Publication date: Available online 17 May 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Onur Akın, Mutluay Arslan, Cem Haymana, Erdem Karabulut, Bulent Hacihamdioglu, Suleyman Tolga Yavuz
BackgroundChildhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.ObjectiveTo investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma.MethodsChildren without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry.ResultsA total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV1/FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV1, FEV1/FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV1 and FEV1/FVC values.ConclusionWe identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity.
http://ift.tt/2qviMEm
Τετάρτη 17 Μαΐου 2017
Association of neck circumference and pulmonary function in children
Bullöses Pemphigoid: Doxycyclin statt Prednisolon?
Bekommen Patienten mit bullösem Pemphigoid weniger schwere Nebenwirkungen unter Doxycyclin als unter der Standardtherapie mit oralem Prednisolon? Eine aktuelle Studie gibt Aufschluss.
http://ift.tt/2pIjL57
Melanom: Lymphknotendissektion auch therapeutisch von Nutzen?
Eine Sentinellymphknotendissektion bei Melanompatienten könnte nicht nur einen diagnostischen, sondern auch einen therapeutischen Nutzen haben. Hinweise dafür liefert eine Studie mit fast 600 Patienten ohne Fernmetastasen.
http://ift.tt/2pIpfNc
Jahreshighlight der Kongresssaison
Offensichtlich kam das Konzept 2015 gut an: Auch in diesem Jahr wurde bei der Tagung der Deutschen Dermalogischen Gesellschaft (DDG) vom 26.–29. April im Berliner City Cube in über 60 Kursen, Symposien und Plenarvorträgen versucht, die Neuerungen auf dem weiten Feld der Dermatologie abzudecken. Präsentiert und diskutiert wurden unter anderem kutane Nebenwirkungen der Immuntherapie, Biosimilars bei Psoriasis und die Zukunft molekularer Diagnostik von entzündlichen Dermatosen.
http://ift.tt/2pICIEE
Infliximab wirkt rasch gegen Psoriasis
In einer Vergleichsstudie haben Patienten mit Psoriasis unter Infliximab rascher einen PASI 75 erreicht als unter Etanercept. Längerfristig war aber kein Unterschied im Therapieerfolg festzustellen.
http://ift.tt/2qtQw2X
Streifen auf dem Nagel: Wann besteht Melanomverdacht?
Hochauflösende Dermatoskopie-Aufnahmen haben europäische Dermatologen retrospektiv ausgewertet, um zu prüfen, wie gut sich ein Melanom bei streifenförmiger Nagelpigmentierung dermatoskopisch diagnostizieren lässt.
http://ift.tt/2pIzyRc
Die Rente der Ärzte ist sicher – aber...
Auch die ärztlichen Versorgungswerke müssen die Gürtel in Zeiten niedriger Zinsen enger schnallen. Daher lohnt es sich für Ärzte durchaus, eine komplementäre Vorsorgestrategie zu ihrer – an sich sicheren – Rente zu verfolgen.
http://ift.tt/2pJ0Dnl
Klinische Studien: Viele Patienten sind interessiert und wissbegierig
Klinische Arzneimittelstudien sind integraler Bestandteil des medizinischen Versorgungsalltags. Optimierungspotenzial gibt es laut Umfrage aber bei der Rekrutierung der Probanden.
http://ift.tt/2quesDf
Histaminarme Diät gegen chronische Urtikaria
Kann man durch den Verzicht auf stark histaminhaltige Lebensmittel die Symptome einer chronisch spontanen Urtikaria bessern? In einer deutschen Studie funktionierte das Rezept.
http://ift.tt/2pIFklL
PDT: Wie wird die Haut optimal vorbereitet?
Um die Aufnahme von topischen Photosensibilisatoren zu erleichtern, wird eine physikalische Vorbehandlung der Haut empfohlen. Die effektivste Methode wurde nun in einer Vergleichsstudie ermittelt.
http://ift.tt/2quoFQd
Mukosales Melanom: Kombination geprüft
Mit einer gepoolten Datenanalyse wurde erstmals die Sicherheit und Wirksamkeit von Nivolumab als Monosubstanz und in Kombination mit Ipilimumab beim seltenen, hochaggressiven Schleimhautmelanom untersucht.
http://ift.tt/2pIZ9cV
Junge Ärzte wollen sanften Einstieg in die eigene Praxis
Niederlassung als Chance? Viele junge Mediziner sehen das eher skeptisch. Dabei bietet die Selbstständigkeit tatsächlich gute Entfaltungsmöglichkeiten – wenn man es richtig anpackt.
http://ift.tt/2qus41w
Narben als Schmuck und Initiation
Feine Linien überziehen die Gesichter der Bétamarribé. Die Männer der Kaningara ahmen die schuppige, raue Haut des Krokodils nach. Viele Kulturen kennen Narben als Zeichen der Schönheit und der Initiation.
http://ift.tt/2pIpesC
Pediatric nasal surgery prior to puberty is not only safe, but may prevent facial deformity in certain patients.
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Improve the Treatment of Thoracic Esophageal Cancer
Interventions: Drug: adjuvant chemotherapy; Procedure: standard two field Lymphadenectomy; Procedure: Total two field Lymphadenectomy; Procedure: three field Lymphadenectomy
Sponsor: Sun Yat-sen University
Recruiting - verified May 2017
http://ift.tt/2qUgmjR
Effects of Vaccination with the C-Strain Vaccine on Immune Cells and Cytokines of Pigs Against Classical Swine Fever Virus
Viral Immunology , Vol. 0, No. 0.
http://ift.tt/2qUamHR
Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review
Summary
Background
It has been proposed that the frequent ingestion of baked hen's egg or cow's milk accelerates the resolution of hen's egg or cow's milk allergy. This practice is being introduced into clinical practice.
Objective
To systematically review the evidence to determine whether the introduction of baked hen's egg or cow's milk into the diet of children with hen's egg or cow's milk allergies respectively leads to a larger proportion of children outgrowing these allergies than expected.
Methods
A systematic review of the literature was conducted in Medline, Embase and CINAHL. The inclusion criteria were as follows: randomized control trials, case-control or cohort studies; children aged 0–18 years with hen's egg or cow's milk allergy; baked hen's egg or cow's milk intervention with or without a comparator; and resolution of the hen's egg or cow's milk allergy as determined by food challenge as the outcome. Studies were critically appraised using the quality assessment tool for quantitative studies. PROSPERO reference CRD42015026029.
Results
We identified 851 and 2816 hen's egg and cow's milk articles respectively. Only three hen's egg and three cow's milk studies fulfilled our pre-specified inclusion criteria. The studies concluded that baked products either increased the likelihood of the resolution of allergy or accelerated resolution. However, when critiqued, all studies were classified as weak because they were observational, lacking an appropriate control group; this brings into doubt the study's conclusions. There were a number of examples of severe reactions to baked products.
Conclusion
There is little evidence to address the hypothesis that the ingestion of baked hen's egg or cow's milk results in more patients outgrowing their hen's egg or cow's milk allergy respectively. Data are required from a trial comparing the resolution rates of baked-tolerant participants who are randomized to ingest or avoid baked products to assess the accuracy of this hypothesis.
http://ift.tt/2quCfVN
Psychoonkologische Betreuung von Patienten mit Kopf-Hals-Tumoren
Laryngo-Rhino-Otol 2017; 96: 319-331
DOI: 10.1055/s-0043-102814
Onkologische Erkrankungen und ihre Behandlungen führen zu starken Einschränkungen in der körperlichen sowie psychosozialen Lebensqualität, wobei Patienten mit Kopf-Hals-Tumoren zu den am stärksten belasteten Gruppen von Krebspatienten zählen. Der Beitrag vermittelt einen aktuellen Überblick über zentrale Aspekte der psychoonkologischen Betreuung dieser Patienten.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2pYb8hR
Tiefer Halsabzess: Verspätete Drainage bei Erwachsenen nachteilig, bei Kindern nicht
Laryngo-Rhino-Otol 2017; 96: 275-276
DOI: 10.1055/s-0042-123653
Cramer JD et al. The Impact of Delayed Surgical Drainage of Deep Neck Abscesses in Adult and Pediatric Populations. Laryngoscope 2016; 126: 1753–1760 Bei Erwachsenen besteht die konventionelle Therapie des tiefen Halsabzesses aus Antibiotikagabe und rascher chirurgischer Drainage. Bei Kindern ist man oft zurückhaltender. Hintergrund sind Berichte über Fälle von erfolgreicher alleiniger Antibiose. Unklar ist, inwieweit der Zeitpunkt der Drainage den Therapieerfolg bei Erwachsenen und Kindern beeinflusst. US-Mediziner haben das untersucht.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2qtyC21
Seltene Differenzialdiagnose bei Tinnitus und Hörstörung
Laryngo-Rhino-Otol 2017; 96: 314-315
DOI: 10.1055/s-0043-105794
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2pYbntt
Peritonsillarabszess – Schmerzfreiheit durch kraniale Tonsil-lotomie
Laryngo-Rhino-Otol 2017; 96: 276-277
DOI: 10.1055/s-0043-101049
Windfuhr JP et al. Cranial tonsillotomy for peritonsillar abscess: what a relief! Eur Arch Otorhinolaryngol 2016; 273: 4507–4513 Beim Peritonsillarabszess (PTA) hat sich u. a. die Inzisionsdrainage (ID) als wirksam erwiesen, erfordert aber immer wieder ein schmerzhaftes Nachspreizen. HNO-Ärzte der Kliniken Maria Hilf in Mönchengladbach ergänzten daher die ID um eine kraniale Tonsillotomie zur zuverlässigen Drainage von Wundsekret.
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© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2qtq9fc
Kommentar der Schriftleitung
Laryngo-Rhino-Otol 2017; 96: 273-273
DOI: 10.1055/s-0043-102241
Liebe Leserinnen und Leser,in den Mai starten wir mit der Diskussion, wann ein tiefer Halsabszess drainiert werden muss; eine wichtige Frage im klinischen Alltag, die selten wissenschaftlich untersucht wird. Dann wird eine Modifikation der Abszessdrainage bei Peritonsillarabszess diskutiert, die für den Patient weniger Schmerzen zu Bedeuten scheint. Hörtest per App, ein Thema, das uns sicher noch die nächsten Jahre begleiten wird, rundet die Rubrik „Referat + Kommentar" ab.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2pYotGM
Hörtests funktionieren mit entsprechender App auch am heimischen Tablet-Computer
Laryngo-Rhino-Otol 2017; 96: 277-278
DOI: 10.1055/s-0043-101081
Whitton PJ et al; Validation of a Self-Administered Audiometry Application: An Equivalence Study; Laryngoscope 2016; 126: 2382–2388 Die Häufigkeit von Hörverlusten wird in den nächsten Jahrzehnten noch deutlich zunehmen. Das flächendeckende Angebot entsprechender Hörtests durch speziell geschultes Personal kann somit leicht an seine Grenzen stoßen. US-amerikanische HNO-Ärzte aus Boston haben jetzt untersucht, ob sich mit einer entsprechenden Software das eigene Hörvermögen nicht auch am heimischen Computer testen lässt.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2qtoi9Y
Aus der Gutachtenpraxis: Gibt es Gehörschäden durch Vibrationen, Infraschall, Ultraschall und/oder Körperschall?
Laryngo-Rhino-Otol 2017; 96: 316-318
DOI: 10.1055/s-0043-102233
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2pYai4J
Schluckstörungen bei tracheo(s)tomierten Patienten
Laryngo-Rhino-Otol 2017; 96: 280-292
DOI: 10.1055/s-0043-103279
Hintergrund Seit vielen Jahren sind in der Fachliteratur Hinweise zu finden, wonach bei tracheo(s)tomierten Patienten mit Schluckstörungen zu rechnen ist, deren schwerwiegendster Aspekt die Aspiration darstellt. Die vorliegende Arbeit soll einen aktuellen Beitrag zur Diskussion leisten, ob ein Tracheostoma eine Dysphagie verursacht oder verstärkt oder lediglich eine zeitliche Koinzidenz vorliegt. Material und Methoden Die Übersichtsarbeit beruht auf einer Recherche in der textbasierten Datenbank PubMed des National Center for Biotechnology Information (NCBI). Ergebnisse Es wurden die Effekte einer Tracheotomie/Tracheostomie sowie die Effekte einzelner Kanülentypen auf motorische und sensorische Aspekte des Schluckvorgangs geprüft. Die erfassten Studien fokussieren dabei in besonderer Weise die Aspirationshäufigkeit und zeigen eine insgesamt uneinheitliche Datenlage, welche keine zwingenden Beweise für eine eindeutige und kausale Beziehung zwischen dem Vorhandensein eines Tracheostomas und einer schweren Beeinträchtigung des Schluckens erkennen lassen. Schlussfolgerungen Patienten mit einem Tracheostoma bedürfen ohne Zweifel einer besonderen Aufmerksamkeit im Hinblick auf das Vorhandensein relevanter Schluckstörungen. Diese sind aber möglicherweise eher einer schweren Grunderkrankung geschuldet als dem Vorhandensein des Tracheostomas per se.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2qtxo6I
Fragen für die Facharztprüfung
Laryngo-Rhino-Otol 2017; 96: 332-333
DOI: 10.1055/s-0043-102234
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2pYng2q
Korrektur einzelner Septumabschnitte
Laryngo-Rhino-Otol 2017; 96: 334-340
DOI: 10.1055/s-0043-107264
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2qtEOad
Repeated haemorrhages in peripheral nerve sheath tumours of the salivary glands after minor injury
Repeated haemorrhages in peripheral nerve sheath tumours of the salivary glands are rare. We report the case of a patient with neurofibromatosis type 1 who had two episodes of massive haemorrhage in his right parotid gland the day after a minor injury. Oral and maxillofacial surgeons should be aware that vasculopathy may occur in patients with these tumours.
http://ift.tt/2qTo1yH
Adaptation, validity, and reliability of the Preschool Language Scale–Fifth Edition (PLS–5) in the Turkish context: The Turkish Preschool Language Scale–5 (TPLS–5)
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): A. Sanem Sahli, Erol Belgin
IntroductionSpeech and language assessment is very importantin early diagnosis of children with hearing and speech disorders. Aim of this study is to determine the validity and reliability of Preschool Language Scale (5th edition) test with its Turkish translation andadaptation.Methods and materialsOur study is conducted on 1320 children aged between 0-7 years 11 months. While 1044 of these children have normal hearing, language and speech development, 276 of them have receptive and/or expressive language disorder. After the English-Turkish and Turkish-English translations of PLS-5 made by two experts command of both languages, some of the test items are reorganized because of the grammatical features of Turkish and the cultural structure of the country. The pilot study was conducted with 378 children. The test which is reorganized in the light of data obtained in pilot application, is applied to children chosen randomly with layering technique from different regions of Turkey, then 15 days later the first test applied again to 120 children.ResultsWhile 1044 of 1320 children aged between 0 and 7 years 11 months are normal, 276 of them have receptive and/or expressive language disorder. While 98 of 103 healthy children of 120 taken under the second evaluation have normal language development, 8 of 9 who used to have language development disorder in the past still remaining (Kappa coefficient:0,468, p<0,001). Pearson correaltion coefficient for TPLS-5 standard gauge are; IA raw score:0,937, IED raw score: 0,908 and TDP: 0,887 respectively. Correlation coefficient for age equivalance is found as IA:0,871, IED: 0,896, TDP: 0,887.ConclusionsTPLS-5 is the first and only language test in our country that can evaluate receptive and/or expressive language skills of children aged between 0-7 years 11 months. Results of the study show that TPLS-5 is a valid and reliable language test for the Turkish children.
http://ift.tt/2rsB0DA
Polysomnography results versus clinical factors to predict post-operative respiratory complications following pediatric adenotonsillectomy
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): John S. Saur, Scott E. Brietzke
ObjectiveSystematically review the published literature comparing the presence of clinical features (age, BMI, co-morbidities, etc.) versus polysomnogram (PSG) results in the prediction of major post-operative respiratory complications following pediatric adenotonsillectomy (T/A) for the treatment of Obstructive Sleep Apnea Syndrome (OSAS).MethodsA systematic review of the PUBMED and EMBASE databases was performed to identify studies containing both clinical and PSG data predicting major post-operative respiratory complications following T/A. Inclusion criteria included English language and extractable data. Major respiratory complications were defined as events that required significant intervention (intubation, CPAP,etc.) and/or altered patient disposition. Random effect modeling was performed and study quality was assessed using the Newcastle-Ottawa Scale.ResultsTwenty-two studies met the inclusion criteria with a median sample size of 157 (range 26–1735) and published between 1992 and 2015. The most common study design was a case series. Most studies included multiple patients at high risk for respiratory complications (Syndromic, obese, etc.). The summary estimate of the major respiratory complication rate following T/A was only 5.8% (95% CI = 4.2–7.4%, p < 0.001, I2 = 99%). For studies with extractable data, 102 of 112 patients (91.1%) with a post-operative respiratory complication had a clearly identifiable clinical risk factor, the remainder (8.9%) had only moderate or severe OSAS on PSG and no other predictor.ConclusionThe major respiratory complication rate following pediatric T/A for OSAS is low even amongst series of high risk patients. The majority of the published literature report that readily identified clinical factors predict the large majority of post-operative respiratory complications following T/A.
http://ift.tt/2quhppv
Dental age is more appropriate than chronological age for evaluating the mandibular movement range in children
The measurement of excursive jaw movements is an important instrument for evaluating the functional condition of the temporomandibular system. Dento-maxillofacial development differs widely within different age, weight or height clusters. Tooth eruption is part of the development of the temporomandibular system. Therefore, the dental developmental stage might reflect temporomandibular development more appropriately. The aim of this study is to investigate whether the dental age is a more suitable parameter for evaluating the mandibular movement range of children in the mixed dentition stage than chronological age.
http://ift.tt/2qTdeEO
The epidemiological analysis of maxillofacial fractures in Italy: The experience of a single tertiary center with 1720 patients
Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy.
http://ift.tt/2rsxvhg
Can cyst volume be used to stratify risk of complications following cyst defect reconstruction with iliac crest graft?
Jaw cysts represent common lesions in the oral and maxillofacial region (Swantek et al. 2012). They are defined as a pathological cavity which is not created by the accumulation of pus and which contains fluid, semifluid or gaseous contents (Kramer 1974). The most common odontogenic cysts are radicular (56%) and dentigerous cysts (17%) (Manor et al. 2012). In the early stages, odontogenic cysts often go along with unspecific symptoms and are commonly diagnosed incidentally through routine panoramic radiographs (Ochsenius et al.
http://ift.tt/2rsPTqC
A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part IV: 3D analysis─is there evidence?
The planning of orthognathic surgery has traditionally been performed using two-dimensional (2D) technology and 2D cephalograms. Most studies have been conducted using this methodology, whereby the soft tissue response to bone movements under different surgical conditions can be determined (San Miguel de Moragas et al., 2014; San Miguel de Moragas et al., 2015; Olate et al., 2016); however, the same articles have shown variability related to surgical technique in 2D analyses.
http://ift.tt/2qTatDn
Association of neck circumference and pulmonary function in children
Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.
http://ift.tt/2qTfAn9
Advances in Radiation Oncology
Treatment of squamous cell carcinoma of the head and neck is rapidly evolving due to changing patient populations, an emphasis on quality of life–related outcomes, and advances in radiotherapy concepts and techniques to meet these new demands. This review includes recent and ongoing studies that are potentially practice changing, including improvements in intensity-modulated radiotherapy planning, the use of deintensified regimens in the human papilloma virus–related setting, and adjuvant therapy after transoral robotic surgery. Additionally, recent studies of modern proton therapy are reviewed.
http://ift.tt/2pMC2yb
Precision Medicine
Precision medicine is the application of genotypic and Omics biomarkers to determine the most appropriate, outcome-driven therapy for individual patients. To determine the best choice of therapy, institutions use significant information technology–enabled data from imaging, electronic medical records, sensors in the clinic/hospitals, and wearable sensors to determine treatment response. With genomic profiling, targets to affect a disease course are continuing to be developed. As clonal mutational prevalence continues to be understood, information can be communicated to patients to inform them that resistance is common, requiring collection of more genetic mutations from patients with further biopsies or blood collection.
http://ift.tt/2qxHx0D
Multicenter Patch Testing With Methylchloroisothizoline/Methylisothiazolinone in 100 and 200 ppm Within the International Contact Dermatitis Research Group
Background: The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known contact sensitizer. Historically, there have been different opinions on the optimal patch test concentration of MCI/MI, and both 0.01% and 0.02% aqueous (aq.) have been proposed. In 2011, based on literature reviews, it was recommended that the concentration of 0.02% aq. should be used in the international baseline series. Objectives: The aim of this study was to verify the recommendation from 2011 by comparing the patch test results from consecutive patch testing with MCI/MI 0.01% and 0.02% in clinics representing countries around the world. Patients and Methods: Two thousand seven hundred three consecutive patients with dermatitis in 8 dermatology clinics representing 8 countries were patch tested with MCI/MI 0.01% aq. and, in parallel with MCI/MI 0.02% aq., provisionally included in the baseline series. Results: Contact allergy to MCI/MI at 0.01% and 0.02% was found in 3.7% and 5.6% of the patients, respectively (Phttp://ift.tt/2qSZEB1
Unreported Sources of Nickel Exposure in Community-Based Facilities Frequented by Children
No abstract availablehttp://ift.tt/2qSWj5f
Preventing Occupational Skin Disease: A Review of Training Programs
Occupational contact dermatitis (OCD) is a common occupational disease that impacts a variety of worker groups. Skin protection and disease prevention training programs have shown promise for improving prevention practices and reducing the incidence of OCD. This review details the features of training programs for primary prevention of OCD and identifies gaps in the literature. Twelve studies were identified for in-depth review: many studies included wet workers employed in health care, hairdressing, cleaning, and food preparation; 1 program featured manufacturing workers. Few programs provided content on allergic contact dermatitis, and only 1 was evaluated for long-term effectiveness. Effective programs were similar in content, delivery method, and timing and were characterized by industry specificity, multimodal learning, participatory elements, skin care resource provision, repeated sessions, and management engagement. Long-term effectiveness, generalizability beyond OCD, workplace health and safety culture impact, and translation of programs in the North American context represent areas for future research.http://ift.tt/2qTceR9
The Latest Occult “Hypoallergenic” Allergen: Ethylhexylglycerin
No abstract availablehttp://ift.tt/2qSVHwk
Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014
Background: Little is known about the epidemiology of contact dermatitis in production workers (PWs). Objective: The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. Methods: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. Results: Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (Phttp://ift.tt/2qSSywA
Occupational Contact Dermatitis in North American Print Machine Operators Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014
Background: Little is known about the epidemiology of contact dermatitis (CD) in print machine operators (PMOs). Objective: The aims of this study were to estimate the prevalence of CD and characterize clinically relevant and occupationally related allergens among PMOs undergoing patch testing. Methods: This was a retrospective cross-sectional analysis of the North American Contact Dermatitis Group data from 1998 to 2014. Results: Of 39,332 patch-tested patients, 132 (0.3%) were PMOs. Among PMOs, most were male (75.0%) and white (92.4%). The majority were printing press operators (85.6%). The most frequent sites of dermatitis were hands (63.6%), arms (29.5%), and face/scalp (24.2%). More than half had an occupationally related skin condition (56.1%). Final diagnoses were most commonly allergic CD (58.3%) and irritant CD (33.3%). Cobalt (20.8%), carba mix (12.5%), thiuram mix (8.3%), and formaldehyde (8.3%) were the most frequent occupationally related allergens. The top allergen sources included inks (22.9%), gloves (20.8%), and coatings/dye/copy/photographic chemicals (14.6%). Conclusions: Allergic CD, irritant CD, and involvement of exposed body areas were common among PMOs. Common allergens included rubber accelerators, metals, and preservatives.http://ift.tt/2rsiBrD
Brushing Your Way to Allergic Contact Dermatitis: Anethole Allergy
No abstract availablehttp://ift.tt/2rsedIR
Epidemic of Isothiazolinone Allergy in North America: Prevalence Data From the North American Contact Dermatitis Group, 2013–2014
Background: Preservative sensitivity patterns evolve with changing use patterns in products. During the last decade, the use of methylisothiazolinone (MI) at higher concentrations in both leave-on and rinse-off products has significantly increased. This is the first North American Contact Dermatitis Group reporting cycle that includes both methylchloroisothiazolinone (MCI)/MI and MI data. Objective: The aim of this study was to report the prevalence of isothiazolinone allergy (MCI/MI and MI) in the North American Contact Dermatitis Group patch-test population from January 1, 2013, to December 31, 2014. Methods: At 13 centers in North America, 4860 patients were patch tested in a standardized manner with a series of 70 allergens, including MCI/MI 0.01% aqueous (aq) and MI 0.2% aq. Results: Three hundred five patients (6.3%) had a positive reaction to MCI/MI; this is a significant increase from the previous cycle (5.0%, 2011–2012; P = 0.011). Five hundred twenty-one patients (10.7%) had a positive reaction to MI. These 2 isothiazolinones were among the most common preservative allergens in the 2013 to 2014 cycle; 11.9% of patch-tested individuals were allergic to 1 or both isothiazolinones. Individuals with MCI/MI and MI allergy were significantly more likely to have occupationally related skin disease (Phttp://ift.tt/2rspf0G
Intralesional Treatment With 5-Fluorouracil and Steroid Improves Allergic Contact Dermatitis Without Causing Skin Atrophy and Rebound Lesions
No abstract availablehttp://ift.tt/2rsmYmn
Multicenter Patch Testing With Methylisothiazolinone and Methylchloroisothiazolinone/Methylisothiazolinone Within the International Contact Dermatitis Research Group
Background: The preservatives methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI are well-known contact sensitizers. Recently, an increase in the contact allergy frequency for MI 0.2% aqueous (aq) has been seen in many European countries paralleled with an increase in MCI/MI allergy. Many of the MI-allergic patients do not react to MCI/MI 0.01% or 0.02% because the concentration of MI in these preparations is too low (25 and 50 ppm, respectively) to elicit a positive patch test reaction. Objectives: The aims of this study were to investigate the prevalence of contact allergy to MI in the participating clinics representing various countries all over the world, to assess how many additional individuals with contact allergy are found by testing MI 0.2% aq in parallel with MCI/MI 0.02%, and to assess the clinical relevance of MI and MCI/MI allergies. Patients and Methods: In 9 dermatology clinics representing 9 countries, 3865 consecutive patients with dermatitis were patch tested with MI 0.2% aq and in parallel with MCI/MI 0.02% aq, provisionally included into the baseline series. An assessment of clinical relevance in those allergic to MI was also made. Results: Contact allergy to MI was found in 284 patients (7.3%). The frequency of contact allergy varied from 0.8% to 10.9% in different centers. Simultaneous reactivity to 200 ppm of MCI/MI was found in 67.3% of the MI-positive patients. Contact allergy to MI alone without any simultaneous contact allergy to 200 ppm of MCI/MI was diagnosed in 93 patients (32.7%; 2.4% of all tested patients). The contact allergy to MI and/or MCI/MI could explain or contribute to dermatitis in more than 60% of the MI-allergic patients. Conclusions: Methylisothiazolinone of 2000 ppm needs to be patch tested on its own to not miss contact allergy.http://ift.tt/2rsrZeE
Contact Allergens in Food Handlers of Kashmir Valley in North India
No abstract availablehttp://ift.tt/2rsrYHC
Index
Source:Anesthesiology Clinics, Volume 35, Issue 2
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Copyright
Source:Anesthesiology Clinics, Volume 35, Issue 2
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Contributors
Source:Anesthesiology Clinics, Volume 35, Issue 2
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Contents
Publication date: June 2017
Source:Anesthesiology Clinics, Volume 35, Issue 2
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Forthcoming Issues
Source:Anesthesiology Clinics, Volume 35, Issue 2
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Pharmacology
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Lee A. Fleisher
http://ift.tt/2pXySTt
Pharmacology
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Alan D. Kaye
http://ift.tt/2qsVLSd
The Future of Pharmacology in Anesthesia Practice
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Alan D. Kaye
http://ift.tt/2pXlmiC
Anticoagulation and Neuraxial/Peripheral Anesthesia
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Mudit Kaushal, Ryan E. Rubin, Alan D. Kaye, Karina Gritsenko
Teaser
Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges. In addition to discussing NAGs, we also review the existing American Society of Regional Anesthesia guidelines for heparin, low-molecular-weight heparin, and antiplatelet agents.http://ift.tt/2qsVjmM
Pharmacology of Antiemetics
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Alan D. Kaye, Elyse M. Cornett, John Chalabi, Natale Z. Naim, Matthew B. Novitch, Justin B. Creel, Preya Jhita, Thomas N. Trang, Jacquelyn R. Paetzold, Nicholas Darensburg, Burton D. Beakley, Richard D. Urman
Teaser
Postoperative nausea and vomiting (PONV) is associated with delayed recovery and dissatisfaction after surgical procedures. A key component to management is identifying risk factors and high-risk populations. Advances in pharmacologic therapeutics have resulted in agents targeting different pathways associated with the mediation of nausea and vomiting. This review focuses on these agents and the clinical aspects of their use in patients postoperatively. Combination therapies are reviewed, and studies demonstrate that when 2 or more antiemetic agents acting on different receptors are used, an overall improved efficacy is demonstrated when compared with a single agent alone in patients.http://ift.tt/2pXwDPT
Pharmacology of Octreotide
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Reza M. Borna, Jonathan S. Jahr, Susanna Kmiecik, Ken F. Mancuso, Alan D. Kaye
Teaser
Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and begin a continuous infusion of 500 μg/h for all NET patients. Advantages include low cost and excellent safety profile. High-dose octreotide for midgut and foregut NETs requires an appreciation of the pathophysiology involved in the disease, pharmacology, drug–drug interactions, and side effects.http://ift.tt/2qsY6fN
Perioperative Pharmacologic Considerations in Obesity
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Simon Willis, Gregory J. Bordelon, Maunak V. Rana
Teaser
Obesity has increased in incidence worldwide. Along with the increased number of obese patients, comorbid conditions are also more prevalent in this population. Obesity leads to changes in the physiology of patients along with an altered response to pharmacologic therapy. Vigilant perioperative physicians must be aware of the unique characteristics of administered agents in order to appropriately provide anesthetic care for obese patients. Because of the variability in tissue content in obese patients and changes in pharmacokinetic modeling, a one-size-fits-all approach is not justified and a more sophisticated and prudent approach is indicated.http://ift.tt/2pXJstn
Pharmacogenomics in Anesthesia
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Ramsey Saba, Alan D. Kaye, Richard D. Urman
Teaser
A significant number of commonly administered medications in anesthesia show wide clinical interpatient variability. Some of these include neuromuscular blockers, opioids, local anesthetics, and inhalation anesthetics. Individual genetic makeup may account for and predict cardiovascular outcomes after cardiac surgery. These interactions can manifest at any point in the perioperative period and may also only affect a specific system. A better understanding of pharmacogenomics will allow for more individually tailored anesthetics and may ultimately lead to better outcomes, decreased hospital stays, and improved patient satisfaction.http://ift.tt/2qt1Rlv
Pharmacogenomics in Pain Management
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Ramsey Saba, Alan D. Kaye, Richard D. Urman
Teaser
There is interpatient variability to analgesic administration. Much can be traced to pharmacogenomics variations between individuals. Certain ethnicities are more prone to reduced function of CYP2D6. Weak opioids are subject to interpatient variation based on their CYP2D6 type. Strong opioids have variations based on their transport and individual metabolism. Several cytochrome enzymes have been found to be involved with ketamine but there is no strong evidence of individual polymorphisms manifesting in clinical outcomes. Nonsteroidal anti-inflammatory drugs have adverse outcomes that certain CYP variants are more prone toward. There are now recommendations for dosing based on specific genomic makeup.http://ift.tt/2qxrQGD
Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines
Source:Anesthesiology Clinics, Volume 35, Issue 2
Author(s): Anair Beverly, Alan D. Kaye, Olle Ljungqvist, Richard D. Urman
Teaser
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS). We describe current evidence and important future directions for effective perioperative multimodal analgesia in enhanced recovery pathways.http://ift.tt/2pMlxlz
A Side-by-Side Look at the Most Common Rosacea Treatments
A quick comparison of the most common treatments for rosacea.
Medscape Dermatology
http://ift.tt/2rsiv2S
How Are Rosacea and Migraines Connected?
Dr Graeme Lipper reviews the literature on the link between rosacea and migraine.
Medscape Dermatology
http://ift.tt/2rruzRv
Optimized immunohistochemistry using the D5F3 antibody provides a reliable test for identification of ALK-positive lung adenocarcinomas
Abstract
We used optimized immunohistochemistry (IHC) with the D5F3 antibody for detection of tumours in a prospective study of 307 pulmonary adenocarcinomas. Cases positive by IHC (1+, 2+, 3+) were further investigated by fluorescent in situ hybridization (FISH). Of 307 cases, 22 (7.2%) were moderately intensely positive (2+/3+); 18 of these (82%) were also positive by FISH. Of the four IHC-positive/FISH-negative cases, one was unsuitable for FISH and three had abnormalities of the ALK gene. All cases with weak reactivity with D5F3 (1+) were FISH-negative. The FISH positive/IHC-positive cases with moderately intense reactivity had the typical clinicopathologic features of ALK-positive patients (younger age, p < 0.01; higher frequency in metastatic sites, p < 0.01; cribriform/mucinous/signet histology, p < 0.01; stage IV disease, p < 0.01). In conclusion, our findings indicate that optimized IHC using the D5F3 antibody provides a reliable and inexpensive test for identification of ALK-positive adenocarcinomas. Inclusion of this information in the pathology report at the time of the histological diagnosis might significantly shorten time to treatment.
http://ift.tt/2qxJGcV
Accept or Decline? An Analytics-Based Decision Tool for Kidney Offer Evaluation.
http://ift.tt/2rsccwe
Hepatic hemodynamics and portal flow modulation: The A2ALL experience.
http://ift.tt/2qSyavp
Die Kopfhaut im Alter
Zusammenfassung
Nichtmelanozytärer Hautkrebs und seine Frühformen sind aufgrund von steigender Inzidenz und Prävalenz häufige Diagnosen im dermatologischen Alltag. Die Diagnostik erfolgt zumeist klinisch mit konsekutiver histologischer Sicherung. Die Therapie der Wahl bei invasiven Tumoren ist die vollständige Exzision, erst bei nicht möglicher Exzision sollten andere Therapieoptionen wie Bestrahlung und Systemtherapien erwogen werden. Häufig an für ältere Menschen schlecht einsehbaren und erreichbaren Bereichen der Kopfhaut lokalisiert, stellen sie im klinischen Alltag eine besondere Herausforderung für Arzt und Patienten dar. Die Therapieoptionen sind insbesondere im Bereich der Vorstufen zahlreich und sollte individuell auf den Patienten abgestimmt werden. Der größte Risikofaktor für die Entstehung von nichtmelanozytärem Hautkrebs und seinen Frühformen ist die chronische UV-Exposition. Ein möglicher beruflicher Zusammenhang sollte immer erwogen werden. Insbesondere die Prävention durch Patientenedukation und ausreichende Sonnenschutzmaßnahmen steht im Vordergrund. Die Prognose des nichtmelanozytären Hautkrebses verbessert sich signifikant bei frühzeitiger Diagnosestellung und leitliniengerechter Therapie und Nachsorge.
http://ift.tt/2qSI3Jv
Serial Neck Ultrasonographic Evaluation of Changes in Papillary Thyroid Carcinoma During Pregnancy
http://ift.tt/2rrQQ2n
Comparison of Survival Outcomes Following Postsurgical Radioactive Iodine Versus External Beam Radiation in Stage IV Differentiated Thyroid Carcinoma
Thyroid , Vol. 0, No. 0.
http://ift.tt/2rs9iHW
Patient-Centered Outcomes in Food Allergy
Abstract
Purpose of Review
Food allergy prevalence is increasing very rapidly, causing a significant disease burden. The threat of severe allergic reactions occurring unexpectedly and in settings that are not equipped to recognize and treat anaphylaxis is a constant source of worry for individuals and families with food allergies. Inadequate knowledge and understanding in the community significantly impairs the overall quality of life of these individuals and families. Additionally, families face challenges in finding and affording appropriate allergen-free foods.
Recent Findings
Advancements have been made in understanding the impact of food allergies on patient-centered outcomes such as quality of life and economic impact, and attempts have been made to develop tools to assess patient-centered variables. Innovative national and regional initiatives are helping to spread awareness of the disease condition and to create resources, including access to allergen-free foods.
Summary
While there is a growing momentum toward recognition of food allergic disorders as a condition that profoundly impacts activities of daily living, greater effort needs to be expounded to develop validated tools and interventions that can adequately address these issues.
http://ift.tt/2qRkoJz
Assessment of condyle, masseter and temporal muscles volumes in patients with juvenile systemic lupus erythematosus: A cross-sectional study
Publication date: Available online 16 May 2017
Source:Journal of Oral Biology and Craniofacial Research
Author(s): Sandra Lucia Golin, Nailu Angélica Sinicato, Karyna Valle-Corotti, Acácio Fuziy, Ana Carla Nahas-Scocate, Simone Appenzeller, Andre Luiz Ferreira Costa
AimsThe purpose of this study was to evaluate the effect of the corticosteroid therapy for both treatment of juvenile systemic lupus erythematosus and disease activity on two masticatory muscles and condyle of the temporomandibular joint.MethodsA total of 21 controls and 48 juvenile systemic lupus erythematosus patients were investigated. Volumes of the temporal and masseter muscles and condyle of the subjects were assessed by using a 3D reconstruction in magnetic resonance imaging. The ITK-SNAP, a medical imaging software, was used for 3D reconstruction. A dental examination with registration of occlusion was performed in subjects. Data were statistically analyzed by means of the Dahlberg's test associated with paired t-test, Fisher's exact test and Chi-square.ResultsThere was a positive correlation between temporalis muscle and age (p=0.032), masseter volume (p=0.029) and condyle volume (p=0.013). The mean volume measurements of temporal and masseter muscles and condyle were not statistically associated with juvenile systemic lupus erythematosus regarding disease activity and corticosteroid therapy (p>0.05). There were no significant differences between malocclusion and volume of muscles and condyle.ConclusionThis study suggested that volume of the target structures has no correlation with cumulative corticosteroid dose, disease activity, and malocclusion.
http://ift.tt/2qx9K7V
Inflammation related genes upregulates in surgical margins of advanced stage oral squamous cell carcinoma
Publication date: Available online 17 May 2017
Source:Journal of Oral Biology and Craniofacial Research
Author(s): Jaijam Suwanwela, Thanaphum Osathanon
AimsAdvanced stage of oral squamous cell carcinoma (OSCC) exhibits different properties compared with the early stage for example an invasion ability. The present study investigated a differential gene expression of surgical margin between advanced and early stage of OSCC.MethodsGene Expression Omnibus dataset (GSE31056) was downloaded and re-analyzed. Surgical margin samples were categorized into 2 groups; early stage and late stage. Differential gene expression analysis was performed. Dysregulated genes were further analyzed for gene ontology, enriched pathway, and disease association using a network-based analysis tools.ResultsEighty-five dysregulated genes were identified in margin of late stage OSCC. Metabolic process and biological regulation were the main gene ontology of dysregulated genes. Genes involved in Jak-STAT signaling pathway were upregulated in late stage of surgical margin samples. In addition, seven upregulated genes in late stage group, namely CEBPB, S1PR1, IL6, CEBPD, CHI3L1, PTX3, and SOCS3, were categorized in acute phase reaction and inflammation categories of disease association analysis.ConclusionThe differential expressed genes in surgical margin of late stage OSCC could be further employed to understand cancer's behavior and to identify target pathway to prevent OSCC invasion.
http://ift.tt/2pMfkWH
Onco-testicular sperm extraction (onco-TESE) for bilateral testicular tumors: two case reports
Most patients with testicular cancer are infertile; thus, the preservation of the sperm after surgery is an important factor to consider. We report two cases of bilateral testicular cancer in patients who unde...
http://ift.tt/2rg0yYf
POU4F3 mutation screening in Japanese hearing loss patients: Massively parallel DNA sequencing-based analysis identified novel variants associated with autosomal dominant hearing loss
by Tomohiro Kitano, Maiko Miyagawa, Shin-ya Nishio, Hideaki Moteki, Kiyoshi Oda, Kenji Ohyama, Hiromitsu Miyazaki, Hiroshi Hidaka, Ken-ichi Nakamura, Takaaki Murata, Rina Matsuoka, Yoko Ohta, Nobuhiro Nishiyama, Kozo Kumakawa, Sakiko Furutate, Satoshi Iwasaki, Takechiyo Yamada, Yumi Ohta, Natsumi Uehara, Yoshihiro Noguchi, Shin-ichi Usami
A variant in a transcription factor gene, POU4F3, is responsible for autosomal dominant nonsyndromic hereditary hearing loss, DFNA15. To date, 14 variants, including a whole deletion of POU4F3, have been reported to cause HL in various ethnic groups. In the present study, genetic screening for POU4F3 variants was carried out for a large series of Japanese hearing loss (HL) patients to clarify the prevalence and clinical characteristics of DFNA15 in the Japanese population. Massively parallel DNA sequencing of 68 target candidate genes was utilized in 2,549 unrelated Japanese HL patients (probands) to identify genomic variations responsible for HL. The detailed clinical features in patients with POU4F3 variants were collected from medical charts and analyzed. Novel 12 POU4F3 likely pathogenic variants (six missense variants, three frameshift variants, and three nonsense variants) were successfully identified in 15 probands (2.5%) among 602 families exhibiting autosomal dominant HL, whereas no variants were detected in the other 1,947 probands with autosomal recessive or inheritance pattern unknown HL. To obtain the audiovestibular configuration of the patients harboring POU4F3 variants, we collected audiograms and vestibular symptoms of the probands and their affected family members. Audiovestibular phenotypes in a total of 24 individuals from the 15 families possessing variants were characterized by progressive HL, with a large variation in the onset age and severity with or without vestibular symptoms observed. Pure-tone audiograms indicated the most prevalent configuration as mid-frequency HL type followed by high-frequency HL type, with asymmetry observed in approximately 20% of affected individuals. Analysis of the relationship between age and pure-tone average suggested that individuals with truncating variants showed earlier onset and slower progression of HL than did those with non-truncating variants. The present study showed that variants in POU4F3 were a common cause of autosomal dominant HL.http://ift.tt/2qtfKAn
Prospective External Validation of Three Preoperative Risk Scores for Prediction of New Onset Atrial Fibrillation After Cardiac Surgery.
http://ift.tt/2rrflf1
Preoperative Warming Versus no Preoperative Warming for Maintenance of Normothermia in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Single Blinded, Randomized Controlled Trial.
http://ift.tt/2rrwR2V
Patient Blood Management in Major Orthopedic Surgery: Less Erythropoietin and More Iron?.
Relationship Between a Sepsis Intervention Bundle and In-Hospital Mortality Among Hospitalized Patients: A Retrospective Analysis of Real-World Data.
http://ift.tt/2rrwNjH
Use of the Fluid Challenge in Critically Ill Adult Patients: A Systematic Review.
http://ift.tt/2rryC07
An Etomidate Analogue With Less Adrenocortical Suppression, Stable Hemodynamics, and Improved Behavioral Recovery in Rats.
http://ift.tt/2qtduJE
Cancellation of Elective Cases in a Recently Opened, Tertiary/Quaternary-Level Hospital in the Middle East.
http://ift.tt/2rrcjHC
Cerebral Oxygen Saturation in Children With Congenital Heart Disease and Chronic Hypoxemia.
http://ift.tt/2qt8RPu
Automated Cleft Speech Evaluation Using Speech Recognition
Publication date: Available online 17 May 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Megan Vucovich, Rami R. Hallac, Alex A. Kane, Julie Cook, Cortney Van'T Slot, James R. Seaward
Perceptual evaluation remains the gold-standard evaluation of cleft speech, but with any human interpretation, there can be bias. Eliminating bias, allowing comparison of speech data between units, is labor and time intensive. Globally, there is a shortage of listeners. We have developed a computer learning system to evaluate cleft speech.Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors. Speech recognition engines typically ignore voice characteristics and speech errors of the speaker, but in cleft speech evaluation, these features are paramount. Our evaluator targets these to distinguish between normal speech, velopharyngeal dysfunction and articulatory speech errors. Speech samples from our Craniofacial Team clinic were recorded and rated independently by two experienced speech pathologists: 60 patients were used to train the evaluator, and the evaluator was tested on the 13 subsequent patients.The inter-speech pathologist agreement rate was 79%. Our cleft speech evaluator achieved 77% on its best sentence and a median of 65% for all sentences.This automated cleft speech evaluator has applications for global cleft speech evaluation when no speech pathologist is available, and for unbiased evaluation, facilitating collaboration between teams. We anticipate that as the training samples increase, the accuracy will match human listeners.
http://ift.tt/2qt0LGA
Screening for psychological distress: a new approach to identify the patient´s psychological needs in a pilot study on oral cancer patients
Publication date: Available online 17 May 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Franziska Sisolefsky, Madiha Rana, Philipp Herzberg, Nils-Claudius Gellrich, Majeed Rana
ObjectiveA new screening tool has been developed to predict the psychological needs of patients with oral cancer.MethodThe new screening method was developed inductively. Screening was pretested using interviews and implemented with 71 patients with oral cancer. Factor analysis was carried out to shorten the questionnaire.ResultsNegative and positive aspects explain forty per cent of the variance in distress, which should be adequate for a first screening. Seventy-nine per cent of the items deal with stable traits such as personality. The patients' objective need for support has to be another important part of this new screening.ConclusionsPersonality and other traits are good predictors for psychological distress. Longitudinal studies need to assess these new aspects of screening cancer patients to find out if they need psycho-oncological support.
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Acute Cerebellar Syndrome After Topical Application of Fluorouracil
http://ift.tt/2rr8p1A
Pediatric Psoriasis Comorbidity Screening Guidelines
http://ift.tt/2qsUOcR
How Microneedles Can Change Cutaneous Drug Delivery
http://ift.tt/2rrjkZi
Expedited Microneedle-Assisted Photodynamic Therapy for Actinic Keratoses
http://ift.tt/2qsLnu1
Disseminated Erythematous Crusted and Pustular Plaques on the Trunk
http://ift.tt/2rrgpzG
British Association of Dermatologists guidelines for biologic therapy for psoriasis 2017
Abstract
The overall aim of the guideline is to provide evidence-based recommendations on the use of biologic therapies (adalimumab, etanercept, infliximab, ixekizumab, secukinumab and ustekinumab) in adults, children and young people for the treatment of psoriasis; consideration is given to the specific needs of people with psoriasis and psoriatic arthritis. Biologic therapies have now been in use for over 10 years, and with accrued patient-years exposure and clinical experience, many areas that were covered in previous versions of the guideline are now part of the Summary of Product Characteristics (SPC) and/or routine care so that specific recommendations are redundant (see Toolkit A: Summary of licensed indications and posology for biologic therapy, in Supporting information 2). Therefore, in this update we focus on areas where there has been a major change in the evidence base or clinical practice, where practice is very varied and/or where clear consensus or guidelines are lacking (see section 3.1 in Supporting information 1).
This article is protected by copyright. All rights reserved.
http://ift.tt/2rrgEvo
Identification of a plasma miRNA biomarker-signature for allergic asthma: a translational approach
Abstract
Background
Asthma is a heterogeneous chronic disease with different phenotypes and treatment responses. Thus, there is a high clinical need for molecular disease biomarkers to aid in differentiating these distinct phenotypes. As MicroRNAs (miRNAs), that regulate gene expression at the post-transcriptional level, are altered in experimental and human asthma, circulating miRNAs are attractive candidates for the identification of novel biomarkers.
This study aimed to identify plasmatic miRNA-based biomarkers of asthma, through a translational approach.
Methods
We pre-screened miRNAs in plasma samples from two different murine models of experimental asthma (ovalbumin and house dust mite); miRNAs deregulated in both models were further tested in a human training cohort of 20 asthma patients and 9 healthy controls. Candidate miRNAs were then validated in a second, independent group of 26 asthma patients and 12 healthy controls.
Results
10 miRNA ratios consisting of 13 miRNAs were differentially regulated in both murine models. Measuring these miRNAs in the training cohort identified a biomarker signature consisting of 5 miRNA ratios (7 miRNAs). This signature showed a good sensitivity and specificity in the test cohort with an area under the receiver operating characteristic curve (AUC) of 0.92. Correlation of miRNA ratios with clinical characteristics further revealed associations with FVC % predicted, and oral corticosteroid or antileukotriene use.
Conclusion
Distinct plasma miRNAs are differentially regulated both in murine and human allergic asthma and were associated with clinical characteristics of patients. Thus, we suggest that miRNA levels in plasma might have future potential to subphenotype patients with asthma.
This article is protected by copyright. All rights reserved.
http://ift.tt/2pU6D8G
Aspergillus fumigatus in cystic fibrosis: an update on immune interactions and molecular diagnostics in ABPA
Abstract
A wide spectrum of pathological conditions may result from the interaction of Aspergillus fumigatus and the immune system of its human host. Allergic bronchopulmonary aspergillosis is one of the most severe Aspergillus fumigatus-related diseases due to possible evolution towards pleuropulmonary fibrosis and respiratory failure. Allergic bronchopulmonary aspergillosis occurs almost exclusively in cystic fibrosis or asthmatic patients. An estimated 8 to 10% of cystic fibrosis patients experience this condition. The diagnosis of allergic bronchopulmonary aspergillosis relies on criteria first established in 1977. Progress in the understanding of host-pathogen interactions in Aspergillus fumigatus and cystic fibrosis patients and the ongoing validation of novel laboratory tools concur to update and improve the diagnosis of allergic bronchopulmonary aspergillosis.
This article is protected by copyright. All rights reserved.
http://ift.tt/2pKTanC
Patient-Centered Outcomes in Food Allergy
Abstract
Purpose of Review
Food allergy prevalence is increasing very rapidly, causing a significant disease burden. The threat of severe allergic reactions occurring unexpectedly and in settings that are not equipped to recognize and treat anaphylaxis is a constant source of worry for individuals and families with food allergies. Inadequate knowledge and understanding in the community significantly impairs the overall quality of life of these individuals and families. Additionally, families face challenges in finding and affording appropriate allergen-free foods.
Recent Findings
Advancements have been made in understanding the impact of food allergies on patient-centered outcomes such as quality of life and economic impact, and attempts have been made to develop tools to assess patient-centered variables. Innovative national and regional initiatives are helping to spread awareness of the disease condition and to create resources, including access to allergen-free foods.
Summary
While there is a growing momentum toward recognition of food allergic disorders as a condition that profoundly impacts activities of daily living, greater effort needs to be expounded to develop validated tools and interventions that can adequately address these issues.
http://ift.tt/2qRkoJz
Real-World Evidence and Treatment Patterns: Head and Neck Cancer
Intervention: Other: Non-Interventional
Sponsors: Bristol-Myers Squibb; Ono Pharmaceutical
Not yet recruiting - verified May 2017
http://ift.tt/2rq9hDB
Phase 1 Study of LOXO-292 in Patients With Advanced Solid Tumors, RET-Fusion Lung Cancer and Medullary Thyroid Cancer
Intervention: Drug: LOXO-292
Sponsor: Loxo Oncology, Inc.
Recruiting - verified May 2017
http://ift.tt/2qsf12i
Salvage of postcranioplasty implant exposure using free tissue transfer
Abstract
Background
Refractory implant exposure is frustrating after cranioplasty. The purpose of this study was for the authors to present their experience with free tissue transfer for salvage of postcranioplasty implant exposure.
Methods
A retrospective medical chart review was conducted on all free tissue transfers performed for exposed implant coverage after cranioplasty between January 2004 and February 2016.
Results
Twelve free flaps were performed in 11 patients who underwent postcranioplasty with implant exposure, and whose attempted implant coverage using locoregional flaps had failed. The free flaps used included anterolateral thigh flap, radial forearm flap, anteromedial thigh and rectus femoris chimeric flap, latissimus dorsi flap, gracilis flap, and Juri flap. The flap survival rate was 100%, and 10 of 11 implants (91%) were salvaged without removal.
Conclusions
Free tissue transfer should be considered as the preferred reconstructive option for postcranioplasty exposed implant salvage. High rate of implant salvage (>90%) is possible even with chronic implant exposure (>3 months).
http://ift.tt/2pTBnXu
Relationship between iodine levels and papillary thyroid carcinoma: A systematic review and meta-analysis
Abstract
Background
Iodine excess has been suggested as an exogenous risk factor of papillary thyroid cancer (PTC). We performed a systematic review and meta-analysis to assess the relationship between iodine exposure measured in various forms and PTC prevalence.
Methods
We searched MEDLINE, Embase, and the Cochrane Library for case-control studies on iodine and PTC published up to December 2015. Exposure to iodine was compared between PTC and control groups.
Results
From the 16 selected studies, the odds ratio (OR) for the overall effect size between high iodine exposure and PTC risk was 1.418 (95% confidence interval [CI] 1.054-1.909). Based on 7 studies conducted in high iodinated regions, a positive association between iodine exposure and PTC was observed (OR 2.200; 95% CI 1.389-3.483).
Conclusion
This study demonstrated a higher exposure to iodine in patients with PTC compared with controls, especially for patients from high iodinated regions.
http://ift.tt/2reeja4
One-year quality of life and functional outcomes of transoral robotic surgery for carcinoma of unknown primary
Abstract
Background
The purpose of this study was to assess the quality of life (QOL) outcomes in patients who underwent transoral robotic surgery (TORS) for carcinoma of unknown primary (CUP).
Methods
Twenty-nine patients with CUP were administered the Head and Neck Cancer Inventory (HNCI) prospectively to evaluate QOL preoperatively and postoperatively.
Results
There was statistically and clinically significant deterioration in 2 of 4 domains (eating and social disruption) in the immediate aftermath of TORS. There was statistically and clinically meaningful deterioration in all 4 domains at 3 months relative to baseline, and there remained statistically and clinically meaningful deterioration in 2 of 4 domains at 6 months compared to baseline. These 2 domains remained statistically and clinically worse than baseline at 12 months. Speech and aesthetics domain scores were comparable at baseline and 12 months.
Conclusion
Patients reported difficulties with eating and social disruption over the course of 1 year, but problems with speech and appearance abated.
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Prospective analysis of radiation oncology image and plan-driven peer review for head and neck cancer
Abstract
Background
Departmental "chart rounds" is an established form of review in radiation oncology, however, evidence is lacking that identifies links between features of a more subspecialized disease site-specific review and the likelihood and characteristics of recommendations made. We prospectively analyzed our head and neck group's review process to identify associations that could guide future practice.
Methods
Our group reviewed proposed management and treatment volumes for radiation simulated patients on a weekly basis, and we collected data encompassing recommendations made by individuals or group consensus.
Results
Changes in management, prescribed dose, radiation fractionation, clinical target volumes, or target contours were suggested in 85 of 182 cases. The most frequently recommended changes were adjustment of regions treated or target contours, and an inverse correlation was observed between the number of attending physicians present and specific changes suggested to the gross tumor volume (GTV).
Conclusion
We find that site-specific head and neck peer review results in frequent recommendations largely independent of the type of case reviewed.
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Determination of role of ceruloplasmin in oral potentially malignant disorders and oral malignancy – A cross sectional study
Abstract
Objectives
In the process of carcinogenesis, lipid peroxidation and increased oxidative stress leads to changes in certain antioxidants. The present study was aimed to assess and co-relate serum levels of ceruloplasmin in oral premalignancies and oral cancer so as to gauge its possible association with the process of carcinogenesis and to determine its role as tumor marker.
Material and Methods
The total of 300 participants, were equally divided in six study groups i.e. Oral Submucous Fibrosis (OSMF), Oral Leukoplakia (OL), Nicotina Stomatitis (NS), Oral Malignancy (OM), Controls (C) and Healthy Controls (HC). 5 ml of blood was collected from ante cubetal vein from each participant. The serum was analyzed for ceruloplasmin levels using ERBA CHEM 5 PLUS semi automated chemistry analyzer and diagnostic kit by turbidimetric immunoassay.
Results
There were total 242 males and 58 females, who were between 18 to 82 years of age, with a mean of 45.31 ± 13.97 years. The serum ceruloplasmin levels were significantly increased in OM, OSMF, OL & NS groups as compared to C and HC groups (p<0.001). No statistically significant difference was found in intragroup analysis of the disease groups (p>0.05).
Conclusion
Serum ceruloplasmin can be used as diagnostic marker for oral premalignant and malignant lesions.
This article is protected by copyright. All rights reserved.
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B cells influence sex specificity of arthritis via myeloid suppressors and chemokines in humanized mice
Source:Clinical Immunology, Volume 178
Author(s): Marshall Behrens, David Luckey, Harvinder Luthra, Chella David, Veena Taneja
Rheumatoid arthritis (RA) occurs two times more often in women than men. B cell depletion has been shown to be efficacious in treating RA. Our previous studies suggested that antigen presentation via B cells results in a sex-specific immune response in DR4 and DR4/DQ8 mice. Here we evaluated the mechanism of efficacy of the B cell depletion in treating arthritis-susceptible DQ8 mice. The data show that arthritic DQ8 mice treated with anti-CD20 antibody in therapeutic protocols show milder disease severity in females as compared to males, which is associated with decreased antibodies to citrullinated proteins and reduced levels of IL-23 and CCL5. Treatment led to significantly increased numbers of T regulatory and monocyte-derived suppressor F4/80+Gr1hi cells in females as compared to male DQ8 mice. Our observations suggest that therapeutic strategies that target B cells may benefit females while functions of DCs might be relatively more important for men than women.
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Systemic manifestations of primary Sjögren's syndrome in the NOD.B10Sn-H2b/J mouse model
Source:Clinical Immunology
Author(s): Jeremy Kiripolsky, Long Shen, Yichen Liang, Alisa Li, Lakshmanan Suresh, Yun Lian, Quan-Zhen Li, Daniel P. Gaile, Jill M. Kramer
Animal models that recapitulate human disease are crucial for the study of Sjögren's Syndrome (SS). While several SS mouse models exist, there are few primary SS (pSS) models that mimic systemic disease manifestations seen in humans. Similar to pSS patients, NOD.B10Sn-H2b/J (NOD.B10) mice develop exocrine gland disease and anti-nuclear autoantibodies. However, the disease kinetics and spectrum of extra-glandular disease remain poorly characterized in this model. Our objective was to characterize local and systemic SS manifestations in depth in NOD.B10 female mice at early and late disease time points. To this end, sera, exocrine tissue, lung, and kidney were analyzed. NOD.B10 mice have robust lymphocytic infiltration of salivary and lacrimal tissue. In addition, they exhibit significant renal and pulmonary inflammation. We identified numerous autoantibodies, including those directed against salivary proteins. In conclusion, the NOD.B10 model recapitulates both local and systemic pSS disease and represents an excellent model for translational studies.
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Editorial Board
Source:Clinical Immunology, Volume 178
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Clonal and constricted T cell repertoire in Common Variable Immune Deficiency
Source:Clinical Immunology, Volume 178
Author(s): Manish Ramesh, David Hamm, Noa Simchoni, Charlotte Cunningham-Rundles
We used high throughput sequencing to examine the structure and composition of the T cell receptor β chain in Common Variable Immune Deficiency (CVID). TCRβ CDR3 regions were amplified and sequenced from genomic DNA of 44 adult CVID subjects and 22 healthy adults, using a high-throughput multiplex PCR. CVID TCRs had significantly less junctional diversity, fewer n-nucleotide insertions and deletions, and completely lacked a population of highly modified TCRs, with 13 or more V-gene nucleotide deletions, seen in healthy controls. The CVID CDR3 sequences were significantly more clonal than control DNA, and displayed unique V gene usage. Despite reduced junctional diversity, increased clonality and similar infectious exposures, DNA of CVID subjects shared fewer TCR sequences as compared to controls. These abnormalities are pervasive, found in out-of-frame sequences and thus independent of selection and were not associated with specific clinical complications. These data support an inherent T cell defect in CVID.
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Is the oral fungal pathogen Candida albicans a cariogen?
Abstract
Pathobiology of dental caries is complex. Data from recent molecular microbiologic studies have further redefined the role of the oral microbiome in the etiology of dental caries. This new information challenges the conventional view on the hegemony of classic cariogenic prokaryotes such as Streptococcus mutans in caries aetiology, and raises the intriguing possibility of the participation of the eukaryotic oral fungal pathogen Candida in the caries process. The virulence attributes of Candida species such as their acidogenicity and aciduric nature, the ability to develop profuse biofilms, ferment and assimilate dietary sugars, and produce collagenolytic proteinases are all indicative of their latent cariogenic potential. Based on the above, oral candidal counts have been used by some as a caries risk indicator. On the contrary, other studies suggest that Candida is merely a passenger extant in an acidic cariogenic milieu, and not a true pathogen. In this review, we critically examine the varying roles of Candida, and traditionally accepted cariogens such as the mutans group of streptococci in the pathobiology of dental caries. The weight of available data tends to imply that Candida may play a pivotal role as a secondary agent perpetuating the carious process, especially in dentinal caries.
This article is protected by copyright. All rights reserved.
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HLA-Cw6-positive patients with psoriasis show improved response to methotrexate treatment
Summary
It is well documented that patients with human leucocyte antigen (HLA)-Cw6+ (type 1) psoriasis have increased severity and reduced age of onset of psoriasis. However, not much is known about any differential response of this genetic subgroup to various treatments. We set out to determine if there was any genetic association of the HLA-Cw6 allele with the first-line systemic treatment commonly used in psoriasis, methotrexate. A cohort of patients from Tayside in Scotland was recruited through a novel generic consenting process (GoShare); they were extensively phenotyped and analysed for an association of their HLA-Cw6 genotype status with treatment outcomes. HLA-Cw6+ patients showed notably improved response to methotrexate (P = 0.05), and further analysis demonstrated an even greater response in a subcohort of the HLA-Cw6+ patients, who did not have concomitant psoriatic arthritis (P = 0.01). HLA-Cw6+ patients also exhibited fewer treatment-limiting adverse events. In addition to these findings, the methodology and primary clinical outcome phenotype, which we validate here, will greatly facilitate replication of the present results in independent cohorts.
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Alpha-1-antitrypsin deficiency-related panniculitis: two cases with diverse clinical courses
Summary
Alpha-1-antitrypsin deficiency (AATD)-related panniculitis is an extremely rare and underdiagnosed entity, and there is a paucity of data on its treatment. We report two cases of AATD-related panniculitis. The first was a 24-year-old woman with known AATD who presented with painful leg ulcers refractory to treatment with corticosteroids and colchicine. She had a good response to α1-antitrypsin infusions but required dose adjustment due to flares in disease activity. The second case was a 38-year-old woman who presented with painful nodules on the legs refractory to corticosteroid therapy. Laboratory investigations revealed severe AATD. She had an excellent response to colchicine therapy. In both these cases of AATD, panniculitis was the first clinical manifestation of the disease. AATD-related panniculitis may have none of the typical clinical clues for AATD, such as a family history, cirrhosis or emphysema. Early identification may help prevent these complications from developing.
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Pediatric nasal surgery: timing and technique.
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Complications in facial Mohs defect reconstruction.
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