Head and Neck Medicine by Alexandros G.Sfakianakis: 07/06/18

Παρασκευή 6 Ιουλίου 2018

The role of the otolaryngologist in the evaluation and management of headaches

Publication date: Available online 7 July 2018

Source: American Journal of Otolaryngology

Author(s): Shirley Hu, Samuel Helman, Peter Filip, Jonathan Cabin, Patrick Colley

Abstract

Background

Headaches are commonly evaluated in otolaryngology and often represent a diagnostic dilemma. This review addresses rhinogenic headache as well as trigeminal neuralgia and migraine, both of which can masquerade as sinus headache and whose management increasingly involves otolaryngology intervention. Discussion considers diagnostic criteria and novel therapies and derives an algorithm for clinical decision-making.

Data sources

OVID MEDLINE, Cochrane Library, and Google Scholar databases.

Methods

A literature search was performed to identify relevant articles published in the past 10 years addressing the diagnosis and management of rhinogenic headache, trigeminal neuralgia and/or migraine.

Findings

Rhinogenic headache: Identification of the specific cause must be achieved before treatment. No studies have mentioned the effect of certain therapies on the amelioration of headache. New techniques of balloon dilation for sinusitis are controversial, and their use remains contingent on surgeon preference. Removal of mucosal contact points has been shown to benefit quality of life in patients with contact point headache. Trigeminal neuralgia: Microvascular decompression is considered the gold standard for treatment, but percutaneous therapies can be effective for achieving pain control. Migraine: Patients who report amelioration of symptoms after targeted botulinum toxin injection may benefit from definitive decompression or nerve avulsion. Patients with mucosal contact points may have less favorable outcomes with migraine surgery if they are not simultaneously addressed.

Conclusions

A comprehensive understanding of the diagnostic workup and therapeutic options available for common headache etiologies is key to the management of a patient presenting with headache attributed to a rhinogenic cause.

https://ift.tt/2J1KtKw

Cadaveric dissection in oral and maxillofacial surgery: is it time for a new approach?

Publication date: Available online 7 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): A. Kanatas, D.A. Mitchell

https://ift.tt/2MVywbL

Preconceptional allergen immunization can induce offspring IL-17 secreting B cells (B17): do they share similarities with regulatory B10 cells?

Publication date: Available online 7 July 2018

Source: Allergologia et Immunopathologia

Author(s): Aline Aparecida de Lima Lira, Marília Garcia de-Oliveira, Amanda Harumi Sabô Inoue, Giovanna Rossi Beltrame, Alberto José da Silva Duarte, Jefferson Russo Victor

Abstract

Background

IL-17-producing B cells can be identified in both mice and human and were named B17 cells. The role of B17 cells still needs to be elucidated and its inflammatory or regulatory functions remain controversial.

Objective

We evaluate the effect of maternal immunization with OVA on offspring B cells that produces IL-17 and can show a regulatory potential by IL-10 production.

Methods

C57BL/6 WT, IL-10^−/− or CD28^−/− female mice were immunized or not with OVA in Alum, and immunized females were boosted after 10 and 20 days. Immunized and non-immunized females were mated, and pups from both groups were evaluated at 3 or 20 days old (d.o.). Some offspring from the aforementioned two groups were immunized with OVA at 3 d.o., boosted after 10 days and evaluated at 20 d.o.

Results

Maternal immunization with OVA induced offspring B cells to produce IL-17 at higher intensity compared to the control group of offspring at 3 d.o. This effect was maintained until 20 d.o. and even after neonatal immunization with OVA. The co-production of IL-10 on offspring IL-17 + B cells is up-regulated in response to maternal immunization with OVA. Maternal immunization with OVA on IL-10^−/− mice reveals reduced percentage and mean of fluorescence intensity of IL-17 on B cells of offspring.

Conclusion

Preconception OVA immunization can induce offspring B cells that produce IL-17 at higher intensity and co-produce mainly IL-10. This could be the reason why B17 cells had been described in the literature with controversial roles upon their regulatory function.

https://ift.tt/2tYmOpU

Salivary IgA Deficiency in a Patient with Cystic Fibrosis (genotype M470V/V520F)

Publication date: Available online 7 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Jessica Oh, David P McGarry, Nancy Joseph, Brian Peppers, Robert Hostoffer

https://ift.tt/2MYnra2

Pediatric Ambulatory Continuous Peripheral Nerve Blocks

Publication date: Available online 7 July 2018

Source: Anesthesiology Clinics

Author(s): Sible Antony, Harshad Gurnaney, Arjunan Ganesh

https://ift.tt/2lXVAuR

Regional Anesthesia and Analgesia for Acute Trauma Patients

Publication date: Available online 7 July 2018

Source: Anesthesiology Clinics

Author(s): Ian R. Slade, Ron E. Samet

https://ift.tt/2ub5j4U

What Can Regional Anesthesiology and Acute Pain Medicine Learn from “Big Data”?

Publication date: Available online 7 July 2018

Source: Anesthesiology Clinics

Author(s): Nabil M. Elkassabany, Stavros G. Memtsoudis, Edward R. Mariano

https://ift.tt/2lXQZZC

Prevention of Frey Syndrome

Publication date: Available online 7 July 2018

Source: Operative Techniques in Otolaryngology-Head and Neck Surgery

Author(s): Phillip K Pellitteri

Abstract

Frey syndrome (gustatory sweating) is a common and often times significant consequence of parotid gland surgery. The classic signs and symptoms include facial sweating, flushing, rubor and sensation of heat over the preauricular region during oral stimulation. These clinical findings may provoke quality of life changes, and thus, are considered significant. Both surgical and non- surgical treatment modalities have been advanced in the treatment of this disorder. Surgical treatment is aimed at prevention of the development of Frey syndrome and consists of a constellation of techniques which are designed to interpose tissue in the parotid surgical bed to act as a barrier to prevent aberrant parasympathetic fiber ingrowth and innervation to facial skin eccrine sweat glands. These techniques include: limiting the extent of parotid surgery when possible, use of local tissue as advancement or rotational flaps, autologous transfer of tissue, and use of allograft material.

https://ift.tt/2KUGuRK

Enhanced visualization of the surgical field in pediatric direct laryngoscopy using a three-dimensional endoscopic system

Publication date: Available online 6 July 2018

Source: American Journal of Otolaryngology

Author(s): Oshri Wasserzug, Gad Fishman, Anat Wengier, Yael Oestreicher-Kedem, Ophir Handzel, Dan M. Fliss, Nevo Margalit, Ahmad Safadi, Ari DeRowe

Abstract

Background

Direct laryngoscopy and rigid bronchoscopy are currently performed using 2-dimensional endoscopic systems. Our objective was to determine whether a 3-dimensional endoscopic system can enhance visualization of the surgical field in pediatric direct laryngoscopy and rigid bronchoscopy.

Methods

A prospective cohort study was conducted. Thirty three children who underwent direct laryngoscopies in a tertiary referral children's hospital were enrolled. Direct laryngoscopy was performed using both 2- and 3-dimensional endoscopic systems, after which the surgeons scored the quality of the images obtained with each system on a scale from 1 (low) to 5 (high). Comparison of the scores obtained with the 2 endoscopic systems was performed.

Results

The 33 study children (mean age 2.3 years, M:F ratio 1:1.6) underwent 47 direct laryngoscopies. The mean score for visualization of the glottis was 4.8 for the three-dimensional system compared to 4.0 for the two-dimensional system (P = .025), 4.7 vs. 3.8, respectively, (P = .019) for the subglottis, and 4.6 vs. 3.9, respectively (P = .031) for visualization of the proximal trachea. The mean score for visualization of the distal trachea was 3.0 vs. 3.7, respectively (P = .020). In a child with recurrent type 3 laryngotracheal cleft a residual tracheo-esophageal fistula could not be detected using the 2D system, but was immediately detected using the 3D system.

Conclusions

Visualization of the glottis, subglottis and proximal trachea during direct laryngoscopy using a 3-dimensional endoscopic system was rated by the surgeons as being superior to the conventional 2-dimensional technique. Further outcome studies that will demonstrate the clinical advantage of the 3D technology are highly required.

Level of evidence: 2b.

https://ift.tt/2uaURKA

Sleep study indices and early post-tonsillectomy outcomes

Publication date: Available online 6 July 2018

Source: American Journal of Otolaryngology

Author(s): Daniel C. O'Brien, Yuti Desai, Robert T. Swanson, Uma Parekh, Jane Schubart, Michele M. Carr

Abstract

Objectives

To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay.

Study design

Retrospective case series with chart review.

Setting

Tertiary care children's hospital.

Subjects and methods

All children aged 1–17 years who had undergone adenotonsillectomy between 2013 and 2016 were included. Apnea-hypopnea index (AHI), central apnea index (CAI), oxygen saturation nadir, and end-tidal carbon dioxide were compared with the in-operating room times, recovery room time, and length of stay.

Results

Three hundred and fourteen patients with a mean age of 6.67 (95% CI 6.25–7.09) years were included. Mean AHI was 9.14 (95% CI 7.33–10.95), mean CI was 0.88 (95% CI 0.50–1.26), mean oxygen saturation nadir was 82.9% (95% CI 81.41–84.32), mean end-tidal carbon dioxide was 50.3 (95% CI 49.39–51.15). Mean emergence time was 16 min (95% CI 15:11–17:13 min), recovery room time was 66 min (95% CI 1:00–1:11 h), and length of stay was 25.7 h (95% CI 21:43–30:00 h).

When controlled for age, gender and BMI, linear regression showed that children with a higher AHI had a significantly longer operating room and operative times (p < 0.001), emergence time (p < 0.001) and length of stay (p = 0.01). CAI was related to shorter total operating room times (p = 0.03). AHI, oxygen saturation nadir, CAI and end-tidal carbon dioxide were not associated with recovery room time.

Conclusion

Preoperative sleep study indices are associated with longer in-operating room times and length of stay, and can be useful in planning operating room and hospital flow.

https://ift.tt/2u02rbx

Effect of Sleep Deprivation on Hearing Levels in Rats

Publication date: Available online 6 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Jae Hyun Jung, Miryeong Kim, Seung Jae Lee, Eunsang Lee, Se A. Lee, Jong Dae Lee, Ji Ho Choi, Bo Gyung Kim

Abstract

Objectives

To our knowledge, the influence of sleep deprivation on hearing levels has yet to be assessed in animals. Therefore, we evaluated whether auditory function was affected by sleep deprivation in rats.

Methods

Male Wistar rats (aged 9 weeks, weighing 300-400 g) were used for the study and were randomly assigned to a control (n=15) or sleep deprivation group (n=12). Hearing levels were evaluated at baseline and 9 days after sleep deprivation using auditory evoked brainstem responses (ABRs) and distortion product otoacoustic emission (DPOAE) measurements. Blood was collected for the measurement of interleukin-1β and corticosterone levels.

Results

The ABR thresholds (at 8, 16, and 32 kHz) at 9 days were significantly elevated in the sleep deprivation group compared to the control group (p<0.05, respectively). The sleep deprivation group showed a defect in the function of outer hair cells, as evidenced by decreased levels of distortion product otoacoustic emission. IL-1β was significantly increased in the sleep deprivation group. Sleep-deprived rats exhibited rupture of Reissner's membrane and morphological damage to stereocilia.

Conclusion

These results suggest that sleep deprivation induces damage to the cochlea and results in hearing loss in Wistar rats.

https://ift.tt/2KHT62Q

The Wound Healing Capacity Of Undifferentiated And Differentiated Airway Epithelial Cells In Vitro

Publication date: Available online 6 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Cynthia M. Schwartz, Braedyn A. Dorn, Selam Habtemariam, Cynthia L. Hill, Tendy Chiang, Susan D. Reynolds

Abstract

Introduction

Congenital or acquired tracheal lesions alter airway epithelial structure and can lead to long-segment tracheal defects. Tissue engineered tracheal grafts (TETG) have the potential to cure such defects; however, clinical applications have been plagued with numerous complications including delayed graft epithelialization. The knowledge that epithelial cells migrate from native tissue to the TETG raises the possibility that TETG performance can be improved by increasing the rate of epithelialization.

Objectives

We developed a model that can be used quantify epithelial migration in clinically-relevant conditions.

Methods

Existing histological analyses determined the differentiation status of the normal and injured human tracheal epithelium and were used to identify in vitro culture conditions that mimic these parameters. The classical scratch assay was adapted to permit analysis of migratory velocity as a function of differentiation status. Migration of undifferentiated (UD), partially-differentiated (PD), and well-differentiated (WD) epithelia was quantified.

Results

The normal and injured epithelium can be modeled using human cells that are cultured using a modified air-liquid-interface culture system. PD cell cultures are similar to the remodeled epithelium; whereas; WD cultures are similar to the normal epithelium. Preliminary results indicate that PD cells migrate more rapidly than WD cells and that PD and WD cells migrate more rapidly than UD cells.

Conclusion

Pending verification of these results, we suggest that epithelial migration is significantly altered by differentiation status. Thus, efforts to improve TETG epithelialization should use model systems that faithfully-represent the differentiation state of the native tissue.

https://ift.tt/2MSMhIe

Adjuvante Elektrostimulationstherapie bei chronischer Rhinosinusitis

Laryngo-Rhino-Otol
DOI: 10.1055/a-0642-1917

Hintergrund Die chronische Rhinosinusitis (CRS) zählt in Deutschland zu den häufigsten chronischen Erkrankungen und geht nicht selten mit einem jahrelangen Verlauf einher. Nach der aktuellen deutschen Leitlinie Rhinosinusitis sind für eine symptomatische Therapie der CRS die nasale Anwendung von Salzlösungen, topische Kortikosteroide, in Einzelfällen auch systemische Kortikosteroide sinnvoll. Die Evidenzlage für andere therapeutische Verfahren wie Akupunktur, Homöopathie und Phytotherapeutika wird als nicht ausreichend gesehen. In der vorliegenden Studie sollte untersucht werden, ob antiinflammatorische Effekte einer Elektrostimulationstherapie auch bei einer CRS nachgewiesen werden können. Methodik randomisierte, prospektive Single center Studie, primäres Setting; 16 Patientinnen und Patienten mit mittelgradig ausgeprägter chronischer Rhinosinusitis mit Polypen (cRScNP), entsprechend einem Lund / Mackay score von 6–12; heimbasierte Elektrostimulationstherapie (EST) mit amplitudenmoduliertem Strom (Basisfrequenz von 4000 Hz, Frequenzband von 100–250 Hz) über 2 Wochen adjuvant zu einer leitliniengerechten Sinusitistherapie mit topischen Kortikosteroiden; Messung der nasalen Stickstoffmonoxid Konzentration und Selbstbewertung der Beschwerden mit dem Fragebogeninstrument SNOT-20 GAV; Erhebungszeitpunkte t0 vor EST, t1 nach EST, t2 6 Wochen nach t1. Ergebnisse Die heimbasierte EST wurde von 16 Patientinnen und Patienten durchgeführt. Die vorliegenden Ergebnisse deuten darauf hin, dass die bereits seit langem bekannten positiven Effekte einer Elektrostimulationstherapie bei inflammatorischen Prozessen auch bei einer CRS bestehen. Diskussion Die adjuvante transsinuidale Elektrostimulation könnte somit die konservative Therapie der CRS bereichern. Weitere Studien mit größeren Kollektiven sind wünschenswert.
[...]

Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2ufUDCa

Partners in anti-crime: how interferon-inducible GTPases and autophagy proteins team up in cell-intrinsic host defense

Jörn Coers | Hailey M Brown | Seungmin Hwang | Gregory A Taylor

https://ift.tt/2u0MamW

Modern postoperative monitoring of free flaps

Purpose of review Flap failure in microvascular reconstruction is a costly complication with total flap loss being the worst-case scenario. With the aim to rapidly identify a postoperative circulatory problem, some susceptible flaps can be saved by careful clinical monitoring or by various technical monitoring methods. In head and neck surgery, where the flaps are often buried and difficult to monitor clinically, a reliable technical monitoring method would be useful. A broad range of different techniques are in use varying according to practical and personal preferences among clinics and surgeons. However, no evidence for any particular technique being superb has emerged. We review reports of some frequently used and modern free flap monitoring techniques. Recent findings Clinical monitoring is still the gold standard to which other techniques are compared to. Laser Doppler flowmetry and near-infrared spectroscopy have been reported to identify early circulatory problems, but both techniques are not well suited for buried flaps. Implantable Doppler, flow coupler, partial tissue oxygen pressure and microdialysis are invasive monitoring methods suitable for buried flaps. Summary More research with practical and clinically relevant parameters, that is flap salvage rate, false positive rate and cost-efficiency are needed before objective comparisons between different monitoring techniques can be made.

https://ift.tt/2Nvk8YM

Editorial introductions

No abstract available

https://ift.tt/2KS76WN

Update on complications in cleft orthognathic surgery

Purpose of review To give an update on recent publications and tendencies concerning complications in cleft orthognathic surgery. Recent findings Cleft-specific changes after orthognathic surgery and their impact on surgical outcomes are discussed. Focus lays on the causes and mechanisms of cleft-related surgical complications and strategies to prevent or minimize these complications. Bimaxillary surgery is seen as a safe procedure for cleft patients. Maxillary distraction, total or segmental, is pointed out as an alternative method to improve outcomes. Different techniques for osteotomies and maxillary mobilization could decrease adverse events. Summary Cleft patients are more susceptible to the occurrence of complications because of peculiar presurgical conditions. Different surgical approaches and techniques are presented to overcome these difficulties, to achieve better results and to increase patient safety. The importance of communication between patient, family and cleft team members is emphasized.

https://ift.tt/2NwMRMJ

Blepharoptosis repair

Purpose of review To review recent advances on the mechanisms and management of acquired aponeurotic blepharoptosis. Recent findings Recent advances over the past year have focused on refining well known methods of ptosis repair, expanding and modifying techniques to treat difficult and more severe conditions, and uncovering the biomechanical and neurostimulatory mechanisms of ptosis and its repair. Summary Innovations in ptosis repair are discussed in the context of current treatment paradigms.

https://ift.tt/2KVE5Xd

Antibiotic use in facial plastic surgery

Purpose of review The aim of this study was to review and discuss recent literature regarding perioperative use of antibiotics in the context of facial plastic surgery. Recent findings Despite research efforts, there continues to be insufficient evidence in support of, or against, the use of antimicrobial prophylaxis. Summary Current available evidence regarding antibiotic use in facial plastic surgery procedures fails to demonstrate routine benefit. Therefore, the advantages accompanying administration of preoperative antibiotics should be weighed against any potential complications on a case-by-case basis. Future large-scale prospective studies will be beneficial in developing standardized criteria directing appropriate antibiotic use.

https://ift.tt/2KW15Iy

Improving aesthetic outcomes after head and neck reconstruction

Purpose of review Tremendous advancements have been made in head and neck reconstruction following oncologic resection. Despite this, many patients are left with disfiguring postoperative changes. The focus of this review highlights various techniques aimed at improving aesthetic outcomes following head and neck cancer therapy, with a focus on liposuction and fat augmentation. Recent findings Over the past decade, the use of liposuction in treating lymphedema after head and neck cancer therapy has showed promising results. Owing to great improvements in harvesting and purification techniques, fat augmentation has been effectively utilized in correcting a wide array of defects. Although free tissue transfer is frequently used in head and neck reconstruction, there is a scarcity of literature on the indications for flap revision procedures. Summary Head and neck reconstructive surgery can lead to significant cosmetic and functional morbidity. Several tools are available to help improve aesthetic outcomes in this patient population. A thorough understanding of the various techniques and their indications is essential for achieving optimal results. Video abstract available: See the Video Supplementary Digital Content 1, https://ift.tt/2IcL93h

https://ift.tt/2KUrmny

Modern management of osteoradionecrosis

Purpose of review Despite recent advances in radiotherapy, osteoradionecrosis (ORN) remains a common and difficult complication of radiation therapy in head and neck cancer patients. Available treatment options are complementary to its complex pathophysiology and the currently available theories of ORN development. The efficacy of hyperbaric oxygen therapy has recently been questioned, and therapies targeting the fibroatrophic process have become a focus of ORN treatment. The objective of this review is to evaluate the literature regarding ORN of the mandible, with a focus on available treatment options. Recent findings The recently proposed fibroatrophic theory has challenged the traditional hypovascular-hypoxic-hypocellular theory as the mechanism of ORN. Medical management targeting this fibroatrophic process offers promising results, but has yet to be confirmed with robust clinical trials. The routine use of hyperbaric oxygen therapy is not substantiated in the literature, but may be justified for select patients. Systemic steroids may also have a role, though data are limited. Summary The fibroatrophic process has gained acceptance as a main mechanism of ORN. No gold standard treatment or consensus guidelines exist, though a combination of therapeutic strategies should be considered, taking into account the severity of disease and individual patient characteristics.

https://ift.tt/2KZ5VS4

Multidisciplinary management of oculo-auriculo-vertebral spectrum

Purpose of review Oculo-auriculo-vertebral spectrum (OAVS) is a complex disorder that is represented by wide variations in phenotypic presentation. Recent publications and systematic reviews of the available literature are presented here. Recent findings Treatment strategies vary among craniofacial centers across the country. Advances in presurgical planning, virtual surgical planning, and computer-aided manufacturing have been incorporated in the treatment of patients. The psychosocial effect of OAVS with longitudinal follow-up is now being studied. Summary Optimal evaluation and management of the OAVS patient requires an awareness of the phenotypic and genetic differences and involves a multidisciplinary team in order to effectively and appropriately diagnose and treat such patients.

https://ift.tt/2NAf5qa

Blood loss mitigation and replacement in facial surgery: a review

Purpose of review To provide a comprehensive overview of the predisposing factors that contribute to a risk of excess bleeding for surgical therapy in the head and neck regions, provide a thorough overview of techniques and tools for managing blood loss complications, and provide intervention algorithms to help guide clinical decision making. Recent findings With the current landscape of medications and reversal agents, protocols for intervention in a variety of situations, and new tools for blood loss management all rapidly changing and being developed it is critical to stay up to date to provide patients the best care in the most critical of situations. Summary With the risk of blood loss complications in head and neck surgery ranging from minimal to extreme surgeons require a comprehensive understanding risk factors, patient evaluation tools, and proper management algorithms. The first opportunity to prevent unnecessary blood loss and blood loss complications is the health history and physical appointment where a clinician can identify any medications, conditions, or other predisposing factors that would elevate a patient's risk of excess bleeding and the necessity for treatment augmentation. Although not all complications can be prevented because of the natural physiological variation that occurs from patient to patient, despite proper and proper diagnostics, a full working knowledge of most likely complications, hemostatic tools, and concise communication with team members can prevent a lot of blood loss and the complications associated.

https://ift.tt/2J0wfJO

Acute catatonia on medical wards: a case series

Catatonia is a behavioral syndrome which presents with an inability to move normally. It is associated with mood disorders and schizophrenia, as well as with medical and neurological conditions. It is an expre...

https://ift.tt/2KUsJT7

Symptomatic bilateral pulmonary embolism without deep venous thrombosis in an adolescent following arthroscopic anterior cruciate ligament reconstruction: a case report and review of the literature

Venous thromboembolism, specifically pulmonary embolism, is a rare complication following elective pediatric orthopedic surgery. Bilateral pulmonary embolism with associated pulmonary hemorrhage/infarct withou...

https://ift.tt/2KPuLas

Appreciating the Intricacies of a Stuffy Nose

Common conditions occur commonly, but identifying the causes and optimizing treatment may be difficult. Nasal airway obstruction, one of the most common complaints related to Otolaryngology, is often reported to health care providers in various fields. These include pediatrics, family practice, internal medicine, geriatrics, obstetrics/gynecology, emergency medicine, and, of course, otolaryngology. Anyone who's spent a sleepless night due to a blocked nose or had difficulty speaking during the day or managing the secondary dry mouth/throat that comes with a significantly obstructed nasal cavity can appreciate the dramatic reduction in quality of life that results from this chronic condition.

https://ift.tt/2m0rMht

Clinical experience with a novel structure designed bridging plate system for segmental mandibular reconstruction: The TriLock Bridging Plate

The innovative TriLock Bridging Plate System (Medartis AG, Switzerland) was developed to reduce common complications related to conventional mandibular reconstruction plates. The novelties regarding the plating system concern the cross-strut structure in the centerpiece, the bendable side elements and the reduction of the plate's thickness to 2.0mm. 4 different models are available, which cover lateral and central segmental mandibular defects. The plating system has only been introduced at selected maxillofacial units so far and clinical assessment is still lacking.

https://ift.tt/2MWovet

Salivary IgA Deficiency in a Patient with Cystic Fibrosis (genotype M470V/V520F)

Secretory Immunoglobulin A (SIgA) plays an important role in immunity by limiting the epithelial adherence and penetration of bacteria throughout the body's mucosal surfaces, including the gastrointestinal tract, oral cavity, and respiratory system.1 Disorders that have involvement of mucosal spaces such as cystic fibrosis in theory rely on mucosal SIgA. Salivary IgA is one example of SIgA and is often utilized as a biomarker for secretory IgA given its ease of collection.2 Cystic fibrosis (CF) is an autosomal recessive disorder that is most commonly caused by a defect in the cystic fibrosis transmembrane conductance regulator (CFTR), leading to abnormally viscous secretions.

https://ift.tt/2KVG2CX

Omalizumab in chronic spontaneous urticaria: a real-life experience of dose and intervals adjustments in Belgium

Omalizumab was clearly shown to be effective and safe for treating refractory chronic spontaneous urticaria (CSU) not adequately controlled with H1-antihistamines (anti-H1). Supported by data of five randomized, placebo-controlled clinical trials,1 the recommended regimen is 300mg every four weeks, 38.1%/55.1% of patients being respectively completely/partially free of urticaria after 12 weeks with this regimen.

https://ift.tt/2NtyuJ7

Correlation between relative bacterial activity and lactate dehydrogenase gene expression of co-cultures in vitro

Abstract

Objectives

The present study aims at correlating the relative bacterial activity with the H⁺ concentration and the ldh expression of caries-associated bacteria in co-cultures.

Materials and methods

Well plates were prepared with BHI medium and cultures of Lactobacillus paracasei and Fusobacterium nucleatum. Bacterial growth at 37 °C was measured using a microplate-photometer before and after adding sucrose to the samples. Samples of co-cultures (n = 12) and single-species cultures (n = 3) were taken and pH was assessed. Real-time quantitative PCRs were applied targeting the 16S-gene, the 16S-rRNA, the ldh-gene, and the ldh-mRNA.

Results

For L. paracasei with sucrose, an increase in relative bacterial activity (62.8% ± 23.5% [mean, SE]) was observed, while F. nucleatum showed a clear decrease in relative bacterial activity (− 35.0% ± 9.6%). Simultaneously, the H⁺ concentration increased (1.15E-05 mol*l-1 ± 4.61E-07 mol*l-1). Consequently, a significant positive correlation was found between L. paracasei's relative bacterial activity and H⁺ concentration (Spearman rank correlation, r = 0.638; p = 0.002), while F. nucleatum exhibited a negative correlation (r = − 0.741; p ≤ 0.001). Furthermore L. paracasei with sucrose showed a moderate, but significant positive correlation between relative bacterial activity and ldh-expression (r = 0.307; p = 0.024).

Conclusions and clinical relevance

The relative bacterial activity after sucrose pulse showed a significant correlation not only to the acid production (H⁺ concentration) but also to ldh expression of L. paracasei. However, further research is required to confirm these findings in a mature biofilm in vivo.

https://ift.tt/2ubSDL4

Enhanced visualization of the surgical field in pediatric direct laryngoscopy using a three-dimensional endoscopic system

Sleep study indices and early post-tonsillectomy outcomes

To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay.

https://ift.tt/2zrqSUP

The role of the otolaryngologist in the evaluation and management of headaches

Effects of leukocyte–platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review

This systematic review aimed to assess the effects of leukocyte–platelet-rich fibrin (L-PRF) on bone regeneration, soft tissue healing, and postoperative complications in patients undergoing ridge preservation, ridge augmentation, and maxillary sinus augmentation procedures. A comprehensive literature search was conducted by two independent reviewers. Only randomized and non-randomized controlled clinical trials were selected. Outcome data were extracted and critically analyzed. A total of 17 articles were included in the qualitative synthesis.

https://ift.tt/2KDXeAQ

Cadaveric dissection in oral and maxillofacial surgery: is it time for a new approach?

Learning anatomy by dissection of cadavers is an essential part of surgical training. Traditionally such courses that involve the transfer of skills are designed by surgeons with an interest in teaching. Currently the clinical pressures in the NHS mean that it is becoming more difficult to run skill-based courses (although similar pressures do seem to be reflected internationally). Those clinicians involved in the organisation of courses in anatomy will recognise difficulties relating to time, funding, appropriate facilities, and the participation of trainees.

https://ift.tt/2u0xaWh

A modified approach for eminectomy for temporomandibular joint dislocation under local anaesthesia: report on a series of 50 patients

Publication date: Available online 6 July 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): N. Segami

Abstract

Conventional eminectomy for habitual dislocation of the temporomandibular joint is usually performed under general anaesthesia. This technique was modified for use under local anaesthesia to treat medically compromised patients. Fifty elderly patients (90 joints) were treated, for whom general anaesthesia was considered a serious risk due to systemic diseases; the dislocation was habitual in 39 and long-standing in 11. Following intravenous sedation and local anaesthesia, a 2-cm superficial vertical skin incision was made directly above the articular eminence. Careful and gentle dissection of the subcutaneous tissue was performed until the lateral joint capsule was exposed. The superior compartment was entered, followed by shaving of the articular eminence in a conventional manner. The surgery was successful in all patients, with a mean operative time of 47 ± 12 minutes. Intraoperative events occurred in 10 patients (20%). Postoperative complications affected 25 patients (50%), varying from severe (two deaths, due to cardiopulmonary arrest and accidental fall) to mild (local infection, etc.). Eleven patients (22%) had facial nerve palsy limited to the temporal branch; all recovered after 6 months. This approach is useful when general anaesthesia is contraindicated due to existing medical conditions. However, prudent consideration may be required to avoid serious complications when local anaesthesia is used.

https://ift.tt/2KQ0Qi9

Branchial Cyst with Branchial Fistula: A Rare Association

Abstract

Branchial arch anomalies are the most common congenital neck masses. The second branchial arch anomalies followed by first arch anomalies are seen commonly in the descending order. They originate from remnants of branchial arches and clefts. They may present as cysts, sinus tracts, fistulae or cartilaginous remnants. They are mostly located in the lateral aspect of the neck anterior to the sternocleidomastoid, anterior to the hyoid bone, preauricular region or at the angle of the mandible. A complete fistula communicating with a branchial arch cyst is a very rare congenital anomaly of the branchial apparatus. These patients are generally asymptomatic but may present with mucoid discharge from the tract. Here we present a case of branchial fistula associated with a branchial cyst in a 11 year old child.

https://ift.tt/2KVNnSM

Sutureless Tragal Cartilage Island Tympanoplasty: Our Experience

Abstract

To evaluate graft take up and hearing improvement using the technique of tragal cartilage island in COM-mucosal type. Prospective study. A total of 258 type 1 tympanoplasty surgeries were done using tragal cartilage island graft from December 2013, to December 2015; in Jubilee Mission Medical College and Research Institute with a follow up of 1 year. Inclusion criteria—all the patients undergoing type 1 tympanoplasty for chronic otitis media (mucosal type, inactive) with an intact ossicular chain by the senior author. The youngest patient was 6 years old and the oldest was 64 years. This pattern was selected for getting a uniform pattern even though cartilage tympanoplasty can be done in other forms of COM also. Graft take up in our study was found to be 96.12% in 1 year of follow up. Closure of tympanic membrane was achieved in 248 of 258 cases. None of the patients showed retraction pockets or cholesteatoma during follow up. The average pre-op AB gap was 21.62 dB which was lowered to 4.22 dB post op. The mean gain in hearing was 17.37 dB. It is worthwhile to consider tragal cartilage island graft as an alternative to temporalis fascia.

https://ift.tt/2NulEKV

Ivermectin: A Novel Method of Treatment of Nasal and Nasopharyngeal Myiasis

Abstract

To evaluate the efficacy of oral Ivermectin, in patients suffering from nasal and nasopharyngeal myiasis. This was a prospective study, comprising 80 patients of nasal and nasopharyngeal myiasis. Patients underwent clinical examination and nasal endoscopy at the time of presentation and findings were recorded. The patients were randomly divided in two groups. In group-I the patients underwent manual extraction of the maggots after instillation of chloroform and turpentine oil mixture, whereas the group-II patients underwent manual extraction with administration of two doses (24 h apart) of oral Ivermectin (6 mg each). The patients were instructed to record the time when they noticed shedding of maggots, and evaluated for the clearance of maggots by endoscopy after 24, 48 h and 7 days after the initial examination. The mean maggot shedding time (by t test) in Group-I was 41.23 ± 4.23 h and in Group-II was 24.60 ± 3.15 h. The difference being highly significant statistically, (p = 0.0001). The endoscopic clearance of maggots (by Chi square test) between the two group of patients was also statistically significant at 24 and 48 h with p value of (p = 0.002) and (p = 0.006) respectively. Oral Ivermectin was effective in treating nasal and nasopharyngeal myiasis, in terms of early clearance, decreased morbidity and less hospital stay. We conclude that oral Ivermectin can be used as a safe and effective method for the treatment of nasal & nasopharyngeal myiasis.

https://ift.tt/2KTlHhk

Vallecular Neurofibroma Successfully Managed with Endoscopic Assisted Coblation: A Novel Technique

Abstract

Although solitary neurofibroma can affect the various subsites of the head and neck region, oropharyngeal neurofibroma is very rare and total five cases (four in the soft palate and one in the palatine tonsil) have been reported. Here we present a 42-year old female patient presented to the out patient department with respiratory obstruction and voice change for 3 months. Complete excision of the mass was achieved by endoscopic coablation and which was confirmed to be a neurofibroma.

https://ift.tt/2KT8gRO

Omalizumab in chronic spontaneous urticaria: a real-life experience of dose and intervals adjustments in Belgium

Publication date: Available online 6 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): de Montjoye Laurence, Herman Anne, Dumoutier Laure, Lambert Michel, Tromme Isabelle, Baeck Marie

https://ift.tt/2lXpa3N

FDA-approved peanut allergy treatment: the first wave is about to crest

Publication date: Available online 6 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Stephen A. Tilles, Daniel Petroni

https://ift.tt/2ucN1QD

Rosmarinic acid affects immunological and inflammatory mediator levels and restores lung pathological features in asthmatic rats

Publication date: Available online 6 July 2018

Source: Allergologia et Immunopathologia

Author(s): F. Shakeri, N. Eftekhar, N. Mohammadian Roshan, R. Rezaee, A. Moghimi, M.H. Boskabady

Abstract

Background

The effects of rosmarinic acid (RA) on immunological and inflammatory mediator levels in bronchoalveolar lavage fluid (BALF) as well as lung pathological changes in asthmatic rats were investigated.

Methods

The levels of IFN-γ, IL-4, IFN-γ/IL-4 ratio, IgE, PLA₂, and total protein (TP) in BALF and pathological changes in the lung were evaluated in control group (C), asthma group (sensitized to ovalbumin) (A), asthma groups treated with RA and dexamethasone.

Results

Compared to the control group, asthmatic rats showed increased levels of IL-4, IgE, PLA2, and TP as well as all pathological scores with decreased levels of IFN-γ and IFN-γ/IL-4 ratio (P < 0.05 to P < 0.001). The levels of IL-4, IgE, PLA₂, and TP significantly reduced in groups treated with all concentrations of RA compared to asthma group (P < 0.001 for all cases). IFN-γ was significantly decreased in groups treated with two lower concentrations of RA but IFN-γ/IL-4 ratio was increased in groups treated with two higher concentrations of RA compared to asthma group (P < 0.05 to P < 0.001). Treatment with all doses of RA led to significant improvement in pathological scores in asthmatic animals (P < 0.05 to P < 0.001). Most measured parameters were also significantly improved in dexamethasone-treated animals (P < 0.01 to P < 0.001) but IFN-γ/IL-4 ratio and the scores of interstitial fibrosis, bleeding and epithelial damage did not change in this group.

Conclusion

The results indicated a preventive effect for RA on immunological and inflammatory mediators as well as lung pathological changes in asthmatic rats which were comparable or even more potent than that of dexamethasone.

https://ift.tt/2lYIZHN

What do we know about cancer immunotherapy? Long-term survival and immune-related adverse events

Publication date: Available online 6 July 2018

Source: Allergologia et Immunopathologia

Author(s): Jesus Miranda Poma, Lorena Ostios Garcia, Julia Villamayor Sanchez, Gabriele D'errico

Abstract

Immunotherapy delivered a new therapeutic option to the oncologist: Ipilimumab (anti-CTLA-4), Nivolumab and Pembrolizumab (anti-PD1), and Atezolizumab (anti-PD-L1) increase overall survival and show a better safety profile compared to chemotherapy in patients with metastatic melanoma, lung, renal cancer among others. But all that glitters is not gold and there is an increasing number of reports of adverse effects while using immune-checkpoint inhibitors. While chemotherapy could weaken the immune system, this novel immunotherapy could hyper-activate it, resulting in a unique and distinct spectrum of adverse events, called immune-related adverse events (IRAEs). IRAEs, ranging from mild to potentially life-threatening events, can involve many systems, and their management is radically different from that of cytotoxic drugs: immunosuppressive treatments, such as corticoids, infliximab or mycophenolate mofetil, usually result in complete reversibility, but failing to do so can lead to severe toxicity or even death. Patient selection is an indirect way to reduce adverse events minimizing the number of subjects exposed to this drugs: unfortunately PDL-1, the actual predictive biomarker, would not allow clinicians select or exclude patients for treatment with checkpoint inhibitors.

https://ift.tt/2zi9NMF

Inflammatory immune response in rabbits with Staphylococcus aureus biofilm–associated sinusitis

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2Nxu97S

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2IZl5Fp

Total intravenous anesthesia improves intraoperative visualization during surgery for high‐grade chronic rhinosinusitis: a double‐blind randomized controlled trial

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2KRsviR

Incorporation of antibiotics and systemic steroids by sinus surgeons: is there widespread consensus?

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2IZkWBR

The lamina push test: an alternative to the globe push test for identifying the medial orbit during endoscopic sinus surgery

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2KOKMgO

Association between allergic rhinitis and poor sleep parameters in U.S. adults

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2J4A0OI

The effect of urban particulate matter on cultured human nasal fibroblasts

International Forum of Allergy &Rhinology, EarlyView.

https://ift.tt/2NuNaYo

Comparative study of the effect of Er:YAG and Er:Cr;YSGG lasers on porcelain: etching for the bonding of orthodontic brackets

Abstract

This study investigated the effect of Er:YAG (smart 2940 Dplus, DEKA, Italy) and Er:CrYSGG (Waterlase iPlus, Biolase, USA) lasers on the shear bond strength (SBS) between the orthodontic brackets and dental porcelain in comparison with conventional acid etching with 9% hydrofluoric acid (HF, Ultradent, USA). A total of 60 specimens of maxillary incisor crown were prepared and randomly assigned to five groups; each group was subjected to a different porcelain surface conditioning: (1) etching with the 9% HF for 2 min; (2) etching with the 9% HF for 2 min followed by irradiation with the Er:CrYSGG laser (3-W power, 10-Hz frequency for 10 s); (3) etching with the 9% HF for 2 min followed by irradiation with the Er:YAG laser (3-W power, 10-Hz frequency for 10 s); (4) Irradiation with the Er:CrYSGG laser (3-W power, 10-Hz frequency for 10 s without acid etching) and (5) irradiation with the Er:YAG laser (3-W power,10-Hz frequency for 10 s without acid etching). After using Transbond XT primer and Transbond XT adhesive, the metal brackets (Dentaurum, Germany equilibrium 2, optimal design) bonded to the conditioned porcelain surface. Subsequently, the specimens were thermocycled for 5000 cycles and then debonded using the Universal Testing Machine (Zwick). In each group, one specimen was not bonded to brackets to allow further examination with electron microscopy. After debonding, the specimens were examined by stereomicroscope to determine their adhesive remnant index (ARI). The average SBS [Mean (SD)] values in the five groups were as follows: HF (32.58 ± 9.21 MPa), Er:CrYSGG + HF (27.81 ± 7.66 MPa), Er:YAG + HF (23.08 ± 9.55 MPa), Er:CrYSGG (14.11 ± 9.35 MPa), and Er:YAG (6.30 ± 3.09 MPa). A statistically significant difference in SBS existed between the first three groups and the two laser groups (df = 4, F = 18.555, p < 0.001). Evaluation of ARI values showed that bond failures in the first three groups were mostly of cohesive and mixed types, but in the laser groups, they were mostly adhesive. Chi-square was not significant between groups (p = 0.219). The Er:YAG laser with the stated specifications is not a suitable alternative to HF etching. In the case of Er:CrYSGG laser, although the conditioning outcome met the bond strength requirement for orthodontic brackets (that is, 6–8 MPa). Therefore, the bond strength must be further improved by fine-tuning the irradiation details.

https://ift.tt/2zhnBqX

Effectiveness of low concentration of sodium hypochlorite activated by Er,Cr:YSGG laser against Enterococcus faecalis biofilm

Abstract

Bacteria living in biofilms exhibit altered growth phenotypes, while the biofilm provides benefits, the foremost of which is a certain protection against both immune system and killing effect by antimicrobials. Laser-activated irrigation (LAI) and passive ultrasonic irrigation (PUI) have been proposed as alternative methods for cleaning and disinfecting the root canal, as an adjuvant to conventional chemo-mechanical preparation in order to improve debridement and disinfection. Nevertheless, the potential antibacterial effect of LAI using 0.5% of sodium hypochlorite (NaOCl) has received little attention. Glass Pasteur pipettes were used to mimic single-tooth root canal and to build Enterococcus faecalis biofilm. Several irrigants and treatments were assayed for 60 s including (I) Saline, (II) NaOCl 0.5%, (III) NaOCl 5%, (IV) Er,Cr:YSGG, (V) Saline + LAI, (VI) NaOCl 0.5% + LAI, (VII) Saline + PUI, and (VIII) NaOCl 0.5% + PUI. Bacterial reduction was measured by counting the colony-forming units (CFUs). Additionally, AFM visualization and measurement of nano-roughness parameters were used to evaluate LAI effect on bacteria. NaOCl 5% unpowered and NaOCl 0.5% + LAI were capable of eliminating all bacteria, whereas non-activated saline solution and NaOCl 0.5% failed to eliminate E. faecalis. Lower efficiencies were achieved by PUI. Surface analysis by AFM revealed apparent alterations in NaOCl + LAI-treated cells. The Er,Cr:YSGG laser-activated irrigation (LAI) increased the bactericidal efficiency of 0.5% NaOCl against E. faecalis biofilm.

https://ift.tt/2KSu7sO

Waiting List Mortality and Transplant Rates for NASH Cirrhosis When Compared to Cryptogenic, Alcoholic or AIH Cirrhosis

Background Patients with NASH cirrhosis have excellent post liver transplant (LT) survival despite having many co-morbidities. We hypothesized that this could be due to a selection bias. Methods We analyzed the UNOS data from 2002 to 2016 and compared post-LT survival of NASH (n=7,935) patients with cryptogenic (CC, n= 6,087), alcoholic AC, n=16,810) and autoimmune hepatitis (AIH, n= 2,734) cirrhosis. Results By 3 years of listing, the cumulative incidence (CI) of death or deterioration was 29% for NASH, 28% for CC and AC, and 24% for AIH, but when adjusted for risk factors, the CI was similar for NASH and AIH. The factors that increased the risk of waiting list removal due to death/deterioration were poor performance status, encephalopathy, diabetes, high MELD, Hispanic race, older age and a low serum albumin. Most patients were transplanted within the first year [median 2 months (1-7 IQR] of listing and by 5 years, the unadjusted CI of transplantation was 54% for NASH, 52% for CC, 51% for AIH and 48% for AC. The adjusted CI of transplantation within 2 months of listing was higher for AC (SHR 1.17), AIH (SHR 1.17) and CC (SHR 1.13) when compared to NASH, but after 2 months adjusted transplantation rates decreased in AC (SHR =0.6), AIH (0.78) and CC (SHR 0.95). The negative predictors of receiving a transplant were dialysis, female gender, non-White race, high albumin and creatinine. Conclusions Patients with NASH cirrhosis are not disadvantaged by higher waitlist removal or lower transplantation rates. Address for correspondence: Paul J. Thuluvath, MD, FAASLD, FRCP, Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD 21202. Tel: 410 332 9308; Fax: 410 659 1178; Email: thuluvath@gmail.com Conflicts of interest: None; Financial support: None Contributions: PJT and SH contributed to the idea, YS did the statistical analysis, PJT wrote the manuscript, SH and YS reviewed the final manuscript Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2IZP7Zo

ECE‐1 overexpression in head and neck cancer is associated with poor tumor differentiation and patient outcome

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IYLRO2

Expression of ameloblastin in the human tooth germ and ameloblastoma

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2NswdxM

Role of oral examination in newly diagnosed multiple myeloma patients: A safe and simple way to detect light chain amyloidosis

Oral Diseases, EarlyView.

https://ift.tt/2KT0ww4

Effects of BMP‐2 on the osteogenic differentiation of bone marrow stem cells in fibrous dysplasia

Oral Diseases, EarlyView.

https://ift.tt/2Nsw6SS

SOD2 is upregulated in periodontitis to reduce further inflammation progression

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KUpgnB

Genetic analysis: Wnt and other pathways in non‐syndromic tooth agenesis

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2tYeRRo

Antirheumatic medication and salivary MMP‐8, a biomarker for periodontal disease

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KUXdEF

Cariogenic microbiome and microbiota of the early primary dentition: a contemporary overview

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2NtYBQc

Evaluation of 3‐Dimensional Superimposition Technique on Parietal Bone of the Puberty Beagle Dogs

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IX22LS

Risk factors for competing non‐cancer mortality after definitive treatment for advanced‐stage head and neck cancer

Oral Diseases, EarlyView.

https://ift.tt/2NvyuIx

Expression of stem cell markers Nanog and Nestin in lip squamous cell carcinoma and actinic cheilitis

Oral Diseases, EarlyView.

https://ift.tt/2KUhE4D

Exosomal biomarkers in oral diseases

Oral Diseases, EarlyView.

https://ift.tt/2tYeu9s

Salivary fetuin‐A, S100A12 and High‐Sensitivity C‐reactive protein levels in periodontal diseases

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KB8zlc

Oral and dental healthcare during pregnancy: Evaluating a theory‐driven intervention

Oral Diseases, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IZ129O

In‐vivo compatibility between pacemakers and dental equipment

European Journal of Oral Sciences, EarlyView.

https://ift.tt/2KPXTOI

In vivo biocompatibility and biomineralization of calcium silicate cements

European Journal of Oral Sciences, EarlyView.

https://ift.tt/2KRDW6R

To Investigate the Molecular Mechanism of Traditional Chinese Medicine Constitution Using Next-generation Sequencing in Nasopharyngeal Carcinoma

Condition: Nasopharyngeal Carcinoma
Interventions: Drug: Danggui Buxue Tang; Drug: Placebo
Sponsor: China Medical University Hospital
Recruiting

https://ift.tt/2KVgoS9

Everolimus in Restoring Salivary Gland Function in Participants With Locally Advanced Head and Neck Cancer Treated With Radiation Therapy

Conditions: Salivary Gland Dysfunction; Xerostomia; Head and Neck Cancer
Interventions: Drug: Everolimus; Other: Laboratory Biomarker Analysis; Other: Survey Administration
Sponsors: University of Arizona; National Cancer Institute (NCI)
Recruiting

https://ift.tt/2MVsmbN

Contrast-Enhanced Ultrasound Identification of Sentinel Nodes in Esophageal Cancer

Condition: Esophagus
Interventions: Procedure: Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA); Procedure: Contrast-Enhanced Ultrasound; Procedure: Fine-Needle Aspiration; Drug: Sonazoid (Perflubutane)
Sponsors: Sidney Kimmel Cancer Center at Thomas Jefferson University; National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2KEY6ow

Neoadjuvant Chemotherapy Followed by Preoperative Chemoradiation in Resectable Squamous-cell Esophageal Cancer

Conditions: Esophageal Neoplasms; Squamous Cell Carcinoma; Concurrent Chemoradiotherapy
Interventions: Drug: Paclitaxel; Drug: Cisplatin; Drug: Fluorouracil; Radiation: chemoradiotherapy; Procedure: Ivor Lewis esophagogastrectomy
Sponsor: Mona Frolova
Recruiting

https://ift.tt/2MVRAq7

HPV-E6-Specific TCR-T Cells in the Treatment of HPV-Positive NHSCC or Cervical Cancer

Conditions: Cervical Cancer; Head and Neck Squamous Cell Carcinoma
Intervention: Drug: HPV E6-specific TCR-T cells
Sponsors: Xinqiao Hospital of Chongqing; TCRCure Biotech Co., Ltd
Not yet recruiting

https://ift.tt/2KGssr6

Anti‐inflammatory effects of the GAG‐binding CXCL9(74‐103) peptide in dinitrofluorobenzene‐induced contact hypersensitivity in mice

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2m1iykJ

Identification of Peptides with Tolerogenic Potential in a Hydrolyzed Whey‐Based Infant Formula

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2ubpgZn

High ambient levels of grass, weed and other pollens are associated with asthma admissions in children and adolescents: A large 5‐year case‐crossover study

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2lZ7ynW

Towards complete identification of allergens in Jack Jumper (Myrmecia pilosula) ant venom and their clinical relevance: An immunoproteomic approach

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2zcqY2s

Prevalence of allergy to human seminal fluid among women with allergy to male dog and sensitization to Can f 5

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2lWjUNR

Threshold‐Stimulated Kallikrein Activity Distinguishes Bradykinin‐ From Histamine‐Mediated Angioedema

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2uagH0D

Cover Image

Clinical &Experimental Allergy, Volume 48, Issue 7, Page i-i, July 2018.

https://ift.tt/2lYWV4C

Best of the Other Journals

Clinical &Experimental Allergy, Volume 48, Issue 7, Page 906-906, July 2018.

https://ift.tt/2zhuVCS

Forthcoming Meetings

Clinical &Experimental Allergy, Volume 48, Issue 7, Page 905-905, July 2018.

https://ift.tt/2lYKhCV

Airway granulocytes in severe preschool wheeze: Predictive of school‐age asthma attacks or disease protection

Clinical &Experimental Allergy, Volume 48, Issue 7, Page 760-761, July 2018.

https://ift.tt/2zi4pJC

Issue Information

Clinical &Experimental Allergy, Volume 48, Issue 7, Page 755-757, July 2018.

https://ift.tt/2lZI7CY

A new approach to oral allergen immunotherapy for food allergy?

Clinical &Experimental Allergy, Volume 48, Issue 7, Page 758-759, July 2018.

https://ift.tt/2zhuMiO

Endoscopic smartphone adaptors in Otolaryngology: How do they compare?

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IYzH7V

Contrast‐enhanced 18F‐FDG‐PET/CT for Differentiating Tumor and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KF8BIR

Laryngeal Dysplasia and narrow band imaging: secondary analysis of published data supports the role in patient follow up

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KPHu9P

Unilateral versus bilateral sphenopalatine artery ligation in adult unilateral epistaxis: a comparative retrospective study of 83 cases

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KPQM8T

Revision stapes surgery: A review of 102 cases

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IYeET1

Endoscopic endonasal surgery to correct congenital obstruction of the lacrimal pathway

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KAMaEC

Minimum clinically important difference for the 22‐item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IYeA5J

Low recurrence rate of head and neck basal cell carcinoma treated with Mohs micrographic surgery: A retrospective study of 1021 cases

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KNXPPD

Patterns of hospital admission in 54, 501 patients with epistaxis over a 20‐year period in Scotland, UK

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KSC11X

Diagnosis of anti‐laminin γ‐1 pemphigoid by immunoblot analysis

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KPQUFp

Physicochemical characterization of inorganic deposits associated with granulomas in cutaneous sarcoidosis

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KSxyfO

A unique presentation of ‘petrified ears’ with pain due to fracture

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KBiQxA

Identifying key components for a psychological intervention for people with vitiligo ‐ a quantitative and qualitative study in the United Kingdom using web‐based questionnaires of people with vitiligo and healthcare professionals

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KPHDdn

A randomized, double‐blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil versus 3% minoxidil solution in the treatment of male androgenetic alopecia

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KCCtFp

Rosacea‐like demodicosis and papulopustular rosacea may be two phenotypes of the same disease, and pityriasis folliculorum may be their precursor. Response to the comment of Tatu

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IZjLm1

Reliability of the hidradenitis suppurativa clinical response (HiSCR) in the assessment of patients with hidradenitis suppurativa

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KV0SFT

Dermatology: More than an outpatient specialty

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KV2coW

Real‐life efficacy and safety of secukinumab: Results from a tertiary hospital in Greece

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KO23Xr

Titanium dioxide nanoparticles and frontal fibrosing alopecia: cause or consequence ?

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KU0P9R

Rosacea‐like demodicosis (but not primary demodicosis) and papulo pustular rosacea may be two phenotypes of the same disease‐a microbioma,therapeutic and diagnostic tools perspective

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KzLpeI

Anti‐TNFα therapy modulates mTORC1signalling in hidradenitis suppurativa

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2J3aaua

Tattooing and psoriasis: dermatologists’ knowledge, attitudes and practices. An international study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KzX3pX

Severe hypocalcemia‐related pustular psoriasis in an 83‐year‐old woman with Fahr's syndrome: a case report

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IWzQsw

Psoriasis, metabolic syndrome and cardiovascular risk factors. A population‐based study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KKnrNp

Photoonycholysis: new findings

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KTF8a2

Dermoscopy in disseminated sporotrichosis

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KLCk1X

Paradoxical Eczematous Reaction to Ixekizumab

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KPHx5v

Prevalence, Predictors and Comorbidity of Dry Skin in the General Population

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KDZnMP

The role of dermoscopy in the diagnosis of deep mycoses and systemic mycoses with cutaneous involvement Comment on “Dermoscopy in disseminated sporotrichosis”

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2IZN6MP

Traumatic Optic Neuropathy and Monocular Blindness following Transnasal Penetrating Optic Canal Injury by a Wooden Foreign Body

Purpose: To report a case of right eye blindness due to a penetrating injury in the contralateral nostril. Methods: This is a case report of a 67-year-old patient who presented to the emergency room complaining of transient blurred vision in his right eye after falling on a small branch with no apparent injury besides minor lacerations. The following day, the patient experienced blindness in the right eye. Physical examination revealed small lacerations on his left forehead and optic neuropathy on the right side with no other obvious discerning physical or imaging abnormalities. Results: After elevated suspicion and reassessment of the neuroimaging findings, a radiolucent track was observed in the nasal cavity, continuing up from the left nostril to the right optic nerve. Transnasal endoscopic surgery was performed and a long wooden branch was removed from the nasal cavity. Conclusion: A nasally penetrating wooden foreign body can cause traumatic optic neuropathy and vision loss on the unaffected side and can be very difficult to locate and image without any clear external evidence as to its presence. This case highlights the importance of maintaining a high level of suspicion in these types of cases.
Case Rep Ophthalmol 2018;9:341–347

https://ift.tt/2KDVZBB

Nuclear nonmetastatic protein 23‐H1 expression and epithelial‐mesenchymal transition in laryngeal carcinoma: A pilot investigation

Head &Neck, EarlyView.

https://ift.tt/2KPMMFp

AHNS Series: Do you know your guidelines? Principles for treatment of cancer of the paranasal sinuses: A review of the National Comprehensive Cancer Network guidelines

Head &Neck, EarlyView.

https://ift.tt/2MP61wj

Visualization of nerve fibers around the carotid bifurcation with use of a 9.4 Tesla microscopic magnetic resonance diffusion tensor imaging with tractography

Head &Neck, EarlyView.

https://ift.tt/2KPMLkP

Compartmentalized endoscopic resection of the olfactory cleft for nasal intestinal adenocarcinomas

Head &Neck, EarlyView.

https://ift.tt/2MSCLEY

Survival benefits of adjuvant radiation in the management of early tongue cancer with depth of invasion as the indication

Head &Neck, EarlyView.

https://ift.tt/2KLz46J

MUC1 deficiency mediates corticosteroid insensitivity in asthma

Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2MVWp34

Immune sensitization during one year in the Antarctic high altitude Concordia Environment

Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2KNVhkt

Omalizumab normalizes the gene expression signature of lesional skin in patients with chronic spontaneous urticaria: a randomized, double‐blind, placebo‐controlled study

Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2MS0Onn

Human milk oligosaccharide profiles and food sensitization among infants in the CHILD Study

Allergy, EarlyView.

https://ift.tt/2KCx7KA

Are high‐ and low‐molecular‐weight sensitizing agents associated with different clinical phenotypes of occupational asthma?

Allergy, Volume 0, Issue ja, -Not available-.

https://ift.tt/2MTPIyo

Combination of 5‐aminolaevulinic acid and iron prevents skin fibrosis in murine sclerodermatous grafts‐versus‐host disease

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2zpU7r5

X‐linked ichthyosis: Clinical and molecular findings in 35 Italian patients

Experimental Dermatology, EarlyView.

https://ift.tt/2NrYpRo

FAM83G/Fam83g genetic variants affect canine and murine hair formation

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2u6Zbup

A proposed mechanism for central centrifugal cicatricial alopecia

Experimental Dermatology, EarlyView.

https://ift.tt/2NrYepc

Peptidylarginine deiminases and deiminated proteins at the epidermal barrier

Experimental Dermatology, EarlyView.

https://ift.tt/2zfWdcS

Red grape (Vitis vinifera L.) flavonoids down‐regulate collagen type III expression after UV‐A in primary human dermal blood endothelial cells

Experimental Dermatology, EarlyView.

https://ift.tt/2tZ7ppj

Inherited epidermolysis bullosa: New diagnostics and new clinical phenotypes

Experimental Dermatology, EarlyView.

https://ift.tt/2zfW35g

Heparinoid suppresses Der p‐induced IL‐1β production by inhibiting ERK and p38 MAPK pathways in keratinocytes

Experimental Dermatology, EarlyView.

https://ift.tt/2tYOQkS

New insights into the roles of myofibroblasts and innervation during skin healing and innovative therapies to improve scar innervation

Experimental Dermatology, EarlyView.

https://ift.tt/2u6DI4M

A bald statement — Current approaches to manipulate miniaturisation focus only on promoting hair growth

Experimental Dermatology, EarlyView.

https://ift.tt/2tUV45p

UVA, metabolism and melanoma: UVA makes melanoma hungry for metastasis

Experimental Dermatology, EarlyView.

https://ift.tt/2zggHSH

Texture analysis of second‐harmonic‐generation images for quantitative analysis of reticular dermal collagen fibre in vivo in human facial cheek skin

Experimental Dermatology, EarlyView.

https://ift.tt/2Nvuw2U

Construction of low contracted 3D skin equivalents by genipin crosslinking

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2u8XFbe

Serum VEGFR‐3 as a potential biomarker in psoriasis

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2NrYwfM

In vitro models of dermatophyte infection to investigate epidermal barrier alterations

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2zf5EcF

Physical properties of the photodamaged human skin dermis: rougher collagen surface and stiffer/harder mechanical properties

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2NxCLLw

Recent evolution of the human skin barrier

Experimental Dermatology, EarlyView.

https://ift.tt/2zeIV02

Life before and beyond blistering: The role of collagen XVII in epidermal physiology

Experimental Dermatology, EarlyView.

https://ift.tt/2NuaK7S

Tiled array‐based sequencing identifies enrichment of loss‐of‐function variants in the highly homologous filaggrin gene in African‐American children with severe atopic dermatitis

Experimental Dermatology, EarlyView.

https://ift.tt/2zbjGf8

ATP6V0A2‐related cutis laxa in ten novel patients: focus on clinical variability and expansion of the phenotype

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

https://ift.tt/2Ns8A8B

Clinical, dermoscopic and histopathological features of a rare cutaneous neural tumour

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KBGjii

Clinical, histological and high‐frequency ultrasonographic evaluation (50 MHz) of morphoea treated with ultraviolet A1 phototherapy

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KPVsbI

Identification and interaction analysis of key genes and microRNAs in atopic dermatitis by bioinformatics analysis

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KBc7Um

Atypical variant of trigeminal trophic syndrome successfully treated with pregabalin: a case report series

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KUUUS6

Squamous cell carcinomas in linear epidermal naevi

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KythBY

The impact of transplant rejection on cutaneous squamous cell carcinoma in renal transplant recipients

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KUV0Js

Diagnostic features of acquired dermal melanocytosis of the face and extremities

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2KCGpWZ

Identification of a novel splice site mutation in the LIPH gene in a Japanese family with autosomal recessive woolly hair

The Journal of Dermatology, EarlyView.

https://ift.tt/2u91E7t

Usefulness of dual‐energy computed tomography for the evaluation of psoriatic arthritis accompanied by knee osteoarthritis

The Journal of Dermatology, EarlyView.

https://ift.tt/2tYc9eN

Microbiome analysis of forehead skin in patients with atopic dermatitis and healthy subjects: Implication of Staphylococcus and Corynebacterium

The Journal of Dermatology, Volume 45, Issue 7, Page 876-877, July 2018.

https://ift.tt/2uaKTsH

Issue Information

The Journal of Dermatology, Volume 45, Issue 7, Page 878-878, July 2018.

https://ift.tt/2Nu65mc

Carboplatin and epirubicin combination therapy for advanced malignant epithelial skin tumors: Retrospective study of six patients

The Journal of Dermatology, Volume 45, Issue 7, Page 874-875, July 2018.

https://ift.tt/2zhu8C2

Issue Information

The Journal of Dermatology, Volume 45, Issue 7, Page i, 753-754, July 2018.

https://ift.tt/2NwT0bR

Long‐term survival of a patient with neurofibromatosis type 1 diagnosed with multiple malignant peripheral nerve sheath tumors

The Journal of Dermatology, EarlyView.

https://ift.tt/2u6DdaU

Chronological clinicopathological characterization of rapidly progressive alopecia areata resistant to multiple i.v. corticosteroid pulse therapies: An implication for improving the efficacy

The Journal of Dermatology, EarlyView.

https://ift.tt/2u24DiQ

Lichen myxedematosus associated with monoclonal gammopathy of undetermined significance: A case report and a review of Japanese patients

The Journal of Dermatology, EarlyView.

https://ift.tt/2uaDPfA

Incidence of Stevens–Johnson syndrome following combination drug use of allopurinol, carbamazepine and phenytoin in Taiwan: A case–control study

The Journal of Dermatology, EarlyView.

https://ift.tt/2NwhBOe

Germline BRCA1‐associated protein 1 mutation presenting as BAP1 inactivated melanocytic nevi in a child of a father with fatal paraganglioma

Pediatric Dermatology, EarlyView.

https://ift.tt/2zfmAQ4

Clinical algorithm to manage anemia in epidermolysis bullosa

Pediatric Dermatology, EarlyView.

https://ift.tt/2NxBBzE

Guidelines for pediatric anogenital examination: Insights from our vulvar dermatology clinic

Pediatric Dermatology, EarlyView.

https://ift.tt/2uaD85T

Fractional 532‐nm KTP diode laser and 595‐nm pulsed dye laser in treatment of facial telangiectatic erythema

Journal of Cosmetic Dermatology, EarlyView.

https://ift.tt/2KUqG4C

Effective permeation of 2.5 and 5% lidocaine hydrochloride in human skin using iontophoresis technique

International Journal of Dermatology, EarlyView.

https://ift.tt/2MTZJvg

Psoriasis in Israel: demographic, epidemiology, and healthcare services utilization

International Journal of Dermatology, EarlyView.

https://ift.tt/2KyHBdT

Acne prevalence in 9 to 14‐year‐old old patients attending pediatric ambulatory clinics in Italy

International Journal of Dermatology, EarlyView.

https://ift.tt/2MQXwAQ

Direct‐acting antiviral drugs are triggers for psoriasis: report of three cases

International Journal of Dermatology, EarlyView.

https://ift.tt/2KOJeDC

Early psoriatic arthritis in psoriatic patients: risk factors and screening for rheumatological evaluation

International Journal of Dermatology, EarlyView.

https://ift.tt/2MSoJD9

Skin bacterial colonizations and superinfections in immunocompetent patients with scabies

International Journal of Dermatology, EarlyView.

https://ift.tt/2KBblqq

Recurrent deep venous thrombosis in a leprosy patient on Sofosbuvir regimen for HCV: a lepra reaction?

International Journal of Dermatology, EarlyView.

https://ift.tt/2MRXCbn

Tracing the origins of active amide group‐positive drug‐induced pemphigus vulgaris along the Silk Road: a case report of candesartan‐induced pemphigus vulgaris and review of nonthiol drug‐induced pemphigus

International Journal of Dermatology, EarlyView.

https://ift.tt/2KQMGNK

An acute acral papulovesicular eruption

International Journal of Dermatology, EarlyView.

https://ift.tt/2MQAUAy

Novel mutation in MBTPS2 causes keratosis follicularis spinulosa decalvans in a large Chinese family

International Journal of Dermatology, EarlyView.

https://ift.tt/2KB5yB3

Upper First Premolar Positioning Evaluation for the Stability of the Dental Occlusion: Anatomical Considerations

The present study aimed to find the proper distorotation of the upper first premolar to achieve the therapeutic ideal advocated for the stability of the human occlusion. Normal teeth were analyzed and occlusal photocopies of upper arch were made to perform the 2 measurements. The first parameter was the angle formed by the perpendicular to the wire through the buccal cusp and a line connecting the buccal and the lingual cusps of the upper first premolar. The second one was the angle from the buccal line and the sagittal plane of the model. The amount of distorotation was calculated and a method to bond the bracket was suggested.

https://ift.tt/2u6Leg7

Normalization of Speech Processing After Whole-Vault Cranioplasty in Sagittal Synostosis

Background: Neurocognitive studies have found impairments in language-related abilities in nonsyndromic craniosynostosis, highlighting clinical importance of early language processing. In this study, neural response to speech sounds in infants with nonsyndromic sagittal craniosynostosis (NSC) is compared, preoperatively and postoperatively, using event-related potentials (ERPs) to objectively characterize development in language processing. Methods: Electroencephalogram was recorded while 39 infants (12 NSC and 27 controls; ages 73–283 days) listened to the Hindi dental / JOURNAL/jcrsu/04.02/00001665-201807000-00009/math_9MM1/v/2018-07-05T070331Z/r/image-tiff a/ and retroflex /da/ phonemes (non-native phonemic discrimination task). The mismatch negativity (MMN) ERP was extracted as the peak amplitude of the largest negative deflection in the difference wave over 80 to 300 milliseconds poststimulus. Differences in MMN were analyzed using repeated measures analysis of variance. Results: The MMN amplitude was attenuated in the infants with NSC preoperatively compared with controls (P = 0.047). A significant region by group interaction (P = 0.045) was observed, and infants with NSC displayed attenuated MMN in the frontal electrodes compared with controls (P = 0.010). Comparing the preoperative and postoperative MMN, a time by group interaction trend (P = 0.070) was observed. Pair-wise comparisons showed a trend for increase in MMN amplitude from preoperatively to postoperatively in the infants with NSC (P = 0.059). At the postoperative time point, infants with NSC showed no significant difference in MMN from controls (P = 0.344). Conclusion: Infants with NSC demonstrated atypical neural response to language preoperatively. After undergoing surgery, infants with NSC showed increased MMN amplitude which was not significantly different from controls. These findings support the idea that whole vault cranioplasty may improve neurocognitive outcomes in sagittal craniosynostosis.

https://ift.tt/2lWMQoQ

Three-Dimensional Virtual Treatment Planning: Presurgical Evaluation

Objective: This article describes a virtual protocol designed to optimize surgical orthodontic diagnosis and treatment plan. Methods: A total of 15 patients undergoing orthodontic-surgical treatment have been analyzed with a presurgical virtual three-dimensional (3D) treatment planning, which involves 9 steps. All the patients have been treated with the use of occlusal splint guides projected on the basis of the surgical and orthodontic visualized treatment objective . Results: In all the analyzed patients, a precise and optimal orthodontic presurgical preparation has been obtained. Conclusions: The 3D analysis seems more precise to interpret than two-dimensional; it provides information and images of craniofacial structures free from perspective distortion and it reduces the steps of the presurgical diagnosis. The simplicity of the protocol described in this paper makes possible to apply it in everyday practice. The study described here allows high-precision planning of orthodontic-surgical therapy and optimization of each treatment phase, with consequent advantages in clinical practice: a more accurate orthognathic surgery with predictable results.

https://ift.tt/2zlMqCe

Adipofascial Flaps With Acellular Dermal Matrix Compared With Myocutaneous Flap Reconstruction in Lumbar Myelomeningocele Defects

Background: Adipofascial flaps (AFF) with acellular dermal matrix (ADM) have the potential to reconstruct neural tube defects without sacrificing muscle that may be critical for long-term function. Comparative studies between myocutaneous flap (MF) reconstruction, the accepted standard reconstructive technique, and AFF/ADM remain under-reported. The aim of this study was to evaluate the safety and efficacy of myelomeningocele reconstruction using muscle sparing AFF/ADM versus MF. Methods: A retrospective comparison was conducted on consecutive myelomeningocele patients reconstructed with MF or AFF/ADM over an 84-month period. Data analyzed included: basic demographics, defect size, reconstructive technique, complications, and length of follow-up. A supplemental meta-analysis based on systematic review of literature was performed to compare alternative reconstructive options. Results: Twelve patients were identified who met inclusion criteria. Median age, weight, and defect size at reconstruction in the AFF/ADM group (n = 6) was 37.5 weeks, 3.25 kg, and 20.0 cm2, respectively, and in the MF group (n = 6) was 37 weeks, 3.6 kg, and 22.5 cm2 (P > 0.5). For the AFF/ADM versus MF groups, median follow-up was 33.8 versus 22.6 months, reoperation rate was 0% versus 17% (P = 1.0), and complex skin flap closure rate was 17% versus 100% (P = 0.015). No cerebrospinal fluid leaks or surgical site infections occurred in either group. Meta-analysis of the literature revealed no statistically significant difference in complications rates between muscle and nonmuscle flap reconstruction (P > 0.5); potential long-term sequelae of muscle flap harvest were not included. Conclusions: Muscle sparing AFF with ADM is a safe and effective surgical alternative to muscle flaps for lumbar myelomeningocele reconstruction.

https://ift.tt/2lV4F7E

Evaluation of the Efficacy of Different Concentrations of Dextrose Prolotherapy in Temporomandibular Joint Hypermobility Treatment

Purpose: The aim of this study was to compare and evaluate the efficacy of different concentrations of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. Patients and Methods: A prospective, randomized clinical trial including patients with subluxation or dislocation was performed. The study comprised 40 patients. Patients were randomly divided into 4 groups: control group, 10% dextrose, 20% dextrose, and 30% dextrose group. Patients in all groups received injections into 4 different areas of each TMJ in 4 sessions at monthly intervals. Visual analog scale of TMJ pain intensity, maximum mouth opening (MMO), joint sounds, and frequency of luxations were recorded preoperatively and postoperatively after 1 month of last injection. The collected data were then statistically analyzed. Results: Each group showed postoperatively significant improvement in TMJ pain, significant decrease in both MMO and joint sound. Besides that, TMJ locking was not observed in any patient during the follow-up period. There were no statistically significant differences throughout the study intervals between the groups. Conclusion: It was concluded that there was no significant difference between control group and dextrose groups and there is no superiority of any concentration of dextrose over the others in TMJ prolotherapy, and all treatment procedures were efficient in improvement of clinical symptoms related to TMJ hypermobility. If dextrose is used as a proliferant, it can be said that 10% dextrose can be sufficient in TMJ hypermobility treatment.

https://ift.tt/2zhskJe

Outcome of Conventional Adipose Tissue Grafting for Contour Deformities of Face and Role of Ex Vivo Expanded Adipose Tissue-Derived Stem Cells in Treatment of Such Deformities

Objectives: To evaluate the outcomes of conventional fat grafting for facial contour deformities and to describe clinical outcome of a patient with contour deformity of face treated with ex vivo expanded adipose tissue-derived mesenchymal stem cells (ASCs) enriched fat graft. Place and Duration of Study: The Department of Plastic Surgery and Tissue Engineering and Regenerative Medicine Laboratory, King Edward Medical University/Mayo Hospital, Lahore, from September 2015 to September 2017. Methods: Patients with contour deformities of face requiring soft tissue augmentation were included. Fat was harvested, processed, and injected following a standard protocol. Both subjective and objective assessments were performed and complications were also noted. Results: Twenty-five patients underwent 51 fat-grafting sessions over a period of 24 months. Eighteen (72%) patients underwent multiple fat-grafting sessions. Mean (standard deviation) soft tissue thickness after 72 hours and 6 months of first fat graft session was 18.62 (7.2) and 12.88 (6.21) mm, respectively, which corresponds to 30.77 (13)% reduction of transplanted fat. Physician and patient assessment scores were 3.42 (0.92) and 4 (1.04), respectively. Few minor complications were observed. In the patient undergoing ex vivo expanded ASCs enriched fat graft, there was minimal decrease in soft tissue thickness of treated area (44 mm vs 42 mm) 6 months postoperatively and patient was highly satisfied with the outcome after the single session. Conclusion: Conventional fat grafting is safe for correction of facial contour deformities. However, procedure needs to be repeated multiple times to produce satisfactory results. Beneficial effects of ex vivo expanded ASCs enriched fat grafting have a potential to alter the current treatment paradigm of fat grafting for soft tissue reconstruction.

https://ift.tt/2lVPOdl