Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Δευτέρα 30 Ιουλίου 2018

Platelet-rich fibrin in oral surgical procedures: a systematic review and meta-analysis

Publication date: Available online 30 July 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J.V.d.S. Canellas, P.J.D. Medeiros, C.M.d.S. Figueredo, R.G. Fischer, F.G. Ritto

Abstract

The effect of platelet-rich fibrin (PRF) in enhancing the healing after oral surgical interventions is still a matter of debate. The purpose of this study was to identify instances where PRF has been shown to be effective in oral surgical procedures. A comprehensive literature search was performed up to 2017 on PubMed/MEDLINE, Cochrane Library, Web of Science, Scopus and LILACS databases and grey literature. The full-text of potentially relevant studies were reviewed and only randomized clinical trials (RCTs) were included. A total of 559 studies were found, of which 30 were included for qualitative analysis and 13 for quantitative analysis. Three review authors assessed the risk of bias independently. The available literature suggests that PRF has a positive effect in improving alveolar preservation on extraction sockets and around dental implants. The qualitative analysis showed a significantly better effect of PRF in promoting bone regeneration for alveolar cleft reconstruction. The meta-analysis for third molar surgery showed a decrease in prevalence of alveolar osteitis. PRF increased implant stability 1 week and 1 month after surgery (P = 0.0005 and 0.0003). Due to the lack of studies with low risk of bias and a limited number of patients available, further RCTs are needed to confirm these results.



https://ift.tt/2LGDcGb

Speech audiometry in noise: Development of the French-language VRB (vocale rapide dans le bruit) test

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): F. Leclercq, C. Renard, C. Vincent

Abstract
Introduction

Understanding speech in noise is a major challenge for most hearing-impaired subjects, with or without hearing aids. To overcome the weaknesses of French-language speech-in-noise tests, we developed a new instrument, with a balanced mix of difficulty of the speech material.

Material and methods

The speech material comprised 127 sentences taken from the "Marginal Benefit from Acoustic Amplification" (MBAA) corpus, each including 3 keywords. The noise was created using the "onde vocale globale" (global vocal wave: OVG), described by Dodelé. The 127 speech/noise pairs were recorded individually after root-mean-square equalization. The first experiment, on 10 normal-hearing adults, determined the signal-to-noise ratio (SNR) associated with 50% correct keyword identification in each sentence (SNR-50), using an ascending method with noise level set at 73 dB SPL. Relative levels between sentences and noise were then adjusted sentence by sentence to achieve an SNR-50 of 0 dB. The second experiment, with 12 normal-hearing adults, validated the equalization of sentence difficulty.

Results

Mean SNR-50 was −6.64 dB (σ = 1.47). Mean adjusted SNR-50 was 0.08 dB (σ = 0.55). Mean psychometric curve slope was 19.3%/dB, with low standard deviations, testifying to the sensitivity of the speech material.

Conclusion

The VRB (vocale rapide dans le bruit: rapid speech in noise) test is based on sentences from the MBAA corpus with background noise based on the OVG at different signal-to-noise ratios. The test is feasible and able to detect slight variations in speech-in-noise performance between subjects.



https://ift.tt/2AxkCeK

Zinc deficiency and severe protein–energy malnutrition in a child with atopic eczema

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2mZF5z6

Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis

Abstract

Objectives

The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis.

Materials and methods

This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay.

Results

The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups.

Conclusions

Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings.

Clinical relevance

Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.



https://ift.tt/2KciSHd

Comparing the Prognostic Value of the Eighth Edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer

Thyroid, Ahead of Print.


https://ift.tt/2v2yQyH

The Prognostic Impact of Tumor Size in Papillary Thyroid Carcinoma is Modified by Age

Thyroid, Ahead of Print.


https://ift.tt/2Kd00I3

Early Determinants of Thyroid Function Outcomes in Children with Congenital Hypothyroidism and a Normally Located Thyroid Gland: A Regional Cohort Study

Thyroid, Ahead of Print.


https://ift.tt/2LKefZR

Protective Effect of Ginseng on Salivary Dysfunction Following Radioiodine Therapy in a Mouse Model

Thyroid, Ahead of Print.


https://ift.tt/2KcjsEM

A Novel Mutation in NKX2-1 Shows Dominant-Negative Effects Only in the Presence of PAX8

Thyroid, Ahead of Print.


https://ift.tt/2LKefsP

Iron Deficiency May Predict Greater Risk for Hypothyroxinemia: A Retrospective Cohort Study of Pregnant Women in China

Thyroid, Ahead of Print.


https://ift.tt/2M2rmSN

Predicting Malignancy in Thyroid Nodules: Radiomics Score Versus 2017 American College of Radiology Thyroid Imaging, Reporting and Data System

Thyroid, Ahead of Print.


https://ift.tt/2vnfzHN

In Memoriam to the man behind the camera: David J LIM, MD November 27 1935–June 29, 2018

Publication date: Available online 30 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Bernd Fritzsch



https://ift.tt/2KcrugW

In vivo imaging reveals increased eosinophil uptake in the lungs of obese asthmatics

Publication date: Available online 30 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Neda Farahi, Chrystalla Loutsios, Nicola Tregay, Adam K.A. Wright, Rachid Berair, Laurence S.C. Lok, Daniel Gillett, Ian Cullum, Rosalind P. Simmonds, Charlotte Summers, Anna Wong, Chandra K. Solanki, John Buscombe, Pee Hwee Pang, Arthikkaa Thavakumar, A.Michael Peters, Christopher E. Brightling, Alison M. Condliffe, Edwin R. Chilvers

Capsule Summary

Using radiolabeled eosinophils coupled with SPECT/CT the authors quantify eosinophilic inflammation in the lungs of patients with asthma and focal pulmonary eosinophilic inflammation, revealing important differences in eosinophil kinetics between obese and non-obese asthmatics.



https://ift.tt/2NZCErU

Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty?

Publication date: Available online 30 July 2018

Source: American Journal of Otolaryngology

Author(s): Mustafa Sitki Gozeler, Muhammed Sedat Sakat, Korhan Kilic, Ozgur Ozmen, Abdullah Can, Ilker Ince

Abstract
Purpose

Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty.

Material and methods

50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n = 25) was administered 100 mL iv saline solution 30 min preoperatively, while Ibuprofen group (n = 26) received 800 mg ibuprofen iv. in 100 Ml saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible.

Results

VAS scores at 10, 20, and 30 min and at 1, 2, 4, 8, 12 and 24 h were lower in the ibuprofen group than in the control group (p < 0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8 ± 86.4 mcq vs 338.00 ± 81.00 mcq), respectively.

Conclusion

We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800 mg 30 min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores.



https://ift.tt/2Ov746f

Editorial Board/Reviewing Committee



https://ift.tt/2v1AWiB

Letter to the editor: “Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis”

We would like to take the opportunity to comment on the recently published article by Moya-Plana [1] et al. "Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis". Survival benefits of sentinel node biopsy (SNB) were previously demonstrated over watchful waiting in the management of squamous cell carcinoma of oral cavity (OCSCC) with clinically negative neck (cN0) [2–4]. We also know the END could benefit cN0 OCSCC patients compared with watchful waiting [5].

https://ift.tt/2LLVsNB

An Unusual Case of Deep Vein Thrombosis (DVT) after Orthognathic Surgery: A Case Report and Review of Literatures

Publication date: Available online 30 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sahand Samieirad, Hadi Tohidi, Majid Eshghpour, Mayam Sadat Hashemipour

Abstract

Deep vein thrombosis (DVT) is primarily caused by obstruction of blood flow in the deep veins in the lower limbs. It is a form of thrombophlebitis and can be a major cause of morbidity and mortality in hospitalized patients. This paper aims to report an unusual case of DVT in a 21-year-old female class III patient who underwent bimaxillary orthognathic surgery (BSSO and LeFort I osteotomy) under general anesthesia. She developed DVT unexpectedly one week after the surgery, with episodes of sweating and chills, as well as lower limb edema, tenderness and rigidity. D-dimer lab test and the venous doppler sonography were performed and DVT diagnosis was confirmed; therefore, the patient was admitted to the ICU for anticoagulant and supportive therapy. Although the incidence rate of thromboembolism in the hospitalized patients undergoing oral and maxillofacial surgery is low, it is not a DVT risk-free operation. This complication can potentially cause fatal acute pulmonary thromboembolism and death. This case study illustrated that the pharmacological treatment of menorrhagia with mefenamic acid when combined with intra-operative use of tranexamic acid for control of blood loss might put the patient at an increased risk of DVT. Hence, maxillofacial surgeons should assess all their patients pre-operatively in terms of thromboembolism risk; if they suspect any risk factors in the patient, prompt diagnostic tests and management should be ordered.



https://ift.tt/2LUN6DG

Periodontal regenerative therapy for preventing bone defects distal to mandibular second molars after surgical removal of impacted third molars. A systematic review and meta-analysis of randomized clinical trials

Publication date: Available online 30 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Octavi Camps-Font, Cristina Caro-Bonfill, Maria Àngels Sánchez-Garcés, Cosme Gay-Escoda

Abstract
Background

To assess which regenerative techniques are most effective for preventing periodontal defects after the extraction of the third molars and compare these procedures with the spontaneous healing of the socket.

Methods

Five electronic databases were searched to identify randomized clinical trials that fulfilled the eligibility criteria. 2 independent reviewers conducted literature screening, article selection, and data extraction independent reviewers. Outcome measures were mean clinical attachment level (CAL) gain, mean probing depth (PD) reduction, mean alveolar bone level (ABL) gain and adverse events. The influence of several variables of interest on the outcomes of periodontal regenerative therapy was explored via subgroup analyses.

Results

Out of 1,205 potentially eligible papers, 21 randomized clinical trials were included. 18 trials assessed periodontal regenerative therapy as an alternative to extraction alone. Statistically significant differences were found in CAL gain (1.98 mm; 95% CI: 1.44 to 2.52; p<0.001), PD reduction (1.76 mm; 95% CI: 1.20 to 2.31; p<0.001) and ABL gain (1.21 mm; 95% CI: 0.21 to 2.21; p=0.018). The risk of developing complications at treated sites did not increase with the regenerative procedures (OR: 1.49; 95% CI: 0.71 to 3.14; p=0.290). There was no evidence of any regenerative procedure being better than any other. However, osseous grafting techniques were associated with a significantly higher adverse event rate.

Conclusion

Regenerative periodontal therapy, compared to the spontaneous healing of the wound, is more effective at initial improvement in CAL gain, PD reduction, and ABL gain, without increasing the risk of postoperative complications.



https://ift.tt/2vshmLV

Embedded tooth: unique mimicker of keratoacanthoma

Publication date: Available online 30 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Rita de Cassia Rossini, Lara Silveira Abdo, Stanislav Nickolaevich Tolkachjov, Felipe Bochnia Cerci



https://ift.tt/2v2YXpr

Furazolidone‐containing triple and quadruple eradication therapy for initial treatment for Helicobacter pylori infection: A multicenter randomized controlled trial in China

Helicobacter, EarlyView.


https://ift.tt/2v84wTJ

Treatment of Sweet's syndrome in pregnancy

Dermatologic Therapy, EarlyView.


https://ift.tt/2v28KMj

Mohs micrographic surgery combined local flaps in treatment of EMPD: A retrospective case

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bYTD

Brimonidine tartrate gel plus topical steroid for the prevention of laser therapy‐related postinflammatory hyperpigmentation

Dermatologic Therapy, EarlyView.


https://ift.tt/2LQFa6i

Focal multimodality radiation therapy: A promising treatment for recalcitrant Darier disease

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bzAB

21st Chinese Society of Dermatology Annual Meeting, Hefei, Anhui, China

Dermatologic Therapy, EarlyView.


https://ift.tt/2v2UjYC

An enlightening tripartite event in Hanoi: Third Indochina Academy of Dermatology Conference, World Health Academy Dermatology Summit, and the Vietnamese Society of Dermatology Annual Meeting

Dermatologic Therapy, EarlyView.


https://ift.tt/2Kb25UR

A cost‐effective treatment model in dystrophic epidermolysis bullosa with congenital absence of skin

Dermatologic Therapy, EarlyView.


https://ift.tt/2LRuqo0

Reorganization of motor unit activity at different sites within the human masseter muscle during experimental masseter pain

European Journal of Oral Sciences, EarlyView.


https://ift.tt/2AwxRfI

Micro‐computed tomography assessment of root dentin around fluoride‐releasing restorations after demineralization/remineralization

European Journal of Oral Sciences, EarlyView.


https://ift.tt/2OvIsdJ

Dental caries and externalizing behaviour problems in a high‐risk child population

European Journal of Oral Sciences, EarlyView.


https://ift.tt/2ApjDgu

Dose‐ and time‐dependent effects of triethylene glycol dimethacrylate on the proteome of human THP‐1 monocytes

European Journal of Oral Sciences, EarlyView.


https://ift.tt/2mVFLp2

Assessing the association between subsistence strategies and the timing of weaning among indigenous archaeological populations of the Caribbean

International Journal of Osteoarchaeology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AngnST

Evidence of probable subadult scurvy in the Early Medieval cemetery of Castel Tirolo, South Tyrol, Italy

International Journal of Osteoarchaeology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ot9JgJ

Quantitative Polymerase Chain Reaction‐based detection of HPV 16 E6 and E7 DNA in oral squamous cell carcinoma

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


https://ift.tt/2NYI9qJ

Growth‐regulated oncogene‐α from oral submucous fibrosis fibroblasts promotes malignant transformation of oral pre‐cancerous cells

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


https://ift.tt/2Os4FJw

Immunoexpression of calcitonin and glucocorticoid receptors in central giant cell lesions of the jaws

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


https://ift.tt/2M4og0J

Clinical Value of Naa10p and CEA Levels in Saliva and Serum for Diagnosis of Oral Squamous Cell Carcinoma

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


https://ift.tt/2LMHrzj

Lingual lymph nodes in patients with squamous cell carcinoma of the tongue and the floor of the mouth

Head &Neck, EarlyView.


https://ift.tt/2M358QI

Oncologic outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: Results of the French Robotic Surgery Group of GETTEC

Head &Neck, EarlyView.


https://ift.tt/2LRgaM0

Sinonasal renal cell‐like adenocarcinoma: Easily misdiagnosed sinonasal tumor

Head &Neck, EarlyView.


https://ift.tt/2M34YJ6

Identification of lymphatic channels in the tracheoesophageal groove during central neck dissection for thyroid cancer

Head &Neck, EarlyView.


https://ift.tt/2LUA4pL

Pretreatment metabolic tumor volume as a prognostic factor in HPV‐associated oropharyngeal cancer in the context of AJCC 8th edition staging

Head &Neck, EarlyView.


https://ift.tt/2M40WjP

Radiotherapy for extranodal classic Hodgkin lymphoma of the maxillary sinus: Case report and literature review

Head &Neck, EarlyView.


https://ift.tt/2M7I0As

AsthmaMap: An expert‐driven computational representation of disease mechanisms

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 916-918, August 2018.


https://ift.tt/2Kax8QF

Implementing primary prevention of food allergy in infants: New BSACI guidance published

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 912-915, August 2018.


https://ift.tt/2LPdL4r

Best of the Other Journals

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 1074-1074, August 2018.


https://ift.tt/2Kgs2CI

A summer's tale

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 910-911, August 2018.


https://ift.tt/2v2BMvz

Cover Image

Clinical &Experimental Allergy, Volume 48, Issue 8, Page i-i, August 2018.


https://ift.tt/2K6NlXb

Tumstatin fragment selectively inhibits neutrophil infiltration in experimental asthma exacerbation

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


https://ift.tt/2M1peL7

Comparison Of Therapeutic Response Of Lycopene And Curcumin In Oral Submucous Fibrosis: A Randomized Controlled Trial

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


https://ift.tt/2LFf6vC

Head and neck squamous cell carcinoma drives line‐1 hypomethylation in the peripheral blood mononuclear cells

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


https://ift.tt/2NTZZv2

Circadian rhythms and influencing factors of xerostomia among Parkinson's disease patients

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


https://ift.tt/2NWiEpP

Otogenic cerebral venous thrombosis in children: A review of 16 consecutive cases

Publication date: Available online 30 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Gil Coutinho, Sara Júlio, Ricardo Matos, Margarida Santos, Jorge Spratley

Abstract
Objectives

Management of otogenic cerebral venous thrombosis (OCVT) is controversial. Despite the modern antibiotic era OCVT still represents a potential life-threatening condition. This study aims to report the clinical presentation and management in a series of children with OCTV. The coexisting intracranial complications (ICC), the extent of the surgical treatment and the role of hypocoagulation were the analysed outcomes.

Material and Methods

Retrospective chart review of patients aged less than 16 years and consecutively treated for OCVT at a tertiary university hospital between January 2007 and March 2015.

Results

Sixteen children with ages ranging between 25 months to 16 years (9 girls/7 boys) with OCVT were identified. Acute otitis media was the causative factor in the majority of cases (n = 13). The remaining cases resulted from chronic otitis media with cholesteatoma (COMC). Eleven patients were under antibiotic therapy prior to admission. Other ICC were simultaneously present: intracranial abscess (n = 6); otitic hydrocephalus (n = 3); and meningitis (n = 1). Thrombus extension correlated with the presence of additional ICC (p = 0.035). Treatment in all cases comprised of broad-spectrum antibiotics, mastoidectomy, and long-range hypocoagulation with warfarin. Transtympanic ventilation tubes were inserted in all cases but one with COMC. Perioperative sigmoid sinus exposure was performed in seven patients, with drainage of perisinus empyema in three cases. Five children underwent simultaneous craniotomy for intracranial abscess drainage. Follow-up imaging performed in 12 cases revealed partial or complete recanalization in three and seven cases, respectively. After a mean hypocoagulation duration of nine months, no hemorrhagic or major neurologic complications were observed.

Conclusions

The clinical course of OCVT can be masked by previous antibiotic therapy. As such, a high suspicion index is needed for diagnosis. Simultaneous ICC appears to be more frequently found if an extensive thrombosis was present. The high recanalization rate in this series with low morbidity and no mortality can be obtained with a timely combination of antibiotics, mastoidectomy with transtympanic tube insertion and hypocoagulation. However, the decision to start hypocoagulation and its duration should be undertaken on an individual basis owing the possible adverse effects. Prospective and case-control studies are still needed to better clarify the role of the hypocoagulation treatment in OCVT.



https://ift.tt/2mXKXsE

Otitis Media with Effusion in Nasal Polyposis and Outcomes Following Surgery: a Longitudinal Observational Study

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


https://ift.tt/2v2HihI

Olfactory bulb neuroplasticity: A prospective cohort study in patients with chronic rhinosinusitis with nasal polyps

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


https://ift.tt/2Ka7AD6

Findings on 7000 mri of the iam: To scan or not to scan? : A retrospective cohort study

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


https://ift.tt/2M0zPpS

Issue Information

Clinical Otolaryngology, Volume 43, Issue 4, Page ii-v, August 2018.


https://ift.tt/2M2XoOM

Cover Image

Clinical Otolaryngology, Volume 43, Issue 4, Page i-i, August 2018.


https://ift.tt/2LACOZL

Author Guidelines

Clinical Otolaryngology, Volume 43, Issue 4, Page 1192-1193, August 2018.


https://ift.tt/2K78Reo

Efficacy of fibre‐optic laryngeal potassium titanyl phosphate laser surgery under local anaesthesia for the treatment of vocal polyps: A prospective study of 65 patients

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


https://ift.tt/2Lz4pdQ

Antibiotic prophylaxis in clean head and neck surgery: A prospective randomized controlled trial

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


https://ift.tt/2Kb6W8N

Video Head Impulse Test Results Suggest that Different Pathomechanisms Underlie Sudden Sensorineural Hearing Loss with Vertigo and Vestibular Neuritis:Our Experience in Fifty‐Two Patients

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


https://ift.tt/2mXAk9i

The efficacy of hesperidin for treatment of acute otitis media

In this experimental study, the effect of hesperidin on the treatment of acute otitis media (AOM) was investigated in an AOM-induced rat model.

https://ift.tt/2mStIZM

Gene Therapy for C1 Esterase Inhibitor Deficiency in a Murine Model of Hereditary Angioedema

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


https://ift.tt/2LP9f65

Staphylococcus aureus small colony variants: prevalence in chronic rhinosinusitis and induction by antibiotics

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


https://ift.tt/2M4v7HF

Hyper IgE in the Allergy Clinic‐ when is it Primary Immunodeficiency?

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


https://ift.tt/2LK0ASB

microRNA‐146a is linked to the production of IgE in mice but not in Atopic Dermatitis patients

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


https://ift.tt/2K9ePeQ

Stability of Diluted Neuromuscular Blocking Agents Utilized in Perioperative Hypersensitivity Evaluation

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


https://ift.tt/2LK0lqF

Highlights of the 8th Drug Hypersensitivity Meeting: Amsterdam, April 19‐21, 2018

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


https://ift.tt/2M3kmW2

Japanese cedar pollinosis in Tokyo residents born after massive national afforestation policy

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


https://ift.tt/2v4u0RA

Comparing the different diagnostic criteria of Asthma‐COPD overlap

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


https://ift.tt/2v14DjP

Asthma diagnosis using integrated analysis of eosinophil microRNAs

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


https://ift.tt/2M1kNjr

Prevention of allergy by virus‐like nanoparticles (VNP) delivering shielded versions of major allergens in a humanized murine allergy model

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


https://ift.tt/2v14wop

Egg allergen specific IgE diversity predicts resolution of egg allergy in the population cohort HealthNuts

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


https://ift.tt/2M2W7qQ

Protective effects of breastfeeding on respiratory symptoms in infants with 17q21 asthma risk variants

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


https://ift.tt/2M3SDEF

The soluble isoform of human FcɛRI is an endogenous inhibitor of IgE‐mediated mast cell responses

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


https://ift.tt/2v4tF1g

De novo sensitization to Aspergillus fumigatus in adult asthma over a 10‐year observation period

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


https://ift.tt/2M6tNDV

The Health and Economic Outcomes of Early Egg Introduction Strategies

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


https://ift.tt/2LTWyXA

EAACI position paper on how to classify cutaneous manifestations of drug hypersensitivity

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


https://ift.tt/2KbFxDk

Control of Allergic Rhinitis and Asthma Test (CARAT) with one‐week recall; validation of paper and electronic version

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


https://ift.tt/2v4tiDU

Platelet-rich fibrin in oral surgical procedures: a systematic review and meta-analysis

The effect of platelet-rich fibrin (PRF) in enhancing the healing after oral surgical interventions is still a matter of debate. The purpose of this study was to identify instances where PRF has been shown to be effective in oral surgical procedures. A comprehensive literature search was performed up to 2017 on PubMed/MEDLINE, Cochrane Library, Web of Science, Scopus and LILACS databases and grey literature. The full-text of potentially relevant studies were reviewed and only randomized clinical trials (RCTs) were included.

https://ift.tt/2v1MaDt

Characteristics and management of Asian skin

International Journal of Dermatology, EarlyView.


https://ift.tt/2viSu91

In situ and invasive melanoma in a high‐risk, New Zealand, population: A population‐based study

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2v2EiSp

A novel dermoscopic pattern observed in furuncular myiasis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KftYeq

The use of an innovative film‐forming topical gel in preventing Striae Gravidarum and treating Striae Distensae

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkHPm

Multiple perianal ulcers due to suppositories

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2M7k3tq

Progress of an isolated collagenoma during pregnancy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkwDG

Unexpected positron emission tomography/computed tomography uptake in benign dermal naevus

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kftll4

Medicine and body image: resource planning for the poor. A memoir by Terence Ryan

International Journal of Dermatology, EarlyView.


https://ift.tt/2LDenuY

Retrospective analysis of a single‐center clinical experience toward development of curative treatment of 123 pemphigus patients with a long‐term follow‐up: efficacy and safety of the multidrug protocol combining intravenous immunoglobulin with the cytotoxic immunosuppressor and mitochondrion‐protecting drugs

International Journal of Dermatology, EarlyView.


https://ift.tt/2NUbNxg

Comments concerning “ALK positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature”

International Journal of Dermatology, EarlyView.


https://ift.tt/2OsY01H

White and yellow dots as new trichoscopic signs of severe female androgenetic alopecia in dark skin phototypes

International Journal of Dermatology, EarlyView.


https://ift.tt/2vkUUUG

Chronic generalized pruritus without primary skin lesions: a longitudinal prospective observational study

International Journal of Dermatology, EarlyView.


https://ift.tt/2OqFk2y

Morphology, growth rate, and thickness of the nail plate during the pregnancy

International Journal of Dermatology, EarlyView.


https://ift.tt/2LBC6M6

An effective and promising treatment with adalimumab for impetigo herpetiformis with postpartum flare‐up

International Journal of Dermatology, EarlyView.


https://ift.tt/2NSWR2r

A study on gender differences in newly detected leprosy cases in Sichuan, China, 2000–2015

International Journal of Dermatology, EarlyView.


https://ift.tt/2LFY0xP

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

International Journal of Dermatology, EarlyView.


https://ift.tt/2vkUFce

Productivity changes following medical and surgical treatment of chronic rhinosinusitis by symptom domain

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2AopthZ

Effects of decongestant addition to intranasal corticosteroid for chronic rhinitis: a systematic review and meta‐analysis

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2LLajI5

Risk factors and strategies in nonadherence with subcutaneous immunotherapy: a real‐life study

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2AngQ7k

Nitric oxide‐releasing microparticles as a potent antimicrobial therapeutic against chronic rhinosinusitis bacterial isolates

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2v4ou1k

Reliability and validity of the Korean version of the Questionnaire of Olfactory Disorders

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2M4oCof

Sex bias in rhinology research

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2LQlsYm

Additional options in chronic rhinosinusitis management

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2M0vFOM

Tissue changes over time after polydioxanone thread insertion: An animal study with pigs

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ou5CRu

Topography of the dorsal nasal artery and its clinical implications for augmentation of the dorsum of the nose

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Asp12o

A red pumpkin seed extract reduces melanosome transfer to keratinocytes by activation of Nrf2 signaling

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mWdGy5

Applications and efficacy of platelet‐rich plasma in dermatology: A clinical review

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwngBs

Perspectives in cosmetic dermatology: What is in front of the mirror?

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mUvzx3

Assessment of the moisturizing properties of a magnetic mask containing iron oxide particles

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2ArH0Gg

Comparison of three strip harvesting technqiues (Haber's, Pathomvanich's and Ahmad's techniques)

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2OvuCrI

Identification and integrated analysis of microRNA expression profiles in keloid

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwmZyq

Lipoma removal using a high‐frequency ultrasound‐guided injection of a Class III CE‐marked device—Empirical findings

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mXoqw8

Antiaging efficacy of a retinaldehyde‐based cream compared with glycolic acid peel sessions: A randomized controlled study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ar13oa

Oral propranolol for infantile hemangiomas beyond the proliferative phase

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ovecj2

Rapid alteration of serum interleukin‐6 levels may predict the reactivity of i.v. cyclophosphamide pulse therapy in systemic sclerosis‐associated interstitial lung disease

The Journal of Dermatology, EarlyView.


https://ift.tt/2ApM25T

Increase in antinuclear antibody levels through biologic treatment for psoriasis

The Journal of Dermatology, EarlyView.


https://ift.tt/2mUvoln

Urticarial vasculitis and subcutaneous nodules in the extremities seen in a patient with mucopolysaccharidosis II after hematopoietic stem cell therapy

The Journal of Dermatology, EarlyView.


https://ift.tt/2AlwqjU

Indeterminate cell histiocytosis presenting as a single nodule of the nose

The Journal of Dermatology, EarlyView.


https://ift.tt/2OvubO6

Undifferentiated pleomorphic sarcoma in a patient with Cowden syndrome after radiotherapy for breast cancer

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ar0Z7U

Characteristics of multiple basal cell carcinomas: The first study on Japanese patients

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ovu2Ky

Effectiveness of etretinate/yokuinin combination therapy for lip squamous cell carcinoma

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ar0Pxk

Azathioprine‐induced myelosuppression in two pemphigus vulgaris patients with homozygous polymorphism of NUDT15

The Journal of Dermatology, EarlyView.


https://ift.tt/2OvQtiz

Cutis laxa for diagnosis of γ1‐heavy‐chain deposition disease: Report of four cases

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ama1Di

Skin sensitivity and skin microbiota: Is there a link?

Experimental Dermatology, EarlyView.


https://ift.tt/2AnG9WV

Serum Level of IL‐4 Predicts Response to Topical Immunotherapy with Diphenylcyclopropenone (DPCP) in Alopecia Areata

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


https://ift.tt/2OuauGs

UVB‐inhibited H19 activates the melanogenesis axis by paracrine effects

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


https://ift.tt/2AqABuX

RIP4 upregulates CCL20 expression through STAT3 signaling in cultured keratinocytes

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


https://ift.tt/2mXy8P2

SIG1459: A novel phytyl‐cysteine derived TLR2 modulator with in vitro and clinical anti‐acne activity

Experimental Dermatology, EarlyView.


https://ift.tt/2AqAtvt

Loss of Gata6 causes dilation of the hair follicle canal and sebaceous duct

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


https://ift.tt/2Ou5gKE

Corneocyte Proteomics: Applications to Skin Biology and Dermatology

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


https://ift.tt/2AqAjUT

Characterization of stem‐like cancer cells in basal cell carcinoma and its surgical margins

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


https://ift.tt/2mXxqBm

Dissociated Skin Cells Regenerate Hair Follicles in a MicroWound, “The Punch Assay”

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


https://ift.tt/2AqA7F9

Ex‐vivo fluorescence confocal microscopy for intraoperative, real time diagnoses of cutaneous inflammatory diseases: a preliminary study

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


https://ift.tt/2OvTY90

Inactivation of autophagy leads to changes in sebaceous gland morphology and function

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


https://ift.tt/2AqzRWH

A dipeptidyl peptidase‐4 inhibitor promotes wound healing in normoglycemic mice by modulating keratinocyte activity

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


https://ift.tt/2mXnnfG

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through August 13, 2018.
Read Now:

Higher Preconception Maternal Iodine Intakes Are Associated with Higher Child IQ
Elizabeth N. Pearce 

Some Advanced Thyroid Cancer Patients Have a Prolonged Response to Lenvatinib
Brian W. Kim

Analysis of Clinical Factors 1 Year After Surgery for Thyroid Cancer Enables Prediction of Treatment-free Survival
Jerome M. Hershman 

New Genomic Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules Shows Improved Results
Stephanie Fish

 

 

The post Clinical Thyroidology<sup>®</sup>High-Impact Articles appeared first on American Thyroid Association.



https://ift.tt/2KaH4db

Detection of thrombosis in microvessels with indocyanine green videoangiography

Atherosclerosis is a systemic condition that is responsible for many diseases, and becomes a problem in cases where plaques form at several sites. The formation of a thrombotic embolus may jeopardise vascular operations, including microvascular anastomoses in replantation procedures or free tissue transfers. A mobile imaging tool for the detection of thrombosis preoperatively or intraoperatively would be valuable. An intimal injury, simulating removal of atherosclerotic plaques, was made microsurgically in 60 rat aortas, and results were analysed macroscopically, histologically, and with intraoperative indocyanine green (ICG) videoangiography immediately postoperatively.

https://ift.tt/2v0Jxlm

Morbidity of donor flaps from the lower limbs

The accepted standard of reconstruction in the oropharynx is microsurgical tissue transfer, particularly for composite defects. One of the challenges of microsurgery is to minimise morbidity at the donor site, and we have found that flaps taken from the leg can have considerable morbidity after multidisciplinary treatment for cancer. We propose an alternative method to close the skin at the donor site in an attempt to reduce this.

https://ift.tt/2M46mLB

Detection of thrombosis in microvessels with indocyanine green videoangiography

Publication date: Available online 30 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): T. Mücke, C. Wolff, A.M. Fichter, M. von Düring, A. Kanatas, L.M. Ritschl

Abstract

Atherosclerosis is a systemic condition that is responsible for many diseases, and becomes a problem in cases where plaques form at several sites. The formation of a thrombotic embolus may jeopardise vascular operations, including microvascular anastomoses in replantation procedures or free tissue transfers. A mobile imaging tool for the detection of thrombosis preoperatively or intraoperatively would be valuable. An intimal injury, simulating removal of atherosclerotic plaques, was made microsurgically in 60 rat aortas, and results were analysed macroscopically, histologically, and with intraoperative indocyanine green (ICG) videoangiography immediately postoperatively. The Spearman and Pearson correlation tests were used to compare the three techniques. The sensitivity and specificity of ICG videoangiography was calculated in relation to both macroscopic and histological results. Detection of thrombosis was possible in 25 cases, and in 18 cases no thrombosis was correctly diagnosed by all methods used. In 31 of 60 specimens formation of thrombus was detected histologically, and in 29 of 60 examinations it was detected clinically, which yielded a correlation of 93.5% between the two examinations. Macroscopic analysis correlated better with ICG videoangiography (sensitivity 86.2% and specificity 64.5%) than histological observations (sensitivity 80.6% and specificity 62.1%). There was a significant correlation among all comparisons (each p ≤ 0.001) with correlation indexes of 0.94, 0.52, and 0.44 for macroscopic/histological, clinical/ICG videoangiographic, and ICG videoangiographic/histological results, respectively. Our results show that ICG videoangiography is an important method for the detection of formation of acute thrombi and may be an important tool in vascular procedures.



https://ift.tt/2LQvdWi

Morbidity of donor flaps from the lower limbs

Publication date: Available online 30 July 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): C.J. Lewis, J. Callear, D.B. Saleh



https://ift.tt/2LZTnKS

Relapse rates in patients with unilesional primary cutaneous B‐cell lymphoma treated with radiation therapy: a single‐institution experience

British Journal of Dermatology, EarlyView.


https://ift.tt/2vm7yCT

Anthropometric factors and Breslow thickness: prospective data on 2570 cases of cutaneous melanoma in the population‐based Janus Cohort

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkGPQ

Patient preferences for topical treatment of actinic keratoses: a discrete‐choice experiment

British Journal of Dermatology, EarlyView.


https://ift.tt/2vkBTSt

Impact of anti‐interleukin‐17 treatment on cutaneous and genital human papillomavirus infection

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkFeK

Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4‐aminoquinoline antimalarials: a meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vlbZOn

The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from patients with atopic dermatitis

British Journal of Dermatology, EarlyView.


https://ift.tt/2LyIe7A

Cumulative exposure to biological therapy and risk of cancer in patients with psoriasis: a meta‐analysis of Psonet studies from Israel, Italy, Spain, the U.K. and Republic of Ireland

British Journal of Dermatology, EarlyView.


https://ift.tt/2vk2PSi

Is melanoma mortality declining in Spain? Analysis of trends from 1975 to 2016

British Journal of Dermatology, EarlyView.


https://ift.tt/2LEpxiO

Pembrolizumab‐associated mucous membrane pemphigoid in a patient with Merkel cell carcinoma

British Journal of Dermatology, EarlyView.


https://ift.tt/2vrk3xh

Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in pediatric cutaneous lupus among pediatric dermatologists and rheumatologists

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


https://ift.tt/2Ou2xko

Efficacy and safety of ixekizumab in a randomized, double‐blinded, placebo‐controlled phase IIIb study of patients with moderate‐to‐severe genital psoriasis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevMiq

Risk of skin cancer in people with vitiligo: a systematic review and meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2Ou2mWg

International Initiative for outcomes (INFO) for vitiligo: Workshops with vitiligo patients on repigmentation

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


https://ift.tt/2vlbWCb

Correlation of psoriasis activity with socioeconomic status: cross‐sectional analysis of patients enrolled in the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

British Journal of Dermatology, EarlyView.


https://ift.tt/2LBgWgY

Polysensitivity in delayed cutaneous adverse drug reactions to macrolides, clindamycin and pristinamycin: clinical history and patch testing

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevfNs

Effective sirolimus treatment for refractory spindle cell haemangioma

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAcTBr

Oral ulcers as a presentation of secondary syphilis

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2LCQN1q

Tildrakizumab Gets EMA Panel Nod for Plaque Psoriasis

A European Medicines Agency panel has recommended tildrakizumab for the treatment of moderate to severe plaque psoriasis.
International Approvals

https://ift.tt/2NXCeC2

Tasks, competences and educational needs of dermatology health care providers in the public and private sectors.results of the EADV‐NWAG survey in Belgium

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


https://ift.tt/2mThfVD

The use of prp (platelet‐rich plasma) in patients affected by genital lichen sclerosus: clinical analysis and results

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


https://ift.tt/2KaALGj

Polymorphisms in melanocortin system and MYG1 genes are associated with vitiligo

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


https://ift.tt/2mTgYC5

Lichen planus pigmentosus inversus in a Finnish man

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


https://ift.tt/2KbDu2i

Incidence and characteristics of thick second primary melanomas. A study of the German Central Malignant Melanoma Registry

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


https://ift.tt/2mUAWwn

An original exploration of genital lichen sclerosus: the semantic connectivity map

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


https://ift.tt/2K6bWeJ

Enhancing survival of Demodex mites in vitro

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


https://ift.tt/2LAaZAS

Immune‐regulatory genes as possible modifiers of familial pityriasis rubra pilaris – lessons from a family with PRP and psoriasis

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


https://ift.tt/2KbD4ZM

Patients’ needs and psoriasis treatment

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


https://ift.tt/2mRAK0K

8% Capsaicin ‐ a hot medicine for neuropathic itch

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


https://ift.tt/2K8RIB4

Forthcoming Events

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1391-1391, August 2018.


https://ift.tt/2LyxHcJ

RASopathic comedone‐like or cystic lesions induced by vemurafenib: a model of skin lesions similar but not identical to those induced by dioxins MADISH

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1368-1372, August 2018.


https://ift.tt/2KabLih

Characterizing clinicopathological and immunohistochemical findings in dermatomyositis panniculitis

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1231-1232, August 2018.


https://ift.tt/2mWOirX

Issue Information

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1225-1230, August 2018.


https://ift.tt/2Kb2B59

Pioneers in dermatology and venereology: An interview with Prof. Jose Maria Mascaro

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1235-1237, August 2018.


https://ift.tt/2LAhzr8

Aryl hydrocarbon receptor signalling in the skin and adverse vemurafenib effects

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1233-1234, August 2018.


https://ift.tt/2KaAh2X

Announcement

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1392-1392, August 2018.


https://ift.tt/2mUxh1l

Adverse events associated with apremilast use and withdrawal for psoriasis in a real‐world setting

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


https://ift.tt/2KaxpDr

A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): J. Kortes, H. Dehnad, A.N.T. Kotte, W.M.M. Fennis, A.J.W.P. Rosenberg

Abstract

Partial or complete resection of the maxilla during tumour surgery causes oronasal defects, leading to oral-maxillofacial dysfunction, for which the surgical obturator (SO) is an important treatment option. Traditional manufacturing of SOs is complex, time-consuming, and often results in inadequate fit and function. This technical note describes a novel digital workflow to design and manufacture a three-dimensional (3D)-printed hollow SO. Registered computed tomography and magnetic resonance imaging images are used for gross tumour delineation. The produced RTStruct set is exported as a stereolitography (STL) file and merged with a 3D model of the dental status. Based on these merged files, a personalized and hollow digital SO design is created, and 3D printed. Due to the proper fit of the prefabricated SO, a soft silicone lining material can be used during surgery to adapt the prosthesis to the oronasal defect, instead of putty materials that are not suitable for this purpose. An STL file of this final SO is created during surgery, based on a scan of the relined SO. The digital workflow results in a SO weight reduction, an increased fit, an up-to-date digital SO copy, and overall easier clinical handling.



https://ift.tt/2AzX4WD

Molecular alterations of newly formed mandibular bone caused by zoledronate

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): Y. Yoshioka, E. Yamachika, M. Nakanishi, T. Ninomiya, K. Nakatsuji, M. Matsubara, N. Moritani, Y. Kobayashi, T. Fujii, S. Iida

Abstract

Bone quality is defined by structural and material characteristics. Most studies on the mandible have focused on the analysis of structural characteristics, with insufficient investigation of material characteristics. This study tested whether zoledronate affects the material characteristics of newly formed mandibular bone. Thirty-six female Wistar rats were assigned to three groups: sham-ovariectomized rats (SHAM, n = 12), ovariectomized rats (OVX, n = 12), and ovariectomized rats treated with zoledronate (ZOL, n = 12). The left side of the mandibular ramus of all rats was drilled bicortically. Twenty-eight days after surgery, all surviving rats were euthanized and all mandibles were removed. Raman microspectroscopy was performed, and five spectra per specimen of newly formed mandibular bone were analysed. Compared with OVX rats, the mineral/matrix ratio in ZOL rats was significantly increased (5.43 ± 1.88 vs. 7.86 ± 2.05), while crystallinity (0.055 ± 0.002 vs. 0.050 ± 0.002), relative proteoglycan content (0.43 ± 0.10 vs. 0.31 ± 0.05), and collagen structural integrity (1.16 ± 0.21 vs. 0.72 ± 0.06) were significantly decreased. These changes in material characteristics may explain why rats that received zoledronate exhibited peculiar biological phenomena such as bisphosphonate-related osteonecrosis of the jaw.



https://ift.tt/2OvJwht

An innovative virtual reality training tool for orthognathic surgery

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): Y. Pulijala, M. Ma, M. Pears, D. Peebles, A. Ayoub

Abstract

Virtual reality (VR) surgery using Oculus Rift and Leap Motion devices is a multi-sensory, holistic surgical training experience. A multimedia combination including 360° videos, three-dimensional interaction, and stereoscopic videos in VR has been developed to enable trainees to experience a realistic surgery environment. The innovation allows trainees to interact with the individual components of the maxillofacial anatomy and apply surgical instruments while watching close-up stereoscopic three-dimensional videos of the surgery. In this study, a novel training tool for Le Fort I osteotomy based on immersive virtual reality (iVR) was developed and validated. Seven consultant oral and maxillofacial surgeons evaluated the application for face and content validity. Using a structured assessment process, the surgeons commented on the content of the developed training tool, its realism and usability, and the applicability of VR surgery for orthognathic surgical training. The results confirmed the clinical applicability of VR for delivering training in orthognathic surgery. Modifications were suggested to improve the user experience and interactions with the surgical instruments. This training tool is ready for testing with surgical trainees.



https://ift.tt/2AzWTur

Palatal orthodontic miniscrew insertion using a CAD-CAM surgical guide: description of a technique

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): M. Cassetta, F. Altieri, R. Di Giorgio, E. Barbato

Abstract

The aim of this report was to describe a new computer-guided technique for a controlled site preparation and palatal orthodontic miniscrew insertion using a dedicated software. A surgical guide was designed after planning the appropriate insertion sites on three-dimensional images created by the fusion of cone-beam computed tomography (CBCT) and digital dental model images. Pre- and postoperative CBCT images were compared and the angular, coronal, and apical deviations between the planned and the placed miniscrews were calculated. The mean coronal and apical deviations were 1.38 mm (range: 3.48–0.15 mm; standard deviation (SD): 0.65) and 1.73 mm (range: 5.41–0.10 mm; SD: 1.03), respectively, while the mean angular deviation was 4.60° (range: 15.23–0.54°; SD: 2.54). The present surgical guide allows a controlled and accurate palatal miniscrew placement in three dimensions.



https://ift.tt/2Oqtky2

Risk factors and clinical outcomes of sinus membrane perforation during lateral window sinus lifting: analysis of 120 patients

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): H.C. Tükel, U. Tatli

Abstract

The aim of this study was to identify the risk factors associated with sinus membrane perforation and the effect of sinus membrane perforation and other risk factors on graft success and postoperative sinusitis. Sinus membrane perforation, graft failure, and postoperative sinusitis were tested for an association with age, sex, operator experience, side of the operation, residual bone height, presence of septa, presence of a mucous retention cyst, and smoking (χ2 test). Logistic regression analysis was used to model the odds ratio (OR) with corresponding risk factors. One hundred and twenty patients were included in this study. A total of 22 (18.3%) perforations occurred. A residual bone height of 3–6 mm (OR 6.808, P = 0.002) and presence of septa (OR 4.023, P = 0.025) were identified as significant risk factors. Twenty-eight (23.3%) sinus grafts were classified as failed. Membrane perforation (OR 16.819, P < 0.005) and residual bone height of 3–6 mm (OR 5.363, P = 0.01) were identified as significant risk factors for graft failure. None of the risk factors investigated in this study was significantly associated with postoperative sinusitis. These results suggest that the presence of septa and a residual bone height of 3–6 mm are associated with an increased risk of sinus membrane perforation, and that sinus membrane perforation has a negative effect on graft success.



https://ift.tt/2AzXagX

Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): V.E. de Souza Batista, A.J. Vechiato-Filho, J.F. Santiago, M.V. Sonego, F.R. Verri, D.M. dos Santos, M.C. Goiato, E.P. Pellizzer

Abstract

The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel–Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P = 0.45) or prosthetic failure (P = 0.65): RR 1.06 (95% CI 0.91–1.23) and RR 0.88 (95% CI 0.51–1.51), respectively; OR 2.56 (95% CI 0.27–24.39; P = 0.41) and OR 0.44 (95% CI 0.15–1.26; P = 0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.



https://ift.tt/2OuUrZ2

Three-dimensional radiographic evaluation of root migration patterns 4–8.5 years after lower third molar coronectomy: a cone beam computed tomography study

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): A.W.K. Yeung, N.S.M. Wong, M.M. Bornstein, Y.Y. Leung

Abstract

This prospective study in patients with a follow-up of 4–8.5 years aimed to describe the long-term, three-dimensional changes of coronectomized lower third molar roots. Pre- and postoperative cone beam computed tomography (CBCT) scans were compared. The distance of root migration, the direction of root translation and rotation, and the amount of bone regeneration at the adjacent second molar and superficially to the third molar root were recorded. Age, gender, time elapsed following surgery, the status of the retained root including, impaction pattern and depth of impaction were tested to check if they were influencing factors for the above outcomes. A total of 57 coronectomized third molars from 44 patients were included. The distance of the mean root migration was 2.82 mm, and they predominantly translated mesially (76.8%). Age negatively correlated with the distance of migration. Root remnants with a soft tissue coverage had less bone regenerated at the adjacent second molar (1.27 mm vs. 2.95 mm) in comparison to their impacted counterparts. Based on the present radiographic results and the absence of any pathological findings, coronectomy can be recommended for selected cases of third molar removal as a safe procedure with favourable long-term outcomes.



https://ift.tt/2An6TH0

Intra-alveolar epsilon-aminocaproic acid for the control of post-extraction bleeding in anticoagulated patients: randomized clinical trial

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): R.V. da Silva, T.B. Gadelha, R.R. Luiz, S.R. Torres

Abstract

The aim of this study was to compare the effectiveness of the intra-alveolar administration of epsilon-aminocaproic acid (EACA) and daily gentle rinsing with EACA mouthwash with that of routine postoperative procedures for the control of bleeding after tooth extraction in anticoagulated patients. A randomized clinical trial was conducted involving 52 patients submitted to 140 tooth extractions, assigned randomly to two groups. The intervention group was treated with intra-alveolar administration of EACA immediately after surgery and gentle rinsing with EACA mouthwash during the postoperative period. The control group received routine postoperative recommendations. A single episode of immediate bleeding occurred in the intervention group. Late bleeding episodes occurred in 23 procedures (16.4%): 11 (15.7%) in the intervention group and 12 (17.1%) in the control group. Among the patients with late bleeding, 18 (78.3%) events were classified as moderate and were controlled by the patient applying pressure to a gauze pack placed over the extraction socket. The remaining five cases (21.7%) required re-intervention. No statistically significant difference in the frequency of postoperative bleeding was observed between the groups. Thus, routine measures were as effective for the control of bleeding after simple tooth extractions in anticoagulated patients as the topical administration of EACA.



https://ift.tt/2mUey6b

A prospective study examining the effects of treatment timing in the management of mandible fractures

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): M.J.L. Hurrell, M.C. David, M.D. Batstone

Abstract

The ideal timing for treatment of mandible fractures has not been well established. The objective of this study was to analyse the effects of treatment timing in the surgical management of mandible fractures. A prospective evaluation of 215 continuous patients with a total of 359 mandible fractures was undertaken. Nine outcome variables were analysed in relation to treatment delay by logistic regression modelling: wound dehiscence, hardware exposure, local postoperative infection, malocclusion, trismus, nerve damage, fracture non-union, return to theatre, and radiographic outcome. Nineteen additional variables were included in the analysis to adjust for potential confounding. Delay was measured in days and ranged from 0 to 41 days, with a mean delay of 4.6 days. The incidence of wound dehiscence, hardware exposure, local postoperative infection, trismus, nerve damage, fracture non-union and return to theatre was 6%, 4%, 11%, 8.5%, 47%, 2% and 8%, respectively. Objective malocclusion and poor radiographic outcomes were evident in 13% and 4.5% of cases, respectively.

No statistically significant association was found between treatment delay and treatment outcomes.

The findings of this study suggest it may be safe to delay the definitive treatment of mandible fractures. Treatment delay may allow for improved resource distribution and prioritization of more time-dependent interventions.



https://ift.tt/2AqQCku

Bicycle helmets are protective against facial injuries, including facial fractures: a meta-analysis

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): D.G. Fitzpatrick, M. Goh, D.C. Howlett, M. Williams

Abstract

Cycling is a popular activity. However there are risks associated with cycling, including facial injury. Helmets are often worn to prevent head injury. Evidence for their protection against facial injury is limited. This meta-analysis investigated the effect of bicycle helmets on the incidence of facial injury. The PubMed/MEDLINE, Google Scholar, and Cochrane Library databases were searched. Studies included were observational and involved adult participants. Paediatric studies, studies on helmet legislation, and those combining facial injuries with other injury types were excluded. The studies were evaluated by two reviewers. Risk of bias was assessed using the RevMan bias assessment tool. Odds ratios (OR) were extracted for facial injuries and facial fractures. Two meta-analyses were performed using these categories. Nine of the 102 studies identified were included. Helmets were protective against facial injury (OR 0.69, 95% confidence interval 0.63–0.75, P < 0.0001). Five studies reported facial fracture rates; helmets were protective against these also (OR 0.79 95% confidence interval 0.70–0.90, P = 0.0003). There are no randomized controlled trials on this topic and the number of studies available is small. Bicycle helmets offer protection against facial injuries and this should be considered by cyclists when deciding whether or not to use one.



https://ift.tt/2OrKBal

Clefts of the lip and palate: is the Internet a trustworthy source of information for patients?

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): G.A. Karamitros, N.A. Kitsos

Abstract

Great numbers of patients use the Internet to obtain information and familiarize themselves with medical conditions. However, the quality of Internet-based information on clefts of the lip and palate has not yet been examined. The goal of this study was to assess the quality of Internet-based patient information on orofacial clefts. Websites were evaluated based on the modified Ensuring Quality Information for Patients (EQIP) instrument (36 items). Three hundred websites were identified using the most popular search engines. Of these, 146 were assessed after the exclusion of duplicates, irrelevant sites, and web pages in languages other than English. Thirty-four (23.2%) web pages, designed mostly by academic centres and hospitals, covered more than 22 items and were classified as high-score websites. The EQIP score achieved by websites ranged between 4 and 30, out of a total possible 36 points; the median score was 19 points. The top five high-scoring web pages are highlighted. The overall quality of Internet-based patient information on orofacial clefts is low. Also, the majority of web pages created by medical practitioners have a marketing perspective and in order to attract more patients/customers avoid mentioning the risks of the reconstructive procedures needed.



https://ift.tt/2AsgkFi

Septal anchoring suture: a key suture to improve the nasolabial symmetry in unilateral cheiloplasty

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s): T.-C. Lu, S. Filson, C.-F. Yao, P.K.-T. Chen

Abstract

Since 2008, a septal anchoring suture has been used in unilateral cleft lip repair at Chang Gung Memorial Hospital in order to stabilize the lateral lip centrally. This study compared the symmetry of two groups of patients: those treated with and without an anchoring suture. Multiple standardized direct and photographic facial measurements were performed on the faces of all patients pre-cheiloplasty and at 5 years post-cheiloplasty. The degree of nasolabial symmetry was evaluated by comparing the ratios of measurements of the cleft vs. non-cleft sides. The ratio of change in these measurements was also compared postoperatively. The vertical lip length ratio approached 1 in the septal anchoring suture group, which differed significantly from the group without the suture (0.968 vs. 0.873, P < 0.001). As expected, the horizontal lip length and central lip height ratios showed no statistically significant change. The ratio of change from pre- to postoperative also showed a significant improvement (P = 0.028) in the vertical lip length of the group with the septal anchoring suture compared to the one without. The septal anchoring suture is a useful method to correct the tendency of the lip to shift to the cleft side.



https://ift.tt/2mUFliI

Editorial Board/Reviewing Committee

Publication date: September 2018

Source: International Journal of Oral and Maxillofacial Surgery, Volume 47, Issue 9

Author(s):



https://ift.tt/2Apwjnl

CD8+ Cytotoxic T Lymphocyte Responses and Viral Epitope Escape in Acute HIV-1 Infection

Viral Immunology, Ahead of Print.


https://ift.tt/2NZeMEP

Maxillary sinusitis complicated by stroke

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): C. Fabre, I. Atallah, I. Wroblewski, C.A. Righini

Abstract
Introduction

Neurological complications of acute sinusitis are exceptional, but potentially serious.

Case report

The authors report the case of a 6-year-old diabetic girl who presented with middle cerebral artery ischemic stroke secondary to inflammatory arteritis of the left internal carotid artery in a context of bilateral acute maxillary sinusitis. MRI confirmed ischaemic stroke associated with carotid arteritis and complete obstruction of the maxillary sinuses. A favourable outcome was observed after endoscopic drainage of the sinuses associated with broad-spectrum antibiotic therapy.

Discussion

This complication was probably due to spread of an infectious inflammatory reaction of the intrapetrosal carotid artery and its branches via the pterygoid venous plexus. To our knowledge, this is the first published case report of maxillary sinusitis complicated by stroke.



https://ift.tt/2vn9NGi

Reconstruction of the anterior wall of the frontal sinus by a custom-made titanium prosthesis after resection of a giant osteoma of the frontal sinus

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J. Fanchette, B. Faucon, F. Cartry, M. Ratajczak

Abstract

Osteoma is a benign, usually asymptomatic bone tumour, frequently arising in the nose and paranasal sinuses. Surgical treatment is required when the patient becomes symptomatic or presents ophthalmological or neurological complications. Although an endoscopic approach is increasingly used, depending on the size and site of the osteoma, open surgery may be preferable and remains the standard treatment. This technical note describes a case of giant osteoma of the frontal sinus that required a bicoronal approach with reconstruction by a custom-made titanium prosthesis.



https://ift.tt/2Oqcm2O

“The changing face of anaphylaxis in adults and adolescents”

Publication date: Available online 30 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Debendra Pattanaik, Phil Lieberman, Jay Lieberman, Thanai Pongdee, Alexandria Tran Keene

Abstract
Background

Our institution has published serial studies of adults and adolescents experiencing anaphylactic events. The first series was published in 1993 and the last in 2006. It was our perception that the nature of anaphylactic episodes had changed over the two decades since the last review.

Objective

To determine whether the etiologies and presentations of anaphylaxis has changed over the last decade in our population.

Methods

Patient charts were identified based upon ICD-9 codes for anaphylactic shock. Charts identified were analyzed for clinical symptoms reported, comorbidities, etiology, investigative testing, and subsequent treatment. These cases were categorized as definitive, probable, or idiopathic based on history and results from testing, similar to our prior reports.

Results

We identified 281 possible cases, of which 218 met criteria for anaphylaxis. Among the cases, median age was 42 years (range 9-78) and 64% were female. In the review of cases, 85 (39%) were determined to have a definitive etiology, 57 a probable etiology (26%), and 76 (35%) were idiopathic. Interestingly, among those with a definitive cause, the most common etiology identified was galactose-alpha-1,3-galactose (α- gal), accounting for 28 cases (33%). Foods were the 2nd leading cause accounting for 24 cases (28%).

Conclusion

In this follow up report on anaphylaxis etiology from a single center, the most common etiology was α-gal. This varies greatly from the prior reports our center. Interestingly, the percent of cases attributed to idiopathic anaphylaxis decreased from 59% in our past report to 35% in this report, which could largely be explained by the number of α-gal cases.



https://ift.tt/2LTS4R7

Searching for crab-borne antimicrobial peptides: Crustin from Portunus pelagicus triggers biofilm inhibition and immune responses of Artemia salina against GFP tagged Vibrio parahaemolyticus Dahv2

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Ravichandran Rekha, Baskaralingam Vaseeharan, Ramachandran Ishwarya, Mahalingam Anjugam, Naiyf S. Alharbi, Shine Kadaikunnan, Jamal M. Khaled, Mohammed N. Al-anbr, Marimuthu Govindarajan

Abstract

Marine organisms represent a huge source of novel compounds for the development of effective antimicrobial drugs. The present study focus on the purification of the antimicrobial peptide crustin from the haemolymph of the blue swimmer crab, Portunus pelagicus, by blue Sepharose CL-6B matrix assisted affinity column chromatography. Crustin showed a single band with a molecular mass of 17 kDa in SDS-PAGE analysis. The XRD analysis exhibited peaks at 32° and 45° while a distinct peak with a retention time of 1.8 min resulted in high performance liquid chromatography (HPLC) pointing out the crystalline nature and purity of crustin, respectively. Crustin purified from P. pelagicus (Pp-Cru) showed immunological activities, triggering encapsulation, phagocytosis on Sepharose beads and yeast (Saccharomyces cerevisiae) respectively. Furthermore, encapsulation of GFP tagged V. parahaemolyticus in Artemia salina and challenging study were assessed under CLSM and the potential of Pp-Cru was examined in vivo. In addition, the growth reduction and biofilm inhibition potential of Pp-Cru on Staphylococcus aureus, Enterococcus faecalis (Gram- positive bacteria) and Pseudomonas aeruginosa, Escherichia coli (Gram-negative bacteria) was evidenced by inverted and confocal laser scanning microscopic analysis, revealing that 100 μg/ml of Pp-Cru can disrupt the biofilm matrix thereby the thickness of biofilm was significantly reduced. Overall, the present investigation might provide a sensitive platform to realize the significant function of Pp-Cru in crustacean immune mechanism as well as its potential to bacterial growth inhibitor. The functional properties of purified Pp-Cru antimicrobial peptide may lead to a superior understanding of innate immune response in P. pelagicus species, which suggest the promising application for drug development in aquaculture.

Graphical abstract

Graphical abstract for this article



https://ift.tt/2AotUtr

Letter to the editor: “Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis”

Publication date: Available online 30 July 2018

Source: Oral Oncology

Author(s): Tao Wang, Longjiang Li



https://ift.tt/2v0fkms

Clinical and genetic profiles of patients with X-linked agammaglobulinemia from southeast Turkey: Novel mutations in BTK gene

Publication date: Available online 30 July 2018

Source: Allergologia et Immunopathologia

Author(s): D. Doğruel, M. Serbes, A.Ş. Şaşihüseyinoğlu, M. Yılmaz, D.U. Altıntaş, A. Bişgin

Abstract
Background

X-linked agammaglobulinemia (XLA) is characterized by absent or severely reduced B cells, low or undetectable immunoglobulin levels, and clinically by extracellular bacterial infections which mainly compromise the respiratory tract. We aimed to analyze the clinical, immunological and genetic characteristics of 22 male children with XLA.

Methods

Twenty-two children with XLA from 12 unrelated families were enrolled in this study. Clinical and demographic features of patients, serum immunoglobulin levels, percentage of B cells and BTK gene mutations were reviewed retrospectively.

Results

We identified 12 different mutations in 22 patients from 12 unrelated families. The most frequent type of mutation was premature stop codon (33.3%). Ten mutations had been reported previously including three missense mutations (c.1774T>C, c.1684C>T, c.83G>T), three premature stop codons (c.1558C>T, c.1573C>T, c.753G>A), two splice-site (c.683-1G>A, c.1567-12_1567-9delTTTG) and two small nucleotide deletions (c.902-904_delAAG, c.179_181delAGA). Two novel mutations of the BTK gene were also presented and included one splice-site mutation (c.391+1G>C) and one premature stop codon mutation (c.1243_1243delG). Six out of 12 mutations of the BTK gene were located in the SH1 domain, two in the PH domain, two in the SH3 domain and two in the SH2 domain. Three patients had a history of severe infection before diagnosis. We did not identify any correlation between severity of clinical symptoms and the genotype.

Conclusions

Our results show that mutations in southeast Turkey could be different from those in the rest of the world and molecular genetic tests are an important tool for early confirmed diagnosis of XLA.



https://ift.tt/2M3vr9t

Ménière’s disease with unremitting floating sensation is associated with canal paresis, gravity-sensitive dysfunction, mental illness, and bilaterality

Publication date: Available online 30 July 2018

Source: Auris Nasus Larynx

Author(s): Tadashi Kitahara, Masaharu Sakagami, Taeko Ito, Tomoyuki Shiozaki, Koichi Kitano, Akinori Yamashita, Ichiro Ota, Yoshiro Wada, Toshiaki Yamanaka

Abstract
Objective

The aim of the present study was to evaluate the association of neuro-otological examination, blood tests, and scoring questionnaire data with treatment-resistant intractability of persistent dizziness in Ménière's disease.

Methods

We managed 1520 successive vertigo/dizziness patients at the Vertigo/Dizziness Center in Nara Medical University from May 2014 to April 2018. Five hundred and twenty-two patients were diagnosed with Ménière's disease (522/1520; 34.3%) according to the 2015 diagnostic guideline of the International Classification of Vestibular Disorders. Among the patients with Ménière's disease there were 102 with intractable rotatory vertigo attacks for more than 3–6 months (102/522; 19.5%), including 20 bilateral cases (20/102; 19.6%), and 88 with intractable unremitting floating sensation rather than rotatory vertigo attacks for more than 3–6 months (88/522; 16.9%), including 28 bilateral cases (28/88; 31.8%). Sixty out of 88 cases with intractable unremitting floating sensation were unilateral and were enrolled for hospitalization to undergo neuro-otological examinations including pure-tone audiometry (PTA), the caloric test (C-test), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV) test, glycerol test (G-test), electrocochleogram (ECoG), inner ear magnetic resonance imaging (ieMRI), blood tests including anti-diuretic hormone (ADH) and bone alkaline phosphatase (BAP), and self-rating questionnaires of depression score (SDS). Data are presented as positive (+) ratios of the number of patients with examination and questionnaire data outside of the normal range.

Results

The ratios (+) were as follows: C-test = 33.3% (20/60), cVEMP = 25.0% (15/60), SVV = 50.0% (30/60), G-test = 55.0% (33/60), ECoG = 63.3% (38/60), ieMRI = 86.7% (52/60), ADH = 35.0% (21/60), BAP = 11.7% (7/60), and SDS = 40.0% (24/60). Multivariate regression analysis revealed that the periods of persistent dizziness were significantly longer in unilateral Ménière's patients with C-test(+), SVV(+), and SDS(+) compared with those with negative findings. Additionally, the periods in bilateral cases were significantly longer than those in unilateral ones.

Conclusions

Although approximately 70% of patients with Ménière's disease are usually treatable through the appropriate conservative medical therapy, the presence of canal paresis, gravity-sensitive dysfunction, neurosis/depression, and bilaterality may make the persistent dizziness intractable and may thus require additional treatments.



https://ift.tt/2mZpO1n

The efficacy of hesperidin for treatment of acute otitis media

Publication date: Available online 30 July 2018

Source: Auris Nasus Larynx

Author(s): Erdem Atalay Cetinkaya, Osman Ciftci, Saadet Alan, M. Namık Oztanır, Nese Basak

Abstract
Objectives

In this experimental study, the effect of hesperidin on the treatment of acute otitis media (AOM) was investigated in an AOM-induced rat model.

Methods

In total, 35 rats were randomly divided into the following five groups (n = 7): group 1 (control), group 2 (AOM with no treatment), group 3 (AOM + antibiotic), group 4 (AOM + hesperidin), and group 5 (AOM + hesperidin + antibiotic). On day 14, group 3,4 and 5 rats were given antibiotic and hesperidin via gavages, respectively. Histopathological and immunological analyses were performed and the results analyzed.

Results

Serum levels of TNF-α, IL-4, IL-6 and IL-1β were significantly decreased in the hesperidin- and antibiotic-treated groups compared to the AOM group. The AOM + antibiotic and AOM + hesperidin groups demonstrated reduced histological damage compared to the AOM group. Between the AOM + antibiotic and AOM + hesperidin groups, significant differences in tympanic membrane thickness(ThicTM), inflammation(Inf), and sclerosis(Sc) values were observed. However, no difference in epithelial damage(DamEpith), was seen between the two groups. There was a significant difference in the AOM + antibiotic and AOM + antibiotic + hesperidin groups compared to AOM group (P < 0.001).

Conclusions

In this study, we observed that both antibiotic and hesperidin treatment reduced AOM symptoms in an AOM-induced rat model. The values in AOM + antibiotic + hesperidin group were markedly lower than those of the other groups. From our results, we propose that hesperidin, in combination with antibiotics, may provide a successful alternative treatment for AOM compared with antibiotics used alone.



https://ift.tt/2AoUqTl

Prophylaxe des Vulva- und des Vaginalkarzinoms und ihrer Vorstufen

Zusammenfassung

Hintergrund

Vulva- und Vaginalkarzinome sind zunehmend diagnostizierte Tumorentitäten in Deutschland. Vulva- und Vaginalkarzinome entstehen über zwei unterschiedliche pathogenetische Mechanismen: Zum einen kann eine persistierende Infektion mit dem humanen Papillomvirus (HPV, v. a. Typ 16, 31, 33) über eine undifferenzierte vulväre/vaginale intraepitheliale Neoplasie (VIN/VAIN) zum invasiven Vulva‑/Vaginalkarzinom führen. Diese Tumoren finden sich eher bei jüngeren Frauen. Davon abzugrenzen ist das Vulvakarzinom der älteren Frauen, das auf dem Boden einer chronischen Hauterkrankung (z. B. Lichen sclerosus et atrophicus, LSA) über Mutationen im Tumorsuppressorgen p53 entsteht. Auch beim Vaginalkarzinom ist einer der Risikofaktoren ein Lichen sclerosus oder Lichen planus, diese Tumoren sind HPV-negativ. Daneben gibt es eine ganze Reihe von Tumoren, deren Ursache nicht bekannt ist.

Fragestellung

Gibt es primäre oder sekundäre Präventionsmaßnahmen, die die Entstehung dieser Tumoren verhindern können?

Ergebnisse

Die HPV-induzierten Vulva- und Vaginalkarzinome können zu einem bedeutenden Teil durch eine HPV-Impfung von HPV-naiven Frauen primär verhindert werden. Der nonavalente Impfstoff deckt die relevanten HPV-Typen 16, (18), 31 und 33 mit einer Wirksamkeit von 97 % ab, der bivalente Impfstoff hat eine vergleichbar hohe Effektivität aber nur für HPV16 und HPV18.

Ob das licheninduzierte Vulva‑/Vaginalkarzinom durch eine konsequente lokale Dauertherapie mit Kortison oder Calcineurininhibitoren primär präventiv verhindert werden kann wird diskutiert. Erste Daten, die darauf hindeuten, liegen vor.



https://ift.tt/2v2g0Ib

Bildgeführte radiologische Interventionen beim HCC

Zusammenfassung

Hintergrund

Bildgeführte Interventionen wie Radiofrequenz- oder Mikrowellenablation, CT-gesteuerte Brachytherapie oder Stereotaxie (SBRT), Chemoembolisation oder Yttrium-90(90Y)-Radioembolisation sind Teil aktueller Leitlinien zur Therapie des hepatozellulären Karzinoms (HCC) und unterliegen beständiger Validierung in aktuellen klinischen Studien.

Ziel

Dieser Artikel gibt einen Überblick über den aktuellen Stand der Evidenz und Leitlinienempfehlungen zu den genannten radiologischen, nuklearmedizinischen oder auch strahlentherapeutischen Verfahren.

Ergebnisse

Sowohl lokale Tumorablationen als auch die lokoregionäre Chemoembolisation sind Teil aller wesentlichen Leitlinien zur Behandlung des HCC. Die bildgeführten Tumorablationen im Stadium BCLC A oder auch BCLC 0 stellen sich mittlerweile als gleichwertige Alternative zur chirurgischen Resektion dar, wenn die Patientenselektion entsprechend adaptiert wird. Als lokoregionäre Therapie ist die Chemoembolisation im Stadium BCLC B bei gut erhaltener Leberfunktion und begrenzter Tumorlast Therapiestandard. Zum Einsatz der 90Y-Radioembolisation liegen bei BCLC B keine randomisierten Daten vor. Für BCLC C-Patienten ist die Chemoembolisation nicht indiziert. Als Alternativtherapie bei Systemtherapieversagen oder Kontraindikation für Sorafenib, aber auch mit Blick auf die deutlich verbesserte Verträglichkeit gegenüber Sorafenib kann die 90Y-Radioembolisation erwogen werden.



https://ift.tt/2M2qUE8

Update zu uterinen Sarkomen

Zusammenfassung

Uterine Sarkome bilden eine inhomogene Gruppe seltener Tumoren der Uterusmuskulatur. Es sind meist aggressive Neoplasien, die vom uterinen Bindegewebe oder vom endometrialen Stroma ausgehen. Histologisch werden folgende Subtypen unterschieden: das Leiomyosarkom (LMS), das low-grade endometriale Stromasarkom (LG-ESS) und das high-grade endometriale Stromasarkom (HG-ESS) sowie das undifferenzierte Stromasarkom (UES). Die Inzidenz liegt bei 0,5–3,3 pro 100.000 Frauen pro Jahr; insgesamt bilden sie mit 1–2 % nur einen kleinen Anteil der uterinen Malignome. Eine andere Kategorie bilden uterine Sarkome gemischten Ursprungs, wie Adenosarkome, Karzinosarkome (maligne Müller-Mischtumoren) und andere heterologe Sarkome (z. B. Chondrosarkome, Liposarkome, Fibrosarkome etc.). Im Beitrag wird auf das spezifische Management der häufigen Entitäten (LMS, LG-ESS, HG-ESS und UES) Bezug genommen. Im August 2015 wurde die erste Version einer S2k-Leitlinie zu uterinen Sarkomen herausgegeben.



https://ift.tt/2uZR5EY

Verhaltensstörung oder Schmerz?

Zusammenfassung

Hintergrund

Bei Menschen mit geistiger Beeinträchtigung werden Schmerzen zu selten und zu spät diagnostiziert. Diese Patienten erhalten trotz größerer Krankheitslast wesentlich weniger Schmerzmittel als Menschen ohne Behinderung.

Ergebnisse

An die Möglichkeit des Vorliegens von Schmerzen zu denken, ist dabei genauso entscheidend wie eine adäquate und sensible Diagnostik. Neben der Nutzung aller Mittel zur Verbesserung der Kommunikation (Erklärungen in leichter Sprache, Arbeiten mit Bildern und Symbolen) ist die Fremdauskunft zusätzlich oder ersatzweise häufig unverzichtbar (Befragung von Nahestehenden, spezielle Assessment-Instrumente). Jede Veränderung des Verhaltens muss als mögliche Ursache von Schmerzen (oder anderen Symptomen) aufmerksam registriert und weiter abgeklärt werden.

Schlussfolgerung

Die Schmerztherapie kann und sollte grundsätzlich wie bei nichtbehinderten Menschen durchgeführt werden, nichtmedikamentöse Maßnahmen stehen dabei im Vordergrund. Die Medikamentengabe sollte wie bei alten Menschen niedrig begonnen und nur langsam gesteigert werden. Mit häufigerem Einsatz von – ggf. auch probatorischer – Schmerztherapie lassen sich viele sog. Verhaltensstörungen adäquat und besser als mit Psychopharmaka behandeln.



https://ift.tt/2M30ySx

HOXB13 is not expressed in pleomorphic giant cell carcinoma of the bladder



https://ift.tt/2K7S1Mr

Reply to the letter “How to standardize the evaluation of tumor regression grading of gastrointestinal cancers after neoadjuvant therapy?” by Dr. Nasierowska-Guttmejer and Dr. Szawlowski, VIAR-D-18-00181



https://ift.tt/2LLBse4

Letter to the editor: reply to Valeria Barresi “HOXB13 is not expressed in pleomorphic giant cell carcinoma of the bladder”



https://ift.tt/2NUN3Vu

In this issue



https://ift.tt/2v0p0xs

A case of multiple familial trichoepitheliomas responding to treatment with the Hedgehog signaling pathway inhibitor vismodegib

Abstract

Multiple familial trichoepitheliomas (MFT) is an autosomal dominantly inherited disease characterized by multiple skin appendage tumors. We describe a patient showing a continuous spectrum of follicular differentiated neoplasms including classical trichoepitheliomas but also infiltrative growing and finally metastasizing malignant follicular differentiated tumors. Germline mutation analysis revealed a nonsense mutation in the cylindromatosis (CYLD) gene. Gene expression analysis by real-time PCR of tumor tissue showed overexpression of glioma-associated oncogene Gli1 mRNA. Treatment with the Hedgehog pathway inhibitor vismodegib resulted in a significant regression of the highly differentiated trichoepitheliomas. Gli upregulation is indicative of an active Hedgehog signaling pathway. We hypothesize that its upregulation is indirectly caused by CYLD mutation which promotes tumor development. Vismodegib treatment could thus provide a new treatment option for patients with this debilitating disorder.



https://ift.tt/2M1KFvP

Neuroendocrine tumor of the pancreas with rhabdoid feature

Abstract

Imaging of a 53-year-old Japanese man revealed two tumors in the liver and a tumor in the head of the pancreas with a swelling lymph node. A needle biopsy for the liver tumors was performed, revealing a neuroendocrine tumor. Enucleation, lymphadenectomy, and partial hepatectomy were performed. The microscopic examination identified many tumor cells with intracytoplasmic inclusions arranged in a nested, cord, or tubular fashion. The intracytoplasmic inclusions displayed densely eosinophilic globules and displaced the nuclei toward the periphery, which constitutes "rhabdoid" features. The tumor cells were positive for synaptophysin and weakly positive for NCAM, but negative for chromogranin A. Epithelial markers (AE1/AE3 and CAM5.2) accentuated intracytoplasmic globules. Pancreatic neuroendocrine tumors with rhabdoid features are very rare. Generally, rhabdoid features are aggressive and dedifferentiated characteristics of various types of tumor. Pancreatic neuroendocrine tumors containing rhabdoid cells tend to display extrapancreatic spread at the time of presentation, although some of these tumors with rhabdoid features are not always associated with aggressive behavior.



https://ift.tt/2v0oTC2

How to standardize the evaluation of tumor regression grading of gastrointestinal cancers after neoadjuvant therapy?



https://ift.tt/2M2nZeE

Cytogenetic and immunohistochemical study of 42 pigmented microcystic chromophobe renal cell carcinoma (PMChRCC)

Abstract

Pigmented microcystic chromophobe renal cell carcinoma (PMChRCC) is a recently described morphologic variant of ChRCC. We have identified 42 cases in 40 patients in the last 24 years. We have investigated their clinical, morphologic, immunohistochemical, and cytogenetic features. Chromosomal abnormalities of chromosomes 7 and 17 were evaluated by automated dual-color silver-enhanced in situ hybridization on paraffin-embedded tissue. Chromosomal imbalance was defined on the basis of changes in both chromosomal index and signal distribution. The main age was 60.20 years, being 34 males and 6 women. The mean tumor diameter was 4.84 cm, with 39 intrarenal tumors. Grossly, the tumors were solid with a brown dark colored. Microscopically, tumors consisted of pale and eosinophilic cells arranged in microcysts or microalveolar in a cribriform pattern; there were microcalcifications and a dark brown pigment, mostly extracellular. One case showed sarcomatoid transformation. All tumors were positive for epithelial membrane antigen (EMA), Claudin 7, and E-cadherin. Monosomy of 7 and 17 chromosomes was present in 1/36 cases and 2/37 cases, respectively. Polysomy of chromosome 7 and 17 was found in 26/36 cases and in 4/37, respectively. With a median follow-up of 74.05 months, 37 patients were alive without disease and two were alive with disease progression. PMChRCCs expand the morphologic spectrum of the ChRCC with an unusual immunohistochemical profile. Cytogenetically, they showed monosomy to chromosome (CHR) 17 as other ChRCCs and polysomy of CHR 7 infrequent to ChRCCs. We present the probably largest series of PMCRCC, confirming their low aggressive behavior, with exceptional sarcomatoid transformation and distant metastases.



https://ift.tt/2v1BUvg

Comparative clinicopathological and cytomorphological analyses of peritoneal carcinomatosis associated with metastatic breast carcinoma and primary peritoneal/ovarian carcinoma in patients with a history of breast carcinoma

Abstract

Causes of peritoneal carcinomatosis (PC) in patients with a history of breast carcinoma include both metastatic breast carcinoma (MBC) and primary peritoneal/ovarian carcinoma (PPOC). The origin of PC is important to determine the appropriate treatment strategy. Cytological examination of the peritoneal fluid (PF), which may be the first diagnostic approach to PC, is of distinct value in confirming the presence of malignant cells and determining the origin of PC. We analyzed the clinicopathological and cytomorphological characteristics of 33 patients with a history of breast carcinoma whose PF cytology contained malignant cells. Cases showing positive immunoreactivity for PAX8 and a lack of GATA3 expression were considered as PPOC. Sixteen patients developed PC caused by PPOC. PPOC patients were characterized by early-stage primary breast carcinoma, absence of non-peritoneal MBC before PC, and normal serum levels of CEA and CA15-3. Fourteen PPOC patients had pathogenic germline BRCA mutations. Cytological examination revealed that most of the PPOC cases had a dominant papillary arrangement of the tumor cells with severe nuclear pleomorphism, occasional bizarre nuclei, and atypical mitotic figures. Patients with PPOC who underwent cytoreductive surgery had a significantly longer survival time compared to those who did not, or MBC patients. In patients with a history of breast carcinoma presenting with PC, the presence of early-stage primary breast carcinoma, no prior non-peritoneal MBC, and a dominant papillary cellular arrangement pattern in the PF cytology were independent predictors of PPOC. Cytoreductive surgery significantly improved survival for patients with PPOC.



https://ift.tt/2M1jaSO

Acute liver failure secondary to ABVD use

Hodgkin's lymphoma (HL) is a type of cancer originating in the lymph nodes. The preferred therapy for advanced HL is a combination of chemotherapies including doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). ABVD has been standard therapy for advanced HL. It is generally considered as safe and rarely has been reported to cause acute liver failure. We present a case of 79-year-old woman with HL, who developed acute liver failure secondary to first cycle of ABVD chemotherapy.



https://ift.tt/2vc6CB0

Recurrent invasive group A streptococcal infection with four-limb amputation in an immunocompetent child

We report a previously well paediatric patient with two distinct presentations of invasive group A streptococcus (GAS) infection resulting in significant morbidity. The first episode, following GAS pharyngitis, involved multiorgan dysfunction syndrome. This included cardiorespiratory and acute hepatorenal failure and purpura fulminans that eventually necessitated four-limb amputation. The second episode occurred 12 months later, from undetermined aetiology, and resulted in septic shock. Molecular analysis of the emm gene and PCR for Serum Opacity Factor revealed that the initial isolate was M Type 4 and sof gene positive while the second isolate was M Type 1 and sof gene negative. Immunological investigations, including CH50, quantitative IgA, IgM and IgG, and flow cytometry measuring lymphocyte subsets, and vaccine response to measles, mumps, rubella and pneumococcus were normal. This is the first report of recurrent bacteraemia from different strains of Streptococcus pyogenes infection in an apparently immunocompetent child.



https://ift.tt/2Oo9weR

Primary renal angiosarcoma

An older male patient with a history of tachycardia treated with atenolol presented to an outside hospital on 22 February 2017 with acute right flank pain. He had a CT scan which revealed a large right renal mass with acute haemorrhage. He was initially managed with interventional radiology guided embolism on 25 February 2017 due to the ongoing bleeding and haemodynamic instability. He was then transferred to our institution. He underwent right radical nephrectomy on 13 March 2017. His pathology revealed a 12.5x6x4.5 cm mass consistent with angiosarcoma of the right kidney with negative margins. Final pathology was pT2b with extension of the mass into the renal vein and perirenal adipose tissue. He was discharged soon after surgery. He was recommended to undergo adjuvant chemotherapy.



https://ift.tt/2vlN3Xc

Extensive Mongolian spots and normocephaly: an uncommon presentation of infantile Sandhoffs disease

Description 

A 10-month-old male infant was brought to us with developmental stagnation since 5 months of age. He attained age-appropriate developmental milestones until 5 months of age, however over the next 2 months, he did not gain any new milestones followed by subsequent developmental regression in the form of loss of neck holding ability, social smile, mother regard, visual fixation and cooing. He was a first born to non-consanguineous parents, at term by caesarean delivery (due to non-progression of labour). The antenatal and perinatal periods were normal. There was no history of seizures, exaggerated startle response and extrapyramidal symptoms. The family history was unremarkable. On examination, he had normal head size (46.2 cm, 50th centiles), dysmorphic facial features (flat nasal bridge, hypertelorism, thick upper lip and upturned nose), bilateral cherry-red spots, extensive Mongolian spots (figure 1) and hepatomegaly. He also had generalised hypotonia, hyperactive muscle stretch reflexes and bilateral...



https://ift.tt/2Ov9amz

Platypnoea-orthodeoxia syndrome exacerbated by kyphosis progression

This is a case of an 86-year-old woman with gradually progressive dyspnoea and hypoxaemia that occurred after a cardiac surgery. It was underdiagnosed for several years, but diagnosis was triggered by the finding of hypoxaemia even during supplemental oxygen administration when in the upright position, such as when taking a shower, that rapidly improved when the patient returned to the supine position. A thorough workup disclosed platypnoea–orthodeoxia syndrome (POS) associated with right-to-left shunting through a patent foramen ovale (PFO). Percutaneous closure of the PFO was performed. After treatment, the patient's arterial oxygen saturation gradually recovered to 98% on room air while she was in the sitting position and her symptoms disappeared. Reviewing this case retrospectively, we determined that the deviation of the spine with kyphosis progression had apparently proceeded as POS worsened over time. We therefore hypothesised that kyphosis progression had played a major role in the POS progression.



https://ift.tt/2vihBch

Liver failure associated with mahogany seed extract consumption

A 45-year-old woman presented to the emergency department with jaundice of 2 weeks' duration. This was associated with mahogany seed extract (Skyfruit supplement) consumption for 6 months prior to admission. Examination was normal apart from scleral icterus and grade 2 encephalopathy. Liver function tests showed a hepatocellular pattern of derangement: alanine transaminase, 1267 U/L (10–36); aspartatetransaminase, 1255 U/L (10–30); alkaline phosphatase, 124 U/L (22–104); bilirubin, 258 µmol/L (3–21) with a prolonged prothrombin time of 16.8 s (9.2–11.0). Viral hepatitis work-up was largely unremarkable and liver biopsy showed moderate inflammatory infiltrates (mostly lymphocytic with scattered eosinophils) in the periportal region and lobule with bridging necrosis, favouring drug-induced liver injury. Withdrawal of the drug resulted in normalisation of liver function.



https://ift.tt/2LB74np

Posterior shoulder dislocation: its worth another look

A 40-year-old woman presented to the emergency department with a painful left shoulder following a fall from a mountain bike. A radiograph of the clavicle and shoulder was carried out. A diagnosis of fractured left clavicle was made, which was treated conservatively in a sling. On day 3, she was reviewed in the fracture clinic and was found to still be in pain with reduced movement of the shoulder joint. A repeat radiograph of the shoulder joint showed a posterior dislocation. This required a closed reduction under general anaesthesia.



https://ift.tt/2vh4vMq

Unusual case of bilateral haemotympanum after endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA)

We present a case of bilateral haemotympanum (HT) during endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA). A 64 year-old-man underwent EBUS-TBNA for mediastinal lymph nodes (LN) staging. Medical history included emphysema and angina. Medication included aspirin until the day before procedure. Full blood count and clotting screen were normal. He received sedation (5 mg midazolam, 1000 mcg alfentanil) and topical anaesthesia (16 mL 1% lignocaine) but coughed excessively throughout the procedure. Left hilar LN was the only area sampled. Spontaneous bleeding ensued from both ears towards the end of the procedure. Patient remained haemodynamically stable. The procedure was aborted and otolaryngology consult sought. Otoscopy showed bilateral haematoma from anterior ear canal with normal tympanic membranes and no hearing loss. Nasendoscopy revealed erythematous ostium of both Eustachian tubes. Bleeding stopped spontaneously and patient required no further imaging or treatment. We report this case to increase awareness of this very rare complication resulting from excessive coughing during EBUS-TBNA.



https://ift.tt/2LzHL5g

MYH9-related disorders: a rare cause of neonatal thrombocytopaenia

Myosin heavy chain 9-related disorders (MYH9RD) are a genetic condition characterised by large platelets and thrombocytopaenia. The May-Hegglin anomaly (MHA), an uncommon condition with a potential risk of bleeding complications once thought to be separate, is now known to be part of MYH9RD.

There are very limited data on the clinical course and neonatal/paediatric outcome in children with MHA. We present the case of a newborn with a normal physical examination whose mother had MHA. Peripheral blood examination revealed a platelet count of 16x109/L with giant platelets and neutrophils containing Döhle bodies. Neonatal brain ultrasound examination showed no haemorrhage. The infant received three platelet transfusions during the first 29 days of life, remaining asymptomatic. The genetic molecular test was positive for MYH9RD. It is important to identify at-risk infants with this condition and to initiate therapy to prevent related complications, if needed, in a multidisciplinary team approach.



https://ift.tt/2vlMSv0

Fatal case of macrophage activation syndrome (MAS) in a patient with dermatomyositis and cytomegalovirus (CMV) viraemia

We describe a case of an adult with dermatomyositis (DM) who presents with a rash, high fevers, tachycardia and hypotension, initially concerning for an infectious aetiology or a DM flare. She was found to have cytomegalovirus viraemia which improved after starting valganciclovir. After extensive workup and lack of improvement with broad-spectrum antimicrobial therapy, intravenous immunoglobulin and steroids, the patient was diagnosed with macrophage activation syndrome after bone marrow biopsy and levels of soluble CD25 (soluble interleukin (IL)-2 receptor) and IL2 were obtained. Unfortunately, despite therapy with dexamethasone, anakinra and etoposide, the patient decompensated and the patient's family opted for comfort care. The patient subsequently expired in the intensive care unit.



https://ift.tt/2LxGOdu

Florid hyperandrogenism due to a benign adrenocortical adenoma

A 26-year-old woman with a history of polycystic ovarian syndrome presented with secondary amenorrhea, worsening hirsutism, acne, deepening of voice and unexplained 10–20 kg weight gain. Her Ferriman-Gallway hirsutism score was 12 with cystic facial acne and increased masculine phenotype. Urine Beta-Human Chorionic Gonadotropins (bHCG) was negative. She had elevated serum testosterone of 551 ng/dL, androstenedione at 7.46 ng/mL and dehydroepiandrosterone sulfate (DHEAS) at 4243 µg/L. Overnight dexamethasone suppression test showed mildly unsuppressed cortisol (2.89 µg/dL). Urinary free cortisol along with paired serum cortisol and adrenocorticotrophic hormone (ACTH) tests were normal (55.4 µg/24 hours, 13.44 mcg/dL, 30.4 pg/mL respectively). Her leutinizing hormone (LH) was low(<0.1 mIU/mL), follicle stimulating hormone (FSH) low/normal (1.41 mIU/mL) with sex hormone binding globulin (SHBG) level 45nmol/L and the rest of the pituitary and adrenal workup was unremarkable. Thyroid stimulating hormone (TSH) was 2.15mU/mL. MRI revealed a 3.1 cm, indeterminate but well-defined left adrenal lesion and polycystic ovaries without abdominal lymphadenopathy. Given radiological appearances and despite biochemical concerns for adrenocortical malignancy, a multidisciplinary team meeting decision was made to proceed with laparoscopic adrenalectomy. Histology was consistent with a benign adenoma. Postoperatively, there was clinical and biochemical resolution of the disease.



https://ift.tt/2vlsgTk