Melanoma and mastocytosis: is really only a coincidence?

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2NchJoK

Management of Nasoorbitoethmoidal Fracture: An Institutional Experience

Abstract

The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.

https://ift.tt/2wCaAoc

Bacteriological Profile in Attico-antral type of Chronic Suppurative Otitis Media

Abstract

Chronic suppurative otitis media is defined as a chronic inflammation of the middle ear cleft, which presents with recurrent ear discharge through a tympanic membrane perforation. The purpose of this study was to find pattern of bacteriology in patients of atticoantral type of chronic suppurative otitis media as it will help the clinician to decide the effective antibiotics to be prescribed. This prospective and observational study was conducted in the Department of ENT in collaboration with Department of Microbiology, Government Medical College and Hospital, Chandigarh. The ear discharge specimen of all patients meeting the inclusion criteria were collected and sent for microbial examination. Culture positive samples were subjected to antibiotic sensitivity. A total of one hundred ears (mean age 27.33 years) clinically diagnosed with chronic suppurative otitis media, atticoantral type were included in this study based on the preset inclusion and exclusion. The male: female ratio in our patients was 0.94:1. Ninety-seven (96.9%) patients had unilateral disease, while 3 (3.1%) patients had bilateral disease. Twenty-eight percent of the total samples were sterile. The most common bacteria isolated were Pseudomonas aeruginosa (27.1%), Methicillin sensitive Staphylococcus aureus (23.3%) and Proteur mirabilis (6.5%). was sensitive to polymyxin B (100%) followed by ciprofloxacin (46.4%), neomycin (42.9%) and gentamicin (42.9%). Polymyxin B is the most effective antibiotic against the cultured bacteria followed by gentamicin, ciprofloxacin and neomycin.

https://ift.tt/2Cex7wl

Use of vismodegib for the treatment of multiple basal cell carcinomas in a patient with xeroderma pigmentosum

Pediatric Dermatology, EarlyView.


https://ift.tt/2NO4szP

Management of Nasoorbitoethmoidal Fracture: An Institutional Experience

Abstract

The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.

https://ift.tt/2wCaAoc

Bacteriological Profile in Attico-antral type of Chronic Suppurative Otitis Media

Abstract

Chronic suppurative otitis media is defined as a chronic inflammation of the middle ear cleft, which presents with recurrent ear discharge through a tympanic membrane perforation. The purpose of this study was to find pattern of bacteriology in patients of atticoantral type of chronic suppurative otitis media as it will help the clinician to decide the effective antibiotics to be prescribed. This prospective and observational study was conducted in the Department of ENT in collaboration with Department of Microbiology, Government Medical College and Hospital, Chandigarh. The ear discharge specimen of all patients meeting the inclusion criteria were collected and sent for microbial examination. Culture positive samples were subjected to antibiotic sensitivity. A total of one hundred ears (mean age 27.33 years) clinically diagnosed with chronic suppurative otitis media, atticoantral type were included in this study based on the preset inclusion and exclusion. The male: female ratio in our patients was 0.94:1. Ninety-seven (96.9%) patients had unilateral disease, while 3 (3.1%) patients had bilateral disease. Twenty-eight percent of the total samples were sterile. The most common bacteria isolated were Pseudomonas aeruginosa (27.1%), Methicillin sensitive Staphylococcus aureus (23.3%) and Proteur mirabilis (6.5%). was sensitive to polymyxin B (100%) followed by ciprofloxacin (46.4%), neomycin (42.9%) and gentamicin (42.9%). Polymyxin B is the most effective antibiotic against the cultured bacteria followed by gentamicin, ciprofloxacin and neomycin.

https://ift.tt/2Cex7wl

Yellowish‐orange plaques and slack skin in a Chinese boy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2CbUtCI

Allergic contact dermatitis caused by propolis‐enriched honey: A case of severe penile oedema

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2MHtkMZ

An unsuspected complication with immune checkpoint blockade: a case report

Immunotherapy treatment with immune-checkpoint blockade has become a new paradigm in cancer treatment. Despite its efficacy, it has also given rise to a new class of adverse events, immune-related adverse even...

https://ift.tt/2Q2geru

Huge chronic expanding hematoma of the iliac bone following multiple hip surgeries: a case report

Chronic expanding hematoma is a rare entity resulting from trauma or surgery. This condition usually occurs in soft tissue, such as the trunk or extremities, while chronic expanding hematoma arising from bone ...

https://ift.tt/2wAb3WQ

A neonate with marked prolonged mixed apneas and CHARGE syndrome: a case report

Upper airway abnormalities in the newborn are associated with obstructive breathing but not with mixed apneas. A tracheostomy is necessary to treat severe obstructive apneas but will not have an effect on the ...

https://ift.tt/2Q2mGPi

Editorial Board/Reviewing Committee

https://ift.tt/2wNejP5

Grundlagen und Praxis der Neuroanästhesie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 618-630
DOI: 10.1055/s-0043-111004

Zentrale Aspekte der Anästhesieführung bei neurochirurgischen Operationen sind das Aufrechterhalten der zerebralen Homöostase sowie die Vermeidung sekundärer Hirnschäden. Die wichtigsten Variablen sind zerebraler Metabolismus, zerebraler Blutfluss, zerebraler Perfusionsdruck, zerebrales Blutvolumen und ihr Einfluss auf den intrakraniellen Druck. Die Ausgewogenheit dieser Faktoren ist Ziel bei jeder neurochirurgischen Operation oder Intervention.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NHM0sw

Placebos mit Heilkraft? Placeboeffekt und -einsatz in der (Schmerz-)Therapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 574-578
DOI: 10.1055/a-0636-1776

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LZElUQ

Knieendoprothetik: Adduktorenkanalblockade oder lokale Infiltrationsanalgesie?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 567-568
DOI: 10.1055/a-0668-3904

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE9iEG

Musikermedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-569
DOI: 10.1055/a-0668-3886

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MLDiNu

Placebo-Nocebo-Ethik für die Patientenkommunikation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 592-604
DOI: 10.1055/s-0043-121685

Die Patientenaufklärung ist „täglich Brot" des klinisch tätigen Anästhesisten und gleichzeitig ein zentrales Rechtfertigungselement medizinischer Behandlungsmaßnahmen. Durch Auslösen von Placebo- und Noceboeffekten kann sie den Behandlungserfolg aber auch selbst maßgeblich beeinflussen. Einem daraus drohenden Konflikt verschiedener medizinethischer Prinzipien kann mit entsprechenden praktischen Strategien wirksam begegnet werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2LZDX8Q

Tiefe Relaxierung kann laparoskopische Eingriffe erleichtern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-568
DOI: 10.1055/a-0668-3958

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHkWf

Weiterbildung in der Anästhesie nach Novellierung der Musterweiterbildungsordnung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 635-638
DOI: 10.1055/a-0591-1169

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle" stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NKBoJ8

Critical-Illness-Polyneuromyopathie verschlechtert Outcomes auf Intensivstation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 569-570
DOI: 10.1055/a-0668-3750

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHexR

Placeboeffekte in der Akutschmerztherapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 579-590
DOI: 10.1055/s-0043-121684

Placebo- und Noceboeffekte stehen aktuell sehr im Fokus der klinischen und experimentellen Schmerzforschung. Neuro- sowie psychophysiologische Prozesse scheinen eine wichtige Rolle bei der Entstehung sowie Vermittlung zu spielen. So werden Placebo- und Noceboeffekte im Wesentlichen über das Netzwerk des opioidergen, absteigenden, schmerzmodulierenden Systems vermittelt. Für das Zustandekommen eines Placeboeffektes wiederum werden 3 psychologische Mechanismen verantwortlich gemacht: klassische Konditionierung, soziales Lernen sowie die Schmerzerwartung. Eine offene Analgetikagabe, eine ausführliche Aufklärung über Wirkung und Nebenwirkung (ohne diese zu sehr in den Fokus zu stellen) der im perioperativen Bereich eingesetzten Medikamente und Interventionen sowie eine Einbindung des Patienten in die Therapie (z. B. durch patientenkontrollierte Systeme) können zu einer additiven Verbesserung der Akutschmerztherapie (bis zu 30%) führen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NNa8d1

50 Jahre Plastische Chirurgie und 25 Jahre Facharzt für Plastische Chirurgie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-572
DOI: 10.1055/a-0667-9094

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oB2E23

Placeboeffekte bei chronischen Schmerzen: Forschungsstand und klinische Anwendung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 605-617
DOI: 10.1055/s-0043-121683

Spielte der Placeboeffekt ehemals vorwiegend eine (eher unliebsame) Rolle bei randomisierten kontrollierten Studien, so treten nun vermehrt die mit dem Placeboeffekt verbundenen Chancen in den Vordergrund. Dieser Beitrag bespricht bisherige Forschungserkenntnisse zum Placeboeffekt bei chronischen Schmerzen und zeigt, wie durch eine gezielte Beeinflussung des therapeutischen Kontexts die Wirksamkeit pharmakologisch aktiver Schmerzmedikamente gesteigert werden kann.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NFo2xU

Warnhinweis auf rezeptfreien Schmerzmitteln soll künftig Risiken verringern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-573
DOI: 10.1055/a-0667-9117

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE8M9I

Kinderanästhesie: Risikopatienten profitieren von intravenöser Einleitung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 566-567
DOI: 10.1055/a-0668-3940

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LQvjt6

Rapid Sequence Induction

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 631-634
DOI: 10.1055/a-0628-3122

Die „Rapid Sequence Induction and Intubation" (RSI oder RSII) ist bei Patienten mit erhaltener Kreislauffunktion die Standardmethode, um schnellstmöglich eine Atemwegssicherung im Rahmen einer Notfallsituation bzw. Narkose durchzuführen. Ziel einer RSI ist es, eine Aspiration durch die schnelle endotracheale Intubation und den Verzicht auf eine Zwischenbeatmung zu verhindern.Auch heute besitzen nur wenige europäische Länder eine explizite Handlungsempfehlung zur Durchführung einer RSI. In der täglichen klinischen Routine hat sich die Kopfhochlagerung etabliert, die gegenüber den anderen Lagerungsarten gewisse Vorteile bietet. Eine liegende Magensonde sollte i. d. R. während der RSI belassen werden und muss nicht zwingend in den Ösophagus zurückgezogen werden. Wenn keine Magensonde gelegt wurde bzw. bereits lag, ist die Einlage einer Magensonde nach Intubation sinnvoll. Vor der RSI sollte im Normalfall ein Opioid appliziert werden, da die Dosis kreislaufwirksamer Hypnotika und die hämodynamische Stimulation bei der Intubation reduziert werden können.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2MKGSav

Shared decision making and decisional conflict in the Management of Vestibular Schwannoma: a prospective cohort study

Abstract

Background

Patients with vestibular schwannomas (VS) are faced with complex management decisions. Watchful waiting, surgical resection, and radiation are all viable options with associated risks and benefits. We sought to determine if patients with VS experience decisional conflict when deciding between surgery or non-surgical management, and factors influencing the degree of decisional conflict.

Methods

A prospective cohort study in two tertiary ambulatory skull-base clinics was performed. Patients with newly diagnosed or newly growing vestibular schwannomas were recruited. Patients were given a demographic form and the decisional conflict scale (DCS), a validated measure to assess the degree of uncertainty when making medical decisions. The degree of shared decision making (SDM) experienced by the patient and physician were assessed via the SDM-Q-10 and SDM-Q-Doc questionnaires, respectively. Non-parametric statistics were used. Questionnaires and demographic information were correlated with DCS using Spearman correlation coefficient and Mann-Whitney U. Logistic regression was performed to determine factors independently associated with DCS scores.

Results

Seventy-seven patients participated (55% female, aged 37–81 years); VS ranged in size from 2 mm–50 mm. Significant decisional conflict (DCS score 25 or greater) was experienced by 17 (22%) patients. Patients reported an average SDM-Q-10 score of 86, indicating highly perceived level of SDM. Physician and patient SDM scores were weakly correlated (p = 0.045, Spearman correlation coefficient 0.234). DCS scores were significantly negatively correlated with a decision to pursue surgery, presence of a trainee, and higher SDM-Q-10 score. DCS was higher with female gender. Using logistic regression, the SDM-Q-10 score was the only variable associated with significantly reduced DCS.

Conclusions

About one fifth of patients deciding how to manage their vestibular schwannoma experienced a significant degree of decisional conflict. Involving the patients in the process through shared decision-making significantly reduced the degree of uncertainty patients experienced.

https://ift.tt/2MKggXa

Re-visiting the ATA 2015 sonographic guidelines - who are we missing?: A retrospective review

Abstract

Background

The American Thyroid Association published revised guidelines in 2015 on the management of differentiated thyroid cancer in adults. One of the key changes introduced in the revision proposes that diagnostic biopsy be based on ultrasound findings (i.e. size and nodule characteristics). The overall effect of these changes results in fewer nodules requiring biopsy. This study was conducted to determine if the changes to the guidelines will result in overlooked thyroid cancers, specifically malignancies with aggressive characteristics measuring between 1 and 1.49 cm.

Methods

Patients (n = 2083) with thyroid nodules who underwent total or subtotal/hemi thyroidectomy with or without neck dissection by a single surgeon between 2006 and 2016 were retrospectively enrolled. Demographic information and nodule characteristics were collected for all patients. Ultrasonography and final pathology reports were reviewed for patients with thyroid nodules between the sizes of 1–1.49 cm (n = 155).

Results

45% (n = 70) of patients with nodules between 1 and 1.49 cm were "low suspicion" nodules according to ultrasound. 47 of these nodules contained malignancies on final histopathological examination, 100% of which were of the papillary subtype. 21% (n = 10) of these malignant nodules demonstrated extrathyroidal extension and 34% (n = 16) were associated with regional metastases.

Conclusions

Reliance on sonographic patterns alone could result in missed cancer diagnoses in patients with thyroid nodules measuring between 1 and 1.49 cm. Moreover, a portion of these malignancies may be associated with aggressive features. The effect of this finding on long-term outcomes is unclear.

https://ift.tt/2NPOqVK

Effectiveness of skull X-RAY to determine cochlear implant insertion depth

Abstract

Background

Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however its effectiveness has not been well established. Our primary objective was to assess the accuracy of post-op skull X-RAYs to determine insertion depth, compared to CT as the gold standard. Secondary objectives were to compare experience level of raters and different skull X-RAY views.

Methods

Thirteen patients with Advanced Bionic HiRes 90 K implants, and post-operative temporal bone CT scans were selected from the CI database at Sunnybrook Health Sciences Centre. Medical students, otology fellows, and CI surgeons evaluated insertion depths on post-op skull X-RAYs, while neuroradiologists evaluated CT scans. Descriptive statistics, regression analysis, and paired t-tests were used to compare the two types of imaging.

Results

X-RAYs and CTs provided an equivalent mean insertion depth of 337 degrees (p = 0.93), a mean difference of − 0.9 degrees and a standard deviation of paired differences of 43 degrees. Although means were similar across rater groups, CI surgeons (45 degrees) had the lowest standard deviation of paired differences. Comparing X-RAY views, Caldwell (29 degrees) had less variation than Towne (59 degrees) for standard deviation of paired differences.

Conclusions

Skull X-RAYs provide accurate and reliable measurements for CI insertion depth. The Caldwell view alone may be sufficient for evaluations of insertion depth, and experience has a minor impact on the variability of estimates.

https://ift.tt/2MKBYKD

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through September 14, 2018.
Read Now:

Hypothyroidism Is Associated with Increased Mortality Risk in Individuals 65 Years of Age or Older
Elizabeth N. Pearce  

Alemtuzumab, a Monoclonal Antibody to CD52, Frequently Causes Graves' Disease
Jerome M. Hershman 

Patients with Differentiated Thyroid Cancer Who Undergo Reoperation for Recurrence Have Increased Mortality
Masha J. Livhits, Michael W. Yeh 

Serum TSH Remains Normal in Those without Significant Risk Factors for Thyroid Dysfunction
Angela M. Leung 

The post Clinical Thyroidology^®High-Impact Articles appeared first on American Thyroid Association.

https://ift.tt/2CaCOvg

Pathological factors involved in local failure in squamous cell carcinoma of the oral cavity: retrospective study and proposal of a new clinical classification

The control of local failure (LF) is essential to improve outcomes in patients with squamous cell carcinoma of the oral cavity (OSCC). In this study, LF of OSCC was classified into three clinical types: deep recurrence (type 1R), adjacent superficial recurrence (type 2R), and distant primary tumour (type 3R). LF was analyzed after surgical resection of OSCC to determine the validity and usefulness of this classification system. Of 257 patients with OSCC, 58 experienced LF; 21 had type 1R, 23 had type 2R, and 20 had type 3R.

https://ift.tt/2NIiEKl

Risk Factors for Recurrent Anaphylaxis-Related ED Visits in the United States

Anaphylaxis is an acute systemic allergic reaction that may be life-threatening1. Patients with a history of anaphylaxis live with a chronic risk of relapse with the subsequent event being unpredictable. In one of the earliest studies examining anaphylaxis recurrence, Mullins2 reported that one in twelve patients with anaphylaxis will experience recurrence and one in fifty will require adrenaline or hospital attention.

https://ift.tt/2oIt4z3

Molecular pathogenesis of proliferative verrucous leucoplakia: a systematic review

Proliferative verrucous leucoplakia (PVL) is a potentially premalignant lesion that undergoes malignant transformation in over 40% of cases. Its clinical homogeneity suggests that a single or a small number of molecular pathogenic pathways may exist. Using the Cochrane protocol for systematic reviews, we have looked at the reported evidence of the molecular aetiology and pathogenesis of PVL and compared it with that of conventional oral epithelial dysplasia (OED). Of the 43 papers studied, 19 met the inclusion criteria including 13 proteins assayed in 344 tissues, and genes investigated were TP53, p14ARF, and p16INK4A.

https://ift.tt/2PZOHHk

Innovative use of a stereolithographic model together with the mirror image technique to reconstruct a defect in mandibular continuity

Reconstruction of mandibular defects after resection of a tumour is complicated by anatomical and functional complexities,1 and autografts together with reconstruction plates are among the most commonly used techniques. One shortcoming is the relatively long time spent on bending the plate during the operation, which not only increases the operating time, but also causes metal fatigue of the plate.1,2 Ideal symmetry between the affected and non-affected sides is impossible to achieve, but the use of a stereolithographic model (introduced in the 1980s3), combined with mirroring and superimposition of the non-affected side on to the affected side, is a suitable way to reduce or eliminate these complications.

https://ift.tt/2Pv0GeX

Orthodromic transfer of the temporalis tendon with extension of the fascia lata to reanimate the smile in facial palsy

Facial nerve palsy is a debilitating condition. The gold standard for facial reanimation is free tissue transfer with cross-facial grafts,1,2 but the outcome is unpredictable and the procedure depends upon the precision with which the technique is used. Orthodromic transfer of the temporalis muscle with or without an extension graft can re-establish the harmony of facial muscles during rest and animation.3,4 Unlike other techniques, it is predictable and offers early animation of the oral commissure and lower face.

https://ift.tt/2PZOy6K

Survival, disease progression and prognostic factors in elderly patients with mycosis fungoides and Sézary syndrome: a retrospective analysis of 174 patients

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


https://ift.tt/2MJ6yEC

Management of patients with hereditary angioedema in Germany: comparison to other countries in the Icatibant Outcome Survey

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


https://ift.tt/2NKARHi

Secukinumab survival and long‐term efficacy in patients with plaque psoriasis: real‐life data from a tertiary hospital in Greece

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


https://ift.tt/2MOcagU

Comparison of clinical and ultrasound scores in patients with hidradenitis suppurativa: results from an Italian ultrasound working group

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


https://ift.tt/2NIU8sK

Hidradenitis suppurativa/acne inversa: A practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

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


https://ift.tt/2MNjqt4

Anatomic evaluation of the incisive canal with cone beam computed tomography and its relevance to surgical procedures in the mental region: a retrospective study in a Brazilian population

Abstract

Background and objective

To evaluate the prevalence, location, length, diameter, and distances related to the incisive canal (IC) and the need for cone beam computed tomography (CBCT) as a complementary exam prior to surgery in the mental region.

Materials and methods

One hundred CBCT images from patients of both genders aged 27 to 73 years were evaluated. At every 3 mm, the diameter (DIAM) of the right and left ICs and their location, their distance to base of the jaw (BIC), the buccal (BAIC) and lingual (LAIC) aspects, and their length were measured.

Results

The 100 patients comprised 50 men (50%) and 50 women (50%). The IC was detected in 78 patients, more frequently in women (80%) than in men (76%). Measurements were taken in millimeters. The mean measurements for the two sides and for men and women combined were as follows: BIC = 10.0, BAIC = 4.0, LAIC = 6.2, ICL = 19.9, and DIAM = 1.4.

Conclusions

The measurements show the need for care from professionals when performing intraosseous surgical procedures in the mental region. The distances between the IC and the references studied must be observed. Thus, CBCT becomes essential for surgical planning in the mental region.

Clinical relevance

The mental region of the mandible is considered a safe area to perform surgical procedures such as the placement of osseointegrated implants, orthognathic surgery, and the removal of bone grafts. However, this region includes important neurovascular structures that must be considered or else hemorrhage and neurologic disorders can be experienced.

https://ift.tt/2Ceh4i7

Anatomic evaluation of the incisive canal with cone beam computed tomography and its relevance to surgical procedures in the mental region: a retrospective study in a Brazilian population

Abstract

Background and objective

To evaluate the prevalence, location, length, diameter, and distances related to the incisive canal (IC) and the need for cone beam computed tomography (CBCT) as a complementary exam prior to surgery in the mental region.

Materials and methods

One hundred CBCT images from patients of both genders aged 27 to 73 years were evaluated. At every 3 mm, the diameter (DIAM) of the right and left ICs and their location, their distance to base of the jaw (BIC), the buccal (BAIC) and lingual (LAIC) aspects, and their length were measured.

Results

The 100 patients comprised 50 men (50%) and 50 women (50%). The IC was detected in 78 patients, more frequently in women (80%) than in men (76%). Measurements were taken in millimeters. The mean measurements for the two sides and for men and women combined were as follows: BIC = 10.0, BAIC = 4.0, LAIC = 6.2, ICL = 19.9, and DIAM = 1.4.

Conclusions

The measurements show the need for care from professionals when performing intraosseous surgical procedures in the mental region. The distances between the IC and the references studied must be observed. Thus, CBCT becomes essential for surgical planning in the mental region.

Clinical relevance

The mental region of the mandible is considered a safe area to perform surgical procedures such as the placement of osseointegrated implants, orthognathic surgery, and the removal of bone grafts. However, this region includes important neurovascular structures that must be considered or else hemorrhage and neurologic disorders can be experienced.

https://ift.tt/2Ceh4i7

Bowel perforation in chronic idiopathic megarectum and megacolon

Chukwuebuka Anyaegbuna<br />Aug 20, 2018; 2018:bcr-2018-225406-bcr-2018-225406<br />Images in...

https://ift.tt/2Nhejki

Penile fracture after priapism due to sildenafil ingestion: out of frying pan into the fire

Deepanshu Sharma<br />Aug 14, 2018; 2018:bcr-2018-226562-bcr-2018-226562<br />Images in...

https://ift.tt/2PAsf6N

Unexpected cause for eyelid swelling and ptosis: rigid gas permeable contact lens migration following a 28-year-old trauma

Sirjhun Patel<br />Aug 10, 2018; 2018:bcr-2018-225767-bcr-2018-225767<br />Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

https://ift.tt/2Na1EQh

Follow-up of water-only fasting and an exclusively plant food diet in the management of stage IIIa, low-grade follicular lymphoma

Toshia R Myers<br />Aug 9, 2018; 2018:bcr-2018-225520-bcr-2018-225520<br />Images in...

https://ift.tt/2NJFCkg

Auto-amputation of penis due to advanced carcinoma penis

Gaurav Garg<br />Aug 9, 2018; 2018:bcr-2018-226505-bcr-2018-226505<br />Images in...

https://ift.tt/2NatUSJ

A new molecular multiplex IgE assay for the diagnosis of pollen allergy in Mediterranean countries: a validation study

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


https://ift.tt/2NIe7b0

Development of Central Serous Chorioretinopathy following Chalazion Removal with Intralesional Triamcinolone Injection: A Case Report

We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease.
Case Rep Ophthalmol 2018;9:416–420

https://ift.tt/2NLEmx4

A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis

International Journal of Dermatology, EarlyView.


https://ift.tt/2NIjAyu

Tonsillenchirurgie: Einfluss des Tonsillenspatels auf den Pharynxdurchmesser

Zusammenfassung

Hintergrund

Die Selektivverträge der Krankenkassen mit den Leistungserbringern sehen eine Fotodokumentation vor, um die Indikationsstellung der Tonsillotomie adäquat rechtfertigen zu können. Im Jahr 2017 führte die HNO-Klinik Mönchengladbach eine standardisierte Fotodokumentation bei diesem Eingriff ein.

Ziel der Arbeit

Anhand der archivierten Fotodokumente sollte überprüft werden, ob sich die Abstände der medialen Tonsillenflächen durch das Aufspannen des Tonsillenspatels signifikant verändern.

Material und Methoden

Fotos wurden durch das Operationsmikroskop unmittelbar nach Einsetzen und Öffnen des Spatels angefertigt, ohne ihn aufzuspannen (D1), dann nach zusätzlichem Einhängen vor (D2) und nach der Tonsillotomie (D3). Es wurde jeweils ein 10-mm-Ausschnitt eines Einmal-Papierlineals in den Situs gebracht, um die Abstände genau messen zu können. Die Fotos wurden aus der digitalen Patientenakte in eine Powerpoint-Datei kopiert, um über ein eingefügtes, variabel gestaltbares Rechteck die Distanzbestimmungen vorzunehmen.

Ergebnisse

Die Dokumentation von 149 Patienten in einem 6‑Monats-Zeitraum wurde analysiert. Es handelte sich um etwa gleich viele männliche wie weibliche Patienten, der jüngste Patient war 16 Monate, der älteste 48 Jahre alt (Durchschnitt: 6,95; Median: 5 Jahre). Bei allen Patienten fand sich eine signifikante Weitung des Pharynxdurchmessers (p < 0,001) mit scheinbarer Verkleinerung der Tonsillengröße.

Schlussfolgerung

Das Aufspannen des Tonsillenspatels führt zu einer Weitung des Pharynxdurchmessers, in Relation dazu erscheinen die Tonsillen kleiner, als sie sind. Dies sollte berücksichtigt werden, um eventuellen Diskussionen mit Krankenkassen vorzubeugen. Inwieweit das Aufspannen des Spatels auch zu einer Annäherung der umgebenden Arterien führt, sollten weitere Studien klären.

https://ift.tt/2LSYaNw

Visual analogue scale for sino-nasal symptoms severity correlates with sino-nasal outcome test 22: paving the way for a simple outcome tool of CRS burden

A visual analogue scale (VAS) is a psychometric instrument widely used in the Rhinology field to subjectively quantify patient's symptoms severity. In allergic rhinitis, VAS has been found to correlate well wi...

https://ift.tt/2Pzzufa

Four compartment method as an efficacious and simplified technique for autologous non‐cultured epidermal cell suspension preparation in vitiligo surgery: A randomized, active‐controlled study

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


https://ift.tt/2CeoaDk

Skin type differences in solar simulated radiation‐induced oxidative stress

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


https://ift.tt/2oHiPLn

Multifocal Warthin’s Tumor: An Uncommon Presentation of Bilateral Cervical Lymphadenopathy

Warthin's tumor is the second most common benign lesion of the parotid gland. It is most commonly encountered in male smokers in the fifth to seventh decades of life. Uniquely, among benign lesions of the parotid gland, it can be seen bilaterally in 7–10% of cases. Very rarely, Warthin's tumor can also mimic malignant or metastatic disease by presenting within cervical lymph nodes. We present a rare case of a 71-year old male smoker with bilateral parotid lesions in addition to progressively enlarging cervical and mediastinal lymphadenopathy. Excisional biopsy of a cervical lymph node ultimately revealed Warthin's tumor.

https://ift.tt/2CezLSY

Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow up

Abstract

Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders causing pain and functional impairment. The purpose of the study is to compare the effects of high-intensity laser therapy (HILT), conventional physical therapy (CPT), and exercise therapy (ET) on pain and function in patients with KOA. The study was designed as an assessor-blind randomized controlled trial. Ninety-three patients (aged between 50 and 75 years) with proved KOA were included and randomly allocated into three groups, and received 12 sessions of HILT, CPT, or ET. The outcomes were pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), timed up and go test (TUG), 6-min walk test (6MWT), and functionality of knee measured by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire. Statistical analyses were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks. HILT was significantly more effective than the other groups in decreasing the VAS, increasing FROM and improving the scores of WOMAC (total and function subscale) both after treatment and after 12 weeks. The effect of HILT and CPT on the TUG, 6MWT, and WOMAC pain subscale was not significantly different after treatment, and both were better than ET. HILT was significantly better than the others after follow-up, particularly more effective on the stiffness subscale of WOMAC. HILT combined with exercise therapy, as a useful therapeutic approach, could have positive influences on KOA patients.

https://ift.tt/2CfddS6

Anaphylaxis to xylitol diagnosed by skin prick test and basophil activation test

Publication date: Available online 3 September 2018

Source: Allergology International

Author(s): Kaoru Okamoto, Michiko Kagami, Manabu Kawai, Yuji Mori, Kazuo Yamawaki, Yoichi Nakajima, Yasuto Kondo, Ikuya Tsuge

https://ift.tt/2oH5vXn

The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin‐gut axis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2ClAaDg

Setting sun pattern in dermoscopy of a scalp nodule

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2wBSwKG

A framework for quality measurement in the presurgical care of chronic rhinosinusitis: a review from the Quality Improvement Committee of the American Rhinologic Society

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2oxM0jL

Combination of submandibular salivary gland transfer and intensity‐modulated radiotherapy to reduce dryness of mouth (xerostomia) in patients with head and neck cancer

Head &Neck, EarlyView.


https://ift.tt/2PzWOcL

Effectiveness of small monitoring skin paddle in free muscle flap for scalp reconstruction

Head &Neck, EarlyView.


https://ift.tt/2Ne31gK

Morphological Alterations in Minor Salivary Glands of HTLV1+ Patients: a pilot study

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


https://ift.tt/2Pxy0SB

Histological analysis of 41 dentigerous cysts in a paediatric population

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


https://ift.tt/2NixwT3

Cytokine targets in lupus nephritis: Current and future prospects

Publication date: Available online 2 September 2018

Source: Clinical Immunology

Author(s): Christina Adamichou, Spyros Georgakis, George Bertsias

Abstract

Despite advancements in the care of lupus nephritis, a considerable proportion of patients may respond poorly or flare while on conventional immunosuppressive agents. Studies in murine and human lupus have illustrated a pathogenic role for several cytokines by enhancing T- and B-cell activation, autoantibodies production and affecting the function of kidney resident cells, therefore supporting their potential therapeutic targeting. To this end, there is limited post-hoc randomized evidence to suggest beneficial effect of belimumab, administered on top of standard-of-care, during maintenance therapy in lupus nephritis. Type I interferon receptor blockade has yielded promising results in preliminary SLE trials yet data on renal activity are unavailable. Conversely, targeting interleukin-6 and interferon-γ both failed to demonstrate a significant renal effect. For several other targets, preclinical data are encouraging but will require confirmation. We envision that high-throughput technologies will enable accurate patient stratification, thus offering the opportunity for personalized implementation of cytokine-targeting therapies.

https://ift.tt/2Q0p5tO

An investigator‐blinded, randomized, prospective, comparative study of efficacy of four anti‐inflammatory and barrier hand moisturizers in patients with chronic hand dermatitis

Dermatologic Therapy, EarlyView.


https://ift.tt/2PwFQvA

The use of etanercept for treatment of toxic epidermal necrolysis when toxic shock syndrome is in the differential

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAPSjU

Values of body mass index (BMI) and body surface area (BSA) in patients with psoriatic arthritis treated with adalimumab: Preliminary report

Dermatologic Therapy, EarlyView.


https://ift.tt/2PzPaiz

“SENECA” Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAik5J

Adipose tissue, fillers, and skin tightening

Dermatologic Therapy, EarlyView.


https://ift.tt/2PxHGMH

Risk Factors for Recurrent Anaphylaxis-Related ED Visits in the United States

Publication date: Available online 3 September 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Megan S. Motosue, M. Fernanda Bellolio, Holly K. Van Houten, Nilay D. Shah, Ronna L. Campbell

https://ift.tt/2wE2fjT

Tri-dimensional model for ventilation tube permeability

Abstract

Purpose

Ventilation tubes (VT) in the tympanic membrane expose the middle ear (ME) to the external auditory canal and its content. It carries the risk of penetration of contaminated material and could provide a pathway for the delivery of drugs into the ME. The aim of this study was to use a printed 3D-model of the external auditory canal (EAC) and ME to assess the permeability of various VTs to different fluids.

Methods

CT scan of the external and ME was 3D-reconstructed and printed. Five different types of VT were inserted in the model's tympanic membrane and the minimal pressure for penetration to the ME was measured. Liquids with different viscosities, including commonly used ear drops, were tested.

Results

Water passed through the standard 1.14 mm diameter VTs after filling the EAC with a volume of 2 ml and through a narrower grommet or a T-tube after filling the canal with 2.5 ml. Soapy-water had the highest penetration in all VTs (1–2 ml). The initial volume of dexamethasone needed for penetration was 2.5 ml in the standard tubes. It did not pass at any volume through the narrow grommet or the T-tube.

Conclusion

In the printed 3D-model, the volume of most solutions, including water, required to provide enough pressure in order to pass through the VTs was as high as the EAC volume or exceeded it. Soapy water had the highest penetrance while Dexamethasone needed volume of 2.5 ml to pass through the VT, questioning its reliability as a passive drug delivery channel to the ME.

https://ift.tt/2wDiT30

Ultrasonographic features associated with false-negative and false-positive results of extrathyroidal extensions in papillary thyroid microcarcinoma

Abstract

Purpose

To assess the ultrasonographic features affect accuracy of extrathyroid extension (ETE) evaluation on preoperative ultrasonography (US) in papillary thyroid microcarcinoma (PTMC).

Methods

Of the total patients who underwent thyroid surgery, 516 patients with a tumor measuring less than 1 cm on preoperative US were enrolled in this study. One blinded head and neck radiologist reviewed the preoperative US images to evaluate the US features of PTMC, and the pathologic reports were reviewed. The diagnostic accuracy rates, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated, and the factors associated with false-negative and false-positive results for ETE were analyzed.

Results

The sensitivity, specificity, PPV, NPV, and accuracy for predicting ETE according to sonographic criteria were 32.8%, 87.5%, 51.0%, 76.6%, and 71.7%, respectively. Non-adjacent to the trachea and unilateral lesion on US were significant factors associated with false-negative results.

Conclusion

Size, shape, and location of PTMC on US are important factors that affect the US results in ETE evaluation.

https://ift.tt/2Pybzge

Analysis of key genes and signaling pathways involved in Helicobacter pylori‐associated gastric cancer based on The Cancer Genome Atlas database and RNA sequencing data

Helicobacter, EarlyView.


https://ift.tt/2CdlBBs