A 20-year-old Danish woman with melorheostosis in her right femoral shaft and disabling pain in the affected area, whose symptoms did not in the long term respond to zoledronic acid, experienced continuous rem...
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Τετάρτη 26 Σεπτεμβρίου 2018
Clinical improvement in a patient with monostotic melorheostosis after treatment with denosumab: a case report
Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology
Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.
https://ift.tt/2zy8nMt
Immune-Related Thyroiditis with Immune Checkpoint Inhibitors
Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.
https://ift.tt/2OR7bZy
Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice
Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.
https://ift.tt/2OXH3fS
Deep Learning–Based Computer-Aided Diagnosis System for Localization and Diagnosis of Metastatic Lymph Nodes on Ultrasound: A Pilot Study
Thyroid, Volume 28, Issue 10, Page 1332-1338, October 2018.
https://ift.tt/2NJxC7b
Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy
Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.
https://ift.tt/2xUmLwf
Dynamic Risk Stratification in the Follow-Up of Children and Adolescents with Differentiated Thyroid Cancer
Thyroid, Volume 28, Issue 10, Page 1285-1292, October 2018.
https://ift.tt/2NKBJ2w
Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis
Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.
https://ift.tt/2xTt0R5
Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women
Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.
https://ift.tt/2NKBgNO
Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions
Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.
https://ift.tt/2xTtiaD
Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid
Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.
https://ift.tt/2NJHoWU
Use of Synthetic Peptides and Multiple Antigen Blot Assay in the Immunodiagnosis of Hepatitis C Virus Infection
Viral Immunology, Ahead of Print.
https://ift.tt/2IktrbN
The Video Head Impulse Test: Our Experience in 45 Cases
Abstract
To evaluate the role of video head impulse test in the diagnosis of peripheral vestibular disorders, we performed an observational study in the outpatient department in a tertiary setup in which the clinical head impulse test and the video head impulse test were performed on 45 patients with clinically suspected peripheral vestibular disorders, and their results were correlated. To analyse our results, each ear was counted individually and hence, among 45 patients, 12 out of 90 ears showed abnormal clinical head impulse test for lateral semicircular canals and 27 out of 90 ears showed abnormal video head impulse test for lateral semicircular canals. This gave us an additional diagnostic accuracy of 21.1% on using video head impulse test for the lateral semicircular canals as compared to the clinical head impulse test. Video head impulse test is a physiological, quick and well tolerated test for assessing the vestibular function, and the only practical test for assessing the vertical semicircular canal function. Video head impulse test provides valuable information in localising the site of lesion as it assesses the semicircular canals individually. Video head impulse is merely not an objectification and registration system for the clinical head impulse test as it provides additional information such as vestibulo–ocular reflex gain, and occurrence of covert refixation saccades which cannot be picked up by naked eyes.
https://ift.tt/2DyFu6M
Physicians’ Perception on Allergic Rhinitis and Its Management: A Questionnaire Based Survey
Abstract
Despite high prevalence and impact on quality of life, Allergic Rhinitis (AR) is undertreated. Furthermore, existence of a relationship between AR and upper respiratory tract infection (URTI) is less explored. This Pan-India survey intended to assess physicians' perception about AR and URTI, and management practices in Indian setting. This questionnaire-based survey was conducted by telephonically interviewing 300 physicians [Consultant Physicians (CP): 33%; General Physicians (GP): 32%; ENT surgeons: 16%; pediatricians: 11%; allergy specialists: 8%] across India. CPs (33%) and GPs (32%) treated more AR patients in a month, versus other specialties. According to physicians, about 29.6% of patients with AR develop URTI in a month. Majority of the physicians (98%) believed that recurrent URTI can be considered as an indicator of undiagnosed AR. Majority of the physicians (98%) also considered AR to be a predisposing factor for increased risk of URTI. About 62% agreed that prompt diagnosis and treatment of AR can reduce the risk of complications such as URTI. Most preferred first- and second-line of treatment (alone or in combination) in AR management were oral antihistamines (41%) and intranasal corticosteroids (40%), respectively. Similar treatment preferences were observed irrespective of physicians' specialization and years of experience. This survey sheds light on the need to implement clear guidelines for the diagnosis and management of AR.
https://ift.tt/2R1w3PR
The Video Head Impulse Test: Our Experience in 45 Cases
Abstract
To evaluate the role of video head impulse test in the diagnosis of peripheral vestibular disorders, we performed an observational study in the outpatient department in a tertiary setup in which the clinical head impulse test and the video head impulse test were performed on 45 patients with clinically suspected peripheral vestibular disorders, and their results were correlated. To analyse our results, each ear was counted individually and hence, among 45 patients, 12 out of 90 ears showed abnormal clinical head impulse test for lateral semicircular canals and 27 out of 90 ears showed abnormal video head impulse test for lateral semicircular canals. This gave us an additional diagnostic accuracy of 21.1% on using video head impulse test for the lateral semicircular canals as compared to the clinical head impulse test. Video head impulse test is a physiological, quick and well tolerated test for assessing the vestibular function, and the only practical test for assessing the vertical semicircular canal function. Video head impulse test provides valuable information in localising the site of lesion as it assesses the semicircular canals individually. Video head impulse is merely not an objectification and registration system for the clinical head impulse test as it provides additional information such as vestibulo–ocular reflex gain, and occurrence of covert refixation saccades which cannot be picked up by naked eyes.
https://ift.tt/2DyFu6M
Physicians’ Perception on Allergic Rhinitis and Its Management: A Questionnaire Based Survey
Abstract
Despite high prevalence and impact on quality of life, Allergic Rhinitis (AR) is undertreated. Furthermore, existence of a relationship between AR and upper respiratory tract infection (URTI) is less explored. This Pan-India survey intended to assess physicians' perception about AR and URTI, and management practices in Indian setting. This questionnaire-based survey was conducted by telephonically interviewing 300 physicians [Consultant Physicians (CP): 33%; General Physicians (GP): 32%; ENT surgeons: 16%; pediatricians: 11%; allergy specialists: 8%] across India. CPs (33%) and GPs (32%) treated more AR patients in a month, versus other specialties. According to physicians, about 29.6% of patients with AR develop URTI in a month. Majority of the physicians (98%) believed that recurrent URTI can be considered as an indicator of undiagnosed AR. Majority of the physicians (98%) also considered AR to be a predisposing factor for increased risk of URTI. About 62% agreed that prompt diagnosis and treatment of AR can reduce the risk of complications such as URTI. Most preferred first- and second-line of treatment (alone or in combination) in AR management were oral antihistamines (41%) and intranasal corticosteroids (40%), respectively. Similar treatment preferences were observed irrespective of physicians' specialization and years of experience. This survey sheds light on the need to implement clear guidelines for the diagnosis and management of AR.
https://ift.tt/2R1w3PR
VideoEndocrinology™ High-Impact Videos
VideoEndocrinology™
The Official Journal of: American Thyroid Association
FREE ACCESS through October 8, 2018.
Watch now:
Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III
Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris
Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh
Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano
The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.
https://ift.tt/2zxc8Sa
Parapharyngeal Abscesses Caused by Group G Streptococcus
Deep neck abscess is a life-threatening infection that causes laryngeal edema and upper airway occlusion. The predominant bacterial species involved in this disorder is group A streptococcus. Group G streptococcus (GGS) constitutes the normal commensal flora of the human upper airway. Although rarely, it can cause pharyngitis, tonsillitis, and peritonsillar abscess. Here, we report a case of a woman with parapharyngeal abscess caused by GGS. A 56-year-old woman presented to the emergency department with complaints of sore throat and cervical swelling, and a diagnosis of parapharyngeal abscess was established. She had upper airway occlusion, requiring urgent tracheostomy. Endoscopic incision and drainage of the abscess using a specially designed, rigid curved laryngoscope was successfully performed. Since a rigid curved laryngoscope creates a wide viewing field and working space, it was useful for incision and drainage of the parapharyngeal abscess.
https://ift.tt/2Q9IAiY
Tooth crown discoloration induced by endodontic sealers: a 3-year ex vivo evaluation
Abstract
Objectives
The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1 month and 1 and 3 years.
Materials and methods
The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1 month and 1 and 3 years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α = 0.05).
Results
All sealers caused discoloration. At 1 month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p < 0.05). At 1 year, ΔE values were significantly lower in group 3 than in the other groups (p < 0.05). At 3 years, ΔE values were significantly higher in group 1 than in the other groups (p < 0.05).
Conclusions
All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration.
Clinical relevance
Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.
https://ift.tt/2Od9dWW
Results of a nationwide epidemiologic survey of autosomal recessive congenital ichthyosis and ichthyosis syndromes in Japan
Autosomal recessive congenital ichthyosis (ARCI) and ichthyosis syndrome (IS) are rare genetic skin disorders.
https://ift.tt/2xPqsDu
Follicular Involvement is Frequent in Lentigo Maligna: Implications for Treatment
Follicular involvement is a characteristic of lentigo maligna (LM) with unknown frequency. 95.8% of LM specimens demonstrated intrafollicular lesional melanocytes, with a mean depth of 0.45mm. When managing LM, follicular involvement should be assumed.
https://ift.tt/2zwuHFW
Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis
This meta-analysis suggests that photodynamic therapy combined with ablative laser treatment for actinic keratosis is more efficient but not more painful than either therapy alone. Laser-assisted photodynamic therapy is an attractive option for patients with multiple actinic keratoses or field cancerization
https://ift.tt/2xPqjQs
Long-term follow-up of repair of external nasal deformities in rhinoscleroma patients
Rhinoscleroma (RS) is a chronic, progressive, granulomatous infectious disease endemic in Egypt and the Middle East, affecting the nose in 95–100% of cases, and resulting in functional and esthetic sequelae. The aim of the study was to investigate the feasibility of performing reconstructive procedures to improve external deformities in RS patients, with long-term follow up.
https://ift.tt/2zxgSHy
Salivary gland tumors in a Brazilian population: a 20-year retrospective and multicentric study of 2292 cases
Neoplasms of the salivary glands comprise more than thirty subtypes of lesions with various clinical behaviors. The present study aimed to describe the incidence and main features of salivary gland tumors in Brazil.
https://ift.tt/2xVkxwu
Normal angulation of skull base in Apert’s syndrome
Apert's syndrome is characterized by the severe craniofacial deformities. The subsequent process of skeletal maldevelopment is likely to be influenced by multiple interactions at several levels, at a given time. In this study, we aimed to explore the evolution of cranial basal dysmorphology and the chronology of these deformities in Apert's syndrome, by objectively analyzing three-dimensional measurements. Fifty-four CT scans from unoperated patients (Apert, n=18; control, n=36) were included in this study, with age range from 3 days to 24 years.
https://ift.tt/2zxgQ2o
Gracilis transplantation and temporalis transposition in longstanding facial palsy in adults: patient-reported and aesthetic outcomes
In longstanding facial palsy, gracilis free functional muscle transfer (FFMT) is currently considered to be the gold standard in smile reanimation. An alternative to muscle free flaps is local muscle transposition, with the temporalis muscle transposition being the preferred procedure, because of its direction of pull when transposed. The present study aimed to compare outcomes of gracilis FFMT neurotised by the masseteric nerve and temporalis muscle transposition in longstanding facial palsy using patient-reported and aesthetic outcomes.
https://ift.tt/2xVMrJ8
Reply to: 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
https://ift.tt/2IiM6VA
A Content Analysis of Local Media Framing of Intimate Partner Violence
Violence and Gender, Ahead of Print.
https://ift.tt/2OcUivN
A high number of IgG4-positive plasma cells rules out nodular lymphocyte predominant Hodgkin lymphoma
Abstract
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a subtype of Hodgkin lymphoma that frequently shows a nodal growth pattern with abundant reactive B cells in the microenvironment. Early NLPHL cases can be particularly difficult to differentiate from progressively transformed germinal centers (PTGC). Since PTGC have been described to be IgG4 associated in a relatively high proportion of cases, the aim of the present study was to determine if IgG4 immunostaining can be helpful in the differential diagnosis between NLPHL and PTGC. We furthermore aimed to learn if LP cells can express IgG4. For this purpose, 58 cases of PTGC and 56 cases of NLPHL were assessed using IgG4 immunostaining. We could confirm that a significant number of PTGC cases showed high numbers of IgG4-positive plasma cells (22/58, 38%), whereas hot spot areas of IgG4-positive plasma cells were not found in any of the NLPHL cases. In lymph node areas with the differential diagnosis of NLPHL and PTGC, IgG4 immunostaining can therefore provide a helpful diagnostic tool to rule out NLPHL when a high number of IgG4-positive plasma cells are encountered. We also assessed 13 cases with a combination of NLPHL and PTGC in the same lymph node. Five of these cases presented hot spot areas of IgG4-positive plasma cells in the PTGC regions, while no significant numbers of IgG4-positive plasma cells were observed in the NLPHL part of the lymph node. LP cells were never IgG4 positive. Furthermore, immunoglobulin heavy chain rearrangements of single IgG4-positive plasma cells were analyzed, revealing a polyclonal plasma cell population. In summary, our data suggest that IgG4 immunostaining can provide additional information in the diagnostic workup of cases with the differential diagnosis of NLPHL and PTGC. IgG4's inefficiency in clearing antigens may explain why lymph nodes with PTGC are usually strongly enlarged and develop a high number of hyperplastic germinal centers. Polyclonal immunoglobulin heavy chain rearrangements in IgG4-positive plasma cells further support the hypothesis that PTGC represent a misled immune reaction.
https://ift.tt/2IhUpAO
Miller Laryngoscope Blade: An Aid to Pediatric Laryngeal Surgery
Abstract
Pediatric upper airway disorders are a major cause of morbidity and mortality. They can be congenital or acquired and provide diagnostic and therapeutic challenge to the paediatrician and otolaryngologists. Though fibreoptic laryngoscopy or bronchoscopy is the initial mode of assessing the pathology, detailed assessment and therapeutic intervention can only be done combining both direct laryngoscopy and bronchoscopy. Any kind of intervention routinely requires rigid direct laryngoscope with suspension. Identifying the potential use of Miller laryngoscope blade for pediatric airway surgery is the aim of the study. We have included pediatric patients from new born to 12 years of age in our clinical study. We have been using Miller laryngoscope blade for approaching till the level of subglottis for diagnostic laryngoscopy along with Hopkins 0 degree endoscope and performing surgical procedures like supraglottoplasty, vallecular cysts, subglottic stenosis etc. Miller laryngoscope blade can be used as an aid to upper airway surgery for the otolaryngologists with minimal operating time and effort.
https://ift.tt/2N3Od0e
The micromass formation potential of human adipose-derived stromal cells isolated from different various origins
Abstract
Background
Adult stem cells appear to be a promising subject for tissue engineering, representing an individual material for regeneration of aged and damaged cells. Especially adipose derived stromal cells (ADSC), which are easily to achieve, allow an encouraging perspective due to their capability of differentiating into miscellaneous cell types. Here we describe the in vitro formation of human subcutaneous, visceral and omental ADSC micromasses and compare their histological attributes while being cultivated on collagen membranes.
Methods
Subcutaneous, visceral and omental fat tissue derived cells were isolated and processed according to standard protocols. Positively stained cells for CD13, CD44 and CD90 were cultivated on agarose in order to study micromass formation using a special method of cell tracking. Stained paraffin-embedded micromasses were analysed morphologically before and after being plated on collagen membranes.
Results
The micromass formation process was similar in all three tissue types. Subcutaneous fat tissue derived micromasses turned out to develop a more homogeneous and compact shape than visceral and omental tissue. Nevertheless all micromasses adhered to collagen membranes with visible spreading of cells. The immune histochemical (IHC) staining of subcutaneous, visceral and omental ADSC micromasses shows a constant expression of CD13 and a decrease of CD44 and CD 90 expression within 28 days. After that period, omental fat cells don't show any expression of CD44.
Conclusion
In conclusion micromass formation and cultivation of all analysed fat tissues can be achieved, subcutaneous cells appearing to be the best material for regenerative concepts.
https://ift.tt/2N6a8Uu
Miller Laryngoscope Blade: An Aid to Pediatric Laryngeal Surgery
Abstract
Pediatric upper airway disorders are a major cause of morbidity and mortality. They can be congenital or acquired and provide diagnostic and therapeutic challenge to the paediatrician and otolaryngologists. Though fibreoptic laryngoscopy or bronchoscopy is the initial mode of assessing the pathology, detailed assessment and therapeutic intervention can only be done combining both direct laryngoscopy and bronchoscopy. Any kind of intervention routinely requires rigid direct laryngoscope with suspension. Identifying the potential use of Miller laryngoscope blade for pediatric airway surgery is the aim of the study. We have included pediatric patients from new born to 12 years of age in our clinical study. We have been using Miller laryngoscope blade for approaching till the level of subglottis for diagnostic laryngoscopy along with Hopkins 0 degree endoscope and performing surgical procedures like supraglottoplasty, vallecular cysts, subglottic stenosis etc. Miller laryngoscope blade can be used as an aid to upper airway surgery for the otolaryngologists with minimal operating time and effort.
https://ift.tt/2N3Od0e
Juvenile Spring Eruption Associated With Parvovirus B19 Infection
This case report describes the occurrence of juvenile spring eruption associated with parvovirus B19 infection.
https://ift.tt/2O9toVN
https://ift.tt/2O9toVN
Multispectral Optoacoustic Tomography for Vascular Malformations
This pilot study evaluates the use of multispectral optoacoustic tomography for assessment of biomarkers among patients with arteriovenous and venous malformation.
https://ift.tt/2OVXgCh
https://ift.tt/2OVXgCh
Differences in Use of Outpatient Dermatology Services in the United States
This study examines nationwide differences in demographic and socioeconomic characteristics and use of outpatient dermatologic care among Medical Expenditure Panel Survey respondents.
https://ift.tt/2Qahet3
https://ift.tt/2Qahet3
Vasculitis
This Patient Page describes vasculitis, focusing especially on skin vasculitis, how to recognize it, and how it might be treated.
https://ift.tt/2OP4nfG
https://ift.tt/2OP4nfG
Spontaneous asymptomatic rupture of pseudocyst into stomach
Description
A 27-year-old woman presented with complaints of pain in the epigastric region radiating to back for 20 days. She was treated initially at local hospital and was diagnosed as acute pancreatitis as her amylase and lipase levels were >1000 U/mL. She was managed with analgesics and intravenous fluids and was discharged in 4 days. She then presented to our emergency, with complaints of epigastric pain, awareness of lump in the epigastric region and non-passage of stool or flatus for past 3 days. She also gave history of fever and multiple episodes of bilious vomiting. Patient denied previous history of similar episodes in past and is non-alcoholic. On abdominal examination, a lump of size 20x15 cm was palpable in the epigastric region extending into the umbilical region. On ultrasonogram abdomen, a cystic swelling was seen along with multiple gall stones in the gall bladder. Contrast-enhanced CT (CECT) abdomen was suggestive of a large cystic...
https://ift.tt/2IntjIR
Primary retroperitoneal filariasis: a common disease of tropics with uncommon presentation and review of literature
Lymphatic filariasis is caused by nematode filariae Wuchereria bancrofti, Brugia malayi or Brugia timori. It is commonly seen in tropical and subtropical regions of the world and affects the lymphatic system of humans, who are the definitive host while mosquito is the intermediate host. The most common manifestation of the disease is hydrocele followed by lower limb lymphoedema and elephantiasis. Although filariasis is much more common entity in north India, its presentation as retroperitoneal cyst is very rare with reported incidence rate of 1/105 000. We present a case of primary retroperitoneal filariasis in a 52-year-old man, without any classic signsandsymptoms, diagnosed postoperatively after surgical resection following diagnostic uncertaintyandfailure of other medical therapies.
https://ift.tt/2OfbCjV
Gossypiboma: a ghastly find
A gossypiboma is a mass within a patient's body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.
https://ift.tt/2Ih30Us
Primary renal diffuse large B-Cell lymphoma causing haemodialysis-dependent nephromegaly in a child
A 4-year-old boy presented with fatigue and was found to have severe kidney injury requiring haemodialysis. A renal ultrasound demonstrated bilateral nephromegaly with mild loss of corticomedullary differentiation but preserved echogenicity. He had a persistent isolated monocytosis. Renal biopsy revealed extensive infiltration by primary renal diffuse large B-cell lymphoma. He required haemodialysis for 18 days and received chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab and intrathecal methotrexate. He achieved remission with an estimated glomerular filtration rate of 50 mL/min/1.73 m2, and his kidneys returned to normal size. Nephromegaly due to renal-limited haematolymphoid disease is extremely rare, especially in children.
https://ift.tt/2ObiE9s
Impact of genetic variants of GLCCI1 on operational therapy in Chinese chronic rhinosinusitis patients
International Forum of Allergy &Rhinology, EarlyView.
https://ift.tt/2zvZ2oe
MicroRNA Profiling of Salivary Duct Carcinoma Versus Her2/Neu Overexpressing Breast Carcinoma Identify miR-10a as a Putative Breast Related Oncogene
Abstract
Salivary duct carcinomas (SDC) and Her2/Neu3-overexpressing invasive breast carcinomas (HNPIBC/IBC) are histologically indistinguishable. We investigated whether common histopathologic and immunophenotypic features of SDC and IBC are mirrored by a similar microRNA (miRNA) profile. MiRNA profiling of 5 SDCs, 6 IBCs Her2/Neu3+, and 5 high-grade ductal breast carcinoma in situ (DCIS) was performed by NanoString platform. Selected miRNAs and HOXA1 gene were validated by RT-PCR. We observed similar miRNA expression profiles between IBC and SDC with the exception of 2 miRNAs, miR-10a and miR-142-3p, which were higher in IBC tumors. DCIS tumors displayed increased expression of miR-10a, miR-99a, miR-331-3p and miR-335, and decreased expression of miR-15a, miR-16 and miR-19b compared to SDC. The normal salivary gland and breast tissues also showed similar expression profiles. Interestingly, miR-10a was selectively increased in both IBC and normal breast tissue compared to SDC and normal salivary gland tissue. Moreover, our NanoString and RT-PCR data confirmed that miR-10a was upregulated in IBC and DCIS compared to SDC. Finally, we show downregulation of HOXA1, a miR-10 target, in IBC tumors compared to normal breast tissue. Taken together, our data demonstrates that, based on miRNA profiling, SDC is closely related to HNPIBC. Our results also suggest that miR-10a is differentially expressed in IBC compared to SDC and may have potential utility as a diagnostic biomarker in synchronous or metachronous malignant epithelial malignancies involving both organs. In addition, miR-10a could be playing an important role as a mammary-specific oncogene, involved in breast cancer initiation (DCIS) and progression (IBC), through mechanisms that include modulation of HOXA1 gene expression.
https://ift.tt/2ObyCjF
Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction
Publication date: Available online 25 September 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Mahmut Huntürk Atilla, Selda Kargın Kaytez, Gülin Gökçen Kesici, Sibel Baştimur, Sebahattin Tuncer
Abstract
Introduction
Adenoidectomy can be performed with many ways, including curettage and microdebrider endoscopic-assisted adenoidectomy. Those two techniques have advantages and disadvantages.
Objective
The objective of this study is to research the effects of curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy on the tympanum pressures in pediatric patients with adenoid hypertrophy without otitis media with effusion.
Methods
This prospective descriptive study was performed with 65 patients who had a normal tympanic membrane and normal tympanogram and then underwent adenoidectomy or adenotonsillectomy for adenoid and tonsil hypertrophy. The subjects were randomly divided into two groups: curettage adenoidectomy group and endoscopic microdebrider-assisted adenoidectomy group. They underwent tympanometry, and the preoperative as well as 1st and 7th day postoperative values of the tympanum pressures were compared within and among the groups.
Results
There were 32 patients in the curettage adenoidectomy group and 33 patients in the microdebrider adenoidectomy group. Statistically significant differences were observed in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears with curettage adenoidectomy (p < 0.001, p < 0.001). This difference occurred on the 1st postoperative day, and the value returned to normal on the 7th day. There was no significant difference in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears in the microdebrider adenoidectomy group (p = 0.376, p = 0.128).
Conclusion
Postoperative Eustachian tube dysfunction is seen less often with the endoscopic-assisted microdebrider adenoidectomy technique than with the conventional adenoidectomy technique.
Resumo
Introdução
A adenoidectomia pode ser realizada de várias maneiras, incluindo a adenoidectomia por curetagem e por microdebridador, assistida por endoscopia. Essas duas técnicas têm algumas vantagens e desvantagens quando comparadas.
Objetivo
O objetivo deste estudo é investigar os efeitos da técnica de adenoidectomia por curetagem e da adenoidectomia por microdebridador assistida por endoscopia sobre a pressão timpânica em pacientes pediátricos com hipertrofia adenoideana sem otite média com efusão.
Método
Este estudo descritivo prospectivo foi realizado com 65 pacientes que apresentavam membrana timpânica e timpanograma normais, que foram então submetidos à adenoidectomia ou adenotonsilectomia por hipertrofia adenoamigdaliana. Os pacientes foram divididos aleatoriamente em dois grupos: grupo adenoidectomia por curetagem e grupo adenoidectomia por microdebridador assistida por endoscópio. Todo os pacientes realizaram timpanometria, e os valores das pressões do tímpano pré-operatórios e pós-operatórios no 1° e 7° dias foram comparados intragrupos e entre os grupos.
Resultados
Foram incluídos 32 pacientes no grupo adenoidectomia por curetagem e 33 pacientes no grupo adenoidectomia com microdebridador. Diferenças estatisticamente significativas foram observadas na mediana da diferença entre a pressão timpânica no pré-operatório e no 1° e 7° dias de pós-operatório para ambas as orelhas, direita e esquerda, na adenoidectomia por curetagem (p < 0,001, p < 0,001). Essa diferença ocorreu no 1° dia do pós-operatório e o valor retornou ao normal no 7° dia. Não houve diferença significativa na mediana entre pressão timpânica no pré-operatório e no 1° e 7° dias de pós-operatório para as orelhas direita e esquerda no grupo de adenoidectomia com microdebridador (p = 0,376, p = 0,128).
Conclusão
A disfunção tubária no pós-operatório é observada menos frequentemente com a técnica de adenoidectomia por microdebridador assistida por endoscopia quando comparada com a técnica de adenoidectomia convencional.
https://ift.tt/2Q7MXuG
MicroRNA Profiling of Salivary Duct Carcinoma Versus Her2/Neu Overexpressing Breast Carcinoma Identify miR-10a as a Putative Breast Related Oncogene
Abstract
Salivary duct carcinomas (SDC) and Her2/Neu3-overexpressing invasive breast carcinomas (HNPIBC/IBC) are histologically indistinguishable. We investigated whether common histopathologic and immunophenotypic features of SDC and IBC are mirrored by a similar microRNA (miRNA) profile. MiRNA profiling of 5 SDCs, 6 IBCs Her2/Neu3+, and 5 high-grade ductal breast carcinoma in situ (DCIS) was performed by NanoString platform. Selected miRNAs and HOXA1 gene were validated by RT-PCR. We observed similar miRNA expression profiles between IBC and SDC with the exception of 2 miRNAs, miR-10a and miR-142-3p, which were higher in IBC tumors. DCIS tumors displayed increased expression of miR-10a, miR-99a, miR-331-3p and miR-335, and decreased expression of miR-15a, miR-16 and miR-19b compared to SDC. The normal salivary gland and breast tissues also showed similar expression profiles. Interestingly, miR-10a was selectively increased in both IBC and normal breast tissue compared to SDC and normal salivary gland tissue. Moreover, our NanoString and RT-PCR data confirmed that miR-10a was upregulated in IBC and DCIS compared to SDC. Finally, we show downregulation of HOXA1, a miR-10 target, in IBC tumors compared to normal breast tissue. Taken together, our data demonstrates that, based on miRNA profiling, SDC is closely related to HNPIBC. Our results also suggest that miR-10a is differentially expressed in IBC compared to SDC and may have potential utility as a diagnostic biomarker in synchronous or metachronous malignant epithelial malignancies involving both organs. In addition, miR-10a could be playing an important role as a mammary-specific oncogene, involved in breast cancer initiation (DCIS) and progression (IBC), through mechanisms that include modulation of HOXA1 gene expression.
https://ift.tt/2ObyCjF
Adenomatoid odontogenic tumor: an updated analysis of the cases reported in the literature
Journal of Oral Pathology &Medicine, Volume 0, Issue ja, -Not available-.
https://ift.tt/2zw8ZSq
Cancer Chemoprevention by Metformin Hydrochloride Compared to Placebo in Oral Potentially Malignant Lesions
Condition: Oral Cancer
Interventions: Drug: Metformin Hcl 500Mg 24Hr Sa Tab; Other: starch tablet
Sponsor: Ain Shams University
Recruiting
https://ift.tt/2ORkqcQ
Interventions: Drug: Metformin Hcl 500Mg 24Hr Sa Tab; Other: starch tablet
Sponsor: Ain Shams University
Recruiting
https://ift.tt/2ORkqcQ
Sensitivity and Specificity of Serum and Salivary CYFRA21-1 in the Detection of Malignant Transformation in Oral Potentially Malignant Mucosal Lesions (Diagnostic Accuracy Study)
Condition: Oral Potentially Malignant Leions, Oral Cancer
Intervention: Diagnostic Test: Enzyme Linked Immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R0ANoL
Intervention: Diagnostic Test: Enzyme Linked Immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R0ANoL
A Phase 1b/2 Study of AST-008 Combined With Pembrolizumab in Patients With Advanced Solid Tumors
Conditions: Advanced or Metastatic Solid Tumors; Advanced or Metastatic Melanoma; Advanced or Metastatic Head and Neck Squamous Cell Carcinoma; Advanced or Metastatic Cutaneous Squamous Cell Carcinoma; Advanced or Metastatic Merkel Cell Carcinoma
Interventions: Drug: AST-008; Biological: Pembrolizumab
Sponsor: Exicure, Inc.
Not yet recruiting
https://ift.tt/2ORkeu8
Interventions: Drug: AST-008; Biological: Pembrolizumab
Sponsor: Exicure, Inc.
Not yet recruiting
https://ift.tt/2ORkeu8
CoreHip - Post Market Clinical Follow-Up Study
Conditions: Degenerative Osteoarthritis; Rheumatic Arthritis; Fractures, Hip; Necrosis, Femur Head
Intervention: Device: CoreHip Total Hip Arthroplasty
Sponsor: Aesculap AG
Not yet recruiting
https://ift.tt/2QXgLeW
Intervention: Device: CoreHip Total Hip Arthroplasty
Sponsor: Aesculap AG
Not yet recruiting
https://ift.tt/2QXgLeW
Cancer Chemoprevention by Metformin Hydrochloride in Oral Potentially Malignant Lesions
Condition: Oral Cancer
Interventions: Drug: Metformin Hydrochloride 500 MG; Drug: Placebo Oral Tablet
Sponsor: Cairo University
Recruiting
https://ift.tt/2ORk71G
Interventions: Drug: Metformin Hydrochloride 500 MG; Drug: Placebo Oral Tablet
Sponsor: Cairo University
Recruiting
https://ift.tt/2ORk71G
Long-term follow-up of repair of external nasal deformities in rhinoscleroma patients
Publication date: Available online 26 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Mohamed A. Amer, Mohamed O. Tomoum
Abstract
Introduction
Rhinoscleroma (RS) is a chronic, progressive, granulomatous infectious disease endemic in Egypt and the Middle East, affecting the nose in 95–100% of cases, and resulting in functional and esthetic sequelae. The aim of the study was to investigate the feasibility of performing reconstructive procedures to improve external deformities in RS patients, with long-term follow up.
Patients & Methods
This prospective, controlled cohort study included 25 patients who were seeking rhinoplasty to improve their esthetic appearance, with evident clinical and histopathological history of RS. Another 25 patients seeking esthetic augmentation rhinoplasty in the same period formed the control group. All the participants were evaluated objectively by two independent rhinoplasty surgeons, and subjectively with ROE 2 years postoperatively.
Results
All the participants showed significant improvement in esthetic facial evaluation postoperatively, with a correlative rise in ROE score. There was an insignificant difference between the studied groups. Inconsequential complications were encountered throughout the follow-up period, but with insignificant incidence in both groups.
Conclusion
Rhinoplasty for correction of RS external deformities is both safe and beneficial, with no risks of flaring up or increased complications.
Level of evidence
Level 2b.
https://ift.tt/2xClwTa
Comparative evaluation of different fixation techniques of the sagittal split ramus osteotomy in 10 mm advancements: mechanical testing and screw insertion torque
Publication date: Available online 26 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Eder Alberto Sigua-Rodriguez, Raquel Correia de Medeiros, Douglas Rangel Goulart, Veber Luiz Bomfim-Azevedo, Sergio Olate, Jose Ricardo de Albergaria-Barbosa
Abstract
Purpose
To compare the mechanical characteristics of five techniques for the functionally stable fixation of simulated sagittal split ramus osteotomy with 10 mm of advancement and to evaluate the screw insertion torque.
Materials and methods
Fifty polyurethane hemimandibles with sagittal split ramus osteotomy and containing an advancement of 10 mm fixed and distributed as follows: Customized 3D Plate Group: 1 customized 3D miniplate; 4-Hole Plate Group: 2 miniplates with 4 holes; 6-Hole Plate Group: 2 miniplates with 6 holes; Hybrid Group: 1 flat miniplate with 4 holes and 1 bicortical screw; and Bicortical Screw Group: 3 bicortical screws. We conducted a mechanical test using vertical linear loading with a displacement velocity of 1 mm/min on a universal testing machine and assessed the screw insertion torque using a digital torque wrench.
Results
The means of strength for the 1-, 3- and 5-mm displacements were determined by a one-way analysis of variance (ANOVA) followed by the post hoc Tukey test. Statistically significant differences were observed only for the 5-mm displacement (F=3.36; p=0.01). There was a difference between the 4-H2P and HG groups (p=0.04).
Conclusion
The customized miniplate, the fixation methods with three bicortical screws, or with two straight miniplates with either 4 or 6 holes, all offer a similar mechanical resistance suitable for fixation.
https://ift.tt/2Ii2fdK
The prevalence of pneumatized articular eminence in the temporal bone. Do we need a high resolution computed tomography-based novel risk classification for eminectomy?
Publication date: Available online 25 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Nils Heim, Werner Götz, Rudolf Reich, Anton Faron
https://ift.tt/2xClr1O
Quantification of the mandibular defect healing by micro CT morphometric analysis in rats
Publication date: Available online 25 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): T. Kustro, T. Kiss, D. Chernohorskyi, Y. Chepurnyi, Z. Helyes, A. Kopchak
Summary
Purpose
The goal of this study was the evaluation of the bone tissue structural characteristics over the time course of mandibular defect healing using micro-CT technique, as well as determination of the inter-relationships between different micro-CT parameters used for assessment of the bone regeneration process and the patterns of their dynamic changes.
Materials and Methods
The body and ramus of the mandible was exposed in 24 Wistar rats. A 2-mm full thickness bony defect was created. Animals were randomized into four groups, which were ended 3, 6, 12 and 24 weeks after operation. The mandible was excised and underwent micro-CT analysis. For statistical evaluation, the Mann–Whitney U test, polynomial or exponential regression and Spearman analysis were applied.
Results
The absolute volume of the bone regenerate increased from 1.69+0.53 mm3 (3 weeks) to 3.36 mm3+0.56 (6 months), as well as percentage of bone volume, increased significantly from 12.5+2.3% at the 3-week term to 26.4+8.7% at the 3-month term or 23.1+8.7% at the 6-month term. Structural (trabecular) thickness gradually increased from 0.13+0.007 mm at the 3-week term to 0.3+0.11 mm at the 6-month term. The structural model index was 0.79+0.46 in the early phase after trauma and then decreased to negative values.
Conclusion
The bone regeneration process was characterised by a significant increase (p<0.05) in bone volume, percentage of bone volume, structural thickness and bone mineral density, and a decrease in bone surface-to-volume ratio and volume of pore space from the 3-week term to the 6-month term. These changes can be mathematically described by nonlinear exponential regression models.
https://ift.tt/2Ii2a9W
Management of Atrophic Mandibular Fractures: An Italian Multicentric Retrospective Study
Publication date: Available online 25 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Giovanni Gerbino, Stefan Cocis, Fabio Roccia, Giorgio Novelli, Gabriele Canzi, Davide Sozzi
Abstract
Purpose
The aim of this multicentric study was to retrospectively evaluate the surgical outcome of atrophic mandible fractures treated with open reduction and rigid fixation (ORIF), using load-bearing plates.
Materials and methods
55 patients from three trauma centers were retrieved for the study. Inclusion criteria were: edentulous patients with mandibular body fractures; mandibular body thickness <20 mm. Collected data included: cause of fracture; degree of atrophy (according to Luhr's classification); characteristics of the fracture; adequacy of reduction; postoperative complications. All patients were treated with ORIF, using 2.0 mm, large-profile, locking bone plates and 2.4 mm locking bone plates. No bone graft was used in any case.
Results
12 patients were classified as class I atrophy, 18 patients as class II, and 25 patients as class III. Mean mandibular height at the site of fracture was 12.8 mm (ranging from 5.4 mm to 20 mm). 22 were unilateral fractures and 23 were bilateral. Mild displacement was observed in 11 fractures, moderate in 34, severe in 16, and comminution was present in seven fractures. Adequacy of reduction was judged good in 62 fractures and poor in six fractures. Transient weakness of the marginal branch of the facial nerve was recorded in 11 patients and permanent weakness in two patients. All patients achieved a complete fracture healing.
Conclusion
External open reduction and rigid fixation (ORIF) with locking, load-bearing plates is a reliable and predictable treatment for atrophic edentulous mandible fracture. Immediate bone grafting should not be considered mandatory mandatory unless there is consistent bone loss.
https://ift.tt/2xDrNOm
Using principal component analysis to describe the midfacial deformities in patients with craniofacial microsomia
Publication date: Available online 25 September 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Britta D.P.J. Maas, Britt I. Pluijmers, Paul G.M. Knoops, Clifford Ruff, Maarten J. Koudstaal, David Dunaway
Summary
Purpose
Craniofacial microsomia (CFM) is the result of a disturbance in embryologic development and is characterised by an asymmetric, mostly unilateral facial underdevelopment. The aim of this study is to understand the midfacial involvement in CFM using principal component analysis (PCA).
Materials and Methods
Pre-operative data from 19 CFM and 23 control patients were collected. A set of 71 landmarks was placed on three-dimensional (3D) reconstructions of all skulls to compare both populations. PCA visualised variation within both groups and calculated the vector of change. Linear measurements were taken to compare ratios between the populations and between the affected and unaffected sides in CFM patients.
Results
PCA defined a vector that described shape changes between both populations. Videos showed the variation within the control and CFM group and the transformation from a mean CFM skull into a normal phenotype. Linear measurements showed a significant difference between the affected and unaffected sides in CFM patients.
Conclusion
PCA has not been applied on asymmetrical data before, but it has proved to be a useful method to describe CFM. The virtual normalisation of a mean CFM skull enables visualisation of the bony shape changes, which is promising to delineate and to plan surgical correction and could be used as an outcome measure.
https://ift.tt/2Ii9VMZ
MicroRNA Profiling of Salivary Duct Carcinoma Versus Her2/Neu Overexpressing Breast Carcinoma Identify miR-10a as a Putative Breast Related Oncogene
Abstract
Salivary duct carcinomas (SDC) and Her2/Neu3-overexpressing invasive breast carcinomas (HNPIBC/IBC) are histologically indistinguishable. We investigated whether common histopathologic and immunophenotypic features of SDC and IBC are mirrored by a similar microRNA (miRNA) profile. MiRNA profiling of 5 SDCs, 6 IBCs Her2/Neu3+, and 5 high-grade ductal breast carcinoma in situ (DCIS) was performed by NanoString platform. Selected miRNAs and HOXA1 gene were validated by RT-PCR. We observed similar miRNA expression profiles between IBC and SDC with the exception of 2 miRNAs, miR-10a and miR-142-3p, which were higher in IBC tumors. DCIS tumors displayed increased expression of miR-10a, miR-99a, miR-331-3p and miR-335, and decreased expression of miR-15a, miR-16 and miR-19b compared to SDC. The normal salivary gland and breast tissues also showed similar expression profiles. Interestingly, miR-10a was selectively increased in both IBC and normal breast tissue compared to SDC and normal salivary gland tissue. Moreover, our NanoString and RT-PCR data confirmed that miR-10a was upregulated in IBC and DCIS compared to SDC. Finally, we show downregulation of HOXA1, a miR-10 target, in IBC tumors compared to normal breast tissue. Taken together, our data demonstrates that, based on miRNA profiling, SDC is closely related to HNPIBC. Our results also suggest that miR-10a is differentially expressed in IBC compared to SDC and may have potential utility as a diagnostic biomarker in synchronous or metachronous malignant epithelial malignancies involving both organs. In addition, miR-10a could be playing an important role as a mammary-specific oncogene, involved in breast cancer initiation (DCIS) and progression (IBC), through mechanisms that include modulation of HOXA1 gene expression.
https://ift.tt/2ObyCjF
Regulation of systemic tissue injury by coagulation inhibitors in B6.MRL/lpr autoimmune mice
Publication date: Available online 25 September 2018
Source: Clinical Immunology
Author(s): C. Moratz, R. Robbins, J. Eickhoff, J. Edison, H. Lui, S. Peng
Abstract
Impaired fibrinolysis and complement activation in Systemic Lupus Erythematosus contributes to disease amplification including increased risk of thrombosis and tissue Ischemia/Reperfusion (IR) injury. Previous work has demonstrated complement is a key regulator of tissue injury. In these studies inhibitors had varying efficacies in attenuating injury at primary versus systemic sites, such as lung. In this study the role of coagulation factors in tissue injury and complement function was evaluated. Tissue Factor Pathway Inhibitor (TFPI), an extrinsic pathway inhibitor, and Anti-Thrombin III, the downstream common pathway inhibitor, were utilized in this study. TFPI was more effective in attenuated primary intestinal tissue injury. However both attenuated systemic lung injury. However, ATIII treatment resulting in enhanced degradation of C3 split products in lung tissue compared to TFPI. This work delineates the influence of specific early and late coagulation pathway components during initial tissue injury versus later distal systemic tissue injury mechanism.
https://ift.tt/2xTPJfG
Intérêt du dosage de la calprotectine fécale au cours des panniculites chroniques d’étiologie indéterminée
Publication date: Available online 25 September 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): K. Kaddour, J. Lemasson, B. Haettich-Pialoux, N. Guedj, N. Belmatoug, X. Treton, H. Becheur, B. Fantin, V. Descamps, P. Le Bozec
https://ift.tt/2OdePk1
Treatment of Objective Tinnitus with Transpalatal Botox® Injection in a Pediatric Patient with Middle Ear Myoclonus: A case report
Publication date: Available online 25 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Jennifer Dang, Yi-Chun Carol Liu
Abstract
We describe a case of bilateral middle ear myoclonus (MEM) that was treated with trans-palatal Botox® injection after failing surgery to section the tensor tympani and stapedial tendons. MEM is a rare disorder resulting from rhythmic contraction of middle ear muscles. An 8-year old girl presented with audible clicking tinnitus, and resultant inability to focus in school. Her parents declined medical therapy, and she underwent surgeries for tendon lysis, with only temporary relief. She had successful response to trans-palatal Botox® injection to the tensor veli palatini aponeurosis. Trans-palatal Botox® injection is a safe and reasonable alternative for treatment of MEM.
https://ift.tt/2IhT1hC
Tracheostomy Care: Clinical practice patterns of pediatric otolaryngologists-head and neck surgeons in a publicly funded (Canadian) health care system
Publication date: Available online 25 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Sunita K. Rai, Theresa Holler, Evan J. Propst, Nikolaus E. Wolter, Reshma Amin
Abstract
Objectives
To investigate variability in paediatric tracheostomy tube care practice patterns and access to resources across Canada.
Methods
Canadian paediatric otolaryngologists-head & neck surgeons reported their own practice patterns for children with chronic tracheostomy tubes using a web-based, 29-item multiple choice and short answer questionnaire. Domains investigated included tracheostomy team membership, inpatient care practices, caregiver education, homecare resources, speech and communication, and completeness of emergency tracheostomy kits.
Results
The response rate was 86.4% (38/44). Most respondents care for children with tracheostomy tubes as part of an inter-professional team (25/36; 69.4%) and arrange routine follow-up with a speech and language pathologist (22/36; 61.1%). However, the majority (23/34; 67.6%) of respondents do not formally reassess caregiver competencies (i.e. cardiopulmonary resuscitation, emergency tracheostomy care). Notably, respondents were also unsure 36.1% (13/36) of how frequently Shiley tracheostomy tubes should be washed and reused with the majority (15/36; 41.7%) reporting never. Most (15/36; 41.7%) respondents were also unsure of reuse recommendations for Bivona tracheostomy tubes. One third (12/36; 33.3%) of respondents were unsure about government-funded homecare services being provided in their community to children with tracheostomy tubes.
Conclusion
There is much variability in paediatric tracheostomy tube care practice patterns across Canada. Results suggest that an evidence-based Canadian clinical practice guideline may help to streamline care provided to Canadian children with tracheostomy tubes.
https://ift.tt/2QZjc0s
Outcomes of Early Intervention for Deaf Children with Additional Needs following an Auditory Verbal Approach to Communication
Publication date: Available online 25 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Abigail.R.C. Hitchins, Sarah.C. Hogan
Abstract
Objectives
To determine and compare the rates of progress made by pre-school aged children with all degrees and types of hearing impairment and deafness, both with and without additional needs as catalogued using SNOMED CT, at the end of a non-statutory programme of individualised Auditory Verbal (AV) intervention.
Methods
An audit was conducted using a retrospective and comparative study design to examine spoken language outcomes in children who had spent more than two years on an AV programme and had completed their programmes between January 2007 and December 2017. The children were stratified according to i) whether they achieved age appropriate language (AAL) (n =102) or not (n =27); ii) whether they had deafness alone (n = 77) or deafness with additional needs (n =52); and iii) whether children with additional needs achieved AAL (n= 27) or not (n =25). Children undertook standardised spoken language assessments on joining the AV programme and then at intervals of at least 6 months for the duration of their programme. Derived measures of rates of language development (RLD) were used to compare the groups at i) the outset (initial RLD), and ii) the conclusion of the AV programme (programme RLD).
Results
Overall, 79% of children within this cohort achieved age appropriate spoken language scores. Children with additional needs (40%) embarked on a non-statutory AV programme at a significantly older age (corrected for prematurity), with significantly lower initial RLD and, as a group, attained significantly lower programme RLD compared with children with deafness alone. One in two of the children with additional needs reached AAL by the end of their individualised programme. The children with additional needs also demonstrated a highly significant increase in their mean programme RLD compared with the mean initial RLD indicating an acceleration in acquiring spoken language competencies while on the AV programme.
Conclusions
For deaf children with additional needs who stay on an AV programme for more than two years, listening and spoken communication is significantly enhanced. Specific access to the AV approach in addition to generic, statutory early intervention could facilitate deaf children with additional needs to achieve or approach AAL. Ensuring families have access to effective early intervention increases the chances that i) a suitable communication approach is adopted at the earliest opportunity, and ii) a child with additional needs acquires listening and spoken language at a rate commensurate with their full potential. Applying the SNOMED CT framework as a means of categorizing children's additional needs will enable more effective comparisons across studies from different centres around the world.
https://ift.tt/2IjNd7l
Giants in Allergy-Immunology: Richard Studley Farr, M.D.
Publication date: Available online 25 September 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Charles H. Kirkpatrick
https://ift.tt/2xQhMwt
TLR Activation and Allergic Disease: Early Life Microbiome and Treatment
Abstract
Purpose of Review
Allergy and asthma are growing problems in the developed world. The accelerated increase of these diseases may be related to microbiome modification that leads to aberrant activation of Toll-like receptors (TLRs). Current research supports the concept that changes in microbial communities in early life impact TLR activation, resulting in an altered risk for the development of asthma and allergies.
Recent Findings
Prenatal and early childhood events that generate microbiome modification are closely related with TLR activation. Early childhood exposure to a rich array of TLR agonists, particularly lipopolysaccharide, strongly predicts protection against allergic disease later in life even when other lifestyle factors are accounted for. Genetic deletion of TLR signaling components in mice results in reduced function of tolerogenic cell populations in the gut. In contrast, weak TLR signaling can promote allergic sensitization later in life.
Summary
This review summarizes the role of TLR signaling in microbiome-mediated protection against allergy.
https://ift.tt/2O6EScH
Telemedicine Technology: a Review of Services, Equipment, and Other Aspects
Abstract
Purpose of Review
Telemedicine uses technology to connect patients with providers at a distance. While the clinical aspects of this have been reviewed extensively, the technical aspects are not as well understood by allergists when they consider adding telemedicine to their practice. This review focuses on the technical aspects of setting up a telemedicine program.
Recent Findings
With the advent of new technologies including high-speed Internet, video conferencing solutions, and digital examination equipment, facilitated virtual visits as replacements for in-person visits are now possible. The technical requirements for a successful telemedicine program include secure, high-speed Internet connection, a clinical telemedicine cart to serve as the hub for the interaction, patient access software, and access to IT professionals to set up the program and to be available when the system malfunctions.
Summary
A carefully designed telemedicine program is more likely to be successful if the technical aspects are included in the planning process.
https://ift.tt/2xQnQoQ
Congenital Granular Cell Tumor: Case Report and Review
Congenital granular cell tumors are infrequently occurring masses occurring on a neonate's gingiva/alveolus. These lesions are benign with no noted malignant transformation, and treatment of excision is based on its effect on the neonate's respiratory ability and/or nutritional intake. The purpose of this review is to discuss a case of a congenital granular cell tumor and its treatment and review of the literature including demographics, histopathology, and operative treatment.
https://ift.tt/2xUaZ5g
TLR Activation and Allergic Disease: Early Life Microbiome and Treatment
Abstract
Purpose of Review
Allergy and asthma are growing problems in the developed world. The accelerated increase of these diseases may be related to microbiome modification that leads to aberrant activation of Toll-like receptors (TLRs). Current research supports the concept that changes in microbial communities in early life impact TLR activation, resulting in an altered risk for the development of asthma and allergies.
Recent Findings
Prenatal and early childhood events that generate microbiome modification are closely related with TLR activation. Early childhood exposure to a rich array of TLR agonists, particularly lipopolysaccharide, strongly predicts protection against allergic disease later in life even when other lifestyle factors are accounted for. Genetic deletion of TLR signaling components in mice results in reduced function of tolerogenic cell populations in the gut. In contrast, weak TLR signaling can promote allergic sensitization later in life.
Summary
This review summarizes the role of TLR signaling in microbiome-mediated protection against allergy.
https://ift.tt/2O6EScH
Telemedicine Technology: a Review of Services, Equipment, and Other Aspects
Abstract
Purpose of Review
Telemedicine uses technology to connect patients with providers at a distance. While the clinical aspects of this have been reviewed extensively, the technical aspects are not as well understood by allergists when they consider adding telemedicine to their practice. This review focuses on the technical aspects of setting up a telemedicine program.
Recent Findings
With the advent of new technologies including high-speed Internet, video conferencing solutions, and digital examination equipment, facilitated virtual visits as replacements for in-person visits are now possible. The technical requirements for a successful telemedicine program include secure, high-speed Internet connection, a clinical telemedicine cart to serve as the hub for the interaction, patient access software, and access to IT professionals to set up the program and to be available when the system malfunctions.
Summary
A carefully designed telemedicine program is more likely to be successful if the technical aspects are included in the planning process.
https://ift.tt/2xQnQoQ
In vitro analysis of growth patterns of invasive fungal species on commonly used endonasal hemostatic agents
Publication date: Available online 25 September 2018
Source: American Journal of Otolaryngology
Author(s): Christopher Ito, Daniel Sharbel, Allison McMullen, Stilianos Kountakis
Abstract
Objective
Previous studies have not examined the potential role of endonasal hemostatic agents in facilitating growth of fungal species. We aim to determine the possibility of these to serve as a nutrient source for fungal growth.
Methods
Cultures of Aspergillus, Fusarium, and Mucor were harvested and placed in solution in sterile saline at standardized high and low concentrations. Thrombin gelatin matrix, carboxyl methylcelluose, and potato starch derivative agents were prepared following manufacturer instructions and applied to two separate Petri dishes per agent. Each substrate was then inoculated with either high or low concentrations of fungal species. A negative and positive control plates with each organism were included. Dishes were sealed, incubated, and examined daily for fourteen days for microscopic and macroscopic growth.
Results
Thrombin gelatin matrix was relatively resilient to growth, although Fusarium growth was noted on all packing material by day three. Carboxyl methylcellulose also supported growth of high-concentration Mucor appreciated on day five. The potato starch derivative supported fulminant growth of all fungal species.
Conclusions
Endonasal hemostatic agents may be nutrient sources that facilitate growth of fungal species. This may be a consideration in a surgeon's decision to use a hemostatic agent. Prompt initial post-operative debridement may be warranted in select patients. Our findings serve as a model for further testing of fungal growth on other hemostatic materials. Future studies are needed to confirm the clinical significance of these findings in vivo.
https://ift.tt/2IgmmsI
CBCT assessment of gubernacular canals in relation to eruption disturbance and pathological condition associated with impacted/unerupted teeth
Publication date: Available online 26 September 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Nagihan Koc, Hatice Boyacioglu Dogru, L. Berna Cagirankaya, Sema Dural, Paul F. van der Stelt
Abstract
Objectives
To demonstrate the imaging characteristics of gubernacular canals (GCs) in impacted/unerupted permanent teeth and to determine whether these characteristics differ by the presence of eruption disturbances or pathological conditions associated with impacted/unerupted teeth.
Study Design
GCs were retrospectively analyzed by using cone beam computed tomography in 250 patients with 753 impacted/unerupted permanent teeth (105 male, 145 female; mean age, 21.09 ± 14.45 years; range, 6 to 70 years).
Results
The detection rate of GCs was significantly lower in cases with eruption disturbances than in those without eruption disturbances. An inverse correlation was observed between age and detection of GC. Similarly, root resorption of the adjacent teeth and resorption of the impacted/unerupted teeth were associated with lower detection rates of GCs. However, no association was found for widening of the follicular space. Regression analysis determined disturbed eruption pattern as the most important factor for the absence of GCs.
Conclusions
The absence of GC may indicate a disturbed eruption pattern of the tooth and may increase the risk of complications related to impaction resulting in a tooth that is more likely to remain unerupted.
https://ift.tt/2OPGJiV
Is infrared thermography effective in the diagnosis of temporomandibular disorders? A systematic review
Publication date: Available online 26 September 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Daniela Pita de Melo, Patrícia Meira Bento, Larissa Rangel Peixoto, Sheyla Kátia Lúcio Dornelas Martins, Carolina Castro Martins
Abstract
Objective
The aim was to systematically review the scientific efficacy of infrared thermography (IT) on the diagnosis of temporomandibular joint disorders (TMD).
Study Design
An electronic search was performed in eight databases up to May 2018. Additionally, a hand search of the reference lists was conducted. There were no restrictions on language or on year of publication. Two independent reviewers selected studies, reviewed the abstract information, and assessed the quality. The methodology of the included articles was evaluated using the QUADAS-2 tool.
Results
Nine studies fulfilled the eligibility criteria and were included in the systematic review. Four studies concluded that IT presents low accuracy or is not an accurate instrument for TMD diagnosis but there was substantial variation in sensitivity, specificity, and ROC curve values. Five studies concluded that IT appears to be promising or may be a complementary diagnostic aid in the evaluation of TMD. These studies presented sensitivity values ranging from 70% to 90% and specificity values ranging from 62% to 92%. All studies were judged as "at risk of bias" and as having "concerns regarding applicability".
Conclusion
The literature is still scarce regarding the reliability of IT for the diagnosis of TMD.
https://ift.tt/2xD1KXO
Decreased Expression of Folate Transport Proteins in Oral Cancer
Publication date: Available online 26 September 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Joanna Goral, current medical student at William Carey University, Lenore Pitstick, Alice Meyer, Bruno Jham, Eduardo Pereira Guimaraes, João Adolfo Costa Hanneman, Jacalyn M. Green
Abstract
Objectives
The purpose of this study was to assess the expression of the three major folate transporters – folate receptors (FR), reduced folate carrier (RFC), and proton-coupled folate transporter (PCFT) – in oral squamous cell carcinoma (OSCC). We hypothesized that patterns of expression of folate transporters would be different in OSCC when compared to normal oral epithelium.
Study Design
We used immunohistochemistry to examine the expression of FR, RFC, and PCFT in fifteen primary specimens collected from OSCC patients, two human cadaveric samples of OSCC, and twelve normal human cadaveric oral tissues from a medical gross anatomy laboratory. Possible correlations were determined between expression of each folate transporter with patients' clinical data.
Results
All three folate transporters were highly expressed in normal oral epithelium. In contrast, OSCC samples generally demonstrated low expression of FR, RFC, and PCFT, with wide distribution in the invading cancer cells. There were no differences in folate transporter expression between OSCC collected from patients and from human cadavers. The lowest expression of FR and PCFT characterized less-differentiated tumors, and the lowest expression of RFC correlated with higher lymph node involvement.
Conclusions
Human oral cancer samples expressed decreased amounts of all three major folate transport proteins when compared to controls from normal cadaveric oral tissues.
https://ift.tt/2OOyALL
The performance of metal artifact reduction algorithms in CBCT images considering the effects of materials, metal positions, and fields of view
Publication date: Available online 26 September 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Karla de Faria Vasconcelos, Marina Codari, Polyane Mazucatto Queiroz, Laura Ferreira Pinheiro Nicolielo, Deborah Queiroz Freitas, Chiarella Sforza, Reinhilde Jacobs, Francisco Haiter-Neto
Abstract
Objective
To assess the performance of two metal artifact reduction (MAR) algorithms in CBCT imaging, considering different materials, metal positions, and fields of view (FOVs).
Materials and Methods
Nine phantoms containing cylinders of amalgam, copper-aluminum alloy, and titanium were scanned using Picasso Trio and ProMax 3D CBCT units with small and medium FOVs. Scans were made with and without MAR algorithms. The standard deviation (SD) of voxel gray values was measured in the neighborhood of the cylinders. Differences in SD were statistically evaluated for effects of MAR and the other parameters with 5% significance level.
Results
Significant differences between images with and without MAR for both devices (p≤0.0001) were observed. Amalgam showed the largest artifact expression, followed by Cu-Al and titanium. After correction, differences remained only in Picasso Trio images (p = 0.002). Considering positions, no significant difference in MAR performance was observed in either device. Considering FOVs, significant differences were observed for ProMax 3D (p = 0.005), with less artifact expression in the medium FOV after MAR correction.
Conclusion
MAR algorithms were effective for artifact reduction, despite performing differently according to device, FOV, and material properties. The position of the metal cylinder within the FOV had no significant effect.
https://ift.tt/2xDf1iS
Effectiveness of Platelet-Rich Plasma Injection in Patients with Temporomandibular Joint Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Publication date: Available online 26 September 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Pei-Yu Chung, Meng-Ting Lin, Hsien-Po Chang
Abstract
Objective
To investigate the effectiveness of platelet-rich plasma (PRP) injection after arthrocentesis or arthroscopy in patients with temporomandibular joint (TMJ) osteoarthritis (OA).
Study Design
Electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched up to July 30, 2018. We included all published or unpublished randomized controlled trials (RCT). The primary outcome was pain reduction, and the secondary outcome was the improvement of maximal mouth opening (MMO). Weighted mean differences (WMD) were utilized for random-effect meta-analysis.
Results
Five RCTs were enrolled in the meta-analysis, comparing PRP injection to placebo [hyaluronic acid (HA) injection, saline injection, or no injection]. The results revealed that PRP injection was more effective than placebo in pain reduction, but no in the improvement of MMO, in the long term. In the subgroup analysis, PRP injection yielded better outcome only in pain reduction comparing to hyaluronic acid (HA) injection [WMD: 1.34, 95% confidence interval (CI): 0.95–1.73].
Conclusions
This meta-analysis demonstrated that PRP injection provided adjuvant efficacy to arthrocentesis or arthroscopy in pain reduction for TMJ OA in the long term. Furthermore, PRP injection significantly reduced pain compared with HA injection, saline injection, or no injection.
https://ift.tt/2OOynYZ
CD19 + tumor-infiltrating B-cells prime CD4 + T-cell immunity and predict platinum-based chemotherapy efficacy in muscle-invasive bladder cancer
Abstract
Purpose
CD19+ tumor-infiltrating B-cells (CD19+ TIB) play a crucial role in tumorigenesis, but their clinical relevance in muscle-invasive bladder cancer (MIBC) remains unknown. This study aimed to investigate the prognostic value of CD19+ TIB for post-surgery survival and adjuvant chemotherapy response in MIBC.
Experimental design
We assessed TIB by immunohistochemical staining of CD19 in 246 MIBC patients from Zhongshan Hospital and Shanghai Cancer Center. We evaluated the survival benefit of platinum-based chemotherapy according to CD19+ TIB. The mechanism underlying CD19+ TIB antitumor immunity was explored through the Cancer Genome Atlas (TCGA) dataset analysis and an in vitro Ag presentation assay.
Results
CD19+ TIB extensively infiltrated into the tumor stroma of MIBC. Adjuvant chemotherapy (ACT) led to a significantly increased benefit in the high CD19+ TIB MIBC patients (P = 0.003). In multivariate analysis, high CD19+ TIB MIBC patients had significantly longer OS with ACT in the discovery set (HR = 0.487, P = 0.038). TCGA gene expression analyses showed enrichment of adaptive immunity, T-cell-mediated immunity, and antigen-presentation signaling pathways in high CD19+ TIB MIBC patients. Moreover, CD19+ TIB co-localized with activated CD4+ TIT and expressed surface markers characteristic of antigen-presenting cells. Finally, an antigen-presentation assay demonstrated the antigen-presentation function of CD19+ TIB.
Conclusion
CD19+ TIB was identified as an independent prognostic factor, which could predict for post-surgery survival and platinum-based ACT benefits in MIBC. CD19+ TIB serve as antigen-presenting cells (APCs) to activate CD4+ TIT in the tumor environment of MIBC.
https://ift.tt/2IkdxOU
Oncological and functional outcomes of trans-oral robotic surgery for pyriform sinus carcinoma: A French GETTEC group study
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Paul Mazerolle, Pierre Philouze, Renaud Garrel, Karine Aubry, Sylvain Morinière, Sophie El Bedoui, Jean Ton Van, Christophe Ferron, Olivier Malard, Franck Jegoux, Emilie Berard, Sébastien Vergez
Abstract
Background
Pyriform sinus carcinomas (SCC) present specific functional and oncological issues. The recent advent of trans-oral robotic surgery (TORS), as a conservative procedure, has opened up new perspectives.
Objectives
To present the oncological and functional outcomes of TORS for pyriform sinus SCC.
Materials and methods
We included, retrospectively, all TORS procedures for pyriform sinus SCC performed between 2009 and 2017 in eight French tertiary referral centers. We excluded lesions involving the pyriform sinus that had developed from the oropharynx, larynx, or other anatomic sub-sites of the hypopharynx.
Results
We included 57 TORS procedures. Median hospital stay was 10 days. A preventive tracheotomy was performed in seven cases (12%), and all were successfully decannulated. Oral re-feeding was possible for 93%, after a median of 5 days. The main surgical complications were hemorrhages (three cases), all successfully handled, although 2 patients with heavy comorbidities died from blood loss in the days after. Adjuvant therapy was proposed in 31 cases (54%), including two cases of salvage surgery (total pharyngolaryngectomy). After a median follow-up of 23 months, overall and disease-free survival were, respectively, 84% and 74% at 24 months, and 66% and 50% at 48 months. At the end of follow-up, organ preservation rate was 96%. None of the surviving patients needed a tracheotomy and oral diet was possible for 96%.
Conclusion
The functional and oncological outcomes of TORS for pyriform sinus cancer are encouraging, and this procedure can be considered safe for selected early or moderately advanced cases as a conservative treatment.
https://ift.tt/2MZQkC1
Triggering TLR3 pathway promotes tumor growth and cisplatin resistance in head and neck cancer cells
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Hui-Ching Chuang, Ming-Huei Chou, Chih-Yen Chien, Jiin-Haur Chuang, Yu-Li Liu
Abstract
Over the last decades, significant advances in targeted therapies have helped provide more effective treatment for head and neck cancer patients. However, chemo-resistance to cisplatin significantly contributes to treatment failure in the clinical management of patients. In response to chemotherapeutic agents, certain molecules inside the cell are released or secreted from damaged or dead/dying cells, named damage-associated molecular patterns (DAMPs), thereby initiating an immune response through interaction with pattern recognition receptors (PRRs), such as Toll-like receptors (TLRs).
In present study, we investigated the link between cisplatin-induced DAMPs and TLR3 signaling. We found that cisplatin could be a potential activator of TLR3 and cisplatin treatment results in activation of PRRs' signaling and down-stream associated cytokine/chemokine, IFNβ, and CCL5 in TLR3High OC2 cells, but not in TLR3Low FaDu cells. Furthermore, knockdown of the TLR3 gene attenuates the expression of IFNβ and CCL5 mRNA and enhances the cytotoxicity of cisplatin in TLR3High OC2 cells.
To determine whether TLR3 status affects the stress response of OC2 cells to cisplatin, we generated TLR3 knockdown OC2 cells (psi-TLR3 cells) with a psiRNA-hTLR3 plasmid containing shRNA to TLR3 and control OC2 cells (psi-NT cells) expressing non-silencing shRNA. OC2 cells were more sensitive to cisplatin treatment after TLR3 knockdown. In our animal model, OC2 psi-NT cells were more tumorigenic than were OC2 psi-TLR3 cells. Together, our in vitro and in vivo data imply TLR3 may contribute to tumor development and protect cisplatin-induced DNA damage response leading to cisplatin resistance in head and neck cancer cells.
https://ift.tt/2zvbSDl
Performance of different imaging techniques in the diagnosis of head and neck cancer mandibular invasion: A systematic review and meta-analysis
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Xianghe Qiao, Wei Liu, Yubin Cao, Cheng Miao, Wenbin Yang, Naichuan Su, Li Ye, Longjiang Li, Chunjie Li
Abstract
Background
To assess diagnostic efficacy of imaging techniques for mandibular invasion by head and neck cancer.
Methods
Thirteen databases were searched. Study inclusion, data-extraction and quality assessment were performed independently. STATA 14.0 were mainly used for meta-analysis.
Results
Forty-nine studies were included. For mandibular invasion (cortex and marrow), CBCT, SPECT, CT, MRI, orthopantomography, PET-CT and bone-scintigraphy showed pooled sensitivities of 90%, 97%, 73%, 88%, 75%, 90%, 92%, specificities of 85%, 69% 91%, 90%, 83%, 89%, 79%, AUC of 0.9461, 0.9434, 0.8995, 0.9296, 0.8761, 0.9290, 0.9207, respectively. The combined SROC curves indicated CBCT and SPECT were superior to other techniques. For mandibular medullary invasion (marrow), CT and MRI showed pooled sensitivities of 85% and 93%, specificities of 86% and 84%.
Conclusions
CBCT was top-priority choice for bone invasion diagnosis. SPECT was recommended for exclusion, CT and MRI were suitable for conformation. Further investigations are needed for mandibular medullary involvement.
https://ift.tt/2N2ITdm
The interplay of IMRT and transoral surgery in HPV-mediated oropharyngeal cancer: Getting the balance right
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Shao Hui Huang, Ezra Hahn, Raymond K. Tsang, Zhi-Jian Chen, Brian O'Sullivan
Abstract
Transoral surgery (TOS) and IMRT represent two primary local ablative treatment modalities for oropharyngeal cancer (OPC). The choice of one over the other represents an interplay between the chance of cure vs risk of late sequelae. HPV-mediated (HPV+) OPC patients generally have excellent outcomes, especially in TNM-8 stage I disease. Controversies exist over which treatment has a more favorable toxicity profile and equal efficacy in the management of this population. Non-randomized retrospective data show comparable oncological and functional outcomes between TOS-based vs IMRT-based treatment for this disease. Several de-intensification concepts have been explored in this subset in both primary surgery-based vs primary radiotherapy-based trials. However, no robust mature trial data are available to convincingly guide treatment selection. TOS is often presented as one of the de-intensification options although the majority of series also describe the use of adjuvant treatments which inevitably result in non-negligible toxicities. Patient selection and surgeons' training are paramount. Understanding tumor biology and the prognostic value of traditional 'adverse' features will further guide trial design for refinement of risk tailored approach. In conclusion, comparative data suggests TOS and IMRT are both effective treatment for TNM-8 stage I HPV+ OPC with similar oncological and functional outcomes. TOS as a single modality has potential advantages in mitigating radiation included toxicities. TOS should be avoided in the presence of clinically overt extranodal extension or when negative margins are unlikely to be achieved. TOS is also less ideal for cases with radiological features predicting a high risk of distant metastasis.
https://ift.tt/2NJbdGU
Possible association of oestrogen and Cryba4 with masticatory muscle tendon‐aponeurosis hyperplasia
Oral Diseases, EarlyView.
https://ift.tt/2OT4UNp
Quantitative profiling of cytokines and chemokines in DOCK8 deficient and Atopic dermatitis patients
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2DvFeW3
The glomus tumor resorbed bone and teeth in the mandible: a case report
A glomus tumor is a rare neoplasm usually found in the dermis or subcutaneous tissue of the extremities. It is rare for the glomus tumor to occur on the head and face. Only 26 glomus tumors of the oral region ...
https://ift.tt/2Q9nC3I
Patient‐reported outcomes: A 5‐year long study reveals previously unreported therapeutic, demographic, socio‐economic, and other correlations in vitiligo
Dermatologic Therapy, EarlyView.
https://ift.tt/2Ih0WM8
Efficacy of oral tranexemic acid in refractory melasma: A clinico–immuno‐histopathological study
Dermatologic Therapy, EarlyView.
https://ift.tt/2QYKS5C
Occlusion therapy in inflammatory cutaneous diseases
Dermatologic Therapy, EarlyView.
https://ift.tt/2Il6BRy
Efficacy of topical calcineurin inhibitors in pyoderma gangrenosum
Dermatologic Therapy, EarlyView.
https://ift.tt/2QYKynq
Sequential methyl‐aminolevulinate daylight photodynamic therapy and diclofenac plus hyaluronic acid gel treatment for multiple actinic keratosis evaluation
Dermatologic Therapy, EarlyView.
https://ift.tt/2Iitd5d
Remittive effect of Dupilumab in atopic dermatitis
Dermatologic Therapy, EarlyView.
https://ift.tt/2QXIPPc
Prevention and management of iatrogenic blindness associated with aesthetical filler injections
Dermatologic Therapy, EarlyView.
https://ift.tt/2IgFVkR
Use of botulinum toxin in the treatment of aquagenic keratoderma: One case report
Dermatologic Therapy, EarlyView.
https://ift.tt/2Ihyvhj
Controversies in the treatment of androgenetic alopecia: The history of finasteride
Dermatologic Therapy, EarlyView.
https://ift.tt/2QZmqRF
Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma with Unique HPV type 52 Association: A Case Report with Review of Literature
Abstract
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a recently described distinctive clinicopathologic entity defined by association to high risk HPV, localization to sinonasal tract and close histologic resemblance to salivary gland tumors. Lack of awareness of its pathologic features and biology among pathologists and oncologists make this entity susceptible to misdiagnosis and erroneous management. Herein, we illustrate a case of HMSC of the nasal cavity associated with heretofore unreported subtype HPV-52 and discuss the challenges associated with diagnosis and management of this rare tumor. A 48-year-old woman with intermittent epistaxis for 6 months presented with a nasal mass and underwent middle turbinectomy. Histology showed a tumor with features typical of adenoid cystic carcinoma (ACC) in the form of basaloid cells and cribriform architecture. However, careful inspection revealed findings uncommon in ACC; such as surface pagetoid tumor spread, areas of solid sheets of myoepithelial cells accompanied by increased mitotic figures which prompted immunohistochemistry. Multidirectional differentiation into ductal (CK7, AE1/AE3) and myoepithelial (p63, p40, S100, calponin) lineage together with strong and diffuse immunopositivity for p16 distinguished this tumor from ACC. HPV genotyping was positive for high risk HPV subtype HPV52, which confirmed the diagnosis of HMSC. HPV-related multiphenotypic sinonasal carcinoma is an under-recognized unique clinicopathologic entity that needs awareness to avoid mistaking it for commoner salivary gland tumors. Making accurate diagnosis of this newly-described tumor is imperative in order to understand its biology and to develop optimal therapeutic strategies.
https://ift.tt/2NDfJqm
Solitary facial cutaneous chronic inflammatory lesions induced by anti‐tumour necrosis factor‐α antagonist
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zu5JqX
Topical sodium thiosulfate for calcinosis cutis associated with autoimmune connective tissue diseases: the Mayo Clinic experience, 2012–2017
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2OObULK
Blaschkoid distribution of composite syringocystadenoma papilliferum and tubular apocrine adenoma without naevus sebaceous
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zu6GiU
Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma with Unique HPV type 52 Association: A Case Report with Review of Literature
Abstract
Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is a recently described distinctive clinicopathologic entity defined by association to high risk HPV, localization to sinonasal tract and close histologic resemblance to salivary gland tumors. Lack of awareness of its pathologic features and biology among pathologists and oncologists make this entity susceptible to misdiagnosis and erroneous management. Herein, we illustrate a case of HMSC of the nasal cavity associated with heretofore unreported subtype HPV-52 and discuss the challenges associated with diagnosis and management of this rare tumor. A 48-year-old woman with intermittent epistaxis for 6 months presented with a nasal mass and underwent middle turbinectomy. Histology showed a tumor with features typical of adenoid cystic carcinoma (ACC) in the form of basaloid cells and cribriform architecture. However, careful inspection revealed findings uncommon in ACC; such as surface pagetoid tumor spread, areas of solid sheets of myoepithelial cells accompanied by increased mitotic figures which prompted immunohistochemistry. Multidirectional differentiation into ductal (CK7, AE1/AE3) and myoepithelial (p63, p40, S100, calponin) lineage together with strong and diffuse immunopositivity for p16 distinguished this tumor from ACC. HPV genotyping was positive for high risk HPV subtype HPV52, which confirmed the diagnosis of HMSC. HPV-related multiphenotypic sinonasal carcinoma is an under-recognized unique clinicopathologic entity that needs awareness to avoid mistaking it for commoner salivary gland tumors. Making accurate diagnosis of this newly-described tumor is imperative in order to understand its biology and to develop optimal therapeutic strategies.
https://ift.tt/2NDfJqm
Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial
British Journal of Dermatology, EarlyView.
https://ift.tt/2xDhhqz
Hypotonic stress response of human keratinocytes involves LRRC8A as component of volume‐regulated anion channels
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xCNo9U
Acute generalized exanthematous pustulosis induced by terbinafine in a child confirmed by patch testing
International Journal of Dermatology, EarlyView.
https://ift.tt/2Q3Ynjc
Antineutrophil cytoplasmic antibodies negative levamisole‐induced leukocytoclastic vasculitis: a presumed case and literature review
International Journal of Dermatology, EarlyView.
https://ift.tt/2xFw7wN
Telogen hair loss and androgenetic‐like alopecia in GAPO syndrome
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2NJLcYb
Use of a qualitative case study to learn lessons from severe preeclampsia causing a maternal near-miss: a case report
Maternal mortality is a critical indicator in assessing the quality of services provided by a health care system. Approximately 99% of all maternal deaths occur in developing countries; where a majority of the...
https://ift.tt/2xCK2DQ
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