Head and Neck Medicine by Alexandros G.Sfakianakis: 01/15/17

The incidence of difficult mask ventilation and difficult tracheal intubation is higher in obese and obstructive sleep apnea (OSA) patients [1]. When a "cannot intubate cannot ventilate" (CICV) situation is encountered, a supraglottic airway device (SAD) should be inserted to rescue ventilation. Unfortunately, failure to achieve adequate ventilation with a SAD is also common in obese and OSA patients [2] which may lead to a catastrophic outcome if a surgical airway is not immediately established.

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Acute renal injury in the course of a large pleural effusion

Furst B. and colleagues described in this journal [1] an abrupt hemodynamic decompensation after performing pericardial window in a patient with malignant pericardial effusion (PRE). The hemodynamic consequences promptly reversed when a concurrent large pleural effusion (PLE) was evacuated.

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The sedative effects of the intranasal administration of dexmedetomidine in children undergoing surgeries compared to other sedation methods: A systematic review and meta-analysis

Administration of intranasal dexmedetomidine for sedation is comfortable and effective in children who are afraid of needles, and it offers efficient sedation similar to that of intravenous administration. We performed a systematic review and meta-analysis to evaluate the clinical effects of the pre-procedural administration of intranasal dexmedetomidine.

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Immune transcriptome reveals the mincle C-type lectin receptor acts as a partial replacement for TLR4 in lipopolysaccharide-mediated inflammatory response in barramundi (Lates calcarifer)

Publication date: March 2017
Source:Molecular Immunology, Volume 83
Author(s): Emmanuelle Zoccola, Stuart Kellie, Andrew C. Barnes
Fish represent the most diverse and abundant extant vertebrate infraclass. They are also one of the earliest divergent phyla with adaptive immunity based on antigen recognition by MHC and immunoglobulin. The aquaculture industry, which currently provides more than half of the fish for human consumption globally, has successfully exploited the adaptive immune system of fish through mass vaccination programs. However, vaccination against highly diverse antigens, mostly carbohydrates, such as capsular polysaccharides and lipopolysaccharide (LPS) is challenging. Fish have a subdued innate response to LPS, but adaptive response is generally high and type-specific. To better understand the link between initial innate response and early onset of adaptive immunity to carbohydrate antigens in the perciform barramundi (Lates calcarifer), an immune transcriptome was prepared from pronephros and spleen following vaccination with LPS and peptidoglycan. From 163,661 transcripts derived by Illumina mRNA-Seq, most grouped in neuronal, endocrine or immune system categories, suggesting a close relationship between the three systems. Moreover, digestive enzyme transcripts in spleen appeared to be highly inducible in barramundi. Most of the known TLRs were transcribed in the barramundi spleen and HK transcriptome, with the notable exception of TLR4, which is primarily responsible for LPS recognition in mammals. Several C-type lectin receptors were also identified, including CD209, CD205, and CLEC4E (Mincle). As Mincle has been shown to bind LPS and is abundant on dendritic cells, its role in response to LPS in barramundi was further investigated. A high dose of LPS induced TNF-alpha expression via Mincle. However, IL-6 regulation, whilst still regulated in response to LPS, did not depend upon the Mincle pathway, suggesting other routes of activation. This study thus suggests that Mincle acts as a partial substitute for TLR4 in barramundi in the processing of LPS.

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American Thyroid Association Guidelines for Diagnosis and Management of Thyroid Disease During Pregnancy Published in Thyroid Journal

New evidence-based recommendations from the American Thyroid Association (ATA) provide guidance to clinicians in diagnosing and managing thyroid disease during pregnancy and the postpartum period. Pregnancy has a profound effect on thyroid gland function, and thyroid disease is common in pregnancy. The 97 recommendations presented in the new Guidelines help define current best practices for thyroid function testing, iodine nutrition, pregnancy complications, and treatment of thyroid disease during pregnancy and lactation. The American Thyroid Association (ATA) guidelines are available free on the website of Thyroid, the official peer-reviewed journal of the ATA, published by Mary Ann Liebert, Inc., publishers.

The "2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum" were coauthored by an international task force of expert clinicians and researchers in the field of thyroidology. Led by Co-chairs Erik Alexander MD, Brigham and Women's Hospital and Harvard Medical School, Boston, MA and Elizabeth Pearce, MD, MSc, Boston University School of Medicine, the task force provides a solid foundation of knowledge on the assessment and treatment of thyroid disease in women during pregnancy, preconception, and the postpartum period. The Guidelines include recommendations related to the diagnosis and management of hypothyroidism, thyrotoxicosis, thyroid nodules, and thyroid cancer, as well as thyroid considerations in infertile women, fetal and neonatal considerations, and directions for future research.

"These guidelines provide a superb overview on the pathophysiology and the clinical management of thyroid disorders during and after pregnancy. In addition, they also define areas where additional research is needed; this will allow keeping the document living with further updates in the coming years," says Peter A. Kopp, MD, Editor-in-Chief of Thyroid and Professor of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago.

"Produced by an international panel of recognized experts, these updated guidelines add to the library of similar documents on thyroid disease that serve as the gold standard for diagnosis and management of thyroid disorders and identify critical areas where more research and knowledge is needed," says, John C. Morris, III, MD, President of the ATA, Mayo Clinic, Rochester, MN.

"With an estimated 300,000 pregnancies impacted by thyroid disease in the United States annually, these guidelines coalesce the best available evidence into clear clinical recommendations, and will improve the health of many, many mothers and newborns alike," say Dr. Alexander and Dr. Pearce.

About the Journal
Thyroid, the official journal of the American Thyroid Association, is an authoritative peer-reviewed journal published monthly online with open access options and in print. The Journal publishes original articles and timely reviews that reflect the rapidly advancing changes in our understanding of thyroid physiology and pathology, from the molecular biology of the cell to clinical management of thyroid disorders. Complete tables of content and a sample issue may be viewed on the Thyroid website. The complete Thyroid Journal Program includes the highly valued abstract and commentary publication Clinical Thyroidology, led by Editor-in-Chief Jerome M. Hershman, MD and published monthly, and the groundbreaking videojournal companion VideoEndocrinology, led by Editor Gerard Doherty, MD and published quarterly. Complete tables of content and sample issues may be viewed on the Thyroid website.

About the Society
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international multi-discipline medical society with over 1,700 endocrinologists, surgeons, oncologists from 43 countries around the world. Celebrating its 94^th anniversary, the ATA delivers its mission—of being devoted to thyroid biology and to the treatment of thyroid disease through excellence in research, clinical care, education, and public health—through several key endeavors: the publication of highly regarded professional journals, Thyroid, Clinical Thyroidology, and VideoEndocrinology; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease and thyroid cancer. The ATA promotes thyroid awareness and information through its online Clinical Thyroidology for the Public (distributed free of charge to over 11,000 patients and public subscribers) and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet.

About the Publisher
Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Diabetes Technology & Therapeutics, Journal of Women's Health, and Metabolic Syndrome and Related Disorders. Its biotechnology trade magazine, GEN (Genetic Engineering & Biotechnology News), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's more than 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.

The post American Thyroid Association Guidelines for Diagnosis and Management of Thyroid Disease During Pregnancy Published in Thyroid Journal appeared first on American Thyroid Association.

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Autophagy and autoimmunity

Publication date: Available online 15 January 2017
Source:Clinical Immunology
Author(s): Dennis J. Wu, Iannis E. Adamopoulos
Autophagy is a highly conserved protein degradation pathway from yeasts to humans that is essential for removing protein aggregates and misfolded proteins in healthy cells. Recently, autophagy-related genes polymorphisms have been implicated in several autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, psoriasis, and multiple sclerosis. Numerous studies reveal autophagy and autophagy-related proteins also participate in immune regulation. Conditional deletions of autophagy-related proteins in mice have rendered protection from experimental autoimmune encephalomyelitis, and TNF-mediated joint destruction in animal models of multiple sclerosis and experimental arthritis respectively. As autophagy is strongly implicated in immune functions such as removal of intracellular bacteria, inflammatory cytokine secretion, antigen presentation, and lymphocyte development, in this review we summarized current understanding of the roles of autophagy and autophagy proteins in autoimmune diseases.

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Ultrasensitive detection of oncogenic human papillomavirus in oropharyngeal tissue swabs

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) caused by oncogenic human papillomavirus (HPV) is rising worldwide. HPV-OPSCC is commonly diagnosed by RT-qPCR of HPV E6 and E7 oncoproteins or by...

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Use of an intraoperative navigation system for retrieving a broken dental instrument in the mandible: a case report

A fracture of root canal instruments, with a fractured piece protruding beyond the apex, is a troublesome incident during an endodontic treatment. Locating and retrieving them represents a challenge to maxillo...

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