Source:Clinical Immunology, Volume 175
http://ift.tt/2l6X6cQ
Τρίτη 14 Φεβρουαρίου 2017
Editorial Board
Source:Clinical Immunology, Volume 175
http://ift.tt/2l6X6cQ
Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients
Abstract
Background
Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies.
Methods
The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of São Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1.
Results
The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease.
Conclusions
The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study.
http://ift.tt/2lOwJbB
Vulvar infections: beyond sexually transmitted infections
Abstract
The vulva is an under-studied area of the female genitourinary tract which is prone to maceration, overgrowth of organisms, and atypical presentations of common dermatologic conditions. In current practice, dermatologists must recognize and manage vulvar infections and infestations beyond the more commonly recognized sexually transmitted infections. Herein, this article reviews the literature on a selection of under-recognized viral, bacterial, fungal, and parasitic vulvar infections and infestations.
http://ift.tt/2kRxe6s
Standardized methods for photography in procedural dermatology using simple equipment
Abstract
Photography is an important tool in dermatology. Reproducing the settings of before photos after interventions allows more accurate evaluation of treatment outcomes. In this article, we describe standardized methods and tips to obtain photographs, both for clinical practice and research procedural dermatology, using common equipment. Standards for the studio, cameras, photographer, patients, and framing are presented in this article.
http://ift.tt/2koMmJK
Biomarkers in diagnosis and therapy of oral squamous cell carcinoma: A review of the literature
Oral squamous cell carcinoma (OSCC) represents the sixth most common cancer, accounting for 2-4% of all malignancies worldwide. The overall survival rate of less than 60% remains generally poor, with prognosis heavily relying on the TNM staging system. Tumor size as well as the presence and extent of lymph node metastases are widely recognized as the most important predictors. However, the underlying mechanisms that lead to an aggressive phenotype are not yet fully understood. Therefore, possible biomarkers are much in need to predict prognosis, to help individualize therapy approaches, and to overcome possible resistance mechanisms.
http://ift.tt/2l7bsKx
Simulation-Guided Navigation for Vector Control in Pediatric Mandibular Distraction Osteogenesis
Navigation technology has given surgeons the capacity to know precisely where their instruments are during surgery, and simulation-guided navigation is a surgical method which is based on the use of navigation technology linked to 3D virtual surgery simulation. The aim of the present study was to evaluate the absolute accuracy of simulation-guided navigation as an aid to reproduce the planned position of the distraction device vector in pediatric mandibular distraction osteogenesis.
http://ift.tt/2kIwC0m
Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis
Abstract
The objective is to determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve after transpalatal advancement pharyngoplasty (TPAP) with obstructive sleep apnea (OSA) in adults, using a systematic review and meta-analysis. Nine databases, including PubMed/MEDLINE, were searched through April 1, 2016. All studies that included patients who underwent TPAP alone were included in this analysis. Fifty-six studies were potentially relevant, 37 were downloaded and five studies met criteria with 199 patients (age: 42.5 ± 9.7 years and body mass index: 29.0 ± 4.0 kg/m2). The grand mean (M) and standard deviation (SD) for AHI (199 patients) pre and post-TPAP decreased from 54.6 ± 23.0 [95 % CI 51.4, 57.8] to 19.2 ± 16.8 [95 % CI 16.9, 21.5] events/h (relative reduction: 64.8 %). Random effects modeling demonstrated a mean difference (MD) of −36.3 [95 % CI −48.5, −24.1], overall effect Z = 5.8 (p < 0.00001), and I 2 = 85 % (significant inconsistency). The standardized mean difference (SMD) for TPAP demonstrated a large magnitude of effect for AHI −1.76 [95 % CI −2.4, −1.1]. For LSAT (70 patients), the pre and post-TPAP M ± SD improved from 81.9 ± 8.1 [95 % CI 80.0, 83.8] to 85.4 ± 6.9 [95 % CI 83.8, 87.0], with a MD of 3.55, overall effect Z = 1.79 (p = 0.07). Thus far, few studies have evaluated transpalatal advancement pharyngoplasty; therefore, we recommend additional studies, especially prospective studies. Research comparing TPAP to pharyngoplasty procedures without palatal advancement would help determine the optimal role for this procedure.
http://ift.tt/2l5ZyQU
The impact of dizziness on quality-of-life in the elderly
Abstract
Dizziness is a common medical condition that has been related to falls in the elderly, and it is, therefore, considered a severe social health problem. Particularly in the elderly, the impact of dizziness may be relevant, as it has been linked to several conditions, such as isolation, depression, reduced self autonomy, and self control. The social, functional, and psychological well-being of those affected can be hampered significantly, thus reducing the quality-of-life (QoL) perception. In addition, due to the aging of the population in the developed world, dizziness is becoming a growing public health problem; an optimal management of this condition includes, nowadays, the improvement of rehabilitative programs, as well as the evaluation of QoL status and its management. The aim of this paper is to evaluate the impact of dizziness on the QoL in the elderly, also analyzing the instruments available, nowadays, to evaluate QoL of dizzy patients.
http://ift.tt/2leKjaX
Chronic rhinosinusitis with nasal polyps is associated with chronic otitis media in the elderly
Abstract
Chronic rhinosinusitis (CRS) and chronic otitis media (COM) are common diseases in the otorhinolaryngology field. Although clinicians frequently encounter patients presenting both diseases simultaneously, a few studies have shown relationships between them. We examined whether CRS was associated with COM in adults who participated in the Korea National Health and Nutrition Examination Survey from 2009 to 2012. A total of 27,492 participants were examined in this cross-sectional epidemiological study. Regression analyses was performed and adjusted for socio-demographics, general health behavior, and other comorbidities. All analyses used complex sampling designs; subgroup analyses were performed according to age, hearing loss, and the presence of cholesteatoma or nasal polyps. The weighted prevalence of COM and CRS was 3.6 ± 0.2 and 6.0 ± 0.2%, respectively. COM prevalence was significantly higher in subjects with CRS (5.1%) than in those without (3.5%). In the multivariate analysis, COM was more prevalent in subjects with CRS (adjusted odds ratio = 1.738; P = 0.038) after adjusting for other factors. The subgroup analysis showed that this association was significant only in older subjects (≥50 years) with nasal polyps. Non-serviceable hearing and cholesteatoma were not significantly associated with CRS. Our findings demonstrated that CRS with nasal polyps might be associated with COM in older patients.
http://ift.tt/2leAiKY
Effects of polymer-based, silver nanoparticle-coated silicone splints on the nasal mucosa of rats
Abstract
Infection is a serious complication after nasal packing that otolaryngologists seek to avoid. The aim of this study is to investigate the use of silver (Ag) nanoparticle, which serves as antimicrobial agents, with nasal tampons. The study design is an experimental animal model and the setting is tertiary referral center. Twenty-four rats were randomized into the following four groups: (1) control group (n = 6); (2) silicone nasal splint (SNS) group (n = 6); (3) polypropylene-grafted polyethylene glycol (PP-g-PEG) amphiphilic graft copolymer-coated SNS group (n = 6); and (4) Ag nanoparticle-embedded PP-g-PEG (Ag-PP-g-PEG) amphiphilic graft copolymer-coated SNS group (n = 6). These tampons were applied to rats for 48 h, after which they were removed in a sterile manner, and the rats were sacrificed. The nasal septa of the rats were excised, and assessments of tissue changes in the nasal mucosa were compared among the groups. The removed tampons were microbiologically examined, and quantitative analyses were made. When the groups were compared microbiologically, there were no significant differences in bacterial colonization rates of coagulase-negative Staphylococcus spp. among the three groups (p = 0.519), but there was a statistically significant difference among bacterial colonization rates of Heamophilus parainfluenzae and Corynebacterium spp. (p = 0.018, p = 0.004). We found that H. parainfluenzae grew less robustly in the Ag-PP-g-PEG than the PP-g-PEG group (p = 0.017). However, we found no significant difference between the Ag-PP-g-PEG and SNS groups, or between the SNS and PP-g-PEG groups. The growth of Corynebacterium spp. did not differ significantly between the Ag-PP-g-PEG and SNS groups (p = 1.000). When Group 4 was compared with Group 2, the former showed less inflammation. Compared with other tampons, Ag-PP-g-PEG amphiphilic graft copolymer-coated silicone nasal tampons caused less microbiological colonization and inflammation. Therefore, the use of these tampons may prevent secondary infections and reduce the risk of developing complications by minimizing tissue damage.
http://ift.tt/2l65sBK
Chronological changes in microbial profiles in external and middle ear diseases: a 20-year study in Korea
Abstract
Microbial infection is one of the most significant causes of ear diseases, but microbial profiles are very diverse according to the diseases and change over time. The purpose of the study was to clarify differences and chronological changes in causative pathogens among infectious ear diseases over the last 20 years, and to identify antibiotic resistance. In total, 1191 isolates were included from patients diagnosed with chronic otitis media without cholesteatoma (COM), cholesteatomatous otitis media (Chole), middle ear effusion (MEE), including acute otitis media and otitis media with effusion, and external otitis (EO). Data were collected periodically for the years 1995, 2000, 2004, 2009, and 2013. Culture results and antibiotic resistance were assessed. The most common microorganism identified was S. aureus. The microbial profiles differed significant among the COM, Chole, and MEE groups (p < 0.001). In contrast, there was no distinct difference between COM and EO (p = 0.332). COM, Chole, and MEE also showed significant chronological changes in microbial profiles over time. The frequency of CNS increased markedly in COM and Chole (p = 0.029 and 0.028, respectively); however, S. pneumoniae infection decreased significantly in MEE (p = 0.016). Methicillin-resistant S. aureus (MRSA) demonstrated a constant trend (p = 0.564), whereas ciprofloxacin-resistant P. aeruginosa increased over time (p < 0.001). Microbial profiles have changed over a 20-year period. Increases in the frequency of coagulase-negative Staphylococcus (CNS) and bacterial resistance to ciprofloxacin, used widely in treating ear infections, are noteworthy.
http://ift.tt/2leJH50
Classification of congenital nasal deformities: a proposal to amend the existing classification
Abstract
Congenital nasal anomalies are rare malformations with a broad spectrum of defects. The only existing classification strictly relating to nasal anomalies was presented by Losee et al. (Plast Reconstr Surg 113(2):676–689, 2004). The aim of this paper is to propose some suggestions, based on our current knowledge and experience gained by treating our patients in the clinic, in creating a specification of patients with congenital nasal anomalies. All patients with congenital nose defects treated in our health center were selected for this study. The research was retrospective and included years from 1995 to 2015. Nasal anomaly associated with cleft lip and palate was excluded. Patients were classified into four categories of congenital nasal anomalies, according to Losee et al. classification. In the period of 20 years, 191 patients with congenital nasal anomalies were treated in our health center. Type 1 defects were found in 124 patients, type 2 in 15, type 3 in 32 and type 4 in 20 patients. The nasal defect accompanying craniofacial syndrome is the most common type of nose malformation. The nose cleft is not always a part of craniofacial clefts; isolated forms of such malformations can occur. Vascular anomalies, due to different etiology, categorization and treatment, should not be recognized as nasal malformation.
http://ift.tt/2l624a2
The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility
Abstract
Vagus nerve stimulation (VNS) is a useful tool for drug-resistant epilepsy, but it induces known laryngeal side effects, with a significant role on patients' quality of life. VNS patients may show persistent left vocal fold (LVF) palsy at rest and/or recurrent LVF adduction during stimulation. This study aims at electromyographically evaluating laryngeal muscles abnormalities in VNS patients. We compared endoscopic laryngeal evaluation data in six VNS patients with laryngeal muscle electromyography (LMEMG) carried out on the thyroarytenoid, cricothyroid, posterior cricoarytenoid, and cricopharyngeal muscles. Endoscopy showed LVF palsy at rest in 3/6 patients in whom LMEMG documented a tonic spastic activity with reduced phasic modulation. In four out of six patients with recurrent LVF adduction during VNS activation, LMEMG showed a compound muscle action potential persisting for the whole stimulation. This is the first LMEMG report of VNS-induced motor unit activation via recurrent laryngeal nerve and upper laryngeal nerve stimulation. LMEMG data were could, therefore, be considered consistent with the endoscopic laryngeal examination in all patient.
http://ift.tt/2leJ5fX
Types of laryngomalacia in children: interrelationship between clinical course and comorbid conditions
Abstract
The aim of this study was to: (1) find out whether laryngomalacia (LM) types are related to clinical course; (2) which patients with LM are at higher risk of other airway malacia [tracheomalacia (TM) and/or bronchomalacia (BM)]; and (3) evaluate the prevalence of LM in our region. Patients with established LM diagnosis and complete clinical and endoscopy records were enrolled. They were classified into different LM types according to classification based on the side of supraglottic obstruction. One hundred ten children were included. The most common LM appearance was type I—58 children, followed by combine types (I + II and I + III)—38. The other airway malacia were found in 47 patients: TM in 31, BM in 10, and TM with BM in 6. Other comorbidities (cardiac, neurological, and genetic disorders) were identified in 30 children. Patients with combine types of LM differ from those with single type of LM in terms of prematurity (13 vs 31 %, p = 0.04) and higher weight on the examination day (p = 0.006). Patients with other airway malacia differ from children with isolated LM in terms of prematurity (40 vs 13 %, p = 0.008), comorbidities (38 vs 19 %, p = 0.024), and lower weight on the examination day (p = 0.014). The prevalence of clinically relevant LM was one in 2600–3100 newborns. Clinical course of LM cannot be anticipated on the basis of solely endoscopic evaluation of the larynx. Comorbidities and prematurity increase the risk of other airway malacia. The prevalence of LM is relatively high in the middle-south part of Poland.
http://ift.tt/2leKiDV
Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods
Abstract
Limited olfactory improvement after topical steroid therapy in chronic rhinosinusitis (CRS) patients might result from restricted drug access to the olfactory cleft. The aim of our study was to investigate the difference between two methods to topically administer steroids with respect to olfaction: (1) conventional nasal spray and (2) a device using pressure and vibration to distribute steroid aerosol endonasally. A prospective study was performed in patients with olfactory impairment due to chronic rhinosinusitis with and without nasal polyps. While the first group used the conventional dexamethasone nasal spray, the second group used the device over a period of 12 days. Olfactory testing was done at 0, 2, and 8 weeks using Sniffin' Sticks test. A significant olfactory improvement was found after 2 weeks of treatment with either steroid (p = 0.005). However, there was no significant difference between the different methods of steroid application. There is a significant olfactory improvement in CRS patients following topical dexamethasone therapy, but no obvious superiority of one of the two ways to administer the steroid.
http://ift.tt/2l5TU1c
Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful?
Abstract
The aim of this study is to present our management protocol of sphenopalatine artery bleeding, demonstrating that nasoendoscopic cautery (NC) was a more effective method than the nasal packing, in terms of shorter inpatient stay and reduced complications rate. We present ten posterior epistaxis not resolved by nasal packing. Tabotamp® was placed in the area of sphenopalatine foramen and/or in those parts of the posterior nasal cavity, where it was suspected that bleeding origins. In two cases, the bleeding was resolved in this way, instead eight cases needed of subperiosteal cauterization of sphenopalatine artery by Dessi bipolar forceps (MicroFrance®). 4 of these 8 patients evidenced a remarkable bleeding removing nasal packing (Hb before-nasal packing = 15 ± 0.69 versus Hb after-nasal packing = 13.3 ± 0.81; t student = 2.94; p value = 0.025). These four patients showed a deviation of the nasal septum ipsilateral to epistaxis, and according our experience, a traumatism of sphenopalatine area can be caused by Merocel® nasal packing in this condition. During follow-up, no recurrences of nasal bleeding have been observed in such patients. Nasal packing must be considered if posterior epistaxis is severe, but always taking into account the specific anatomy of patient and in particular septal spurs that can further compromise sphenopalatine artery. In our experience, the endoscopic endonasal cauterization of the sphenopalatine branches represented a safe and effective procedure.
http://ift.tt/2leLTcE
Associations between the probabilities of frequency-specific hearing loss and unaided APHAB scores
Abstract
The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHABu) to determine whether the APHABu could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20–75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHABu subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHABu subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHABu score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHABu subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert's evaluation of the subject's hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry.
http://ift.tt/2l5TRT4
Incidence of IP and risk of malignant transformation in the Swedish population 1960–2010
Abstract
The true incidence of inverted papilloma (IP) is not yet known. From hospital-based studies, its incidence has been estimated to approximately 0.5/100,000 person years. Earlier hospital case studies have shown that IP can undergo a malignant transformation in 1–53 %. The frequency of its malignant transformation on a population basis is unknown. To our knowledge, no standardised incidence ratio (SIR) has been reported for malignancies among IPs. This study aims to investigate these incidences on a population basis. Using the data from the Swedish Cancer Registry (SCR), we have identified patients with IP and patients with Squamous Cell Carcinoma (SCC) diagnosed between 1960 and 2010 in Sweden. Incidence of IP and incidence of SCC among patients with IP and SIR were analyzed. Eight hundred and fourteen patients with IP were identified. The incidence of IPs reported to the SCR increased from 1960 to 2010. In this cohort, SCC was overrepresented, as compared with the general population. The incidence of IP in the Swedish population seems to have increased.
http://ift.tt/2lerR20
Untreated head and neck cancer in Korea: a national cohort study
Abstract
Few studies have analyzed the survival of patients with untreated head and neck cancer. The objective of this study is to assess the survival rates of untreated head and neck cancer patients and to determine why the patients were not treated. Using data from a national patient sample cohort (1,025,340 cases) from the Korean Health Insurance Review and Assessment Service, 605 patients with diagnoses of head and neck cancer (lip and oral cavity, oropharynx, hypopharynx, and laryngeal cancer) between 2003 and 2013 were evaluated. Cox proportional hazards modeling and multiple logistic regression analysis were performed. Of the considered cases of head and neck cancer, 32.2% were untreated. The median survival rate of untreated groups was 9 months. The untreated group showed poorer survival than the treatment groups. Old age [adjusted odds ratio (AOR) = 1.37, 95% confidence internal (CI) 1.25–1.49, P < 0.001] and low income (AOR = 0.94, 95% CI 0.89–1.00, P = 0.028) were related to not receiving treatment. Many head and neck cancers go untreated. Clinicians should focus on untreated patients and seek to understand the reasons for their lack of treatment.
http://ift.tt/2leLQO0
Rhinophototherapy in persistent allergic rhinitis
Abstract
Previous published results have revealed that Rhinolight® intranasal phototherapy is safe and effective in intermittent allergic rhinitis. The present objective was to assess whether phototherapy is also safe and effective in persistent allergic rhinitis. Thirty-four patients with persistent allergic rhinitis were randomized into two groups; twenty-five subjects completed the study. The Rhinolight® group was treated with a combination of UV-B, UV-A, and high-intensity visible light, while the placebo group received low-intensity visible white light intranasal phototherapy on a total of 13 occasions in 6 weeks. The assessment was based on the diary of symptoms, nasal inspiratory peak flow, quantitative smell threshold, mucociliary transport function, and ICAM-1 expression of the epithelial cells. All nasal symptom scores and nasal inspiratory peak flow measurements improved significantly in the Rhinolight® group relative to the placebo group and this finding persisted after 4 weeks of follow-up. The smell and mucociliary functions did not change significantly in either group. The number of ICAM-1 positive cells decreased non-significantly in the Rhinolight® group. No severe side-effects were reported during the treatment period. These results suggest that Rhinolight® treatment is safe and effective in persistent allergic rhinitis.
http://ift.tt/2l622Ps
Laser tracheobronchoplasty: a novel technique for the treatment of symptomatic tracheobronchomalacia
Abstract
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years. Symptoms included severe dyspnea, dry cough, recurrent pulmonary infections, and respiratory failure. Fifty percent of patients presented with wheezing refractory to traditional treatment. Tracheobronchomalacia was associated with gastroesophageal reflux disease (n = 8), obstructive sleep apnea (n = 5), and tracheal stenosis (n = 3). Only 50 % of patients presented with morbid obesity. All cases showed significant improvement of their respiratory symptoms with a mean postoperative difference of 22.3 out of a maximum impairment score of 40 (P < 0.01) on the Dyspnea Index. The mean number of procedures was 2.3 per patient with the average laser energy delivered per procedure of 1600 J. Laser tracheobronchoplasty is a safe, easy to adopt, and effective technique for the treatment of membranous tracheobronchomalacia. It presents a simple alternative to the commonly used procedures like endoluminal stenting and open tracheobronchoplasty.
http://ift.tt/2leNS0H
Corrigendum to “Chondroitin sulfate is involved in the hypercalcification of the organic matrix of bovine peritubular dentin” [Archives of Oral Biology 62 (2016) 93–100]
Source:Archives of Oral Biology, Volume 76
Author(s): Jason R. Dorvee, Lauren Gerkowicz, Sara Bahmanyar, Alix Deymier-Black, Arthur Veis
http://ift.tt/2lfCDVW
Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 76
http://ift.tt/2kIjJ6J
Review of flavonoids: A diverse group of natural compounds with anti-Candida albicans activity in vitro
Source:Archives of Oral Biology, Volume 76
Author(s): Dalia Seleem, Vanessa Pardi, Ramiro Mendonça Murata
Flavonoids are a subdivision of polyphenols, a versatile class of natural compounds that represent secondary metabolites from higher plants and are abundant in human diet. Various protective effects of flavonoids have been reported, including antimicrobial and antifungal activities. Due to the nature of oral candidiasis and the increased use of antifungal agents, several drug-resistant strains have emerged making it impractical to rely on one standard therapeutic regime. The aim of this review is to summarize the antifungal activity of some examples of the major subclasses of flavonoids in pure extract forms against C. albicans in vitro, as reported in literature over the past 10 years (2004–2015). In addition, this review outlines the potential mechanism of actions of flavonoids studied in vitro, which may contribute to a better understanding of flavonoids as multi-targets agents in the treatment and/or prevention of oral candidiasis in clinical settings.
http://ift.tt/2lfrtjL
Corrigendum to “Chondroitin sulfate is involved in the hypercalcification of the organic matrix of bovine peritubular dentin” [Archives of Oral Biology 62 (2016) 93–100]
Source:Archives of Oral Biology, Volume 76
Author(s): Jason R. Dorvee, Lauren Gerkowicz, Sara Bahmanyar, Alix Deymier-Black, Arthur Veis
http://ift.tt/2lfCDVW
Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 76
http://ift.tt/2kIjJ6J
Review of flavonoids: A diverse group of natural compounds with anti-Candida albicans activity in vitro
Source:Archives of Oral Biology, Volume 76
Author(s): Dalia Seleem, Vanessa Pardi, Ramiro Mendonça Murata
Flavonoids are a subdivision of polyphenols, a versatile class of natural compounds that represent secondary metabolites from higher plants and are abundant in human diet. Various protective effects of flavonoids have been reported, including antimicrobial and antifungal activities. Due to the nature of oral candidiasis and the increased use of antifungal agents, several drug-resistant strains have emerged making it impractical to rely on one standard therapeutic regime. The aim of this review is to summarize the antifungal activity of some examples of the major subclasses of flavonoids in pure extract forms against C. albicans in vitro, as reported in literature over the past 10 years (2004–2015). In addition, this review outlines the potential mechanism of actions of flavonoids studied in vitro, which may contribute to a better understanding of flavonoids as multi-targets agents in the treatment and/or prevention of oral candidiasis in clinical settings.
http://ift.tt/2lfrtjL
Breathing parameters associated to two different external nasal dilator strips in endurance athletes
Source:Auris Nasus Larynx
Author(s): Giancarlo Ottaviano, Andrea Ermolao, Ennio Nardello, Flavio Muci, Vittorio Favero, Marco Zaccaria, Lorenzo Favero
ObjectiveThe aim of the study was to investigate and compare the effects of two different external nasal dilator strips (ENDS) on nasal respiratory flow, maximal oxygen uptake (VO2max), nasal VO2max, time to exhaustion and subjective nasal obstruction in adult triathletes participating in exhaustive, controlled physical exercise tests.MethodsThirteen healthy triathletes without nasal symptoms were recruited and randomly tested in three different conditions: without ENDS, wearing the Breathe Right® dilator strip and wearing the Master-aid Roll-flex® strip. We investigated the variations in the peak nasal inspiratory flow (PNIF) and the Nasal Obstruction Symptom Evaluation questionnaire before and after an exhaustive treadmill test. VO2max, nasal VO2max, time to exhaustion, total time of nasal respiration values were also registered and compared.ResultsPost-exercise PNIF was higher than the pre-exercise PNIF. Pre-exercise PNIF was higher in athletes wearing the Master-aid Roll-Flex® than in those wearing the Breathe Right® strips; no differences in post-exercise PNIF values were found in the three different conditions. Nasal VO2max value was higher when both types of ENDS were worn. Nasal respiration time to exhaustion was longer when the athletes were wearing either type of ENDS. Both ENDS gave a better sensation of nasal airflow passage after physical exercise.ConclusionENDS had similar effects, improving the subjective sensation of nasal patency, the nasal respiration time, and the nasal VO2max, anyway Master-aid Roll-flex® is more economic than the Breathe Right® and it can be cut to fit the nasal anatomy.As ENDS affect the cross-sectional area, especially at the level of the nasal valve, in future studies should be conducted also by means of acoustic rhinometry in order to evaluate if any difference could be find at this level when wearing either one of the two ENDS.
http://ift.tt/2kvJ2b4
Does bone grafting improve outcomes in coronectomy surgery? Long-term (5-9 years) clinical and radiographic follow-up of 78 adult patients
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jeffrey A. Elo, Ho-Hyun (Brian) Sun, Fanglong Dong, Katina Nguyen, Kirollos Zakhary
PurposeTo report the long-term outcomes of 78 adult patients who underwent coronectomy with bone graft (CWG) of the bony crypt.Patients and Methods78 patients with follow-up of at least 5-9 years underwent CWG. Preoperative imaging and probing depths were recorded, as were yearly follow-up radiographs or CBCT and yearly post-op probing depths.ResultsPeriodontal probing depths and bone levels on the distal surfaces of adjacent mandibular molars showed marked improvement compared to preoperative probing depths and bone levels. All retained roots maintained their immediate postoperative positions with no migrations and no re-operations required.ConclusionCWG is a predictable procedure that should be considered for patients at risk for developing sensory disturbances or for those with deeper (>4mm) preoperative probing depths on the distal surfaces of the adjacent molars. Adding bone graft appears to aid in preventing root migration and reducing probing depths on the distal of adjacent molars.
http://ift.tt/2lNUwIY
A case of nuclear protein in testis midline carcinoma arising from the submandibular gland duct in a pregnant patient
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Younghoon Cho, Bhum Suk Keam, Kyeong Cheon Jung, Kim Bo Hae
We provide the first reported case of a nuclear protein in testis midline carcinoma (NMC) arising from the submandibular gland (SMG) duct in a pregnant woman. A 29-year-old pregnant woman presented with a left-sided mass in the floor of the mouth. A NMC arising from the SMG duct was confirmed by excisional biopsy. Intensive treatment, including surgery and chemotherapy, was provided without termination of pregnancy. Additional chemotherapy and radiotherapy were provided after delivery. The treatment was successful, neither the patient nor her infant had any complications and the patient remained disease-free 20 months after her initial surgery. We here report the successful diagnosis and treatment of a rare presentation of a NMC of the SMG duct in a pregnant woman.
http://ift.tt/2kRdgZH
Risk Factor Analysis of Graft Failure with Concomitant Cyst Enucleation of the Jaw Bone: a Retrospective Multicenter Study
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ho-Kyung Lim, Jin-Woo Kim, Ui-Lyong Lee, Ju-Won Kim, Ho Lee
PurposeCysts are common pathological entities in the oral and maxillofacial region. Enucleation is commonly used for treatment and is occasionally followed by bone grafting. However, no studies have evaluated factors affecting the failure of grafts used for cystic defects in the oral and maxillofacial region. Therefore, we conducted the present study to determine the risk factors for postoperative graft failure in patients treated with cyst enucleation and simultaneous bone grafting.MethodsClinical data for 305 patients who had undergone cyst enucleation with simultaneous bone grafting were retrospectively investigated in this multicenter, case–control study. The predictor variables included host, pathological, and treatment factors. The outcome variable was success or failure of the bone graft. Descriptive statistics were computed, and the P-value was set at .05.ResultsBone graft failure was observed in 48 cases. The mean duration from surgery to failure was 38.7 days. Multivariable logistic regression analysis revealed a significant association between graft failure and a lower age [odds ratio (OR), 1.033; P = .016], smoking (OR, 2.598; P = .017), preoperative infection (OR, 4.660; P = .001), large cysts (OR, 1.052; P = .010), impaction of the mandibular third molar in the cystic cavity (OR, 3.021; P = .007), perilesional sclerosis (OR, 4.973; P = .001), and the use of mixed nonautogenous and autogenous bone grafts (OR, 3.891; P = .007).ConclusionsOur study provides a list of important factors that should be considered by clinicians planning enucleation and simultaneous bone grafting for cysts in the oral and maxillofacial region.
http://ift.tt/2lOuJ2r
Navigation-guided Extraction of Impacted Supernumerary Teeth: A Case Report
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jing Wang, Nianhui Cui, Yujiao Guo, Wei Zhang
Supernumerary teeth usually result in retarded eruption, malocclusion, poor esthetics, and cyst formation. Management involves surgical extraction, which can be challenging in certain complicated cases owing to the risk of injury to young permanent tooth germs or fragile roots. The present report describes a novel preoperative computer-assisted, intraoperative, navigation-guided surgical treatment for a case of complicated impacted supernumerary teeth. The report highlights accurate tooth location and minimal invasion with use of the navigation-guided system. Moreover, it discusses various treatment considerations during such a procedure.
http://ift.tt/2lfC0eR
Histological and immunohistochemical characteristics of undifferentiated small round cell sarcomas associated with CIC-DUX4 and BCOR-CCNB3 fusion genes
Abstract
CIC-DUX4 and BCOR-CCNB3 fusion-gene-associated small round cell sarcomas account for a proportion of pediatric small round cell sarcomas, but their pathological features have not been sufficiently clarified. We reviewed a large number of soft tissue tumors registered at our institution, retrieved the cases of unclassified tumors with a small round cell component, and subjected them to histopathological, immunohistochemical, and gene profile analysis. We reviewed 164 cases of unclassified tumors with a small round cell component and analyzed them by RT-PCR and FISH. Tumors positive for a specific fusion-gene were also subjected to histopathological and immunohistochemical examinations. We identified 16 cases of BCOR-CCNB3/CIC-associated (CIC-DUX4 or CIC gene rearrangement-positive) sarcomas. These included seven BCOR-CCNB3 sarcomas and nine CIC-associated sarcomas. Heterogeneous elements included a myxoid spindle cell component in three BCOR-CCNB3 sarcomas and an epithelioid cell component in two CIC-associated sarcomas (one CIC-DUX4-positive and one CIC-DUX4-negative sarcomas). Mitotic activity was low in both heterogeneous components. By immunohistochemistry, in seven BCOR-CCNB3 sarcomas expression of EMA was positive in two cases, of p63 in three, of CD56 in six, of TLE1 in seven, of NKX2.2 in two, of CCNB3 in seven, and of BCOR in six cases (one case could not be tested for BCOR). In nine cases of CIC-associated sarcoma, CD56 was expressed in five, alpha-smooth muscle actin in one, ERG in three, and CD99, WT1 and TLE1 each in eight cases. Both sarcoma types showed not only a small round cell component, but also a myxoid/epithelioid component with low mitotic activity.
http://ift.tt/2kojktX
Prevalence of minimal hearing loss in South Korea
by Ji Eun Choi, Jungmin Ahn, Hyun Woo Park, Sun-Young Baek, Seonwoo Kim, Il Joon Moon
This study evaluated the prevalence of minimal hearing loss (MHL) in South Korea based on the 2010 to 2012 Korea National Health and Nutrition Examination Survey. A total of 16,630 representative individuals (older than 12 years) who completed ear examinations and structured questionnaires were analyzed. Only participants who had normal tympanic membranes were included. MHL was categorized into the following three groups: 1) unilateral sensorineural hearing loss (USHL, pure-tone average (PTA) ≥ 15 dB in the affected ear), 2) bilateral sensorineural hearing loss (BSHL, 15 dB ≤ PTA 25 dB in either ear). To evaluate clinical symptoms, subjective hearing status, tinnitus, and quality of life of each MHL group were compared to those of normal-hearing listeners. The use of hearing aids (HAs) was also investigated in the MHL population. The prevalence of normal hearing and MHL were 58.4% and 37.4%, respectively. In univariate analyses, the prevalence of MHL increased with age. It was significantly increased in males. Regarding clinical symptoms, 13.0% and 92.1% of participants with MHL reported difficulties with hearing and annoying tinnitus, respectively. In multivariate analyses, these proportions were significantly higher in the MHL groups than in normal-hearing listeners. Participants with MHL also showed significantly lower Euro Qol-5D index scores than did normal-hearing listeners. Regarding hearing rehabilitation, among minimally hearing impaired participants with subjective hearing loss, only 0.47% of individuals used HAs. Our results reveal that MHL is common in South Korea. It is associated with significant subjective hearing loss, tinnitus, and poor quality of life. Therefore, clinicians need to pay attention to this special group and provide proper counselling and rehabilitative management.http://ift.tt/2lMWdFq
The alpha-herpesviridae in dermatology
Abstract
This review on herpes simplex virus type I and type II (HSV‑I, HSV‑II) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSV‑I infection; HSV-related folliculitis; verrucous HSV‑I and HSV‑II lesions; the role of recurrent HSV‑I infection in burning mouth syndrome; HSV‑I and HSV‑II infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSV‑I or HSV‑II are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSV‑I and anti-HSV‑II agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSV‑I and HSV‑II infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.
http://ift.tt/2lOeP8l
Alpha-Herpesviridae in der Dermatologie
Zusammenfassung
In der vorliegenden Übersichtsarbeit zum Herpes-simplex-Virus Typ I und II (HSV-I, HSV-II) werden aktuelle Entwicklungen in Bezug auf klinische Symptome, Behandlungsmaßnahmen bei primärem und rezidivierendem Lippen- und Genitalherpes sowie Fragen zur Impfung zusammengefasst. Hinsichtlich der klinischen Manifestationen werden der Zusammenhang zwischen pyogenem Granulom und chronischer HSV-I-Infektion, die HSV-bedingte Follikulitis, verruköse HSV-I- und HSV-II-Läsionen, die Rolle der rezidivierenden HSV-I-Infektion beim „burning mouth syndrome", die HSV-I- und HSV-II-Infektion des periareolären Bereichs, die zosteriforme HSV-Infektion, das „knife-cut sign" (Messerschnittzeichen) und die bevorzugte Kolonisierung und Infektion vorbestehender Dermatosen durch HSV-I oder HSV-II erörtert. Die üblichen antiviralen Therapieschemata bei primärem und rezidivierendem Lippen- und Genitalherpes werden mit den Optionen der Kurzzeit- und der Eintagestherapie verglichen. Zu den neuen Anti-HSV-I- und Anti-HSV-II-Agenzien gehören Amenavir, Pritelivir, Brincidofovir, Valomaciclovir und FV-100. Die therapeutische oder präventive Impfung gegen HSV-I- und HSV-II-Infektionen bleibt ein sehr wünschenswertes Therapieziel, zu dem es bisher leider noch keine klinisch relevanten Anwendungen gibt.
http://ift.tt/2lIDu1N
Alpha-Herpesviridae in der Dermatologie
Zusammenfassung
Der zweite Teil der vorliegenden Übersichtsarbeit befasst sich mit dem Varicella-Zoster-Virus (VZV) und bietet einen Überblick über neue, seltene und atypische klinische Symptome: fotolokalisierte Varizellen (an lichtexponierten Stellen), hämorrhagische Bullae während der Varizelleninfektion, die Bedeutung des VZV bei Immunglobulin-A-Vaskulitis, VZV-bedingte Alopezie, ulcerative Varizellen-Hautläsionen, kindlicher Herpes zoster (HZ), anhaltende Prodromalschmerzen, rezidivierender HZ, Bedeutung des VZV beim „burning mouth syndrome", warzenähnliche VZV-Läsionen, Bedeutung von Satellitenläsionen bei HZ und neurologische oder internistische Spätkomplikationen des HZ. Darüber hinaus werden bestimmte Zusammenhänge zwischen dem Auftreten des HZ und nachfolgenden internistischen Erkrankungen, Risikofaktoren für HZ und neue Entwicklungen bei der Impfung gegen HZ dargestellt.
http://ift.tt/2lOoPOy
The alpha-herpesviridae in dermatology
Abstract
The second part of this publication deals with varicella zoster virus (VZV) and presents an overview of new, rare, and atypical clinical manifestations, including photolocalized varicella, hemorrhagic bullae during varicella, the implication of VZV in immunoglobulin A vasculitis, VZV-related alopecia, ulcerative varicella skin lesions, childhood herpes zoster (HZ), prolonged prodromal pains, recurrent HZ, VZV implication in burning mouth syndrome, verruciform VZV lesions, the significance of satellite lesions during HZ, and late HZ complications, either neurological or internal. Furthermore, certain associations between the occurrence of HZ and subsequent internal pathologies, as well as risk factors for HZ and new developments in vaccination against HZ will be addressed.
http://ift.tt/2lIJVCh
Innovative Formen der spezifischen Immuntherapie
Zusammenfassung
Der Erfolg allergenspezifischer Immuntherapie hängt von ihrer toleranzinduzierenden Immunogenität ab und ist derzeit limitiert durch therapieassoziierte unerwünschte Wirkungen. Ein wichtiges Ziel innovativer Therapieansätze ist daher die Verbesserung der Verträglichkeit. Die epikutane Immuntherapie (EPIT), bei der kommerziell verfügbare Extraktpräparate über ein Pflaster auf der Haut appliziert werden, zeichnet sich bei guter klinischer Wirksamkeit durch eine ausgezeichnete Verträglichkeit aus. Erste vielversprechende Ergebnisse mit einer epikutanen Erdnuss-Immuntherapie wurden 2016 publiziert. Die intralymphatische Immuntherapie (ILIT) fällt neben ihrer guten Verträglichkeit durch die ausgeprägte Immunogenität auf, die es, nach den Ergebnissen erster klinischer Studien zu urteilen, erlaubt, mit nur 3 Injektionen einer minimalen Dosis eines etablierten Extraktes eine dauerhafte Immuntoleranz zu erreichen. Den Aspekt der Toleranzinduktion berücksichtigen in besonderem Maße neue Entwicklungen synthetischer Allergievakzine. Diese sind, da rekombinant hergestellt, von reproduzierbarer Qualität und genau definiertem Wirkprofil. Damit soll einerseits eine ausgeprägte Immunogenität der enthaltenen antigenen Determinanten und andererseits ein optimiertes Sicherheitsprofil erreicht werden. Derzeit werden Gräser-, Birken-, Katzen- und Hausstaubmilbenpräparate in unterschiedlichen klinischen Prüfungsphasen evaluiert. Welche Produkte die Marktreife erreichen werden, ist noch unklar. Die Ergebnisse klinischer Studien mit Nahrungsmittelimmuntherapeutika erlauben bis dato aufgrund durchgehend schlechter Verträglichkeit und limitierter Wirksamkeit keine vielversprechende Perspektive.
http://ift.tt/2lOqZ0N
Re: Should we consider devolution of “head and neck” surgery from the specialties of oral and maxillofacial surgery; ear, nose and throat surgery; and plastic surgery?
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R. Elledge, G. Walton, R. Sandhu, S. Prasad, D. Howe
http://ift.tt/2kQSWY1
Expression pattern of heat shock protein 90 in patients with oral squamous cell carcinoma in northern Taiwan
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): W.-C. Chang, P.-T. Tsai, C.-K. Lin, Y.-S. Shieh, Y.-W. Chen
Heat shock protein 90 (HSP90), which is expressed in cancer cells, profoundly affects progression, invasion, and metastasis. However, to our knowledge, in East Asia, the correlation between the expression of HSP90 and clinicopathological variables has seldom been discussed. We therefore investigated this and its prognostic value in 36 patients newly diagnosed with oral squamous cell carcinoma (SCC) in northern Taiwan. Samples of tumour and normal samples from the patients were compared immunohistochemically. HSP90 was expressed mainly in the samples of tumour, and was significantly higher in these than in the normal epithelium (p<0.001). Metastases to the lymph nodes in the 36 patients also correlated with expression of HSP90. Correlation between expression of HSP90 and the size of the tumour or pathological staging was not significant, but strong expression correlated with poor survival. In general, expression was low among our samples (30/36). It was significantly higher in the tumour samples than in normal samples, and correlated with metastases to lymph nodes in the neck.
http://ift.tt/2lNuOEh
Are you a cut above the rest? Read on to find out
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): M. Evans, D.A. Mitchell
http://ift.tt/2lNEZso
Are you a cut above the rest? Read on to find out
If you are among the brightest, or the most careless, authors you will know that the journal checks all references cited – the brightest because you will have noticed, and the most careless because you will have been asked to provide a copy of the title page of any reference that we were unable to find.
http://ift.tt/2kvkgYv
Re: Should we consider devolution of “head and neck” surgery from the specialties of oral and maxillofacial surgery; ear, nose and throat surgery; and plastic surgery?
We were interested in Islam's editorial regarding the devolution of head and neck surgery from the parent specialties that feed into it.1 We have had a devolved arrangement of practice at University Hospitals Coventry and Warwickshire Hospitals NHS Trust since 2003. To the best of our knowledge this is the only service in the country in which this is the case, and it is recognised as such within the clinical and management structure of the hospital. The service has a separate clinical lead, QIPS (Quality, Improvement, and Patient Safety), business, and departmental meetings.
http://ift.tt/2kvjtqK
Kutanes Plattenepithelkarzinom
Zusammenfassung
Das Plattenepithelkarzinom (PEK) der Haut ist eine der häufigsten Krebsarten der kaukasischen Population und macht 20 % aller Hauttumoren aus. Die Diagnose basiert auf der klinischen Untersuchung und der histologischen Sicherung. Therapie der 1. Wahl ist die histologisch kontrollierte vollständige Exzision. Eine Sentinel-Lymphknotenbiopsie kann bei PEK >6 mm Tumordicke erwogen werden, ihre Aussagekraft ist jedoch unklar. Die Radiatio ist eine Alternative zur Chirurgie bei inoperablen PEK oder kann adjuvant bei hohem Rezidivrisiko erwogen werden. Im fernmetastasierten Stadium können verschiedene Chemotherapeutika, EGFR-Inhibitoren (EGFR: „epidermal growth factor receptor") oder Immun-Checkpoint-Blocker – aufgrund der geringen Evidenz vorzugsweise in klinischen Studien – eingesetzt werden. Die Nachsorge sollte risikoadaptiert stattfinden und schließt primär eine dermatologische Kontrolle, bei Hochrisikopatienten auch Ultraschalluntersuchungen ein.
http://ift.tt/2leLqHu
Progredienzangst ≥5 Jahre nach Krebsdiagnose
Zusammenfassung
Hintergrund und Studienziele
Auch Jahre nach Erstdiagnose und Abschluss der medizinischen Behandlung berichten Krebspatienten Ängste vor einem Wiederauftreten oder einem Fortschreiten der Erkrankung. Um repräsentative Studien über die Progredienzangst bei Langzeitüberlebenden zu ermöglichen, ist eine Identifizierung und Rekrutierung von Studienteilnehmern über Krebsregister besonders geeignet.
Material und Methoden
Die von der Deutschen Krebshilfe geförderte CAESAR-Studie wurde vom Deutschen Krebsforschungszentrum in Kooperation mit 6 populationsbasierten deutschen Krebsregistern durchgeführt. Potenzielle Studienteilnehmer wurden über die Krebsregister identifiziert. Zwischen 2008 und 2011 wurde allen potenziellen Teilnehmern ein Fragebogen zugesendet, der unter anderem die Kurzform des Progredienzangstfragebogens von Herrschbach et al. enthielt.
Ergebnisse
Insgesamt nahmen über 7000 Personen mit einem durchschnittlichen Alter von 69 Jahren an der Studie teil. Auch Jahre nach Erstdiagnose gab die Mehrheit der Langzeitüberlebenden Ängste vor einem Fortschreiten oder Wiederauftreten der Erkrankung an. Vor allem Frauen und jüngere Langzeitüberlebende scheinen besonders vulnerabel für hohe, potenziell einschränkende Progredienzangst zu sein.
Schlussfolgerung
Vor allem Frauen und jüngere Langzeitüberlebende sollten in der klinischen Praxis die notwendige Aufmerksamkeit und Unterstützung erhalten, um Progredienzängste zu erkennen und deren negative Auswirkungen auf Wohlbefinden und Lebensqualität zu vermeiden oder zu minimieren.
http://ift.tt/2lIpNjI
Patienten wollen die Online-Verordnung
Ein Online-Kontakt zum Arzt und dann die verschreibungspflichtige Arznei verordnet bekommen: Viele Patienten in Deutschland können sich das laut einer Umfrage vorstellen. Allerdings nicht ganz ohne Einschränkungen.
http://ift.tt/2kHWOZ1
Minimalinvasive Behandlung von Varizen
Zusammenfassung
Mit Einführung der Farbduplexsonografie in die Diagnostik von Venenerkrankungen zu Beginn der 1990er-Jahre wurde rasch die Möglichkeit des Einsatzes der Sonografie in der Therapie von Varizen erkannt: Die Echosklerotherapie von Stammvenen durch sonografisch kontrollierte Punktion war das erste endovenöse Verfahren [1]. Seit dem Jahre 2000 wurden verschiedene thermische und nicht thermische endovenöse Verfahren so erfolgreich etabliert, dass die klassische Saphenaresektion mit Krossektomie nicht mehr automatisch Methode der ersten Wahl ist. Neben diesen ablativen Verfahren finden in jüngster Zeit organerhaltende Verfahren wie die extraluminale Valvuloplastie und die CHIVA-Methode wieder mehr Beachtung, um bei entsprechendem Risikoprofil älterer Patienten bypassfähige Stammvenenabschnitte zu erhalten.
http://ift.tt/2kHZB4l
Abschied ohne Schrecken
2018 soll endgültig Schluss sein mit dem seit Jahrzehnten bewährten ISDN-Netz. Dann wollen die Telekom, 1&1 und andere große Telefonnetzanbieter ihre Leitungen endgültig auf „All-IP" umstellen. Gerade gewerbliche Kunden wie Arztpraxen kann es auch schon früher treffen. Welche Optionen haben Betroffene?
http://ift.tt/2kHRzJ3
An extreme Klimate angepasstes Leben
Menschen, die am Rand des Eises beheimatet sind, bewältigen harte Lebensumstände durch ihre Naturnähe und Kreativität. Unter dem verbindenden Titel „EisZeiten" bringen zwei Teilausstellungen „Die Kunst der Mammutjäger" im Archäologischen Museum Hamburg und „Die Menschen des Nordlichts" im Museum für Völkerkunde Hamburg bis 14. Mai 2017 nah.
http://ift.tt/2kI6LG3
Die Ethik der Ästhetik
Orthografisch sind es von der Ethik zur Ästhetik nur ein paar Buchstaben. Geht es aber um die ethische Basis für die ästhetische Chirurgie, ist es mit Buchstabenklauberei nicht getan. Denn ethisch stellt sich bei ästhetisch motivierten Operationen manches anders dar als bei Eingriffen mit Krankheitsbezug. Der Wortlaut moralischer Regeln hilft da oft nicht weiter.
http://ift.tt/2kHOubU
Anpassung der ärztlichen Vergütung
Ein erhöhter Arbeitsaufwand kann nach §5, Absatz 2, der Gebührenordnung für Ärzte (GOÄ) mit einem bis zu 2,3-fachen Gebührensatz bemessen werden. Für die weitere Erhöhung des Abrechnungssatzes ist zwingend eine Begründung erforderlich.
http://ift.tt/2kHYulc
Langkettige Omega-3-Fettsäuren bei atopischer Dermatitis und Psoriasis
Langkettige, mehrfach ungesättigte Fettsäuren sind Ausgangssubstrate für Prostaglandine, Leukotriene und neu identifizierte Lipidmediatoren. Aufgrund ihrer antiinflammatorischen Wirkung wird die Anwendung langkettiger Omega-3-Fettsäuren bei diversen Erkrankungen diskutiert, die mit einem entzündlichen Geschehen oder einer subklinischen Entzündung verbunden sind. Im Folgenden wird die Datenlage für den Einsatz langkettiger Omega-3-Fettsäuren zur Prävention und Therapie der atopischen Dermatitis und zur Therapie der Psoriasis dargestellt.
http://ift.tt/2kI67s3
Dynamic hyperinflation in patients with asthma and exercise-induced bronchoconstriction
Little is known about the behavior of operative lung volumes during exercise in patients with asthma and exercise-induced bronchoconstriction (EIB).
http://ift.tt/2lNZZOR
Erosive pustular dermatosis of the scalp: Clinical, trichoscopic, and histopathologic features of 20 cases
Erosive pustular dermatosis of the scalp is a chronic eruption that leads to scarring alopecia.
http://ift.tt/2l66v4H
Aus der Gutachtenpraxis: Einteilung der Schwerhörigkeit nach WHO-Kriterien
Laryngo-Rhino-Otol 2017; 96: 45-46
DOI: 10.1055/s-0042-121458
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2leUtIJ
Scaling up strategies of the Chronic Respiratory Disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3 – Area 5)
Publication date: Available online 14 February 2017
Source:Alergologia Polska - Polish Journal of Allergology
Author(s): J. Bousquet, J. Farrell, G. Crooks, P. Hellings, E.H. Bel, M. Bewick, N.H. Chavannes, J. Correia de Sousa, A.A. Cruz, T. Haahtela, G. Joos, N. Khaltaev, J. Malva, A. Muraro, M. Nogues, S. Palkonen, S. Pedersen, C. Robalo-Cordeiro, B. Samolinski, T. Strandberg, A. Valiulis, A. Yorgancioglu, T. Zuberbier, A. Bedbrook, W. Aberer, M. Adachi, A. Agusti, C.A. Akdis, M. Akdis, J. Ankri, A. Alonso, I. Annesi-Maesano, I.J. Ansotegui, J.M. Anto, S. Arnavielhe, H. Arshad, C. Bai, I. Baiardini, C. Bachert, A.K. Baigenzhin, C. Barbara, E.D. Bateman, B. Beghé, A. Ben Kheder, K.S. Bennoor, M. Benson, K.C. Bergmann, T. Bieber, C. Bindslev-Jensen, L. Bjermer, H. Blain, F. Blasi, A.L. Boner, M. Bonini, S. Bonini, S. Bosnic-Anticevitch, L.P. Boulet, R. Bourret, P.J. Bousquet, F. Braido, A.H. Briggs, C.E. Brightling, J. Brozek, R. Buhl, P.G. Burney, A. Bush, F. Caballero-Fonseca, D. Caimmi, M.A. Calderon, P.M. Calverley, P.A.M. Camargos, G.W. Canonica, T. Camuzat, K.H. Carlsen, W. Carr, A. Carriazo, T. Casale, A.M. Cepeda Sarabia, L. Chatzi, Y.Z. Chen, R. Chiron, E. Chkhartishvili, A.G. Chuchalin, K.F. Chung, G. Ciprandi, I. Cirule, L. Cox, D.J. Costa, A. Custovic, R. Dahl, S.E. Dahlen, U. Darsow, G. De Carlo, F. De Blay, T. Dedeu, D. Deleanu, E. De Manuel Keenoy, P. Demoly, J.A. Denburg, P. Devillier, A. Didier, A.T. Dinh-Xuan, R. Djukanovic, D. Dokic, H. Douagui, G. Dray, R. Dubakiene, S.R. Durham, M.S. Dykewicz, Y. El-Gamal, R. Emuzyte, L.M. Fabbri, M. Fletcher, A. Fiocchi, A. Fink Wagner, J. Fonseca, W.J. Fokkens, F. Forastiere, P. Frith, M. Gaga, A. Gamkrelidze, J. Garces, J. Garcia-Aymerich, B. Gemicioğlu, J.E. Gereda, S. González Diaz, M. Gotua, I. Grisle, L. Grouse, Z. Gutter, M.A. Guzmán, L.G. Heaney, B. Hellquist-Dahl, D. Henderson, A. Hendry, J. Heinrich, D. Heve, F. Horak, J.O'B. Hourihane, P. Howarth, M. Humbert, M.E. Hyland, M. Illario, J.C. Ivancevich, J.R. Jardim, E.J. Jares, C. Jeandel, C. Jenkins, S.L. Johnston, O. Jonquet, K. Julge, K.S. Jung, J. Just, I. Kaidashev, M.R. Kaitov, O. Kalayci, A.F. Kalyoncu, T. Keil, P.K. Keith, L. Klimek, B. Koffi N'Goran, V. Kolek, G.H. Koppelman, M.L. Kowalski, I. Kull, P. Kuna, V. Kvedariene, B. Lambrecht, S. Lau, D. Larenas-Linnemann, D. Laune, L.T.T. Le, P. Lieberman, B. Lipworth, J. Li, K. Lodrup Carlsen, R. Louis, W. MacNee, Y. Magard, A. Magnan, B. Mahboub, A. Mair, I. Majer, M.J. Makela, P. Manning, S. Mara, G.D. Marshall, M.R. Masjedi, P. Matignon, M. Maurer, S. Mavale-Manuel, E. Melén, E. Melo-Gomes, E.O. Meltzer, A. Menzies-Gow, H. Merk, J.P. Michel, N. Miculinic, F. Mihaltan, B. Milenkovic, G. Moda Y. Mohammad, M. Molimard, I. Momas, A. Montilla-Santana, M. Morais-Almeida, M. Morgan, R. Mösges, J. Mullol, S. Nafti, L. Namazova-Baranova, R. Naclerio, A. Neou, H. Neffen, K. Nekam, B. Niggemann, G. Ninot, T.D. Nyembue, R.E. O'Hehir, K. Ohta, Y. Okamoto, K. Okubo, S. Ouedraogo, P. Paggiaro, I. Pali-Schöll, P. Panzner, N. Papadopoulos, A. Papi, H.S. Park, G. Passalacqua, I. Pavord, R. Pawankar, R. Pengelly, O. Pfaar, R. Picard, B. Pigearias, I. Pin, D. Plavec, D. Poethig, W. Pohl, T.A. Popov, F. Portejoie, P. Potter, D. Postma, D. Price, K.F. Rabe, F. Raciborski, F. Radier Pontal, S. Repka-Ramirez, S. Reitamo, S. Rennard, F. Rodenas, J. Roberts, J. Roca, L. Rodriguez Mañas, C. Rolland, M. Roman Rodriguez, A. Romano, J. Rosado-Pinto, N. Rosario, L. Rosenwasser, M. Rottem, D. Ryan, M. Sanchez-Borges, G.K. Scadding, H.J. Schunemann, E. Serrano, P. Schmid-Grendelmeier, H. Schulz, A. Sheikh, M. Shields, N. Siafakas, Y. Sibille, T. Similowski, F.E.R. Simons, J.C. Sisul, I. Skrindo, H.A. Smit, D. Solé, T. Sooronbaev, O. Spranger, R. Stelmach, P.J. Sterk, J. Sunyer, C. Thijs, T. To, A. Todo-Bom, M. Triggiani, R. Valenta, A.L. Valero, E. Valia, E. Valovirta, E. Van Ganse, M. van Hage, O. Vandenplas, T. Vasankari, B. Vellas, J. Vestbo, G. Vezzani, P. Vichyanond, G. Viegi, C. Vogelmeier, T. Vontetsianos, M. Wagenmann, B. Wallaert, S. Walker, D.Y. Wang, U. Wahn, M. Wickman, D.M. Williams, S. Williams, J. Wright, B.P. Yawn, P.K. Yiallouros, O.M. Yusuf, A. Zaidi, H.J. Zar, M.E. Zernotti, L. Zhang, N. Zhong, M. Zidarn, J. Mercier
Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases (CRD) as a model. The CRD action plan includes (i) AIRWAYS integrated care pathways (ICPs), (ii) the joint initiative between the Reference site MACVIA-LR (Reference Site, Contre les Maladies Chroniques pour un Vieillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (iii) commitments for Action to the EIP on AHA and the AIRWAYS ICPs network. It is deployed in collaboration with the WHO Global Alliance against Chronic Respiratory Diseases (GARD). The EIP on AHA has proposed a 5-step framework for developing an individual scaling up strategy: (i) what to scale up: (i-a) databases of good practices, (i-b) assessment of viability of the scaling up of good practices, (i-c) classification of good practices for local replication and (ii) how to scale up: (ii-a) facilitating partnerships for scaling up, (ii-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the CRD action plan of the EIP on AHA.
http://ift.tt/2kuOMlx
Elevated basal antibody-dependent cell-mediated cytotoxicity (ADCC) and high epidermal growth factor receptor (EGFR) expression predict favourable outcome in patients with locally advanced head and neck cancer treated with cetuximab and radiotherapy
Abstract
Background
Antibody-dependent cell-mediated cytotoxicity (ADCC) may contribute to the antitumor activity of cetuximab. However, the extent of this contribution is unclear. In this study, we investigated the impact of baseline ADCC on the outcome of patients with locally advanced squamous cell carcinoma treated with cetuximab and radiotherapy.
Methods
We determined baseline ADCC in 28 patients treated with cetuximab and radiotherapy and in 15 patients treated with chemoradiation. We linked the values observed with complete response and with overall survival. We also considered the role of epidermal growth factor receptor (EGFR) expression and studied the combined effect of EGFR and ADCC.
Results
We observed a wide range of baseline values of ADCC. Complete response did not correlate with either ADCC or EGFR expression. However, when ADCC and EGFR were considered together using a mixed score, they significantly correlated with achieving a complete response (p = 0.04). High baseline ADCC significantly correlated with outcome compared to low (p = 0.03), but not in patients treated without cetuximab. Patients showing high baseline levels of both ADCC and EGFR3+ achieved the best outcome compared to the others (p = 0.02).
Conclusions
In this study, patients treated with cetuximab and radiotherapy, showing high baseline of both ADCC and EGFR3+, have significant higher probability of achieving a complete response and a long overall survival compared to the others.
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Anthocyanin suppresses CoCrMo particle-induced osteolysis by inhibiting IKKα/β mediated NF-κB signaling in a mouse calvarial model
Source:Molecular Immunology, Volume 85
Author(s): Yamin Li, Juehong Li, Bin Li, Hui Qin, Xiaochun Peng, Yaochao Zhao, Yunsu Chen
Wear particle-induced osteolysis and bone resorption have been identified as critical factors of implant failure and total joint revision, in which nuclear factor kappa B (NF-κB) signaling and chronic inflammation have been shown to play key roles. Although anthocyanin is known to have anti-inflammatory function via blocking NF-κB pathway, it is still unclear whether anthocyanin has a protective effect on particle-induced osteolysis. In the present study, we aimed to investigate the detailed effects and the underlying mechanism of anthocyanin on CoCrMo particle-induced osteolysis in a mouse calvavial model. One hundred and twelve male BALB/c mice were divided randomly into four groups: sham group (sham operation and injection with PBS), vehicle group (CoCrMo particle treatment and injection with PBS), low-dose anthocyanin group (CoCrMo particle treatment and injecting anthocyanin with 0.1mg/g/day), and high–dose anthocyanin group (CoCrMo particle treatment and injecting anthocyanin with 0.4mg/g/day). Mice were sacrificed after two weeks, harvesting the calvariae tissue for in depth analysis by micro-CT, histomorphometry, immunohistochemical and molecular biology analysis. As expected, anthocyanin markedly inhibited CoCrMo particle–induced inflammatory infiltration and decreased bone loss in vivo. Anthocyanin also reversed the increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL)/osteoproteger (OPG) and suppressed osteoclast formation in CoCrMo particle–stimulated calvaria. Additionally, anthocyanin significantly reduced the expression and secretion of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in the calvaria of CoCrMo-stimulated mice. Furthermore, we confirmed that anthocyanin attenuated osteolysis by blocking NF-κB pathway via inhibiting inhibitor of nuclear factor kappa-B kinase α/β (IKKα/β) phosphorylation. In conclusion, our study demonstrated that anthocyanin can protect against CoCrMo particle–induced inflammatory osteolysis via inhibiting the IKKα/β-NF-κB pathway, and have a potential therapeutic effect on the treatment of wear particle–induced osteolysis.
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Identification of triosephosphate isomerase as a novel allergen in Octopus fangsiao
Source:Molecular Immunology, Volume 85
Author(s): Yang Yang, Zhong-Wei Chen, Barry K. Hurlburt, Gui-Ling Li, Yong-Xia Zhang, Dan-Xia Fei, Hai-Wang Shen, Min-Jie Cao, Guang-Ming Liu
Octopus is an important mollusk in human dietary for its nutritional value, however it also causes allergic reactions in humans. Major allergens from octopus have been identified, while the knowledge of novel allergens remains poor. In the present study, a novel allergen with molecular weight of 28kDa protein was purified from octopus (Octopus fangsiao) and identified as triosephosphate isomerase (TIM) by mass spectrometry. TIM aggregated beyond 45°C, and its IgE-binding activity was affected under extreme pH conditions due to the altered secondary structure. In simulated gastric fluid digestion, TIM can be degraded into small fragments, while retaining over 80% of the IgE-binding activity. The full-length cDNA of O. fangsiao TIM (1140bp) was cloned, which encodes 247 amino acid residues, and the entire recombinant TIM was successfully expressed in Escherichia coli BL21, which showed similar immunoreactivity to the native TIM. Different intensity of cross-reactivity among TIM from related species revealed the complexity of its epitopes. Eight linear epitopes of TIM were predicted following bioinformatic analysis. Furthermore, a conformational epitope (A71G74S69D75T73F72V67) was confirmed by the phage display technology. The results revealed the physicochemical and immunological characteristics of TIM, which is significant in the development of hyposensitivity food and allergy diagnosis.
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Temporal regulation of Wnt/β-catenin signaling is important for invariant NKT cell development and terminal maturation
Source:Molecular Immunology, Volume 85
Author(s): Kalyani Pyaram, Jyoti Misra Sen, Cheong-Hee Chang
The Wnt/β-catenin signaling pathway plays important roles during various cellular functions including survival and proliferation of immune cells. The critical role of this pathway in conventional T cell development is established but little is known about its contributions to innate T cell development. In this study, we found that β-catenin level, an indication of the strength of Wnt/β-catenin signaling, is regulated during invariant NKT (iNKT) cell development. β-catenin levels were greatly increased during iNKT cell selection from double positive thymocytes to Stage 0 of iNKT cell development and during subsequent development to Stage 1. Thereafter, β-catenin levels decrease from Stage 2, which is essential for the terminal maturation of iNKT cells. Failure to dampen Wnt/β-catenin signaling as in mice expressing a stabilized active form of β-catenin (CATtg) resulted in increased Stage 2 and decreased Stage 3 iNKT cells. Inefficient transition from Stage 2 to 3 in CATtg iNKT cells seems to be contributed by poor expression of IL-15R (CD122) and transcription factor T-bet, both of which are necessary for terminal maturation of iNKT cells in the thymus. Consequently, IFN-γ+ iNKT cells were greatly reduced in CATtg mice. Together, our findings reveal that proper regulation of β-catenin and in turn Wnt signaling plays an important role in the terminal maturation and function of iNKT cells.
http://ift.tt/2lHJhVv
CD47 limits antibody dependent phagocytosis against non-malignant B cells
Source:Molecular Immunology, Volume 85
Author(s): Sandra Gallagher, Sean Turman, Kristen Lekstrom, Susan Wilson, Ronald Herbst, Yue Wang
Recent studies have demonstrated the importance of CD47 in protecting malignant B cells from antibody dependent cellular phagocytosis (ADCP). Combined treatment of anti-CD47 and −CD20 antibodies synergistically augment elimination of tumor B cells in xenograft mouse models. This has led to the development of novel reagents that can potentially enhance killing of malignant B cells in patients. B cell depleting therapy is also a promising treatment for autoimmune patients. In the current study, we aimed to investigate whether or not CD47 protects non-malignant B cells from ADCP. We show that CD47 is expressed on all B cells in mice, with the highest level on plasma cells in bone marrow and spleen. Although its expression is dispensable for B cell development in mice, CD47 on B cells limits antibody mediated phagocytosis. B cell depletion following in vivo anti-CD19 treatment is more efficient in CD47-/- mice than in wild type mice. In vitro, both naïve and activated B cells from CD47-/- mice are more sensitive to ADCP than wild type B cells. Lastly, we show in an ADCP assay that blocking CD47 can enhance anti-CD19 antibody mediated phagocytosis of wild type B cells. These results suggest that in addition to its already demonstrated benefit in cancer, targeting CD47 may be used as an adjunct in combination with B cell depletion antibodies for treatment of autoimmune diseases.
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Lactobacillus buchneri S-layer as carrier for an Ara h 2-derived peptide for peanut allergen-specific immunotherapy
Source:Molecular Immunology, Volume 85
Author(s): Julia Anzengruber, Merima Bublin, Eva Bönisch, Bettina Janesch, Angelika Tscheppe, Matthias L. Braun, Eva-Maria Varga, Christine Hafner, Heimo Breiteneder, Christina Schäffer
Peanut allergy is an IgE-mediated severe hypersensitivity disorder. The lack of a treatment of this potentially fatal allergy has led to intensive research on vaccine development. Here, we describe the design and initial characterization of a carrier-bound peptide derived from the most potent peanut allergen, Ara h 2, as a candidate vaccine. Based on the adjuvant capability of bacterial surface (S-) layers, a fusion protein of the S-layer protein SlpB from Lactobacillus buchneri CD034 and the Ara h 2-derived peptide AH3a42 was produced. This peptide comprised immunodominant B-cell epitopes as well as one T cell epitope. The fusion protein SlpB-AH3a42 was expressed in E. coli, purified, and tested for its IgE binding capacity as well as for its ability to activate sensitized rat basophil leukemia (RBL) cells. The capacity of Ara h 2-specific IgG rabbit-antibodies raised against SlpB-AH3a42 or Ara h 2 to inhibit IgE-binding was determined by ELISA inhibition assays using sera of peanut allergic patients sensitized to Ara h 2. IgE specific to the SlpB-AH3a42 fusion protein was detected in 69% (25 of 36) of the sera. Despite the recognition by IgE, the SlpB-AH3a42 fusion protein was unable to induce β-hexosaminidase release from sensitized RBL cells at concentrations up to 100ng per ml. The inhibition of IgE-binding to the natural allergen observed after pre-incubation of the 20 sera with rabbit anti-SlpB-AH3a42 IgG was more than 30% for four sera, more than 20% for eight sera, and below 10% for eight sera. In comparison, anti-Ara h 2 rabbit IgG antibodies inhibited binding to Ara h 2 by 48% ±13.5%. Our data provide evidence for the feasibility of this novel approach towards the development of a peanut allergen peptide-based carrier-bound vaccine. Our experiments further indicate that more than one allergen-peptide will be needed to induce a broader protection of patients allergic to Ara h 2.
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Prevalence of minimal hearing loss in South Korea
by Ji Eun Choi, Jungmin Ahn, Hyun Woo Park, Sun-Young Baek, Seonwoo Kim, Il Joon Moon
This study evaluated the prevalence of minimal hearing loss (MHL) in South Korea based on the 2010 to 2012 Korea National Health and Nutrition Examination Survey. A total of 16,630 representative individuals (older than 12 years) who completed ear examinations and structured questionnaires were analyzed. Only participants who had normal tympanic membranes were included. MHL was categorized into the following three groups: 1) unilateral sensorineural hearing loss (USHL, pure-tone average (PTA) ≥ 15 dB in the affected ear), 2) bilateral sensorineural hearing loss (BSHL, 15 dB ≤ PTA 25 dB in either ear). To evaluate clinical symptoms, subjective hearing status, tinnitus, and quality of life of each MHL group were compared to those of normal-hearing listeners. The use of hearing aids (HAs) was also investigated in the MHL population. The prevalence of normal hearing and MHL were 58.4% and 37.4%, respectively. In univariate analyses, the prevalence of MHL increased with age. It was significantly increased in males. Regarding clinical symptoms, 13.0% and 92.1% of participants with MHL reported difficulties with hearing and annoying tinnitus, respectively. In multivariate analyses, these proportions were significantly higher in the MHL groups than in normal-hearing listeners. Participants with MHL also showed significantly lower Euro Qol-5D index scores than did normal-hearing listeners. Regarding hearing rehabilitation, among minimally hearing impaired participants with subjective hearing loss, only 0.47% of individuals used HAs. Our results reveal that MHL is common in South Korea. It is associated with significant subjective hearing loss, tinnitus, and poor quality of life. Therefore, clinicians need to pay attention to this special group and provide proper counselling and rehabilitative management.http://ift.tt/2lMWdFq
Age-related reduction of dermal fibroblast size up-regulates multiple matrix metalloproteinases as observed in aged human skin in vivo
Summary
Background
Fragmentation of collagen fibrils, the major structure protein in skin, is a hallmark of dermal aging. Matrix metalloproteinases (MMPs) are largely responsible for fragmentation of collagen fibrils. However, the alteration of all known mammalian MMPs and the mechanism underlying altered expression of MMPs in chronologically aged human skin are less understood.
Objectives
To quantify gene expression of all 23 known mammalian MMPs in sun-protected young and aged human skin in vivo, and investigate the potential mechanism underlying age-related alteration of multiple MMPs.
Methods
MMPs mRNA expression levels and MMPs activity in sun-protected young and aged human skin in vivo were determined by real-time RT-PCR and in situ zymography, respectively. The relative contributions to elevated MMPs in epidermis and dermis were quantified by laser capture microdissection (LCM) coupled real-time RT-PCR. Dermal fibroblast morphology and collagen fibrils fragmentation in human skin in vivo were assessed by second harmonic generation microscopy and atomic force microscopy, respectively. In vitro cell morphology was assessed by CellTracker® fluorescent dye and Phalloidin staining. Protein levels were determined by ProteinSimple capillary electrophoresis immunoassay.
Results
Among all 23 known mammalian MMPs, multiple MMPs are elevated in aged human skin dermis. Consistent with this finding, increased MMPs activity and collagen fibrils fragmentation were observed in aged skin dermis. As dermal fibroblasts are the major MMPs producing cells in the dermis, reduction of dermal fibroblast size, which is observed in aged human skin, contributes to elevation of age-related multiple MMPs. Reduction of fibroblast size up-regulates c-Jun/c-Fos and activates AP-1, the major regulator of multiple MMPs.
Conclusions
Combined actions of the wide variety of MMPs that are constitutively elevated in aged dermis may be involved in progressive degradation of dermal collagen fibrils. Age-related elevations of multiple MMPs are likely resulted from the reduction of fibroblast size via activation of AP-1.
This article is protected by copyright. All rights reserved.
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Detection of human parvovirus B19 DNA in 22% of 1,815 cutaneous biopsies of a wide variety of dermatologic conditions suggests viral persistence after primary infection and casts doubts on its pathogenic significance
Summary
Background
Human parvovirus B19 (B19V) has been associated with a number of dermatologic and systemic conditions, including myocarditis and autoimmune syndromes.
Objectives
To determine the frequency of B19V deoxyribonucleic acid (DNA) detection in a large dermatopathology practice, and to characterize the histopathologic patterns involved.
Methods
We selected for polymerase chain reaction (PCR) detection of B19V a total of 1,815 skin biopsies pertaining to entities allegedly related to Parvovirus B19, as well as cases suspected clinically of representing paraviral exanthemas. Immunohistochemical detection of B19V viral protein 2 (VP2) was performed in 92 PCR-positive cases.
Results
B19V DNA was found by PCR in 402 out of 1,825 biopsy specimens (22%). VP2 protein was identified by immunohistochemistry only in three instances of papular purpuric "gloves and socks" syndrome.
Conclusions
Since the virus has the capacity to persist in different tissues (including the skin) for long periods, it could represent merely an innocent bystander, so no pathogenetic significance can be inferred from the PCR positivity for B19V in the vast majority of dermatologic conditions studied.
This article is protected by copyright. All rights reserved.
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Safe obstetric anaesthesia in low- and middle-income countries
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Application of selected scaffolds for bone tissue engineering: a systematic review
Abstract
Purpose
The current systematic review investigated the results of application of some of the most commonly used scaffolds in conjugation with stem cells and growth factors in animal and clinical studies.
Methods
A comprehensive electronic search was conducted according to the PRISMA guidelines in NCBI PMC and PubMed from January 1970 to December 2015 limited to English language publications with available full texts. In vivo studies in relation to "bone healing," "bone regeneration," and at least one of the following items were investigated: allograft, β-tricalcium phosphate, deproteinized bovine bone mineral, hydroxyapetite/tricalcium phosphate, nanohydroxyapatite, and composite scaffolds.
Results
A total of 1252 articles were reviewed, and 46 articles completely fulfilled the inclusion criteria of this study. The highest bone regeneration has been achieved when combination of all three elements, given scaffolds, mesenchymal stem cells, and growth factors, were used. Among studies being reported in this review, bone marrow mesenchymal stem cells are the most studied mesenchymal stem cells, β-tricalcium phosphate is the most frequently used scaffold, and platelet-rich plasma is the most commonly used growth factor.
Conclusion
The current review aimed to inform reconstructive surgeons of how combinations of various mesenchymal stem cells, scaffolds, and growth factors enhance bone regeneration. The highest bone regeneration has been achieved when combination of all three elements, given scaffolds, mesenchymal stem cells, and growth factors, were used.
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Teratoma of the Neonatal Head and Neck: A 41-Year Experience
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Jacob R. Brodsky, Alexandria L. Irace, Amanda Didas, Karen Watters, Judy A. Estroff, Carol E. Barnewolt, Antonio Perez-Atayde, Reza Rahbar
ObjectiveTo review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population.DesignRetrospective case series (November 1970 through September 2011).SettingTertiary care children's hospital.Patients14 patients (12 boys and 2 girls).InterventionDetailed review of presentation, diagnostic approaches, surgical management, and outcomes.Main Outcome MeasuresAnatomic sites, use of pre and post-natal imaging, use of EXIT (ex utero intrapartum treatment) procedure, presenting symptoms, surgical approaches, additional therapeutic modalities, and outcomes are reviewed.ResultsSeven patients were diagnosed prenatally, while the remaining 7 patients were diagnosed at birth or shortly thereafter. The tumor emanated from the neck in 9 patients, the nasopharynx/oropharynx in 3 patients, the external nose in 1 patient and the face in 1 patient. Nine patients had associated upper airway obstruction. Four underwent an EXIT procedure, with 3 requiring intubation and 1 requiring tracheostomy. All patients underwent surgical resection. One patient demonstrated recurrence at follow-up.ConclusionsTeratoma of the head and neck, though rare, is an important part of the differential diagnosis of neck masses in children, particularly in the perinatal period. The ability to make this diagnosis prenatally with high-resolution fetal ultrasound and MRI (magnetic resonance imaging) permits planning for airway and tumor management prior to delivery. An EXIT procedure should be considered when airway compromise by tumor compression is suspected. Early surgical excision is the treatment of choice and recurrence is rare when a complete resection is achieved.
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Pediatric post-tonsillectomy hemorrhage in the setting of post-transplantation immunosuppression
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Lourdes Quintanilla-Dieck, Sivakumar Chinnadurai, Christopher Wootten, Steven L. Goudy, Frank W. Virgin
INTRODUCTIONLong-term immunosuppressants form an integral part of therapy for post-transplantation patients. Immunosuppressants may also have an anticoagulant effect, and little is known about their effects on bleeding risk after adenotonsillectomy. Our objective was to investigate whether there is an increased observed rate of post-tonsillectomy hemorrhage in a population of pediatric patients on long-term immunosuppressants after solid organ transplantation, compared to healthy controls.METHODSThis was a retrospective chart review of pediatric patients with a history of renal or heart transplant undergoing adenotonsillectomy at our institution between 2000 and 2014. All patients underwent tonsillectomy with monopolar electrocautery. Retrieved data included perioperative medications, occurrence of post-operative bleeding and associated treatment. For comparison, we obtained a population of age-matched controls with no history of immunosuppression who underwent the same procedure.RESULTSA total of 34 patients meeting criteria were identified, of which 3 (8.82%) suffered a postoperative bleed. Forty-seven controls were obtained, with a total of 2 (4.26%) postoperative hemorrhages (p=0.65). Two of the post-transplantation patients who bled postoperatively required cauterization in the operating room. None of the controls required surgical treatment. The incidences of postoperative bleeding requiring surgical treatment were 5.88% and 0%, respectively (p=0.17).CONCLUSIONWe failed to demonstrate an increased risk of bleeding after undergoing adenotonsillectomy in our cohort of post-transplantation pediatric patients on chronic immunosuppression. Future research, likely requiring a multi-institutional effort, could stratify by immunosuppressive agent to elucidate bleeding risk with specific medications.
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A novel missense mutation in the SLC26A4 gene causes nonsyndromic hearing loss and enlarged vestibular aqueduct
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Xiaoguang He, Qi Peng, Siping Li, Pengyuan Zhu, Chunqiu Wu, Chunbao Rao, Jiang Chang, Mingyu Xie, Baimao Zhong, Xiaomei Lu
ObjectivesWe aimed to investigate the genetic causes of hearing loss in a Chinese proband with nonsyndromic hearing loss and enlarged vestibular aqueduct syndrome.MethodsWe conducted clinical and genetic evaluations in a deaf proband and his normal-hearing parents. Multiplex PCR technology combined with Ion Torrent™ next-generation sequencing technology was used to detect the pathogenic mutations. As a control, a group of 1500 previously studied healthy newborns from the same ethnic background were subjected to deafness gene screening using the same method as in our previous study.ResultsThe proband harbored two mutations in the SLC26A4 gene in the form of compound heterozygosity. He was found to be heterozygous for a novel mutation named c.1742 G>T (p.Arg581Met) in exon 13 and for the known mutation c.589 G>A (p.Gly197Arg). These variants were carried in the heterozygous state by the parents and therefore co-segregated with the genetic disease. The c.1742 G>T (p.Arg581Met) mutation was absent in 1500 healthy newborns. Protein alignment indicated high evolutionary conservation of the p.R581 residue, and this mutation was predicted by PolyPhen-2 and other online tools to be damaging.ConclusionThis study demonstrates that the novel mutation c.1742 G>T (p.Arg581Met) in compound heterozygosity with c.589 G>A in the SLC26A4 gene is the main cause of deafness in a family clinically diagnosed with enlarged vestibular aqueduct (EVA). Our study will provide a basic foundation for further investigations to elucidate the SLC26A4-related mechanisms of hearing loss.
http://ift.tt/2kPL5dA
Cystic cervical teratoma: A diagnostic and management challenge
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Nikolaus E. Wolter, Bradford Siegele, Michael J. Cunningham
Cervical teratomas are relatively rare congenital tumors pathologically defined by their three germ cell layer composition. Classically they manifest as solid or mixed solid-cystic lesions. Purely cystic teratomas pose a diagnostic challenge due to their clinical and radiologic similarity to lymphatic vascular malformations. Sclerotherapy, rather than operative excision, may be offered as therapy. We present an unusual cystic neck mass to highlight this dilemma.
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Refractory sleep-disordered breathing due to unilateral lingual tonsillar hypertrophy in a child with Proteus Syndrome
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Courtni R. Salinas, Brian A. Nuyen, Aria Jafari, Javan Nation
Proteus Syndrome (PS) is a rare congenital overgrowth disease affecting bones, skin, adipose and the central nervous system. The result is asymmetric, disfiguring hypertrophy which can manifest as craniofacial dysmorphia and aerodigestive tract abnormalities. We report the case of obstructive lingual tonsillar hypertrophy resulting in residual sleep disordered breathing after adenotonsillectomy in a child with PS, a previously unrecognized manifestation of the disease. Endoscopic treatment with coblation effectively and safely treated the obstructive symptoms.
http://ift.tt/2kPSZUa
Dynamic hyperinflation in patients with asthma and exercise-induced bronchoconstriction
Source:Annals of Allergy, Asthma & Immunology
Author(s): Olga Mediano, Raquel Casitas, Carlos Villasante, Elisabet Martínez-Cerón, Raúl Galera, Ester Zamarrón, Francisco García-Río
BackgroundLittle is known about the behavior of operative lung volumes during exercise in patients with asthma and exercise-induced bronchoconstriction (EIB).ObjectivesTo compare the presence of dynamic hyperinflation (DH) in patients with mild asthma with and without EIB and in healthy individuals and to relate the changes in end-expiratory lung volume (EELV) with postexercise airflow reduction.MethodsA total of 122 consecutive stable patients (>12 years of age) with mild asthma and 38 controls were studied. Baseline lung volumes were measured, and all patients performed an exercise bronchial challenge. At each minute of exercise, EELV and end-inspiratory lung volume (EILV) were estimated from inspiratory capacity measurements to align the tidal breathing flow-volume loops to within the maximal expiratory curve.ResultsDH was more frequent in patients with asthma and EIB (76%) than in patients with asthma but without EIB (11%) or controls (18%). The EELV increased in patients with asthma and EIB and decreased in patients with asthma without EIB and controls during exercise. In the patients with asthma, the decrease in forced expiratory volume in 1 second after the exercise challenge correlated with age (r = −0.179, P = .05), baseline forced vital capacity (r = 0.255, P = .005), EELV increase (r = 0.447, P < .001), and EILV increase (r = 0.246, P = .007). Age, baseline forced vital capacity, and magnitude of DH were retained as independent predictors of EIB intensity.ConclusionIn patients with asthma and EIB, the development of DH is very frequent and related to the intensity of postexercise bronchoconstriction. This finding could implicate DH in the development of EIB.
http://ift.tt/2lHD2RN
Influence of basis images and skull position on evaluation of cortical bone thickness in cone-beam CT
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Monikelly do Carmo Chagas Nascimento, Solange Maria de Almeida Boscolo, Francisco Haiter- Neto, Emanuela Carla dos Santos, Ivo Lambrichts, Ruben Pauwels, Reinhilde Jacobs
ObjectivesTo assess the influence of the number of basis images and the orientation of the skull on the evaluation of cortical alveolar bone in cone-beam CT (CBCT).Study DesignEleven skulls with a total of 59 anterior teeth were selected. CBCT images were acquired using four protocols, by varying the rotation of the tube-detector arm and the orientation of the skull (protocol 1: 3600/00; protocol 2: 1800/00; protocol 3: 1800/900; protocol 4: 1800/1800). Observers evaluated the cortical bone as absent, thin, or thick. Direct observation of the skulls was used as the gold standard. Intra- and inter-observer agreement as well as agreement of scoring between the three bone thickness classifications were calculated using the kappa statistic. The Wilcoxon signed-rank test was used to compare the four protocols.ResultsFor lingual cortical bone, protocol 1 showed no statistical difference from the gold standard. Higher reliability was found in protocol 3 for absent (k=0.80) and thin (k=0.47) cortices, while for thick cortical bone, protocol 2 was more consistent (k=0.60). In buccal cortical bone, protocol 1 obtained the highest agreement for absent cortices (k=0.61), while protocol 4 was better for thin (k=0.38), and protocol 2 for thick cortical plates (k=0.40).ConclusionNo consistent effect of the number of basis images or head orientation for visual detection of alveolar bone was detected, except for lingual cortical bone, for which full rotation scanning showed improved visualization.
http://ift.tt/2ku0Nrc
Case of coeliac disease presenting in the psychiatry ward
Albino J Oliveira-Maia<br />Dec 21, 2016; 2016:bcr2016216825-bcr2016216825<br />case-report
http://ift.tt/2kngjdg
Muscle mania: the quest for the perfect body
Maira Hameed<br />Dec 1, 2016; 2016:bcr2016217208-bcr2016217208<br />case-report
http://ift.tt/2kH0Qkn
Rare cause of acute hepatitis: a common energy drink
Jennifer Nicole Harb<br />Nov 1, 2016; 2016:bcr2016216612-bcr2016216612<br />case-report
http://ift.tt/2knsRS2
When plenty is too much: water intoxication in a patient with a simple urinary tract infection
Laura Christine Lee<br />Nov 1, 2016; 2016:bcr2016216882-bcr2016216882<br />case-report
http://ift.tt/2kGOxog
Resolution of left ventricular postinfarction thrombi in patients undergoing percutaneous coronary intervention using rivaroxaban in addition to dual antiplatelet therapy
Constantinos Andreas Makrides<br />Oct 26, 2016; 2016:bcr2016217843-bcr2016217843<br />case-report
http://ift.tt/2kngoxO
Severe hypercalcaemia in a child secondary to use of alternative therapies
Catriona Boyd<br />Oct 6, 2016; 2016:bcr2016215849-bcr2016215849<br />case-report
http://ift.tt/2knzJP9
Acute severe hyponatraemia secondary to polydipsia and associated herbal remedy use
Oliver T R Toovey<br />Sep 28, 2016; 2016:bcr2016216348-bcr2016216348<br />case-report
http://ift.tt/2kH3GG6
Post-streptococcal reactive arthritis: where are we now
Himanshu Pathak<br />Aug 12, 2016; 2016:bcr2016215552-bcr2016215552<br />case-report
http://ift.tt/2knnX7E
Trousseau's sign at the emergency department
Bas C T van Bussel<br />Aug 1, 2016; 2016:bcr2016216270-bcr2016216270<br />case-report
http://ift.tt/2kHakMD
Unusual case of appendicitis
Luke Nelson Allen<br />Jun 30, 2016; 2016:bcr2016214944-bcr2016214944<br />case-report
http://ift.tt/2kngohi
Lick of death: Capnocytophaga canimorsus is an important cause of sepsis in the elderly
James P Wilson<br />Jun 30, 2016; 2016:bcr2016215450-bcr2016215450<br />case-report
http://ift.tt/2kGLMn2
Carotid sheath 'intubation during an emergency surgical cricothyroidotomy
Tricia Cheah<br />May 25, 2016; 2016:bcr2016214898-bcr2016214898<br />case-report
http://ift.tt/2lHkGzZ
Penile fracture
Anurag Chahal<br />May 13, 2016; 2016:bcr2016215385-bcr2016215385<br />case-report
http://ift.tt/2lMRS5p
Paintball-related traumatic liver injury
Joshua Luck<br />Apr 27, 2016; 2016:bcr2015213780-bcr2015213780<br />case-report
http://ift.tt/2lHv1w3
Open dislocation of the interphalangeal joint associated with running barefoot
Hank Joseph Schneider<br />Apr 21, 2016; 2016:bcr2016214972-bcr2016214972<br />case-report
http://ift.tt/2lMTbRD
Tuberculous epididymo-orchitis masquerading as acute scrotum
Ned Kinnear<br />Feb 4, 2016; 2016:bcr2015214060-bcr2015214060<br />case-report
http://ift.tt/2lMFS3O
Obstruction and perforation of the small bowel caused by inadvertent ingestion of a blister pill pack in an elderly patient
Ghassan Al-Ramahi<br />Oct 16, 2015; 2015:bcr2015212822-bcr2015212822<br />case-report
http://ift.tt/2lHq8TG
Pulmonary infiltrate and painful nodular leg lesions in a patient with membranous glomerulonephritis
Florian Grahammer<br />Jul 28, 2015; 2015:bcr2015210032-bcr2015210032<br />case-report
http://ift.tt/2lMMCP2
Rhabdomyolysis and acute kidney injury in dengue fever
Arvind Mishra<br />Jul 14, 2015; 2015:bcr2014209074-bcr2014209074<br />case-report
http://ift.tt/2lHqZ6R
Laparoscopic management of midgut malrotation and tuberculous peritonitis in an adolescent boy
Ramnik V Patel<br />Jun 26, 2014; 2014:bcr2013200714-bcr2013200714<br />case-report
http://ift.tt/2lMOxTX
Bilateral anterior lenticonus in a case of Alport syndrome: a clinical and histopathological correlation after successful clear lens extraction
Shilpa Sonarkhan<br />Jun 26, 2014; 2014:bcr2013202036-bcr2013202036<br />case-report
http://ift.tt/2lHq7PB
Pneumocystis jiroveci pneumonitis complicating ruxolitinib therapy
Samantha C Lee<br />Jun 2, 2014; 2014:bcr2014204950-bcr2014204950<br />case-report
http://ift.tt/2lMFRwM
Invisibility of moving objects: a core symptom of motion blindness
Nobuko Otsuka-Hirota<br />Apr 12, 2014; 2014:bcr2013201233-bcr2013201233<br />case-report
http://ift.tt/2lHoSQh
Management of internal resorption of central incisor using hybrid technique
Prabakaran Gayathri<br />Jan 28, 2014; 2014:bcr2013201570-bcr2013201570<br />case-report
http://ift.tt/2lMCFBk
Percutaneous treatment of symptomatic aneurysmal bone cyst of L5 by percutaneous injection of osteoconductive material (Cerament)
Gianluigi Guarnieri<br />Nov 1, 2013; 2013:bcr2013010912-bcr2013010912<br />case-report
http://ift.tt/2lHqp93
Recurrent atraumatic metatarsal, rib and sacral insufficiency fractures in a woman with the antiphospholipid syndrome
Joseph Villiers<br />Oct 30, 2013; 2013:bcr2013201311-bcr2013201311<br />case-report
http://ift.tt/2lMXkFj
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