Non-corticosteroid adherence and itch severity influence perception of itch in atopic dermatitis

Abstract

Topical corticosteroid phobia is an important problem in the treatment of atopic dermatitis as it can affect the ability to control disease severity and itch by reducing treatment adherence. Topical corticosteroid phobia often ends up even non-corticosteroid adherence. As such, non-corticosteroid adherence, disease severity and itch are likely to be associated with each other, but their relationship has yet to be thoroughly investigated. Thus, the purpose of this study is to investigate it in atopic dermatitis. Using data from 1190 participants in an Internet survey, we identified 255 non-corticosteroid users and 225 with moderate to severe itch who were defined as non-corticosteroid adherents. Corticosteroid users with the same itch categories (n = 878) served as controls. We also examined how itch severity affects the perception of itch in atopic dermatitis. Unexpectedly, non-corticosteroid adherents were less sensitive to the conditions to elicit itch such as perspiring, commuting homeward, drinking alcohol and wearing woolen clothes compared with the control. We also found that patients with severer itch were more sensitive to itch during/after bathing, when lying in bed, commuting homeward, studying/working, drinking alcohol, undressing, getting up in the morning, after a meal, ingesting piquant foods and when they were unoccupied, angry, busy, nervous, sad or enjoying themselves. In conclusion, we found that non-corticosteroid adherence and itch severity influence perception of itch in atopic dermatitis and discuss possible mechanisms underlying these results. The information obtained in this study may be useful for communication with and education of atopic dermatitis patients and their treatment in outpatient clinics.

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Three cases of Nagashima-type palmoplantar keratosis associated with atopic dermatitis: A diagnostic pitfall

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Waardenburg syndrome type IIE in a Japanese patient caused by a novel non-frame-shift duplication mutation in the SOX10 gene

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Abrupt generalized pustules in patients with rheumatoid arthritis and interstitial lung disease

Abstract

We report a case of a 30-year-old Chinese woman with rheumatoid arthritis and interstitial lung disease who abruptly developed generalized pustules and a high fever for 10 days. She had been taking oral prednisone, iguratimod and total glucosides of peony regularly for 5 months prior. In addition, she had taken metronidazole for 3 days 20 days prior which she had used before with no adverse reaction. She had no history of similar lesions and psoriasis. A biopsy of a pustule on the back showed spongiform pustule of Kogoj. She was suspected of having generalized pustular psoriasis or acute generalized exanthematous pustulosis. Finally, she was diagnosed with generalized pustular psoriasis (von Zumbusch type) considering the characteristics and clinical course of the rash. In addition to the above three drugs, systemic cyclosporin (5 mg/kg per day) was applied, and the lesions and fever resolved within the proceeding 2 months.

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Economic assessment of actual prescription of drugs for treatment of atopic dermatitis: Differences between dermatology and pediatrics in large-scale receipt data

Abstract

Using large-scale receipt data, we analyzed the differences in the prescription of drugs and their costs between dermatology and pediatrics in the treatment of atopic dermatitis (AD) in children. Between August 2010 and July 2011, 50 706 patients were diagnosed as having AD, and the data of 21 075 (15 257 dermatology, 5818 pediatric) patients aged 0–14 years were included in this study. The use of classes I (strongest), II (very strong), and III (strong) topical corticosteroids and tacrolimus was significantly higher in dermatology than in pediatrics (class I, 2.88% vs 0.76%; class II, 27.68% vs 8.32%; class III, 52.53% vs 39.88%; tacrolimus, 5.05% vs 2.82%; all P < 0.05). Although total drug costs were higher in dermatology than in pediatrics, mean drug costs per person were significantly higher in pediatrics. Moisturizers and protective agents had the highest cost (~ ¥690 million). The introduction rate of generic drugs was low at 8.3% among classes I–V. The introduction rate of moisturizers and protective agents, for which costs were the highest, was approximately 9%. The prescription of generic classes II–V topical corticosteroids and moisturizers and protective agents was also significantly higher in dermatology than in pediatrics (P < 0.05). Among patients younger than 2 years, 4405 received drugs for AD; classes I and II topical corticosteroids and tacrolimus (against the guidelines) were administrated in 35 (0.8%), 474 (10.8%) and 29 patients (0.7%), respectively. The introduction of generic drugs is still low, and the use of generic moisturizers and protective agents should be addressed further.

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Unusual subcutaneous invasion of myxoid liposarcoma

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Transverse nasal crease with milia and comedones: Dermoscopic observation

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Successful treatment of hidradenitis suppurativa with rituximab for a patient with idiopathic carpotarsal osteolysis and chronic active antibody-mediated rejection

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Agranulocytosis associated with voriconazole-induced hypersensitivity syndrome

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Effectiveness of Gastrostomy for Improving Nutritional Status and Quality of Life in Patients with Epidermolysis Bullosa: A Systematic Review

Abstract

Inherited epidermolysis bullosa (EB) is a group of rare genetic disorders clinically characterized by a wide range of skin and mucosal blistering after minor trauma¹. This condition is caused by mutations on genes coding for structural proteins of the skin and affects both genders from all ethnic groups, and its estimated prevalence is about 500,000 cases worldwide².

This article is protected by copyright. All rights reserved.

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Acknowledgements to Reviewers

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Author Guidelines

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The COL5A3 and MMP9 genes interact in eczema susceptibility

Abstract

Background

Genetic studies of eczema have identified many genes, which explain only 14% of the heritability. Missing heritability may be partly due to ignored Gene–Gene (G-G) interactions.

Objective

Our aim was to detect new interacting genes involved in eczema.

Methods

The search for G-G interaction in eczema was conducted using a two-step approach, which included as a first step, a biological selection of genes, which are involved either in the skin or epidermis development or in the collagen metabolism, and as a second-step, an interaction analysis of the selected genes. Analyses were carried out at both SNP and gene levels in three asthma-ascertained family samples: the discovery dataset of 388 EGEA (Epidemiological study on the Genetics and Environment of Asthma) families and the two replication datasets of 253 SLSJ (Saguenay-Lac-Saint-Jean) families and 207 MRCA (Medical Research Council) families.

Results

One pair of SNPs, rs2287807 in COL5A3 and rs17576 in MMP9, that were detected in EGEA at P ≤ 10^-5 showed significant interaction by meta-analysis of EGEA, SLSJ and MRCA samples (P=1.1x10^-8 under the significant threshold of 10^-7). Gene-based analysis confirmed strong interaction between COL5A3 and MMP9 (P=4x10^-8 under the significant threshold of 4x10^-6) by meta-analysis of the three datasets. When stratifying the data on asthma, this interaction remained in both groups of asthmatic and non-asthmatic subjects.

Conclusion

This study identified significant interaction between two new genes, COL5A3 and MMP9, which may be accounted for by a degradation of COL5A3 by MMP9 influencing eczema susceptibility.

Further confirmation of this interaction as well as functional studies are needed to better understand the role of these genes in eczema.

This article is protected by copyright. All rights reserved.

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Nasal Cytology: a Precision Medicine tool in clinical practice

Abstract

The BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis represents a precise and accurate document in defining the different sub-groups of patients suffering from allergic rhinitis (AR) and non-allergic rhinitis (NAR). We would like to stimulate the debate about this matter, mainly concerning the definition and classification of NAR. In particular, we would convince the readers that there are different phenotypes/endotypes of NAR in addition to non-allergic rhinitis with eosinophils (NARES). This concept is clinically relevant as deserves an adequate work-up and constitutes the background for the Precision Medicine (PM) approach.

This article is protected by copyright. All rights reserved.

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Synergistic inhibition of cell proliferation by combined targeting with kinase inhibitors and dietary xanthone is a promising strategy for melanoma treatment

Summary

α-Mangostin is a dietary xanthone that displays various biological activities, and numerous reports have shown its efficacy in cancer prevention and inhibition. As most agents have been shown to be ineffective as single-agent therapy for malignant melanoma (MM), the principle of targeted chemotherapy for MM is to use effective inhibitors and combination methods. In this study, we tested the cytotoxicity of several kinase inhibitors, including the glycogen synthase kinase (GSK)-3 inhibitor CHIR99021, and rapamycin, in combination with a dietary xanthone, α-mangostin, by screening from a kinase inhibitor library for melanogenesis in SK-MEL-2 MM cells, and verified these by clone formation efficiency, terminal dUTP nick end labelling, and expression of apoptosis-related proteins. We also explored the molecular mechanisms for the apoptosis-inducing effects reported. We found a marked synergistic effect of CHIR99021 or rapamycin in combination with α-mangostin, which we verified through apoptosis-related methods. These data provide a strong rationale for the use of α-mangostin as an adjunct to GSK-3 inhibitor or mammalian target of rapamycin inhibitor treatment. The intrinsic mechanism behind α-mangostin might be inhibition of phosphatidylinositol 3-kinase/AKT signalling and autophagy, and induction of reactive oxygen species generation.

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Response Regarding Surgical Techniques for Retrograde Parotidectomy

Publication date: Available online 22 November 2017
Source:American Journal of Otolaryngology
Author(s): Maxwell Kligerman, Uchechukwu Megwalu, Davud Sirjani




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Noise exposure while commuting in Toronto - a study of personal and public transportation in Toronto

Abstract

Background

With an increasing proportion of the population living in cities, mass transportation has been rapidly expanding to facilitate the demand, yet there is a concern that mass transit has the potential to result in excessive exposure to noise, and subsequently noise-induced hearing loss.

Methods

Noise dosimetry was used to measure time-integrated noise levels in a representative sample of the Toronto Mass Transit system (subway, streetcar, and buses) both aboard moving transit vehicles and on boarding platforms from April – August 2016. 210 measurements were conducted with multiple measurements approximating 2 min on platforms, 4 min within a vehicle in motion, and 10 min while in a car, on a bike or on foot. Descriptive statistics for each type of transportation, and measurement location (platform vs. vehicle) was computed, with measurement locations compared using 1-way analysis of variance.

Results

On average, there are 1.69 million riders per day, who are serviced by 69 subway stations, and 154 streetcar or subway routes. Average noise level was greater in the subway and bus than in the streetcar (79.8 +/− 4.0 dBA, 78.1 +/− 4.9 dBA, vs 71.5 +/−1.8 dBA, p < 0.0001). Furthermore, average noise measured on subway platforms were higher than within vehicles (80.9 +/− 3.9 dBA vs 76.8 +/− 2.6 dBA, p < 0.0001). Peak noise exposures on subway, bus and streetcar routes had an average of 109.8 +/− 4.9 dBA and range of 90.4–123.4 dBA, 112.3 +/− 6.0 dBA and 89.4–128.1 dBA, and 108.6 +/− 8.1 dBA and 103.5–125.2 dBA respectively. Peak noise exposures exceeded 115 dBA on 19.9%, 85.0%, and 20.0% of measurements in the subway, bus and streetcar respectively.

Conclusions

Although the mean average noise levels on the Toronto transit system are within the recommended level of safe noise exposure, cumulative intermittent bursts of impulse noise (peak noise exposures) particularly on bus routes have the potential to place individuals at risk for noise induced hearing loss.

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To infinity…. and beyond!!

Wynand Van Der Linden

Annals of Maxillofacial Surgery 2017 7(2):163-164



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Rehabilitation of unilateral congenital microtia by implant-retained prosthesis

Abhay Datarkar, Surendra Daware, Ravi Dande, Ujwala Datarkar

Annals of Maxillofacial Surgery 2017 7(2):291-295

Microtia is a major congenital anomaly of the external ear. It includes a spectrum of deformities from a grossly normal but small ear to the absence of the entire external ear. These deformities account for three in every 10,000 births, with bilaterally missing ears seen in fewer than 10% of all cases. Extraoral implant-retained ear prosthesis has been proven to be a predictable treatment option for rehabilitation of such congenital anomalies. This paper aims to present principles of maxillofacial implants, review of literature, advantages, disadvantages, and considerations in treatment planning and treatment phases of an implant-supported auricular prosthesis and prospective developments for ear prosthesis are also discussed. Implant supported ear reconstruction provides excellent support, good retention, and esthetically acceptable appearance to the patient.

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Understanding and prevention of orofacial clefting: A myth or possibility?

SM Balaji

Annals of Maxillofacial Surgery 2017 7(2):165-165



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Guided bone regeneration for the reconstruction of alveolar bone defects

Arash Khojasteh, Lida Kheiri, Saeed Reza Motamedian, Vahid Khoshkam

Annals of Maxillofacial Surgery 2017 7(2):263-277

Background: Guided bone regeneration (GBR) is the most common technique for localized bone augmentation. Purpose: The purpose of this review was to categorize and assess various GBR approaches for the reconstruction of human alveolar bone defects. Materials and Methods: Electronic search of four databases including PubMed/Medline, EMBASE, Web of Science, and Cochrane and hand searching were performed to identify human trials attempting GBR for the reconstruction of alveolar bony defects for at least 10 patients from January 2000 to August 2015. To meet the inclusion criteria, studies had to report preoperative defect dimensions in addition to outcomes of bone formation and/or resorption. Results: Twenty-five human clinical trials were included of which 17 used conventional technique that is the use of space maintaining membrane with bone grafting particles (GBR I). Application of block bone graft with overlying membrane and particulate fillers was reported in seven studies (GBR II), and utilizing cortical bone block tented over a defect preserving particulate fillers was reported by one study (GBR III). A wide range of initial defects' sizes and treatment results were reported. Conclusions: This review introduces a therapeutically oriented classification system of GBR for treating alveolar bone defects. High heterogeneity among studies hindered drawing definite conclusions in regard to superiority of one to the other GBR technique.

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Fast-track orthognathic surgery: An evidence-based review

Joel Joshi Otero, Olivier Detriche, Maurice Yves Mommaerts

Annals of Maxillofacial Surgery 2017 7(2):166-175

The aim of this study was to establish a fast-track protocol for bimaxillary orthognathic surgery (OGS). Fast-track surgery (FTS) is a multidisciplinary approach where the pre-, intra-, and postoperative management is focusing maximally on a quick patient recovery and early discharge. To enable this, the patients' presurgical stress and postsurgical discomfort should be maximally reduced. Both referral patterns and expenses within the health-care system are positively influenced by FTS. University hospital-literature review through Medline, Embase, and the Cochrane Library (January 2000– July 2016) using the following words – "fast track, enhanced recovery, multimodal, and perioperative care" – to define a protocol evidence based for OGS, as well as evidenced-based medicine search of every term added to the protocol during the same period. The process has resulted in an OGS protocol that may improve the outcome of the patient through several nonoperative and operative measures such as preoperative patient education and intra/postoperative measures that should improve overall patient satisfaction, decrease morbidity such as postoperative nausea, headache, dizziness, pain, and intubation discomfort, and shorten hospital stay. A literature review allowed us to fine-tune a fast-track protocol for uncomplicated OGS that can be prospectively studied against currently applied ones.

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Unusual case of acquired capillary hemangioma of the eyelid in an adult

S Vijayanand, Narahari Ranganatha, Madhumati Singh, Ramesh Babu

Annals of Maxillofacial Surgery 2017 7(2):308-311

Acquired capillary hemangioma of the eyelid is very uncommon in adults. To our knowledge, only eight such cases have been reported in the literature till date. We report the case of a 25-year-old female with acquired capillary hemangioma of the left lower eyelid treated by cutting diathermy followed by reconstruction of the cutaneous and cartilaginous defect. This patient had a history of a similar lesion in the left malar region treated 5 years back. This case is being presented to highlight the occurrence of such lesions in an adult and to discuss the dilemmas in the diagnosis and management.

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Orthognathic surgery or overlay prosthesis: Quality of life in bilateral cleft lip and palate patients

Michelly Lima Moro Alves, José Fernando Scarelli Lopes, Ana Lúcia Pompéia Fraga de Almeida, Karin Hermana Neppelenbroek, Thais Marchini de Oliveira, Simone Soares

Annals of Maxillofacial Surgery 2017 7(2):176-179

Background: The concern to restore and evaluate bilateral cleft lip and palate (BCLP) patients' quality of life, after rehabilitation, is an issue that has been discussed in the literature because it is the ultimate goal of any proposed treatment. Objective: To evaluate the overall and oral quality of life of BCLP patients who had completed their treatment with orthognathic surgery (OrSg) compared to those who completed theirs with prosthetic rehabilitation in the form of overlay prosthesis (OP). Materials and Methods: The study comprised 40 patients, 20 in OrSg group and 20 in OP group. Epidemiological survey and application of two questionnaires (World Health Organization Quality of Life-brief [WHOQOL-bref] and Oral Health Impact Profile-14 [OHIP-14]) were done. The final results were evaluated statistically by the Mann– Whitney test. Results: Regarding the comparison with the WHOQOL-bref, no significant statistical differences between groups were found. In the analysis of the OHIP-14, only in "psychological limitation" field difference could be observed, where OrSg group showed more negative impact when compared to the OP group. Conclusion: Both rehabilitations provide a satisfactory quality of life for patients.

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Tomographic analysis of the impact of mandibular advancement surgery on increased airway volume

Danilo Louzada De Oliveira, Thiago Calcagnotto, Thessio Mina Vago, Hugo Nary Filho, Danilo Pinelli Valarelli, Caio Peres Bellato

Annals of Maxillofacial Surgery 2017 7(2):256-259

Purpose: This study aimed to quantify, using cone-beam computed tomography (CBCT) in patients who underwent a mandibular advancement surgery associated with genioplasty, three-dimensional changes in airway space and to evaluate whether these changes differ between men and women. Materials and Methods: Preoperative and 8-month postoperative CBCT scans of 38 patients aged 18– 45 years of either sex and any ethnicity who underwent mandibular advancement surgery associated with genioplasty were analyzed using the Xoran software (Xoran Technologies, Ann Arbor, MI, USA). The linear distances gonion-gnathion (Go-Gn) and condylion-menton (Co-Me) were obtained. Airway volume was measured using the Dolphin Imaging software, version 11.0. Then, data were tabulated and analyzed using Student's t-test. Results: Mean patient age was 30.3 years; 39.47% were men and 60.63% were women. The mean Go-Gn distance was 72.05 mm before surgery and 78.56 mm after surgery, with a mean gain of 6.51 mm. The mean Co-Me distance was 113.47 mm before surgery and 119.89 mm after surgery, with a mean increase of 6.42 mm. Both differences were statistically significant. The mean volume of airway space was 17,272.92 mm3 before surgery and 24,173.74 mm3 after surgery, with a statistically significant mean increase of 6900.82 mm3. There was no statistically significant difference in mean volumetric gain between men (7566.69 mm3) and women (7456.69 mm3). Conclusion: Mandibular advancement surgery results in significant increase of airway space, and there is no difference in airway volume between men and women.

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A study on dorsal pedicled tongue flap closure of palatal fistulae and oronasal communications

Priya Esther Jeyaraj

Annals of Maxillofacial Surgery 2017 7(2):180-187

Introduction: Residual defects of the palatal region following ablative resection of tumors and Gunshot wounds (GSWs) of the maxillofacial region can be quite painstaking, daunting and challenging to reconstruct, due to the extent and composite nature of the tissue loss. A shortage of available donor areas and local flap options in the intraoral region, add to the difficulty. Further compounding the situation, are factors such as excessive fibrosis and scarring of the palatal tissues as a result of multiple previous surgeries in the region. Objective: To evaluate the effectiveness of the Dorsal Pedicled Tongue Flap in the reconstruction of complex palatal defects resulting from maxillofacial GSWs and ablative tumor resections. To also device techniques to reduce the incidence of postoperative tongue flap detachment, thus improving its efficiency and reliability. Results: The palatal fistulas in all the patients were closed successfully, with no post-operative complications such as bleeding, hematoma formation, congestion, infection, partial or total flap necrosis or flap detachment. The tongue flap at the recipient site remained healthy with no recurrence of the fistula in any of the patients in the two years follow up period. There was a complete resolution of the problem of nasal regurgitation of orally ingested fluids and food particles. There was observed no deformity or articulation defect resulting from the flap harvested from the tongue dorsum, in any of the patients. Conclusion: In GSWs and tumor ablative surgery, where composite tissue defects are involved, the tongue provides a reliable and efficient means of restoring lost tissue bulk as well as ensuring a permanent closure and sealing off of the oronasal fistulas. Its reliability can be further increased by avoiding a common complication, namely, flap detachment in the postoperative period brought on by movements of the tongue, by immobilizing the tongue by tethering it to the maxillary teeth and also, maintaining the patient on Nasogastric feeding for the three weeks postoperative period, until the patient is taken up for surgical separation the pedicle. This helps to ensure a successful and predictable take of the flap at the donor site.

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Multiple dentigerous cysts as a rare presentation of maroteaux– Lamy syndrome

Ajaz Ahmad Shah, Tajamul Ahmad Hakim, Shahid Farooq, Mubashir Younis, Shamina Kosar, Altaf Malik, Latief Najar

Annals of Maxillofacial Surgery 2017 7(2):282-286

Maroteaux– Lamy syndrome is one of the genetic disorders involving disturbances in mucopolysaccaride metabolism, due to deficiency of aryl sulfatase-B which leads to accumulation of dermatan sulfate in tissues and their excretion in urine. The diseases has several oral and dental manifestations, is first diagnosed on the basis of clinical findings. It is characterized by coarse facial features, normal intelligence, organomegaly, enlarged head, short neck, corneal clouding, enlarged tongue, and prominent metachromatic inclusions in leukocytes. Death is usually a result of either respiratory tract infection or cardiac disease, which is caused by the deposition of mucopolysaccharides. An 18-year-old with Maroteaux– Lamy syndrome is described in this article with multiple dentigerous cysts as the first presentation.

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Lugol chromoscopy in the follow-up of head and neck carcinoma

Cesar Augusto Simões, Marcelo Doria Durazzo, Flávia Caló de Aquino Xavier, Marina Helena Cury Gallottini, Sílvia Vanessa Lourenço, Décio dos Santos Pinto Júnior, Natália Martins Magacho de Andrade, Aline Paterno Miazaki, Rogério Aparecido Dedivitis, Cláudio Roberto Cernea

Annals of Maxillofacial Surgery 2017 7(2):188-193

Introduction: Lugol is helpful in identifying early second primary tumors (SPTs) during oroscopy and pharyngoscopy, but this technique has not been assessed during follow-up visits with these patients. Aim: The aim of this study is to describe the use of Lugol (a low-cost method) to diagnose SPTs in the oral cavity and oropharynx. Methods: Patients treated for squamous cell carcinoma of the head and neck were randomly assigned to two groups. Group A was examined with routine oroscopy and pharyngoscopy without Lugol, and Group B was examined with routine oroscopy and pharyngoscopy without stain and with Lugol. A total of 211 patients were included during 4 years. Results: Six oral and oropharynx carcinomas were detected in Group A. Eighteen oral and oropharynx carcinomas were detected in Group B, twelve of which were not seen without chromoscopy but were detected with Lugol. Conclusion: Lugol increases the detection of malignant lesions compared to routine examination alone.

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Karapandzic flap for esthetic and functional reconstruction of large defect of lower lip

Anuj S Dadhich, Seemit Shah, Harish Saluja, Parul Tandon, Vinayak More

Annals of Maxillofacial Surgery 2017 7(2):300-303

Squamous cell carcinoma is the most common cancer occurring in the oral cavity. The lips are one of the most common sites of occurrence with involvement, lower lip being more common than upper. Reconstruction of large defects of lower lip with good functional and esthetic outcome is the biggest challenge faced by the surgeon. Karapandzic flap is one the most commonly used technique for reconstruction of large defects of the lower lip.

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Evaluation of the sternoclavicular graft for the reconstruction of temporomandibular joint after gap arthroplasty

JK Dayashankara Rao, Nahida Dar, Aadya Sharma, Anil K Sheorain, Vijaylaxmi Malhotra, Varun Arya

Annals of Maxillofacial Surgery 2017 7(2):194-201

Introduction: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. A number of interpositional materials have been used including alloplastic materials (acrylic, proplast– teflon, silastic), and autogenous tissues (temporalis muscle flaps, buccal fat pad, dermis, costochondral grafts, metatarsal, fibula, tibia, iliac crest, cranial bone and Sternoclavicular graft SCG and cartilage). Literature suggests that rather than growth centre, we need adaptive centre. SCG is presumed to be a more suitable material for interpositional arthroplasty because Sternoclavicular Joint (SCJ) and TMJ are very similar developmentally, histologically and morphologically throughout the growth period. Material and Method: Patients with TMJ ankylosis (8 males, 2 females) underwent release of the ankylosed joint by the senior author, between June 2013 and Novemeber 2015. The age of the patients ranged from 10 to 19 years. Pre- and post- operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate. Result: MIO at 6 months follow up was 37.4±2.633 mm (range 32-40 mm), greater than MIO achieved in immediate postoperatively {34.4±2.22 mm (range 30-38 mm). After reconstruction of temporomandibular joint with sternoclavicular graft in the growing child there was a significant increase in the growth of mandible which was stunned due to ankylosis. And the ramal height also increased. Conclusion: The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.

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Dual pathology of mandible

Suday G Rajurkar, Mohan D Deshpande, Noaman Kazi, Dhanashree Jadhav, Pallavi Ranadive, Snehal Ingole

Annals of Maxillofacial Surgery 2017 7(2):316-318

Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed.

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A randomized control trial of awake oral to submental conversion versus asleep technique in maxillofacial trauma

Shahna Ali, Manazir Athar, Syed Moied Ahmed, Obaid Ahmad Siddiqi, Amrin Badar

Annals of Maxillofacial Surgery 2017 7(2):202-206

Aim: This study was designed to evaluate the efficacy of awake oral to submental conversion over asleep technique. Materials and Methods: This randomized clinical study was conducted in maxillofacial department of a tertiary care hospital in patients who had panfacial or mandibular fractures requiring elective surgical correction. The patients were randomly divided into two groups of 12 patients each, asleep fiberoptic-assisted submental intubation (SMI) (Group G; n = 12) and awake fiberoptic-assisted SMI (Group A; n = 12). The primary predictor was mean conversion time of oral to SMI while other predictors were overall success rate, ease of conversion, and complications. Data are presented as mean (±standard deviation) and frequencies (%) as appropriate. Statistical analysis done using unpaired t-test or Chi-square test was performed and P < 0.05 was considered statistically significant. Results: Twenty-four patients (19:5;Male:Female) aged 18– 55 years (Group G = 35.96; Group A = 32.43 years) were included in the study. SMI was successful in all except two patients in group G. Overall success rate was similar in both groups. Time to convert orotracheal intubation to SMI was significantly less in group A (Group G = 9.55 ± 1.42, Group A = 5.67 ± 1.73; P < 0.001). Ease of SMI was found Grade I in 30% and 83% of the patients of group G and A, respectively. No serious complications were observed except 2 cases of bleeding, and 1 case of tube damage. Conclusion: Awake oral to submental conversion requires lesser time in comparison to asleep technique besides improving the ease (Δ = 53%) of the procedure.

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Efficacy of exclusive lingual nerve block versus conventional inferior alveolar nerve block in achieving lingual soft-tissue anesthesia

Sasikala Balasubramanian, Elavenil Paneerselvam, T Guruprasad, M Pathumai, Simin Abraham, VB Krishnakumar Raja

Annals of Maxillofacial Surgery 2017 7(2):250-255

Objective: The aim of this randomized clinical trial was to assess the efficacy of exclusive lingual nerve block (LNB) in achieving selective lingual soft-tissue anesthesia in comparison with conventional inferior alveolar nerve block (IANB). Materials and Methods: A total of 200 patients indicated for the extraction of lower premolars were recruited for the study. The samples were allocated by randomization into control and study groups. Lingual soft-tissue anesthesia was achieved by IANB and exclusive LNB in the control and study group, respectively. The primary outcome variable studied was anesthesia of ipsilateral lingual mucoperiosteum, floor of mouth and tongue. The secondary variables assessed were (1) taste sensation immediately following administration of local anesthesia and (2) mouth opening and lingual nerve paresthesia on the first postoperative day. Results: Data analysis for descriptive and inferential statistics was performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp. Released 2013) and a P < 0.05 was considered statistically significant. In comparison with the control group, the study group (LNB) showed statistically significant anesthesia of the lingual gingiva of incisors, molars, anterior floor of the mouth, and anterior tongue. Conclusion: Exclusive LNB is superior to IAN nerve block in achieving selective anesthesia of lingual soft tissues. It is technically simple and associated with minimal complications as compared to IAN block.

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Low-level laser therapy on postoperative pain after mandibular third molar surgery

May Ayad Hamid

Annals of Maxillofacial Surgery 2017 7(2):207-216

Introduction: The analgesic effect of low-level laser therapy (LLLT) after mandibular third molar (MTM) extraction is controversial. The aim is to evaluate the effect of intraoral LLLT on postoperative pain after MTMs extraction. Methods: Thirty patients with bilateral symmetrical impacted MTMs underwent surgical extractions. Experimental and control sides were randomly selected to receive LLLT or placebo. Following suturing, a dental assistant applied 810 nm gallium aluminum arsenide (GaAlAs) at three points for 30 s each with a total energy of 9 J. Pain was recorded on a visual analog scale on the 7 successive days. Results: Data analyzed by IBM SPSS Statistics 23 for Windows with P ≤ 0.05 signifi cance level. LLLT appeared to have a high signifi cant effect on pain reduction; however, there was a mild increase in pain after the 4th day. Conclusion: Intraoral 810 nm GaAlAs is effective in reducing postoperative pain when a dose of 32.86 J/cm2 is used.

http://ift.tt/2B5pd3c

Computed tomographic analysis of the sagittal orbit-globe relationship

Zachary R Abramson, Srinivas M Susarla, Anand R Kumar, Asim F Choudhri

Annals of Maxillofacial Surgery 2017 7(2):260-262

Identifying the normal relationship of the orbital rims to the globes is critical in planning surgical correction of craniofacial deformities affecting the orbit. This article illustrates a technical proof of principle and mathematical basis for a computed tomography-based measurement of the sagittal orbit-globe relationship. The technique does not require subject cooperation and is, therefore, optimal for pediatric craniofacial surgical treatment planning and outcome evaluation.

http://ift.tt/2iHl2np

Evaluation of knowledge of physical education students on dental trauma

Danilo Louzada de Oliveira, Paulo Domingos Ribeiro-Junior, Ana Camila Sbroggio, Priscila Góis dos Santos, Graziela Garrido Mori

Annals of Maxillofacial Surgery 2017 7(2):217-221

Introduction: Sports' practitioners are vulnerable to dental trauma; if this occurs, the emergency treatment should be fast and efficient. This may be performed by any person at the site of the accident, not only by dental professionals. Physical educators may face dental trauma and should be able to provide proper care. This study had the objective evaluated the knowledge of physical education graduates on dental trauma. Materials and Methods: A questionnaire containing questions on dental trauma was applied to 199 physical education students; after collection of the questionnaires, data were tabulated and processed on the software Epi Info 2000 (Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA). As a result, only 36.7% of participants would take the individual suffering trauma to the dental professional, 56.8% believe that the avulsed tooth should be replanted, and 42.2% would replant it. Only 7.5% would store the avulsed tooth in an ideal storage medium for transportation. Conclusion: It was concluded that there is a lack of knowledge on dental trauma among physical education graduates, evidencing the need of public policies to allow education on this issue.

http://ift.tt/2B3SFWZ

Post herpetic frey's syndrome

Jigna S Shah, Vijay K Asrani

Annals of Maxillofacial Surgery 2017 7(2):278-281

Frey's syndrome is characterized by unilateral sweating and flushing of the skin in the area of the parotid gland, occurring during meal, or on salivary stimulation. It is a common complication following surgery/injury in the parotid gland region/temporomandibular joint surgery; however, very few cases have been reported of its occurrence following herpetic infection. It is important for the clinician to recognize its unusual symptoms as early as possible to prevent its potential negative social and psychological effect on the patient. It is diagnosed on clinical presentation and confirmed by objective testing methods. The treatment ranges from topical application of glycopyrrolate to local injections of botulinum toxin and lastly to surgical intervention. An interesting case of Frey's syndrome is presented in a young patient having the previous history of herpes zoster infection, which was diagnosed clinically and confirmed by starch-iodine test and was successfully treated with topical application of glycopyrrolate.

http://ift.tt/2iH1Nu2

Small-diameter compression screws completely embedded in bone for rigid internal fixation of the condylar head of the mandible

Complications after open reduction and internal fixation of the condylar head include irritation of the sensitive soft tissues surrounding the temporomandibular joint (TMJ) caused by permanent friction from the screw head,1 and resorption beneath the screw heads because of bony remodelling around the lateral pole.1,2 However, a second operation can risk damage to the facial nerve.

http://ift.tt/2A3HM8o

Survival in patients with primary Dermatofibrosarcoma Protuberans: National Cancer Data Base analysis

Large tumor size of dermatofibrosarcoma protuberans (DFSP) was found to predict mortality when relevant institution-based and treatment-specific factors were not considered, Older age, comorbidities. anaplastic histology, and positive margins predicted mortality while female gender, private insurance, and academic facility or Integrated Network Cancer Program (INCP) predicted survival, Thorough analysis of risk factors in DFSP patients is needed to improve management and increase survival.

http://ift.tt/2jP8uh0

The effect of supragingival biofilm re-development on the subgingival microbiota in chronic periodontitis

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Fátima Aparecida Rocha Resende Hartenbach, Carina Maciel Silva-Boghossian, Ana Paula Vieira Colombo
ObjectiveIn this study, we hypothesized that in the absence of oral hygiene, re-growth of the climax microbial communities of supra and subgingival biofilm happens in a faster and more intense fashion in individuals with chronic periodontitis (CP) compared to periodontally healthy controls (PH).DesignThirty patients (PH=15 and CP=15) received professional supragingival prophylaxis, and were asked to refrain from oral hygiene for 7days. Supra and subgingival biofilm samples and GCF were collected from randomly selected quadrants at baseline (before prophylaxis), immediately after prophylaxis, 2h, 6h, 24h, and 7days after prophylaxis. The composition of the biofilm was determined by the checkerboard method.ResultsAll subjects developed gingivitis at the end of 7days without oral hygiene. GCF mean volumes were significantly higher in CP than PH patients at baseline, but they started decreasing 2h after prophylaxis, returning to baseline levels after 24h in both groups. Significant increases in mean counts for most of the species evaluated were observed in both groups and biofilms over time (p<0.05). Few hours after prophylaxis, a more marked reduction in microbial counts happened in the supragingival biofilm of the CP group, and re-development of biofilm started later than in the PH group. At 7days, no differences were seen between groups. Significant differences in kinetics of re-colonization between groups were observed only in the subgingival biofilm for T. denticola and F. nucleatum ss vicentii (increased in the CP), and N. mucosa (increased in the PH group; p<0.05).ConclusionsBiofilm re-development was very similar between CP and PH individuals, although microbial re-growth occurred few hours earlier in PH than PC. Only 3 species in the subgingival biofilm differed in re-colonization between groups. Thus, we reject the hypothesis that re-colonization of biofilm in CP patients is more intense and faster than in individuals with PH.



http://ift.tt/2A3x9SV

Aims & Scope/Editorial board

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85





http://ift.tt/2jeYPw8

Homeobox genes and tooth development: Understanding the biological pathways and applications in regenerative dental science

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Anand Ramanathan, Thekkeparambil Chandrabose Srijaya, Prema Sukumaran, Rosnah Binti Zain, Noor Hayaty Abu Kasim
ObjectivesHomeobox genes are a group of conserved class of transcription factors that function as key regulators during the embryonic developmental processes. They act as master regulator for developmental genes, which involves coordinated actions of various auto and cross-regulatory mechanisms. In this review, we summarize the expression pattern of homeobox genes in relation to the tooth development and various signaling pathways or molecules contributing to the specific actions of these genes in the regulation of odontogenesis.Materials and methodsAn electronic search was undertaken using combination of keywords e.g. Homeobox genes, tooth development, dental diseases, stem cells, induced pluripotent stem cells, gene control region was used as search terms in PubMed and Web of Science and relevant full text articles and abstract were retrieved that were written in English. A manual hand search in text books were also carried out. Articles related to homeobox genes in dentistry and tissue engineering and regenerative medicine of odontogenesis were selected.ResultsThe possible perspective of stem cells technology in odontogenesis and subsequent analysis of gene correction pertaining to dental disorders through the possibility of induced pluripotent stem cells technology is also inferred.ConclusionsWe demonstrate the promising role of tissue engineering and regenerative medicine on odontogenesis, which can generate a new ray of hope in the field of dental science.



http://ift.tt/2A3skJq

Novel methodology for determining the effect of adsorbates on human enamel acid dissolution

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): N. Pechlivani, D.A. Devine, P.D. Marsh, A. Mighell, S.J. Brookes
ObjectiveThe effect of various interventions on enamel demineralisation can be determined by chemically measuring mineral ions dissolved by the attacking acid. Results are usually expressed as mineral loss per surface area of enamel exposed. Acid resistant varnish or adhesive tape are typically used to delineate an area of enamel. However, enamel surface curvature, rugosity and porosity reduce the reliability of simple area measurements made at the macro scale. Our aim was to develop a simple method for investigating the effect of adsorbates on enamel demineralisation that does not rely on knowing the area of enamel exposed. As an exemplar we have used salivary proteins as a model adsorbate.DesignNatural human tooth enamel surfaces were subjected to five sequential acid challenges and then incubated in adsorbate (whole clarified saliva) followed by a further 15 acid challenges. Demineralisation was determined by measuring the phosphate released into the acid during each exposure by a spectrophotometric assay. The initial five challenges established a mean baseline mineral loss for each tooth against which the effect of subsequently adsorbed proteins could be compared.ResultsSalivary proteins significantly reduced the acid demineralisation of human enamel by 43% (p<0.01). Loss of proteins during each challenge corresponded to a gradual reduction in the degree of protection afforded.ConclusionsThe methodology provides a simple and flexible means to investigate the effect of any adsorbate on enamel acid dissolution. Knowledge of the area of exposed enamel is irrelevant as each tooth acts as its own negative control.



http://ift.tt/2jf1Pcd

Raloxifene reduces the risk of local alveolar bone destruction in a mouse model of periodontitis combined with systemic postmenopausal osteoporosis

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Ryota Ichimaru, Tsukasa Tominari, Shosei Yoshinouchi, Chiho Matsumoto, Kenta Watanabe, Michiko Hirata, Yukihiro Numabe, Gillian Murphy, Hideaki Nagase, Chisato Miyaura, Masaki Inada
OBJECTIVEPeriodontitis is characterized by local inflammation leading to tooth loss and severe destruction of alveolar bone. Raloxifene is a selective estrogen receptor modulator (SERM) that halts estrogen deficiency-induced systemic bone loss in postmenopausal osteoporosis without the side effects of cancer in breast and uterus. In this study, we examined the effects of raloxifene on alveolar bone mass in a mouse model with estrogen deficiency-induced periodontitis.METHODSPeriodontitis was induced by the injection of lipopolysaccharide (LPS) into the lower gingiva in ovariectomized (OVX) mice, and the alveolar bone and femur bone mineral density (BMD) were analyzed by dual-energy X-ray absorptiometry. To explore the direct osteoclast inhibitory effect of raloxifene, a co-culture system for osteoclast formation and organ culture of alveolar bone was established.RESULTSWhen OVX mice were treated with raloxifene, the bone loss in both alveolar bone and femur were abrogated. Interleukin 1 and/or LPS stimulated the osteoclast formation and bone-resorbing activity; however, raloxifene did not show any inhibitory effect on the osteoclast formation or function. In vivo local injection of raloxifene also did not prevent bone resorption in a mouse model of periodontitis. However, the systemic treatment of raloxifene using a mini-osmotic pump did prevent the loss of BMD of alveolar bone induced by LPS.CONCLUSIONThese results suggest that the SERM raloxifene systemically maintain alveolar bone mass in a mouse model of periodontitis with osteoporosis. Increasing the alveolar bone mass by SERMs treatment in patients with postmenopausal osteoporosis may be a useful approach to preventing the destruction of alveolar bone in late-onset periodontitis.



http://ift.tt/2A4xqFo

Cdc42 is essential for the polarized movement and adhesion of human dental pulp stem cells

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Mingwei Li, Liang Ma, Bing Song, Dingyi Yu, Min Xiao, Xiaohan Mei, Huihui Guo, Qing Yu
ObjectiveStem cell-based tissue repair and regeneration require the regulation of cell migration and adhesion. As a regulator of cell polarization, Cdc42 (cell division control protein 42) plays a basic role at the initial stage of cell migration and adhesion. This study explores the effect of Cdc42 on the polarized migration and adhesion of hDPSCs (human dental pulp stem cells).DesignHDPSCs were isolated from extracted third molars and transfected with siRNA targeted against Cdc42. Scratch wound assays and transwell assays were performed to detect the migration of human dental pulp stem cells. Polarization assays were applied to explore the polarized movement of Golgi bodies and nuclei.Western blot was used to examine the expression of related proteins.ResultsThe expression of Cdc42 was knocked down by siRNA transfection, which inhibited the migration of hDPSCs in both the scratch wound assays and transwell assays. Meanwhile, the proportion of polarized hDPSCs during migration was also decreased, and the adhesion ability of hDPSCs was downregulated. Western blot demonstrated that these effects were dependent on FAK (focal adhesion kinase), β-catenin and GSK3β (Glycogen synthase kinase-3β).ConclusionOur study demonstrates that Cdc42 plays an essential role during the polarized movement and adhesion of hDPSCs.



http://ift.tt/2jfOqQW

Inhibitory effect of probiotic lactobacilli supernatants on single and mixed non-albicans Candida species biofilm

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Yulong Tan, Matthias Leonhard, Doris Moser, Su Ma, Berit Schneider-Stickler
ObjectivesOral candidiasis is one of the most common human fungal infections. While most cases of the Candida species isolated from the oral cavity are Candida albicans, a large number of candidiasis is attributed to non-albicans Candida species. In this study, we aim to evaluate the in vitro inhibition of supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus on the single and mixed species biofilm of non-albicans Candida species, including Candida tropicalis, Candida krusei and Candida parapsilosis.DesignCell-free supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus were prepared. Single and mixed non-albicans Candida species biofilm were formed in the 96-well microplate and on the surfaces of medical grade silicone. Biomass and cell viability were tested with crystal violet and cell counting kit-8. In order to examine the ability of the supernatant to disrupt pre-formed biofilm, supernatant was added to 24h-old biofilms. Biofilm architecture on silicone was investigated by scanning electron microscopy and confocal laser scanning microscopy was used to examine live/dead organisms within biofilm.ResultsSingle and mixed species biofilms and cell viability of non-albicans Candida biofilms were inhibited by probiotic lactobacilli supernatants. Matrue biofilm formation was disrupted by lactobacilli supernatants added at 24h after biofilm initiation. Examination with confocal laser scanning microscopy and scanning electron microscopy confirmed that lactobacilli supernatants inhibited the mixed biofilms and damaged the cells.ConclusionsOur data elucidate the inhibitory activity of probiotic lactobacilli on non-albicans Candida biofilm, so as to support their utility as an adjunctive therapeutic mode against oral candida infections.



http://ift.tt/2A5s38S

Colonization of oropharynx and lower respiratory tract in critical patients: Risk of ventilator-associated pneumonia

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
ObjectiveTo investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied. The last objective was to analyses correlation between blood cultures and VAP.DesignThe samples were collected from ten patients in intensive care unit with medical prescription of orotracheal intubation and mechanical ventilation. Clinical data were tabulated and blood cultures were performed according medical indication. For checkerboard samples collection, chosen sites were the dorsal side of the tongue and gingival sulcus at 12h, 48h, 96h, BAL, at 12h, endotracheal aspirate at 48 and 96h, and orotracheal tube at extubation time, when feasible.ResultsIt was possible to identify the presence of bacterial species in mouth and in the BAL/endotracheal aspirate. The data demonstrated an increase in the quantity of bacterial associated with prolonged use of mechanical ventilation (48 and 96h).ConclusionsBacterial species may migrate rapidly from mouth and upper airways during orotracheal intubation which contributes to the pathogenesis of VAP. There were associations between VAP and Enterococcus faecalis, Fusobacterium periodonticum, Gemella morbillorum, Neisseria mucosa, Propionibacterium acnes, Prevotella melaninogenica, Streptococcus oralis, Streptococcus sanguinis, Treponema denticola, Treponema socransckii, and Veillonella parvula.



http://ift.tt/2jgn3pQ

Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Heli Jäsberg, Taina Tervahartiala, Timo Sorsa, Eva Söderling, Anna Haukioja
ObjectiveTo study the effect of orally administered Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosus GG on the salivary levels of Matrix Metalloproteinases (MMP)-8, MMP-9 and of Tissue Inhibitor of Metalloproteinases (TIMP)-1 in healthy adults. Furthermore, the correlations between MMP-8, MMP-9 and TIMP-1 and plaque and gingival indices, salivary mutans streptococci and lactobacilli counts, and stimulated saliva secretion rate were analysed.DesignThe salivary samples originated from a randomized controlled trial where healthy student volunteers consumed probiotic or placebo lozenges twice a day for four weeks. The saliva samples were collected and clinical parameters measured at the baseline and at the end of the original study. For this study, the salivary levels of MMP-8, MMP-9 and TIMP-1 were analysed with immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA).ResultsIn the probiotic group (n=29), salivary MMP-9 levels increased (p<0.01) and TIMP-1 levels decreased (p<0.01) significantly during the intervention. Furthermore, MMP-9/TIMP-1 ratio differed significantly from the baseline level (p<0.01). These changes were not observed in the control group (n=31). In the whole data, salivary MMP-9 and gingival index correlated (r=0.260, p<0.05 at baseline and r=0.354, p<0.01 at the end of the study). Intergroup differences or correlations with other clinical parameters were not found. Probiotic consumption did not affect the saliva flow rate.ConclusionsIncreased MMP-9 and decreased TIMP-1 levels in saliva may indicate that probiotics have immunomodulatory effects in the oral cavity. Furthermore, increased salivary MMP-9 levels may be an indication of the defensive potential of matrix metalloproteinases.



http://ift.tt/2A4BmG9

Reactivation of peroxidase activity in human saliva samples by polyphenols

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Jana Gau, Jürgen Arnhold, Jörg Flemmig
ObjectivesThe enzyme lactoperoxidase (LPO), which is released into several body fluids like saliva, is an essential part to maintain the oral bacterial homeostasis by catalysing the oxidation of thiocyanate (SCN⁻) to hypo-thiocyanite (⁻OSCN). The formation of unreactive redox intermediates (like Compound II) leads to a decreased pseudo-halogenating enzyme activity, which is associated with a higher risk for oral infections. According to former studies with bovine LPO selected flavonoids were tested in respect to their potential to reactivate the enzymatic activity in a more physiological, human salivary system.DesignSaliva samples from healthy donors were collected and characterized by using several gel staining methods and immunoblotting. Afterwards kinetic measurements were performed by applying the TNB-assay to evaluate the pseudo-halogenating salivary peroxidase (SAPX) activity. The measurements were performed in the presence of excess H2O2 to simulate pro-inflammatory conditions. Moreover selected flavonoids or an ethanolic extract of Tormentillae rhizoma were applied to test their regenerating effect on the LPO-derived ⁻OSCN production.ResultsDespite the complex protein composition of the collected saliva samples, an SAPX-derived pseudo-halogenating activity could be identified. The ⁻OSCN regenerating effects of the tested polyphenols were completely comparable to previous in vitro experiments with bovine LPO. Thus, we could show that phenolic substances are suitable to regenerate the peroxidase activity in human saliva samples after H2O2-induced inactivation.ConclusionThe studies provide new insights into the effect of pharmaceutical relevant polyphenols on salivary peroxidase activity and thus, suggest this enzyme as a new target for the prevention and therapy of oral inflammatory diseases.



http://ift.tt/2jhtjO7

The effect of supragingival biofilm re-development on the subgingival microbiota in chronic periodontitis

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Fátima Aparecida Rocha Resende Hartenbach, Carina Maciel Silva-Boghossian, Ana Paula Vieira Colombo
ObjectiveIn this study, we hypothesized that in the absence of oral hygiene, re-growth of the climax microbial communities of supra and subgingival biofilm happens in a faster and more intense fashion in individuals with chronic periodontitis (CP) compared to periodontally healthy controls (PH).DesignThirty patients (PH=15 and CP=15) received professional supragingival prophylaxis, and were asked to refrain from oral hygiene for 7days. Supra and subgingival biofilm samples and GCF were collected from randomly selected quadrants at baseline (before prophylaxis), immediately after prophylaxis, 2h, 6h, 24h, and 7days after prophylaxis. The composition of the biofilm was determined by the checkerboard method.ResultsAll subjects developed gingivitis at the end of 7days without oral hygiene. GCF mean volumes were significantly higher in CP than PH patients at baseline, but they started decreasing 2h after prophylaxis, returning to baseline levels after 24h in both groups. Significant increases in mean counts for most of the species evaluated were observed in both groups and biofilms over time (p<0.05). Few hours after prophylaxis, a more marked reduction in microbial counts happened in the supragingival biofilm of the CP group, and re-development of biofilm started later than in the PH group. At 7days, no differences were seen between groups. Significant differences in kinetics of re-colonization between groups were observed only in the subgingival biofilm for T. denticola and F. nucleatum ss vicentii (increased in the CP), and N. mucosa (increased in the PH group; p<0.05).ConclusionsBiofilm re-development was very similar between CP and PH individuals, although microbial re-growth occurred few hours earlier in PH than PC. Only 3 species in the subgingival biofilm differed in re-colonization between groups. Thus, we reject the hypothesis that re-colonization of biofilm in CP patients is more intense and faster than in individuals with PH.



http://ift.tt/2A3x9SV

Aims & Scope/Editorial board

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85





http://ift.tt/2jeYPw8

Homeobox genes and tooth development: Understanding the biological pathways and applications in regenerative dental science

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Anand Ramanathan, Thekkeparambil Chandrabose Srijaya, Prema Sukumaran, Rosnah Binti Zain, Noor Hayaty Abu Kasim
ObjectivesHomeobox genes are a group of conserved class of transcription factors that function as key regulators during the embryonic developmental processes. They act as master regulator for developmental genes, which involves coordinated actions of various auto and cross-regulatory mechanisms. In this review, we summarize the expression pattern of homeobox genes in relation to the tooth development and various signaling pathways or molecules contributing to the specific actions of these genes in the regulation of odontogenesis.Materials and methodsAn electronic search was undertaken using combination of keywords e.g. Homeobox genes, tooth development, dental diseases, stem cells, induced pluripotent stem cells, gene control region was used as search terms in PubMed and Web of Science and relevant full text articles and abstract were retrieved that were written in English. A manual hand search in text books were also carried out. Articles related to homeobox genes in dentistry and tissue engineering and regenerative medicine of odontogenesis were selected.ResultsThe possible perspective of stem cells technology in odontogenesis and subsequent analysis of gene correction pertaining to dental disorders through the possibility of induced pluripotent stem cells technology is also inferred.ConclusionsWe demonstrate the promising role of tissue engineering and regenerative medicine on odontogenesis, which can generate a new ray of hope in the field of dental science.



http://ift.tt/2A3skJq

Novel methodology for determining the effect of adsorbates on human enamel acid dissolution

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): N. Pechlivani, D.A. Devine, P.D. Marsh, A. Mighell, S.J. Brookes
ObjectiveThe effect of various interventions on enamel demineralisation can be determined by chemically measuring mineral ions dissolved by the attacking acid. Results are usually expressed as mineral loss per surface area of enamel exposed. Acid resistant varnish or adhesive tape are typically used to delineate an area of enamel. However, enamel surface curvature, rugosity and porosity reduce the reliability of simple area measurements made at the macro scale. Our aim was to develop a simple method for investigating the effect of adsorbates on enamel demineralisation that does not rely on knowing the area of enamel exposed. As an exemplar we have used salivary proteins as a model adsorbate.DesignNatural human tooth enamel surfaces were subjected to five sequential acid challenges and then incubated in adsorbate (whole clarified saliva) followed by a further 15 acid challenges. Demineralisation was determined by measuring the phosphate released into the acid during each exposure by a spectrophotometric assay. The initial five challenges established a mean baseline mineral loss for each tooth against which the effect of subsequently adsorbed proteins could be compared.ResultsSalivary proteins significantly reduced the acid demineralisation of human enamel by 43% (p<0.01). Loss of proteins during each challenge corresponded to a gradual reduction in the degree of protection afforded.ConclusionsThe methodology provides a simple and flexible means to investigate the effect of any adsorbate on enamel acid dissolution. Knowledge of the area of exposed enamel is irrelevant as each tooth acts as its own negative control.



http://ift.tt/2jf1Pcd

Raloxifene reduces the risk of local alveolar bone destruction in a mouse model of periodontitis combined with systemic postmenopausal osteoporosis

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Ryota Ichimaru, Tsukasa Tominari, Shosei Yoshinouchi, Chiho Matsumoto, Kenta Watanabe, Michiko Hirata, Yukihiro Numabe, Gillian Murphy, Hideaki Nagase, Chisato Miyaura, Masaki Inada
OBJECTIVEPeriodontitis is characterized by local inflammation leading to tooth loss and severe destruction of alveolar bone. Raloxifene is a selective estrogen receptor modulator (SERM) that halts estrogen deficiency-induced systemic bone loss in postmenopausal osteoporosis without the side effects of cancer in breast and uterus. In this study, we examined the effects of raloxifene on alveolar bone mass in a mouse model with estrogen deficiency-induced periodontitis.METHODSPeriodontitis was induced by the injection of lipopolysaccharide (LPS) into the lower gingiva in ovariectomized (OVX) mice, and the alveolar bone and femur bone mineral density (BMD) were analyzed by dual-energy X-ray absorptiometry. To explore the direct osteoclast inhibitory effect of raloxifene, a co-culture system for osteoclast formation and organ culture of alveolar bone was established.RESULTSWhen OVX mice were treated with raloxifene, the bone loss in both alveolar bone and femur were abrogated. Interleukin 1 and/or LPS stimulated the osteoclast formation and bone-resorbing activity; however, raloxifene did not show any inhibitory effect on the osteoclast formation or function. In vivo local injection of raloxifene also did not prevent bone resorption in a mouse model of periodontitis. However, the systemic treatment of raloxifene using a mini-osmotic pump did prevent the loss of BMD of alveolar bone induced by LPS.CONCLUSIONThese results suggest that the SERM raloxifene systemically maintain alveolar bone mass in a mouse model of periodontitis with osteoporosis. Increasing the alveolar bone mass by SERMs treatment in patients with postmenopausal osteoporosis may be a useful approach to preventing the destruction of alveolar bone in late-onset periodontitis.



http://ift.tt/2A4xqFo

Cdc42 is essential for the polarized movement and adhesion of human dental pulp stem cells

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Mingwei Li, Liang Ma, Bing Song, Dingyi Yu, Min Xiao, Xiaohan Mei, Huihui Guo, Qing Yu
ObjectiveStem cell-based tissue repair and regeneration require the regulation of cell migration and adhesion. As a regulator of cell polarization, Cdc42 (cell division control protein 42) plays a basic role at the initial stage of cell migration and adhesion. This study explores the effect of Cdc42 on the polarized migration and adhesion of hDPSCs (human dental pulp stem cells).DesignHDPSCs were isolated from extracted third molars and transfected with siRNA targeted against Cdc42. Scratch wound assays and transwell assays were performed to detect the migration of human dental pulp stem cells. Polarization assays were applied to explore the polarized movement of Golgi bodies and nuclei.Western blot was used to examine the expression of related proteins.ResultsThe expression of Cdc42 was knocked down by siRNA transfection, which inhibited the migration of hDPSCs in both the scratch wound assays and transwell assays. Meanwhile, the proportion of polarized hDPSCs during migration was also decreased, and the adhesion ability of hDPSCs was downregulated. Western blot demonstrated that these effects were dependent on FAK (focal adhesion kinase), β-catenin and GSK3β (Glycogen synthase kinase-3β).ConclusionOur study demonstrates that Cdc42 plays an essential role during the polarized movement and adhesion of hDPSCs.



http://ift.tt/2jfOqQW

Inhibitory effect of probiotic lactobacilli supernatants on single and mixed non-albicans Candida species biofilm

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Yulong Tan, Matthias Leonhard, Doris Moser, Su Ma, Berit Schneider-Stickler
ObjectivesOral candidiasis is one of the most common human fungal infections. While most cases of the Candida species isolated from the oral cavity are Candida albicans, a large number of candidiasis is attributed to non-albicans Candida species. In this study, we aim to evaluate the in vitro inhibition of supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus on the single and mixed species biofilm of non-albicans Candida species, including Candida tropicalis, Candida krusei and Candida parapsilosis.DesignCell-free supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus were prepared. Single and mixed non-albicans Candida species biofilm were formed in the 96-well microplate and on the surfaces of medical grade silicone. Biomass and cell viability were tested with crystal violet and cell counting kit-8. In order to examine the ability of the supernatant to disrupt pre-formed biofilm, supernatant was added to 24h-old biofilms. Biofilm architecture on silicone was investigated by scanning electron microscopy and confocal laser scanning microscopy was used to examine live/dead organisms within biofilm.ResultsSingle and mixed species biofilms and cell viability of non-albicans Candida biofilms were inhibited by probiotic lactobacilli supernatants. Matrue biofilm formation was disrupted by lactobacilli supernatants added at 24h after biofilm initiation. Examination with confocal laser scanning microscopy and scanning electron microscopy confirmed that lactobacilli supernatants inhibited the mixed biofilms and damaged the cells.ConclusionsOur data elucidate the inhibitory activity of probiotic lactobacilli on non-albicans Candida biofilm, so as to support their utility as an adjunctive therapeutic mode against oral candida infections.



http://ift.tt/2A5s38S

Colonization of oropharynx and lower respiratory tract in critical patients: Risk of ventilator-associated pneumonia

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
ObjectiveTo investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied. The last objective was to analyses correlation between blood cultures and VAP.DesignThe samples were collected from ten patients in intensive care unit with medical prescription of orotracheal intubation and mechanical ventilation. Clinical data were tabulated and blood cultures were performed according medical indication. For checkerboard samples collection, chosen sites were the dorsal side of the tongue and gingival sulcus at 12h, 48h, 96h, BAL, at 12h, endotracheal aspirate at 48 and 96h, and orotracheal tube at extubation time, when feasible.ResultsIt was possible to identify the presence of bacterial species in mouth and in the BAL/endotracheal aspirate. The data demonstrated an increase in the quantity of bacterial associated with prolonged use of mechanical ventilation (48 and 96h).ConclusionsBacterial species may migrate rapidly from mouth and upper airways during orotracheal intubation which contributes to the pathogenesis of VAP. There were associations between VAP and Enterococcus faecalis, Fusobacterium periodonticum, Gemella morbillorum, Neisseria mucosa, Propionibacterium acnes, Prevotella melaninogenica, Streptococcus oralis, Streptococcus sanguinis, Treponema denticola, Treponema socransckii, and Veillonella parvula.



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Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Heli Jäsberg, Taina Tervahartiala, Timo Sorsa, Eva Söderling, Anna Haukioja
ObjectiveTo study the effect of orally administered Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosus GG on the salivary levels of Matrix Metalloproteinases (MMP)-8, MMP-9 and of Tissue Inhibitor of Metalloproteinases (TIMP)-1 in healthy adults. Furthermore, the correlations between MMP-8, MMP-9 and TIMP-1 and plaque and gingival indices, salivary mutans streptococci and lactobacilli counts, and stimulated saliva secretion rate were analysed.DesignThe salivary samples originated from a randomized controlled trial where healthy student volunteers consumed probiotic or placebo lozenges twice a day for four weeks. The saliva samples were collected and clinical parameters measured at the baseline and at the end of the original study. For this study, the salivary levels of MMP-8, MMP-9 and TIMP-1 were analysed with immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA).ResultsIn the probiotic group (n=29), salivary MMP-9 levels increased (p<0.01) and TIMP-1 levels decreased (p<0.01) significantly during the intervention. Furthermore, MMP-9/TIMP-1 ratio differed significantly from the baseline level (p<0.01). These changes were not observed in the control group (n=31). In the whole data, salivary MMP-9 and gingival index correlated (r=0.260, p<0.05 at baseline and r=0.354, p<0.01 at the end of the study). Intergroup differences or correlations with other clinical parameters were not found. Probiotic consumption did not affect the saliva flow rate.ConclusionsIncreased MMP-9 and decreased TIMP-1 levels in saliva may indicate that probiotics have immunomodulatory effects in the oral cavity. Furthermore, increased salivary MMP-9 levels may be an indication of the defensive potential of matrix metalloproteinases.



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Reactivation of peroxidase activity in human saliva samples by polyphenols

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Jana Gau, Jürgen Arnhold, Jörg Flemmig
ObjectivesThe enzyme lactoperoxidase (LPO), which is released into several body fluids like saliva, is an essential part to maintain the oral bacterial homeostasis by catalysing the oxidation of thiocyanate (SCN⁻) to hypo-thiocyanite (⁻OSCN). The formation of unreactive redox intermediates (like Compound II) leads to a decreased pseudo-halogenating enzyme activity, which is associated with a higher risk for oral infections. According to former studies with bovine LPO selected flavonoids were tested in respect to their potential to reactivate the enzymatic activity in a more physiological, human salivary system.DesignSaliva samples from healthy donors were collected and characterized by using several gel staining methods and immunoblotting. Afterwards kinetic measurements were performed by applying the TNB-assay to evaluate the pseudo-halogenating salivary peroxidase (SAPX) activity. The measurements were performed in the presence of excess H2O2 to simulate pro-inflammatory conditions. Moreover selected flavonoids or an ethanolic extract of Tormentillae rhizoma were applied to test their regenerating effect on the LPO-derived ⁻OSCN production.ResultsDespite the complex protein composition of the collected saliva samples, an SAPX-derived pseudo-halogenating activity could be identified. The ⁻OSCN regenerating effects of the tested polyphenols were completely comparable to previous in vitro experiments with bovine LPO. Thus, we could show that phenolic substances are suitable to regenerate the peroxidase activity in human saliva samples after H2O2-induced inactivation.ConclusionThe studies provide new insights into the effect of pharmaceutical relevant polyphenols on salivary peroxidase activity and thus, suggest this enzyme as a new target for the prevention and therapy of oral inflammatory diseases.



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Juvenile Nasopharyngeal Angiofibroma: Our Experience in a Tertiary Hospital

Abstract

Nasopharyngeal angiofibroma is a highly vascular tumor seen typically in young adolescent males. It is an uncommon tumor accounting for less than 0.5% of all head and neck tumors. This peculiar tumor is thought to arise from the area of the sphenopalatine foramen and it classically presents with progressive nasal obstruction and epistaxis. This is a retrospective study of angiofibroma treated at our hospital over 3 years. The study discusses about clinical features, management options and the role of embolization in reducing the intra-operative blood loss.

http://ift.tt/2A0KTR4

Sentinel Node Biopsy for High-Risk Squamous Cell Carcinoma

Reuters Health Information

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Probiotics Mix May Curb Atopic Dermatitis Severity, Topical Steroid Use in Young People

An oral probiotic formulation may reduce both atopic dermatitis severity and use of topical steroids to treat it in young people with moderate disease, researchers say.
Reuters Health Information

http://ift.tt/2zcoUaa

Juvenile Nasopharyngeal Angiofibroma: Our Experience in a Tertiary Hospital

Abstract

Nasopharyngeal angiofibroma is a highly vascular tumor seen typically in young adolescent males. It is an uncommon tumor accounting for less than 0.5% of all head and neck tumors. This peculiar tumor is thought to arise from the area of the sphenopalatine foramen and it classically presents with progressive nasal obstruction and epistaxis. This is a retrospective study of angiofibroma treated at our hospital over 3 years. The study discusses about clinical features, management options and the role of embolization in reducing the intra-operative blood loss.

http://ift.tt/2A0KTR4

Geographic Distribution of Nonphysicians Who Billed Medicare for Dermatologic Services

This study uses Medicare and US Census data to discover which dermatology-related services are independently billed by nonphysician clinicians treating Medicare beneficiaries, and where these clinicians are located.

http://ift.tt/2jRq9ox

Hair Repigmentation With Anti–PD-1 and Anti–PD-L1 Immunotherapy—Reply

In Reply We read with interest the letter by Manson et al. They describe another case of hair repigmentation (HR) in a male patient with concomitant advanced colorectal cancer and Hodgkin lymphoma treated with nivolumab and showing a good response. Interestingly, this new case seems to support the association between a good response and HR.

http://ift.tt/2hU43AZ

Hair Repigmentation With Anti–PD-1 and Anti–PD-L1 Immunotherapy

To the Editor We read with great interest the article by Rivera and colleagues reporting on hair repigmentation in patients receiving immunotherapy with anti–programmed cell death 1 (PD-1) and anti–programmed cell death 1 ligand 1 (PD-L1) immunotherapy.

http://ift.tt/2jMSX1k

Reticular Hyperpigmented Eruption in a Young Woman

A woman in her 20s was seen with a 6-year history of recurrent, pruritic skin eruptions involving the middle and lower back. Physical examination showed several discrete, erythematous, scaly papules admixed with light brown reticulated macules and patches. What is your diagnosis?

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Hair Repigmentation With Anti–PD-1 and Anti–PD-L1 Immunotherapy

To the Editor The article by Rivera et al is the first report of a previously undescribed side effect of checkpoint inhibitors: hair repigmentation (HR). In this significant case series of 14 patients, all patients received an anti–programmed cell death 1 (PD-1) and anti–programmed cell death 1 ligand 1 (PD-L1) antibody for the treatment of a lung cancer.

http://ift.tt/2jQsHTx

Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients

This cohort study addresses whether current skin surveillance intervals and threshold for biopsy of suspicious lesions are adequate for the increased tendency of solid organ transplant recipients to develop potentially aggressive cutaneous squamous cell carcinomas.

http://ift.tt/2hW3C9v

Treatment of Refractory Mycosis Fungoides With Brentuximab Vedotin

This case report describes the treatment of CD30-negative refractory mycosis fungoides with brentuximab vedotin.

http://ift.tt/2jMkkZj

Worsening Respiratory Distress in a 7-Month-Old Infant

A 7-month-old male presented with noisy breathing; he fed poorly from the bottle with frequent choking, grunting, and irritability; nasopharyngolaryngoscopy showed no laryngomalacia, laryngeal lesions, or cord paralysis. What is your diagnosis?

http://ift.tt/2B3BWmI

Hearing Difficulty in the United States

This survey study analyzes the epidemiologic features and treatment patterns of hearing difficulty in the United States using data from responses from the 2014 National Health Interview Survey.

http://ift.tt/2iIC3NO

Association of Neurocognitive Decline Treated With Radiotherapy or Chemoradiotherapy for Head and Neck Cancer

This prospective, longitudinal study assesses objective neurocognitive function before and after definitive radiation therapy for patients with head and neck cancer.

http://ift.tt/2B3da6o

First-Generation Deescalation Trials in HPV-Positive Oropharyngeal Cancer

This Viewpoint discusses the limitations of precision medicine in patients with human papillomavirus–positive oropharyngeal cancer.

http://ift.tt/2iH0LhL

Thyroid High-Impact Articles

FREE ACCESS through December 5, 2017.
Read now:

Latest Impact Factor: 5.515
The Official Journal of: American Thyroid Association

Reintroducing the Sodium-Iodide Symporter to Anaplastic Thyroid Carcinoma
Kathrin A. Schmohl, Patrick Dolp, Christina Schug, Kerstin Knoop, Kathrin Klutz, Nathalie Schwenk, Peter Bartenstein, Peter J. Nelson, Manfred Ogris, Ernst Wagner, Christine Spitzweg  

Pathologic Reporting of Tall-Cell Variant of Papillary Thyroid Cancer: Have We Reached a Consensus?
Juan C. Hernandez-Prera, Rosalie A. Machado, Sylvia L. Asa, Zubair Baloch, William C. Faquin, Ronald Ghossein, Virginia A. LiVolsi, Ricardo V. Lloyd, Ozgur Mete, Yuri E. Nikiforov, Raja R. Seethala, Saul Suster, Lester D. Thompson, Andrew T. Turk, Peter M. Sadow, Mark L. Urken, Bruce M. Wenig  

Risk Stratification of Thyroid Nodules on Ultrasonography: Current Status and Perspectives
Eun Ju Ha, Jung Hwan Baek, Dong Gyu Na  

Founder Effect of the RETC^611Y Mutation in Multiple Endocrine Neoplasia 2A in Denmark: A Nationwide Study
Jes Sloth Mathiesen, Jens Peter Kroustrup, Peter Vestergaard, Kirstine Stochholm, Per Løgstrup Poulsen, Åse Krogh Rasmussen, Ulla Feldt-Rasmussen, Mette Gaustadnes, Torben Falck Ørntoft, Maria Rossing, Finn Cilius Nielsen, Anders Albrechtsen, Kim Brixen, Christian Godballe, Anja Lisbeth Frederiksen  

 

The post <i>Thyroid</i> High-Impact Articles appeared first on American Thyroid Association.

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A Prospective Study of Apatinib Plus Concurrent Neoadjuvant Chemoradiotherapy for Siewert II ，III of Locally Advanced HER-2 Negative Adenocarcinoma at Gastroesophageal Junction

Condition:   Gastroesophageal Junction Adenocarcinoma
Intervention:   Combination Product: apatinib XELOX radiotherapy
Sponsor:   Hebei Medical University
Not yet recruiting

http://ift.tt/2zsRxjH

Efficacy of rTMS and VCT on Upper Limb Function in Patients With Stroke

Condition:   Cerebral Vascular Accident
Interventions:   Device: intermittent theta burst stimulation;   Device: continuous theta burst stimulation;   Device: iTBS+cTBS group;   Device: sham theta burst stimulation;   Device: VCT;   Device: VCT+optimal rTMS group
Sponsors:   Chang Gung Memorial Hospital;   Ministry of Science and Technology, Taiwan
Recruiting

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The properdin pathway: an “alternative activation pathway” or a “critical amplification loop” for C3 and C5 activation?

Abstract

This review is not intended to cover in detail all aspects of the discovery and evolution of our understanding of the "alternative pathway" of complement activation, there are many excellent reviews that do this (see Fearon (CRC Crit Rev Immunol 1:1–32, 1979), Pangburn and Müller-Eberhard (Springer Semin Immunopathol 7:163–192, 1984)), but instead to give sufficient background for current concepts to be put in context. The prevailing textbook view, of components having a primary role as an alternative "pathway" for C3 activation, is challenged, with an argument developed for the primary role of the system being that of providing a surface-dependent amplification loop for both C3 and C5 activation. Whatever the mechanism by which the initial C3b molecule is generated, deposition onto a surface has the potential to target that surface for elimination. Elimination or escape from initial targeting is determined by a sophisticated and highly regulated amplification loop for C3 activation. This viewpoint of the system is then briefly developed to provide a context for therapeutic treatment of disease caused, at least in part, by dysregulated amplification of C3 activation, and to highlight some of the challenges that such therapies will face and need to address.

http://ift.tt/2BduB51

Safety of transtympanic application of probiotics in a chinchilla animal model

Abstract

Background

Chronic suppurative otitis media can be recalcitrant and difficult to treat, particularly with the increasing occurrence of antibiotic resistance. Lactobacillus plantarum is a probiotic that has been shown to decrease S. aureus and P. aeruginosa growth in wounds, making it a good candidate for the treatment of chronic suppurative otitis media. However, before it can be applied in the ear, its ototoxicity potential must be evaluated.

Methods

A prospective controlled trial was conducted in a chinchilla animal model at the Animal care research facilities of the Montreal Children's Hospital Research Institute to determine whether Lactobacillus plantarum is ototoxic when applied transtympanically. Ten chinchillas each had one ear randomly assigned to receive 10⁹ CFU/mL of Lactobacillus plantarum solution, while the contralateral ear received saline. Auditory brainstem responses were measured bilaterally at 8, 20, 25 kHz before, at 7–10 days after application, and at 28 days after application of probiotic or saline. Facial nerve and vestibular function were assessed clinically.

Results

There were no statistically significant differences in hearing thresholds between control and experimental ears at 28 days after application. A difference of 11 dB was noted in the 25 kHz range at day 7–10, but resolved by day 28. No animals receiving probiotics developed vestibular nerve dysfunction. There was no histologic evidence of auditory hair cell damaged evidenced by scanning electron microscopy.

Conclusion

Our study suggests that a single application of Lactobacillus plantarum at 10⁹ CFU/mL does not cause ototoxicity in a chinchilla animal model. These preliminary safety evaluations and the pathogen inhibitory effects of L. plantarum demonstrated by previous studies present this probiotic as a candidate of interest for further investigation.

http://ift.tt/2zcH7QF

Nerve injury associated with high-intensity focused ultrasound: A case report

Summary

Skin laxity is a common cosmetic concern in middle-aged women. High-intensity focused ultrasound (HIFU) is one of noninvasive modalities that provides safe and effective improvement in skin laxity and tightening with minimal adverse effects. Concerning an extensive use of HIFU for facial rejuvenation, dermatologists should be aware of potential adverse effects of HIFU treatment. We herein present a case of 33-year-old Thai female with facial nerve injury after HIFU treatment for skin laxity.

http://ift.tt/2jfXfdB

Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients

Background

Abnormal nasal aerodynamics or trigeminal functions have been frequently implicated in the symptomology of empty nose syndrome (ENS), yet with limited evidence.

Methods

Individual computed tomography (CT)-based computational fluid dynamics (CFD) was applied to 27 ENS patients to simulate their nasal aerodynamics and compared with 42 healthy controls. Patients' symptoms were confirmed with Empty Nose Syndrome 6-item Questionnaire (ENS6Q), 22-item Sino-Nasal Outcome Test (SNOT-22), and Nasal Obstruction Symptom Evaluation (NOSE) scores. Nasal trigeminal sensitivity was measured with menthol lateralization detection thresholds (LDTs).

Results

ENS patients had significantly lower (∼25.7%) nasal resistance and higher (∼2.8 times) cross-sectional areas compared to healthy controls (both p < 0.001). Despite inferior turbinate reductions, CFD analysis demonstrated that ENS patients had increased airflow concentrated in the middle meatus region (66.5% ± 18.3%) compared to healthy controls (49.9% ± 15.1%, p < 0.0001). Significantly less airflow (25.8% ± 17.6%) and lower peak wall shear stress (WSS) (0.58 ± 0.24 Pa) were found in the inferior meatus (vs healthy: 36.5% ± 15.9%; 1.18 ± 0.81 Pa, both p < 0.05), with the latter significantly correlated with the symptom scores of ENS6Q (r = −0.398, p = 0.003). Item-wise, complaints of "suffocation" and "nose feels too open" were also found to be significantly correlated with peak WSS around the inferior turbinate (r = −0.295, p = 0.031; and r = −0.388, p = 0.004, respectively). These correlations were all negative, indicating that less air-mucosal stimulations resulted in worse symptom scores. ENS patients (n = 12) also had impaired menthol LDT when compared to healthy controls (p < 0.0001).

Conclusion

This is the first CFD examination of nasal aerodynamics in a large cohort of ENS patients. The results indicated that a combination of loss of neural sensitivity and poorer inferior air-mucosal stimulation may potentially lead to ENS symptomology.

http://ift.tt/2zreMua

Adaptation and validation of the Turkish version of the Nasal Obstruction Symptom Evaluation scale

Background

The Nasal Obstruction Symptom Evaluation (NOSE) scale is a questionnaire used to assess the quality of life in patients with nasal obstruction. The aim of this study was to validate the Turkish translation of the NOSE questionnaire.

Methods

The NOSE questionnaire was translated into Turkish and then back to English. Fifty patients with septal deviation leading to nasal obstruction and 50 healthy subjects without any nasal complaints and pathologies were recruited into the study. The Cronbach α was used to test internal consistency. The Mann-Whitney U test was used to compare the NOSE scores of the 2 groups. Psychosomatic features (reliability, repeatability, validity, responding) were evaluated by concerning the criteria as test-retest procedure, self consistency, within-score and inter-score correlation and sensitivity of responding between the 2 groups.

Results

There was no statistically significant difference between patients and healthy subjects in terms of age, gender, and body mass index. Test-retest results among control subjects also did not demonstrate significant difference and the Cronbach α value of the NOSE scale was found to be 0.966. There was a positive correlation among every question of the NOSE scale and it was statistically significantly different from the control group. Total scores of the NOSE scale were significantly higher than the control group.

Conclusion

The Turkish version of the NOSE scale is a valid tool for assessing patients with septal deviation and measuring the subjective severity of nasal obstruction.

http://ift.tt/2mT0i0f

Treatment of severe drug reactions by hemodialysis

Abstract

Background

Extracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions.

Methods

Here, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction.

Results

In the cases of severe cutaneous drug reactions reviewed, patients presented with linear immunoglobulin A bullous dermatosis, acute generalized exanthematous pustulosis, and toxic epidermal necrolysis. Salvage treatment with hemodialysis therapy drastically influenced the course of disease, resulting in remission.

Conclusions

This novel and highly effective treatment option is not considered in current algorithms for adverse drug reactions. Hence, in addition to the rarity of these reactions, the main limitation of the study is the small number of patients. Hemodialysis can substantially alter the prognosis and, in some cases, be a lifesaving treatment for patients with severe adverse cutaneous drug reaction associated with systemic toxicity.

http://ift.tt/2Al29AU

Rust-colored patches on the lower extremities: lichen aureus

http://ift.tt/2zY0PU5

Congenital unilateral reticulate keratotic papules on the lower extremity

http://ift.tt/2AnsZso

Juvenile xanthogranuloma with angiomatous appearance and a peculiar immunophenotype

Abstract

Juvenile xanthogranuloma is the most common form of non-Langerhans cell histiocytosis in childhood. The clinical differential diagnosis of a solitary juvenile xanthogranuloma includes molluscum contagiosum, Spitz nevus, and melanoma. Lesions larger than 2 cm in diameter may be misdiagnosed as hemangiomas, but this is not typical of smaller juvenile xanthogranuloma. We report a case of solitary juvenile xanthogranuloma in a 10-year-old boy with angiomatous appearance and peculiar immunophenotype.

http://ift.tt/2AnlBgs

Discordance of pediatric morphea treatment by pediatric dermatologists

Abstract

Background/Objectives

Studies describing treatment efficacy in pediatric morphea are lacking. Subspecialists have reached no consensus on how to optimally treat pediatric morphea. The objective of the current study was to describe the most common treatment practices of pediatric dermatologists worldwide who care for children with morphea.

Methods

A survey regarding topical treatment practices of pediatric morphea, with representative case-based scenarios, was distributed to pediatric dermatologists and results were tallied.

Results

The survey response rate was 13.4%, with 110 respondents in the final analysis. The majority of respondents agreed on red violaceous rim (99%), increased local warmth (75%), raised borders (69%), and dermal thickening (64%) as signs of disease activity. Respondents had less agreement on sclerotic lesions (41%), scaling (43%), dyspigmentation (19%), and atrophy (13%) as signs of disease activity. Ninety-two percent of respondents used primary therapy or monotherapy with topical medications, including 45% in linear morphea of the limbs and 37% in linear morphea of the head or neck. High-potency topical corticosteroids were most commonly used (80%), although respondents did not agree on specific regimens. Sixteen different treatment regimens were selected as first-line therapy for one case scenario of active disease.

Conclusion

The survey found large variation in how pediatric dermatologists treat pediatric morphea. Consensus treatment guidelines developed by pediatric dermatologists and pediatric rheumatologists are urgently needed regarding the efficacy of therapies for pediatric morphea. Prospective studies of treatment efficacy in pediatric morphea are urgently needed as well.

http://ift.tt/2zX13L8

Morbihan disease treated with Tripterygium wilfordii successfully

http://ift.tt/2zYj5ge

International Bullous Diseases Group - Consensus on Diagnostic Criteria for Epidermolysis Bullosa Acquisita

Summary

Background

Epidermolysis bullosa acquisita (EBA) is a complex autoimmune bullous disease disease with variable clinical presentations and multiple possible diagnostic tests making an international consensus on diagnosis of EBA needed.

Objectives

To obtain an international consensus on the clinical and diagnostic criteria for EBA.

Methods

The international bullous diseases group (IBDG) met three times to discuss the clinical and diagnostic criteria for EBA. For the final voting exercise, 22 experts from 14 different countries voted on 50 different items. When more than 30% disagreed with a proposal, a discussion was held and revoting occurred.

Results

48/50 proposals achieved consensus after discussion. This included 9 diagnostic criteria that are summarized in a flow chart. The IBDG was unable to determine one procedure which would be applicable worldwide.

Limitations

Differential diagnosis of bullous systemic lupus erythematosus has not been addressed.

Conclusion

This first international consensus conference established generally agreed upon clinical and laboratory criteria defining the clinical classification and diagnostic testing for EBA. Holding these voting exercises in person with the possibility of discussion prior to voting has advantages in reaching consensus over Delphi exercises with remote voting.

This article is protected by copyright. All rights reserved.

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Double-blind placebo-controlled trial of the effect of omalizumab on basophils in chronic urticaria patients

Abstract

Background

Omalizumab has been shown to be effective in treating chronic spontaneous urticaria (CSU). The reduction of FcεRI receptor density on the surface of basophils and mast cells is thought to play a major role in its effectiveness. We conducted a double-blind, randomized, placebo-controlled trial to investigate the mode of action of omalizumab in patients with antihistamine-resistant CSU.

Methods

Thirty patients were randomized in a 2:1 ratio to receive either 300 mg omalizumab or placebo. Four monthly applications of omalizumab/placebo were followed up with a visit 2 months after the last injection. The primary endpoint was the FcεRI receptor density change on basophils.

Results

Omalizumab led to a significant reduction of FcεRI receptor density on

basophils as soon as 1 week after the first injection: baseline omalizumab vs. placebo group, 80.31 ± 47.18x10³ vs. 78.29 ± 45.09x10³ receptors/basophil ± SD; 1 week, 72.89 ± 47.79x10³ vs. 27.83 ± 20.87x10³, p=0.001. This effect continued during the treatment phase and persisted for 2 months after the last injection: 93.81 ± 56.50x10³ vs. 21.09 ± 15.23x10³, p=0.002. Values for basophil "releasability" and the basophil activation test (CU-BAT) of patient serum using donor basophils were unchanged despite treatment: CU-BAT, CD63 10.75% (7.35) in the placebo group vs. 8.35% (15.20) in the omalizumab group, p=0.778.

Conclusion

We demonstrated a rapid reduction of FcεRI receptor density on basophils following treatment with omalizumab. Because CU-BAT using well-characterized, omalizumab-naïve donor basophils did not change during the treatment phase, autoreactive serum factors seem to remain unaltered. This points towards a cellular effect of omalizumab on basophils. To predict the omalizumab response time and to monitor disease, FcεRI density and CU-BAT might be promising cellular-based assays.

This article is protected by copyright. All rights reserved.

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