Head and Neck Medicine by Alexandros G.Sfakianakis: 03/30/17

Πέμπτη 30 Μαρτίου 2017

Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with cutaneous angiosarcoma: A retrospective study of 18 cases

Abstract

Cutaneous angiosarcoma (CAS) is a rare soft tissue sarcoma with rapid growth and poor prognosis. We retrospectively analyzed the data of 18 patients with CAS who underwent ¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) at the initial visit to the Department of Dermatology, Okayama University Hospital from September 2006 to March 2016. In the univariate survival analysis, patients with high standardized uptake values (SUV_max) of the primary tumor showed significantly poorer prognosis than those with low SUV_max. Early assessment of prognosis using PET/CT may predict patient survival and is useful in the selection of therapeutic strategies.

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Serum levels of genomic DNA of α1(I) collagen are elevated in scleroderma patients

Abstract

Recent studies have indicated that various nucleic acids are present in human sera, and attracted attention for their potential as novel disease markers in many human diseases. In this study, we tried to evaluate the possibility that DNA and RNA of collagens exist in human sera, and determined whether their serum levels can be useful biomarkers in scleroderma patients. The RNA or DNA of collagens were purified from sera, and detected by polymerase chain reaction or quantitated by real-time polymerase chain reaction. Among approximately 18 360 bases of full-length α1(I) collagen DNA, various regions were detected by polymerase chain reaction in human sera. However, α2(I) collagen DNA, α1(I) collagen RNA or α2(I) collagen RNA were not detectable. α1(I) Collagen DNA in sera was quantitative using our method. The levels of serum α1(I) collagen DNA were significantly increased in scleroderma patients compared with healthy control subjects or systemic lupus erythematosus patients. According to the receiver–operator curve analysis, serum α1(I) collagen DNA levels were shown to be effective as a diagnostic marker of scleroderma. Furthermore, when we determined the association of serum α1(I) collagen DNA levels with clinical/laboratory features in scleroderma patients, those with elevated α1(I) collagen DNA levels showed significantly higher prevalence of pitting scars/ulcers. In summary, elevation of serum α1(I) collagen DNA levels in scleroderma patients may be useful as the diagnostic marker, reflecting the presence of vasculopathy.

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Angiomatoid fibrous histiocytoma of the scalp mimicking cutaneous angiosarcoma in incisional biopsy containing CD31-positive histiocytes: A potential histopathological pitfall

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Impact of anti-tumor necrosis factor-α agents on serum levels of KL-6 and surfactant protein-D in patients with psoriasis

Abstract

We longitudinally examined the influence of anti-tumor necrosis factor (TNF)-α treatment on serum levels of KL-6 and surfactant protein-D (SP-D). The study group comprised 22 patients with psoriasis treated with infliximab or adalimumab and with no history of interstitial lung disease (ILD). KL-6 and SP-D levels were measured in serum samples. Twelve of the 22 patients (55%) showed at least a 20% increase in KL-6 levels compared with baseline. Of these 12 patients, none exhibited any signs of ILD on chest computed tomography and nine who showed an increase in KL-6 levels (75%) showed at least a 20% increase in SP-D levels. Some patients showed simultaneous increases in KL-6 and SP-D levels after treatment with anti-TNF-α agents. Although these patients may have undetectable or subtle alveolar damage, careful observation is needed.

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Understanding patient and physician perceptions of male androgenetic alopecia treatments in Asia–Pacific and Latin America

Abstract

This survey aimed to explore patient and physician attitudes towards male androgenetic alopecia (AGA), satisfaction with currently available male AGA treatments and investigate the factors affecting treatment choice. The survey was carried out in five countries (Japan, South Korea, Taiwan, Mexico and Brazil) between November and December 2015 using a standard market research methodology. Questionnaires were completed by patients with male AGA or hair loss/thinning and practicing physicians who were responsible for prescribing AGA treatment. In total, 835 patients and 338 physicians completed the questionnaire. Overall, 37.6% of patients reported satisfaction with the treatments they had used. The highest patient satisfaction was reported for 5-alpha-reductase inhibitors (53.9% of patients satisfied). In all countries, physicians were more likely than patients to think that male AGA has a major impact on patient confidence (89.3% vs 70.4%, respectively). There was agreement by physicians and patients that male AGA patients who are involved in their treatment decisions have better outcomes. Patients who were satisfied with AGA treatments were more likely to have the level of involvement they desired in treatment decisions (69.1% of satisfied patients) than dissatisfied patients (56.4% of dissatisfied patients). This survey provides valuable insights into the attitudes of patients and physicians in Asia and Latin America about male AGA and its treatments. The survey identified areas of disconnect between physicians and patients regarding the impact of male AGA, treatment consultations and the importance of treatment attributes. It also highlights the need for physicians to spend sufficient time with patients discussing AGA treatment approaches.

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Motorbike-handlebar hernia - a rare traumatic abdominal wall hernia: a case report and review of the literature

Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia w...

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Salvage Islet Auto Transplantation After Relaparatomy.

Background: To assess feasibility, safety and metabolic outcome of islet auto transplantation (IAT) in patients undergoing completion pancreatectomy because of sepsis or bleeding following pancreatic surgery. Methods: From November 2008 to October 2016, 22 patients were candidates to salvage IAT during emergency relaparotomy because of postpancreatectomy sepsis (n=11) or bleeding (n=11). Feasibility, efficacy, and safety of salvage IAT were compared to those documented in a cohort of 36 patients who were candidate to simultaneous IAT during nonemergency preemptive completion pancreatectomy through the pancreaticoduodenectomy. Results: The percentage of candidates that received the infusion of islets was significantly lower in salvage IAT than simultaneous IAT (59.1% vs 88.9%; p=0.008), mainly due to a higher rate of inadequate islet preparations. Even if microbial contamination of islet preparation was significantly higher in candidates to salvage IAT than in those to simultaneous IAT (78.9% vs 20%, p

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Association of atopy phenotypes with new development of asthma and bronchial hyperresponsiveness in school-aged children

Publication date: Available online 30 March 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Eun Lee, Si Hyeon Lee, Young-Ho Kim, Hyun-Ju Cho, Jisun Yoon, Song-I. Yang, Young-Ho Jung, Hyung Young Kim, Ju-Hee Seo, Ji-Won Kwon, Hyo-Bin Kim, So Yeon Lee, Ho-Jang Kwon, Soo-Jong Hong
BackgroundAlthough previous studies have investigated the association between atopy phenotypes and allergic diseases, atopy characterizations in association with the development of allergic diseases remain poorly understood.ObjectiveTo identify atopy phenotypes in school-age children and to evaluate the association between atopy phenotypes and allergic diseases.MethodsWe enrolled 616 children with atopy defined as 1 or more positive allergen responses on skin prick tests and 665 children without atopy from the Children's Health and Environmental Research (CHEER) study. All children were followed up for 4 years at 2-year intervals. Atopy phenotypes were classified using latent class analysis.ResultsFour atopy phenotypes were characterized: later sensitization to indoor allergens (cluster 1); multiple early sensitization (cluster 2); early sensitization to outdoor allergens, especially Alternaria, and later sensitization to indoor allergens, including Aspergillus (cluster 3); and early sensitization to indoor allergens and later sensitization to outdoor allergens (cluster 4). New cases of asthma during follow-up were increased in clusters 2 and 3 (adjusted odds ratio [aOR], 2.76 and 4.25, respectively). The risk of new-onset bronchial hyperresponsiveness was highest in cluster 3 (aOR, 5.03). Clusters 2 and 4 had an increased risk of allergic rhinitis (aOR, 7.21 and 2.37, respectively).ConclusionIdentification of atopy phenotypes facilitates prediction of the development of asthma and bronchial hyperresponsiveness in school-age children. Our study suggests prevention of additional sensitization is required to modify the progression of allergic diseases.

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Hyper–immunoglobulin E-like syndrome in a patient with multiple genetic mutations

Publication date: Available online 30 March 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Ayobami T. Akenroye, Melissa Iammatteo, Gabriele S. de Vos

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Association between atopic manifestations and eosinophilic esophagitis

Publication date: Available online 30 March 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jesús González-Cervera, Ángel Arias, Olga Redondo-González, María M. Cano-Mollinedo, Ingrid Terreehorst, Alfredo J. Lucendo
BackgroundEosinophilic esophagitis (EoE) has repeatedly been associated with atopic manifestations, which are reported more frequently in these patients than in the general population.ObjectiveTo systematically assess the evidence and strength of the associations between EoE and atopy.MethodsWe performed a systematic search of the MEDLINE, EMBASE, and SCOPUS databases for case-control studies comparing the frequency of atopic diatheses among patients with EoE and control subjects representing the general population without EoE. Using random-effects meta-analyses, we calculated summary estimates, including 95% confidence intervals (CIs), for bronchial asthma, atopic rhinitis, and eczema. Publication bias risks were assessed by means of funnel plot analysis and specific statistical tests.ResultsOf the 2,954 references identified, data were collected from 21 studies, including a total of 53,542 patients with EoE and 54,759 controls. The criteria for defining a diagnosis of atopy in patients with EoE or controls was not structurally considered in most of the studies. Overall, allergic rhinitis was significantly more common among patients with EoE compared with control subjects (odds ratio [OR], 5.09; 95% CI, 2.91–8.90; I² = 86.7%) as were bronchial asthma (OR, 3.01; 95% CI, 1.96–4.62; I² = 84.5%) and eczema (OR, 2.85; 95% CI, 1.87–4.34; I² = 57.1%). Food allergies and other atopic conditions were also assessed. No significant publication bias was found for studies dealing with allergic rhinitis and eczema in EoE.ConclusionsDespite pointing to a significant association between atopy and EoE, most of the studies provided no normalized diagnostic criteria for atopy. Further research should provide clear and standardized definitions of such conditions.Trial http://ift.tt/2nC1Mc7 Trial Identifier: CRD42016036161.

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Control of Allergic Rhinitis and Asthma Test for Children (CARATKids)

Publication date: Available online 31 March 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Rita Amaral, Ana C. Carneiro, Gustavo Wandalsen, João A. Fonseca, Dirceu Sole
BackgroundThe Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) assesses asthma and allergic rhinitis control in children younger than 12 years.ObjectiveTo validate the Brazilian Portuguese version of the CARATKids and to define the cutoff values for identifying uncontrolled disease.MethodsChildren aged 6 to 12 years with asthma and allergic rhinitis were studied (n = 102). CARATKids, childhood Asthma Control Test (cACT), total nasal symptom score (TNSS), and visual analog scale (VAS) scores were obtained at baseline and after 4 to 6 weeks. Internal consistency, test-retest reliability, responsiveness, and validity of the Brazilian CARATKids were assessed according to the Consensus-based Standards for the Selection of Health Measurements Instruments checklist. The minimal clinically important difference (MCID) was evaluated using distribution and anchor methods. Spearman correlations were used to compare CARATKids scores with external measures of control. Receiver operating characteristic curve analysis was performed to establish cutoff values.ResultsFifty children completed both visits. The Cronbach α and intraclass correlation coefficient of CARATKids were 0.81 and 0.85, respectively. The Guyatt responsiveness index was −1.34, and within-patient change in clinically unstable patients (n = 31) was significant (P = .02). As for cross-sectional and longitudinal validity, correlation coefficients ranged from 0.58 to 0.77 (P < .001) and 0.30 to 0.57 (P < .05), respectively. The estimated MCID for CARATKids was 3. The optimal cutoffs (sensitivity and specificity) to exclude uncontrolled and controlled disease were 3 or less (97% and 67%) and 6 or greater (56% and 96%), respectively.ConclusionCARATKids is a reliable and valid tool to assess asthma and allergic rhinitis control in Brazilian children. A score of 6 or higher on CARATKids identifies uncontrolled disease, and a score of 3 or lower excludes poor disease control.

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Ethics in the twenty first century otolaryngology

Charles W. Cummings
Braz J Otorhinolaryngol.2017;83:119

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Human Papillomavirus and students in Brazil: an assessment of knowledge of a common infection – preliminary report

João Cesar Frizzo Burlamaqui, Ana Carolina Cassanti, Gabriela Bastos Borim, Edward Damrose, Luisa Lina Villa, Leonardo Silva
Braz J Otorhinolaryngol.2017;83:120-5

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Characteristics of 419 patients with acquired middle ear cholesteatoma

Letícia Petersen Schmidt Rosito, Maurício Noschang Lopes da Silva, Fábio André Selaimen, Yuri Petermann Jung, Marcos Guilherme Tibes Pauletti, Larissa Petermann Jung, Luiza Alexi Freitas, Sady Selaimen da Costa
Braz J Otorhinolaryngol.2017;83:126-31

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Feasibility of ossicular chain reconstruction with resin cement

Fernando de Andrade Quintanilha Ribeiro, Yumi Tamaoki, Gabriel Wynne Cabral
Braz J Otorhinolaryngol.2017;83:132-6

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Effect of conductive hearing loss on central auditory function

Arash Bayat, Mohammad Farhadi, Hesam Emamdjomeh, Nader Saki, Golshan Mirmomeni, Fakher Rahim
Braz J Otorhinolaryngol.2017;83:137-41

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Temporal processing and long‐latency auditory evoked potential in stutterers

Raquel Prestes, Adriana Neves de Andrade, Renata Beatriz Fernandes Santos, Andrea Tortosa Marangoni, Ana Maria Schiefer, Daniela Gil
Braz J Otorhinolaryngol.2017;83:142-6

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Assessment of hearing threshold in adults with hearing loss using an automated system of cortical auditory evoked potential detection

Alessandra Spada Durante, Margarita Bernal Wieselberg, Nayara Roque, Sheila Carvalho, Beatriz Pucci, Nicolly Gudayol, Kátia de Almeida
Braz J Otorhinolaryngol.2017;83:147-54

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Specific immediate early gene expression induced by high doses of salicylate in the cochlear nucleus and inferior colliculus of the rat

Paula Santos, Lilian Eslaine Costa Mendes da Silva, Ricardo Maurício Leão
Braz J Otorhinolaryngol.2017;83:155-61

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Intrasphenoid septations inserted into the internal carotid arteries: a frequent and risky relationship in transsphenoidal surgeries

Clauder Oliveira Ramalho, Horacio Armando Marenco, Francisco de Assis Vaz Guimarães Filho, Marcos Devanir Silva da Costa, Bruno Fernandes de Oliveira Santos, Rodrigo de Paula Santos, Samuel Tau Zymberg
Braz J Otorhinolaryngol.2017;83:162-7

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Effects of ozone therapy on facial nerve regeneration

Isa Ozbay, Ilker Ital, Cuneyt Kucur, Raziye Akcılar, Aysenur Deger, Savas Aktas, Fatih Oghan
Braz J Otorhinolaryngol.2017;83:168-75

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Evaluation of electrocardiographic parameters in patients with hearing loss genotyped for the connexin 26 gene (GJB2) mutations

Agnieszka Sanecka, Elzbieta Katarzyna Biernacka, Magdalena Sosna, Malgorzata Mueller‐Malesinska, Rafal Ploski, Henryk Skarzynski, Ryszard Piotrowicz
Braz J Otorhinolaryngol.2017;83:176-82

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Surgical treatment of choanal atresia with transnasal endoscopic approach with stentless single side‐hinged flap technique: 5 year retrospective analysis

Carmelo Saraniti, Manuela Santangelo, Pietro Salvago
Braz J Otorhinolaryngol.2017;83:183-9

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Effect of sublingual immunotherapy on platelet activity in children with allergic rhinitis

Yanqiu Chen, Lifeng Zhou, Yan Yang
Braz J Otorhinolaryngol.2017;83:190-4

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Speech perception in noise in the elderly: interactions between cognitive performance, depressive symptoms, and education

Laura Maria Araújo de Carvalho, Elisiane Crestani de Miranda Gonsalez, Maria Cecília Martineli Iorio
Braz J Otorhinolaryngol.2017;83:195-200

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Surveillance of bacteria Pseudomonas aeruginosa and MRSA associated with chronic suppurative otitis media

Sibanarayan Rath, Saumya Ranjan Das, Rabindra Nath Padhy
Braz J Otorhinolaryngol.2017;83:201-6

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Tracheostomy in childhood: review of the literature on complications and mortality over the last three decades

Ana Paula Ligoski Dal'Astra, Ariane Vieira Quirino, Juliana Alves de Sousa Caixêta, Melissa Ameloti Gomes Avelino
Braz J Otorhinolaryngol.2017;83:207-14

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Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases

Olavo de Godoy Mion, João Ferreira de Mello, Daniel Lorena Dutra, Nilvano Alves de Andrade, Washington Luiz de Cerqueira Almeida, Wilma Teresinha Anselmo‐Lima, Leonardo Lopes Balsalobre Filho, Jair de Carvalho e Castro, Roberto Eustáquio dos Santos Guimarães, Marcus Miranda Lessa, Sérgio Fabrício Maniglia, Roberto Campos Meireles, Márcio Nakanishi, Shirley Shizue Nagata Pignatari, Renato Roithmann, Fabrizio Ricci Romano, Rodrigo de Paula Santos, Marco César Jorge dos Santos, Edwin Tamashiro
Braz J Otorhinolaryngol.2017;83:215-27

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Primary laryngeal aspergillosis in the immunocompetent state: a clinical update

Mainak Dutta, Arijit Jotdar, Sohag Kundu, Bhaskar Ghosh, Subrata Mukhopadhyay
Braz J Otorhinolaryngol.2017;83:228-34

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Oculopharyngeal muscular dystrophy or oculopharyngeal distal myopathy: case report

Marilia Yuri Maeda, Tais Yuri Hashimoto, Isabella Christina Oliveira Neto, Luciano Rodrigues Neves
Braz J Otorhinolaryngol.2017;83:235-8

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Hearing loss in congenital Zika virus

Viroj Wiwanitkit
Braz J Otorhinolaryngol.2017;83:239

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Hypochlorous acid gel technology—Its impact on postprocedure treatment and scar prevention

Summary

Background

A pre-and postprocedure regime aimed at prevention of infection, reduction of inflammation and risk of scarring, is to enable optimal outcomes.

Objectives

The role of a hypochlorous acid containing spray and translucent scar gel formulation that combines modified silicon oil with hypochlorous acid, was explored for pre- and postprocedure treatment and scar management.

Methods

For this purpose a literature review was conducted to explore the value of the technology used in pre-and postprocedural regimes. A panel of dermatologists and plastic surgeons who practice in the United States discussed the summarized search results, taking into account their current clinical practice. A nominal group process for consensus was used, followed by online reviews of the manuscript.

Results

Based on panel discussions, consensus was reached regarding clinical recommendations given for postprocedure treatment and scar management. The hypochlorous acid products are produced with electrolysis and are classified among biocidal substances. The technology has demonstrated efficacy and safety for pre-and postprocedure use. The safety of hypochlorous solution use demonstrated to be comparable to that of standard local antiseptics. Small studies demonstrated better results with the scar gel compared to silicone gel regarding the appearance of hypertrophic and keloid scars, relief of associated pruritus and pain.

Conclusions

A postprocedure regime using this technology, aimed at preventing infection, reducing inflammation, and promoting healing is proposed to have benefits over current regimes as it appears to be effective, safe, and well tolerated.

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Wasserstrahlassistierte Liposuktion zur Therapie des Lipödems

Zusammenfassung

Hintergrund

Ein Lipödem ist eine chronische Erkrankung mit subkutaner Fettgewebsvermehrung an den Beinen, Schmerzen, Ödemen und Neigung zu Hämatomen. Zur operativen Behandlung dieses Leidens gewinnt die wasserstrahlassistierte Liposuktion (WAL) zunehmend an Bedeutung.

Fragestellung

Sicherheit und Effizienz der WAL werden analysiert und mit der Tumeszenzliposuktion (TL) verglichen.

Material und Methode

Es wurden 141 Patientinnen mit Lipödem zwischen 01.07.2010 und 31.07.2016 mittels WAL (Body-Jet Evo®, HumanMed, Schwerin) operiert; 71 konnten nach einer durchschnittlichen Beobachtungszeit von 35,9 Monaten reevaluiert werden.

Ergebnisse

In jedem Fall konnten eine deutliche Reduktion der subkutanen Fettschicht und eine Verbesserung der Proportionen erzielt werden. In der Kontrolle zeigte sich eine signifikante Verbesserung aller 10 Beschwerdeparameter (Score-Reduktion auf einer 10-Punkte-Skala von 6,1 auf 3,1; Wilcoxon-Test, p < 0,05). Konservative Therapien waren in 38,3 % der Fälle nicht mehr nötig, konnten reduziert werden oder wurden als wirksamer empfunden.

Schlussfolgerung

Die Liposuktion des Lipödems verspricht dauerhafte und gute Ergebnisse, wenn die Operationstechnik auf die Schonung der Lymphbahnen fokussiert ist. Im Vergleich zur TL bietet die WAL den Vorteil, dass die Adipozyten selektiv und unter maximaler Schonung der Gefäße entfernt werden. Die Anästhesielösung wird gezielt im abzusaugenden Areal appliziert, was eine optimale Analgesie und Vasokonstriktion bewirkt. Außerdem entstehen dadurch weniger Schwellungen, und die Liposuktion ist intraoperativ präziser beurteilbar. Mittels WAL lassen sich sehr oft eindrückliche Resultate bezüglich Reduktion der Schmerzen, Verminderung der Ödemneigung, Verbesserung der Körperkontur und Steigerung der Lebensqualität erzielen.

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Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): A. Kensche, C. Holder, S. Basche, N. Tahan, C. Hannig, M. Hannig
ObjectiveThe present in situ - investigation aimed to specify the impact of pure hydroxyapatite microclusters on initial bioadhesion and bacterial colonization at the tooth surface.DesignPellicle formation was carried out in situ on bovine enamel slabs (9 subjects). After 1min of pellicle formation rinses with 8ml of hydroxyapatite (HA) microclusters (5%) in bidestilled water or chlorhexidine 0.2% were performed. As negative control no rinse was adopted. In situ biofilm formation was promoted by the intraoral slab exposure for 8h overnight. Afterwards initial bacterial adhesion was quantified by DAPI staining and bacterial viability was determined in vivo/in vitro by live/dead-staining (BacLight). SEM analysis evaluated the efficacy of the mouthrinse to accumulate hydroxyapatite microclusters at the specimens' surface and spit-out samples of the testsolution were investigated by TEM.ResultsCompared to the control (2.36×10⁶±2.01×10⁶bacteria/cm²), significantly reduced amounts of adherent bacteria were detected on specimens rinsed with chlorhexidine 0.2% (8.73×10⁴±1.37×10⁵bacteria/cm²) and likewise after rinses with the hydroxyapatite testsolution (2.08×10⁵±2.85×10⁵bacteria/cm², p<0.001). No demonstrable effect of HA-particles on Streptococcus mutans viability could be shown. SEM analysis confirmed the temporary adsorption of hydroxyapatite microclusters at the tooth surface. Adhesive interactions of HA-particles with oral bacteria were shown by TEM.ConclusionHydroxyapatite microclusters reduced initial bacterial adhesion to enamel in situ considerably and could therefore sensibly supplement current approaches in dental prophylaxis.

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Effect of iRoot SP and mineral trioxide aggregate (MTA) on the viability and polarization of macrophages

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Xiaodan Zhu, Zhenglin Yuan, Ping Yan, Yuhong Li, Han Jiang, Shengfu Huang
ObjectiveThis study was performed to investigate the effect of iRoot SP and mineral trioxide aggregate (MTA) on the viability and polarization of macrophages.MethodsThe effect of iRoot SP and MTA on the viability of RAW 264.7 macrophages was tested using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay after 1 and 2days of culture. The gene expression levels of interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), interleukin 10 (IL-10), interleukin 12p40 (IL-12p40) were measured by quantitative real time polymerase chain reaction (qRT-PCR) after stimulation of the RAW 264.7 macrophages with iRoot SP and MTA. The expression levels of CD11c and CD206 in RAW 264.7 macrophages were examined by immunofluorescence and flow cytometry after stimulation with iRoot SP and MTA. The data were analyzed by one-way analysis of variance and the Tukey test.ResultsBoth iRoot SP and MTA were non-toxic to the RAW 264.7 macrophages. The use of iRoot SP and MTA increased the expression of IL-1β, TNF-α, IL-10, IL-12p40 on the first day of culture and could promote macrophage M1 and M2 polarization.ConclusionsMTA and iRoot SP have good biocompatibility with macrophages, and they induced both M1 and M2 polarization of the RAW 264.7 macrophages.

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Enhanced osteogenic differentiation of rat bone marrow mesenchymal stem cells on titanium substrates by inhibiting Notch3

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Huiming Wang, Zhiwei Jiang, Jing Zhang, Zhijian Xie, Ying Wang, Guoli Yang
ObjectiveThe role of the Notch pathway has already been identified as a crucial regulator of bone development. However, the Notch signaling pathway has gone largely unexplored during osseointegration. This study aims to investigate the role of Notch signaling on osteogenic differentiation of rat derived bone marrow mesenchymal stem cells (BMSCs) on sandblasted, large-grit, acid-etched (SLA) treated Ti disks.MethodsThe involved target genes in Notch pathways were identified by in vitro microarray and bioinformatics analyses with or without osteogenic induction. Adhesion, proliferation, and osteogenic related assay were subsequently conducted with target gene shRNA treatment.ResultsWe found that 11 genes in the Notch signaling pathway were differentially expressed after osteogenic induction on SLA-treated Ti disks, which included up-regulated genes (Notch2, Dll1, Dll3, Ncstn, Ncor2, and Hes5) and down-regulated genes (Notch3, Lfng, Mfng, Jag2 and Maml2). With Notch3 shRNA treatment, the adhesion and proliferation of BMSCs on SLA-treated Ti disks were inhibited. Moreover, the expression levels of alkaline phosphatase (ALP), osteocalcin (OCN), calcium deposition, BMP2 and Runx2 increased significantly compared with that observed in control groups, suggesting that the function of Notch3 was inhibitory in the osteogenic differentiation of BMSCs on SLA-treated titanium.ConclusionsInhibition Notch3 can enhance osteogenic differentiation of BMSCs on SLA-treated Ti disks, which potentially provides a gene target for improving osseointegration.

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De novo synthetic short antimicrobial peptides against cariogenic bacteria

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Yufei Wang, Yingying Fan, Zhengli Zhou, Huanxin Tu, Qian Ren, Xiuqing Wang, Longjiang Ding, Xuedong Zhou, Linglin Zhang
ObjectiveAntimicrobial peptides (AMPs) have shown the ability to inhibit planktonic bacteria and biofilms. The objectives of this study were to de novo design and synthesize a series of cationic, amphipathic α-helical AMPs that would be shorter, less cytotoxic, and more potent than existing AMPs against cariogenic bacteria.DesignThree short AMPs (GH8, GLLWHLLH-NH2; GH12, GLLWHLLHHLLH-NH2; and GH16, GLLWHLLHHLLHLLHH-NH2) were designed, synthesized and characterized structurally. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) against eight major cariogenic bacteria were tested to select the most promising peptide. Scanning electron microscopy (SEM) was used to observe the bacterial membrane after treatment with selected peptides. The bactericidal kinetics, effects on biofilm and cytotoxity were further investigated.ResultsOf the three AMPs, GH12 had the most balanced structural parameters and a high content of α-helical structure. GH12 had a MIC of 4.0-8.0μg/mL and MBC of 8.0-32.0μg/mL. The corresponding values for the other two AMPs were 2- to 64- fold higher. In time-kill assays, GH12 killed all bacterial strains within 60min at 4- fold MBC. SEM observed lysis and pore formation of the cytomembrane after treatment with GH12. 8.0μg/mL GH12 inhibited Streptococcus mutans biofilm formation. Confocal laser scanning microscopy showed that GH12 effectively reduced the biomass of 1-day-old S. mutans biofilm. Cytotoxicity assays indicated that GH12 showed little toxic effect on the viability of human gingival fibroblasts.ConclusionThese results indicate that GH12 shows antimicrobial activity against cariogenic bacteria and biofilms in vitro.

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Obesity altered T cell metabolism and the response to infection

William D Green | Melinda A Beck

http://ift.tt/2nQFiGt

Starving for survival—how catabolic metabolism fuels immune function

Maria L Balmer | Christoph Hess

http://ift.tt/2noPrHv

Role of germinal centers for the induction of broadly-reactive memory B cells

Yoshimasa Takahashi | Garnett Kelsoe

http://ift.tt/2nQFju1

Regulation of memory B and plasma cell differentiation

Ryo Shinnakasu | Tomohiro Kurosaki

http://ift.tt/2np4wbS

Memory B cells: total recall

Tri Giang Phan | Stuart G Tangye

http://ift.tt/2np9llm

Developmental options and functional plasticity of innate lymphoid cells

Ai Ing Lim | Thomas Verrier | Christian AJ Vosshenrich | James P Di Santo

http://ift.tt/2of0Ahv

Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ

Effect of iRoot SP and mineral trioxide aggregate (MTA) on the viability and polarization of macrophages

Enhanced osteogenic differentiation of rat bone marrow mesenchymal stem cells on titanium substrates by inhibiting Notch3

De novo synthetic short antimicrobial peptides against cariogenic bacteria

Spatial Gradients in the Size of Inner Hair Cell Ribbons Emerge Before the Onset of Hearing in Rats

Abstract

The size and locations of pre-synaptic ribbons and glutamate receptors within and around inner hair cells are correlated with auditory afferent response features such as the spontaneous discharge rate (SR), threshold, and dynamic range of sound intensity representation (the so-called SR-groups). To test if the development of these spatial gradients requires experience with sound intensity, we quantified the size and spatial distribution of synaptic ribbons from the inner hair cells of neonatal rats before and after the onset of hearing (from post-natal day (P) 3 to P33). To quantify ribbon size, we used high resolution fluorescence confocal microscopy and 3-D reconstructions of immunolabeled ribbons. The size, density, and spatial distribution of ribbons changed during development. At P3, ribbons were densely clustered near the basal/modiolar face of the hair cell where low SR-groups preferentially contact adult hair cells. By P12, the disparity in ribbon count was less striking and ribbons were equally likely to occupy both faces. At all ages before P12, ribbons were larger on the modiolar face than on the pillar face. These differences initially grew larger with age but collapsed around the onset of hearing. Between P12 and P33, the spatial gradients remained small and began to re-emerge around P33. Even by P12, we did not find spatial gradients in the size of the post-synaptic glutamate receptors as is found on afferent terminals contacting adult inner hair cells. These results suggest that spatial gradients in ribbon size develop in the absence of sensory experience.

http://ift.tt/2nkCI7B

Methylmercury Exposure Reduces the Auditory Brainstem Response of Zebra Finches ( Taeniopygia guttata )

Abstract

Mercury contamination from mining and fossil fuel combustion causes damage to humans and animals worldwide. Mercury exposure has been implicated in mammalian hearing impairment, but its effect on avian hearing is unknown. In this study, we examined whether lifetime dietary mercury exposure affected hearing in domestic zebra finches (Taeniopygia guttata) by studying their auditory brainstem responses (ABRs). Zebra finches exposed to mercury exhibited elevated hearing thresholds, decreased amplitudes, and longer latencies in the ABR, the first evidence of mercury-induced hearing impairment in birds. Birds are a more appropriate model for the human auditory spectrum than most mammals because of similarities in frequency discrimination, vocal learning, and communication behavior. When mercury is considered in combination with other anthropogenic stressors such as noise pollution and habitat alteration, the hearing impairments we document here could substantially degrade avian auditory communication in wild birds.

http://ift.tt/2mTL62P

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System

As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment.

http://ift.tt/2mUuPKL

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology

With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall.

http://ift.tt/2nlblud

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and CHIP Reauthorization Act of 2015

With the introduction of Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA), the yearly discussions about how to manage the legislated Medicare cuts from the sustainable growth rate are over.1 MACRA introduces 2 new reimbursement models: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs), which are each discussed in detail in respective articles in this issue. Starting in 2017, all clinicians who provide Medicare part B services must choose between these 2 reimbursement models.

http://ift.tt/2mUokYr

Histomorphometric analysis of unilateral condylar hyperplasia in the temporomandibular joint: the value of the condylar layer and cartilage island

This study aimed to describe the condylar layer and cartilage island in subjects with unilateral condylar hyperplasia (UCH). Five individuals (15–18 years old) with a diagnosis of UCH, treated in a university hospital in Temuco, Chile, were included. The analysis examined the presence, extension, and thickness of the layers on the condylar surface, the number, depth, and area of the cartilage islands, and the argyrophilic proteins of the nucleolar organizer region (AgNOR) score. Statistical significance was set at P<0.05.

http://ift.tt/2nl4mRW

Islanded facial artery musculomucosal flap for tongue reconstruction

We read with great interest the technical note by Joseph et al.1, concerning the use of a "technical modification to the FAMM flap" in order to reconstruct a post-ablative lingual side defect. This modification consists in the harvest of a buccinator myomucosal island flap pedicled on the facial vessels. The flap is then carried in the neck through a paramandibular passage and finally brought back into the oral cavity through a lingual tunnel. This modification allows the flap's arc of rotation to be increased and avoids secondary pedicle section.

http://ift.tt/2nFDcIU

How much does experience in guided implant surgery play a role in accuracy? A randomized controlled pilot study

The current literature is not consistent on whether experience influences accuracy. The aim of this study was to analyze the accuracy of implant insertion performed by inexperienced versus experienced surgeons. Thirty-three implants were inserted by the inexperienced group and 37 implants by the experienced group. Planning and post-surgical computed tomography images were matched and the accuracy data compared. The positioning error was also evaluated. Quantitative data for the two groups were described and illustrated using box plots.

http://ift.tt/2nl7eyg

Role of local alendronate delivery on the osseointegration of implants: a systematic review and meta-analysis

There is controversy regarding whether locally delivered alendronate enhances osseointegration. The aim of this systematic review was to assess the role of local alendronate delivery (topical, or as a coating on implant surfaces) in the osseointegration of implants. The focused question was, "Does the local delivery of alendronate affect osseointegration around implants?". To address this question, indexed databases were searched, without time or language restriction, up to and including January 2017.

http://ift.tt/2nFADGY

Measuring the condylar unit in condylar hyperplasia: from the sigmoid notch or from the mandibular lingula?

The objective of this study was to determine, in patients with active unilateral condylar hyperplasia, which is the most reliable point to measure the length of the condylar unit: from the sigmoid notch or from the mandibular lingula to the condylar head. On cone beam computed tomography, an observational cross-sectional study was designed for 20 patients with active unilateral condylar hyperplasia. We measured and compared ramus length (affected and healthy sides) and condylar length (measured from the mandibular lingula and from the mandibular sigmoid notch) on both sides.

http://ift.tt/2nkTzay

Lateral ridge augmentation with Bio-Oss alone or Bio-Oss mixed with particulate autogenous bone graft: a systematic review

The objective of this systematic review was to test the hypothesis of no difference in implant treatment outcomes when using Bio-Oss alone or Bio-Oss mixed with particulate autogenous bone grafts for lateral ridge augmentation. A search of the MEDLINE, Cochrane Library, and Embase databases in combination with a hand-search of relevant journals was conducted. Human studies published in English from 1 January 1990 to 1 May 2016 were included. The search provided 337 titles and six studies fulfilled the inclusion criteria.

http://ift.tt/2nFCYld

Cancer immunotherapy: how low-level ionizing radiation can play a key role

Abstract

The cancer immunoediting hypothesis assumes that the immune system guards the host against the incipient cancer, but also "edits" the immunogenicity of surviving neoplastic cells and supports remodeling of tumor microenvironment towards an immunosuppressive and pro-neoplastic state. Local irradiation of tumors during standard radiotherapy, by killing neoplastic cells and generating inflammation, stimulates anti-cancer immunity and/or partially reverses cancer-promoting immunosuppression. These effects are induced by moderate (0.1–2.0 Gy) or high (>2 Gy) doses of ionizing radiation which can also harm normal tissues, impede immune functions, and increase the risk of secondary neoplasms. In contrast, such complications do not occur with exposures to low doses (≤0.1 Gy for acute irradiation or ≤0.1 mGy/min dose rate for chronic exposures) of low-LET ionizing radiation. Furthermore, considerable evidence indicates that such low-level radiation (LLR) exposures retard the development of neoplasms in humans and experimental animals. Here, we review immunosuppressive mechanisms induced by growing tumors as well as immunomodulatory effects of LLR evidently or likely associated with cancer-inhibiting outcomes of such exposures. We also offer suggestions how LLR may restore and/or stimulate effective anti-tumor immunity during the more advanced stages of carcinogenesis. We postulate that, based on epidemiological and experimental data amassed over the last few decades, whole- or half-body irradiations with LLR should be systematically examined for its potential to be a viable immunotherapeutic treatment option for patients with systemic cancer.

http://ift.tt/2nzyuuD

Association between atopic manifestations and eosinophilic esophagitis

Eosinophilic esophagitis (EoE) has repeatedly been associated with atopic manifestations, which are reported more frequently in these patients than in the general population.

http://ift.tt/2noG4XZ

Hyper–immunoglobulin E-like syndrome in a patient with multiple genetic mutations

A 44-year-old African-American woman with hidradenitis suppurativa, scoliosis, and idiopathic avascular necrosis of the hips presented to the emergency department with transient monocular visual loss, purulent discharge at the site of a gold-plate implant in the left upper eyelid for lagophthalmos secondary to Bell palsy, and a right thigh abscess. Since her diagnosis of hidradenitis suppurativa at 16 years old, she developed multiple abscesses in the axilla, groin, thighs, and nape of the neck requiring incision and drainages, skin grafting, and antibiotics.

http://ift.tt/2nQtXWG

Control of Allergic Rhinitis and Asthma Test for Children (CARATKids)

The Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) assesses asthma and allergic rhinitis control in children younger than 12 years.

http://ift.tt/2noz5P7

Atypical dermal melanocytosis: diagnostic clue in constitutional mismatch repair deficiency syndrome

Abstract

A twenty-three month old female presented with abnormal pigmentation since birth. She had a past history of mediastinal non-Hodgkin's lymphoma diagnosed at the age of 9 months and treated with surgery and chemotherapy. Family history revealed that her grandfathers were brothers, and both died of colon cancer in their fifth decade. Parents were both fit and well in their early thirties.

http://ift.tt/2nQvo7Q

Comparative effectiveness of biologic therapies on improvements in quality of life in patients with psoriasis

Abstract

Background

Evidence of the comparative effectiveness of biologic therapies for psoriasis on health related quality of life (HRQoL) in routine clinical practice is limited.

Objectives

To examine the comparative effectiveness of adalimumab, etanercept and ustekinumab on HRQoL in psoriasis patients, and to identify potential predictors for improved HRQoL.

Method

Prospective cohort study in which changes in HRQoL were assessed using the Dermatology Life Quality Index (DLQI) and EuroQoL-5D (EQ-5D) at 6 and 12 months. Multivariable regression models were developed to identify factors associated with achieving a DLQI of 0/1 and improvements in the EQ5D utility score.

Results

In total, 2152 psoriasis patients (adalimumab (n = 1239), etanercept (n = 517) and ustekinumab (n = 396); 81% were biologic-naïve) were included. For the entire cohort, the median (interquartile range) DLQI and EQ-5D improved from 18 (13 - 24) and 0.73 (0.69 - 0.80) at baseline to 2 (0 - 7) and 0.85 (0.69 - 1.00) at 6 months, respectively (p < 0.0001). Similar improvements were achieved at 12 months. At 12 months, multivariable regression modelling showed that female gender, multiple comorbidities, smoking, and a higher DLQI or a lower EQ-5D utility score at baseline predicted lower likelihood of achieving a DLQI of 0/1 or improvement in EQ-5D. Compared against adalimumab, patients receiving etanercept, but not ustekinumab, were less likely to achieve a DLQI of 0/1. There was no significant difference between the biologics in EQ-5D improvement.

Conclusion

In routine clinical practice, biologics produce marked improvement in HRQoL which is influenced by the choice of biologic, baseline impairment in HRQoL, lifestyle characteristics and comorbidities. These findings should help inform selection of optimal biologic therapy for patients related to improvements in HRQoL.

http://ift.tt/2noJBpm

Temporal Trends in Healthcare Utilization following Primary Melanoma Diagnosis among Medicare Beneficiaries

Summary

Background

Despite increasing melanoma incidence in the United States, little is known about the impact of primary melanoma diagnosis on healthcare utilization and changes in utilization over time.

Objective

To evaluate population-based temporal trends in healthcare utilization following primary melanoma diagnosis.

Methods

We conducted a before-after multiple time series study of Medicare beneficiaries ages ≥66 years with primary melanoma diagnoses between 2000 and 2009 using the Surveillance, Epidemiology, and End Results-Medicare database. The primary exposure was time from primary melanoma diagnosis at three to six months (+91 to +180 days) and six to 24 months (+91 to +720 days) post-diagnosis. Covariates include tumor-, patient-, and geographic-level characteristics and health care utilization during the six months prior to diagnosis (-91 to -180 days). Poisson regression was used to estimate population-based risk-adjusted utilization rates (per 1,000 person-years) for skin biopsies (based on biopsy days), benign skin excisions, internal medicine office visits, and dermatology office visits.

Results

The study population included 56,254 patients with first diagnoses of primary melanoma. Most patients were ≥75 years old (56.8%), male (62.1%), and staged with in situ melanoma (42.4%) or localized invasive melanoma (45.9%). From 2000 to 2009, risk-adjusted skin biopsy rates 24 months post-diagnosis increased from 358.3 to 541.3 per 1,000 person-years (P-value for trend <0.001), and dermatology visits increased from 989.0 to 1535.6 per 1,000 person-years (P-value for trend <0.001). Benign excisions and internal medicine visits remained stable. In 2000, risk-adjusted skin biopsy rates 6 months post-diagnosis increased by 208.5 relative to the 6 months pre-diagnosis (148.7 versus 357.2), compared to an observed absolute increase of 272.5 (290.9 versus 563.1) in 2009. Trends in dermatology visits were similar.

Conclusions

Utilization of skin biopsies and dermatology office visits following primary melanoma diagnosis has increased substantially over time. These results may inform optimization of care delivery for melanoma within the Medicare population.

http://ift.tt/2nQuN5P

Fingernail Psoriasis Data Added to Humira Prescribing Info

The FDA has approved the addition of moderate to severe fingernail psoriasis data to the Humira prescribing information for those with moderate to severe chronic plaque psoriasis.
FDA Approvals

http://ift.tt/2nEM4OR

The past, present and future of the postanesthesia care unit (PACU) in Japan

Abstract

The postanesthesia care unit (PACU), which is run and coordinated by anesthesiologists, delivers general medical supervision as well as close and constant care to patients who have just undergone a surgical procedure under anesthesia. Although PACU management has been considered a standard procedure in many developed countries since the 1940s, Japanese hospitals have tended to cease their management, and only 16.1% of hospitals in Japan currently have PACUs. In today's efficiency-required atmosphere in Japan, we need to consider a better postoperative management method, including facilities similar to the PACU, to prevent serious adverse events and improve the postoperative outcomes and quality of life. Nevertheless, the way postoperative patients are treated and cared for, and the location in which they receive such attention, will likely need to be modified to fit the Japanese style due to Japan's unique medical systems and traditions. Here, we describe the past, present and future of the PACU and postanesthesia care in Japan compared with other countries.

http://ift.tt/2nAYbeg

Introduction

Publication date: Available online 18 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Jessyka G. Lighthall

http://ift.tt/2oesIkL

Embryology and anatomy of the ear

Publication date: Available online 15 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Lauren B. Moneta, Lourdes Quintanilla-Dieck
External ear anomalies are common and range from mild asymmetries to severe deformity or complete lack of external ear development. An in depth knowledge of the developmental stages and embryology allows for an understanding of patterns of ear malformation. Here we review the embryology of the ear as well as the anatomy of a normally formed ear as a preface for discussing reconstruction in future chapters of this issue.

http://ift.tt/2nAWkpM

Brent Technique for Microtia Reconstruction

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Brittany J. Behar, Donald R. Mackay
The Brent technique for microtia repair was first published in 1974 and developed from principles espoused by Tanzer.^1,2 This process involves careful meticulous planning with creation of preoperative templates. The surgical reconstruction involves four stages. Stage one is started as early as six years of age with harvest of a contralateral costal cartilage and subdermal placement through an anterior auricular incision. Additional stages involved creation and inset of a lobule, elevation of the auricle and creation of a posterior sulcus and grafting of a tragus and deepening of the conchal bowl.³ Long term outcomes are successful with this technique with minimal incidence of infection, extrusion and hematoma. These cartilage constructs grow simultaneously with the patient and the unaffected ear.⁴

http://ift.tt/2oevree

The Nagata Technique for Microtia Reconstruction

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Tom Shokri, David R. White
Multiple techniques for auricular reconstruction for microtia have been described. Reconstruction using autologous costal cartilage continues to be the most widely implemented technique for repair. Recreation of a three-dimensional framework mimicking the curves and contours of a normal ear, while also maximizing stability, is crucial in reconstructing the auricle. Additionally, soft tissue management, although generalized in approach, is specific to each patient and greatly influences surgical outcomes. In the present article, we discuss the Nagata technique for auricular reconstruction, a two-staged technique using costal cartilage grafts to rebuild the auricle.

http://ift.tt/2nATfWO

Reconstruction of Upper Third Auricular Defects

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Sunthosh K. Sivam, Christine B. Taylor, Christian L. Stallworth
The objective of this article is to summarize the current methodology for addressing upper third auricular defects based on comprehensive literature review and the senior author′s experience.Partial thickness defects may be addressed using secondary intent, primary closure, excision of exposed cartilage followed by primary closure, or use of skin grafting. This decision is often dictated by the status of the perichondrium. Small full thickness defects (<1.5cm) are sometimes amenable to primary closure and others may require conversion to a wedge excision in order to facilitate closure. Medium size defects (1.5–2.0cm) are more likely to require local tissue re-arrangement including chondrocutaneous advancement flaps for helical defects or composite grafts for defects beyond the helical rim. Reconstruction of larger defects (>2.0cm) can often be facilitated by pedicled flaps that require detailed knowledge of the surrounding blood supply.There are a variety of solutions available for the reconstructive surgeon to effectively address this unique challenge.

http://ift.tt/2oeq8vf

Prosthetic reconstruction of the ear

Publication date: Available online 29 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Robert Saadi, Jessyka G. Lighthall
Among the options for the reconstructive surgeon in repairing an auricular defect, prosthetics are often not strongly considered due to unfamiliarity with benefits and outcomes. In many patients who are poor surgical candidates or who do not wish a multi-staged reconstruction, auricular prostheses can be an excellent option and should be discussed when counseling patients. Osseintegrated implant-retained prostheses are becoming more popular given the relative simplicity of the surgical procedure, reliable retention and orientation, and low complication rates. Adhesive-retained prostheses provide a non-surgical option with good aesthetic results. Studies have found successful long term stability and improvements in quality of life.

http://ift.tt/2nAWjSK

Reconstruction of the Conchal Bowl

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Jonathan A. Harounian, Christopher Fundakowski
The auricular concha is derived from the cleft ectodermal tissue of the first branchial groove. Deformities of the concha may result from congenital malformations, traumatic injury, or oncological resection. While multiple studies have demonstrated the negative psychosocial impact of auricular deformity, various surgical techniques have been developed in order to reconstruct the ear and obtain satisfactory cosmetic outcomes. Reconstruction of the concha will largely depend on depth and size of the overall defect, with options largely varying between secondary intention, skin grafting, and soft tissue flaps.

http://ift.tt/2oeyOSp

Firmin Technique for Microtia Reconstruction

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Natalie Justicz, Joseph R. Dusseldorp, David Shaye
Microtia reconstruction is a challenging yet rewarding procedure. Many techniques exist for reconstruction of congenital auricular deformities. Although autologous costal cartilage reconstruction has been around for many years, modifications upon these techniques with the goal to provide high quality results while minimizing the number of surgeries and surgical morbidity continue to be published. The Firmin techniques represents modifications based on the Brent and Nagata techniques and will be discussed here.

http://ift.tt/2nB3me6

Advances in Microtia Reconstruction

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Kofi Derek Boahene, James A. Owusu

http://ift.tt/2oektVZ

Congenital anomalies of the external ear

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Jeffrey Liaw, Vijay A. Patel, Michele M. Carr
Congenital malformations of the auricle are the result of a series of insults during the embryologic development of fetal auricular cartilage. Various anomalies described in the literature include microtia, aural atresia, prominent auricles, preauricular pits, and accessory auricular appendages. These anomalies have varying degrees of functional impairment and severity, which may or may not require surgical intervention. In addition, these aberrations can be associated with other congenital syndromes, however are most often found in isolation. Management involves recognizing the benefits and limitations of therapy, which should be thoroughly discussed with the parents and, when appropriate, the patient. Here, we present an overview of the anomalies of the external ear.

http://ift.tt/2nATf9g

Reconstruction of Lower Third Auricular Defects

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Christopher Pool, Jessyka G. Lighthall
Defects of the lower third of the auricle, also known as the lobule, are relatively common, especially among patients who wear earrings. Lobular defects have many causes including congenital deformity, trauma, gauge defects, and extirpation for malignancy. Patients may also wish to have their earlobes cosmetically reduced after elongation due to years of wearing heavy, pendulous earrings. Because the auricle has many convex and concave surfaces of each with different amounts of elasticity, rigidity, and flexibility, the types of defects and their reconstruction are widely varied. In this article, we discuss common isolated lobular defects, their management, and their reconstruction.

http://ift.tt/2oeomdF

Alloplastic reconstruction of the microtic ear

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Scott Owen, Tom Wang, Scott Stephan
Alloplast microtia repair offers many advantages over autologous costal cartilage as a framework. Advantages include earlier reconstruction, fewer procedures, avoidance of donor site morbidity, shorter surgeon learning curve and improved consistency in size and contour match. Though multiple implantable materials have been used in microtia reconstruction with variable success, pre-formed porous polyethylene frameworks combined with advances in soft tissue envelope techniques have significantly improved alloplast outcomes. The authors describe their technique in single-stage microtia reconstruction with the use of porous polyethylene as an alloplast framework.

http://ift.tt/2nB6FSD

Reconstruction of the middle third auricular defects

Publication date: Available online 14 March 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Harley Dresner, Emily Waselchuk
A variety of reconstructive methods exist for defects involving the middle third of the auricle. Depending on the specific three-dimensional characteristics of a defect, local flaps involving the rearrangement of adjacent tissues are oftentimes effective and aesthetically favorable procedures. In this paper we describe two techniques for reconstructing defects of the middle third of the auricle: the pedicled post-auricular interpolation flap and single- or bi-pedicled chondrocutaneous composite advancement flaps.

http://ift.tt/2oevmHs

Daily Coffee Intake Inhibits Pancreatic Beta Cell Damage and Nonalcoholic Steatohepatitis in a Mouse Model of Spontaneous Metabolic Syndrome, Tsumura-Suzuki Obese Diabetic Mice

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

http://ift.tt/2nAK7RY

Time-Dependent Differences in the Influence of Perivascular Adipose Tissue on Vasomotor Functions in Metabolic Syndrome

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

http://ift.tt/2oefbtF

Spatial Gradients in the Size of Inner Hair Cell Ribbons Emerge Before the Onset of Hearing in Rats

Abstract

http://ift.tt/2nkCI7B

Methylmercury Exposure Reduces the Auditory Brainstem Response of Zebra Finches ( Taeniopygia guttata )

Abstract

http://ift.tt/2mTL62P

Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Abstract The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA–DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler.

http://ift.tt/2oD9TnX

Orofacial clefts in Brazil and surgical rehabilitation under the Brazilian National Health System

Abstract The objective of this study was to investigate the prevalence of live births with orofacial clefts in Brazil from 2009 to 2013, according to Brazil's federative units and regions, and correlate it with the number of corrective surgery procedures for cleft lip and palate performed through the Brazilian National Health System in the same period. The data were collected from the National Live Birth System (SINASC in Portuguese) and the Hospital Information System (SIH-SUS in Portuguese). The results showed that the average prevalence of oral clefts in the period was 5.86 per 10,000 live births, with differences observed between the federative units and the regions. The correlation between the prevalence of orofacial clefts and the number of medical procedures associated with this anomaly was statistically significant (r=0.94; p <0.001). This result indicates that greater investments are being made in areas with a higher number of cases. The relationship between supply and demand for corrective surgeries suggests that only 18.91% of the live births with orofacial clefts in this period may have received this service under the Brazilian National Health System.

http://ift.tt/2nDWzSS

Dental caries and quality of life of preschool children: discriminant validity of the ECOHIS

Abstract The aim of the present study was to confirm the discriminant validity (obtained using traditional statistical methods) of the Early Childhood Oral Health Impact Scale (ECOHIS) between preschool children with and without caries (mean score) through an evaluation of the effect size. A systematic search of electronic databases and a manual search were performed for studies published up to December 2015 involving the use of the ECOHIS for the evaluation of the impact of dental caries on oral health–related quality of life (OHRQoL) among preschool children. Two independent raters performed the selection of the studies and data extraction. Only papers published in English and Spanish were selected. No restrictions were imposed regarding the year of publication. Twelve studies were included, and the magnitude of standardized differences between the means of the "without caries" and "with caries" groups was calculated using Cohen's d. Most studies demonstrated a large magnitude in the difference between the groups evaluated. The estimate of the effect size confirmed the discriminant validity of the ECOHIS obtained through traditional statistics. Thus, the magnitude of the difference should be considered an important analytical tool for the confirmation of statistical findings regarding null hypotheses and demonstrates the clinical significance of these research results.

http://ift.tt/2oDiJ50

Relationship between articular eminence inclination and alterations of the mandibular condyle: a CBCT study

Abstract This study aimed at verifying the correlation among angulation of the articular eminence (AE), shape of the condyle and its degenerative bone diseases (DBDs), according to age and sex, through Cone Beam Computed Tomography (CBCT). Five hundred and twenty-eight temporomandibular joints (TMJ) were evaluated. The condyles were classified as: flat, convex, angled and rounded, and the AE angulation was measured. The DBDs evaluated were osteophytes, flattening, erosion, subcortical cysts and spinal sclerosis. There was no difference in the mean angulations in relation to age group (p>0.05). In age groups of 60-69 years (p=0.003) and 70 years or over (p=0.021), the angulation was higher in males. There was an association between DBD and sex (p=0.047), in that the prevalence was higher in females. Differences in AE angles were not observed in condyles with one or no DBDs (p>0.05). However, the presence of two or more DBDs led to a decrease in the angle (p<0.05). Angled condyles showed higher AE angulations than the flat and convex types (p<0.01). In conclusion, the AE inclination is influenced by DBD and condyle shape; an association of two or more bone diseases in the condyle, or its flat or convex anatomy, results in a decrease in the angulation.

http://ift.tt/2nEjAot

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

Abstract The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

http://ift.tt/2oCUy72

Granulocyte and monocyte apheresis can control juvenile generalised pustular psoriasis with mutation of the IL36RN gene

Abstract

Patients with 'deficiency of the interleukin-36 receptor antagonist' (DITRA), caused by mutation of the IL36RN gene, exhibit psoriatic phenotypes, typically generalised pustular psoriasis (GPP). We report a paediatric case with DITRA, whose cutaneous lesions varied from psoriasis vulgaris in infancy to annular pustular psoriasis with acute exacerbation to GPP at 13 years of age. Conventional systemic treatments for GPP, which include oral retinoids, cyclosporine and methotrexate, are controversial in paediatric cases, because of their adverse effects and uncertain long-time consequences. Granulocyte monocyte apheresis, a process associated with few adverse events, promptly controlled our paediatric case of GPP, and has potential as a suitable alternative treatment for paediatric patients with DITRA.

http://ift.tt/2nzYIxb

Slowly Enlarging Neck Mass

A man had an enlarging, nontender, neck mass at the angle of the mandible; computed tomography showed a heterogeneous mass adjacent to the tail of the left parotid, and pathologic findings revealed an encapsulated soft nodule within the specimen. What is your diagnosis?

http://ift.tt/2oD7rhu

Transoral Robotic Surgery and Long-term Outcomes and Costs

This cross-sectional analysis investigates the association of transoral robotic surgery with short- and long-term outcomes and costs in surgically treated patients with oropharyngeal cancer.

http://ift.tt/2nDZECa

Parathyroid Gland Biopsy Excision Technique and Ex Vivo Radiation Counts

This case series study examines the proportion of a hyperfunctional parathyroid gland that must be evaluated with the gamma probe to satisfy the Norman 20% rule.

http://ift.tt/2oCYfcD

Evaluation of a New Surgical Technique for Closing Oroantral Fistula Using Auto-transplanted Upper Third Molar: A 1-Year Follow-Up Study

Abstract

Background

Oroantral fistula (OAF) is considered a frequent complication in dental practice. Many surgical techniques/methods have been proposed to close it. The aim of this study was to evaluate the auto-transplantation of upper third molar for closing OAF.

Materials and Methods

Twenty patients participated in this study aged between 20 and 40 years old. The OAF was closed by auto-transplantation of upper third molar placed directly in the socket of the extracted tooth. Results were evaluated clinically and radiographically through the period of observation which lasted for 1 year.

Results

Final results showed that the success rate of closing OAF was 95% while the success rate of upper third molar auto-transplantation was 90%.

Conclusion

This technique is simple, applicable, provides immediate replacement of the missing tooth, and does not require complicated instruments or procedures.

http://ift.tt/2nDUXZ1

A Study of Apatinib Plus Tegafur Gimeracil Oteracil in Recurrent/Metastatic Head and Neck Cancers

Condition: Head and Neck Squamous Cell Carcinoma
Interventions: Drug: Apatinib Mesylate Tablets; Drug: Tegafur Gimeracil Oteracil Potassium Capsules
Sponsor: Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Not yet recruiting - verified March 2017

http://ift.tt/2olmfSh

Investigation of Single Ascending Doses of NNC9204-1706 in Male Subjects Being Overweight or With Obesity

Conditions: Metabolism and Nutrition Disorder; Obesity
Interventions: Drug: NNC9204-1706 A; Drug: Placebo
Sponsor: Novo Nordisk A/S
Recruiting - verified March 2017

http://ift.tt/2ocHrgd

Pembrolizumab and XL888 in Patients With Advanced Gastrointestinal Cancer

Conditions: Adenocarcinoma of the Gastroesophageal Junction; Colorectal Adenocarcinoma; Metastatic Pancreatic Adenocarcinoma; Non-Resectable Cholangiocarcinoma; Non-Resectable Hepatocellular Carcinoma; Recurrent Cholangiocarcinoma; Recurrent Colorectal Carcinoma; Recurrent Gastric Carcinoma; Recurrent Hepatocellular Carcinoma; Recurrent Pancreatic Carcinoma; Recurrent Small Intestinal Carcinoma; Small Intestinal Adenocarcinoma; Stage III Colorectal Cancer; Stage III Gastric Cancer; Stage III Hepatocellular Carcinoma; Stage III Pancreatic Cancer; Stage III Small Intestinal Cancer; Stage IIIA Colorectal Cancer; Stage IIIA Gastric Cancer; Stage IIIA Hepatocellular Carcinoma; Stage IIIA Small Intestinal Cancer; Stage IIIB Colorectal Cancer; Stage IIIB Gastric Cancer; Stage IIIB Hepatocellular Carcinoma; Stage IIIB Small Intestinal Cancer; Stage IIIC Gastric Cancer; Stage IV Colorectal Cancer; Stage IV Gastric Cancer; Stage IV Hepatocellular Carcinoma; Stage IV Pancreatic Cancer; Stage IV Small Intestinal Cancer; Stage IVA Colorectal Cancer; Stage IVA Hepatocellular Carcinoma; Stage IVA Pancreatic Cancer; Stage IVB Colorectal Cancer; Stage IVB Hepatocellular Carcinoma; Stage IVB Pancreatic Cancer; Unresectable Pancreatic Carcinoma; Unresectable Small Intestinal Carcinoma
Interventions: Drug: XL888; Biological: Pembrolizumab
Sponsors: Emory University; Merck Sharp & Dohme Corp.; Exelixis
Not yet recruiting - verified March 2017

http://ift.tt/2olgmED

Sirolimus and Familial Adenomatous Polyposis (FAP)

Condition: Adenomatous Polyposis Coli
Intervention: Drug: Sirolimus
Sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Recruiting - verified March 2017

http://ift.tt/2ocyEuK

Adaptive Radiotherapy for Head and Neck Cancer

Conditions: Head and Neck Cancer; Paranasal Sinus Cancer; Oropharynx Cancer; Oral Cavity Cancer; Nasopharynx Cancer; Larynx Cancer; Hypopharynx Cancer
Intervention: Radiation: Adaptive Radiotherapy
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting - verified March 2017

http://ift.tt/2olrGAW

A CR-UK Phase I Trial of LY3143921

Conditions: a. Colorectal Cancer; b. High Grade Serous Ovarian Cancer; c. Non Small-cell Lung Cancer (Squamous Cell Variant); d. Squamous Carcinoma of the Oesophagus; e. Squamous Carcinoma of the Head and Neck (HPV Negative); f. Urothelial Cancer; g. Breast Cancer (Triple Negative Type); h. Pancreatic Cancer
Intervention: Drug: LY3143921 hydrate
Sponsor: Cancer Research UK
Not yet recruiting - verified March 2017

http://ift.tt/2nDI15L

The Global Burden of Melanoma: Results from Global Burden of Disease Study 2015

Abstract

Background

Despite recent improvements in prevention, diagnosis, and treatment, vast differences in melanoma burden still exist between populations. Comparative data can highlight these differences and lead to focused efforts to reduce the burden of melanoma.

Objectives

To assess global, regional, and national melanoma incidence, mortality, and disability-adjusted life year (DALY) estimates from the Global Burden of Disease 2015 study.

Methods

Vital registration system and cancer registry data were used for melanoma mortality modeling. Incidence and prevalence were estimated using separately modeled mortality-to-incidence (MI) ratios. Total prevalence was divided into four disease phases and multiplied with disability weights to generate years lived with disability (YLDs). Deaths in each age group were multiplied with the reference life expectancy to generate years of life lost (YLLs). YLDs and YLLs were added to estimate DALYs.

Results

The five world regions with the greatest melanoma incidence, DALY, and mortality rates were Australasia, North America, Eastern Europe, Western Europe, and Central Europe. With the exception of regions in sub-Saharan Africa, DALY and mortality rates were greater in males than females. DALY rate by age was highest in those aged 75-79 years, 70-74 years, and 80+ years.

Conclusions

The greatest burden from melanoma falls on Australasian, North American, European, elderly, and male populations, consistent with previous investigations. These substantial disparities in melanoma burden worldwide highlight the need for aggressive prevention efforts. GBD results can help shape melanoma research and public policy.

http://ift.tt/2of99tl

Initial in vitro functional characterization of serum exosomal microRNAs from patients with metastatic basal cell carcinoma

Abstract

Basal cell carcinoma (BCC) is the most common of human malignancies, but the mechanism by which metastasis occurs is poorly understood¹. Serum exosomes, 30-100 nanometer membrane-bound vesicles containing regulatory microRNAs (miRs), are emerging as a mechanism for cancer metastasis in melanoma², breast³, prostate⁴, and lung cancers⁵, but the role of exosomes in BCC metastasis is not known. In this pilot study, we assessed for differences in exosomal composition in BCC patients with and without metastasis, and whether these differences confer functional changes in vitro.

http://ift.tt/2nzpiqj

In-Utero Presentation of Aggressive Systemic Mastocytosis in a Neonate

Abstract

Mastocytosis is a clinically heterogenous disease characterized by mast cell hyperplasia in skin, bone marrow, and/or visceral organs. Cutaneous mastocytosis (CM) is more frequently observed in children, while indolent systemic mastocytosis (ISM) is more commonly observed in adults. Aggressive systemic presentation, particularly, of the neonate, is exceptionally rare. We present a rare case of congenital aggressive systemic mastocytosis (ASM). The patient was a 37-week old male, born by Cesarean section due to hepatosplenomegaly and ascites diagnosed in-utero, who exhibited extensive cutaneous and systemic manifestations of mastocytosis at birth. Mutation analysis of c-kit identified D816V mutation in exon 17. Although initial bilateral bone marrow aspirates demonstrated no mast cell infiltrates or hematologic neoplasm, subsequent bone marrow biopsies postmortem exhibited multifocal mast cell aggregates. Clinical course was complicated by bacteremia and cardiorespiratory failure, leading to death at 10 weeks.

http://ift.tt/2oeKPYm

Response to: Dermatological content of U.K. undergraduate curricula: where are we now?

Abstract

We read with interest the report by Yaakub et al regarding undergraduate dermatology education in UK and Irish medical schools.¹ This reported that students at 25% of medical schools did not receive any dermatology education. A significant number of medical graduates progress to a career in general practice (25.8% of all 237,351 GMC registered doctors are GPs²). The prevalence estimate for skin conditions in GP consultations is 24%,³ but dermatology training is not compulsory within the GP curriculum.

http://ift.tt/2nzsFgA

Epigenetic biomarkers associated with anti-TNF drugs response in moderate-to- severe psoriasis

Abstract

It has recently been discovered that epigenetic modifications, specially DNA methylation, participates in the pathology of psoriasis. DNA methylation is a covalent modification dynamic and heritable that takes place in Cytosine-Phosphate-Guanine (CpG) sites and may exert transcriptional effects. Although anti-tumour necrosis factor α (TNF) therapies (adalimumab, etanercept and infliximab) are efficient drugs for moderate-to-severe psoriasis, around 30–50% of psoriasis patients present an inadequate response.

http://ift.tt/2oeOTbc

Skin biopsy PCR for rapid microbiological diagnosis in patients with purpura fulminans

Abstract

Purpura fulminans (PF) is mostly caused by Neisseria meningitidis or Streptococcus pneumoniae. Prompt identification of the causative bacteria is essential, but cerebrospinal fluid (CSF) and blood cultures may lack sensitivity, mostly because of prior antibiotic administration, and be time-delayed. A skin biopsy of a purpuric lesion with N. meningitidis polymerase chain reaction (PCR) is now recommended by French guidelines, still, the usefulness of this tool remains debated in some countries, owing to the lack of high-level evidence.

http://ift.tt/2nzmpFV

Human Immune Monitoring Techniques during Food Allergen Immunotherapy

Abstract

Purpose of Review

Encouraging results from recent food allergen immunotherapy clinical trials indicate that the immune system plays an essential role in peripheral tolerance to food allergen. Thus, the monitoring of changes in immune responses and their possible correlation with clinical outcome in allergic patients receiving immunotherapies could theoretically serve as surrogate markers and be harnessed as rationale for food allergen immunotherapy development.

Recent Findings

A shift towards antigen specificity in recent assays has provided a solid foundation for the elucidation of cellular mechanisms involved in food allergen immunotherapy as well as the tracking of allergen-specific immune cells.

Summary

In this review, we overview the current challenges and technologies used in immune monitoring during immunotherapy in allergic patients with a focus on cell-mediated immunity. We also discuss critical steps involved in some of the cellular immune assays utilized in clinical trials.

http://ift.tt/2nODGgx

Forthcoming Meetings

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Issue Information

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Cover Image

The cover image, by N. Saito et al., is based on the Original Article Assessment of biological, psychological and adherence factors in the prediction of step-down treatment for patients with well-controlled asthma, DOI 10.1111/cea.12888

http://ift.tt/2njs9Sp

Quality of life, when to step down asthma therapy and remembering allergic rhinitis

http://ift.tt/2njDLEM

Medical simulation app aids intubation training

By EMS1 Staff CHICAGO — A free smartphone app will now allow you to test your airway procedure skills —no medical supplies needed. Anesthesiology News reported that Airway EX, launched October 2016 from Level EX Inc., is an interactive and virtual patient airway simulator of rare and difficult cases. The app is available on any iOS or Android smartphone or tablet. The app was developed by ...

http://ift.tt/2nza30i

Disseminated MRSA infection with purulent pericarditis

The risk of developing pericarditis secondary to Methicillin-Resistant Staphylococcus aureus (MRSA) infection in the absence of preceding surgical procedure is extremely low. We present a case report of a 36-year-old woman who developed disseminated MRSA infection leading to purulent pericarditis.

http://ift.tt/2nz9iEo

Surgical correction of mandibular hypoplasia in hemifacial microsomia, a retrospective study in 39 patients

Publication date: Available online 30 March 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): H. Bertin, J. Mercier, A. Cohen, J. Giordanetto, N. Cohen, S.H. Lee, J.P. Perrin, P. Corre
PurposeRepair of the mandibular deformity in hemifacial microsomia (HFM) remains controversial, and there is scant information in the literature regarding the late outcomes. The aim of this study was to evaluate architectural and aesthetic long-term outcomes for primary mandibular surgery in patients with HFM.Materials and MethodsThirty-nine patients with types II and type III HFM were included in this retrospective study. Depending on the nature of the mandibular deformity, patients were treated using a costochondral graft (CCG) or a vertical ramus osteotomy (VRO). Architectural and aesthetic parameters were evaluated preoperatively, postoperatively, and at the end of the follow-up period.ResultsThe architectural analysis revealed the restoration of a level occlusal canting at the end of the follow-up period (p<0.0001); the chin deviation was corrected immediately by the surgery, although a trend to recurrence was noted at the last follow-up evaluation (p<0.0001). The aesthetic assessment revealed a significant improvement of the chin deflection, and correction of the lip commissural line tilt (p<0.0001). Twenty-three percent of the patients required an additional orthognathic revision.ConclusionCCG and VRO continue to be suitable and safe procedures with good outcomes that allow a single-stage correction of occlusion and preservation of mandibular growth in young patients with type II and type III HFM.

http://ift.tt/2oer9Uy

Microcarrier culture enhances osteogenic potential of human periodontal ligament stromal cells

Publication date: Available online 29 March 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Alina Čebatariūnienė, Akvilė Jarmalavičiūtė, Virginijus Tunaitis, Alina Pūrienė, Algirdas Venalis, Augustas Pivoriūnas
Regeneration of periodontal tissue represents a major challenge to modern tissue engineering, since cell-based therapies require large amounts of periodontal ligament stromal cells (PLSC), which can be obtained only by in vitro expansion. Ideally, the period of the in vitro expansion should be optimized for the generation of large enough numbers of pre-specified progenitor cells ready to contribute to the restoration of periodontal tissues.In the present study, we used a commercially available, three-dimensional culturing platform and alginate microcarrier cell culture system for the propagation of human PLSCs, which were derived using the explant outgrowth method. Induction of osteogenic differentiation resulted in rapid and robust mineralization of the extracellular matrix in PLSCs grown on microcarriers, but not in PLSCs grown under standard culture conditions. Gene expression studies revealed upregulation of osteogenesis-related genes, BMP2, ALP, RUNX2, MSX2, cementum protein 23, bone sialoprotein, osteopontin and periostin, in undifferentiated and differentiating microcarrier cultures of PLSCs. In addition, the microcarrier culture enhanced the expression of β-catenin, intermediate filament protein vimentin and focal adhesion proteins vinculin and paxillin.Our study shows that microcarrier culture allows rapid generation of large numbers of PLSCs pre-specified towards an osteogenic-like phenotype. This method may be useful for the development of new tissue engineering protocols for the reconstruction of periodontal tissues.

http://ift.tt/2oC8v58

Case 10-2017 — A 6-Month-Old Boy with Gastrointestinal Bleeding and Abdominal Pain

Presentation of Case. Dr. Akash Gupta (Medicine and Pediatrics): A 6-month-old boy was seen in the emergency department of this hospital because of gastrointestinal bleeding and abdominal pain. The patient had been in his usual state of health until 2 days before presentation, when his parents…

http://ift.tt/2nCQHJA

High-Risk Neuroblastoma with Metastases to Bilateral Kidneys at Diagnosis

Renal metastasis at diagnosis with neuroblastoma is rare. We present a 14-month-old boy who was diagnosed with high-risk neuroblastoma with multiple metastases, including bilateral kidneys. He received five cycles of induction chemotherapy and high-dose chemotherapy with autologous peripheral blood stem cell transplantation. All of the lesions shrank, and magnetic resonance imaging indicated that some of the metastases had disappeared. However, there were residual masses in the bilateral kidneys, and histological examination revealed the presence of tumor cells. Therefore, the patient underwent unrelated cord blood stem cell transplantation, which involved killer-ligand incompatibility in the graft-versus-host direction, in addition to human leukocyte antigen C and DRB1 mismatches. Three months later, tumor progression occurred from the residual mass in the sacral canal and a new lesion in the pancreas. Although tumor progression could not be controlled by additional chemotherapy and local radiotherapy, the metastatic nodules in bilateral kidneys did not increase in size before his death. To the best of our knowledge, this is the first report of neuroblastoma with bilateral renal metastases in the English medical literature. In addition, this case suggests that the combination of chemotherapy and immunotherapy may inhibit the progression of the renal lesions under certain conditions.

http://ift.tt/2njlfN2

The effect of skin moisture, pH, and temperature on the density of Demodex folliculorum and Demodex brevis (Acari: Demodicidae) in students and staff of the Erzincan University, Turkey

Abstract

Background

The aim of this study was to determine the prevalence and density of Demodex folliculorum and Demodex brevis in students and staff of the Erzincan University, Turkey, and to define the influence of age, gender, educational level, and hygiene as well as skin moisture, pH, and temperature on the presence of Demodex mites.

Methods

Healthy people without apparent facial dermatoses from nine faculties and five vocational schools of the university were included in the study. The measurements for moisture, pH, and temperature were conducted in the cheek region, while samples for mite presence were taken from the same region using the standard superficial skin biopsy technique.

Results

A total of 538 healthy people, 385 students and 153 university staff, were included in the study. Demodex mites were detected in 50.1% of the students (mean 7.1/cm²) and in 69.3% of the university staff (mean 13.1/cm²). There were statistical differences between the groups of people who were cleaning their face one, two, three, or more times daily and between those who were using and not using personal towels. There was a borderline significant difference between the different age groups and people with different education levels. The density of mites was higher in those with a skin moisture of less than 50%, with a pH of 5–6.5 and temperature of 24–28 °C, however the differences between the groups with different skin moisture, skin pH, and skin temperature were not statistically significant.

Conclusion

Demodex mites are very prevalent in healthy individuals of both sexes, and this should be taken into consideration when epidemiological and clinical studies are conducted with patients having different dermatological ailments.

http://ift.tt/2nmPseJ

Αρχειοθήκη ιστολογίου

Πέμπτη 30 Μαρτίου 2017

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