Great progress has recently been made in the treatment of metastatic renal cell carcinoma, including the introduction of nivolumab, an immune checkpoint inhibitor. Despite promising results, this treatment bri...
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Παρασκευή 14 Σεπτεμβρίου 2018
Nivolumab induced encephalopathy in a man with metastatic renal cell cancer: a case report
Auch Melanompatienten mit Hirnmetastasen profitieren von neuen Behandlungsmethoden
Moderne Therapeutika haben das Leben von Melanompatienten verlängert. Ob und in welchem Ausmaß das auch für Patienten mit Hirnmetastasen zutrifft, wurde nun anhand von Beobachtungsdaten analysiert.
https://ift.tt/2NPwldI
Biopsie der Sentinellymphknoten: prognostischer Wert bei Melanomen fraglich
Eine Biopsie der Sentinellymphknoten ist neben der Beurteilung der Tumordicke nach Breslow eine zweite gängige Methode, bei Melanomen Informationen zu Stadium und Prognose zu sammeln. Ob der Befund tatsächlich zusätzliche prognostische Informationen liefert, wurde nunin einer retrospektiven Studie untersucht.
https://ift.tt/2MA6NNn
Anwendung der ABC-Regel in der Melanomdiagnostik
Bei der Bewertung der Dignität von Pigmentmalen der Haut gilt die ABC-Regel mit den drei Hauptmerkmalen Asymmetrie, (unregelmäßige) Begrenzung und (uneinheitliches) Colorit. Wie Experten die Regel anwenden, und ob sie in ihren Einschätzungen übereinstimmen, wurde nun getestet.
https://ift.tt/2NLLpcv
Melissa de la Cruz: Tochter der Finsternis
In New York hat sich eine geheime Parallelgesellschaft etabliert: Wichtige Positionen in der Kunst- und Kulturszene, aber auch in der Politik sind von Vampiren besetzt. Sie und ihre Familien verbindet nicht nur ein äußerlich sichtbares Mal, sondern auch ein gemeinsamer Feind, den die meisten längst besiegt glaubten.
https://ift.tt/2MA6GRX
Gewichtsreduktion wichtigste Kointervention bei Psoriasis und Psoriasisarthritis
Mit einer therapiebegleitenden Kostumstellung kann der Schweregrad einer Psoriasis beziehungsweise Psoriasisarthritis reduziert werden. Die National Psoriasis Foundation hat jetzt Ernährungsempfehlungen für diese Patientengruppe veröffentlicht.
https://ift.tt/2MA6DFL
TNF-α-Hemmer gut für Haut und Herz?
Psoriasis gilt als eigenständiger Risikofaktor für kardiovaskuläre Ereignisse. Eine Schlüsselrolle wird dem Tumornekrose-Faktor α zugeschrieben — von der Behandlung mit dessen Inhibitioren könnten Patienten mehrfach profitieren.
https://ift.tt/2NMJLHE
Über App statt Überweisung
Beim Modellprojekt „mSkin" in Mecklenburg-Vorpommern können Hausärzte bei Hautveränderungen ihrer Patienten per App einen Dermatologen konsultieren.
https://ift.tt/2NL3GXi
Androgenetische Alopezie: Laserlicht scheint Haarausfall am besten zu stoppen
Bei androgenetischer Alopezie ist Laserlicht möglicherweise am wirksamsten. Ein indirekter Vergleich per Netzwerkmetaanalyse findet für dieses Verfahren die stärksten Therapieeffekte.
https://ift.tt/2Mtpy4U
Akne: Überzeugende Belege nur für Glykolsäure-Peeling
Aknepatienten suchen oft nach nichtmedikamentösen Optionen. Deren Wirksamkeit ist aber nur wenig verlässlich belegt.
https://ift.tt/2NM2RgV
Photodynamische Therapie mit Tageslicht bei aktinischer Keratose langfristig erfolgreich
Die konventionelle photodynamische Therapie aktinischer Keratosen ist sehr effektiv, bringt aber einige Unannehmlichkeiten mit sich: Die Durchführung nimmt viel Zeit in Anspruch und kann für den Patienten schmerzhaft sein. Seit einiger Zeit gibt es mit der photodynamischen Therapie mit Tageslicht eine in der Anwendung einfachere Alternative.
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Patienten sollen Arztbriefe verstehen
Die Menschen wüssten heutzutage mehr über Medizin, meinen die Gesundheitsminister — die Ärzteschaft sollte dies in der Kommunikation mit ihren Patienten berücksichtigen.
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Von Acne inversa bis Zosterimpfung
Das Münchner Kindl auf der Spitze des Rathausturms breitete seine Arme aus und hieß vom 24. bis 28. Juli 2018 die Teilnehmer der zweijährlichen Fortbildungswoche für praktische Dermatologie und Venerologie im Internationalen Congress Center in München willkommen. Trotz verdichtetem Kernprogramm auf vier Tage war die Auswahl dermatologischer Themen wieder einmal breit gefächert.
https://ift.tt/2NMJDb8
Tongue-in-Groove Technique for Rhinoplasty: Technical Refinements and Considerations
Facial plast Surg
DOI: 10.1055/s-0038-1670647
A key concept in successful rhinoplasty surgery is maintaining or increasing tip support, and addressing tip projection and rotation. The tongue-in-groove (TIG) technique is a method to achieve this goal using sutures to create a strong connection between the septum and medial crura to change tip rotation and projection. Criticisms of this method include that it may cause stiffness of the nasal tip and columellar retraction. TIG is routinely used by the authors during anterior septal reconstructions (a modified extracorporeal septoplasty technique), as well as in primary and revision aesthetic and functional rhinoplasties. Through this review, technical aspects of the TIG technique are discussed, as well as how pitfalls of the technique can be avoided, as illustrated by several rhinoplasty patient examples.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Letter to the Editor about the article published in Clinical Oral Investigations tilted “Impacted and transmigrated mandibular canines: an analysis of 3D radiographic imaging data” (Bertl MH, Frey C, Bertl K, Giannis K, Gahleitner A, Strbac GD (2018), Clin Oral Investig , doi: 10.1007/s00784-018-2342-0)
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Mineral density changes in bovine carious dentin after treatment with bioactive dental cements: a comparative micro-CT study
Abstract
Objectives
To evaluate the potential of conventional glass ionomer cement (GIC), Biodentine™, MTA, and Portland cement to induce mineral density changes in carious dentin compared to zinc oxide eugenol control cement (ZOE).
Materials and methods
Fifty blocks of bovine root dentin were prepared and a biofilm model using ATCC strains of S.mutans, S.sobrinus, and L.casei was used to promote artificial dentin lesions. After demineralization, the blocks were randomly divided into the five cement groups. Half of the surface of each specimen received the tested material and the other half was covered with wax (control). Samples were stored in phosphate buffered saline solution for 30 days and after that were scanned in a micro-CT with standardized parameters. Dentin mineral density changes were calculated using differences in plot profiles of the exposed and control carious dentin. Friedman's test, followed by Wilcoxon signed-rank test was used with 5% significance.
Results
Mean ΔZ values for the cements were 48.63 ± 19.09 for the control (ZOE), 63.31 ± 32.59 for Biodentine™, 114.63 ± 72.92 for GIC, 109.56 ± 66.28 for MTA, and 106.88 ± 66.02 for Portland cement. All cements showed a statistically significant increase in ΔZ values compared to the control, but Biodentine™ values were statistically significantly lower compared to GIC and the other calcium silicate cements.
Conclusions
Tested materials present potential to induce mineral density changes in carious bovine dentin. MTA, Portland, and GIC showed higher bioactivity potential than Biodentine™.
Clinical relevance
Based on minimally invasive concept, materials with remineralization potential can be used to preserve diseased but still repairable dental tissue.
https://ift.tt/2CVAatW
Clinical, double blind, randomized controlled trial of experimental adhesive protocols in caries-affected dentin
Abstract
Objective
To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD).
Material and methods
A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%.
Results
The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (p < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (p < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance.
Conclusion
Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD. Clinical significance: Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.
https://ift.tt/2QC5b90
The effects of photobiomodulation therapy on mouse pre-osteoblast cell line MC3T3-E1 proliferation and apoptosis via miR-503/Wnt3a pathway
Abstract
Photobiomodulation therapy (PBMT) has been demonstrated as regulating osteoblast proliferation. MicroRNAs (miRNAs) are involved in various pathophysiologic processes in osteoblast, but the role of miRNAs in the PBMT-based promotion of osteoblast proliferation remains unclear. This study aimed to investigate the effects of PBMT treatment (3.75 J/cm2) on mouse pre-osteoblast cell line MC3T3-E1 proliferation and apoptosis via the miR-503/Wnt3a pathway; meanwhile, detect the expressions of miR-503 and Wnt3a after PBMT treatment and the role of miR-503 in regulating Wnt signaling molecules Wnt3a, β-catenin, Runx2, apoptotic proteins caspase-3, and Bcl-2 in vitro. The PBMT parameters were as follows: 808 nm continuous wavelength, 0.401 W output power, 0.042 W/cm2 power density, 9.6 cm2 spot size, 36 J energy, 3.75 J/cm2 energy density, 90 s irradiation for three times per 12 h, 14.5 cm distance of the laser source and the angle of divergence of the laser beam was 7°. In our present study, the target relationship was predicted and verified by bioinformatics analysis and luciferase reporter assays. Gene mRNA and protein expressions were examined by qPCR and western blot analysis. The MTT method was used to evaluate the effect of miR-503 on MC3T3-E1 cells proliferation. And cell apoptosis was examined by flow cytometry. The results showed that PBMT treatment reduced the expression of miR-503 and increased the level of Wnt3a (p < 0.01). Bioinformatics analysis and luciferase reporter assays revealed that Wnt3a was a target of miR-503, and Wnt3a was regulated by miR-503. Furthermore, miR-503 was found to functionally inhibit proliferation and promote apoptosis (p < 0.01). And during this process, Wnt3a, β-catenin, Runx2, and Bcl-2 expressions were significantly inhibited (p < 0.01); however, caspase-3 level was upregulated (p < 0.01). These results suggest that miR-503 plays a role in osteoblast proliferation and apoptosis in response to PBMT, which is potentially amenable to therapeutic manipulation for clinical application.
https://ift.tt/2MzmfZO
Asthma phenotypes based on health services utilization for allergic diseases in a province-wide birth cohort
Previous studies on asthma phenotypes were often conducted in selected clinical populations and overlooked changes over the life course.
https://ift.tt/2Mx0zhc
An In-Depth Characterization of a Large Cohort of Adults Patients with Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is a chronic allergic, immune-mediated disease associated with increased risk of comorbid atopic conditions.
https://ift.tt/2NKQguj
Is bromelain an effective drug for the control of pain and inflammation associated with impacted third molar surgery? Systematic review and meta-analysis
The aim of this systematic review was to determine whether bromelain is an effective drug for the control of pain and inflammation associated with third molar surgery. Randomized, controlled clinical trials on the subject were identified through a systematic search of the literature using the PubMed/MEDLINE, Scopus, and Cochrane Library databases. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent, blinded reviewers selected studies based on the inclusion criteria.
https://ift.tt/2OmDxv5
Comparison of temporalis fascia and tragal cartilage grafts in type 1 tympanoplasty in elderly patients
To investigate the success rates and hearing outcomes of temporalis fascia and tragal cartilage grafts used for type-1 tympanoplasty in the elderly (³65 years)
https://ift.tt/2Qyw9Ou
Margins and survival in oral cancer
Publication date: Available online 13 September 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): D.A. Mitchell, A. Kanatas, C. Murphy, P. Chengot, A.B. Smith, T.K. Ong
Abstract
In the surgical management of oral squamous cell carcinoma (SCC) we aim to resect the tumour with clear margins in all planes. The aim of this study was to identify and compare overall survival in a group of 591 patients who had resections, and to relate this to the clearance of margins at the tumour bed. We used life tables to calculate survival at one, two, three, five, and 10 years after diagnosis by margin (clear = 5 mm or more; close = 2–5 mm; and involved = less than 2 mm). Kaplan–Meier curves were produced for the margins alone, which were defined as clear in 480 patients (81%), close in 63 (11%), and involved in 48 (8%). Five-year survival was 81%, 75%, and 54% for clear, close, and involved margins, respectively, which highlights the importance of clear margins for survival. There is a significant prognostic implication associated with close, and particularly with involved, margins.
https://ift.tt/2MBUobK
Primary reconstruction of orbital fractures using patient-specific titanium milled implants: the Helsinki protocol
Publication date: Available online 13 September 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): M. Kärkkäinen, T. Wilkman, K. Mesimäki, J. Snäll
Abstract
Preoperative virtual planning and the use of patient-specific implants enable exact reconstruction of orbital fractures. We present our results and experience of reconstruction of isolated orbital fractures with patient-specific implants, according to the Helsinki protocol, in 15 patients who were followed up for at least three months postoperatively. The mean (range) difference between the positions of virtually planned, and postoperative, implants was 1.9 (0.5–5.6) mm. The postoperative volume of the fractured orbit was 1.34 ml less than that of the non-fractured side, but this was not clinically relevant. None of the patients required reoperation and none had any implant-related complications during follow up. We conclude that patient-specific implants are an adaptable and reliable treatment for primary orbital trauma, and that the Helsinki protocol may have wider applications in the treatment of facial fractures.
https://ift.tt/2xdrGsH
Manufacture of a high definition ocular prosthesis
Publication date: Available online 13 September 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): E. Walshaw, T. Zoltie, P. Bartlett, T. Gout
https://ift.tt/2MxWFEu
Neurosensory recovery after trauma to the orbital floor: a prospective trial with dexamethasone
Publication date: Available online 13 September 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): A. Haapanen, H. Thorén, S. Apajalahti, A.L. Suominen, J. Snäll
Abstract
Our aims were to document the occurrence of neurosensory disturbances of the infraorbital nerve six months after operation for an orbital blow-out fracture, and to find out whether dexamethasone facilitates neurosensory regeneration. Patients were randomly assigned to one of two groups: the study group was given a total of dexamethasone 30 mg, whereas the control group were given neither glucocorticoid nor placebo. Each patient's infraorbital neurosensory state was recorded preoperatively, immediately postoperatively, and six months later. A total of 18 patients were included, eight of whom had neurosensory disturbances six months after the initial trauma that was not affected by dexamethasone. Six of the seven patients who had a delay of seven days or more between trauma and operation had significantly prolonged disturbance at the 180-day clinical follow up compared with those in whom it was less than seven days (p = 0.005). Other possible predictors made no significant difference. Although dexamethasone did not facilitate sensory recovery, its benefits in the management of pain and reduction of swelling may justify its use in the management of facial trauma in selected patients.
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The impact and effect of emotional resilience on performance: an overview for surgeons and other healthcare professionals
Publication date: Available online 13 September 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): F. Murden, D. Bailey, F. Mackenzie, R.S. Oeppen, P.A. Brennan
Abstract
Medicine and surgery can be demanding professions with high levels of burnout, but few healthcare professionals are given training or education in the management of stress, and the ability of individuals to cope with work and other pressures is often taken for granted. Emotional resilience – the ability to recover from a stressful event, whether at work or at home – is influenced by factors that are both within and outside our control. In this review, we provide an overview of emotional resilience for surgeons and other healthcare professionals, and focus on the factors that can be modulated to help us cope with difficult or complex situations. We also discuss the importance of teamwork and camaraderie, which can easily be forgotten in busy working practice. A greater awareness and understanding of emotional resilience and ways to cope with stress and pressure at work are essential if we are to look after ourselves better, improve the work of our teams, and provide the best care for our patients.
https://ift.tt/2MxVMMa
Diagnosis and Management of NSAID‐Exacerbated Respiratory Disease (N‐ERD) – a EAACI position paper
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2MwkwEQ
Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study
Abstract
Objectives
This study aimed to evaluate the effect of low-level laser therapy (LLLT) in terms of enhancing wound healing, reducing free gingival graft (FGG) shrinkage and postoperative pain.
Materials and methods
Thirty patients were randomly assigned to receive either FGG + LLLT (test, n = 15) or FGG + plasebo LLLT (control, n = 15). In the test group, a diode laser (810 nm, 0.1 W, energy density 6 J/cm2) was applied immediately after surgery and 1, 3, 7, and 14 days later. Measurements of the graft surface areas of the groups were made with an image-analyzing software at baseline and first, third, and sixth months. Complete wound epithelialization and visual analogue scale (VAS) for pain score were evaluated after surgery.
Results
Shrinkage of the graft was statistically higher in the control than the test group at third and sixth months (p < 0.05). In terms of epithelization of the graft area, the test and control groups did not show any significant difference during the 28-day period (p > 0.05). Besides this, statistically significant differences were observed for VAS pain score and the number of analgesic used (p < 0.05).
Conclusions
The use of an 810-nm diode laser provided additional benefits to FGG in terms of less shrinkage of the graft dimensions and postoperative pain.
Clinical relevance
Low-level laser therapy reduced the shrinkage of free gingival graft's surface area after 6 months and enhanced postoperative pain relief.
https://ift.tt/2p7IUmJ
Effects of oral prophylaxis including tongue cleaning on halitosis and gingival inflammation in gingivitis patients—a randomized controlled clinical trial
Abstract
Objective
The objective of this study was to assess the effect of oral prophylaxis including tongue scraping on level of halitosis, clinical periodontal parameters and local cytokine response in gingivitis patients.
Materials and methods
In this randomized controlled clinical trial, 36 gingivitis patients were randomly assigned into two subgroups after scaling and polishing. Group 1 received oral hygiene instructions including the use of tongue scraper; group 2 received oral hygiene instructions alone without tongue cleaning. Levels of volatile sulfur compounds (VSC), organoleptic and tongue coating scores, clinical periodontal parameters and gingival crevicular fluid (GCF) samples were collected at baseline and 7 days after oral prophylaxis. GCF samples were analyzed using multiplexing analysis for the simultaneous measurements of cytokines. The Chi-square, Mann-Whitney U, Wilcoxon, and Student's paired and unpaired t tests were used for statistical analysis.
Results
Statistically significant reductions were found in terms of clinical periodontal parameters in both groups. However, significant improvements in VSC levels, organoleptic and tongue coating scores were observed just in tongue scraping group. Moreover, the GCF levels of IL-1β and IL-8 significantly decreased after the treatment in group 1 according to the baseline values.
Conclusion
The present study indicated that oral prophylaxis including tongue scraping was effective in improving intra-oral halitosis and pro-inflammatory cytokine response in GCF in gingivitis patients.
Clinical relevance
The results suggest that tongue scraping can be taken into consideration in order to manage gingival inflammation as well as VSC levels in gingivitis patients but further clinical studies are required to judge the clinical relevance.
https://ift.tt/2MypEbs
Pro‐inflammatory role of transient receptor potential canonical channel 6 in the pathogenesis of chronic rhinosinusitis with nasal polyps
International Forum of Allergy &Rhinology, EarlyView.
https://ift.tt/2xhOerx
Serum fatty acid‐binding protein 4 level is inversely correlated with serum thymus and activation‐regulated chemokine level in psoriatic patients achieving clear skin by biologics
The Journal of Dermatology, EarlyView.
https://ift.tt/2OobyuY
Study on site‐specific expression of bone formation and resorption factors in human dental follicles
European Journal of Oral Sciences, EarlyView.
https://ift.tt/2Mx6a70
Diffuse papulopustular eruption in a newborn
Pediatric Dermatology, Volume 35, Issue 5, Page 683-684, September/October 2018.
https://ift.tt/2NawjOe
Enlarging verrucous plaques in a teenager
Pediatric Dermatology, Volume 35, Issue 5, Page 671-672, September/October 2018.
https://ift.tt/2Mv0ivb
Red‐brown macules in a linear distribution on the arm
Pediatric Dermatology, Volume 35, Issue 5, Page 685-687, September/October 2018.
https://ift.tt/2Naw85w
Skin lesions in a 5‐year‐old boy with recent unusual course of pneumonia
Pediatric Dermatology, Volume 35, Issue 5, Page 673-675, September/October 2018.
https://ift.tt/2Mv09I9
Response to “Doing the math: A simple approach to topical timolol dosing for infantile hemangiomas”
Pediatric Dermatology, Volume 35, Issue 5, Page 700-700, September/October 2018.
https://ift.tt/2NavYLs
Child with flagellate skin eruptions
Pediatric Dermatology, Volume 35, Issue 5, Page 676-677, September/October 2018.
https://ift.tt/2MuZYfX
An infant with a capillary malformation on the lower lip
Pediatric Dermatology, Volume 35, Issue 5, Page 681-682, September/October 2018.
https://ift.tt/2NaQ8oy
A hair out of place in a 6‐year‐old boy
Pediatric Dermatology, Volume 35, Issue 5, Page 669-670, September/October 2018.
https://ift.tt/2Mw3w1t
A comprehensive next‐generation sequencing assay for the diagnosis of epidermolysis bullosa
Pediatric Dermatology, Volume 35, Issue 5, Page 732-735, September/October 2018.
https://ift.tt/2N9EqKZ
A rapidly‐growing, exophytic papule on the nose of a 9‐year‐old Native American boy
Pediatric Dermatology, Volume 35, Issue 5, Page 678-680, September/October 2018.
https://ift.tt/2Mw3mHp
Comment on “Doing the math: A simple approach to topical timolol dosing for infantile hemangiomas”
Pediatric Dermatology, Volume 35, Issue 5, Page 698-699, September/October 2018.
https://ift.tt/2Ndwngg
Patient Perspectives: What is Diaper Rash?
Pediatric Dermatology, Volume 35, Issue 5, Page 667-668, September/October 2018.
https://ift.tt/2Mw343h
Comment on “Excellent response to ustekinumab in a 9‐year‐old girl with severe psoriasis”
Pediatric Dermatology, Volume 35, Issue 5, Page 701-701, September/October 2018.
https://ift.tt/2Ndwatu
Issue Information
Pediatric Dermatology, Volume 35, Issue 5, Page 541-546, September/October 2018.
https://ift.tt/2MvZXrO
Society for Pediatric Dermatology 43rd Annual Meeting Poster Presentations July 2018 | Lake Tahoe, California
Pediatric Dermatology, Volume 35, Issue 5, Page 702-731, September/October 2018.
https://ift.tt/2NdvTXu
A challenging case: Multiple and Blaschkoid hair follicle naevi or supernumerary accessory tragi?
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2NHX1gA
Polymorphisms in P53 and VEGFA genes in different subtypes of periorbital hyperpigmentation in a Malaysian Chinese population
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2xeCPJ5
Angina bullosa haemorrhagica‐like lesions in pemphigus vulgaris
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2NHWRWw
Coronary artery ectasia: a rare cause of acute coronary syndrome
Coronary artery ectasia (CAE) is defined as a localised or diffuse dilatation of coronary artery lumen more than 1.5 times that of an adjacent normal segment. CAE may present with or without functionally significant stenosis. Such patients may manifest with stable angina or with acute coronary syndrome. Ectasia may serve as a nidus for thrombus formation with likelihood of distal embolisation or it may lead to dissection or spasm. This condition presents a challenge for an interventionist. Should we intervene or manage it medically. We describe a case of CAE where all the vessels were diffusely ectatic with variable degree of stenosis. In brief we discuss the causes and management issues in ectasia.
https://ift.tt/2Qvj60h
Pineoblastoma in a child with 22q11.2 deletion syndrome
Description
A 4-year-old girl with a history of chromosome 22q11.2 deletion syndrome presented to the emergency department with 2–3 weeks of worsening emesis. CT of the head revealed a large pineal region calcified tumour with associated hydrocephalus. Contrast-enhanced MRI of the brain and spine status postexternal ventricular drain placement confirmed a pineal tumour with diffuse metastatic leptomeningeal spinal spread (figure 1A,B). The child had a normal MRI of the brain 2 years prior (figure 1C) as work-up for her developmental delay. The diagnosis of 22q11.2 deletion syndrome was made by chromosomal microarray testing, which revealed a 2.5 MB deletion of 22q11.2 that included the TBX1 gene. Neuropathology on a subtotal resection showed clusters and sheets of tightly packed, small, blue cells with oval or slightly angulated nuclei and scant cytoplasm, consistent with a primitive neuroectodermal tumour. The tumour showed no loss of expression of INI...
https://ift.tt/2MvHxra
Uncommon cause of chest pain in a postoperative spinal patient
An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones. To date, we have not come across a case of spontaneous sternal fracture as a complication of spinal surgery at our regional spinal unit. Most cases of sternal fractures are secondary to blunt anterior chest wall trauma with spontaneous fractures and stress fractures being rare.
https://ift.tt/2MvHmfu
Spin-top-like encrustation of suprapubic cystostomy catheter: when proper counselling is all that it takes!
Description
A 25-year-old man from a rural background and suffering from psychiatric illness had complaints of acute urinary retention 1 year ago for which trocar-guided suprapubic cystostomy (SPC) Foley catheter placement was done elsewhere after failed attempt of per-urethral catheterisation.
There was no history of haematuria, lithuria, catheterisation and endourological intervention in the past. On further eliciting the history, there was a retrograde urethrogram film taken 1 year back which revealed a short segment (1.0 cm) bulbar urethral stricture. He had undergone optical internal urethrotomy with Foley catheter placement (14F) under regional anaesthesia for his urethral stricture. Per-urethral catheter was removed after 7 days and he voided well with good urinary stream. He was sent back home and instructed to follow-up after 3 days for removal of SPC catheter and need of de-clamping SPC catheter in case of urinary retention again.
However, a thorough counselling about catheter's care and related complications was not...
https://ift.tt/2QviVlD
A rare case of cellular angiofibroma affecting the periurethral region in a 38-year-old woman
Cellular angiofibroma (CAF) is a rare, site-specific, benign mesenchymal tumour affecting both women and men in the genitourinary region. The tumour usually presents as a small, asymptomatic lesion involving the vulvovaginal regions in women and inguinoscrotal regions in men. We report the case of a 38-year-old woman presenting with a painless mass in the vulval region, especially on the right side of urethral meatus for 8 years with progressively increasing lower abdominal discomfort. A simple excision was performed. The diagnosis of CAF was confirmed histopathologically.
https://ift.tt/2MvGd7Z
Cervical tuberculous lymphadenitis in an elderly adult
Description
A 94-year-old man presented with complaints of increasing fatigue and generalised weakness for 1 month's duration. On admission, the patient had tachycardia of 112 bpm and fever of 101.1 °F. His initial physical examination was otherwise normal. Lactic acid was elevated (4.13 pg/mL), but other laboratory markers were within normal limits. No apparent source of infection was identified by initial urinalysis, chest radiography or CT of the abdomen without contrast. The lactic acidosis resolved after administration of normal saline, but he continued to have fever, which prompted more thorough physical examination that revealed a painless right-sided neck mass. CT of the neck without contrast confirmed a low-density neck mass in the right posterior cervical region measuring 7 cm in the maximum diameter (figures 1 and 2), suspicious for necrotic tumour or an abscess. Ultrasound-guided drainage of the mass recovered 50 mL of purulent material that was submitted for...
https://ift.tt/2QstE0d
Cytomegalovirus-associated haemophagocytic lymphohistiocytosis: a rare cause of febrile neutropenia during cancer chemotherapy
Febrile neutropenia (FN) is a common complication in patients with cancer during treatment with antineoplastic drugs. The initial cause is usually bacterial, and treatment of FN follows well-defined algorithms. We report a case of a 62-year-old patient with chronic lymphocytic leukaemia (CLL), who developed FN, which was unresponsive to both empirical antibacterial and empirical antifungal therapy. Surprisingly, a diagnosis of the life-threatening condition haemophagocytic lymphohistiocytosis (HLH) associated with cytomegalovirus (CMV) infection was made and treated successfully. CMV-associated HLH has not previously been described in patients with CLL treated with rituximab and bendamustine. It is concluded that HLH should be considered in patients with cancer with FN not responding to conventional antibiotic therapy.
https://ift.tt/2MvH2NO
Patella incarceration with associated patella fracture: a rare case of a paediatric patient with no associated femoral fracture
We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Open reduction and fixation was performed using suture anchors. We feel that this case is particularly pertinent since nearly all previous case reports describe an incarcerated patella with an associated femur fracture. Furthermore, no previous case reports have been published in a child.
https://ift.tt/2QviAzn
Tibial osteomyelitis with cold abscess within calf muscles in a toddler referred with suspected oligoarthritis to rheumatology clinic
Description
A 2-year-old male child was referred to the paediatric rheumatology clinic with history of limping, swelling of right knee and low-grade fevers for 6 weeks. About 2 months prior to this presentation, he had an episode of upper respiratory infection which was followed by swelling of the right knee. He was initially treated with oral analgesics by his primary physician. After 6 weeks when there was no improvement, he was referred for evaluation of possible juvenile idiopathic arthritis.
On examination, there was visible swelling of his right knee compared with his left and he was refusing to bear weight on his right lower limb (figure 1). On closer observation, a diffuse swelling was noted over the right calf region with fullness of the popliteal fossa (figure 1). The swelling was not warm or tender. There was no contact history with tuberculosis. The patient...
https://ift.tt/2MwD73l
Management of oesophageal intramucosal carcinoma
We present an interesting case of an intramucosal carcinoma (IMC) in the setting of Barrett's oesophagus in a 66-year-old woman. Her clinical course highlights the shifting paradigm in the approach to management of Barrett's oesophagus and IMC. With innovation in imaging and endoscopic treatment modalities, patients are detected earlier and managed prior to development of malignancy. The patient was treated with endoscopic modalities, and after 3 years' follow-up, she remains recurrence free.
https://ift.tt/2QtDVcH
Rehabilitation Planning Consult Phase II Trial
Condition: Head and Neck Neoplasms
Interventions: Behavioral: Rehabilitation Planning Consult (RPC); Other: Wait list control (WLC)
Sponsor: University Health Network, Toronto
Not yet recruiting
https://ift.tt/2Qsf1dr
Interventions: Behavioral: Rehabilitation Planning Consult (RPC); Other: Wait list control (WLC)
Sponsor: University Health Network, Toronto
Not yet recruiting
https://ift.tt/2Qsf1dr
Combination of Chemotherapy Plus RT and SHR-1210 to Treat Patients With ESCC
Condition: Esophageal Cancer
Interventions: Drug: SHR-1210; Radiation: IMRT or VMAT; Drug: Apatinib
Sponsors: Tianjin Medical University Cancer Institute and Hospital; Jiangsu HengRui Medicine Co., Ltd.
Not yet recruiting
https://ift.tt/2MvyUNv
Interventions: Drug: SHR-1210; Radiation: IMRT or VMAT; Drug: Apatinib
Sponsors: Tianjin Medical University Cancer Institute and Hospital; Jiangsu HengRui Medicine Co., Ltd.
Not yet recruiting
https://ift.tt/2MvyUNv
Perioperative Perfusion Measurement - a Feasibility and Usability Study
Condition: Esophageal Cancer
Interventions: Device: Q-ICG; Procedure: White light perfusion assessment; Procedure: Fluorescence angiography
Sponsor: Rigshospitalet, Denmark
Recruiting
https://ift.tt/2QuutWg
Interventions: Device: Q-ICG; Procedure: White light perfusion assessment; Procedure: Fluorescence angiography
Sponsor: Rigshospitalet, Denmark
Recruiting
https://ift.tt/2QuutWg
IgA nephropathy: clearance kinetics of IgA-containing immune complexes
Abstract
IgA nephropathy (IgAN) is associated predominantly IgA deposition in the affected glomeruli and has been shown to be the most common glomerular disorder among young people in the world. Although the exact pathogenic mechanism underlying IgAN remains largely unknown, circulating IgA-containing immune complexes (IgA ICs) is considered to play a major role in initiating the development and evolution of the renal disorder. In this review article, we discuss the fundamental mechanisms of clearance kinetics of IgA ICs and related issues, covering the following: (1) role of circulating IgA ICs in the pathogenesis of IgAN and (2) elimination of IgA ICs from the body, with emphasis of the role of the liver and Fc receptors in immune cells.
https://ift.tt/2Nfs7Nh
Three-dimensional reconstruction of the temporal bone: Comparison of in situ, CT, and CBCT measurements
Publication date: Available online 13 September 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Guyader, J. Savéan, C. Clodic, P. Letellier, P. Meriot, R. Marianowski
Abstract
Objective
To evaluate the accuracy of three-dimensional (3D) Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT) reconstructions of human temporal bones compared with in situ measurements.
Material and methods
Experimental anatomical study of 10 human temporal bones. Wilcoxon's test was used to compare 8 distances on each temporal bone measured in situ and then on 3D CT and CBCT reconstructions. Six landmarks were used: external auditory canal (EAC), tip of the mastoid process, tip of the occiput, zygoma, a point situated 1 cm above the tip of the mastoid process (T0) (open technique: lower limit of the mastoidectomy), head of stapes.
Results
No significant difference was observed between the 3 measuring techniques for any of the distances studied (P > 0.05).
Discussion
This study demonstrates the equivalence of CBCT and CT for temporal bone measurements.
Conclusion
CBCT is a new imaging modality providing 3D reconstructions of the temporal bone that are as reliable as those obtained by CT. As a result of better spatial resolution compared to CT, CBCT is associated with a significantly lower radiation dose. This technique constitutes a morphological progress, as CBCT is comparable to CT, allowing investigation of pathological ears with a lower radiation dose.
https://ift.tt/2Ol62JB
Outcomes and Swallowing Evaluations after Injection Laryngoplasty for Type I Laryngeal Cleft: Does Age Matter?
Publication date: Available online 13 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Elisabeth Cole, Alexandra Dreyzin, Amber D. Shaffer, Allison B.J. Tobey, David H. Chi, Tony Tarchichi
Abstract
Objectives
To improve the recognition of differences in presentation amongst patients with type 1 laryngeal clefts of various ages and better understand the age dependent outcomes of injection laryngoplasty. A second aim was to analyze the discrepancies between swallow assessment modalities in various age groups with type I laryngeal clefts undergoing injection laryngoplasty.
Methods
A retrospective review of electronic medical records of patients who underwent injection laryngoplasty from 2009 through 2015 at a tertiary care children's hospital. Data extracted included: Demographics, histories and physical exam findings, diagnostic studies, and medical and surgical treatments.
Results
Most (72/102, 70.6%) patients were male with a median gestational age at birth of 37 weeks (range 24–41 weeks). Formula thickening and GERD medications were used in 94/102 (92.2%) and 97/102 (95.1%) patients, respectively. Comorbid GERD, laryngomalacia, tracheomalacia, and subglottic stenosis were present in 98/102 (96.1%), 40/102 (39.2%), 9/102 (8.8%), and 14/102 (13.7%) patients, respectively. There was no significant difference in demographics, comorbidities or medical therapy between age groups. Symptoms at presentation differed between age groups with stridor (χ2(1) =11.6, p=0.002) and cyanosis (χ2(1) =8.13, p=0.012) being more common in the 0–3-month group compared to the 12-36 month group. Symptom resolution and the odds of undergoing additional surgery (second injection or suture repair) over time, however, did not differ. There was a significant reduction in aspiration with thins during FEES (McNemar χ2(1) =10.7, p=0.002) and aspiration with nectar during MBS (McNemar χ2(1) =5.26, p=0.035) post-injection. After injection, there was significant agreement in aspiration with thins between FEES and MBS (kappa=0.308 ± SE 0.170, p=0.035). However, finding aspiration with thins was more common during MBS than during FEES (McNemar χ2(1) =7.00, p=0.016). There were no differences in swallow evaluation findings between the age groups.
Conclusions
Symptoms of type I laryngeal clefts may differ by age. However, there was no impact of age on the safety and efficacy of surgical intervention.
https://ift.tt/2NcVcZK
Use of the Pediatric Intensive Care Unit for Post-Procedural Monitoring in Young Children Following Microlaryngobronchoscopy: Impact on Resource Utilization and Hospital Cost
Publication date: Available online 13 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Elizabeth J. Kerris, Jason T. Patregnani, Matthew Sharron, Anthony A. Sochet
Abstract
Objective
To assess the frequency of post-procedural complications, medical interventions, and hospital costs associated with microlaryngobronchoscopy (MLB) in children prophylactically admitted for pediatric intensive care unit (PICU) monitoring for age ≤ 2 years.
Methods
We performed a single-center, retrospective, descriptive study within a 44-bed PICU in a stand-alone, tertiary, pediatric referral center. Inclusion criteria were age ≤ 2 years and pre-procedural selection of prophylactic PICU monitoring after MLB between January 2010 and December 2015. Children were excluded for existing tracheostomy, if undergoing concurrent non-otolaryngeal procedures, or if intubated at the time of PICU admission. Primary outcomes were the development of major and minor procedural complications and medical rescue interventions. Secondary outcomes were hospital cost and length of stay (LOS).
Results
One hundred and eight subjects met inclusion criteria with a median age of 5.3 (IQR: 2.6-10.9) months. A majority (86%) underwent therapeutic instrumentation in addition to diagnostic MLB. There were no observed major complications or rescue interventions. Minor complications were noted within 5 hours of monitoring and included isolated stridor (24%), desaturation <90% (10%), and nausea/emesis (8%). Minor interventions included supplemental oxygen via regular nasal cannula (39%), single-dose inhaled racemic epinephrine (19%), single-dose systemic corticosteroids (19%), or high flow nasal cannula (HFNC) therapy (4%). Save for two cases of HFNC, interventions were completed or discontinued within 5 hours. Median PICU LOS was 1.1 days and median cost was $9,650 (IQR: $8,235- $14,861) per encounter. Estimated cost of same day observation in our post anesthesia care unit (PACU) following MLB without PICU admission is $1,921 per encounter.
Conclusions
In children ≤ 2 years of age prophylactically admitted for PICU observation, we did not observe severe complications or major interventions after MLB. Minor interventions and complications were noted early during post-procedural monitoring. PICU monitoring was substantially more expensive than same-day PACU observation. Young age as the sole criteria for prophylactic PICU monitoring after diagnostic or therapeutic MLB may be unjustified when comparable, cost-conscious care can be achieved in a PACU setting. Prior to pre-procedural selection of PICU monitoring, we recommend a broad contextual risk assessment including a review of comorbidities, operative plan, and intended anesthetic exposure.
https://ift.tt/2Mw3yGu
LipoxinA4 attenuates acute pancreatitis-associated acute lung injury by regulating AQP-5 and MMP-9 expression, anti-apoptosis and PKC/SSeCKS-mediated F-actin activation
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Zhehao Shi, Wen Ye, Jiecheng Zhang, Fan Zhang, Dinglai Yu, Huajun Yu, Bicheng Chen, Mengtao Zhou, Hongwei Sun
Abstract
An essential component of acute pancreatitis(AP)-induced acute lung injury(ALI) is the inflammation that is part of the body's systemic inflammatory response to a variety of systemic stimuli. Lipoxins(LXs) are considered important endogenous lipids that mediate the resolution of inflammation. In previous studies, we found that Lipoxin A4 (LXA4) reduced AP-induced pulmonary oedema and TNF-α production in lung. However, the underlying mechanism remains unclear. Due to the above studies, we investigated the aquaporin, matrix metalloprotein, apoptosis and PKC/SSeCKS signal pathway in cellular and animal models of AP-associated lung injury following LXA4 intervention. In this study, we first proved LXA4 could effectively promote F-actin reconstruction and regulate its expression in pulmonary microvascular endothelial cells both in vivo and vitro via suppressing PKC/SSeCKS signalling pathway. Next, we found that LXA4 attenuated cell growth inhibition and apoptosis in lung tissues of AP-ALI mice and HPMECs. Additionally, we demonstrated that LXA4 could regulate the expression of AQP-5 and MMP-9 to stabilize the permeability of pulmonary microvascular endothelial cell. In summary, our results suggest that the anti-inflammatory eff ;ects of LXA4 may be due to the inhibition of both the PKC/SSeCKS pathway and apoptosis to reduce alveolar fluid exudation and to the regulation of AQP-5 and MMP-9 expression to maintain the clearance of alveolar fluid. Thus, LXA4 is capable of exerting protective eff ;ects on AP-induced ALI.
https://ift.tt/2MuZO87
Increase of follicular helper T cells skewed toward a Th1 profile in CVID patients with non-infectious clinical complications
Publication date: Available online 13 September 2018
Source: Clinical Immunology
Author(s): Delphine Turpin, Adeline Furudoi, Marie Parrens, Patrick Blanco, Jean-François Viallard, Dorothée Duluc
Abstract
Common variable immunodeficiency (CVID) is characterized by low levels of circulating immunoglobulins and defects in B cell maturation leading to an increased susceptibility to infections. Some patients develop complications such as autoimmune diseases, enteropathy, and lymphoproliferation, resulting in higher morbidity and mortality. Follicular helper T (Tfh) cells are specialized in helping B cell differentiation into Ig-producing cells. Three subsets have been described, namely non B-cell helper Tfh1 and the two B-helper cell subsets Tfh2 and Tfh17. We determined that circulating Tfh cells were elevated in CVID patients and skewed toward a Tfh1 profile. Interestingly, elevated levels of Tfh1 cells were significant only in patients harboring non-infectious complications regardless of the type of complication and inversely correlated with switched memory B cells. Moreover, CXCR3+ cells are increased in splenic CVID germinal centers. Our observations suggest that the altered balance in Tfh subsets in CVID is linked to a more severe disease.
https://ift.tt/2NcoIyt
Chronic hyperglycemia with elevated glycated hemoglobin level and its association with postoperative acute kidney injury after a major laparoscopic abdominal surgery in diabetes patients
Abstract
Background
The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery.
Methods
We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016. Patients were divided into two groups based on a cut-off value of hemoglobin A1c (HbA1c) at 6%. Serum creatinine value was used for the diagnosis of AKI, and all assessments and diagnoses of postoperative AKI were performed on 0–3 postoperative days (POD) using the criteria of Kidney Disease: Improving Global Outcomes.
Results
In all, 1885 patients were included in the final analysis, and patients were divided into the following groups: < 6.0% group with 1257 patients (66.7%), and ≥ 6.0% group with 628 patients (33.3%). Sixty-nine patients (3.7%) were diagnosed with postoperative AKI within 3 POD. Multivariable logistic regression analysis showed no significant difference in the incidence rate of postoperative AKI between the HbA1c ≥ 6.0% group and the < 6.0% group (odds ratio 1.10, 95% confidence interval 0.57–2.15; P = 0.770). In addition, there was no significant interaction between preoperative HbA1c group and exposure to acute hyperglycemia (serum glucose > 200 mg/dL) for incidence of AKI on POD 0–3 (P = 0.181).
Conclusions
In diabetic patients, preoperative chronic hyperglycemia is not associated with postoperative AKI occurrence within 3 POD after a major laparoscopic abdominal surgery.
https://ift.tt/2xcqeqv
Traditional face-bow transfer versus three-dimensional virtual reconstruction in orthognathic surgery
Publication date: Available online 13 September 2018
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): A. Quast, P. Santander, D. Witt, A. Damm, N. Moser, H. Schliephake, P. Meyer-Marcotty
Abstract
Face-bow transfer is an essential step in articulator-based orthognathic surgery planning. However, it can be a source of inaccuracy. Virtual computer-based planning avoids this error through the use of direct patient-related three-dimensional imaging data. The aim of this prospective observational study was to determine the error of face-bow transfer three-dimensionally and correlate it to the different types of malocclusion. Orthognathic surgery performed on 38 patients (10 male, 28 female; mean (standard deviation) age 24.7 (6.9) years) was planned twice: first articulator-based with plaster models and second computer-based with surgery planning software. Both models were digitized and compared regarding the angle between the Frankfort horizontal plane and the occlusal plane. In most cases, the angle in the sagittal dimension was higher in the articulator-based model than in the computer-based model. The angle in the transverse dimension was as often under- as over-represented. The type of malocclusion, i.e. skeletal class, vertical relationship, and degree of asymmetry, had no significant impact on the amount of error. In conclusion, this study indicates that computer-based planning should be considered as an advantageous alternative in orthognathic surgery planning.
https://ift.tt/2CS3NMu
Title: P120 catenin expression and its correlation with E-cadherin in salivary gland neoplasms
Publication date: Available online 14 September 2018
Source: Journal of Oral Biology and Craniofacial Research
Author(s): Ekarat Phattarataratip, Nicha Kositkittiwanit, Pruch Kajornkiatkul, Pataraporn Yeunyong, Ratanatip Ratanapitak
Abstract
Objectives
Altered P120 catenin expression has been associated with E-cadherin loss and poor prognosis in several cancers. The objectives of this study were to examine the P120 catenin expression in salivary gland neoplasms in correlation with E-cadherin and assess the relationships between their expression levels and pathologic characteristics.
Methods
Fifty-two cases of salivary gland neoplasms, i.e. 25 mucoepidermoid carcinomas (MEC), 13 adenoid cystic carcinomas (ACC), 12 pleomorphic adenomas (PA) and 2 polymorphous adenocarcinomas (PAC) were included. The expression of P120 catenin and E-cadherin was investigated immunohistochemically.
Results
Both P120 catenin and E-cadherin were overexpressed in salivary gland neoplasms, compared to normal tissue. P120 catenin was primarily detected on the membrane of neoplastic cells in most cases. A significant correlation between levels of expression of both proteins was noted in MECs. In ACCs and PA, ductal cells showed positive immunoreactivity, whereas myoepithelial cells variably expressed both proteins. Increased P120 catenin expression was significantly associated with the solid subtype of ACCs.
Conclusions
The cadherin-catenin complex is preserved in the heterogenous tumor cell population in salivary gland neoplasms. Overexpression of P120 catenin may be involved in the progression to solid ACCs.
https://ift.tt/2CTOnYj
Cephalometric appraisal of the effects of orthodontic treatment on total airway dimensions in adolescents
Publication date: Available online 13 September 2018
Source: Journal of Oral Biology and Craniofacial Research
Author(s): Maj Raj kumar Maurya, Col Prasanna Kumar, Lt Col Mohit Sharma, Lt Col Karan Nehra, Harpreet Singh, Prabhat Kumar Chaudhari
Abstract
Aim
This retrospective study was performed to rule out any jeopardizing effect of extraction therapy of four first premolars on airway at any level of its anatomic course.
Materials and methods
Lateral cephalograms of 50 adolescent patients divided into two groups of 25 each, based on orthodontic treatment by first premolar extraction as group I and without extraction as group II, were selected for the study. 13 angular and 11 linear measurements were compared pre-and post-treatment via statistical analyses using SPSS (Version 17.5, SPSS, Chicago) software. Paired 't' tests were used to assess the variability. P-value < 0.05 was considered to be statistically significant.
Results
Comparison of angular parameters showed that the average percentage (%) change in SNA, SNB, ANB, IMPA, FMA, saddle, articulare, gonial, total angle and hyoid did not differ significantly across two study groups (P > 0.05), but values of UI/LI, UI/NA, LI/NB, differed significantly among both groups. Similarly, linear parameters showed that the average % change in nasopharyngeal airway space (NAS) and width of soft palate differed significantly across two study groups (P-value<0.05), whereas the average % change in posterior airway space (PAS), hypopharyngeal airway space (HAS), hyoid distance and length of tongue did not differ significantly (P-value>0.05). However, no significant differences were observed during intragroup and intergroup comparisons of the combined angular and linear measurements of both groups.
Conclusions
Present study showed no significant change on airway after therapeutic orthodontic tooth movement with or without extraction treatment.
https://ift.tt/2QuuM3y
A gene expression profile associated with perineural invasion identifies a subset of HNSCC at risk of post-surgical recurrence
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Zuzana Saidak, Florian Clatot, Denis Chatelain, Antoine Galmiche
Abstract
Objectives
Perineural invasion (PNI) is a common histopathological finding in head and neck squamous cell carcinoma (HNSCC). We aimed to explore the molecular mechanisms involved in PNI and the role of PNI as an aggressive pathological feature.
Materials and methods
We used data from The Cancer Genome Atlas (TCGA) to relate the histological presentation of 528 HNSCC tumours to clinical, whole genome expression and proteomic data.
Results
We identified a specific gene expression profile highly enriched in genes related to muscle differentiation/function and associated with PNI in HNSCC. We explored the clinical significance of this profile in three groups of HNSCC tumours stratified according to their low, intermediate or high risk of post-surgical recurrence. In the "low-risk" group, defined as tumours indicated for surgery without adjuvant radiotherapy (n = 51), the PNI gene expression profile identified a subset of HNSCC with a higher rate of tumour recurrence, decreased Disease Free Survival (DFS) and Overall Survival (OS) (p < 0.0001 and p = 0.0064, respectively). Comparable results were observed in "intermediate risk" tumours (n = 112), but not in "high risk" tumours (n = 147), whose prognosis was driven by the presence of lymph node extracapsular spread. Finally, we found that tumours with histological PNI had increased activation levels of the Akt/PKB and mTOR (mammalian Target Of Rapamycin) kinases.
Conclusion
PNI is characterised by a specific gene expression profile and distinct biological characteristics. Analysing the PNI gene expression profile holds potential for therapeutic stratification of HNSCC and identification of a subset of tumours with a higher risk of recurrence.
https://ift.tt/2p6W7MR
Editorial Board/Aims & Scope
Publication date: October 2018
Source: Oral Oncology, Volume 85
Author(s):
https://ift.tt/2D4cfsm
Atopic dermatitis in African American patients is TH2/TH22-skewed with TH1/TH17 attenuation
African Americans/(AA) are disproportionately impacted by atopic dermatitis/(AD) with increased prevalence and therapeutic challenges unique to this population. Molecular profiling data informing development of targeted therapeutics for AD are derived primarily from European American/(EA) patients. These studies are absent in AA, hindering development of effective treatments for this population.
https://ift.tt/2p68GYA
Hyperhidrose – Ätiopathogenese, Diagnostik, Klinik und Therapie
Zusammenfassung
Die Hyperhidrose tritt meist als primäre, selten als sekundäre symptomatische Hyperhidrose auf. Die primäre Hyperhidrose wird als komplexe neuropathische Dysregulation mit genetischer Disposition verstanden, die ein pathologisches Schwitzverhalten mit vermehrter Schweißsekretion über mindestens 6 Monate bedingt und mindestens 4 der folgenden Diagnosekriterien erfüllt: Betroffenheit der Axillae und/oder der Handinnenflächen und/oder der Fußsohlen und/oder des Stirnbereiches, symmetrisches Auftreten, kein nächtliches Schwitzen, Häufigkeit des Auftretens mindestens wöchentlich, Beginn der Erkrankung vor dem 25. Lebensjahr, positive Familienanamnese sowie Beeinträchtigung der täglichen Aktivitäten. Zur Therapie der primären Hyperhidrose werden v. a. topisch Aluminiumsalze und Anticholinergika, Leitungswasseriontophorese sowie intrakutan Botulinumtoxin angewendet. In der systemischen Therapie kommen ebenfalls verschiedene Anticholinergika zum Einsatz. Meist als Ultima-Ratio-Therapie werden chirurgische Verfahren angewendet. Außerdem sind Verfahren zur Thermolyse entwickelt worden.
https://ift.tt/2Qv9hQf
Accurate quantification of T-cells expressing PD-1 in patients on anti-PD-1 immunotherapy
Abstract
Increasing numbers of trials employing anti-PD-1 immunotherapy emphasize the requirement for predictive biomarkers of clinical response. Many studies examine the cell surface expression of PD-1 and other key regulators of T-cell activation and inhibition. Here, we compared common commercially available anti-PD-1 diagnostic antibodies and tested whether they can bind the PD-1 receptor in the presence of the therapeutic antagonists pembrolizumab and nivolumab. We observed that currently no antibodies are available that can reliably stain all PD-1 receptors on T-cells from patients treated with anti-PD-1 antibodies. Furthermore, none of the diagnostic antibodies detected the entire population of PD-1+ T-cells relative to indirect staining using the therapeutic antibodies themselves. To overcome this problem, here we present a reliable method for quantifying PD-1 expression on immune cells from treated patients which can be included in any conventional flow or mass cytometry antibody panel used for patient monitoring.
https://ift.tt/2NEwsch
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