Effect of the temperature of nasal lavages on mucociliary clearance: a randomised controlled trial

Abstract

Background

The respiratory epithelium is mainly constituted by caliciform (produces mucus, responsible of keeping moisture and trapping particles) and ciliated cells (transports mucus into the pharynx, by the movement of multiple cilia). For centuries, nasal lavages have been used for different rhinosinusal conditions. Some studies suggest not only a direct effect on the mobilisation of secretions, but also an improvement in mucociliary clearance rates. To our knowledge, the impact of temperature in nasal lavages has been scarcely studied.

Methodology/principal

We used the saccharin test—applying it in the inferior turbinate and timing the detection of its taste—, to estimate mucociliary clearance rates before and after nasal lavages with saline solution at room (20 °C) or body (37 °C) temperatures.

Results

78 healthy subjects were studied, with a mean saccharin test time of 13.88 min. Then, a nasal lavage was performed, half with 20 °C saline and the other with 37 °C. In both, times improved from baseline (from 13.66 to 11.59 and 14.06 to 9.4 min, respectively) with p values < 0.05.

Conclusions

Nasal lavages with saline solution improve mucociliary clearance as measured by saccharin test. Temperature seems to matter, which should be taken into account when indicating nasal lavages to our patients.

https://ift.tt/2KUxcsW

Role of Electronystagmography in Diagnosis of Secondary BPPV in Elderly Patients with Vertigo: A Retrospective Study

Abstract

Elderly population is frequently affected by vertigo which affects their mobility and makes them vulnerable to fall and other morbidities. Often these patient visit neurologist and are often subjected to CT scan, MRI brain etc. to rule out a central cause of vertigo; whereas majority of these patients suffer from vestibular cause of vertigo. A schematic approach by detailed history, simple tests for vestibular functions like Dix Hallpike, supine roll and head impulse test give important clue to diagnosis. Often the diagnosis is benign paroxysmal positional vertigo (BPPV) which is treated by repositioning maneuver. There are often other vestibular causes which may be diagnosed by Electronystagmography (ENG), electrocochleography and other tests. This study was undertaken to study occurrence of secondary BPPV utilizing various parameters of ENG. The study group comprised of 131 patients from the neuro-otology proforma data base at ENT centre and vertigo clinic from January 2015 to December 2017. Inclusion criterion was male and female aged 51 years and above presenting with dizziness, imbalance, rotational vertigo, unsteadiness as the chief complaint. Exclusion criterion was BPPV relieved after Epley's maneuver, Otitis externa, acute Otitis media, Suppurative Otitis media, pre existing neurological condition and history of ear surgery. Neuro-otology Data obtained and the ENG findings were tabulated in the master chart and the observations interpreted and transferred to Claussen's butterfly chart. The study group comprised of 58 male (44.27%) and 73 female (55.73%) with a male female ratio of 1:1.25. ENG exhibited 36 patients (27.49) to have recurrent BPPV, 53 (40.45%) were found to have unilateral/bilateral canal paresis. Meniere's disease was diagnosed in 39 (29.77%) patients and brain stem pathology identified in 3 (2.29%) cases.

https://ift.tt/2L6xFYs

Surgical Management of Parapharyngeal Space Tumours in a Single Tertiary Care Center

Abstract

Because of the inaccessibility and overcrowding of the vital neurovascular structures, management of the parapharyngeal space (PPS) tumour is always a challenge to the surgeons. Here we have discussed the clinical findings and management of the PPS tumours with special concern to the surgical approaches. It is a retrospective study containing 14 patients of PPS tumour from June 2015 to January 2018 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital. 14 consecutive patients with PPS tumours were included in the study. The retrospective clinical data, diagnostic procedures, surgical approaches and the complications were analyzed after 12 months of surgery. Of 14 patients included in the study, 10 patients were males and 4 were females. Prestyloid and poststyloid spaces were involved in 28.57% and 71.42% cases respectively. Transcervical excision of the tumours were performed in 10 patients, 2 patients had undergone transcervical-transoral approach. Transcervical transmandibular and transcervical transparotid excision of tumours were performed in one patient each. Facial nerve injury was detected in 3(21.42%) patients. Injury to the internal carotid artery and wound infection were detected in one patient each. Radiological imaging, especially the MRI helps by narrowing the spectrum of the differential diagnosis distinguishing the benign from malignant lesions, especially in cases where FNAC is contraindicated. Although the transcervical approach is commonly practiced, the combined surgical approach can be effectively applied specially for extensive PPS tumours associated with satisfactory clinical outcomes.

https://ift.tt/2JkEnVF

How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children

Publication date: Available online 13 July 2018

Source: Allergologia et Immunopathologia

Author(s): Genoveva Del-Río Camacho, Ana María Montes Arjona, José Fernández-Cantalejo Padial, Rodríguez Catalán Jesús

Abstract

Introduction

Specific immunotherapy (SIT) is used to treat asthma and allergic rhinitis, and a dose–response relationship has been found for SIT efficacy, creating a need to accurately select the allergen used in therapy. This need is especially pronounced in poly-sensitized children living in areas where different pollen allergen sources coexist in the same season, as this circumstance complicates diagnostic efforts. In such cases, component-resolved diagnosis (CRD) can increase diagnostic accuracy and aid in SIT prescription.

Materials and Methods

We hypothesized that CRD results would lead to modifications in classical immunotherapy prescription based on sources such as medical history, season of symptom presentation, and skin testing. We studied a sample of children indicated for immunotherapy in whom classical methods had not pointed out the most relevant allergen due to sensitization to more than two pollens. We used a small panel of recombinant allergens, analyzing the percentage of changes to prescription considering the findings of molecular studies.

Results

Of the 70 children included, CRD led to modified immunotherapy prescription in 54.3%. Indications of single-allergen therapy increased from 18% to 51% when CRD was included. The decision to prescribe immunotherapy was reversed following CRD in 9.3% of cases.

Discussion

CRD use alters the choice of specific immunotherapy in poly-sensitized children. A wide panel of recombinant allergens may not be necessary to improve immunotherapy indication using molecular techniques; rather, a smaller panel adapted to include those allergens prevalent in the geographical area in question appears to be sufficient for more effective immunotherapy, also leading to an improved cost–benefit ratio.

https://ift.tt/2NcYWFZ

Dendritic cells in sepsis: Potential immunoregulatory cells with therapeutic potential

Publication date: Available online 12 July 2018

Source: Molecular Immunology

Author(s): V. Kumar

Abstract

Sepsis is a disease of dysfunctional immune response against the pathogen causing a profound immune-mediated damage to the vital organs and death of the patient in most cases. However, when sepsis is described much attention is given to monocytes/macrophages, complement system, neutrophils, cytokine storm, and T cells. Dendritic cells (DCs) get less attention in this scenario despite comprising the major immune cell population. Therefore the present review is designed to highlight the importance of DCs in the pathogenesis of sepsis, sepsis-associated immunosuppression, and organ damage. The article starts with an introduction of sepsis as a major medical problem needing an urgent therapeutic targeting. Thereafter it provides a brief information regarding classical and plasmacytoid DCs and their role in the maintenance of immune homeostasis. The subsequent sections describe the role of DCs in the immunopathogenesis of sepsis via immunoregulation, impact of sepsis on DCs including their immunometabolic changes, and their therapeutic targeting during sepsis.

Graphical abstract

https://ift.tt/2LeWwWV

Ketamine and Electroconvulsive Therapy for Depression

No abstract available

https://ift.tt/2zyZsMu

Can Cerebral Near-infrared Spectroscopy Predict Cerebral Ischemic Events in Neurosurgical Patients? A Narrative Review of the Literature

Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review. A meta-analysis was not feasible because of high heterogeneity of patients' groups, different NIRS techniques used in the studies and different outcome criteria selected. The qualitative assessment showed controversial data on the threshold value of cerebral near-infrared spectroscopy used for detecting cerebral ischemia in neurosurgical patients. The evidence on the selected studies is not strong enough, at the moment, to recommend cerebral NIRS as a mandatory monitor to detect cerebral deoxygenation able to predict the future neurological outcome in neurosurgical patients. Further studies are needed to validate a threshold value for cerebral ischemia and the relationship between NIRS-detected cerebral desaturation and clinical outcome in the neurosurgical population. M.L. is a scientific advisor of MASIMO Corp., Irvine, CA. The remaining authors declare that they have nothing to disclose. Address correspondence to: Andrey Khozhenko, MD, DESA, Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Sowwah Square, 112412, Abu Dhabi, UAE (e-mail: ahozhenko@gmail.com). Received December 25, 2017 Accepted May 30, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

https://ift.tt/2uin6YM

Management of retrosternal goiter: Retrospective study of 72 patients at two secondary care centers

Publication date: Available online 12 July 2018

Source: Auris Nasus Larynx

Author(s): Wai Keat Wong, Subhaschandra Shetty, Randall P. Morton, Nicholas P. McIvor, Tony Zheng

Abstract

Objective

Data pertaining to the outcomes of retrosternal goiter surgeries performed at secondary care centers, where thoracic surgery expertise is not readily available, is infrequently reported. Careful patient selection is crucial to avoid an unexpected need for a sternotomy during surgery. We sought to evaluate the surgical management of patients with retrosternal goiters treated at two secondary care centers.

Methods

Retrospective review of clinical records and computed tomographic (CT) scans of 557 patients who underwent thyroid surgery at the Departments of Otolaryngology, Head and Neck Surgery of Manukau Surgery Center and Whangarei Base Hospital. Inclusion criterion was extension of goiter below the plane of the thoracic inlet on CT scan. Clinicopathologic features and surgical outcomes were recorded.

Results

The prevalence of retrosternal goiter was 72 of 557 patients (12.9%). All patients in this series underwent thyroidectomy transcervically. Dyspnea was present in 48 patients (66.7%). On preoperative CT scans, the goiter was noted to extend beyond the aortic arch in seven patients (9.7%), tracheal bifurcation in five patients (6.9%) and posterior mediastinum in 15 patients (20.8%). Malignancy was diagnosed in eight patients (11.1%) histologically. Postoperatively, vocal cord paralysis was temporary in 5 patients (6.9%) and permanent in 1 patient (1.4%). Hypocalcaemia was transient in 10 patients (13.9%). No permanent hypocalcemia, tracheomalacia, postoperative hematoma or patient death was reported. During the study period, 4 patients were encountered in the outpatients setting whereby the evaluation of their CT imaging demonstrated features deemed to be at high risk of requiring a sternotomy: primary mediastinal goiter (n = 2) and inferior extent of goiter to the level of right atrium (n = 2). These patients were pre-emptively referred to a tertiary center where thoracic surgery service was available and their data was reported separately.

Conclusion

With careful patient selection, the majority of retrosternal goiter can be resected transcervically with minimal morbidities. Preoperative CT scan yielded useful surgical information; in the presence of primary mediastinal goiter or inferior extent of goiter to the level of the right atrium, surgery should be planned in a tertiary center where thoracic surgeon is available.

https://ift.tt/2zAsIme

Tracheostomy reversal years after patient lost to follow-up

Pediatric tracheostomies occur for various reasons, including prologned intubation, and require a multidisciplinary approach with routine follow-up.

https://ift.tt/2NLBfG0

Reconstruction of the oral commissure in patients with unilateral transverse facial cleft

Publication date: Available online 13 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): M. Tuersunjiang, X. Long, Y. Fu, J. Ke, H. He, J. Li

Abstract

The normal commissure is not a simple joint of the upper and lower lip, but a triangular mucosal area. To reconstruct a symmetrical oral commissure in patients with a unilateral transverse facial cleft, we designed composite vermilion flaps, including triangular flaps. We retrospectively studied 17 patients with unilateral transverse facial clefts from 2013–2016. Three-dimensional images were obtained with a 3-dimensional photogrammetry system at the 1-year follow-up, and we used an anthropometric method to evaluate the postoperative symmetry of the commissure. No obvious deformity was found during the follow-up examination, and comparison of the cleft and non-cleft sides by the paired samples t test showed that in all cases both horizontally and vertically symmetrical commissures had been achieved.

https://ift.tt/2mgW6nP

Three-layered technique to repair an oroantral fistula using a posterior-pedicled inferior turbinate, buccal fat pad, and buccal mucosal advancement flap

Publication date: Available online 13 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): A. Darr, K. Jolly, T. Martin, A. Monaghan, P. Grime, M. Isles, T. Beech, S. Ahmed

https://ift.tt/2usVyiE

Re: Management of oral and maxillofacial infections in a regional unit: a seven day service?

Publication date: Available online 13 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Thomas F.A. Lees

https://ift.tt/2mffFNF

Publication of scientific research presented at scientific meetings of the British Association of Oral and Maxillofacial Surgeons: 10 years on – have we published or perished?

Publication date: Available online 12 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): L. Watson, A. Reed, N. Shah, P.A. Brennan, D. Hammond, J. Collier

Abstract

In 2009 we evaluated the publication of research presented at annual scientific meetings of the British Association of Oral and Maxillofacial Surgeons (BAOMS) 2002–2006, inclusive. Since then, the format of these meetings has changed, there has been a rapid increase in the number of online-only journals, and restraints on time during training and consultant practice have continued. We have therefore investigated the pattern of publication after presentation at these meetings between 2010 and 2014. All abstracts accepted for oral presentations or posters were included, and publication had to follow no more than four years later. We searched PubMed for papers in peer-reviewed journals and compared the data with those from 2002–2006. A total of 975 abstracts were accepted (2010–2014) of which 221 (23%) went on to be published. The median (IQR) delay to publication was 13 (4–25) months. Most were clinical papers from groups based in the UK (p < 0.001) and most were published in BJOMS (p < 0.001). The rate of publication has not changed significantly between the two periods (23% compared with 24%), and patterns in the type of papers, delays, journals, and research groups, were similar. Despite consistent rates of publication within the specialty, OMFS produces fewer publications after presentation than other surgical specialties. Further research is required to evaluate this more fully.

https://ift.tt/2zBB2lM

Biopsy of the sentinel lymph node in oral squamous cell carcinoma: analysis of error in 100 consecutive cases

Publication date: Available online 12 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): A.M. Holden, D. Sharma, C. Schilling, G. Gnanasegaran, E.W. Odell, I. Sassoon, M. McGurk

Abstract

UK national guidelines in 2016 recommended that sentinel lymph node biopsy should be offered to patients with early oral cancer (T1-T2 N0) in which the primary site can be reconstructed directly. This study describes the pitfalls that can be avoided in the technique of biopsy to improve outcomes. We retrospectively analysed the data from 100 consecutive patients and recorded any adverse events. Lymphatic drainage of tracer failed in two patients as a result of procedural errors. Two patients with invaded nodes developed recurrence after total neck dissection, one after micrometastases had been diagnosed, and the other as a result of extranodal spread that had led to understaging and therefore undertreatment. Two results would not have been mistakenly classified as clear if all the harvested nodes had been analysed histologically according to the protocol. The disease-specific (96%) and disease-free (92%) survival were better than expected for a group of whom a third had stage 3 disease. If all harvested nodes had been analysed by the correct protocol then two of the three nodes wrongly designated clear would have been detected, two deaths potentially avoided, and the false-negative rate would have fallen from 8.3% to 2.7%. We conclude that minor deviations from protocol can result in a detrimental outcome for the patient.

https://ift.tt/2mcC26b

Tracheostomy reversal years after patient lost to follow-up

Abstract

Background

Pediatric tracheostomies occur for various reasons, including prologned intubation, and require a multidisciplinary approach with routine follow-up.

Case presentation

This report reviews the history and clinical outcome of a 29 year old female patient who was lost to follow-up for nearly two decades after a pediatric tracheostomy. When she presented to the Otolaryngology service as an adult the original indication for tracheostomy had resolved and decannulation was initiated, but a profound psychological dependence had developed.

Conclusion

This case outlines the importance of regular follow-up for tracheostomy patients, as well as health care barriers faced in remote rural communities.

https://ift.tt/2zz6YXX

Eine seltene Raumforderung des Mittelohres – von der Parazentese zur Diagnose

Laryngo-Rhino-Otol
DOI: 10.1055/a-0648-4710

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2Lcjkql

Lethal outcome of granulomatous acanthamoebic encephalitis in a man who was human immunodeficiency virus-positive: a case report

Acanthamoeba species can cause disseminating infections in immunocompromised individuals.

https://ift.tt/2NN2Iaq

Prevalence and incidence of clinically significant patulous Eustachian tube: A population-based study using the Korean National Health Insurance Claims Database

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Sung-Won Choi, Jinmi Kim, Hyun Min Lee, Se-Joon Oh, Il-Woo Lee, Eui-Kyung Goh, Soo-Keun Kong

Abstract

Objectives

The aim of this study is to estimate the entire population-based prevalence and incidence of Patulous Eustachian tube (PET) using the Korean National Health Insurance (NHI) claims database. The annual trends of prevalence and incidence of PET were also investigated.

Methods

Retrospective analysis of PET patients was performed between 2010 and 2016, from the NHI claims database. PET patients were defined as those who had at least one service claim with a primary diagnosis under an ICD-10-based PET code (H69.0).

Results

During the study period, there were 20,533 new PET patients in Korea. In 2016 there were 4482 incident cases, and the standardized annual incidence rate was 8.8 per 100,000 persons. The standardized annual prevalence rate increased significantly from 7.2 per 100,000 persons in 2010 to 10.3 per 100,000 persons in 2016. The prevalence increased significantly on annual basis, whereas the incidence rate fluctuated over time. Interestingly, the incidence and prevalence of PET in women was almost twice as high as that in men, and peaked in their 20s.

Conclusions

This study demonstrated the substantial annual increase of the NHI claims with PET code (H69.0) in Korea from 2010 to 2016. Statistical results based on the NHI claims, we confirmed the high prevalence and incidence rates of clinically significant PET in women than in men. This study only covered patient using the medical service for PET and missed PET sufferers not seeking medical service. However, this study can provide basic epidemiological information on clinically significant PET.

https://ift.tt/2uoJizq

Utilizing prestin as a predictive marker for the early detection of outer hair cell damage

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Murat Dogan, Mustafa Sahin, Nesibe Cetin, Mustafa Yilmaz, Buket Demirci

Abstract

Purpose

To evaluate prestin as a biomarker for the identification of early ototoxicity.

Materials and methods

Rats (n = 47) were randomly assigned to five groups: low-dose (LAG) or high-dose (HAG) amikacin (200 and 600 mg/kg/day, respectively, for 10 days), low-dose (LCIS)or high-dose (HCIS) cisplatin (single doses of 5 and 15 mg/kg, respectively, for 3 days), and control (n = 8). At the end of the experiment, measurement of distortion product-evoked otoacoustic emissions (DPOAE) were performed to evaluate hearing, then blood samples and both ear tissues were collected under anesthesia. Prestin levels were determined by ELISA. Cochlear damage was evaluated histologically using a 4-point scoring system.

Results

The mean serum prestin levels were 377.0 ± 135.3, 411.3 ± 73.1, 512.6 ± 106.0, 455.0 ± 74.2 and 555.3 ± 47.9 pg/ml for control, LCIS, HCIS, LAG and HAG groups, respectively. There was significant difference between prestin levels of Control–LCIS-HCIS groups (p = 0.031) and prestin levels of Control-LAG-HAG groups (p = 0.003). There were also significant differences in prestin levels between the low- and high-dose cisplatin and amikacin groups (p = 0.028 and p = 0.011, respectively). Each group had significantly lower DPOAE results at 4, 6 and 8 kHz than control groups (p < 0.001). The LAG, HAG, LCIS and HCIS groups had significantly higher cochlear damage scores than the control group (p < 0.05).

Conclusions

Higher doses of cisplatin and amikacin were associated with the greatest increases in serum prestin level and cochlear damage score. The results of this study suggest that prestin is a promising early indicator of cochlear damage.

https://ift.tt/2ugCHrE

Intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Daowen Wang, Peng Xu

Abstract

Purpose

This study aimed to analyze outcomes of intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss (SSNHL).

Materials and methods

The cases of simultaneous bilateral SSNHL treated in our hospital from March 2007 to March 2018 were retrospectively analyzed. During the earlier period (March 2007 to February 2012), the cases were treated by intravenous prednisolone only, and classified into group A. During the late period (February 2012 to March 2018), intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was employed to treat simultaneous bilateral SSNHL, and these patients were enrolled in group B. Effective rates of the two treatment modalities in groups A and B were compared.

Results

In group A, 3 of 40 ears obtained complete recovery, and 4 ears achieved partial recovery after intravenous prednisolone treatment, with the effective rate of only 17.5% (7/40 ears). In contrast, 6 of 44 ears in group B achieved complete recovery, and 10 ears got partial recovery, with the effective rate of 36.4% (16/44 ears). There was significant difference in the effective rate between the two groups.

Conclusion

Intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was a better choice for simultaneous bilateral SSNHL compared to traditional intravenous prednisolone therapy.

https://ift.tt/2zwF52x

Er:YAG laser application in caries removal and cavity preparation in children: a meta-analysis

Abstract

The aim of this meta-analysis was to systematically evaluate the applications of Er:YAG lasers for the removal of caries and cavity preparation in children. The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was conducted with data extracted from seven relevant randomized controlled trials (RCTs) published from 1997 to July 2017. The data heterogeneity of each study was assessed by a Q test. We used the heterogeneity results to calculate the standard mean difference (SMD) or relative risk (RR) and 95% confidence interval (95%CI) using STATA version 10.0. The publication bias was evaluated using Begger's test. There were seven randomized controlled trials included in this study. The analysis results indicate that compared to the conventional mechanical method, more time was needed for Er:YAG laser treatment (SMD 1.945, 95%CI 0.942 to 2.948). However, the pain reported by patients was reduced with Er:YAG laser treatment (SMD − 1.013, 95%CI − 1.892 to − 0.196). There were no significant differences between the groups in the complete retention rate (RR 1.021, 95%CI 0.963 to 1.114), the marginal discoloration (RR 1.638, 95% CI 0.240 to 11.986) and the marginal adaptation (RR 1.480, 95%CI 0.257 to 8.515). In conclusion, our data indicate that the time required for Er:YAG laser treatment was longer than that for the conventional mechanical method, but there was less pain associated with the Er:YAG laser treatment. There were no significant differences in the complete retention rate, marginal discoloration, and marginal adaptation between the two groups.

https://ift.tt/2KPPKdT

Subglottic Hemangioma: understanding the association with facial segmental hemangioma in a beard distribution

Publication date: Available online 12 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Andrew A. McCormick, Tony Tarchichi, Christopher Azbell, Lorelei Grunwaldt, Noel Jabbour

Abstract

Objective

A subglottic hemangioma (SGH) is a benign tumor of infancy that can cause severe obstruction of the airway. Infantile hemangiomas, in general, are the most common head and neck tumor in children, affecting 4–5% of the pediatric population. This retrospective cohort study characterizes subglottic infantile hemangiomas at a single vascular anomaly center over a 5-year period (2013 – 2017) during the era of propranolol treatment.

Methods

Queried the Vascular Anomaly Database at Children's Hospital of Pittsburgh for all infantile hemangioma(s) and then identified case of subglottic hemangiomas. Characterized key features of presentation, natural history and management for subglottic hemangiomas. A secondary differentiation focused on differences between subglottic hemangiomas associated with Beard Distribution (BD) vs not (NBD).

Results

Analysis of 761 cases of infantile hemangiomas demonstrated only 13 patients with subglottic hemangiomas (1.7%). Of those 13 patients, only 4 patients (30%) had BD while 2 patients (15%) had other cutaneous hemangiomas and 7 patients (55%) had no cutaneous hemangiomas. Secondarily, a total of 31 case of beard distribution cutaneous hemangiomas with 11 patients having oropharyngeal involvement (35%) but only 4 patients with subglottic hemangiomas (13%). Interestingly, 2 of the 4 BD patients had treatment failure on propranolol and required second line treatment with steroids or surgical excision while only 1 of 9 NBD patients failed propranolol treatment. As well the same 2 BD patients which failed propranolol also had PHACES syndrome.

Conclusion

Subglottic hemangiomas are a rare presentation of infantile hemangiomas but with significant morbidity. While the classic teaching that a segmental beard distribution hemangioma raises concern for a subglottic hemangioma, this cohort indicates subglottic hemangiomas occur in a NBD presentation (1.3%), and demonstrated only an approximate 10% incidence rate with a beard distribution. But more importantly, this study raises the question that beard distribution in setting of PHACES syndrome may herald a more recalcitrant and complicated natural history for a subglottic hemangioma. This is of significant concern as risk for CVA in setting of PHACES is highest with use of steroid treatment. None of our patients had high risk extra or intra cranial vascular arterial anomalies and no CVA were noted.

https://ift.tt/2KThwX9

Thyroid® New Open Access Article

Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association^®

No-Scar Transoral Thyroglossal Duct Cyst Excision in Children
Jin Pyeong Kim, Jung Je Park, Seung Hoon Woo

The post <i>Thyroid^®</i> New Open Access Article appeared first on American Thyroid Association.

https://ift.tt/2urIFW4

Injectable platelet rich fibrin: cell content, morphological, and protein characterization

Abstract

Objectives

The aim of the present study was to evaluate the blood cell content, morphological aspects, gene expression of type I collagen, and release of growth factors on an injectable platelet rich fibrin (i-PRF).

Materials and methods

Blood samples were collected from 15 volunteers to prepare i-PRF samples. Peripheral blood was used as a control group. Blood clot and i-PRF samples were cultured for 10 days. The supernatant of the samples was collected for ELISA immunoassay quantification of PDGF and VEGF growth factors over periods of 1, 8, 24, 72, and 240 h. I-PRF and blood clot samples were biologically characterized using histological and immunohistochemistry analysis for IL-10, osteocalcin, and TGF-β. Scanning electron microscopy (SEM) was used to inspect the fibrin network and distribution of blood platelets and leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to evaluate gene expression for type I collagen.

Results

A higher concentration of platelets and lymphocytes was recorded in i-PRF than in peripheral blood (p < 0.05). The release of VEGF was higher in blood clot samples (1933 ± 704) than that for i-PRF (852 ± 376; p < 0.001). Immunohistochemistry showed upregulation of TGF-B, IL-10, and osteocalcin in the i-PRF group. RT-PCR showed increased type I collagen gene expression in i-PRF (p < 0.05). SEM images revealed agglomeration of platelets in some regions, while a fibrin networking was noticeable in the entire i-PRF sample.

Conclusions

Injectable platelet rich fibrin becomes a good approach for soft and mineralized tissue healing considering the formation of a three-dimensional fibrin network embedding platelets, leukocytes, type I collagen, osteocalcin, and growth factors. Indeed, the injectable platelet rich fibrin can be indicated in several medical applications regarding bioactivity, simplied technique, and flowable mixing with other biomaterials.

Clinical relevance

Morphological, cell, and protein characterization of platelet rich fibrin provides a better understanding of the clinical effects and improvement of clinical guidelines for several medical applications. Once well physicochemical and biologically characterized, the use of an injectable platelet rich fibrin can be extended to other applications in the field of orthopedics, periodontics, and implant dentistry on the repairing process of both soft and mineralized tissues.

https://ift.tt/2L5hOJG

Characteristics and Treatment Response of Older Adults With Voice Disorders in the United States

This cross-sectional study uses the 2012 National Health Interview Survey to describe sociodemographic characteristics and response to treatment among aging adults with voice disorders.

https://ift.tt/2NcaFoh

Association of Tinnitus and Other Cochlear Disorders With a History of Migraines

This cohort study used claims data from the Taiwan Longitudinal Health Insurance Database 2005 to investigate the risk of tinnitus and other cochlear disorders inr patients with a history of migraines.

https://ift.tt/2KR1Tzs

Association of Symptoms and Clinical Findings With Anticipated Outcomes in Patients With Recurrent Head and Neck Cancer

This cohort study explores whether symptoms and clinical variables are associated with anticipated outcomes in adult patients with recurrent head and neck cancer.

https://ift.tt/2NbFedE

The Role of Migraine in Hearing and Balance Symptoms

Episodic dizziness is a highly prevalent symptom that has historically been a challenge for primary care physicians, neurologists, and otolaryngologists to accurately diagnosis and properly treat. With an array of diagnoses to consider, including benign positional vertigo, vestibular migraine, Ménière disease, vertebrobasilar syndrome, and vestibular schwannoma, among others, considerable effort has been placed by otolaryngology and neurology societies to carefully examine the literature and generate clinical criteria and guidelines to aid the clinician and to standardize diagnostic algorithms and treatment protocols. In recent decades, Ménière disease has been intensely investigated in both clinical and histopathologic studies and has been among the more frequent diagnoses given to patients with episodic dizziness. Even more recently, many studies have reported substantial overlap between the symptoms of vestibular migraine and those of Ménière disease, and, consequently, distinguishing between these 2 disease entities can be difficult. To this end, the presence of sensorineural hearing loss has notably been suggested to be the primary finding to differentiate Ménière disease from vestibular migraine, highlighting the previously held and popular notion that migraine activity will seldom have a negative influence on the auditory pathways and generate cochlear symptoms, such as hearing loss and tinnitus. As Hwang and colleagues eloquently discuss in this issue of JAMA Otolaryngology–Head & Neck Surgery, there is a growing body of evidence of both the association and causal relationship between migraine and the development of cochlear symptoms.

https://ift.tt/2KOBm5E

Cyclooxygenase 1 mediates IL-33-induced extracellular signal regulated kinase activation in mast cells; Implications for aspirin sensitivity

Publication date: Available online 12 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Dingxin Pan, Kathleen M. Buchheit, Sachin K. Samuchiwal, Tao Liu, Haley Cirka, Hannah Raff, Joshua A. Boyce

Abstract

Background

Classical FcεRI-induced mast cell (MC) activation causes synthesis of arachidonic acid (AA)-derived eicosanoids (leukotriene (LT)C₄, prostaglandin D₂ (PGD₂), and thromboxane A₂ (TXA₂)), that mediate vascular leak, bronchoconstriction, and effector cell chemotaxis. Little is known about the significance and regulation of eicosanoid generation in response to non-classical MC activation mechanisms.

Objectives

To determine the regulation and significance of MC-derived eicosanoids synthesized in response to interleukin-33 (IL-33), a cytokine critical to innate type 2 immunity.

Methods

We employed an ex vivo model of mouse bone marrow-derived MCs (BMMCs) and an IL-33-dependent in vivo model of aspirin-exacerbated respiratory disease.

Results

IL-33 potently liberates AA and elicits LTC₄, PGD₂, and TXA₂ production by BMMCs. Unexpectedly, the constitutive function of cyclooxygenase (COX)-1 is required for IL-33 to activate group IVA cytosolic phospholipase A₂ (cPLA₂) with consequent AA release for synthesis of all eicosanoids, including cysLTs. In contrast, COX-1 was dispensable for FcεRI-driven cysLT production. Inhibition of COX-1 prevented IL-33 induced phosphorylation of extracellular signal related kinase (ERK), an upstream effector of cPLA₂, which was restored by exogenous PGH₂, implying that the effects of COX-1 required its catalytic function. The administration of a COX-1-selective antagonist to mice completely prevented the generations of both PGD₂ and LTC₄ in a model of AERD in which MC activation is IL-33-driven.

Conclusions

MC-intrinsic COX-1 amplifies IL-33-induced activation in the setting of innate type 2 immunity, and may help explain the phenomenon of therapeutic desensitization to aspirin by nonselective COX inhibitors in AERD.

https://ift.tt/2KT7jKj

Interactions among myeloid regulatory cells in cancer

Abstract

Mounting evidence has accumulated on the critical role of the different myeloid cells in the regulation of the cancerous process, and in particular in the modulation of the immune reaction to cancer. Myeloid cells are a major component of host cells infiltrating tumors, interacting with each other, with tumor cells and other stromal cells, and demonstrating a prominent plasticity. We describe here various myeloid regulatory cells (MRCs) in mice and human as well as their relevant therapeutic targets. We first address the role of the monocytes and macrophages that can contribute to angiogenesis, immunosuppression and metastatic dissemination. Next, we discuss the differential role of neutrophil subsets in tumor development, enhancing the dual and sometimes contradicting role of these cells. A heterogeneous population of immature myeloid cells, MDSCs, was shown to be generated and accumulated during tumor progression as well as to be an important player in cancer-related immune suppression. Lastly, we discuss the role of myeloid DCs, which can either contribute to effective anti-tumor responses or play a more regulatory role. We believe that MRCs play a critical role in cancer-related immune regulation and suggest that future anti-cancer therapies will focus on these abundant cells.

https://ift.tt/2NLAvAt

BRONCHOPROTECTIVE EFFECT OF VILANTEROL AGAINST METHACHOLINE-INDUCED BRONCHOCONSTRICTION IN MILD ASTHMATICS: A RANDOMIZED THREE-WAY CROSSOVER STUDY

Publication date: Available online 12 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Grace L.M. Westbury, Christianne M. Blais, Beth E. Davis, Donald W. Cockcroft

Abstract

Background

Ultra-long acting β2 agonists (uLABA) are relatively new anti-asthma medications of which there are three different formulations currently available: olodaterol, indacaterol and vilanterol. The first two formulations have been shown to exert bronchoprotective effects; they are able to prevent airway smooth muscle contraction upon exposure to constricting stimuli. However, studies have found that these two drugs produce different degrees and durations of bronchoprotection against methacholine.

Objective

The objective of this study was to investigate the degree of bronchoprotection provided by vilanterol against methacholine-induced bronchoconstriction.

Methods

Fourteen mild-to-moderate asthmatics [8 male; baseline percent predicted forced expiratory volume in 1 second (FEV1) > 65%; provocative concentration of methacholine causing a 20% reduction in FEV1 (PC20) ≤ 8mg/mL] completed this randomized, double-blind, three-way crossover study. Methacholine challenges were performed before treatment administration (placebo, 100μg fluticasone furoate, or 25μg vilanterol+100μg fluticasone furoate) and at 0.5 and 24 hours posttreatment. Each treatment arm was separated by a minimum 7-day wash-out period. A combination therapy of vilanterol+fluticasone furoate was used, as vilanterol is not available as a monotherapy.

Results

Significant bronchoprotection was evident following the combination treatment at both 0.5 and 24 hours with doubling dose shifts in methacholine PC20 of 2.0 (p=0.0004) and 1.6 (p=0.0001), respectively. Clinically significant bronchodilation was only recorded at 24 hours post-combination treatment (p<0.05).

Conclusion

These findings suggest that vilanterol (in combination with fluticasone furoate) provides significant bronchoprotection against methacholineinduced bronchoconstriction for at least 24 hours in mild-to-moderate asthmatics.

https://ift.tt/2LayVGC

What is a normal pharynx? A videofluoroscopic study of anatomy in older adults

Abstract

Purpose

Structural and functional pharyngeal changes occur with age. How these affect swallowing in healthy older adults is not well defined. This study presents quantitative pharyngeal anatomic features in healthy adults using videofluoroscopic study of swallowing (VFSS). This will help our understanding of the normal changes in swallowing that occur with age and illustrate what may constitute normal variation compared with abnormal swallow function.

Methods

138 mixed gender adults with no history of dysphagia were recruited and underwent a standardized VFSS protocol. Parameters including age, BMI, and gender were correlated with the presence of a cricopharyngeal bar, spinal changes and pharyngeal wall thickness at rest.

Results

46% of participants had notable spinal changes. 8% of participants demonstrated cricopharyngeal bars and 12% of subjects revealed osteophytes. Age positively correlated with the presence of a cricopharyngeal bar (r_s = 0.281, p < 0.001) and presence of osteophytes (r_s = 0.334, p < 0.001). The incidence of cricopharyngeal bars in adults over 70 years old was 16%.

Conclusions

A significant number of healthy adults with no swallowing complaints have variant pharyngeal anatomic findings such as cervical vertebral osteophytes and cricopharyngeal bars. This must be taken into account when assessing patients with dysphagia complaints to avoid misattribution of symptoms to these potentially asymptomatic variants. This ensures correct recommendations are made regarding management including diet modification, compensatory strategies, and surgical intervention.

https://ift.tt/2LepGVY

BRONCHOPROTECTIVE EFFECT OF VILANTEROL AGAINST METHACHOLINE-INDUCED BRONCHOCONSTRICTION IN MILD ASTHMATICS: A RANDOMIZED THREE-WAY CROSSOVER STUDY

Ultra-long acting β2 agonists (uLABA) are relatively new anti-asthma medications of which there are three different formulations currently available: olodaterol, indacaterol and vilanterol. The first two formulations have been shown to exert bronchoprotective effects; they are able to prevent airway smooth muscle contraction upon exposure to constricting stimuli. However, studies have found that these two drugs produce different degrees and durations of bronchoprotection against methacholine.

https://ift.tt/2ufEgGc

‘Cervical spine fractures associated with maxillofacial trauma: a 3-year-long study in the greek population’

Maxillofacial fractures occur frequently in severely injured patients, sometimes concomitantly with serious or life-threatening injuries, the knowledge of which is essential for prompt assessment and treatment. Thus, a multidisciplinary and coordinated approach is important for optimal stabilization and ongoing treatment of multi-trauma patients with maxillofacial fractures (Alvi et al., 2003).

https://ift.tt/2utLMfY

Evaluation of a computed-tomography-based assessment scheme in treatment decision-making for isolated orbital floor fractures

Treatment decisions for fractures of the orbital floor are based on clinical appearance, ophthalmological examination, and computed tomography (CT) scans. In extensive fractures, decisions are easily made between conservative and surgical treatment. However, objective parameters are rare in inconclusive cases.

https://ift.tt/2ucSxDU

Effects of Nd:YAG low-level laser irradiation on cultured human osteoblasts migration and ATP production: in vitro study

Abstract

Low-level laser therapy has become one of the fastest growing fields of medicine in recent years. Many in vivo and in vitro studies have shown that laser irradiation activates a range of cellular processes in a variety of cell types and can promote tissue repair. However, few in vitro experiments have evaluated the effects of laser irradiation on cells in real time. The purpose of this study was to examine the effects of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiation on the migration of cultured human osteoblasts. A dedicated 96-well plate was used, and confluent cultures of the human osteoblast-like cell line, Saos-2, were injured with a wound maker. The wounded cells were then exposed to the Nd:YAG laser (wavelength of 1064 nm) for 60 s at 0.3 W (10 pps, 30 mJ). The total energy density was about 10.34 J/cm². Images of the wounds were automatically acquired inside the CO₂ incubator by the IncuCyte ZOOM™ software. In addition, after laser irradiation, the production of adenosine triphosphate (ATP) was measured using the CellTiter-Glo™ Luminescent Cell Viability Assay. Migration of cells from the border of the original scratch zone was accelerated by laser irradiation. In addition, compared with the control group, significant enhancement of ATP production was observed in the irradiated group. The present study showed that Nd:YAG laser irradiation (wavelength of 1064 nm, 0.3 W, 10 pps, 30 mJ, 10.34 J/cm², irradiation time 60 s) may contribute to the regeneration of bone tissues owing to enhanced osteoblast cell migration.

https://ift.tt/2mf7PmR

Tinnitus perception in patients after vagal nerve stimulator implantation for epilepsy

Vagal nerve stimulation in conjunction with sound therapy has been proposed as a treatment for subjective tinnitus. The purpose of this study is to retrospectively review the effect of VNS on perception of tinnitus in epilepsy patients. We explore the incidence of tinnitus and its perceived reduction in patients requiring implantation of VNS for medically refractory seizures.

https://ift.tt/2L4JZZe

Intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss

This study aimed to analyze outcomes of intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss (SSNHL).

https://ift.tt/2L7J86L

Utilizing prestin as a predictive marker for the early detection of outer hair cell damage

To evaluate prestin as a biomarker for the identification of early ototoxicity.

https://ift.tt/2L6xU5C

Prevalence and incidence of clinically significant patulous Eustachian tube: A population-based study using the Korean National Health Insurance Claims Database

The aim of this study is to estimate the entire population-based prevalence and incidence of Patulous Eustachian tube (PET) using the Korean National Health Insurance (NHI) claims database. The annual trends of prevalence and incidence of PET were also investigated.

https://ift.tt/2L7J2Mr

Is human papillomavirus and p16 expression associated with survival outcomes in nasopharyngeal cancer?

Human papillomavirus (HPV) is a known prognostic indicator in oropharyngeal cancer. Not much is known about the prognostic role of HPV in Nasopharyngeal cancer (NPC). Here, we performed a systematic review and meta-analysis of the literature to investigate if HPV status was a prognostic factor for NPC.

https://ift.tt/2L2iPlF

CME Part II Psoriasis: Which Therapy for Which Patient Focus on special populations and chronic infections

Despite the availability of several new systemic agents for psoriasis treatment, it can be challenging to choose the right therapy in certain patient populations. There are few up-to-date reviews on systemic drugs for moderate to severe psoriasis in pregnant and pediatric patients and in patients with concomitant chronic infections such as hepatitis, HIV and latent tuberculosis. These groups are usually excluded from clinical trials and much of the available evidence is based on anecdotal case reports and case series.

https://ift.tt/2urj0ge

CME Part I Psoriasis: Which Therapy for Which Patient Psoriasis comorbidities and preferred systemic agents

Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities such as psoriatic arthritis, Crohn disease, malignancy, obesity and cardiovascular diseases. All these factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis which has led to identification of new therapeutic targets. Several new drugs have gained FDA approval, expanding the psoriasis armamentarium but still a large number of patients continue to be untreated or undertreated.

https://ift.tt/2mdlB9E

Issue Information

Helicobacter, Volume 23, Issue 4, August 2018.


https://ift.tt/2Ji8M7c

Expression of 15‐lipoxygenase‐1 in Merkel cell carcinoma is linked to advanced disease

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


https://ift.tt/2LcQ96y

The radial forearm free flap for scalp and forehead reconstruction: a 20 year experience

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


https://ift.tt/2L3IZVi

Different rhinologic diseases cause a similar multidimensional decrease in generic health‐related quality of life

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


https://ift.tt/2JgPKya

Nasal airflow resistance measured by rhinomanometry in a healthy population of China

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2KNDbQi

Trends in inferior turbinate surgery: analysis of patients using the Medicare database

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2N8EPIZ

Psoriasis and cancer. An Australian/New Zealand narrative

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2N6Rooo

Exome sequencing identifies novel compound heterozygous mutations in GJB3 gene that cause erythrokeratodermia variabilis et progressiva

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KTvFnj

Narrow‐band imaging patterns classification in oral cavity

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


https://ift.tt/2L81Vim

The efficacy of polidocanol sclerotherapy in mucocele of the minor salivary gland

Journal of Oral Pathology &Medicine, Volume 0, Issue ja, -Not available-.


https://ift.tt/2N8A425

Salivary S100A8/A9 in Sjögren's syndrome accompanied by lymphoma

Journal of Oral Pathology &Medicine, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KN8JWF

ALIGNed on Adherence: subanalysis of adherence in immune‐mediated inflammatory diseases in the DACH region of the Global‐ALIGN study

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


https://ift.tt/2zwuiFL

Efficacy of non‐surgical treatments for androgenetic alopecia: a systematic review and network meta‐analysis

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2mdGOk0

Position Statement for the Management of Comorbidities in Psoriasis

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


https://ift.tt/2zwtTTL

Acute generalized exanthematous pustulosis: a case‐series of 13 patients in Brazil

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


https://ift.tt/2m8BePI

Factors influencing sessions’ and speakers’ evaluation: an analysis of seven consecutive EADV congress editions

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


https://ift.tt/2urtY5k

The skin barrier: Epidermis versus environment

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


https://ift.tt/2uqcxC4

Population pharmacokinetics of subcutaneous C1‐inhibitor for prevention of attacks in patients with hereditary angioedema

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


https://ift.tt/2NJrlVa

Tropomyosins in mosquito and house dust mite cross‐react at the humoral and cellular level

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


https://ift.tt/2JdgQWF

Epithelial barrier dysfunctions in atopic dermatitis: a skin–gut–lung model linking microbiome alteration and immune dysregulation

British Journal of Dermatology, EarlyView.


https://ift.tt/2makFmr

In situ bio‐distribution and residency of a topical anti‐inflammatory using fluorescence lifetime imaging microscopy

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2urquzM

Stratum corneum analysis provide a minimal invasive tool to study immune response and skin barrier in atopic dermatitis children

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mcOYcp

Quality of life in patients with acquired pigmentation: An observational study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2L7nMqd

Nonsurgical treatment of earlobe aging in Mowlawi stages I and II earlobe ptosis with Hyaluronic acid fillers

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2NJqpAk

Incidentally detected pancreatic neuroendocrine microadenoma with lymph node metastasis

Abstract

Pancreatic neuroendocrine microadenomas (NEMAs) are non-functioning neuroendocrine tumors < 0.5 cm with a low proliferation rate and are considered benign. We report on a pancreatic NEMA with lymph node metastasis. A male in his 70s had pylorus-preserving pancreaticoduodenectomy for a distal bile duct carcinoma, which was a 2.1 cm well-differentiated-infiltrating adenocarcinoma with invasion limited to the bile duct wall. An incidental separate 0.4 cm well-differentiated NEMA was found in the pancreatic head with metastatic well-differentiated neuroendocrine tumor in one peripancreatic lymph node. Both neuroendocrine tumors in the pancreatic head and in the lymph node were composed of nests of uniform neoplastic cells with a fine chromatin pattern. The Ki-67 labeling index of NEMA was 0.85%. The neoplastic neuroendocrine cells in both the pancreas and node were diffusely positive for synaptophysin, chromogranin, and insulin. Therefore, this unusual case provides an exception to the current classification system which regards NEMAs as benign lesions.

https://ift.tt/2KPWAQO

Differential expression of cyclooxygenase-2 and cyclin D1 in salivary gland tumors

Abstract

Purpose

Salivary gland tumors are complex and have a great histomorphological diversity; more than 30 histological subtypes are currently described and the study of proteins that help understand and differentiate these tumors is essential. We aimed to analyze the immunoexpression of cyclooxygenase-2 (COX-2) and cyclin D1 proteins in pleomorphic adenomas (PA), mucoepidermoid carcinomas (MEC) and adenoid cystic carcinomas (AdCC) of salivary glands.

Methods

A total of 38 PA, 12 AdCC and 12 MEC underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed semi-quantitatively. For statistical analysis, a significance level was set at p ≤ 0.05.

Results

Overall, these tumors were more prevalent in women (n = 37). The mean age of these patients was 58-year-old and the parotid gland was the most affected anatomic site (n = 33). All cases of AdCC and MEC showed immunopositivity to cyclin D1; however, 39.5% of the PAs were negative (p < 0.001). Regarding COX-2 immunoexpression, we observed that all cases of CME were positive, whereas 60.5% of the PA and 75% of the CAC analyzed were completely negative (p = 0.042).

Conclusions

The overexpression of COX-2, observed only in MEC, emphasizes that salivary gland tumors have different profiles. Cyclin D1 is more immunoexpressed in malignant tumors. Together, these immunohistochemical findings may be useful in differentiating the studied tumors.

https://ift.tt/2uqjWBy

TNF-alpha G/A308 polymorphism association with nasal polyposis in North part of Iran

Abstract

Nasal Polyposis (NP) is a complex multi-factorial disease; associated with several environmental, genetic and inflammatory factors. TNF-alpha is one of the major pro-inflammatory cytokines involved in NP pathogenesis. Some of the polymorphisms of this gene affect its expression. Therefore, the aim of this study was to evaluate the polymorphism of TNF-alpha G/A308 gene and its association with nasal polyposis in north part of Iran. In this case-control study, 60 patients with NP and 75 healthy individuals referred to Guilan University hospital were evaluated. After DNA extraction, RFLP-PCR was used to determine polymorphism. Chi-square test was used to compare the frequency distribution of genotype and alleles of TNF-alpha gene with NP. The frequency of genotype G/G, A/A and G/A in the NP group was 46.7, 10.0 and 43.3%, and in the control group was 65.3, 5.3 and 29.3%, respectively. There was a statistically significant difference between genotype G/G in two groups (P = 0.006, OR 2.58, CI 1.27–5.23). In addition, the frequency of allele A in patients and controls was 31.7 and 20%, respectively; and this difference was statistically significant (p = 0.02). The findings of this study demonstrated that polymorphism in TNF-alpha gene might be a risk factor for NP in north part of Iran and the minor frequency of G308A allele in the current study is slightly more than other major populations. However, more investigations with high number of population are necessary in future.

https://ift.tt/2ue1H2D

Pemphigus foliaceus associated with imatinib therapy in a patient with gastrointestinal stromal tumor

International Journal of Dermatology, EarlyView.


https://ift.tt/2zx42Ll

Eccrine hamartoma with spectrum of histologic findings associated with limb deformity

International Journal of Dermatology, EarlyView.


https://ift.tt/2mahsmX

A comparative study of various modalities in the treatment of keloids

International Journal of Dermatology, EarlyView.


https://ift.tt/2zuFuCP

Efficacy of omalizumab 150 mg/month as a maintenance dose in patients with severe chronic spontaneous urticaria showing a prompt and complete response to the drug

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


https://ift.tt/2zy3PYf

Pediatric Wells syndrome (eosinophilic cellulitis) after vaccination: A case report and review of the literature

Pediatric Dermatology, EarlyView.


https://ift.tt/2N4d3NG

Increased incidence of Bell’s palsy with worse outcomes in pregnancy

A 32-year-old woman presented to the University Hospital, Wales, with a 24-hour history of left-sided headache and facial weakness. She had lower motor neurone facial nerve weakness, but a full neurological examination was otherwise normal. The patient had healthy ear canals and tympanic membranes. She was 37-weeks' pregnant with her first baby, and otherwise healthy with no allergies and taking no medication. We made a provisional diagnosis of Bell's palsy, gave her an obstetric review, eye protection, and prednisolone, 25mg, twice a day for 10days (to follow a reducing regimen).

https://ift.tt/2KOtkcZ

Increased incidence of Bell’s palsy with worse outcomes in pregnancy

Publication date: Available online 12 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): A. Geddes, J. Barry, C. Thomas

https://ift.tt/2Jl4ZpS