Πέμπτη 16 Αυγούστου 2018
Necrotizing fasciitis of the head and neck: our experience with vacuum-assisted closure therapy
Abstract
Objectives
To present the outcomes of our case series of head and neck necrotizing fasciitis (HNNF) in which vacuum-assisted closure (VAC) is used in most of the cases in the treatment.
Methods
Case series in a tertiary referral center.
Results
Eleven patients were treated for HNNF between January 2008 and January 2017. Patients were two females and nine males, the mean age was 57.1. Oral cavity and tracheotomy/tracheostomy sites were the main aetiological foci of the infection. Three patients were treated with aggressive debridements and conventional dressing, whereas eight patients were treated with incision and exploration followed by limited skin excisions and VAC dressing. The mean number of surgical debridements was 2.3. The mean length of hospital stay was 41.8 days. Complications were observed in all patients except one. The mortality rate of HNNF in our series was 18%. The cause of death was severe sepsis and multi-organ failure in one case and mediastinitis followed by respiratory distress syndrome in the other case.
Conclusion
HNNF is still a mortal disease and surgical debridements are crucial. The current study is the only case series in the literature in which VAC treatment was used in consecutive cases of HNNF. VAC treatment can play a major role in the post-operative care of HNNF patients. It reduces the amount of excised skin during debridements and stimulates wound healing. VAC treatment may be included in the treatment protocol of HNNF alongside surgical debridements and medical therapy.
https://ift.tt/2BjKU4m
Current practice in the surgical management of parathyroid disorders: a United Kingdom survey
Abstract
Purpose
Surgery for primary hyperparathyroidism is undertaken by many specialties but predominantly endocrine and ear, nose and throat (ENT) surgeons. There is currently no consensus on the peri-operative management of primary hyperparathyroidism. We sought to determine current surgical practice and identify any inter-specialty variation in the United Kingdom (UK).
Methods
An online survey was disseminated to members of the British Association of Endocrine & Thyroid Surgeons (BAETS) in the UK.
Results
78 surgeons responded (40 Endocrine, 37 ENT and 1 maxillofacial). 90% of surgeons used ultrasound and sestamibi for pre-operative localisation. Intraoperative frozen section (31%) and parathyroid hormone monitoring (41%) were the most common adjuncts used intraoperatively. 68% of surgeons did not use any wound drains. Nearly two-thirds of surgeons (64%) discharged patients from the clinic within 3 months, There were some significant differences (p < 0.05) in particular areas of practice between endocrine and ENT surgeons (%, p): use of single-photon emission computed tomography (SPECT) (Endocrine 25% vs. ENT 5%), preoperative laryngeal assessment (endocrine 58% vs. ENT 95%), intraoperative laryngeal nerve monitoring (endocrine 35% vs. ENT 68%), use of monopolar diathermy (endocrine 58% vs. ENT 22%), bipolar diathermy (endocrine 60% vs. 89%) and surgical ties (endocrine 48% vs. ENT 19%).
Conclusion
Our study demonstrates some similarities as well as some notable differences in practice between endocrine and ENT surgeons, and therefore, highlights the need for national consensus with respect to some key areas in parathyroid surgery.
https://ift.tt/2MVTSWK
Perception of Pulmonary Function in Children with Asthma and Cystic Fibrosis
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2PgLnan
Flexible Bronchoscopy Under Bronchoscopist-Administered Moderate Sedation Versus General Anesthesia: A Comparative Study in Children
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2MQFAH6
Perception of Pulmonary Function in Children with Asthma and Cystic Fibrosis
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2Bin0pZ
Flexible Bronchoscopy Under Bronchoscopist-Administered Moderate Sedation Versus General Anesthesia: A Comparative Study in Children
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2vRwrr3
Development of a UHPLC-FLD method for the analysis of ergot alkaloids and application to different types of cereals from Luxembourg
Abstract
Ergot alkaloids are toxins produced by some species of fungi in the genus Claviceps, that may infect rye and triticale and, in a minor degree, other types of cereals. In this study, a new UHPLC-FLD method for the quantification of the six major ergot alkaloids as well as their corresponding epimers was developed. The sample preparation was done by a solid-liquid extraction with acetonitrile and clean-up via freeze-out. The method was fully validated and then applied to 39 samples (wheat, rye, triticale, and barley) harvested in Luxembourg in 2016. Samples were sieved (1.9 × 20 mm) prior to analysis in order to remove sclerotia, hosting the alkaloids. However, 23 samples still contained at least one ergot alkaloid > LOQ and concentrations of the sum of the 6 ergot alkaloids ranged from 0.3 to 2530.1 μg/kg. Interestingly, the highest concentrations were measured in wheat and not in rye or triticale, suggesting that all kinds of cereals should be included in monitoring programs. The outcome of this study allowed giving a first overview of ergot alkaloid concentrations in cereals harvested in Luxembourg, and the measured concentrations were in similar ranges than in other parts of the world (e.g., Canada, France, Germany).
https://ift.tt/2vQzW1c
Rectal perforation following paclitaxel and carboplatin chemotherapy for advanced ovarian cancer: a case report and review of the literature
Paclitaxel is a chemotherapy drug commonly used in the management of ovarian cancer. Colonic perforation is an extremely rare complication of paclitaxel administration with few case reports in the medical lite...
https://ift.tt/2MSLtn5
A quadricuspid aortic valve in an asymptomatic 40-year-old man: a case report
Integrated transthoracic and transesophageal echocardiography enables identification and characterization of a quadricuspid aortic valve anomaly.
https://ift.tt/2vP6loz
Two siblings with PRKDC defect who presented with cutaneous granulomas and review of the literature
Publication date: Available online 16 August 2018
Source: Clinical Immunology
Author(s): Saliha Esenboga, Can Akal, Betül Karaatmaca, Baran Erman, Sibel Dogan, Diclehan Orhan, Kaan Boztug, Deniz Ayvaz, İlhan Tezcan
Abstract
V(D)J recombination, during which recognition and repair of broken DNA chains are accomplished by non-homologous end joining pathway, is a critical process in B and T cell development.Null mutations of each enzyme or protein of this pathway result in T- B- NK+ severe combined immunodeficiency whereas hypomorphic mutations result in atypical(leaky)severe combined immunodeficiency forms. We present two siblings with PRKDC (Protein Kinase, DNA-Activated, Catalytic Polypeptide) mutation who presented with granulomatous skin lesions and recurrent lung infections. Primary immune deficiencies may initially present with skin findings. Disruption in central and peripheral B-cell tolerance and impaired intrathymic T-cell maturation,a central player in T-cell tolerance, have been identified as the mechanism of autoimmunity and granuloma seen in patients. The variation in clinical phenotypes of patients with PRKDC mutation suggests that additional factors such as modifying genes, epigenetic and environmental factors may affect the severity and clinical phenotype of the disease. Functional studies during the follow-up and evaluation before and after hematopoeitic stem cell transplantation will hopefully increase our knowledge about the autoimmune and inflammatory process of the disease spectrum.
https://ift.tt/2nLScEy
Biomatrix for upper and lower airway biomarker in allergic asthma
Publication date: Available online 16 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Ulrich M. Zissler, Moritz Ulrich, Constanze A. Jakwerth, Sandra Rothkirch, Ferdinand Guerth, Markus Weckmann, Matthias Schiemann, Bernhard Haller, Carsten B. Schmidt-Weber, Adam M. Chaker
https://ift.tt/2vQPQIJ
FPIES in Adults
Publication date: Available online 16 August 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Yue (Jennifer) Du, Anna Nowak-Węgrzyn, Peter Vadas
https://ift.tt/2MVoUhs
Protective effect and related mechanisms of curcumin in rat experimental periodontitis
Curcumin exhibits anti-inflammatory effects and has been suggested as a treatment for inflammatory diseases. The aim of this study was to investigate the effects of curcumin on the lipopolysaccharide induced i...
https://ift.tt/2L1bIG3
How to Use Oral and Topical Cosmeceuticals to Prevent and Treat Skin Aging
Skin aging is caused by DNA damage in nuclei and mitochondria, inflammation, glycation, decreased function of keratinocytes and fibroblasts and breakdown of heparan sulfate, hyaluronic acid, collagen, and elastin. Identifying patients at an increased risk of skin aging using a standardized methodology to diagnose the Baumann Skin Type will allow doctors to prescribe an efficacious antiaging skin care regimen. Cosmeceuticals can activate LGR6+ stem cells, improve cell response to signals such as growth factors, stimulate collagen genes, neutralize free radicals, and decrease breakdown of collagen and elastin. Giving written instructions will increase patient compliance and improve outcomes.
https://ift.tt/2MR1nhG
Mesothelial Stem Cells and Stromal Vascular Fraction for Skin Rejuvenation
The use of stem cells in regenerative medicine and specifically facial rejuvenation is thought provoking and controversial. Today there is increased emphasis on tissue engineering and regenerative medicine, which translates into a need for a reliable source of stem cells in addition to biomaterial scaffolds and cytokine growth factors. Adipose tissue is currently recognized as an accessible and abundant source for adult stem cells. Cellular therapies and tissue engineering are still in their infancy, and additional basic science and preclinical studies are needed before cosmetic and reconstructive surgical applications can be routinely undertaken and satisfactory levels of patient safety achieved.
https://ift.tt/2nK7RnL
Research Grant for Study of Resistance to Precision Medication for Medullary Thyroid Cancer Is Awarded to Brendan Frett, PhD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Brendan Frett, PhD, Assistant Professor in the College of Pharmacy at the University of Arkansas for Medical Sciences. The title of Dr. Frett's project is "Dual Inhibition of RET and Aurora B to Study the Simultaneous Regulation of Multiple Oncogene Pathways in Medullary Thyroid Cancer."
Since its inception in 1971, the War on Cancer has resulted in significant treatment breakthroughs. One of the most important was the discovery of cancer-promoting oncogenes (genes with the potential to cause cancer). Researchers theorized that oncogenes could be strategically targeted while sparing normal cells, which sparked the era of precision medicine for oncology. Early medicine discoveries were quickly followed by the realization that secondary mutations in cancers often resulted in resistance to the drugs and relapse of the disease. This was solved by generating inhibitors that achieved activity on multiple forms of the oncogenes. However, additional cancer-promoting pathways were activated by the oncogenes. Therefore, although precision medicine for oncology has had great upfront success, the onset and degree of resistance lowers the effectiveness of many treatments. How is it possible to avoid this resistance?
The majority of thyroid cancers (TC) are curable through surgery, radiation, and chemotherapy, with a five-year survival rate of 98%. However, TC can present in certain forms that are highly aggressive, such as metastatic medullary thyroid cancer (MTC). Researchers have identified drivers specific to MTC (RET and VEGFR2, among others) through comprehensive investigation, which led to the clinical development of precision-medicine therapies that target those oncogenes. However, through RET-oncogene mutations and other cancer-promoting pathways, MTC tumors can develop resistance to precision medicine, in which case treatment benefit becomes limited.
The ultimate goal for this project is to uncover pioneering precision-medicine strategies and innovative biology and treatment paradigms that can be used to more effectively combat resistant thyroid disease. More specifically, Dr. Frett's laboratory plans to develop a dual-targeted compound that acts on both RET and cell cycle oncogenes, employing single-agent polypharmacology (SAP) and synergistic medicinal chemistry (SMC). They will focus on understanding MTC-resistance mechanisms. As medicinal chemists, they specialize in the design and development of unique tools to help analyze MTC biology. For this project, they want to investigate the use of precision medicine to target multiple, unrelated cancer-promoting pathways.
- First, they will design tractable inhibitors to block the RET oncogene, because MTC is heavily promoted by the RET oncogene.
- Second, they will expand the RET inhibitor to block the ability of MTC cells to divide, since uncontrolled cell growth is a hallmark of cancer.
- They will repeat the two-step process with cell cycle oncogenes.
Dr. Frett expects that this method of targeting MTC will significantly help delay the degree and onset of resistance to precision medicine.
In 2014, Dr. Brendan Frett received his PhD in Pharmaceutical Sciences, with an emphasis in Drug Discovery and Development, from the University of Arizona. He also received postdoctoral training in Medicinal Chemistry and in Pharmaceutics at the University of Arizona. He has successfully transferred academic-based discoveries to pharmaceutical companies for clinical development, specializing in the development of therapies for orphan diseases (those that offer little financial incentive for the private sector to develop and sell new medications that would treat or prevent them, either because the diseases are rare or because they are not common in the "developed" world). Dr. Frett is interested in pursuing translational research projects, where research completed in his laboratory can directly help patients. Specifically, he investigates resistance mechanisms and the design of next-generation precision-medicine therapies for thyroid cancer. He is interested in tailoring precision medicine to the unique pathology of MTC to generate "synergistic" medicine.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant for Study of Resistance to Precision Medication for Medullary Thyroid Cancer Is Awarded to Brendan Frett, PhD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2L04kuw
Research Grant to Determine the Genes Responsible for Survival and Growth of Medullary Thyroid Cancer Is Awarded to Wayne Miles, PhD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Wayne Miles, PhD, Assistant Professor of Molecular Genetics at the Ohio State University. Dr. Miles's research project is entitled "Proteomic-led discovery of essential genes in Medullary Thyroid Cancer."
Medullary thyroid cancer (MTC) is caused by the malignant growth of C-cells. Although MTC represents only a small fraction (2-4%) of all thyroid cancer cases and overall survival rates from MTC are good, patients diagnosed with advanced disease have poor five-year survival rates (28%). The genetic aberrations of the cancer result in C-cells receiving a continuous signal to grow and proliferate. To sustain their elevated growth rates, MTC cells adapt their genome (DNA), transcriptome (RNA), and proteome (the entire set of proteins expressed by a cell, tissue, or organism).
Dr. Miles's laboratory has specialized in profiling the protein changes in human MTC cancer cell lines, revealing many exciting and potentially exploitable changes within these cells. However, before they begin to translate these specific MTC cell-line changes into new strategies to treat human MTC, they first need to determine: (1) whether these changes are also seen in preclinical mouse models of MTC and (2) which of the protein changes are essential for the survival of human MTC cells.
Using quantitative proteomics, they will measure the protein composition of mouse MTC tumors and normal mouse thyroids. With Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), a genome editing technology, they will then conduct a genome-wide screen to determine the genes responsible for the survival and growth of MTC and C-cells. This unbiased methodology systematically disables one gene per cell and enables the identification of essential genes. With this approach, the project will profile a C-cell line and two human MTC cancer cell lines. Collectively, these results will generate new insights into MTC biology and uncover opportunities to therapeutically target MTC cells.
Dr. Miles's research has long focused on understanding how loss of the Retinoblastoma 1 or RB tumor-suppressor gene contributes to cancer growth. His laboratory's previous work has found that RB loss results in widespread cellular reprogramming that effects not only transcription but also metabolism and the proteome. These discoveries were made possible by utilizing cutting-edge quantitative proteomic approaches and these past projects have been excellent training for the upcoming project. More recently, their research has expanded to investigate the roles of RB-inactivation in Medullary Thyroid Cancer.
Wayne Miles received his PhD in 2008 from the University of Manchester (UK), and pursued postdoctoral work the following year at Harvard Medical School and the Massachusetts General Hospital Cancer Center. In 2016 he was appointed Assistant Professor at The James Comprehensive Cancer Center, Ohio State University.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant to Determine the Genes Responsible for Survival and Growth of Medullary Thyroid Cancer Is Awarded to Wayne Miles, PhD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2vJHfaT
Research Grant to Identify the Source and Mechanism of Thyroid and Kidney Comorbidity Is Awarded to Nicholas Tardi, PhD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Nicholas J. Tardi, PhD, Instructor in Internal Medicine at Rush University Medical Center in Chicago. Dr. Tardi's project is titled "Deiodinase 3: A Thyroid Hormone-Associated Renoprotective Protein."
The long-term goal of this project is to identify the source and mechanism of kidney and thyroid comorbidity. Thyroid hormone (TH) is a circulating, lipid-soluble molecule that plays an important physiological and developmental role in nearly all cells. Accordingly, precise control of TH activity is crucial to maintain metabolic homeostasis in several tissues.
Scientists have known for 30 years about the interplay between kidney disease and TH disorders, yet the underlying mechanism that links these two diseases has yet to be defined. Studying the effect of poor enzyme regulation of TH activity in the kidney may identify a causative disease mechanism. Dr. Tardi's lab has previously shown that deiodinase 3 (D3), an enzyme that deactivates TH, is highly expressed in podocytes, which wrap around the capillaries of kidney filtration units and filter toxins from blood. This suggests that low TH activity is required for proper podocyte function. Mature podocytes cannot divide and cannot be replaced, so it is especially important that they continue to function properly. Unfortunately, they are a primary target of kidney disease. D3-deficient podocytes are more susceptible to injury, indicating that TH stability is important in preventing kidney disease.
Dr. Tardi's laboratory will study the local effect of TH imbalance in both cell and mouse models to determine how D3 protects podocytes from injury. Additionally, they will define the prevalence of D3 misexpression in patients suffering from various kidney diseases. Identifying a local regulatory mechanism causing TH metabolism dysfunction will aid in developing targeted therapies to combat kidney and/or thyroid diseases that share a disease source.
Patients with hyperthyroidism show increased kidney filtration pressure and absorption capacity, while those with hypothyroidism show thickening of the glomerular basement membrane and reduced filtration rate. Despite the prevalence of overlapping complications of thyroid hormone disorders and kidney disease, a unifying mechanism regulating T3 stability in the kidney is absent. Though well studied in endocrine tissues, the role of D3 in the regulation of thyroid hormone in renal tissue has not been addressed in the past. This study will use samples from clinical patients and representative disease models to define a therapeutic target.
Specifically, Dr. Tardi's study will aim to:
- Identify pathways associated with D3 dysfunction in podocytes: The laboratory will use microarray experiments to identify D3-responsive genes in podocytes and to screen potential activators and inactivators of D3. They will compare gene-expression profiles under healthy and injury-promoting conditions and set priorities to guide future studies of the signaling events that regulate D3 activity.
- Establish the renoprotective mechanism of D3: The lab will use molecular biology-based experiments and morphological analysis to identify the mechanism by which D3 protects against podocyte injury. With confocal microscopy, they will examine cytoskeletal structure for hallmarks of podocyte injury. Protein analysis on known markers of podocyte health, metabolic processes, cellular stress, and protein trafficking will help to determine the mechanism of D3. They will correlate these cellular-level effects with the heavy proteinuria observed in D3-knockout mice models.
- Define the prevalence of D3 misexpression in patients with kidney disease at single stages of its development: Dr. Tardi's lab will analyze patient samples from the nephrology clinic at Rush University Medical Center to assess D3 as a potential biomarker for TH-associated kidney disease. They will use this data to develop studies targeting specific deiodinases to treat kidney disease. This is different from current therapeutic approaches that attempt to balance systemic TH levels to prevent the development of overlapping kidney disease.
Dr. Nicholas Tardi earned his PhD in Molecular and Cellular Biology in 2013 from Illinois State University, where he developed expertise in cell signaling, molecular mechanisms of disease, protein biology, and analytical processing to answer questions about cellular regulation of growth control pathways. Since joining Rush University, he has been investigating the molecular mechanisms of thyroid hormone imbalance in kidney disease and characterizing pharmacologically active agents to rescue kidney disease in mice. Recently, he has worked closely with two mentors to develop a niche to study kidney and thyroid comorbidity. Dr. Tardi's passion for research, scientific expertise, and unusual technical perspective is reflected in publications in Nature Medicine, Science, Cell, and Genetics.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant to Identify the Source and Mechanism of Thyroid and Kidney Comorbidity Is Awarded to Nicholas Tardi, PhD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2L03uhm
Research Grant Focused on Identifying T3-Forming Sites in Thyroglobulin Is Awarded to Cintia Eliana Citterio, PhD, by the American Thyroid Association
Cintia Eliana Citterio, Ph.D.
Instituto de Inmunología, Genética y Metabolismo (INIGEM), Universidad de Buenos Aires (UBA) – Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)
Buenos Aires, Argentina
Bio
Instituto de Inmunología, Genética y Metabolismo (INIGEM), Universidad de Buenos Aires (UBA) – Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)
Buenos Aires, Argentina
Bio
The American Thyroid Association has awarded a 2018 Research Grant to Cintia Eliana Citterio, PhD, Assistant Professor of Genetics and Molecular Biology at the Instituto de Inmunología, Genética y Metabolismo (INIGEM), Universidad de Buenos Aires (UBA) – Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Dr. Citterio's project is called "De novo triiodothyronine (T3) formation in T3 toxicosis of Graves' Disease."
The project focuses on identifying T3-forming sites in thyroglobulin (TG, the protein from which thyroid hormone is made) that are responsible for excess T3 production in patients with autoimmune hyperthyroidism or Graves' Disease (GD). The long-term objectives are:
- To dissect the molecular mechanisms that underlie de novo T3 synthesis in GD and in other thyroid conditions that are characterized by hyperactive thyroid TSH-receptors and preferential T3 formation within thyroglobulin
- To understand these mechanisms
- To develop treatments that will repair them, if possible
Although thyroid hormone is perhaps the smallest chemical hormone known, the TG protein is a very large, complex molecule that has been very difficult to understand. Thyroid stimulating hormone (TSH) stimulates synthesis of the hormone by binding to a receptor (called TSH-receptor), which triggers many responses in the thyroid gland, including making more of the active thyroid hormone called T3. For reasons yet to be discovered, the TG protein sometimes makes too much T3, causing the anxiety, irritability, weight loss, enlargement of the thyroid gland, bulging eyes, and/or other symptoms that combine to indicate Graves' Disease or related diseases.
Dr. Citterio proposes that, when TSH stimulates the thyroid gland, the TG protein structure is modified by a special enzyme that increases the ability of TG to make T3. She has evidence that this special enzyme, named Fam20C, can add a phosphate residue at a particular site on the TG molecule, changing its structure. Increasing the amount of Fam20C in thyroid cells results in those cells making a TG protein that produces more T3; inhibiting the enzyme results in less T3 production. In GD, the stimulated thyroid gland makes more of the Fam20C enzyme; Dr. Citterio believes this is why patients end up with too much T3 in their blood.
This project will attempt to find the specific location on the TG molecule where the extra T3 is released, which is likely from one of three sites. Using mutagenesis to eliminate each of those sites one at a time, Dr. Citterio will then test the TG protein to see whether it still makes more T3 in cells that express more of the Fam20C enzyme, or in thyroid cells stimulated with a lot of TSH. The long-term objective is to understand, at a molecular level, why patients with Graves' disease (and some other diseases) make too much T3.
Dr. Citterio received her undergraduate degree from the UBA with a double major in biochemistry (Certificate of Honor) and pharmaceutical sciences. Her interest in thyroid function and disease began during her PhD research (completed in 2014, Summa Cum Laude) under the direction of Dr. Héctor M. Targovnik at the UBA. She has since published her research in 16 publications. In 2014, she was named a Fulbright Scholar to conduct postdoctoral studies in Dr. Peter Arvan's lab at the University of Michigan, where she developed a new assay to measure de novo T3 formation within thyroglobulin secreted from hyperstimulated thyrocytes (Citterio et al., 2017) and characterized the molecular mechanisms of T3 formation at the antepenultimate tyrosine residue of thyroglobulin (Citterio et al., 2018).
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant Focused on Identifying T3-Forming Sites in Thyroglobulin Is Awarded to Cintia Eliana Citterio, PhD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2KZq5L9
Research Grant to Determine How Specific Drugs Work or Fail in Anaplastic Thyroid Cancer Is Awarded to Miles Miller, PhD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Miles Miller, PhD, principal investigator at the Massachusetts General Hospital Center for Systems Biology and Assistant Professor of Radiology at Harvard Medical School. Dr. Miller's research project is titled "Co-opting tumor-associated macrophages in anaplastic thyroid cancer to enhance immune-checkpoint blockade response."
Treatment of advanced metastatic cancer has seen a revolution over the last several years, as new therapeutic strategies have become successful at harnessing the power of the immune system to durably attack malignant and mutated cancer cells. Immune-checkpoint blockade therapies targeting programmed-death 1 (PD1) signaling on T-cells have been successful in the treatment of solid cancers, including heavily mutated melanomas and lung cancers. Unfortunately, these treatments only work in a fraction of patients, and resistance is often associated with the presence of a type of tumor-promoting immune cell: the tumor-associated macrophage. Highly aggressive anaplastic thyroid cancers (ATC) can contain extremely high levels of these macrophages, which may be why drug resistance is so common in these cancers.
Although ATC represents less than 10% of thyroid malignancies worldwide, it contributes to a disproportionately high fraction of deaths from thyroid cancer, ranging from 15 to 50% by some estimates. Ongoing clinical trials are testing PD1-targeted immunotherapy, but initial indications suggest large numbers of patients will not see durable responses. Thus, a clear need exists to understand the mechanisms: Why doesn't ATC respond better to immune-checkpoint blockade or to other advanced biologic therapies? New strategies against the disease are urgently needed.
This project will bring together new techniques for simultaneously imaging the delivery and action of biologics in tumors in vivo, combined with expertise in mouse models of metastatic thyroid cancer, to offer fundamental, mechanistic knowledge of how specific drugs work or fail in ATC. Strikingly little is known about how much of a given drug accumulates in ATC, what the heterogeneity of drug accumulation is across primary tumors and metastases, and how drug exposure ultimately impacts response or nonresponse.
Dr. Miller's laboratory recently discovered that tumor-associated macrophages critically influence the delivery and action of biologic therapies (including PD1-targeted drugs) and may be co-opted to synergistically improve drug response. ATC shows special promise for this approach, as macrophages outnumber tumor cells themselves in some ATC cases. New unpublished findings reveal ATC-macrophage content can increase substantially with targeted therapy. Dr. Miller's approach promises to clarify the relationships between drug exposure and trajectories of cell response or resistance, which are monitored over time using fluorescent readouts of immune activity and tumor-cell killing. Dr. Miller hypothesizes that variability in local macrophage levels will play a key role in mediated drug response, especially at sites of metastasis, and aims to test whether combination treatments can repurpose macrophages for enhancing treatment efficacy.
This project will leverage the recent discoveries of Miller's lab into the function and therapeutic potential of tumor-associated macrophages, along with expertise and compelling new observations from Sareh Parangi, MD, Director of the MGH Thyroid Cancer Research Laboratory, who for over a decade has developed and tested treatment strategies in an impressive array of advanced, preclinical, metastatic thyroid cancer models.
In addition to serving as a principal investigator at the Massachusetts General Hospital Center for Systems Biology and Assistant Professor of Radiology at Harvard Medical School, Dr. Miller is also a faculty member of the Harvard Bioinformatics and Integrative Genomics PhD Program. For the last 10 years he has developed new approaches and technologies for parsing mechanisms of drug action and cancer behavior in disease microenvironments from a quantitative, network-level perspective. He has extensive training and publications in computational modeling, multivariate statistics, in vivo microscopy, nanotechnology, and cancer pharmacology. As an NIH-funded postdoctoral fellow, he developed new techniques for imaging the in vivo transport, cellular uptake, and pharmacodynamics of novel chemotherapeutic formulations at a single-cell level within live tumor models. Dr. Miller received a Ph.D. from the Massachusetts Institute of Technology Department of Biological Engineering. He graduated summa cum laude from Princeton University.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant to Determine How Specific Drugs Work or Fail in Anaplastic Thyroid Cancer Is Awarded to Miles Miller, PhD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2vOuAU9
Research Grant to Study Common Resistance to Papillary Thyroid Cancer Treatment Is Awarded to Ann-Kathrin Eisfeld, MD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Ann-Kathrin Eisfeld, MD, Clinical Fellow in Internal Medicine at Ohio State University. The topic of Dr. Eisfeld's project is "Novel NRAS isoform mediates BRAF-inhibitor resistance in papillary thyroid cancer—thinking outside the box to overcome 'inevitable' treatment failure."
Papillary thyroid cancer (PTC) is one of the 10 most common malignancies in the United States, with almost 60,000 new people diagnosed each year. While almost all patients initially respond well to the current standard treatment with radioactive iodine, almost half of them will eventually develop resistance. Therapies that can provide additional treatment options for those patients are greatly needed.
The BRAF oncogene is the BRAF gene mutated from its natural state, which may contribute to tumor growth. Because about 60% of PTC patients harbor the BRAF oncogene, targeted treatment with a BRAF inhibitor seemed to be a promising treatment option for these patients. The BRAFV600E-inhibitor Vemurafenib was initially effective in many patients, but eventually all patients developed resistance. It seems apparent that resistance and escape mechanisms exist that prevent complete response to selective BRAF inhibitors. Several resistance mechanisms have already been identified, including increased expression of BRAF's upstream regulator, RAS. Eisfeld's laboratory recently pioneered the discovery of five splice variants of the NRAS gene, among which NRAS isoform 2 appears likely to facilitate resistance to Vemurafenib.
In this project, the laboratory will perform comprehensive in vitro and in vivo studies in mice to:
- Understand whether and how NRAS isoform 2 contributes to the development of resistance to Vemurafenib
- Understand the pathobiology of the new isoform of this major human oncogene
They will use a range of methods including gene splicing, RNA sequencing, and mass spectrometry, among others.
This novel approach may eventually lead to new treatment options for PTC patients who develop resistance to the current standard therapy.
Dr. Eisfeld grew up in Northern Germany watching her father practice medicine and wanting to do the same. However, she did not discover her passion for research until attending medical school at the University of Leipzig, Germany, and realized the power that translational genetics has on cancer treatment. There she began research projects that eventually led to a hematology residency/fellowship in Leipzig. Her passion for genetics led her to pause her fellowship in 2009 to take a research position in Albert de la Chapelle's and Clara D. Bloomfield's Laboratories at The Ohio State University. Together they undertook studies focused on genetics in acute myeloid leukemia and solid tumors, for which Dr. Eisfeld assumed a senior role. In 2016 she resumed her clinical training in the OSU Physician-Scientist-Training Program, so she could maintain a research lab. She plans to finish her clinical training and finally unite her two passions—research and patient care—as a Physician Scientist.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant to Study Common Resistance to Papillary Thyroid Cancer Treatment Is Awarded to Ann-Kathrin Eisfeld, MD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2KZq35Z
Research Grant to Study the Action of T-Regulatory Cells in Thyroid-Antibody-Positive Pregnant Women Awarded to Stephanie Behringer-Massera, MD, by the American Thyroid Association
The American Thyroid Association has awarded a 2018 Research Grant to Stephanie Behringer-Massera, MD, Clinical Fellow at the Icahn School of Medicine at Mount Sinai. Dr. Behringer-Massera's project is titled "T regulatory cells in thyroid-antibody-positive pregnant women."
A fetus, which shares half its genetic material with the father, is considered a foreign body in the mother's womb. The only way that it can implant in the uterus without being rejected is if the mother's immune system is suppressed, which happens through T-regulatory-cell action. The more T regulatory cells (Tregs) are released, the more the immune system is suppressed and the more likely the pregnancy can successfully be brought to term. In women with autoimmune thyroid disease, this process is disrupted. These women are found to have an abnormal Treg response to pregnancy and have Treg levels as low as women who are not pregnant. They are more likely to have miscarriages in the first trimester.
Through this project, Dr. Behringer-Massera hopes to understand the underlying pathology in this immune response to the fetus, enabling the development of targeted therapies to prevent these miscarriages. She plans to measure the proportion of Tregs in pregnant women during each trimester and in those who are 6-weeks postpartum, comparing the proportions in thyroid-antibody-positive versus thyroid-antibody-negative women, as well as in a control group of normal nonpregnant women. Her laboratory will also examine the functional status of Treg cells in both normal and thyroid-antibody positive women during pregnancy to determine their effectiveness at immune control. They will also analyze the Treg cells isolated from the control group and from the antibody-positive women to evaluate clonal expansion during and after pregnancy.
Dr. Behringer-Massera's previous studies of patients with increased thyroid autoantibodies during the first trimester of pregnancy demonstrated the increased rate of miscarriage and led to her proposed further studies.
Dr. Behringer-Massera completed her medical studies at the University of Heidelberg in Germany in December 2009. She continued her medical training as a resident in Internal Medicine at the St. Josef Hospital in Heidelberg. In 2011 she was accepted for a residency in Internal Medicine at Montefiore Medical Center, Bronx, New York. She successfully completed her Internal Medicine training in 2014 and was awarded a research fellowship in the Empire Clinical Research Investigator Program (ECRIP) at the Albert Einstein College of Medicine, where she joined a multi-center clinical trial on glycemia-reduction approaches in diabetes (GRADE) funded by the NIH. During this time she also conducted a qualitative study on barriers to enrollment into research studies. In 2016 she started training as a Clinical Fellow in Endocrinology at the Mount Sinai Hospital in New York. When she completes her fellowship in June 2018, she will begin a position as Assistant Professor at the Icahn School of Medicine at Mount Sinai with clinical duties at Mount Sinai Beth Israel Medical Center.
Dr. Antonio Di Cristofano, Chair, ATA Research Committee, says, "The ATA research grant program represents a unique and invaluable mechanism to foster the development of a new generation of basic, translational, and clinical researchers. Through this program, we allow these outstanding young scientists to test innovative hypotheses and generate preliminary data that will give them a significant competitive advantage when applying for traditional NIH-type funding.
This year we received 63 applications from 18 countries, spanning the whole spectrum of thyroid-related research. While, through a rigorous process, we have selected the most promising projects for funding, at the same time we regret we had to leave behind a number of excellent proposals. We are extremely thankful for the support we receive from members and organizations, including thyroid cancer survivors, which makes this outstanding program possible and allows the ATA to nurture the next generation of leaders in thyroidology."
The American Thyroid Association (ATA) has awarded 99 thyroid research grants totaling over $2.8 million since the inception of the Research Fund. In addition, the ATA rigorously manages the selection of research projects and the distribution of over $1.8 million generously donated to the ATA specifically for research grants from: ThyCa, the Thyroid Cancer Survivors' Association, Inc.; Bite Me Cancer; and the Thyroid Head and Neck Cancer Foundation.
The Thyroid Cancer Survivors' Association, Inc. (ThyCa), has provided funding since 2003 in support of 72.5 special research grants totaling $2,084,375 focused on thyroid cancer and medullary thyroid cancer. In 2018 ThyCa is supporting half of a new medullary thyroid cancer grant with Bite Me Cancer, two new thyroid cancer research grants, and four renewing grants. ThyCa is a member of the ATA Alliance for Patient Education. Find out more at www.thyca.org.
Bite Me Cancer (BMC) is our newest grant funder, supporting 8.5 thyroid cancer grants since 2014 for a total of $201,250. BMC will be supporting a half of a new medullary thyroid cancer grant in 2018 with ThyCa and one renewing thyroid cancer grant. BMC is a member of the ATA Alliance for Patient Education. Find out more at www.bitemecancer.org.
###
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 Research Grant to Study the Action of T-Regulatory Cells in Thyroid-Antibody-Positive Pregnant Women Awarded to Stephanie Behringer-Massera, MD, by the American Thyroid Association appeared first on American Thyroid Association.
https://ift.tt/2PcYIQW
FPIES in Adults
Non-IgE-mediated food allergic disorders are poorly characterized in adults. Some adult patients report gastrointestinal (GI) symptoms that recur consistently after ingestion of specific foods, in the absence of cutaneous, respiratory or cardiovascular manifestations. These patients have no evidence of food-specific IgE, either by in vivo or in vitro testing. It has been speculated that these patients have an adult variant of food protein-induced enterocolitis syndrome (FPIES), which is a non-IgE-mediated food hypersensitivity, generally diagnosed in infants1.
https://ift.tt/2L0IxCW
Use of the masseteric nerve to treat segmental midface paresis
Segmental midface paresis with or without synkinesis reflects incomplete recovery from Bell's palsy, operations on the cranial base or parotid, or trauma, in 25%–30% of cases. To correct the deficit, the masseteric nerve was used to deliver a powerful stimulus to the zygomatic muscle complex, with the addition of a cross-face sural nerve graft to ensure more spontaneous smiling. By doing this, the orbicularis oculi muscle continues to have an appropriate stimulus from the facial nerve, and the zygomatic muscle complex is separately innervated, which considerably reduces synkinesis between the two muscle compartments.
https://ift.tt/2MV8TrQ
Sinonasal pleomorphic adenoma: A single institution case series combined with a comprehensive review of literatures
This study aimed to reveal diagnosis, management, and treatment outcome characteristics of sinonasal pleomorphic adenoma and to identify predictors for disease recurrence.
https://ift.tt/2OHKVky
Clinical efficacy of anti-IL-5 monoclonal antibody mepolizumab in the treatment of eosinophilic otitis media
Eosinophilic otitis media (EOM) is an intractable otitis media characterized by a highly viscous effusion containing eosinophils, and it is mostly associated with bronchial asthma. Recently, anti-IL-5 therapy using mepolizumab has been reported to be effective for patients with severe and refractory eosinophilic bronchial asthma. EOM shows accumulation of eiosinophils in the middle ear effusion and most EOM patients have high numbers of peripheral blood eosinophils. Therefore, we carried out a retrospective study to determine whether anti-IL-5 therapy is also effective in the treatment of EOM.
https://ift.tt/2PgV1d1
Developments in anti-complement therapy; from disease to clinical trial
Publication date: Available online 16 August 2018
Source: Molecular Immunology
Author(s): Claire L. Harris, Richard B. Pouw, David Kavanagh, Ruyue Sun, Daniel Ricklin
Abstract
The complement system is well known for its role in innate immunity and in maintenance of tissue homeostasis, providing a first line of defence against infection and playing a key role in flagging apoptotic cells and debris for disposal. Unfortunately complement also contributes to pathogenesis of a number of diseases; in some cases driving pathology, and in others amplifying or exacerbating the inflammatory and damaging impact of non-complement disease triggers. The role of complement in pathogenesis of an expanding number of diseases has driven industry and academia alike to develop an impressive arsenal of anti-complement drugs which target different proteins and functions of the complement cascade. Evidence from genetic and biochemical analyses, combined with improved identification of complement biomarkers and supportive data from sophisticated animal models of disease, has driven a drug development landscape in which the indications selected for clinical trial cluster in three 'target' tissues: the kidney, eye and vasculature. While the disease triggers may differ, complement activation and amplification is a common feature in many diseases which affect these three tissues. An abundance of drugs are in clinical development, some show favourable progression whereas others experience significant challenges. However, these hurdles in themselves drive an ever-evolving portfolio of 'next-generation' drugs with improved pharmacokinetic and pharmacodynamics properties. In this review we discuss the indications which are in the drug development 'spotlight' and review the relevant indication validation criteria. We present current progress in clinical trials, highlighting successes and difficulties, and look forward to approval of a wide selection of drugs for use in man which give clinicians choice in mechanistic target, modality and route of delivery.
https://ift.tt/2PfZHQv
Slow, slurred speech as an initial complaint in amyotrophic lateral sclerosis
Publication date: Available online 16 August 2018
Source: Auris Nasus Larynx
Author(s): Koichi Tsunoda, Mihiro Takazawa, Tonghyo Chong, Yoko Morita
Abstracts
Objective
Otorhinolaryngologic examinations at an early stage, particularly those conducted by vocal specialists, can make potentially important contributions to the diagnosis of bulbar-onset ALS patients.
Methods
We analyzed 2623 patients (2010–2017) visited the ENT Voice Clinic, National Hospital Organization Tokyo Medical Center, with the primary complaint of speech or vocal dysfunction at the initial visit. Among those, 12 patients visited the voice clinic after consultations with other physicians but before receiving a diagnosis and we initially suspected bulbar-onset ALS due to slow, slurred speech (SSS). We analyzed the detail of those suspected ALS cases.
Results
Every patient suspected ALS patients consulted an average of 2.2 physicians before visiting the voice clinic and a total of 3.2 physicians before receiving the final diagnosis. The mean speech symptom duration before visiting the vocal clinic was 7.83 months in ALS, 24 months in MSA patients. The duration until final diagnosis after we referred them to neurologists was 2.16 months and 15.3 months, respectively.
Conclusion
Otolaryngologists and primary care physicians to consider the possibility of ALS when patients present even with an only symptom of SSS. They should then refer such patients to neurologists for definitive diagnoses, leading to early detection and treatment of ALS.
https://ift.tt/2MlVI6Y
Patient-specific Printed Plates Improve Surgical Accuracy in Vitro
Publication date: Available online 16 August 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Kasper Stokbro, R Bryan Bell, Torben Thygesen
Abstract
Purpose
It remains unclear to what extent patient-specific printed (PSP) plates can improve surgical outcomes in orthognathic procedures. This study aims to quantify the surgical accuracy of PSP plates in vitro and to compare the result with patients' actual surgical outcomes.
Methods
This in vitro study enrolled 20 postoperative orthognathic surgical patients, all treated with inferior maxillary repositioning. The preoperative midfaces were recreated in a 3D-printed model. The osteotomy and screw holes were placed at prespecified positions using a 3D guide. The dental segment was repositioned by means of the patient-specific plates. The primary outcome was the mean reposition at 3 dental reference points. The primary predictor variable was the obtained surgical reposition in vitro compared with the virtual surgical plan. Confounding variables were sex, age, occlusion and bimaxillary surgery. The secondary outcome was the surgical accuracy, and the secondary predictor was the in vitro outcomes versus the patients' surgical outcomes. The surgical accuracy was defined as the difference between the obtained reposition and the virtual surgical plan on a continuous scale. The differences were recorded in 3 dimensions according to the positive value of the 3 axes: right, anterior and posterior. Results were analyzed using mixed model regression and 1-sample t-tests.
Results
In the 20 patients (age: 18–64, 40% female), the mean planned reposition was 2.9 mm anterior and 1.8 mm inferior. In all models, the osteotomy edge was rounded off to position the plate in the predetermined position. Overall, the maxilla was positioned 0.5 mm anterior and 0.3 mm inferior to the planned position using patient-specific plates.
Conclusion
The patient-specific plates positioned the maxilla in close approximation to the planned position without surgically relevant differences. The osteotomy edge must be carefully inspected for interferences with the patient-specific plates to avoid displacement of the planned maxillary repositioning.
https://ift.tt/2OKIygX
Artificial Saliva vs Saline Solution and Suture Degradation in Oropharyngeal Surgery
This in vitro study examines artificial saliva vs saline solution and their association with the strength of common types of absorbable sutures used in oral surgery.
https://ift.tt/2MuaMis
https://ift.tt/2MuaMis
Catastrophizing and Dizziness-Related Disability Assessed With the Dizziness Catastrophizing Scale
This medical record review validates a measure of dizziness catastrophizing and assesses its association with dizziness-related disability compared with other negative affect constructs (eg, anxiety and depression) in adults with a balance disorder.
https://ift.tt/2OI5dKr
https://ift.tt/2OI5dKr
Physician Adherence to Guidelines for Benign Paroxysmal Positional Vertigo in Ambulatory Care Settings
This cohort study uses data from the National Ambulatory Medical Care Survey to evaluate the prevalence of patient visits to ambulatory care clinics for benign paroxysmal positional vertigo and whether physicians' diagnostic and treatment recommendations adhered to clinical practice guidelines over time.
https://ift.tt/2MuqKZD
https://ift.tt/2MuqKZD
Prevalence and Risk Factors for Olfactory Hallucinations in the United States
Olfactory dysfunction can result in substantial reductions in quality of life if left untreated. The presence of phantom smells, or phantosmia, is a clinically distinct olfactory dysfunction where patients sense odors when no odor source is present. The cause of phantosmia is not completely understood and has been most commonly associated with head trauma, psychiatric conditions, chronic rhinosinusitis, epilepsy, and a number of neurologic and neurodegenerative disorders.
https://ift.tt/2BiN18s
https://ift.tt/2BiN18s
Factors Associated With Phantom Odor Perception Among US Adults
This cross-sectional study of data from the National Health and Nutrition Examination Survey examines the prevalence of phantom odor perception among US adults and evaluates differences by age, sex, socioeconomic position, health status, health behaviors, smell function, and oral and sinonasal symptoms.
https://ift.tt/2MAub0W
https://ift.tt/2MAub0W
Tumoren der Nasennebenhöhlen mit Übergreifen auf die Orbita
Zusammenfassung
Die Invasion der Orbita durch ein Malignom der Nasennebenhöhlen (NNH) bedeutet, dass eine Erkrankung bereits in einem fortgeschrittenen Tumorstadium vorliegt. Die Prognose hat sich trotz aller Bemühungen mittels multimodaler Ansätze in den letzten Jahrzehnten nur wenig verbessert. Die komplette Resektion des Malignoms verspricht weiterhin die beste Prognose. Die Exenteratio der Orbita stellt hierbei einen großen Einschnitt in die Psyche und Lebensqualität der Betroffenen dar. Bei letztsehendem Auge sollte zugunsten der Lebensqualität auf eine Exenteratio verzichtet werden, was jedoch letztendlich dem aufgeklärten Patienten obliegt. Durch chirurgisch rekonstruktive Ansätze und epithetische Verfahren kann die Ästhetik nach Exenteratio wiederhergestellt werden. Die Wahl der Epithesenfixierung sollten mit dem Patienten im Rahmen der Therapieplanung festgelegt werden, den individuellen Ansprüchen gerecht werden und dem manuellen Geschick des Patienten entsprechen. Bei der funktionellen Rehabilitation stehen die Erleichterung der lokalen Pflege und die Verhinderung der endonasalen Krustenbildung durch Wiederherstellung der nasalen Spalträume im Vordergrund. Karzinome der NNH mit Übergreifen auf die Orbita stellen eine diagnostische und therapeutische Herausforderung dar. Die Aufklärung des Patienten über Prognose, therapeutische Ansätze, posttherapeutische Lebensqualität und Möglichkeiten der Rehabilitation sollte am Anfang der Behandlung stehen und von Patient und Therapeut gemeinsam getragen werden.
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Restrictions in Communicative Participation
Communication is about connecting with people. Whether for business, or leisure, or love, communication is about understanding and being understood. Communication disorders disrupt those connections in various ways. Vocal fold paralysis weakens your voice. Aphasia scrambles the meaning of words. Hearing loss leaves you grasping at fragments of conversations. On the surface, these examples represent disparate impairments of communication. However, careful listening to the lived experiences of people with different communication disorders reveals many shared stories. For example, with a communication disorder you cannot overpower loud and distracting background noise in restaurants to communicate with waitstaff. It is rare that you can order what you actually want—and to actually receive what you ordered. Thus, you shrug, point to the person sitting next to you, and say, "I'll have what he's having." Telephones and intercoms at drive-through windows—daily conveniences for most people—pose insurmountable barriers when you have a communication disorder, so you drive on by without your latte or takeout pizza. Other people regard you with a look, or tone of voice, or comment that reveals their discriminating assumptions that because you cannot talk well, you must not be able to think well, or do anything else well. Hearing the same stories from people with different communication disorders leads to the realization that communication cannot be reduced to the mechanics of vocal fold vibration or speech articulation. Symptoms of various disorders interact with common barriers in the physical and social environments, leading to shared restrictions in communicative participation; that is, restricted involvement in and fulfillment of communication needs in daily life.
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https://ift.tt/2lHCp8M
Spontaneous Recovery Rates in Patients With Idiopathic Sudden Sensorineural Hearing Loss
This Viewpoint discusses the literature surrounding the assessment of spontaneous complete recovery rates in patients with idiopathic sudden sensorineural hearing loss to help physicians better understand when treatment is warranted.
https://ift.tt/2th2pff
https://ift.tt/2th2pff
Consensus-Based Attributes for Identifying Patients With Spasmodic Dysphonia and Other Voice Disorders
This study examines interrater agreement among clinicians who did not use standard guidelines to classify patients with adductor spasmodic dysphonia, abductor spasmodic dysphonia, voice tremor, and muscular tension dysphonia and develops expert consensus attributes for classifying patients for research.
https://ift.tt/2MK1mN2
https://ift.tt/2MK1mN2
Outcomes in Head and Neck Resections That Require Multiple-Flap Reconstructions
This systematic review characterizes the outcomes of large-scale head and neck resections that require multiple-flap reconstructions.
https://ift.tt/2IUIMyE
https://ift.tt/2IUIMyE
Association Between Portable Music Player Use and Hearing Loss Among School-Aged Children
This population-based study examines the presence of early hearing loss in school-aged children in the Netherlands and its association with use of portable music players.
https://ift.tt/2JXFX4a
https://ift.tt/2JXFX4a
Can Your Smartphone Save Your Hearing?
The article in this issue of JAMA Otolaryngology–Head and Neck Surgery by le Clercq et al shows evidence that 1 in 7 children in Rotterdam, the Netherlands, has signs of hearing loss that may be attributed to noise exposure from portable music players (PMPs). The association of the apparent increased use of PMPs with hearing loss has been widely discussed in the popular press. Broad population-based data such as these are welcome contributions to the conversation. As with all such studies, they exist during times of change. In the period covered by this evaluation, a number of regulatory, technological, and cultural changes were happening.
https://ift.tt/2LNuzoS
https://ift.tt/2LNuzoS
Association of Vertigo With Hearing Outcomes in Sudden Sensorineural Hearing Loss
This systematic review and meta-analysis investigates the association of vertigo with prognosis of hearing variables in patients with sudden sensorineural hearing loss with and without vertigo.
https://ift.tt/2yBW1V8
https://ift.tt/2yBW1V8
The Role of Migraine in Hearing and Balance Symptoms
Episodic dizziness is a highly prevalent symptom that has historically been a challenge for primary care physicians, neurologists, and otolaryngologists to accurately diagnosis and properly treat. With an array of diagnoses to consider, including benign positional vertigo, vestibular migraine, Ménière disease, vertebrobasilar syndrome, and vestibular schwannoma, among others, considerable effort has been placed by otolaryngology and neurology societies to carefully examine the literature and generate clinical criteria and guidelines to aid the clinician and to standardize diagnostic algorithms and treatment protocols. In recent decades, Ménière disease has been intensely investigated in both clinical and histopathologic studies and has been among the more frequent diagnoses given to patients with episodic dizziness. Even more recently, many studies have reported substantial overlap between the symptoms of vestibular migraine and those of Ménière disease, and, consequently, distinguishing between these 2 disease entities can be difficult. To this end, the presence of sensorineural hearing loss has notably been suggested to be the primary finding to differentiate Ménière disease from vestibular migraine, highlighting the previously held and popular notion that migraine activity will seldom have a negative influence on the auditory pathways and generate cochlear symptoms, such as hearing loss and tinnitus. As Hwang and colleagues eloquently discuss in this issue of JAMA Otolaryngology–Head & Neck Surgery, there is a growing body of evidence of both the association and causal relationship between migraine and the development of cochlear symptoms.
https://ift.tt/2KOBm5E
https://ift.tt/2KOBm5E
Speech and Communicative Participation in Patients With Facial Paralysis
This survey study assesses the association of facial paralysis with communicative participation among US adults with unilateral facial paralysis caused by Bell palsy, tumor, and other causes.
https://ift.tt/2tIVz1u
https://ift.tt/2tIVz1u
The Pathogenesis of Choanal Atresia
This case report describes a 3-month-old female infant with craniosynostosis, frontal bossing, and limb abnormalities who presented with nasal obstruction and failure to thrive.
https://ift.tt/2z0YTuX
https://ift.tt/2z0YTuX
Association of Video Head Impulse Test With Improvement of Dynamic Balance and Fall Risk
This study evaluates the vestibuloocular reflex gain and change in fall risks after administration of the video head impulse test among patients with subacute or chronic dizziness.
https://ift.tt/2lI91iG
https://ift.tt/2lI91iG
Classifying and Diagnosing Laryngeal Dystonia
Laryngology is a relatively young subspecialty in otolaryngology. Although some practitioners focused on or limited their practices to laryngology in the late 1980s and early 1990s, the subspecialty began its more formal development near the turn of the century when laryngology programs began to produce the first fellowship-trained laryngologists, initially at about the rate of 10 per year.
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https://ift.tt/2ts60pR
Transcutaneous Osseointegrated Implants for Pediatric Patients With Atresia
This case series describes the processes, advantages, and outcomes of transcutaneous osseointegrated implantation for pediatric patients with aural atresia.
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https://ift.tt/2KxrxsN
Vertigo as a Prognostic Indicator of Outcome in Sudden Sensorineural Hearing Loss
In this issue of JAMA Otolaryngology–Head & Neck Surgery, Yu et al report results of their meta-analysis of sudden sensorineural hearing loss (SSHL) literature, addressing the association of vertigo with the hearing outcome. They screened 685 articles, of which 10 met inclusion criteria, including 4814 patients with SSHL, of whom 1709 (35.5%) had vertigo and 3105 (64.5%) did not. Overall, the rate of hearing recovery was 42.13% in the vertigo group and 60.29% in the nonvertigo group, suggesting that vertigo is negatively associated with the hearing outcome in SSHL. Subgroup analysis by treatment modality (systemic corticosteroid alone vs systemic corticosteroid and/or intratympanic corticosteroid) found that the difference in hearing outcome as a function of vertigo was present only in the systemic corticosteroid treatment subgroup; no difference in rates of hearing recovery were found between vertigo and nonvertigo groups in patients treated with intratympanic corticosteroids. The authors do not report the recovery rates of each subgroup. They conclude that use of intratympanic treatment might be preferable in patients with SSHL who present with vertigo, but methodologic limitations of the study preclude drawing a strong conclusion.
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https://ift.tt/2tsjDFJ
Association of Tinnitus and Other Cochlear Disorders With a History of Migraines
This cohort study used claims data from the Taiwan Longitudinal Health Insurance Database 2005 to investigate the risk of tinnitus and other cochlear disorders inr patients with a history of migraines.
https://ift.tt/2KR1Tzs
https://ift.tt/2KR1Tzs
Trend Toward the Use of Transcutaneous Osseointegrated Hearing Devices in Pediatric Patients
Transcutaneous osseointegrated hearing implants, instead of percutaneous implants, are increasingly becoming the choice of surgeons when considering osseointegrated hearing aids in children. Transcutaneous implants use a magnet under the skin coupled with a magnet on the processor, whereas percutaneous implants have an abutment through the skin to which the processor connects. For aural atresia and maximum conductive hearing loss, surgeons and patients have multiple options for hearing rehabilitation, including canalplasty and an osseointegrated hearing aid. Pediatric otolaryngologists seem to be choosing the transcutaneous devices because they present fewer complications and less wound care, which is better tolerated by pediatric patients. Most studies into osseointegrated hearing aids have focused on adult outcomes, and data in the pediatric population are lacking, especially information related to newer transcutaneous, rather than percutaneous, devices. Previous studies have shown a complication rate of more than 50% for pediatric patients with percutaneous implants, with most of the complications related to soft-tissue infections or growth. These studies have shown high rates of parental satisfaction with percutaneous devices but low compliance rates, indicating that satisfaction scores may be misleading.
https://ift.tt/2IWSlNf
https://ift.tt/2IWSlNf
Characteristics and Treatment Response of Older Adults With Voice Disorders in the United States
This cross-sectional study uses the 2012 National Health Interview Survey to describe sociodemographic characteristics and response to treatment among aging adults with voice disorders.
https://ift.tt/2NcaFoh
https://ift.tt/2NcaFoh
Multiple-Flap Reconstruction of Head and Neck Defects
The goals of head and neck reconstruction of cancer-related defects are to restore speech, swallowing, and cosmesis and maximize patient quality of life. During the past 2 decades, our ability to achieve these goals with free, pedicled, and local tissue transfer alone or in combination has steadily improved. The reconstructive surgeon now has a robust armamentarium with an array of tissue choices, including bone, muscle, viscera, skin (thick, thin, hair bearing, and color match to facial skin). In addition, there has been an expansion of recipient vessels, which allows an increased range of options for patients in whom prior therapy has failed and who present for head and neck reconstruction. These advances have changed the way that we think about the various components of the head and neck and increased the number of creative choices to restore form and function and minimize morbidity.
https://ift.tt/2KLem6S
https://ift.tt/2KLem6S
Antibiotic Prescription Patterns for Management of Acute Otitis Media in Lebanon
Publication date: Available online 16 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Ali Nasrallah, Ali Bacharouch, Fadia Jaafar, Mariam Ayyash, R. Alexander Blackwood
Abstract
Objectives
The high incidence of Acute Otitis Media (AOM) along with low antibiotic efficacy in the treatment of AOM is particularly favorable for the emergence of antimicrobial resistance. The promotion of more conservative antibiotic prescription habits has become an important focus of governments and academic societies. Little is known about the awareness and use of AOM practice guidelines by physicians in the Middle East. Our aim is to characterize AOM management in Lebanon by using an anonymous survey instrument to uncover potential disparities in treatment trends and evaluate differences in clinical guideline adherence patterns.
Methods
A total of 75 practicing physicians were anonymously surveyed in Beirut, Saida, Nabatieh, Bekaa and Tripoli, Lebanon. The survey tool used was previously used in Amman, Jordan by our colleagues at the University of Michigan. The survey we used assessed awareness of and adherence to practice guidelines by prompting responses to hypothetical AOM cases. Differences in performance between various physician groups were noted.
Results
Overall, physician participants answered 67% of the survey questions correctly. Trainees did better overall in terms of AOM management (62% correct responses as compared to 48% in attending physicians, p=0.0175). Trainees also performed better in terms of their ability to manage cases of potential AOM in two-year old children and their ability to choose the appropriate medications (79% correct response rate compared to 71% in attending physicians, p=0.0278). Participants who reported guideline adherence most or all of the time had a 67% correct response rate in regards to their ability to diagnosis AOM, compared to a 57% correct response rate in those who reported adhering sometimes or rarely to the guidelines (p=0.0489). In the cases requiring antibiotic treatment for body temp of over 39C with/without otalgia, only 47-57% of participants identified the appropriate antibiotic regimen.
Conclusion
There are areas of potential improvement in adherence to clinical guidelines in the management, diagnosis, and treatment of AOM by Lebanese physicians. Conducting interventions among physicians to improve awareness of clinical guidelines and current treatment recommendations in Lebanon will likely improve adherence to guidelines, enhance clinical outcomes, and may help advance the fight against antimicrobial resistance.
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3-Dimensional Printed Haptic Simulation Model To Teach Incomplete Cleft Palate Surgery In An International Setting
Publication date: Available online 16 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Valerie Cote, Marissa Schwartz, Jose F. Arbouin Vargas, Michael Canfarotta, Katherine Kavanagh, Usama Hamdan, Tulio Valdez
Abstract
Introduction
Cleft palate is one of the most common congenital anomalies, yet surgical repair remains challenging and can lead to significant complications in the hands of inexperienced surgeons. There is a great need for the development of a simulation model that will allow surgeons worldwide to learn and practice the intricate skills needed for cleft palate surgery.
Objectives
1. To develop a low-cost incomplete cleft palate simulation model using additive manufacturing technology (3D printing). 2. To evaluate its validity and utility to teach palatoplasty in a global health care setting.
Methods
Three-dimensional models of a soft palate cleft and an incomplete hard and soft palate cleft were developed using 3D printing and silicone casting. The cost and time of assembly of the 3D printed models were calculated. The models were then assessed for validity by cleft surgeons and trainees during a cleft mission in Ecuador. 3D models were assessed for resemblance to anatomy and tissue characteristics, the ability to incise the soft tissue, dissect and reposition the palatal flaps, and the ease of suture placement. Models were rated using the Likeness to Human Tissue Scale.
Results
Cleft palate simulators were successfully developed using 3D printing and silicone casting. Participants reported that models provided a realistic representation of human anatomy and were adequate for novice surgeons to practice the procedure. The models were portable, low cost, and easily assembled.
Conclusion
The use of 3D printed haptic simulation models for teaching and learning cleft palate repair techniques could enhance skill acquisition and possibly improve surgical outcomes. In outreach settings, it could help achieve local, sustainable comprehensive care for cleft palate patients.
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Facial vein thrombophlebitis: A Case Report and literature review
Publication date: Available online 16 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Miki Paker, Jacob T. Cohen, Nedal Moed, Lev Shleizerman, Muhamed Masalha, Dror Ashkenazi, Salim Mazzawi
https://ift.tt/2BfsZf0
Cloning, expression analysis and functional characterization of an interleukin-1 receptor-associated kinase 4 from Apostichopus japonicus
Publication date: September 2018
Source: Molecular Immunology, Volume 101
Author(s): Yi Cui, Liting Jiang, Ronglian Xing, Zhengdong Wang, Zhenhui Wang, Yina Shao, Weiwei Zhang, Xuelin Zhao, Chenghua Li
Abstract
Interleukin 1 receptor-associated kinase 4 (IRAK4) is a key factor in TLR-mediated host immune function. In this study, an IRAK4 homologue molecule was identified from Apostichopus japonicus (designated as AjIRAK4) by RACE approach. The full-length cDNA of AjIRAK4 was of 2024 bp containing an open reading frame of 1311 bp encoding a 436-amino-acid (aa) residue polyprotein with the typical death domain (10-113aa) and the kinase domain (160-426aa). The mRNA transcripts of AjIRAK4 displayed constitutively expressed in all examined tissues with highest expression in the muscles (7.20-fold increase compared to the coelomocytes). The pathogen Vibrio splendidus challenge and LPS exposure could both significantly up-regulate the mRNA expression of AjIRAK4. Silencing AjIRAK4 in vitro and in vivo could inhibit the expression of TLR members at mRNA and protein levels, suggesting AjIRAK4 was an important component of TLR cascade in sea cucumber. More importantly, knockdown of AjIRAK4 by specific siRNA resulted in the significant promotion of coelomocyte apoptosis by 1.82-fold increase in vitro and 1.95-fold in vivo. Taken together, all our results suggested that AjIRAK4 might be served as coelomocyte apoptosis regulator via TLR cascade.
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