Early Detection of Xeroderma in Older Patients

This study discusses how clinicians might look for white scale sign to detect and diagnose xeroderma in aging patients.

http://ift.tt/2gJadCl

Answers to CME examination

http://ift.tt/2h0CO1K

Valuable or vain: An ethical analysis of free skin cancer screening

See related articles on pages 129 and 181

http://ift.tt/2gIWefD

CME examination

http://ift.tt/2h0JSvm

Reply to: “On the utility of soak and smear”

To the Editor: We thank our colleagues, Drs James, Gutman, and Kirby, for their comments. It is an honor to have the physicians who published the first study on soak and smear reflect on our work.1

http://ift.tt/2gJ2rs0

Prevention and management of glucocorticoid-induced side effects: A comprehensive review

Systemic glucocorticoids are an essential therapy for a range of conditions, but their multiple side effects can produce significant morbidity for patients. The objective of this review is to discuss these side effects while addressing 3 questions: 1) What dose and duration of glucocorticoid therapy should prompt concern for individual side effects?; 2) How should clinicians counsel patients about these complications?; and 3) How can these problems be prevented or managed? To accomplish these objectives, we have created a series of tables and algorithms based on a review of relevant data to guide counseling, prophylaxis, and management of 11 glucocorticoid side effects.

http://ift.tt/2gJbM31

Tender nodule on the finger

A 27-year-old man presented with a tender lesion on the fifth finger on his left hand. This lesion initially started as a linear laceration that he obtained while skinning a sheep 2 to 3 weeks earlier. The physical examination revealed a tender nodule with a central hemorrhagic crust, a white middle ring, and a violaceous periphery over the left fifth extensor finger (Fig 1). A shave biopsy specimen was obtained to confirm the diagnosis (Fig 2).

http://ift.tt/2h0Izwx

Information for Readers

http://ift.tt/2gJ8D3g

Pruritic annular papules and plaques on the face and back

A 35-year-old previously healthy man presented with a 1-year history of multiple pruritic lesions on both his face and back. The lesions presented with crops of papules measuring 1 to 2 mm in diameter, grouped to form annular plaques, with central hyperpigmentation (Fig 1). Antifungal treatment, including oral terbinafine for 2 weeks and topical bifonazole for 1 month, was given in another hospital without any improvement. A skin biopsy specimen was obtained from the patient's face. The histopathologic examination revealed a heavy infiltrate of eosinophils and lymphocytes surrounding the hair follicles and sebaceous glands.

http://ift.tt/2h0GD78

The natural history of actinic keratoses in organ transplant recipients

To the Editor: Actinic keratoses (AKs) are common, highly dynamic, sun-induced lesions that frequently regress and recur.1,2 We sought to investigate whether there is an association between the degree of AK turnover and squamous cell carcinoma (SCC) incidence.

http://ift.tt/2gJ2Hak

Violaceous papules and plaques associated with Crohn's disease

A 25-year-old woman with Crohn's disease that was well controlled with infliximab presented with a 10-month history of violaceous plaques. Physical examination revealed multiple red to violaceous papules and plaques on the extensor surfaces of her elbows, knees, toes, fingers, and dorsal aspects of her feet (Fig 1). She denied fever, arthralgias, pain, or other systemic symptoms. The skin lesions had been unsuccessfully treated with oral prednisone, intralesional triamcinolone, topical clobetasol, and pimecrolimus.

http://ift.tt/2h0CWi1

Reply to: “Is treatment of acne as simple as encouraging primary care physicians to prescribe more retinoids?”

To the Editor: Defining the role of the primary care provider in the management of skin diseases is a multifactorial issue. Perhaps from the dermatologist's perspective it might seem ideal for dermatologists to manage all cases of acne, as dermatologists have extensive training and experience with the condition. But acne is highly prevalent, and the existing shortage of dermatologists may make having every patient with acne see a dermatologist unfeasible, if not undesirable.1,2

http://ift.tt/2gJ07RH

Hyperkeratotic plaques on the trunk and extremities

An 8-year-old white boy presented for a lifelong skin condition. At birth he had widespread blisters and erosions and later developed generalized, thick scaly plaques on his body and thinner scaling on his face. Biopsy specimens obtained for electron microscopy performed at birth revealed dyscohesive keratinocytes and clumped keratin intermediate filaments of suprabasal keratinocytes (Fig 1). The physical examination revealed generalized, thick, scaly plaques predominantly involving the flexural surfaces and brown hyperkeratotic, verrucous, scaly plaques on his trunk, legs, and arms (Fig 2).

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Change of Address

http://ift.tt/2gIYMKT

Iotaderma #275

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Use of a cotton-tipped applicator for superior clinical diagnosis and biopsy of suspected basal cell carcinoma of the nasal ala

Although the nose is a common location for basal cell carcinoma (BCC), the nasal ala represents a location where visualization and biopsy of suspected BCC can prove especially difficult. The ala's angulated structure and background features, such as telangiectases, can make the characteristic features of BCC challenging to appreciate (Fig 1). In addition, biopsy of the region can be cumbersome because of the inherent flexures of the nasal ala.

http://ift.tt/2gJ0AUe

A double-blind, placebo-controlled, phase-II clinical trial to evaluate oral simvastatin as a treatment for vitiligo

To the Editor: Vitiligo is an autoimmune disease caused by autoreactive CD8+ T lymphocytes that target melanocytes, and interferon-γ-induced CXCL10 plays an important role.1 Simvastatin inhibits interferon-γ signaling by blocking activation of STAT12 and prevented and reversed disease in our mouse model.3 A case report described a patient with vitiligo who repigmented with simvastatin.4 We conducted a small, randomized, double-blind, placebo-controlled, phase II clinical trial to test simvastatin as a treatment for vitiligo.

http://ift.tt/2h0LNAk

Wisely choosing thin melanomas for sentinel lymph node biopsy

To the Editor: The routine use of sentinel lymph node (SLN) biopsy (SLNB) in the management of thin melanomas is controversial. For this reason, we read with great interest the article of Wat et al1 in which the authors examined 1072 cases of melanoma submitted to SLNB. Among these, 171 cases were thin melanomas and 15 of them (8.8%) showed SLNB positivity. Today, the scientific community is precisely focusing on the clinical significance of different histologic subtypes of thin melanoma. The current staging system for melanoma of the American Joint Committee on Cancer uses Breslow thickness as the primary attribute and up to 1-mm-thick melanoma is defined as "thin" because it shows good prognosis after surgical excision, with 10-year survival of 85% to 90% in case of tumor-free margin of at least 1 cm.

http://ift.tt/2gJ6e8M

Total body skin exams (TBSEs): Saving lives or wasting time?

The central ethical issue raised by this scenario is whether it is morally obligatory to perform TBSEs, or at least offer them, to all new dermatology patients and at routine screening visits for patients at risk for skin cancer. Those supporting TBSEs make claims that the practice increases detection of skin cancer (general beneficence or utility), represents a professional duty to patients (deontology), and upholds patient preferences (autonomy). Those supporting lesion-directed exams over TBSEs suggest that the time saved from more focused exams permits seeing more patients while only making a small sacrifice in skin cancer detection, a utilitarian claim.

http://ift.tt/2h0GPU0

A proactive approach to ending the use of university debit cards for indoor tanning

To the Editor: Indoor tanning is associated with increased risk of melanoma, particularly when used during adolescence and early adulthood.1 The ability of young adults to use indoor tanning is partially limited by the cost of purchasing these services.2 Many universities sponsor debit cards that parents can fund to support student expenses. Students can use these debit cards at various vendors that have entered into an agreement with the university, including tanning salons.3 Recently, a review of the top 125 colleges ranked by US News and World Report found that 14.4% of universities have a campus debit card that can be used to purchase tanning services.

http://ift.tt/2gJazc6

Percutaneous ligature of the superficial temporal artery: A simple technique to reduce bleeding

Excision of skin lesions within close proximity of the branches of the superficial temporal artery can be challenging because bleeding from severed arteries readily results in a loss of visibility.

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Deliberate chemical dermatoglyphic burns in a political refugee

Publication date: Available online 14 December 2016
Source:Annales de Dermatologie et de Vénéréologie
Author(s): P. Charlier, A. Haroun, C. Hervé




http://ift.tt/2gITHSL

Inequalities in access to biological treatments for psoriasis: Results from the Italian Psocare Registry

Abstract

Background

Limited evidence is available on the impact of socioeconomic factors in drug prescriptions for psoriasis.

Objectives

To investigate factors influencing prescription of conventional versus biological treatment for psoriatic patients, based on the Psocare registry with a special focus on socioeconomic factors.

Methods

This was a cross-sectional study evaluating the baseline data of patients included in the Italian Psocare Registry. All of the consecutive adult patients with a diagnosis of chronic plaque psoriasis (Ps) or psoriatic arthritis and who were prescribed a systemic treatment for Ps at the participating centres were included in this study. Univariate and multivariate analyses of the baseline factors associated with a biologics prescription were performed.

Results

From September 2005 to September 2009, 12,838 patients were identified. A multivariate analysis revealed that, among other factors, completing a level of education higher than lower secondary school and being employed as a manager or a professional were independent factors associated with a biologics prescription at entry in the registry. Additional analyses on the association between these two variables and a severe Ps condition (i.e., psoriasis area and severity index [PASI] score > 20) revealed a significant increasing trend of severe disease towards lower educational attainment, while unemployed patients were more likely to have a more severe condition as compared to the other categories of workers.

Conclusions

We documented inequalities of drug prescriptions for Ps in Italy, with a trend towards a higher frequency of prescription for more expensive biologics in higher socio-economic sectors of the population.

This article is protected by copyright. All rights reserved.

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Enhanced regeneration potential of mobilized dental pulp stem cells from immature teeth

Abstract

Objectives

We have previously demonstrated that dental pulp stem cell (DPSCs) isolated from mature teeth by granulocyte-colony stimulating factor (G-CSF)-induced mobilization method can enhance angiogenesis/vasculogenesis and improve pulp regeneration when compared with colony-derived DPSCs. However, the efficacy of this method in immature teeth with root-formative stage has never been investigated. Therefore, the aim of this study is to examine the stemness, biological characteristics and regeneration potential in mobilized-DPSCs compared with colony-derived DPSCs from immature teeth.

Materials And Methods

Mobilized-DPSCs isolated from immature teeth were compared to colony-derived DPSCs using methods including flow cytometry, migration assays, mRNA expression of angiogenic/neurotrophic factor, and induced differentiation assays. They were also compared in trophic effects of the secretome. Regeneration potential was further compared in an ectopic tooth transplantation model.

Results

Mobilized-DPSCs had higher migration ability and expressed more angiogenic/neurotrophic factors than DPSCs. The mobilized-DPSC secretome produced a higher stimulatory effect on migration, immunomodulation, anti-apoptosis, endothelial differentiation and neurite extension. In addition, vascularization and pulp regeneration potential were higher in mobilized-DPSCs than in DPSCs.

Conclusions

G-CSF-induced mobilization method enhances regeneration potential of colony-derived DPSCs from immature teeth.

This article is protected by copyright. All rights reserved.

http://ift.tt/2hNpkGO

Amianto. Cáncer de laringe

Publication date: Available online 14 December 2016
Source:Acta Otorrinolaringológica Española
Author(s): Luis Sánchez Galán




http://ift.tt/2hNxVJz

Electrocauterización endoscópica para el tratamiento de las fístulas congénitas del seno piriforme en pediatría. Serie de casos

Publication date: Available online 14 December 2016
Source:Acta Otorrinolaringológica Española
Author(s): Giselle Cuestas, Flavia Doormann, Verónica Rodríguez, Patricio Bellia Munzón, Gastón Bellia Munzón
Las fístulas del seno piriforme son anomalías infrecuentes de los arcos branquiales. La mayoría se localizan en el lado izquierdo y se extienden desde el ápex del seno piriforme de la hipofaringe hasta la glándula tiroides o el espacio peritiroideo.El diagnóstico se sospecha ante la presencia de tiroiditis aguda supurada o abscesos cervicales laterales recurrentes, y se confirma mediante la visualización endoscópica del orificio de la fístula. El tratamiento clásico consiste en la exéresis del trayecto fistuloso por vía cervical, con o sin lobectomía tiroidea. Sin embargo, se han desarrollado alternativas menos invasivas y con menos riesgos de complicaciones que obliteran el trayecto de la fístula, como la electrocauterización endoscópica.Describimos nuestra experiencia con 7 pacientes que presentaban esta afección, tratados con cauterización endoscópica utilizando electrobisturí de radiofrecuencia, y evaluamos la eficacia y la seguridad del tratamiento realizado.Pyriform sinus fistulas are rare anomalies of the branchial arches. Most of them are located on the left side. They extend from the apex of the pyriform sinus of the hypopharynx to the thyroid gland or adjacent tissues.The diagnosis is suspected in the presence of acute suppurative thyroiditis or recurrent cervical abscesses, and is confirmed by endoscopic visualization of the fistula hole. The traditional treatment consists of excision of the fistulous tract, with or without thyroid lobectomy, by cervical approach. However, less invasive alternatives that obliterate the path of the fistula have been developed, such as endoscopic electrocautery.We describe our experience with 7 patients with this condition, who were treated with endoscopic cauterization using radiofrequency electrocautery, and we evaluate the effectiveness and safety of the treatment performed.



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Erratum to: Picosecond lasers for tattoo removal: a systematic review

http://ift.tt/2hNqstX

The efficacy and safety of 2-μm continuous laser in the treatment of high-risk patients with benign prostatic hyperplasia

Abstract

Two-micrometer laser resection of prostate-tangerine technique dissects whole prostatic lobes off the surgical capsular, similar to peeling a tangerine. The present study aimed to evaluate the safety and efficacy of 2-μm continuous laser vaporization in the treatment of high-risk patients with benign prostatic hyperplasia (BPH) during the 24-month follow-up. The study included 248 patients with moderate to severe lower urinary tract symptoms who underwent 2-μm continuous laser vaporization of the prostate. All patients were accompanied with different degree comorbidities and 94 patients were taking oral anticoagulants. BPH was successfully treated with 2-μm continuous laser vaporization in all patients. Mean pre-operative prostate volume was 76 ± 25.3 ml and mean operative time was 49.8 ± 16.5 min. There were no major complications intra-operatively or postoperatively, and no blood transfusions were needed. About 20 patients (8.1%) needed bladder irrigation postoperatively. Average catheterization time was 2.0 ± 1.8 days (range 1–5 days). Four patients required reoperation due to enlarged prostates from residual adenoma. At 3-, 6-, 12-, and 24-month follow-ups, maximum urinary flow rates (Qmax) increased from 6.9 ± 1.7 to 19.1 ± 4.2, 19.5 ± 4.6, 19.4 ± 4.6, and 19.5 ± 4.1 ml/s, respectively. Mean International Prostate Symptom Scores (IPSS) decreased from 27.6 ± 5.1 (pre-operation) to 9.2 ± 2.6, 7.12 ± 1.42, 6.18 ± 1.32, and 6.25 ± 1.30 at 3-, 6-, 12-, and 24-month post-operation, respectively. Two-micrometer continuous laser vaporization is a safe and effective surgical endoscopic technique associated with low complication rate in BPH patients at high risk and those on anticoagulation therapy who have severe LUTS caused by BPH.

http://ift.tt/2gWO9QE

Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)

In the presented case, the authors describe an obese middle-aged man that presented to the emergency department for persistent oedema, scleral icterus and fatigue. He was admitted to the hospital and diagnosed with liver cirrhosis via transjugular liver biopsy. He continued to bleed from the biopsy site for 5 days from accelerated intravascular coagulation and fibrinolysis (AICF) requiring multiple transfusions of packed red blood cells, fresh-frozen plasma and cryoprecipitate. The authors then used thromboelastography (TEG) to further characterise the patient's coagulopathy, which revealed platelet inhibition. The results of the TEG significantly changed future transfusion management. Finally, the authors conducted a literature review to summarise the current literature available for the use of TEG in the management of liver cirrhosis with AICF.

http://ift.tt/2hELpLR

Combined central retinal vein and branch retinal artery occlusion in hyperhomocysteinaemia

Description

A woman aged 30 years reported of blurred vision in the right eye (RE) for 2 days. Visual acuity was 6/24 in the RE and 6/6 in the left eye (LE). Funduscopy of RE showed combined non-ischaemic central retinal vein occlusion (CRVO) and supero-temporal branch retinal artery occlusion (BRAO) (figure 1A). LE examination was normal. Optical coherence tomography (OCT) of the RE showed thickening of inner retinal layers corresponding to the area of BRAO (figure 1A: white arrow). Thorough systemic investigations and cardiac workup revealed raised serum homocysteine levels (37.21 μmol/L). She was started on oral folic acid and pyridoxine. Over the next 6 months, her visual acuity improved to 6/12 with clearing of retinal whitening and resolution of retinal haemorrhages (figure 1B–D).

Figure 1

Funduscopy of the right eye (RE) showing dilated torturous retinal veins with multiple retinal haemorrhages in all four quadrants...

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Iliopsoas abscess caused by chronic urolithiasis and pyelonephritis

Description

A man aged 45 years, with a history of recurrent urolithiasis and pyelonephritis, presented with a 3-month history of fever. Physical examination revealed a nodule in his right inguinal area. CT with contrast showed a right iliopsoas abscess that extended to the inguinal area and a right urethral stone (figure 1). Drainage under fluoroscopic guidance was performed, and the contrast was injected into the cavity from the drainage tube to assess the abscess cavity. The contrast study demonstrated a connection between the urethra and abscess cavity (figure 2). The patient was administered 1 g cefotiam every 8 hours. Blood, urine and fluid cultures from the abscess were positive for Escherichia coli. Surgical drainage and right nephrectomy was performed. The patient was discharged 3 months after the surgery without any complication. The penetration of an iliopsoas abscess into the urinary tract is extremely rare, while the symptoms...

http://ift.tt/2hEU5Sc

Vertical muscle transposition with silicone band belting in VI nerve palsy

A woman aged 60 years developed a Millard-Gubler syndrome after a diagnosis of a cavernous angioma in the median and paramedian areas of the pons. In this context, she presented a right VI nerve palsy, right conjugate gaze palsy, facial palsy and left hemiparesis. To improve the complete VI nerve palsy, we planned a modified transposition approach, in which procedure we made a partial transposition of vertical rectus with a silicone band that was fixated posteriorly. After the procedure, the patient gained the ability to slightly abduct the right eye. We found no compensatory torticollis in the primary position of gaze. There was also an improvement of elevation and depression movements of the right eye. We obtained satisfactory results with a theoretically reversible technique, which is adjustable intraoperatively with no need of muscle detachment, preventing anterior segment ischaemia and allowing simultaneous recession of the medial rectus muscles, if necessary.

http://ift.tt/2gAxbXn

Indian Journal of Medical and Paediatric Oncology (Indian J Med Paediatr Oncol)

EDITORIAL COMMENTARY

Classical or pylorus-preserving pancreatoduodenectomy in pancreatic and periampullary cancer: "The jury is still out!" [pg. 209]
Savio George Barreto
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

REVIEW ARTICLES

Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy? [pg. 211]
Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Skin: A mirror of internal malignancy [pg. 214]
Rita V Vora, RahulKrishna S Kota, Nilofar G Diwan, Nidhi B Jivani, Shailee S Gandhi
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Status of barium studies in the present era of oncology: Are they a history? [pg. 223]
Abhishek Mahajan, Subash Desai, Nilesh Pandurang Sable, Meenakshi Haresh Thakur
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

ORIGINAL ARTICLES

Protection behaviors for cytotoxic drugs in oncology nurses of chemotherapy centers in Shiraz hospitals, South of Iran [pg. 227]
Khadijeh Abbasi, Maryam Hazrati, Abolfazl Mohammadbeigi, Jasem Ansari, Mahboubeh Sajadi, Azam Hosseinnazzhad, Esmail Moshiri
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India [pg. 232]
K Govind Babu, MC Suresh Babu, D Lokanatha, Gita R Bhat
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Effect of areca nut chewing and maximal mouth opening in schoolgoing children in Ahmedabad [pg. 239]
Azizfatema Munawer Khan, Megha S Sheth, Romsha R Purohit
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Clinicopathological features and outcomes in advanced nonsmall cell lung cancer with tailored therapy [pg. 242]
Stalin Bala, Sadashivudu Gundeti, Vijay Gandhi Linga, Lakshmi Srinivas Maddali, Raghunadha Rao Digumarti, Shantveer G Uppin
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Clinicopathological profile of gastrointestinal lymphomas in Kashmir [pg. 251]
Mehnaaz Sultan Khuroo, Summyia Farooq Khwaja, Ajaz Rather, Zhahid Hassan, Ruby Reshi, Naira Sultan Khuroo
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Metabolic toxicities in patients undergoing treatment for nonhematological malignancy: A cross-sectional study [pg. 256]
Subhash Gupta, Kunhi Parambath Haresh, Soumyajit Roy, Lakhan Kashyap, Narayan Adhikari, Rambha Pandey, Dayanand Sharma, Pramod Kumar Julka, Goura Kishor Rath
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Managing metastatic renal cell carcinoma-challenges, pitfalls, and outcomes in the real world [pg. 260]
Karnam Ashok Kumar, Gundeti Sadashivudu, KV Krishnamani, Vijay Gandhi Linga, Lakshmi Srinivas Maddali, Raghunadha Rao Digumarti
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Evaluation of thyroid lesions by fine-needle aspiration cytology based on Bethesda system for reporting thyroid cytopathology classification among the population of South Bihar [pg. 265]
Richa Bhartiya, Mahasweta Mallik, Nawanita Kumari, Brijendra Narayan Prasad
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Oxaliplatin-related neuropathy in Indian patients – no difference between generic and original molecules [pg. 271]
Bhawna Sirohi, Vikas Ostwal, Shaheenah Dawood, Gilberto Lopes, Sanjay Talole, Chaitali Nashikkar, Shailesh Shrikhande
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Burden of cervical cancer and role of screening in India [pg. 278]
Saurabh Bobdey, Jignasa Sathwara, Aanchal Jain, Ganesh Balasubramaniam
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Cognizance and utilization about breast cancer screening among the health professional female students and staffs of University Kuala Lumpur, Royal College of Medicine Perak, Malaysia [pg. 286]
ATM Emdadul Haque, Muhammad Afif Bin Mohd Hisham, Noor Azwa Laili Binti Ahmad Adzman, Nur Atiqah Binti Azudin, Nursakinah Binti Shafri, Mainul Haque
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

CASE REPORTS

Juvenile granulosa cell tumor associated with Ollier disease [pg. 293]
Abhilasha Ashok Sampagar, Rahul R Jahagirdar, Vibha Sanjay Bafna, Sandip P Bartakke
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Thymoma masquerading as transfusion dependent anemia [pg. 296]
Javvid Muzamil, Aejaz Aziz Shiekh, Gull Mohammad Bhat, Abdul Rashid Lone, Shuaeb Bhat, Firdousa Nabi
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

PRACTITIONER SECTION

A rare case of lung cancer presenting as an ischioanal fossa mass [pg. 300]
Nishitha Shetty, Ranvijay Singh, Maryam Naveed, Ashwini M Ronghe, Falguni Shashikant Barot
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Multiple solitary extramedullary anaplastic plasmacytomas [pg. 303]
Sandesh Madi, Vishnu Senthil, Monappa Naik, Sandeep Vijayan
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

LETTERS TO EDITOR

Folate supplementation in transfusion-dependent thalassemia: Do we really need such high doses? [pg. 305]
Gaurav Tripathi, Manas Kalra, Amita Mahajan
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Early tumor shrinkage as an "on-treatment" clinical predictor of long-term outcome in solid organ cancers [pg. 306]
Pratishtha Banga Chaudhari
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Cancer risk of general people due to using joss stick for religious worshiping [pg. 307]
Beuy Joob, Viroj Wiwanitkit
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

A rare case of hepatoid carcinoma of the ovary with pancytopenia and hypocellular marrow [pg. 307]
Manoj Lakhotia, Hans Raj Pahadiya, Akanksha Choudhary, Ronak Gandhi, Ramesh Chand Purohit
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Multiple cutaneous malignancies in a child with xeroderma pigmentosum: A case report [pg. 309]
Rita V Vora, RahulKrishna SureshKumar Kota, Nilofar G Diwan
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

The masquerading splenic lesion [pg. 311]
Mansoor C Abdulla, Jemshad Alungal, Ram Naryan, Neena Mampilly
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

ASCO 2016 GI CANCER UPDATE

Focused update on Gastrointestinal (GI) Oncology from ASCO 2016 [pg. 314]
Ravi Kumar Paluri
[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

ERRATUM

Erratum: Evaluation of myeloid cells (tumor associated tissue eosinophils and mast cells) infiltration in different grades of oral squamous cell carcinoma [pg. 319]

[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Erratum: Isolated humeral recurrence in endometrial carcinoma [pg. 320]

[ABSTRACT]   [HTML FULL TEXT]   [PDF]   [Mobile HTML Full text ]   [EPub]

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

A connection between neurovascular conflicts within the cerebellopontine angle and vestibular neuritis, a case controlled cohort study.

A connection between neurovascular conflicts within the cerebellopontine angle and vestibular neuritis, a case controlled cohort study.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):421-427

Authors: Loader B, Linauer I, Korkesch S, Krammer-Effenberger I, Zielinski V, Schibany N, Kaider A, Vyskocil E, Tscholakoff D, Franz P

Abstract
This retrospective, observer blinded case-control study aims to compare the prevalence of neurovascular conflicts (NVCs) of the vestibulocochlear nerve and the anterior inferior cerebellar artery (AICA) in patients presenting with clinical signs of acute vestibular neuritis with and without subsequent objective vestibular function loss (VFL). 58 acute cases of clinically suspected acute vestibular neuritis were investigated with same day cranial MRI at a tertiary referral centre and compared to 61 asymptomatic controls. The prevalence of NVCs in cases with objective VFL were also compared to cases without VFL. Radiologists described the NVC as "no contact" (Grade 0), "contact < 2 mm" (Grade 1), "contact > 2 mm" (Grade 2) and "vascular loop presence" (Grade 3) without knowledge of neurotological data. Neurotological data was collected without knowledge of MRI findings. Vestibular function was tested by bithermic caloric irrigation. 26 cases (45%) showed caloric VFL (Group A), whereas 32 (55%) exhibited no VFL (Group B). Group A included 13 cases with NVCs (50%), Group B included 26 NVC cases (82%) (p = 0.012) and the control group included 16 individuals (26%) (p < 0.001 for comparison of all 3 groups). Group B had a significantly higher NVC-Grading than Group A (p = 0.009). There was no statistically significant association between NVCs and either SNHL or tinnitus (p > 0.05). Our results suggest that patients presenting with clinical signs of acute vestibular neuritis who show symmetrical caloric vestibular function test results have a significantly higher NVC prevalence in the cerebellopontine angle.

PMID: 27958603 [PubMed - in process]

http://ift.tt/2hsssvm

Severe to profound deafness may be associated with MYH9-related disease: report of 4 patients.

Severe to profound deafness may be associated with MYH9-related disease: report of 4 patients.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):415-420

Authors: Canzi P, Pecci A, Manfrin M, Rebecchi E, Zaninetti C, Bozzi V, Benazzo M

Abstract
MYH9-related disease (MYH9-RD) is a rare genetic syndromic disorder characterised by congenital thrombocytopenia and is associated with the risk of developing progressive sensorineural hearing loss, nephropathy and presenile cataracts during childhood or adult life. All consecutive patients enrolled in the Italian Registry for MYH9-RD with severe to profound deafness were included in a retrospective study. The study population involved 147 Italian patients with MYH9-RD: hearing loss was identified in 52% of cases and only 4 patients (6%) presented severe to profound deafness at a mean age of 33 years. Deafness was associated with mild spontaneous bleeding in all patients and with kidney involvement in 3 cases. Cochlear implantation was carried out in 3 cases with benefit, and no major complications were observed. Diagnosis was performed about 28 years after the first clinical manifestation of MYH9-RD, which was never suspected by an otolaryngologist. The clinical and diagnostic aspects of 4 patients with severe to profound deafness are discussed with a focus on therapeutic implications.

PMID: 27958602 [PubMed - in process]

http://ift.tt/2huxAfv

Open partial horizontal laryngectomies: is it time to adopt a modular form of consent for the intervention?

Open partial horizontal laryngectomies: is it time to adopt a modular form of consent for the intervention?

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):403-407

Authors: Giordano L, Di Santo D, Crosetti E, Bertolin A, Rizzotto G, Succo G, Bussi M

Abstract
Nowadays, open partial horizontal laryngectomies (OPHLs) are well-established procedures for treatment of laryngeal cancer. Their uniqueness is the possibility to modulate the intervention intraoperatively, according to eventual tumour extension. An OPHL procedure is not easy to understand: there are several types of procedures and the possibility to modulate the intervention can produce confusion and lack of adherence to the treatment from the patient. Even if the surgery is tailored to a patient's specific lesion, a unified consent form that discloses any possible extensions, including a total laryngectomy, is still needed. We reviewed the English literature on informed consent, and propose comprehensive Information and Consent Forms for OPHLs. The Information Form is intended to answer any possible questions about the procedure, while remaining easy to read and understand for the patient. It includes sections on laryngeal anatomy and physiology, surgical aims and indications, alternatives to surgery, complications, and physiology of the operated larynx. The Consent Form is written in a "modular" way: the surgeon defines the precise extension of the lesion, chooses the best OPHL procedure and highlights all possible expected extensions specific for the patient. Our intention, providing these forms both in Italian and in English, is to optimise communication between the patient and surgeon, improving surgical procedure arrangements and preventing any possible misunderstandings and medico-legal litigation.

PMID: 27958601 [PubMed - in process]

http://ift.tt/2hst6Jl

Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.

Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):395-402

Authors: Fattori B, Giusti P, Mancini V, Grosso M, Barillari MR, Bastiani L, Molinaro S, Nacci A

Abstract
The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.

PMID: 27958600 [PubMed - in process]

http://ift.tt/2gzVRPw

Association between oral habits, mouth breathing and malocclusion.

Association between oral habits, mouth breathing and malocclusion.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):386-394

Authors: Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R

Abstract
The ratio of bad habits, mouth breathing and malocclusion is an important issue in view of prevention and early treatment of disorders of the craniofacial growth. While bad habits can interfere with the position of the teeth and normal pattern of skeletal growth, on the other hand obstruction of the upper airway, resulting in mouth breathing, changes the pattern of craniofacial growth causing malocclusion. Our crosssectional study, carried out on 3017 children using the ROMA index, was developed to verify if there was a significant correlation between bad habits/mouth breathing and malocclusion. The results showed that an increase in the degree of the index increases the prevalence of bad habits and mouth breathing, meaning that these factors are associated with more severe malocclusions. Moreover, we found a significant association of bad habits with increased overjet and openbite, while no association was found with crossbite. Additionally, we found that mouth breathing is closely related to increased overjet, reduced overjet, anterior or posterior crossbite, openbite and displacement of contact points. Therefore, it is necessary to intervene early on these aetiological factors of malocclusion to prevent its development or worsening and, if already developed, correct it by early orthodontic treatment to promote eugnatic skeletal growth.

PMID: 27958599 [PubMed - in process]

http://ift.tt/2huDCwK

Advanced oxidation protein product levels as a marker of oxidative stress in paediatric patients with chronic tonsillitis.

Advanced oxidation protein product levels as a marker of oxidative stress in paediatric patients with chronic tonsillitis.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):381-385

Authors: Ozbay I, Kucur C, Koçak FE, Savran B, Oghan F

Abstract
We aimed to determine whether advanced oxidation protein product (AOPP) levels can serve as a marker of oxidative stress in paediatric patients with chronic tonsillitis. Thirty children with chronic tonsillitis and 30 healthy children (control group) were recruited from the Otorhinolaryngology (ORL) and Paediatric Surgery departments, respectively, of Dumlupinar University Hospital. In the patient group, blood samples were collected before tonsillectomy, and tonsil tissue was sampled during the operation. Blood samples were also obtained from the control subjects. AOPP levels in the serum and tonsil tissue were measured by the spectrophotometric method. Serum AOPP levels were significantly higher in the patient group (13.1 ± 3.3 ng/ml) than in the control group (11.6 ± 2.3 ng/ml; P < 0.05). In addition, the mean AOPP level (41.9 ± 13.5 ng/mg protein) in the tonsil tissue in the patient group was significantly higher than the mean serum AOPP levels in the control and patient groups (P < 0.05). AOPP levels are elevated in the tonsil tissue and serum of patients with chronic tonsillitis compared to the serum AOPP levels in healthy controls. AOPPs may represent a novel class of pro-inflammatory molecules that are involved in oxidative stress in chronic tonsillitis. AOPPs may be used as a marker of oxidative stress in paediatric patients with chronic tonsillitis.

PMID: 27958598 [PubMed - in process]

http://ift.tt/2hssrri

Salvage total laryngectomy after conservation laryngeal surgery for recurrent laryngeal squamous cell carcinoma.

Salvage total laryngectomy after conservation laryngeal surgery for recurrent laryngeal squamous cell carcinoma.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):373-380

Authors: De Virgilio A, Greco A, Bussu F, Gallo A, Rosati D, Kim SH, Wang CC, Conte M, Pagliuca G, De Vincentiis M

Abstract
The aim of the present study was to evaluate the oncological efficacy of salvage total laryngectomy in patients who had previously undergone supracricoid partial laryngectomy or transoral laser microsurgery for treatment of laryngeal squamous cell carcinoma. We retrospectively reviewed the medical, surgical and pathological records of 35 patients who underwent salvage total laryngectomy after recurrence of laryngeal cancer (following supracricoid partial laryngectomy or transoral laser microsurgery). Kaplan-Meier survival curves as well as univariate and multivariate analyses of prognostic factors were performed. No statistically significant differences were seen comparing the supracricoid partial laryngectomy group with the transoral laser microsurgery group for overall survival and disease-specific survival at 3 years (OS = 38% vs. 52%, p = 0.16; DSS = 40% vs. 61%, p = 0.057) or locoregional control at 2 years (LRC = 40% vs. 54%, p = 0.056). A trend indicating worse survival and locoregional control for supracricoid partial laryngectomy patients emerged. Preservation of the osteocartilaginous frame in transoral laser microsurgery could hypothetically result in better salvageability of anterior recurrences with extralaryngeal spread.

PMID: 27958597 [PubMed - in process]

http://ift.tt/2huEFNa

Lipofilling as refinement procedure in maxillo-mandibular malformations.

Lipofilling as refinement procedure in maxillo-mandibular malformations.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):368-372

Authors: Cervelli D, Gasparini G, Moro A, Pelo S, Foresta E, Grussu F, D'Amato G, De Angelis P, Saponaro G

Abstract
Maxillo-mandibular asymmetry has numerous aetiologies: congenital, traumatic, iatrogenic and post-oncologic. Patients with congenital dentofacial malformations are generally submitted to orthognathic surgery and/or additional procedures (genioplasty, alloplastic implants) with satisfactory results. However, despite achieving skeletal symmetry, noticeable facial asymmetry may persist.This study was performed in 45 patients (29 women and 16 men) operated between December 2012 and June 2014. All patients were affected by maxilla-mandibular asymmetry and underwent orthognatic surgery for hard tissue correction of the deformity. Residual facial alterations were then treated with lipofilling refinement proceure. In all cases good integration of the grafted fat was observed in the recipient sites. Retrospective analysis of photographic documentation showed progressive volumetric decrease for up to approximately 6 months after surgery; after that graft volume remained relatively stable. There were no significant surgical complications, either from the fat harvest site or the reconstructed site. Mild oedema and bruising were frequent during the first post-operative week. No haematomas, infections, vascular or nervous injuries were recorded. Twenty-four patients felt the need to have a second procedure. A second fat transfer was performed in 22 cases, and a third in 2 (total of 69 procedures). Based on the observations of our study, fat grafting is a simple, effective and reproducible technique, with a high satisfaction rate and few disadvantages or complications. We demonstrated that the success of lipofilling is dependent on the treated aesthetic subunits of the face. The malar and lateral cheek regions seem to be highly favourable for fat grafting, unlike the upper and lower lips subunits. Composite procedures using orthognathic surgery and autologous fat provide the surgeon with an additional, more customisable option for patients with maxillo-mandibular malformations.

PMID: 27958596 [PubMed - in process]

http://ift.tt/2hMFEb0

Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies.

Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies.

Acta Otorhinolaryngol Ital. 2016 Oct;36(5):345-367

Authors: Ruggieri M, Praticò AD, Serra A, Maiolino L, Cocuzza S, Di Mauro P, Licciardello L, Milone P, Privitera G, Belfiore G, Di Pietro M, Di Raimondo F, Romano A, Chiarenza A, Muglia M, Polizzi A, Evans DG

Abstract
Neurofibromatosis type 2 [NF2; MIM # 101000] is an autosomal dominant disorder characterised by the occurrence of vestibular schwannomas (VSs), schwannomas of other cranial, spinal and cutaneous nerves, cranial and spinal meningiomas and/or other central nervous system (CNS) tumours (e.g., ependymomas, astrocytomas). Additional features include early onset cataracts, optic nerve sheath meningiomas, retinal hamartomas, dermal schwannomas (i.e., NF2-plaques), and (few) café-au-lait spots. Clinically, NF2 children fall into two main groups: (1) congenital NF2 - with bilateral VSs detected as early as the first days to months of life, which can be stable/asymptomatic for one-two decades and suddenly progress; and (2) severe pre-pubertal (Wishart type) NF2- with multiple (and rapidly progressive) CNS tumours other-than-VS, which usually present first, years before VSs [vs. the classical adult (Gardner type) NF2, with bilateral VSs presenting in young adulthood, sometimes as the only disease feature]. Some individuals can develop unilateral VS associated with ipsilateral meningiomas or multiple schwannomas localised to one part of the peripheral nervous system [i.e., mosaic NF2] or multiple non-VS, non-intradermal cranial, spinal and peripheral schwannomas (histologically proven) [schwannomatosis]. NF2 is caused by mutations in the NF2 gene at chromosome 22q12.1, which encodes for a protein called merlin or schwannomin, most similar to the exrin-readixin-moesin (ERM) proteins; mosaicNF2 is due to mosaic phenomena for the NF2 gene, whilst schwannomatosis is caused by coupled germ-line and mosaic mutations either in the SMARCB1 gene [SWNTS1; MIM # 162091] or the LZTR1 gene [SWNTS2; MIM # 615670] both falling within the 22q region and the NF2 gene. Data driven from in vitro and animal studies on the merlin pathway [e.g., post-translational and upstream/downstream regulation] allowed biologically targeted treatment strategies [e.g., Lapatinib, Erlotinib, Bevacizumab] aimed to multiple tumour shrinkage and/or regression and tumour arrest of progression with functional improvement.

PMID: 27958595 [PubMed - in process]

http://ift.tt/2hstgQT

Consultation with a specialized pain clinic reduces pain after oral and maxillofacial surgery

Publication date: Available online 14 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Eva-Maria Dietrich, Norbert Griessinger, Friedrich Neukam, Tilo Schlittenbauer
PurposePostoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment.Materials and MethodsA total of 128 patients treated at our clinic in the period 2012-2015 who required analgesic treatment adaptation by our pain clinic were included. They were further divided into 10 groups: tumor, temporomandibular joint disorder, tooth extraction, osteomyelitis, bisphosphonate-related osteonecrosis of the jaw, submandibular abscess, orthognathic surgery, cyst, sinusitis, and fracture. Pain characteristics evaluated were intensity on a numerical rating scale (NRS) before and after intervention of the pain clinic, quality, genesis, and type.ResultsPosttreatment pain intensity values at rest 1.8 (SD: 1.4) and on exercise 4 (SD: 2) were statistically significant better compared to pretreatment values (4.2, SD: 2.5, and 6.8 SD: 2, respectively). The highest pain intensities were reported after tooth extractions, orthognathic surgery, cystectomies, and fracture reposition. Pain was mainly continuous and related to a combination of a somatic and a neuropathic pathophysiological mechanism.ConclusionsIntervention by a specialized pain clinic leads to reduction of postoperative pain.



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The versatility of the Karapandzic flap: A review of 65 cases with patient-reported outcomes

Publication date: Available online 14 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Trevor A. Teemul, Alexander Telfer, Rabindra P. Singh, Martin R. Telfer
ObjectiveThe Karapandzic flap is an established technique for reconstruction of large lip defects and in our experience is particularly valuable in repair of the upper lateral lip and the commissures as well. We present our experience in a case series of 65 patients under one consultant.MethodThis is a retrospective study of patients who underwent Karapandzic flap repair for lip defects following cancer resection from 2007 to 2014 in North Yorkshire. A data collection tool was used which incorporated patient demographics, tumour location, histology, complications, resection margins and recurrence including functional and aesthetic outcomes. The Patient and Observer Scar Assessment Scale (POSAS) was used to assess post operative outcome at more than 1 year.ResultsThe clearance rate was 98.4%. For those with a follow-up greater than 1 year, there was no recurrence or surgical revision, whilst the most common concern was temporary lip paraesthesia. The mean POSAS scores were low for both patients and observers reflecting a high satisfaction rate.ConclusionThe technique of Karapandzic flap reconstruction for defects in both upper and lower lip allows adequate margin clearance with a low level of complications. The advantages of this technique include preservation of both function and sensation utilising local tissue to allow successful aesthetic outcomes.



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Synovial chondromatosis of the temporomandibular joint: Immunohistochemical examinations regarding the role of insulin-like growth factors and their binding proteins in the etiology of this disease

Publication date: Available online 14 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Christian T. Wilms, Nils Heim, Marcus Teschke, Rudolf R. Reich, Werner Götz
Synovial chondromatosis (SC) is a benign disease of the joints without a known cause. It sometimes affects the temporomandibular joint (TMJ) and is accompanied by pain, swelling, malocclusion, and crepitation. It has been divided into three stages by Milgram and is supposed to originate from the synovia and cartilage of a joint (Milgram 1977b). The aim of this study was to examine an involvement of the insulin-like growth factors (IGF-I/-II) and their binding proteins (IGFBP-1 to -6) in the etiology of this disease. Therefore 23 specimen of SC from 16 patients were immunohistochemically stained and microscopically examined. Staining was assessed semiquantitatively: negative (−), weakly positive (+), moderately positive (+), strongly positive (++) and very strongly positive (+++). It could be seen that especially the chondro- and fibrocytes and the synovia showed positive staining for almost all IGFs and IGFBPs. The underlying tissue, consisting of connective tissue or chondroid matrix, was stained as well but more weakly so. We conclude that the IGF/IGFBP system seems to contribute to the pathogenesis of SC, especially IGF-I and –II, and their effects enhancing binding protein 5.



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Anaphylaxis after Zoster Vaccine: Implicating Alpha-Gal Allergy as a Possible Mechanism

Publication date: Available online 14 December 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Cosby A. Stone, Jonathan A. Hemler, Scott P. Commins, Alexander P. Schuyler, Elizabeth J. Phillips, R. Stokes Peebles, John M. Fahrenholz

Teaser

A patient with alpha-gal allergy presented with anaphylaxis after receiving zoster vaccine. Subsequent testing of selected vaccines revealed the presence of alpha-gal allergen in MMR and zoster vaccines, which have in common a higher content of gelatin and content of bovine calf serum.


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Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease

Publication date: Available online 14 December 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): L. Robard, J. Michel, V. Prulière Escabasse, E. Bequignon, B. Vérillaud, O. Malard, L. Crampette
ObjectivesThe authors present the guidelines of the French Oto-Rhino-Laryngology – Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) concerning specific treatment of epistaxis in Rendu-Osler-Weber disease.MethodsA multidisciplinary work-group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence.ResultsRendu-Osler-Weber disease is diagnosed from the presence of at least three of Curaçao's four criteria. In acute epistaxis, bidigital compression is recommended. Embolization is reserved for resistant epistaxis. Non-resorbable nasal packing and cauterization are contraindicated. Patient education is essential. Telangiectasia of the nasal mucosa can be treated by various local means. In the event of insufficient control, systemic administration of tranexamic acid is recommended.



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Mullerian-Type Ciliated Cyst of the Thigh with PAX-8 and WT1 Positivity: A Case Report and Review of the Literature

Mullerian-type ciliated cysts are uncommon lesions usually found in the lower extremities and perineal region of young females. They have however been reported in males and in other anatomic sites. The cyst lining is typically positive for estrogen receptor (ER), progesterone receptor (PR), PAX-8, and WT1 immunohistochemical stains. This staining pattern has led to the notion that these cysts are of Müllerian origin. The vast majority of cases are located in the dermis where the preferred nomenclature is cutaneous ciliated cyst (CCC). We report a case of Müllerian-type ciliated cyst in the thigh of a 16-year-old girl. Unlike most of the cases reported in the English literature, this cyst was not centered in the dermis. Only a few other cases of Müllerian-type ciliated cysts with no cutaneous connection have been reported. We propose the term ectopic Müllerian cyst for this rare subset of lesions that are not skin based as is the current case.

http://ift.tt/2gzJRxA

Vertebral artery ruptures manifesting as hoarseness

Publication date: Available online 13 December 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Chih-Jen Yang, Sheng-Yao Cheng, Cheng-Chung Cheng, Chi-Tun Tang, Shih-Hung Tsai




http://ift.tt/2hrUXsQ

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