Inflammatory cytokines in normal and irreversibly inflamed pulps: A systematic review

Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Vivian Hirsch, Michael Wolgin, Aleksandr V. Mitronin, Andrej M. Kielbassa
ObjectiveTo review the available literature in regard to the inflammatory process and pulpitis. Setting forth to evaluate if differences in the levels of various cytokines (TNF-α, IL-1β, IL-2, IL-6 and IL-8) can be observed in clinically diagnosed normal and irreversibly inflamed pulps that could serve as possible markers and/or diagnostic tools to predict and differentiate between certain states of inflammation.Methods used to measure and assess levels of cytokines have been limited to two protein quantification methods ELISA and/or Multiplex Array.DesignThe databases PubMed, EMBASE/Ovid, The Cochrane Central Register of Controlled Trials, Cochrane Reviews and Scopus were consulted for the electronic literature search. Screening of titles and abstracts followed the PRISMA guidelines while data extraction and the assessment of the full texts were carried out in accordance to the GRADES assessment.ResultsThe review showed that significant increases in levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α in irreversible pulpitis samples exist, in comparison to normal pulp samples which serve as a good basis for potential markers. Due to larger discrepancies in available literature, IL-2 seems rather unsuitable at the moment, while IL-6 and TNF alpha seem to be more promising.ConclusionIt may be concluded that even by combining two protein quantification methods inconsistencies between studies exist. At the moment it is difficult to select just one specific cytokine suitable for testing, rather it supports the rationale that further high-quality clinical studies are needed.



http://ift.tt/2sG1L9g

Inflammatory cytokines in normal and irreversibly inflamed pulps: A systematic review

Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Vivian Hirsch, Michael Wolgin, Aleksandr V. Mitronin, Andrej M. Kielbassa
ObjectiveTo review the available literature in regard to the inflammatory process and pulpitis. Setting forth to evaluate if differences in the levels of various cytokines (TNF-α, IL-1β, IL-2, IL-6 and IL-8) can be observed in clinically diagnosed normal and irreversibly inflamed pulps that could serve as possible markers and/or diagnostic tools to predict and differentiate between certain states of inflammation.Methods used to measure and assess levels of cytokines have been limited to two protein quantification methods ELISA and/or Multiplex Array.DesignThe databases PubMed, EMBASE/Ovid, The Cochrane Central Register of Controlled Trials, Cochrane Reviews and Scopus were consulted for the electronic literature search. Screening of titles and abstracts followed the PRISMA guidelines while data extraction and the assessment of the full texts were carried out in accordance to the GRADES assessment.ResultsThe review showed that significant increases in levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α in irreversible pulpitis samples exist, in comparison to normal pulp samples which serve as a good basis for potential markers. Due to larger discrepancies in available literature, IL-2 seems rather unsuitable at the moment, while IL-6 and TNF alpha seem to be more promising.ConclusionIt may be concluded that even by combining two protein quantification methods inconsistencies between studies exist. At the moment it is difficult to select just one specific cytokine suitable for testing, rather it supports the rationale that further high-quality clinical studies are needed.



http://ift.tt/2sG1L9g

Novel serum metabolomics-based approach by gas chromatography/triple quadrupole mass spectrometry for detection of human skin cancers: Candidate biomarkers

Abstract

Skin cancer incidence rates are continuing to rise; however, if detected at an early stage, they can be cured with minimally invasive treatment. Therefore, the identification of novel and robust biomarkers for the early detection of skin cancer is required to improve the quality of life of the patient after treatment. In the present study, we aimed to identify novel biomarkers of skin cancers. We carried out serum metabolomics using gas chromatography/triple quadrupole mass spectrometry for two types of skin cancer: squamous cell carcinoma and melanoma. The changes in the expression of metabolites compared with healthy volunteers were analyzed by principal component analysis. Among all 118 metabolites, 27 in patients with squamous cell carcinoma and 33 in patients with melanoma showed significant changes in comparison with healthy volunteers. Principal component analysis showed that both skin cancer groups could be distinguished from the healthy volunteers group. We further investigated the specific metabolites most useful for these distinctions. In the squamous cell carcinoma group, these metabolites were glycerol, 4-hydroxybenzoic acid, sebacic acid, fucose and suberic acid. In the melanoma group, these metabolites were glutamic acid, sebacic acid, suberic acid, 4-hydroxybenzoic acid and phenylalanine. The present study identified several metabolites that were distinct for certain skin cancer types, which could potentially be used as diagnostic biomarkers leading to novel clinical management strategies.

http://ift.tt/2qYUEau

Aging in hair follicle stem cells and niche microenvironment

Abstract

Hair graying and hair loss are prominent and common characteristics of the elderly population. In some individuals these processes can significantly impact their quality of life, leading to depression, anxiety and other serious mental health problems. Accordingly, there has been much interest in understanding the complex physiological changes within the hair follicle in the aging individual. It is now known that hair follicles represent a prototypical stem cell niche, where both micro- and macroenvironmental influences are integrated alongside stem cell–stem cell and stem cell–stem niche interactions to determine hair growth or hair follicle senescence. Recent studies have identified imbalanced stem cell differentiation and altered stem cell activity as important factors during hair loss, indicating new avenues for the development of therapeutic agents to stimulate hair growth. Here, we pull together the latest findings on the hair follicle stem cell niche and the multifactorial interactions underlying the various forms of hair loss.

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Dermoscopic features of mucoepidermoid carcinoma of the lip

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Overview of surgery for laryngeal and hypopharyngeal cancer in Ontario, 2003-2010

Abstract

Background

The primary purpose of this study was to describe variations in incidence rates, resections rates, and types of surgical resection for patients diagnosed with laryngeal and hypopharyngeal cancers in Ontario.

Methods

All laryngeal and hypopharyngeal cancer cases in Ontario (2003-2010) were identified from the Ontario Cancer Registry (n = 3034). Variations in incidence rates, resection rates, and type of surgical resection were compared by sex, age group, neighborhood income, community population, health region, and physician specialty.

Results

Incidence rates per 100 000 vary significantly by sex, age, neighborhood income, and community size. Women, the elderly (75+ years), those in the higher income quintiles, and those living in larger communities were significantly less likely to receive a laryngectomy procedure.

Conclusions

Laryngeal and hypopharyngeal cancer incidence rates vary by sex, age, neighborhood income, community size, and health region. Resection rates vary by age, sex, and health region. These disparities warrant further evaluation to improve the quality of delivered care in Ontario.

http://ift.tt/2rXMBy2

Outcomes for patients with synchronous and metachronous primary lung cancer after diagnosis of head and neck cancer

ABSTRACT

Background

Not-infrequently patients with head and neck cancer are also diagnosed with synchronous lung cancer or metachronous primary lung cancer, which complicates the treatment decisions and prognosis.

Methods

Patients were identified from a database of patients with head and neck cancer with second primary non-small cell lung cancer (NSCLC).

Results

Thirty-four eligible patients (15 with synchronous lung cancer and 19 with metachronous lung cancer) were identified. Thirteen of 15 patients with synchronous lung cancer received curative intent treatment for head and neck cancer first. Six of 15 patients were in complete remission, 5 of 15 patients had died, and 4 were alive with progressive disease. Median time between 2 diagnoses was 47 months in the metachronous lung cancer group. Twelve patients had died, 3 were alive with disease, and 4 were lost to follow-up. Median survival from the time of lung cancer diagnosis was 13 months with a trend to better survival with synchronous lung cancer (15 vs 11 months; p = .11).

Conclusion

Aggressive multidisciplinary management of second primary lung malignancies in patients with head and neck cancer can result in respectable long-term disease control particularly in patients with synchronous lung cancer. © 2017 Wiley Periodicals, Inc. Head Neck, 2017

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Analysis of archived newborn dried blood spots (DBS) identifies congenital cytomegalovirus as a major cause of unexplained pediatric sensorineural hearing loss

Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL). However, accurate diagnosis of cCMV as the etiology of SNHL is problematic beyond the neonatal period. This study therefore examined whether cCMV infection could be identified retrospectively in children presenting with unexplained SNHL to a multidisciplinary diagnostic outpatient otolaryngology clinic at an academic medical center in Minnesota.

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Ultraviolet A photosensitivity profile of dexchlorpheniramine maleate and promethazine-based creams: Anti-inflammatory, antihistaminic, and skin barrier protection properties

Summary

Background

Unwanted side effects such as dryness, hypersensitivity, and cutaneous photosensitivity are challenge for adherence and therapeutical success for patients using treatments for inflammatory and allergic skin response.

Aims

In this study, we compared the effects of two dermatological formulations, which are used in inflammatory and/or allergic skin conditions: dexchlorpheniramine maleate (DCP; 10 mg/g) and promethazine (PTZ; 20 mg/g).

Methods

We evaluated both formulations for phototoxicity potential, skin irritation, anti-inflammatory and antihistaminic abilities, and skin barrier repair in vitro and ex vivo using the standard OECD test guideline n° 432, the ECVAM protocol n° 78, and cultured skin explants from a healthy patient. Ultraviolet A was chosen as exogenous agent to induce allergic and inflammatory response.

Results

Both PTZ and DCP promoted increases in interleukin-1 (IL-1) synthesis in response to ultraviolet A (UVA) radiation compared to control. However, the increase observed with PTZ was significantly greater than the DCP, indicating that the latter has a lower irritant potential. DCP also demonstrated a protective effect on UVA-induced leukotriene B4 and nuclear factor kappa B (NF-κB) synthesis. Conversely, PTZ demonstrates more robust UVA antihistaminic activity. Likewise, PTZ promoted a significantly greater increase in the production of involucrin and keratin 14, both associated with protective skin barrier property.

Conclusion

In conclusion, these data suggest possible diverging UVA response mechanisms of DCP and PTZ, which gives greater insight into the contrasting photosensitizing potential between DCP and PTZ observed in the patients.

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Constant maintenance of an alternative route of coronary flow in radical surgery for gastric cancer following coronary artery bypass grafting involving the right gastroepiploic artery: a case report

Abstract

We describe a 64-year-old man diagnosed as having gastric cancer with a patent right gastroepiploic artery (RGEA) used for coronary artery bypass grafting (CABG). Before gastrectomy, the native coronary artery was revascularized to safely dissect the infrapyloric lymphatic tissue along the layer recently identified as an appropriate layer for radical lymphadenectomy, in anticipation of preserving the radically skeletonized RGEA. The perioperative strategy was feasible. Postoperatively, hemorrhage extended the stopping period of antiplatelet therapy. However, since the RGEA was preserved, an alternative route was available for coronary flow. After a 41-month postoperative follow-up, the patient remained in good health, with no recurrence or cardiac ischemia. In this case, the alternative route of coronary flow could be constantly maintained, although radical infrapyloric lymphadenectomy had been performed. Preoperative revascularization and preserving the RGEA with radical skeletonization can be a safe yet permissibly radical strategy for gastric cancer treatment following CABG involving the RGEA.

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Primary solitary peritoneal tumor of the abdominal wall—report of a rare case and review of the literature

Abstract

Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, bilateral oophorectomy, omentectomy and appendectomy were performed. No signs of malignancy were proved on histology, leading to the final diagnosis of a primary serous peritoneal tumor. This is the third described case of solitary primary serous peritoneal tumor located in the abdominal wall. This condition should be included in the differential diagnosis of a probable metastatic ovarian carcinoma, as both present similar histologic characteristics.

http://ift.tt/2qYN6Vj

Synchronous contralateral adrenal metastasis of colorectal cancer: case report

Abstract

The most frequent sites of distant metastasis of colorectal cancer (CRC) are primarily liver and lung, followed by brain and bone metastases. Infrequently, metastases are found in the adrenal glands. They usually have a metachronous and homolateral character. We present a case of contralateral synchronic adrenal metastasis of CRC and its surgical resolution.

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Cost Effectiveness of Lenvatinib, Sorafenib and Placebo in Treatment of Radioiodine-Refractory Differentiated Thyroid Cancer

Thyroid , Vol. 0, No. 0.


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Stability and surgical complications in segmental Le Fort I osteotomy: a systematic review

This systematic review was conducted to evaluate the stability and surgical complications of segmental Le Fort I osteotomy. The search was divided into a main search (PubMed, Embase, and Cochrane Library), grey literature search (Google Scholar), and manual search. Twenty-three studies were included: 14 evaluating stability as the outcome and nine evaluating surgical complications. The level of agreement between the authors was considered excellent (κ=0.893 for study selection and κ=0.853 for study eligibility).

http://ift.tt/2rXTEXK

Farmakoekonomiczne aspekty zastosowania immunoterapii alergenowej w leczeniu alergicznego nieżytu nosa i astmy

Publication date: Available online 7 June 2017
Source:Alergologia Polska - Polish Journal of Allergology
Author(s): Radosław Gawlik, Grzegorz Zagórny, Andrzej Bożek
Allergic rhinitis is a most common allergic disease affecting 40% of the population. The impact of AR on health-related quality of life (QoL) and productivity results in a significant economic burden. Allergen immunotherapy is the only causative treatment of allergic rhinitis and asthma. However, it is still unclear whether AIT is more cost-effective than the other treatments of AR without long-term cost-effectiveness studies. There is a need for further economic evaluations comparing different ways of immunotherapy and immunotherapy with pharmacotherapy.



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New Frontiers in Surgical Innovation

It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted.

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Erratum to: Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue

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Erratum to: Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue

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Genetic architecture of acne vulgaris

Abstract

Background

Acne vulgaris is a ubiquitary skin disease characterized by chronic inflammation of the pilosebaceous unit resulting from bacterial colonization of hair follicles by Propionibacterium acnes, androgen-induced increased sebum production, altered keratinization and inflammation.

Objective

Here we review our current understanding of the genetic architecture of this intriguing disease and want to show rare and corresponding diseases like PCOS with acne vulgaris.

Methods

We conducted a data research identifying genome-wide association studies (GWAS), candidate genes studies as case reports for acne vulgaris. Moreover, we included GWAS for the PCOS as it revealed shared genes with acne vulgaris.

Results

The data research revealed from different ethnic populations sixteen genes with single nucleotide polymorphisms (SNPs), two repeat polymorphisms, one gene mutation as five diseases associated with acne vulgaris. Moreover, the GWAS PCOS identified twenty-six SNPs from twenty-one susceptible loci.

Conclusion

The genetic architecture is complex which has been revealed by GWAS. Further and larger studies in different populations are required to confirm or disprove results from candidate gene studies as well to identify signals that may overlap between different populations. Finally, studies on rare genetic variants in acne and associated diseases like PCOS may deepen our understanding of its pathogenesis.

This article is protected by copyright. All rights reserved.

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Eye Movements Are Correctly Timed During Walking Despite Bilateral Vestibular Hypofunction

Abstract

Individuals with bilateral vestibular hypofunction (BVH) often report symptoms of oscillopsia (the perception that the world is bouncing or unstable) during walking. Efference copy/proprioception contributes to locomotion gaze stability in animals, sometimes inhibiting the vestibulo-ocular reflex (VOR). Gaze stability requires both adequate eye velocity and appropriate timing of eye movements. It is unknown whether eye velocity (VOR gain), timing (phase), or both are impaired for individuals with BVH during walking. Identifying the specific mechanism of impaired gaze stability can better inform rehabilitation options. Gaze stability was measured for eight individuals with severe BVH and eight healthy age- and gender-matched controls while performing a gaze fixation task during treadmill walking. Frequency response functions (FRF) were calculated from pitch eye and head velocity. A one-way ANOVA was conducted to determine group differences for each frequency bin of the FRF. Pearson correlation coefficients were calculated to determine the relationship between the real and imaginary parts of the FRF and the Oscillopsia Visual Analog Scale (oVAS) scores. Individuals with BVH demonstrated significantly lower gains than healthy controls above 0.5 Hz, but their phase was ideally compensatory for frequencies below 3 Hz. Higher oVAS scores were correlated with lower gain. Individuals with BVH demonstrated ideal timing for vertical eye movements while walking despite slower than ideal eye velocity when compared to healthy controls. Rehabilitation interventions focusing on enhancing VOR gain during walking should be developed to take advantage of the intact timing reported here. Specifically, training VOR gain while walking may reduce oscillopsia severity and improve quality of life.

http://ift.tt/2r7qocY

Eye Movements Are Correctly Timed During Walking Despite Bilateral Vestibular Hypofunction

Abstract

Individuals with bilateral vestibular hypofunction (BVH) often report symptoms of oscillopsia (the perception that the world is bouncing or unstable) during walking. Efference copy/proprioception contributes to locomotion gaze stability in animals, sometimes inhibiting the vestibulo-ocular reflex (VOR). Gaze stability requires both adequate eye velocity and appropriate timing of eye movements. It is unknown whether eye velocity (VOR gain), timing (phase), or both are impaired for individuals with BVH during walking. Identifying the specific mechanism of impaired gaze stability can better inform rehabilitation options. Gaze stability was measured for eight individuals with severe BVH and eight healthy age- and gender-matched controls while performing a gaze fixation task during treadmill walking. Frequency response functions (FRF) were calculated from pitch eye and head velocity. A one-way ANOVA was conducted to determine group differences for each frequency bin of the FRF. Pearson correlation coefficients were calculated to determine the relationship between the real and imaginary parts of the FRF and the Oscillopsia Visual Analog Scale (oVAS) scores. Individuals with BVH demonstrated significantly lower gains than healthy controls above 0.5 Hz, but their phase was ideally compensatory for frequencies below 3 Hz. Higher oVAS scores were correlated with lower gain. Individuals with BVH demonstrated ideal timing for vertical eye movements while walking despite slower than ideal eye velocity when compared to healthy controls. Rehabilitation interventions focusing on enhancing VOR gain during walking should be developed to take advantage of the intact timing reported here. Specifically, training VOR gain while walking may reduce oscillopsia severity and improve quality of life.

http://ift.tt/2r7qocY

Geographic Tongue: assessment of Peripheral Nerve Status, Langerhans cell and HLA-DR Expression

Publication date: Available online 7 June 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): M.R. Darling, N. Su, S. Masen, P. Kwon, D. Fortino, T.R. McKerlie, M. Grushka
ObjectivesThe objectives of this study were to determine whether geographic tongue is an antigen-driven condition by assessing Langerhans cell numbers, and HLA-DP, -DQ and -DR expression in the epithelium of geographic tongue cases, and to assess peripheral nerve status for any possible damage/injury association by quantifying neurite area in the connective tissue of geographic tongue cases.Study DesignRandomly selected cases of geographic tongue were examined using routine immunoperoxidase staining methods to S100 protein, Neurofilament, CD1a and HLA class II. Student's t-tests and Mann-Whitney U tests were used to assess statistical significance.ResultsLangerhans cell numbers were increased in geographic tongue. HLA expression was also seen in Langerhans cells, inflammatory cells, and, in two cases of geographic tongue, in the spinous layer and parabasal epithelial cells. Total nerve tissue, based on area measurements, was not significantly different in geographic tongue and controls.ConclusionsThe increase in Langerhans cells suggests that geographic tongue is an antigen-driven condition, probably by an unknown external antigen. Peripheral nerve damage was not apparent, suggesting that this is not a mechanism whereby patients become symptomatic in geographic tongue.



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Prognostic Significance of hMSH2, hMSH3 and hMSH6 Expression in Ameloblastoma

Publication date: Available online 7 June 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Gleyson Kleber do Amaral-Silva, Celeste Sánchez-Romero, Vivian Petersen Wagner, Manoela Domingues Martins, Hélder Antônio Rebelo Pontes, Eduardo Rodrigues Fregnani, Fernando Augusto Soares, Oslei Paes de Almeida, André Caroli Rocha, Alan Roger Santos-Silva, Felipe Paiva Fonseca, Pablo Agustin Vargas
AimsTo investigate hMutS proteins in human dental germ, ameloblastomas and ameloblastic carcinoma, and to determine whether the expression of these proteins has any prognostic potential.Methods and resultsTen cases of human dental germs, 39 ameloblastomas and 2 ameloblastic carcinomas were used to determine the distribution of the proteins during the carcinogenesis process. Simultaneously, another sample of 73 ameloblastomas was arranged in tissue microarray and their clinical, microscopic and radiographic features, treatment outcome, presence of BRAF-V600E mutation and follow-up data, were assessed to determine the prognostic relevance of the proteins. Immunohistochemistry was performed using antibodies against hMutS (hMSH2, hMSH3, hMSH6) and Ki67. hMSH2 and hMSH6 were significantly down-expressed in ameloblastomas (p=0.0059) than in human dental germs (p<0.0001). hMSH2, hMSH3 and the protein combinations were significantly associated with BRAF-V600E mutation (p<0.05). Simultaneous over-expression of hMutS was associated with recurrences (p=0.035); however, the proteins did not predict the disease-free survival of patients (p>0.05).ConclusionshMutS proteins are down-regulated in ameloblastoma; moreover, simultaneous over-expression of these proteins in ameloblastoma was associated with recurrence, but did not predict disease-free survival.



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Analysis of archived newborn dried blood spots (DBS) identifies congenital cytomegalovirus as a major cause of unexplained pediatric sensorineural hearing loss

Publication date: Available online 7 June 2017
Source:American Journal of Otolaryngology
Author(s): Lucy Meyer, Bazak Sharon, Tina C. Huang, Abby C. Meyer, Kristin E. Gravel, Lisa A. Schimmenti, Elizabeth C. Swanson, Hannah E. Herd, Nelmary Hernandez-Alvarado, Kirsten R. Coverstone, Mark McCann, Mark R. Schleiss
PurposeCongenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL). However, accurate diagnosis of cCMV as the etiology of SNHL is problematic beyond the neonatal period. This study therefore examined whether cCMV infection could be identified retrospectively in children presenting with unexplained SNHL to a multidisciplinary diagnostic outpatient otolaryngology clinic at an academic medical center in Minnesota.MethodsOver a 4-year period, 57 patients age 3months to 10years of age with unexplained SNHL were recruited to participate in this study. Informed consent was obtained to test the archived dried blood spots (DBS) of these patients for cCMV infection by real-time PCR, targeting a highly conserved region of the CMV UL83 gene. Results were normalized to recovery of an NRAS gene control. Chart review was conducted to identify subjects who underwent genetic testing and/or neurodiagnostic imaging to investigate possible genetic, syndromic, or anatomical causes of SNHL.ResultsIn total, 15 of the 57 children with unexplained SNHL tested positive for CMV DNA in their DBS (26%). A mean viral load of 8.3×10⁴ (±4.1×10⁴) [range, 1×10³–6×10⁵] copies/μg DNA was observed in subjects retrospectively diagnosed with cCMV. No statistically significant correlation was found between viral load and SNHL severity.ConclusionsA retrospective DBS analysis demonstrated 26% of patients presenting with unexplained SNHL in childhood had cCMV. DBS testing is useful in the retrospective diagnosis of cCMV, and may provide definitive diagnostic information about the etiology of SNHL.



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Pneumococcal meningitis with normal cerebrospinal biochemistry and no pneumococci at microscopy, mimicking a stroke: a case report

Bacterial meningitis commonly presents with symptoms such as headache, impaired consciousness, neck stiffness, and fever. In most cases, cerebrospinal fluid analysis will yield white cell counts >100/mm3. Atypica...

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Thyroid Open Access Articles

Thyroid

Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association

Read these new open access articles today:

Contrasting Phenotypes in Resistance to Thyroid Hormone α Correlate with Divergent Properties of Thyroid Hormone Receptor α1 Mutant Proteins
Carla Moran, Maura Agostini, Anne McGowan, Erik Schoenmakers, Louise Fairall, Greta Lyons, Odelia Rajanayagam, Laura Watson, Amaka C Offiah, John Stephen Barton, Susan Price, John WR Schwabe, V. Krishna Chatterjee

A 10-gene Classifier for Indeterminate Thyroid Nodules: Development and Multicenter Accuracy Study
Hernan E Gonzalez, Jose R. Martínez, Sergio Vargas, Antonieta Solar, Loreto Pamela Véliz, Francisco Cruz, Tatiana Arias, Soledad Loyola, Eleonora Horvath, Hernán Tala, Eufrosina Traipe, Manuel Meneses, Luis Marin, Nelson Wohllk, RENE EDUARDO DIAZ, Jesús Véliz, Pedro Pineda, Patricia Arroyo, Natalia Mena, Milagros Bracamonte, Giovanna Miranda, Elsa Bruce, Soledad Urra

 

The post Thyroid Open Access Articles appeared first on American Thyroid Association.

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Issue Information - Journal Info page

No abstract is available for this article.

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Issue Information - TOC

No abstract is available for this article.

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Olfactory loss in chronic rhinosinusitis

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Response to: Finding clinical efficacy with balloon sinus dilation in pediatric chronic rhinosinusitis patients

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Issue Information

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Vertical bone regeneration using rhBMP-2 and VEGF

Abstract

Background

Sufficient vertical and lateral bone supply and a competent osteogenic healing process are prerequisities for the successful osseointegration of dental implants in the alveolar bone. Several techniques including autologous bone grafts and guided bone regeneration are applied to improve quality and quantity of bone at the implantation site. Depending on the amount of lacking bone one- or two-stage procedures are required. Vertical bone augmentation has proven to be a challenge particularly in terms of bone volume stability. This study focuses on the three dimensional vertical bone generation in a one stage procedure in vivo. Therefore, a collagenous disc-shaped scaffold (ICBM = Insoluble Collagenous Bone Matrix) containing rhBMP-2 (Bone Morphogenetic Protein-2) and/or VEGF (Vascular Endothelial Growth Factor) was applied around the coronal part of a dental implant during insertion. RhBMP-2 and VEGF released directly at the implantation site were assumed to induce the generation of new vertical bone around the implant.

Methods

One hundred eight titanium implants were inserted into the mandible and the tibia of 12 mini pigs. Four experimental groups were formed: Control group, ICBM, ICBM + BMP-2, and ICBM + BMP-2 + VEGF.

After 1, 4 and 12 weeks the animals were sacrificed and bone generation was investigated histologically and histomorphometrically.

Results

After 12 weeks the combination of ICBM + rhBMP2 + VEGF showed significantly more bone volume density (BVD%), a higher vertical bone gain (VBG) and more vertical bone gain around the implant (PVBG) in comparison to the control group.

Conclusion

By using collagenous disc-shaped matrices in combination with rhBMP-2 and VEGF vertical bone can be generated in a one stage procedure without donor site morbidity. The results of the presenting study suggest that the combination of rhBMP-2 and VEGF applied locally by using a collagenous carrier improves vertical bone generation in vivo. Further research is needed to establish whether this technique is applicable in clinical routines.

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Editorial Board

Publication date: July 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 7





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EACMFS Prizes and Awards

Publication date: July 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 7





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Announcements

Publication date: July 2017
Source:Journal of Cranio-Maxillofacial Surgery, Volume 45, Issue 7





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Surgery-first approach in orthognathic surgery: psychological and biological aspects - a prospective cohort study

Publication date: Available online 6 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Sebastian Zingler, Emad Hakim, Dominic Finke, Monika Brunner, Daniel Saure, Jürgen Hoffmann, Christopher J. Lux, Ralf Erber, Robin Seeberger
IntroductionThe aim of this pilot study was to investigate psychological and biological changes after application of a surgery-first orthognathic treatment approach.MethodsA prospective cohort study of 9 patients (6 women and 3 men; mean age 26.7 years) suffering from skeletal Class II and III deformities was conducted. Skeletal changes from pre-to post-treatment were analyzed based on data acquired by use of cone-beam computed tomography (CBCT). Psychological changes were analyzed using the orthognathic quality of life (OQLQ) questionnaire, Sense of Coherence 29-item scale (SOC-29) and longitudinal day-to-day questionnaire. For biological evaluation, concentrations of IL-1β, IL-6, TGF β1-3, MMP-2 and VEGF were assessed in crevicular fluid by bead-based multiplex assays at one preoperative and various postoperative time points.ResultsA significant improvement (P=0.015) in quality of life, as measured with the OQLQ, was observed between baseline and 3 months post-surgery. The most affected dimensions were: facial aesthetics (p=0.022), oral function (p=0.051) and social aspects (p=0.057). Sense of coherence (SOC) significantly improved after treatment by 9 points (P= 0.029). Despite the significant improvement in OQLQ and SOC during the course of the study, the personal experience of appearance varied distinctly in course and intensity. In accordance with the temporal pattern of fracture healing, the analysis of crevicular fluid revealed an increase in pro-resorptive factors (IL-1 β, IL-6 and MMP-2) at early postoperative time points, while remodeling factors (members of the TGF-β superfamily) were detected at later postoperative time points.ConclusionsOrthognathic treatment using the surgery-first approach has a positive impact on patient's psychosocial status. Accelerated tooth movement after surgery might, to a certain extent, be due to elevated levels of bone remodeling factors with overlapping functions during fracture healing and tooth movement.



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Intraoperative arthroscopy of the TMJ during surgical management of condylar head fractures: „A preliminary report"

Publication date: Available online 6 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Dusan Hirjak, Branislav Galis, Michal Beno, Vladimír Machon, Louis G. Mercuri, Andreas Neff
PurposeThe purpose of this preliminary study was to evaluate intraarticular soft tissues of the temporomandibular joint (TMJ) using intraoperative arthroscopy during open reduction and internal fixation (ORIF) of condylar head fractures (CHF).Materials and Methods26 patients (29 joints) were diagnosed in period of 5 years (2011 -2015) with CHF, 5 patients had concomitant mandibular fracture. Fractures were diagnosed on basis of conventional orthopantomogram (OPG) and computed tomography (CT).ResultsIntraoperative arthroscopy revealed hyperemia and hypervascularity in all 29 joints, anterior disc dislocation in 26 joints, cartilage erosion in 21 joints and hemorrhagic clots were present in 10 joints. Major hemarthrosis or tear of the posterior band, as often described in MRI, could not be shown in our patients. Data from the study further the understanding of intraarticular pathology of the TMJ after acute trauma in a group with CHF.ConclusionIntraoperative arthroscopy is useful for direct evaluation and accurate diagnosis of the extent of soft tissue damage to TMJ in CHF. Larger and more long-term studies including comparison to MRI findings should be helpful to refine the treatment and postoperative management of patients after CHF.



http://ift.tt/2rMdxPo

Survival after refusal of surgical treatment for locally advanced laryngeal cancer

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Sean T. Massa, Nosayaba Osazuwa-Peters, Joel Franco, Gregory W. Ward, Ronald J. Walker
ObjectiveSurvival of advanced laryngeal cancer is declining while the popularity of organ preservation protocols grows. This study assesses the survival impact of refusing surgical treatment for locally advanced, resectable laryngeal cancer.MethodsAdult patients with T3 and T4a non-metastatic laryngeal squamous cell carcinoma were identified from the Surveillance, Epidemiology and End Results 18 database from 2004 to 2013. Patients were stratified based on a recommendation for extirpative surgery and the refusal of surgery. Multivariate logistic regression modeling identified variables associated with refusal. A multivariate cox proportional hazard model produced adjusted Kaplan-Meier survival curves. Survival was compared using adjusted hazard ratios (aHR) with 95% confidence intervals (CI).ResultsOf 5786 patients in the study, 2877 were recommended for surgical treatment and 138 (4.8%) refused. Refusal of surgery was associated with unmarried status (Single, odds ratio (OR) 1.79, CI 1.10–2.92), black race (OR 1.50, CI 1.00–2.22), T3 tumors (OR 1.80, CI 1.26–2.61) and N3 nodal disease (OR 3.50, CI 1.24–8.48). Compared to patients undergoing surgery, those who refused had lower 5-year cancer specific survival and increased hazard of cancer-specific mortality (aHR 1.60, CI 1.24–2.07) which resulted in decreased 5-year survival (50.0vs 60.1%), after controlling for other factors.ConclusionRefusal of surgery for locally advanced laryngeal cancer is more common in patients without marital support and with T3 tumors. This decision results in a 10% survival decrease at 5-year. Future study is needed to understand patients' reasoning behind this decision and to investigate additional factors not available in this dataset.



http://ift.tt/2r2Escu

External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Leandro Luongo Matos, Rogerio Aparecido Dedivitis, Marco Aurélio Vamondes Kulcsar, Evandro Sobroza de Mello, Venâncio Avancini F. Alves, Claudio Roberto Cernea
Objectives: To evaluate the new American Joint Committee on Cancer (AJCC) cancer staging manual (8th edition) in an independent cohort of patients surgically treated for oral squamous cell carcinoma in order to determine whether the upstaging of pT and pN classification was indicative of a worse prognosis. Methods: A cohort of 298 patients was analyzed retrospectively. Results: Of these patients, 22.8% received an upstaging when the depth of invasion was included into the pT classification. Similarly, 29.2% of them were upstaged when extracapsular extension was added to pN classification. Twenty-eight of 68 patients (41.2%) that received an upstaging of pT classification died, and 23 (33.8%) experienced disease recurrence compared to 98/229 (42.8%) and 68/229 (29.7%), respectively, for those with the same pT during follow-up. With regard to pN classification, 70.6% of upstaged patients (60/85) died, and 50.6% (43/85) developed recurrence of the disease compared to 63/205 (30.7%) and 42/205 (20.5%), respectively, for those with the same pN during follow-up. Patients who were upstaged in pT classification presented a worse DFS (51.1% versus 80.4%, P=0.007) and OS (31.5% versus 58.6%, P=0.017). Similarly, those that were upstaged in pN classification presented a worse DFS (17.1% versus 61.2%, P=0.001) and OS (8.5% versus 37.9%, P<0.001). Conclusion: The new AJCC cancer staging manual (8th edition) allows a better stratification of oral SCC patients. By including the depth of invasion to the pT classification and extranodal extension to the pN classification, a worse disease-free and overall survival was assessed for these patients.



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Impact of combined modality treatment with radiotherapy and S-1 on T2N0 laryngeal cancer: Possible improvement in survival through the prevention of second primary cancer and distant metastasis

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Yosuke Kitani, Akira Kubota, Madoka Furukawa, Yukiko Hori, Yuko Nakayama, Tetsuo Nonaka, Nobutaka Mizoguchi, Yuka Kitani, Hiromitsu Hatakeyama, Nobuhiko Oridate
BackgroundIn patients with head and neck cancer, the management of second primary cancer (SPC) is particularly important for improving survival because of its high incidence and associated mortality. We evaluated the impact of combination chemotherapy on survival and SPC.MethodWe retrospectively analyzed data from 49 patients treated with definitive radiation therapy (RT) for T2N0M0 laryngeal squamous cell carcinoma between 2003 and 2011. Among them, 22 patients received combined modality treatment with radiotherapy and S-1 (RT+CT group).ResultsThe median follow-up period was 71months (32–111months). A significant difference in overall survival (OS, P<0.01) was observed between the RT+CT group (n=22) and the RT alone group (n=27) though no significant differences were observed in local control and disease specific survival. Univariate analyses showed that an older age (P<0.05) and a higher grade (P<0.05) were associated with OS. Multivariate analysis identified chemotherapy as the most significant predictor of survival (OR, 0.056; 95% CI, 0.008–0.353, P<0.01). A significantly lower incidence of distant metastasis (DM)+SPC (5-year incidence: 5% vs. 19%, P<0.05) and fewer deaths from these causes (1 vs. 8: P<0.05) were observed in the RT+CT group. Multivariate analysis showed that chemotherapy was the most significant factor for the incidence of DM+SPC (OR, 0.074; 95% CI, 0.0065–0.84; P<0.05).ConclusionThe findings of this study suggest the possibility that combined modality treatment with radiotherapy and S-1 improve survival by preventing distant metastasis and second primary cancer.



http://ift.tt/2r2xPHi

Respiratory Syncytial virus infection compromises asthma tolerance by recruiting interleukin-17A-producing cells via CCR6-CCL20 signaling

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Tianyun Shi, Yanchao He, Wei Sun, Yi Wu, Ling Li, Zhijun Jie, Xiao Su
Asthma tolerance can be induced by breast-feeding or oral feeding with ovalbumin (OVA). Anergy or deletion of specific T cells and generation of T regulatory cells might contribute to this process. However, whether respiratory syncytial virus (RSV) infection would affect asthma tolerance is not very clear. Here, we first established asthma and oral tolerance mouse models and then analyzed airway hypersensitivity and asthma-related genes in the lung, CCR6-expressing IL-17A⁺ cells in the lungs, hilar or mesenteric lymph nodes (HLN or MLN) among control, asthmatic, tolerized, RSV infection, and RSV-infected asthmatic and tolerized groups. We also administrated CCL20 or IL-17A neutralizing antibody to RSV-infected tolerized mice to test whether RSV infection would mobilize CCR6-expressing IL-17A⁺ cells from MLN to the infected lungs. We found that tolerized mice infected with RSV developed asthma-like responses manifested by increasing airway hypersensitivity, exacerbating peribronchial inflammation, elevating lung asthma-related genes (Il17a, Mu5ac, and Gob5), accumulating CCR6-expressing IL-17A⁺ cells in the lungs and HLN with a reduction of this cell population in MLN. CCL20-CCR6 co-expression in RSV-infected tolerized MLN was reduced. Neutralization of CCL20 reduced CD3⁺CD4⁺CCR6⁺ cells in the RSV-infected tolerized HLN. Neutralization of IL-17A mitigated the compromising effects of RSV infection on asthma tolerance. Taken together, RSV infection impairs asthma tolerance by recruiting IL-17A-producing cells via CCR6-CCL20 signaling. The findings provide novel insight into exacerbation and therapeutic strategy of asthma under RSV infection.



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THP-1 and human peripheral blood mononuclear cell-derived macrophages differ in their capacity to polarize in vitro

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Hiromi Shiratori, Carmen Feinweber, Sonja Luckhardt, Bona Linke, Eduard Resch, Gerd Geisslinger, Andreas Weigert, Michael J. Parnham
Macrophages (Mφ) undergo activation to pro-inflammatory (M1) or anti-inflammatory (M2) phenotypes in response to pathophysiologic stimuli and dysregulation of the M1-M2 balance is often associated with diseases. Therefore, studying mechanisms of macrophage polarization may reveal new drug targets. Human Mφ polarization is generally studied in primary monocyte-derived Mφ (PBMC Mφ) and THP-1-derived Mφ (THP-1 Mφ). We compared the polarization profile of THP-1 Mφ with that of PBMC Mφ to assess the alternative use of THP-1 for polarization studies. Cellular morphology, the expression profiles of 18 genes and 4 cell surface proteins, and phagocytosis capacity for apoptotic cells and S. aureus bioparticles were compared between these Mφ, activated towards M1, M2a, or M2c subsets by stimulation with LPS/IFNγ, IL-4, or IL-10, respectively, for 6h, 24h and 48h. The Mφ types are unique in morphology and basal expression of polarization marker genes, particularly CCL22, in a pre-polarized state, and were differentially sensitive to polarization stimuli. Generally, M1 markers were instantly induced and gradually decreased, while M2 markers were markedly expressed at a later time. Expression profiles of M1 markers were similar between the polarized Mφ types, but M2a cell surface markers demonstrated an IL-4-dependent upregulation only in PBMC Mφ. Polarized THP-1 Mφ but not PBMC Mφ showed distinctive phagocytic capacity for apoptotic cells and bacterial antigens, respectively. In conclusion, our data suggest that THP-1 may be useful for performing studies involving phagocytosis and M1 polarization, rather than M2 polarization.



http://ift.tt/2s4p2EH

Novel insights into the expression pattern of anaphylatoxin receptors in mice and men

Publication date: Available online 7 June 2017
Source:Molecular Immunology
Author(s): Yves Laumonnier, Christian M. Karsten, Jörg Köhl
The anaphylatoxins (AT) C3a and C5a play important roles as mediators of inflammation. Further, they regulate and control multiple innate and adaptive immune responses through binding and activation of their cognate G protein-coupled receptors, i.e. C3a receptor (C3aR), C5a receptor 1 (C5aR1) and C5a receptor 2 (C5aR2), although the latter lacks important sequence motifs for G protein-coupling. Based on their pleiotropic functions, they contribute not only to tissue homeostasis but drive, perpetuate and resolve immune responses in many inflammatory diseases including infections, malignancies, autoimmune as well as allergic diseases. During the past few years, transcriptome expression data provided detailed insights into AT receptor tissue mRNA expression. In contrast, our understanding of cellular AT receptor expression in human and mouse tissues under steady and inflammatory conditions is still sketchy. Ligand binding studies, flow cytometric and immunohistochemical analyses convincingly demonstrated tissue-specific C5aR1 expression in various cells of myeloid origin. However, a detailed map for C3aR or C5aR2 expression in human or mouse tissue cells is still lacking. Also, reports about AT expression in lymphoid cells is still controversial. To understand the multiple roles of the ATs in the innate and adaptive immune networks, a detailed understanding of their receptor expression in health and disease is required. Recent findings obtained with novel GFP or tdTomato AT-receptor knock-in mice provide detailed insights into their expression pattern in tissue immune and stroma cells. Here, we will provide an update about our current knowledge of AT receptor expression pattern in humans and mice.



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The role of the complement system in hereditary angioedema

Publication date: Available online 7 June 2017
Source:Molecular Immunology
Author(s): Dorottya Csuka, Nóra Veszeli, Lilian Varga, Zoltán Prohászka, Henriette Farkas
Hereditary angioedema (HAE) is a rare, but potentially life-threatening disorder, characterized by acute, recurring, and self-limiting edematous episodes of the face, extremities, trunk, genitals, upper airways, or the gastrointestinal tract. HAE may be caused by the deficiency of C1-inhibitor (C1-INH-HAE) but another type of the disease, hereditary angioedema with normal C1-INH function (nC1-INH-HAE) was also described. The patient population is quite heterogeneous as regards the location, frequency, and severity of edematous attacks, presenting large intra- and inter-individual variation. Here, we review the role of the complement system in the pathomechanism of HAE and also present an overview on the complement parameters having an importance in the diagnosis or in predicting the severity of HAE.



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Demodex-Positive Acneiform Eruption Responsive to Ivermectin

This case report describes a man taking cetuximab with a tetracycline-resistant acneiform eruption successfully treated with oral ivermectin.

http://ift.tt/2s4yNTs

Asymptomatic Pigmented Lesions of the Gingiva

A white woman in her 50s with a medical history of orolabial melanotic macules presented to an oral medicine clinic for evaluation of asymptomatic pigmented lesions affecting the maxillary and mandibular gingiva. What is your diagnosis?

http://ift.tt/2sE9CUI

Gender-Based Price Differences in Over-the-Counter Minoxidil

This observational study compares the prices of minoxidil products for men and women at retail pharmacies.

http://ift.tt/2s528Nk

Factors Associated With a Mole-Prone Phenotype in Late Adolescence

This cohort study from the Study of Nevi in Children examines host, behavioral, and dermoscopic factors in early adolescence that are associated with a mole-prone phenotype in late adolescence.

http://ift.tt/2sE1hjQ

Skin Cancer Screening in a Veterans Affairs Health Care System

This study assesses the association of skin cancer training and screening by primary care practitioners with dermatology referral patterns and rates of skin biopsies.

http://ift.tt/2s4Bvbw

Faziale Manifestationen granulomatöser Erkrankungen

Zusammenfassung

Klinische Manifestationen granulomatöser Erkrankungen sind eine wiederkehrende Herausforderung im dermatologischen Alltag. Die klinische Präsentation und das histologisches Reaktionsmuster sind dabei, abhängig von der jeweiligen Erkrankung, durchaus variabel. Das Wissen um die Differenzialdiagnose granulomatöser Veränderungen am Gesicht ist von entscheidender Bedeutung für die Steuerung einer rationalen Diagnostik und Therapie im Sinne des Patientenwohles. Histologische und klinische Merkmale wichtiger granulomatöser Erkrankungen, die sich typischerweise am Gesicht manifestieren, sollen hier daher vorgestellt werden.

http://ift.tt/2sgw6xL

What can Global Health Case Reports do for the “Neglected Stepchild of Global Health”?

By Nathan Douthit

Access to safe, affordable surgery is an essential aspect of global health. Eight million people are killed or injured every year due to inadequate availability of surgical services. Five billion are at risk due to lack of access to these services. Despite investment in surgery providing a 10:1 benefit:cost ratio for developing economies, surgery remains "the neglected stepchild of global health."

 

The case report "Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence" by Pol et al addresses some of these issues. The report includes two cases, both of young men. This represents a demographic at greater risk for perpetrating and being victims of violence. The case report addresses the issue raised by the greater availability of cheap firearms, so called 'desi-kattas' in India. Readily available firearms represent a risk for global health in both developed and developing nations. Pol et al discuss the importance of government initiative to curb violence as well as to build multi-disciplinary surgical teams capable of handling the surgical emergencies created by these underlying issues. One third of the global burden of disease is addressed surgically, and without these systems in place, needless death and disability will occur.

 

BMJ Case Reports invites authors to draw more attention to problems created by violence and conflict and the need for surgery in global health as well as the successes in this field. Case reports can expose:

-Increasing prevalence of surgical disease in developing countries

-Complications associated with delayed presentation

-Issues faced by vulnerable populations in the developed and developing world

-Management of surgical care in limited resource settings

-Violence and conflict and their effect on the health of populations

The Lancet Commission on Global Surgery discussed the importance of supporting research in developing countries by partnering with local practitioners in the developing world. This literature can be submitted by students, physicians and other medical professionals and will be necessary in helping to develop solutions to these global health problems.

 

Selected references on conflict, resilience and surgery within BMJ Global Health Case Reports:

–Landmines in the Golan Heights: a patient's perspective

–Complications of Dysgerminoma: meeting the health needs of patients in conflict zones

–The Tell-Tale Thigh

–Rheumatic fever with severe carditis: still prevalent in the South West Pacific

–Birth brachial plexus palsy: a race against time

–A Syrian Man with Abdominal Pain

For further guidance on how to write for BMJ Case Reports, please see here.

Selected references outside of BMJCR

1. Ng-Kamstra JS, Greenberg SL, Abdullah F, Amado V, Anderson GA, Cossa M, Costas-Chavarri A, Davies J, Debas HT, Dyer GS, Erdene S. Global Surgery 2030: a roadmap for high income country actors. BMJ Global Health. 2016 Apr 1;1(1):e000011.
2. Stewart F. Root causes of violent conflict in developing countries. BMJ: British Medical Journal. 2002 Feb 9;324(7333):342
3. Bruno E, Shrine MG. Surgery: The Neglected Stepchild of Global Health. The New York Times: Opinion. 2016 Apr 20. Accessed online at http://ift.tt/2rByfTt on 2017 June 4
4. Weinberger SE. Curbing Firearm Violence: Identifying a Target for Physician Action. Annals of internal medicine. 2016 Aug 2;165(3):221-2.

 

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Impact of Ribociclib on Head and Neck Squamous Cell Cancer

Condition:   Squamous Cell Carcinoma of the Head and Neck
Intervention:   Drug: Ribociclib
Sponsor:   Fox Chase Cancer Center
Not yet recruiting - verified June 2017

http://ift.tt/2s4vNpU

Triglyceride to high density lipoprotein cholesterol ratio and its association with periodontal disease in Korean adults: findings based on the 2012–2014 Korean national health and nutrition examination survey

Abstract

Objectives

The aim of this study is to evaluate whether the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is associated with periodontal disease in Korean adults.

Materials and methods

This cross-sectional study included 12,249 individuals (4,941 men and 7,308 women) who took part in the 2012–2014 Korean National Health and Nutrition Examination Survey. We categorized the TG/HDL-C ratio into three groups. Periodontal disease was defined as a community pocket index score ≥3 with at least one affected site. Multiple logistic analyses were used to analyze the association between TG/HDL-C ratio and periodontal disease.

Results

In the study population, prevalence of periodontal disease was 31.6% in men and 21% in women. Compared to the lowest tertile group, OR (95% CI) of the highest tertile group for periodontal disease was 1.474 (1.220–1.780) in men and 1.259 (1.041–1.522) in women after adjusting for age, waist circumference, systolic blood pressure, fasting glucose, current smoking, alcohol drinking, physical activity, household income, oral health behavior, and use of anti-dyslipidemia medication.

Conclusion

Our study suggests that the TG/HDL-C ratio is associated with periodontal disease in Korean adults.

Clinical relevance

TG/HDL-C ratio is a simple and useful marker to reflect insulin resistance. And periodontal disease is also known to be related with insulin resistance. This study indicates that TG/HDL-C ratio was associated with periodontal disease in Korean adults.

http://ift.tt/2qVUp02

Complex pain in children and young people: part I—assessment

1H022E033J02

http://ift.tt/2sDvGiq

Diagnostik und Therapie akuter venöser Erkrankungen

Zusammenfassung

Akute Venenerkrankungen, insbesondere die tiefe Bein- und Beckenvenenthrombose, stellen einen phlebologischen Notfall dar und können akut zu lebensgefährlichen Komplikationen durch Entwicklung einer Lungenarterienembolie und längerfristig zu schweren Folgeschäden im Sinne eines postthrombotischen Syndroms an den betroffenen Körperpartien führen. Sie zählen neben dem Myokardinfarkt und Schlaganfall zu den häufigsten kardiovaskulären Erkrankungen. Eine frühe und zielorientierte Diagnostik sowie rasche Therapieeinleitung sind hierbei essenziell.

http://ift.tt/2sSkYnb

Severe pelvic fracture with profound hypotension: a case report and treatment algorithm

Abstract

Approximately 9% of all blunt trauma patients suffer pelvic fractures. These fractures can range from insignificant and requiring almost no therapy to massive destruction of the pelvic ring with associated with multisystem injury and life-threatening hypotension which mandates the attention of the trauma surgeon, the orthopedic surgeon, the interventional radiologists and possibly other subspecialists. We present a case of a patient who presented to the emergency room in extremis from massive bleeding from a complex pelvic fracture. The patient developed abdominal compartment syndrome. The patient was emergently taken to the operating room but we were unable to control his pelvic bleeding. We propose an algorithm which might be helpful in these critically ill patients.

http://ift.tt/2r1jafm

Thoracic outlet syndrome as a consequence of isolated atraumatic first rib fracture

Abstract

Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms. Although apparent atraumatic isolated first rib fractures are infrequently reported etiologies for TOS in athletes, they are a reasonable consideration in this population with corresponding presentations.

http://ift.tt/2r1IlOE

Cutaneous presentation of gastrointestinal adenocarcinoma

Abstract

Seeding of a central nervous system malignancy to the abdominal cavity is an uncommon but well documented complication of a ventriculoperitoneal (VP) shunt. However, the metastasis of a primary gastrointestinal cancer to the skin via a VP shunt is extremely rare. We report the clinical case of an 85-year-old male who presented with a right upper quadrant nodule over his shunt, which on histopathology and tumour marker profile was diagnosed as an adenocarcinoma of likely upper gastrointestinal origin. This case illustrates the importance of proceeding to biopsy to inform prognosis and management, despite the risks of shunt infection.

http://ift.tt/2r1K075

Editorial board

Publication date: June–July 2017
Source:Annales de Dermatologie et de Vénéréologie, Volume 144, Issues 6–7





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Keloid occurring in a tattoo

Publication date: June–July 2017
Source:Annales de Dermatologie et de Vénéréologie, Volume 144, Issues 6–7
Author(s): N. Kluger, S. Bosonnet




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Calendrier

Publication date: June–July 2017
Source:Annales de Dermatologie et de Vénéréologie, Volume 144, Issues 6–7





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Pigmented macular variant of chronic cutaneous lupus erythematosus: an under-recognized subset in dark skin

http://ift.tt/2qWfO9k

T regulatory cells and other lymphocyte subsets in patients with bullous pemphigoid

Summary

Background

Bullous pemphigoid (BP) is the most common autoimmune blistering disease, and is associated with autoantibodies to the hemidesmosomal BP autoantigens BPAG1 and BPAG2.

Aim

We aimed to investigate the significance of T regulatory cells and other lymphocyte subsets in patients with BP.

Methods

In total, 31 inpatients with BP were treated with systemic prednisolone in a tapered dose regimen, while 28 healthy individuals matched for age and sex served as the healthy control (HC) group., Blood samples were taken at baseline and after treatment, and levels of inducer/helper and suppressor/cytotoxic T lymphocytes, B lymphocytes, natural killer cells, CD4+CD25++CD127− cells were assessed by flow cytometry, while CD4, CD8, and FOXP3 positivity were assessed by immunohistochemistry, and FOXP3 mRNA was assessed by reverse transcription (RT)-PCR.

Results

Flow cytometry showed that numbers of CD8+ and CD4+CD25++CD127− cells were significantly increased, while the number of CD4+ cells and the CD4/CD8 ratio were significantly decreased at baseline and after therapy in patients with BP compared with HCs. Immunohistology revealed that CD4+, CD8+ and FOXP3+ cells were significantly increased at baseline and post-treatment in patients with BP compared with HCs. FOXP3 mRNA levels were significantly increased in the blood of patients with BP compared with HCs.

Conclusion

These results indicate that increased numbers of CD8+, CD4+CD25++CD127− cells and FOXP3+ cells may play a pathogenetic role during the course of BP.

http://ift.tt/2sfouva

Annular itchy rash in a woman with chronic pancreatitis

http://ift.tt/2qWgjAc

The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study

Suspected penicillin allergy (Pen-A) is often not verified by diagnostic testing. In third line penicillin allergy labels were associated with prescription of broad spectrum antibiotics, hospital stay duration...

http://ift.tt/2sD9XHa

Safety and efficacy of laryngeal mask airway ventilation in obese patients with airway stenosis

Objective

To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis.

Study Design

A retrospective chart review was conducted in an academic practice in a tertiary care center.

Methods

We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O₂ saturation and maximum-end tidal carbon dioxide (CO₂) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded.

Results

Fourteen bronchoscopies with laser incisions and dilation were performed in patients with airway stenosis exclusively using LMA ventilation. Thirteen of 14 procedures were performed on patients who had body mass index (BMI) > 30 kg/m². Mean BMI was noted to be 38 kg/m² (range 25–54). All patients underwent successful laser incisions and dilation via LMA anesthesia without major or minor adverse events. The mean lowest O₂ saturation level was noted to be 92%; the mean highest CO₂ level was noted to be 56 mm Hg; and no patients required endotracheal intubation.

Conclusion

In this small series of obese patients with airway stenosis, LMA anesthesia was effectively used without major or minor complications.

Level of Evidence

4. Laryngoscope, 2017

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Cover 2 - Masthead (p/u from previous issue)

Publication date: June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 2





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Editorial Board (p/u from previous issue)

Publication date: June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 2





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Contents

Publication date: June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 2





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Future and recent issues (p/u from previous issue and update)

Publication date: June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 2





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Information for authors (p/u from previous issue)

Publication date: June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 2





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Cervical thymic cysts

Publication date: Available online 6 June 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Hongzhao Ji, Eric Gantwerker
Thymic cysts are rarely occurring benign neck masses, most frequently seen in children. They are remnants of the 3^rd and 4^th branchial pouches. They may occur at any point along the thymic tract, though they have a predilection for the left side of the neck, often deep in the neck. Patients often present with compressive symptoms. Treatment is surgical excision. Care must be taken, however, to confirm the presence of thoracic thymic tissue prior to excision this neck lesion. On histology, they are defined by the presence of thymic parenchyma and Hassal corpuscles in the cyst wall.



http://ift.tt/2sCXumQ

Immediate hypersensitivity to chlorhexidine

Abstract

Chlorhexidine is a widely used and effective antiseptic agent. Although skin contact is usually well tolerated, it may cause both immediate and delayed hypersensitivity reactions. We report a case of immediate hypersensitivity to chlorhexidine causing both skin and respiratory symptoms following occupational exposure to chlorhexidine in a health-care worker.

http://ift.tt/2rTUjJq

Lentigo maligna of the face: A quantitative simple method to identify individual patient risk probability on dermoscopy

Abstract

Background/Objectives

The clinical and dermoscopic differential diagnosis of flat pigmented facial lesions represents a great challenge for the clinicians. Our aim was to report a quantitative method based on dermoscopic features to better classify pigmented facial lesions.

Methods

This is a retrospective case-series study that analysed the dermoscopic features of 582 pigmented facial lesions.

Results

The individual patient probability of lentigo maligna (LM) was predicted by a multivariate model, with an accuracy of 0.72. According to the odds ratio at the multivariate analysis, an individual scoring index was assigned to each criterion, and a value of 4.56 was identified as optimal cut-off point. Up to a score of 2.5, the probability that a lesion is an LM is 0. The probability increases from 10 to 50% for a score ranging between 4.5 and 6. It is about 90% for a score of 7.

Conclusion

The optimal cut-off point obtained and the curve that identifies the probability of a patient having a LM could improve the classification and the management strategies of equivocal pigmented facial lesions.

http://ift.tt/2sROHN8

Vesiculobullous melanoma: an unusual manifestation of in-transit metastasis

Summary

Malignant melanoma (MM), a well-known skin cancer with a poor prognosis, has various clinical manifestations, but vesiculobullous lesions have seldom been reported. We report a case of MM forming amelanotic vesicles at the site of an in-transit metastasis, and we also review the published reports on vesiculobullous MM. Our patient was an 87-year-old man with a history of a treated plantar MM 2 years previously, who had recurrence of the MM and development of an in-transit metastasis in his lower leg. Histopathological findings revealed vesicles caused by infiltration of the tumour. A review of the English literature revealed nine cases with various clinical presentations of the vesicles or blisters. For patients with MM with vesiculobullous lesions, an accurate medical history and examination of biopsies are of primary importance for management.

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Ulcerated nodules in the groin of an immunosuppressed patient

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The importance of full skin examination in diagnosing cutaneous melanoma

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Thyroid autoimmunity in patients with hidradenitis suppurativa: a case–control study

Summary

The aetiopathogenesis of hidradenitis suppurativa (HS) is not fully understood; however, increasing evidence suggests that it may be an immune-mediated disorder. Autoimmune thyroid disease (AITD) has classically been considered as the 'paradigm' of autoimmunity, and it has been linked to a variety of skin disorders. To our knowledge, the prevalence of AITD has not been investigated in patients with HS. The aim of the present study was to assess and compare, for the first time, the prevalence of thyroid autoimmunity in 70 patients with HS and in 70 age- and sex-matched controls. In all participants, thyroid autoantibodies and thyroid function tests were analysed. No statistically significant difference was detected between patients with HS and controls, either for the prevalence of thyroid antibodies or for thyroid function parameters. This lack of an association between HS and thyroid autoimmunity suggests that conventional autoimmune mechanisms may not be implicated in the pathogenesis of HS.

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Differential expression between “DSP-only” and DSP-PP523 transcripts in rat molar teeth

Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Ya-Qin Zhu, Ryan M. Song, Helena H. Ritchie
ObjectiveTo compare the expression patterns of two multiple transcripts derived from DSP-PP gene during tooth development. One is DSP-only transcript (i.e. does not encode PP) and the other is DSP-PP523 transcript, a main DSP-PP transcript.DesignUnique antisense and sense riboprobes were generated from DSP-only and DSPPP523 cDNAs for in situ studies to examine DSP-only and DSP-PP523 transcript expression in developing molars. Paraffin-embedded sections (5–7μ m) from embryonic 20day, postnatal 2, 3 and 6days were deparaffined and hydrated. Tissues were prehybridized, then hybridized with DSP-only and DSP-PP523 anti-sense (AS) or sense (S) Digoxigenin labeled-riboprobes overnight, and washed. Anti-Digoxigenin antibodies conjugated to alkaline phosphatase were used to detect the presence of bound riboprobes by color reaction with NBT/BCIP. Stro-1 antibody was used for immunohistochemical analysis of Stro-1 protein expression in rat molars.ResultsWe found that unlike the DSP-PP523 transcript, the DSP-only transcript does not express in the entire polarized mature odontoblasts but is expressed in the areas subjacent to the mature odontoblast layer. In addition, DSP-only transcript is expressed in the dental pulp. Interestingly, Stro-1 protein, a stem cell marker, was also identified in the areas subjacentto odontoblasts and in dental pulp.ConclusionDifferential expression of DSP-only and DSP-PP523 transcripts suggest that these two kinds of transcripts may play different roles during dentinogenesis. DSP-PP523 transcript is expressed in mature odontoblasts, which actively participates in dentin formation. DSP-only transcript might have a different function.



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Differential expression between “DSP-only” and DSP-PP523 transcripts in rat molar teeth

Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Ya-Qin Zhu, Ryan M. Song, Helena H. Ritchie
ObjectiveTo compare the expression patterns of two multiple transcripts derived from DSP-PP gene during tooth development. One is DSP-only transcript (i.e. does not encode PP) and the other is DSP-PP523 transcript, a main DSP-PP transcript.DesignUnique antisense and sense riboprobes were generated from DSP-only and DSPPP523 cDNAs for in situ studies to examine DSP-only and DSP-PP523 transcript expression in developing molars. Paraffin-embedded sections (5–7μ m) from embryonic 20day, postnatal 2, 3 and 6days were deparaffined and hydrated. Tissues were prehybridized, then hybridized with DSP-only and DSP-PP523 anti-sense (AS) or sense (S) Digoxigenin labeled-riboprobes overnight, and washed. Anti-Digoxigenin antibodies conjugated to alkaline phosphatase were used to detect the presence of bound riboprobes by color reaction with NBT/BCIP. Stro-1 antibody was used for immunohistochemical analysis of Stro-1 protein expression in rat molars.ResultsWe found that unlike the DSP-PP523 transcript, the DSP-only transcript does not express in the entire polarized mature odontoblasts but is expressed in the areas subjacent to the mature odontoblast layer. In addition, DSP-only transcript is expressed in the dental pulp. Interestingly, Stro-1 protein, a stem cell marker, was also identified in the areas subjacentto odontoblasts and in dental pulp.ConclusionDifferential expression of DSP-only and DSP-PP523 transcripts suggest that these two kinds of transcripts may play different roles during dentinogenesis. DSP-PP523 transcript is expressed in mature odontoblasts, which actively participates in dentin formation. DSP-only transcript might have a different function.



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Comparison of different regimens of pimecrolimus 1% cream in the treatment of facial seborrheic dermatitis

Summary

Background

Pimecrolimus 1% cream has already been proved to be an effective and safe alternative to treat seborrheic dermatitis. However, the treatment periods were inconstant in previous studies.

Objective

To evaluate the comparative efficacy of pimecrolimus 1% cream with different regimens for the treatment of facial seborrheic dermatitis.

Method

Thirty patients with facial seborrheic dermatitis were enrolled and randomly distributed to three groups. Patients of Group 1 were treated with topical pimecrolimus cream 1% twice daily for 2 weeks and then a moisturizer cream twice daily for 2 weeks. Patients of Group 2 were treated with pimecrolimus cream 1% twice daily for 2 weeks and then once daily for another 2 weeks. Patients of Group 3 had a consecutive course of pimecrolimus cream 1% twice daily for 4 weeks. Objective symptoms, subjective symptoms, and dermatology life quality index (DLQI) were measured at weeks 0, 2, 4, and 6.

Results

At week 4, the clinical severity scores of all three regimens significantly decreased (P<.01). The improvement of total severity score in Group 3 was more remarkable than groups 1 and 2 (both P<.05). This effect was maintained until the end of the study in Group 3. Life quality of all three groups was significantly improved at week 4 (P<.001), while there was no statistical difference on the improvement of life quality among three groups.

Conclusion

We recommend pimecrolimus 1% cream could be applied twice a day for 4 weeks to treat seborrheic dermatitis.

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