Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study

Laryngopharyngeal reflux is a prevalent, not well-understood disease affecting a high proportion of patients who seek laryngology consultation. The objective of this prospective case series is to explore the s...

http://journalotohns.biomedcentral.com/articles/10.1186/s40463-016-0171-1

Hyperuricemia and Cardiovascular Disease: What is Left to Prove?

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.


http://online.liebertpub.com/doi/abs/10.1089/met.2016.29010.win?ai=sl&mi=6tjo9k&af=R

Microarchitectural study of the augmented bone following ridge preservation with a porcine xenograft and a collagen membrane: preliminary report of a prospective clinical, histological, and micro-computed tomography analysis

Publication date: Available online 8 November 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): M. Kivovics, B.T. Szabó, O. Németh, N. Tari, F. Dőri, P. Nagy, C. Dobó-Nagy, G. Szabó
Socket preservation using a combination of porcine xenograft and collagen membrane maintains the vertical and horizontal dimensions of the ridge. The aim of this study was to evaluate the microarchitecture of the grafted area by histological analysis and micro-computed tomography. Patients in the test group (group 1; nine patients) underwent socket preservation, while the sockets in the control group (group 2; eight patients) were allowed to heal without preservation. After a 6-month healing period, bone core biopsy samples were obtained and implants were placed in the augmented sites in the test group (12 biopsy samples) and the non-augmented sockets of the control group (12 biopsy samples). Analysis of the biopsy samples obtained from group 1 revealed that particles of the graft were surrounded by newly formed bone in eight cases and by granulation tissue in four cases. Micromorphometric data showed statistically significant differences in several parameters between the microarchitecture of the native bone and the newly formed bone within the augmented sites, which suggests that the xenograft particles interfere with the bony healing of the alveoli.



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Successful switch from enzyme replacement therapy to miglustat in an adult patient with type 1 Gaucher disease: a case report

Gaucher disease is one of the most common lipid-storage disorders, affecting approximately 1 in 75,000 births. Enzyme replacement therapy with recombinant glucocerebrosidase is currently considered the first-l...

http://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-016-1060-y

Early-onset fetal growth restriction treated with the long-acting phosphodiesterase-5 inhibitor tadalafil: a case report

Severe early-onset fetal growth restriction occurs in 0.4 % of all pregnancies, and the prognoses of these patients are dismal. Severely growth-restricted fetuses (far below 500 g) are thought to be nonviable....

http://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-016-1098-x

Micafungin versus caspofungin in the treatment of Candida glabrata infection: a case report

Micafungin and caspofungin, which are both echinocandins, elicit their antifungal effects by suppressing the synthesis of β-D-glucan, an essential component of fungal cell walls. If micafungin is not effective...

http://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-016-1096-z

Reference Intervals of Thyroid Function During Pregnancy: Self-Sequential Longitudinal Study Versus Cross-Sectional Study

Thyroid , Vol. 0, No. 0.


http://online.liebertpub.com/doi/abs/10.1089/thy.2016.0002?ai=s4&mi=6k8niu&af=R

CAD/CAM milled removable complete dentures: an in vitro evaluation of trueness

Abstract

Objectives

This study aimed to compare the trueness of one type of CAD/CAM milled complete removable dental prostheses (CRDPs) with injection-molding and conventionally manufactured CRDPs.

Materials and methods

Thirty-three CRDPs were fabricated by three different manufacturing techniques (group CAD/CAM (AvaDent™): n = 11; group injection molding (Ivocap™): n = 11; group flask-pack-press: n = 11) using a single master reference model and incubated in artificial saliva for 21 days. The trueness of the entire intaglio surface along with five specific regions of interest (vestibular-flange, palate, tuberosities, alveolar crest, and post-dam areas) was compared. Non-parametric tests were used with a level of significance set at p < 0.05.

Results

At baseline, there was no difference in the trueness of the total intaglio surfaces between the groups. After incubation, only the conventional CRDPs showed a significant improvement in trueness of the entire intaglio surface (p = 0.0044), but improved trueness was confirmed for all three techniques in most individual regions of interest. The 80–20 % /2 median quantile of the CAD/CAM group demonstrated the highest variability of individual readings, probably due to the size of the milling instrument. However, for all three techniques, 80 % of all deviations of the complete intaglio surface after incubation in saliva were below 0.1 mm.

Conclusions

In this in vitro study, the trueness of the intaglio surface of all three investigated techniques seems to remain within a clinically acceptable range. Additional research is warranted on material-related aspects, cost-effectiveness, clinical performance, patient-centered outcomes, as well as other CAD/CAM techniques for CRDP fabrication.

Clinical relevance

The intaglio surface trueness is an essential aspect in the clinical performance of CRDPs.

http://link.springer.com/10.1007/s00784-016-1989-7

Persistierende Rötung und Induration nach Wundspülung mit Octenidin

Zusammenfassung

Octenidin ist mit seiner lang anhaltenden Wirkung ein Präparat der ersten Wahl zur antiseptischen Wundversorgung, jedoch darf es laut Hersteller nicht unter Druck in das Gewebe eingebracht werden. Eine 50-jährige Patientin präsentierte sich mit einem Erythem sowie ausgeprägten Weichteilindurationen nach Spülung einer Abszesswunde mit Octenidin unter Druck. Die fehlende Resorption des Präparates führte zu einem lang anhaltenden interstitiellen Weichteilödem. Dieser Fall demonstriert, wie essenziell die Einhaltung der Anwendungsvorgaben für Octenidin ist, denn nur bei korrekter Anwendung können die Patienten von den Vorteilen des Präparates wie einer fehlenden Systemtoxizität oder dem breiten Wirkspektrum profitieren.

http://link.springer.com/10.1007/s00105-016-3895-y

Skabies im Kindes- und Jugendalter

Zusammenfassung

Skabies ist eine häufige, weltweit und in jedem Alter vorkommende Parasitose, die durch den Juckreiz und die Stigmatisierung die Lebensqualität des Patienten und seiner Familie beeinträchtigt. Die Abtötung der Krätzemilbe Sarcoptes scabiei variatio hominis, die das Stratum corneum befällt, und die Reduktion des Juckreizes sind Ziele der Therapie. Diese erfordern eine sorgfältige Aufklärung der Patienten bzw. der Eltern betroffener Kinder, da die Anweisungen zur Anwendung der Medikamente und auch die zusätzlich notwendigen Maßnahmen häufig nicht korrekt befolgt werden. Viele Besonderheiten, die die klinischen Symptome und auch die Therapie betreffen, sollten im frühen Kindesalter beachtet werden.

http://link.springer.com/10.1007/s00105-016-3901-4

Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study

Abstract

Background

Laryngopharyngeal reflux is a prevalent, not well-understood disease affecting a high proportion of patients who seek laryngology consultation. The objective of this prospective case series is to explore the subjective and objective voice modifications in Laryngopharyngeal reflux (LPR), especially the usefulness of acoustic parameters as treatment outcomes, and to better understand the pathophysiological mechanisms underlying the development of voice disorder.

Methods

Forty-one patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily for three months. RSI, RFS, Voice Handicap Index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) were assessed at baseline and after three months post-therapy. Acoustic parameters were measured by selecting the most stable interval of the vowel /a/. A study of correlations between acoustic measurements and laryngoscopic signs was conducted in patients with roughness. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS).

Results

Significant improvement in RSI, RFS, VHI, jitter, percent jitter, relative average perturbation (RAP), shimmer, percent shimmer, and amplitude perturbation quotient (APQ) was found at 3 months of treatment (p < .05). A correlation analysis revealed significant correlations between the grade of dysphonia, breathiness, asthenia, instability and jitter, percent jitter, RAP, shimmer, percent shimmer and APQ. In dividing our cohort into two groups of patients according to the presence of roughness, shimmer, percent shimmer and APQ significantly improved in patients with roughness, but no positive correlation was found between acoustic parameters and laryngoscopic signs.

Conclusion

Acoustic parameters can help to better understand voice disorders in LPR and can be used as treatment outcomes in patients with roughness.

http://link.springer.com/10.1186/s40463-016-0171-1

Optimising ballistic facial coverage from military fragmenting munitions: a consensus statement

VIRTUS is the first United Kingdom (UK) military personal armour system to provide components that are capable of protecting the whole face from low velocity ballistic projectiles. Protection is modular, using a helmet worn with ballistic eyewear, a visor, and a mandibular guard. When all four components are worn together the face is completely covered, but the heat, discomfort, and weight may not be optimal in all types of combat. We organized a Delphi consensus group analysis with 29 military consultant surgeons from the UK, United States, Canada, Australia, and New Zealand to identify a potential hierarchy of functional facial units in order of importance that require protection.

http://www.bjoms.com/article/S0266-4356(16)30333-3/fulltext?rss=yes

Protection of free tissue used to reconstruct occipital scalp with a prone-positioning helmet

Defects in the scalp caused by severe trauma or extensive resections of malignant disease are commonly reconstructed using free-tissue transfer. In the occipital region flaps are at risk of compression and vascular compromise when the patient lies on their back. A previous study1 reported three cases in which a halo ring was used to avoid pressure on the flaps after operation. The PMT Model 1200 Series Halo (PMT Corporation, Chanhassen, MN, USA) was applied upside down with the opening anteriorly, and the ring was fixed to the skull with four titanium pins.

http://www.bjoms.com/article/S0266-4356(16)30301-1/fulltext?rss=yes

Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea

Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series.

http://www.jaad.org/article/S0190-9622(16)30752-6/fulltext?rss=yes

Ocular pyoderma gangrenosum: A systematic review

Pyoderma gangrenosum (PG) is a rare, ulcerative cutaneous disorder. Ophthalmic involvement in PG is atypical, but can have devastating consequences.

http://www.jaad.org/article/S0190-9622(16)30736-8/fulltext?rss=yes

Threat to Criminal Justice Officials: If It Is Predictable, It Is Preventable

Violence and Gender , Vol. 0, No. 0.


http://online.liebertpub.com/doi/abs/10.1089/vio.2016.0016?ai=2ldv&mi=6tjo9k&af=R

Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA).

http://www.jcafulltextonline.com/article/S0952-8180(16)30672-9/fulltext?rss=yes

Glucose Metabolism and Its Complicated Relationship with Tumor Growth and Perfusion in Head and Neck Squamous Cell Carcinoma

by Noriyuki Fujima, Tomohiro Sakashita, Akihiro Homma, Kenji Hirata, Tohru Shiga, Kohsuke Kudo, Hiroki Shirato

Objective

To determine the relationship between tumor glucose metabolism and tumor blood flow (TBF) in head and neck squamous cell carcinoma (HNSCC).

Methods

We retrospectively analyzed 57 HNSCC patients. Tumor glucose metabolism was assessed by maximum and mean standardized uptake values (SUVmax and SUVmean) obtained by ¹⁸F-fluorodeoxyglucose positron-emission tomography. TBF values were obtained by arterial spin labeling with 3-tesla MRI. The correlations between both SUVs and TBF were assessed in the total series and among patients divided by T-stage (T1–T3 and T4 groups) and tumor location (pharynx/oral cavity and sinonasal cavity groups). Pearson's correlation coefficients were calculated for significant correlations.

Results

Significant correlations were detected: a negative correlation in the advanced T-stage group (TBF and SUV max: r, −0.61, SUVmean: r, −0.62), a positive correlation in the non-advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, 0.70, SUVmean: r, 0.73), a negative correlation in the advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, −0.62, SUVmean: r, −0.65), and a negative correlation in the advanced T-stage sinonasal cavity group (TBF and SUVmax: r, −0.61, SUVmean: r, −0.65).

Conclusion

Significant correlations between glucose uptake and TBF in HNSCC were revealed by the division of T-stage and tumor location.

http://ift.tt/2ej2ppu

Clinical predictors of aminoglycoside-induced ototoxicity in drug-resistant Tuberculosis patients on intensive therapy

Publication date: Available online 8 November 2016
Source:Auris Nasus Larynx
Author(s): Olusola Ayodele Sogebi, Bolanle Olufunlola Adefuye, Stephen Oluwatosin Adebola, Susan Modupe Oladeji, Taiwo Olugbemiga Adedeji
ObjectiveThe study objectives were to determine the incidence of aminoglycoside-induced ototoxicity in institutionalized patients on intensive phase of therapy for drug-resistant Tuberculosis (DR Tb) and also to assess clinical factors which could predict the ototoxicity.MethodsThe study was a prospective analytical study among consecutive DR Tb patients who were admitted for intensive phase of therapy (of 4 months) at the DR-Tb center over a 12-month period. Patients were diagnosed as DR Tb using the Gene Xpert machine to confirm Rifampicin resistance. All eligible 70 out of 87 consenting patients were consecutively recruited into the study. Patients had baseline (admission) and serial pure tone audiometries (PTAs) performed at 4 weekly intervals until discharge after 4 months of admission. Audiometric confirmation of aminoglycoside-induced ototoxicity was done by comparing serial with baseline PTA.ResultsAmong the 70 patients the male:female ratio was 1.7:1. Nine patients (12.9%) were retroviral-positive, and 16 patients (22.9%) were confirmed to have ototoxicity by audiometric criteria. The duration of treatment when ototoxicity was detected in the patients ranged 4–17 (Mean±SD; 9.4±3.4) weeks. Ototoxicity was detected in the audiometric low frequency ranges in 7 (43.8%) and at the high frequencies in 4 (25.0%) of the patients. Univariate analyses of clinical parameters found that age, underlying diabetes mellitus, deranged baseline PTAv >25dB HL, BMI on admission and retroviral status were significantly associated, while sex and previous drug regimen failure were not associated with ototoxicity. Multivariate adjusted logistic regression analyses, controlling for sex, revealed age (OR=1.068, p=0.018), BMI on admission (OR=0.673, p=0.012) and retroviral positivity (OR=8.822, p=0.014) of patients could significantly predict aminoglycoside-induced ototoxicity.ConclusionIncidence of aminoglycoside-induced ototoxicity in DR Tb patients was 22.9%. The clinical predictors for ototoxicity were age, BMI on admission, and co-existing retroviral infection in the patients. Clinicians should consider these factors in making choices of aminoglycosides to be used during intensive phase of treatment with second line anti-Tuberculous therapy.



http://ift.tt/2fB3N4v

Astma ciężka – leczenie biologiczne omalizumabem – opis przypadku

Publication date: Available online 8 November 2016
Source:Alergologia Polska - Polish Journal of Allergology
Author(s): Grzegorz Osmenda, Barbara Jasiewicz-Honkisz
A patient with long-lasting atopic asthma, allergic rhinitis, chronic idiopathic urticaria, decreased lung function, complaints of recurrent day and night symptoms, and exacerbations that need systemic GKS often visits the ER departments. During chronic treatment, the patient used a large dose of GKS and LABA, which were inhaled. The patient's condition changed after initiating treatment with omalizumab. We achieved clinical improvement, confirmed by the spirometry results, and reduction of intensity of asthma and urticaria with treatment.



http://ift.tt/2fzNeYS

Cellulitis: Misdiagnoses Common and Costly

One third of patients admitted to the hospital for cellulitis were misdiagnosed, resulting in unnecessary hospitalizations and avoidable health costs, a new study has found.
Medscape Medical News

http://ift.tt/2faWFxn

Evaluation of salivary nitric oxide levels and C-reactive protein in patients with oral lichen planus and burning mouth syndrome

Abstract

Objectives

The aim of this study was to evaluate oxidative stress factors and C-reactive protein in the saliva of patients with oral lichen planus (OLP) and burning mouth syndrome (BMS).

Methods

This consecutive, cross-sectional study included 20 patients with OLP, 19 with burning mouth syndrome (BMS), and 31 control subjects. The oral cavity of each patient was examined and patients responded to a quality of life questionnaire (OHIP-14) and the Xerostomia Inventory. The following parameters were measured in whole non-stimulated saliva: trolox equivalent antioxidant capacity (TEAC); total antioxidant capacity (TAC); cupric reducing antioxidant capacity (CUPRAC); and ferric reducing ability of plasma (FRAP); C-reactive protein (CRP); nitric oxide; nitrates; and nitrites.

Results

The OLP group presented statistically significant differences in reactive oxygen species (ROS) (26916 cps/g) in comparison with the control group (P<0.05). In the BMS group, ROS was 36028 cps/g with significant difference in comparison with the control group (P<0.05). Significantly higher salivary nitric oxide (254.2 umol/g) and nitrite (182.6 umol/g) levels were found in OLP patients in comparison with BMS and control groups (P<0.05).

Conclusion

Increases in nitric oxide and C-reactive protein were found in the saliva of OLP patients in comparison with BMS and control patients. Further studies are required to confirm these findings.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fko0Lj

A Loss of Profilin-1 in Late Stage Oral Squamous Cell Carcinoma

Abstract

Background

The genes for PFN1 and TMSB4 are both highly expressed in oral tissue and both encode actin monomer binding proteins thought to play a role in cell motility and possibly other crucial parts of tumor progression. METHODS: Oral brush cytology of epithelium from Oral Squamous Cell Carcinoma (OSCC) was used to measure PFN1 and TMSB4 mRNA in OSCC while immunohistochemical analysis of tissue was used to check protein levels.

Results

High but variable expression of mRNAs encoding these two proteins was observed suggesting they may contribute to tumor characteristics in a subset of OSCCs. Both proteins were highly expressed in normal appearing basal epithelium, in the cytoplasm and perinuclear area, while expression was minimal in upper epithelial layers. In OSCCs, expression of these proteins varied. In tumors classified as later stage, based on size and/or lymph node involvement, PFN1 levels were lower in tumor epithelium. A control gene, KRT13, showed expression in normal differentiated basal and suprabasal oral mucosa epithelial cells and as reported was lost in OSCC cells.

Conclusion

Loss of PFN1in tumor cells has been associated with lymph node invasion and metastasis in other tumor types, strengthening the argument that the protein has the potential to be a tumor suppressor in late stage OSCC.

http://ift.tt/2fzB16s

Head and neck squamous cell carcinoma: Ambiguous human papillomavirus status, elevated p16, and deleted retinoblastoma 1

ABSTRACT

Background

Head and neck squamous cell carcinoma (HNSCC) is potentially curable, but treatment planning remains a challenge. Oncogenic human papillomavirus (HPV)-positive disease is often associated with a good prognosis compared with HPV-negative disease. However, some HPV-positive HNSCC recurs, often with distant metastases and significant treatment resistance.

Methods and Results

We performed p16 immunohistochemistry (IHC), in situ hybridization (ISH) for high-risk HPV, and comprehensive genomic profiling on oropharyngeal HNSCC with basaloid features and particularly aggressive disease course, noting a rare genetic event: a deleting mutation (exons 5–17) of the tumor suppressor and dominant cell cycle regulator retinoblastoma 1 (RB1). Genomic and transcriptomic data available through FoundationOne and The Cancer Genome Atlas (TCGA) were reviewed for additional HNSCC cases with RB1 alterations.

Conclusion

RB1 alterations may have important prognostic implications, particularly in the context of high p16 expression, in both HPV-positive and HPV-negative HNSCC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

http://ift.tt/2fzJIvB

Clinical predictors of aminoglycoside-induced ototoxicity in drug-resistant Tuberculosis patients on intensive therapy

The study objectives were to determine the incidence of aminoglycoside-induced ototoxicity in institutionalized patients on intensive phase of therapy for drug-resistant Tuberculosis (DR Tb) and also to assess clinical factors which could predict the ototoxicity.

http://ift.tt/2fzokbZ

Oral Tuberculosis: A Rare Manifestation of Disseminated Disease in a Patient with Dermatomyositis on Chronic Corticosteroids

Tuberculosis remains one of the leading causes of death around the world despite advancements in diagnostic testing and medical therapies. It commonly affects the lungs, but isolated extra pulmonary clinical manifestations have been reported. Tuberculosis of the oral cavity is exceedingly rare. We present a case of a patient with dermatomyositis on chronic steroid therapy, who presented with tuberculosis involving the tongue as the only clinical manifestation of disseminated disease. Physicians must be aware of extra pulmonary manifestations of tuberculosis in patients at risk, in order to avoid delays in diagnosis and treatment and to prevent further contagion.

http://ift.tt/2fcMSH3

Circulating CLA+ T-cells in atopic dermatitis and their possible role as peripheral biomarkers

Abstract

Cutaneous lymphocyte-associated antigen (CLA⁺) T-cells are specialized for skin homing and represent the main T-cell population in atopic dermatitis (AD) lesions. CLA⁺ is expressed on the surface of circulating CD45RO⁺ memory T-cells and most skin infiltrating T-cells. Mechanistic studies and thus treatment advancements are limited by the need of large number of skin biopsies. Circulating CLA⁺ T-cells may be a reliable surrogate marker of the inflammatory events occurring in the skin, and thus the evaluation of CLA⁺ T-cells in the blood may eliminate the need for skin biopsies. Preliminary work in AD has established that disease associated T-cell abnormalities can be approached by either a study of skin lesions or activated CLA⁺ T-cell subsets in peripheral blood. Future studies in adults and children, across different skin disorders, correlating blood and skin phenotypes and determining skin homing T-cell functional properties are needed in order to establish whether CLA⁺ memory subsets can be used as biomarkers and a substitute to skin biopsies. This review summarizes the latest advancements reached on circulating CLA⁺ in AD and the great potential they harbor in understanding AD mechanisms.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fcWIsz

Adrenal insufficiency associated with long-term use of inhaled steroid in asthma

We previously reported that as many as one third of hospitalized patients with asthma treated with a low to medium daily dose of inhaled steroids (ICSs) for an average of 4.5 years showed adrenal insufficiency (AI).

http://ift.tt/2fzHM6l

Comparison of allergens collected from furnace filters and vacuum floor dust

The ideal determinant of allergen exposure would be knowing the specific types and amounts of allergen material deposited in the airways during any period.1 Because this is impractical, proxies for exposure determination have been used. In homes with forced-air heating ventilation and air conditioning, all air is passed through the system approximately once every hour.2 The filter in that system should collect a representative sample of airborne allergens. We previously reported that dust from high-efficiency furnace filters (FFs) contains substantial amounts of aeroallergen.

http://ift.tt/2fcVbm9

Meta-analysis of the association between asthma and serum levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol

The reported associations of blood lipid profiles with asthma are ambiguous.

http://ift.tt/2fzLyg3

Re: Le Fort I advancement osteotomies of 1cm or more. How safe or stable?

I read with interest the article by Bhatia et al,1 regarding the safety and stability of Le Fort I advancement osteotomies of 1cm or more. They corrected the skeletal discrepancy by maxillary advancement with no evidence of serious complications, such as ischaemia and necrosis, and a year later relapse was rare. The procedure is therefore considered to be safe and stable.

http://ift.tt/2fXiYry

Piezoelectric compared with conventional rotary osteotomy for the prevention of postoperative sequelae and complications after surgical extraction of mandibular third molars: a systematic review and meta-analysis

The purpose of this review was to determine if postoperative sequelae (facial swelling, trismus, pain) and neurological complications are reduced when mandibular third molars are surgically extracted using a piezoelectric device for osteotomy compared with conventional rotary burs, and to determine if there is a difference in operating time between the two techniques. Clinical trials were identified through a search (April 2015) on the PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases.

http://ift.tt/2eAkSZW

Misoprostol 400 µg Versus 200 µg for Cervical Ripening in 1st Trimester Miscarriage

Condition:   Miscarriage, Incomplete
Interventions:   Drug: Misoprostol 400 µg;   Drug: Misoprostol 200 µg
Sponsor:   Hospital de Clinicas de Porto Alegre
Not yet recruiting - verified November 2016

http://ift.tt/2fziuaj

Single-agent Capecitabine as Adjuvant Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Carcinoma
Intervention:   Drug: Capecitabine
Sponsor:   Sun Yat-sen University
Not yet recruiting - verified November 2016

http://ift.tt/2fk8pew

Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause

Rhabdomyolysis can occur because of multiple causes and account for 7% of all cases of acute kidney injury annually in the United States. Identification of specific cause can be difficult in many cases where multiple factors could potentially cause rhabdomyolysis. We present a case of 16-year-old male who had seizures and was given levetiracetam that resulted in rhabdomyolysis. This side effect has been rarely reported previously and like in our case diagnosis may be delayed.

http://ift.tt/2fzEgcb

Persistent Tachypnea and Alveolar Hemorrhage in an Infant: An Unexpected Etiology

Persistent tachypnea and failure to thrive during infancy have a broad differential diagnosis which includes pulmonary and cardiovascular disorders. Diffuse alveolar hemorrhage (DAH) is a rare entity in children. DAH requires an extensive work-up as certain conditions may need chronic therapy. Cardiovascular disorders are included in the etiology of DAH. We present a case of an 8-month-old female with a moderate, restrictive patent ductus arteriosus (PDA) admitted to the hospital with respiratory distress and failure to thrive. An extensive work-up into tachypnea including multiple echocardiograms did not find an etiology. Open lung biopsy was performed and consistent with pulmonary hypertension. After closure of the PDA, patient's tachypnea improved, and she was discharged home with periodic follow-up showing a growing, thriving child. When an infant presents with tachypnea, a respiratory viral illness is often a common cause. The diagnosis of persistent tachypnea requires further investigation. Echocardiography, although readily available, may not always be sensitive in detecting clinically significant pulmonary hypertension. A clinician must have a heightened index of suspicion to proceed in evaluating for causes of tachypnea with a nonrespiratory etiology.

http://ift.tt/2fzyXcH

Microarchitectural study of the augmented bone following ridge preservation with a porcine xenograft and a collagen membrane: preliminary report of a prospective clinical, histological, and micro-computed tomography analysis

Socket preservation using a combination of porcine xenograft and collagen membrane maintains the vertical and horizontal dimensions of the ridge. The aim of this study was to evaluate the microarchitecture of the grafted area by histological analysis and micro-computed tomography. Patients in the test group (group 1; nine patients) underwent socket preservation, while the sockets in the control group (group 2; eight patients) were allowed to heal without preservation. After a 6-month healing period, bone core biopsy samples were obtained and implants were placed in the augmented sites in the test group (12 biopsy samples) and the non-augmented sockets of the control group (12 biopsy samples).

http://ift.tt/2fk6dUm

Reply

Publication date: November–December 2016
Source:The Journal of Allergy and Clinical Immunology: In Practice, Volume 4, Issue 6
Author(s): Paul J. Turner, Audrey DunnGalvin, Jonathan O'B Hourihane




http://ift.tt/2fvzPib

Comparison of allergens collected from furnace filters and vacuum floor dust

Publication date: Available online 7 November 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Ryan Allenbrand, Charles S. Barnes, Mubeen Mohammed, Luke Gard, Freddy Pacheco, Kevin Kennedy, Anita DiDonna, Jay Portnoy, Chitra Dinakar




http://ift.tt/2fvAbFo

Adrenal insufficiency associated with long-term use of inhaled steroid in asthma

Publication date: Available online 7 November 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Inseon S. Choi, Da-Woon Sim, Seung-Hoon Kim, Jin-Woo Wui
BackgroundWe previously reported that as many as one third of hospitalized patients with asthma treated with a low to medium daily dose of inhaled steroids (ICSs) for an average of 4.5 years showed adrenal insufficiency (AI).ObjectiveTo re-examine this issue in consecutive outpatients with asthma because of possible subject selection bias.MethodsOne hundred twenty-one consecutive adult patients with asthma under ICS treatment for at least 6 months underwent a rapid adrenocorticotrophic hormone stimulation test. AI was defined as a morning serum cortisol level no higher than 3 μg/dL or lower than 18 μg/dL before and after administration of 250 μg of adrenocorticotrophic hormone.ResultsThe mean durations of ICS use in the short-term (less than the median) and long-term (at least the median) users were 3.8 and 11.5 years, respectively. The proportion of subjects affected by AI tended to increase with the increasing cumulative dose of ICS (short-term users at a low to medium daily dose: mean cumulative dose 502 mg [15 of 34, 44.1%]; short-term users at a high dose of 941 mg [16 of 26, 61.5%]; long-term users at a low to medium dose of 1,077 mg [25 of 41, 61.0%]; long-term users at a high dose of 2,805 mg [13 of 20, 65.0%]), although not significantly. In short-term users, daily and cumulative ICS doses were significantly related to serum cortisol levels 60 minutes after taking adrenocorticotrophic hormone (r = −0.300 and −0.287, respectively; P < .05).ConclusionA large number of patients with asthma might have AI even with low- to medium-dose ICS treatment when ICSs are administered over a long period. Thus, it is essential that patients with asthma under ICS treatment be checked for AI much more frequently.



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Meta-analysis of the association between asthma and serum levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol

Publication date: Available online 7 November 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jiayu Peng, Ying Huang
BackgroundThe reported associations of blood lipid profiles with asthma are ambiguous.ObjectiveTo explore the association between asthma and the serum levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).MethodsA systematic search was performed in the PubMed, MEDLINE, Cochrane Library, and Chinese Biomedical Literature databases.Study SelectionTen studies were identified. We divided these studies into 2 subgroups according to age: children (<18 years old) and adults (≥18 years old).ResultsIn children, the asthma group had lower HDL-C levels (weighted mean difference, −3.44; 95% confidence interval [CI], −5.83 to −1.04; P = .005) compared with the nonasthma group, whereas the serum levels of LDL-C in these 2 groups were not statistically different. In contrary, in adults, the asthma group had higher LDL-C levels (weighted mean difference, 8.95; 95% confidence interval, 3.55–14.35; P = .001) compared with the nonasthma group, whereas the HDL-C levels were not statistically different.ConclusionThere is a significant association between asthma and the serum levels of HDL-C and LDL-C. Moreover, this association differs in children and adults.



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Erratum to: An update on peripheral ossifying fibroma: case report and literature review

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Severe Hiatal Hernia as a Cause of Failure to Thrive Discovered by Transthoracic Echocardiogram

A newborn infant with failure to thrive presented for murmur evaluation on day of life three due to a harsh 3/6 murmur. During the evaluation, a retrocardiac fluid filled mass was seen by transthoracic echocardiogram. The infant was also found to have a ventricular septal defect and partial anomalous pulmonary venous return. Eventually, a large hiatal hernia was diagnosed on subsequent imaging. The infant ultimately underwent surgical repair of the hiatal hernia at a tertiary care facility. Hiatal hernias have been noted as incidental extracardiac findings in adults, but no previous literature has documented hiatal hernias as incidental findings in the pediatric population.

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