The sensitiveness and stigma associated with sexual assault deter many victims from speaking about their experiences. This silence of victims worsens the problem, especially in patriarchal communities like Eth...
https://ift.tt/2BTZlMC
Σάββατο 25 Αυγούστου 2018
Testimony of an Ethiopian girl sexually assaulted by her stepfather: a case report
Centennial Recognized at Annual Meeting
Publication date: Available online 24 August 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s):
https://ift.tt/2PD4j3e
Treatment of Genital Psoriasis: A Systematic Review
Abstract
Genital psoriasis affects approximately 63% of psoriasis patients at least once in their lifetime. More than any other area on the body, genital lesions significantly impair patients' psychologic well-being and quality of life. We aimed to systematically review the published evidence on the safety, efficacy, and tolerability of treatments of genital psoriasis and synthesize the available clinical data. A total of 1 randomized controlled trial, 11 open-label studies, and 26 case reports were included in our analysis, representing a total of 458 patients, of which 332 were adults and 126 were children. Topical corticosteroids were commonly used first-line for genital psoriasis and were well tolerated. Nonsteroidal agents, such as topical calcineurin inhibitors or vitamin D analogs, were also efficacious, but were often irritating. One systemic agent, ixekizumab, demonstrated efficacy in reducing genital psoriasis symptoms in a large, randomized, placebo-controlled trial. Various systemic and topical medications may improve genital psoriasis lesions, but there is a lack of high-quality evidence to guide clinical decision-making. Specific reporting of efficacy for genital psoriasis in larger controlled studies of psoriasis treatments are necessary to improve the available evidence regarding the optimal treatment regimen for genital psoriasis.
https://ift.tt/2oanBAu
New Animal Model of Extrinsic Dental Erosion—Erosive Effect on the Mouse Molar Teeth
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Amela Tulek, Muhammad Saeed, Aida Mulic, Kjersti Refsholt Stenhagen, Tor Paaske Utheim, Hilde Kanli Galtung, Cuong Khuu, Minou Nirvani, Marthe Smedmoen Kristiansen, Amer Sehic
Abstract
Objective
Consumption of acidic food and drinks is considered as important risk factor for development of dental erosion. There are severalin vitro and in situ studies focusing on the risk indicators and preventive treatment, however, the need for a standardized animal model has been emphasised for many years. The aim was to establish an animal model of extrinsic dental erosion, which may serve as a standard for future studies to improve our understanding of the erosion.
Design
Two acidic drinks, sports drink and cola drink, were given to young mice for six weeks. Experimental and control (water) molars and incisors were dissected out and observed by scanning electron microscopy (SEM). Mandibular first molars were subsequently ground transversely and observed again by SEM. The tooth height and enamel thickness were measured on the SEM images.
Results
The lingual surface of the mandibular molars was most eroded after consumption of acidic drinks. The cola drink exhibited higher erosive effect on mandibular molars compared to sports drink. The lingual tooth height, compared to control, was about 34% and 18% lower in the cola drink and sports drink molars, respectively. Compared to the control molars, the lingual enamel was about 23% thinner in the sports drink molars and totally eroded on the certain lingual areas of the cola drink molars.
Conclusions
This new animal model of extrinsic dental erosion and the presented method with ground molars observed in SEM are suitable for further studies, which will gain deeper insights into the erosive disease.
https://ift.tt/2o9LfgJ
Platycarya strobilacea leaf extract inhibits tumor necrosis factor-α production and bone loss induced by Porphyromonas gingivalis-derived lipopolysaccharide
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Joo-Hee Lee, Hyungkeun Kim, Jae Hoon Shim, Junhee Park, Sun Kyoung Lee, Kwang-Kyun Park, Won-Yoon Chung
Abstract
Objective
Remodeling of alveolar bone is controlled by osteoclast-mediated bone resorption and osteoblast-induced bone formation. LPS of Porphyromonas gingivalis, a major causative agent of periodontitis, produces proinflammatory cytokines in host immune cells, which thereby triggers osteoclastogenesis and leads to alveolar bone resorption. We investigated the anti-periodontitis potential of Platycarya strobilacea leaf extract (PLE), which is used as a traditional medicine in Asian countries.
Design
TNF-α levels in cell culture media were measured using a commercially available enzyme-linked immunosorbent assay kit. Osteoclast differentiation was observed by tartrate-resistant acid phosphatase staining, and the expression levels of osteoclastogenic genes were measured by quantitative real-time PCR. Bone-resorbing activity was confirmed by the resorption pit formation, gelatin zymographic, and the cathepsin K activity assays. Osteogenic differentiation was confirmed with an ALP activity assay and alizarin red S staining.
Results
PLE treatment inhibited the production of TNF-α inP. gingivalis LPS-stimulated RAW264.7 macrophages. In bone marrow-derived macrophages serving as osteoclast precursors, PLE treatment blocked RANKL-induced osteoclastogenesis and gene expression levels of the osteoclastogenic transcription factor NFATc1, DC-STAMP for osteoclast fusion, and cathepsin K for osteoclast activity. In addition, PLE treatment reduced the formation of resorption pits and the secretion of MMP 9 and cathepsin K from the differentiated osteoclasts. Furthermore, PLE treatment induced osteogenesis by increasing ALP activity and calcium content in preosteoblastic cells.
Conclusion
PLE inhibitsP. gingivalis LPS-induced TNF-α production and bone resorption and induces bone formation. PLE may be a beneficial agent to promote oral health by inhibiting periodontitis-induced alveolar bone loss.
https://ift.tt/2BLPrg7
Non-syndromic tooth agenesis patterns and their association with other dental anomalies: A retrospective study
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Bianca Núbia Souza-Silva, Walbert de Andrade Vieira, Ítalo de Macedo Bernardino, Marília Jesus Batista, Marcos Alan Vieira Bittencourt, Luiz Renato Paranhos
Abstract
Objective
This study aimed to investigate the prevalence and the factors associated with non-syndromic tooth agenesis, besides identifying its pattern of occurrence.
Study Design
Pre-orthodontic exams of 3400 subjects, aged 8 to 30 years, were selected from a radiographic center in Brazil. Panoramic and periapical radiographs were analyzed to verify the presence of tooth agenesis and other six dental anomalies. Descriptive statistics were calculated using the Tooth Agenesis Code tool and, to evaluate significant associations, a negative binomial regression model was constructed. Besides, unadjusted and adjusted prevalence ratios (PR) were calculated for the bivariate and the multivariate analysis.
Results
Prevalence of tooth agenesis was 3.0% (n = 68) and 41 different phenotypic patterns were observed. Teeth most often symmetrically missing were maxillary lateral incisors (13.2%) and mandibular second premolars (8.8%). Females (PR = 3.49, CI 95% = 1.96-6.19) presented more tooth agenesis. Other dental anomalies, such as palatal displacement of maxillary canine and infraocclusion of primary molar were significantly more frequent (p < 0.001) in subjects with agenesis.
Conclusion
There was a strong relationship between tooth agenesis and gender and the association with other dental anomalies was significant, with the exception of the supernumerary teeth, which seems to be independent.
https://ift.tt/2o9L4SB
New Animal Model of Extrinsic Dental Erosion—Erosive Effect on the Mouse Molar Teeth
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Amela Tulek, Muhammad Saeed, Aida Mulic, Kjersti Refsholt Stenhagen, Tor Paaske Utheim, Hilde Kanli Galtung, Cuong Khuu, Minou Nirvani, Marthe Smedmoen Kristiansen, Amer Sehic
Abstract
Objective
Consumption of acidic food and drinks is considered as important risk factor for development of dental erosion. There are severalin vitro and in situ studies focusing on the risk indicators and preventive treatment, however, the need for a standardized animal model has been emphasised for many years. The aim was to establish an animal model of extrinsic dental erosion, which may serve as a standard for future studies to improve our understanding of the erosion.
Design
Two acidic drinks, sports drink and cola drink, were given to young mice for six weeks. Experimental and control (water) molars and incisors were dissected out and observed by scanning electron microscopy (SEM). Mandibular first molars were subsequently ground transversely and observed again by SEM. The tooth height and enamel thickness were measured on the SEM images.
Results
The lingual surface of the mandibular molars was most eroded after consumption of acidic drinks. The cola drink exhibited higher erosive effect on mandibular molars compared to sports drink. The lingual tooth height, compared to control, was about 34% and 18% lower in the cola drink and sports drink molars, respectively. Compared to the control molars, the lingual enamel was about 23% thinner in the sports drink molars and totally eroded on the certain lingual areas of the cola drink molars.
Conclusions
This new animal model of extrinsic dental erosion and the presented method with ground molars observed in SEM are suitable for further studies, which will gain deeper insights into the erosive disease.
https://ift.tt/2o9LfgJ
Platycarya strobilacea leaf extract inhibits tumor necrosis factor-α production and bone loss induced by Porphyromonas gingivalis-derived lipopolysaccharide
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Joo-Hee Lee, Hyungkeun Kim, Jae Hoon Shim, Junhee Park, Sun Kyoung Lee, Kwang-Kyun Park, Won-Yoon Chung
Abstract
Objective
Remodeling of alveolar bone is controlled by osteoclast-mediated bone resorption and osteoblast-induced bone formation. LPS of Porphyromonas gingivalis, a major causative agent of periodontitis, produces proinflammatory cytokines in host immune cells, which thereby triggers osteoclastogenesis and leads to alveolar bone resorption. We investigated the anti-periodontitis potential of Platycarya strobilacea leaf extract (PLE), which is used as a traditional medicine in Asian countries.
Design
TNF-α levels in cell culture media were measured using a commercially available enzyme-linked immunosorbent assay kit. Osteoclast differentiation was observed by tartrate-resistant acid phosphatase staining, and the expression levels of osteoclastogenic genes were measured by quantitative real-time PCR. Bone-resorbing activity was confirmed by the resorption pit formation, gelatin zymographic, and the cathepsin K activity assays. Osteogenic differentiation was confirmed with an ALP activity assay and alizarin red S staining.
Results
PLE treatment inhibited the production of TNF-α inP. gingivalis LPS-stimulated RAW264.7 macrophages. In bone marrow-derived macrophages serving as osteoclast precursors, PLE treatment blocked RANKL-induced osteoclastogenesis and gene expression levels of the osteoclastogenic transcription factor NFATc1, DC-STAMP for osteoclast fusion, and cathepsin K for osteoclast activity. In addition, PLE treatment reduced the formation of resorption pits and the secretion of MMP 9 and cathepsin K from the differentiated osteoclasts. Furthermore, PLE treatment induced osteogenesis by increasing ALP activity and calcium content in preosteoblastic cells.
Conclusion
PLE inhibitsP. gingivalis LPS-induced TNF-α production and bone resorption and induces bone formation. PLE may be a beneficial agent to promote oral health by inhibiting periodontitis-induced alveolar bone loss.
https://ift.tt/2BLPrg7
Non-syndromic tooth agenesis patterns and their association with other dental anomalies: A retrospective study
Publication date: Available online 24 August 2018
Source: Archives of Oral Biology
Author(s): Bianca Núbia Souza-Silva, Walbert de Andrade Vieira, Ítalo de Macedo Bernardino, Marília Jesus Batista, Marcos Alan Vieira Bittencourt, Luiz Renato Paranhos
Abstract
Objective
This study aimed to investigate the prevalence and the factors associated with non-syndromic tooth agenesis, besides identifying its pattern of occurrence.
Study Design
Pre-orthodontic exams of 3400 subjects, aged 8 to 30 years, were selected from a radiographic center in Brazil. Panoramic and periapical radiographs were analyzed to verify the presence of tooth agenesis and other six dental anomalies. Descriptive statistics were calculated using the Tooth Agenesis Code tool and, to evaluate significant associations, a negative binomial regression model was constructed. Besides, unadjusted and adjusted prevalence ratios (PR) were calculated for the bivariate and the multivariate analysis.
Results
Prevalence of tooth agenesis was 3.0% (n = 68) and 41 different phenotypic patterns were observed. Teeth most often symmetrically missing were maxillary lateral incisors (13.2%) and mandibular second premolars (8.8%). Females (PR = 3.49, CI 95% = 1.96-6.19) presented more tooth agenesis. Other dental anomalies, such as palatal displacement of maxillary canine and infraocclusion of primary molar were significantly more frequent (p < 0.001) in subjects with agenesis.
Conclusion
There was a strong relationship between tooth agenesis and gender and the association with other dental anomalies was significant, with the exception of the supernumerary teeth, which seems to be independent.
https://ift.tt/2o9L4SB
UK Immunotherapy Study: Reanalysis by a combined symptom and medication score
Publication date: Available online 24 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Anthony J. Frew, Christian Ljørring, Hendrik Wolf, Eike Wüstenberg, Stephen R. Durham, Christopher J. Corrigan, Richard J. Powell, Oliver Pfaar
https://ift.tt/2woA8nQ
Topical platelet rich plasma versus hyaluronic acid during fat graft myringoplasty
Publication date: Available online 24 August 2018
Source: American Journal of Otolaryngology
Author(s): Yasser Ahmed Fouad, Mohammad Abdelhady, Mohammad El-anwar, Ezzat Merwad
Abstract
Objectives
To evaluate the effect of adding platelet rich plasma (PRP) or Hyaluronic acid (HA) to fat graft myringoplasty (FGM) for medium sized central tympanic membrane (TM) perforations.
Methods
This is a retrospective study conducted on 69 patients with medium sized central TM perforations. In 21 patients, PRP was used with the FGM; and in 23 patients, HA was used with the FGM; while in 25 patients, pure FGM was performed without adding an enhancing material.
Results
Successful TM perforation repair was achieved in 18 ears (85.7) with using PRP with FGM and in 20 ears (87%) with using HA with FGM and in 15 ears (60%) with pure FGM.
Conclusion
FGM with adding PRP or HA is more successful in closure of TM perforation than pure FGM in case of medium sized central TM perforation.
https://ift.tt/2BIk5qG
A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins
Abstract
Day surgery is being more and more adopted by clinicians. Higher wavelength lasers give patients better experience than lower wavelength lasers, which makes it more suitable for day surgery. This study compares the short- and mid-term efficacy, postoperative morbidity, and patient satisfaction of "1470-nm endovenous laser ablation (EVLA) combining foam sclerotherapy in day surgery" with "810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery" on great saphenous vein (GSV) insufficiency postoperatively. A single-institution historical cohort study of 194 patients was performed in Shanghai Ninth People's Hospital, China. Ninety-seven patients received 1470-nm EVLA combining foam sclerotherapy in day surgery ("1470-nm group"), and 97 patients received 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery recommended by guidelines ("810-nm group"). No significant difference was found between the 1470-nm group and the 810-nm group in terms of GSV occlusion rate (both 100%), complication rate, and recurrence rate (8.2 vs. 11.3%) during the period of 1–12 months after surgery. Serious complications in the 1470-nm group and 810-nm group were 0 and 1.0%. Minor complications in the 1470-nm group and 810-nm group were ecchymosis at 20.6 and 18.6%, edema at 69.1 and 63.9%, and paresthesia around ankle at 0 and 3.1%, respectively. Advantage of the 1470-nm group over the 810-nm group was statistically significant considering the patient perioperative comfort and economic cost. Treatment of 1470-nm EVLA combining foam sclerotherapy in day surgery has similar efficacy as the 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery in GSV insufficiency and is more comfortable with less incision, hospitalization procedure, and medical costs. It may be a new option for patients who are afraid or unable to be hospitalized.
https://ift.tt/2MUR3sa
Time-dependent antimicrobial effect of photodynamic therapy with TONS 504 on Pseudomonas aeruginosa
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is a major cause of infectious keratitis, which itself is a major cause of blindness worldwide. We have now evaluated the time-dependent effectiveness of photodynamic antimicrobial chemotherapy (PACT) with the chlorin derivative TONS 504 and a light-emitting diode (LED) on P. aeruginosa in vitro. PACT with TONS 504 (10 mg/L) and irradiation (30 J/m2) by an LED device that delivers light centered on a wavelength of 660 nm was applied to 1 × 106 colony-forming units of P. aeruginosa in liquid medium. The bacteria were then cultured at 37 °C for various times before assay of viability by determination of colony formation on agar plates. The effect of a second irradiation at 3 h after the initial LED exposure was also examined. Bacterial growth was markedly inhibited between 3 and 9 h after PACT with TONS 504, with the maximal effect being apparent at 3 h. Furthermore, a second exposure to LED irradiation at 3 h after the first treatment enhanced the inhibitory effect on bacterial growth. PACT with TONS 504 thus inhibited the growth of P. aeruginosa in a time-dependent manner, and an additional irradiation exposure applied 3 h after the first LED treatment greatly increased the effectiveness of PACT. This antibacterial system thus warrants further evaluation with regard to its potential effectiveness for the treatment of infectious keratitis.
https://ift.tt/2LnPkH3
Photobiomodulation effects on mRNA levels from genomic and chromosome stabilization genes in injured muscle
Abstract
Muscle injuries are the most prevalent type of injury in sports. A great number of athletes have relapsed in muscle injuries not being treated properly. Photobiomodulation therapy is an inexpensive and safe technique with many benefits in muscle injury treatment. However, little has been explored about the infrared laser effects on DNA and telomeres in muscle injuries. Thus, the aim of this study was to evaluate photobiomodulation effects on mRNA relative levels from genes related to telomere and genomic stabilization in injured muscle. Wistar male rats were randomly divided into six groups: control, laser 25 mW, laser 75 mW, injury, injury laser 25 mW, and injury laser 75 mW. Photobiomodulation was performed with 904 nm, 3 J/cm2 at 25 or 75 mW. Cryoinjury was induced by two applications of a metal probe cooled in liquid nitrogen directly on the tibialis anterior muscle. After euthanasia, skeletal muscle samples were withdrawn and total RNA extracted for evaluation of mRNA levels from genomic (ATM and p53) and chromosome stabilization (TRF1 and TRF2) genes by real-time quantitative polymerization chain reaction. Data show that photobiomodulation reduces the mRNA levels from ATM and p53, as well reduces mRNA levels from TRF1 and TRF2 at 25 and 75 mW in injured skeletal muscle. In conclusion, photobiomodulation alters mRNA relative levels from genes related to genomic and telomere stabilization in injured skeletal muscle.
https://ift.tt/2w6X2Rh
Fractional CO 2 laser contributes to the treatment of non-segmental vitiligo as an adjunct therapy: a systemic review and meta-analysis
Abstract
The treatment of stable non-segmental vitiligo is often challenging, which new therapies are being searched. Multiple clinical trials have proposed the benefits and safety of using fractional carbon dioxide (CO2) laser as an adjunct therapy to conventional treatments. This study aimed to evaluate the safety and efficacy of fractional carbon dioxide laser as a combination therapy to conventional treatments in patients with stable non-segmental vitiligo. A literature search using PubMed, EMBASE, and the Cochrane Library was performed for comparative studies among vitiligo patients treated with additional fractional CO2 laser. Clinical outcomes in the selected studies were compared, and a meta-analysis was performed via Review Manager version 5.3, according to the PRISMA guidelines. Six studies with a total of 184 patches/patients were included in the present meta-analysis. The combination therapy group had significantly superior results than that of the control group (≥ 75% re-pigmentation, risk ratio [RR] 2.80, 95% confidence interval [CI] 1.29–6.07; ≥ 50% re-pigmentation, RR 2.26, 95% CI 1.23–5.9; < 25% re-pigmentation, RR 0.57, 95% CI 0.43–0.75). Limitations of the study included the small number of studies and sample size, inadequate blinding of participants, and variation between therapy protocols. Meta-analysis revealed that using fractional CO2 laser in combination with conventional treatments is efficient and safe, and may be considered as an adjunct therapeutic option for patients with refractive non-segmental vitiligo.
https://ift.tt/2P2FkW0
Effects of different treatments on chemical and morphological features of eroded dentin
Abstract
To evaluate the treatment of eroded dentin (Sensodyne Repair & Protect™, Er:YAG laser and combinations). The occlusal surfaces of 25 third molars were sectioned 1.5 mm in thickness. After an erosion cycle (5 min in demineralizing solution + 3 h in remineralizing solution; six cycles a day for 8 days), the samples were divided into five groups (n = 5): (E) erosion − control; (ES) erosion + Sensodyne Repair & Protect (NovaMin); (EL) erosion + Er:YAG laser (40 mJ, 10 Hz, 0.4 W, 50 μs, 3.1 J/cm2, 63 W/cm2); (ELS) erosion + Er:YAG laser + Sensodyne; and (ESL) erosion + Sensodyne + Er:YAG laser. Following storage in ultrapure water (37 °C/14 days), the Ca/P ratio was evaluated by EDXRF and the morphology surfaces examined in SEM. The percentage of exposed dentin tubules was calculated. One-way analysis of variance and Tukey's test at 5% were used to treat the data. The Ca/P ratio was higher in E and ES groups. More exposed dentin tubules were found in E group and less exposed tubules were found in the ES group (p < 0.0001). When the toothpaste and laser were combined, the number of occluded dentin tubules was higher when laser was performed first (ELS). A positive effect was found when the laser and toothpaste were combined.
https://ift.tt/2w6Wj2v
Photodynamic inactivation in the expression of the Candida albicans genes ALS3, HWP1, BCR1, TEC1, CPH1, and EFG1 in biofilms
Abstract
The objective of this study was to evaluate the effects of photodynamic inactivation (PDI) on Candida albicans biofilms, evaluating its effects on gene expression of ALS3, HWP1, BCR1, TEC1, CPH1, and EFG1 by yeast. Three samples of C. albicans were used in this study: a clinical sample from a patient with HIV (39S), a clinical sample from a patient with denture stomatitis lesion (Ca30), and a standard strain ATCC 18804. The quantification of gene expression was related to the production of those genes in the samples referred above using quantitative polymerase chain reaction (qPCR) assay in real time. The photosensitizer methylene blue at 300 uM and erythrosine at 400 uM, sensitized with low-power laser (visible red, 660 nm) and green LED (532 nm), respectively, were used for PDI. Four groups of each sample and PDI protocol were evaluated: (a) P+L+: sensitization with the photosensitizer and irradiation with light, (b) P+L−: only treatment with the photosensitizer, (c) P−L+: only irradiation with light, and (d) P−L−: without sensitization with the dye and absence of light. The results were analyzed by t test, with a significance level of 5%. The photodynamic inactivation was able to reduce the expression of all genes for both treatments, laser and LED. The fold-decrease for the genes ALS3, HWP1, BCR1, TEC1, CPH1, and EFG1 were 0.73, 0.39, 0.77, 0.71, 0.67, and 0.60 for laser, respectively, and 0.66, 0.61, .050, 0.43, 0.54, and 0.66 for LED, respectively. It could be concluded that PDI showed a reduction in the expression of C. albicans genes, suggesting its virulence decrease.
https://ift.tt/2Lsit42
Thulium (Tm:YAG) laser vaporesection of prostate and bipolar transurethral resection of prostate in patients with benign prostate hyperplasia: a systematic review and meta-analysis
Abstract
Thulium laser vaporesection (ThuVARP) and bipolar transurethral resection of the prostate (B-TURP) are novel surgeries for benign prostate hyperplasia (BPH). This paper is a systematic review and analysis of literatures comparing efficacy indicators, operative parameters, as well as safety indicators between ThuVARP and B-TURP for the treatment of BPH. A systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science, Embase, and China National Knowledge Internet (CNKI), was carried out up to December 1, 2015 (updated on March 1, 2016). The captivating outcomes included basic clinical characteristics, perioperative parameters, local complications, and efficacy indicators which included International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR). After assessing the quality of methodology and extracting data, a meta-analysis was carried out by using STATA 12.0 software. Five studies involving 500 patients met the standard. The outcomes of this analysis were as follows: (a) efficacy indicators: there were no significant differences in IPSS, QoL, PVR, and Qmax between the two groups (all P > 0.05); (b) perioperative indicators: ThuVARP had longer operative time [standardized mean difference (SMD) = 0.843; 95% confidence interval (CI) − 0.391, 1.296; P < 0.001] but less serum hemoglobin decreased (SMD = − 0.561; 95% CI − 0.796, − 0.327; P < 0.001), shorter hospital stay (SMD = − 1.558; 95% CI − 2.709, − 0.407; P < 0.01), and catheterization time (SMD = − 1.274; 95% CI − 2.158, − 0.390; P < 0.01). Additionally, no significant difference was found in estimated resected weight (P > 0.05); (c) safety indicators: no significant difference was found in local complication rates (all P > 0.05) between ThuVARP and B-TURP. In our analysis, there exists no statistical difference between ThuVARP and B-TURP group in efficacy. However, in spite of requiring longer surgical time, ThuVARP was better in terms of less blood loss as well as shorter hospitalization and catheterization time.
https://ift.tt/2MN0g5P
IL-11 antagonist suppresses Th17 cell-mediated neuroinflammation and demyelination in a mouse model of relapsing-remitting multiple sclerosis
Publication date: Available online 24 August 2018
Source: Clinical Immunology
Author(s): Xin Zhang, Nazanin Kiapour, Sahil Kapoor, Joseph R. Merrill, Yongjuan Xia, Woomi Ban, Stephanie M. Cohen, Bentley R. Midkiff, Valerie Jewells, Yen-Yu I. Shih, Silva Markovic-Plese
Abstract
IL-11 induced differentiation and expansion of Th17 cells in patients with early relapsing-remitting multiple sclerosis (RRMS). In mice with relapsing-remitting experimental autoimmune encephalomyelitis (RREAE), IL-11 exacerbated disease, induced demyelination in the central nervous system (CNS), increased the percentage of IL-17A+CD4+ Th17 cells in the CNS in the early acute phase, and up-regulated serum IL-17A levels and the percentage of IL-17A+CD4+ Th17 cells in lymph nodes, and IFN-γ+CD4+ T cells in spinal cord in the RR phase. IL-11 antagonist suppressed RREAE disease activities, inhibited IL-17A+CD4+ cell infiltration and demyelination in the CNS, and decreased the percentage of IL-17A+CD4+ T cells in peripheral blood mononuclear cells and ICAM1+CD4+ T cells in brain and SC. Diffusion Tensor Imaging indicated that IL-11 antagonist inhibited demyelination in several brain regions. We conclude that by suppressing Th17 cell-mediated neuroinflammation and demyelination, IL-11 antagonist can be further studied as a potential selective and early therapy for RRMS.
https://ift.tt/2NhsLWx
Transposable element dysregulation in systemic lupus erythematosus and regulation by histone conformation and Hsp90
Publication date: Available online 24 August 2018
Source: Clinical Immunology
Author(s): Maurer Kelly, Shi Lihua, Zhang Zhe, Song Li, Paucar Yoselin, Petri Michelle, E. Sullivan Kathleen
Abstract
Systemic lupus erythematosus (SLE) represents an autoimmune disease in which activation of the type I interferon pathway leads to dysregulation of tolerance and the generation of autoantibodies directed against nuclear constituents. The mechanisms driving the activation of the interferon pathway in SLE have been the subject of intense investigation but are still incompletely understood. Transposable elements represent an enormous source of RNA that could potentially stimulate the cell intrinsic RNA-recognition pathway, leading to upregulation of interferons. We used RNA-seq to define transposable element families and subfamilies in three cell types in SLE and found diverse effects on transposable element expression in the three cell types and even within a given family of transposable elements. When potential mechanisms were examined, we found that Hsp90 inhibition could drive increased expression of multiple type of transposable elements. Both direct inhibition and the delivery of a heat shock itself, which redirects heat shock regulators (including Hsp90) off of basal expression promoters and onto heat shock-responsive promoters, led to increased transposable element expression. This effect was amplified by the concurrent delivery of a histone deacetylase inhibitor. We conclude that transposable elements are dysregulated in SLE and there are tissue-specific effects and locus-specific effects. The magnitude of RNAs attributable to transposable elements makes their dysregulation of critical interest in SLE where transposable element RNA complexed with proteins has been shown to drive interferon expression.
https://ift.tt/2PCmeXR
Association of Preferences for Papillary Thyroid Cancer Treatment With Disease Terminology: A Discrete Choice Experiment.
| Related Articles |
Association of Preferences for Papillary Thyroid Cancer Treatment With Disease Terminology: A Discrete Choice Experiment.
JAMA Otolaryngol Head Neck Surg. 2018 Aug 22;:
Authors: Nickel B, Howard K, Brito JP, Barratt A, Moynihan R, McCaffery K
Abstract
Importance: Given recent evidence of overdiagnosis and overtreatment of small papillary thyroid cancers (PTCs) and other low-risk cancers, strategies are needed to help patients consider less invasive treatment options.
Objectives: To determine which factors influence treatment preferences for patients with PTC, and the trade-offs in treatment factors people are willing to accept, and to understand how terminology influences preferences and benefit-harm trade-offs.
Design, Setting, and Participants: Preferences in PTC treatment were evaluated using a discrete choice experiment (DCE) conducted as a web-based survey using an existing public online research panel. Participants were randomized to receive 1 of 2 frames of information based on the terminology used to describe the condition: "cancer" or "lesion." Participants chose between 3 treatment options for PTC (thyroidectomy, hemithyroidectomy, and active surveillance). Analyses were conducted using a mixed logit model.
Main Outcomes and Measures: The main outcome variable was treatment preference; attributes of treatment options and sociodemographic characteristics were explanatory variables.
Results: The DCE was completed by 2054 participants (993 [48.3%] men and 1061 [51.7%] women; mean [SD] age, 46.0 [16.5] years) with no history of thyroid cancer. Participants preferred options with less frequent follow-up, lower out-of-pocket costs, lower chances of having voice and calcium level problems, and a lower risk of developing invasive thyroid cancer and of dying of thyroid cancer. When trading benefits against harms, participants were willing to accept a higher number of extra patients experiencing adverse effects to avoid a thyroid cancer death when the condition was described as a cancer compared with a lesion. Specifically, participants for whom the condition was described as a cancer were willing to accept more patients requiring lifelong medication (mean, 273; 95% CI, 207-339 vs mean, 98; 95% CI, 66-131), experiencing calcium problems (mean, 110; 95% CI, 77-144 vs mean, 56; 95% CI, 55-58), and fatigue (mean, 958; 95% CI, 691-1224 vs mean, 469; 95% CI, 375-564). For both the cancer and lesion terminology, health literacy consistently was associated with preferences for treatment options. Those with lower health literacy had a significantly lower preference for less invasive treatment options.
Conclusions and Relevance: This study makes an important contribution to understanding how attributes of treatment options, terminology, and patient characteristics, in particular health literacy, influence treatment decision making for PTC. As a result of increasing evidence of the indolent nature of PTC and other low-risk cancers, strategies to deal with potential overtreatment are critically needed.
Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12617000066381.
PMID: 30140909 [PubMed - as supplied by publisher]
https://ift.tt/2MUHycu
Association of the Word Cancer With Thyroid Cancer Treatment Decisions-A Rose by Any Other Name.
| Related Articles |
Association of the Word Cancer With Thyroid Cancer Treatment Decisions-A Rose by Any Other Name.
JAMA Otolaryngol Head Neck Surg. 2018 Aug 22;:
Authors: Haymart MR
PMID: 30140895 [PubMed - as supplied by publisher]
https://ift.tt/2MQHZ7F
Circulating tumor cells and cell-free nucleic acids in patients with gynecological malignancies
Abstract
The ability to detect cancer cells in the blood or in the bone marrow offers invaluable information which potentially impacts early diagnosis, monitoring of treatment, and prognosis. Accessing blood or other body fluids has the additional advantage of being less invasive than biopsy. Consequently, considerable effort has been invested in the last 20 years in optimizing assays which may identify malignant cells at these anatomic sites. Detection of nucleic acids has been applied as alternative approach in this context, first targeting single cancer-associated genes using PCR-based technology, and recently using assays which identify different DNA classes, as well as microRNAs and exosomes. The present review focuses on studies which applied these assays to the detection of cells or cellular components originating from gynecological cancers.
https://ift.tt/2wmUNIR
Telemedicine: a Primer
Abstract
Purpose of Review
Due to rapid advancements in quality of real-time, interactive, audio-visual, and digital technologies as well as impressive gains in internet speed and capacity, medicine delivered over distance is happening faster than many healthcare providers and leaders can grasp.
Recent Findings
Depending on which market report you ascribe to, industry projections for the global compounded annual growth rate of telemedicine are between 13 and 27%, with valuation growing to over 20 billion US dollars in the next several years. The Mayo Clinic has reworked its entire telemedicine interest to a model with centralized operations, one virtual technology platform, standardized training, and connectedness for all of its locations. The National Quality Forum spent 2016 and 2017 formulating 70 some pages of recommendations for expanded measures to valuate telemedicine over the foreseeable future. There are so many patient experience studies indicating high satisfaction with telemedicine, that professionals in the industry accept it as fact. Telemedicine is leaving novel to the past.
Summary
This short, informative piece of writing includes expert opinion and research findings about what is telemedicine, why one should practice telemedicine, and how one should approach implementation; a primer from which to grow.
https://ift.tt/2wc6dQi
A Review of Portable Electronic Spirometers: Implications for Asthma Self-Management
Abstract
Purpose of Review
Although portable electronic spirometers allow for at-home lung function monitoring, a comprehensive review of these devices has not yet been conducted. We conducted a systematic search and review of commercially available portable electronic spirometers designed for asthma patient use.
Recent Findings
All devices (N = 16) allowed for monitoring of basic lung function parameters, but only 31% provided in-app videos on how to perform breathing maneuvers. Most devices (63%) provided graphical representations of lung function results, but only 44% gave immediate feedback on the quality of the breathing maneuver. Several devices (25%) were FDA-approved and cost ranged from US$99 to $1390. Information on data security (63%), measurement accuracy (50%), and association with patient outcomes (0%) was commonly limited.
Summary
This review found that providers' ability to make informed decisions about whether asthma patients may benefit from portable electronic spirometers is limited due to lack of patient outcome data.
https://ift.tt/2P4tF9e
The Role of Imaging in the Management of Cystic Formations of the Mobile Spine (CYFMOS)
Abstract
Purpose of Review
The purpose of this review is to give a better understanding of the pathogenesis of cystic formations of the mobile spine (CYFMOS) and the correlating imaging findings. This would help with medical decision-making, given the plethora of conservative, interventional, and surgical treatment options.
Recent Findings
There has been a general understanding that CYFMOS are associated with degenerative spine changes. More recent articles however have suggested that identifying detailed imaging characteristics can assist in determining outcomes when CYFMOS are treated with interventional percutaneous methods or surgical decompression with or without concomitant fusion.
Summary
CYFMOS although uncommon are not a rare finding seen in the spine when there is a background of degenerative spine changes. These cystic lesions are generally symptomatic by exhibiting mass effect on adjacent structure. Most treatments are aimed at decompression by interventional percutaneous or surgical means. Various imaging characteristics of these CYFMOS described in this article including their signal intensity, presence of spinal instability, particular patterns of adjacent degenerative changes, and imaging changes following interventional treatments can help guide physicians when managing these cases.
https://ift.tt/2NhK0ab
The Nonsurgical Management of Orbital Dystopia Using Refractive Lenses and Prosthetic Shells
Surgical rehabilitation of orbital dystopia can be challenging. The authors demonstrate the effective use of spectacle lenses to visually correct misalignments of the globe and the orbit. Presented is a retrospective review of 4 patients undergoing aesthetic rehabilitation through use of spectacle lenses and in a number patients a cosmetic shell. Two patients with neurofibromatosis presented with inferior dystopia of the globe and orbit. A base-down prismatic lens applied to the spectacles in conjunction with a prosthetic shell successfully visually corrected the facial asymmetry and improved patients' aesthetic appearance. One patient with a history of traumatic retinal detachment, who did not want any surgical intervention, a "plus" (hypermetropic) lens was used to magnify the perceived image of an enophthalmic and phthisical globe, to enhance appearance and improve symmetry. In the fourth patient, with Goldenhar syndrome, the appearance of a hypotropia and concurrent esotropia was successfully treated with a Fresnel prism and a prosthetic shell. This case series illustrates the successful role of various refractive lenses often in conjunction with prosthetic shells in patients with reduced vision and orbital dystopia to improve facial symmetry. This conservative treatment is especially useful when surgery is not a desired or not considered a suitable option for the patient.https://ift.tt/2LoYTpr
Repairing a Facial Cleft by Polyether–Ether–Ketone Implant Combined With Titanium Mesh
The Tessier Number 4 cleft is one of the rarest, most complex craniofacial anomalies that presents difficulties in surgical treatment. In this article, we report a case of simultaneous facial depression, eye displacement, and medial canthus deformity. In this case, the maxillary bony defect was reconstructed using computer-assisted design computer-assisted manufacturing (CAD-CAM) polyether–ether–ketone (PEEK) material, and the orbital floor defect was repaired with AO prefabricated titanium mesh. Additionally, the medial canthus was modified with canthopexy and a single Z-plasty flap. Owing to its relative rarity and varied clinical presentations, no definitive operative methods have been accepted for Tessier No. 4 facial cleft. This study presents the combination of CAD-CAM manufactured PEEK material and titanium mesh as an alternative approach for reconstructing the bony defect of Tessier No. 4 facial clefts.https://ift.tt/2MyxKWw
Innovation, Knowledge, Networking and a New Organization Dedicated to Craniofacial Surgery in Latin America
No abstract availablehttps://ift.tt/2Lp9G2S
Maternal Folic Acid Supplementation and the Risk of Oral Clefts in Offspring
Introduction: There is controversial evidence from the literature regarding the protective effect of folic acid supplementation during pregnancy against orofacial clefts. The authors undertook this meta-analysis to assess whether folate supplementation during pregnancy can reduce the risk of nonsyndromic cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO) in infants. Methods: Eligible articles were identified by searching databases, including PubMed, Medline, Scopus, ISI (Web of Knowledge) to September 2017. A meta-analysis was performed to evaluate the effects of maternal supplementation on oral clefts. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using Stata software. Publication bias was assessed by the Begg and Egger test. (Registration ID: CRD42018083922) Results: Out of the 1630 articles found in the authors' initial literature searches, 6 cohort studies, and 31 case-control studies were included in the authors' final meta-analysis. The results of the main analysis revealed that maternal folate supplementation was associated with a modest but statically significant decreased risk of all cleft subtypes (OR = 0.69, 95% CI: 0.60, 0.78). Folic acid intake alone was inversely associated with CL/P (OR = 0.73, 95% CI: 0.62–0.85,) but to a lesser extent than CPO (OR = 0.75, 95% CI = 053–1.04). Multivitamin intake had a significant protective effect for CL/P (OR = 0.65 95% CI = 0.55–0.80) as well as CPO (OR = 0.69, 95% CI = 0.53–0.90). Conclusions: Our results indicate that maternal supplementation in early pregnancy reduces the risk of nonsyndromic CL/P and CPO in infants. These data can serve to reassure women planning a pregnancy to consume multivitamins during the periconception period to protect against oral clefts.https://ift.tt/2MAX4v6
Cervicofacial Necrotizing Fasciitis and Drugs
Necrotizing fasciitis (NF) is a devastating disease that typically affects immunocompromised patients, chronically debilitated patients or drug users, but can also affect healthy patients. Necrotizing fasciitis can rapidly produce septic shock and requires immediate surgical management of the necrotic tissue. It is a bacterial infection that progresses rapidly and has a high mortality generally caused by aerobic and anaerobic bacteria. The patient was immunocompromised and drug user. During treatment, a combination of broad-spectrum antibiotic therapy with Ciprofloxacin and Metronidazole, besides the use of activated charcoal dressing composed of carbonized fabric and impregnated with 0.15% silver nitrate enveloped by layer of fabric without activated carbon, chemical–mechanical debridement with hydrogen peroxide, 0.9% saline, and povidone iodine. According to the patient presented, for the treatment of NF there is a need for broad-spectrum antibiotic therapy associated with surgical debridement, use of activated charcoal for antiseptic compression and general intensive care.https://ift.tt/2Mz7JGg
Rhoton's Atlas of Head, Neck, and Brain by Mara Peris-Celda, Francisco Martinez-Soriano, and Albert L. Rhoton, Jr. New York, NY: Thieme, 2018
No abstract availablehttps://ift.tt/2MvUHJZ
Clinical Study of Second Branchial Cleft Anomalies
Objective: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of second branchial cleft anomalies, and to evaluate the usefulness and accuracy of preoperative fine-needle aspiration cytology (FNAC) in the diagnosis of branchial cleft cysts. Methods: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2010 to December 2016. Results: Among 25 patients with second branchial cleft anomalies, in 23 patients (92.0%), these anomalies presented as cysts, and in the remaining 2 patients (8.0%), these anomalies presented as fistulas. Fine-needle aspiration cytology had a diagnostic sensitivity of 100%, a positive-predictive value of 100%, and accuracy of 100% for diagnosing second branchial cleft cyst. All patients of second branchial cleft anomalies were treated surgically under general anesthesia. No recurrence of second branchial cleft anomalies was observed. Conclusion: Branchial cleft cysts were the most common type of second branchial cleft anomalies. Preoperative FNAC is a useful and accurate method for preoperative evaluation of branchial cleft cysts. Surgical excision of second branchial cleft anomalies is the treatment of choice without any complications and with no recurrence.https://ift.tt/2MA7T06
Changes in Cervical Lordosis After Orthognathic Surgery in Skeletal Class III Patients
The purpose of this study was to evaluate cervical lordosis and head posture changes using lateral cephalographs after bimaxillary orthognathic surgery for mandibular prognatism by null hypothesis. Twenty-five patients with skeletal class III dentofacial deformities (10 men, 15 women; mean age, 29.28 ± 8.23 years; range 18–48 years) were included in this prospective clinical study. Lateral cephalographs were taken in natural head position (NHP) 2 weeks before and 6 months after orthognathic surgery. The reproducibility of the radiographer's technique of taking radiographs in NHP was investigated using a photographic method and found to be acceptable. All measurements for cervical lordosis (CV1/CV2; CV3/CV7; CV1/CV7), head posture (NSL/OPT; NSL/VER), and other cephalometric values (NSL/Go-Gn; NSL/OCL; Overjet) were repeated 3 times by the same blinded investigator at 2-week intervals and the average values of the 3 measurements were calculated to use in statistical analysis. Intraclass correlation coefficients (ICC) ranged between 0.996 and 1.000, demonstrating a high reliability of the measures. Statistically significant differences were found for CV3/CV7 (P = 0.006) and CV1/CV7 (P = 0.005) and no significant differences were identified in head posture for both cranio-cervical and cranio-vertical angles. The null hypothesis was rejected. Orthognathic surgery resulted in significant cervical lordosis extension, and a tendency for head extension could also be observed.https://ift.tt/2MA7Ils
Application of Autologous Human Bone Marrow-Derived Mesenchymal Stem Cells in Distraction Osteogenesis for the Treatment of Bilateral Mandibular Hypoplasia
Distraction osteogenesis a surgical procedure conducted to improve craniofacial deformities. Compared with conventional operations, this technique has advantages such as the ability to lengthen the soft tissue and hard tissue. Therefore, this method is used to treat severe craniofacial abnormalities. The major disadvantage of distraction osteogenesis is the long treatment period. If the consolidation period is not sufficiently long after the distraction period, complications such as discontinuity or contraction of newly formed bone may occur. Recently, many researchers have attempted to develop methods for enhancing the ossification of newly formed bone, reducing shrinkage, and shortening the overall treatment period. The authors injected autologous bone marrow-derived mesenchymal stem cells during the consolidation phase after distraction osteogenesis surgery in a bilateral mandibular hypoplasia patient. Here, the authors report the treatment results, which were found to be favorable.https://ift.tt/2MRGtCn
Comparison of Bone Grafts From Various Donor Sites in Human Bone Specimens
The objective of the current study was to compare the three-dimensional (3D) morphometric microstructure in human cadaveric bone specimens taken from various commonly utilized donor sites for autogenous bone grafting. Autogenous bone grafts can be harvested from various anatomic sites and express heterogeneous bone quality with a specific 3D microstructure for each site. The long-term structural integrity and susceptibility to resorption of the graft depend on the selected donor bone. Micro-computed tomography generates high-resolution datasets of bone structures and calcifications making this modality versatile for microarchitecture analysis and quantification of the bone. Six bone specimens, 10 mm in length, where anatomically possible, were obtained from various anatomical sites from 10 human dentate cadavers (4 men, 6 women, mean age 69.5 years). Specimens were scanned using a micro-computed tomography device and volumetrically reconstructed. A virtual cylindrical inclusion was reconstructed to analyze the bone mineral density and structural morphometric analysis using bone indices: relative bone volume, surface density, trabecular thicknesses, and trabecular separation. Calvarial bone specimens showed the highest mineral density, followed by the chin, then mandibular ramus then the tibia, whereas iliac crest and maxillary tuberosity had lower bone mineral densities. The pairwise comparison revealed statistically significant differences in the bone mineral density and relative bone volume index in the calvaria, mandibular ramus, mandibular symphysis groups when compared with those in the iliac crest and maxillary tuberosity, suggesting higher bone quality in the former groups than in the latter; tibial specimens expressed variable results.https://ift.tt/2MWkfPT
Founding of the Brazilian Association of Apert Syndrome
No abstract availablehttps://ift.tt/2MMs6zc
Serious Complications After Le Fort III Distraction Osteogenesis in Syndromic Craniosynostosis: Evolution of Preventive and Therapeutic Strategies
Background: There is a paucity of studies that report complication rates following a subcranial Le Fort III advancement using distraction osteogenesis. The purpose of this study was to identify and describe serious postoperative complications following Le Fort III advancement with distraction osteogenesis, and provide strategies to assist in the resolution of these complications. Methods: An observational retrospective study was performed on consecutive patients with Apert, Crouzon, or Pfeiffer syndromes (n = 16) who underwent Le Fort III advancement using distraction osteogenesis between 2008 and 2017. Serious complications were defined as frontal bone loss, cerebrospinal fluid leak, meningitis, seizures, or major blood loss (ie, massive transfusion within the first postoperative day). Results: Three (18.7%) patients presented serious complications, namely cerebrospinal fluid leak (n = 1; 6.2%), seizures (n = 1; 6.2%) due to a halo-type device trans-pin intracranial migration, and major blood loss (n = 1; 6.2%). Adopting well-delineated interventions, all of these complications were resolved without fatality. Conclusion: A Le Fort III advancement has a significant morbidity rate, with 3 of our patients (18.7%) in this study presenting serious complications. Appropriate management reduced this morbidity, and all complications were resolved without fatality.https://ift.tt/2Lp2CTW
An Unusual Case of Headache: Isolated Fungus Ball in Concha Bullosa
A concha bullosa forms when the middle turbinate becomes pneumatized, which is a common anatomic variation; however, fungus ball in concha bullosa is rather rare. An otherwise healthy 52-year-old man presented to our ear, nose and throat clinic with the complaints of midfacial pressure headache and malodorous postnasal drip. Computed tomography of the paranasal sinuses demonstrated a polypoid hyperdense lesion with slight microcalcifications in the right nasal cavity, accompanied with a complicated fluid collection in the right frontoethmoideal recess seen as hypodensity in contrast to this hyperdensity. The histopathological examination reported a fungal infection. We present an extremely rare case of isolated fungal mass in the right middle concha detected in an early stage without any evidence of fungal infection of the other paranasal sinuses and discuss the importance of reevaluation of the computed tomography scans in suspicion of a fungal sinusitis.https://ift.tt/2MULjis
Telemedicine: a Primer
Abstract
Purpose of Review
Due to rapid advancements in quality of real-time, interactive, audio-visual, and digital technologies as well as impressive gains in internet speed and capacity, medicine delivered over distance is happening faster than many healthcare providers and leaders can grasp.
Recent Findings
Depending on which market report you ascribe to, industry projections for the global compounded annual growth rate of telemedicine are between 13 and 27%, with valuation growing to over 20 billion US dollars in the next several years. The Mayo Clinic has reworked its entire telemedicine interest to a model with centralized operations, one virtual technology platform, standardized training, and connectedness for all of its locations. The National Quality Forum spent 2016 and 2017 formulating 70 some pages of recommendations for expanded measures to valuate telemedicine over the foreseeable future. There are so many patient experience studies indicating high satisfaction with telemedicine, that professionals in the industry accept it as fact. Telemedicine is leaving novel to the past.
Summary
This short, informative piece of writing includes expert opinion and research findings about what is telemedicine, why one should practice telemedicine, and how one should approach implementation; a primer from which to grow.
https://ift.tt/2wc6dQi
A Review of Portable Electronic Spirometers: Implications for Asthma Self-Management
Abstract
Purpose of Review
Although portable electronic spirometers allow for at-home lung function monitoring, a comprehensive review of these devices has not yet been conducted. We conducted a systematic search and review of commercially available portable electronic spirometers designed for asthma patient use.
Recent Findings
All devices (N = 16) allowed for monitoring of basic lung function parameters, but only 31% provided in-app videos on how to perform breathing maneuvers. Most devices (63%) provided graphical representations of lung function results, but only 44% gave immediate feedback on the quality of the breathing maneuver. Several devices (25%) were FDA-approved and cost ranged from US$99 to $1390. Information on data security (63%), measurement accuracy (50%), and association with patient outcomes (0%) was commonly limited.
Summary
This review found that providers' ability to make informed decisions about whether asthma patients may benefit from portable electronic spirometers is limited due to lack of patient outcome data.
https://ift.tt/2P4tF9e
The use of mineralized bone allograft as a single grafting material in maxillary sinus lifting with severely atrophied alveolar ridge (1–3 mm) and immediately inserted dental implants. A 3- up to 8-year retrospective study
Abstract
Objective
The primary aim of our study was to evaluate the efficacy of mineralized bone allograft alone in sinus floor augmentation with simultaneous implant placement in cases with severe atrophy of the residual maxillary bone (bone height < 4 mm).
Methods
Thirty-five dental implants were placed in 29 patients who underwent sinus augmentation via traditional lateral window technique from 2008 to 2013. Patients with residual alveolar height between 1 and 3 mm at the site of implantation were included in the study. The height of residual bone was initially estimated by plain panoramic X-ray and reevaluated intraoperatively by precise micrometric measurement at the site of implantation. Implants of 13 mm height and 3.5 or 4.3 mm in diameter were inserted simultaneously. Mineralized bone allograft was used alone to augment the sinus floor.
Results
No wound dehiscence was recorded. In one case there was a postoperative site infection which subsided with antibiotics without implant failure. One implant migrated during the postoperative period to the maxillary sinus and was removed. One implant failed. The remaining 33 implants were successfully loaded. Follow-up ranged from 3 to 8 years.
Conclusions
Maxillary sinus lift in severely absorbed alveolar ridges with simultaneous implant placement could be safely performed using mineralized allograft alone, rendering the procedure less invasive and less time-consuming.
https://ift.tt/2sEAcxZ
Comparison of intravenous tramadol versus ketorolac in the management of postoperative pain after oral and maxillofacial surgery
Abstract
Background
The aim of this study was to assess the better postoperative analgesic, tramadol, and ketorolac, in patients with maxillofacial trauma and who had undergone maxillofacial surgery, i.e., open reduction internal fixation, under general anesthesia.
Materials and methods
After taking ethical approval from the institution and informed consent, 46 ASA grade I–II patients were block randomized (ABAB) based on inclusion and exclusion criteria and equally divided into two groups in which one group of patients was given intravenous tramadol 100 mg and another group of patients was given intravenous ketorolac 30 mg at the time of closure of skin and was repeated after 8 and 16 h following surgery. Pain using VAS at the 2nd, 4th, 6th, 12th, and 24th postoperative was assessed, and association of results was compared using Cramer's V test SPSS (Version 22). Vital signs and side effects were recorded.
Results
Although both drugs resulted in significant decrease in pain intensity from the 2nd to 24th postoperative hour, intravenous tramadol always resulted in better pain control than intravenous ketorolac at every postoperative hour (p value < 0.05) except at 2nd hour where changes are non-significant (p value > 0.05).
Conclusion
Apart from first 2 h where the changes are non-significant, this study clearly demonstrates the advantage of the intravenous tramadol in the management of postoperative pain and ease of administration in postoperative patient through IV cannula. The side effects of both the drugs were insignificant and did not have any effect on the result.
https://ift.tt/2IYz1jD
Influence of cortical bone anchorage on the primary stability of dental implants
Abstract
Purpose
This retrospective chart review study assessed patient records to determine implant insertion torque (IT) and implant stability quotient (ISQ) values during implant placement to evaluate the correlation with cortical bone anchorage (mono- or bicortical).
Methods
Primary stability data (IT during implant placement surgery and ISQ values immediately after implant placement) and cone beam computed tomography of 33 patients (165 implants) were assessed. Patients were divided into the following groups: G1, implants with apical cortical bone contact; G2, implants with bicortical bone contact (apical and cervical regions); and G3, implants with cervical cortical bone contact.
Results
Sixty-eight implants were excluded due to cortical bone contact on regions other than implant apical or cervical. Ninety-seven implants were therefore assessed for this study. No implant failure was found after a mean 70.42-month follow-up time. Implants with bicortical anchorage (G2) showed higher IT (64.1 Ncm) during implant placement and higher ISQ values (76) (p < 0.05). Monocortical implants (G1, apical, and G3, cervical) showed similar IT (G1 52.3 and G3 54.3) and ISQ values (G1 71.9 and G3 73) (p > 0.05). No correlation (Pearson correlation coefficient) was found between the two stability measurement devices for the different cortical bone anchorages that were analyzed (G1 0.190, G2 0.039, and G3 − 0.027) (p > 0.05).
Conclusions
Insertion torque values and implant stability quotients were influenced by cortical bone contact. No significant correlation was found between IT and ISQ values—higher insertion torque values do not necessarily lead to higher implant stability quotients.
https://ift.tt/2xUkdBo
Relationship between body mass index and outcomes for patients with oral squamous cell carcinoma
Oral Diseases, Volume 0, Issue ja, -Not available-.
https://ift.tt/2Ni6Uy4
Ultrastructural analysis of collagen fibril diameter distribution in cleft lip
Oral Diseases, Volume 0, Issue ja, -Not available-.
https://ift.tt/2o9jftF
The oral microbiome in oral lichen planus during a one‐year randomized clinical trial
Oral Diseases, Volume 0, Issue ja, -Not available-.
https://ift.tt/2BLTSaS
Fronto Ethmoidal Mucocele Associated with Type 4 Kuhn Cells
Abstract
A mucocele is an epithelial lined mucous containing sac completely filling the sinus and capable of expansion. We report a case with unilateral frontoethmoidal mucocele in relation with type IV Kuhn cell. A 26 year old man came to the ENT department at SDUMC, Tamaka, Kolar, presenting complaints of proptosis of left eye since 3 years. After detailed examination and investigations patient was Diagnosed to have mucocele of left frontoethmoidal region. Intraoperatively we found a rare picture of type IV kuhn cells completely seated in the frontal sinus. After externally assisted modified Lothrop's approach, marsupialization of mucocele was done in the nasal cavity and symptoms of the patient relieved. We state that, in cases of frontoethmoidal mucocele, externally assisted modified Lothrop procedure offers an alternative for endoscopic management of frontoethmoidal mucocele for the complete clearance of disease.
https://ift.tt/2P5TgPa
Hearing Improvement in Interposition Ossiculoplasty and Myringostapediopexy
Abstract
Chronic otitis media (COM) may lead to partial or complete loss of tympanic membrane and erosion of the ossicles. Ossicular chain reconstruction may be done by interposition ossiculoplasty or myringostapediopexy. The aim of our study was to determine the hearing outcome in interposition ossiculoplasty and myringostapediopexy using autologous incus or cortical bone graft in intact canal wall tympanoplasty. 64 patients with COM, who underwent interposition ossiculoplasty or myringostapediopexy were included in the study. Audiometric evaluation was done after 3 months after surgery and all patients were followed up for a period of 1 year. The hearing results were compared in terms of mean pre-op and post-op Air conduction thresholds, Air-Bone gap (ABG) and hearing gain or ABG closure. In this study the mean ABG closure for interposition ossiculoplasty and myringostapediopexy was 15.4 dB and 21.8 dB, respectively. Hearing gain with cortical bone graft was higher than hearing gains with incus in both the groups, but not statistically significant. Myringostapediopexy provides marginally better hearing gain compared to interposition ossiculoplasty. Aulogous incus, and cortical bone graft are suitable autologous materials for ossicular reconstruction and provide similar hearing outcome.
https://ift.tt/2MAgX5p
Access to Round Window Niche via Posterior Tympanotomy and Impact of Drilling Its Overhangs: A Cadaveric Descriptive Study
Abstract
We intended to study the morphological parameters of round window region and assess the gain in exposure achieved by drilling the round window niche overhang. The Exposure of the round window membrane (RWM) is of prime importance to carry out atraumatic electrode insertion for cochlear implantation. The anatomy of round window has been a subject of considerable debate in literature. Fifty-one Formalin preserved adult cadaveric temporal bones were micro-dissected to carry out an 'optimal' posterior tympanotomy to expose the round window region. The bony overhangs of round window niche (RWN) were next drilled to achieve maximal possible exposure the RWM without violating the annulus of the same. The exposure was classified as per St Thomas' Hospital classification. The round window could not be visualized in 3 bones (5.9%). The commonest morphology of RWN was dome shaped, found in 18 (37.5%) and that of the RWM was oval shaped, found in 14 (29.2%) bones. Pre drilling 41 bones had a > 50% exposure of RWM while post drilling > 50% exposure could be achieved in all the bones except the 3 bones in which RWN could not be visualized to begin with. The drilling of the RWN overhangs exposed RWM in entirety in 91.7% of bones with a visible morphology of RWN pre drilling. RWN and RWM exhibit varied morphology. Drilling of the round window niche overhangs can considerably enhance the exposure of RWM.
https://ift.tt/2LoW87w
Obstructive sleep apnea, low transferrin saturation levels, and male‐pattern baldness
International Journal of Dermatology, EarlyView.
https://ift.tt/2Nk7xr7
Comorbidities or Different Entities? Phenotype Variability Associated with PSENEN Mutations
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2MzWy0g
Preventability of SCARs
British Journal of Dermatology, Volume 179, Issue 2, Page e109-e109, August 2018.
https://ift.tt/2LtAU8m
Aspirin, folic acid and risk of basal cell carcinoma
British Journal of Dermatology, Volume 179, Issue 2, Page e110-e110, August 2018.
https://ift.tt/2MuYSFC
幼儿的角质层
British Journal of Dermatology, Volume 179, Issue 2, Page e125-e125, August 2018.
https://ift.tt/2P5UKc6
News and Notices
British Journal of Dermatology, Volume 179, Issue 2, Page 547-547, August 2018.
https://ift.tt/2MRtjFt
Differences in immune infiltrates in SCC under immunosuppression
British Journal of Dermatology, Volume 179, Issue 2, Page e101-e101, August 2018.
https://ift.tt/2P3qe2m
酒渣鼻的流行病学
British Journal of Dermatology, Volume 179, Issue 2, Page e115-e115, August 2018.
https://ift.tt/2MuZB9O
Phospho flow cytometry of PBMCs in psoriasis
British Journal of Dermatology, Volume 179, Issue 2, Page e100-e100, August 2018.
https://ift.tt/2LqD6xl
Comparison of eczema severity measures
British Journal of Dermatology, Volume 179, Issue 2, Page e99-e99, August 2018.
https://ift.tt/2MMC7fH
Pyoderma gangrenosum and systemic treatment
British Journal of Dermatology, Volume 179, Issue 2, Page e98-e98, August 2018.
https://ift.tt/2LqD8oX
严重皮肤不良反应(SCAR)的可预防性
British Journal of Dermatology, Volume 179, Issue 2, Page e129-e129, August 2018.
https://ift.tt/2MKPygn
Demodex mites modulate sebocyte immune reaction
British Journal of Dermatology, Volume 179, Issue 2, Page e96-e96, August 2018.
https://ift.tt/2P4ikG5
阿司匹林、叶酸和基底细胞癌风险
British Journal of Dermatology, Volume 179, Issue 2, Page e130-e130, August 2018.
https://ift.tt/2MQDDgV
Cover Image: The manifestation of adult mite Sarcoptes scabiei under scanning electron microscope
British Journal of Dermatology, Volume 179, Issue 2, Page 545-546, August 2018.
https://ift.tt/2LlWtYA
Children with facial morphoea managing everyday life
British Journal of Dermatology, Volume 179, Issue 2, Page e97-e97, August 2018.
https://ift.tt/2Mx96FB
The worldwide epidemiology of rosacea
British Journal of Dermatology, Volume 179, Issue 2, Page 239-240, August 2018.
https://ift.tt/2Lnm7vT
Corrigendum
British Journal of Dermatology, Volume 179, Issue 2, Page 546-546, August 2018.
https://ift.tt/2MQADBh
Biologics: targeting systemic inflammation in psoriasis
British Journal of Dermatology, Volume 179, Issue 2, Page 247-248, August 2018.
https://ift.tt/2P4iiOt
Issue Information
British Journal of Dermatology, Volume 179, Issue 2, Page i-vi, August 2018.
https://ift.tt/2MuZhYE
Towards a better understanding of outcome measurement instruments for atopic eczema
British Journal of Dermatology, Volume 179, Issue 2, Page 246-247, August 2018.
https://ift.tt/2LoGbhv
Comparison of the efficacy and mechanisms of intranasal budesonide, montelukast, and their combination in treatment of patients with seasonal allergic rhinitis
International Forum of Allergy &Rhinology, EarlyView.
https://ift.tt/2o8gSHh
Fronto Ethmoidal Mucocele Associated with Type 4 Kuhn Cells
Abstract
A mucocele is an epithelial lined mucous containing sac completely filling the sinus and capable of expansion. We report a case with unilateral frontoethmoidal mucocele in relation with type IV Kuhn cell. A 26 year old man came to the ENT department at SDUMC, Tamaka, Kolar, presenting complaints of proptosis of left eye since 3 years. After detailed examination and investigations patient was Diagnosed to have mucocele of left frontoethmoidal region. Intraoperatively we found a rare picture of type IV kuhn cells completely seated in the frontal sinus. After externally assisted modified Lothrop's approach, marsupialization of mucocele was done in the nasal cavity and symptoms of the patient relieved. We state that, in cases of frontoethmoidal mucocele, externally assisted modified Lothrop procedure offers an alternative for endoscopic management of frontoethmoidal mucocele for the complete clearance of disease.
https://ift.tt/2P5TgPa
Hearing Improvement in Interposition Ossiculoplasty and Myringostapediopexy
Abstract
Chronic otitis media (COM) may lead to partial or complete loss of tympanic membrane and erosion of the ossicles. Ossicular chain reconstruction may be done by interposition ossiculoplasty or myringostapediopexy. The aim of our study was to determine the hearing outcome in interposition ossiculoplasty and myringostapediopexy using autologous incus or cortical bone graft in intact canal wall tympanoplasty. 64 patients with COM, who underwent interposition ossiculoplasty or myringostapediopexy were included in the study. Audiometric evaluation was done after 3 months after surgery and all patients were followed up for a period of 1 year. The hearing results were compared in terms of mean pre-op and post-op Air conduction thresholds, Air-Bone gap (ABG) and hearing gain or ABG closure. In this study the mean ABG closure for interposition ossiculoplasty and myringostapediopexy was 15.4 dB and 21.8 dB, respectively. Hearing gain with cortical bone graft was higher than hearing gains with incus in both the groups, but not statistically significant. Myringostapediopexy provides marginally better hearing gain compared to interposition ossiculoplasty. Aulogous incus, and cortical bone graft are suitable autologous materials for ossicular reconstruction and provide similar hearing outcome.
https://ift.tt/2MAgX5p
Access to Round Window Niche via Posterior Tympanotomy and Impact of Drilling Its Overhangs: A Cadaveric Descriptive Study
Abstract
We intended to study the morphological parameters of round window region and assess the gain in exposure achieved by drilling the round window niche overhang. The Exposure of the round window membrane (RWM) is of prime importance to carry out atraumatic electrode insertion for cochlear implantation. The anatomy of round window has been a subject of considerable debate in literature. Fifty-one Formalin preserved adult cadaveric temporal bones were micro-dissected to carry out an 'optimal' posterior tympanotomy to expose the round window region. The bony overhangs of round window niche (RWN) were next drilled to achieve maximal possible exposure the RWM without violating the annulus of the same. The exposure was classified as per St Thomas' Hospital classification. The round window could not be visualized in 3 bones (5.9%). The commonest morphology of RWN was dome shaped, found in 18 (37.5%) and that of the RWM was oval shaped, found in 14 (29.2%) bones. Pre drilling 41 bones had a > 50% exposure of RWM while post drilling > 50% exposure could be achieved in all the bones except the 3 bones in which RWN could not be visualized to begin with. The drilling of the RWN overhangs exposed RWM in entirety in 91.7% of bones with a visible morphology of RWN pre drilling. RWN and RWM exhibit varied morphology. Drilling of the round window niche overhangs can considerably enhance the exposure of RWM.
https://ift.tt/2LoW87w
Enhanced Therapeutic Effects of Human Mesenchymal Stem Cells Transduced with Superoxide Dismutase 3 in a Murine Atopic Dermatitis‐Like Skin Inflammation Model
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2Nh3mw2
Mapping of conformational IgE epitopes of food allergens
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2PDHooK
Pulmonary function and bronchial reactivity 4 years after the first virus‐induced wheezing
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2wplMn8
Time spent in an endemic area is a crucial clue to diagnose scrub typhus without eschar
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2wbbLe3
Reply to ‘Pruritic arthropod bite‐like papules in T‐cell large granular lymphocytic leukaemia and chronic myelomonocytic leukaemia’
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2P768EJ
Post‐bariatric surgery hidradenitis suppurativa: a new patient subset associated with malabsorption and micronutritional deficiencies
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2wbbrfl
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