Thyroid, Ahead of Print.
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Παρασκευή 30 Νοεμβρίου 2018
Levothyroxine Replacement Therapy and Overuse: A Timely Diagnostic Approach
Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recession defects in dogs
Abstract
Objectives
The potential additive effect of an enamel matrix derivative (EMD) to a subepithelial connective tissue graft (CTG) for recession coverage is still controversially discussed. Therefore, the aim of this study was to histologically evaluate the healing of gingival recessions treated with coronally advanced flap (CAF) and CTG with or without EMD in dogs.
Materials and methods
Gingival recession defects (5 mm wide and 7 mm deep) were surgically created on the labial side of bilateral maxillary canines in 7 dogs. After 8 weeks of plaque accumulation and subsequent 2 weeks of chemical plaque control, the 14 chronic defects were randomized to receive either CAF with CTG (CAF/CTG) or CAF with CTG and EMD (CAF/CTG/EMD). The animals were sacrificed 10 weeks after reconstructive surgery for histologic evaluation.
Results
Treatment with CAF/CTG/EMD demonstrated statistically significantly better results in terms of probing pocket depth reduction (P < 0.05) and clinical attachment level gain (P < 0.001). The length of the epithelium was statistically significantly shorter in the CAF/CTG/EMD group than in the CAF/CTG group (1.00 ± 0.75 mm vs. 2.38 ± 1.48 mm, respectively, P < 0.01). Cementum formation was statistically significantly greater in the CAF/CTG/EMD group than following treatment with the CAF/CTG group (3.20 ± 0.89 mm vs. 1.88 ± 1.58 mm, respectively, P < 0.01). The CAF/CTG/EMD group showed statistically significantly greater complete periodontal regeneration (i.e., new cementum, new periodontal ligament, and new bone) than treatment with CAF/CTG (0.54 ± 0.73 mm vs. 0.07 ± 0.27 mm, respectively, P < 0.05).
Conclusion
Within their limits, the present findings indicate that the additional use of EMD in conjunction with CAF + CTG favors periodontal regeneration in gingival recession defects.
Clinical relevance
The present findings support the use of EMD combined with CTG and CAF for promoting periodontal regeneration in isolated gingival recession defects.
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The South Asian Facial Anthropometric Profile: A Systematic Review
Craniofacial anatomy, as measured by facial anthropometric data, varies significantly between races. South Asia, comprised of eight countries, represents a large proportion of the global population and is the fastest-growing region of the world. This systematic review presents the facial anthropometric data collected for populations from this region.
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Semiautomatic device for in vitro/ experimental bone perforation in dental implant research
The present study presents a semiautomatic device developed to perform in vitro experiments using surgical drills for assisting dental implant research. It was built to perform tests independent of human direct contact, and contains an adjustable toolholder for engaging different types of implant contra angle hand pieces, in which different drills can be adapted. The researcher is able to make a range of adjustments on the machine, such as controlling the drilling force and depth.
https://ift.tt/2FZGDpg
Distinct transcriptomic profiles of early-onset atopic dermatitis in blood and skin of pediatric patients
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. The pipeline of novel targeted treatments for AD is expanding, largely based on our growing knowledge of disease mechanisms, with new therapeutics particularly focused on immune modulation.1 Most of our understanding of AD is derived from profiling tissues and blood of longstanding AD in adults, due to the difficulty of obtaining samples from infants and young children. However, initiation of AD typically happens very early in life, and the disease is already chronically established in the majority of patients by 5yrs of age.
https://ift.tt/2KKrFC9
Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients
Severe exacerbations are well-known complications of asthma, which increase the total and asthma-related health care costs1 and decrease the quality of life of patients2. Although some exacerbation predictors have been reported3,4, it is difficult to predict and prevent severe exacerbations in a large percentage of patients affected by asthma.
https://ift.tt/2BI6IVo
Foreign bodies in the ear, nose, and throat in Japan: association with sociocultural and geographical conditions
Foreign bodies (FBs) in ear, nose, and throat (ENT) are common ENT emergencies but are sometimes life-threatening. However, FBs could be avoidable by the efficient announcement about the risk of these occurrence to the public. Fish bones are commonly found as throat FBs, and small toys are commonly found as pediatric ear and nose FBs. We hypothesized that there were relationships between the occurrence of FBs and sociocultural/geographical conditions. The purpose of this study is to clarify the risk factors of FBs in ENT regions related to eating customs and weather conditions.
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Changes in the clinical and histological characteristics of Chinese chronic rhinosinusitis with nasal polyps over 11 years
Background
Traditionally, it was believed that chronic rhinosinusitis with nasal polyps (CRSwNP) demonstrated less eosinophilic and more neutrophilic inflammation in China compared to North America and Europe. However, inflammatory patterns may change over time. The study aimed to analyze the changing trends in the clinical and histological characteristics of CRSwNP over time in China.
Methods
A total of 115 consecutive CRSwNP patients from 2003 to 2005 and 114 consecutive CRSwNP patients from 2014 to 2016 were enrolled in this retrospective study. The clinical and histological data were compared between patients from the 2 time periods.
Results
The percentage of eosinophils in nasal polyp tissue increased, and the percentage of neutrophils and total inflammatory cell count decreased, over 11 years. The proportion of eosinophilic CRSwNP significantly increased from 59.1% to 73.7% over 11 years. The proportion of neutrophils and the total inflammatory cell count in nasal polyps decreased, and the proportion of eosinophilic CRSwNP patients using intranasal corticosteroids 1 month before surgery increased remarkably over 11 years. Moreover, eosinophilic CRSwNP patients had better compliance with intranasal corticosteroid use than non‐eosinophilic CRSwNP patients, and patients with comorbid allergic rhinitis and asthma had better compliance with intranasal corticosteroid use than patients without those conditions.
Conclusion
Eosinophilic CRSwNP, which was previously a minor subtype in East Asians, has increased remarkably in incidence to become the predominant CRSwNP subtype in Beijing, China, indicating that rhinologists should place greater emphasis on its diagnosis and treatment.
https://ift.tt/2SkgySU
Optic neuritis following diphtheria, tetanus, pertussis, and inactivated poliovirus combined vaccination: a case report
Diphtheria, tetanus, pertussis, and inactivated poliovirus combined vaccine is widely used in young children as part of a series of immunizations before they start attending school. Case studies of demyelinati...
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Efficacy and Safety of a Water-Based Head Lice Lotion: A Randomized, Controlled, Investigator-Blinded, Comparative, Bicentric Study
Abstract
Introduction
Silicones (e.g., dimethicone) are effective and safe alternatives to insecticides for the treatment of head lice. However, silicones are lipophilic substances and do not only leave the hair greasy but they are also difficult to wash out. We have evaluated the efficacy and safety of a potential solution to this problem: an aqueous dispersion of a novel silylated polyol that has the same mode of action as dimethicone (suffocation) without its negative impact on hair characteristics.
Methods
This was a randomized, controlled, investigator-blinded, bicentric study that was conducted at two locations in the state of Florida (USA) to compare the test product (medical device) to a pyrethrum-based pediculicide that is a first-line, prescription-free treatment against head lice in the USA. The subjects (n = 70) were randomly divided into two groups of 35 persons (test product group and reference product group), with each participant receiving two applications (day 0 and 7) of the product to be tested, according to the instructions for use. Efficacy and safety was evaluated at distinct time points. The primary objective was to establish a cure rate for the test product that was better than 70% at study end (day 10). Esthetic effects of the test product versus dimethicone were evaluated in a blinded, cross-over consumer study (n = 100).
Results
At study end, the cure rate (corrected for re-infestation) of 88.2% with the test product significantly surpassed the pre-defined target of 70%, and thus the superiority of the test product versus the reference product was confirmed. The number of subjects cured (free of head lice) after the first treatment was remarkably higher with the test product than with the reference product (57.1 vs. 2.9%, respectively). Both products were safe and well tolerated and both showed beneficial esthetical effects. The consumer test demonstrated that the test product had better washing-out properties than dimethicone, as reflected by a significantly lower average rinsing time and number of washings required to restore the visual aspect of the hair, especially in terms of greasiness.
Conclusion
Aqueous dispersions of silylated polyols are a promising new class of pediculicides that combine high cure rates with optimal user convenience (short treatment period, easy wash-out with positive effect on hair quality).
Trial Registration
ClinicalTrials.gov identifier, NCT03617926.
Funding
Oystershell Laboratories.
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A rare presentation of a paediatric sinonasal inverted papilloma
Abstract
Sinonasal inverted papilloma (IP) is a benign tumour with an extremely low incidence in children. We report the case of an 11-year-old Caucasian male presenting with recurrent right-sided epistaxis, nasal obstruction and a mass in the right nasal cavity. An initial diagnosis of a nasopharyngeal angiofibroma was considered; however, on detailed histological examination, the mass was found to be an inverted papilloma. This report aims to increase awareness of IP in the paediatric age group, as well as reinforcing the role of endoscopic surgery in the management of this condition.https://ift.tt/2DUXRS1
Brunner’s gland hyperplasia: an unusual duodenal submucosal lesion seen in four patients
Abstract
Brunner's gland hyperplasia is an extremely rare benign hamartomatous lesion seen in proximal duodenum. Difficulty in diagnosing the condition pre-operatively puts the surgeon in dilemma for deciding appropriate management. We retrieved details from prospectively maintained retrospective data from January 2014 to April 2018. Four patients were identified of which three were males and one was female. Symptoms ranged from 4 days to 4 years, with abdominal pain, vomiting and malena being predominant. No patients were identified with diagnosis pre-operatively. Diagnosis was made on histopathological examination of the resected specimen and none of them were having malignant features. At a median follow up of 11 months, no patient had recurrence and were symptom free. Brunner's gland hyperplasia is a rare elusive duodenal pathology, symptomatically mimicking alarming duodenal lesions and mostly diagnosed on histopathology of specimen. Patients may harbour the lesion for long periods with little symptoms and upon treatment have good outcomes.https://ift.tt/2Qv60TE
Minimally invasive drainage of a giant ovarian mucinous cystadenoma associated with a mature cystic teratoma
Abstract
A 26-year-old, otherwise healthy female presented to the Emergency Room for the evaluation of abdominal pain. It was immediately apparent that she had a massively distended abdomen. History revealed progressive abdominal distension over several years. Evaluation for pregnancy was negative and a computed tomography (CT) scan demonstrated a 38 × 32 × 23 cm septated cystic mass. Careful controlled partial needle decompression of the cyst, removing 18.5 l of fluid, was followed by a mini-laparotomy with complete removal of a multi-loculated cystic ovarian mass approximately 45 lb in weight. Pathology was consistent with mucinous cystadenoma of the ovary in association with a mature cystic teratoma. This surgical technique of percutaneous drainage of the cyst, followed by mini-laparotomy is a valuable example of a safe and effective minimally invasive treatment modality for giant ovarian mucinous cystadenomas.https://ift.tt/2DQ62yG
Histologic Improvements in Irradiated Bone Through Pharmaceutical Intervention in Mandibular Distraction Osteogenesis
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): Kevin M. Urlaub, Jeremy V. Lynn, Edward G. Carey, Noah S. Nelson, Yekaterina Polyatskaya, Alexis Donneys, Amanda C. Mazzoli, Steven R. Buchman
Purpose
Despite the relative surgical ease and reduced donor-site morbidity of distraction osteogenesis (DO) in comparison with free tissue transfer, DO is currently precluded as a reconstructive option for head and neck cancer (HNC) patients because of the destructive effects of radiotherapy (XRT). This study investigates the ability of a novel combined therapy (CT) of radioprotective amifostine (AMF) and angiogenic deferoxamine (DFO) to mitigate XRT-induced bone injury in a murine model of DO.
Materials and Methods
Thirty male Sprague-Dawley rats were divided into 5 groups: DO (primary control), XRT (secondary control), AMF, DFO, and CT. With the exclusion of the DO group, all rats were administered a fractionated, human-equivalent XRT dose of 35 Gy, comparable with 70 Gy administered to HNC patients clinically. All groups underwent mandibular osteotomy and distraction to 5.1 mm. After euthanasia administration on postoperative day 40, the mandibles were sectioned and stained with Gomori trichrome. Osteocyte number, bone volume, and osteoid volume were compared between all groups by analysis of variance (P < .05).
Results
All rats survived and were included in the final analysis. The XRT group exhibited substantial bone injury, evidenced by a decreased osteocyte number and bone volume, as well as an increase in immature osteoid volume, compared with DO controls. The AMF, DFO, and CT groups showed significant increases in osteocyte proliferation compared with the XRT group and were not statistically different from the DO group. Notably, the CT group showed remediation of XRT-induced impairment of bone maturation and exhibited significantly greater bone volume and reduced osteoid volume in comparison with all groups.
Conclusions
Combined AMF and DFO treatment showed the capacity to remediate the deleterious effects of XRT, restore cellularity to nonirradiated levels, and surpass all groups in mature bone formation. Although further investigations of AMF and DFO are warranted, this study provides preliminary support for the potential use of DO in HNC patients through pharmaceutical facilitation of irradiated bone healing.
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Is There a Difference in Orbital Volume Between Affected and Unaffected Sides in Patients With Unilateral Craniofacial Microsomia?
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): Maria N. Gribova, Britt I. Pluijmers, Cory M. Resnick, Cornelia J.J.M. Caron, Alessandro Borghi, Maarten J. Koudstaal, Bonnie L. Padwa
Purpose
Craniofacial microsomia (CFM) is characterized by malformations of structures derived from the first and second pharyngeal arches. The orbit is variably affected. The purpose of this study was to determine whether there is a difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. The specific aims were to 1) measure orbital volume, 2) compare affected and unaffected sides, 3) evaluate the correlation between clinical evaluation of orbital size and volumetric measurement, and 4) determine whether there is a correlation between orbital volume and severity of mandibular deformity.
Materials and Methods
This study is a retrospective case series of patients with unilateral CFM from Boston Children's Hospital (Boston, MA) who had a computed tomographic (CT) scan. Manual segmentation of the orbit using Mimics software (Materialise, Leuven, Belgium) was performed on CT images of the 2 orbits. The predictor variable was laterality (affected vs unaffected side) and the primary outcome variable was orbital volume. Wilcoxon signed rank test was used to compare these measurements and determine whether the affected side differed from the unaffected side. The correlation between orbital volume and Pruzansky-Kaban type of mandibular deformity, as documented in the medical record, was determined using the Spearman rank correlation coefficient.
Results
Thirty-nine patients were included. Orbital volume was 10% smaller on the affected side (P = .001) in 80% of patients. There was no correlation between orbital size and severity of mandibular involvement.
Conclusion
The results of this study showed a marked difference in orbital volume between affected and unaffected sides in patients with unilateral CFM. These differences were small and might not be clinically relevant. Orbital volume did not correlate with severity of mandibular deformity.
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Surgical Accuracy in Inferior Maxillary Reposition
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): Kasper Stokbro, Torben Thygesen
Purpose
Inferior maxillary repositioning is among the least stable and least predictable orthognathic procedures. The purpose of this study was to investigate whether posterior movement occurred with inferior maxillary repositioning and to analyze potential causes.
Materials and Methods
This retrospective observational study evaluated all consecutive patients treated at the Department of Oral and Maxillofacial Surgery of the Odense University Hospital (Odense, Denmark) with inferior maxillary repositioning from 2011 to 2013. The obtained repositioning was compared with the virtual surgical plan to determine surgical accuracy. Measurements were performed at 3 dental reference points. Linear and rotational measurements were performed along and around the right, anterior, and superior axes. Measurements were compared by paired t tests. Internal correlations and confounding variables were analyzed by mixed model regression analysis.
Results
Twenty patients were included for analysis. On average, the maxilla was positioned 1 mm posterior and 0.4 mm superior to the planned position. The virtual surgically planned reposition was statistically correlated with surgical accuracy. No other confounding variable influenced the outcome.
Conclusion
The correlation between planned advancement and inferior repositioning suggests that inferior repositioning destabilizes the maxillary position and that a perioperative or early postoperative relapse occurs in response to the advancement. This immediate relapse of 1 mm should be considered in the virtual surgical plan to ensure that the maxilla is placed closer to the desired position. Thus, this procedure could still benefit from increased surgical precision and stability based on technologic advancements, such as positioning guides or printed patient-specific plates.
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Use of Nasal Conformer After Birth Effectively Improves Nostril Symmetry in Patients With Unilateral Incomplete Cleft Lip
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): Spencer C.H. Kuo, Jui-Pin Lai, Ching-Hua Hsieh, Tzu-Ying Chen, Yu-Jen Chang, Faye Huang
Purpose
To investigate the clinical effects of preoperative nasoalveolar molding (NAM) and nasal conformer use in patients with unilateral incomplete cleft lip on the basis of their medical records and images.
Patients and Methods
Data and images of 16 patients born with unilateral incomplete cleft lip who were hospitalized between January 2015 and August 2017 were retrieved from the medical records. The primary outcome was the extent of improvement in columella height (CH) before cheiloplasty. Other outcome measurements included the CH, nostril width, and nostril height, which were measured by ImageJ image processing software (version 1.4; National Institutes of Health, Bethesda, MD) and presented as ratios. Mann-Whitney U tests were used to compare the non–normally distributed data.
Results
Patients in the NAM group and those in the nasal conformer group showed significantly improved (P < .05) preoperative cleft-side CH–to–normal-side CH ratios compared with the corresponding ratios at birth. There was no significant difference in terms of the extent of improvement in CH between the groups.
Conclusions
Preoperative use of nasal conformers in patients with unilateral incomplete cleft lip not only corrects the deformed nasal cartilage but also increases the CH and improves the overall preoperative nasal symmetry. In addition, compared with NAM, this method costs less, is more straightforward, and requires fewer outpatient clinic visits.
https://ift.tt/2Pc9mpR
A History of Orthognathic Surgery in North America
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): R. Bryan Bell
This review highlights the contributions of American oral and maxillofacial surgeons to the field of orthognathic surgery. The present state of the art and science of orthognathic surgery is the harvest of yesterday's innovation and research. An improved understanding of the biological and surgical principles and the routine involvement of orthodontics have fueled widespread adoption of a coordinated approach to the treatment of dentofacial problems. Technologic advances in rigid internal fixation, virtual surgical planning with computer-aided manufacturing of occlusal splints and cutting guides, custom implants, and worldwide interest in the correction of dentofacial and craniofacial deformities have resulted in highly predictable, efficient, and safe treatment, which scarcely resembles the situation 70 years ago.
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When Net Loss Threatens Safety Net Loss
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s): Thomas B. Dodson
https://ift.tt/2PbMhUv
AAOMS Author Disclosure forms
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s):
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Table of Contents
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s):
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Editorial Board Page
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s):
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Journal of Oral and Maxillofacial Surgery
Publication date: December 2018
Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 12
Author(s):
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Salvage laryngectomy following organ-preservation therapy – An evidence-based review
Publication date: January 2019
Source: Oral Oncology, Volume 88
Author(s): Dustin A. Silverman, Sidharth V. Puram, James W. Rocco, Matthew O. Old, Stephen Y. Kang
Abstract
Salvage total laryngectomy is often indicated in patients with recurrent or persistent laryngeal cancer after radiation or chemoradiation treatment. This article reviews and discusses key considerations regarding salvage laryngectomy. Within this article, a review of the salvage laryngectomy incidence in the major organ preservation trials, survival rates, predictors of outcomes, complication rates, and the roles of elective neck dissection and free tissue transfer for reconstruction in patients undergoing salvage laryngectomy is provided.
https://ift.tt/2AFEybN
Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases
Publication date: Available online 30 November 2018
Source: Auris Nasus Larynx
Author(s): Hiroshi Inui, Tsuyoshi Sakamoto, Taeko Ito, Tadashi Kitahara
Abstract
Objective
To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.
Methods
Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images.
Results
The cochlear ELS/total fluid space (TFS) volume ratio was 10.2 ± 6.7% (mean ± standard deviation) in the CS group, 12.1 ± 5.7% in ALHL patients, 15.2 ± 8.7% in SD patients, 18.1 ± 8.2% in cMD patients, and 21.9 ± 16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7 ± 10.2% in the CS group, 18.9 ± 8.3% in ALHL patients, 19.9 ± 11.3% in SD patients, 22.5 ± 13.7% in cMD patients, and 35.7 ± 24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS = ALHL < SD < cMD = uMD: p < 0.05 for CS vs. SD and p < 0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS = ALHL = SD = cMD < uMD: p < 0.01 for uMD vs. all other groups).
Conclusion
The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.
https://ift.tt/2Rl6fOp
Role of phosphorylcholine in Streptococcus pneumoniae and nontypeable Haemophilus influenzae adherence to epithelial cells
Publication date: Available online 29 November 2018
Source: Auris Nasus Larynx
Author(s): Hiroyuki Iuchi, Junichiro Ohori, Takayuki Kyutoku, Kotoko Ito, Yuichi Kurono
Abstract
Objective
Phosphorylcholine (PC) is a structural component of Streptococcus pneumoniae (Spn) and nontypeable Haemophilus influenzae (NTHi), and is known to be associated with adherence through the platelet activating factor receptor (PAF-R). Furthermore, high PC expression is considered to be involved in Spn and NTHi virulence. In this study, we examined the influence of PC expression on the adherence of Spn and NTHi to epithelial cells in order to clarify the potential effectiveness of a vaccine targeting PC.
Methods
Twenty-seven strains of Spn and twenty-two strains of NTHi were used, cultured overnight, and PC expression was evaluated by fluorescence activated cell sorting; the strains were divided into two groups: PC low expression (PC-low) and PC high expression (PC-high) groups. Bacterial adherence was then examined using Detroit 562 cells and BALB/c mice. Bacterial invasion was then examined in Detroit 562 cells.
Results
The adherence of Spn and NTHi and invasion of NTHi in the PC-high group was significantly reduced by pretreatment with a monoclonal anti-PC antibody (TEPC-15), PAF-R antagonist (ABT-491), and PC-keyhole limpet hemocyanin (PC-KLH). However, such findings were not observed in the PC-low group.
Conclusion
The present study suggests that PC is involved in the mucosal adhesion of Spn and NTHi, and the mucosal invasion of NTHi with PC-high strains, but not PC-low strains. These results suggest that a PC-targeting mucosal vaccine only affects PC-high Spn and NTHi strains and does not disturb commensal bacterial flora in the upper respiratory tract, which comprises nonpathogenic PC-low bacteria.
https://ift.tt/2Q0IH4G
Corrigendum to “Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study” [Auris Nasus Larynx 45 (2018) 1006–1013]
Publication date: Available online 29 November 2018
Source: Auris Nasus Larynx
Author(s): Hironobu Nishijima, Sayaka Suzuki, Kenji Kondo, Tatsuya Yamasoba, Shintaro Yanagimoto
https://ift.tt/2RuSehm
Klassifikation und Pathophysiologie von Angioödemen
Zusammenfassung
Hintergrund
Die differenzialdiagnostische Einordung von Angioödemen kann im klinischen Alltag eine Herausforderung darstellen.
Ziel der Arbeit
Ziel ist es, eine Übersicht über die aktuelle Klassifikation von Angioödemen zu geben und deren zugrunde liegende Pathophysiologie zu erläutern.
Material und Methoden
Es erfolgte die Auswertung aktueller Leitlinien und Forschungsarbeiten zur Pathophysiologie und Klassifikation von Angioödemen.
Ergebnisse
Angioödeme werden grundlegend in Mastzellmediator-induziert und Bradykinin-vermittelt unterschieden. Akute Angioödeme durch allergische Reaktionen oder im Rahmen einer akuten Urtikaria bzw. rezidivierende Angioödeme bei Patienten mit chronischer Urtikaria sind klassische Beispiele für Mastzellmediator-induzierte Angioödeme. Zu den Bradykinin-vermittelten Angioödemformen gehören das hereditäre Angioödem und das ACE(„angiotensin-converting enzyme")-Hemmer-induzierte Angioödem. Bradykinin-vermittelte Angioödeme kommen deutlich seltener vor als Mastzellmediator-induzierte Angioödeme und verlaufen of schwerer. Die Basis zur klinischen Unterscheidung beider Formen von Angioödemen ist die gezielte Anamneseerhebung und laborchemische Diagnostik.
Schlussfolgerungen
In den meisten Fällen lassen sich Angioödeme in Zusammenschau von Klinik und Diagnostik als Mastzellmediator-induziert oder Bradykinin-vermittelt unterscheiden. In sehr seltenen Fällen bleiben die Ursache und die verantwortlichen Mediatoren unklar.
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Large-Scale Otoscopic and Audiometric Population Assessment: A Pilot Study
Publication date: Available online 30 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Kenny H. Chan, Susan Dreith, Kristin M. Uhler, Veronica Tallo, Marilla Lucero, Joanne De Jesus, Eric AF. Simões
ABSTRACT
Objective
Large-scale otoscopic and audiometric assessment of populations is difficult due to logistic impracticalities, particularly in low- and middle-income countries (LMIC). We report a novel assessment methodology based on training local field workers, advances in audiometric testing equipment and cloud-based technology.
Methods
Prospective observational study in Bohol, Philippines. A U.S. otolaryngologist/audiologist team trained 5 local nurses on all procedures in a didactic and hands-on process. An operating otoscope (Welch-AllynR) was used to clear cerumen and view the tympanic membrane, images of which were recorded using a video otoscope (JedMedR). Subjects underwent tympanometry and distortion product otoacoustic emission (DPOAE) (Path SentieroR), and underwent screening audiometry using noise cancelling headphones and a handheld Android device (HearScreenR). Sound-booth audiometry was reserved for failed subjects. Data were uploaded to a REDCap database. Teenage children previously enrolled in a 2000-2004 Phase 3 pneumococcal conjugate vaccine trial, were the subjects of the trainees.
Results
During 4 days of training, 47 Filipino children (M/F = 28/19; mean/median age = 14.6/14.6 years) were the subjects of the trainee nurses. After the training, all nurses could perform all procedures independently. Otoscopic findings by ears included: normal (N=77), otitis media with effusion (N=2), myringosclerosis (N=5), healed perforation (N=6), perforation (N=2) and retraction pocket/cholesteatoma (N=2). Abnormal audiometric findings included: tympanogram (N=4), DPOAE (N=4) and screening audiometry (N=0).
Conclusion
Training of local nurses has been shown to be robust and this methodology overcomes challenges of distant large-scale population otologic/audiometric assessment.
https://ift.tt/2BHfVgO
Dog Bite Injuries to the Face: Is there Risk with Breed Ownership? A Systematic Review with Meta-Analysis
Publication date: Available online 29 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Garth Essig, Cameron Sheehan, Shefali Rikhi, Charles Elmaraghy, J. Jared Christophel
Abstract
Introduction
Dog bite injuries to the face are a serious, yet modifiable public health concern. This study explores the relationship between dog breed and the risk of biting and injury. The objective of this study is to determine the relative risk and severity of dog bite injuries to the face by breed.
Methods
Retrospective chart review of facial dog bite injuries presenting to the University of Virginia Health System and Nationwide Children's Hospital. Additionally, descriptive data was collected from 240 patients over the last 15 years. Bite risk by breed was assessed by a literature search from 1970 to current. A composite measure was used to determine the severity of injury, and characterize each patient into an ordinal scale of bite severity. An average of each breed bite rate within each study was calculated and combined to create an empiric bite risk by breed. Dog breeds were also further characterized morphologically.
Results
Bite risk by breed from the literature review and bite severity by breed from our case series were combined to create a total bite risk plot. Injuries from Pitbull's and mixed breed dogs were both more frequent and more severe. This data is well-suited for a bubble plot showing bite risk on the x-axis, bite severity on the y-axis, and size of the bubble by number of cases. This creates a "risk to own" graphic for potential dog owners.
Conclusions
Breeds vary in both rates of biting and severity. The highest risk breeds had both a high rate of biting and caused significant tissue injury. Physical characteristics can also help determine risk for unknown or mixed dog breeds. Potential dog owners can utilize this data when assessing which breed to own.
https://ift.tt/2KHFKjy
Surgical ablation of lingual tonsils in the treatment of obstructive sleep apnea
Publication date: Available online 30 November 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): C. Mure, M. Blumen, A. Alali, L. Page, F. Chabolle
Abstract
Objectives/Hypothesis
The retrolingual space is one of the potential sites of obstruction identified in patients with obstructive sleep apnea syndrome (OSAS). Hypertrophied lingual tonsils (LT) can obstruct the airway at this level. The goal of this study was to measure the tolerance and efficacy of lingual tonsillectomy in patients with OSAS.
Study design
A retrospective chart review was conducted recruiting all patients with OSAS confirmed on sleep recording, who either had failed or refused medical treatment and who underwent lingual tonsillectomy.
Materials and methods
Diagnosis of LT hypertrophy was made by full ENT clinical examination using a flexible endoscopy, completed by MRI and followed by drug-induced sleep endoscopy. The surgical intervention was carried out endoscopically by diode laser or coblation. The primary endpoint to measure efficacy was drop in apnea-hypopnea index (AHI) on sleep recording at 6 months. Secondary endpoints comprised reduced snoring and Epworth Sleepiness Scale (ESS) and postoperative symptom tolerance.
Results
Eleven patients aged 44.3 ± 12.6 years were included. AHI dropped from 29.5 ± 21.7/h to 11.6 ± 9.6/h: i.e., by 60% (P = 0.005). Five patients had AHI < 10/h: i.e., cure rate of 45%. ESS dropped from 13 ± 3.4 to 8.1 ± 4.9 (P = 0.012). No complications were observed.
Conclusions
LT ablation seemed effective in OSAS with retrolingual obstruction in failure of medical treatment.
Level of evidence
4.
https://ift.tt/2BHd0EK
Risk factors for severity of juvenile-onset recurrent respiratory papillomatosis at first endoscopy
Publication date: Available online 29 November 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Moreddu, E. Lambert, D. Kacmarynski, R. Nicollas, J.-M. Triglia, R.J. Smith
Abstract
Objective
The study objective was to determine risk factors for severity of juvenile-onset recurrent respiratory papillomatosis (RRP) at first endoscopic evaluation.
Methods
Based on a review of all cases undergoing surgery for juvenile-onset RRP in two pediatric otolaryngology departments in the USA and France, the following severity risk factors were analyzed: number of laryngeal levels involved, extension to the subglottis, and bilateral involvement.
Results
Thirty-two patients were included, with 571 endoscopic procedures. Number of endoscopies per patient varied according to initial extension: 30.67 procedures when all three levels were involved, 15.57 procedures when two and 14.08 procedures when only one (P = 0.03). The odds ratio for risk of > 14 procedures in 3-level involvement was 20.43 (P = 0.047). Initial subglottic extension tended to be associated with more endoscopic procedures (23.67 vs 15.56, P = 0.16).
Conclusions
RRP severity correlated with initial laryngeal extension of papillomatous lesions at first endoscopy. This finding allowed a short 3-item assessment scale to be created for routine use, complementary to Derkay's assessment scale.
https://ift.tt/2KJ9wVf
Tramadol hydrochloride: An alternative to conventional local anaesthetics for intraoral procedures- a preliminary study
Publication date: Available online 30 November 2018
Source: Journal of Oral Biology and Craniofacial Research
Author(s): Shoeb Kasim Jendi, Abhishek Talathi
Abstract
Purpose
To evaluate and compare the soft tissue anaesthesia produced by tramadol hydrochloride on gingival tissues in maxilla.
Methods
A total of 50 ASA physical status I subjects between 18 and 35 years of age, both male and female were included in the study. Each individual received 0.5 ml of 50 mg tramadol in the soft tissues over maxillary canine tooth as local infiltration on one and 0.5 ml of 20 mg lignocaine on the contralateral side in a double-blinded fashion. After completing the injection, the author recorded pain on injection, the onset of action, duration of anaesthesia, side effects, and feedback from patient.
Results
The mean onset of anaesthesia for tramadol was 172.00 s (standard deviation 39.898) while for lignocaine it was 162.60 s (standard deviation 35.098) and there was no statistically significant difference between the two groups (p = 0.214). The mean duration of anaesthesia for tramadol group was 45.70 min with a standard deviation of 8.512 min whereas for lignocaine group it was 44.70 min with a standard deviation of 8.107 min. There was no statistical relevant difference between the two groups in duration of anaesthesia (p = 0.549). None of the subjects reported any side effect in both the groups. There was no significant difference in pain on injection between the two groups.
Conclusions
Tramadol has a local anaesthetic effect similar to lignocaine when injected as infiltration in oral soft tissues.
https://ift.tt/2FQPz02
Erratum
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s):
https://ift.tt/2KLOQvC
Anti-microbial Resistance In Atopic Dermatitis: Need for an Urgent Rethink
Publication date: Available online 29 November 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): C.P. Harkins, M.T.G. Holden, A.D. Irvine
https://ift.tt/2BJbyBW
Challenges in allergy immunology practice: Solutions needed for persistent patient problems
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s): Gailen D. Marshall
https://ift.tt/2So2d89
Author Index
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s):
https://ift.tt/2E5OVdl
A new acronym for PPI-REE?
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s): Russell Hopp
https://ift.tt/2SmBYil
Editorial Board
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s):
https://ift.tt/2E6hdUR
Information for Authors
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s):
https://ift.tt/2SmBRTX
Table of Contents
Publication date: December 2018
Source: Annals of Allergy, Asthma & Immunology, Volume 121, Issue 6
Author(s):
https://ift.tt/2E44KkB
Increased IRF4 expression in isolated B cells from common variable immunodeficiency (CVID) patients
Publication date: Available online 30 November 2018
Source: Allergologia et Immunopathologia
Author(s): S. Afshar-Ghasemlou, N. Esmaeil, R. Sherkat, R. Yazdani, F. Abbasi-Rad, M. Ganjalikhani-Hakemi, A. Rezaei
Abstract
Background
Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by low serum levels of immunoglobulins (Igs) and recurrent infection. In most CVID patients, a defect in the differentiation of B cells into plasma cells has been observed. Several factors play an important role in the proliferation and differentiation of B cells, including IRF4 and XBP1 transcription factors.
Methods
In the present study we investigated the expression of IRF4 and XBP1 in the B-cells of CVID and healthy controls (HCs). For this purpose, we assessed the expression of IRF4 and XBP1 at both mRNA and protein levels by real time-PCR and flow cytometry, respectively.
Results
We found that IRF4 expression was significantly increased in CVID patients compared with controls. Although the XBP1 protein level was lower in patients in comparison to controls, this difference was not significant.
Conclusion
Taken together, increased IRF4 expression could be involved in defective functions of B cells in CVID patients.
https://ift.tt/2SfHIKK
Development of a tool for screening adverse food reactions and food allergy in Portuguese children
Publication date: Available online 30 November 2018
Source: Allergologia et Immunopathologia
Author(s): A. Jorge, M. Santos Silva, C. Lozoya-Ibánez, F. Lorente, E. Sarinho, R.M. Afonso, H. Pereira, L. Taborda-Barata
Abstract
Introduction and objectives
A standardised questionnaire may be an excellent tool for epidemiological studies aiming at screening children with suspected food allergies. Thus, the aim of the present study was to develop a screening questionnaire for assessing children with suspected food allergy and to analyse its reproducibility.
Materials and methods
A questionnaire of adverse food reactions was developed by literary review of similar questionnaires validated in other countries as well as less well defined, non-validated Portuguese questionnaires. Peer review of the questionnaire by a panel of specialists and subsequent exploratory analysis was carried out by applying the questionnaire in children with confirmed food allergy. Test–retest analysis was performed by giving a face-to-face questionnaire to 159 children with suspected adverse food reactions, aged between three and 11 years. Temporal stability using Spearman Rho correlation test and reproducibility was studied using Cohen's Kappa index.
Results
115 children confirmed adverse food reactions that occurred with one or more foods. Retest was given about three weeks after the test, to 50 of these children who were randomly selected. The questionnaire showed good temporal stability (Spearman correlation coefficient of 0.834), and good reproducibility (only two of the 27 items had a Kappa index <0.60).
Conclusions
This questionnaire showed good temporal stability and reproducibility. Its validation for screening children with suspected food allergy will allow a standardised approach to diagnosis and comparison of results obtained in different centres.
https://ift.tt/2E3Si4z
Changes in the prevalence of asthma and related risk factors in adolescents: Three surveys between 1994 and 2015
Publication date: Available online 30 November 2018
Source: Allergologia et Immunopathologia
Author(s): J. Mallol, V. Aguirre, M. Mallol-Simmonds, A. Matamala- Bezmalinovic, L. Calderón-Rodriguez, F. Osses-Vergara
Abstract
Methods
This study assesses the temporal trend of current asthma symptoms prevalence and associated factors in Chilean adolescents from South-Santiago, considering surveys performed in 1994, 2002 and 2015.
Results
The prevalence of current asthma symptoms showed a trend to increase from 11.1% in 1994 to 13.4% in 2015 (p < 0.001); physician-diagnosed asthma increased from 11.5% to 13.8%, (p < 0.001) whereas severe asthma and asthma with exercise decreased (p < 0.001). Female adolescents had a higher prevalence of current asthma in the three surveys (p < 0.001), and was a risk factor for asthma in the three surveys. In 2002, frequent consumption of meat and potatoes were associated with current asthma while frequent vigorous exercise was protective. Frequent exercise and parental tobacco smoking were risk for asthma in 2015 (p < 0.001). Current active tobacco smoking showed a trend to increase reaching a prevalence of 28.9% in 2015 (p < 0.001). There was a consistently low proportion of adolescents with current wheezing and asthma diagnosis (32.1% in 2015) and 37.6% of them had no asthma treatment.
Conclusion
The prevalence of current asthma in adolescents from the studied area would be still increasing. As in other studies, female adolescents had a higher prevalence of current asthma. Current active tobacco smoking has strikingly increased in the studied children while indoor passive tobacco exposure remains inadmissibly high. Our findings suggest that asthma in children is underdiagnosed and undertreated. More attention should be given to female gender, tobacco exposure, air pollution and local diagnostic preferences when studying and interpreting trends of asthma prevalence in adolescents from developing localities.
https://ift.tt/2SfHGCC
Self-reported hypersensitivity and allergy to foods amongst Mexican adolescents: Prevalence and associated factors
Publication date: Available online 30 November 2018
Source: Allergologia et Immunopathologia
Author(s): T.R. Bedolla-Pulido, M. Bedolla-Barajas, J. Morales-Romero, T.I. Bedolla-Pulido, M.V. Domínguez-García, D.D. Hernández-Colín, M.V. Flores-Merino
Abstract
Background
The prevalence of food allergy is on the rise on a global scale.
Objective
To determine the prevalence of food hypersensitivity (FHS) and probable food allergy (PFA), as well as the foods and factors associated with these occurrences.
Methods
A cross-sectional study was carried out among 1992 adolescents (aged 15–18 years). Each adolescent answered a structured questionnaire. A multivariate analysis was used to identify the association between the variables.
Results
The prevalence of FHS was 10.6% (the most commonly associated foods were shrimp, cow's milk and avocado) and the PFA was 7.8% (shrimp, cow's milk and pecan). The prevalences of oral allergy syndrome, food-associated urticaria and systemic reaction were 4.9%, 3.6% and 1.5%, respectively. The following factors were associated with FHS: personal history of asthma (OR 1.63; 95% CI: 1.11–2.41), allergic rhinitis (OR 2.60; 95% CI: 1.75–3.87), atopic dermatitis (OR 2.07; 95% CI: 1.25–3.43), maternal history of asthma (OR 1.80; 95% CI: 1.02–3.16), atopic dermatitis (OR 6.11; 95% CI: 2.45–15.29), and female sex (OR 1.89; 95% CI: 1.38–2.59). PFA was associated with a personal history of asthma (OR 1.65; 95% CI: 1.06–2.56), allergic rhinitis (OR 2.46; 95% CI: 1.56–3.88), atopic dermatitis (OR 2.02; 95% CI: 1.15–3.54), paternal allergic rhinitis (OR 2.52; 95% CI: 1.15–5.51), maternal atopic dermatitis (OR 7.46; 95% CI: 2.93–19.00), and female sex (OR 1.89; 95% CI: 1.31–2.72).
Conclusion
The adverse reactions associated with foods among late adolescents are a frequent occurrence, and the most commonly associated factor is atopy.
https://ift.tt/2E5MJCn
Corrigendum to “National Wisdom Tooth Treatment Audit” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) e71]
Publication date: Available online 30 November 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): Christine Wanis, Katy Martin, Shrina Nathwani
https://ift.tt/2FYJMpk
Plasma CXCL13 is a predictive factor for HBsAg loss and clinical relapse after discontinuation of nucleos(t)ide analogue treatment
Publication date: Available online 30 November 2018
Source: Clinical Immunology
Author(s): Muye Xia, Guichan Liao, Hongjie Chen, Yin Wu, Rong Fan, Xiaoyong Zhang, Jie Peng
Abstract
In this study, we investigated whether plasma cytokine/chemokine levels could predict HBsAg loss or clinical relapse (CR) after stopping nucleos(t)ides analogue (NA) treatment. Theplasma cytokines/chemokines levels were measured at 0, 4, 8, 12, 24 and 48 weeks after NA discontinuation by using the enzyme-linked immunoassay (ELISA) kit. Cox regression analysis revealed that CXCL13 level at the end of treatment (EOT) was an independent predictor for CR (HR 0.26, p < 0.001) and HBsAg loss (HR 3.01, p = 0.008) after treatment cessation. Among the patients with EOT CXCL13 level < 80 pg/ml, the cumulative incidences of CR and HBsAg loss were 65% and 0% at 4 years, respectively. As for the patients with EOT CXCL13 level ≥ 1000 pg/ml, 47.5% cases had HBsAg loss. Our study showed that EOT CXCL13 level was associated with off-treatment response, which may be used to guide cessation of NA treatment in clinical practice.
https://ift.tt/2PaZooG
Πέμπτη 29 Νοεμβρίου 2018
Styloid-stylohyoid syndrome: a rare cause of cranio-facial pain—a retrospective case series of 12 patients
Abstract
Purpose
Elongated styloid process results in severe cranio-facial/cervico-facial pain. The purpose of this study is to determine the efficacy of treatment outcomes using transcervical approach in the management of styloid-stylohyoid syndrome/styloid syndrome.
Study design
This is a retrospective cohort study. Subjects were enrolled from out-patient clinics reporting between the periods Jan 2016–Jan 2018.
Methods & methods
Twelve patients diagnosed with styloid syndrome based on history, thorough clinical workup, and assessment were included in the study. The primary outcomes—improvement in pain and regression of chief complaints following surgery were assessed. Elongated styloid was resected using transcervical approach under general anesthesia.
Results
The intra-operative lengths of the styloid process varied from 40 to 43 mm. No post-operative complications were encountered and the symptoms regressed completely after surgery in all the patients at follow-up of 6 months.
Conclusions
Transcervical styloidectomy is an effective treatment for exposure and resection of the styloid process with minimal complications in patients with stylo-stylohyoid syndrome.
https://ift.tt/2E5m6xy
Erratum zu: Primärversorgung von akutem Schwindel
Erratum zu:
HNO 2018 66:472–479
https://ift.tt/2E8VWdk
Die Autoren möchten auf einen Tippfehler im Manuskript hinweisen. Dabei wurde die Arbeit von Maxwell et al. [40] zitiert, welche die Bedeutung der Kopf-Anteflexion für die Durchführung des vKIT untersucht hat. Diese Arbeit kam zu dem …
https://ift.tt/2SnJBoN
Case 37-2018: A 23-Year-Old Woman with Vision Loss
Presentation of Case. Dr. Seth N. Levin (Neurology): A 23-year-old right-handed woman with a history of migraines was evaluated at this hospital for vertigo and vision loss affecting the right eye. Six days before admission, a right frontal headache and right retro-orbital pain developed; these…
https://ift.tt/2DS7Ebe
Case 35-2018: A 68-Year-Old Woman with Back Pain and a Remote History of Breast Cancer
Presentation of Case. Ms. Diane P. Doyle, M.S.N. (Medicine): A 68-year-old woman with a history of bilateral breast cancer was evaluated at the oncology clinic of this hospital for back and pelvic pain. Twenty-five years before the current evaluation, the patient was noted to have a small lump in…
https://ift.tt/2QqlnwB
Role of phosphorylcholine in Streptococcus pneumoniae and nontypeable Haemophilus influenzae adherence to epithelial cells
Phosphorylcholine (PC) is a structural component of Streptococcus pneumoniae (Spn) and nontypeable Haemophilus influenzae (NTHi), and is known to be associated with adherence through the platelet activating factor receptor (PAF-R). Furthermore, high PC expression is considered to be involved in Spn and NTHi virulence. In this study, we examined the influence of PC expression on the adherence of Spn and NTHi to epithelial cells in order to clarify the potential effectiveness of a vaccine targeting PC.
https://ift.tt/2Q3I8XN
Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases
To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.
https://ift.tt/2RnDgcV
Corrigendum to “Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study” [Auris Nasus Larynx 45 (2018) 1006–1013]
In the ethical considerations section of the article, the ethical committee should read as follows: "The University of Tokyo, Graduate School of Medicine".
https://ift.tt/2Q4G6H8
Anti-microbial Resistance In Atopic Dermatitis: Need for an Urgent Rethink
Atopic dermatitis (AD) results from a complex interplay of host genetic and environmental factors. There is a long established association between AD and Staphylococcus aureus. In healthy individuals this organism has a dichotomous relationship with the host, being a frequent component of the human microbiome, carried asymptomatically, and on occasion, an opportunistic pathogen capable of causing or influencing a broad ranging disease. In AD, high carriage rates of S. aureus on affected skin is commonly observed, with recent meta-analysis evidence demonstrating colonisation in approximately 70% of affected individuals 1.
https://ift.tt/2BHCLVB
Corrigendum to “National Wisdom Tooth Treatment Audit” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) e71]
The authors regret that Kate Matin's name was missed of the author list in the original article. It appears correctly above.
https://ift.tt/2rcXFpF
Incidence of Thyroid Cancer Among Residents Within 5 Years of the 2011 Fukushima Nuclear Accident
This cohort study of 324 301 children and young adults in Fukushima, Japan, evaluates the number of detected thyroid cancers by age group within 5 years of the 2011 Fukushima Daiichi nuclear power station accident and compares basic clinical characteristics and demographic patterns in first-round and second-round examinations.
https://ift.tt/2BHFyxY
https://ift.tt/2BHFyxY
Effect of TIVA vs VIMA on Emergence Agitation After Nasal Surgery
This randomized clinical trial investigates the effect of total intravenous anesthesia (TIVA) vs volatile induction with maintenance anesthesia (VIMA) on the occurrence of emergence agitation among patients undergoing nasal surgery.
https://ift.tt/2KLmAcU
https://ift.tt/2KLmAcU
Care of Patients With Endocrine Conditions
In this issue, we present the study by Ohtsuru and colleagues who analyzed clinical characteristics of thyroid cancers screened by ultrasonography in children and young adults during the first 5 years after the 2011 Fukushima Daiichi Nuclear Power Station accident. Along with the publication of this landmark study, I am excited to announce a new section editor in JAMA Otolaryngology–Head & Neck Surgery who will be dedicated to the care of patients with endocrine conditions. I invited Louise Davies, MD, MS, to serve as the first Endocrinology Section Editor. Dr Davies is an internationally recognized expert on thyroid cancer with a focus on appropriate treatment of adults diagnosed with small thyroid nodules and has methodologic expertise in epidemiology and mixed-methods research approaches. I am also excited to announce the appointment of Luc G. T. Morris, MD, MSc, to the editorial board. Dr Morris' research program straddles head and neck cancer genomics and the epidemiology of overdiagnosis, and he has methodologic expertise in biostatistics and bioinformatics. Together, they will provide breadth and depth to this renewed area of clinical focus.
https://ift.tt/2BHhE5N
https://ift.tt/2BHhE5N
Why the Data From the Fukushima Daiichi Nuclear Power Station Accident Are Important
On March 11, 2011, the Great East Japan Earthquake and subsequent giant tsunami led to catastrophic damage at the TEPCO (Tokyo Electric Power Company Holdings) Fukushima Daiichi nuclear power station. Radioactive materials spread into the Fukushima Prefecture. Although the estimated release of radioactive material was quite small, the accident caused great alarm within the population. In response, 4 months later, in July 2011, the Fukushima Health Management Survey was launched to monitor for potential radiation-induced health effects, including a large-scale thyroid surveillance program. In this issue of JAMA Otolaryngology–Head & Neck Surgery, Ohtsuru and colleagues provide data from the initial 2 rounds of ultrasound screening during the first 5 years after the accident, the first round between 2011 and 2013 and the second round between 2014 and 2015. Ultimately, 324 301 individuals who had been younger than 18 years at the time of the accident (the age group at higher risk of thyroid cancer after radiation exposure) were included in the analysis. During the 4 years after the accident that the screening rounds took place, 187 children and adolescents were diagnosed with thyroid cancer; the most common pathologic diagnosis was papillary thyroid cancer (98.0%).
https://ift.tt/2KG4tot
https://ift.tt/2KG4tot
Thyroid Cancer Screening After Nuclear Accidents
This guideline recommendation by an expert group convened by the International Agency for Research on Cancer outlines recommendations for thyroid screening after nuclear events.
https://ift.tt/2BF8FSs
https://ift.tt/2BF8FSs
An Indolent Middle Ear Mass
A woman in her 30s with a 1-year history of left ear fullness presented with left-sided hearing that improved temporarily with autoinsufflation. What is your diagnosis?
https://ift.tt/2KHySD0
https://ift.tt/2KHySD0
Anemia and 30-Day Morbidity and Mortality After Thyroidectomy in Thyroid Cancer Treatment
This cross-sectional cohort study uses the American College of Surgeons National Surgical Quality Improvement Program database to evaluate whether an association exists between preoperative anemia and postoperative 30-day morbidity and mortality outcomes following thyroidectomy in adult patients with thyroid cancer.
https://ift.tt/2BHhDyL
https://ift.tt/2BHhDyL
Elevated expression of IL-17RB and ST2 on myeloid dendritic cells is associated with a Th2-skewed eosinophilic inflammation in nasal polyps
Interleukin(IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP) underlie the crosstalk between epithelial cells and dendritic cells (DCs) during the development of Th2 responses. This study aimed to measure...
https://ift.tt/2PbLFhs
Factors associated with successful switching between biologic therapies for the treatment of psoriasis in daily dermatological real‐life practice: The Resoswitch study
The main aim of this study was to describe switching practices in daily practice. Patients included were those seen in daily routine practice. Efficacy was defined as the achievement of at least 75% improvement in the PASI score (PASI75). A total of 1,157 patients were included. The frequency of switching was 29.9% and switching was efficient in 71.9% of the cases. The study's results allows a better understanding of the profile of patients who require switch and he appears a change of therapeutic class appears to be more effective in psoriasis patients who require a switch in their therapy.
This article is protected by copyright. All rights reserved.
https://ift.tt/2Rmw4gZ
Sexual dimorphism in hepatitis B and C and hepatocellular carcinoma
Abstract
The incidence of viral hepatitis B or C (HBV/HCV) infection and hepatocellular carcinoma is higher in male compared to female populations, showing a faster disease progression and results in a worse overall survival. Indeed, women are in general better protected from viral infections and show a lower risk of death from malignant cancer in comparison to men. Females mount stronger innate and adaptive immune responses than males, and therefore, most of the autoimmune diseases occur predominantly in females. Next to occupational and/or behavioral factors, cellular and molecular differences between the two sexes contribute to this observation. In this review, we will discuss underlying mechanisms that are important for the observed sex-related differences in liver diseases. A better appreciation of these differences between the two sexes might be of value for better and gender-specific treatment options.
https://ift.tt/2rdq6DO
Advancements in MAPK signaling pathways and MAPK‐targeted therapies for ameloblastoma: A review
Abstract
Numerous signal transduction pathways are closely associated with the occurrence, development, and prognosis of ameloblastoma(AM). Mitogen‐activated protein kinase (MAPK) is a serine/threonine‐specific protein kinase that transduces intracellular signals in critical cellular phenomena. A number of recent analyses have reported that the MAPK signaling pathway contributes significantly to AM. High‐throughput DNA sequencing methods, such as next‐generation sequencing using Illumina have yielded advancements in studies on MAPK signaling pathways and their association with AM; in particular, BRAF V600E is mediated by the activation of the Ras/Raf/MAPK pathway. This review discusses advancements in studies on MAPK signaling pathways and MAPK‐targeted inhibitors or antibodies, along with the merits and demerits of MAPK‐targeted therapies, finally followed by a discussion regarding more efficient potential MAPK‐targeted therapies to treat AM with few side effects, thereby providing novel insights into targeted therapy for AM.
This article is protected by copyright. All rights reserved.
https://ift.tt/2P9czXx
Overexpression of ADAR1 into the cytoplasm correlates with a better prognosis of patients with oral squamous cells carcinoma
Abstract
Background
ADAR1 is an enzymatic protein, which catalyzes a RNA‐editing reaction by converting Adenosine to Inosine and its expression has been found to be dysregulated in many cancer types. The aim of this study was to analyze the expression of ADAR1 in oral squamous cells carcinoma.
Methods
In order to analyze the ADAR1 mRNA expression, data from The Cancer Genome Atlas (TCGA) database were downloaded and analyzed. In addition, immunohistochemistry analysis was performed on an institutional database including 46 samples of oral squamous cell carcinoma in a tissue microarray (TMA).
Results
No statistically significant correlation linked the mRNA ADAR1 expression to any clinic‐pathological variables in the TCGA database. Immunohistochemistry analysis of ADAR1 showed different expression between normal mucosa and tumor tissue. Focusing on the subcellular localization, the nuclear expression of ADAR1 correlated with higher grading of differentiation (ρ = 0,442 p‐value = 0,002); the general expression of ADAR1 either in cytoplasm or in nuclei, correlated with the Gender of patients (Cytoplasm expression: ρ = ‐0,295; p‐value = 0,049; while for nuclear expression: ρ = +0,374 p = 0,011); cytosol expression resulted to be an independent protective prognostic factor (HR = 0,047; C.I. 95% 0,007‐0,321; p‐value = 0,002).
Conclusion
Higher expression of ADAR1 into the cytoplasm resulted to be an independent prognostic factor. In order to understand ADAR1 role in cancer, further studies should be performed, in bigger cohort and under a bio‐molecular point of view.
This article is protected by copyright. All rights reserved.
https://ift.tt/2zzAwSH
A role for Th1-like Th17 cells in the pathogenesis of inflammatory and autoimmune disorders
Publication date: January 2019
Source: Molecular Immunology, Volume 105
Author(s): Ali N. Kamali, Seyedeh Masoomeh Noorbakhsh, Haleh Hamedifar, Farhad Jadidi-Niaragh, Reza Yazdani, José M. Bautista, Gholamreza Azizi
Abstract
The T helper 17 (Th17) cells contain a dynamic subset of CD4+ T-cells that are able to develop into other different lineage subsets, including the Th1-like Th17 cells. These cells co-express retinoic acid-related orphan receptor gamma t (RORγt) and transcription factor T-box-expressed-in-T-cells (T-bet) and produce both interleukin (IL)-17 and interferon (IFN)-γ. Recent reports have shown that Th1-like Th17 cells play crucial roles in the pathogenesis of autoimmune diseases such as inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis, as well as, some primary immunodeficiency with autoimmune features. Here, the actual mechanisms for Th17 cells plasticity to Th1-like Th17 cells are discussed and reviewed in association to the role that Th1-like Th17 cells have on inflammatory and autoimmune disorders.
https://ift.tt/2TZwfAq
The ins and outs of type I iNKT cell development
Publication date: January 2019
Source: Molecular Immunology, Volume 105
Author(s): Susannah C. Shissler, Tonya J. Webb
Abstract
Natural killer T (NKT) cells are innate-like lymphocytes that bridge the gap between the innate and adaptive immune responses. Like innate immune cells, they have a mature, effector phenotype that allows them to rapidly respond to threats, compared to adaptive cells. NKT cells express T cell receptors (TCRs) like conventional T cells, but instead of responding to peptide antigen presented by MHC class I or II, NKT cell TCRs recognize glycolipid antigen in the context of CD1d. NKT cells are subdivided into classes based on their TCR and antigen reactivity. This review will focus on type I iNKT cells that express a semi invariant Vα14Jα18 TCR and respond to the canonical glycolipid antigen, α-galactosylceramide. The innate-like effector functions of these cells combined with their T cell identity make their developmental path quite unique. In addition to the extrinsic factors that affect iNKT cell development such as lipid:CD1d complexes, co-stimulation, and cytokines, this review will provide a comprehensive delineation of the cell intrinsic factors that impact iNKT cell development, differentiation, and effector functions – including TCR rearrangement, survival and metabolism signaling, transcription factor expression, and gene regulation.
https://ift.tt/2ACzyEP
Sequence and functional variability of Toll-like receptor 9 gene in equines
Publication date: Available online 28 November 2018
Source: Molecular Immunology
Author(s): Anju Manuja, Balvinder K. Manuja, Harisankar Singha
Abstract
Significant structural differences in the extracellular domain of toll-like receptor 9 (TLR9) account for species-specific recognition of its ligand CpG-ODN sequences. TLR9 is extensively studied in human, mice and some domestic animals. The recognition ability appears to be utilized differently by various species and breeds, but so far no comprehensive study exists about the equine TLR9 gene. We characterized TLR9 sequences of Marwari and Zanskari breeds of horses and Poitu donkey. We sequenced and identified the protein coding regions of equine TLR9 and compared with other animals and human beings. Furthermore, we also analyzed the amino acid substitutions and their likely implications on functions. The analysis revealed 14% evolutionary divergence between equine and human TLR9, while it was 1% between the Equus caballus and Equus asinus and less than 1% within Equus caballus. In phylogenetic analysis of predicted amino acids, the indigenous equines grouped with thoroughbred Equus caballus, while human, cattle, dog, sheep, mice, and buffalo formed separate clades. Furthermore, we also analyzed the amino acid substitutions and their likely implications on functions by sorting intolerant from tolerant (SIFT) analysis and predicted two substitutions of amino acids (D80N and S822P) in Marwari horses in leucine rich repeat 1 (LRR1) without any functional effects. The substitutions (V214A and Y579C) in LRR 3 and LRR11 in Zanskari horses were predicted to have functional consequences. Out of overall 8 substitutions, three substitutions (I420V, S970R and R1001C) were found in Equus asinus in LRR7, LRR 13, and toll interleukin receptor (TIR) domains, while the substitution G649S is observed in Poitu donkey only. We report for the first time that despite the conserved residues, the striking effect of substitutions, found within the TLR9 genes of different equine breeds/species may have possible implications.
https://ift.tt/2TRjnMZ
Perspectives of Sunless‐Only Tanning Business Owners
Abstract
To date, 16 states in the US restrict minors from using tanning beds.1 The principal argument against policy restricting indoor tanning is the concern it would harm small businesses.2‐4 One counterargument is that tanning businesses could stay financially viable by offering UV‐free sunless tanning services (e.g., spray or airbrush tanning) which would serve customers' desire for a tan while not exposing them to the risks associated with ultraviolet (UV) radiation exposure. Sunless only tanning businesses are already in existence and owners may provide insights on this alternative business model.
This article is protected by copyright. All rights reserved.
https://ift.tt/2FMWmHP
A prospective, observational safety study of patients with BRAFV600‐mutated unresectable or metastatic melanoma treated with vemurafenib [Zelboraf Safety Study (ZeSS)]
Abstract
Vemurafenib is approved in more than 90 countries for the treatment of patients with BRAF V600‐mutated metastatic melanoma.1,2 In the pivotal BRIM‐3 trial, treatment‐emergent cutaneous side effects were associated with vemurafenib, including the development of epithelial tumours and, in rare cases, new primary melanomas.3,4 QTc interval prolongation and hepatic laboratory abnormalities were also noted.3,4
This article is protected by copyright. All rights reserved.
https://ift.tt/2re3jrs
Comparison of microneedling and full surface erbium laser dermabrasion for autologous cell suspension grafting in non‐segmental vitiligo: a randomized controlled trial
Abstract
Autologous cell suspension is a well‐demonstrated effective approach for treating segmental or stable and localized forms of vitiligo1. Full surface dermabrasion is considered as the gold standard technique for preparing the skin before grafting. Fractional ablative laser or microneedling have been shown to enhance the penetration into the skin of topical agents2.
This article is protected by copyright. All rights reserved.
https://ift.tt/2FO0oQe
Association of Pyrin mutations and Autoinflammation with Complex Phenotype Hidradenitis Suppurativa: A Case Control Study
Abstract
Background
Hidradenitis suppurativa (HS) is a rare, debilitating neutrophilic dermatosis characterised by chronic inflammation of hair follicles. Many inflammatory conditions may accompany HS.
Aim
To investigate the association of variants of the MEFV gene with a complex HS phenotype.
Methods
First, we identified the clinical characteristics of 119 HS patients with a complex phenotype (Hurley stage III disease and/or additional inflammatory symptoms). Then, we searched for MEFV variants among these patients. The odds ratios (OR) for pathogenic MEFV mutations were calculated using data from these HS patients and 191 healthy controls.
Results
The male/female ratio was higher, and the mean age of onset was earlier, in our complex HS group compared with HS patients in general. Five of the HS patients (4.2%) had a diagnosis of familial Mediterranean fever (FMF) with a standardized morbidity ratio of 45 (CI: 16.50‐99.84, p<0.001) when compared with the frequency of FMF in the general Turkish population. Of the patients with complex HS, 38% were positive for pathogenic variants of MEFV. The odds ratio for carrying a pathogenic MEFV allele was 2.80 (CI: 1.31‐5.97, p<0.001).
Conclusion
The frequency of MEFV mutations in a group of patients with complex HS was higher than that in healthy controls, suggesting that MEFV mutations may contribute to the pathogenesis of HS. Understanding the role of autoinflammation in HS is of fundamental importance for the development of novel therapies.
This article is protected by copyright. All rights reserved.
https://ift.tt/2raMw8D
Safety of guselkumab in patients with moderate‐to‐severe psoriasis treated through 100 weeks: a pooled analysis from the randomised VOYAGE 1 and VOYAGE 2 studies
Summary
Background
Long‐term evaluation is required to confirm the safety profile of newer biologic agents. Objectives
To report on pooled safety data from the on‐going VOYAGE 1 (NCT02207231) and VOYAGE 2 (NCT02207244) trials through 100 weeks of follow‐up.
Methods
Patients were randomized to guselkumab 100 mg at weeks 0 and 4 and every‐8‐weeks thereafter; placebo at weeks 0, 4, 12 followed by guselkumab 100 mg at weeks 16 and 20 and every‐8 weeks thereafter; or adalimumab 80 mg at week 0, 40 mg at week 1, and 40 mg every 2 weeks thereafter. Adalimumab patients crossed over to guselkumab at week 52 (VOYAGE1) and at/after week 28 based on clinical response (VOYAGE2). Open‐label extensions, when all patients received guselkumab, started at week 52 (VOYAGE1) and week 76 (VOYAGE2). Rates of adverse events (AEs) per 100 patient‐years [PY] are presented through 100 weeks of follow up.
Results
Through week 52, observed rates for guselkumab‐ and adalimumab‐treated patients, respectively, were 262.45/100PY and 328.28/100PY for AEs, 6.20/100PY and 7.77/100PY for serious AEs (SAEs), 1.22/100PY and 1.79/100PY for serious infections (SIs), 0.28/100PY and 0.40/100PY for malignancies other than nonmelanoma skin cancers (NMSCs), 0.56/100PY and 0.40/100PY for NMSCs, and 0.47/100PY and 0.40/100PY for MACE. Rates among guselkumab‐treated patients through week 52 and week 100, respectively, were (262.45/100PY and 210.41/100PY) for AEs, 6.20 and 6.29/100PY), for SAEs, 1.22/100PY and 1.06/100PY for SIs, 0.28/100PY and 0.38/100PY for malignancies, 0.56/100PY and 0.39/100PY for NMSCs, and 0.47/100PY and 0.38/100PY for MACE. Among adalimumab‐treated patients, rates of AEs (328.28/100PY vs 160.15/100PY), SAEs (7.77/100PY vs 4.44/100PY), SIs (1.79/100PY vs 0/100PY), malignancies (0.40/100PY vs 0.40/100PY), NMSCs (0.40/100PY vs 0.81/100PY), and MACE (0.40/100PY vs 0.20/100PY) showed some variability before and after crossover to guselkumab, though no new safety signals were noted after crossover.
Conclusions
The safety profile for guselkumab remains favorable through 100 weeks of treatment in patients with moderate‐to‐severe psoriasis.
This article is protected by copyright. All rights reserved.
https://ift.tt/2FPtpLp
Dupilumab reduces local type 2 pro‐inflammatory biomarkers in chronic rhinosinusitis with nasal polyposis
Abstract
Background
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a type 2‐mediated inflammatory disease associated with significant clinical, social, and economic burdens and high unmet therapeutic need. Dupilumab, a fully human monoclonal antibody targeting the interleukin‐4 receptor α (IL‐4Rα) subunit, demonstrated efficacy and acceptable safety in CRSwNP and other type 2 diseases (e.g. atopic dermatitis and asthma). We now report the local effects of dupilumab on type 2 inflammatory biomarkers in nasal secretions and nasal polyp tissues of patients with CRSwNP in a randomized, placebo‐controlled, phase 2 trial (NCT01920893).
Methods
Cytokines, chemokines, and total immunoglobulin E (IgE) levels were measured using immunoassay techniques in nasal secretions and nasal polyp tissue homogenates of CRSwNP patients receiving dupilumab 300 mg or placebo weekly for 16 weeks.
Results
With dupilumab, type 2 biomarker concentrations decreased in nasal secretions (LS mean area under the curve from 0–16 weeks for the change from baseline) vs placebo for eotaxin‐3 (−30.06 vs −0.86 pg/mL; P=0.0008) and total IgE (−7.90 vs −1.86 IU/mL; P=0.022)). Dupilumab treatment also decreased type 2 biomarker levels in nasal polyp tissues at Week 16 versus baseline for ECP (P=0.008), eotaxin‐2 (P=0.008), eotaxin‐3 (P=0.031), pulmonary and activation‐regulated chemokine (P=0.016), IgE (P=0.023), and IL‐13 (P=0.031).
Conclusions
Dupilumab treatment reduced multiple biomarkers of type 2 inflammation in nasal secretions and polyp tissues of patients with CRSwNP, demonstrating that antagonism of IL‐4Rα signaling suppresses IL‐4‐/IL‐13‐dependent processes, such as mucosal IgE formation, as well as the expression of chemokines attracting inflammatory cells to the nasal mucosa.
This article is protected by copyright. All rights reserved.
https://ift.tt/2E35lmF
R‐Ras regulates vascular permability, but not overall healing in skin wounds
Abstract
Wounds close by keratinocytes migrating from the edge of the wound and re‐epithelializing the epidermis. It has been proposed that the major stimuli for wound closure are blood‐derived growth factors, chemokines, and cytokines. The small GTPase R‐Ras, a known integrin activator, also regulates vascular permeability during angiogenesis, and blood vessels lacking R‐Ras leak plasma proteins constantly. We explored whether the access to blood‐derived proteins influences skin wound healing in R‐Ras knockout (KO) mice. In skin wounds, R‐Ras expression was mostly restricted to the vasculature in the granulation tissue. Angiogenic blood vessels in the R‐Ras KO mice were significantly more permeable than in wild‐type (WT) controls. Although the distances between epidermal tongues, and the panniculus carnosus muscles, were significantly longer in R‐Ras KO than WT controls before the granulation tissue formation took place, there were no differences in the wound closure or re‐epithelialization rates or granulation tissue formation. These findings were also corroborated in a special splint excision wound model. Our study shows that although R‐Ras does not influence the skin wound healing itself, but the blood vessels lacking R‐Ras are leaky and thus could facilitate the access of blood‐derived proteins to the wound.
This article is protected by copyright. All rights reserved.
https://ift.tt/2Sibgar
Computational fluid dynamics after endoscopic endonasal skull base surgery—possible empty nose syndrome in the context of middle turbinate resection
Background
Empty nose syndrome (ENS) is a rare and debilitating disease with a controversial definition, etiology, and treatment. One puzzling fact is that patients who undergo an endoscopic endonasal approach (EEA) often have resection of multiple anatomic structures, yet seldom develop ENS. In this pilot study, we analyzed and compared the computational fluid dynamics (CFD) and symptoms among post‐EEA patients, ENS patients, and healthy subjects.
Methods
Computed tomography scans of 4 post‐EEA patients were collected and analyzed using CFD techniques. Two patients had significant ENS symptoms based on results of the Empty Nose Syndrome 6‐item Questionnaire (score >11), whereas the other 2 were asymptomatic. As a reference, their results were compared with previously published CFD results of 27 non‐EEA ENS patients and 42 healthy controls.
Results
Post‐EEA patients with ENS symptoms had a similar nasal airflow pattern as non‐EEA ENS patients. This pattern differed significantly from that of EEA patients without ENS symptoms and healthy controls. Overall, groups with ENS symptoms exhibited airflow dominant in the middle meatus region and a significantly lower percentage of airflow in the inferior turbinate region (EEA with ENS, 17.74 ± 4.00% vs EEA without ENS, 51.25 ± 3.33% [t test, p < 0.02]; non‐EEA ENS, 25.8 ± 17.6%; healthy subjects, 36.5 ± 15.9%) as well as lower peak wall shear stress (EEA with ENS, 0.30 ± 0.13 Pa vs EEA without ENS, 0.61 ± 0.03 Pa [p = 0.003]; non‐EEA ENS, 0.58 ± 0.24 Pa; healthy subjects, 1.18 ± 0.81 Pa).
Conclusion
These results suggest that turbinectomy and/or posterior septectomy may have a varying functional impact and that ENS symptoms go beyond anatomy and correlate with aerodynamic changes. The findings open the door for CFD as a potential objective diagnosis tool for ENS.
https://ift.tt/2TW5xsz
Noninvasive exosomal proteomic biosignatures, including cystatin SN, peroxiredoxin‐5, and glycoprotein VI, accurately predict chronic rhinosinusitis with nasal polyps
Background
Exosomes are secreted epithelial‐derived vesicles that contain a conserved protein array representative of their parent cell. Exosomes may be reproducibly and noninvasively purified from nasal mucus. The exosomal proteome can be quantified using SOMAscanTM, a highly multiplexed, aptamer‐based proteomic platform. The purpose of this study was to determine whether chronic rhinosinusitis with nasal polyps (CRSwNP) has a unique predictive exosomal proteomic biosignature.
Methods
Exosomes were isolated from whole mucus sampled from control and CRSwNP patients (n = 20 per group) by differential ultracentrifugation. The SOMAscanTM platform was used to simultaneously quantify 1310 biologically relevant human proteins. Matched tissue and whole mucus proteomes were also analyzed. Differential protein expression and discriminatory power were calculated using the unweighted pair group method with arithmetic‐mean and principal component analysis, respectively. Bioinformatic analysis was performed using Ingenuity Pathway, MetaCore, and GeneMANIA analyses.
Results
The exosomal proteome demonstrated 123 significantly (p < 0.05) differentially regulated proteins in CRSwNP relative to control. Eighty of these proteins overlapped with the matched CRSwNP tissue proteome as compared with only 4 among matched whole mucus samples. Forty‐three significantly dysregulated pathway networks overlapped between the exosomal and tissue proteome in CRSwNP as compared with only 3 among matched whole mucus samples. The best‐performing protein set (cystatin‐SN, peroxiredoxin‐5, and glycoprotein VI) achieved an area under the curve (AUC) value of up to 99%.
Conclusion
Our data contribute a significant advance in the development of a reproducible, noninvasive, serial, and quantitative "liquid biopsy" for rhinosinusitis. The exosomal proteomic approach has revealed a unique biosignature associated with CRSwNP, which outperforms whole mucus sampling, and thus provides a method of noninvasive disease detection and proposes new potential therapeutic targets.
https://ift.tt/2AxMhc6
Endoscopic Evaluation of the Eustachian Tube: assessment of a novel tool for grading Eustachian tube inflammation
Background
Signs of inflammation are commonly encountered during endoscopic examination of the Eustachian tube (ET) region. The clinical applicability of these findings may be enhanced by use of a standardized assessment score.
Methods
Digital video recordings were obtained of 50 nasal endoscopy examinations of the nasopharyngeal portion of the ET. Four fellowship‐trained rhinologists independently reviewed the videos with regard to specific physical findings: edema of the ET torus, erythema of the ET torus, exudate at the ET orifice, and presence of tubal tonsil. Scoring of this Endoscopic Evaluation of the Eustachian Tube (3ET) was reported using both 2‐point and 3‐point scales. Each reviewer repeated the scoring at a 10‐day interval. Interrater and intrarater agreement were calculated for each item and the total scores.
Results
Interrater and intrarater agreement were greater for the 3‐point scale than the 2‐point scale. Interrater agreement for overall instrument using the 3‐point scale was in the "acceptable" range for Krippendorff's alpha on both the first trial (0.6922) and second trial (0.7238). Intrarater agreement was generally "excellent" for individual items as well as the overall instrument.
Conclusion
The 3ET comprising these 4 physical findings has acceptable interrater and intrarater reliability, and may be applied to future clinical studies of ET function and disease.
https://ift.tt/2TVHABM
Patterns of olfactory dysfunction in chronic rhinosinusitis identified by hierarchical cluster analysis and machine learning algorithms
Background
Olfactory dysfunction is a common symptom of chronic rhinosinusitis (CRS). We previously identified several cytokines potentially linked to smell loss, potentially supporting an inflammatory etiology for CRS‐associated olfactory dysfunction. In the current study we sought to validate patterns of olfactory dysfunction in CRS using hierarchical cluster analysis, machine learning algorithms, and multivariate regression.
Methods
CRS patients undergoing functional endoscopic sinus surgery were administered the Smell Identification Test (SIT) preoperatively. Mucus was collected from the middle meatus using an absorbent polyurethane sponge and 17 inflammatory mediators were assessed using a multiplexed flow‐cytometric bead assay. Hierarchical cluster analysis was performed to characterize inflammatory patterns and their association with SIT scores. The random forest approach was used to identify cytokines predictive of olfactory function.
Results
One hundred ten patients were enrolled in the study. Hierarchical cluster analysis identified 5 distinct CRS clusters with statistically significant differences in SIT scores observed between individual clusters (p < 0.001). A majority of anosmic patients were found in a single cluster, which was additionally characterized by nasal polyposis (100%) and a high incidence of allergic fungal rhinosinusitis (50%) and aspirin‐exacerbated respiratory disease (AERD) (33%). A random forest approach identified a strong association between olfaction and the cytokines interleukin (IL)‐5 and IL‐13. Multivariate modeling identified AERD, computed tomography (CT) score, and IL‐2 as the variables most predictive of olfactory function.
Conclusion
Olfactory dysfunction is associated with specific CRS endotypes characterized by severe nasal polyposis, tissue eosinophilia, and AERD. Mucus IL‐2 levels, CT score, and AERD were independently associated with smell loss.
https://ift.tt/2AAtYDf
Titanium ossicular chain reconstruction in single stage canal wall down tympanoplasty for chronic otitis media with mucosa defect
Publication date: Available online 28 November 2018
Source: American Journal of Otolaryngology
Author(s): Feng-Ming Gu, Fang-Lu Chi
Abstract
Purpose
To evaluate surgical outcomes for chronic otitis media with mucosa defect underwent titanium ossicular chain reconstruction (OCR) in single stage canal wall down tympanoplasty (CWD).
Methods
A clinical retrospective study was performed on 83 cases of the chronic otitis media with mucosa defect and 123 ears with mucosa integrity according to intraoperative findings that underwent synchronous titanium OCR in single stage CWD form January 2012 to January 2018. Pre- and postoperative air conduction threshold (AC), air-bone gap (ABG) and ABG closure at 0.5, 1, 2, and 4 kHz were investigated.
Results
The overall mean AC threshold of 53.4 ± 16.5 dB was lowered to 41.2 ± 15.9 dB postoperatively (p < 0.01). The mean pre- and postoperative ABG of all patients were 27.9 ± 9.9 dB and 17.2 ± 9.3 dB (p < 0.01), respectively, with a mean ABG closure of 10.7 ± 8.4 dB. The total rate of success, postoperative ABG ≤ 20 dB was achieved in 71.4%. In the mucosa defect group underwent TORP, the mean pre- and postoperative ABG were 28.1 ± 9.8 dB and 20.1 ± 9.0 dB (p < 0.01), respectively, with the ABG closure was 8.0 ± 7.9 dB. In the mucosa defect group underwent PORP, the mean pre- and postoperative ABG were 27.9 ± 10.1 dB and 16.5 ± 9.1 dB (p < 0.01), respectively, with the ABG closure was 11.4 ± 8.6 dB. Furthermore, in the mucosa defect group, there was significant difference in success rate of achieved postoperative ABG ≤ 20 dB between the TORP (48.9%) and PORP (77.5%) (p < 0.05).
Conclusion
It is revealed PORP in single stage CWD tympanoplasty for the patients suffered from chronic otitis media with mucosa defect is favored.
https://ift.tt/2zwY0b1
Aluminum granuloma in a child secondary to DTaP‐IPV vaccination: A case report
Abstract
Reports detailing the acute formation of aluminum granulomas, which can cause persistent, intensely pruritic nodules secondary to the administration of aluminum‐containing vaccines, are infrequently described in medical literature. To our knowledge, this is the first report describing the development of an aluminum granuloma causing a persistent, pruritic nodule at the injection site following the administration of the DTaP‐IPV vaccine. We present the case of a 6‐year‐old girl who developed a severely pruritic subcutaneous nodule on her anterior right thigh at the injection site three weeks after the administration of the aluminum‐containing DTaP‐IPV (Kinrix) vaccine. The nodule was eventually excised 14 months after its initial appearance, after which her symptoms resolved. Histologic inspection demonstrated a dense, deep dermal and subcutaneous nodular mixed infiltrate of lymphocytes, histiocytes, and eosinophils, with germinal center formation. The bluish, amphophilic granular cytoplasm found in most of the histiocytes is a characteristic feature of "aluminum granulomas." This adverse reaction should be considered in any patient presenting with similar findings in the weeks following a DTaP‐IPV vaccination or other aluminum‐containing vaccines. Furthermore, the self‐limiting tendency of these nodules should not preclude affected patients from any future vaccinations, though vaccines without aluminum should be preferentially selected when possible.
https://ift.tt/2AzPCHx
Characteristics of persistent diaper dermatitis in children with food allergy
Abstract
Background/Objectives
Diaper dermatitis is often caused by irritant contact occurring beneath the diaper of an infant, and it is aggravated by factors such as dampness, friction, urea, and feces. Food‐allergic patients are known to exhibit various skin lesions ranging from urticaria to eczema. This study aims to determine the relationship between persistent diaper dermatitis and food allergy.
Methods
A retrospective chart review was conducted of pediatric patients with a diagnosis of persistent diaper dermatitis between August 2015 and November 2017.
Results
The study included 157 patients diagnosed with persistent diaper dermatitis (67 male, 72 female; median age: 13 months). Diaper dermatitis was more common and included the whole perineum in children who had multiple food allergies (P = 0.001). In children with multiple food allergies, the course of diaper dermatitis was more severe, and the condition did not respond to topical treatment (P = 0.025). A longer elimination diet was required for patients with Type I reactions and persistent diaper dermatitis (P = 0.018). In patients with Type II and mixed reactions, diaper dermatitis was more diffuse and covered the whole perineum (P = 0.025). In patients with Type II and mixed reactions, diaper dermatitis was more severe and did not respond to topical treatment (P = 0.025).
Conclusions
Persistent diaper dermatitis lasting longer than a month may be associated with food allergy. The diaper rash may also be the only indicator of the food allergy. Elimination of the responsible food may allow these patients to recover from persistent diaper dermatitis.
https://ift.tt/2TWEY6M
Corneal Toxicity Induced by ABT-414 Therapy for Glioblastoma Multiforme: A Case Report
Background: To describe a case of corneal toxicity associated with the use of the epidermal growth factor receptor (EGFR) inhibitor ABT-414 in the treatment of glioblastoma multiforme. Case Presentation: Case report of a 56-year-old male with glioblastoma multiforme who developed mild painless blurred vision after systemic treatment with the investigational EGFR inhibitor ABT-414. The patient had best corrected visual acuity of 20/60 right eye and 20/50 left eye. Ophthalmic examination revealed corneal toxicity with whorl-like opacities in the inferior interpalpebral cornea. The patient was treated with topical fluoromethalone and lifitegrast, and his ocular symptoms as well as the corneal findings improved. Conclusions: The systemic use of EGFR inhibitor ABT-414 may be associated with corneal toxicity and the effects are reversible with treatment.
Case Rep Ophthalmol 2018;9:479–483
https://ift.tt/2E46RFe
Case Rep Ophthalmol 2018;9:479–483
https://ift.tt/2E46RFe
Presence in head and neck cancer multidisciplinary team meeting: The patient's experience and satisfaction
Publication date: Available online 28 November 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): D. Chaillou, G. Mortuaire, V. Deken-Delannoy, B. Rysman, D. Chevalier, F. Mouawad
Abstract
Background
In oncology, multi-disciplinary team meetings improve overall survival and reduce time to treatment in head and neck cancer. Interestingly, no study has examined the experience of patients attending an MTM. The present study addressed two questions: Does the MTM cause anxiety/depression for patients who are present? Are patients satisfied at the end of the meeting?
Patients and methods
The study included all patients attending an MTM, who agreed to participate in the study and who fully completed two questionnaires. The Hospital Anxiety and Depression Scale (HADS) and a satisfaction questionnaire were filled out at three time-points: T0 before MTM, T1 at end of MTM, and T2 1 month after MTM for the HADS; and T1 and T2 for the satisfaction questionnaire.
Results
There were no significant differences in the number of patients experiencing anxiety between T0 and T1 (P = 0.6085), T0 and T2 (P = 1) or T1 and T2 (P = 1). Likewise, there were no significant differences in the number of patients in depression between T0 and T1 (P = 0.9397), T0 and T2 (P = 1) or T1 and T2 (P = 1). Mean satisfaction was good (question 14 on the satisfaction questionnaire: 8.7/10 at T1 and 7.7/10 at T2), but with a significant decrease between T1 and T2 (P = 0.0009: i.e., < 0.05). Percentage information remembered (question 12) significantly decreased between T1 (mean 86%, standard deviation 0.2, median 94%) and T2 (78% ± 0.2, median 81%) (P = 0.03). Presence in the MTM did not appear to induce or increase anxiety or pre-existing depressive syndrome.
https://ift.tt/2KGBXmD
Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysis
Abstract
Purpose
This study was conducted in order to determine whether marsupialization before definitive enucleation of nonsyndromic odontogenic keratocysts (OKCs) is capable of decreasing the recurrence rate more effectively than just enucleation.
Methods
We searched MEDLINE, Web of Science, Scopus, and Cochrane Library, until August 5th of 2017 for original studies reporting on the treatment of OKCs with and without previous marsupialization and the related recurrence rate. All records and data were independently assessed, meta-analysis was performed, and the odds ratio of recurrence was the effect measure; P value for the summary effect of < 0.05 was considered statistically significant.
Results
The 748 records retrieved were reduced to 6 studies to be qualitatively assessed and 5 studies were included in the meta-analysis. The overall odds ratio of 0.57 [0.25–1.28] of the pooled values pointed that marsupialization reduced the recurrence rate in comparison to just enucleation; however, the P value showed that there is no strong evidence to support this statement.
Conclusions
Marsupialization followed by enucleation after 12 to 18 months reduces the recurrence rate, but more studies are necessary to support this statement.
https://ift.tt/2KG5MDW
Identification of DNA methylation module in seasonal allergic rhinitis
Publication date: Available online 29 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Zhenfeng Gao, Mengmeng Huang, Zhe Qu, Junchao Wang, Xiaolan Cai
Abstract
Objective
In this study, we aimed to characterize the significant DNA methylation module of seasonal allergic rhinitis.
Methods
Methylation profiling E-GEOD-50222 was obtained from ArrayExpress database. Differential co-methylation network (DCN) was constructed based on the methylation data. From the DCN, we characterized multiple differential modules (M-DMs). Significant module was mapped to pathways to identify significant enriched pathways.
Results
At the criteria of absolute Pearson coefficient value > 0.8, the edges were chose to construct DCN. In the DCN, 16 seed genes were identified. Seed genes were used to construct M-DMs. After statistical analysis, one significant module with p<0.05 were obtained. After pathways enrichment analysis, 17 significant pathways with p<0.05 were obtained, and most of these pathways were associated with DNA replication.
Conclusion
One multiple differential module was identified in SAR, and seventeen significant pathways mapped by the module were identified as important factors in SAR. These results may provide new insights into the molecular mechanism of DNA methylation in SAR.
https://ift.tt/2DUPrtV
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