Abstract
- Skin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic AcidSkin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic Acid:BACKGROUND: Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place.OBJECTIVE: To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system.MATERIALS AND METHODS: An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid.RESULTS: Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a “ceiling effect” was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment.CONCLUSION: For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid.
- Reconstruction After Full-Thickness Loss of the Antihelix, Scapha, and Triangular Fossa
- Intensity-modulated proton beam therapy (IMPT) versus intensity-modulated photon therapy (IMRT) for patients with oropharynx cancer – A case matched analysisPublication date: Available online 21 June 2016
Source:Radiotherapy and Oncology
Author(s): Pierre Blanchard, Adam S. Garden, G. Brandon Gunn, David I. Rosenthal, William H. Morrison, Mike Hernandez, Joseph Crutison, Jack J. Lee, Rong Ye, C. David Fuller, Abdallah S.R. Mohamed, Kate A. Hutcheson, Emma B. Holliday, Nikhil G. Thaker, Erich M. Sturgis, Merrill S. Kies, X. Ronald Zhu, Radhe Mohan, Steven J. Frank
BackgroundOwing to its physical properties, intensity-modulated proton therapy (IMPT) used for patients with oropharyngeal carcinoma has the ability to reduce the dose to organs at risk compared to intensity-modulated radiotherapy (IMRT) while maintaining adequate tumor coverage. Our aim was to compare the clinical outcomes of these two treatment modalities.MethodsWe performed a 1:2 matching of IMPT to IMRT patients. Our study cohort consisted of IMPT patients from a prospective quality of life study and consecutive IMRT patients treated at a single institution during the period 2010–2014. Patients were matched on unilateral/bilateral treatment, disease site, human papillomavirus status, T and N status, smoking status, and receipt of concomitant chemotherapy. Survival analyzes were performed using a Cox model and binary toxicity endpoints using a logistic regression analysis.ResultsFifty IMPT and 100 IMRT patients were included. The median follow-up time was 32months. There were no imbalances in patient/tumor characteristics except for age (mean age 56.8years for IMRT patients and 61.1years for IMPT patients, p-value=0.010). Statistically significant differences were not observed in overall survival (hazard ratio (HR)=0.55; 95% confidence interval (CI): 0.12–2.50, p-value=0.44) or in progression-free survival (HR=1.02; 95% CI: 0.41–2.54; p-value=0.96). The age-adjusted odds ratio (OR) for the presence of a gastrostomy (G)-tube during treatment for IMPT vs IMRT were OR=0.53; 95% CI: 0.24–1.15; p-value=0.11 and OR=0.43; 95% CI: 0.16–1.17; p-value=0.10 at 3months after treatment. When considering the pre-planned composite endpoint of grade 3 weight loss or G-tube presence, the ORs were OR=0.44; 95% CI: 0.19–1.0; p-value=0.05 at 3months after treatment and OR=0.23; 95% CI: 0.07–0.73; p-value=0.01 at 1year after treatment.ConclusionOur results suggest that IMPT is associated with reduced rates of feeding tube dependency and severe weight loss without jeopardizing outcome. Prospective multicenter randomized trials are needed to validate such findings.
from Rathiotherapy via xlomafota13 on Inoreader http://ift.tt/28VNIBR - Radiotherapy and immune checkpoints inhibitors for advanced melanomaPublication date: Available online 23 June 2016
Source:Radiotherapy and Oncology
Author(s): Andrea Riccardo Filippi, Paolo Fava, Serena Badellino, Chiara Astrua, Umberto Ricardi, Pietro Quaglino
IntroductionThe therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical studies (many of them still ongoing). We here summarize the rationale and the preliminary clinical results of this approach.Materials and methodsIn the first part of this review article, redacted with narrative non-systematic methodology, we describe the clinical results of immune checkpoints blockade in melanoma as well as the biological basis for the combination of ICI with RT; in the second part, we systematically review scientific publications reporting on the clinical results of the combination of ICI and RT for advanced melanoma.ResultsThe biological and mechanistic rationale behind the combination of ICI and radiation is well supported by several preclinical findings. Retrospective observational series and few prospective trials support the potential synergistic effect between radiation and ICI for metastatic melanoma.ConclusionRT may potentiate anti-melanoma activity of ICI by enhancing response on both target and non-target lesions. Several prospective trials are ongoing with the aim of further exploring this combination in the clinical setting, hopefully confirming initial observations and opening a new therapeutic window for advanced melanoma patients.
from Rathiotherapy via xlomafota13 on Inoreader http://ift.tt/28VNwlM - Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomiaPublication date: Available online 23 June 2016
Source:Radiotherapy and Oncology
Author(s): Charlotte L. Brouwer, Roel J.H.M. Steenbakkers, Arjen van der Schaaf, Chantal T.C. Sopacua, Lisanne V. van Dijk, Roel G.J. Kierkels, Hendrik P. Bijl, Johannes G.M. Burgerhof, Johannes A. Langendijk, Nanna M. Sijtsema
Background and purposeThe aim of this study was to develop and validate a method to select head and neck cancer patients for adaptive radiotherapy (ART) pre-treatment. Potential pre-treatment selection criteria presented in recent literature were included in the analysis.Materials and methodsDeviations from the planned parotid gland mean dose (PG ΔDmean) were estimated for 113 head and neck cancer patients by re-calculating plans on repeat CT scans. Uni- and multivariable linear regression analyses were performed to select pre-treatment parameters, and ROC curve analysis was used to determine cut off values, for selecting patients with a PG dose deviation larger than 3Gy. The patient selection method was validated in a second patient cohort of 43 patients.ResultsAfter multivariable analysis, the planned PG Dmean remained the only significant parameter for PG ΔDmean. A sensitivity of 91% and 80% could be obtained using a threshold of PG Dmean of 22.2Gy, for the development and validation cohorts, respectively. This would spare 38% (development cohort) and 24% (validation cohort) of patients from the labour-intensive ART procedure.ConclusionsThe presented method to select patients for ART pre-treatment reduces the labour of ART, contributing to a more effective allocation of the department resources.
from Rathiotherapy via xlomafota13 on Inoreader http://ift.tt/291NOeC - Effect of tumor dose, volume and overall treatment time on local control after radiochemotherapy including MRI guided brachytherapy of locally advanced cervical cancerPublication date: Available online 24 June 2016
Source:Radiotherapy and Oncology
Author(s): Kari Tanderup, Lars Ulrik Fokdal, Alina Sturdza, Christine Haie-Meder, Renaud Mazeron, Erik van Limbergen, Ina Jürgenliemk-Schulz, Primoz Petric, Peter Hoskin, Wolfgang Dörr, Søren M. Bentzen, Christian Kirisits, Jacob Christian Lindegaard, Richard Pötter
Background and purposeCurrently, there is no consensus on dose prescription in image guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer. The purpose of this study was to provide evidence based recommendations for tumor dose prescription based on results from a multi-center patient series (retroEMBRACE).Materials and methodsThis study analyzed 488 locally advanced cervical cancer patients treated with external beam radiotherapy±chemotherapy combined with IGABT. Brachytherapy contouring and reporting was according to ICRU/GEC-ESTRO recommendations. The Cox Proportional Hazards model was applied to analyze the effect on local control of dose-volume metrics as well as overall treatment time (OTT), dose rate, chemotherapy, and tumor histology.ResultsWith a median follow up of 46months, 43 local failures were observed. Dose (D90) to the High Risk Clinical Target Volume (CTVHR) (p=0.022, HR=0.967 per Gy) was significant for local control, whereas increasing CTVHR volume (p=0.004, HR=1.017 per cm3), and longer OTT (p=0.004, HR=1.023 per day) were associated with worse local control. Histology (p=0.084), chemotherapy (p=0.49) and dose rate (p=1.00) did not have significant impact on local control. Separate analyses according to stage of disease showed that dose to CTVHR, residual gross tumor volume (GTVres), and Intermediate Risk CTV (CTVIR) has significant impact on local control.ConclusionCTVHR dose of ⩾85Gy (D90) delivered in 7weeks provides 3-year local control rates of >94% in limited size CTVHR (20cm3), >93% in intermediate size (30cm3) and >86% in large size (70cm3) CTVHR. CTVIR and GTVres dose of ⩾60Gy and ⩾95Gy (D98) leads to similar local control. A dose of 5Gy (CTVHR) is required to compensate an increase of OTT by one week. Increased CTVHR volume by 10cm3 requires additional 5Gy for equivalent local control.
from Rathiotherapy via xlomafota13 on Inoreader http://ift.tt/291O7pR - Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.:
Abstract
BACKGROUND: To date, no study has confronted the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification.OBJECTIVE: To illustrate these features in healthy children.METHODS: The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan.RESULTS: The mean FMA of 6.49 cm2 in girls was significantly inferior to the FMA of 7.67 cm2 in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously.CONCLUSION: The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P <= .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01).ABBREVIATIONS: AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years oldCopyright (C) by the Congress of Neurological Surgeons - Reversible Edema-Like Changes Along the Optic Tract Following Pipeline-Assisted Coiling of a Large Anterior Communicating Artery Aneurysm.Reversible Edema-Like Changes Along the Optic Tract Following Pipeline-Assisted Coiling of a Large Anterior Communicating Artery Aneurysm.: Aneurysmal volume expansion after endovascular treatment is caused by intra-aneurysmal thrombosis in the early postembolization period. Although postembolization mass effect on cranial nerves and other adjacent structures has been previously reported, we are unaware of reports involving the anterior visual pathway. A 66-year-old woman with a 2-week history of blurred vision without headache was found to have a large, unruptured anterior communicating artery aneurysm. One month after endovascular treatment of the aneurysm with coiling and flow diversion, the patient developed decreased vision in her right eye and a left homonymous hemianopia. Magnetic resonance imaging demonstrated compression of the right optic nerve, chiasm, and edema of the right optic tract. The patient was treated with a course of high dose corticosteroids, and over the course of several weeks, her vision improved and the optic tract edema resolved. We alert clinicians to this rare but potentially reversible visual complication of endovascular treatment of intracranial aneurysms.(C) 2016 by North American Neuro-Ophthalmology Society
- Congenital Tonic Pupils Associated With Congenital Central Hypoventilation Syndrome and Hirschsprung Disease.Congenital Tonic Pupils Associated With Congenital Central Hypoventilation Syndrome and Hirschsprung Disease.:Autonomic dysfunction can be associated with pupillary abnormalities. We describe a rare association of tonic pupils, congenital central hypoventilation syndrome, and Hirschsprung disease in a newborn with a mutation in the PHOX2B gene, a key regulator of neural crest cells. Hirschsprung disease is characterized by the congenital absence of neural crest-derived intrinsic ganglion cells. Tonic pupils may result from an abnormality of the ciliary ganglion, another structure of neural crest origin. The close association of these conditions in this child suggests a common abnormality in neural crest migration and differentiation.(C) 2016 by North American Neuro-Ophthalmology Society
- Pulsed Dye Laser Treatment of Multiple Common Acquired Melanocytic Nevi: A Novel Approach
- Advanced Scalp Measurement Using a Phototrichogram With a Protractor and Tapeline
- Neodymium-Doped Yttrium Aluminium Garnet Laser Treatment of Pediatric Venous Malformation in the Oral CavityNeodymium-Doped Yttrium Aluminium Garnet Laser Treatment of Pediatric Venous Malformation in the Oral Cavity:
BACKGROUND: Treatment of venous malformations in the orofacial region remains a challenge. Laser therapy is an alternative treatment in inoperable cases.
OBJECTIVE: To retrospectively evaluate the effectiveness and complications associated with neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment of oral venous malformations.MATERIALS AND METHODS: A total of 10 children (mean age: 7.3 years; range: 10 months-15 years) with oral venous malformation were treated with Nd:YAG laser during 2005 to 2013. Clinical improvement, including degree of color lightening and size reduction, and treatment complications, including dyspigmentation, textural change, and scarring were evaluated.RESULTS: Color clearing of 51% to 75% and >75% was seen in 25% and 45% of patients, respectively. Size reduction of 25% to 50%, 51% to 75%, and >75% was observed in 30%, 15%, and 45% of patients, respectively. Mild and moderate scarring was observed in 15% and 5% of cases, respectively.CONCLUSION: Nd:YAG laser is a promising alternative treatment in pediatric patients with inoperable venous malformations in the oral cavity. Mild to moderate scarring was the most common complication. - Skin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic AcidSkin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic Acid:BACKGROUND: Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place.OBJECTIVE: To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system.MATERIALS AND METHODS: An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid.RESULTS: Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a “ceiling effect” was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment.CONCLUSION: For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid.
- Reconstruction After Full-Thickness Loss of the Antihelix, Scapha, and Triangular Fossa
- Histologic Findings of Tumor Lysis in Advanced Basal Cell Carcinoma Treated With Vismodegib
- Continuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma PalpebrarumContinuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma Palpebrarum: BACKGROUND: Although not an accepted standard treatment, the 532-nm continuous wave potassium titanyl phosphate (CW-KTP) laser might be a powerful device to treat xanthelasma palpebrarum (XP).OBJECTIVE: To determine the safety and efficacy of CW-KTP laser treatment for XP.MATERIALS AND METHODS: Between January 2013 and January 2015, 30 consecutive patients with XP were treated with a 532-nm CW-KTP laser (spot size: 0.9 mm, power: 5.0 W, fluence: 36–38 J/cm2, pulse width: 46 milliseconds, frequency: 2.0 Hz, passes per session: 3). In a retrospective study design, safety and efficacy data were collected and analyzed.RESULTS: Overall, 29/30 (97%) of patients had an excellent cosmetical result. Downtime was 1 week with crusted lesions. Although slight hypopigmentation was common, only 1/30 (3%) patients had hypopigmentation that was more than expected. Recurrences (13/30; 43%) were frequent, so that yearly maintenance therapy was warranted. No major side effects were noticed.CONCLUSION: Continuous wave KTP laser therapy is safe and highly effective for XP, although regular follow-up treatments are often necessary to maintain the achieved cosmetic results.
- Aging in the Male Face:Intrinsic and Extrinsic Factors: BACKGROUND: Gender is one of the most significant factors that influence facial anatomy and behavior, both key factors in the aging process.OBJECTIVE: To review male facial anatomy, physiology, and behavior and how it contributes to sexual dimorphism in facial aging.METHODS: A MEDLINE search was performed for publications on gender differences in facial anatomy, aging, cutaneous physiology, and behavior.RESULTS: There are differences in both intrinsic and extrinsic aging factors in men. Men have a thicker epidermis and dermis with more active cutaneous appendages including hair growth. Male skin has a reduced antioxidant capacity and increased ultraviolet-induced immunosuppression. The male face is larger and has a unique square shape with less subcutaneous soft tissue, especially at the medial cheek. Men are also more prone to smoking and exhibiting poor sun-protective behavior. The differences in intrinsic and extrinsic aging factors contribute to poor facial aging in men. Men develop more severe rhytides in a unique pattern, show increased periocular aging changes, and are more prone to hair loss.CONCLUSION: This review provides insight into the factors contributing to accelerated male facial aging. Understanding gender differences in aging will help physicians tailor cosmetic treatments for men and minimize extrinsic aging factors.
- Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening
BACKGROUND: Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening.
OBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.RESULTS: Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.CONCLUSION: Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT. - Motor Unit Number Estimation Based on High-Density Surface Electromyography DecompositionMotor unit number estimation (MUNE) techniques are clinically useful by estimating the number of functioning motor units in a muscle, which can serve as a biomarker for the progression of motor neuron diseases or neuromuscular disorders. Various MUNE methods have been developed since the incremental counting technique was introduced in 1971 (McComas et al., 1971). The main limitation with the incremental counting technique is the problem known as “alternation”, which leads to an erroneous overestimation of the MUNE.
from #ORL via xlomafota13 on Inoreader http://ift.tt/296q3zG - Effects of chronic neck-shoulder pain on normalized mutual information analysis of surface electromyography during functional tasksNeck and shoulder pain is a common problem that affects a large number of people worldwide (Van Tulder et al., 2007). This problem is exacerbated by the escalating use of electronic devices such as smartphones and portable tablet computers (Berolo et al., 2011). The research concerning the etiology of chronic neck-shoulder pain has mainly focused on the study of muscle activation in the postural muscles such as cervical erector spinae (CES) and upper trapezius (UT) muscle (Visser and van Dieën 2006).
from #ORL via xlomafota13 on Inoreader http://ift.tt/28T1FTR - Motor Unit Number Estimation Based on High-Density Surface Electromyography DecompositionMotor unit number estimation (MUNE) techniques are clinically useful by estimating the number of functioning motor units in a muscle, which can serve as a biomarker for the progression of motor neuron diseases or neuromuscular disorders. Various MUNE methods have been developed since the incremental counting technique was introduced in 1971 (McComas et al., 1971). The main limitation with the incremental counting technique is the problem known as “alternation”, which leads to an erroneous overestimation of the MUNE.
from #ORL via xlomafota13 on Inoreader http://ift.tt/296q3zG - Effects of chronic neck-shoulder pain on normalized mutual information analysis of surface electromyography during functional tasksNeck and shoulder pain is a common problem that affects a large number of people worldwide (Van Tulder et al., 2007). This problem is exacerbated by the escalating use of electronic devices such as smartphones and portable tablet computers (Berolo et al., 2011). The research concerning the etiology of chronic neck-shoulder pain has mainly focused on the study of muscle activation in the postural muscles such as cervical erector spinae (CES) and upper trapezius (UT) muscle (Visser and van Dieën 2006).
from #ORL via xlomafota13 on Inoreader http://ift.tt/28T1FTR - Reversed cortical over-activity during movement imagination following neurofeedback treatment for central neuropathic painCentral neuropathic pain (CNP) is a frequent secondary consequence of spinal cord injury (SCI), affecting about 40% of patients (Siddall et al. 2003). Although CNP is caused by an injury to the somatosensory system (Haanpää et al. 2011) it can show first symptoms years after SCI. Neuroimaging studies have demonstrated changes in the resting state brain activity in the presence of CNP, which is reflected in increased thalamo-cortical coherence in the theta band (Stern et al. 2006, Sarnthein and Jeandmond 2008), as well as increased resting state EEG power and a dominant alpha frequency shift towards lower frequencies (Stern et al.
from #ORL via xlomafota13 on Inoreader http://ift.tt/296qkCZ - What is the optimal task difficulty for reinforcement learning of brain self-regulation?Neurofeedback and brain-interface technology are being increasingly applied in fields of research aiming to restore upper-limb functionality in stroke survivors. Greater gains are currently being achieved by subacute (Pichiorri et al. 2015) than by chronic patients (Ang et al. 2014). On the basis of the neurophysiological correlates of motor imagery (Kaiser et al. 2011) and motor cortex excitability (Takemi et al. 2013; Kraus et al. 2016a), such as modulation of β-power (15-30 Hz), these devices may provide an effective backdoor to the motor system (Sharma 2006; Bauer et al.
from #ORL via xlomafota13 on Inoreader http://ift.tt/28T1OGE - Intradural extramedullary spinal tumorImproved patient quality of life following intradural extramedullary spinal tumor resection: Journal of Neurosurgery: Spine, Ahead of Print.
OBJECTIVE Resection significantly improves the clinical symptoms and functional outcomes of patients with intradural extramedullary tumors. However, patient quality of life following resection has not been adequately investigated. The aim in this retrospective analysis of prospectively collected quality of life outcomes is to analyze the efficacy of resection of intradural extramedullary spinal tumors in terms of quality of life markers. METHODS A retrospective review of a single institutional neurosurgical administrative database was conducted to analyze clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) for pain, and the EQ-5D-3 L descriptive system were used to analyze quality of life preoperatively, less than 1 month postoperatively, 1–3 months postoperatively, 3–12 months postoperatively, and more than 12 months postoperatively. RESULTS The ODI scores increased perioperatively at the < 1-month follow-up from 36 preoperatively to 47. Relative to preoperative values, the ODI score decreased significantly at 1–3, 3–12, and > 12 months to 23, 17, and 20, respectively. VAS scores significantly decreased from 6.1 to 3.5, 2.4, 2.0, and 2.9 at the < 1-month, 1- to 3-, 3- to 12-, and > 12-month follow-ups, respectively. EQ-5D mobility significantly worsened at the < 1-month follow-up but improved at the 3- to 12-and > 12-month follow-ups. EQ-5D self-care significantly worsened at the < 1-month follow-up but significantly improved by the 3- to 12-month follow-up. EQ-5D usual activities improved at the 1- to 3-, 3- to 12-, and > 12-month follow-ups. EQ-5D pain and discomfort significantly improved at all follow-up points. EQ-5D anxiety and depression significantly improved at 1- to 3-month and 3- to 12-month follow-ups. CONCLUSIONS Resection of intradural extramedullary spine tumors appears to significantly improve patient quality of life by decreasing patient disability and pain and by improving each of the EQ-5D domains.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VUIPK
via IFTTT - Re-irradiation stereotactic body radiotherapy for spinal metastasesa multi-institutional outcome analysis: Journal of Neurosurgery: Spine, Ahead of Print.
OBJECTIVE This study is a multi-institutional pooled analysis specific to imaging-based local control of spinal metastases in patients previously treated with conventional external beam radiation therapy (cEBRT) and then treated with re-irradiation stereotactic body radiotherapy (SBRT) to the spine as salvage therapy, the largest such study to date. METHODS The authors reviewed cases involving 215 patients with 247 spinal target volumes treated at 7 institutions. Overall survival was calculated on a patient basis, while local control was calculated based on the spinal target volume treated, both using the Kaplan-Meier method. Local control was defined as imaging-based progression within the SBRT target volume. Equivalent dose in 2-Gy fractions (EQD2) was calculated for the cEBRT and SBRT course using an α/β of 10 for tumor and 2 for both spinal cord and cauda equina. RESULTS The median total dose/number of fractions of the initial cEBRT was 30 Gy/10. The median SBRT total dose and number of fractions were 18 Gy and 1, respectively. Sixty percent of spinal target volumes were treated with single-fraction SBRT (median, 16.6 Gy and EQD2/10 = 36.8 Gy), and 40% with multiple-fraction SBRT (median 24 Gy in 3 fractions, EQD2/10 = 36 Gy). The median time interval from cEBRT to re-irradiation SBRT was 13.5 months, and the median duration of patient follow-up was 8.1 months. Kaplan-Meier estimates of 6- and 12-month overall survival rates were 64% and 48%, respectively; 13% of patients suffered a local failure, and the 6- and 12-month local control rates were 93% and 83%, respectively. Multivariate analysis identified Karnofsky Performance Status (KPS) < 70 as a significant prognostic factor for worse overall survival, and single-fraction SBRT as a significant predictive factor for better local control. There were no cases of radiation myelopathy, and the vertebral compression fracture rate was 4.5%. CONCLUSIONS Re-irradiation spine SBRT is effective in yielding imaging-based local control with a clinically acceptable safety profile. A randomized trial would be required to determine the optimal fractionation.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VUEj8
via IFTTT - Retro-odontoid pseudotumors are considered to be associated with atlantoaxial instability in patients with rheumatoid arthritis (RA)Factors associated with retro-odontoid soft-tissue thickness in rheumatoid arthritis: Journal of Neurosurgery: Spine, Ahead of Print.
OBJECTIVE Increasing soft-tissue mass posterior to the odontoid process causes spinal cord compression. Retro-odontoid pseudotumors are considered to be associated with atlantoaxial instability in patients with rheumatoid arthritis (RA), but the exact mechanism by which these lesions develop has not been elucidated. The purpose of this study was to identify the relationships between retro-odontoid soft-tissue (ROST) thickness and radiological findings or clinical data in patients with RA. METHODS A total of 201 patients with RA who had been followed up at the outpatient clinic of the authors’ institution were enrolled in this study. ROST thickness was evaluated on midsagittal T1-weighted MRI. The correlations between ROST thickness and radiographic findings or clinical data on RA were examined. The independent factors related to ROST thickness were analyzed using stepwise multiple regression analysis. RESULTS The average thickness of ROST was 3.0 ± 1.4 mm. ROST thickness showed an inverse correlation with disease duration (r = −0.329, p < 0.01), Steinbrocker stage (r = −0.284, p < 0.01), the atlantodental interval (ADI) in the neutral position (r = −0.326, p < 0.01), the ADI in the flexion position (r = −0.383, p < 0.01), and the ADI in the extension position (r = −0.240, p < 0.01). On stepwise multiple regression analysis, ADI in the flexion position and Steinbrocker stage were independent factors associated with ROST thickness. CONCLUSIONS Although the correlations were not strong, ROST thickness in patients with RA was inversely correlated with ADI and Steinbrocker stage. In other words, ROST thickness tends to be smaller as atlantoaxial instability and peripheral joint destruction worsen. Clinical trial registration no.: UMIN000000980 (UMIN Clinical Trials Registry)
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VUKHq
via IFTTT - Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagiaA randomized, double-blind clinical trial.:
Authors: Du J, Yang F, Liu L, Hu J, Cai B, Liu W, Xu G, Liu X
Abstract
OBJECTIVE: This randomized, sham-controlled, double-blind study was conducted to investigate the effects of high-frequency versus low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with poststroke dysphagia during early rehabilitation.
METHODS: Forty patients with poststroke dysphagia were randomized to receive five daily sessions of sham, 3-Hz ipsilesional, or 1-Hz contralesional rTMS. Swallowing function, the severity of stroke and functional disability, and cortical excitability were examined before, immediately after five daily sessions, as well as the first, second, and third month after the last session.
RESULTS: At baseline, no significant differences between groups were observed in terms of demographic and clinical rating scales. However, a significantly greater improvement in swallowing function as well as functional disability was observed after real rTMS when compared with sham rTMS, which remained 3 months after the end of the treatment sessions. In addition, 1-Hz rTMS increased cortical excitability of the affected hemisphere and decreased that of the non-affected hemisphere; however, 3-Hz rTMS only increased cortical excitability of the affected hemisphere.
CONCLUSION: rTMS (both high and low frequency) improved swallowing recovery in patients with poststroke dysphagia, and the effects lasted for at least 3 months.
SIGNIFICANCE: rTMS appears to be a beneficial therapeutic modality for patients with dysphagia during the early phase of stroke.
PMID: 26778719 [PubMed - indexed for MEDLINE]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28Vcvdv
via IFTTT - A New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy.Structure of a
Acta Med Okayama. 2016 Jun;70(3):205-211
Authors: Kozaki KI, Kawakami S, Konishi T, Ohta K, Yano J, Onoda T, Matsumoto H, Mizukawa N, Kimata Y, Nishizaki K, Iida S, Gofuku A, Abe M, Minagi S, Okayama Dream Speech Project
Abstract
A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAP’s effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects.
PMID: 27339210 [PubMed - as supplied by publisher]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/29biSpX
via IFTTT - Palatal augmentation prosthesis (PAP)Structure of a New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy.:
Acta Med Okayama. 2016 Jun;70(3):205-211
Authors: Kozaki KI, Kawakami S, Konishi T, Ohta K, Yano J, Onoda T, Matsumoto H, Mizukawa N, Kimata Y, Nishizaki K, Iida S, Gofuku A, Abe M, Minagi S, Okayama Dream Speech Project
Abstract
A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAP’s effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects.
PMID: 27339210 [PubMed - as supplied by publisher]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VFdtb
via IFTTT - Esophageal atresia (EA),Severe respiratory morbidity and gastroesophageal reflux (GER) symptomsPhysiological Studies at 7 Years of Age in Children Born with Esophageal Atresia.:
Authors: Olbers J, Gatzinsky V, Jönsson L, Friberg LG, Abrahamsson K, Sillén U, Gustafsson P
Abstract
OBJECTIVE: For many years, esophageal atresia (EA) has been curable by surgery. However, severe respiratory morbidity and gastroesophageal reflux (GER) symptoms remain a problem in many patients. The purpose of this study was to describe respiratory and esophageal morbidity, esophageal function, and lung function, including the small airways, in patients with the most common type of the malformation (EA with a distal fistula).
METHODS: The study comprised 26 children undergoing surgery for EA, who had performed respiratory and esophageal function studies at the age of 7 years in a follow-up program. The study design was retrospective analysis of both these 7-year functional investigations and esophageal and respiratory morbidity from birth to the age of 7 years, as documented in medical records. Pulmonary function was evaluated mainly by spirometry and multiple breath washout (MBW), whereas esophageal function was evaluated by 24-hour pH studies.
RESULTS: We found a high prevalence of both respiratory (69%) and esophageal (62%) morbidity between birth and 7 years among the EA children. Examination with MBW (peripheral airway function) revealed few abnormal results, whereas spirometry revealed high airway obstruction in half the children, which also correlated well with overall respiratory symptoms (p = 0.047), as well as recurrent pneumonias (p = 0.035). However, no association with GER symptoms was found. In addition, 46% of the children had GER according to pH measurements, which were correlated to clinical GER symptoms but not to respiratory symptoms.
CONCLUSION: This study confirms a high prevalence of respiratory and esophageal morbidity. In terms of respiratory function, the high proportion with a spirometric abnormality indicated an associated developmental delay/dysfunction in the central airways, whereas the peripheral airways appeared to have normal function at this age. Tracheomalacia may explain the spirometric abnormalities, but this need to be studied in more detail.
PMID: 25302538 [PubMed - indexed for MEDLINE]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VFbkW
via IFTTT - Sleep Stage Coordination of Respiration and SwallowingA Preliminary Study.:
Dysphagia. 2016 Jun ;
Authors: Okuno K, Nohara K, Takai E, Sakai T, Fleetham JA, Ayas NT, Lowe AA, Almeida FR
Abstract
Swallowing is an important physiological response that protects the airway. Although aspiration during sleep may cause aspiration pneumonia, the mechanisms responsible have not yet been elucidated. We evaluated the coordination between respiration and swallowing by infusing water into the pharynx of healthy young adults during each sleep stage. Seven normal subjects participated in the study. During polysomnography recordings, to elicit a swallow we injected distilled water into the pharynx during the awake state and each sleep stage through a nasal catheter. We assessed swallow latency, swallow apnea time, the respiratory phase during a swallow, the number of swallows, and coughing. A total number of 79 swallows were recorded. The median swallow latency was significantly higher in stage 2 (10.05 s) and stage 3 (44.17 s) when compared to awake state (4.99 s). The swallow latency in stage 3 showed a very wide interquartile range. In two subjects, the result was predominantly prolonged compared to the other subjects. There was no significant difference in the swallow apnea time between sleep stages. The presence of inspiration after swallowing, repetitive swallowing, and coughing after swallowing was more frequent during sleep than when awake. This study suggests that the coordination between respiration and swallowing as a defense mechanism against aspiration was impaired during sleep. Our results supported physiologically the fact that healthy adult individuals aspirate pharyngeal secretions during sleep.
PMID: 27338262 [PubMed - as supplied by publisher]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/29biUyg
via IFTTT - Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma.
Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma.
Case Rep Urol. 2016;2016:7050981
Authors: Yoshie H, Nakazawa R, Usuba W, Kudo H, Sato Y, Sasaki H, Chikaraishi T
Abstract
We report the first case in Japan of paraneoplastic dermatomyositis with pure seminoma, a tumor that extremely rarely accompanies dermatomyositis. The patient presented to the hospital with muscle weakness and erythema and was diagnosed with dermatomyositis from skin biopsy. Routine radiological screening revealed testicular tumor and massive lymph node metastases. We initially performed orchiectomy along with conventional immunotherapy. However, muscle weakness gradually worsened, and he eventually showed dysphagia and forced respiration and became bedridden. Although he seemed close to being too unstable to tolerate further treatment, we started carefully adjusted chemotherapy comprising 4 courses of etoposide plus cisplatin, which proved highly successful. Lymph node metastases completely disappeared and swallowing and respiration fully normalized after completing chemotherapy. We believe that this clinical success was due to our decision to initiate chemotherapy even in such a weak patient.
PMID: 27340589 [PubMed]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VclTk
via IFTTT - Per-oral endoscopic myotomy (POEM)Reduced postoperative pain scores and narcotic use favor per-oral endoscopic myotomy over laparoscopic Heller myotomy.:
Surg Endosc. 2016 Jun ;
Authors: Docimo S, Mathew A, Shope AJ, Winder JS, Haluck RS, Pauli EM
Abstract
INTRODUCTION: Per-oral endoscopic myotomy (POEM) is a less invasive therapy for achalasia with a shorter hospitalization but with similar short- and long-term outcomes as a laparoscopic Heller myotomy (LHM). Previous literature comparing POEM to LHM has focused primarily on postoperative outcome parameters such as complications, dysphagia scores and gastro-esophageal reflux severity. This study specifically compares postoperative pain following POEM to pain following LHM, the current gold-standard operation.
METHODS: A retrospective review of all patients undergoing POEM or LHM for achalasia was performed from 2006 to 2015. Data collection included demographics, comorbidities, length of stay (LOS) and pain scores (arrival to the recovery room, 1 h postoperative, average first 24 h and upon discharge). Statistical analysis was performed using Student’s t test and Chi-square test.
RESULTS: Forty-four POEM patients and 122 LHM patients were identified. The average age (52.2 ± 20.75 vs 50.9 ± 17.89 years, p = 0.306) and BMI (28.1 ± 7.62 vs 27.6 ± 7.07 kg/m(2), p = 0.824) did not differ between the POEM and LHM groups, respectively; however, the American Society of Anesthesiology scores were higher in the POEM patients (2.43 ± 0.62 vs 2.11 ± 0.71, p = 0.011). There were no differences in rates of smoking, diabetes, cardiac disease or pulmonary disease. The average pain scores upon arrival to the recovery room and 1 h postoperatively were lower in the POEM group (2.3 ± 3.014 vs 3.61 ± 3 0.418, p = 0.025 and 2.2 ± 2.579 vs 3.46 ± 3.063, p = 0.034, respectively). There was no difference in the average pain score over the first 24 h (2.7 ± 2.067 vs 3.29 ± 1.980, p = 0.472) or at the time of discharge (1.6 ± 2.420 vs 2.09 ± 2.157, p = 0.0657) between the POEM and LHM groups. After standardizing opioid administration against 10 mg of oral morphine, the POEM group used significantly less narcotics that the LHM group (35.8 vs 101.8 mg, p < 0.001) while hospitalized. The average LOS for the POEM group was 31.2 h and 55.79 for the LHM group (p < 0.0001). At discharge, fewer POEM patients required a prescription for a narcotic analgesic (6.81 vs 92.4 %, p < 0.0001).
CONCLUSION: POEM demonstrated significantly less postoperative pain upon arrival to the recovery room and 1 h postoperatively. To achieve similar pain scores during the first 24 h and at discharge, LHM patients required more narcotic analgesic administration. Despite a significantly shorter LOS, fewer POEM patients require a prescription for narcotic analgesics compared to LHM. POEM is a less painful procedure for achalasia than LHM, permitting earlier hospital discharge with little need for home narcotic use.
PMID: 27338580 [PubMed - as supplied by publisher]
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VFiNE
via IFTTT - RET protein is overexpressed in oral squamous cell carcinomaRearranged during transfection (RET) protein has been identified as a molecular therapeutic target in multiple types of cancer. Amongst these cancers are papillary thyroid, non-small cell lung (NSCLC), breast, pancreatic and prostate cancer, and tumours related to MEN2 syndrome.1 Tumours harboring RET oncogenic aberrations are successfully treated with various multikinase inhibitors in clinical setting, e.g. cabozantinib and vandetanib. RET oncogenic aberrations include RET protein overexpression, RET gene fusions, copy-number changes and RETpoint mutations.2This article is protected by copyright. All rights reserved.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VUb0a
via IFTTT - Working 9–5: Vocal HealthWorking 9–5: Causal Relationships Between Singers’ “Day Jobs” and Their Performance Work, With Implications for Vocal Health: It is acknowledged generally that professional contemporary commercial music (CCM) singers engage in supplementary employment (“the day job”) to achieve and maintain a reliable living wage. In this paper, consideration is given to the impact of such nonperformance employment on CCM’s sustainable vocal health.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VUjNp
via IFTTT - Patients with chronic cold urticaria may benefit from doxycycline therapy
Abstract
Chronic cold urticaria (ColdU) is a rare but severe and potentially life-threatening form of chronic urticaria characterized by the development of wheal and flare type skin reactions or angioedema after skin exposure to cold1. Extensive cold contact (e.g. swimming in cold water) and low trigger thresholds (i.e. wheal responses to temperatures of 20°C or higher) may lead to systemic reactions including anaphylactic shock2.This article is protected by copyright. All rights reserved.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VciXI
via IFTTT - Gastric peroral endoscopic myotomy (G-POEM)Gastric peroral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video):
Gastric peroral endoscopic myotomy (G-POEM) has been recently reported as minimally invasive therapy for gastroparesis. The aims of this study were to report the first multicenter experience with G-POEM and assess the efficacy and safety of this novel procedure for gastroparetic patients with symptoms refractory to medical therapy.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28Vckih
via IFTTT - The retromolar canal and foramenRetromolar foramen: an anatomical study with clinical considerations: The retromolar canal and foramen, an anatomical variation in the mandibular retromolar area, houses and transmits neurovascular elements that may innervate the mandibular third molar and associated tissues. These structures have been implicated in local anaesthetic failure, loss of sensation in the normal distribution of the buccal nerve, and local haemorrhage during surgery. Examination of 885 dry mandibles showed that 70 had a retromolar foramen (8%). There were no significant differences between groups according to age, sex, or ancestry.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28Vcfv6
via IFTTT - Impact of midface and upper face fracture on bite force, mandibular mobility, and electromyographic activityImpact of midface and upper face fracture on bite force, mandibular mobility, and electromyographic activity: This study evaluated the bite force, electromyographic activity, and mandibular mobility in patients undergoing surgery for facial fracture treatment that required a coronal approach. Ten men were divided into two groups: group I, coronal approach with pre-auricular extension (n=4, average age 34.5 years); group II, coronal approach (n=6, average age 24.8 years). The maximum bite force was measured using a dynamometer and mandibular mobility using a calliper. The electromyographic activity of the right masseter (RM), left masseter (LM), right temporal (RT), and left temporal (LT) muscles was evaluated using a Myosystem-Br1 apparatus.
from OtoRhinoLaryngology - Alexandros G. Sfakianakis http://ift.tt/28VU7xo
via IFTTT - Skin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic AcidSkin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic Acid:BACKGROUND: Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place.OBJECTIVE: To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system.MATERIALS AND METHODS: An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid.RESULTS: Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a “ceiling effect” was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment.CONCLUSION: For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid.
- Reconstruction After Full-Thickness Loss of the Antihelix, Scapha, and Triangular Fossa
- Histologic Findings of Tumor Lysis in Advanced Basal Cell Carcinoma Treated With Vismodegib
- Continuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma PalpebrarumContinuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma Palpebrarum: BACKGROUND: Although not an accepted standard treatment, the 532-nm continuous wave potassium titanyl phosphate (CW-KTP) laser might be a powerful device to treat xanthelasma palpebrarum (XP).OBJECTIVE: To determine the safety and efficacy of CW-KTP laser treatment for XP.MATERIALS AND METHODS: Between January 2013 and January 2015, 30 consecutive patients with XP were treated with a 532-nm CW-KTP laser (spot size: 0.9 mm, power: 5.0 W, fluence: 36–38 J/cm2, pulse width: 46 milliseconds, frequency: 2.0 Hz, passes per session: 3). In a retrospective study design, safety and efficacy data were collected and analyzed.RESULTS: Overall, 29/30 (97%) of patients had an excellent cosmetical result. Downtime was 1 week with crusted lesions. Although slight hypopigmentation was common, only 1/30 (3%) patients had hypopigmentation that was more than expected. Recurrences (13/30; 43%) were frequent, so that yearly maintenance therapy was warranted. No major side effects were noticed.CONCLUSION: Continuous wave KTP laser therapy is safe and highly effective for XP, although regular follow-up treatments are often necessary to maintain the achieved cosmetic results.
- Aging in the Male Face:Intrinsic and Extrinsic Factors: BACKGROUND: Gender is one of the most significant factors that influence facial anatomy and behavior, both key factors in the aging process.OBJECTIVE: To review male facial anatomy, physiology, and behavior and how it contributes to sexual dimorphism in facial aging.METHODS: A MEDLINE search was performed for publications on gender differences in facial anatomy, aging, cutaneous physiology, and behavior.RESULTS: There are differences in both intrinsic and extrinsic aging factors in men. Men have a thicker epidermis and dermis with more active cutaneous appendages including hair growth. Male skin has a reduced antioxidant capacity and increased ultraviolet-induced immunosuppression. The male face is larger and has a unique square shape with less subcutaneous soft tissue, especially at the medial cheek. Men are also more prone to smoking and exhibiting poor sun-protective behavior. The differences in intrinsic and extrinsic aging factors contribute to poor facial aging in men. Men develop more severe rhytides in a unique pattern, show increased periocular aging changes, and are more prone to hair loss.CONCLUSION: This review provides insight into the factors contributing to accelerated male facial aging. Understanding gender differences in aging will help physicians tailor cosmetic treatments for men and minimize extrinsic aging factors.
- Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lighteningOBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.RESULTS: Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.CONCLUSION: Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT.
- Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar LentiginesBACKGROUND: Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening.OBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.RESULTS: Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.CONCLUSION: Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT.
- Risk of Cerebral Air Emboli Associated With Calvarial Fenestration
- Décolleté aging includes skin dyspigmentation, laxity, and visible wrinklingValidated Assessment Scales for Décolleté Wrinkling and Pigmentation: BACKGROUND: Décolleté aging includes skin dyspigmentation, laxity, and visible wrinkling. The development of globally accepted scales for the assessment of décolleté aging is essential for aesthetic research and patient evaluation.OBJECTIVE: To develop a set of grading scales for the objective assessment of décolleté aging criteria and establish the reliability and validity of these scales.MATERIALS AND METHODS: To describe age-related changes to the décolleté, 3 photonumeric grading scales were created and validated: décolleté wrinkles—at rest, décolleté wrinkles—dynamic, and décolleté pigmentation—at rest. Thirteen aesthetic experts rated photographs of the décolleté of 50 women at rest and at dynamic “hand-to-elbow” positions in 2 validation sessions. Responses were analyzed to assess interrater and intrarater reliability.RESULTS: Interrater and intrarater reliability were both “almost perfect” (≥0.81, intraclass correlation coefficient and weighted kappa) for décolleté wrinkles—dynamic, summary score for décolleté, and estimated age. Reliability was “substantial” (0.61–0.80) for all other décolleté assessments. There was high correlation between all décolleté scales, estimated age, and estimated aesthetic treatment effort.CONCLUSION: Consistent outcomes between raters and by individual raters at different time points confirm the reliability of the décolleté grading scales, indicating that they will be a valuable tool for use in clinical research and practice.
- Scalp Basal Cell CarcinomaReview of 2,202 Cases: BACKGROUND: Increases in the incidence of basal cell carcinoma (BCC) in women, younger age groups and in aggressive scalp subtypes in younger women have been reported.OBJECTIVE: To describe lesion and patient characteristics in scalp BCC.MATERIALS AND METHODS: Retrospective audit of scalp BCCs from 3 pathology laboratories in Adelaide, South Australia, January 2009–December 2013.RESULTS: Scalp BCC was 2.6% of all BCC. Of 2,202 patients with scalp BCC, 62% were male and 78% were >60 years. Histologic subtypes included nodular (55%), mixed (30%), and superficial (8%). The concordance between biopsy and excision was 83% for division into nonaggressive and aggressive subtypes. The incomplete excision rate was 16%. Aggressive subtypes were larger and had perineural invasion (PNI) in 8.5% and incomplete excision in 26%.CONCLUSION: Basal cell carcinoma on the scalp was less common. Men and the elderly had the majority of cases, with no predilection for women, including aggressive histologic subtypes in younger women. Aggressive subtypes were associated with increased size, incomplete excision, and PNI. A preliminary biopsy assisted division into aggressive and nonaggressive histologic subtypes. Incomplete excision rates were higher and increased in aggressive histologic subtypes and PNI. Mohs surgery or wider margins are suggested in these cases.
- Soft-Tissue Augmentation With Hyaluronic Acid Filler
- Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.:
Abstract
BACKGROUND: To date, no study has confronted the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification.OBJECTIVE: To illustrate these features in healthy children.METHODS: The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan.RESULTS: The mean FMA of 6.49 cm2 in girls was significantly inferior to the FMA of 7.67 cm2 in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously.CONCLUSION: The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P <= .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01).ABBREVIATIONS: AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years oldCopyright (C) by the Congress of Neurological Surgeons - Reversible Edema-Like Changes Along the Optic Tract Following Pipeline-Assisted Coiling of a Large Anterior Communicating Artery Aneurysm.Reversible Edema-Like Changes Along the Optic Tract Following Pipeline-Assisted Coiling of a Large Anterior Communicating Artery Aneurysm.: Aneurysmal volume expansion after endovascular treatment is caused by intra-aneurysmal thrombosis in the early postembolization period. Although postembolization mass effect on cranial nerves and other adjacent structures has been previously reported, we are unaware of reports involving the anterior visual pathway. A 66-year-old woman with a 2-week history of blurred vision without headache was found to have a large, unruptured anterior communicating artery aneurysm. One month after endovascular treatment of the aneurysm with coiling and flow diversion, the patient developed decreased vision in her right eye and a left homonymous hemianopia. Magnetic resonance imaging demonstrated compression of the right optic nerve, chiasm, and edema of the right optic tract. The patient was treated with a course of high dose corticosteroids, and over the course of several weeks, her vision improved and the optic tract edema resolved. We alert clinicians to this rare but potentially reversible visual complication of endovascular treatment of intracranial aneurysms.
(C) 2016 by North American Neuro-Ophthalmology Society - Congenital Tonic Pupils Associated With Congenital Central Hypoventilation Syndrome and Hirschsprung Disease.Congenital Tonic Pupils Associated With Congenital Central Hypoventilation Syndrome and Hirschsprung Disease.:Autonomic dysfunction can be associated with pupillary abnormalities. We describe a rare association of tonic pupils, congenital central hypoventilation syndrome, and Hirschsprung disease in a newborn with a mutation in the PHOX2B gene, a key regulator of neural crest cells. Hirschsprung disease is characterized by the congenital absence of neural crest-derived intrinsic ganglion cells. Tonic pupils may result from an abnormality of the ciliary ganglion, another structure of neural crest origin. The close association of these conditions in this child suggests a common abnormality in neural crest migration and differentiation.
(C) 2016 by North American Neuro-Ophthalmology Society - Pulsed Dye Laser Treatment of Multiple Common Acquired Melanocytic Nevi: A Novel Approach
- Advanced Scalp Measurement Using a Phototrichogram With a Protractor and Tapeline
- Neodymium-Doped Yttrium Aluminium Garnet Laser Treatment of Pediatric Venous Malformation in the Oral CavityNeodymium-Doped Yttrium Aluminium Garnet Laser Treatment of Pediatric Venous Malformation in the Oral Cavity:
BACKGROUND: Treatment of venous malformations in the orofacial region remains a challenge. Laser therapy is an alternative treatment in inoperable cases.
OBJECTIVE: To retrospectively evaluate the effectiveness and complications associated with neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment of oral venous malformations.
MATERIALS AND METHODS: A total of 10 children (mean age: 7.3 years; range: 10 months-15 years) with oral venous malformation were treated with Nd:YAG laser during 2005 to 2013. Clinical improvement, including degree of color lightening and size reduction, and treatment complications, including dyspigmentation, textural change, and scarring were evaluated.
RESULTS: Color clearing of 51% to 75% and >75% was seen in 25% and 45% of patients, respectively. Size reduction of 25% to 50%, 51% to 75%, and >75% was observed in 30%, 15%, and 45% of patients, respectively. Mild and moderate scarring was observed in 15% and 5% of cases, respectively.
CONCLUSION: Nd:YAG laser is a promising alternative treatment in pediatric patients with inoperable venous malformations in the oral cavity. Mild to moderate scarring was the most common complication. - Skin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic AcidSkin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic Acid:
BACKGROUND: Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place.
OBJECTIVE: To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system.
MATERIALS AND METHODS: An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid.
RESULTS: Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a “ceiling effect” was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment.
CONCLUSION: For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid. - Reconstruction After Full-Thickness Loss of the Antihelix, Scapha, and Triangular Fossa
- Histologic Findings of Tumor Lysis in Advanced Basal Cell Carcinoma Treated With Vismodegib
- Continuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma PalpebrarumContinuous Wave Potassium Titanyl Phosphate Laser Treatment is Safe and Effective for Xanthelasma Palpebrarum: BACKGROUND: Although not an accepted standard treatment, the 532-nm continuous wave potassium titanyl phosphate (CW-KTP) laser might be a powerful device to treat xanthelasma palpebrarum (XP).
OBJECTIVE: To determine the safety and efficacy of CW-KTP laser treatment for XP.
MATERIALS AND METHODS: Between January 2013 and January 2015, 30 consecutive patients with XP were treated with a 532-nm CW-KTP laser (spot size: 0.9 mm, power: 5.0 W, fluence: 36–38 J/cm2, pulse width: 46 milliseconds, frequency: 2.0 Hz, passes per session: 3). In a retrospective study design, safety and efficacy data were collected and analyzed.
RESULTS: Overall, 29/30 (97%) of patients had an excellent cosmetical result. Downtime was 1 week with crusted lesions. Although slight hypopigmentation was common, only 1/30 (3%) patients had hypopigmentation that was more than expected. Recurrences (13/30; 43%) were frequent, so that yearly maintenance therapy was warranted. No major side effects were noticed.
CONCLUSION: Continuous wave KTP laser therapy is safe and highly effective for XP, although regular follow-up treatments are often necessary to maintain the achieved cosmetic results. - Aging in the Male Face:Intrinsic and Extrinsic Factors: BACKGROUND: Gender is one of the most significant factors that influence facial anatomy and behavior, both key factors in the aging process.
OBJECTIVE: To review male facial anatomy, physiology, and behavior and how it contributes to sexual dimorphism in facial aging.
METHODS: A MEDLINE search was performed for publications on gender differences in facial anatomy, aging, cutaneous physiology, and behavior.
RESULTS: There are differences in both intrinsic and extrinsic aging factors in men. Men have a thicker epidermis and dermis with more active cutaneous appendages including hair growth. Male skin has a reduced antioxidant capacity and increased ultraviolet-induced immunosuppression. The male face is larger and has a unique square shape with less subcutaneous soft tissue, especially at the medial cheek. Men are also more prone to smoking and exhibiting poor sun-protective behavior. The differences in intrinsic and extrinsic aging factors contribute to poor facial aging in men. Men develop more severe rhytides in a unique pattern, show increased periocular aging changes, and are more prone to hair loss.
CONCLUSION: This review provides insight into the factors contributing to accelerated male facial aging. Understanding gender differences in aging will help physicians tailor cosmetic treatments for men and minimize extrinsic aging factors. - Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lighteningA Prospective Trial Comparing Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar Lentigines:
BACKGROUND: Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening.
OBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.
METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.
RESULTS: Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.
CONCLUSION: Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT. - Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar LentiginesA Prospective Trial Comparing
BACKGROUND: Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening.
OBJECTIVE: This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.
METHODS: In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.
RESULTS: Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.
CONCLUSION: Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT. - Risk of Cerebral Air Emboli Associated With Calvarial Fenestration
- Décolleté aging includes skin dyspigmentation, laxity, and visible wrinklingValidated Assessment Scales for Décolleté Wrinkling and Pigmentation: BACKGROUND: Décolleté aging includes skin dyspigmentation, laxity, and visible wrinkling. The development of globally accepted scales for the assessment of décolleté aging is essential for aesthetic research and patient evaluation.
OBJECTIVE: To develop a set of grading scales for the objective assessment of décolleté aging criteria and establish the reliability and validity of these scales.
MATERIALS AND METHODS: To describe age-related changes to the décolleté, 3 photonumeric grading scales were created and validated: décolleté wrinkles—at rest, décolleté wrinkles—dynamic, and décolleté pigmentation—at rest. Thirteen aesthetic experts rated photographs of the décolleté of 50 women at rest and at dynamic “hand-to-elbow” positions in 2 validation sessions. Responses were analyzed to assess interrater and intrarater reliability.
RESULTS: Interrater and intrarater reliability were both “almost perfect” (≥0.81, intraclass correlation coefficient and weighted kappa) for décolleté wrinkles—dynamic, summary score for décolleté, and estimated age. Reliability was “substantial” (0.61–0.80) for all other décolleté assessments. There was high correlation between all décolleté scales, estimated age, and estimated aesthetic treatment effort.
CONCLUSION: Consistent outcomes between raters and by individual raters at different time points confirm the reliability of the décolleté grading scales, indicating that they will be a valuable tool for use in clinical research and practice. - Scalp Basal Cell CarcinomaReview of 2,202 Cases: BACKGROUND: Increases in the incidence of basal cell carcinoma (BCC) in women, younger age groups and in aggressive scalp subtypes in younger women have been reported.
OBJECTIVE: To describe lesion and patient characteristics in scalp BCC.
MATERIALS AND METHODS: Retrospective audit of scalp BCCs from 3 pathology laboratories in Adelaide, South Australia, January 2009–December 2013.
RESULTS: Scalp BCC was 2.6% of all BCC. Of 2,202 patients with scalp BCC, 62% were male and 78% were >60 years. Histologic subtypes included nodular (55%), mixed (30%), and superficial (8%). The concordance between biopsy and excision was 83% for division into nonaggressive and aggressive subtypes. The incomplete excision rate was 16%. Aggressive subtypes were larger and had perineural invasion (PNI) in 8.5% and incomplete excision in 26%.
CONCLUSION: Basal cell carcinoma on the scalp was less common. Men and the elderly had the majority of cases, with no predilection for women, including aggressive histologic subtypes in younger women. Aggressive subtypes were associated with increased size, incomplete excision, and PNI. A preliminary biopsy assisted division into aggressive and nonaggressive histologic subtypes. Incomplete excision rates were higher and increased in aggressive histologic subtypes and PNI. Mohs surgery or wider margins are suggested in these cases. - Soft-Tissue Augmentation With Hyaluronic Acid Filler
- Horns presented on invasive SCC with reduced tumor diameters and reduced invasion depths compared to nonhorns. Horns presenting on invasive SCC were usually well differentiated. However, moderate and even poor differentiation can occur within a horn base.Invasive Squamous Cell Carcinoma: A Comparison of Tumors With or Without Horn Presentation Based on Age, Sex, Anatomic Site, Tumor Diameter, Depth of Invasion, and Grade of Differentiation in 1,666 Cases:
Abstract
INTRODUCTION: Invasive squamous cell carcinoma (SCC) may present clinically with or without a horn.OBJECTIVE: To compare invasive SCC with or without horn presentation by anatomic site, tumor diameter, depth, and grade of differentiation.MATERIALS AND METHODS: The above characteristics of invasive SCC with or without horns were compared using a logistic regression model adjusted for potential confounders.RESULTS: There were 7.0% horns (n = 116) and 93.0% nonhorns (n = 1,550) in 1,666 cases. The median tumor diameter was 6 mm for horns, and 8 mm for nonhorn cases, p < .001. The median depth of invasion was 0.8 mm for horn cases and 1.3 mm for nonhorns, p < .001. Most cases were well-differentiated SCC for both horns (n = 102, 87.9%) and nonhorns (n = 1,265, 81.6%) p = .07. Horn cases had a borderline significant shift to well differentiation with moderate differentiation in 11.2% of cases (n = 13) and poor differentiation in 0.9% (n = 1).CONCLUSION: Horns presented on invasive SCC with reduced tumor diameters and reduced invasion depths compared to nonhorns. Horns presenting on invasive SCC were usually well differentiated. However, moderate and even poor differentiation can occur within a horn base. - Photodynamic TherapyA Clinical Consensus Guide:
BACKGROUND: The American Society of Dermatologic Surgery (ASDS) periodically develops consensus documents for its members concerning various aspects of dermatologic surgery. Advances in photodynamic therapy (PDT) have been many and PDT use has been established in a variety of skin conditions.
OBJECTIVE: The ASDS board of directors proposed a committee of experts in the field to develop consensus documents on different treatments. An expert panel reviewed the literature on PDT and discussed the findings. The consensus was reached with evidence-based recommendations on different clinical applications for PDT.
PATIENTS AND METHODS: This consensus document includes discussions regarding PDT, including different photosensitizers and various light source activators, historical perspective, mechanism of action, various therapeutic indications and expected outcomes, pre- and post-care, and management of adverse outcomes.
RESULTS: Photodynamic therapy is highly effective for pre-cancerous lesions, superficial nonmelanoma skin cancers, inflammatory acne vulgaris and other conditions. New protocols including laser mediated PDT significantly improve results for several indications.
CONCLUSION: The ASDS consensus document on PDT will be helpful for educating members on safe and effective PDT for a variety of indications. - Object Marker: A Unique Assistive Teaching Tool in a Mohs Surgery Fellowship
Endobronchial Recurrence of Gastric Mucosa–associated Lymphoid Tissue Lymphoma
Alexandros G. SfakianakisστοΝοσολογίαΠριν από 6 δευτερόλεπτα
[image: image]Mucosa-associated lymphoid tissue (MALT) lymphoma is a diagnostic challenge when arising from bronchiolar submucosal tissue. The case herein describes a man with a lung mass and a remote history of gastric MALT lymphoma. After undergoing a bronchoscopic examination and tissue sampling, he was diagnosed with pulmonary recurrence of gastric MALT lymphoma. The diagnosis of MALT lymphoma in the lung can be challenging. Radiographic findings are typically nonspecific, and tissue biopsy by surgical means is often required. The diagnosis of bronchus-associated lymphoid tissue... περισσότερα »
Study of analgesic effect of amiloride compared to aspirin in chemically induced pain models in rats and mice
Alexandros G. SfakianakisστοΝοσολογίαΠριν από 6 δευτερόλεπτα
2016-06-26T00-48-19Z *Source:* National Journal of Physiology, Pharmacy and Pharmacology Bhanu Prakash Kolasani, Raghunatha Rao Ponnaluri, Raghunandan Mudium. Background: Acid-sensing ion channels (ASIC) contribute to acid-evoked pain in many painful inflammatory and ischemic conditions such as rheumatoid arthritis, cardiac ischemia, and exhausted skeletal muscles, which are accompanied by local tissue acidosis. Amiloride, a potassium-sparing diuretic was recently discovered to be a blocker of these ASIC. Aims and Objectives: The objective of present study is to evaluate the analgesic ... περισσότερα »
Hemangiomas of the cavernous sinus
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Gamma Knife radiosurgery for hemangioma of the cavernous sinus: Journal of Neurosurgery, Ahead of Print. OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare vascular tumors. A direct microsurgical approach usually results in massive hemorrhage and incomplete tumor resection. Although stereotactic radiosurgery (SRS) has emerged as a therapeutic alternative to microsurgery, outcome studies are few. Authors of […]
Epstein-Barr virus (EBV)–associated smooth muscle tumors (SMTs)
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Epstein-Barr virus–associated smooth muscle tumor of the cavernous sinus: a delayed complication of allogenic peripheral blood stem cell transplantation: case report: Journal of Neurosurgery, Ahead of Print. Epstein-Barr virus (EBV)–associated smooth muscle tumors (SMTs) have recently been associated with primary and secondary immunodeficiencies. They are broadly divided into 3 subgroups: HIV-related, posttransplant, and congenital immunodeficiency. […]
Motor Unit Number Estimation Based on High-Density Surface Electromyography Decomposition
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Motor unit number estimation (MUNE) techniques are clinically useful by estimating the number of functioning motor units in a muscle, which can serve as a biomarker for the progression of motor neuron diseases or neuromuscular disorders. Various MUNE methods have been developed since the incremental counting technique was introduced in 1971 (McComas et al., 1971). […]
Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
A randomized, double-blind clinical trial.: Authors: Du J, Yang F, Liu L, Hu J, Cai B, Liu W, Xu G, Liu X Abstract OBJECTIVE: This randomized, sham-controlled, double-blind study was conducted to investigate the effects of high-frequency versus low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with poststroke dysphagia during early rehabilitation. METHODS: Forty patients […]
Palatal augmentation prosthesis (PAP)
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Structure of a New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy.: Acta Med Okayama. 2016 Jun;70(3):205-211 Authors: Kozaki KI, Kawakami S, Konishi T, Ohta K, Yano J, Onoda T, Matsumoto H, Mizukawa N, Kimata Y, Nishizaki K, Iida S, Gofuku A, Abe M, Minagi S, Okayama Dream […]
A New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy.
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Structure of a Acta Med Okayama. 2016 Jun;70(3):205-211 Authors: Kozaki KI, Kawakami S, Konishi T, Ohta K, Yano J, Onoda T, Matsumoto H, Mizukawa N, Kimata Y, Nishizaki K, Iida S, Gofuku A, Abe M, Minagi S, Okayama Dream Speech Project Abstract A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech […]
Esophageal atresia (EA),Severe respiratory morbidity and gastroesophageal reflux (GER) symptoms
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Physiological Studies at 7 Years of Age in Children Born with Esophageal Atresia.: Authors: Olbers J, Gatzinsky V, Jönsson L, Friberg LG, Abrahamsson K, Sillén U, Gustafsson P Abstract OBJECTIVE: For many years, esophageal atresia (EA) has been curable by surgery. However, severe respiratory morbidity and gastroesophageal reflux (GER) symptoms remain a problem in many […]
Sleep Stage Coordination of Respiration and Swallowing
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
A Preliminary Study.: Dysphagia. 2016 Jun ; Authors: Okuno K, Nohara K, Takai E, Sakai T, Fleetham JA, Ayas NT, Lowe AA, Almeida FR Abstract Swallowing is an important physiological response that protects the airway. Although aspiration during sleep may cause aspiration pneumonia, the mechanisms responsible have not yet been elucidated. We evaluated the coordination […]
Per-oral endoscopic myotomy (POEM)
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Reduced postoperative pain scores and narcotic use favor per-oral endoscopic myotomy over laparoscopic Heller myotomy.: Surg Endosc. 2016 Jun ; Authors: Docimo S, Mathew A, Shope AJ, Winder JS, Haluck RS, Pauli EM Abstract INTRODUCTION: Per-oral endoscopic myotomy (POEM) is a less invasive therapy for achalasia with a shorter hospitalization but with similar short- and […]
Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma.
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 7 δευτερόλεπτα
Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma.: Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma. Case Rep Urol. 2016;2016:7050981 Authors: Yoshie H, Nakazawa R, Usuba W, Kudo H, Sato Y, Sasaki H, Chikaraishi T Abstract We report the first case in Japan of paraneoplastic dermatomyositis with pure seminoma, a tumor that extremely rarely accompanies dermatomyositis. The patient presented […]
Effects of chronic neck-shoulder pain on normalized mutual information analysis of surface electromyography during functional tasks
Αλέξανδρος ΣφακιανάκηςστοOtoRhinoLaryngology by Alexandros G.SfakianakisΠριν από 21 δευτερόλεπτα
Neck and shoulder pain is a common problem that affects a large number of people worldwide (Van Tulder et al., 2007). This problem is exacerbated by the escalating use of electronic devices such as smartphones and portable tablet computers (Berolo et al., 2011). The research concerning the etiology of chronic neck-shoulder pain has mainly focused on the study of muscle activation in the postural muscles such as cervical erector spinae (CES) and upper trapezius (UT) muscle (Visser and van Dieën 2006). from #ORL via xlomafota13 on Inoreader http://ift.tt/28T1FTR via IFTTT
Reversed cortical over-activity during movement imagination following neurofeedback treatment for central neuropathic pain
Αλέξανδρος ΣφακιανάκηςστοOtoRhinoLaryngology by Alexandros G.SfakianakisΠριν από 21 δευτερόλεπτα
Central neuropathic pain (CNP) is a frequent secondary consequence of spinal cord injury (SCI), affecting about 40% of patients (Siddall et al. 2003). Although CNP is caused by an injury to the somatosensory system (Haanpää et al. 2011) it can show first symptoms years after SCI. Neuroimaging studies have demonstrated changes in the resting state brain activity in the presence of CNP, which is reflected in increased thalamo-cortical coherence in the theta band (Stern et al. 2006, Sarnthein and Jeandmond 2008), as well as increased resting state EEG power and a dominant alpha frequ... περισσότερα »
What is the optimal task difficulty for reinforcement learning of brain self-regulation?
Αλέξανδρος ΣφακιανάκηςστοOtoRhinoLaryngology by Alexandros G.SfakianakisΠριν από 21 δευτερόλεπτα
Neurofeedback and brain-interface technology are being increasingly applied in fields of research aiming to restore upper-limb functionality in stroke survivors. Greater gains are currently being achieved by subacute (Pichiorri et al. 2015) than by chronic patients (Ang et al. 2014). On the basis of the neurophysiological correlates of motor imagery (Kaiser et al. 2011) and motor cortex excitability (Takemi et al. 2013; Kraus et al. 2016a), such as modulation of β-power (15-30 Hz), these devices may provide an effective backdoor to the motor system (Sharma 2006; Bauer et al. from ... περισσότερα »
Study of analgesic effect of amiloride compared to aspirin in chemically induced pain models in rats and mice
AlexAndros SfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026Πριν από 23 δευτερόλεπτα
2016-06-26T00-48-19Z *Source:* National Journal of Physiology, Pharmacy and Pharmacology Bhanu Prakash Kolasani, Raghunatha Rao Ponnaluri, Raghunandan Mudium. Background: Acid-sensing ion channels (ASIC) contribute to acid-evoked pain in many painful inflammatory and ischemic conditions such as rheumatoid arthritis, cardiac ischemia, and exhausted skeletal muscles, which are accompanied by local tissue acidosis. Amiloride, a potassium-sparing diuretic was recently discovered to be a blocker of these ASIC. Aims and Objectives: The objective of present study is to evaluate the analgesi... περισσότερα »
One man’s little slice of nature is a historical microcosm
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 26 δευτερόλεπτα
Richard Fortey bought 4 acres of wooded wonderland and treats us to a diary of its natural and local history, inhabitants and future – even a few recipes from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/28V9jys via IFTTT
OtoRhinoLaryngology
otolaryngologistsfakianakisστοOtoRhinoLaryngology by Sfakianakis G.Alexandros,,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,tel : 00302841026182,00306932607174Πριν από 42 δευτερόλεπτα
8h OtoRhinoLaryngology – Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader Impact of prophylactic gastrostomy or reactive NG tube upon patient-reported long term swallow function following chemoradiotherapy for oropharyngeal carcinoma: A matched pair analysis Long term dysphagia remains a major treatment-related morbidity of organ preserving approaches to the treatment of head and neck cancers […]
One man’s little slice of nature is a historical microcosm
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 1 ώρα
Richard Fortey bought 4 acres of wooded wonderland and treats us to a diary of its natural and local history, inhabitants and future – even a few recipes from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/28V9jys via IFTTT
Radiotherapy and immune checkpoints inhibitors for advanced melanoma
Alexandros G. SfakianakisστοMelanoma by Alexandros G. SfakianakisΠριν από 1 ώρα
Publication date: Available online 23 June 2016 *Source:*Radiotherapy and Oncology Author(s): Andrea Riccardo Filippi, Paolo Fava, Serena Badellino, Chiara Astrua, Umberto Ricardi, Pietro Quaglino IntroductionThe therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical studie... περισσότερα »
Journal of Reproductive Biotechnology and Fertility
alsfakianakisστοOtolaryngology lifelong learning : Otolaryngology by Alexandros Sfakianakis,Greece Crete,Anapafseos 5 Agios Nikolaos 72100,tel : 00302841026182,00306932607174Πριν από 2 ώρες
Journal of Reproductive Biotechnology and Fertility, published by SAGE Publications, last updated on 2016-06-24, available at http://rbf.sagepub.com from #ORL-AlexandrosSfakianakis via simeraentaxei on Inoreader http://rbf.sagepub.com/ via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Assisted suicide
alsfakianakisστοOtolaryngology lifelong learning : Otolaryngology by Alexandros Sfakianakis,Greece Crete,Anapafseos 5 Agios Nikolaos 72100,tel : 00302841026182,00306932607174Πριν από 2 ώρες
Assisted suicide: The deliberate hastening of death by a terminally ill patient with assistance from a doctor, family member, or another individual. MedTerms (TM) is the Medical Dictionary of MedicineNet.com. We Bring Doctors’ Knowledge To You from #ORL-AlexandrosSfakianakis via simeraentaxei on Inoreader http://ift.tt/28Zfe6d via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & […]
Integrity of lipid nanocarriers in bloodstream and tumor quantified by near-infrared ratiometric FRET imaging in living mice
alsfakianakisστοOtolaryngology lifelong learning : Otolaryngology by Alexandros Sfakianakis,Greece Crete,Anapafseos 5 Agios Nikolaos 72100,tel : 00302841026182,00306932607174Πριν από 2 ώρες
Publication date: 28 August 2016 Source:Journal of Controlled Release, Volume 236 Author(s): Redouane Bouchaala, Luc Mercier, Bohdan Andreiuk, Yves Mély, Thierry Vandamme, Nicolas Anton, Jacky G. Goetz, Andrey S. Klymchenko Lipid nanocarriers are considered as promising candidates for drug delivery and cancer targeting because of their low toxicity, biodegradability and capacity to encapsulate drugs and/or […]
Freeze-dried mucoadhesive polymeric system containing pegylated lipoplexes: Towards a vaginal sustained released system for siRNA
alsfakianakisστοOtolaryngology lifelong learning : Otolaryngology by Alexandros Sfakianakis,Greece Crete,Anapafseos 5 Agios Nikolaos 72100,tel : 00302841026182,00306932607174Πριν από 2 ώρες
Publication date: 28 August 2016 Source:Journal of Controlled Release, Volume 236 Author(s): Tania Furst, George R. Dakwar, Elisa Zagato, Anna Lechanteur, Katrien Remaut, Brigitte Evrard, Kevin Braeckmans, Geraldine Piel Topical vaginal sustained delivery of siRNA presents a significant challenge due to the short residence time of formulations. Therefore, a drug delivery system capable to adhere […]
Radiotherapy and immune checkpoints inhibitors for advanced melanoma
Alexandros G. SfakianakisστοΘεραπείαΠριν από 2 ώρες
Publication date: Available online 23 June 2016 *Source:*Radiotherapy and Oncology Author(s): Andrea Riccardo Filippi, Paolo Fava, Serena Badellino, Chiara Astrua, Umberto Ricardi, Pietro Quaglino IntroductionThe therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical stud... περισσότερα »
Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomia
Alexandros G. SfakianakisστοΘεραπείαΠριν από 2 ώρες
Publication date: Available online 23 June 2016 *Source:*Radiotherapy and Oncology Author(s): Charlotte L. Brouwer, Roel J.H.M. Steenbakkers, Arjen van der Schaaf, Chantal T.C. Sopacua, Lisanne V. van Dijk, Roel G.J. Kierkels, Hendrik P. Bijl, Johannes G.M. Burgerhof, Johannes A. Langendijk, Nanna M. Sijtsema Background and purposeThe aim of this study was to develop and validate a method to select head and neck cancer patients for adaptive radiotherapy (ART) pre-treatment. Potential pre-treatment selection criteria presented in recent literature were included in the analysis.Materi... περισσότερα »
Intensity-modulated proton beam therapy (IMPT) versus intensity-modulated photon therapy (IMRT) for patients with oropharynx cancer – A case matched analysis
Alexandros G. SfakianakisστοΘεραπείαΠριν από 2 ώρες
Publication date: Available online 21 June 2016 *Source:*Radiotherapy and Oncology Author(s): Pierre Blanchard, Adam S. Garden, G. Brandon Gunn, David I. Rosenthal, William H. Morrison, Mike Hernandez, Joseph Crutison, Jack J. Lee, Rong Ye, C. David Fuller, Abdallah S.R. Mohamed, Kate A. Hutcheson, Emma B. Holliday, Nikhil G. Thaker, Erich M. Sturgis, Merrill S. Kies, X. Ronald Zhu, Radhe Mohan, Steven J. Frank BackgroundOwing to its physical properties, intensity-modulated proton therapy (IMPT) used for patients with oropharyngeal carcinoma has the ability to reduce the dose to org... περισσότερα »
Effect of tumor dose, volume and overall treatment time on local control after radiochemotherapy including MRI guided brachytherapy of locally advanced cervical cancer
Alexandros G. SfakianakisστοΘεραπείαΠριν από 2 ώρες
Publication date: Available online 24 June 2016 *Source:*Radiotherapy and Oncology Author(s): Kari Tanderup, Lars Ulrik Fokdal, Alina Sturdza, Christine Haie-Meder, Renaud Mazeron, Erik van Limbergen, Ina Jürgenliemk-Schulz, Primoz Petric, Peter Hoskin, Wolfgang Dörr, Søren M. Bentzen, Christian Kirisits, Jacob Christian Lindegaard, Richard Pötter Background and purposeCurrently, there is no consensus on dose prescription in image guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer. The purpose of this study was to provide evidence based recommendations for tum... περισσότερα »
Chinese Journal of Cancer, Year 2016, Issue 05 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Chinese Journal of Cancer. Year 2016 Issue 05 is now available on CAOD. In this issue: About the Cover …… page:204 Cell-free circulating tumor DNA in cancer Zhen […]
Anatomy Research , Year 2016, Issue 02 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Anatomy Research . Year 2016 Issue 02 is now available on CAOD. In this issue: Protective effect of estrogen to the injury of N2a cell induced by H2O2 […]
Stomatology, Year 2016, Issue 05 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Stomatology. Year 2016 Issue 05 is now available on CAOD. In this issue: The application of skeletal age in the assessment of craniofacial growth and development and related […]
Chinese Nursing Research, Year 2016, Issue 17 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Chinese Nursing Research. Year 2016 Issue 17 is now available on CAOD. In this issue: sheng ming (声明) Editorial Department of Chinese Nursing Research …… page:2 Clinical research […]
Chinese Journal of Pharmacoepidemiology, Year 2016, Issue 05 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Chinese Journal of Pharmacoepidemiology. Year 2016 Issue 05 is now available on CAOD. In this issue: Interpretation of the New Guidelines for Good Pharmacoepidemiology Practice (新版《规范药物流行病学研究指南》解读) Ding Chengyi, […]
Pharmaceutical Biotechnology, Year 2016, Issue 02 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Pharmaceutical Biotechnology. Year 2016 Issue 02 is now available on CAOD. In this issue: Construction and Expression of Mutant Human Neural Acetylcholine Receptor α7 (突变型人源乙酰胆碱神经受体α7的构建表达纯化) ZHANG Si-wei, CHENG […]
Chinese Journal of CT and MRI, Year 2016, Issue 06 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Chinese Journal of CT and MRI. Year 2016 Issue 06 is now available on CAOD. In this issue: MRI and Perfusion Imaging Analysis of Radiation-induced Brain Injury (放射性脑损伤的MRI及灌注成像分析) […]
Journal of Oncology, Year 2016, Issue 06 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Journal of Oncology. Year 2016 Issue 06 is now available on CAOD. In this issue: Ultrasonic Elastic Strain Rate Ratio in Differential Diagnosis of BI-RADS 4 Breast Lesions […]
Oncology Progress, Year 2016, Issue 04 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Oncology Progress. Year 2016 Issue 04 is now available on CAOD. In this issue: gu xing tai fa sheng dan bai yu ru xian ai de yan jiu […]
Cancer Rehabilitation, Year 2016, Issue 02 -New Issue Alert.
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 2 ώρες
From: order@email.oriprobe.com Date: June 26, 2016 at 08:05AM New Issue TOC Alert Dear Valued Customer, We are pleased to deliver your requested table of contents alert for Cancer Rehabilitation. Year 2016 Issue 02 is now available on CAOD. In this issue: xin xi dong tai (信息动态) …… page:1,84-85,封3 shen du dui hua liu duan zuo […]
Bacterial diversity along a 2600 km river continuum
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Environmental microbiology from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28V2r44 via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Language lateralization of hearing native signers: A functional transcranial Doppler sonography (fTCD) study of speech and sign production
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Brain and language from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28VKi2J via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Journal of Reproductive Biotechnology and Fertility
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Journal of Reproductive Biotechnology and Fertility, published by SAGE Publications, last updated on 2016-06-24, available at http://rbf.sagepub.com from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://rbf.sagepub.com/ via IFTTT
Assisted suicide
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Assisted suicide: The deliberate hastening of death by a terminally ill patient with assistance from a doctor, family member, or another individual. MedTerms (TM) is the Medical Dictionary of MedicineNet.com. We Bring Doctors’ Knowledge To You from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/28Zfe6d via IFTTT
Predisposition or side effect of the duration: the reactivity of the HPA-axis under psychosocial stress in panic disorder
Alexandros G. SfakianakisστοPhysiology by Alexandros G.SfakianakisΠριν από 3 ώρες
Publication date: Available online 25 June 2016 *Source:*International Journal of Psychophysiology Author(s): Gloria-Beatrice Wintermann, Clemens Kirschbaum, Katja Petrowski Graphical abstract[image: image] from Physiology via xlomafota13 on Inoreader http://ift.tt/29aMOm1
Assisted suicide
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Assisted suicide: The deliberate hastening of death by a terminally ill patient with assistance from a doctor, family member, or another individual. MedTerms (TM) is the Medical Dictionary of MedicineNet.com. We Bring Doctors’ Knowledge To You from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28Zfe6d via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & […]
Recent Progress in Development of siRNA Delivery Vehicles for Cancer Therapy
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 3 ώρες
Publication date: Available online 25 June 2016 Source:Advanced Drug Delivery Reviews Author(s): Hyun Jin Kim, Ahram Kim, Kanjiro Miyata, Kazunori Kataoka Recent progress in RNA biology has broadened the scope of therapeutic targets of RNA drugs for cancer therapy. However, RNA drugs, typically small interfering RNAs (siRNAs), are rapidly degraded by RNases and filtrated in […]
A Formulation Study of 5-Aminolevulinic Encapsulated in DPPC Liposomes in Melanoma Treatment
Alexandros G. SfakianakisστοMelanoma by Alexandros G. SfakianakisΠριν από 4 ώρες
Photodynamic therapy (PDT) is a widely used technique for epithelial skin cancer treatment. 5-aminolevulinic acid (5-ALA) is a drug currently used for PDT and is a hydrophilic molecule at its physiological pH, and this limits its capacity to cross the stratum corneum of skin. Since skin penetration is a key factor in the efficacy of topical 5-ALA-mediated PDT, numerous strategies have been proposed to improve skin penetration. Yet this problem is still ongoing. The results of a previous study showed a low rate of 5-ALA encapsulated in liposomes (5.7%) that were 400 nm in size. In ... περισσότερα »
Ablation of Neuropilin 1 from glioma-associated microglia and macrophages slows tumor progression
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 4 ώρες
Oncotarget from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28VZIoO via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Multiple roles of timing in somite formation
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 4 ώρες
Seminars in cell & developmental biology from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28Zd4DN via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Nuclear membrane diversity: underlying tissue-specific pathologies in disease?
medicinesfakianakisστοMedicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 4 ώρες
Current opinion in cell biology from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/28VZKgl via IFTTT Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Integrity of lipid nanocarriers in bloodstream and tumor quantified by near-infrared ratiometric FRET imaging in living mice
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 4 ώρες
Publication date: 28 August 2016 Source:Journal of Controlled Release, Volume 236 Author(s): Redouane Bouchaala, Luc Mercier, Bohdan Andreiuk, Yves Mély, Thierry Vandamme, Nicolas Anton, Jacky G. Goetz, Andrey S. Klymchenko Lipid nanocarriers are considered as promising candidates for drug delivery and cancer targeting because of their low toxicity, biodegradability and capacity to encapsulate drugs and/or […]
Freeze-dried mucoadhesive polymeric system containing pegylated lipoplexes: Towards a vaginal sustained released system for siRNA
sfakianakisdiseasesστοHuman Diseases Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174Πριν από 4 ώρες
Publication date: 28 August 2016 Source:Journal of Controlled Release, Volume 236 Author(s): Tania Furst, George R. Dakwar, Elisa Zagato, Anna Lechanteur, Katrien Remaut, Brigitte Evrard, Kevin Braeckmans, Geraldine Piel Topical vaginal sustained delivery of siRNA presents a significant challenge due to the short residence time of formulations. Therefore, a drug delivery system capable to adhere […]
Predisposition or side effect of the duration: the reactivity of the HPA-axis under psychosocial stress in panic disorder
Αλέξανδρος ΣφακιανάκηςστοMedicine by Alexandros G.SfakianakisΠριν από 4 ώρες
Publication date: Available online 25 June 2016 *Source:*International Journal of Psychophysiology Author(s): Gloria-Beatrice Wintermann, Clemens Kirschbaum, Katja Petrowski Graphical abstract [image: image] from #Medicine via ola Kala on Inoreader http://ift.tt/29aMOm1 via IFTTT
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