Adenotonsillectomy in children with sickle cell disease and obstructive sleep apnea

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Annie N. Farrell, Steven L. Goudy, Marianne E. Yee, Roberta M. Leu, April M. Landry
IntroductionObstructive sleep apnea (OSA) is prevalent and may be more severe in children with Sickle Cell Disease (SCD) compared to the general pediatric population.ObjectivesThe objective of this study was to describe the therapeutic effects and complications of tonsillectomy and adenoidectomy (T&A) for treatment of OSA in children with SCD.MethodsA comprehensive database of pediatric SCD patients was reviewed to identify all patients who underwent T&A between 2010 and 2016. An IRB-approved, retrospective review of laboratory values, perioperative course, pre- and post-T&A hospital utilization, and polysomnography was conducted.ResultsThere were 132 SCD children (108 HbSS) who underwent T&A. Mean age was 7.6 ± 4.6 years. The mean baseline hemoglobin of these patients was 9.3 ± 1.4 g/dL; 72.7% of patients had pre-operative transfusion, such that the mean Hb at time of T&A was 11.4 ± 1.0 g/dL. The average admission length surrounding T&A was 3.5 ± 1.2 days. Complications were documented in 11.4% of operative cases. Polysomnography was available in 104 pre-T&A and 45 post-T&A. The Apnea-Hypopnea Index decreased on post-T&A polysomnogram (7.6 ± 8.7 vs. 1.3 ± 1.9, p = 0.0001). The O2 nadir improved on post-T&A polysomnogram (81.2 ± 10.8 vs. 89.3 ± 7, p = 0.0003). Emergency room visits (mean events per year) decreased post-operatively (2.6 ± 2.8 vs. 1.8 ± 2.2, p = 0.0002).ConclusionsT&A can be a safe and effective option to treat OSA in pediatric patients with SCD and was significantly associated with reduced AHI and fewer ER visits post-operatively.



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Substrate micropatterns produced by polymer demixing regulate focal adhesions, actin anisotropy, and lineage differentiation of stem cells

Publication date: Available online 12 June 2018
Source:Acta Biomaterialia
Author(s): Sebastián L. Vega, Varun Arvind, Prakhar Mishra, Joachim Kohn, N. Sanjeeva Murthy, Prabhas V. Moghe
Stem cells are adherent cells whose multipotency and differentiation can be regulated by numerous microenvironmental signals including soluble growth factors and surface topography. This study describes a simple method for creating distinct micropatterns via microphase separation resulting from polymer demixing of poly(desaminotyrosyl-tyrosine carbonate) (PDTEC) and polystyrene (PS). Substrates with co-continuous (ribbons) or discontinuous (islands and pits) PDTEC regions were obtained by varying the ratio of PDTEC and sacrificial PS. Human mesenchymal stem cells (MSCs) cultured on co-continuous PDTEC substrates for 3 days in bipotential adipogenic/osteogenic (AD/OS) induction medium showed no change in cell morphology but exhibited increased anisotropic cytoskeletal organization and larger focal adhesions when compared to MSCs cultured on discontinuous micropatterns. After 14 days in bipotential AD/OS induction medium, MSCs cultured on co-continuous micropatterns exhibited increased expression of osteogenic markers, whereas MSCs on discontinuous PDTEC substrates showed a low expression of adipogenic and osteogenic differentiation markers. Substrates with graded micropatterns were able to reproduce the influence of local underlying topography on MSC differentiation, thus demonstrating their potential for high throughput analysis. This work presents polymer demixing as a simple, non-lithographic technique to produce a wide range of micropatterns on surfaces with complex geometries to influence cellular and tissue regenerative responses.Statement of SignificanceGaining a better understanding of how engineered microenvironments influence stem cell differentiation is integral to increasing the use of stem cells and materials in a wide range of tissue engineering applications. In this study, we show the range of topography obtained by polymer demixing is sufficient for investigating how surface topography affects stem cell morphology and differentiation. Our findings show that co-continuous topographies favor early (3-day) cytoskeletal anisotropy and focal adhesion maturation as well as long-term (14-day) expression of osteogenic differentiation markers. Taken together, this study presents a simple approach to pattern topographies that induce divergent responses in stem cell morphology and differentiation.

Graphical abstract

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CytID Analysis of Oral Lesions

Conditions:   Oral Cavity Cancer;   Oropharyngeal Cancer
Interventions:   Other: Oral examination with incandescent light;   Other: Oral examination with OralID;   Diagnostic Test: Biopsy;   Diagnostic Test: CytID;   Diagnostic Test: hpvID
Sponsors:   The University of Texas Health Science Center, Houston;   M.D. Anderson Cancer Center
Recruiting

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Vestibular Treatment in Adolescents Following Sport Related Concussion

Condition:   Vestibular Disorder
Interventions:   Behavioral: Vestibular Exercise Intervention;   Behavioral: Standard of Care
Sponsor:   University of Pittsburgh
Not yet recruiting

https://ift.tt/2LKGnZ2

CytID Analysis of Oral Lesions

Conditions:   Oral Cavity Cancer;   Oropharyngeal Cancer
Interventions:   Other: Oral examination with incandescent light;   Other: Oral examination with OralID;   Diagnostic Test: Biopsy;   Diagnostic Test: CytID;   Diagnostic Test: hpvID
Sponsors:   The University of Texas Health Science Center, Houston;   M.D. Anderson Cancer Center
Recruiting

https://ift.tt/2JUDY0R

Vestibular Treatment in Adolescents Following Sport Related Concussion

Condition:   Vestibular Disorder
Interventions:   Behavioral: Vestibular Exercise Intervention;   Behavioral: Standard of Care
Sponsor:   University of Pittsburgh
Not yet recruiting

https://ift.tt/2LKGnZ2

Ocular Basidiobolomycosis: A Case Report

Background: Ocular basidiobolomycosis is an unusual infection caused by fungus of the order Entomophthorales. This fungus has been previously reported as a common cause of skin, subcutaneous, and gastrointestinal tract infection. The fungus isolation and its typical characteristics are clues for diagnosis of this uncommon pathogen. Case Report: A 47-year-old male patient with nodular scleritis in the left eye after an eye injury from sawdust was treated as bacterial scleritis. The lesion improved with early surgical drainage and antibacterial therapy; then, he was discharged from the hospital. Thereafter, the patient was re-admitted due to progression of infectious scleritis with keratitis and orbital cellulitis. Surgical abscess drainage was performed again. The microbiological study demonstrated Basidiobolus ranarum. The patient was treated with topical ketoconazole, subconjunctival fluconazole injection, and oral itraconazole with partial response to the treatment. However, the patient eventually denied any further treatment and did not return for follow-up. Conclusions: B. ranarum is a rare pathogen of ocular infection in which a definite diagnosis requires isolation of the causative organism. Delay in diagnosis and appropriate treatment can lead to extension of the infection and poor outcomes.
Case Rep Ophthalmol 2018;9:315–321

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