Wasp stings are commonly encountered worldwide and result in a variety of clinical manifestations including local and systemic reactions. Neurological and vascular complications are rarely reported following a...
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Σάββατο 13 Οκτωβρίου 2018
Ischemic stroke following a wasp sting – a rare complication: a case report
Coverage from the American Thyroid Association® (ATA) 88th Annual Meeting
Coverage from the 88th Annual Meeting of the American Thyroid Association®
From Medscape Diabetes & Endocrinology
The post Coverage from the American Thyroid Association<sup>®</sup> (ATA) 88<sup>th</sup> Annual Meeting appeared first on American Thyroid Association.
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ATA® Announces Recipients of 2018 Special Awards
The post ATA<sup>®</sup> Announces Recipients of 2018 Special Awards appeared first on American Thyroid Association.
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News from the 88th Annual Meeting of the American Thyroid Association®
ATA 2018 Abstracts Available Online
The American Thyroid Association holds its 88th Annual Meeting at the Marriott Marquis, Washington DC from October 3-7, 2018
Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting
Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
The post News from the 88<sup>th</sup> Annual Meeting of the American Thyroid Association<sup>®</sup> appeared first on American Thyroid Association.
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Effects of inhalational anti-asthmatic medications on oral health between 7 and 14 years of age
Sapna Konde, Manisha Agarwal, Rachna Chaurasia
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):70-73
Introduction: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The World Health Organization considers asthma as the most important chronic respiratory disease of the childhood. Aim: The aim of this study was to observe the changes in oral health and salivary pH, of asthmatic children aged between 7 and 14 years, treated with different combinations of inhaled medication. Materials and Methods: A total of 120 children aged between 7 and 14 years were divided into two groups of which 60 were asthmatic children and the rest 60 were nonasthmatic which were served as control group. Dental caries was assessed using decayed missing filled tooth (DMFT) index for permanent teeth and decayed extracted filled tooth (DEFT) index for primary teeth. Oral hygiene status was determined by simplified oral hygiene index (OHI-S) and modified (OHI-S) index for primary teeth. The resting salivary pH was estimated using pH strips and comparison was made between both groups. Results: The mean value of dental caries (DMFT and DEFT) was found to be significantly higher among study group compared to control group (P < 0.05), while for salivary pH, it was significantly lower among the study group compared to control (P < 0.05), whereas oral hygiene status was statistically not significant in relation to anti-asthmatic medications. Conclusions: Children with asthma have higher caries prevalence, lower salivary pH compared to the control group, which can be due to use of anti-asthmatics medications.
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Indian Journal of Allergy, Asthma and Immunology 2018 32(2):70-73
Introduction: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The World Health Organization considers asthma as the most important chronic respiratory disease of the childhood. Aim: The aim of this study was to observe the changes in oral health and salivary pH, of asthmatic children aged between 7 and 14 years, treated with different combinations of inhaled medication. Materials and Methods: A total of 120 children aged between 7 and 14 years were divided into two groups of which 60 were asthmatic children and the rest 60 were nonasthmatic which were served as control group. Dental caries was assessed using decayed missing filled tooth (DMFT) index for permanent teeth and decayed extracted filled tooth (DEFT) index for primary teeth. Oral hygiene status was determined by simplified oral hygiene index (OHI-S) and modified (OHI-S) index for primary teeth. The resting salivary pH was estimated using pH strips and comparison was made between both groups. Results: The mean value of dental caries (DMFT and DEFT) was found to be significantly higher among study group compared to control group (P < 0.05), while for salivary pH, it was significantly lower among the study group compared to control (P < 0.05), whereas oral hygiene status was statistically not significant in relation to anti-asthmatic medications. Conclusions: Children with asthma have higher caries prevalence, lower salivary pH compared to the control group, which can be due to use of anti-asthmatics medications.
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Allergen immunotherapy: What does the future hold?
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):41-42
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Future modalities in allergen immunotherapy: A brief overview
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):43-46
Allergen immunotherapy (AIT) is the only disease-modifying modality for the treatment of allergic diseases. The well-known and approved formulations are subcutaneous immunotherapy (SCIT), sublingual immunotherapy (SLIT) and allergoids. The drawbacks of the conventional AIT such as the risk of anaphylaxis led to the development of allergoids, Future approaches in AIT may permit (1) shorter treatment regimens, (2) improved safety, (3) improved compliance and (4) newer indications for AIT, which are discussed in the article.
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Hypersensitivity vasculitis in a young adult
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):78-81
This is a case report of a case of hypersensitive vasculitis in a young man. After a comprehensive history and analysis of his symptoms, the symptoms were triggered probably after exposure to yellow fever vaccine. The patient's symptoms were brought under control after starting on immunosuppressive medication.
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A study of skin sensitivity to various allergens by skin prick test in patients of bronchial asthma and allergic rhinitis
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):47-53
Background: Bronchial asthma (BA) and allergic rhinitis (AR) are among the most common allergic disorders. Identification of specific causative allergens is of paramount importance for further management. Aims: This study aims (1) to find out the prevalence of various allergens leading to AR and/or BA through skin prick test (SPT), (2) to identify the trigger factors in these patients, (3) to study correlations of allergens and seasonal variations in patients suffering from AR and/or BA. Materials and Methods: A total of 134 patients were collected from outpatient department and inpatient department of Respiratory Medicine Department of Geetanjali Medical College and Hospital, Udaipur, from January 2016 to December 2017. The diagnosis of BA and AR was made according to the GINA and ARIA guidelines, respectively. SPT was done with 78 different types of aeroallergens, which included 23 types of pollens, 6 types of fungi, 10 types of insects, 6 types of dusts, 6 types of dander, 3 fabrics, 2 feathers, and 22 food allergens. Patients who had taken short-acting oral antihistaminics, beta-blockers, steroids, tricyclic antidepressants or any other drug that could affect the test within one week prior to testing were excluded. Also, patients on long-acting oral antihistaminics within four weeks of testing and pregnant women were excluded. Results: A total of 134 patients consisting of 73 (54.48%) males and 61 (45.52%) females, in the age group of 5–65 years, were included in the study. The maximum numbers of patients (50; 37.31%) were between the age group of 20 and 35 years. The maximum number of patients (94; 70.15%) had a duration of suffering from >1 years. AR was found in 60 (44.78%), BA associated with AR was found in 39 (29.1%), while BA alone was found in 35 (26.12%). In 54% of patients, triggers were found for exacerbation of their symptoms, the most common being air pollution (48%) followed by cold exposure (20%), physical activity (12%), irritants (9%), smoke (7%), and fumes and odors (4%). A total of 10,452 SPTs were done, out of which 265 (%) showed positive reactions. The positivity for pollens was seen in 116 (43.77%) patients followed by insects [79 (29.81%)], fungi [22 (8.3%)], house dust mite [15 (5.66%)], dusts [11 (4.15%)], fabrics [10 (3.77%)], danders [9 (3.4%)], and feathers [3 (1.13%)], respectively. Food allergens showed no significant reactions to SPT. Conclusions: Our study showed that insects were the most common allergen in BA patients, while pollens were the most common allergen in patients of AR with or without BA. Intermittent symptoms were common with pollen allergy.
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Study on impact of air pollution on asthma among school going children residing in urban Agra
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):65-69
Background: Air pollution is one of the world's most serious environmental problems. Air pollution has many negative health effects on the general population, especially children, individuals with underlying chronic disease, and the elderly. The aims of this study were to evaluate the effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in schoolgoing children in Agra, suffering from asthma compared with healthy subjects, and to estimate the association between incremental increases in principal pollutants and the incidence of respiratory symptoms. Materials and Methods: We enrolled 702 children aged 6–18 years in this prospective study. A total of 342 children with asthma and 360 healthy subjects were monitored for 6 months from September 2013 to February 2014. Clinical data were combined with the results obtained using an air pollution monitoring system of the five most common pollutants. A total of 328 children with asthma and 345 healthy subjects completed follow-up. Results: Children with asthma reported significantly more days of fever (P <0.001) and cough (P < 0.001), episodes of rhinitis (P = 0.087), asthma attacks (P < 0.001), episodes of pneumonia (P < 0.003), and hospitalizations (P = 0.01). In the asthma cohort, living close to the street with a high traffic density was a risk factor for asthma exacerbations (odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.13–2.84), whereas living near green areas was found to be protective (OR = 0.50; 95% CI, 0.31–0.80). Conclusion: There is a significant association between traffic-related pollution and the development of asthma exacerbations and respiratory infections in children suffering from asthma. These findings suggest that environmental control may be crucial for respiratory health in children with the underlying respiratory disease.
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Prevalence of respiratory symptoms in automobile spray painters of Mumbai: A cross-sectional study
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):54-58
Background: Spray painting poses health hazards that affect the respiratory system. During spray painting, workers are exposed to different paint components. Toluene diisocyanates, methylene diisocyanates, and hexamethylene diisocyanates are commonly used isocyanates in the spray painting. The major route of occupational exposure to isocyanates is the inhalation of the vapor or aerosol that can sensitize workers. The short- and long-term consequences of the respiratory system can be raised from these occupations. Hence, the aim and objective of this study were to find the prevalence of respiratory symptoms in automobile spray painters of Mumbai and to study the use of safety measures in automobile spray painters. Materials and Methods: The study was a cross-sectional study. A total of 50 automobile spray painters were selected based on inclusion criteria. The self-made validated questionnaire was used as an outcome measure. Results: About 90% of the automobile spray painters have reported respiratory symptoms in their occupation among which 88% had the most prevalent symptom of breathlessness followed by 84% workers had the symptom of coughing. Nearly 60% of workers were aware about the safety measures, but only 33% were using the safety measures during work. Conclusion: The study showed a high prevalence of respiratory symptoms. The lack of awareness and the use of safety measures had increased the severity of the symptoms.
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Clinical, radiological, and microbiological profile of pulmonary aspergillosis in treated cases of pulmonary tuberculosis
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):74-77
Context: Clinical studies about detailed spectrum of aspergillosis in treated tuberculosis (TB) patients are lacking. Hence, a study was undertaken at the Institute of Respiratory Disease, Jaipur, Rajasthan, India. Treated patients of pulmonary TB having any symptom such as hemoptysis, cough with expectoration, weight loss, and whose chest X-ray showed residual cavitation were enrolled for the study. Aims: This study aimed to determine the prevalence of pulmonary aspergillosis in treated cases of pulmonary TB and to study the social, demographical, and clinical characteristics of these patients. Settings and Design: A descriptive type of observational study was conducted at the Department of Respiratory Medicine in a tertiary care center of Rajasthan. Subjects and Methods: This descriptive type of observational study was conducted on seventy patients, whose sputum or bronchial wash showed isolation of Aspergillus. Demographic details, predisposing factors, and clinical findings were noted. Statistical Analysis Used: Data collected were entered into Excel spreadsheet and quantitative data were expressed as number and percentage. Results: The presentation of pulmonary aspergillosis in treated cases of pulmonary TB varies from aspergilloma (57%) to chronic necrotizing pulmonary aspergillosis (36%) to allergic bronchopulmonary aspergillosis (7%). The most common symptom was recurrent hemoptysis. Most of the patients were farmers by occupation, but no significant comorbid illness was seen. X-ray chest missed about 70% of cases. The most common species were Aspergillus fumigatus; others were Aspergillus terreus (13%), Aspergillus flavus (13%), and Aspergillus niger (7%). Conclusions: All treated cases of pulmonary TB presenting with recurrent hemoptysis and/or cough with expectoration should be evaluated in detail for pulmonary aspergillosis as chest X-ray alone can miss the diagnosis.
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Air pollution and respiratory dysfunction among adolescents: A case–control study from North West India
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):59-64
Introduction: Children are vulnerable to the effects of air pollution because of immature organ system and immune system. Air pollutants can lead to both upper and lower respiratory tract symptoms. Methodology: Adolescents in the age group of 10–19 years children from residential areas with established maximal and low pollution levels as reported by State Pollution Control Board were included in the study using age-, sex-, weight-, and height-matched case–control study design. For the assessment of respiratory dysfunction, the values of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, and forced expiratory flow (FEF) 25%–75% were included in this study. Odds ratio with 95% confidence interval was calculated to ascertain the strength of association. Results: The distribution of abnormalities for a restrictive pattern in males in polluted group was 42% as compared to 29% in low polluted group (P = 0.007). The mean values of pulmonary function parameters FVC, FEV1, FEV1/FVC, and FEF 25%–75% (expressed as percentage of predicted values) were compared in two groups, a deficit of approximately 4.5%, 6%, 1.06%, and 3.4% was observed in males versus 4.9%, 6.3%, 2.44%, and 2.4%, respectively for females. Conclusion: There is a statistically significant difference in the pulmonary functions in the polluted versus less polluted areas with the children being affected in a harmful manner in the former areas.
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Detection of immunoglobulin A deficiency in celiac disease suspects
Indian Journal of Allergy, Asthma and Immunology 2018 32(2):82-83
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ORAL FOOD CHALLENGE FAILURES AMONG FOODS RESTRICTED DUE TO ATOPIC DERMATITIS
Recent studies have suggested that removing foods from the diet to manage atopic dermatitis (AD), based on positive allergy tests, may lead to immediate allergic reactions on reintroduction of that food.
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Within-tester repeatability and between-tester reproducibility of skin test endpoint titration: A quality assurance study
Airway response to allergen depends on two independent factors: the degree of IgE sensitivity to the allergen and the level of lower airway response as quantified by histamine or methacholine challenge.1,2 The former can be assessed by skin prick titration (SPT) to determine the skin test endpoint (STE), which for research purposes is the smallest concentration of allergen that produces a skin wheal ≈ 2mm x 2mm (according to the standard operating procedure, SOP, for the AllerGen NCE Clinical Investigator Collaborative, CIC).
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Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes
Chronic rhinosinusitis (CRS) is a heterogeneous disorder with distinct pathophysiologic mechanisms. Based on the transcription factor expression and cytokine production patterns in different types of innate lymphoid cells (ILCs), in parallel with those of adaptive CD4+ T helper (Th) cells and CD8+ cytotoxic T (Tc) cells, new perspectives on endotypes of patients are emerging around the immune response deviation into type 1 (orchestrated by ILC1s, Tc1 and Th1 cells), type 2 (characterized by ILC2s, Tc2 and Th2 cells), and type 3 (mediated by ILC3s, Tc17 and Th17 cells) responses.
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Author's Response to Hopp's Commentary
We would thank Dr. Hopp for his interesting correspondence "A New Acronym for PPI-REE"?)1 in response to our summary of the new consensus agreement for the diagnosis of Eosinophilic Esophagitis (EoE)2. One goal of the new guidelines was to simplify the diagnosis and terminology. In addition, the new diagnostic criteria were developed so that patients diagnosed with EoE with previous consensus guidelines would still be considered to have EoE. However, the proposed abbreviation of EoE-PPI-R (Eosinophilic Esophagitis-Proton Pump Inhibitor Responsive) seems to add extra complexity to the terminology.
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Avocado: An Emerging Culprit in Food Protein-Induced Enterocolitis Syndrome?
Food protein-induced enterocolitis syndrome (FPIES) is a poorly understood, immunologically mediated, gastrointestinal food-associated hypersensitivity often presenting in infants and toddlers.1 Incidence data are limited; estimates vary from 1.5 to 30 per 10,000.2,3 Despite being more prevalent than previously thought, diagnostic delay is common4 and clinician awareness of FPIES appears to be low.5 Reactions are typified by profuse vomiting, often accompanied by diarrhea, lethargy, and pallor; and may be progress to severe dehydration, acidosis, and shock.
https://ift.tt/2A7I2Fc
Prevalence of auto-antibodies associated to pulmonary arterial hypertension in scleroderma – A review
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): José Pedro L. Nunes, André C. Cunha, Tiago Meirinhos, Alzira Nunes, Paulo M. Araújo, Ana R. Godinho, Eduardo M. Vilela, Carlos Vaz
Abstract
The prevalence of auto-antibodies associated to pulmonary arterial hypertension in scleroderma patients was reviewed, based on reports cited in two major scientific databases.
Data was collected on the following types of antibodies: antinuclear, anti-double-stranded DNA, anticentromere, anti-CENP-A, anti-CENP-B, anti-bicaudal D2, anti-nucleolar, anti-Scl-70 (anti-topoisomerase I), anti-topoisomerase II α, anti-RNP, anti-U1RNP, anti-U3RNP, anti-RNA polymerase III, anti-Th/To, anti-histone, antiphospholipid, anti-PmScl, anti-Sm, anti SSA (anti-Ro), anti SSB (La), anti-Ro52 (TRIM 21), anti-Ku, anti-B23, anti-RuvBL1, anti-RuvBL2, anti-fibrin bound tissue plasminogen activator, anti-endothelial cell, anti-phosphatidylserine-prothrombin complex, anti-endothelin-1 type A receptor, anti-angiotensin II type 1 receptor, anti‑carbonic anhydrase II, anti-fibroblast, anti-cyclic citrullinated peptide, anti-4-sulfated N-Acetyl-lactosamine, class I and II anti-human leukocyte antigen.
Auto-antibodies were shown by different authors to be associated to this condition, with different prevalence values for each type of auto-antibody. Antinuclear antibodies, anti-centromere antibodies, antiphospholipid antibodies, anti-U3 RNP antibodies and anti-Th/To antibodies would appear to show a particularly important prevalence in scleroderma patients with pulmonary hypertension, appearing in about 8/10 (antinuclear), 1/ 2 (anti-centromere, anti-phospholipid), and 1/4 (anti-U3RNP, anti-Th/To) of patients.
The available evidence points in the direction of a strong association between auto-immune mechanisms and pulmonary hypertension in the setting of scleroderma.
https://ift.tt/2A6C7Ag
HIBISCUS: HYDROXYCHLOROQUINE FOR THE SECONDARY PREVENTION OF THROMBOTIC AND OBSTETRICAL EVENTS IN PRIMARY ANTIPHOSPHOLIPID SYNDROME
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Cristina Belizna, Francesca Pregnolato, Sebastien Abad, Jaume Alijotas-Reig, Howard Amital, Zahir Amoura, Laura Andreoli, Emmanuel Andres, Achile Aouba, Sule Apras Bilgen, Laurent Arnaud, Boris Bienvenu, Viktoria Bitsadze, Patrick Blanco, Miri Blank, Maria Orietta Borghi, Antonia Caligaro, Elisabeta Candrea, Valentina Canti, Laurent Chiche
Abstract
The relapse rate in antiphospholipid syndrome (APS) remains high, i.e. around 20%–21% at 5 years in thrombotic APS and 20–28% in obstetrical APS (Cervera et al., 2009, 2015 [2,3]).
Hydroxychloroquine (HCQ) appears as an additional therapy, as it possesses immunomodulatory and anti-thrombotic various effects (Pericleous et al., 2016; Andrade and Tektonidou, 2016; Belizna, 2015; Erkan et al., 2014; Erkan and Lockshin, 2012; De Carolis et al., 2015; Mekinian et al., 2015; Merashli et al., 2015; Galli, 2014; Lopez-Pedrera et al., 2015; Hu et al., 2017; Ben-Zvi et al., 2012; Belizna et al., 2017 [[4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]]).
Our group recently obtained the orphan designation of HCQ in antiphospholipid syndrome by the European Medicine Agency.
Furthermore, the leaders of the project made the proposal of an international project, HIBISCUS, about the use of Hydroxychloroquine in secondary prevention of obstetrical and thrombotic events in primary APS. This study has been launched in several countries and at now, 53 centers from 16 countries participate to this international trial.
This trial consists in two parts: a retrospective and a prospective study.
The French part of the trial in thrombosis has been granted by the French Minister of Health in December 2015 (the academic trial independent of the pharmaceutical industry PHRC N PAPIRUS) and is coordinated by one of the members of the leading consortium of HIBISCUS.
https://ift.tt/2QMHdqS
Celiac disease and endocrine autoimmunity – the genetic link
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): George J. Kahaly, Lara Frommer, Detlef Schuppan
Abstract
Celiac disease is a small intestinal inflammatory disease with autoimmune features that is triggered and maintained by the ingestion of the storage proteins (gluten) of wheat, barley and rye. The prevalence of celiac disease is increased in patients with monoglandular and/or polyglandular autoimmunity and their relatives. Between 10 and 30% of patients with celiac disease are thyroid and/or type 1 diabetes antibody positive, while around 5 to 7% of patients with autoimmune thyroid disease and/or type 1 diabetes are IgA anti-tissue transglutaminase antibody positive. The close relationship between celiac disease and endocrine autoimmunity is largely explained by sharing a common genetic background. The HLA antigens DQ2 (DQA1*0501-DQB1*0201) and/or DQ8 (DQA1*0301-DQB1*0302), that are tightly linked to DR3 and DR4, respectively, are the major common genetic predisposition. Moreover, functional single nucleotide polymorphisms of various genes that are involved in immune regulation have been identified as "overlap" susceptibility genes for both celiac disease and monoglandular or polyglandular autoimmunity. While plausible, it remains to be established how far a gluten free diet may prevent or ameliorate glandular autoimmunity. In conclusion, all patients with celiac disease should be screened for type 1 diabetes and/or autoimmune thyroid disease. Conversely, patients with the above autoimmune endocrine disorders should be also screened for celiac disease.
https://ift.tt/2A7cwHh
Low-dose tocilizumab for relapsing giant cell arteritis in the elderly, fragile patient: Beyond the GiACTA trial
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Giovanni Maria Rossi, Alessandro Mannoni, Gerardo Di Scala, Elena Silvestri, Rafaela Diana Cojan, Lorenzo Vannozzi, Alessandra Bettiol, Augusto Vaglio, Giacomo Emmi
https://ift.tt/2QMH8Ds
Autoinflammatory/autoimmunity syndrome induced by adjuvants (ASIA; Shoenfeld's syndrome): A new flame
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Jan Willem Cohen Tervaert
Abstract
In the present review, recent findings regarding autoimmune/inflammatory syndrome by adjuvants (ASIA) are described. Patients with ASIA present with complaints such as fatigue, cognitive impairment, arthralgias, myalgias, pyrexia, dry eyes and dry mouth. During the last few years, it has been postulated that these symptoms in patients with foreign body implants are due to a chronic inflammatory process and an adjuvant effect of the implanted biomaterial. Ultimately, these inflammatory reactions result in (an increase of) allergies, autoimmune diseases, immune deficiency and/or lymphomas.
Pre-existent allergic disease has been found to be an important risk factor for the development of ASIA after foreign body implantation. Explantation of the foreign body results in the majority of patients in an amelioration of the symptoms. There is an urgent need to start adequately adjusted epidemiological studies to obtain better evidence which percentage of patients does develop symptoms and/or diseases such as ASIA, immune deficiency, and/or autoimmune diseases after implant surgery.
https://ift.tt/2A6roWs
Anti-neutrophil cytoplasmic antibody-associated chronic inflammatory arthritis without vasculitis. Data from a French nationwide survey
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Guillermo Carvajal Alegria, Matthieu Groh, Dewi Guellec, Eric Toussirot, Julien Rigaud, Martin Soubrier, Sébastien Ottaviani, Guillaume Direz, Alain Saraux, Divi Cornec, CRI (Club Rhumatisme et inflammation)
https://ift.tt/2QJpH6L
with focus on autoimmune liver diseases
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Audrey Beringer, Pierre Miossec
Abstract
The pro-inflammatory cytokine interleukin(IL)-17 and IL-17-producing cells are important players in the pathogenesis of many autoimmune / inflammatory diseases. More recently, they have been associated with liver diseases. This review first describes the general knowledge on IL-17 and IL-17 producing cells. The second part describes the in vitro and in vivo effects of IL-17 on liver cells and the contribution of IL-17 producing cells to liver diseases. IL-17 induces immune cell infiltration and liver damage driving to hepatic inflammation and fibrosis and contributes to autoimmune liver diseases. The circulating levels of IL-17 and the frequency of IL-17-producing cells are elevated in a variety of acute and chronic liver diseases. The last part focuses on the effects of IL-17 deletion or neutralization in various murine models. Some of these observed beneficial effects suggest that targeting the IL-17 axis could be a new therapeutic strategy to prevent chronicity and progression of various liver diseases.
https://ift.tt/2A6sstf
Recent advances in mouse models for systemic sclerosis
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Xiaoyang Yue, Xinhua Yu, Frank Petersen, Gabriela Riemekasten
Abstract
SSc is a complex rheumatoid disease characterized by autoimmunity, fibrosis and vasculopathy. Mouse models provide powerful research tools for exploring the pathogenesis of the human diseases. Each mouse model can represent a specific way leading to the development of disease. Moreover, mouse models can be used to investigate the role of candidate molecule in the pathogenesis of disease. So far, more than twenty mouse models for SSc have been established and provide new insights in the understanding of the pathogenesis of SSc. In this review, we provide an overview on recent advances in the field of experimental SSc. We introduce novel mouse models generated in the recent years and discuss their relevance to the SSc pathogenesis. Moreover, we summarize and discuss recent findings in the pathogenesis of classical SSc mouse models.
https://ift.tt/2QKSXtO
Dimethyl fumarate treatment in multiple sclerosis: Recent advances in clinical and immunological studies
Publication date: Available online 12 October 2018
Source: Autoimmunity Reviews
Author(s): Gwendoline Montes Diaz, Raymond Hupperts, Judith Fraussen, Veerle Somers
Abstract
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS) in which demyelination and neurodegeneration occurs. The immune system of MS patients is characterized by a dysregulation in the balance between pro- and anti-inflammatory immune cells, whereby both the innate and adaptive immune system are involved. Dimethyl fumarate (DMF) was licensed in 2013 as an oral first-line therapy for relapsing-remitting (RR)MS patients. It has a strong efficacy with neuroprotective and immunomodulatory effects and a favourable benefit-risk profile. However, the effects of DMF on the immune system of MS patients were not clear before entering the market. During the last years, numerous in vitro and ex vivo studies have clarified the working mechanism of DMF in MS. Here, we discuss the pharmacokinetics of DMF and its effect on molecular immune-related pathways, which is further linked to the clinical and immunological effects of DMF treatment. The efficacy and safety of DMF treatment for RRMS is discussed as reported from clinical trials. Further, the immunological effects of DMF treatment in RRMS patients are addressed in more detail, including the distribution and function of immune cells. Taken together, evidence from recent studies points to a multifactorial working mechanism of DMF treatment in MS which leads to a restored immune balance favouring a more tolerogenic or anti-inflammatory immune profile.
https://ift.tt/2A5MnJ0
Giant--cell arteritis--related mortality in France: A multiple--cause--of--death analysis Giant--cell arteritis--related mortality in France
Publication date: Available online 11 October 2018
Source: Autoimmunity Reviews
Author(s): Thibaud Chazal, Raphael Lhote, Grégoire Rey, Julien Haroche, Mireille Eb, Zahir Amoura, Fleur Cohen Aubart
Abstract
Objectives: Giant--cell arteritis (GCA) is a large vessel vasculitis. Data regarding mortality are controversial. We describe the mortality data of the French death certificates for the period of 2005 to 2014.
Methods: Using multiple--cause--of--death (MCOD) analysis, we calculated age--adjusted mortality rates for GCA, examined differences in mortality rates according to age and gender and analyzed the underlying causes of death (UCD).
Results
We analyzed 4628 death certificates listing a diagnosis of GCA as UCD or non-underlying cause of death (NUCD). The mean age of death was 86 (±6.8) years. The overall age--standardized mortality rate among GCA patients was 7.2 per million population. Throughout the study period, the mean age of death was significantly increased (r = 0.17, p < .0001) in both genders. There was no significant difference with age repartition of death in the general population (p = .26). When GCA was listed as the UCD, most frequent associated diseases were cardiovascular (79%) and infectious diseases (35%). When GCA was reported as the NUCD, the listed UCD was a cardiovascular event in 40% of cases, neoplasm in 13%, neurodegenerative disorder in 11% and infectious disease in 10%. When GCA was the UCD or NUCD, an age--adjusted observed/expected ratio > 1 in GCA--associated mortality compared with the general population mortality was observed for tuberculosis, pneumonia and cardiovascular diseases.
Conclusion: In this analysis of French death certificates mentioning GCA, we observed a.
stable standardized mortality rate between 2005 and 2014. The most frequent associated diseases were cardiovascular diseases and infections.
https://ift.tt/2QRKa9J
What speech can tell us: A systematic review of dysarthria characteristics in Multiple Sclerosis
Publication date: Available online 11 October 2018
Source: Autoimmunity Reviews
Author(s): Gustavo Noffs, Thushara Perera, Scott Camaron Kolbe, Camille Jessica Shanahan, Frederique Maria Christina Boonstra, Andrew Evans, Helmut Butzkueven, Anneke van der Walt, Adam Phillip Vogel
Abstract
IMPORTANCE: Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased communication skills and quality of life. Advancements in technology now makes it possible to use quantitative acoustic assessment of speech as biomarkers of disease progression.
OBSERVATIONS: Four domains of speech have been identified: articulation (slow articulation and imprecise consonants), voice (pitch and loudness instability), respiration (decreased phonatory time and expiratory pressure) and prosody (longer and frequent pauses, deficient loudness control). Studies also explored I) predictive models for diagnosis of MS and of ataxia using speech variables, II) the relationship of dysarthria with cognition and III) very few studies correlated neuroimaging with dysarthria. We could not identify longitudinal studies of speech or dysarthria in Multiple Sclerosis.
CONCLUSION AND RELEVANCE: Refinement of objective measures of speech has enhanced our understanding of Multiple Sclerosis-related deficits in cross-sectional analysis while both integrative and longitudinal studies are identified as major gaps. This review highlights the potential for using quantitative acoustic assessments as clinical endpoints for diagnosing, monitoring progression and treatment in disease modifying trials.
https://ift.tt/2A6BcQn
Polymerase-1 pathway activation in acute multiple sclerosis relapse
Publication date: Available online 11 October 2018
Source: Autoimmunity Reviews
Author(s): Anat Achiron, Rina Falb, Anna Feldman, Maria Bovim, Onn Rosenblum, Ida Sarova Pinhas, David Magalashvili, Mark Dolev, Shay Menascu, Michael Gurevich
Abstract
Background
The operating molecular mechanisms that characterize a multiple sclerosis (MS) relapse has not been thoroughly studied. We have shown that increased expression of RNA polymerase 1 (POL1) molecular pathway is associated with increased MS disease activity.
Objective
To assess POL1 pathway expression during acute MS relapse.
Methods
We studied POL1 pathway activation and associated biomarkers during the first acute optic neuritis attack of MS, and in relapsing-remitting MS patients treated with disease-modifying drugs (DMDs) experiencing an acute MS relapse or a radiological relapse using gene expression microarrays and quantitative RT-PCR.
Results
In MS patients (N = 6) during the first acute optic neuritis attack POL1 pathway activation was evident by over-expression of POL1 related network including transcription factor UBTF and downstream components of Assembly of RNA POL1 complex (1.92E-03). POL1 related biomarkers RRN3, POLR1D and LRPPRC were over-expressed x1.6 (p = .002), ×1.7 (p = .01) and x2.0 (p = .001) times higher respectively, in MS patients (N = 30) during acute clinical relapse as compared with remission. Similarly, in MS patients (N = 21) that presented with a radiological relapse, we observed significant activation of POL1 related biomarkers including RRN3 (p = .01), POLR1D (p = .002), POLR1E (p = .0001) and LRPPRC (p = .006), as compared with remission, as well as overexpression of a large group of genes encoding ribosomal proteins like RPS6KA3 (p = 7.2E-6), RRP8 (p = .0002) and RPCS9 (p = .0008).
Conclusions
Our findings suggest that targeted inactivation of Pol-1 pathway may represent a novel strategy for a better treatment of acute MS relapse.
https://ift.tt/2A63335
Intramuscular injection of dexamethasone for the control of pain, swelling, and trismus after third molar surgery: a systematic review and meta-analysis
This systematic review aimed to answer the following PICO question: Does the intramuscular injection of dexamethasone result in less pain, swelling, and trismus after mandibular third molar removal when compared to other routes of administration or a control group (saline solution injection or no treatment)? An electronic search was conducted in Virtual Health Library, PubMed, and Web of Science, through March 2018. Eligibility criteria included clinical trials. The search strategy resulted in 331 studies.
https://ift.tt/2IU5dp6
The prevalence of pneumatized articular eminence in the temporal bone. Do we need a high resolution computed tomography-based novel risk classification for eminectomy?
Besides mastoid air filled cells, pneumatizations (PN) occasionally occur in the articular eminence (AE) of the temporomandibular joint (TMJ). These findings represent no pathological character but may increase the risk of perforating the AE during eminectomy with potential harming the skull base. Various classifications catagorize the degree of temporal PN without focussing solely on the AE. Panoramic radiograph (PR) and computed tomographie (CT) are both described as suitable for diagnosing PNs.
https://ift.tt/2OWAJIF
Parental anxiety towards ‘refer’ results in Newborn Hearing Screening (NHS) in South India: A hospital based study
Publication date: Available online 13 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Vijaya Kumar Beaula Vincy, Jayashree Seethapathy, Prakash Boominathan
https://ift.tt/2OYuUdM
The Diagnostic Role of Triple Endoscopy in Pediatric Patients with Chronic Cough
Publication date: Available online 13 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): M. Shannon Fracchia, Gillian Diercks, Anna Cook, Cheryl Hersh, Stephen Hardy, Marina Hartnick, Christopher Hartnick
https://ift.tt/2OYUW0i
Management of Velopharyngeal Dysfunction in Patients with 22q11.2 Deletion Syndrome: A Survey of Practice Patterns
Publication date: Available online 12 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Oksana A. Jackson, Kaitlyn Paine, Leanne Magee, Meg Ann Maguire, Elaine Zackai, Donna M. McDonald-McGinn, Susan McCormack, Cynthia Solot
Abstract
Objective
To determine demographics and practice patterns of surgeons treating velopharyngeal dysfunction (VPD) in patients with 22q11.2 deletion syndrome (22q11.2DS).
Methods
An anonymous electronic survey study was administered to the surgical membership of the American Cleft Palate-Craniofacial Association and the Society for Ear Nose and Throat Advances in Children. The survey queried surgeon demographics and differences in management practices for submucous cleft palate (SMCP), pharyngoplasty algorithms, and self-reported complications for nonsyndromic versus 22q11.2DS patients.
Results
126 surveys were returned from 9 international regions with the majority from the United States (73%), followed by Western Europe (9.5%) and Canada (7.9%). Plastic surgery was the most common specialty (61.9%), followed by otolaryngology (27.8%). 88.1% reported fellowship training, and 33% completed multiple fellowships. Prior to proceeding with pharyngoplasty in 22q11.2DS patients, surgeons required the following assessments: speech evaluation (79.4%), velopharyngeal imaging (51.6%), cardiac evaluation (50.0%), carotid artery MRI (29.4%), and cervical spine x-rays (11.1%). Nasoendoscopy was the most common modality used for imaging the velopharynx. Overall, providers managed patients with 22q11.2DS similarly to nonsyndromic patients, with several significant exceptions including that they were more likely to perform SMCP repair alone as a first approach in nonsyndromic patients (p=0.031) and posterior pharyngeal flap without SMCP repair in those with 22q11.2DS (p=0.017).
Conclusions
Practice patterns for the management of VPD in patients with 22q11.2DS vary across providers. Further collaborative studies are needed to develop optimal treatment paradigms for VPD in patients with 22q11.2 DS.
https://ift.tt/2Px2AMy
Speech development in young children with Mondini dysplasia who had undergone cochlear implantation
Publication date: Available online 12 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Shuang Qi, Ying Kong, Tianqiu Xu, Ruijuan Dong, Jing Lv, Xianlei Wang, Beier Qi, Shuo Wang, Fei Yan, Yongxin Li, Lihui Huang, Xueqing Chen
Abstract
Objective
The purpose of this study was to investigate the development of speech skills in young children with Mondini dysplasia and age-matched deaf children with radiologically normal inner ears over a period of 5 years after cochlear implantation (CI).
Methods
In total, 700 congenitally severely to profoundly deaf children (281 girls and 419 boys) participated in this study. All of the participants had undergone unilateral CI surgery before 36 months of age. The participants were categorized into two groups based on the absence or presence of Mondini dysplasia in the implanted ear, as assessed via high-resolution, thin-slice computerized tomography or magnetic resonance imaging: group A comprised 592 children with radiologically normal inner ears and group B comprised 108 children with Mondini dysplasia. The Meaningful Use of Speech Scale (MUSS) and Speech Intelligibility Rating (SIR) were used to evaluate the speech performance of all young children at various time points: pre-surgery and at 1, 3, 6, 12, 24, 36, 48, and 60 months after switch-on programming.
Results
The mean scores of SIR and MUSS in children from both group A and group B showed significant improvements over time. No significant differences were found in the mean scores of SIR between the two groups at any time interval during the 5-year follow-up. The mean score of MUSS was significantly different between group A and group B at 12, 24, and 36 months after implantation, whereas no obvious differences were noted pre-surgery, and at 1, 3, 6, 48, and 60 months post-operation.
Conclusions
Young children with Mondini dysplasia develop their speech skills at a fast rate and achieve similar speech acquisition compared to age-matched children with radiologically normal inner ears 5 years post-operation. Therefore, CI is an effective intervention method for young children with Mondini dysplasia.
https://ift.tt/2Px2Aw2
The wheel-shaped composite cartilage graft (WsCCG) and temporalis fascia for type 1 tympanoplasty: a prospective, randomized study
Abstract
Objectives
To compare the anatomical and functional outcomes of two different grafts which are used for the reconstruction of subtotal or total tympanic membrane perforations: the wheel-shaped composite cartilage graft (WsCCG) and temporalis fascia (TF).
Methods
Ninety patients (94 ears) who underwent type 1 tympanoplasty for non-complicated chronic otitis media between March 2014 and June 2016 in a tertiary referral center were included in a randomized, controlled, prospective clinical trial. Tympanic membranes were reconstructed with the WsCCG or TF.
Results
Outcomes of 91 surgeries performed on 87 adults (> 18 years of age) were evaluated in the study. Forty-three patients (44 ears) were included in the WsCCG group; 44 patients (47 ears) were included in the TF group. The mean post-operative follow-up was 14.9 months for the WsCCG group and 15.1 months for the TF group. There was no statistically significant difference in post-operative pure tone average (PTA) (p = 0.19), air-bone gap (ABG) (p = 0.64), PTA gain (p = 0.82) and ABG closure (p = 0.89) values between two groups. Graft success rates at 6 months after surgery were 82.9% (39/47) and 97.7% (43/44) for TF and WsCCG, respectively. At the first year, success rates were 85.1% (40/47) for TF and 97.7% (43/44) for WsCCG. A statistically significant difference was observed in graft success rates between two groups (p = 0.039).
Conclusions
Both TF and WsCCG lead to satisfactory functional results, but the WsCCG clearly leads to superior anatomical outcomes with a graft success rate of 97.7%. The WsCCG is a suitable graft for subtotal or total tympanic membrane perforations and has the advantages of being a one-piece, flexible, composite, and physically resistant graft.
https://ift.tt/2OUTv32
The aging effect on upper airways collapse of patients with obstructive sleep apnea syndrome
Abstract
Purpose
To evaluate, using drug-induced sleep endoscopy (DISE), sites of upper airway obstruction and pattern of collapse in patients over 65 years old affected by obstructive sleep apnea. To compare sites and pattern of collapse of elderly patients with a group of patients younger than 65 years.
Methods
A group of 55 patients aged over 65 years were enrolled in this prospective study. Fifty patients under 65 years old were collected in the control group. Polysomnographic data and clinical parameters such as the daytime sleepiness, and body mass index were evaluated for both groups of patients. All patients underwent DISE examination with VOTE classification.
Results
The AHI value increased with aging whereas elderly patients presented a reduction in daytime sleepiness. Elderly patients showed a higher incidence of total collapse in the velum region compared to younger patients (90.9% vs 70%;); the older patients showed a lower degree of total oropharyngeal lateral wall collapse with respect to younger patients, (20% vs 50%). No difference in tongue base collapse emerged between the two subgroups of patients.
Conclusion
Elderly patients showed a higher incidence of total collapse in the velum and a lower incidence in the oropharyngeal lateral wall compared to younger patients.
https://ift.tt/2CfL4c0
Outcomes after up-front surgery and metronomic neoadjuvant chemotherapy with S-1 or UFT for early tongue squamous cell carcinoma
Abstract
Background
Our aim was to investigate the disease-free survival in patients with tongue squamous cell carcinoma receiving metronomic neoadjuvant chemotherapy with 5-fluorouracil prodrugs (UFT or S-1) plus bleomycin compared with those who had up-front surgery retrospectively.
Methods
In this retrospective study, 108 patients with stages I to II tongue squamous cell carcinoma who had undergone surgery were divided into the "surgery group" or "neoadjuvant chemotherapy group."
Results
A total of 41 patients received up-front surgery; 67 received metronomic neoadjuvant chemotherapy with UFT plus bleomycin (39) or S-1 plus bleomycin (28). The rate of disease-free survival was the primary outcome measure. Neoadjuvant 5-fluorouracil prodrugs did not correlate higher with improved disease-free survival than up-front surgery (72 and 54%, respectively; hazard ratio for recurrence or death, 0.54; 95% confidence interval [CI], 0.28 to 1.03; P = 0.06). Patients who received S-1 were more likely than those who received UFT to have pathological complete response (46% vs. 15%; P = 0.007). Neoadjuvant S-1 significantly improved disease-free survival as compared with up-front surgery (79% vs. 54%; hazard ratio, 0.41; 95% CI, 0.15 to 0.98; P = 0.04). However, neoadjuvant UFT did not improve disease-free survival as compared with up-front surgery (67% vs. 54%, respectively; hazard ratio, 0.66; 95% CI, 0.31 to 1.33; P = 0.24).
Conclusions
Neoadjuvant S-1 chemotherapy, as compared with up-front surgery, significantly improved disease-free survival among patients with tongue squamous cell carcinoma.
Clinical relevance
A choice of drugs before neoadjuvant metronomic chemotherapy is needed.
https://ift.tt/2pRU53B
Mucosal Bromodomain-Containing Protein 4 (BRD4) Mediates Aeroallergen-induced Inflammation and Remodeling
Publication date: Available online 13 October 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Bing Tian, Koa Hosoki, Zhiqing Liu, Jun Yang, Yingxin Zhao, Hong Sun, Jia Zhou, Erik Rytting, Lata Kaphalia, William J. Calhoun, Sanjiv Sur, Allan R. Brasier
Abstract
Background
Frequent exacerbations of allergic asthma leads to airway remodeling and a decline in pulmonary function, producing morbidity. Cat dander is an aeroallergen associated with asthma risk.
Objective
We sought to elucidate the mechanism of cat dander-induced inflammation-remodeling.
Methods
We identified remodeling in mucosal samples from allergic asthma by Q-RT-PCR. We developed a model of aeroallergen-induced experimental asthma by repetitive cat dander extract exposure. We measured airway inflammation using immunofluorescence, leukocyte recruitment and Q-RT-PCR. Airway remodeling was measured using histology, collagen content, myofibroblast numbers and selected reaction monitoring. Inducible NFκB-BRD4 interaction was measured by proximity ligation assay in situ.
Results
Enhanced mesenchymal signatures are observed in bronchial biopsies from patients with allergic asthma. Cat dander induces innate inflammation via NFκB signaling, followed by producing a pro-fibrogenic, mesenchymal transition (EMT) in primary human small airway epithelial cells. The IκB kinase (IKK)-NFκB signaling pathway is required for mucosal inflammation-coupled airway remodeling and myofibroblast expansion in the mouse model of aeroallergen exposure. Cat dander induces NFκB/RelA to complex with and activate BRD4, resulting in modifying the chromatin environment of inflammatory and fibrogenic genes through its atypical histone acetyltransferase (HAT) activity. A novel, small-molecule BRD4 inhibitor (ZL0454) disrupts BRD4 binding to the NFκB-RNA Pol II complex and inhibits its HAT activity. ZL0454 prevents EMT, myofibroblast expansion, IgE sensitization, and fibrosis in airways of naïve mice exposed to cat dander.
Conclusions
NFκB-inducible BRD4 activity mediates cat dander-induced inflammation and remodeling. Therapeutic modulation of the NFκB-BRD4 pathway affects allergen-induced inflammation, epithelial cell-state changes, ECM production and expansion of the subepithelial myofibroblast population.
Graphical abstract
https://ift.tt/2RMJcwv
Periorbital Rejuvenation
Publication date: Available online 13 October 2018
Source: Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Tom Shokri, Jessyka G. Lighthall
Abstract
The periorbital region, consisting of the eyebrows, upper and lower eyelids, glabella, and pericanthal region, is particularly susceptible to early signs of aging. Overall, this process is influenced by both genetic and environmental factors. Periorbital rejuvenation continues to be an area of advancement with evolution in both noninvasive and invasive techniques. In this article, we will review minimally invasive and surgical procedures in the treatment of periorbital aging.
https://ift.tt/2IV93OG
INTRODUCTION
Publication date: Available online 13 October 2018
Source: Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Michael Wilkinson
https://ift.tt/2OnhKY1
Indication and Technique of Orbital Exenteration
Publication date: Available online 12 October 2018
Source: Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Gregory M. Notz, Nicholas Purdy
Abstract
Orbital exenteration is a rare, severely disfiguring operation for the treatment of malignant orbital tumors. The tumors can arise from the orbit, metastasize to the orbit from distant sites, or invade the orbit from surrounding structures. The technique of exenteration mandates complete removal of the intraorbital contents, sometimes including the encompassing bony structures. This article will describe the indications and technique of orbital exenteration, as well as complications and several reconstructive strategies.
https://ift.tt/2ITnXVK
Anatomy of the Human Orbit
Publication date: Available online 12 October 2018
Source: Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Michael J. Wilkinson
Abstract
The contents of the human orbit develop from all embryonic germinal layers to form diverse and specialized interconnected structures, whose unified function is that of providing sight. A thorough knowledge of these structures and their inter-relationships is imperative for the head and neck surgeon. This article will discuss the structures contained within the orbit from a surgical perspective in the hope of expanding the head and neck surgeon's knowledge and comfort when treatment indication necessitates entry into this space.
https://ift.tt/2OpiR9E
Proteomic analysis of lipopolysaccharide activated human monocytes
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Mads Lausen, Thomas B.G. Poulsen, Gunna Christiansen, Kenneth Kastaniegaard, Allan Stensballe, Svend Birkelund
Abstract
Monocytes are key mediators of innate immunity and comprise an important cellular defence against invading pathogens. However, exaggerated or dysregulated monocyte activation can lead to severe immune-mediated pathology such as sepsis or chronic inflammatory diseases. Thus, detailed insight into the molecular mechanisms of monocyte activation is essential to understand monocyte-driven inflammatory pathologies. We therefore investigated the global protein changes in human monocytes during lipopolysaccharide (LPS) activation to mimic bacterial activation. Purified human monocytes were stimulated with LPS for 17 h and analyzed by state-of-the-art liquid chromatography tandem mass spectrometry (LC–MS/MS). The label-free quantitative proteome analysis identified 2746 quantifiable proteins of which 101 had a statistically significantly different abundance between LPS-stimulated cells and unstimulated controls. Additionally, 143 proteins were exclusively identified in either LPS stimulated cells or unstimulated controls. Functional annotation clustering demonstrated that LPS, most significantly, regulates proteasomal- and lysosomal proteins but in opposite directions. Thus, seven proteasome subunits were upregulated by LPS while 11 lysosomal proteins were downregulated. Both systems are critically involved in processing of proteins for antigen-presentation and together with LPS-induced regulation of CD74 and tapasin, our data suggest that LPS can skew monocytic antigen-presentation towards MHC class I rather than MHC class II. In summary, this study provides a sensitive high throughput protein analysis of LPS-induced monocyte activation and identifies several LPS-regulated proteins not previously described in the literature which can be used as a source for future studies.
https://ift.tt/2OlS12u
Preoperative Patient Evaluation: Practicing Evidence-Based, Cost-Effective Medicine
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Zdravka Zafirova, Richard D. Urman
https://ift.tt/2pRO1bm
Preoperative Assessment of the Pregnant Patient Undergoing Nonobstetric Surgery
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Michael P. Webb, Erik M. Helander, Ashley R. Meyn, Trevor Flynn, Richard D. Urman, Alan D. Kaye
https://ift.tt/2NFuowk
Stratification and Risk Reduction of Perioperative Acute Kidney Injury: An Update
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Sheela Pai Cole
https://ift.tt/2pNkIGO
Perioperative Surgical Home Models
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Thomas R. Vetter
https://ift.tt/2NFufJi
Hematologic Disorders
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Germán Echeverry, Allison Dalton
https://ift.tt/2pP1Yqa
Management of Challenging Pharmacologic Issues in Chronic Pain and Substance Abuse Disorders
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Elyse M. Cornett, Rebecca Budish, Dustin Latimer, Brendon Hart, Richard D. Urman, Alan David Kaye
https://ift.tt/2NGdT35
Preoperative Laboratory Testing
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Angela F. Edwards, Daniel J. Forest
https://ift.tt/2pRNPZG
Genomics Testing and Personalized Medicine in the Preoperative Setting
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Rodney A. Gabriel, Brittany N. Burton, Richard D. Urman, Ruth S. Waterman
https://ift.tt/2NFuLqR
Preoperative Evaluation: Estimation of Pulmonary Risk Including Obstructive Sleep Apnea Impact
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Yamini Subramani, Mahesh Nagappa, Jean Wong, Talha Mubashir, Frances Chung
https://ift.tt/2pOM7YQ
Preoperative Management of the Geriatric Patient: Frailty and Cognitive Impairment Assessment
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Allison Dalton, Zdravka Zafirova
https://ift.tt/2NFoD1J
Optimizing Preoperative Anemia to Improve Patient Outcomes
Publication date: Available online 12 October 2018
Source: Anesthesiology Clinics
Author(s): Brittany N. Burton, Alison M. A'Court, Ethan Y. Brovman, Michael J. Scott, Richard D. Urman, Rodney A. Gabriel
https://ift.tt/2pR1lMR
The processing of xenografts will result in different clinical responses.
Publication date: Available online 12 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Michael S. Block
Abstract
Clinicians may decide to use a xenograft to reconstruct an osseous defect. Xenografts are processed differently depending on manufacturer.
The purpose of this article is to review processing methods and the clinical ramifications of these processing methods on the behavior of xenografts. The difference in surface morphology of xenografts based on processing is reviewed. When used for grafting the extraction socket, ridge contour preservation or reconstruction, xenografts may result in different resorption rates over time. Xenografts used for sinus augmentation are reviewed. Onlay grafting using particulate xenograft is reviewed. The clinical trials available are reviewed. Based on the available information gleaned from the literature, clinical recommendations are included for specific clinical application.
https://ift.tt/2pS9RLu
Conservative treatment of a periapical cementoblastoma: a case report
Publication date: Available online 12 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Daniella Cristina Borges, Paulo Rogério de Faria, Helvécio Marangon Júnior, Leonardo Bíscaro Pereira
ABSTRACT
Cementoblastoma is a rare, benign odontogenic neoplasm of ectomesenchymal origin, accounting for less than 6% of all odontogenic tumors. Although the tumor characteristics are well-known, the standard practice to treat this lesion is surgical excision along with the extraction of the affected tooth, with few reported cases using a tooth-conservative treatment approach. This report presents the case of a 33-year-old cementoblastoma-affected woman who underwent conservative treatment to preserve her tooth in the oral cavity. Endodontic treatment of the tooth was performed; 30 days later, the lesion was removed along with the apical third of the root of the tooth. After 7 years of follow-up, no recurrence was observed, and the tooth retains its masticatory function. In certain cases of cementoblastoma, the affected tooth may be kept in the oral cavity instead of being extracted, thereby preserving the oral health of patients.
https://ift.tt/2ND7zti
Interleukin-10 polymorphisms (rs1800871, rs1800872 and rs1800896) and periodontitis risk: A meta-analysis
Publication date: Available online 12 October 2018
Source: Archives of Oral Biology
Author(s): Shu-Liang Yang, Shi-Jie Huang
Abstract
Objective
The objective of this meta-analysis was to assess the association between three interleukin-10 (IL-10) promoter single nucleotide polymorphisms (rs1800871, rs1800872, and rs1800896) and periodontitis risk.
Methods
A systematic search was conducted in PubMed, Embase, and China National Knowledge Infrastructure databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
Results
Twenty-six studies met the inclusion criteria. The pooled analysis showed that rs1800871 was associated with an increased periodontitis risk under dominant model (CT + TT vs. CC: p = 0.004, OR = 1.79, 95% CI: 1.21-2.65) in Latin American populations but not in Asian (CT + TT vs. CC: p = 0.229, OR = 0.81, 95% CI: 0.58-1.14) and Caucasian (CT + TT vs. CC: p = 0.910, OR = 1.02, 95% CI: 0.75-1.39) populations. Similarly, rs1800872 conferred an increased risk of periodontitis only in Latin American populations (CA + AA vs. CC: p = 0.012, OR = 2.32, 95% CI: 1.20-4.47; A allele vs. C allele: p = 0.001, OR = 1.61, 95% CI: 1.22-2.14). No significant association was observed between rs1800896 and periodontitis risk. Subgrouping data according to periodontitis type revealed that rs1800872 was associated with both chronic periodontitis (A allele vs. C allele: p = 0.011, OR = 1.72, 95% CI: 1.13-2.62) and aggressive periodontitis (A allele vs. C allele: p = 0.038, OR = 1.32, 95% CI: 1.02-1.72).
Conclusion
The studies reviewed support that theIL-10 rs1800871 and rs1800872 polymorphisms may represent a potential genetic biomarker for periodontitis risk in Latin American populations.
https://ift.tt/2A9hjbh
A sialo-oligosaccharide-rich mucin-like molecule specifically detected in the submandibular glands of aged mice
Publication date: Available online 12 October 2018
Source: Archives of Oral Biology
Author(s): Mayu Iida, Yu-ki Matsuno, Atsushi Watanabe, Mitsuo Maruyama, Akihiko Kameyama, Kimi Yamakoshi
Abstract
Objectives
Mucins are heavily glycosylated large glycoproteins produced in the salivary glands that contribute to salivary viscosity. This study aimed to characterize age-related changes in mucin production in mouse submandibular salivary gland (SMG).
Methods
The paraffin sections of the SMGs of the young and aged mice were stained with HE or Alcian blue (AB). SMGs mucins derived from the young and aged mice were separated using supported molecular matrix electrophoresis (SMME). After SMME, the membranes were stained with AB and subsequent glycan analysis or subjected to immunoblotting. The expression of 18 mucin genes and 4 sialyltransferase genes in the young and aged SMGs were determined by qPCR. The neuraminidase activity in the SMG homogenates was determined using Neuraminidase Assay Kit.
Results
The mouse SMG is more strongly stained by AB with increasing age. On SMME, a characteristic band not found in the young SMG is detected in aged SMG. Based on migration position and the MALDI MS, the band that appeared specifically with aging was determined to be acidic mucin. Additionally, most glycans of this acidic mucin were sialo-oligosaccharides. Furthermore, there was an increase in the expression of sialyltransferase genes ST6GalNAc I and ST6GalNAc II, but not a decrease in neuraminidase activity, in the SMG of aged mice.
Conclusion
A sialomucin or sialylated mucin-like molecule not found in the SMGs of young WT mice is expressed in aged WT mice. The increase in the sialo-oligosaccharide content in this aging-associated molecule may be attributed to the increased expression of the sialyltransferase genes.
https://ift.tt/2QOngjk
Interleukin-10 polymorphisms (rs1800871, rs1800872 and rs1800896) and periodontitis risk: A meta-analysis
Publication date: Available online 12 October 2018
Source: Archives of Oral Biology
Author(s): Shu-Liang Yang, Shi-Jie Huang
Abstract
Objective
The objective of this meta-analysis was to assess the association between three interleukin-10 (IL-10) promoter single nucleotide polymorphisms (rs1800871, rs1800872, and rs1800896) and periodontitis risk.
Methods
A systematic search was conducted in PubMed, Embase, and China National Knowledge Infrastructure databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
Results
Twenty-six studies met the inclusion criteria. The pooled analysis showed that rs1800871 was associated with an increased periodontitis risk under dominant model (CT + TT vs. CC: p = 0.004, OR = 1.79, 95% CI: 1.21-2.65) in Latin American populations but not in Asian (CT + TT vs. CC: p = 0.229, OR = 0.81, 95% CI: 0.58-1.14) and Caucasian (CT + TT vs. CC: p = 0.910, OR = 1.02, 95% CI: 0.75-1.39) populations. Similarly, rs1800872 conferred an increased risk of periodontitis only in Latin American populations (CA + AA vs. CC: p = 0.012, OR = 2.32, 95% CI: 1.20-4.47; A allele vs. C allele: p = 0.001, OR = 1.61, 95% CI: 1.22-2.14). No significant association was observed between rs1800896 and periodontitis risk. Subgrouping data according to periodontitis type revealed that rs1800872 was associated with both chronic periodontitis (A allele vs. C allele: p = 0.011, OR = 1.72, 95% CI: 1.13-2.62) and aggressive periodontitis (A allele vs. C allele: p = 0.038, OR = 1.32, 95% CI: 1.02-1.72).
Conclusion
The studies reviewed support that theIL-10 rs1800871 and rs1800872 polymorphisms may represent a potential genetic biomarker for periodontitis risk in Latin American populations.
https://ift.tt/2A9hjbh
A sialo-oligosaccharide-rich mucin-like molecule specifically detected in the submandibular glands of aged mice
Publication date: Available online 12 October 2018
Source: Archives of Oral Biology
Author(s): Mayu Iida, Yu-ki Matsuno, Atsushi Watanabe, Mitsuo Maruyama, Akihiko Kameyama, Kimi Yamakoshi
Abstract
Objectives
Mucins are heavily glycosylated large glycoproteins produced in the salivary glands that contribute to salivary viscosity. This study aimed to characterize age-related changes in mucin production in mouse submandibular salivary gland (SMG).
Methods
The paraffin sections of the SMGs of the young and aged mice were stained with HE or Alcian blue (AB). SMGs mucins derived from the young and aged mice were separated using supported molecular matrix electrophoresis (SMME). After SMME, the membranes were stained with AB and subsequent glycan analysis or subjected to immunoblotting. The expression of 18 mucin genes and 4 sialyltransferase genes in the young and aged SMGs were determined by qPCR. The neuraminidase activity in the SMG homogenates was determined using Neuraminidase Assay Kit.
Results
The mouse SMG is more strongly stained by AB with increasing age. On SMME, a characteristic band not found in the young SMG is detected in aged SMG. Based on migration position and the MALDI MS, the band that appeared specifically with aging was determined to be acidic mucin. Additionally, most glycans of this acidic mucin were sialo-oligosaccharides. Furthermore, there was an increase in the expression of sialyltransferase genes ST6GalNAc I and ST6GalNAc II, but not a decrease in neuraminidase activity, in the SMG of aged mice.
Conclusion
A sialomucin or sialylated mucin-like molecule not found in the SMGs of young WT mice is expressed in aged WT mice. The increase in the sialo-oligosaccharide content in this aging-associated molecule may be attributed to the increased expression of the sialyltransferase genes.
https://ift.tt/2QOngjk
Affiliation of XRCC-1 Gene Arg194Trp polymorphism in alcohol and tobacco substance users and loco-regionally progressed LSCC
Publication date: Available online 12 October 2018
Source: Journal of Oral Biology and Craniofacial Research
Author(s): Raturi Vijay Parshuram, Rajendra Kumar, Madanlal Bhatt, Rahul Singh, Devendra Parmar, Jalaj Gaur, Dewesh Kishan, Mandira Saha, Rupali, Pranay Katepogu, Prasad Senthamizh, Tridiv Katiyar
Abstract
Objectives
The correlation of XRCC-1 Gene Arg194Trp polymorphism with alcohol and tobacco substance user and with loco-regionally advanced squamous cell cancer of the larynx (LSCC) was assessed in this research study. The result of this research study is described herein.
Material and methods
A tertiary hospital-based observational case-control research was carried out. DNA segregation and Genotype examination were done from the blood sample of the control group and cases to know the correlation between XRCC-1 gene polymorphism with loco-regionally progressed LSCC and with hazard factors tobacco and alcohol.
Results
In the cases, the existence of DNA repair XRCC-1 gene polymorphic variants (Hetero CT and Mutant TT) was recognizable in contrary to the control group arm. The XRCC-1 gene polymorphic hetero (CT) genotype (O.R-1.96; 95% C.I: 1.23–3.13; P < 0.004) and mutant (TT) genotype variants (O.R-1.95; 95% C.I: 0.59–6.44; P = 0.27) was correlated with access hazard of loco-regionally progressed LSCC, and its statistically convincing for polymorphic hetero (CT) variant. The data were adapted for the age of the patients and control group, circadian alcohol intake, tobacco chewing habits, and the tobacco smoking habits during application of multivariate logistic regression. Its apparent that the hazard is amalgamated with hetero (CT) genotype variant (O.R- 1.67; 95% C.I: 0.98–2.82; P = 0.05) and mutant (TT) genotype variant (O.R- 1.62; 95% C.I: 0.88–2.78; P = 0.11) and its statistically convincing for polymorphic hetero (CT) genotype variant. Cases with the record of substance use (alcohol and tobacco) have an abundance of XRCC-1 hetero (CT) and mutant (TT) genotype variants in allegory to control group. Increased hazard is related with XRCC-1 hetero (CT) variant in smokers (O.R 3.28; 95% C.I: 1.45–7.41; P = 0.004), in tobacco chewers (O.R-3.79; 95% C.I: 1.87–7.71; P = 0.0002), and in alcohol consumers (O.R- 4.24; 95% C.I: 2.21–8.15; P= <0.0001) which is statistically significant.
Conclusion
This research investigation demonstrates the correlation of XRCC-1 polymorphic hetero genotype (CT) & mutant genotype (TT) variants as hazard factor in loco-regionally progressed LSCC. Cases with the record of alcohol intake habits, tobacco smoking and chewing habits and XRCC-1 hetero genotype (CT) variant have statistically increased the hazard of loco-regionally progressed LSCC, which demonstrate the role of gene-ecological interconnection in modifying the vulnerability of loco-regionally progressed LSCC.
https://ift.tt/2ygRFQC
Assessment of clinical ability in the removal of teeth among undergraduate dental students: a longitudinal comparative study
Publication date: Available online 12 October 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): O.W. Majid
Abstract
To evaluate the clinical ability of undergraduate students to remove teeth, we have developed a new, structured, and objective assessment scale including 11 items that measure the various skills required on a visual analogue scale (VAS). We did a pilot study to validate the new format and included 10 students, each one of whom was rated by three examiners. The assessment form was then used to evaluate the ability of students taking teeth out throughout the academic year 2017–2018. Results showed high inter-examiner reliability, significant correlation of mean scores (p < 0.001), and high internal validity of the assessment form (Cronbach's α from 0.8257 to 0.9191). A total of 340 extractions were assessed (228 by fifth-year, and 112 by fourth-year, students). In addition, 73 students (47 fifth-year, and 26 fourth-year) were assessed halfway through the year and at their final examinations. The fail/pass rate was (64/164) for the fifth year students, and (43/69) for the fourth year students, with no significant difference between them (chi squared 3.719; p = 0.054). Fifth-year students had significantly higher mean scores than fourth-year students in the subscales "use of the elevator" and "confidence" (p = 0.004 and 0.003 respectively). Both groups showed significant improvement in their mean scores between the mid-term and final examinations (p = 0.001 and 0.010, respectively). The newly developed VAS-based format for assessing the removal of teeth offered an objective, standardised, and feasible method for assessment of clinical skills of undergraduate students for both formative and summative purposes.
https://ift.tt/2QPN0vO
Shear bond strength and interface analysis between a resin composite and a recent high-viscous glass ionomer cement bonded with various adhesive systems
Abstract
Objective
This study investigated the shear bond strength (SBS) and interface between a resin composite and a new high-viscous glass ionomer cement (HV-GIC), a HV-GIC, a resin-modified glass ionomer cement (RM-GIC), a bulk-fill flowable composite, and a regular flowable composite bonded with various adhesive systems.
Methods and materials
A resin composite (Filtek Z350) was bonded to a new HV-GIC (EQUIA Forte Fil) using various adhesive systems, including a universal adhesive in self-etch and etch-and-rinse mode (Scotchbond Universal), a two-step etch-and-rinse adhesive (Scotchbond 1-XT), a one-step self-etch adhesive (Optibond All-in-one) tested also after silane application (Monobond Plus), and a coating material (EQUIA Forte Coat). The resin composite was also bonded to a HV-GIC (Fuji IX GP), a RM-GIC (Fuji II LC), a bulk-fill flowable composite (SDR), and a regular flowable composite (Tetric Evo Flow) with the universal adhesive in self-etch mode (Scotchbond Universal). Two-way ANOVA followed by Dunnett's post hoc test was used to investigate the difference in SBS. Failures were analyzed by chi-square test. Bonding interfaces were examined by environmental scanning electron microscopy (E-SEM).
Results
SBS to EQUIA Forte Fil was significantly lower with Scotchbond 1-XT than with all other adhesive systems. By using Scotchbond Universal with the self-etch technique, the SBS to EQUIA Forte Fil was significantly higher than the SBS to Fuji IX GP and significantly lower than the SBS to Fuji II LC, SDR, and Tetric Evo Flow. E-SEM images showed an intimate contact at all interfaces examined.
Conclusion
EQUIA Forte Fil showed satisfactory SBS and interfaces with all adhesives tested.
Clinical relevance
Bonding between the resin composite and HV-GIC can be achieved using a universal adhesive in self-etch mode, an easy-to-use adhesive system.
https://ift.tt/2CEPnP7
Nanocrystalline cellulose as a reinforcing agent for electrospun polyacrylonitrile (PAN) nanofibers
Publication date: Available online 13 October 2018
Source: Journal of Oral Biosciences
Author(s): Bernardo Urbanetto Peres, Hugo Alberto Vidotti, Luana Dutra de Carvalho, Adriana Pigozzo Manso, Frank Ko, Ricardo Marins Carvalho
Abstract
Objectives
Nanocrystalline cellulose (NCC) is a sustainable material with excellent mechanical properties and can potentially be used as a reinforcement agent. The objective of this work was to test the effects of NCC incorporation on the mechanical properties of electrospun polyacrylonitrile (PAN) nanofibers.
Methods
Eleven percent in weight of PAN (molecular weight 150 kD) in a dimethylformamide (DMF) solution was electrospun at 14.6 kV. Nonfunctionalized NCC was added to the solution at 1%, 2%, or 3 wt% (NCC/PAN). Suspensions were mixed and sonicated for 2 h before spinning. Strips (5 × 0.5 cm) were cut from the spun mat, parallel and perpendicular to the rotational direction of the fiber collection drum. Tensile tests were performed, and ultimate tensile strength (UTS), yield strength (YS; 0.3%), elastic modulus (E), and elongation at maximum stress (EMS, %) were calculated from stress–strain plots. Data were analyzed by multiple t tests and one-way ANOVA (α = 0.05).
Results
Among all groups, samples with 3 wt % NCC loading had significantly superior mechanical properties. The fiber mats showed anisotropic behavior.
Conclusions
Regardless of concentration, the addition of NCC resulted in increased UTS, E, and YS of the nanofibers.
https://ift.tt/2NFkydS
Analysis of the Mechanism in Salivary Gland Development using Gene Database
Publication date: Available online 13 October 2018
Source: Journal of Oral Biosciences
Author(s): Takayoshi Sakai, Hitomi Ono Minagi, Aya Obana-Koshino, Manabu Sakai
Abstract
Objectives
Salivary gland hypofunction, known as xerostomia, caused by radiation therapy for head & neck cancer and Sjӧgren's syndrome, causes various problems in oral health, and profoundly reduces quality of life. This review describes our database in the area of oral biology to establish new therapies for patients suffering from xerostomia.
Highlight
Here we review the recent approaches that have enabled us to better understand the mechanisms of salivary gland development. Furthermore, we highlight proposed approaches intended to recover salivary gland function using both gene and cell-based therapy.
Conclusions
A thorough understanding of the mechanisms involved in salivary gland is necessary in order to design effective therapies for regeneration of damaged salivary glands.
https://ift.tt/2pT2Om1
Slowly progressive facial paralysis: Intraneural squamous cell carcinoma of unknown primary
Publication date: Available online 13 October 2018
Source: American Journal of Otolaryngology
Author(s): Michael Eggerstedt, Hannah N. Kuhar, Peter Revenaugh, Ritu Ghai, R. Mark Wiet
Abstract
Background
In this report, we present a unique case of intraneural squamous cell carcinoma of unknown primary found within the facial nerve and the proposed algorithms for diagnosis and management of progressive idiopathic facial paralysis.
Case presentation
A 66-year-old female with a previous history of basal cell carcinoma presented with right-sided progressive facial paralysis. Repeated magnetic resonance imaging as well as targeted workup failed to reveal a diagnosis. 20 months following symptom onset, after the patient's facial function slowly progressed to a complete paralysis, repeat magnetic resonance imaging revealed enhancement at the stylomastoid foramen. The patient underwent superficial parotidectomy, transmastoid facial nerve decompression and resection of descending and proximal extratemporal facial nerve segments, as well as great auricular nerve interposition grafting. Intraoperatively, frozen sections from the surface of the facial nerve, and the proximal and distal segments of the facial nerve following resection, were negative for malignancy. The final pathology revealed infiltrating poorly differentiated squamous cell carcinoma of the facial nerve with negative margins.
Conclusion
In cases of slowly progressive facial paralysis the clinician needs to consider malignancy until proven otherwise. Without an identifiable primary malignancy, early algorithmic assessment of presenting characteristics may facilitate expedited clinical decision making and surgical management of malignancy involving the facial nerve. In cases of slowly progressive facial paralysis, when the time comes for surgical exploration and biopsy, head and neck surgeons must be aware that malignancy can exist entirely within the facial nerve, without pathologic changes on the surface of the nerve or in the surrounding tissue.
https://ift.tt/2OSUFfu
Shared decision making during surgical consultations: An observational study in pediatric otolaryngology
Publication date: Available online 12 October 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): J. Melong, J. Meier, P. Hong
Abstract
Aims
Shared decision-making (SDM) is a collaborative process in which patients and family members make healthcare decisions together with their clinician. The objective of this study was to explore how pediatric otolaryngologists involve parents in SDM and which factors influence this process.
Material and methods
Ninety-six children being assessed by pediatric otolaryngologists at a tertiary healthcare center for elective surgical procedures (adeno/tonsillectomy or tympanostomy tube insertion) were prospectively enrolled into the study. Surgical consultations were video-recorded and coded using the OPTION instrument to determine level of SDM. To provide a subjective measure of SDM, parents completed the Shared Decision-Making Questionnaire (SDM-Q-9) and surgeons completed the physician version of the questionnaire (SDM-Q-Doc).
Results
Total mean child and parents OPTION scores were 3.16 (SD: 5.43, range: 0–21) and 11.38 (SD: 6.41, range: 1–27) out of 48 respectively. Clinicians were more likely to involve female children in SDM as well as children who had a previous history of surgery. There were no other significant correlations between total OPTION scores and patient/family demographics. A positive correlation was found between length of consultation and total OPTION scores for parents, but not for children. SDM-Q-9 and SDM-Q-Doc scores were not correlated with total OPTION scores.
Conclusion
Decision making during pediatric otolaryngology consultations mostly focused on treatment related decisions and sharing information as opposed to facilitating collaborative decision-making. Parent and physician perceptions of SDM were not correlated with actual observed behavior. Additional research is required to provide insight in how to increase surgeons' assistance towards SDM.
https://ift.tt/2QMGd60
Blood clot stability and bone formation following maxillary sinus membrane elevation and space maintenance by means of immediate implant placement in humans. A computed tomography study
Publication date: Available online 12 October 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Elton Gonçalves Zenóbio, Liziany David Cardoso, Leandro Junqueira de Oliveira, Mário Nazareno Favato, Flávio Ricardo Manzi, Maurício Greco Côsso
Abstract
Objective
The present controlled clinical pilot study proposed to assess blood clot contraction and bone neo-formation following maxillary sinus lift (MSL) with immediate implant placement without using grafts using cone beam tomography exams.
Materials and methods
Ten implants were placed in ten patients with a residual bone crest height ≥ 4 and ≤ 7mm, in maxillary premolars or 1st or 2nd molars regions, using MSL and immediate implant placement without grafts, by means of the lateral window approach. A resorbable membrane (Bio-Gide®, Geistlich, USA) was used to close the window. Computed tomography images were taken after 15 (T1) and 180 (T2) days to assess the rate of blood clot contraction and bone neo-formation. The images were analysed by OsirixMD software. The Shapiro Wilk test was used to verify the normality hypothesis and the data were submitted to Student's paired t-test.
Results
The mean of bone clot height in mesial, apical and distal area referred to implant, presented 4.77mm, 0.77mm and 5.30mm respectively. The mean measurements of new bone formation presented 2.95mm, 0.44mm and 3.45mm. The height contraction (coagulum/new bone formation), between T1 and T2, presented 38%, 43% and 35% respectively, with a significant statistical value p<0.05.
The volume measurements at T1 presented a mean volume of 0.90cm3 sd± 0.60 cm3 and at T2 a mean volume of 0.75cm3 sd± 0.62cm3, with a significant volume contraction between T1 and T2, p<0.005. The mean blood clot contraction was 16.52% ± 8.60%.
Conclusion
The present study demonstrates consistent bone formation around all assessed implants, although with significant contraction of the blood clot. The need for longitudinal studies to establish a long-term prognosis in different modalities of prosthetic rehabilitation of those implants is strongly suggested.
https://ift.tt/2ISwisV
Target delineation for postoperative treatment of head and neck cancer
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Mererid Evans, Matthew Beasley
Abstract
Patients who undergo primary surgical resection for a Head and Neck Squamous Cell Carcinoma (HNSCC) are stratified post-operatively, based on the presence or absence of pathological risk factors for recurrence, to estimate their risk of treatment failure. Post-operative radiotherapy, with or without concurrent chemotherapy, is offered if there is a significant risk of recurrence, in order to eradicate potential microscopic residual cancer cells and ultimately improve loco-regional control and survival.
This review will offer practical guidelines for delineation of the post-operative primary and nodal Clinical Target Volumes (CTVs) based on a geometric expansion of the pre-operative primary and nodal Gross Tumour Volumes (GTVs), as already implemented in the definitive radiotherapy setting. Nodal levels requiring elective treatment are defined for inclusion in the prophylactic CTV. Optimising patient selection for post-operative treatment is discussed as well as areas of controversy, relating to the dose prescription and extent of nodal volumes to be included in the CTV. Finally, clinical trials exploring the prospect of adjuvant treatment de-intensification after transoral surgery for HPV-positive oropharyngeal cancer are outlined. The aim is to improve consensus amongst clinicians and contribute towards improving outcomes for surgically treated patients with HNSCC.
https://ift.tt/2A7Mpju
Operative R0 resection of diffuse large B-cell lymphoma of the pelvis: a case report
Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma with or without involvement of extranodal sites. Rituximab in combination with cyclophosphamide, doxorubicin, vincristine and pr...
https://ift.tt/2yDFMTU
Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence
Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2NDs4Gf
Role of House Dust Mite‐Derived Extracellular Vesicles in a Murine Model of Airway Inflammation
Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2pSUQcA
Effect of light-emitting diodes, platelet-rich plasma, and their combination on the activity of sheep tenocytes
Abstract
Healthy tendons play an important role in joint movements and subjected to a group of pathologies called tendinopathy due to multiple factors. Tendons have a slowly repairing process due to the low vascularity and cellularity. Treatment options aimed at potentiating the healing response and relieving symptoms. Phototherapy and platelet-rich plasma were novel treatment modalities in tendons based on photobiomodulation and growth factors during healing, and the results were encouraging suggesting calibrating treatment parameters. This study utilizes cell culture to explore the potential effect of light-emitting diode and/or growth factors in the form of platelet-rich plasma (PRP) on the activity of tenocytes isolated from sheep Achilles tendons by measuring the cell metabolism and cell mobility using cell viability and migration assays to proof safety and confirm activity. Results showed that sheep tenocyte-cultured groups treated with 5% platelet-rich plasma alone or combined with 4 J/cm2 light-emitting diode have increased viability significantly when compared to control group after a 48 h, while light-emitting diode treatment has not decreased cell migration significantly when compared with control. Result suggests that using platelet-rich plasma alone or combined with light-emitting diode might have potential to enhance healing response at the conditions applied. PRP could enhance proliferation while LED could enhance migration and proliferation. Further research is needed at longer durations.
https://ift.tt/2NDnNCH
IgE Test in Secretions of Patients with Respiratory Allergy
Abstract
Purpose of Review
IgE is a key player in multiple inflammatory airway diseases. Ample literature demonstrates its presence in mucosa of patients with allergic rhinitis (AR), local allergic rhinitis (LAR), asthma, or chronic rhinosinusitis with nasal polyposis (CRSwNP).
Recent Findings
Current evidence shows that high-affinity IgE in blood stream of allergic individuals derives mainly from the mucosae. Also, mucosal synthesis of IgE can occur in the absence of systemic atopy, and may be relevant in atopic and non-atopic phenotypes of rhinitis as demonstrated in LAR. Specific IgE (sIgE) detection varies depending on technique used for sample collection and its measurement. sIgE detection is highly specific for diagnosis of LAR. Moreover, measurement of sIgE in secretions could be useful in monitoring response to allergen-specific immunotherapy in both AR and LAR phenotypes.
Summary
This review will focus on recent developments in the role of IgE in respiratory diseases, and the clinical implications of its measurement in secretions.
https://ift.tt/2IRCxwT
Response of head and neck epithelial cells to a DNA damage‐differentiation checkpoint involving polyploidization
Head &Neck, EarlyView.
https://ift.tt/2yA2GM4
Long‐term neurological morbidity following endoscopic transnasal resection of juvenile angiofibroma
The Laryngoscope, EarlyView.
https://ift.tt/2OYkWc4
Cryotherapy has antifibrotic and regenerative effects on human vocal fold fibroblasts
The Laryngoscope, EarlyView.
https://ift.tt/2PsSSe5
Validation of the OMNI vocal effort scale in the treatment of adductor spasmodic dysphonia
The Laryngoscope, EarlyView.
https://ift.tt/2OTFXon
Predictive value of globus pharyngeus in patients with functional dysphonia versus organic dysphonia
The Laryngoscope, EarlyView.
https://ift.tt/2PrmzMp
Maternity and paternity leave in otolaryngology residency training in the United States
The Laryngoscope, EarlyView.
https://ift.tt/2P0jQwu
The 100 top‐cited publications in psoriatic arthritis: a bibliometric analysis
International Journal of Dermatology, EarlyView.
https://ift.tt/2PwMz9s
Balanitis xerotica obliterans: a review of diagnosis and management
International Journal of Dermatology, EarlyView.
https://ift.tt/2P2MkpL
Two case reports of telangiectasia macularis multiplex acquisita
International Journal of Dermatology, EarlyView.
https://ift.tt/2PvyZTL
Two cases of erosive pustular dermatosis of the scalp occurring after topical 3,75% imiquimod for actinic keratoses
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2OTMn74
Psoriasis and Suicidality: A Review of the Literature
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2PwMwui
Máxime “Max” Kuczyński: Father of Peruvian Public Health and of the 66th President of Peru
Dermatologic Therapy, EarlyView.
https://ift.tt/2OUXi07
Comparison the effects of topical application of olive and calendula ointments on Children's diaper dermatitis: A triple‐blind randomized clinical trial
Dermatologic Therapy, EarlyView.
https://ift.tt/2Pvsy31
Is C‐11 Methionine PET an alternative to 18‐F FDG PET for identifying recurrent laryngeal cancer after radiotherapy?
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2CGQzRQ
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