Head and Neck Medicine by Alexandros G.Sfakianakis: 06/16/17

Παρασκευή 16 Ιουνίου 2017

Re: “Comprehensive Survey Results of Childhood Thyroid Ultrasound Examinations in Fukushima in the First Four Years After the Fukushima Daiichi Nuclear Power Plant Accident” by Suzuki et al. (Thyroid 2016;26:843–851)

Thyroid , Vol. 0, No. 0.

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Hepatitis C Virus in Pakistan: Community Education Is an Effective Weapon Against the Killer

Viral Immunology , Vol. 0, No. 0.

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Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique

One hundred and one patients with complete or incomplete cleft lip underwent the anatomical subunit approximation technique for repair. The patients were followed up prospectively for 1year. The objective of this study was to determine the outcomes for the nasolabial area through anthropometric measurements and assessment of the Asher-McDade Aesthetic Index and Steffensen's criteria at 1year after surgery. Six assessors (three cleft surgeons and three non-surgeon medical professionals) examined cropped images; reliability was assessed using Cronbach's alpha.

http://ift.tt/2rpsHZT

Extracapsular dissection in the parapharyngeal space: benefits and potential pitfalls

The aim of this study was to investigate the benefits and potential pitfalls of transcervical extracapsular dissection in the treatment of parotid gland tumours in the parapharyngeal space. We retrospectively evaluated the records of all patients with parapharyngeal parotid gland lesions treated between 2000 and 2015 by transcervical extracapsular dissection. Patients having revision operations and patients whose records were not complete were excluded, leaving 49 patients in the study. We found acceptable oncological and functional outcomes throughout.

http://ift.tt/2txvRva

Re: Ipsilateral full-thickness skin grafts to repair the donor site defect of a radial forearm free flap: a reflection on technique

I read with interest the recent paper by Krishnan and Mitchell.1 As a trainee, I worked in two head and neck units with different approaches to closing the donor sites of radial forearm free flaps (RFFF). The preferred sites were the ipsilateral forearm, and a combination of the iliac fossa and forearm (biased towards the iliac fossa). We used a validated system (the Patient and Observer Scar Assessment Scale)2 to assess the appearance, function, and symptoms at the RFFF of the donor or recipient sites about 18 months after operation.

http://ift.tt/2szwwyY

Evaluation of four designs of short implants placed in atrophic areas with reduced bone height: a three-year, retrospective, clinical and radiographic study

The aim of the present study was to evaluate retrospectively the clinical and radiographic behaviour of four commercially-available short implants with different macrodesigns and microdesigns in areas in which the height of the bone was reduced. We took into account the success and survival, peri-implant crestal bone loss, and the level of probing at which the gum bled. Patients were included if they had been given one or more short implants (≤8.5mm long) in the posterior jaws at least three years earlier.

http://ift.tt/2txnBeC

New approach to improve the keratinised peri-implant soft tissues in patients with intraoral osteocutaneous reconstruction using a free flap

Patients with large mandibular bony defects after operations for oral cancer or trauma have the defects reconstructed with osteocutaneous microvascular free flaps. These provide adequate bone and soft tissue for reconstruction, but result in altered anatomy that can affect both function and aesthetics (Fig. 1).

http://ift.tt/2szsjeu

Myositis in the head and neck: challenges in diagnosis and management

Myositis in the head and neck may present with non-specific symptoms, and radiographically may mimic malignancy. Multidisciplinary management is often essential, and we describe the challenges in an effort to raise awareness of the condition.

http://ift.tt/2txakm7

Can sagittal approach for cadaveric study of TTP block spread more than transverse approach?

An ultrasound-guided transversus thoracic plane (TTP) block can release the pain at internal mammary area [1,2]. An injection point of the TTP block was between the transversus thoracic muscle and the intercostal muscle between the fourth and fifth ribs next to the sternum [3]. The spread of local anesthetic for peripheral nerve block is important for good perioperative pain management. In particular, the spread of local anesthetic for the TTP block is more important because of trunk block. There was no study, which investigated the difference of local anesthetic's spread in approach of the TTP block.

http://ift.tt/2sIAcPm

Inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting: A systematic review and meta-analysis of randomized controlled trials

To compare the use of inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting.

http://ift.tt/2rpA3fJ

Neuraxial hypothermia incidence misinterpreted

We read with interest the recent systematic review by Shaw et al. [1] and applaud the authors for discussing the prevalence of perioperative hypothermia in patients receiving neuraxial anesthetics. However, we have concerns that they have inaccurately interpreted the data of a 2017 publication by Frisch et al. [2] examining hypothermia in patients undergoing total hip and knee arthroplasty, a population that often receives neuraxial anesthesia. When describing the Frisk et al. study, the Shaw et al.

http://ift.tt/2sI9BSI

Overnight call and cognitive functioning: Will tablet-based assessment be the solution for safety check in residents?

In this issue of the Journal of Clinical Anesthesia, Williams and colleagues investigated whether measurable sensorimotor and executive function differences exist in anesthesiology residents after a single overnight call shift versus a routine daytime shift using two tablet-based pointing tasks (i.e., ProPoint and AntiPoint) [1]. They found increased reaction times on both tasks amongst overnight call residents compared to those residents working daytime hours, which was suggestive of sensorimotor and cognitive slowing in the overnight call residents.

http://ift.tt/2rpJ5JL

Dexmedetomidine and Renal Protection after Cardiac Surgery

Dexmedetomidine is a well-known alpha 2 adrenergic agonist and widely used drug. First approved by Food and Drug Administration (FDA) in 1999 as a sedative, now dexmedetomidine has been a focus of extensive research because of its anti-inflammatory, sympatholytic actions. In a recent study Brandao et al. has described significantly lower reoperation rate, neurological injury, decrease hospital stay and improved thirty day mortality in their retrospective analysis of cardiac surgical patients who received dexmedetomidine during procedure [1].

http://ift.tt/2sIATIz

Sensorimotor and executive function slowing in anesthesiology residents after overnight shifts

Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist following a single overnight call versus routine shift, and whether factors like stress, rest and caffeine affect these measures.

http://ift.tt/2rpIebP

The LMA Supreme: Is it a suitable alternative to the i-gel and LMA ProSeal for airway maintenance in children?

In this issue of the Journal of Clinical Anesthesia, Bhattacharjee and colleagues [1] present their results from a meta-analysis of randomized controlled trials comparing the LMA Supreme™ (Teleflex; Triangle park, NC USA) with the i-gel™ (Intersurgical, Wokingham UK) and LMA ProSeal™ (Teleflex; Triangle park, NC USA) in children. This comparison of supraglottic airway (SGA) devices is timely, as emerging data continues to suggest that SGA use for airway management in children result in fewer peri-operative airway complications when compared to tracheal intubation [2,3].

http://ift.tt/2rpuRZk

Erratum to “Anesthesiologists' perceptions of minimum acceptable work habits of nurse anesthetists” [J Clin Anesth 38 (2017) 107–110]

The authors regret that the affiliation A was incorrectly displayed. This affiliation should read "Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA".

http://ift.tt/2sIEiHk

Fishing for answers in an ocean of data: The potential for big data analytics to enhance our knowledge of the complex regional pain syndromes

In an era of expanding costs and declining reimbursement, the healthcare industry has dramatically expanded the collection of demographic and clinical data to facilitate billing efficiency and maintain financial solvency. Electronic health data collection has primarily emphasized the capture of diagnostic coding, medication delivery, laboratory utilization, and procedural interventions to support third party reimbursement claims, improve efficiency, and provide transparency. Although much of the electronic stored data was never directly intended to answer clinical questions, or guide clinical care, the use of data analytics has created opportunities to winnow through the vast data collections and pull out useful insights into previously unrecognized patterns of common and uncommon medical disorders [1–3].

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Bioimpedence: A noninvasive measure of stroke volume and cardiac output

If a non-invasive measure of cardiac output is not accurate is it still non-invasive?

http://ift.tt/2sIyde5

Revolutionizing medication administration safety: Automated carts are here - Are anesthesiologists ready?

In this month's issue of the Journal of Clinical Anesthesia, Wang and colleagues [1] present a randomized controlled trial assessing the use of an automated operating room anesthesia cart and its effect on the recording of medication errors. A search of the US National Library of Medicine database (PubMed, at http://ift.tt/1cTZOuj) for the term, "medication error" performed at the time of the writing of this editorial retrieved a total of 17,808 citations. So, why is another such article needed? In this innovative and important study, 78 anesthesiologists were trained on the use of an automated medication-dispensing cart, and the anesthetic management then was randomized to intraoperative medication administration using either the automated cart or a conventional manual cart [1].

http://ift.tt/2rpryS2

Acute pain management in the pediatric ambulatory setting: How do we optimize the child's postoperative experience?

The accompanying article by Cai and colleagues in this edition of The Journal of Clinical Anesthesia characterizes factors that influence postoperative pain in 204 healthy preschool age children during the first two weeks following outpatient surgery. [1] Postoperative pain management is a complex and challenging issue in pediatrics, especially with regard to ambulatory surgery. The authors, in their prospective study, explored the impact of various demographic, intra-operative, and parental factors on both pain and behavior-related outcomes in young children undergoing outpatient surgical procedures.

http://ift.tt/2rpGTBT

Did we open a treasure chest of chest blocks? The jury is out.

According to estimates from the American Cancer Society, there will be more than 250,000 new cases of breast cancer diagnosed in the United States with breast cancer remaining as the second leading cause of over 40,000 cancer deaths in women in the year 2017 [1]. Many patients who are diagnosed will choose to undergo multiple oncoplastic surgical interventions, including breast conserving and reconstructive procedures. For these patients, acute postoperative and chronic pain remains a prevalent and devastating outcome that impacts on physical and psychosocial well-being.

http://ift.tt/2sIWobZ

Acetaminophen and ondansetron: The central serotonergic connection

Acetaminophen is one of the most widely used analgesic drugs, yet the exact mechanism of its analgesic effect remains largely unknown. Although originally thought to share similar mechanistic properties with cyclooxygenase (COX) inhibitors, acetaminophen is only weakly anti-inflammatory [1] and appears to inhibit prostaglandin synthesis centrally rather than peripherally, accounting for its antipyretic activity [2]. However, COX inhibition by acetaminophen may only occur under specific low peroxide conditions, likely explaining its known tissue selectivity [3].

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Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists

Clinical repercussions of perioperative treatment with ACEIs/ARBs.

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Workload, efficiency, and productivity following open access scheduling in a gastrointestinal endoscopy suite

In this issue of the Journal, Tsai and colleagues describe a managerial intervention in their gastrointestinal endoscopy suite to accommodate the scheduling of additional cases for a new pediatric gastroenterologist on one day of the week [1]. Their intervention was to share the 2 existing locations with first case starts among the 3 separate gastroenterology groups, rather to expand the number of anesthetizing locations staffed at the start of the workday from 2 to 3 locations. One anesthesia provider was allocated to one adult group, and the other provider was shared between a second adult gastroenterology group and a new pediatric gastroenterologist in the third group.

http://ift.tt/2rpDNy0

Maurice S. Albin, pioneer neuroanesthesiologist dies at 93; pioneered spinal cord injury care

Maurice Simeon Albin, MD, MSc, a pioneering anesthesiologist who specialized in neuroanesthesia, died at age 93 in Birmingham, Alabama.

http://ift.tt/2sIJoTN

Assessing effects of intubating stylet use on early postoperative pharyngeal pain

In a small size randomized clinical trial assessing the effects of stylet use during tracheal intubation on early postoperative pharyngeal pain in anesthetized patients, Komasawa et al. [1] show that stylet use results in an increased incidence of early postoperative pharyngeal pain. To differentiate the effects of one factor on primary study endpoint, however, all of other factors have to be standardized for avoidance of potential biases. In this study, postoperative pharyngeal pain was evaluated when patients leaved operation room after sufficient recovery.

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The effect of ondansetron on analgesic efficacy of acetaminophen after hysterectomy: A randomized double blinded placebo controlled trial

To determine that perioperative ondansetron reduces the analgesic efficacy of acetaminophen.

http://ift.tt/2sIpMzb

Post-operative cognitive dysfunction after total knee arthroplasty: It ain't what you do, it's the way that you do it

In this edition, Tanaka et al. [1] describe a prospective study designed to ascertain whether propofol vs desflurane anesthesia affects the incidence of early postoperative cognitive dysfunction (POCD) in elderly obese patients undergoing elective total knee arthroplasty (TKA).

http://ift.tt/2rAASGW

Undifferentiated sarcoma of the sphenoid sinus

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Masaya Nagaishi, Kensuke Suzuki, Yoshiki Sugiura, Issei Takano, Yoshihiro Tanaka, Akio Hyodo
Paranasal sinuses sarcomas are rare and no treatments have been established. We report a young-adult case of sphenoid sinus sarcoma treated by carbon-ion radiotherapy. The patient presented with progressive left-sided visual impairment. A tumor was then identified and partial resection by transnasal approach was performed. The resected mass showed typical morphology of mesenchymal tumor, and morphological and molecular analyses ruled out a predominant-differentiation phenotype. The pathological diagnosis was undifferentiated sarcoma. The residual lesion was treated with carbon-ion radiotherapy, and tumor progression was absent for one year. The patient died of the tumor regrowth 20 months after initial diagnosis. Although this case had a poorer outcome compared with cases of the more-common sarcoma types, our experience suggested that carbon-ion radiotherapy is potentially beneficial in unresectable undifferentiated sarcomas cases of sphenoid sinus.

http://ift.tt/2txg8ME

A case grafted with polyglycolic acid sheets and fibrin glue for protection after temporary resection of a metastatic cervical skin tumor

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Takashi Matsuzuka, Masahiro Suzuki, Masakazu Ikeda, Kaoru Sato, Junko Fujimoto, Rumi Hosaka, Yuko Tanji, Shu Soeda, Shigeyuki Murono
The aim of this case report was to evaluate the usefulness of a grafting with polyglycolic acid sheet and a fibrin glue spray (PGA sheet grafting) after resection of a cervical skin tumor. A 61-year-old woman presented with left cervical skin tumor resistance to chemo-radiotherapy. She had been undergoing multimodal therapy for ovarian serous papillary adenocarcinoma for the previous six years. Although she had a poor general condition and a cervical skin tumor of 9cm in diameter, which was painful and easy bleeding, had offensive smell, she hoped to return to her job. Under local anesthesia, resection was performed, and PGA sheet grafting were used to shield the skin defect. After resection, she was relieved from pain, and could stay home without daily wound treatment. One and half months after resection, the wound was almost epithelialized. The PGA sheets consist of soft, elastic, nonwoven fabric made of PGA. In recent years, PGA sheet grafting has been widely used in the reconstruction and was chosen to shield the skin defect for this case. PGA sheet grafting after resection of cervical skin tumor can be an acceptable method for palliative care to relieve pain, bleeding, offensive smell, and ugly appearance.

http://ift.tt/2szdqJj

Squamous cell carcinoma of the retromolar trigone: Treatment outcomes

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Hideaki Nishi, Takeshi Shinozaki, Toshifumi Tomioka, Takashi Maruo, Ryuichi Hayashi
ObjectiveSquamous cell carcinoma (SCC) of the retromolar trigone is uncommon, accounting for 1.4% of all oral cancer cases in Japan. Few studies have examined the optimal treatment for this cancer. The aim of this study was to evaluate the outcome of treatment for primary SCC of the retromolar area.MethodsWe retrospectively analyzed the outcome and prognosis of 45 patients (38 men, 7 women) with SCC of the retromolar trigone who underwent treatment in our department between July 1992 and March 2011.ResultsMean age was 62.4 years. Clinical stages were: stage I (n=4, 8.9%); stage II (n=10, 22.2%); stage III (n=5, 11.1%); and stage IVa (n=26, 57.8%). Surgical resection was performed in all patients and 6 patients also received postoperative radiotherapy. Reconstructive surgery using free flaps was performed in 38 patients; postoperative complications occurred in 5 of these patients. The 3-year local control rate was 80%, and the 3-year over all survival rates for stage I, II, III, and IV disease were 100%, 80%, 40%, and 49.2%, respectively. Cause of death was the original disease in 23 cases and other diseases in 2 cases. The most common cause of death from the original disease was cervical lymph node metastasis.ConclusionThe presence of cervical lymph node metastasis was a negative prognostic factor. Marginal mandibulectomy may be selected for patients without distinct bone-marrow infiltration.

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The extended bundle of the tensor veli palatini: Anatomic consideration of the dilating mechanism of the Eustachian tube

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Ryuhei Okada, Satoru Muro, Kohtaro Eguchi, Kohei Yagi, Hisayo Nasu, Kumiko Yamaguchi, Koh Miwa, Keiichi Akita
ObjectiveThe aim of this study was to analyze the topographical structures of the muscles surrounding the Eustachian tube.Materials and methodsWe conducted macroscopic and histological studies of 24 halves of 12 heads from Japanese cadavers.ResultsThe main findings were as follows: 1) the infero-lateral muscle bundles of the tensor veli palatini didn't turn medially at the pterygoid hamulus but were distributed laterally and continuous with the buccinator; 2) the tensor veli palatini attached laterally to the membranous part of the Eustachian tube; 3) the superior pharyngeal constrictor was not only adjacent to the buccinator at the pterygomandibular raphe but also had muscular continuation with it laterally and 4) some bundles of the superior pharyngeal constrictor adhered with the palatine aponeurosis.ConclusionWe believe that the cooperation of the muscles contributes to the dilating mechanism of the Eustachian tube, due to the complex topographical structures of the surrounding muscles: the tensor veli palatini, the levator veli palatini, the superior pharyngeal constrictor and the buccinator.

http://ift.tt/2twU7NN

Acute pediatric neck infections: Outcomes in a seven-year series

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Filipa Camacho Côrte, João Firmino-Machado, Carla Pinto Moura, Jorge Spratley, Margarida Santos
ObjectivesThe aim of this study was to analyse the epidemiology, clinical presentation, diagnostic clues, as biochemical parameters and imaging studies, of children with acute neck infections (ANI) to identify possible independent prognostic factors leading to complications and prolonged hospitalization. Methods: Records of children admitted to a tertiary university hospital from January 2008 to December 2014 with a diagnosis of ANIs were reviewed retrospectively. Diseases were categorized according to the site of infection and patients were divided into two groups: children (aged<10 years) and adolescents (aged 10–18 years).ResultsA total of 102 patients belonged to the children's group and 57 were adolescents. Forty-nine patients (27.2%) received antibiotics prior to presentation. The most frequent ANI was peritonsillar abscess (n = 72). Four peritonsillar abscesses progressed to parapharyngeal and retropharyngeal abscesses (n = 2 respectively). An association between age and type of abscess was found, with most of the retropharyngeal abscesses occurring in children (p = 0.05), and the submandibular abscesses in adolescents (p < 0.001). The most frequent symptoms/signs were fever (63.9%) and odynophagia (50.6%). Upon admission, all patients received intravenous antibiotics and 86.8% underwent drainage of the abscess. Cultures were harvested in 87 abscesses and the most frequent pathogen isolated was Streptococcus pyogenes. Signs of airway obstruction occurred in two patients with submandibular abscess, one with peritonsillar and one with parapharyngeal abscess. There were no cases of death or severe sequelae. Recurrent ANIs were observed in eight patients including two infected branchial cysts. Children, presence of multiple abscesses and palpable cervical mass on admission, absence of odynophagia and pharyngeal bulging, surgery with general anaesthesia and surgery after 24 h, were associated with prolonged hospitalization. Presence of toothache and neck pain on admission were identified as predictors of complications.ConclusionsThe present study found, that often, the diagnosis and treatment of neck abscesses in paediatric patients is not straightforward, but can achieve a favourable outcome. The primary location of the ANI appears to vary in different paediatric age groups. Younger age, presence of multiple abscesses or a palpable cervical mass on admission, were associated with prolonged hospitalization. Presence of toothache and neck pain on admission was identified as possible predictors of complications.

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American Thyroid Association Awards Research Grant to to Connie Rhee, MD, MSc, The Regents of the University of California (University of California Irvine)

Supported by the ATA

The American Thyroid Association (ATA) is pleased to announce that it has awarded a 2016 Thyroid Research Grant to Connie Rhee, MD, Assistant Professor, Department of Medicine, Division of Nephrology and Hypertension, University of California Irvine (Orange, CA), for the project entitled "Thyroid Functional Disease, Mental Health, and Quality of Life in Chronic Kidney Disease Patients." The overall goal of Dr. Rhee's project is to determine whether thyroid functional disorders increase risk of depression and reduced health-related quality of life (QOL) in patients with chronic kidney disease (CKD) and, if so what is the potential to ameliorate these effects using thyroid hormone replacement.

Patients with CKD, many of whom require dialysis, are more likely to have thyroid functional disease than their peers without CKD. Recent findings indicate that hypothyroidism is associated with a higher risk of death in patients with CKD, but no mechanism to explain this link has been identified. Depression may be an important contributor to this increased mortality risk, as it is a complication of both thyroid dysfunction and CKD.

Dr. Rhee will first examine of thyroid dysfunction on patient-reported mental health and quality of life in a group of patients with CKD undergoing hemodialysis, based on data collected in an NIH-sponsored study. She will then explore the association between hypothyroidism and the development of new-onset depression in pre-dialysis CKD patients and whether the use of thyroid hormone replacement can impact the development of depression and reduced QOL using data from hundreds of thousands of U.S. veterans.

Dr. Motoyasu Saji, Chair, ATA Research Committee says, "The ATA research grant program has been supporting young scientists in various thyroid-related research area, including clinical, translational, and basic areas. Every year we receive over 50 Grant applications from various countries. We excite to see young thyroid researchers, who attack current clinical problems and basic scientific questions using state of art technologies, new ideas, and new views. Many current leaders in the ATA were award recipients and this tells us how this program is important for us. We hope that this grant will be one of gateway to succeed in carrier as thyroid researchers and they will become leaders in next generation in the ATA. Finally, we appreciate all supports from members and various organizations, including cancer survivors, to make us possible creating excellent program."

The American Thyroid Association (ATA) has awarded 85 thyroid research grants totaling over $2.2 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and distribution of over $1.8 million generously donated to the ATA specifically for research grants from ThyCa: Thyroid Cancer Survivors' Association, Inc., Bite Me Cancer and Thyroid Head and Neck Cancer Foundation. For information on other research grants underway and funded by the ATA, see http://ift.tt/2l3TSGC.

ThyCa: Thyroid Cancer Survivors' Association, Inc. (ThyCa) has provided funding in support of 60 special research grants totaling $1,680,000 focused on thyroid cancer and medullary thyroid cancer since 2003. ThyCa is supporting three research grants in 2016 and three renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.

Bite Me Cancer (BMC) is our newest grant funder supporting five thyroid cancer grants since 2014 for a total of $143,750. BMC will be supporting a new thyroid cancer grant in 2016 and one renewing grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.

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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis and treatment of thyroid disorders and thyroid cancer. ATA is an international individual membership organization for over 1,700 clinicians and researchers from 43 countries around the world, representing a broad diversity of medical disciplines. It also serves the public, patients and their family through education and awareness efforts.

Celebrating its 94^th anniversary, ATA delivers its mission through several key endeavors: the publication of highly regarded monthly journals, THYROID, Clinical Thyroidology, VideoEndocrinology and Clinical Thyroidology for the Public; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease.

More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to to Connie Rhee, MD, MSc, The Regents of the University of California (University of California Irvine) appeared first on American Thyroid Association.

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American Thyroid Association Awards Research Grant to David Sharlin, PhD, Minnesota State University, Mankato

Supported by the ATA

The American Thyroid Association has awarded a Research Grant to David Sharlin, Ph.D., Assistant Professor, Department of Biological Sciences, Minnesota State University, Mankato, for his project entitled "Thyroid Hormone and Local Insulin-like Growth Factor Production in Developing Brain." Reduced levels of thyroid hormone (TH) during development put a child at risk of permanent neurological deficits. Dr. Sharlin proposes that these neurological defects result, at least in part, from a significant decrease in the production of insulin-like growth factor (Igf1) in the brain of patients with developmental hypothyroidism. Furthermore, Dr. Sharlin suggests that the reduced levels of brain Igf1 are independent of changes in blood levels of Igf1 in hypothyroidism. Dr. Sharlin will perform studies in a mouse model to determine in what brain regions Igf1 is reduced following developmental hypothyroidism, to compared the changes in brain and serum Igf1 levels, and to demonstrate that the neurological effects of low TH are a direct result of reduced brain Igf1.

Dr. Motoyasu Saji, Chair, ATA Research Committee says, "The ATA research grant program has been supporting young scientists in various thyroid-related research area, including clinical, translational, and basic areas, over many years. Every year we receive more than 50 Grant applications from various countries around the world. We are excited to see young thyroid researchers, who attack current clinical problems and basic scientific questions using state of art technologies, new ideas, and new views. Many current leaders in the ATA were award recipients, showing the long-lasting importance of the research grant program. The ATA views the grant program as a gateway to a career in thyroid research and further engagement with the ATA. Finally, we appreciate the generous support from members and cancer survivors, to make possible the continuation of this excellent program."

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More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to David Sharlin, PhD, Minnesota State University, Mankato appeared first on American Thyroid Association.

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Tooth brushing motion patterns with manual and powered toothbrushes—a randomised video observation study

Abstract

Introduction

Systematic reviews have shown that powered toothbrushes (PTs) are more effective than manual toothbrushes (MTs), but with only minor effect sizes. Whether PTs are used adequately, however, has not been investigated so far. The aim of the present study was therefore to analyse motion habits with PT in comparison to MT toothbrushes by video observation.

Materials and methods

One hundred subjects were enrolled in this observational trial and brushed their teeth in randomised order with a MT and PT while being video-filmed, resulting in 95 analysable sets of recordings. Parameters of interest were brushing duration (s; median (min;max)), type of brushing strokes, area of brushing, changes between areas (n; median (min;max)) and brushing sequence.

Results

Brushing duration was 145 s (60;354) and 135 s (48;271) for PT and MT, respectively (p ≤ 0.001). Subjects brushed vestibular surfaces completely, but reached oral surfaces to a much lesser extent, regardless of the toothbrush type. With both toothbrushes, subjects moved frequently between areas (MT 35 (14;79); PT 33 (14;85); n.s.) and brushed predominantly with circling and horizontal strokes; with the PT, 50.5% of the subjects spent only <10% of the brushing duration with passive brushing (positioning the brush head on the teeth with ≤2 movements/s).

Conclusions

Intra-individual motion patterns were similar with both MT and PT, and most subjects persisted in their habitual motion patterns regardless of the toothbrush type.

Clinical relevance

The use of PT and MT may need intensive training and supervision from oral hygiene educators in order to help subjects taking full advantage from these devices.

http://ift.tt/2roO0e0

Progress in hydrogen enriched compressed natural gas (HCNG) internal combustion engines - A comprehensive review

Publication date: December 2017
Source:Renewable and Sustainable Energy Reviews, Volume 80
Author(s): Roopesh Kumar Mehra, Hao Duan, Romualdas Juknelevičius, Fanhua Ma, Junyin Li
With the huge growing demand of energy utilization and various threats posed due to the emissions had substantially led the thinkers to put on strategic plans to decrease the usage of energy and reduce the carbon contents of fuels. Moving ahead with these plans hydrogen enriched compressed natural gas (HCNG) engines have emanated as a forthcoming energy carrier for internal-combustion engines. Several nations are endeavoring hard to bring down the pollution level by promoting hydrogen enriched compressed natural gas-fueled vehicles, predominantly by powering medium and heavy transportation vehicles. In general, under precise circumstances the indicated thermal efficiency of the HCNG engine is much better than CNG engines without tolerating the high level of harmful emissions. In spite of that the hydrogen addition to NG provides increased NOx emission because of a great amount of heat generation inside the combustion chamber. However, it can be overcome by some extent of the application of lean burn combustion or with three-way catalyst (TWC). This report presented an encyclopedic overview of hydrogen enriched compressed natural-gas engines. This paper provides a detailed discussion on the hydrogen generation methods, fundamentals of characteristics of HCNG mixture, refinements on different fuel mixture affecting the combustion. For covering the prospects of the HCNG engines, its technical and numerical approaches are discussed. Furthermore, various methods are discussed which increase the power output and thermal efficiency along with a check on the emission parameters. An exploration of HCNG vehicle's demonstration projects worldwide is a key feature of this article.

http://ift.tt/2tbTGJM

First-line Esophageal Carcinoma Study With Chemo vs. Chemo Plus Pembrolizumab (MK-3475-590/KEYNOTE-590)

Condition: Esophageal Neoplasms
Interventions: Biological: Pembrolizumab; Drug: Placebo; Drug: Cisplatin; Drug: 5-FU
Sponsor: Merck Sharp & Dohme Corp.
Not yet recruiting - verified June 2017

http://ift.tt/2rzTE15

Rosacea and demodicidosis associated with gain-of-function mutation in STAT1

Abstract

We report a family in which 3 of 5 children as well as the mother, had a gain-of-function (GOF) mutation in the signal transducer and activator of transcription (STAT1) associated with early-onset rosacea and demodicidosis. The proband case (Fig. 1) was a 13-year-old boy of non-consanguineous parents, known for a hypothyroidism, failure to thrive and chronic mucocutaneous candidiasis (CMC) since he was 5-6 years old. On examination, he had medio-facial erythema with telangiectasia, as well as sometimes pruritic papulopustular lesions of the face and neck.

http://ift.tt/2rEWTzl

Observations from our evaluation of body weight changes after initiation of a biologic therapy in PSOLAR

Abstract

PSOLAR is a global, prospective, observational study designed to evaluate long-term safety and clinical outcomes for over 12,000 psoriasis patients who are receiving, or are eligible to receive, biologic and/or conventional systemic agents. Data from the registry may also be used to test hypotheses for topics of interest to dermatologists.¹ While PSOLAR has produced many viable analyses of safety and efficacy outcomes, including overall safety, serious infections, comparative effectiveness, and persistence of treatment,^2-5 a recently tested hypothesis related to treatment effect on body weight did not generate interpretable results. Our observations may be relevant for future research in this area.

http://ift.tt/2sakCLl

Reflectance confocal microscopic presentation of basosquamous carcinoma

Abstract

Basosquamous carcinoma (BSC) is considered a variant of basal cell carcinoma (BCC) associated with squamous differentiation.¹ It may display local aggressive behavior, and increased potential for recurrence and metastases.² Therefore, early and appropriate treatment will have prognostic repercussion.

http://ift.tt/2rEH4ZC

American Thyroid Association Awards Research Grant to Kristen R. Vella, Ph.D., Beth Israel Deaconess Medical Center and Harvard Medical School

Supported by ATA

The ATA is pleased to present a 2016 Research Grant to Kristen Vella, PhD, to support her project entitled "Neuronal Regulation of Hepatic Thyroid Hormone Clearance." Dr. Vella is an Instructor in the Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.

Dr. Vella presents a research study intended to identify the subset of neurons that activate thyroid hormone (TH) clearance in the liver during fasting and with weight loss, leading to decreased energy expenditure. These regulatory mechanisms work against efforts to maintain weight loss. A better understanding of the mechanisms and of how certain neurons activate or inhibit hepatic TH clearance could lead to the discovery of novel therapeutic targets to treat metabolic disorders and aid in weight loss maintenance.

Dr. Vella and colleagues have previously identified specific genes that suppress TH levels during fasting and regulate hepatic TH clearance. She has hypothesized that these genes are express by neurons in the hypothalamus. Through her research project, Dr. Vella will explore the neuronal and downstream signaling pathways that link the hypothalamus and the liver and how those connections may become altered during metabolic disease and weight loss maintenance.

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More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to Kristen R. Vella, Ph.D., Beth Israel Deaconess Medical Center and Harvard Medical School appeared first on American Thyroid Association.

http://ift.tt/2rzV7Eq

American Thyroid Association Awards Research Grant to Nikita Pozdeyev, MD, PhD, University of Colorado

Supported by ThyCa: Thyroid Cancer Survivors' Association, Inc. and ATA

Nikita Pozdeyev, M.D., Ph.D. is the recipient of the 2016 American Thyroid Association (ATA) ThyCa: Thyroid Cancer Survivors' Association, Inc. Grant. The 2016 Research Grant has been awarded to Dr. Pozdeyev for his project entitled "Rational Combination Therapies with Lenvatinib for Advanced Thyroid Cancer."

Lenvatinib is an FDA-approved treatment for advanced thyroid cancer that no longer responds to radioiodine therapy. Although effective, lenvatinib does not usually result in a complete response, and some tumors develop resistance to the drug. Dr. Pozdeyev proposes to improve the effectiveness of lenvatinib by identifying synergistic combinations with other anti-cancer drugs.

He will test more than 200 drugs in combination with lenvatinib using an automated assay system to determine their potential for causing thyroid cancer cell death. Additional in silico studies will use machine learning algorithms to predict effective drug combinations based on data from public databases and generated in the researchers' laboratory. Dr. Pozdeyev and colleagues will then test the most promising drug combinations in cell culture and in mouse models of thyroid cancer to identify those with potential to advance to human clinical trials.

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More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to Nikita Pozdeyev, MD, PhD, University of Colorado appeared first on American Thyroid Association.

http://ift.tt/2rEXNfg

American Thyroid Association Awards Research Grant to Viswanath Gunda, Ph.D, Massachusetts General Hospital

Supported by ThyCa: Thyroid Cancer Survivors' Association, Inc. and ATA

The American Thyroid Association (ATA) is pleased to announce that Viswanath Gunda, Ph.D., is the recipient of a 2016 ThyCa Research Grant for his project entitled "Combining Immune Checkpoints Inhibitors with BRAF Targeted Therapy in Thyroid Cancer." Dr. Gunda is an Instructor in Surgery at Massachusetts General Hospital, Boston, MA.

This project explores emerging combinatorial approaches to treating thyroid cancer that target oncogene mutations such as BRAFV600E or kinase pathways such as VEGFR and include an immunotherapeutic component designed to stimulate the body's natural defenses to recognize and kill tumor cells. Dr. Gunda's proposal focuses on understanding the role of the immune checkpoint receptors PD-1/PD-L1 in thyroid cancer, and studying the potential for inhibitors of these checkpoint receptors to have synergistic effects when combined with MAPKinase inhibitors and multi-kinase VEGFR inhibitors.

Checkpoint receptors are proteins present on the surface of T-cells that prevent these immune cells from destroying cancer cells. Tumors exploit these checkpoints to evade the immune system and escape detection. Dr. Gunda will study the effectiveness of anti-PD-1 and anti-PD-L1 antibodies in blocking the checkpoint receptors and allowing for immune system recognition and elimination of tumor cells in an immunocompetent mouse model of anaplastic thyroid cancer.

Dr. Motoyasu Saji, Chair, ATA Research Committee says, "The ATA research grant program has been supporting young scientists in various thyroid-related research area, including clinical, translational, and basic areas. Every year we receive over 50 Grant applications from various countries. We excite to see young thyroid researchers, who attack current clinical problems and basic scientific questions using state of art technologies, new ideas, and new views.Many current leaders in the ATA were award recipients and this tells us how this program is important for us. We hope that this grant will be one of gateway to succeed in carrier as thyroid researchers and they will become leaders in next generation in the ATA. Finally, we appreciate all supports from members and various organizations, including cancer survivors, to make us possible creating excellent program."

The American Thyroid Association (ATA) has awarded 85 thyroid research grants totaling over $2.2 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and distribution of over $1.8 million generously donated to the ATA specifically for research grants from ThyCa: Thyroid Cancer Survivors' Association, Inc. (ThyCa) and Bite Me Cancer. The ATA supports all administrative and financial oversight for the research grant program. For information on other research grants underway and funded by the ATA, see http://ift.tt/2l3TSGC.

ThyCa: Thyroid Cancer Survivors' Association, Inc. has provided funding in support of 60 special research grants totaling $1,680,000 focused on thyroid cancer and medullary thyroid cancer since 2003. ThyCa is supporting three research grants in 2016 and three renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.

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More information about ATA is found at www.thyroid.org.

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http://ift.tt/2rEsgtO

American Thyroid Association Awards Research Grant to Irene M. Min, Ph.D., Weill Cornell Medical College

Supported by Bite Me Cancer and ATA

Irene Min, M.D. is the recipient of the 2016 American Thyroid Association (ATA) Bite Me Cancer Grant. Dr. Min, Assistant Research Professor, Department of Surgery, Weill Cornell Medical College, New York, NY, submitted the winning project entitled "Application of Chimeric Antigen Receptor (CAR)-T Cell Therapy in Aggressive Thyroid Cancer." Immunotherapy using T-cell engineered to express chimeric antigen receptor (CAR) specific to tumor-associated cell surface antigen is a promising new approach to stimulate the body's own defenses to recognize and destroy cancer cells. It has shown impressive clinical outcomes in hematologic cancers and recently in preclinical applications in solid tumors.

Dr. Min is using CAR-T immunotherapy to target intercellular adhesion molecule-1 (ICAM-1) in papillary thyroid cancer (PTC) and anaplastic thyroid cancer (ATC), and preliminary results have shown strong and specific destruction of PTC and ATC cells in vitro and in mice. In the proposed study she will evaluate the therapeutic efficacy of ICAM-1-based CAR-T immunotherapy against ATC combined with the BRAF inhibitor vemurafenib or an immune checkpoint inhibitor in vitro and in mice. Adjuvant therapies that target the tumor microenvironment will likely be needed to boost the efficacy of CAR-T immunotherapy against solid tumors in humans.

Dr. Motoyasu Saji, Chair, ATA Research Committee says, "The ATA research grant program has been supporting young scientists in various thyroid-related research areas, including clinical, translational, and basic areas, over many years. Every year we receive more than 50 Grant applications from North America and countries around the world. We are excited to see young thyroid researchers, who attack current clinical problems and basic scientific questions using state of the art technologies, new ideas, and new views. Many current leaders in the ATA were award recipients, showing the long-lasting importance of the research grant program. The ATA views the grant program as a gateway to a career in thyroid research and further engagement with the ATA. Finally, we appreciate the generous support from members and cancer survivors, making possible the continuation of this excellent program."

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Celebrating its 94th anniversary, ATA delivers its mission through several key endeavors: the publication of highly regarded monthly journals, THYROID, Clinical Thyroidology, VideoEndocrinology and Clinical Thyroidology for the Public; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease.

More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to Irene M. Min, Ph.D., Weill Cornell Medical College appeared first on American Thyroid Association.

http://ift.tt/2s9wcq0

Patient reported outcome measures in oral lichen planus: A comprehensive review of the literature with focus on psychometric properties and interpretability

Abstract

Objective

To review the range of patient reported outcome measures (PROMs) used in clinical studies of patients with oral lichen planus (OLP) and to assess their psychometric properties and interpretability.

Methods

Literature searches were performed on MEDLINE, Embase and Web of Science databases (1990 - September 2016) to retrieve relevant studies related to the development, psychometric testing and/or use of PROMs assessing oral symptoms, psychosocial status, and quality of life in individuals with OLP. The identified PROMs were then categorized by concept measured and assessed for instrument characteristics and evidence for psychometric properties and interpretability.

Results

We identified a total of 41 PROMs used in clinical studies for the assessment of patient reported outcomes in patients with OLP. There were 3 PROMs of oral symptoms, 30 PROMs of psychosocial status and 8 PROMs of quality of life. Six instruments (Visual Analog Scale, Numerical Rating Scale, Change in Symptom Scale, Oral Health Impact Profile-14, Oral Health related Quality of Life-UK and Chronic Oral Mucosal Disease Questionnaire) demonstrated some evidence of psychometric properties but no evidence for interpretability of their results in the OLP population.

Conclusion

The range of PROMs used in clinical studies of patients with OLP is wide and include instruments for oral symptoms, psychosocial status and quality of life. The vast majority of these instruments have no evidence of psychometric properties and interpretability for patients with OLP. Further qualitative and validation studies are required to investigate whether these instruments are appropriate for use in this patient population.

http://ift.tt/2rzVuz0

Blockade of CD112R and TIGIT signaling sensitizes human natural killer cell functions

Abstract

Trastuzumab is the first-line drug to treat breast cancer with high Her2 expression. However, many cancers failed to respond, largely due to their resistance to NK cell-triggered antibody-dependent cellular cytotoxicity (ADCC). Poliovirus receptor (PVR)-like molecules are known to be important for lymphocyte functions. We found that all PVR-like receptors are expressed on human NK cells, and only TIGIT is preferentially expressed on the CD16+ NK cell subset. Disrupting the interactions of PVR-like receptors with their ligands on cancer cells regulates NK cell activity. More importantly, TIGIT is upregulated upon NK cell activation via ADCC. Blockade of TIGIT or CD112R, separately or together, enhances trastuzumab-triggered antitumor response by human NK cells. Thus, our findings suggest that PVR-like receptors regulate NK cell functions and can be targeted for improving trastuzumab therapy for breast cancer.

http://ift.tt/2sjenDn

Adalimumab use in patients with psoriasis and hepatitis B: a case series

Abstract

Tumor necrosis factor (TNF) inhibitors neutralize the biologic activity of TNF-alpha, a key cytokine involved in both the pathogenesis of psoriasis and host immune response in suppressing microbial proliferation.¹ It is well known that chronic hepatitis B virus (HBV) carriers are at high risk of HBV reactivation when using immunosuppressive medications, chemotherapy, and TNF inhibitors.^2-4 However, HBV reactivation in patients with resolved HBV infection using TNF inhibitors is exceedingly rare, and to our knowledge has not been reported in the psoriasis literature.

http://ift.tt/2taWtTu

Bullous Pemphigoid Associated with Silicosis

Abstract

An 87-year-old man presented with multiple erythemas accompanied by itching on bilateral axillae, groins and buttocks for 3 months, which aggravated with blisters and bullae for 1 month. The physical examination revealed multiple tense blisters and bullae with erosions and light yellow effusion (Fig. 1a). The histopathological examination of the tissue biopsy showed a subepidermal blister with little inflammatory infiltrate (Fig. 1b).

http://ift.tt/2sBfkdn

Paraneoplastic pemphigus in two pairs of brothers

Abstract

A 65-year-old man (Patient 1A) presented with erosions on the face, upper trunk and the oral mucosa in 1995 (Table 1). He underwent prostatectomy for prostate cancer in 1990. PNP was proven by antibodies to IgG anti-epithelial cell surface (ECS), desmoglein (Dsg)1, and Dsg3.

http://ift.tt/2taNh1n

“Congenital dermatofibrosarcoma protuberans clinically mimicking a melanocytic nevus treated with serial excisions”

Abstract

A 9-year-old female patient was referred to our department with the clinical diagnosis of a congenital melanocytic nevus on the back for serial excisions. The child's parents confirmed that the lesion existed since birth. Only little changes in color and size were observed over the years. The lesion was painless.

http://ift.tt/2taMFbO

Cutaneous pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma FOSB immunohistochemistry demonstrating the SERPINE1-FOSB fusion gene

Abstract

Pseudomyogenic hemangioendothelioma is a distinctive vascular neoplasm characterized by a multicentric presentation that mostly involves the lower extremities of young adults. Histopathologic resemblance to epithelioid sarcoma and co-expression of both keratins and endothelial markers are its hallmarks. A specific SERPINE1-FOSB fusion gene derived from t(7;19)(q22;q13) with significantly higher FOSB mRNA expression in neoplastic cells is the characteristic cytogenetic anomaly of this tumor.

http://ift.tt/2sBer4k

Systemic therapy of ocular and cutaneous rosacea in children

Abstract

Background

In paediatric rosacea, ocular symptoms are often predominant. Literature about systemic therapy of paediatric ocular rosacea is sparse, though.

Objective

Analysis of children with ocular rosacea treated systemically, particularly addressing remission and recurrence rates.

Methods

Retrospective study reviewing the medical records of children with ocular rosacea treated with systemic antibiotic therapy. Nine out of 19 patients were chosen for detailed analysis.

To our knowledge, this is the first study in paediatric ocular rosacea requiring systemic therapy with a larger patient group and a longer follow-up (mean follow-up = 30.2 months).

Results

Seventeen patients (89.5%) suffered from blepharitis, 15 patients (78.9%) from conjunctivitis, twelve patients (63.2%) from chalazia/styes and nine female patients (47.4%) from corneal involvement.

We used erythromycin (n = 9) or roxithromycin (n = 1) in patients younger than eight years and doxycycline (n = 8) or minocycline (n = 1) in patients older than eight years.

Seven out of nine patients treated with erythromycin, one out of eight patients treated with doxycycline and the patient treated with minocycline achieved a complete remission of ocular and cutaneous symptoms. Two out of nine patients treated with erythromycin, seven out of eight patients treated with doxycycline and the patient treated with roxithromycin achieved a partial remission.

Relapses occurred in the patient treated with minocycline (cutaneous), two out of eight patients treated with doxycycline (ocular and cutaneous) and one out of nine patients treated with erythromycin (cutaneous).

Conclusion

To achieve a complete remission of cutaneous and ocular rosacea, a long-term anti-inflammatory treatment of at least six months is necessary. The remission and relapse rates after successful treatment seem to be lower than in adults as all nine patients treated with erythromycin achieved a complete remission and did not show any relapse.

http://ift.tt/2tbeqkS

Detection of Halitosis in Breath: Between the Past, Present and Future

Abstract

In order to develop a new generation of diagnostics for halitosis, replacing the subjective organoleptic assessment, a series of exhaled breath analyzers has been developed and assessed. All three devices rely on the assessment of exhaled Volatile Sulfuric Compounds (VSCs), which are mainly generated in and emitted from the oral cavity, contributing to the malodor. Portable, on-site and easy to use, these devices have potential for non-invasive diagnosis of halitosis. However, global assessment of exhaled VSCs alone has two main drawbacks: (1) the absence of VCSs does not rule out halitosis; (2) non-sulfuric volatile compounds that could be biomarkers of systemic diseases, found in up to 15% of halitosis cases, are neglected.

In this article, we review and discuss progress to date in the field of oral/exhaled volatile compounds as potential noninvasive diagnostics for halitosis. We will briefly describe the generation of these compounds both from local (oral) and distal (extra-oral) sources. In addition, we debate the different analytical approaches in use and discuss the potential value of bio-inspired artificially intelligent olfaction in diagnosing and classifying oral and systemic diseases by analyzing exhaled breath.

http://ift.tt/2taLitK

Sialadenoma papilliferum in the buccal mucosa detected on 18F-fluorodeoxyglucose-positron emission tomography

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): S. Miyamoto, T. Ogawa, D. Chikazu
An incidental discovery of an accumulation of ¹⁸F-fluorodeoxyglucose (FDG) in the oral cavity of patients with malignant tumours on FDG positron emission tomography (PET) can pose a problem regarding the differential diagnosis of metastatic lesions. Large accumulations can often be found even when tumours in the salivary or thyroid gland are benign, so FDG-PET is limited in its ability to differentiate between benign and malignant disease. This report describes a rare case of sialadenoma papilliferum in the buccal mucosa that was discovered incidentally on FDG-PET in a patient with multiple metastases to bone after an operation for rectal cancer.

http://ift.tt/2sAZC1J

Effectiveness of binaural beats in reducing preoperative dental anxiety

Publication date: July 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 6
Author(s): B.K. Isik, A. Esen, B. Büyükerkmen, A. Kilinç, D. Menziletoglu
Binaural beats are an auditory illusion perceived when two different pure-tone sine waves are presented one to each ear at a steady intensity and frequency. We evaluated their effectiveness in reducing preoperative anxiety in dentistry. Sixty patients (30 in each group) who were to have impacted third molars removed were studied (experimental group: 20 women and 10 men, mean (range) age 24 (18-35) years, and control group: 22 women and 8 men, mean (range) age 28 (15-47) years). All patients were fully informed about the operation preoperatively, and their anxiety recorded on a visual analogue scale (VAS). The local anaesthetic was given and the patients waited for 10minutes, during which those in the experimental group were asked to listen to binaural beats through stereo earphones (200Hz for the left ear and 209.3Hz for the right ear). No special treatment was given to the control group. In both groups anxiety was then recorded again, and the tooth removed in the usual way. The paired t test and t test were used to assess the significance of differences between groups. The degree of anxiety in the control group was unchanged after the second measurement (p=0.625), while that in the experimental group showed a significant reduction in anxiety (p=0.001). We conclude that binaural beats may be useful in reducing preoperative anxiety in dentistry.

http://ift.tt/2taEigD

Editorial Board

Publication date: July 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 6

http://ift.tt/2tb300g

Re: Argument for the conservative management of mandibular ameloblastomas

Publication date: July 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 6
Author(s): P. Prasad, R.S. Desai, S. Bansal, P.M. Shirsat

http://ift.tt/2sBsXch

Erratum to “Comparison of cardiovascular responses after injection of lidocaine with either clonidine or adrenaline: a two-year comparative analysis” [Br J Oral Maxillofac Surg 55 (2017) 67–70]

Publication date: July 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 6
Author(s): R. Dandriyal, S. Pachauri, K.Y. Giri, S. Rastogi, N.I.B. Prasad, S. Agarwal, H.P. Singh

http://ift.tt/2sBsYgl

Inspiring a career in oral and maxillofacial surgery: a first-degree medical student’s perspective

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): H. Spiers, J. Ashby

http://ift.tt/2taPoSS

Training Groups

Publication date: July 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 6

http://ift.tt/2sAZAa7

Simultaneous, congenital, mucocoele of the Blandin-Nühn glands and teratoma of the tongue: early management and follow up at one year

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Nathalie Pham Dang, Anne-Claire Melka, Hélène Laurichesse Delmas, Isabelle Barthélémy
Mucocoele of the Blandin-Nühn glands and teratomas of the tongue are rare in newborn babies. We present what is to our knowledge the first documented case of both at the same time, and describe management and follow up over 12 months after the birth. Prenatal diagnosis defined the treatment plan during delivery to establish an airway for the baby promptly. A normal delivery is possible if the cyst is anterior, and can be punctured during delivery. Delayed excision reduces the possibility of oedema and obstruction of the airway, ensures complete resection, avoids recurrence, and confirms the diagnosis. Mucocoeles are classified as extravasation or retention types; our observation supports the hypothesis of a "malformative type". A long follow-up is essential to monitor macroglossia, open bite, and the development of the mandible.

http://ift.tt/2tb8et8

Three-dimensional scanning electron microscopy of maxillofacial biomaterials

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): A.M. Pabst, W.E.G. Müller, M. Ackermann

http://ift.tt/2sBblNV

The link between morphology and complement in ocular disease

Publication date: Available online 15 June 2017
Source:Molecular Immunology
Author(s): Camilla Mohlin, Kerstin Sandholm, Kristina N. Ekdahl, Bo Nilsson
The complement system is a vital component of the immune-priveliged human eye that is always active at a low-grade level, preventing harmful intraocular injuries caused by accumulation of turnover products and controlling pathogens to preserve eye homeostasis and vision. The complement system is a double-edged sword that is essential for protection but may also become harmful and contribute to eye pathology. Here, we review the evidence for the involvement of complement system dysregulation in age-related macular degeneration, glaucoma, uveitis, and neuromyelitis optica, highlighting the relationship between morphogical changes and complement system protein expression and regulation in these diseases. The potential benefits of complement inhibition in age-related macular degeneration, glaucoma, uveitis, and neuromyelitis optica are abundant, as are those of further research to improve our understanding of complement-mediated injury in these diseases.

http://ift.tt/2sBqAGp

American Thyroid Association Awards Research Grant to Liora S. Katz, PhD, Icahn School of Medicine at Mount Sinai

Supported by ATA

The American Thyroid Association (ATA) has awarded a 2016 Research Grant to Liora Katz, Ph.D., Instructor at the Diabetes Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY. Dr. Katz's project, "T3 and Glucose Signaling in Pancreatic ß-cells," will examine how glucose and thyroid hormone (T3) can work together to regulate the number of insulin-producing ß-cells in the pancreas. This work could lead to new therapeutic approaches for increasing ß-cell proliferation to treat diabetes.

Individuals with either underactive or overactive thyroid often also have diabetes. However, the effect, if any, of T3 on the pancreas, and whether it differs depending on a person's blood glucose levels is poorly understand. Previous research by Dr. Katz and others has shown that T3 and glucose act together to increase expression of the ChREBP gene and, in response to T3 and glucose stimulation, the ChREBP protein appears to regulate the number of ß-cells.

Dr. Katz will use the grant funds to identify the genes in ß-cells on which the ChREBP protein acts to increase ß-cell mass. Her team aims to explore how modifications to T3 and glucose signaling might be able to treat or prevent diabetes in people with thyroid dysfunction. The second aspect of her proposal involves studying the effects of thyroid dysfunction in pregnant mice on ß-cell mass in their offspring and future risk for diabetes.

The American Thyroid Association (ATA) has awarded 85 thyroid research grants totaling over $2.2 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and distribution of over $1.8 million generously donated to the ATA specifically for research grants from ThyCa: Thyroid Cancer Survivors' Association, Inc. (ThyCa) and Bite Me Cancer. The ATA supports all administrative and financial oversight for the research grant program. For information on other research grants underway and funded by the ATA, see http://ift.tt/2l3TSGC.

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More information about ATA is found at www.thyroid.org.

The post American Thyroid Association Awards Research Grant to Liora S. Katz, PhD, Icahn School of Medicine at Mount Sinai appeared first on American Thyroid Association.

http://ift.tt/2sxJ75Q

TCR+CD3+CD4−CD8− effector T cells in psoriasis

Publication date: Available online 15 June 2017
Source:Clinical Immunology
Author(s): D. Brandt, M. Sergon, S. Abraham, K. Mäbert, C.M. Hedrich
The autoimmune/inflammatory disorder psoriasis is characterized by keratinocyte proliferation and immune cell infiltration of the skin. TCR⁺CD3⁺CD4⁻CD8⁻ "double negative" (DN) T cells can derive from CD8⁺ T cells through the down-regulation of CD8. The inhibitory molecule programmed death (PD-)1 is expressed on activated T cells and plays a role in the maintenance of peripheral tolerance. A subset of DN T cells, characterized by the expression of PD-1, has recently been demonstrated to be self-reactive.We demonstrate that a majority of DN T cells exhibits effector memory phenotypes, express IFN-γ, and fail to proliferate. DN T cells from psoriasis patients are characterized by reduced DNA methylation of the IFNG gene and increased PD-1 expression. Furthermore, PD-1 positive DN T cells infiltrate the epidermis in psoriatic skin lesions. Our observations offer additional insight into the molecular pathophysiology of plaque psoriasis and show promise as potential disease biomarkers and/or therapeutic targets for future interventions.

http://ift.tt/2sjnqEt

Lack of evidence for post-vaccine onset of autoimmune/lymphoproliferative disorders, during a nine-month follow-up in multiply vaccinated Italian military

Publication date: Available online 15 June 2017
Source:Clinical Immunology
Author(s): Claudia Ferlito, Vincenzo Barnaba, Sergio Abrignani, Mauro Bombaci, Alessandro Sette, John Sidney, Roberto Biselli, Enrico Tomao, Maria Sofia Cattaruzza, Valentina Germano, Michela Ileen Biondo, Gerardo Salerno, Patrizia Lulli, Sara Caporuscio, Andrea Picchianti Diamanti, Mirella Falco, Valentina Biselli, Patrizia Cardelli, Alberto Autore, Elena Lucertini, Donato Pompeo De Cesare, Mario Stefano Peragallo, Florigio Lista, Carmela Martire, Simonetta Salemi, Roberto Nisini, Raffaele D'Amelio
Anecdotal case reports, amplified by mass media and internet-based opinion groups, have recently indicated vaccinations as possibly responsible for autoimmunity/lymphoproliferation development. Multiply vaccinated Italian military personnel (group 1, operating in Italy, group 2, operating in Lebanon) were followed-up for nine months to monitor possible post-vaccine autoimmunity/lymphoproliferation onset. No serious adverse event was noticed in both groups. Multivariate analysis of intergroup differences only showed a significant association between lymphocyte increase and tetanus/diphtheria vaccine administration. A significant post-vaccine decrease in autoantibody positivity was observed. Autoantibodies were also studied by microarray analysis of self-proteins in subjects exposed to ≥4 concurrent vaccinations, without observing significant difference among baseline and one and nine months post-vaccine. Moreover, HLA-A2 subjects have been analyzed for the possible CD8T-cell response to apoptotic self-epitopes, without observing significant difference between baseline and one month post-vaccine. Multiple vaccinations in young adults are safe and not associated to autoimmunity/lymphoproliferation onset during a nine-month-long follow-up.

http://ift.tt/2rz8EMA

DOCK8 deficiency: Insights into pathophysiology, clinical features and management

Publication date: Available online 15 June 2017
Source:Clinical Immunology
Author(s): Catherine M. Biggs, Sevgi Keles, Talal A. Chatila
Dedicator of Cytokinesis 8 (DOCK8) deficiency is a combined immunodeficiency that exemplifies the broad clinical features of primary immunodeficiencies (PIDs), extending beyond recurrent infections to include atopy, autoimmunity and cancer. It is caused by loss of function mutations in DOCK8, encoding a guanine nucleotide exchange factor highly expressed in lymphocytes that regulates the actin cytoskeleton. Additional roles of DOCK8 have also emerged, including regulating MyD88-dependent Toll-like receptor signaling and the activation of the transcription factor STAT3. DOCK8 deficiency impairs immune cell migration, function and survival, and it impacts both innate and adaptive immune responses. Clinically, DOCK8 deficiency is characterized by allergic inflammation as well as susceptibility towards infections, autoimmunity and malignancy. This review details the pathophysiology, clinical features and management of DOCK8 deficiency. It also surveys the recently discovered combined immunodeficiency due to DOCK2 deficiency, highlighting in the process the emerging spectrum of PIDs resulting from DOCK protein family abnormalities.

http://ift.tt/2sjzWUu

Biomechanical comparison of a multidirectional locking plate and conventional plates for the osteosynthesis of mandibular angle fractures—a preliminary study

Publication date: Available online 15 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Catarina Zimmermann, Anders Henningsen, Kai-Olaf Henkel, Jan Klatt, Christian Jürgens, Klaus Seide, Benjamin Kienast
IntroductionThe objective of surgical fracture management is to reduce and fixate fractures accurately and rapidly. Two osteosynthesis plates are usually used in the treatment of mandibular angle fractures in order to enhance torsional stiffness. We conducted biomechanical tests under static and cyclic loading in order to assess whether a single locking plate is as efficacious as two conventional plates in the osteosynthesis of mandibular angle fractures.MethodsFracture gaps were created in synthetic mandible replicas. After pretests, the stiffness of a single locking plate and different types of non-locking two-plate systems was assessed and compared under static and cyclic loading. The plates were subjected to a maximum static load of 750 N and underwent cyclic loading at a constant force of 400 N during a maximum of 500,000 cycles.ResultsNo plastic deformation occurred in the static tests. Both types of osteosynthesis showed high static stability. The locking plate was significantly stiffer than the non-locking plates (p=0.0079). Cyclic loading tests did not reveal any significant differences.ConclusionWithin the limitations of this preliminary study, a single locking miniplate appears to be as efficacious in biomechanical tests as non-locking two-plate systems for the management of mandibular angle fractures.

http://ift.tt/2sjks2v

Endoscope-assisted Neurectomy and Inferior Alveolar Nerve Avulsion in Treating Trigeminal Neuralgia

Publication date: Available online 15 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Daiying Huang, Shuangxi Zhu, Junbing Guo, Songling Chen
ObjectiveTo explore endoscope-assisted surgical treatment for idiopathic trigeminal neuralgia (TN), with neurectomy and avulsion of the inferior alveolar nerve (IAN), when patients are not willing to undergo intracranial procedures.Clinical Materials and MethodsFive TN patients with inferior alveolar neuralgia in the mandibular branch were admitted; endoscope-assisted inferior alveolar neurectomy and avulsion was performed for TN treatment. Clinical observation and postoperative follow-up were conducted.ResultsAfter the operation, all patients had complete relief of pain, with mild postoperative swelling, limited mouth opening, and fast recovery. Patients were followed up for 3–24 months. Facial numbness and paresthesia were felt in the IAN distribution area of the operated side, with no recurrence.ConclusionEndoscope-assisted neurectomy and avulsion of the IAN is a safe surgical method to treat TN in the mandibular branch when craniotomy is contraindicated or when patients decline neurosurgical options.It is effective in pain relief, with limited invasiveness and speedy recovery.

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Cases of the Year

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Issue Information

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Poster Abstracts Not Accepted For Live Presentation

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Front Section

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Live Posters

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Oral Presentations

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13th World Congress of Pediatric Dermatology Author Index

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Des tire-bouchons et des codes-barres

Publication date: Available online 16 June 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): P. Assouly

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Patients atteints de psoriasis : analyse de la population insatisfaite de sa prise en charge

Publication date: Available online 16 June 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): E. Mahé, F. Maccari, A. Beauchet, N. Quiles-Tsimaratos, N. Beneton, J. Parier, H. Barthelemy, C. Goujon-Henry, G. Chaby, D. Thomas-Beaulieu, G. Géner, L. Wagner, V. Pallure, S. Devaux, A. Vermersch-Langlin, P. Pfister, J. Jégou, C. Livideanu, M.-L. Sigal
IntroductionLe Français est souvent considéré comme un râleur. Dans un travail récent, nous avons observé une forte proportion de patients consultant une première fois pour leur psoriasis avec comme motif une insatisfaction quant à leur prise en charge antérieure. Nous avons voulu essayer d'analyser le profil de ces patients « mécontents ».MéthodologieIl s'agissait d'une étude transversale, multicentrique, menée dans 40 centres membres du Groupe d'études multicentriques de Resopso, avec inclusions consécutives pendant 11 mois, en 2014. Tous les patients adultes (âge>18 ans) consultant pour une première fois dans le centre pour un psoriasis pouvaient être inclus.RésultatsParmi les patients, 1205 ont été inclus ; 249 (20,3 %) consultaient car ils étaient mécontents de leur prise en charge antérieure. En analyse univariée, les patients mécontents étaient plus jeunes (p=0,02) et avaient un psoriasis qui avait débuté plus tôt (p<0,0001). Il s'agissait plus souvent de psoriasis en plaques (p=0,047) et de formes plus sévères de psoriasis (PASI et/ou DLQI >10, p<0,02). Ils souffraient moins souvent de rhumatisme psoriasique (p=0,01) et déclaraient plus fréquemment avoir reçu des traitements locaux (p<0,0001), moins souvent des biothérapies (p=0,006) ; ils déclaraient aussi avoir une durée de soins plus élevée (p=0,0005). Ils consultaient à l'hôpital (p=0,01) et avaient vu plus de médecins généralistes et de dermatologues (p ≤ 0,0008). Il n'y avait pas de relation entre le sexe des patients, leurs comorbidités (métaboliques, hypertension, consommation de tabac et d'alcool, et dépression) ou leurs caractéristiques socioéconomiques et leur insatisfaction. En analyse multivariée, seuls un DLQI>10 (p=0,01 ; IC95 : 1,01–1,07) et une durée de soins prolongée (p=0,004 ; IC95 : 1,23–2,99) étaient associés au mécontentement.ConclusionVingt pour cent des patients psoriasiques semblent insatisfaits de leur prise en charge. Il est difficile de dessiner un profil démographique ou socioéconomique du patient mécontent. Seule la sévérité de la maladie et peut-être l'insuffisance de traitement sont associées, lors d'une première consultation, au mécontentement du patient. Des causes liées aux médecins et aux patients peuvent être proposées. Enfin, si le Français est reconnu comme râleur, les chiffres de mécontentement observés dans notre étude ne semblent pas supérieurs à ceux observés dans d'autres pays.BackgroundThe French are frequently regarded as grouchy. In a recent study, we observed a high proportion of patients initially consulting for psoriasis because they were dissatisfied with their previous therapy. We analyzed the characteristics of these patients.Patients and methodsThis was a cross-sectional multicenter study in 40 centers belonging to the ResoPso (psoriasis treatment network) multicenter study group, with consecutive inclusions over a period of 11months in 2014. All adults (age>18 years) consulting for the first time for psoriasis at a center were included in the study.ResultsAmong patients, 1205 were included, of whom 249 (20.3%) were consulting because of their dissatisfaction with treatment. In the univariate analysis, these patients were younger (P=0.02) and presented psoriasis that had begun earlier in life (P<0.0001). It consisted mostly of generalized plaque psoriasis (P=0.047) and more severe forms of psoriasis (PASI and/or DLQI score>10, P<0.02). There were fewer cases of psoriatic arthritis (P=0.01). The "dissatisfied" patients reported significantly more frequent use of topical treatments (P<0.0001) and alternative medicines (P=0.02), and more infrequent use of biologics (P=0.006) as well as longer treatment periods (P=0.0005). They consulted at hospitals (P=0.01) and had previously seen more GPs and dermatologists (P≤0.0008). There was no impact of gender on the dissatisfaction profile by either comorbidities (metabolic, blood pressure, alcohol and tobacco consumption, and depression), or socio-economic data. In the multivariate analysis, DLQI>10 (P=0.01; 95% CI: 1.01–1.07) and longer duration of care (P=0.004; 95% CI: 1.23–2.99) were associated with dissatisfaction.ConclusionTwenty percent of our psoriatic patients seem dissatisfied with their treatment. It is difficult to draw a specific demographic and socioeconomic profile of dissatisfied patients. Only disease severity and possibly inadequate treatment at the initial consultation are associated with patient dissatisfaction. Explanations related to the individual patients and doctors may be proposed. Finally, while the French may be considered grouchy, the frequency of patient dissatisfaction seen in our study does not appear to be any greater than that observed in other countries.

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The management of a cystic hepatic lesion ruptured in the bile ducts: a case report

Hepatic cystadenoma is a rare benign cystic tumor; it tends to recur after incomplete surgical resection and has malignant potential. We report the case of a patient with a ruptured biliary cystadenoma in the ...

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Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report

Hematochezia is a frequent symptom in early infancy. However, it occurs very rarely within the immediate neonatal period, and its occurrence before any oral intake is particularly rare. Because of the "congeni...

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Abstracts from the 10th C1-inhibitor deficiency workshop

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Issue Information

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Validation and comparison of quality-of-life measures for topical 5-fluorouracil treatment: results from a randomized controlled trial

Summary

Background

Topical 5-fluorouracil (5-FU) is commonly used for high-risk patients with keratinocyte carcinoma (KC). Skindex and Skin Cancer Index (SCI) are validated instruments to measure quality of life (QoL) of patients with KC and those who have had surgical treatment of KCs.

Aim

To validate Skindex and SCI for topical 5-fluorouracil (5-FU) application and to compare the two QoL instruments.

Methods

We randomized 932 veterans at high risk for developing a KC to either topical 5-FU or vehicle control cream applied to the face and ears for up to 1 month. We collected their Skindex-29 and SCI scores at baseline and follow-up visits.

Results

Compared with controls, 5-FU reduced QoL, measured by the Skindex symptom, Skindex function and SCI social subscales (P < 0.001, P < 0.01, P = 0.02, respectively). At 1 month, significant changes in QoL in the 5-FU group were observed in the Skindex symptom (10.1, 95% CI 0.36–12.6), Skindex function (6.0, 95% CI 4.0–8.0) and SCI social (−3.5, 95% CI −6.2 to −0.8) subscales, while the other subscales of Skindex and SCI did not show significant changes. All three Skindex subscales at 1 month correlated with patient-reported symptom score and photograph-based toxicity score, whereas social subscale was the only one of the SCI subscales that correlated with patient-reported symptom and photograph-based toxicity scores.

Conclusions

Our study validated Skindex symptom, Skindex function and SCI social subscales for QoL measurement during treatment with topical 5-FU. The study could not provide evidence for construct validity of the other subscales. Skindex was more responsive than SCI in the context of 5-FU treatment.

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Dyslipidemia in patients with androgenetic alopecia. Statins, finasteride or both?

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Issue Information

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Announcement

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Medication non-adherence: the hidden problem in clinical practice

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Occupational skin disease – a major health problem in Europe

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Forthcoming Events

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Mastocytosis: A case series of 107 consecutive patients

Abstract

Mastocytosis is classified by the World-Health-Organisation (WHO)¹ as cutaneous-mastocytosis (CM) and systemic-mastocytosis (SM). CM is subdivided into maculopapular (MPCM), diffuse-CM and mastocytomas. SM is subdivided into indolent (ISM), with-an-associated-haematologic-neoplasm (SM-AHN)², aggressive (ASM) and mast-cell-leukemia (MCL).

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Inflammation in the assessment of salivary cytokines in oral squamous cell carcinoma diagnosis

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Özgün Özçaka, Joel B. Epstein, Pelin Güneri

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Prediction of distant metastases from nasopharyngeal carcinoma: Improved diagnostic performance of MRI using nodal volume in N1 and N2 stage disease: Methodological issues

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Saeid Safiri, Erfan Ayubi

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Primary tuberculosis of cystic duct lymph node

Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult to diagnose preoperatively because of lack of characteristic signs and symptoms of TC. We report a man aged 45 years who presented with right upper abdominal pain since 1week. It was associated with nausea and postprandial fullness. There was no evidence of jaundice and lymphadenopathy. Abdominal examination showed moderate right upper quadrant tenderness with positive Murphy's sign and splenomegaly but no signs of peritonism. Abdomen ultrasound revealed sludge in gallbladder, dilated pancreatic duct, coarse exotexture of liver, splenomegaly and no lymphadenopathy. He underwent laparoscopic cholecystectomy; histological report showed chronic caseating granulomatous lymphadenitis with Langhans type of giant cells in lymph node near cystic duct with chronic cholecystitis of gallbladder. Standard antituberculosis therapy was given for 12 months.

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Αρχειοθήκη ιστολογίου

Παρασκευή 16 Ιουνίου 2017

Supported by the ATA

Supported by the ATA

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Supported by ATA

Supported by ThyCa: Thyroid Cancer Survivors' Association, Inc. and ATA

Supported by Bite Me Cancer and ATA

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Supported by ATA

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