Response to Letter to the Editor

Publication date: Available online 27 December 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Elizabeth Cedars, Dylan Chan, Anna Meyer, Kristina Rosbe




http://ift.tt/2iymcmM

Therapeutic Use of the HPV Vaccine in Recurrent Respiratory Papillomatosis: A Case Report

Publication date: Available online 27 December 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Christopher Sullivan, Stuart Curtis, Jason Mouzakes
Recurrent Respiratory Papillomatosis (RRP) is a condition characterized by recurring squamous papillomas in the aerodigestive tract due to HPV infection. Treatment includes surgical debridement of the lesions often with adjuvant therapy. A newer adjuvant agent being tested is the HPV vaccine. The case report includes a child with RRP who underwent 10 surgeries in a year with an average inter-surgical interval (ISI) of 46 days. The patient then received the scheduled regimen of 3 doses of 9 valent HPV vaccine. Since beginning the vaccination, her average ISI increased to 113 days and as of writing of this paper only 1 surgery in the last 340 days. It is theorized that the increase in humoral response to the virus can slow the course of the disease, lengthen the ISI, and decrease morbidity. The results of this case report lends evidence to the use of the HPV vaccine as a therapeutic adjuvant therapy for RRP.



http://ift.tt/2hiV45R

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

A randomized clinical trial of a culturally responsive intervention for African American women with asthma

Few interventions have focused on the difficulties that African American women face when managing asthma.

http://ift.tt/2iyLi0C

Staphylococcus aureus enterotoxin sensitization involvement and its association with the CysLTR1 variant in different asthma phenotypes

Sensitization to Staphylococcus aureus enterotoxin (SE) is a known risk factor for asthma susceptibility and severity. However, how SE sensitization is involved in asthma, particularly nonatopic asthma and/or late-onset asthma, remains uncertain.

http://ift.tt/2i1QJZ5

Pentoxifylline – a review of its use in osteoradionecrosis

Pentoxifylline has been used to treat complications related to fibrosis for over 20 years. Formerly used to treat those after radiotherapy such as osteoradionecrosis (ORN), it is now being tried for medication-related osteonecrosis of the jaw (MRONJ), which can occur after prolonged use of bisphosphonates. We review theories on the formation of fibrosis in patients with ORN, discuss the pharmacology of pentoxifylline and vitamin E, and report published outcomes. To our knowledge no prospective randomised controlled trial has investigated the benefits of these agents in cases of ORN, but reported outcomes in many published case series are encouraging.

http://ift.tt/2i1TY2p

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella–nasion–A-point (SNA), sella–nasion–B-point (SNB), and A-point–nasion–B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle.

http://ift.tt/2hsGZb0

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

Correlation of Ki-67 Proliferative Antigen Expression and Tumor Response to Induction Chemotherapy Containing Cell Cycle-Specific Agents in Head and Neck Squamous Cell Carcinoma

Abstract

Determine if highly proliferative head and neck squamous cell carcinomas, assessed by pretreatment Ki-67 expression, respond more robustly to induction chemotherapy (IC) that is selectively toxic to cycling cells. Retrospective analysis of 59 patients treated with IC and chemoradiation. IC included either nab-paclitaxel, cisplatin, 5-FU and cetuximab (APF-C, n = 27) or docetaxel, cisplatin, 5-FU +/− cetuximab (TPF+/−C, n = 32). Ki-67 expression was assessed by immunohistochemistry. Tumor response (complete/partial/stable/progressive) at the primary site after two IC cycles was evaluated by visual examination in all patients. In the APF-C sub-group, tumor response (primary site and neck nodes) after two IC cycles was evaluated by computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT. Ki-67 expression (median 66%, range: 16–97) did not differ across the tumor response categories assessed by visual examination (p = 0.95), CT (p = 0.30), or FDG-PET/CT (p = 0.65). Median decrease in summed SUV_max of measured lesions was 71.6% (range: 8.3–100%). The Pearson correlation coefficient between Ki-67 expression and the percent decrease in summed SUV_max was 0.48 (p = 0.02). Ki-67 expression was not different between those with or without a relapse (median: 60 and 71%, p = 0.10). In multivariate regression analysis (MVA) controlling for p16 positive oropharyngeal SCC status and smoking status, Ki-67 expression was not significantly associated with tumor response by visual examination (coefficient estimate −0.002, standard error 0.010, p = 0.84), CT (coefficient estimate −0.007, standard error 0.011, p = 0.54), FDG-PET/CT (coefficient estimate 0.006, standard error 0.008, p = 0.51), the percent decrease in summed SUV_max (coefficient estimate 0.389, standard error 0.222, p = 0.09), or relapse events (OR = 1.02(95%CI:0.99–1.05), p = 0.28). No significant relationships were found in MVA between pretreatment Ki-67 expression and tumor response to IC or to relapse.

http://ift.tt/2hi2lCX

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

Cross-Sectional Study Evaluating Skin, Hair, Nail, and Bone Disease in Patients with Focal Dermal Hypoplasia

Abstract

Focal dermal hypoplasia (FDH) is an X-linked dominant disease characterized by dermal thinning and fat herniation with other ectodermal and mesodermal abnormalities. There is limited literature regarding the symptomatology and progression of skin, hair, and nail disease. The risk of bone fragility has not been explored either. This cross-sectional survey-based study explored these gaps in knowledge and provides direction for future avenues of research in FDH.

http://ift.tt/2ilIZ1A

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents' dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents' dietary behaviors. Methods: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. Results: Theories used to explain dietary intake were the planned behavior and the social cognitive. It was observed evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar-sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). Conclusion: Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences.

http://ift.tt/2ilKRHV

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

What do we know of Roman wall painting technique? Potential confounding factors in ancient paint media analysis

The theory of fresco as the standard painting technique in Roman wall paintings, formulated in the mid-1960s by Paolo Mora and Laura Mora and Paul Philippot, has enjoyed general acceptance among specialists to the present day. However, the fresco theory is based on a series of postulates—such as the feasibility of fresco on pontate, the presence of giornate, or the use of alkali-sensitive pigments—which appear to be unsupported by physical or experimental evidence and which would require further assessment in order to validate the theory. Additionally, chemical analyses of Roman murals have identified the presence of various types of organic binders. A comparative study of these analyses reveals a remarkable difference between results obtained by the different researchers. The clustering of results by research group appears highly unlikely, suggesting the possible presence of confounding factors which could lead to distorted results. These factors might be related both to the difficulty in extracting ancient paint media and the influence of biological contamination. If the extraction method used is not adequate for an ancient binding medium, then part of the binder may not be extracted, producing an incomplete characterization of its composition. The lack of data on both the efficiency of the methods used and the possible influence of microbial contamination in the organic material may cause uncertainty in the degree of reliability of the different results obtained, fomenting uncertainty around the techniques used in ancient paintings as well as the treatments suitable for their conservation. Therefore, in the analysis of ancient paint media, the implementation of a protocol of assessment of both the efficiency of the extraction methods and the influence of biological contamination seems advisable.Graphical abstract.

http://ift.tt/2hILDh5

Correlation of Ki-67 Proliferative Antigen Expression and Tumor Response to Induction Chemotherapy Containing Cell Cycle-Specific Agents in Head and Neck Squamous Cell Carcinoma

Abstract

Determine if highly proliferative head and neck squamous cell carcinomas, assessed by pretreatment Ki-67 expression, respond more robustly to induction chemotherapy (IC) that is selectively toxic to cycling cells. Retrospective analysis of 59 patients treated with IC and chemoradiation. IC included either nab-paclitaxel, cisplatin, 5-FU and cetuximab (APF-C, n = 27) or docetaxel, cisplatin, 5-FU +/− cetuximab (TPF+/−C, n = 32). Ki-67 expression was assessed by immunohistochemistry. Tumor response (complete/partial/stable/progressive) at the primary site after two IC cycles was evaluated by visual examination in all patients. In the APF-C sub-group, tumor response (primary site and neck nodes) after two IC cycles was evaluated by computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT. Ki-67 expression (median 66%, range: 16–97) did not differ across the tumor response categories assessed by visual examination (p = 0.95), CT (p = 0.30), or FDG-PET/CT (p = 0.65). Median decrease in summed SUV_max of measured lesions was 71.6% (range: 8.3–100%). The Pearson correlation coefficient between Ki-67 expression and the percent decrease in summed SUV_max was 0.48 (p = 0.02). Ki-67 expression was not different between those with or without a relapse (median: 60 and 71%, p = 0.10). In multivariate regression analysis (MVA) controlling for p16 positive oropharyngeal SCC status and smoking status, Ki-67 expression was not significantly associated with tumor response by visual examination (coefficient estimate −0.002, standard error 0.010, p = 0.84), CT (coefficient estimate −0.007, standard error 0.011, p = 0.54), FDG-PET/CT (coefficient estimate 0.006, standard error 0.008, p = 0.51), the percent decrease in summed SUV_max (coefficient estimate 0.389, standard error 0.222, p = 0.09), or relapse events (OR = 1.02(95%CI:0.99–1.05), p = 0.28). No significant relationships were found in MVA between pretreatment Ki-67 expression and tumor response to IC or to relapse.

http://ift.tt/2hi2lCX

Correlation of Ki-67 Proliferative Antigen Expression and Tumor Response to Induction Chemotherapy Containing Cell Cycle-Specific Agents in Head and Neck Squamous Cell Carcinoma

Abstract

Determine if highly proliferative head and neck squamous cell carcinomas, assessed by pretreatment Ki-67 expression, respond more robustly to induction chemotherapy (IC) that is selectively toxic to cycling cells. Retrospective analysis of 59 patients treated with IC and chemoradiation. IC included either nab-paclitaxel, cisplatin, 5-FU and cetuximab (APF-C, n = 27) or docetaxel, cisplatin, 5-FU +/− cetuximab (TPF+/−C, n = 32). Ki-67 expression was assessed by immunohistochemistry. Tumor response (complete/partial/stable/progressive) at the primary site after two IC cycles was evaluated by visual examination in all patients. In the APF-C sub-group, tumor response (primary site and neck nodes) after two IC cycles was evaluated by computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT. Ki-67 expression (median 66%, range: 16–97) did not differ across the tumor response categories assessed by visual examination (p = 0.95), CT (p = 0.30), or FDG-PET/CT (p = 0.65). Median decrease in summed SUV_max of measured lesions was 71.6% (range: 8.3–100%). The Pearson correlation coefficient between Ki-67 expression and the percent decrease in summed SUV_max was 0.48 (p = 0.02). Ki-67 expression was not different between those with or without a relapse (median: 60 and 71%, p = 0.10). In multivariate regression analysis (MVA) controlling for p16 positive oropharyngeal SCC status and smoking status, Ki-67 expression was not significantly associated with tumor response by visual examination (coefficient estimate −0.002, standard error 0.010, p = 0.84), CT (coefficient estimate −0.007, standard error 0.011, p = 0.54), FDG-PET/CT (coefficient estimate 0.006, standard error 0.008, p = 0.51), the percent decrease in summed SUV_max (coefficient estimate 0.389, standard error 0.222, p = 0.09), or relapse events (OR = 1.02(95%CI:0.99–1.05), p = 0.28). No significant relationships were found in MVA between pretreatment Ki-67 expression and tumor response to IC or to relapse.

http://ift.tt/2hi2lCX

Systemic Treatment of Adult Atopic Dermatitis: A Review

Abstract

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that predominantly affects children. However, it can persist in adulthood and/or start at older ages. Due to its chronic nature and frequently occurring relapses, AD has a substantial effect on patients' quality of life, often requiring long-term systemic treatment, especially in adult patients, who are more frequently refractory to adequate topical treatment with mid- to high-potent corticosteroids and/or calcineurin inhibitors. Therefore, treatment with systemic therapies is often needed to take control of the disease, prevent exacerbations and improve quality of life. However, data regarding systemic treatment effectiveness and long-term safety in adult patients with AD are insufficient. Indeed, standardized international guidelines are lacking, and the treatment approach widely differs among diverse countries. This review focuses on the use of systemic treatments in adult AD patients analyzing published literature.

http://ift.tt/2iy0TgP

Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial

Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions.

http://ift.tt/2ho1tjF

Rapidly Evolving Large Rhinolith: Cause of Recurrent Nasal Bleed

Abstract

Rhinoliths are a rare cause of nasal obstruction but may also present with other symptoms including nasal bleed. We report a case of a rapidly evolving rhinolith in a patient presenting with the complaint of recurrent epistaxis for 2 years. A high index of suspicion is needed for diagnosing this condition.

http://ift.tt/2hnqjjI

Manoeuvres to Improve Endoscopic Visualization of Hypopharynx

Abstract

The more progress achieved in endoscopy, the more superficial cancers in head and neck region have been diagnosed. There are, however, some areas difficult to observe, particularly the hypopharynx, due to closure of this space. Examination of hypopharynx form an essential part of head and neck examination especially in the suspected malignancies as well as in the cases with unknown primary. As the flexible fiber-optic nasopharyngolaryngoscopy forms an essential part of examination of hypopharynx, the present study aims to evaluate the effectiveness of various manoeuvres devised to aid in better visualization of the hypopharynx. The present prospective study is an observation carried out on 30 patients, which had been followed up for hypopharyngeal or laryngeal disease, in the OPD of the department of Otorhinolaryngology and head and neck surgery in Gandhi Medical College and associated hospital, Bhopal, M.P. In the present study, authors compared the visibility of subsites of hypopharynx in 30 patients undergoing trans nasal flexible fibre optic endoscopy in normal seated position and with head torsion, valsalva manoeuvre and the Killian position. The authors concluded that the above mentioned manoeuvres facilitated the visualization of the entire circumference of the hypopharynx during endoscopic examination, are non invasive and easy to perform and so should be included as a part of routine examination while performing flexible fibre optic endoscopy.

http://ift.tt/2i8dBUF

Rapidly Evolving Large Rhinolith: Cause of Recurrent Nasal Bleed

Abstract

Rhinoliths are a rare cause of nasal obstruction but may also present with other symptoms including nasal bleed. We report a case of a rapidly evolving rhinolith in a patient presenting with the complaint of recurrent epistaxis for 2 years. A high index of suspicion is needed for diagnosing this condition.

http://ift.tt/2hnqjjI

Manoeuvres to Improve Endoscopic Visualization of Hypopharynx

Abstract

The more progress achieved in endoscopy, the more superficial cancers in head and neck region have been diagnosed. There are, however, some areas difficult to observe, particularly the hypopharynx, due to closure of this space. Examination of hypopharynx form an essential part of head and neck examination especially in the suspected malignancies as well as in the cases with unknown primary. As the flexible fiber-optic nasopharyngolaryngoscopy forms an essential part of examination of hypopharynx, the present study aims to evaluate the effectiveness of various manoeuvres devised to aid in better visualization of the hypopharynx. The present prospective study is an observation carried out on 30 patients, which had been followed up for hypopharyngeal or laryngeal disease, in the OPD of the department of Otorhinolaryngology and head and neck surgery in Gandhi Medical College and associated hospital, Bhopal, M.P. In the present study, authors compared the visibility of subsites of hypopharynx in 30 patients undergoing trans nasal flexible fibre optic endoscopy in normal seated position and with head torsion, valsalva manoeuvre and the Killian position. The authors concluded that the above mentioned manoeuvres facilitated the visualization of the entire circumference of the hypopharynx during endoscopic examination, are non invasive and easy to perform and so should be included as a part of routine examination while performing flexible fibre optic endoscopy.

http://ift.tt/2i8dBUF

Bactériose à grains cutanée au cours d’une septicémie à Staphylococcus aureus

Publication date: Available online 26 December 2016
Source:Annales de Dermatologie et de Vénéréologie
Author(s): D. Mermin, A.-L. Védie, M.-L. Jullie, A. Fauconneau, M. Beylot-Barry, A. Pham-Ledard
IntroductionNous rapportons une observation de bactériose cutanée à grains, permettant de discuter du cadre nosologique de cette entité à partir d'une approche clinique et histologique.ObservationUne femme de 62 ans, traitée par méthotrexate pour un syndrome de Sézary, était admise pour fièvre à 38,5̊C et altération de l'état général. Elle présentait un nodule fistulisé du genou droit dont la biopsie cutanée révélait un foyer de suppuration ulcéré avec amas de grains Gram+ et Grocott+ sans filament, entourés de matériel éosinophile (phénomène de Splendore-Hoeppli). Le prélèvement d'un écoulement plantaire droit identifiait une souche de Staphylococcus aureus sensible à la méthicilline, trouvée également dans plusieurs hémocultures. Deux nodules abcédés du lobe moyen droit étaient visibles sur la tomodensitométrie thoracique, contrastant avec l'absence initiale de symptômes respiratoires. Devant cette bactériémie d'origine cutanée avec sepsis à S. aureus méthi-sensible compliqué d'abcès pulmonaires, une bi-antibiothérapie anti-staphylococcique (cloxacilline-gentamicine relayés par rifampicine-ofloxacine) était maintenue pendant deux mois.DiscussionL'image histologique de bactériose à grains fait discuter une botryomycose ou un mycétome. Les botryomycoses correspondent à des abcès suppuratifs chroniques, ulcéro-végétants, récidivants. Les mycétomes sont des tuméfactions fistulisées libérant un matériel séro-sanglant granuleux constitué de filaments. Bien que le staphylocoque identifié orientait vers une botryomycose, la clinique n'était typique d'aucune de ces entités car il s'agissait d'un abcès bactérien aigu. Le terme le plus adéquat est donc celui, plus générique, d'abcès cutané septique à grains.BackgroundHerein we report a case of cutaneous granular bacteriosis, with discussion of the nosological setting of this entity based upon the clinical and histological findings.Patients and methodsA 62-year-old woman receiving methotrexate for Sezary syndrome was admitted for fever of 38.5̊C and overall impairment of her health. She presented a fistulous nodule on her right knee, and skin biopsy revealed a focus of ulcerated suppuration with quantities of Gram+ and Grocott+ granules containing no filament, enclosed by eosinophilic matter (Splendore-Hoeppli phenomenon). A sample of effusion from the sole of her right foot revealed a methicillin-sensitive strain of Staphylococcus aureus, which was also found in several blood cultures. Two abscessed nodules on the middle right lobe were visible on a thoracic CT scan despite the initial absence of respiratory symptoms. In view of this bacteraemia of cutaneous origin with sepsis caused by methicillin-sensitive S. aureus complicated by pulmonary abscesses, dual antibiotic treatment against staphylococci (cloxacillin-gentamicin followed by rifampicin-ofloxacin) was given over a two-month period.DiscussionThe histological picture of granular bacteriosis suggested the possibility of botryomycosis or mycetoma. Botryomycosis involves chronic, relapsing, weeping and ulcero-vegetating abscesses. Mycetoma consists of fistulous swellings that secrete a discharge composed of blood and serum and containing grains made up of filaments. Although the staphylococcal organism identified was evocative of botryomycosis, the clinical findings were not consistent with either of these entities, since they revealed an acute bacterial abscess. The most adequate term is thus the more generic name of septic cutaneous granular abscess.



http://ift.tt/2ikfFbS

Routine postoperative imaging is not indicated in the management of mandibular fractures

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Douglas J. Courtemanche, Richard Barton, Damon Li, Graeme McNeill, Manraj KS. Heran
PurposePrior literature has shown that routine postoperative CT scans for mandibular fractures have no effect on outcomes and complications; however, past surveys report that the majority of clinicians continue to order routine scans. Herein we aim to determine the current use of routine postop CT scans, evaluate what factors contribute to this practice, and identify differences in outcomes and complications amongst patients with either routine, indicated, or no postop CT-scan.MethodsA retrospective review of consecutive patients treated for a mandibular fracture at Vancouver General Hospital from January 1, 2007 to March 1, 2012 was conducted.Results167 patients were included in the study for analysis. No significant differences in outcomes or complications were found between patients who had an indicated postoperative CT scan (27%) or no scan (64%). Only the treating surgeon had a statistically significant effect on whether a patient received a postop CT scan (p<0.001) and those who had an indicated postop CT scan (9%) were more likely to have a decreased level of TMJ function and increased incidence of complications and secondary operations (p=0.002, <0.001, and <0.001).ConclusionRoutine postoperative CT scans were found to have no significant effect on outcomes and complications, and a clinician's individual practice was the most significant factor for whether a patient receives a routine postop CT scan. Future work should aim at providing well-defined indications for postop imaging.



http://ift.tt/2ik3bB1

Combined Anterolateral thigh and Tensor Fasciae Latae flaps: An option for Reconstruction of large Head and Neck defects

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
IntroductionThe advent of microvascular free tissue transfer has supplemented the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than one flap not only increases surgical complexity but also patient morbidity. The combination of the anterior lateral thigh flap and the tensor facia latae flap (ALT/TFL flap) can be used to reconstruct such complex head and neck defects thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site. The present study reports the utilization of the combined ALT/TFL Flap to reconstruct large and complex head and neck defects.MethodsA retrospective chart review was conducted including all microvascular head and neck reconstructions performed by Maxillofacial Tumor and Reconstructive Surgery Service at the University of Miami/Jackson Health System during the period between 2013-2016. Inclusion criteria for the study were as follows: large head and neck defects, classified as greater than 20m X 10cm, reconstruction with soft tissue flaps utilizing perforating vasculature to both the tensor fascia latae (TFL) and the anterior lateral thigh (ALT) vascular territories. Other study data included disease history, location of the defect, size of the flap, recipient vessels, harvest time, ischemia time, surgical complications, and overall flap survival.ResultsSeven patients were found to meet the inclusion criteria. Five patients were treated for the diagnosis of stage III osteoradionecrosis and two patients were reconstructed in conjunction with ablative surgery for head and neck carcinoma. All 7 patients underwent successful ALT/TFL head and neck reconstructions. There was no partial or total flap failure. One patient had a wound healing complication at the donor site that did not require surgical intervention.ConclusionReconstruction of large head and neck soft tissue defect with a combined ALT/TFL flap is a reliable method with minimal donor site morbidity and no major postoperative complications. This combined flap should be considered when defect sized extends beyond the bounds allowed by the ALT flap alone.



http://ift.tt/2iaBKfD

Low pre-treatment Lymphocyte Monocyte Ratio (LMR) and high Platelet Lymphocyte Ratio (PLR) indicates poor cancer outcome in early tongue cancer

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Hui Shan Ong, Sandhya Gokavarapu, LI Zhen Wang, Zhen Tian, Chen Ping Zhang
BackgroundThe WBC indices are reported to have a prognostic impact in cancer of multiple organs including head and neck cancer; however; site and stage stratification was not attempted and compelling evidence shows that the early cancers have different distribution and prognostication to late stages. We studied the prognostic importance of WBC indices in early oral tongue cancers.Patients and methodsA retrospective data of primary pT1-T2N0 oral tongue cancers treated between 2009 to 2013 were charted, the WBC indices such as neutrophil count(NC), lymphocyte count(LC), platelet count(PC) and monocyte count(MC) along with derived indices such as neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR) and lymphocyte monocyte ratio(LMR) were analyzed in multivariate analysis with other clinicopathological prognostic factors.ResultsA total of 133 patients fulfilled the inclusion criteria, minimum follow up for alive patients was 36 months. A total of 22 patients reported disease relapse and 11 patients died of disease. Multivariate analysis showed LC (HR=0.206; 95% CI:0.092-0.46, p<0.001), PC (HR=1.011; 95% CI:1.001-1.021, p=0.026), PLR (HR=1.012; 95% CI:1.008-1.016, p<0.001) and LMR (HR=0.721; 95% CI:0596-0.872, p=0.001) are significant independent prognostic factors for DFS. Distant metastasis (HR=9.014; 95% CI: 2.303-38.914, p=0.004), LC (HR=0.091; 95% CI: 0.015-0.558, p=0.01), PC(HR=1.023; 95% CI: 1.006-1.041, p=0.009), PLR (HR=1.016; 95% CI: 1.004-1.027, p=0.002) and LMR (HR=0.58; 95% CI: 0.387-0.868, p=0.008) are significant independent prognostic factors for OS.ConclusionLow pre-treatment LMR and high PLR indicates poor survival in early tongue cancer. We suggested close followed for this subgroup despite radical resection with clear margin.



http://ift.tt/2ijYWW9

Chin symphysis bone, allograft, and platelet rich fibrin: Whether the combination is effective in repair of alveolar cleft?

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Bijan Movahedian Attar, Navid Naghdi, Milad Etemadi Sh, Mojdeh Mehdizadeh
PurposeSecondary grafting of alveolar defects with iliac crest bone is a common treatment method in cleft patients. The aim of this study was to evaluate the effectiveness of the combination of symphysis bone, allograft and platelet rich fibrin (PRF) in regeneration of alveolar defects compared to iliac bone graft.Methods and materialsIn this randomized clinical trial, patients with unilateral alveolar defect were divided randomly into two categories. Group A comprised the patients considered for treatment with the combination of chin symphysis bone + allogenic bone material + L-PRF. Group B comprised the patients who were considered for iliac bone graft. Cone beam computed tomography (CBCT) before treatment and 1 year post-operation were used for measurement of bone formation (bone volume in cm³). The data was analyzed by Paired T-test and Chi square via SPSS 23 software. P value less than 0.05 was considered as significant.ResultsTen patients were included in each group (6 males in group A, and 5 males in group B). The mean age of patients in groups A and B were 9.5 ± 1.5 and 9.9 ± 1.9 years, respectively. The mean volume of alveolar defects in group A was 0.89 ± 0.29 cm3. This amount in group B was 0.95 ± 0.27 cm³. The percentages of bone regeneration in group A and B were 69.5 and 73.8%, respectively.ConclusionIt seems that "chin symphysis bone + allogenic bone material + PRF" is a proper combination for bone regeneration in alveolar defects with small to moderate volume range.



http://ift.tt/2ik388j

Bilateral Non-Hodgkin’s Lymphoma of the Temporal Bone: A Rare and Unusual Presentation

Primary lymphoma of the temporal bone is an unusual finding in clinical practice and bilateral affection is even more rare. To the best of our knowledge, there are no reports of bilateral primary temporal bone lymphoma without middle ear involvement in the English medical literature so far. We report, for the first time, a case of primary lymphoma involving both temporal bones which presented with left-sided infranuclear facial palsy. A combination of contrast enhanced magnetic resonance imaging (MRI) and high resolution computed tomography (HRCT) was used to characterize and to map the extent of the lesion, as well as to identify the exact site of facial nerve affection. An excision biopsy and immunohistochemistry revealed diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). Whole body fluorodeoxyglucose (FDG) positron emission tomography-computed tomography study (PET-CT) was performed to stage the disease. The patient was treated with chemotherapy and radiation therapy and is now on regular follow-up. The patient is alive and asymptomatic without disease progression for the last twenty months after initial diagnosis.

http://ift.tt/2hqQebP

Isolated Ventricular Noncompaction Cardiomyopathy Presenting as Recurrent Syncope

Isolated ventricular noncompaction (IVNC) occurs because of interruption of trabecular morphogenesis in the myocardium leading to ventricular noncompaction. Patients present with heart failure or with systemic complications secondary to thromboembolism or arrhythmias. High index of suspicion is necessary for early diagnosis. We present a case of 48-year-old male with unexplained recurrent syncope who was eventually diagnosed with IVNC.

http://ift.tt/2hgceBb

Cross-reactive LTP sensitization in food-dependent exercise-induced urticaria/anaphylaxis: a pilot study of a component-resolved and in vitro depletion approach

Challenge tests for food-dependent exercise-induced anaphylaxis (FDEIA) carry some risk and have a high rate of false negatives. Our aim was to explore the usefulness of an in vitro immunodepletion assay and a...

http://ift.tt/2i9FOg4

Fetus in the Bladder: Rare Complication of Vesicouterine Fistula

The work presents a rare case of spontaneous migration of an 11-week fetus from the uterine cavity into the urinary bladder cavity through the long-standing vesicouterine fistula.

http://ift.tt/2ivWpat