Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Σάββατο 25 Ιουνίου 2016

OtoRhinoLaryngology & Medicine


  • Peripheral Venous Pressure as an Indicator of Preload Responsiveness During Volume Resuscitation from Hemorrhage2016-06-25 15:43:35 PM
    Peripheral Venous Pressure as an Indicator of Preload Responsiveness During Volume Resuscitation from Hemorrhage: BACKGROUND: Fluid resuscitation of hypovolemia presumes that peripheral venous pressure (PVP) increases more than right atrial pressure (RAP), so the net pressure gradient for venous return (PVP-RAP) rises. However, the heart and peripheral venous system function under different compliances that could affect their respective pressures during fluid infusion. In a porcine model of hemorrhage resuscitation, we examined whether RAP increases more than PVP, thereby reducing the venous return pressure gradient and blood flow.

    METHODS: Anesthetized pigs (n = 8) were bled to a mean arterial blood pressure of 40 mm Hg and resuscitated with stored blood and albumin for pulmonary artery occlusion pressures (PAOPs) of 5, 10, 15, and 20 mm Hg. Venous pressures, inferior vena cava blood flow (ultrasonic flowprobe), and left ventricular diastolic compliance (Doppler echocardiography) were measured. Stroke volume variability was calculated.

    RESULTS: With volume resuscitation, the slope of RAP exceeded PVP (P ≤ 0.0001) when PAOP is 10 to 20 mm Hg, causing the pressure gradient for venous return to progressively decrease. Inferior vena cava blood flow did not further increase after PAOP > 10 mm Hg. The E/e′ ratio increased (P = 0.001) during resuscitation indicating reduced diastolic compliance. A significant curvilinear relationship was found between PVP and stroke volume variability (R2 = 0.62; P


  • Preventive Audiology: Screening for Hearing Impairment in Children Having Recurrent URTI.2016-06-25 15:43:34 PM
    Preventive Audiology: Screening for Hearing Impairment in Children Having Recurrent URTI.
    Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):163-6
    Authors: Sharma K, Pannu MS, Arora A, Sharma V
    Abstract
    A late detection of hearing impairment in children can affect speech and language development. Otitis media with effusion (OME) associated with risk factors like recurrent upper respiratory tract infections (URTI) is considered the most common cause of silent hearing impairment among children. So this study was carried out to screen such at risk children for hearing impairment. The study was conducted on 1000 children in the age group of 2-12 years who presented to the OPD of ENT and Pediatrics Department, Govt Medical College with the complaint of recurrent URTI. The children were screened by history taking, general physical examination and local ENT examination. This was followed by impedance audiometry and pure tone audiometry (PTA, wherever indicated). Children with discharging ears and perforated tympanic membrane (TM) were excluded from the study. The most common presenting complaint was nasal discharge (67.9 %), followed by mouth breathing (66.3 %) and snoring (65 %). Only 16.2 % cases actually complained of some hearing impairment on exploratory history indicating the silent nature of OME. On examination 52.65 % cases had a normal looking TM whereas 41.2 % had a dull retracted TM. Results of impedance audiometry showed Type A graph in 56.75 %, Type B in 33.4 % indicating OME and Type C in 9.85 % indicating Eustachian tube dysfunction. PTA showed a mild conductive hearing loss in 26.7 % cases. OME is quite prevalent in high risk children and incidence of OME resulting in silent hearing impairment is quite high especially in young children having recurrent URTI. Impedance audiometry has been proved to be an objective screening tool for the same with a diagnostic accuracy of 87 % and thus under preventive audiology, it has a definite role in young children having recurrent URTI.
    PMID: 27340630 [PubMed]
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  • Subscriptions.2016-06-25 15:43:26 PM
    Subscriptions.
    Chem Senses. 2016 Jul;41(6):NP
    Authors:
    PMID: 27340208 [PubMed – in process]
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  • Intralesional Ethanol Injection in Lumbar Hemangioma Leading to Renal Failure2016-06-25 15:38:43 PM


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  • Microsurgical management of primary jugular foramen meningiomas2016-06-25 15:38:43 PM
     a series of 22 cases and review of the literature

    Neurosurg Rev. 2016 Jun ;

    Authors: Tang J, Zhang L, Zhang J, Wu Z, Xiao X, Zhou D, Jia G, Jia W

    Abstract

    This study summarized clinical manifestations, surgical management, histological grading, and long-term outcome of jugular foramen meningiomas (JFMs). Retrospective study was performed in 22 consecutive patients with primary JFMs from January 2004 to October 2010, enrolling 10 men and 12 women with average age of 39.4 (14-57 years). The most common initial symptom is hearing disorder, followed by lower cranial nerve dysfunctions. The tumor was classified into type I (intracranial) in 1, type II (intracranial) in 15, type IV (intracranial-extracranial) in 6, and none type III (extracranial). Surgical approaches mainly included retrosigmoid in 7, far lateral in 10, and juxtacondylar in 5, with some variations. The gross total resection was achieved in 15 cases and subtotal resection in 7. Fourteen patients (63.6 %) developed new or worse neurological deficits immediately after operation, of whom 11 (78.6 %) got alleviation. Postoperatively, keeping airway patency and prevention from aspiration pneumonia is very important. Nasotracheal intubation is much more tolerated than orotracheal intubation for postoperative patient management. WHO grade 2 was found in four cases (18.2 %) and grade 3 in one. During the average time of follow-up in 83.2 months, only one (grade 3) died of tumor regrowth 20 months after surgery and radiosurgery. Five of 17 patients of grade 1 developed tumor regrowth. Radiosurgery provides a good tumor control for tumor regrowth in grade 1, or postoperative grade 2 tumor. In conclusion, JFMs has a favorable long-term overall survival; however, neurological preservation is still challenging, especially low cranial nerves.

    PMID: 27334626 [PubMed - as supplied by publisher]


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  • Children with Bilateral Coronoid Hyperplasia2016-06-25 15:38:43 PM
    Mandibular Movement Restoration in a Child with Bilateral Coronoid Hyperplasia: A Case Report.:

    Open Access Maced J Med Sci. 2016 Jun ;4(2):293-5

    Authors: Monevska DP, Benedetti A, Popovski V, Naumovski S, Grcev A, Bozovic S, Stamatoski A

    Abstract

    BACKGROUND: Coronoid process hyperplasia is an uncommon finding, characterized by an enlargement of the coronoid process, causing a mechanical obstacle by its interposing in the posterior portion of the maxilla or zygomatic arch.

    CASE PRESENTATION: The article presents a case report of a bilateral coronoid process hyperplasia in a 3-year-old girl demonstrated with inability to open the mouth and restricted jaw movement. Panoramic x-ray and 3-dimensional computed tomographic reconstruction showed bilateral elongation of the coronoid processes associated with deformation of the mandibular condyle with no involvement of the articular space. A coronoid resection by intraoral approach was done, followed by an aggressive physiotherapy. A considerable improvement in mouth opening of 30 mm was achieved. We strongly suggest early surgical treatment of coronoid hyperplasia to recover morphology and function consequently to reduce skeletofacial deformities in young patients.

    CONCLUSIONS: The article presents a clinical and surgical case of bilateral coronoidectomy in a 3-year-old girl, with retrognathic mandible. The diagnosis of bilateral coronoid process hyperplasia was confirmed, and the surgical treatment was under general anesthesia, with nasotracheal intubation guided by a nasofiber endoscope, using an intraoral approach.

    PMID: 27335604 [PubMed]


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  • Extradural Hemorrhage Secondary to Skull Pin Fixation Manifesting as Intractable Intraoperative Brain Swelling.2016-06-25 15:38:43 PM
  • Cerebral vasospasm: current understanding.2016-06-25 15:38:43 PM
    Cerebral vasospasm: current understanding.Purpose of review: With recent research trying to explore the pathophysiologic mechanisms behind vasospasm, newer pharmacological and nonpharmacological treatments are being targeted at various pathways involved. This review is aimed at understanding the mechanisms and current and future therapies available to treat vasospasm.

    Recent findings: Computed tomography perfusion is a useful alternative tool to digital subtraction angiography to diagnose vasospasm. Various biomarkers have been tried to predict the onset of vasospasm but none seems to be helpful. Transcranial Doppler still remains a useful tool at the bedside to screen and follow up patients with vasospasm. Hypertension rather than hypervolemia and hemodilution in ‘Triple-H’ therapy has been found to be helpful in reversing the vasospasm. Hyperdynamic therapy in addition to hypertension has shown promising effects. Endovascular approaches with balloon angioplasty and intra-arterial nimodipine, nicardipine, and milrinone have shown consistent benefits. Endothelin receptor antagonists though relieved vasospasm, did not show any benefit on functional outcome.

    Summary: Endovascular therapy has shown consistent benefit in relieving vasospasm. An aggressive combination therapy through various routes seems to be the most useful approach to reduce the complications of vasospasm.

    Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.



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  • Survival benefit following neck dissection even in patients with a cN0 neck at presentation2016-06-25 15:38:43 PM

    Abstract

    The single most important prognostic indicator for survival in oral squamous cell carcinoma (OSCC) is the presence of lymph node metastases in the neck. While the treatment of the clinically node positive (cN+) neck is well established, the management of the clinically negative neck (cN0) is controversial. Various strategies have been advocated including close observation including regular ultrasound imaging, elective neck dissection and sentinel lymph node biopsy. Neck dissection surgery is not without potential morbidity with shoulder dysfunction being the main complication. A number of factors are associated with increased risk of neck node metastasis including primary tumour thickness and peri-neural invasion.
    A recent prospective randomised trial has found survival benefit following neck dissection even in patients with a cN0 neck at presentation. We discuss the latest evidence for managing the cN0 in OSCC and include our own experience on the role of neck dissection in certain cases.
    This article is protected by copyright. All rights reserved.


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  • Cohesin subunits, STAG1 and STAG2, and cohesin regulatory factor, PDS5b, in oral squamous cells carcinomas2016-06-25 15:38:43 PM
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    Background

    Cohesin complex is responsible for sister chromatid cohesion. STAG1/STAG2is part of the complex, which is regulated by PDS5B. Alterations in these genes were described in tumors. PDS5B is a negative regulator of cell proliferation. We aimed to assess molecular alterations in these genes in oral squamous cell carcinoma (OSCC) and predict their expression by the expression of 84 cell cycle genes. In addition, we investigated whether pds5b protein expression impacted ki-67 and p53 immunopositivity.

    Methods

    We assessed loss of heterozygosity (LOH) at STAG1 and STAG2 loci in 15 OSCC using three polymorphic markers. Associations between the immunoexpression of pds5b and ki-67 and p53 were tested in 62 samples. Differences between transcriptional levels of STAG1, STAG2, and PDS5Bbetween OSCC and normal oral mucosa (NM) were evaluated by qPCR. An 84 cell cycle genes qPCR array was carried with OSCC samples, and STAG1,STAG2, and PDS5B were independently used as response variables in multiple linear regression models.

    Results

    Loss of heterozygosity in at least one marker was observed in three samples. pds5b, p53, and ki-67 were highly expressed, and no association was found between pds5b immunoexpression and ki-67 or p53 (P > 0.05). OSCC and NM showed similar transcriptional levels of STAG1, STAG2, andPDS5BSTAG1 and CUL3 expression seem to be related (P = 0.004).

    Conclusions

    There is LOH at STAG1 and STAG2 loci in OSCC, but OSCC and NM showed similar transcriptional levels of STAG1, STAG2, and PDS5B. pds5b immunoexpression in OSCC was high, but it was not associated with proliferation cell index.


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  • Routine preoperative colour Doppler duplex ultrasound scanning in anterior lateral thigh flaps2016-06-25 15:38:43 PM
    Routine preoperative colour Doppler duplex ultrasound scanning in anterior lateral thigh flaps: The anterior lateral thigh flap (ALT) is often used to reconstruct the head and neck and depends on one or more skin perforators, which often present with variable anatomy. The aim of this study was to localise and evaluate the precise position of these perforators preoperatively with colour Doppler duplex ultrasound scanning (US). We detected 74 perforators in 30 patients. The mean duration of examination with colour Doppler was 29 (range 13–51) minutes. Adequate perforators and their anatomical course could be detected preoperatively extremely accurately (p<0.001).



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  • Fibrin sealant versus suture for conjunctival wound closure in orbital wall fracture surgery2016-06-25 15:38:43 PM
    A prospective randomized study comparing fibrin sealant versus suture for conjunctival wound closure in orbital wall fracture surgery: The purpose of this randomized prospective study was to compare the clinical outcomes of orbital wall fracture surgery involving transconjunctival wound closure with fibrin sealant to the outcomes achieved with a conventional suture method. All surgeries were performed using the same technique, except that the conjunctival closure was achieved using either a buried 6–0 Vicryl suture (n=10) or fibrin sealant (n=10). The time to conjunctival closure and time required for complete wound healing were investigated.



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  • Template-guided surgery of the zygomatic implants2016-06-25 15:38:43 PM
    A novel device for template-guided surgery of the zygomatic implants: Zygomatic implants are indicated for the rehabilitation of the severely atrophic maxilla. Similar to standard implant placement, gaining an optimal position of the zygomatic implants is essential for a predictable prosthetic-driven treatment outcome. Stereolithographic templates, either bone-supported or mucosa-supported, have been used to install zygomatic implants in the planned position based on computer-assisted planning. However, there is no effective mechanism to physically control the drilling trajectory for the zygomatic implants.



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  • Maxillofacial trauma – underestimation of cervical spine injury2016-06-25 15:38:43 PM
    Maxillofacial trauma – underestimation of cervical spine injury: Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery.A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed.



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  • Traumatic Dislocation of the Eye Globe into the Maxillary Sinus:2016-06-25 15:38:43 PM
    Immediate Surgical Management of Traumatic Dislocation of the Eye Globe into the Maxillary Sinus: Report of a Rare Case and Literature Review:

    Cranial Maxillofac Trauma Reconstruction
    DOI: 10.1055/s-0036-1584393

    We report a case of complete dislocation of the globe into the maxillary sinus, with immediate repositioning of the globe. This report highlights the importance of early surgical repair of orbital fracture and globe repositioning to regain the maximum amount of ocular functions. A review of literature found 19 cases of globe dislocation into the maxillary sinus: One case was enucleated 2 months after misdiagnosis as traumatic enucleation, six cases were documented no vision or no light perception, three cases did not have reported vision (patients did not survive), and nine cases with postoperative vision. We recommend early surgical intervention to restore the cosmetic and visual function of the dislocated eye.


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  • Endonasal Endoscopic Reposition of Eye from Nose with Complete Vision Regainment2016-06-25 15:38:43 PM
    Eye Inside Out: 

    Cranial Maxillofac Trauma Reconstruction
    DOI: 10.1055/s-0036-1584401

    Faciomaxillary and ocular trauma is a common entity in most emergency and trauma units. We came across a 68-year-old female patient with a history of bull horn injury over the right eye. Examination revealed an empty orbital socket with unreliable perception of light present. Imaging showed that the eye had displaced posteroinferomedially to be lying in the ethmoid air cells in the nasal cavity. Under nasal endoscopic guidance, the eye was reposited back into the orbital socket and conjunctival sutures were taken to stabilize the position. The patient had vision of counting fingers at 1.5 m on the first postoperative day which improved to 6/24 on last follow-up. Such is the rarity that never before has such a case been described in literature where traumatic displacement of eyeball into the nose has been successfully repositioned by an endonasal endoscope with appreciable regaining of vision. It also further promotes endonasal endoscopic approach in the management of orbital blow out injuries.


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  • Anti-erosive effects of fluoride and phytosphingosine2016-06-25 15:38:43 PM
    A selection of commercially available products containing stannous fluoride (SnF2)/sodium fluoride (NaF), SnF2/amorphous calcium phosphate (ACP), SnF2/NaF/ACP, tin (Sn)/fluorine (F)/chitosan were compared with phytosphingosine (PHS) with respect to their anti-erosive properties in vitro. One-hundred and twenty bovine enamel specimens were immersed in the respective product slurries for 2 min, twice daily. The formulations were diluted with either remineralization solution or artificial saliva. After each treatment, an erosive challenge was performed for 10 min, twice daily, using citric acid, pH 3.4. The specimens were stored in remineralization solution or artificial saliva until the next treatment-erosion challenge. After 10 d, tissue loss was determined using profilometry. Enamel softening was determined through surface microhardness measurements. Tissue-loss values (measured in μm and expressed as mean ± SD) for PHS, SnF2/NaF, SnF2/ACP, SnF2/ACP/NaF, and Sn/F/chitosan treatment groups and for the negative-control group, were, respectively, 35.6 ± 2.8, 15.8 ± 1.8, 22.1 ± 2.0, 22.9 ± 1.8, 16.2 ± 1.2, and 51.2 ± 4.4 in the presence of remineralization solution and 31.7 ± 3.3, 15.6 ± 2.9, 16.5 ± 2.7, 16.8 ± 2.1, 13.1 ± 3.0, and 50.7 ± 2.8 in the presence of artificial saliva. There were no significant differences in surface microhardness measurements between the treatment groups. In conclusion, PHS resulted in a significant reduction of tissue loss compared with the negative control, but in comparison, the toothpastes containing Sn2+ and F ions were significantly more effective compared with PHS.


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  • The Ventral Striatum's Olfactory Tubercle.2016-06-25 15:38:43 PM
    Illustrated Review of 

    Chem Senses. 2016 Jun ;

    Authors: Xiong A, Wesson DW

    Abstract

    Modern neuroscience often relies upon artistic renderings to illustrate key aspects of anatomy. These renderings can be in 2 or even 3 dimensions. Three-dimensional renderings are especially helpful in conceptualizing highly complex aspects of neuroanatomy which otherwise are not visually apparent in 2 dimensions or even intact biological samples themselves. Here, we provide 3 dimensional renderings of the gross- and cellular-anatomy of the rodent olfactory tubercle. Based upon standing literature and detailed investigations into rat brain specimens, we created biologically inspired illustrations of the olfactory tubercle in 3 dimensions as well as its connectivity with olfactory bulb projection neurons, the piriform cortex association fiber system, and ventral pallidum medium spiny neurons. Together, we intend for these illustrations to serve as a resource to the neuroscience community in conceptualizing and discussing this highly complex and interconnected brain system with established roles in sensory processing and motivated behaviors.

    PMID: 27340137 [PubMed - as supplied by publisher]


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  • Food Odors.2016-06-25 15:38:43 PM
    Implicit and Explicit Measurements of Affective Responses to Food Odors.:

    Chem Senses. 2016 Jun ;

    Authors: He W, de Wijk RA, de Graaf C, Boesveldt S

    Abstract

    One of the main functions of olfaction is to activate approach/avoidance behavior, toward or away from people, foods, or other odor sources. These behaviors are partly automated and therefore poorly accessible via introspection. Explicit tests need therefore be complemented by implicit tests to provide additional insights into the underlying processes of these behaviors. Affective responses to seven food odors plus one control nonodor were assessed in 28 female participants (18-30 years) using explicit tests [pleasantness, intensity, and non-verbal emotional ratings (PrEmo)] as well as implicit tests that reflect dynamic expressive emotional reactions (facial expressions) as well as behavioral-preparation responses (autonomic nervous system responses: heart rate, skin conductance, and skin temperature). Explicit tests showed significant differences in pleasantness (P < 0.05), and all PrEmo emotions (P < 0.05) except shame. Explicit emotional responses were summarized by valence (explaining 83% of the responses variance) and arousal (14%) as principal components. Early implicit facial and ANS responses (after 1s) seem to reflect the odors’ arousal, whereas later ANS responses (after 3-4s) reflected the odors’ valence. The results suggest that explicit measures primarily reflect the odors’ valence, as result of from relatively long (conscious) processing, which may be less relevant for odor acceptance in the real world where fast and automated processes based on arousal may play a larger role.

    PMID: 27340136 [PubMed - as supplied by publisher]


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  • Copy Number Variation in TAS2R Bitter Taste Receptor Genes2016-06-25 15:38:43 PM
    Structure, Origin, and Population Genetics.:

    Chem Senses. 2016 Jun ;

    Authors: Roudnitzky N, Risso D, Drayna D, Behrens M, Meyerhof W, Wooding SP

    Abstract

    Bitter taste receptor genes (TAS2Rs) harbor extensive diversity, which is broadly distributed across human populations and strongly associated with taste response phenotypes. The majority of TAS2R variation is composed of single-nucleotide polymorphisms. However, 2 closely positioned loci at 12p13, TAS2R43 and -45, harbor high-frequency deletion (Δ) alleles in which genomic segments are absent, resulting in copy number variation (CNV). To resolve their chromosomal structure and organization, we generated maps using long-range contig alignments and local sequencing across the TAS2R43-45 region. These revealed that the deletion alleles (43Δ and 45Δ) are 37.8 and 32.2kb in length, respectively and span the complete coding region of each gene (~1kb) along with extensive up- and downstream flanking sequence, producing separate CNVs at the 2 loci. Comparisons with a chimpanzee genome, which contained intact homologs of TAS2R43, -45, and nearby TAS2Rs, indicated that the deletions evolved recently, through unequal recombination in a cluster of closely related loci. Population genetic analyses in 946 subjects from 52 worldwide populations revealed that copy number ranged from 0 to 2 at both TAS2R43 and TAS2R45, with 43Δ and 45Δ occurring at high global frequencies (0.33 and 0.18). Estimated recombination rates between the loci were low (ρ = 2.7×10(-4); r = 6.6×10(-9)) and linkage disequilibrium was high (D’ = 1.0), consistent with their adjacent genomic positioning and recent origin. Geographic variation pointed to an African origin for the deletions. However, no signatures of natural selection were found in population structure or integrated haplotype scores spanning the region, suggesting that patterns of diversity at TAS2R43 and -45 are primarily due to genetic drift.

    PMID: 27340135 [PubMed - as supplied by publisher]


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  • Paraquat Poisoning Followed by Toxic Epidermal Necrolysis:2016-06-25 15:38:43 PM
    A Report of Two Cases and Published Work Review.:
    http:--misc.karger.com-LinkOutIcons-sk_n
    Authors: Xu W, Wang L, Wang Q, Li XH, Hu D, Li C, Wu T, Mohan C, Peng A, Shi Y

    Abstract

    Toxic epidermal necrolysis (TEN) is a life-threatening, typically drug-induced, mucocutaneous disease. Whether paraquat, one of the most widely used herbicides, could induce TEN is not known. We describe 2 paraquat-poisoned patients with TEN. Both patients presented erythema after hospital discharge following initial paraquat poisoning and then developed a widespread eruption of diffuse erythema on almost the whole body, with bullae, epidermal necrosis and sloughing. They were successfully treated with intravenous immunoglobulin and methylprednisolone. These clinical features were consistent with TEN caused by medications with a high risk to induce Stevens-Johnson syndrome/TEN. Moreover, it is suggested that both skin exposure and ingestion of paraquat could induce TEN. To our knowledge, this is the first case report of TEN related to paraquat poisoning.

    PMID: 26228174 [PubMed - indexed for MEDLINE]



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  • Oral manifestations of gastrointestinal diseases in children2016-06-25 15:38:43 PM
    Part 1: General introduction.:

    Eur J Paediatr Dent. 2016 ;17(1):80-2

    Authors: Mantegazza C, Crippa R, Zuccotti GV

    Abstract

    BACKGROUND: Alterations of the oral cavity are common in children: 22% of children aged less than 4 years and 44% of those aged more than 12 develop dental erosion, 9-95% of children in Europe and in North America develop gingivitis, with adolescents showing a prevalence of more than 60% (Linee guida - Ministero della Salute 2013). Alterations within the oral cavity can be the first sign of systemic diseases and may thus allow for an early diagnosis and treatment. In particular, being the oral cavity a part of the gastrointestinal system, oral alterations can be an expression of a gastrointestinal disease.

    CONCLUSION: A prompt recognition of sYstemic diseases through a careful examination of the oral cavity could allow the child to have appropriate investigations and to be managed in a timely fashion.

    PMID: 26949246 [PubMed - indexed for MEDLINE]


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  • Experimental mucositis and experimental gingivitis in persons aged 70 or over2016-06-25 15:38:43 PM
     Clinical and biological responses.:

    Clin Oral Implants Res. 2016 Jun ;

    Authors: Meyer S, Giannopoulou C, Courvoisier D, Schimmel M, Müller F, Mombelli A

    Abstract

    OBJECTIVES: To compare in persons aged 70 years or older the clinical and inflammatory changes occurring around implants and natural teeth during and after a phase of undisturbed plaque accumulation.

    MATERIAL AND METHODS: Twenty partially edentulous participants with titanium implants refrained from oral hygiene practices while being clinically monitored in weekly intervals for 21 days. Teeth and implants were then cleaned, oral hygiene resumed, and the participants were further monitored for 3 weeks. Twelve biomarkers were assessed in gingival and peri-implant crevicular fluid (GCF, PCF).

    RESULTS: During 3 weeks of oral hygiene abstention, the gingival index (GI) continuously increased. On day 21, there were significantly more sites with GI >1 at implants than at teeth. After restarting oral hygiene, the GI decreased markedly in both groups. Throughout the experiment, the plaque index was significantly higher on teeth than on implants. The different biomarkers reacted variably. IL-1β increased significantly with plaque accumulation. IL-1β, GM-CSF, TNF-α, and IFN-γ were significantly higher in GCF compared to PCF at day 21. IL-8 decreased significantly in GCF up to day 14. MIP-1β decreased significantly in GCF, but not in PCF. At the 3-week follow-up, the levels of all biomarkers assessed in GCF and PCF had returned to baseline values.

    CONCLUSIONS: In an elderly cohort, plaque accumulation induced an inflammatory reaction around both teeth and implants. Although there was less plaque accumulation on implants, the peri-implant mucosa showed a stronger clinical response than gingiva.

    PMID: 27333829 [PubMed - as supplied by publisher]


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