Αρχειοθήκη ιστολογίου

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

Τετάρτη 8 Αυγούστου 2018

SAMHD1 deficient human monocytes autonomously trigger type I interferon

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Alicia Martinez-Lopez, Marta Martin-Fernandez, Sofija Buta, Baek Kim, Dusan Bogunovic, Felipe Diaz-Griffero

Abstract

Germline mutations in the human SAMHD1 gene cause the development of Aicardi-Goutières Syndrome (AGS), with a dominant feature being increased systemic type I interferon(IFN) production. Here we tested the state of type I IFN induction and response to, in SAMHD1 knockout (KO) human monocytic cells. SAMHD1 KO cells exhibited spontaneous transcription and translation of IFN-β and subsequent interferon-stimulated genes (ISGs) as compared to parental wild-type cells. This elevation of IFN-β and ISGs was abrogated via inhibition of the TBK1-IRF3 pathway in the SAMHD1 KO cells. In agreement, we found that SAMHD1 KO cells present high levels of phosphorylated TBK1 when compared to control cells. Moreover, addition of blocking antibody against type I IFN also reversed elevation of ISGs. These experiments suggested that SAMHD1 KO cells are persistently auto-stimulating the TBK1-IRF3 pathway, leading to an enhanced production of type I IFN and subsequent self-induction of ISGs.



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Direct infiltration of botulinum toxin into the pterygoid lateral muscle for repositioning of the disc during arthroscopy of the temporomandibular joint

Publication date: Available online 8 August 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): R. Martín-Granizo, L. Maniegas, L. Colorado, A. Millon-Cruz, M. de Pedro



https://ift.tt/2vTw3Yi

Effects of cold atmospheric plasma (CAP) on bacteria and mucosa of the upper aerodigestive tract

Publication date: Available online 8 August 2018

Source: Auris Nasus Larynx

Author(s): Sven Becker, Julia L. Zimmermann, Philipp Baumeister, Theresa F. Brunner, Tetsuji Shimizu, Yang-Fang Li, Gregor E. Morfill, Ulrich Harréus, Christian Welz

Abstract
Objective

Ear, nose and throat infections are among the most common reasons for absence from work. They are usually caused by various bacteria like Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes. Cold atmospheric plasma (CAP) can effectively eliminate even multi-resistant bacteria and has no cytotoxic or mutagenic effects on the mucosa when applied for less than 60 s. Aim of the study was to evaluate the effects of CAP on common ENT bacteria and on the mucosa of the upper aerodigestive tract.

Methods

The bactericidal effects of CAP against the bacteria most commonly causing ENT infections were investigated using the colony-forming units assay (CFU) on a Müller-Hinton agar plate after applying CAP for 30, 60, 90 and 120 s. To evaluate the interaction of CAP with mucosal cells, 3D mini organ cultures were treated for up to 180 s, after which cell viability and necrosis induction were evaluated.

Results

Treatment with CAP for 60 s or longer induced at least a 3-log10 reduction in the bacterial load (> 99.9%). Treatment times shorter than 60 s had only slight cytotoxic effects on cell viability and necrosis whereas treatment times above 60 s showed a fast increase of cytotoxic side effects.

Conclusion

CAP exhibited strong bactericidal effects on the most common ENT pathogens. Treatment times of up to 60 s showed only minimal adverse reactions in healthy mucosa. CAP could be a promising new therapeutic modality for ENT infections.



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Lessons learnt from managing a case of dengue hemorrhagic fever complicated with acute liver failure and acute kidney injury: a case report

Dengue is a common arboviral infection with a diverse spectrum of clinical manifestations. Dengue hemorrhagic fever is a more severe form of infection characterized by plasma leak and hemoconcentration. Althou...

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Amylose cutanée dychromique autosomique récessive et mutations de GPNMB

Publication date: Available online 8 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): O. Dereure



https://ift.tt/2AVthI1

Efficacy and safety data for checkpoint inhibitors in advanced melanoma under real-life conditions: A monocentric study conducted in Nice from 2010 to 2016

Publication date: Available online 8 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): H. Taquin, E. Fontas, O. Massol, P. Chevallier, R. Balloti, G. Beranger, J.-P. Lacour, T. Passeron, H. Montaudié

Summary
Background

Immunotherapies using anti-CTLA4 and anti-PD1 antibodies have revolutionised the management of patients with advanced melanoma. The aim of our study was to analyse the efficacy and safety of immunotherapies in patients with advanced melanoma under real-life conditions.

Methods

We conducted a monocentric, retrospective, observational study that included all patients treated with immunotherapies (ipilimumab, i.e. ipi; nivolumab, i.e. niv and pembrolizumab, i.e. pbr) for advanced melanoma with exclusion of primary mucosal or ocular melanoma. The primary endpoint was progression-free survival (PFS).

Results

A total of 110 patients were included. Median PFS was better in the anti-PD1 group than in the anti-CTLA4 group (3.9 months vs. 2.9 months, P = 0.025). The frequency of adverse events of any grade was 53.4% with ipi, 66.7% with niv and 75% with pbr.

Discussion

Our study shows slightly inferior efficacy data vs. clinical trials of ipi and niv because patients were presenting more severe illness at inclusion. Nevertheless, the study argues in favour of the superiority of anti-PD1 antibodies vs. anti-CTLA4 antibodies in terms of PFS and best overall response. Moreover, our study exhibits safety data comparable to those from clinical trials except for a lower frequency with ipi.

Conclusion

Our efficacy and safety data obtained under real-life conditions are reassuring since they are consistent with data already published.

Résumé
Introduction

Les immunothérapies par anti-CTLA4 et anti-PD1 ont révolutionné la prise en charge du mélanome avancé. Le but de ce travail était d'étudier l'efficacité et la tolérance des immunothérapies utilisées en conditions de vie réelle chez des patients traités pour un mélanome avancé.

Méthodes

Étude observationnelle, rétrospective, monocentrique, incluant les patients en immunothérapie par ipilimumab (ipi), nivolumab (ni) ou pembrolizumab (pbr) pour un mélanome avancé hors mélanome muqueux ou choroïdien. Le critère principal de jugement était la survie sans progression (SSP).

Résultats

Au total, 110 patients ont été inclus. La médiane de SSP des patients sous anti-PD1 était supérieure à celle des patients traités par anti-CTLA4 (3,9 mois vs. 2,9 mois ; p = 0,025). La fréquence de survenue d'évènements indésirables quel que soit leur grade était de 53,4 % pour l'ipi, 66,7 % pour le niv et 75 % pour le pbr.

Discussion

Notre étude montre des données d'efficacité légèrement inférieures à celles des essais cliniques pour l'ipi et le niv, en lien avec des patients plus sévères à l'inclusion. Néanmoins, notre travail est en faveur de la supériorité des anti-PD1 par rapport à l'anti-CTLA4 en termes de SSP et de meilleure réponse globale. Il objective enfin des données de tolérance comparables à celles des essais cliniques, mis à part une fréquence moindre d'évènements indésirables dans the ipi group.

Conclusion

Nos données d'efficacité et de tolérance des immunothérapies dans le mélanome avancé en vie réelle sont rassurantes car cohérentes avec les données de la littérature.



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Direct infiltration of botulinum toxin into the pterygoid lateral muscle for repositioning of the disc during arthroscopy of the temporomandibular joint

Anterior disc displacement of the temporomandibular joint (TMJ) without reduction is a condition that is included in stage III of the Wilkes classification, and usually requires surgical treatment.1 Arthroscopy is a minimally-invasive procedure that can reposition the disc and fix it in place.2 However, before this can be done an initial myotomy of the upper belly of the lateral pterygoid muscle is necessary to free the disc,3 and is usually done with electrocautery, radiofrequency, or laser.

https://ift.tt/2OYcPtw

Effects of cold atmospheric plasma (CAP) on bacteria and mucosa of the upper aerodigestive tract

Ear, nose and throat infections are among the most common reasons for absence from work. They are usually caused by various bacteria like Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes. Cold atmospheric plasma (CAP) can effectively eliminate even multi-resistant bacteria and has no cytotoxic or mutagenic effects on the mucosa when applied for less than 60s. Aim of the study was to evaluate the effects of CAP on common ENT bacteria and on the mucosa of the upper aerodigestive tract.

https://ift.tt/2M0TlXf

Low level laser therapy reduces oral leukoplakia lesion size: Results from a preliminary study

Dear Editor,

https://ift.tt/2M7Amdy

Root and Root Canal Variations of the Human Maxillary and Mandibular Third Molars in a Chinese Population: a Micro–Computed Tomographic Study

Publication date: Available online 8 August 2018

Source: Archives of Oral Biology

Author(s): Wuyue Zhang, Ying Tang, Chao Liu, Yifen Shen, Xingmei Feng, Yongchun Gu

ABSTRACT
Objectives

To investigate the anatomical variations of the root and root canal configuration of the human third molars.

Designs

A total of 130 maxillary and 130 mandibular third molars were collected from a native Chinese population. All teeth were scanned by micro–computed tomography. After 3D reconstruction, the root and canal morphology of each tooth was examined both qualitatively and quantitatively.

Results

For maxillary molars, a single fused root (67 cases, 51.5%) and a single root canal system (64 cases, 49.2%) was most common root/canal form; the typical three-rooted molars were detected only in 33 cases (25.4%), and the secondary MB canals were detected only in 9 molars (6.9%). For mandibular molars, 62 teeth were single-rooted (47.7%) and 42 had a single root canal system (32.3%); 20 singled-rooted and 60 double-rooted molars exhibited independent mesial and distal root canal systems (61.5%), and the type 1-1 canal was the most common configuration for mesial (57 cases) and distal (81 cases) root canal systems. C-shaped canals were detected in 11 maxillary and 36 mandibular single-rooted molars. The mean root surface area, root and crown volume of mandibular third molars were significantly higher than the maxillary third molars (P <  0.01).

Conclusion

The root canal system of the third molars may exhibit several anatomic variations. Whereas in most of cases, the degree of the canal differentiation was at a low level, and the canal form was not complicate.



https://ift.tt/2voZxOv

Root and Root Canal Variations of the Human Maxillary and Mandibular Third Molars in a Chinese Population: a Micro–Computed Tomographic Study

Publication date: Available online 8 August 2018

Source: Archives of Oral Biology

Author(s): Wuyue Zhang, Ying Tang, Chao Liu, Yifen Shen, Xingmei Feng, Yongchun Gu

ABSTRACT
Objectives

To investigate the anatomical variations of the root and root canal configuration of the human third molars.

Designs

A total of 130 maxillary and 130 mandibular third molars were collected from a native Chinese population. All teeth were scanned by micro–computed tomography. After 3D reconstruction, the root and canal morphology of each tooth was examined both qualitatively and quantitatively.

Results

For maxillary molars, a single fused root (67 cases, 51.5%) and a single root canal system (64 cases, 49.2%) was most common root/canal form; the typical three-rooted molars were detected only in 33 cases (25.4%), and the secondary MB canals were detected only in 9 molars (6.9%). For mandibular molars, 62 teeth were single-rooted (47.7%) and 42 had a single root canal system (32.3%); 20 singled-rooted and 60 double-rooted molars exhibited independent mesial and distal root canal systems (61.5%), and the type 1-1 canal was the most common configuration for mesial (57 cases) and distal (81 cases) root canal systems. C-shaped canals were detected in 11 maxillary and 36 mandibular single-rooted molars. The mean root surface area, root and crown volume of mandibular third molars were significantly higher than the maxillary third molars (P <  0.01).

Conclusion

The root canal system of the third molars may exhibit several anatomic variations. Whereas in most of cases, the degree of the canal differentiation was at a low level, and the canal form was not complicate.



https://ift.tt/2voZxOv

Are Risk Factors for Coronary Artery Disease Different in Persons With and Without Obesity?

Metabolic Syndrome and Related Disorders, Ahead of Print.


https://ift.tt/2MqDLQO

Low level laser therapy reduces oral leukoplakia lesion size: Results from a preliminary study

Publication date: Available online 8 August 2018

Source: Oral Oncology

Author(s): Bhagyashree Jagtap, D.Y. Patil Vidyapeeth, Kalyani Bhate, S.N. Santhoshkumar



https://ift.tt/2Me0mTR

New Ringer's lactate gel formulation on nasal comfort and humidification

Publication date: Available online 8 August 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Maura Catafesta das Neves, Fabricio Ricci Romano, Samuel Guerra Filho

Abstract
Introduction

The use of saline irrigation for nasal washes is a well established procedure in the treatment of sinonasal inflammation and infection. In addition to saline solutions, Ringer's lactate is also an efficient option for nasal washes and humidification.

Objective

To assess the comfort, humidification and tolerance regarding stinging sensation, provided by sodium chloride nasal gel at the concentrations of 4.5 mg/g and 6.0 mg/g through questionnaires answered by the patients.

Methods

A total of 60 patients, 56 females, aged between 22 and 66 years old (mean age of 47) and 4 males, aged between 36 and 66 years (mean age of 49), were included in the study for a period of 17 days (±2 days) treatment. The patients were monitored by a general practitioner throughout the study period. They were instructed to apply each product in both nostrils twice a day during a 7-day period (±2 days). The patients were evaluated prior to the use of the first product at visit 0 (V0), after 7 days of treatment (±2 days) at visit 1 (V1), after 3 days of product discontinuation at visit 2 (V2) and after 7 days (±2 days) of treatment with the second product, in visit 3 (V3).

Results

A significant difference (5% significance) was observed regarding comfort and stinging sensation between the two different concentrations; comfort was higher and stinging was lower with the 6.0 mg/g concentration gel. No difference in humidification was observed between the two treatments.

Conclusion

Ringer's lactate at the concentration of 6.0 mg/g was superior to that at 4.5 mg/g for parameters comfort and stinging sensation. No statistical difference was observed between the two products regarding nasal humidification.

Resumo
Introdução

O uso de soluções salinas para lavagem nasal está consagrado no tratamento de quadros inflamatórios e infecciosos nasossinusais. Além das soluções salinas, o ringer lactato é uma importante opção tanto para lavagem quanto para a hidratação nasal.

Objetivo

Avaliar a tolerabilidade (ardência e conforto) e umidificação do produto gel nasal cloreto de sódio 4,5 mg/g em relação ao ringer lactato 6,0 mg/g, por meio de questionários respondidos pelos pacientes.

Método

No total, 60 pacientes, 56 mulheres (22-66 anos; média: 47 anos) e 4 homens (36-66 anos; média: 49 anos) foram incluídos no estudo de 17 dias (± 2 dias) de tratamento. Os pacientes foram supervisionados por um clínico geral durante todo o período do estudo. Os pacientes utilizaram os produtos com uma borrifada em cada narina duas vezes ao dia, durante 7 dias (± 2 dias). As formulações foram avaliadas antes do uso do primeiro produto na visita 0 (V0), após 7 dias (± 2 dias) de tratamento na visita 1 (V1), após 3 dias de interrupção do primeiro tratamento na visita 2 (V2) e após 7 dias (± 2 dias) de uso do segundo produto na visita 3 (V3).

Resultados

Foi observada diferença significativa para o conforto das vias nasais, (significância de 5%), na comparação entre os tratamentos nos atributos de conforto e ardência. O conforto das vias nasais foi superior e a ardência inferior para o gel nasal ringer lactato 6,0 mg/g em comparação ao gel cloreto de sódio 4,5 mg/g. Não foi observada diferença significativa para a umidificação entre os tratamentos.

Conclusão

O gel ringer lactato 6,0 mg/g foi superior ao produto gel cloreto de sódio 4,5 mg/g nos quesitos conforto e ardência. Não foi observada diferença estatisticamente significante entre os tratamentos em relação à umidificação das vias nasais.



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Interleukin 8 (CXCL8)-CXC chemokine receptor 2 (CXCR2) axis contributes to MiR-4437-associated recruitment of granulocytes and natural killer cells in ischemic stroke

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Qianyi He, Xiaojuan Shi, Bin Zhou, Junfang Teng, Chaoqi Zhang, Shasha Liu, Jingyao Lian, Benyan Luo, Guoqiang Zhao, Hong Lu, Yuming Xu, Yajun Lian, Yanjie Jia, Yi Zhang

Abstract

Granulocytes and natural killer (NK) cells have been linked to brain injury in ischemic stroke. However, their recruitment from peripheral leucocytes in stroke patients is not well understood. Here, the expression of the interleukin 8 (CXCL8) in plasma, and CXC chemokine receptor 2 (CXCR2) in peripheral leucocytes of patients with ischemic stroke were evaluated. Based on the results, CXCR2 expression positively correlated with granulocytes and NK cells, which were in turn attracted by CXCL8. The results also indicated that CXCR2 was a direct target of microRNA (miR)-4437, a negative regulator of CXCR2, which was downregulated in peripheral leucocytes from patients with ischemic stroke. Furthermore, serum CXCL8 levels were associated with the infarct volume and functional outcomes in patients with ischemic stroke. The results of the receiver operating characteristic curve analysis with an optimal cut-off value of 34 pg/mL indicated serum CXCL8 levels could be a prognostic indicator for ischemic stroke. In conclusion, these data highlighted the involvement of the CXCL8-CXCR2 chemotactic axis in the recruitment of granulocytes and NK cells in ischemic stroke. Furthermore, miR-4437 was suggested as a novel target for treating ischemic stroke, while the serum CXCL8 level could be a prognostic factor for ischemic stroke.



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Tumour origin and R1 rates in pancreatic resections: towards consilience in pathology reporting

Abstract

To evaluate differences in the R1 rates of ampullary (AC), pancreatic (PC), and distal bile duct (DBD) cancers in pancreatoduodenectomies (PD) using standardised pathology assessment. Data of PD (2010–2011) analysed in accordance with the Royal College of Pathologists (UK) protocol, were retrieved. Clinicopathologic features, including frequency, topography, and mode of margin involvement in AC (n = 87), PC (n = 18), and DBD (n = 5) cancers were evaluated. The R1 rate was 7%, 67%, and 20% in the AC, PC, and DBD cancers (p < 0.001). Within the PC cohort, R1 rate was heterogeneous (chemo-naïve, 77%; post-neoadjuvant, 40%). Commonest involved margins were as follows: posterior in overall PD (35%), AC (43%), overall PC (33%), and post-neoadjuvant PC (100%); superior mesenteric artery margin in chemo-naïve PC (38%) and common bile duct margin in DBD (100%) cancers. In AC, majority (66%) of R1 were signet ring cell type. Indirect margin involvement due to tumour within lymph node, perineural sheath or lymphovascular space was observed in 26% cases, and altered R1 rate in AC, PC, and DBD cohorts by 1%, 12%, and 0%, respectively. Although not statistically significant, patients with R1 had lower disease-free survival than those with R0 (mean, 25.4 months versus 44.4 months). Tumour origin impacts R1 data in PD necessitating its accurate classification by pathologists. Indirect involvement, histology, and neoadjuvant therapy influence the R1 rate, albeit in a minority of cases. Generating cogent R1 data based on standardised pathology reporting is the foremost need of the hour.



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Effects of Expiratory Muscle Strength Training on Airway Protection and Swallowing in Chronic Dysphagia After Radiation Therapy

Condition:   Cancer of the Head and Neck
Intervention:   Device: Expiratory Muscle Strength Training (EMST)
Sponsor:   Singapore General Hospital
Not yet recruiting

https://ift.tt/2Msm9nH

Surgery Followed by Risk-Directed Post-Operative Adjuvant Therapy for HPV-Related Oropharynx Squamous Cell Carcinoma: "The Minimalist Trial (MINT)"

Condition:   HPV Related Oropharyngeal Squamous Cell Carcinoma
Interventions:   Drug: Cisplatin;   Radiation: Intensity modulated radiation therapy;   Radiation: Intensity modulated proton therapy;   Procedure: Surgery;   Other: FACT-H&N;   Other: MD Anderson Dysphagia Inventory;   Other: University of Michigan Xerostomia Index;   Other: Scale of Subjective Total Taste Acuity;   Other: Neck Dissection Impairment Index
Sponsor:   Washington University School of Medicine
Not yet recruiting

https://ift.tt/2MhV8qo

A Randomized Phase II Study on the Optimization of Immunotherapy in Squamous Carcinoma of the Head and Neck

Conditions:   Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck;   Carcinoma, Squamous Cell of Head and Neck
Interventions:   Drug: Nivolumab and Ipilimumab;   Drug: Docetaxel
Sponsors:   AIO-Studien-gGmbH;   Bristol-Myers Squibb
Recruiting

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Reversing Synchronized Brain Circuits With Targeted Auditory-Somatosensory Stimulation to Treat Phantom Percepts

Condition:   Tinnitus
Interventions:   Device: Sham then Active;   Device: Active then Sham
Sponsors:   University of Michigan;   National Institute of Mental Health (NIMH)
Recruiting

https://ift.tt/2MaG7q3

Sintilimab Combined With Definitive Chemoradiation in Locoregionally-advanced Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Neoplasms
Interventions:   Drug: Sintilimab;   Drug: Gemcitabine;   Drug: Cisplatin;   Radiation: intensity-modulated radiotherapy
Sponsors:   Sun Yat-sen University;   Innovent Biologics (Suzhou) Co. Ltd.
Not yet recruiting

https://ift.tt/2MuLKwj

Elucidation of Critical Epitope of Anti-Rat Podoplanin Monoclonal Antibody PMab-2

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy, Ahead of Print.


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Elevated endotracheal tube cuff pressure in the pediatric emergency department

Publication date: Available online 8 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Edward D. Ferenczy, Michael J. Stoner, Sandra P. Spencer, Samantha W. Gee, Daniel J. Scherzer, Joseph D. Tobias



https://ift.tt/2vO8U9H

Association of Bullous Pemphigoid With Dipeptidyl-Peptidase 4 Inhibitors in Patients With Diabetes

This case-control study evaluates the association between use of dipeptidyl-peptidase 4 (DPP-4) inhibitors and development of bullous pemphigoid (BP) in patients with diabetes and characterizes those patients who develop DPP-4 inhibitor–associated BP.

https://ift.tt/2OUniGb

Topical Crisaborole—A Potential Treatment for Recalcitrant Palmoplantar Psoriasis

This case report describes the use of topical crisaborole to treat previously treatment-refractory palmoplantar psoriasis

https://ift.tt/2AZ8q6m

Evaluation of a Brief Dermatologist-Delivered Intervention vs Usual Care on Sun Protection Behavior

This longitudinal controlled cohort study examines the association of a brief dermatologist-delivered intervention with patient satisfaction and sun protection behavior among adults receiving dermatology care.

https://ift.tt/2OUmQHZ

Avoiding and Managing Medicare Fraud and Abuse Investigations of Mohs Surgery

This Viewpoint discusses ways dermatologists can manage and avoid investigations by the US Department of Justice and the Centers for Medicare & Medicaid Services for alleged Medicare fraud and abuse related to Mohs surgery.

https://ift.tt/2AS7EYS

A White Patch on the Tongue

An 80-year-old woman presented with an asymptomatic white patch affecting the tongue of 1 month's duration; she had a 15-year history of oral lichen planus managed with treatment. What is your diagnosis?

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A Twitter Analysis of the #DontFryDay Campaign

This study assessed the reach of the "Don't Fry Day" campaign on Twitter, using the hashtag #DontFryDay, and identified what types of individuals and/or tweeters are engaging in the campaign.

https://ift.tt/2lp0YHg

Assessing the Competence of Aging Physicians Who Are Young at Heart

This Viewpoint discusses the issues involved in assessing the professional competence of aging physicians as increasing numbers of physicians continue to work past the age of 65 years.

https://ift.tt/2tyenkD

Distinguishing Mild, Moderate, and Severe Hidradenitis Suppurativa—Reply

In Reply We are grateful for the very constructive and positive feedback from Kokolakis and Sabat regarding our newly proposed Severity Assessment of Hidradenitis Suppurativa (SAHS) score.

https://ift.tt/2tnqqQY

Dynamic Trichoscopy

This Viewpoint discusses how the dermoscope is a practical instrument for use in routine practice and describes how its shortcomings can be overcome with increasing familiarity with the use of dynamic vs static trichoscopy.

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Dupilumab Treatment of Very Severe Refractory Atopic Hand Eczema

This case report describes the use of dupilumab to treat a patient with very severe refractory atopic hand eczema.

https://ift.tt/2z7EZ15

Lentigo Maligna—Challenges, Observations, Imiquimod, Confocal Microscopy, and Personalized Treatment

The word melanoma imparts considerable fear and concern in patients. Fortunately, for patients with the lentigo maligna (LM) subtype of melanoma in situ, there is overall good prognosis. The challenge of LM, however, is that it has the highest rate of local recurrence (approximately 20%) of all melanoma subtypes when treated by standard surgical excision alone, owing to frequent, unpredictable, subclinical extension. To reduce this risk, the use of Mohs surgery or staged excision has consistently demonstrated lower recurrence rates of 0.3% to 2.2% yet requires larger surgical margins for histological clearance than other in situ melanoma subtypes. Moyer et al also demonstrated that with increasing lesion size, both the surgical margin required to clear the lesion and the risk of local recurrence increased, suggesting increased subclinical spread with increasing lesion size. In addition, LM is typically located in the head and neck area, a complex zone with potential cosmetic and functional impairment owing to extensive surgery. Finally, differentiating LM from background atypical melanocytic hyperplasia can be challenging. Thus, treatments directed toward reducing the extent of surgery, minimizing morbidity, and providing a cure would enhance patient outcomes.

https://ift.tt/2H50D4K

Friedrich Daniel von Recklinghausen

Friedrich Daniel von Recklinghausen, MD, was one of the most prominent German pathologists of his time. His contributions resulted in the identification of several eponymous conditions, most notably von Recklinghausen disease, or neurofibromatosis type 1.

https://ift.tt/2OV0CWa

Lentigo Maligna Treated With Off-label Neoadjuvant Imiquimod

This medical record review examines the rate of recurrence of lentigo maligna in patients treated with neoadjuvant topical imiquimod, 5%, cream prior to conservatively staged excisions.

https://ift.tt/2H3ShKP

Cutavirus Infection in Primary Cutaneous B- and T-Cell Lymphoma

This virological study examines the association of cutavirus DNA with different types of cutaneous B-cell lymphoma and cutaneous T-cell lymphoma in lesional skin samples.

https://ift.tt/2N2NbTj

Assessment of a Predictive Scoring Model for Dermoscopy of Subungual Melanoma In Situ

This cohort study identifies the dermoscopic features of subungual melanoma in situ in a Korean population and assesses a predictive scoring model that distinguishes the diagnosis of subungual melanoma in situ from longitudinal melanonychia in patients with pigmented nails.

https://ift.tt/2ypUXDF

Strengthening the Case for the Role of Thrombophilia in Calciphylaxis

In Reply We thank Hickson and colleagues for their interest in our Original Investigation titled "Association Between Hypercoagulable Conditions and Calciphylaxis in Patients With Renal Disease: A Case-Control Study" on the role of hypercoagulable conditions in the development of calciphylaxis in patients with renal disease.

https://ift.tt/2KrBYtZ

Decision Tree Model vs Traditional Measures for Associations of Sun-Protective Behaviors

This cross-sectional national survey assesses whether decision-based modeling can identify patterns of sun-protective behaviors and sun sensitivity associated with the likelihood of sunburn among US adults.

https://ift.tt/2KueqnW

Underuse of the Sentinel Lymph Node Biopsy for High-Risk SCC of the Skin—Reply

In Reply We read with interest the response by Glazer et al regarding our study on the underuse of sentinel lymph node biopsy (SLNB) for high-risk cutaneous squamous cell carcinoma (cSCC) and noted several important inquiries and comments.

https://ift.tt/2Nib0qt

Association of Inadequately Controlled Disease With Patient-Reported Disease Burden in Atopic Dermatitis

This cross-sectional study examines the association of atopic dermatitis severity and disease control with the patient-reported disease burden in clinical practice.

https://ift.tt/2zaaLL0

August 2018 Issue Highlights



https://ift.tt/2OQUyOC

Targeting Tropomyosin Receptor Kinase in Cutaneous CYLD Defective Tumors With Pegcantratinib

This phase 2 randomized clinical trial investigates if topical targeting of topical tropomyosin receptor kinase (TRK) with an inhibitor, pegcantratinib, is safe and efficacious in treating tumors in patients with CYLD cutaneous syndrome.

https://ift.tt/2KpGysm

Skin Cancer Detection In Vivo With Reflectance Confocal Microscopy Performed by a Novice Reader

This study evaluates the learning curve, diagnostic accuracy, and challenges for a novice reader of reflectance confocal microscopy for determining a diagnosis of skin cancer.

https://ift.tt/2KRf6rS

Clinical and Laboratory Markers of Relapse in Cutaneous Polyarteritis Nodosa

This case series identifies clinical and laboratory markers that may be associated with relapse among patients with cutaneous polyarteritis nodosa.

https://ift.tt/2txYNFB

Trichophyton erinacei Transmitted to a Pregnant Woman From Her Pet Hedgehogs

This case report describes a pregnant woman who developed tinea manus from Trichophyton erinacei infection transmitted to her from her pet hedgehogs.

https://ift.tt/2IWzDdx

Human Papillomavirus Vaccine to Treat Cutaneous Basaloid Squamous Cell Carcinomas

This case report describes a woman with multiple, inoperable cutaneous basaloid squamous cell carcinomas who was treated with 9-valent human papillomavirus vaccine.

https://ift.tt/2tQgfVZ

Allergic rhinitis and periodontitis among Korean adults: results from a nationwide population-based study (2013–2015)

Abstract

Background

The purpose of this study was to examine whether allergic rhinitis is associated with periodontal disease in a representative sample of elderly Korean people that was adjusted for socio-demographic factors, oral and general health behaviors, and systemic health status.

Methods

A total of 10,643 subjects who were between 20 and 59 years of age participated in the Korean National Health and Nutrition Examination Survey and underwent cross-sectional examination. Medical history of allergic rhinitis was collected from participants by questionnaire; additionally, periodontal status was assessed using a Community Periodontal Index score of 3 or 4. Multivariate logistic regression analysis was conducted to adjust for socio-demographic variables, oral health status and behaviors, and general health status and behaviors. All analyses were performed using a complex sampling design.

Results

Allergic rhinitis and periodontitis showed a significant inverse association. After adjusting for all confounders, a trend of decreasing periodontitis risk was observed as allergic rhinitis increased. The adjusted odds ratio of periodontitis was 0.79 (0.66–0.95) for patients with allergic rhinitis.

Conclusion

A significant inverse association between allergic rhinitis and periodontal status was demonstrated in this patient population.



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Clinical Thyroidology, a Journal of the American Thyroid Association, announces Dr. Angela M. Leung as New Editor-in-Chief

Dr. Angela M. LeungThe American Thyroid Association (ATA®) is pleased to announce that Dr. Angela M. Leung has been selected as the new Editor-in-Chief of the ATA monthly journal Clinical Thyroidology®, as of 2019.

Clinical Thyroidology is one of the ATA official journals distributed electronically. This highly valued abstract and commentary publication provides a broad-ranging look at the clinical thyroid literature. Experts in the field summarize the most cutting-edge, relevant articles of which clinicians should be aware and provide insight into the relevance and impact of each article on patient care.

Dr. Leung was selected based on her abilities to promote the growth, quality, reputation, and scholarship of this important ATA publication. She will continue the strong leadership of Dr. Jerome Hershman who, as EIC for 8 years, has led the diverse editorial board dedicated to making Clinical Thyroidology indispensable to clinicians and scientists interested in thyroid diseases.

Dr. Leung is a Health Sciences Clinical Assistant Professor of Medicine at the David Geffen School of Medicine, University of California Los Angeles (UCLA) and at the Greater Los Angeles VA Healthcare System. She is also an Associate Program Director of the UCLA/VA endocrinology fellowship training program. Since 2012, she has written regular commentaries for Clinical Thyroidology for the Public and, since 2014, reviews of papers in the current literature for Clinical Thyroidology as an Associate Editor. She also serves on the editorial board of Thyroid, the official peer-reviewed ATA journal.

Dr. Leung has been a member of the ATA since 2006 and has chaired committees focused on the scientific meeting program and on public health. For ATA annual meetings since 2006, she has served as a poster judge, been a moderator or speaker, served on the 2016 Program Committee, and co-chaired the program of the 87th Annual Meeting of the ATA.

She is also a current member of the Endocrine Society and the American Association of Clinical Endocrinologists (AACE). Dr. Leung has served on the Endocrine Training Support Committee and Abstract Review Subcommittee for the AACE. She has been a reviewer of trainees' abstracts and a poster judge for Endocrine Society annual meetings, and most recently has worked with the Endocrine Society to consult on a multidisciplinary, international toxicologic review of thyroid disruptors. She serves on the editorial boards of the AACE's Endocrine Practice and of the Journal of Clinical and Translational Endocrinology and since 2013 has co-edited the annual thyroid issue of Current Opinion in Endocrinology, Diabetes, and Obesity.

Dr. Leung received her BA in biochemistry from Occidental College in Los Angeles, her MD from Boston University School of Medicine, and her MSc in epidemiology from Boston University School of Public Health. Between obtaining her MD and beginning studies for her MSc, she spent six years in postdoctoral training at the BU School of Medicine, first as an Intern and Resident, then as a Clinical and Research Fellow in the Section of Endocrinology, Diabetes, and Nutrition, and finally as a Fellow in the BU Clinical Research Training NIH K30 Program.

Following her training and fellowships, she was appointed Instructor of Medicine, then Assistant Professor of Medicine at BU School of Medicine. For the past five years, she has held an Assistant Professor appointment at the UCLA David Geffen School of Medicine. Along with her academic appointments have come Dr. Leung's clinical appointments in the Section of Endocrinology, Diabetes, and Nutrition at Boston Medical Center; the Division of Endocrinology at Harvard Vanguard Medical Associates (Quincy, MA); the Division of Endocrinology, Diabetes, and Metabolism in the VA Greater Los Angeles Healthcare System and to the same-named division in the UCLA Health System.

Dr. Leung has received numerous honors and awards that have recognized her academic, clinical, and research activities. She has lectured nationally and internationally on both clinical topics and on her research in the various fields of thyroid disease, published over 80 papers, reviews, and book chapters, provided online media interviews, and has participated in multiple national oral and poster abstract presentations. Dr. Leung has completed research projects focusing on thyroid disease, iodine nutrition, thyroid disruptors, thyroid cancer, and other topics that have been supported by the NIH.

Dr. Leung will begin her 3-year term as Editor-in-Chief on January 1, 2019.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international, individual membership organization for over 1,700 clinicians and researchers from 43 countries around the world, representing a broad diversity of medical disciplines. It also serves the public, patients, and their families through education and awareness efforts.

Celebrating its 95th anniversary, ATA delivers its mission through several key endeavors: the publication of highly regarded monthly journals, Thyroid®, Clinical Thyroidology®, VideoEndocrinology, and Clinical Thyroidology for the Public; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators; support of online professional, public, and patient educational programs; and the development of guidelines for clinical management of thyroid disease. Find out more about ATA at www.thyroid.org.

The post <i>Clinical Thyroidology</i>, a Journal of the American Thyroid Association, announces Dr. Angela M. Leung as New Editor-in-Chief appeared first on American Thyroid Association.



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Relationship between working memory and comprehension and expression of grammar in Farsi-speaking children with cochlear implants

Publication date: Available online 8 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Soodeh Khoramian, Zahra Soleymani

Abstract
Objectives

Grammar is one of the most fundamental components of language and working memory (WM) is one of the most important cognitive features. These two skills play a vital role in learning, literacy and communication. Children with cochlear implants (CIs) experience delays in both of these skills. The aim of this study was to investigate the relationship between these two skills in children with CIs.

Subjects and methods

The sample consisted of 20 Farsi-speaking children with CIs. WM was estimated by forward and backward auditory digit spans (FBS and BDS) from the Persian (Farsi) version of the Wechsler Intelligence Scale for Children, 4th edition. The comprehension of grammar by participants was evaluated using the Persian Syntax Comprehension Test. Grammar expression was assessed using the Photographic Expressive Persian Grammar Test. Pearson's correlation and simple linear regression were used for data analysis.

Results

The results of linear regression and correlation showed a strong correlation between comprehension of grammar and FDS (r = 0.61; p = 0.004) was obtained, between BDS and comprehension of grammar (r = 0.161; p = 0.080). FDS and expression of grammar (r = 0.163; p = 0.222) showed a positive but insignificant correlation.

Conclusion

The results indicate that WM decisively effects grammar. Enhancement of the phonological loop can improve grammar, especially comprehension of grammar. The effect of the central executive in grammar requires further research.



https://ift.tt/2MbzFPx

Basic choking education to improve parental knowledge

Publication date: Available online 8 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Kathryn C. Bentivegna, Kevin T. Borrup, Meghan E. Clough, Scott R. Schoem

Abstract
Objective

To evaluate the effect of an educational intervention on parental knowledge of choking hazards and prevention.

Methods

A quasi experimental study was performed utilizing an internet based educational video intervention for parents with a child 6 months to 4 years old presenting to a Pediatric Otolaryngology clinic at a Level 1 pediatric hospital. Following the clinic visit, participants were sent a choking video (intervention) or general safety video (control) with a pretest and posttest knowledge survey (via email). An additional posttest knowledge survey was sent 30 days later as a surrogate measure for knowledge retained over time. Frequencies, chi square test, Independent t test and McNemar's test were used for statistical analyses.

Results

202 participants viewed the video and completed both the pretest and immediate posttest knowledge survey. Average change in total knowledge scores from the pretest to immediate posttest was statistically significant between the intervention (μ = 1.88, σ = 1.20) and control group (μ = 0.14, σ = 1.05); t (200) = −10.99, P < .001. This finding was consistent when assessing change from the pretest to 30 day posttest between the intervention (μ = 1.41, σ = 1.32) and control group (μ = 0.17, σ = 1.41); t (118) = −4.95, P < .001. A majority of the knowledge questions (5 of 7) showed a significant change in score from the pretest to immediate posttest (P = .001-.027). Additional analyses revealed accuracy on 4 of 7 knowledge questions significantly changed from the pretest to 30 day later posttest (P < .001- .002).

Conclusion

The brief educational video overall improved parental knowledge of choking hazards and prevention immediately after the video and 30 days later. Importantly, improved parental knowledge may decrease rates of choking among children.



https://ift.tt/2Om0Cxt

Effects of the percentage of air/water in spray on the efficiency of tooth ablation with erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation

Abstract

We aimed at examining the effects of a percentage of air/water in spray on the cutting efficiency of Er,Cr:YSGG laser for enamel and dentin. The intensity and frequency of irradiation were 3.0 W and 20 Hz for the enamel surface and 2.0 W and 20 Hz for the dentin surface, respectively. Flattened surfaces of enamel and dentin were irradiated at nine points for approximately 1 s under various percentages of air/water in spray using Er,Cr:YSGG laser. A high-speed video microscope was used to record each laser irradiation on the tooth surface. A slow video image was used to count the number of water micro-explosions yielded on the tooth surface during laser irradiation. A surface roughness tester was used to measure the depth of the dimple prepared with laser irradiation on each specimen. Each individual depth of dimple was divided by the number of water micro-explosions (pulse). This allowed for the calculation of the cutting depth per pulse. Following laser irradiation, several representative specimens were observed using an SEM. Two-way ANOVA was used as the statistical analysis. This revealed that there was no significant effect of the percentage of air/water in spray on the cutting depth for enamel surface (p > 0.05). On the contrary, a significant effect was observed in air-ratio for dentin cutting (p < 0.05). Both enamel and dentin were characterized by the presence of rough surfaces, as shown by the SEM images of the dimples. The percentage of air/water in spray was not significantly effective in laser cutting for enamel. Air-percentage was significantly effective in laser cutting for dentin.



https://ift.tt/2ATuj7i

Optimizing Value in Otolaryngology Through Patient Safety and Quality Improvements

Abstract

Purpose of Review

The goals of this paper are to explore the relationship between patient safety/quality improvement (PS/QI) activities and value generation in the field of otolaryngology and to suggest future opportunities for improvement or research. Value is defined as the ratio between health outcomes or improvements achieved and resources and dollars spent. It can therefore be increased by improving outcomes, reducing costs, or both. We present information suggesting that PS/QI activities may impact both the numerator and denominator in the value ratio, with the potential for powerful effects on value in health care.

Recent Findings

We describe clinical and administrative strategies demonstrated to increase value across multiple subspecialties in otolaryngology.

Summary

PS/QI can improve both components of value in health care. Relatively simple interventions may have significant impact and serve as good starting points. Larger-scale changes may have even broader impact but may require more infrastructure investment.



https://ift.tt/2ARoZRN

Thoughts on how to do the right thing

In the editorial entitled "Just Do the Right Thing," Theodore Freeman1 discussed the article by Clark et al2 entitled "Changes in Emergency Department Concordance With Guidelines for the Management of Stinging Insect–Induced Anaphylaxis: 1999–2001 vs 2013–2015" in the April issue of the Annals. He comments correctly on the lack of anaphylaxis guidelines in the emergency medicine literature. However, the Joint Task Force on Practice Parameters published in conjunction with emergency department (ED) physicians at the Mayo Clinic a specific parameter on ED diagnosis and treatment of anaphylaxis.

https://ift.tt/2MszFYw

Information for Readers



https://ift.tt/2M8DC7L

Information for Authors



https://ift.tt/2MszufO

Eosinophilic esophagitis 25 years after its recognition

It has been truly amazing to witness the progress made in understanding and managing eosinophilic esophagitis (EoE) since its recognition 25 years ago. If we examine EoE through history, we notice sporadic reports starting in 1978 of patients with presentations consistent with EoE. Not until 1993 did Attwood et al describe their adult case series, raising awareness about this disease.1 Two years later, Kelly et al discovered that EoE was triggered by food antigens rather than caused by acid-induced gastroesophageal reflux disease, through demonstration of disease remission with exclusive feeding with an amino acid-based formula.

https://ift.tt/2vsdOtR

Table of Contents



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Editorial Board



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Histiocytofibrome avec induction sébacée

Publication date: Available online 7 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): E. Lorier Roy, M.-H. Jégou, A. Osio

Résumé
Introduction

L'histiocytofibrome, ou dermatofibrome (DF), est une lésion bénigne commune revêtant de multiples aspects cliniques et histologiques. Le phénomène d'induction sébacée en regard d'un dermatofibrome est rare et peu décrit. L'observation détaillée d'un cas de DF avec induction sébacée permet de préciser et d'illustrer ici la sémiologie clinique et dermatoscopique de cette lésion, ainsi que celle de ses diagnostics différentiels.

Observation

Un homme de 52 ans consultait pour un examen de surveillance, qui révélait une lésion papuleuse ferme du milieu du dos. La surface de la lésion apparaissait comme une zone un peu pigmentée dans sa partie supérieure, faite de plusieurs petits lobules blanchâtres. L'examen histologique concluait à un histiocytofibrome avec induction sébacée.

Discussion

Le phénomène d'induction sébacée en regard d'un dermatofibrome est peu fréquent ; dans la très grande majorité des cas, il est observé sur la région des épaules. L'aspect dermatoscopique de surface, avec de multiples globules ou structures compactes arrondies blanchâtres (clods) regroupés en amas, est caractéristique. L'origine du phénomène d'induction sébacée est inconnue ; on peut évoquer un micro-environnement favorable de la peau des épaules, associé à des facteurs de croissance sécrétés par le DF.

Summary
Background

Histiocytoma or dermatofibroma (DF) is a common benign skin tumour with several clinical and histopathological variants. Sebaceous induction overlying a dermatofibroma is rare and infrequently reported. Using a detailed clinical case, herein the semiological and dermoscopic features of this lesion are described and illustrated, and the differential diagnoses presented.

Patients and methods

A 52-year-old man consulted for a physical examination, which revealed a firm papular lesion of the upper middle back. The upper part of the nodule was covered by a slightly hyperpigmented surface, with numerous small whitish lobules. Microscopic examination revealed a dermatofibroma with sebaceous induction.

Discussion

Sebaceous induction overlying a dermatofibroma is not frequent, and it occurs in most cases on or near the shoulder. The typical dermoscopic pattern involves many whitish globules or clumps grouped into clusters. The aetiology is unknown but could stem from a conducive microenvironment in shoulder skin, associated with growth factors secreted by the DF.



https://ift.tt/2ORmsdi

Pemphigoïde bulleuse localisée sur lambeau cutané

Publication date: Available online 7 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): C. Ivan, H. Kassem Youssef, E. Backobi, F. Chouta Ngaha, H. Nojavan, C. Michel



https://ift.tt/2ASFE7H