Adjusting oral oxybutynin medication for hyperhidrosis to reflect seasonal temperature variations

Dermatologic Therapy, EarlyView.


https://ift.tt/2jKcvzY

Bactericide effect of methylene blue associated with low-level laser therapy in Escherichia coli bacteria isolated from pressure ulcers

Abstract

The present study analyzed the bactericidal effect of methylene blue associated with low-level lasers on Escherichia coli isolated from a pressure ulcer. Microbiological material from a pressure ulcer was isolated using an aseptic swab, and antimicrobial activity was verified using the diffusion disc method. Methylene blue was used at concentrations of 0.001 and 0.005%, and low-level lasers of 670, 830, and 904 nm, with the energy densities of 4, 8, 10, and 14 J/cm², were tested on three plates each and combined with methylene blue of each concentration. In addition, three control plates were used, with each concentration and energy density separated without any interventions. The results were analyzed using the paired sample t test to determine the bactericidal effect of the methylene blue and using the ANOVA test to compare the effects of the energy densities and wavelengths among the low-level laser treatment protocols. The results showed bacterial reduction at wavelengths of 830 and 904 nm and more proliferation in wavelengths of 670 nm. In wavelength of 830 nm, a bacterial reduction was observed in the conditions with 0.001% methylene blue in all energy density utilized, with 0.005% methylene blue in energy density of 10 J/cm², and without methylene blue in energy density at 10 J/cm². And in a wavelength of 904 nm, all condition showed bacterial reduction with or without methylene blue. We concluded that the low-level lasers of 904 and 830 nm have bactericidal effects and at better energy densities (10 and 14 J/cm²).

https://ift.tt/2rwHVyb

Assessment of vestibular function in patients with chronic middle ear disease using the VHIT and VEMP test

Clinical Otolaryngology, EarlyView.


https://ift.tt/2wyZ2EH

Anatomical variations of the ethmoidal roof: differences between men and women

Abstract

Aim

During the paranasal sinuses surgery different complications may occur, both vascular and bony. The objective of the present study was to evaluate the ethmoidal roof configuration through the Keros and Yenigun classifications, analyzing results stratified by gender and side.

Materials and methods

We retrospectively analyzed 120 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in a coronal view and the anterior–posterior length in a cross section.

Results

The Keros Type II was the most frequent and no statistically significant difference was found when comparing by gender. Yenigun type I was more prevalent, and a statistically significant difference was found between men and women in types I and II (p = 0.010 and p = 0.049, respectively). Statistical difference was observed in anterior–posterior means in the comparison between both classifications. In both, right and left side for men (p = 0.003 and p = 0.05) and women (p = 0.029 and p = 0.039).

Conclusion

We demonstrate the morphological variability that exists in this region. Gender differences that must be considered by the surgeon to avoid complications. Further studies are needed to evaluate the value of these findings when predicting surgical complications. A CT before PNS surgery is already widely accepted.

https://ift.tt/2KMuUZp

An evaluation of in-office flexible fiber-optic biopsies for laryngopharyngeal lesions

Abstract

Background

Operative endoscopy and flexible fiber-optic in-office tissue biopsy are common techniques to assess suspicious laryngopharyngeal lesions.

Methods

The primary outcome was the delay to the initiation of treatment. Secondary outcomes were delay to biopsy, histopathological diagnosis, and assessment at a multidisciplinary oncology clinic. A retrospective analysis was performed to assess the relative delays between these approaches to biopsy of laryngopharyngeal lesions.

Results

There were 114 patients in the study cohort; 44 in-office and 70 operative endoscopic biopsies). The mean delay from consultation to biopsy was 17.4 days for the operative endoscopy group and 1.3 days for the in-office group. The mean delay from initial otolaryngology consultation to initiation of treatment was 51.7 days and 44.6 days for the operative endoscopy and in-office groups, respectively.

Conclusion

In-office biopsy reduced the time from initial consultation to biopsy. The temporal gains via in-office biopsy did not translate into faster access to treatment. This outcome highlights the opportunity to improve access to treatment for patients with early diagnosis.

https://ift.tt/2KN6mQ6

Bisphosphonate-related osteonecrosis of the human jaw: A combined 3D assessment of bone descriptors by histology and synchrotron radiation-based microtomography

Bisphosphonate-related osteonecrosis of the jaw (BRONJ), as other bone diseases, is supposed to be associated with an unbalanced bone remodeling process: thus, the full comprehension of the pathophysiology is fundamental to advance its treatment.

https://ift.tt/2FVfZbN

Predictors of dental plaque and gingivitis in patients receiving integrated dental treatment—a longitudinal retrospective study

Abstract

Objectives

The identification of predictors of supragingival biofilm accumulation may improve the results of therapeutic strategies for dental caries and periodontal diseases in general clinical practice. This study aimed to determine predictors of changes in visible plaque (VP) and gingival bleeding (GB) during integrated dental care.

Materials and methods

A retrospective longitudinal study was conducted by a census of patients receiving integrated dental care in a general clinical practice ambulatory at the Federal University of Rio Grande do Sul (Brazil). The sample comprised 91 charts of patients attended over a 6-months period. Gender, age, patient's main complaint, oral hygiene pattern, and clinical data were recorded from charts for the last two dental visits in the ambulatory. Changes in VP and GB were modeled by multiple linear regression and beta coefficients (b) were reported.

Results

The mean follow-up time was 13 months. Significant reductions in VP (32.8 ± 27.9 to 17.4 ± 19.4%; p < 0.001) and GB (27.1 ± 23.8 to 18.5 ± 17.3%; p < 0.001) were observed. Higher plaque reductions were predicted by higher baseline VP levels (p = 0.02), shorter time (< 12 months) elapsed between VP recordings (b = 14.1%, p = 0.02), interproximal cleansing (b = 11.9%, p = 0.03), lower number of sessions for oral hygiene instruction (b = 13.7%, p = 0.02), and presence of pockets ≥ 6 mm (b = − 12.4%, p = 0.02). GB was predicted by time of follow-up > 12 months and baseline VP.

Conclusions

Plaque and gingivitis improved in patients under integrated dental care. Factors related to motivation, oral hygiene practices, and baseline periodontal status might be used as predictors of VP and GB changes.

Clinical relevance

Visible plaque and gingivitis reduced in a sample of patients treated under integrated dental care. Some predictors may determine for which patients the treatment may be maximize and those who will need greater efforts to achieve the therapeutic goal for oral hygiene.

https://ift.tt/2ruF4oy

Comprehensive consideration and design with the virtual surgical planning− assisted treatment for hemifacial microsomia in adult patients

Hemifacial microsomia (HFM) is a frequently encountered congenital malformation syndrome involving both hard and soft tissue. Various surgical methods have been described to correct the deformities of HFM in the literature. This study aims to evaluate the therapeutic efficiency for HFM with the assistance of virtual surgical planning (VSP) and 3-dimensionally printed surgical templates.

https://ift.tt/2ruOPD7

Preforming of Polydioxanone sheets for orbital wall fractures – a technical note

Polydioxanone (PDS) sheets are commonly used in the treatment of orbital wall fractures. A potential drawback of PDS is that it may be difficult to adapt to the anatomy of the orbital walls. Therefore a study was conceived to test the feasibility of preforming PDS sheets.

https://ift.tt/2rtenAI

The Synergistic Effects of IL-6/IL-17A Promote Osteogenic Differentiation by Improving OPG/RANKL Ratio and Adhesion of MC3T3-E1 Cells on Hydroxyapatite

Osseointegration is the dynamic interaction of living bone with a biocompatible implant in the absence of an interposing soft-tissue layer. At a cellular level, the relationship of an implant with the surrounding tissue is highly dependent on the interaction between the materials and biological elements such as osteoblasts, collagen, fibroblasts, and blood components (Alghamdi et al., 2014). Various techniques and additives have been utilized to improve osseointegration; recent studies have demonstrated that biomolecules such as growth factors, proteins, and cytokines play essential roles in enhancing bone regeneration (Vo et al., 2012).

https://ift.tt/2KMReCi

Biomechanıcal evaluatıon of hybrid fixatıon method of sagittal split ramus osteotomy in mandibular advancement

Sagittal split ramus osteotomy (SSRO) is one of the most common methods for the treatment of the congenital and developmental deformities of mandible (Wolford et al., 2000). The most important advantages of the technique are its potential for higher recovery rates and its being a relatively easy surgical technique to perform (Olivera et al., 2012; Ghang et al., 2013). However, stability issues of the segments being positioned during the surgery and the risk of skeletal relapses are problems that may occur postoperatively (Brasileiro et al., 2012; Sato et al., 2014).

https://ift.tt/2rv8bbj

Conservative surgical treatment of medication related osteonecrosis of the jaw (MRONJ) lesions in patients affected by osteoporosis exposed to oral bisphosphonates: 24 months follow-up

The purpose of the study was to evaluate the efficacy of conservative surgical treatment of medication related osteonecrosis of the jaw (MRONJ) in patients affected by osteoporosis and exposed to oral bisphosphonates (BPs).Subjects diagnosed with MRONJ and osteoporosis under oral BPs that had undergone conservative surgery and had at least 24 months follow-up were included. All patients received medical-antibiotic therapy and then underwent conservative surgical treatment consisting of sequestrectomy, soft tissue debridement and bone curettage with limited or no extension.

https://ift.tt/2KHLY2x

Impact of different placement depths on the crestal bone level of immediate versus delayed placed platform-switched implants

The preservation of peri-implant bone is one requirement for long-term success of dental implants. The purpose of this study was to evaluate the impact of subcrestal placement on the crestal bone level of immediate versus delayed placed implants after loading.

https://ift.tt/2KM1s5R

Definitive treatment of the negative vector orbit

In a negative vector orbit, the most anterior globe portion protrudes past the malar eminence. As bulging eyes are considered unaesthetic, patients usually seek correction. However, most current correction techniques produce suboptimal results. Here, we present a surgical technique that sets back the globe and protrudes the malar bone using an intraoral approach. All five patients (aged 17 to 41 years) in our case series reported being satisfied with the improvement achieved using this technique.

https://ift.tt/2HZS5BG

Distress thermometer for preoperative screening of patients with oral squamous cell carcinoma

In this study, we evaluate the association between distress, various demographic and medical variables, and the prevalence of psychosocial distress in preoperative patients with oral squamous cell carcinoma. A total of 100 consecutive patients were recruited into the study and asked to complete the Distress Thermometer (DT) form with the Problem List questionnaire prior to surgical intervention; the average distress score was 5.7 ± 2.7. The distress score was neither correlated with age (r= −0.025; p=0.804) nor with tumor size (r= 0.028; p=0.785).

https://ift.tt/2rv7Yox

Integrated behavioral health care for management of stress in allergic diseases

The present article will review current findings regarding the management of stress in allergic disease.

https://ift.tt/2FXCgpf

The effect of transcutaneous neuromuscular electrical stimulation on laryngeal vestibule closure timing in swallowing

Abstract

Background

The purpose of this study was to investigate the effect of transcutaneous neuromuscular electrical stimulation (NMES) on the timing of laryngeal vestibule closure during the pharyngeal stage of swallowing in healthy adults. The theoretical framework proposed that NMES applied to these muscles would present a perturbation to laryngeal vestibular closure reaction time (the amount of time for the laryngeal vestibule to close once the swallowing reflex has been triggered) by providing an antagonistic force to the direction of vestibule closure.

Methods

Nine healthy adults (2 males, 7 females) received ten consecutive stimulations applied to the submandibular hyolaryngeal muscles while performing dry swallows. Laryngeal vestibule closure reaction time (LVCrt) and the laryngeal vestibule closure duration (LVCd) were measured from videoflouroscopic images pre-stimulation and post-stimulation.

Results

Results indicated a significant effect of stimulation on LVCrt but not LVCd. LVCrt was significantly reduced (timing was faster) during swallows immediately after stimulation compared to pre-stimulation.

Conclusions

Findings from this study support the supposition that laryngeal muscles respond to perturbations via adaptation learning, which might be used for rehabilitation of neuromuscular swallowing impairment. This pilot study supports the need for further research.

https://ift.tt/2K6eAl3

New method of alloplastic reconstruction of the mandible after subtotal mandibulectomy for medication-related osteonecrosis of the jaw

Medication-related osteonecrosis of jaws (MRONJ) may require subtotal mandibulectomy, which can lead to severe mandibular defects.1 Reconstruction of the mandible using osseous free flaps causes morbidity at the donor site, and is often complicated by coexisting conditions and the often advanced age of the patient.2 Alloplastic reconstruction using mandibular reconstruction plates may be followed by fracture or exposure of the plate,3,4 whereas not to reconstruct the defect results in poor functional outcome and disfigurement.

https://ift.tt/2rv5UwN

Radial forearm flaps with venous compromise: correlations between salvage techniques and their rates of success

We retrospectively analysed the reliability of anastomosis of the deep venous system as a salvage technique for a free radial forearm flap that has developed venous compromise. The primary predictors were the salvage techniques, which comprised anastomosis of the deep venous system and a repeat of the original anastomosis, and the primary outcome measure was the rate of success. The potential confounders included original venous outflow, the original causes of the venous compromise, and the number of venous anastomoses.

https://ift.tt/2I0T5pg

Mutations affecting the actin regulator WDR1 lead to aberrant lymphoid immunity

Publication date: Available online 8 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Laurène Pfajfer, Nina K. Mair, Raúl Jiménez-Heredia, Ferah Genel, Nesrin Gulez, Ömür Ardeniz, Birgit Hoeger, Sevgi Köstel Bal, Christoph Madritsch, Artem Kalinichenko, Rico Chandra Ardy, Bengü Gerçeker, Javier Rey-Barroso, Hanna Ijspeert, Stuart G. Tangye, Ingrid Simonitsch-Klupp, Johannes B. Huppa, Mirjam van der Burg, Loïc Dupré, Kaan Boztug
BackgroundThe actin-interacting protein WDR1 promotes cofilin-dependent actin filament turnover. Biallelic WDR1 mutations have recently been identified in an immunodeficiency/autoinflammatory syndrome with aberrant morphology and function of myeloid cells.ObjectiveGiven the pleiotropic expression of WDR1, we here investigated to what extent it might control the lymphoid arm of the immune system in humans.MethodsHistological and detailed immunological analyses were performed to elucidate the role of WDR1 in development and function of B and T lymphocytes.ResultsWe here identified novel homozygous and compound heterozygous WDR1 missense mutations in six patients belonging to three kindreds, who presented with respiratory tract infections, skin ulceration and stomatitis. In addition to defective adhesion and motility of neutrophils and monocytes, WDR1 deficiency was associated with aberrant T-cell activation and B-cell development. T lymphocytes appeared to develop normally in the patients except for the T follicular helper subset. However, peripheral T cells from the patients accumulated atypical actin structures at the immunological synapse and displayed reduced calcium flux and mildly impaired proliferation upon TCR stimulation. WDR1 deficiency was associated with even more severe abnormalities of the B-cell compartment, including peripheral B-cell lymphopenia, paucity of B-cell progenitors in the bone marrow, lack of switched memory B cells, reduced clonal diversity, abnormal B-cell spreading and increased apoptosis upon BCR/TLR stimulation.ConclusionOur study identifies a novel role for WDR1 in adaptive immunity, highlighting WDR1 as a central regulator of actin turnover during the formation of the B-cell and T-cell immunological synapses.

Graphical abstract

Teaser

Capsule summary: Patients harboring biallelic WDR1 mutations present with a complex immunodeficiency characterized by functional defects of myeloid and lymphoid cells and therefore require clinical strategies to compensate for both defective innate and adaptive immunity.


https://ift.tt/2rstk6U

miRNAs are required for Langerhans cell, skin and lung resident macrophage ontogeny

Publication date: Available online 8 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Yi Yao, Carly Martin, Congcong Yin, Chunyuan Guo, Zheng Dong, Li Zhou, Qing-Sheng Mi

Teaser

Capsule summary: Our study demonstrates that miRNAs serve as critical epigenetic regulators in the ontogeny of LCs and TRMs in the skin and lungs, suggesting that miRNAs may be promising targets for LC and TRM-related allergic diseases.


https://ift.tt/2wlDATn

Eosinophilic Esophagitis: time to classify into endotypes?

Publication date: Available online 8 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Anna E. Ferguson, Patricia C. Fulkerson




https://ift.tt/2IpJpUp

Reference Values for Peripheral Blood Lymphocyte Subsets of Healthy Children in China

Publication date: Available online 8 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Yuan Ding, Lina Zhou, Yu Xia, Wei Wang, Ying Wang, Li Li, Zhongxiang Qi, Linqing Zhong, Jinqiao Sun, Wenjing Tang, Fangfang Liang, Haijuan Xiao, Tao Qin, Ying Luo, Xuezhen Zhao, Zhou Shu, Ying Ru, Rongxin Dai, Hong Wang, Yanping Wang, Yongjie Zhang, Suqian Zhang, Cong Gao, Hongqiang Du, Xuan Zhang, Zhaolong Chen, Xiaochuan Wang, Hongmei Song, Jun Yang, Xiaodong Zhao

Teaser

This multi-centered study provides detailed immunophenotyping of peripheral blood lymphocyte subpopulations in a large cohort of children from China, and serves as an important ethnic and age-specific reference tool for evaluation of immune abnormalities.


https://ift.tt/2K1KeAb

A retrospective study of treatment for curative synchronous double primary cancers of the head and neck and the esophagus

Curative synchronous double primary cancers of the head and neck and the esophagus (CSC-HE) are frequently detected, but a standard treatment remains to be established. We studied the clinical course to explore appropriate treatment strategies.

https://ift.tt/2IoFSWK

Extensive subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar surgery

Third molar extraction is a common procedure in dental surgery. Common complications that may occur post procedure include pain, trismus, bleeding, dry socket, and nerve injuries. Subcutaneous emphysema is an uncommon complication. A rare case of extensive cervicofacial subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar extraction is reported here. Issues relating to the diagnosis, aetiology, and management of these complications are discussed.

https://ift.tt/2HZgpUl

Retropharyngeal lipoma presenting with snoring in a child

Retropharyngeal lipoma in a child is an extremely rare pathological entity. The unusual case of a child with a retropharyngeal lipoma presenting with snoring is reported. Retropharyngeal lipoma should be considered in the differential diagnosis of snoring in children.

https://ift.tt/2ruLiVn

Horizontal (vs. vertical) closure of the neo-pharynx is associated with superior postoperative swallowing after total laryngectomy

Giannis Thrasyvoulou, MD, PGCert Med, PhD; Petros V. Vlastarakos, MD, MSc, PhD; Michael Thrasyvoulou, BSc(Math); Aristides Sismanis, MD, FACS

Abstract

We conducted a cross-sectional study to compare the horizontal and vertical methods used in the surgical closure of the neo-pharynx after total laryngectomy in terms of their effect on swallowing function, swallowing-related quality of life (QOL), and overall QOL. We also assessed the potential influence of age (≤64 vs. ≥65 yr) and the type of treatment modality (primary, salvage, or total laryngectomy with radiotherapy) on outcomes. Our final study population was made up of 34 patients-31 men and 3 women, aged 49 to 89 years (mean: 66.8)-who had undergone a total laryngectomy. One year after surgery, all patients were asked to complete the M.D. Anderson dysphagia inventory (MDADI), which quantifies swallowing function and swallowing-related QOL, and the University of Washington quality-of-life questionnaire (UW-QOL), which quantifies overall QOL. Of the 34 patients, 16 had undergone a horizontal surgical closure of their neo-pharynx and 18 a vertical closure. According to the MDADI, patients in the horizontal group experienced significantly better swallowing function/QOL; the mean composite MDADI scores were 91.5 in the horizontal group and 68.3 in the vertical group (p = 0.005). We found no significant difference in terms of overall QOL, as the respective mean UW-QOL scores were 81.0 and 80.8 (p = 0.93). The population correlation coefficient was positive in both groups, but more so in the horizontal group (ρhorizontal = 0.876 and ρvertical = 0.676). Neither age nor the type of treatment modality employed influenced swallowing function/QOL (page = 0.10, ptreatment modality = 0.78) or overall QOL (page = 0.08, ptreatment modality = 0.59). We conclude that horizontal closure of the neo-pharynx is superior to vertical closure in terms postoperative swallowing function/QOL but not overall QOL.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2KKGtAk

Anxiety, depression, and hopelessness in patients before and after treatment for peripheral facial paralysis

Fatih Arslan, MD; Mert Cemal Gokgoz, MD; Murat Binar, MD; Emre Aydemir, MD; Abdullah Durmaz, MD

Abstract

We conducted a prospective study to investigate the effectiveness of pharmacologic treatment on alleviating facial paralysis, as well as the anxiety and depression that are associated with it. Our study population was made up of 105 patients-59 men and 46 women, aged 18 to 60 years (mean: 38.2)-who had acute idiopathic peripheral facial paralysis. Before treatment, paralysis was classified as House-Brackmann grade II or III in 44 patients (41.9%) and grade IV to VI in the remaining 61 (58.1%). After treatment, 73 patients (69.5%) improved to grade I, 29 (27.6%) were at grade II or III, and only 3 (2.9%) remained at grade IV or higher. Mean scores on the Beck anxiety inventory, the Beck depression inventory, and the Beck hopelessness scale were 20.30, 19.75, and 7.57, respectively, before treatment and 5.72, 5.68, and 2.85 afterward; the difference in all three measures was statistically significant (p < 0.001). We found no correlation between the degree of facial paralysis and anxiety levels (r = 0.094, p = 0.338) or depression levels (r = 0.181, p = 0.064). Clinicians should consider asking patients with peripheral facial paralysis about their feelings of anxiety, depression, and hopelessness and refer them for a psychiatric consultation if necessary.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2KLZ6nf

Computational analysis of swallowing mechanics after surgery for obstructive sleep apnea

Mark A. Ellis, MD; Mariah B. Pate, MD; Hugh D. Dorris, BA; William G. Pearson Jr., PhD; Jimmy J. Brown, DDS, MD

Abstract

Multilevel upper airway surgery for obstructive sleep apnea (OSA) has been shown to cause clinically significant dysphagia in some patients. We describe the cases of 2 adults with OSA who developed persistent dysphagia after multilevel upper airway surgery. Patient-specific computational analysis of swallowing mechanics (CASM) revealed absent pharyngeal shortening and aberrant tongue base retraction in both patients. These findings are consistent with the OSA surgical goal of enlarging the hypopharyngeal airway but likely contributed to our patients' dysphagia. Patient-specific CASM allows for sensitive identification of swallowing mechanical dysfunction that might otherwise be overlooked, and it may be utilized in future head and neck surgery patients to analyze swallowing dysfunction associated with treatment.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2rw8JxC

Screening and management of postoperative hypoparathyroidism-induced hypocalcemia in thyroidectomized patients in the endocrine ward compared with the surgical ward

Nina Sauer, MD; Anne Lautenbach, MD; Katharina Pohl, MD; Gerhard Schon, MD; Hans-Peter Brose, MD; Clarissa Alexandra Schulze zur Wiesch, MD; Jens Carsten Aberle, MD

Abstract

Transient hypoparathyroid-associated hypocalcemia is a common side effect after thyroidectomy. Not only may it be life-threatening, but it also can distinctly affect length of hospital stay and treatment costs. Screening and treatment practices are suspected to differ between clinicians in endocrine and surgical wards. We therefore compared discipline-related differences in screening and treatment of hypocalcemia as well as the length of hospital stay of patients after thyroidectomy. Data from 170 patients treated with total thyroidectomy in the Department of Otolaryngology (n = 29), General Surgery (n = 49) and Endocrinology (n = 92) were analyzed, and measurements of postoperative calcium and parathyroid hormone, calcium at time of discharge, percentage of discharge with a calcium level <1.9 mmol/L (defined as severe hypocalcemia), treatment of hypocalcemia, and duration of hospitalization were compared between disciplines. Postoperative calcium levels were measured in 97.8% of patients in endocrine wards compared with 83.3% in surgical departments (p = 0.001), and discharge with a calcium level <1.9 mmol/L was statistically more frequent in surgical vs. endocrine wards. Additional to calcium supplementation, active vitamin D was administered in 95% of patients treated in endocrine wards vs. 35% in surgical wards. Length of hospitalization was 8.12 (±6.62) days (endocrinology) to 10.55 (±9.39) days (surgical wards) (p = 0.05). Monitoring of calcium levels is an important indicator of the quality of postoperative care after thyroidectomy. To prevent postoperative hypocalcemia-induced complications and to reduce the length of hospital stay, an interdisciplinary approach for the management of hypocalcemia after thyroidectomy might be a promising model for future treatment concepts.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2HZeS0x

Esthesioneuroblastoma with widespread distant metastasis: Case report and literature review

Manraj Khosla, MD; Cristina Pecci, DO; Annie Do, MD; Lee McGhan, MD; Mahesh Seetharam, MD; Richard Sue, MD

Abstract

Esthesioneuroblastoma (ENB) is an uncommon sinonasal tract tumor, and it is even more uncommon among all neoplasms. Literature regarding the incidence and spread of the disease is limited. The prognosis of metastatic disease is poor. In this report, we present a case of recurrent ENB in a young woman involving metastasis to the neck, lungs, and ovary. Metastasis to the cervical lymph nodes is relatively common, but metastasis to the lungs is rare. Furthermore, to our knowledge, no cases of ovarian metastases of ENB have been reported. This case highlights the potential for widespread metastatic disease, suggesting the need for more frequent and thorough surveillance of patients diagnosed with recurrences of this tumor.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2rtgEfl

Wireless mobile ultrasonography-assisted parotid duct stone removal

Na Rae Oh, MD; Joo Hyun Woo, MD, PhD; Dong Young Kim, MD, PhD; Min Kwan Baek, MD, PhD

Abstract

Ultrasonography is highly sensitive for the diagnosis of sialoliths. Recently, wireless mobile ultrasonography was developed. We describe the case of a 49-year-old man who presented with painful postprandial left cheek swelling. Computed tomography detected a solitary 5-mm parotid duct stone with infection at the anterior portion of the left masseter muscle. Transoral stone removal was planned, although difficulty was expected in view of the surrounding infection. Surgery was performed under the guidance of mobile ultrasonography, and the stone was removed safely.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2ruy0Iy

An undulating vallecular cyst

Yu-Hsuan Lin, MD; Ming-Yee Lin, MD, PhD

Most vallecular cysts are indolent, but they carry the potential for airway obstruction if they become enlarged.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2KHAT1r

Surgical treatment of symptomatic subglottic stenosis during the third trimester of pregnancy

Erin R. Hamersley, DO, LT MC USN; Angel J. Perez, MD, LCDR MC USN; Michele P. Morrison, DO, CDR MC USN, FACS; Halton W. Beumer, MD, MAJ MC USAF

Abstract

Subglottic stenosis is a narrowing of the airway distal to the glottis. Airway narrowing can be severe and, when coupled with pregnancy, can pose a significant threat to the mother and fetus. There is sparse literature describing treatment of these critical patients, posing a challenge for management. We describe our experience with a 31-year-old woman with idiopathic subglottic stenosis who became symptomatic during her pregnancy, requiring surgical intervention early in her third trimester. The following case report describes this patient's presentation and management, in which an awake dilation technique was used. We also include a literature review on the management of subglottic stenosis in pregnancy.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2ruxQAW

Balloon catheter dilation of a septated frontal sinus

Joseph P. Mirante, MD, MBA, FACS; Dewey A. Christmas, MD; Eiji Yanagisawa, MD, FACS

Balloon catheter dilation has been associated with symptomatic relief comparable to that associated with traditional endoscopic sinus surgery, but with less tissue destruction.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2KNhGM4

Aggressive desmoid fibromatosis of the neck after total thyroidectomy

Alexander Delides, MD, PhD; Ioannis Plioutas, MD; Stephanos Konstantoudakis, MD; Pavlos Maragoudakis, MD, PhD

Treatment for this lesion is surgical resection, but external beam radiation or systemic drug treatment may be used when total resection is impossible.

ENT Journal provides full text articles to our registered members.
Please log in or sign up for a FREE membership to view the full content:

• REGISTER AS A MEMBER
• If you are already registered, SIGN IN

You may also like to:

• Sign Up For The Free eNewsletter

https://ift.tt/2rsZfmQ

Variations of Retromandibular Vein and Its Relation to Facial Nerve Within Parotid Gland

Abstract

Maxillary vein and superficial temporal vein unite to form the retromandibular vein in the parotid gland. The facial nerve lies lateral to external carotid artery and retromandibular vein. Identifying and preserving the facial nerve is the prime motto during parotidectomy. So the variations of facial nerve and the retromandibular vein should be known so as to avoid injury to both. The variations we encountered during parotid surgery will be helpful in avoiding unexpected bleeding and injury to facial nerve.

https://ift.tt/2IrlCDQ

Smartphone adapters for flexible Nasolaryngoscopy: a systematic review

Flexible nasolaryngoscopy is an essential component of the otolaryngological physical exam. Historically, the ability to create and share video recordings of these endoscopic exams has been limited by poor mob...

https://ift.tt/2wrGMNg

Hematoma cervical por sangrado espontáneo de adenoma paratiroideo

Publication date: Available online 8 May 2018
Source:Acta Otorrinolaringológica Española
Author(s): Alberto Martínez-Martínez, Jade García-Espinosa




https://ift.tt/2I3s6Fy

Variations of Retromandibular Vein and Its Relation to Facial Nerve Within Parotid Gland

Abstract

Maxillary vein and superficial temporal vein unite to form the retromandibular vein in the parotid gland. The facial nerve lies lateral to external carotid artery and retromandibular vein. Identifying and preserving the facial nerve is the prime motto during parotidectomy. So the variations of facial nerve and the retromandibular vein should be known so as to avoid injury to both. The variations we encountered during parotid surgery will be helpful in avoiding unexpected bleeding and injury to facial nerve.

https://ift.tt/2IrlCDQ

New onset colitis in an adult patient with chronic granulomatous disease treated with hematopoietic stem cell transplantation: a diagnostic dilemma

Chronic granulomatous disease (CGD) is a rare primary immunodeficiency characterized by recurrent life-threatening bacterial and fungal infections, granuloma formation and intestinal disease. This disease is c...

https://ift.tt/2rrQdY6

Low mood, visual hallucinations, and falls – heralding the onset of rapidly progressive probable sporadic Creutzfeldt–Jakob disease in a 73-year old: a case report

Creutzfeldt–Jakob disease is a rare and rapidly fatal neurodegenerative disease. Since clinicians may see only very few cases during their professional career, it is important to be familiar with the clinical ...

https://ift.tt/2FUNOcZ

Infective endocarditis due to Burkholderia cepacia in a neonate: a case report

Burkholderia is a pathogen that is rarely seen in clinical cases. However, this organism is being found more commonly in hospitals.

https://ift.tt/2KLcEzn

Komplikationen bei Operationen an der Rhinobasis

Zusammenfassung

Operationen der Rhinobasis werden zur Behandlung ernsthafter und komplizierter Krankheitsbilder durchgeführt und zählen zu den komplexen Eingriffen. Komplikationen sind bei diesen Eingriffen trotz erheblicher Fortschritte in den Operationstechniken relativ häufig und teilweise schwerwiegend. Die endoskopischen Operationstechniken der Rhinobasis scheinen seltener mit Komplikationen assoziiert zu sein als offene Operationsmethoden. Es werden verschiedene Klassifikationen zur Kategorisierung dieser Komplikationen vorgeschlagen, deren Anwendung beim Bericht über Komplikationsraten empfohlen werden kann. Zu den wichtigsten und häufigsten Komplikationen bei Rhinobasisoperationen zählen Blutungen, Liquorrhö, Meningitis und Hirnnervenschädigungen. Zur Vermeidung von Komplikationen sind eine sorgfältige Planung, eine enge interdisziplinäre Kooperation, die Kompetenz des Schädelbasiszentrums und seiner Mitarbeiter und ein stringentes Qualitätsmanagement von entscheidender Bedeutung. Im Hinblick auf die Häufigkeit und Schwere der möglichen Komplikationen spielt die sorgfältige und vollständige Aufklärung der Patienten eine zentrale Rolle.

https://ift.tt/2jIqsyD

Metastatic Gallbladder Melanoma Presenting as Acute Emphysematous Cholecystitis

Malignant melanoma is an aggressive tumor with a high potential for distant metastases, including spread to the gallbladder where it represents more than half of all metastases detected at autopsy. Yet, it is rarely symptomatic in life and is a rare cause of acute cholecystitis. Emphysematous cholecystitis is a rare, potentially fatal variant of acute cholecystitis characterized by the presence of gas in the gallbladder lumen or wall. We report a 77-year-old woman with acute emphysematous cholecystitis as the initial feature of recurrent melanoma metastatic to the gallbladder. This exceptional association highlights the need to consider a relapse of malignancy when assessing unexplained abdominal symptoms in any patient with a prior history of melanoma.

https://ift.tt/2FVs3tr

The Outcome of Papillary Thyroid Cancer Associated with Graves’ Disease: A Case Control Study

Introduction. Thyroidectomy is now a less popular therapeutic option for Graves' disease. The frequency of thyroid nodule and the cancer risk of these nodules accompanying Graves' disease are controversial. The outcome of thyroid cancers coexisting with Graves' disease is debated. Study Design. Designed as retrospective case control study of papillary thyroid cancers associated with Graves' disease and those with euthyroid background. Pathological characteristics and outcome of papillary thyroid cancers in the two groups were compared. Results. The tumour characteristics did not differ significantly in the groups. The patients were followed for a mean period of 77.32 months and found significant incidences of disease progression in patients with papillary thyroid cancer associated with Graves' disease (; OR 2.747, CI 1.078–7.004). Disease progression as new distant metastases mostly in skeletal locations was high in this group compared to euthyroid group (; OR 4.121, CI 1.008–15.600). There was higher incidence of cumulative metastatic diseases in papillary thyroid cancer associated with Graves' disease. Conclusion. Papillary thyroid cancers associated with Graves' disease show aggressive biological behaviour and favoured site of distant metastases was osseous locations. Early diagnosis by routine screening of Graves' disease patients with ultrasound imaging and aspiration studies is recommended.

https://ift.tt/2jGy8Bp

Smartphone adapters for flexible Nasolaryngoscopy: a systematic review

Abstract

Background

Flexible nasolaryngoscopy is an essential component of the otolaryngological physical exam. Historically, the ability to create and share video recordings of these endoscopic exams has been limited by poor mobility of fixed endoscopy towers. The advent of smartphone endoscope adapters has allowed physicians to create and share video recordings of endoscopy in a wide variety of locations that would not have previously been feasible. This paper sought to review the literature on the effect of smartphone endoscope adapters on patient care, patient satisfaction, and resident learning.

Methods

This systematic review was conducted according to PRISMA guidelines. A systematic literature search was performed for all relevant English language studies (1946–2017) using Ovid MEDLINE, PubMed, and EMBASE. The study protocol was registered with the PROSPERO database.

Results

A total of 91 abstracts were identified and screened by two independent reviewers. Based on inclusion and exclusion criteria, three studies were selected and subjected to full-text extraction as well as quality assessment. These studies demonstrated high diagnostic accuracy and quality of smartphone adapter-recorded videos, and a benefit of these devices on resident education. Due to the heterogeneity of included studies' methods and measures, a meta-analysis was not possible, so a qualitative synthesis of the literature results was performed.

Conclusion

Despite a paucity of data on the subject, the present study provided a comprehensive review of the literature, and suggested overall high diagnostic accuracy, quality, and enhancement of resident education with the use of smartphone endoscope adapters for flexible nasolaryngoscopy.

Trial registration

CRD42018086714.

https://ift.tt/2KLyUZV

Onkologie und Versorgung in Fach- und Publikumsmedien

https://ift.tt/2I5xQyv

Building a Renewed ImaGe After Head & Neck Cancer Treatment

Conditions:   Head and Neck Squamous Cell Carcinoma;   Body Image Disturbance
Intervention:   Behavioral: cognitive behavioral therapy
Sponsor:   Medical University of South Carolina
Recruiting

https://ift.tt/2FUtsR8

Randomized Multicentric Comparative Study Between a Conventional and an Intensive Follow up Strategy After Treatment of a Head and Neck Squamous Cell Carcinoma

Condition:   Head and Neck Squamous Cell Carcinoma
Interventions:   Procedure: Nasofibroscopy;   Other: Low Dose Chest CTscan;   Other: injected CT-scan;   Other: whole body PET-CT;   Procedure: Lugol upper gastrointestinal endoscopy;   Procedure: Biopsy
Sponsors:   Gustave Roussy, Cancer Campus, Grand Paris;   French National Cancer Institute
Recruiting

https://ift.tt/2jHi8z7

Metronomic Oral Vinorelbine Plus Anti-PD-L1/Anti-CTLA4 ImmunothErapy in Patients With Advanced Solid Tumours

Conditions:   Advanced Solid Tumours;   Breast Cancer;   Head and Neck Cancer;   Cervix Cancer;   Prostate Cancer
Intervention:   Drug: Durvalumab + Tremelimumab + metronomic Vinorelbine
Sponsors:   UNICANCER;   National Cancer Institute, France;   AstraZeneca;   Pierre Fabre Laboratories
Not yet recruiting

https://ift.tt/2FTSwYt

Appaconitine Patch for Oral Mucositis Pain Caused by Chemoradiotherapy in Patients With Nasopharyngeal Cancer

Condition:   Radiation Induced Oral Mucositis
Interventions:   Drug: Lappaconitine Adhesive Patch;   Drug: standard care
Sponsor:   Fujian Cancer Hospital
Not yet recruiting

https://ift.tt/2KHDRDc

A First in Human, Dose Escalation Study of JAB-3068 in Adult Patients With Advanced Solid Tumors

Conditions:   Non-small Cell Lung Cancer;   Head and Neck Cancer;   Esophageal Cancer
Intervention:   Drug: JAB-3068
Sponsor:   Jacobio Pharmaceuticals Co., Ltd.
Not yet recruiting

https://ift.tt/2FUPDGA

Executive summary of the Clinical Guidelines of Pharmacotherapy for Neuropathic Pain: second edition by the Japanese Society of Pain Clinicians

Abstract

Neuropathic pain has a substantial effect on quality of life (QOL). The Japanese Society of Pain Clinicians (JSPC) has developed clinical guidelines of pharmacotherapy for neuropathic pain. These guidelines offer clarity on recommendations based on both the most recent scientific evidence and expert opinions. Understanding the concept, disease entity, and burden of neuropathic pain, as well as its screening and diagnosis are important steps before starting pharmacotherapy. As well as other guidelines, the guidelines propose several lines of pharmacotherapies in a step-wise manner. To name a few different points, our guidelines propose an extract from inflamed cutaneous tissue of rabbits inoculated with vaccinia virus, which has been found to be effective for post-herpetic neuralgia in Japan, as one of the second-line drugs. When prescribing opioid analgesics, proposed as the third-line drugs, for neuropathic pain, the guidelines recommend physicians continue evaluations on either abuse or addiction. The guidelines do not recommend concomitant use of nonsteroidal anti-inflammatory drugs and acetaminophen because of lack of clinical evidence of their efficacy. If patients do not respond well to pharmacotherapy, which is prescribed in a step-wise manner, other treatment strategies should be considered to improve patients' activities of daily living and QOL.

https://ift.tt/2I4zuAe

Pyoderma gangrenosum après allogreffe de cellules souches hématopoïétiques

Publication date: Available online 7 May 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): H. Eddou, A. Ennouhi, M. Sina, A. Zinebi, J. El Benaye, M.K. Moudden, K. Doghmi, J.-V. Malfuson, M. Mikdame, M. El Baaj
IntroductionLe pyoderma gangrenosum (PG) est une dermatose neutrophilique rare qui peut compliquer l'évolution d'un certain nombre de maladies systémiques. Parmi ces dernières, les pathologies hématologiques représentent 3,5 % des cas. Il s'agit essentiellement de gammapathies monoclonales et de leucémies aiguës myéloblastiques.ObservationNous rapportons le cas d'un pyoderma gangrenosum survenu chez une patiente qui avait eu six mois plus tôt une allogreffe de cellules souches hématopoïétiques dans le cadre du traitement d'une leucémie aiguë lymphoblastique T.DiscussionCette association vient enrichir la liste des affections générales qui peuvent être associées au PG et celle des affections dermatologiques qui peuvent survenir chez les sujets greffés de moelle.BackgroundPyoderma gangrenosum (PG) is a rare form of neutrophilic dermatosis and is a potential complication in a number of systemic diseases. These include blood diseases, which represent 3.5% of cases, with the main forms being monoclonal gammopathy and acute myeloid leukemia.Patients and methodsHerein we report a case of pyoderma gangrenosum in a female patient who had undergone haematopoietic stem cell allograft six months earlier as part of her treatment for acute T-cell leukemia.DiscussionThis condition forms one of the general disorders potentially associated with PG and is a dermatological disorder that can occur in marrow graft patients.



https://ift.tt/2I69KDK

Rigid endoscope-assisted orotracheal intubation for vallecular cyst surgery in neonates and young infants

Publication date: July 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 110
Author(s): Haoyue Tan, Qi Huang, Antoine Paul, Wei Wang, Jingjie Li, Huan Jia
ObjectivesTo investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method.MethodsNeonatal and young infantile patients undergoing vallecular cyst surgery with a Cormack-Lehane Grade 3 or 4 glottic view between June 2013 and June 2015 were studied. Fifteen patients were intubated using rigid endoscopic assistance. Fifteen other patients who were intubated using the conventional technique were selected from the previous consecutive cases and used as a matched control group.ResultsREI was successfully performed in all 15 patients in one intubation attempt. The anesthetic preparation duration for the REI group was 6 min (interquartile range 5–7 min), which was shorter than the anesthetic preparation duration for patients intubated using the conventional technique (15 min [interquartile range 10–20 min], p < 0.001). The time required for intubation with a rigid endoscope was 66.5 s (interquartile range 58–74 s). No volume reduction of cysts or tracheotomies was needed in the REI group, and no cysts were ruptured nor did laryngeal mucosa damage occur with this technique. Among patients of conventional group, one required a tracheotomy, and four required cyst volume reduction by needle aspiration. No residual lesions or recurrence were observed during one year of postoperative follow-up in the REI group, and two recurrences were observed in the conventional group.ConclusionREI, which used common pieces of equipment in an otolaryngology operating room, may be a safe and feasible alternative for intubation in neonatal and young infantile patients with vallecular cysts or other difficult airway conditions.



https://ift.tt/2ruX0PV

Fatal choking in infants and children treated in a pediatric intensive care unit: A 7- year experience

Publication date: July 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 110
Author(s): Xiling Wu, Lei Wu, Zhimin Chen, Yunlian Zhou
IntroductionForeign bodies aspiration can lead to significant morbidity, few have examined in detail the deaths resulting from foreign bodies aspiration.MethodsWe conducted a review of children who presented to the pediatric intensive care unit of a university hospital due to fatal foreign bodies aspiration during the period of 2010–2017.ResultOf the 28 patients, 17 (61%) patients were male and 11 (39%) were female. The range of age was 1–63 months, with mean of 15.2 months. The common foreign bodies included milk, nuts and fruits. Majority of them had round shapes. All the patients died due to asphyxia or serious complications after foreign bodies aspiration.ConclusionsPrevention and early recognition remains a critical factor to reduce the mortality of foreign bodies aspiration.



https://ift.tt/2KMnjdk

Orchestration of intestinal homeostasis and tolerance by group 3 innate lymphoid cells

Abstract

The gastrointestinal tract is the primary site of exposure to a multitude of microbial, environmental, and dietary challenges. As a result, immune responses in the intestine need to be tightly regulated in order to prevent inappropriate inflammatory responses to exogenous stimuli. Intestinal homeostasis and tolerance are mediated through a multitude of immune mechanisms that act to reinforce barrier integrity, maintain the segregation and balance of commensal microbes, and ensure tissue health and regeneration. Here, we discuss the role of group 3 innate lymphoid cells (ILC3) as key regulators of intestinal health and highlight how increasing evidence implicates dysregulation of this innate immune cell population in the onset or progression of a broad range of clinically relevant pathologies. Finally, we discuss how the next generation of immunotherapeutics may be utilized to target ILC3 in disease and restore gastrointestinal tolerance and tissue health.

https://ift.tt/2jH7ZT3

Mohs Micrographic Surgery for Treatment of Non-melanoma Skin Cancer

Abstract

Purpose of Review

The aims of this report are to review literature supporting the use of Mohs micrographic surgery for treatment of non-melanoma skin cancer and to address indications and potential limitations of this form of therapy for non-melanoma skin cancer.

Recent Findings

The first randomized controlled trial comparing standard excision to Mohs micrographic surgery for treatment of facial basal cell carcinoma has recently been published, demonstrating a lower recurrence rate after Mohs surgery compared to standard excision after a 5-year and 10-year follow-up period, supporting its use in the treatment of high-risk basal cell skin cancer.

Summary

Mohs micrographic surgery is indicated for treatment of basal cell carcinomas and cutaneous squamous cell carcinomas at high risk of recurrence and for tumors located in areas where tissue conservation and/or functional preservation is desired.

https://ift.tt/2IoJ58x

The role of industry influence in sinus balloon dilation: Trends over time

The Laryngoscope, EarlyView.


https://ift.tt/2HXlJYl

Does the use of steroids perioperatively in parotid surgery affect facial nerve outcomes?

The Laryngoscope, EarlyView.


https://ift.tt/2rslYzC

Subcutaneous Lobular Capillary Hemangioma Presenting as a Facial Mass

Lobular capillary hemangioma is a benign lesion of the skin and mucous membranes. Subcutaneous lobular capillary hemangioma presents as a deeper nodule. Lack of the characteristic surface changes of this subtype of lobular capillary hemangioma makes the clinical diagnosis challenging. We describe clinical, radiologic, and histological features of a subcutaneous lobular capillary hemangioma tissue presenting as a facial mass in a 12-year-old male. The mass was a firm, nontender, immobile, subcutaneous nodule, with no color change of the overlying skin. CT imaging documented a hyperdense and nonlipomatous mass involving soft tissue of the left lateral nasal wall. An excisional biopsy was performed. Histologic evaluation showed subcutaneous lobular capillary hemangioma. Subcutaneous lobular capillary hemangioma, although uncommon, should be considered in the differential diagnosis of lateral nasal wall mass in children.

https://ift.tt/2rrUaMn

Author Correction: Hypericin-based photodynamic therapy induces surface exposure of damage-associated molecular patterns like HSP70 and calreticulin

This correction refers to our Short Communication published in Cancer Immunology Immunotherapy in the year 2012 [1]. It has come to our attention that some errors resulting from accidental oversight concerning incorrect deletion/replacement of temporary placeholder images during figure assembly and mounting occurred during the assembly of the "Intracellular Proteins" immunoblots presented in Fig. 1A and Fig. 1D.

https://ift.tt/2jHb05O

Anaphylaxie auf Kamillentee

Zusammenfassung

Es wird über den Fall eines Patienten mit Typ-I-Allergie berichtet, die nach dem Genuss von Kamillentee auftrat. Etwa 30 min nach Konsum des Tees wurde der Patient mit Juckreiz der Handflächen, Schwellung der Augenlider, Oberlippe und der Nasenschleimhaut sowie Globusgefühl hospitalisiert. Ein hereditäres Angioödem konnte ausgeschlossen werden. Im Pricktest wurde die Diagnose einer Typ-I-Allergie auf Kamillentee bestätigt.

https://ift.tt/2I01VDG

Idiopathic unilateral vocal-fold paralysis in the adult

Publication date: Available online 7 May 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): F. Rubin, A. Villeneuve, L. Alciato, L. Slaïm, P. Bonfils, O. Laccourreye
GoalTo analyze the characteristics of adult idiopathic unilateral vocal-fold paralysis.Material and methodsRetrospective study of diagnostic problems, clinical data and recovery in an inception cohort of 100 adult patients with idiopathic unilateral vocal-fold paralysis (Group A) and comparison with a cohort of 211 patients with isolated non-idiopathic non-traumatic unilateral vocal-fold paralysis (Group B).ResultsDiagnostic problems were noted in 24% of cases in Group A: eight patients with concomitant common upper aerodigestive tract infection, five patients with a concomitant condition liable to induce immunodepression and 11 patients in whom a malignant tumor occurred along the path of the ipsilateral vagus and inferior laryngeal nerves or in the ipsilateral paralyzed larynx. There was no recovery of vocal-fold motion beyond 51 months after onset of paralysis. The 5-year actuarial estimate for recovery differed significantly (P<0.0001): 53.2% in Group A versus 17.9% in Group B. In Group A, recovery occurred before the end of the second year following paralysis onset in 93% of cases. On univariate analysis, recovery in Group A was associated with younger age (P=0.0033), shorter time to consultation (P<0.0001), and absence of oncologic history (P<0.028). In case of non-recovery in Group A, malignant tumor along the ipsilateral vagus or inferior laryngeal nerve was found in 17.2% of cases, 81% of which manifesting during the 30 months following the onset of vocal-fold paralysis.ConclusionIn non-traumatic vocal-fold paralysis in adult patients, without recovery of vocal-fold motion, a minimum three years' regular follow-up is recommended.



https://ift.tt/2wvEtJh

Optical coherence tomography and confocal laser scanning microscopy as non-invasive tools in the diagnosis of sinonasal inverted papilloma: a pilot study

Abstract

Optical coherence tomography (OCT) and confocal laser scanning microscopy (CLSM) are light-based imaging techniques that allow for a visualization of microscopic tissue properties in vivo. Our study was to examine whether they allow for differentiation of inverted papilloma (IP) from nasal polyps (NP). Five cases of IP and NP, respectively, were investigated intraoperatively with OCT and CLSM. Biopsies were taken of the investigated area and were analyzed ex vivo with OCT and CLSM and then underwent HE-staining for standard light microscopy. On OCT images, IP showed the characteristic inverted character of the epithelium, that was thicker with a high degree of variability of thickness compared to the thin and homogenous epithelium of NP. In addition, the characteristic stromal edema of NP could be visualized. On CLSM images, the typical epithelial invaginations of IP appeared as crypts, while in NP the highly organized cylindric epithelium could be visualized. In vivo, OCT acquired images of sufficient quality to visualize these characteristics, while CLSM did not. Our study demonstrates that OCT and CLSM can distinguish IP from NP. Further technical development is required to apply the techniques clinically to guide intranasal biopsies or even to make them dispensable.

https://ift.tt/2KIeAJf

The ratios of pro-inflammatory to anti-inflammatory cytokines in the serum of chronic periodontitis patients with and without type 2 diabetes and/or smoking habit

Abstract

Objective

This study assessed the impact of chronic periodontitis (CP) and CP associated with type 2 diabetes mellitus (DM) and/or smoking on the serum ratios of pro- to anti-inflammatory cytokines.

Materials and methods

Subjects were assigned into one of the following groups: control (n = 25, non-diabetic non-smokers with no history of periodontitis), CP (n = 26, non-diabetic non-smokers with CP), DMCP (n = 30, non-smokers with DM and CP), SCP (n = 27, non-diabetic smokers with CP), and SDMCP (n = 22, smokers with type 2 DM and CP). Serum levels of 18 cytokines were measured using multiplex immunoassays.

Results

Six ratios of pro-inflammatory to anti-inflammatory cytokines were significantly higher in the CP group than in the control group (p < 0.05). Eleven, seventeen and nine ratios of pro-inflammatory to anti-inflammatory cytokines were significantly higher in the DMCP, SCP and SDMCP groups than in the control group, respectively (p < 0.05). The SCP group presented higher serum ratios of tumor necrosis factor (TNF)-α/interleukin (IL)-4, TNF-α/IL-5, IL-17/IL-13 and IL-6/IL-13 (p < 0.05) than the CP group. Cluster analysis revealed a relevant cluster composed of ten cytokines (IL-17, IL-23, interferon-γ, IL-12, IL-1β, IL-2, IL-21, IL-6, IL-4 and granulocyte-macrophage colony-stimulating factor [GM-CSF]) in the serum of subjects from the DMCP group.

Conclusions

The ratios of pro- to anti-inflammatory cytokines shift to favor a pro-inflammatory status in the serum of patients with CP and even more when CP is associated with one or both risk factors.

Clinical relevance

CP and CP associated with hyperglycemia and/or smoking might contribute to a systemic inflammatory burden and increased risk of systemic complications.

https://ift.tt/2IiJV6K

Properties of calcium silicate-monobasic calcium phosphate materials for endodontics containing tantalum pentoxide and zirconium oxide

Abstract

Objective

The aim of the study was to evaluate chemical-physical properties and apatite-forming ability of three premixed calcium silicate materials containing monobasic calcium phosphate (CaH₄P₂O₈) bioceramic, tantalum pentoxide and zirconium oxide, recently marketed for endodontics (TotalFill BC-Sealer, BC-RRM-Paste, BC-RRM-Putty).

Materials and methods

Microchemical and micromorphological analyses, radiopacity, initial and final setting times, calcium release and alkalising activity were tested. The nucleation of calcium phosphates (CaPs) and/or apatite after 28 days ageing was evaluated by ESEM-EDX and micro-Raman spectroscopy.

Results

BC-Sealer and BC-RRM-Paste showed similar initial (23 h), prolonged final (52 h) setting times and good radiopacity (> 7 mm Al); BC-RRM-Putty showed fast initial (2 h) and final setting times (27 h) and excellent radiopacity (> 9 mm Al). All materials induced a marked alkalisation (pH 11–12) up to 28 days and showed the release of calcium ions throughout the entire test period (cumulative calcium release 641–806 ppm). After 28 days ageing, a well-distributed mineral layer was present on all samples surface; EDX demonstrated relevant calcium and phosphorous peaks. B-type carbonated apatite and calcite deposits were identified by micro-Raman spectroscopy on all the 28-day-aged samples; the deposit thickness was higher on BC-RRM-Paste and BC-RRM-Putty, in agreement with calcium release data.

Conclusions

These materials met the required chemical and physical standards and released biologically relevant ions. The CaSi-CaH₄P₂O₈ system present in the materials provided Ca and OH ions release with marked abilities to nucleate a layer of B-type carbonated apatite favoured/accelerated by the bioceramic presence.

Clinical relevance

The ability to nucleate apatite may lead many clinical advantages: In orthograde endodontics, it may improve the sealing ability by the deposition of CaPs at the material-root dentine interface, and in endodontic surgery, it could promote bone and periodontal tissue regeneration. As premixed materials, their application in endodontics may result easier in several complex endodontic situations (apicoectomy, root perforation, presence of wide/wet apices).

https://ift.tt/2K1az18

Bell’s Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy

Abstract

The facial nerve is unique among the motor nerves. It has long and tortuous course through the temporal bone and within the Fallopian canal. Because of this it is more prone to paralysis than any other nerve in the body. The most frequent type of facial palsy is Bell's palsy. This is an acute idiopathic lower motor neuron palsy of the facial nerve which does not normally progress and which is most usually unilateral and self limiting,: the majority of cases remit within 4–6 months and nearly always remission is complete by 1 year. In those cases that do not recover it is my contention that this is caused by Either the progression, or after effects, of secondary ischemia: tertiary ischemia. In turn this causes thickening of the facial nerve sheath with a fibrous band or bands forming with resultant strangulation and compression of the nerve, which hampers its recovery. In such cases facial nerve decompression with slitting of the sheath and cutting of any fibrous bands would be the preferred management when allied with aggressive medical therapy.

https://ift.tt/2jGKkBS

Mögliche psychosoziale Langzeitfolgen onkologischer Behandlung

Zusammenfassung

Hintergrund

Das Überleben einer Krebserkrankung durch die onkologische Behandlung geht oft mit physischen und psychosozialen Langzeitfolgen einher, die besonderer Berücksichtigung bedürfen.

Ziel der Arbeit

Der Übersichtsartikel soll die wesentlichen psychosozialen Langzeitfolgen beschreiben und Ansätze zu ihrer Vorbeugung und Behandlung aufzeigen.

Material und Methoden

Sichtung bestehender relevanter wissenschaftlicher und fachlicher Beiträge im psychoonkologischen Kontext und Darstellung psychoonkologischer Erfahrungen.

Ergebnisse

Sowohl sozial als auch psychologisch bestehen potenziell stark belastende Einschränkungen für Menschen nach einer Krebserkrankung durch Arbeitsplatzkonflikte, finanzielle Einschränkungen, soziale Konflikte, eine Fatiguesymptomatik oder Ängste und depressive Symptome. Es bestehen psychoonkologische Angebote für Krebspatienten und ihre Angehörigen sowie vereinzelt spezifische Angebote für Langzeitüberlebende einer Krebserkrankung.

Diskussion

Es bedarf einer interdisziplinären Aufmerksamkeit für die psychosozialen Langzeitfolgen einer Krebserkrankung und ihrer Behandlung und noch mehr spezifischer Angebote.

https://ift.tt/2FRRTi0