Angiotensin 1-7 inhibits angiotensin II-stimulated head and neck cancer progression

Angiotensin II (Ang II) is the product of the proteolytic action of angiotensin-converting enzyme (ACE) on the precursor peptide, angiotensin I (Ang I). In addition to its vasoactive properties, Ang II is able to stimulate angiogenesis and act as a mitogen, promoting cellular proliferation. Recently, evidence has emerged that Ang II is also able to promote tumour invasion, a key step in the metastatic cascade, although the mechanisms by which it does so remain largely obscure. Here we show that Ang II is able to promote the invasion and migration of head and neck squamous cell carcinoma (HNSCC) cells both in an autocrine manner and by triggering stromal tumour-paracrine interactions. The effects of Ang II on autocrine and paracrine signalling pathways are mediated by angiotensin receptor 1 (AT₁R) and inhibited by angiotensin 1-7 (Ang 1-7), a peptide produced from Ang II by the action of angiotensin-converting enzyme 2 (ACE2). These data are the first to demonstrate a role for the renin–angiotensin system in oral carcinogenesis and raise the possibility of utilizing AT₁R receptor antagonists and/or Ang 1-7 as novel therapeutic agents for HNSCC.

http://ift.tt/2sLXm6J

Oral problems and quality of life of preschool children: self-reports of children and perception of parents/caregivers

The purpose of this study was to evaluate the association between oral health problems and oral health-related quality of life (OHRQoL) of preschool children according to both self-reports and the reports of parents/caregivers. A school-based, cross-sectional study was conducted with 769 preschool children and their parents/caregivers. The OHRQoL was evaluated using the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Based on logistic regression for complex samples, the following variables were found to be associated with poorer OHRQoL in the parent/caregiver version: toothache (OR = 6.77; 95% CI: 3.95–11.59); consequences of untreated dental caries (OR = 2.69; 95% CI: 1.27–5.70); and anterior open bite (OR = 2.01; 95% CI: 1.13–3.56). The following variables were associated with poorer OHRQoL in the child self-report version: toothache (OR = 3.34; 95% CI: 2.11–5.29); cavitated lesions (anterior teeth) (OR = 2.20; 95% CI: 1.26–3.84); occurrence of traumatic dental injury (OR = 1.77; 95% CI: 1.19–2.61); and anterior open bite (OR = 1.95; 95% CI: 1.16–3.29). We conclude that children with dental caries (or its sequelae) had poorer OHRQoL. Having experienced a traumatic dental injury and having a malocclusion were also associated with a poorer OHRQoL.

http://ift.tt/2sgI8Tu

Antibiotic-prescribing habits among Norwegian dentists: a survey over 25 years (1990–2015)

Bacterial antibiotic resistance is a steadily growing global problem, which today is compared with issues such as global warming, ozone depletion, and extinction of species. Consequently, calls come from global, Pan-European, and national authorities to gain insight into, limit, and stringently qualify the use of antibiotics in human and veterinary medicine, as well as in food production. Dentists are not considered to be frequent prescribers of antibiotics. However, few studies have identified how much, and in which situations, dentists prescribe such drugs. The aims of the present study were to survey Norwegian dentists' antibiotic-prescribing habits in 2015 and to compare the findings with previous studies (1990 and 2004) and with the actual numbers of dispensed prescriptions obtained from the 'Norwegian National Prescription Register'. The results from 1990 to 2004 show that there was a general increase in antibiotic prescriptions by Norwegian dentists, followed by a reduction or flattening of the prescription volume curve from 2004 to 2015. Despite this, possibilities for further improvements have been identified and recommendations given for targeted campaigns to reduce the prescription volume in dentistry by a further 30%, which has been ordered by the Norwegian National Assembly.

http://ift.tt/2sLHiSj

Treatment of laryngopharyngeal reflux using a sleep positioning device: A prospective cohort study

Laryngopharyngeal reflux (LPR) symptoms are often resistant to management and cause significant quality of life impairment to patients with this disease. This study assesses the utility of a sleep-positioning device (SPD) in treating LPR.

http://ift.tt/2tQcL4l

Lateral cervical approach for supracricoid partial laryngectomy

The supracricoid partial laryngectomy has been described for the treatment of T3 laryngeal glottic and supraglottic tumors as well as upfront and salvage surgery. Good oncological and functional outcomes are expected, while the post-operative rehabilitation can be quite difficult for the patient. Early and late complications can occur especially in salvage surgery. Neck dissection according to the T stage is often associated with the resection of the primary tumor.

http://ift.tt/2tgUjoo

Optimized DNA Vaccine Enhanced by Adjuvant IL28B Induces Protective Immune Responses Against Herpes Simplex Virus Type 2 in Mice

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2tfp7FT

Genetic Polymorphisms of Tumor Necrosis Factor Alpha and Susceptibility to Dengue Virus Infection in a Mexican Population

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2rVVJ3n

Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis

Knowledge of variants in the formation and position of the ansa cervicalis is important in head and neck surgery, specifically in reconstructions of the tongue that use the infrahyoid muscles, and in the anastomosis of the ansa cervicalis to the recurrent laryngeal nerve when the laryngeal muscles have been paralysed. We describe a rare variant of the superior root of the ansa cervicalis, which had a contribution from the vagus and hypoglossal nerves. The inferior root was formed by the C2 and C3 ventral rami, but it passed medial to the internal jugular vein before it joined the superior root to form the loop.

http://ift.tt/2tdYmkq

Panton-Valentine leukocidin-producing Staphylococcus aureus infection of the neck that mimicked disseminated malignancy

A 50-year-old man presented to the emergency department of a teaching hospital in the UK with a midline swelling of the neck, chest pain, and fever. The swelling had been incised at another hospital two weeks previously, but after initial improvement it had increased in size and become more inflamed. He was taking flucloxacillin and phenoxymethylpenicillin prescribed by a general practitioner. His medical history included repair of a patent ductus arteriosus as a child. His temperature was 38.6°C and oxygen saturation 95% on air.

http://ift.tt/2ubLKb1

Seven-year review of dental foundation year 2/senior house officer training at the Oral and Maxillofacial Surgery Unit in Oxford

The dental senior house officer (SHO)/dental foundation year 2 (DF2) posts in Oxford have provided hospital-based training for dentists, but in 2013 the Oral and Maxillofacial Surgery (OMFS) Unit withdrew from DF2 training because persistent negative feedback from the dental deanery varied from that obtained internally. We sent questionnaires to a consecutive group of 62 dentists who had worked at the John Radcliffe Hospital, Oxford, between 2006 and 2013 to find out about their experience of the posts.

http://ift.tt/2tdqggz

Names and phenotypes of CD163 positive macrophages in oral precancerous lesions

We are quite interested in the recently published article entitled "Programmed death ligand 1 (PD-L1) expression and tumor microenvironment: Implications for patients with oral precancerous lesions" [1]. The authors had explored the PD-L1 expression in the stoma cells in oral precancerous lesions and investigated the relationships among PD-L1 positive cells and malignant transformation of these cells. We have two questions on this article.

http://ift.tt/2tgMKOO

Adult cancer-related hemophagocytic lymphohistiocytosis – a challenging diagnosis: a case report

Adult hemophagocytic lymphohistiocytosis is a secondary immunopathologic phenomenon, mainly secondary to malignancy, infection, or autoimmune disorders.

http://ift.tt/2tfmfJ7

Systemic treatment for psoriasis and malignancies: A real risk?

http://ift.tt/2tfmbJn

Ocular vestibular evoked myogenic potential in patients with myasthenia gravis

Myasthenia gravis (MG) is an archetypic disorder of neuromuscular junctions (NMJs) and autoantibody-mediated disease causing fatigable weakness of skeletal muscles with an ocular onset in up to 85%. The aim of this study was to detect extra ocular muscles (EOMs) abnormalities in MG patients using ocular vestibular evoked myogenic potential (oVEMP) n10 response.

http://ift.tt/2rW1QEL

Prospective analysis of 231 elective neck dissections in oral squamous cell carcinoma with node negative neck—To decide the extent of neck dissection

To evaluate the incidence of level IIB and IV lymph node metastases in patients of oral carcinoma with N0 necks. This study will help to decide the extent and need of routine comprehensive removal of these specific lymph node groups in selective neck dissection.

http://ift.tt/2tfbCpJ

Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis

Publication date: Available online 26 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): S. Nayak B., P. Shetty, D. R., A. Aithal P., N. Kumar
Knowledge of variants in the formation and position of the ansa cervicalis is important in head and neck surgery, specifically in reconstructions of the tongue that use the infrahyoid muscles, and in the anastomosis of the ansa cervicalis to the recurrent laryngeal nerve when the laryngeal muscles have been paralysed. We describe a rare variant of the superior root of the ansa cervicalis, which had a contribution from the vagus and hypoglossal nerves. The inferior root was formed by the C2 and C3 ventral rami, but it passed medial to the internal jugular vein before it joined the superior root to form the loop.



http://ift.tt/2sLmGcR

Panton-Valentine leukocidin-producing Staphylococcus aureus infection of the neck that mimicked disseminated malignancy

Publication date: Available online 26 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): M. Little, N. Renny




http://ift.tt/2sgkmak

Seven-year review of dental foundation year 2/senior house officer training at the Oral and Maxillofacial Surgery Unit in Oxford

Publication date: Available online 26 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): M. Garg, L. Wong, D. Dhariwal
The dental senior house officer (SHO)/dental foundation year 2 (DF2) posts in Oxford have provided hospital-based training for dentists, but in 2013 the Oral and Maxillofacial Surgery (OMFS) Unit withdrew from DF2 training because persistent negative feedback from the dental deanery varied from that obtained internally. We sent questionnaires to a consecutive group of 62 dentists who had worked at the John Radcliffe Hospital, Oxford, between 2006 and 2013 to find out about their experience of the posts. Forty responded (65% response rate). We analysed their expectations, the support provided, their experience of teaching and training, the opportunities available, and free-text feedback about the post and their current posts. They had all found the job helpful, and had gained generic, dental, medical, and surgical skills. The overall mean (SD) score for the post was 8 (2) on a Likert scale of 1-10 (with 10 being excellent). When they completed the questionnaire between December 2013 and July 2014, 18 respondents were working as general dental practitioners and four were training for a career in OMFS. The study showed that work as a dental SHO or DF2 has multiple benefits. We hope that our findings will help to improve OMFS training posts for dental core trainees in Oxford.



http://ift.tt/2sLwVOg

Anesthetic management of spontaneous cervical epidural hematoma during pregnancy: a case report

Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is littl...

http://ift.tt/2sUucAH

The Safety and Effectiveness of Superficial Cervical Plexus Block in Oral and Maxillofacial Surgery as an Alternative to General Anesthesia in Selective Cases: A Clinical Study

Abstract

Aim

To assess the safety and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases.

Subjects and Methods

The total number of patients was 10, out of which 6 were male and 4 were female patients. Five patients had incision and drainage of perimandibular space infections, two patients had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture, and two patients had submandibular lymph node biopsies. Informed & written consent were obtained from the patients after they had the procedure explained to them. Medically compromised patients and those who were excessively anxious and apprehensive, patient who did not want the procedure to be done under regional anesthesia, and patients with a history of allergy to local anesthetic were excluded. All patients had their surgical procedures under regional anesthesia (SCP block with supplemental nerve blocks) performed by the same surgeon under the supervision of anesthesiologist with continuous monitoring.

Results

SCP block with concomitant mandibular nerve and long buccal nerve block has a high success rate, low complication rate, and high patient acceptability as shown in the study.

Conclusion

Superficial cervical plexus block anesthesia is a safe and useful anesthetic technique with the low risk of accidents and complications, thus a good alternative for regional anesthesia in selected cases in oral and maxillofacial surgery.

http://ift.tt/2selbQU

Quantitative Pneumatic Otoscopy Using a Light-Based Ranging Technique

Abstract

Otitis media is the leading cause of hearing loss in children. It is commonly associated with fluid in the ear, which can result in up to 45 dB of hearing loss for extended periods of time during a child's most important developmental years. Accurate assessment of middle ear effusions is an important part of understanding otitis media. Current technologies used to diagnose otitis media with effusion are pneumatic otoscopy, tympanometry, and acoustic reflectometry. While all of these techniques can reasonably diagnose the presence of an effusion, they provide limited information about the infection present behind the tympanic membrane.

We have developed a technique based on low-coherence interferometry—a non-invasive optical ranging technique capable of sensing depth-resolved microscopic scattering features through the eardrum—to quantify eardrum thickness and integrity, as well as detect any effusion, purulence, or biofilm behind the tympanic membrane. In this manuscript, the technique is coupled with a pneumatic otoscope to measure minute deflections of the tympanic membrane from insufflation pressure stimuli. This results in quantitative measurements of tympanic membrane mobility, which may be used to gain a better understanding of the impact of infection on the membrane dynamics. A small pilot study of 15 subjects demonstrates the ability of pneumatic low-coherence interferometry to quantitatively differentiate normal ears from ears with effusions present. Analysis of the strengths and weaknesses of the technique, as well as focus areas of future research, is also discussed.

http://ift.tt/2sTUdjH

Quantitative Pneumatic Otoscopy Using a Light-Based Ranging Technique

Abstract

Otitis media is the leading cause of hearing loss in children. It is commonly associated with fluid in the ear, which can result in up to 45 dB of hearing loss for extended periods of time during a child's most important developmental years. Accurate assessment of middle ear effusions is an important part of understanding otitis media. Current technologies used to diagnose otitis media with effusion are pneumatic otoscopy, tympanometry, and acoustic reflectometry. While all of these techniques can reasonably diagnose the presence of an effusion, they provide limited information about the infection present behind the tympanic membrane.

We have developed a technique based on low-coherence interferometry—a non-invasive optical ranging technique capable of sensing depth-resolved microscopic scattering features through the eardrum—to quantify eardrum thickness and integrity, as well as detect any effusion, purulence, or biofilm behind the tympanic membrane. In this manuscript, the technique is coupled with a pneumatic otoscope to measure minute deflections of the tympanic membrane from insufflation pressure stimuli. This results in quantitative measurements of tympanic membrane mobility, which may be used to gain a better understanding of the impact of infection on the membrane dynamics. A small pilot study of 15 subjects demonstrates the ability of pneumatic low-coherence interferometry to quantitatively differentiate normal ears from ears with effusions present. Analysis of the strengths and weaknesses of the technique, as well as focus areas of future research, is also discussed.

http://ift.tt/2sTUdjH

Primary epithelial salivary gland tumours in children and adolescents

Primary epithelial tumours of the salivary glands are very rare in paediatric patients. The aim of this study was to evaluate the clinical course, treatment, and outcomes of these uncommon neoplasms based on the authors' experience and the recent literature. The medical charts of 12 female patients and seven male patients with primary epithelial salivary gland tumours were reviewed. All were under 19 years of age and underwent surgical treatment between 1994 and 2016. The results of this group of paediatric patients were compared with those of 621 adult patients.

http://ift.tt/2tdqMf2

Immediate full-arch rehabilitation of the severely atrophic maxilla supported by zygomatic implants: a prospective clinical study with minimum follow-up of 6 years

The aim of this study was to evaluate the outcomes of immediate full-arch prostheses supported by zygomatic implants alone or in combination with standard fixtures after a minimum of 6 years of loading. From October 2008 to April 2010, 15 patients with severely atrophic maxillae were treated using four zygomatic implants or two zygomatic implants in conjunction with two conventional fixtures. All subjects received a fixed screw-retained prosthesis within 3hours of surgery, while the final restoration was delivered after 6 months.

http://ift.tt/2rU7SGd

Intranasal Administration of Whole Inactivated Influenza Virus Vaccine as a Promising Influenza Vaccine Candidate

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2s9bxnP

Helper T Cell Responses to Respiratory Viruses in the Lung: Development, Virus Suppression, and Pathogenesis

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2sTGKIJ

Intraoperative sialendoscopy to assist with and confirm repair of Stensen’s duct

We describe the use of a sialendoscope to assist with and to check the repair of a partially transected Stensen's duct despite its late presentation with a sialocele. Sialendoscopy has improved the management of parotid sialolithiasis,1 but in cases of trauma, has been limited to locating the transected ends of ducts.2,3 We are not aware of reports of a scope being used to check for satisfactory repair. We used a sialendoscope to guide the operation, check patency, and detect leaks after repair of the duct.

http://ift.tt/2u9qPFA

Catheter-related right internal jugular vein thrombosis after chest surgery

Abstract

Background: Central venous catheters (CVCs) are frequently used for monitoring haemodynamic status and rapidly delivering fluid therapy during the peri- and postoperative periods. Indwelling CVCs are typically used 7–14 days postoperatively for additional monitoring and treatment, but patients may develop asymptomatic catheter-related thrombosis, leading to life-threatening pulmonary embolism and death. Early detection helps to avoid such complications.Methods: This prospective observational study investigated the risk factors associated with catheter-related right internal jugular vein thrombosis in patients undergoing chest surgery. The study enrolled 24 patients who were scheduled to receive chest surgeries during which catheters were needed. To detect thrombus formation, Doppler ultrasound examinations from the thyroid cartilage level to the supraclavicular region were used after CVC placement and on each of the following days until the catheter was removed.Results: No thrombosis was found in patients before surgery, but it appeared in 75% (18/24) after surgery. The risks of thrombosis increased with a longer duration of anaesthesia, greater amounts of bleeding, and use of postoperative ventilator support.Conclusions: Earlier catheter removal may reduce the risk of catheter-related thrombosis and avoid possibly fatal complications after catheter-related thrombosis.

http://ift.tt/2s9qk1H

Checklists, cognitive aids, and the future of patient safety

On Wednesday, October 30, 1935, an evaluation flight of the Boeing Model 299 was undertaken at Wright Field, northeast of Dayton, OH, USA. The Model 299 was the most technologically sophisticated aircraft of its time and was nicknamed the Flying Fortress because of the extent of its armaments. Major Ployer P. Hill was the pilot, and it was his first flight in the new aircraft. The aircraft appeared to ascend normally, but suddenly stalled, turned on one wing, and crashed, killing two of the aircraft's five crew, including Major Hill. The investigation into the crash discovered that Major Hill had omitted a crucial step during the preflight preparation; he forgot to release a catch, which on the ground locked the aircraft's control flaps.¹ Once in the air, this mistake rendered the aircraft uncontrollable. The crash investigators knew that there was probably no one better qualified to fly the new aircraft than Major Hill—his co-pilot was also highly qualified—yet despite this, the fatal error was still made. The investigators concluded that given the experience of the pilots, further training would not be an effective response to prevent such an event from happening again; a response that is very different from that which often occurs in health care when a mistake is made.² Some commentators initially believed that this meant the new aircraft was simply too complicated to fly reliably. A new approach was needed, and it took the form of a simple list of crucial tasks that must be completed before the aircraft could leave the ground. The first aviation checklist had been devised.¹ With the checklist in use, despite the aircraft's sophistication, the Model 299 (and later versions of it) performed safely for many years.

http://ift.tt/2sTskZ9

Uncovering the role of brain-derived neurotrophic factor (BDNF)/TrkB signaling in head and neck malignancies

Abstract

Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family of growth factors that was first known as responsible for sustain the growth, function and plasticity of neural cells. BDNF exerts its effects by binding to the tyrosine kinase receptor B (TrkB). The BDNF/TrkB axis has been reported to be overexpressed in several neurogenic and non-neurogenic tumors. Its higher expression was associated with a poor prognosis to patients affected by different human malignancies, tumor growth, invasion and metastasis; epithelial-mesenchymal transition (EMT) and resistance to chemotherapy. BDNF/TrkB represent promising targets to the development of novel anticancer therapies. Some clinical trials are currently evaluating the efficacy of Trk proteins-target drugs in different types of solid tumors. To date, few groups have evaluated the BDNF/TrkB pathway in head and neck malignancies. The aims of the present study were to review the literature concerning the role of BDNF/TrkB activation in head and neck squamous cell carcinoma and malignant salivary gland tumors, and to discuss future perspectives of BDNF/TrkB-target therapy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2sdxtsV

Genetic study of the BRAF gene reveals a new variants and high frequency of the V600E mutation among Iranian ameloblastoma patients

Abstract

Background

Ameloblastoma is a benign, slow-growing, locally invasive tumor. It is one of the most prevalent odontogenic tumors, with an incidence rate of 1% of all oral tumors and approximately 18% of odontogenic tumors. A group of genes has been investigated in patients with ameloblastoma. The BRAF V600E mutation has been implicated as the most common mutation in ameloblastoma. The presence or absence of this mutation has been associated with several clinopathological properties, including location, age at diagnosis, histology, and prognosis. Although some populations have been investigated so far, little data are available on the Iranian population. The current research was launched to study the BRAF V600E mutation among a cohort of Iranian patients with ameloblastoma.

Methods

In this clinopathological and molecular biologic study, a total of 19 formalin-fixed, paraffin-embedded tissues were studied. DNA extraction was performed, followed by PCR-sequencing of exons 10 and 15 of the BRAF gene to identify mutations. In silico analysis was done for the identified variants. Results were analyzed by T-test, Chi-square, and Fisher's exact test.

Results

Totally, 12 out of 19 samples (63%) harbored the p. V600E hotspot mutation. In addition, we identified several variants, two of which were novel. The c.1769T>G (p. V590G) and c.1751C>T (p.L584F) as the novel variants showed a possible damaging effect by in silico analysis. No variant was found within exon 10.

Conclusions

Our study confirms the role of BRAF mutations in ameloblastoma in the Iranian patients studied.

This article is protected by copyright. All rights reserved.

http://ift.tt/2sICnS5

Nintedanib as a novel treatment option in hereditary haemorrhagic telangiectasia

A 70-year-old patient with known hereditary haemorrhagictelangiectasia (HHT) was seen regularly in our outpatient clinic. He underwent multiple therapeutical interventions, including both surgical and medical, for the treatment of recurrent epistaxis without sustained success. Due to a concurrent diagnosis of idiopathic pulmonary fibrosis, treatment with the tyrosine kinase inhibitor nintedanib was initiated, after which point the patient reported a dramatic and unanticipated improvement in his epistaxis and skin telangiectasia. On the basis of this case report, we propose that nintedanib may be a potential treatment option for refractory epistaxis in HHT.

http://ift.tt/2tcCbeT

Distant metastases in head and neck cancer

ABSTRACT

Background

Most trials in head and neck cancer emphasize locoregional control, as this is the main pattern of therapy failure. However, up to 15% of patients develop distant metastases. The purpose of this study was to present the investigated factors associated with distant metastasis in a single-center patient cohort.

Methods

A retrospective analysis of a single-center patient cohort over an 18-year period has been performed. We report on prevalence and incidence of distant metastasis, timing in relation to locoregional failure, Kaplan–Meier analysis for actuarial distant control rates, and univariate analysis taking into account histological, etiologic, surgical, site-dependent, stage-dependent characteristics, modality of primary therapy, and locoregional control.

Results

Of 1022 patients, 141 (13.8%) were diagnosed with distant metastases involving 283 sites. Actuarial rates of distant control were 88%, 84%, 80%, and 79% at 1, 2, 5, and 10 years, respectively. Factors associated with distant metastasis are stage grouping and regional node positivity, extranodal extension, locoregional residual disease, and human papillomavirus (HPV) negative status in oropharyngeal squamous cell carcinoma.

Conclusion

Distant metastases in head and neck cancer led to dismal prognosis. Factors associated with distant metastasis are related to characteristics of the primary tumor. © 2017 Wiley Periodicals, Inc. Head Neck, 2017

http://ift.tt/2tac3Rs

Circulating HMGA2 and PLAG1 in blood of patients with oral squamous cell carcinoma

Abstracrt

Background

High mobility group AT-hook 2 (HMGA2) and pleomorphic adenoma gene 1(PLAG1) have been demonstrated to be elevated in many malignant tumors. However, the aim of this study was to evaluate HMGA2 and PLAG1 levels in blood as a non-invasive biomarker for oral squamous cell carcinoma (OSCC) diagnosis.

Methods

qRT-PCR was performed to measure circulating HMGA2 and PLAG1 levels in OSCC patients (n=43) and matched cancer-free blood control group (n=21). Clinical data of all patients were recorded.

Results

Circulating HMGA2 and PLAG1 in the 43 OSCC patients was significantly higher than in control group (p<0.001, p=0.038, respectively). Furthermore, HMGA2 expression in OSCC patients with poor-moderate differentiation was increased compared with well differentiated group. However, no significant differences in PLAG1 expression were detected when differentiation was considered. In addition, the receiver operating characteristic (ROC) curve analysis for circulating HMGA2 revealed an area under the ROC curve of 0.876 (95% confidence interval, 0.793–0.959; P<0.001) with 65.1% sensitivity and 100% specificity in discriminating OSCC from controls at a cut-off value of 14.380, demonstrating significant diagnostic value for OSCC.

Conclusion

Circulating HMGA2 levels are increased in OSCC patients and may potentially serve as a significant index to evaluate OSCC diagnosis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2rSKpFi

A systematic review of the relationship between glycemic control and necrobiosis lipoidica diabeticorum in patients with diabetes mellitus

Abstract

The association of specific skin disorders with diabetes mellitus (DM) has been well established. Current literature suggests that approximately 30–91% of patients with diabetes will experience at least one cutaneous manifestation of this systemic disease in their lifetime. To date, there are limited articles summarizing the link between necrobiosis lipoidica diabeticorum (NLD) prognosis and glycemic control in patients with diabetes. The objective of the study is to summarize and appraise the available evidence assessing the relationship between glycemic control and NLD. A literature search was conducted based on MEDLINE (1946–2015), EMBASE (1980–2015), Google Scholar, and PubMed for publications that described the results of diabetes control and NLD. Further studies were identified from bibliographies of all relevant studies, gray literature, and annual scientific assemblies. All studies investigating the relationship between DM (type 1 and type 2) management and NLD were included. Two reviewers independently extracted data including demographics, type of diabetes management measures (glucose, HbA1c, insulin), comorbidities, and outcome. A total of 622 studies were identified, and 10 studies met the inclusion and exclusion criteria: two case series and eight case reports. Of the 24 patients with NLD, 13 patients reported resolution of NLD after implementing various methods of glycemic control (diabetic diet consisting of 1600 kcal/day [1 patient], insulin regimen [3 patients], and pancreatic transplantation [9 patients]). Glycemic control may have a role in influencing the prognosis of necrobiosis lipoidica in patients with diabetes; however, there is currently insufficient evidence to support or refute this claim.

http://ift.tt/2s8iWnh

Giant rhinophyma in low-resource setting: a case report

http://ift.tt/2sSs4tk

Educational strategies and ART effect on salivary characteristics: a controlled clinical trial

Summary

Objective

To evaluate educational strategies and ART-restoration impact on salivary physicochemical and microbiological characteristics.

Design

Two groups of 6-7-yr-old children were included: G_ART, with at least one decayed primary molar (n=36), submitted to 4 sessions of oral health educational strategy (OHES) and ART-restoration; G_C, a paired caries-free group (n=36), submitted to 4 sessions of OHES. Three evaluations were carried out: baseline, one week after OHES and one month after OHES or ART, when biofilm and gingivitis frequencies, salivary flow, pH, buffer capacity, calcium and phosphorus concentrations were assessed. Total bacteria and S. mutans were quantified in unstimulated saliva (qPCR).

Results

Improvement in biofilm and gingivitis scores, salivary pH and buffering capacity after OHES was observed in G_C, with a decrease in total bacteria and S. mutans counts. G_ART also showed changes in salivary parameters, even before ART-restoration was delivered, and total bacteria count remained lower than baseline one month after ART-restoration, although a trend to increase the proportion of S. mutans was observed.

Conclusion

Improvements in salivary physicochemical and microbiological characteristics were observed after educational strategies, thus reducing the caries-risk of children with decayed teeth, although a trend to increase the S. mutans percentage was observed one month after ART-restoration.

This article is protected by copyright. All rights reserved.

http://ift.tt/2ta9BKM

Detection of Human Polyomaviruses JC and BK in Liver Pre-Transplant Patients

Abstract

Objective

This study aimed to identify and quantify polyomaviruses (BKPyV and JCPyV) in the saliva, mouthwash, blood and urine of liver pre-transplant patients.

Materials & Methods

A case-control study was performed using a convenience sample of 21 end-stage liver disease patients (EG = experimental group) and 20 normoreactive controls (CG = control group). In total, 162 samples were collected. Detection and quantification of polyomaviruses were performed by using real-time PCR method.

Results

In the EG, 21 samples (25%) were positive for BKPyV and 10 (11.90%) for JCPyV, while in the CG 27 samples (34.61%) were positive for BKPyV and 6 (7.69%) for JCPyV. With regard to the number of samples positive for BKPyV and JCPyV, there was no statistically significant difference between EG and CG (P = 0.52 and P = 0.25). In the EG, we observed a panorama similar to that of the CG regarding the presence of polyomaviruses in mouthwash, blood and urine. The greatest difference between the samples was that regarding the identification of BKPyV in saliva.

Conclusion

Cirrhotic patients on the liver transplant waiting list did not show higher prevalence of BKPyV and JCPyV compared to normoreactive controls.

This article is protected by copyright. All rights reserved.

http://ift.tt/2u7DXuR

Neurogenic pulmonary oedema: a rare cause of maternal collapse

Acute pulmonary oedema is a significant cause of morbidity and mortality in pregnant and postpartum women. We present an unusual case of near-fatal acute pulmonary oedema in a pregnant woman, which was attributed to the acute onset of neurogenic pulmonary oedema secondary to epileptic seizure activity. The patient required supportive management in the intensive care setting for a short period and subsequently made complete recovery with regular neurological follow-up arranged for the management of her epilepsy.

http://ift.tt/2sHS5wQ

Fibroblast-derived exosomes promote epithelial cell proliferation through TGF-β2 signaling pathway in severe asthma

Abstract

Background

Bronchial fibroblasts play a key role in airway remodeling in asthma. They regulate epithelial cell functions such as proliferation through growth factors, cytokines, chemokines and exosomes. The role of exosomes in the communication between epithelial cells and fibroblasts by vehiculing these mediators in asthma remains to be determined.

Objective

To evaluate the role of exosomes released by bronchial fibroblasts on epithelial cell proliferation in severe asthma.

Methods

Exosomes were obtained from culture media of primary bronchial fibroblasts and characterized using Western blot, electron microscopy and flow cytometry. Uptake profile of fluorescent-labeled exosomes in epithelial cells was assessed by flow cytometry. Exosome cytokine content was analysed by Cytokine Arrays. Bronchial epithelial cell proliferation was evaluated by BrdU incorporation test. Exosomes biogenesis/release was blocked by using sphingomyelinase inhibitor. Plasmid transfection was used to modulate TGF-β2 gene expression.

Results

We showed that bronchial fibroblasts secreted exosomes, which were internalized by bronchial epithelial cells. Exosomes of severe asthmatic subjects' fibroblasts showed a lower level of TGF-β2 and significantly increased the epithelial cells proliferation of both healthy and severe asthmatic subjects compared to healthy controls' exosomes. Overexpression of TGF-β2 in severe asthmatics' fibroblasts induced enhanced TGF-β2 in exosomes leading to a reduced proliferation of epithelial cells, whereas knockdown of TGF-β2 enhanced epithelial cell proliferation.

Conclusion

Our study shows that exosomes are involved in fine-tuning intercellular communication in asthma. Exosomes of severe eosinophilic asthmatics' fibroblasts can contribute to airway remodeling, at least in part, by modulating epithelial cell proliferation observed in severe asthma.

This article is protected by copyright. All rights reserved.

http://ift.tt/2rSEY9a

RAS screening in colorectal cancer: a comprehensive analysis of the results from the UK NEQAS colorectal cancer external quality assurance schemes (2009–2016)

Abstract

Evidence strongly indicates that extended RAS testing should be undertaken in mCRC patients, prior to prescribing anti-EGFR therapies. With more laboratories implementing testing, the requirement for External Quality Assurance schemes increases, thus ensuring high standards of molecular analysis. Data was analysed from 15 United Kingdom National External Quality Assessment Service (UK NEQAS) for Molecular Genetics Colorectal cancer external quality assurance (EQA) schemes, delivered between 2009 and 2016. Laboratories were provided annually with nine colorectal tumour samples for genotyping. Information on methodology and extent of testing coverage was requested, and scores given for genotyping, interpretation and clerical accuracy. There has been a sixfold increase in laboratory participation (18 in 2009 to 108 in 2016). For RAS genotyping, fewer laboratories now use Roche cobas®, pyrosequencing and Sanger sequencing, with more moving to next generation sequencing (NGS). NGS is the most commonly employed technology for BRAF and PIK3CA mutation screening. KRAS genotyping errors were seen in ≤10% laboratories, until the 2014–2015 scheme, when there was an increase to 16.7%, corresponding to a large increase in scheme participants. NRAS genotyping errors peaked at 25.6% in the first 2015–2016 scheme but subsequently dropped to below 5%. Interpretation and clerical accuracy scores have been consistently good throughout. Within this EQA scheme, we have observed that the quality of molecular analysis for colorectal cancer has continued to improve, despite changes in the required targets, the volume of testing and the technologies employed. It is reassuring to know that laboratories clearly recognise the importance of participating in EQA schemes.

http://ift.tt/2sS1YXf