directness of evidence remained for data extraction. Four of six studies including children with prelingual sensorineural hearing loss and four of seven studies investigating adults with postlingual sensorineural hearing loss found a right ear advantage in at least one outcome measurement related to cochlear implant performance.

Conclusion

The available evidence on the effect of side of implantation is of low quality, since study populations and outcome measures are heterogeneous. The majority of studies reveals evidence for a right ear advantage in prelingually deafened children as well as postlingually deafened adults. In view of the present evidence and since no left ear advantage was identified, we cautiously advise implanting the cochlear implant in the right ear when other prognostic factors do not favour the left ear and sensorineural hearing loss is symmetrical.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fjboVC

Comparative Study of New Autologous Material, Bone-Cartilage Composite Graft (BCCG), for Ossiculoplasty with Polycel® and Titanium

Abstract

Objective

Ossiculoplasty is a surgical procedure that recreates sound transmission of the middle ear in conductive hearing loss. Various materials have been used for ossicular reconstruction, but the most ideal material for ossiculoplasty remains controversial. The purpose of this study is to introduce a novel method of autologous ossiculoplasty, bone-cartilage composite graft (BCCG), and to compare its surgical results with different types of ossiculoplastic prostheses.

Study Design

A retrospective study was performed in a tertiary referral center.

Methods

Data of 275 patients who received ossiculoplasty using the three different materials of BCCG, Polycel^®, and titanium were analyzed according to type of ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP). Hearing results, complication rates, and clinical parameters including age, sex, past history, preoperative diagnosis, and surgery type were compared among different groups.

Results

Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the lowest complication rate among the three different materials. In particular, its extrusion rate was 0%.

Conclusion

We propose that the BCCG technique is a useful alternative method for ossiculoplasty, with proper patient selection.

This article is protected by copyright. All rights reserved.

http://ift.tt/2y2wzqA

The effect of side of implantation on unilateral cochlear implant performance in patients with prelingual and postlingual sensorineural hearing loss – a systematic review

Abstract

Objective

Cerebral lateralization of language processing leads to a right ear advantage in normal hearing subjects. The aim of this study was to present a systematic overview of the effect of implantation side on postoperative cochlear implant performance in patients with symmetrical severe to profound sensorineural hearing loss.

Data sources

PubMed, Embase and The Cochrane Library databases.

Research methods

Databases were searched from database inception up to January 9^th 2017 for cochlear implant and side and all synonyms. Title, abstract and full-text of retrieved articles were screened for eligibility. Then, directness of evidence and risk of bias were assessed. For the included articles, study characteristics and outcome data (hearing and language development) were extracted.

Results

2541 unique articles were screened, of which twenty were eligible for critical appraisal. No randomized controlled trials were identified. Twelve studies with a high directness of evidence remained for data extraction. Four of six studies including children with prelingual sensorineural hearing loss and four of seven studies investigating adults with postlingual sensorineural hearing loss found a right ear advantage in at least one outcome measurement related to cochlear implant performance.

Conclusion

The available evidence on the effect of side of implantation is of low quality, since study populations and outcome measures are heterogeneous. The majority of studies reveals evidence for a right ear advantage in prelingually deafened children as well as postlingually deafened adults. In view of the present evidence and since no left ear advantage was identified, we cautiously advise implanting the cochlear implant in the right ear when other prognostic factors do not favour the left ear and sensorineural hearing loss is symmetrical.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fjboVC