Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Πέμπτη 1 Νοεμβρίου 2018

Strategies for Reducing Diagnostic Delay in Acral Lentiginous Melanoma

J. Bañuls
Actas Dermosifiliogr.2018;109:764

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Coding of Dermatologic Diagnoses: An Unresolved Issue

I. Belinchón Romero
Actas Dermosifiliogr.2018;109:765

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Local Experience with Vismodegib

P. Pasquali
Actas Dermosifiliogr.2018;109:765-6

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An Algorithm to Guide the Rational, Evidence-Based Use of Omalizumab in the Treatment of Chronic Urticaria

R. Ruiz-Villaverde
Actas Dermosifiliogr.2018;109:766

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What We Know About the Clinical Course of Nonsegmental Vitiligo: Experience of a Researcher and a Dermatologist

M.L. Peralta-Pedrero, F. Jurado Santa-Cruz
Actas Dermosifiliogr.2018;109:767-70

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Algorithm for Treatment of Chronic Spontaneous Urticaria with Omalizumab

J. Spertino, L. Curto Barredo, E. Rozas Muñoz, I. Figueras Nart, E. Serra Baldrich, M. Bonfill-Ortí, V. Expósito-Serrano, A. Guilabert, G. Melé Ninot, M. Villar Buil, J. Garcias Ladaria, X. García Navarro, M. Vilavella, I. Bielsa Marsol, G. Aparicio Ortiz, C. Baliu Piqué, A. Álvarez Abella, N. Lamas Domenech, J.M. Mascaró, S. Gómez, J.I. Torné Gutiérrez, A. Vicente Villa, A. Gimenez Arnau
Actas Dermosifiliogr.2018;109:771-6

Abstract - Full Text - PDF

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A Practical Approach to the Diagnosis and Treatment of Adult Erythroderma

A. Cuellar-Barboza, J. Ocampo-Candiani, M.E. Herz-Ruelas
Actas Dermosifiliogr.2018;109:777-90

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Paradoxical Reactions to Biologic Therapy in Psoriasis: A Review of the Literature

M. Munera-Campos, F. Ballesca, J.M. Carrascosa
Actas Dermosifiliogr.2018;109:791-800

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Subungual Melanoma: A Descriptive Study of 34 Patients

A. Talavera-Belmonte, M. Bonfill-Ortí, L. Martínez-Molina, R. Fornons-Servent, A. Bauer-Alonso, J.R. Ferreres-Riera, J. Marcoval
Actas Dermosifiliogr.2018;109:801-6

Abstract - Full Text - PDF

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Evaluation of Structure Indicators for Assessing Skin Cancer Quality of Care in Dermatology Departments

T. Kueder-Pajares, M.A. Descalzo, I. García-Doval, L. Ríos-Buceta, D. Moreno-Ramírez
Actas Dermosifiliogr.2018;109:807-12

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Experience With Vismodegib in the Treatment of Advanced Basal Cell Carcinoma at a Cancer Center

E. Bernia, B. Llombart, C. Serra-Guillén, B. Bancalari, E. Nagore, C. Requena, L. Calomarde, A. Diago, J. Lavernia, V. Traves, C. Guillén, O. Sanmartín
Actas Dermosifiliogr.2018;109:813-20

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Rapidly Growing Lesion on the Chest

G. González-López, R.M. Ceballos-Rodríguez, E. García-Fernández
Actas Dermosifiliogr.2018;109:821-2

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A Flat Pink Plaque On The Right Anterior Forearm

S. Campos, A. João, A. Lencastre
Actas Dermosifiliogr.2018;109:823-4

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Histologic Diagnosis of Melanocytic Lesions and Melanoma: Real Challenges

D. Morgado-Carrasco, S.S. Ertekin, A. Combalia, L. Ferrandiz
Actas Dermosifiliogr.2018;109:825-6

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Necrobiotic Xanthogranuloma: A Cutaneous Manifestation of Monoclonal Gammopathy

I. Pérez-López, J.D. Herrera-García, A. Martínez-López, E. García-Durá
Actas Dermosifiliogr.2018;109:827

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Huge Squamous Cell Carcinoma Arising on Severe Hidradenitis Suppurativa

T. Miura, M. Ishikawa, T. Mori, Y. Hanami, M. Ohtsuka, T. Yamamoto
Actas Dermosifiliogr.2018;109:828

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Dermatitis of the Face and Neck: Response to Itraconazole

R. Ruiz-Villaverde, D. Sánchez-Cano, D. López-Delgado
Actas Dermosifiliogr.2018;109:829-31

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Facial Papules in Frontal Fibrosing Alopecia: Good Response to Isotretinoin

M.Á. Flores-Terry, M. García-Arpa, M. Franco-Muñóz, L. González-Ruiz
Actas Dermosifiliogr.2018;109:831-3

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Multiple Acral Syringomas

C. Gómez-de Castro, B. Vivanco Allende, B. García-García
Actas Dermosifiliogr.2018;109:834-6

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Ultrasound Assessment of a Subcutaneous Eumycetoma of the Eyebrow in an Immunocompromised Patient

A. Combalia, P. Giavedoni, R. Pigem, J.M. Mascaró Jr
Actas Dermosifiliogr.2018;109:836-8

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Adult testicular granulosa cell tumour: an extremely rare entity

Adult granulosa cell tumours are extremely rare and usually benign but sometimes can assume an aggressive behaviour. A 31-year-old man presented with a 45 mm testicular mass. Radical orchiectomy was performed. Histological examination showed elongated cells, with hyperchromatic nuclei and Call-Exner bodies. Immunohistochemical analysis revealed positivity to vimentin, inhibin and negative PLAP and AE1/AE3 staining. The patient did not receive any adjuvant therapy and remained asymptomatic during 10 years. There are few cases of adult granulosa cell tumours and there is no consensus regarding malignancy criteria, treatment and follow-up. The description of these entities is crucial to allow a better management of these patients.



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Acute myeloid leukaemia relapse presenting as cardiac myeloid sarcoma

A 50-year-old woman previously diagnosed with acute myeloid leukaemia presented with a 3-month history of shortness of breath and a right-sided facial rash. A chest CT revealed an intracardiac mass in the right atrium extending into her superior and inferior vena cava. Surgery was performed to remove the mass and pathology was consistent with myeloid sarcoma. After surgery, adjuvant radiation therapy was directed to the residual disease. The patient eventually relapsed in other sites not including the right atrium and eventually succumbed to her disease.



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Incidental discovery of Amyands hernia

Description 

A 58-year-old woman was referred to Hospital Tuanku Ja'afar (Seremban, Malaysia) for contrast-enhanced CT abdomen and pelvis following discovery of a solid mass in the right adnexa on ultrasonography. CT findings revealed a well-defined, fat-containing mass with calcifications in the right adnexa measuring 4.5x7.8x4 cm, consistent with ovarian teratoma (figure 1). Incidentally, the vermiform appendix appeared to be elongated and extended into the right inguinal canal. It was not enlarged, and there was no surrounding fat streakiness (figures 1 and 2). A diagnosis of Amyand's hernia was made. She was advised for conservative (non-surgical) treatment as she was asymptomatic for both ovarian mass and Amyand's hernia. She was then given appointment for ultrasound follow-up.

Figure 1

Contrast-enhanced CT abdomen and pelvis in axial sections showing the appendix (arrows) extending into the right inguinal canal. Right ovarian teratoma is also visualised (asterisk).



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Congenital colonic stenosis with absent caecum and appendix: a rare association

Congenital colonic stenosis is a rare condition with less than 20 cases reported in the literature since 1966. We report an interesting case of a 7-month-old baby girl who presented with features suggestive of acute intestinal obstruction. On exploration, it was a case of ascending colon stenosis with absence of caecum and appendix. A double barrel ileocolostomy was performed. The histopathology confirmed the diagnosis of colonic stenosis and ruled out the presence of Hirschsprung's disease in the distal colon. The child underwent second stage surgery (stoma closure) after 9 months. In complex cases of congenital colonic stenosis, an early decompressive surgery followed by a delayed second stage closure is recommended in patients with poor general condition.



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Central serous chorioretinopathy in a patient of juxtapapillary excavation misdiagnosed as optic disc pit maculopathy

A 29-year-old healthy man had blurring of vision in the left eye for the past 2 months and was referred for the surgical management of optic disc pit maculopathy. Colour fundus examination and optical coherence tomography (OCT) revealed a large deep retinochoroidal excavation close to the temporal edge of the optic disc with an isolated central neurosensory detachment at the macula with underlying multiple small pigment epithelium detachments in the absence of retinoschisis. Fundus fluorescein angiography (FFA) confirmed the presence of multi-focal leakage at the macula and pooling into subretinal space in the form of a 'smoke-stack'. A correct diagnosis of juxtapapillary excavation and central serous chorioretinopathy was made and lifestyle modifications were advised in view of the acute episode. The clinical signs, OCT and FFA feature helped in the differentiation and appropriate management of maculopathy in this case.



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Multifocal avascular osteonecrosis despite appropriate anticoagulation therapy in a patient with systemic lupus erythematosus and antiphospholipid syndrome

Multifocal avascular osteonecrosis (AON) is a serious manifestation of systemic lupus erythematosus (SLE). Prothrombotic factors, especially antiphospholipid antibodies (aPL), have been associated with the development of AON; therefore, attenuating the procoagulant state while balancing the haemorrhagic risks might have a rationale when managing this condition. We report a case of a 37-year-old patient with SLE, treated with low doses of corticosteroids and immunosuppressive therapy, who was started on vitamin K antagonist following an episode of deep vein thrombosis while having persistent positivity for aPL. After 2 years, he presented with multifocal AON, involving both femurs and shoulders. The patient underwent a bilateral hip replacement, but despite appropriate anticoagulation therapy after 2 years, he developed another episode of AON at both distal epiphyses of the femurs and proximal epiphyses of the tibias. Multifocal AON should be suspected, especially in the presence of aPL positivity. Its aetiology is still unknown and is most likely multifactorial. Its management is challenging and requires combined approaches.



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Challenges facing a woman wishing to report intimate partner violence in Belize

We present a case of a 29-year-old woman who presented to a volunteer-run primary care facility in Southern Belize. Her initial presentation was vaginal itching and white discharge; she also requested insertion of a sub-dermal contraceptive implant. During the insertion, marks suspicious for deliberate self-harm were noticed on the patient's arm, and on further exploration she revealed she was being physically and emotionally abused by her husband. With some encouragement, she requested help in taking further action to preserve her safety; however, in Belize clinicians have no power to assist in cases involving adults. Therefore, the victim should self-present to a police station, resulting in a significant potential barrier to reporting intimate partner violence (IPV). Here we discuss this barrier further, as well as other barriers that exist to reporting IPV, and discuss possible policy changes that may improve the situation in Belize.



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Hypoglossal canal schwannoma causing isolated left 12th cranial nerve palsy

A 40-year-old woman presented with insidious onset, gradually progressive dysarthria and inability to manoeuvre bolus of food in her mouth while eating. The duration of her symptoms was 3 months. On evaluation, the left half of her tongue was wasted. The tongue deviated to the left on protrusion. There were no clinical features suggestive of involvement of the ipsilateral 9th, 10th or 11th cranial nerves. MRI of the brain showed a large, fusiform lesion in the left hypoglossal canal, extending into the jugular canal. The lesion was surgically excised and found to be a schwannoma.



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Case of keratoacanthoma centrifugum marginatum treated with acitretin

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma (KA), characterised by a progressively expanding tumour with a lack of spontaneous remission and significant scarring. KCM has been reported previously in less than 50 cases worldwide. We present the case of a large solitary KCM on the right shin of a 71-year-old woman. This was treated successfully with oral acitretin for 16 months with sustained remission at 24 months. Our case provides further supporting evidence for acitretin as a useful treatment for KCM to induce remission, prevent extensive surgery and minimise destructive scarring.



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Cryoablation: a potential treatment option for renal metastasis from lung cancer?

Cryoablation is successfully performed as a treatment for small renal cancers. The occurrence of a solitary renal metastasis from lung cancer is an uncommon finding entailing a limited knowledge on the choice of its optimal treatment. We present two patients diagnosed with non-small cell lung cancer, who were initially treated with curatively intended chemoradiotherapy. In the follow-up period, a non-symptomatic solitary renal metastasis was found in both patients. Both received CT-guided cryoablation of their renal metastases. One patient was successfully treated with no relapse, whereas the other patient received re-cryoablation due to development of a new renal metastasis. In both patients, no residual tumour was found at the 3 months' follow-up examination. Whether the minimally invasive procedure of cryoablation is a feasible treatment in the management of solitary renal metastases from lung cancer is still undetermined. The recurrence and incomplete treatment are concerns requiring further research.



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Perioperative management of an anterior mediastinal teratoma in an infant: one more tool in the toolbox

Anterior mediastinal masses present a significant challenge in the perioperative period. Standard anaesthetic induction and airway management are often not feasible due to the risk of complete respiratory and/or cardiovascular collapse. Invasive manoeuvres, such as extracorporeal membrane oxygenation, cardiac bypass, or tracheal or bronchial stenting, are sometimes not applicable due to significant anatomic aberration. We present a case of anterior mediastinal mass in a 5-month-old infant where typical management techniques in the treatment algorithm were not possible.



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Endodontic management of maxillary central incisor with pulp canal obliteration

Description 

Traumatised teeth usually develop pulp canal obliterations and are characterised by radiographic loss of pulp space and yellowish discoloration of clinical crown.1 2 The American Association of Endodontists included teeth with radiographic indiscernible root canals requiring treatment in high difficulty criteria.3 Proper debridement, disinfection and obturation of root canal is difficult in such cases thus compromising root canal treatment. This article presents case of pulp canal obliteration of maxillary central incisor that was managed with usage of cone beam CT (CBCT), microscopes, periodic radiographs and small sized hand files which helped in achieving patency to the pulp chamber and root canal.

A 35 year old male patient reported with pain in upper front region of jaw since 3 months. The patient gave history of trauma 3 years ago when he met with an accident, thereafter he noticed gradual change in the transparency of the crown but...



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An unusual presentation of gall bladder papillomatosis in association with metachromatic leukodystrophy

A 5-year-old boy with metachromatic leukodystrophy, debilitated by spastic quadriparesis presented to us with massive ascites and respiratory distress. A subtotal cholecystectomy was performed on him from another centre for a gall bladder mass a year before he came to us. Imaging revealed a polypoidal frond-like mass arising from the gall bladder fossa which was supplied by a hypertrophied branch of the right hepatic artery. A decision was made to offer surgical resection preceded by embolisation of the feeding vessel. At surgery, a polypoidal frond-like mass in communication with the peritoneal cavity was seen arising from the remnant gall bladder bed with over 4 L of mucoid ascites. The mass along with the remnant gall bladder was removed. Biopsy revealed villous papilloma of the gall bladder. The child is well and asymptomatic at 5-month follow-up.



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Age (autoimmunity) associated B cells (ABCs) and their relatives

Swati Phalke | Philippa Marrack

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Medicare Plans to Phase in Changes for Office-Visit Payments

CMS delays the start of a controversial E&M payment change but remains committed to collapsing what's now a five-level coding system.
Medscape Medical News

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Postoperative hemorrhage following tonsillectomy in adults: Analysis of population-based inpatient cohort in Taiwan

Because of the lack of population-based analyses, this study elucidated the epidemiology and 30-day postoperative complications of inpatient adult tonsillectomies in Taiwan.

https://ift.tt/2Rw0xsS

Assessment of oropharyngeal swallowing dysfunction in myasthenia gravis patients presenting with difficulty in swallowing

To examine the correlation between the results of a clinical neurological evaluation and swallowing dysfunction in myasthenia gravis (MG) patients who presented with difficulty in swallowing and underwent videofluorographic (VF) and fiber-optic endoscopic (FE) evaluation.

https://ift.tt/2PyKCwd

Characterization of the biomechanical properties of canine trachea using a customized 3D-printed apparatus

The canine trachea is considered to be an excellent preclinical model for tracheal research due to its similar mechanical and dimensional characteristics to the human trachea. However, normative biomechanical properties have yet to be defined and it is one of the main reasons tracheal reconstruction has not succeeded in animal models at large scale. Variation and inaccurate measurement due to a lack of proper apparatus for mechanical tests further prevent determination of normative mechanical data of the trachea.

https://ift.tt/2Rw0mOe

Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2—clinical and microbiological parameters

The aim of this study was to assess the clinical and microbiological parameters around dental zirconia and titanium implants compared with natural teeth during experimental plaque accumulation. Clinical parameters were evaluated (gingival index, plaque index, bleeding on probing, and probing pocket depth). Microbiological samples were analyzed for total bacterial cell counts, as well as Tannerella forsythia and Prevotella intermedia counts. A statistically significant difference over time was observed in the groups in terms of the gingival index (P<0.001), plaque index (P<0.001), and bleeding on probing (P=0.039).

https://ift.tt/2JvbKa2

Hydrophilic modification of sandblasted and acid-etched implants improves stability during early healing: a human double-blind randomized controlled trial



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Oral health management in patients with depression



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A Destructive Sinonasal Process Leading to Sudden Blindness

A woman in her 70s with a history of pulmonary embolism presented with diplopia and blurry vision as well as 4 months of nasal congestion and progressive headaches despite multiple antibiotic courses. What is your diagnosis?

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Defining Optimal Treatment Times in Head and Neck Cancer Care

Navigating patients with head and neck cancer (HNC) through their care is a challenge. Most patients will present with locoregionally advanced disease and, on average, a 5-year survival rate of 65%; this survival rate has increased slightly since the 1970s, but has remained stagnant for the last decade. Most patients will require multimodality treatment, including surgery, radiotherapy, and/or chemotherapy. This treatment regiment, itself, produces complications in 30% to 50% of patients.

https://ift.tt/2OkZB8D

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

This systematic review synthesizes information about the association between delays in the delivery of care for head and neck cancer and oncologic outcomes.

https://ift.tt/2yKZ8Yq

Iodine Deficiency and Hearing Impairment

To the Editor On June 7, 2018, Scinicariello et al published a study in JAMA Otolaryngology–Head & Neck Surgery in which they analyzed data from 1198 adolescents (aged 12-19 years) from NHANES 2007 to 2010, with urinary iodine, audiometric measurements, and demographic and related variables. The authors concluded that this is the first study in which it was demonstrated at a national level that a urinary iodine concentration (UIC) less than 100 μg/L was a predictive risk factor for having speech-frequency hearing loss (SFHL) among adolescents, and more specifically among those with UIC less than 50 μg/L.

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Utility of Routine Spirometry Measures for Surveillance of Idiopathic Subglottic Stenosis

This medical record review of 42 patients compares the use of peak expiratory flow, expiratory disproportion index, and total peak flow measures for monitoring disease progression in patients with idiopathic subglottic stenosis.

https://ift.tt/2yJBewo

Iodine Deficiency and Hearing Impairment—Reply

In Reply We would like to thank Millon-Ramirez and coauthors for bringing our attention to their previous study on the association of iodine deficiency and hearing impairment among 150 children (aged 6-14 years). As we emphasized in our research letter, few studies have been conducted about this potential relationship, and among them we cited the study by Valeix et al. We agree with Millon-Ramirez and coauthors that in populations with adequate nutritional iodine levels there are individuals with less than adequate iodine intake, which could affect the thyroid system and thus auditory function. Moreover, the potential role of other chemical exposures, such as perchlorate, thiocyanate, and nitrate, which may disturb thyroid function should not be discarded. Alterations may occur either at the iodine uptake level in the thyroid cell by competing for the sodium iodine transporter, by inhibition of the deiodinase activity, or by other mechanisms (reviewed by Zoller).

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A primary germ cell tumour in the gastrointestinal tract: a caecal lesion of yolk-sac morphology in a young patient

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Abstract
A 24-year-old man with a history of Crohns disease, whilst undergoing surveillance colonoscopy was found to have an ulcerated caecal lesion. The histopathology from the mucosal biopsy was suggestive of a yolk sac tumour. After thorough re-examination, the patient had no radiological evidence of malignancy in his testes or retroperitoneum. His alpha-fetoprotein levels returned as 2145, whilst his carcinoembryonic antigen was negligible. The patient was therefore consented for and underwent a laparoscopic right hemi-colectomy with an ileocolic anastomosis, without any complications. The formal histopathology confirmed the results from the biopsy, of a yolk sac non seminous germ cell tumour with positive lymph nodes and lymphovascular invasion. The patient was referred on to medical oncology for neoadjuvant chemotherapy. As the literature in his instance is scarce, the patient's overall prognosis remains unclear. To the best of our knowledge this is the first reported primary germ cell tumour of the gastrointestinal tract.

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Giant solitary fibrous tumor of the pleura

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Abstract
Introduction: Solitary fibrous tumors of the pleura (SFTP) are rare mesenchymal tumors representing <5% of all tumors of the pleura. Literature reveals only two case series and a few solitary reports. Case report: A 68-year-old male presented to our hospital after experiencing exertional dyspnea. A chest CT revealed a giant heterogeneous mass. CT-guided transthoracic core needle biopsy demonstrated SFTP. The well-circumscribed, encapsulated resected mass was measured to be 30 cm × 21 cm × 15 cm and weighed 6900 g. Discussion: SFTP are a rare pathology of the pleural cavity, which most of the time develop from submesothelial fibroblasts of the visceral pleura. Due to their non-characteristic clinical picture, SFTP are usually diagnosed in the later stages of the development. A significant issue in the management of giant SFTP is radical resection of the tumor to relieve compression of the lung parenchyma and other mediastinal structures. Conclusion: SFTP are rare neoplasms that fortunately are benign 80% of the time. Only a few cases of giant SFTP that cover almost the entire pleural space are described in the literature. This report represents one of the largest resected SFTP reports in the literature.

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Robotic Versus Thoracolaparoscopic Esophagectomy for Esophageal Cancer

Condition:   Esophageal Cancer
Interventions:   Procedure: Robotic esophagectomy;   Procedure: Thoracolaparoscopic esophagectomy
Sponsor:   GEM Hospital & Research Center
Not yet recruiting

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Porfimer Sodium Interstitial Photodynamic Therapy With or Without Standard of Care Chemotherapy in Treating Patients With Locally Advanced or Recurrent Head and Neck Cancer

Conditions:   Recurrent Head and Neck Carcinoma;   Locally Advanced Head and Neck Carcinoma
Interventions:   Biological: Nivolumab;   Drug: Porfimer Sodium;   Procedure: Interstitial Illumination Photodynamic Therapy;   Biological: Pembrolizumab;   Drug: Cisplatin;   Drug: Carboplatin;   Biological: Cetuximab;   Other: Quality of Life Assessment;   Drug: Fluorouracil
Sponsors:   Roswell Park Cancer Institute;   National Cancer Institute (NCI)
Not yet recruiting

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Influence of foraminal enlargement on the healing of periapical lesions in rat molars

Abstract

Objectives

The aim of this study was to evaluate the influence of foraminal enlargement on the healing of induced apical periodontitis in a rat model.

Material and methods

Periapical lesions were bilaterally induced in mandibular first molars of 24 Wistar rats, through root canals exposure to the oral environment during 3 weeks. Endodontic treatment was performed in the mesial canal of right molars, which were separated into two experimental groups (n = 12/group). The foraminal enlargement group (FEG) received instrumentation in the entire root canal length, including the cemental canal, while in the non-foraminal enlargement group (NFEG), instrumentation was carried out 1 mm short of the apical foramen. Root canals were filled with gutta-percha and AH Plus sealer, in the same visit, 1 mm short of the apical foramen in both experimental groups. Left molars were not treated and served as a baseline control group. The animals were killed after 4 weeks, and their hemi-mandibles were prepared for radiographic and histological analysis. Data were analyzed by Student's t test and ANOVA.

Results

Only FEG presented lower areas of periapical radiolucency compared to the control (p < .05). Both FEG and NFEG allowed decreased inflammation intensity (p < .0001 and p < .01) and higher scores of cementum neoformation when compared to non-treated samples (p < .0001). FEG was more effective than NFEG in promoting biological seal, i.e., apical closure with cementum (p < .01). FEG, but not NFEG, showed lower scores of root resorption than the control.

Conclusions

Foraminal enlargement during root canal preparation improved periapical healing in rat molars.

Clinical significance

Foraminal enlargement has been suggested to improve disinfection at the apical portion of root canals. This procedure may favor the healing of chronic periapical lesions.



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Therapy with Ulipristal Acetate in a Hypertensive Patient

Ulipristal acetate (UPA) is a medical therapy for patients with symptomatic uterine fibroids. The drug has shown efficacy in the control of heavy menstrual bleeding and, as a consequence, in anaemia improvement. We report the case of a hypertensive patient treated with two courses of UPA. In addition to its observed benefits on hypermenorrhea caused by uterine fibroids, no exacerbation of the underlying disease was observed. No adverse effects were observed, and blood pressure levels were well controlled throughout.

https://ift.tt/2SFmmrl

Editorial Board

Publication date: December 2018

Source: Archives of Oral Biology, Volume 96

Author(s):



https://ift.tt/2qmlniH

Editorial Board

Publication date: December 2018

Source: Archives of Oral Biology, Volume 96

Author(s):



https://ift.tt/2qmlniH

TARBP2 negatively regulates IFN-β production and innate antiviral response by targeting MAVS

Publication date: December 2018

Source: Molecular Immunology, Volume 104

Author(s): Ting Ling, Sheng-Na Li, Guang-Xiu Weng, Weiying Wang, Changsheng Li, Lingzhen Cao, Hua Rao, Hong-Bing Shu, Liang-Guo Xu

Abstract

MAVS as an essential receptor protein for anti-virus innate immunity plays an important role in the production of virus-induced typeⅠ interferon and regulation of interferon regulatory factor 3/7. Understanding the MAVS-mediated antiviral signaling pathway can provide detailed insights. In this study, we identify transactivation response element RNA-binding protein (TARBP2), as an inhibitor of the cellular protein kinase PKR, negatively regulates virus -induced IFN-β production by targets MAVS. Overexpression of TARBP2 inhibits virus-induced IFN-β production as well as cellular antiviral response. Then knockdown of TARBP2 inhibited virus-induced IFN-β signaling. Further studies demonstrated that TARBP2 interacted with MAVS and targeted MAVS to abrogate MAVS-RIG-I and MAVS-TRAF3 association. Our findings suggest that TARBP2 is an important non-redundant virus-mediated negative regulator of typeⅠ interferon.



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Editorial Board

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s):



https://ift.tt/2DeY9DD

Two Synchronous Congenital Neck Masses with Facial Nerve Weakness

Publication date: Available online 31 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Elise Lippmann, Taher Valika, John Maddalozzo

Abstract
Objective

To describe a case of a complex neck mass with final pathology significant for two synchronous lesions, a type 1 branchial cleft cyst and an enteric duplication cyst, and to discuss its management given the unique presentation.



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Three-dimensional soft tissue prediction in orthognathic surgery: a clinical comparison of Dolphin, ProPlan CMF, and probabilistic finite element modelling

Publication date: Available online 31 October 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): P.G.M. Knoops, A. Borghi, R.W.F. Breakey, J. Ong, N.U.O. Jeelani, R. Bruun, S. Schievano, D.J. Dunaway, B.L. Padwa

Abstract

Three-dimensional surgical planning is used widely in orthognathic surgery. Although numerous computer programs exist, the accuracy of soft tissue prediction remains uncertain. The purpose of this study was to compare the prediction accuracy of Dolphin, ProPlan CMF, and a probabilistic finite element method (PFEM). Seven patients (mean age 18 years; five female) who had undergone Le Fort I osteotomy with preoperative and 1-year postoperative cone beam computed tomography (CBCT) were included. The three programs were used for soft tissue prediction using planned and postoperative maxillary position, and these were compared to postoperative CBCT. Accurate predictions were obtained with each program, indicated by root mean square distances: RMSDolphin = 1.8 ± 0.8 mm, RMSProPlan = 1.2 ± 0.4 mm, and RMSPFEM = 1.3 ± 0.4 mm. Dolphin utilizes a landmark-based algorithm allowing for patient-specific bone-to-soft tissue ratios, which works well for cephalometric radiographs but has limited three-dimensional accuracy, whilst ProPlan and PFEM provide better three-dimensional predictions with continuous displacements. Patient or population-specific material properties can be defined in PFEM, while no soft tissue parameters are adjustable in ProPlan. Important clinical considerations are the topological differences between predictions due to the three algorithms, the non-negligible influence of the mismatch between planned and postoperative maxillary position, and the learning curve associated with sophisticated programs like PFEM.



https://ift.tt/2AFnW5q

Clinical presentation, immunologic features, and hematopoietic stem cell transplant outcomes for IKBKB immune deficiency

Publication date: Available online 31 October 2018

Source: Clinical Immunology

Author(s): Geoffrey D.E. Cuvelier, Tamar S. Rubin, Anne Junker, Roona Sinha, Alan M. Rosenberg, Donna A. Wall, Marlis L. Schroeder

Abstract

IKBKB deficiency is a rare but life-threatening primary immunodeficiency disorder, involving activation defects in adaptive and innate immunity. We present sixteen cases of a homozygous IKBKB mutation (c.1292dupG) in infants characterized by early-onset bacterial, viral, fungal and Mycobacterial infections. In most cases, T- and B-cells were quantitatively normal, but phenotypically naïve, with severe hypogammaglobulinemia. T-cell receptor excision circles were normal, meaning newborn screening by TREC analysis would miss IKBKB cases. Although IKBKB deficiency does not meet traditional laboratory based definitions for SCID, this combined immune deficiency appears to be at least as profound. Urgent HSCT, performed in eight patients, remains the only known curative therapy, although only three patients are survivors. Ongoing infections after transplant remain a concern, and may be due to combinations of poor social determinants of health, secondary graft failure, and failure of HSCT to replace non-hematopoietic cells important in immune function and dependent upon IKK/NF-κB pathways.



https://ift.tt/2SBNBms

Efficacy and safety of rupatadine in Japanese patients with seasonal allergic rhinitis: A double-blind, randomized, multicenter, placebo-controlled clinical trial

Publication date: Available online 31 October 2018

Source: Allergology International

Author(s): Kimihiro Okubo, Takamasa Suzuki, Ayaka Tanaka, Hiroshi Aoki

Abstract
Background

Rupatadine is a novel non-sedating second-generation H1-antihistamine with antiplatelet-activating factor activity, first marketed in Spain in 2003. It is used for treating allergic rhinitis in more than 80 countries. This study investigated its efficacy and safety in Japanese patients with seasonal allergic rhinitis (SAR).

Methods

This was a randomized, placebo-controlled, double-blind study conducted at 4 medical institutions in Japan (JapicCTI-152785). Adolescent and adult SAR outpatients aged 12–64 years entered a 1-week placebo run-in period. After eligibility was confirmed, patients orally received placebo, rupatadine 10 mg, or 20 mg once daily for 2 weeks. The primary endpoint was a change from baseline to second week of treatment in total 4 nasal symptom score (T4NSS).

Results

Nine hundred patients were randomly assigned to placebo, rupatadine 10 mg, or rupatadine 20 mg (302, 298, and 300 patients, respectively). The least squares mean difference in the primary endpoint between rupatadine and placebo was −1.085 for 10 mg, and −1.415 for 20 mg (analysis of covariance, both P < 0.001). The rates of adverse events were 6.6%, 14.1%, and 15.0% for placebo, rupatadine 10 mg, and rupatadine 20 mg, respectively. Somnolence was most frequently reported: 7.0% for rupatadine 10 mg and 7.3% for rupatadine 20 mg. No serious adverse drug reactions were observed, and no adverse events resulted in premature discontinuation.

Conclusions

Rupatadine 10 and 20 mg were significantly superior to placebo in improving nasal and ocular symptoms of SAR, and were well tolerated.



https://ift.tt/2PB5cMs

The application of artificial intelligence in the IMRT planning process for head and neck cancer

Publication date: December 2018

Source: Oral Oncology, Volume 87

Author(s): Vasant Kearney, Jason W. Chan, Gilmer Valdes, Timothy D. Solberg, Sue S. Yom

Abstract

Artificial intelligence (AI) is beginning to transform IMRT treatment planning for head and neck patients. However, the complexity and novelty of AI algorithms make them susceptible to misuse by researchers and clinicians. Understanding nuances of new technologies could serve to mitigate potential clinical implementation pitfalls. This article is intended to facilitate integration of AI into the radiotherapy clinic by providing an overview of AI algorithms, including support vector machines (SVMs), random forests (RF), gradient boosting (GB), and several variations of deep learning. This document describes current AI algorithms that have been applied to head and neck IMRT planning and identifies rapidly growing branches of AI in industry that have potential applications to head and neck cancer patients receiving IMRT. AI algorithms have great clinical potential if used correctly but can also cause harm if misused, so it is important to raise the level of AI competence within radiation oncology so that the benefits can be realized in a controlled and safe manner.



https://ift.tt/2SwP8Kq

Are gingival cells more sensitive to genotoxic effects caused by dental radiography?

Publication date: Available online 31 October 2018

Source: Oral Oncology

Author(s): Mahesh Shivaji Chavan, Priti Mahesh Chavan, Digamber Sable, Suhas Pande, Harshada Inamdar, Girija Kunjir, Pallavi Channe



https://ift.tt/2zohOwm

Morphological study of the changes after sagittal split ramus osteotomy in patients with facial asymmetry: measurements of 3-dimensional modelling

Publication date: Available online 31 October 2018

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Y.-L. Zhang, Y. Liu, J.-H. Shu, X.-C. Xu, Z. Liu

Abstract

The effects of bilateral sagittal split ramus osteotomy (BSSRO) on the temporomandibular joint (TMJ) are still not well understood. The aim of this study was to compare the morphological differences among unaffected subjects on the one hand, and patients with facial asymmetry before and after BSSRO on the other. Ten Chinese patients (preoperative and postoperative groups, mean (SD) age 25 (5) years) diagnosed with facial asymmetry and 10 unaffected subjects (control group, mean (SD) age 27 (5) years) were recruited prospectively. The 3-dimensional morphological measurements made on 3-dimensional models in each group were assessed by analysis-of-variance (ANOVA) and Student's t test, and probabilities of <0.05 were accepted as significant. The horizontal condylar angle (HCA), coronal condylar angle (CCA), sagittal ramus angle (SRA), medial joint space (MJS), lateral joint space (LJS), and superior joint space (SJS) differed significantly between the preoperative and control groups (HCA: p = 0.000, CCA: p = 0.000, SRA(left/undeviated side): p = 0.002, MJS(left/undeviated side): p = 0.000, MJS(right/deviated side): p = 0.007, LJS(right/deviated side): p = 0.000, SJS(left/undeviated side): p = 0.000, SJS(right/deviated side): p = 0.000). The SRA, MJS, LJS, and SJS differed significantly between the preoperative and postoperative groups (SRA(left/undeviated side): p = 0.012, MJS(left/undeviated side): p = 0.002, LJS(right/deviated side): p = 0.021, SJS(left/undeviated side): p = 0.000, SJS(right/deviated side): p = 0.001), And the SRA, MJS, and LJS in the preoperative group differed significantly between the deviated and undeviated side (SRA: p = 0.006; MJS: p = 0.003; LJS: p = 0.011). However, there were no significant differences in the postoperative and control groups between the deviated and undeviated sides. BSSRO improved the asymmetrical morphology of the TMJ and alleviated the symptoms.



https://ift.tt/2QboYeH

Genetic Loci Determining Total Immunoglobulin E Levels from Birth through Adulthood

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OgDLmJ

Multidrug-resistant Aeromonas hydrophila causing fatal bilateral necrotizing fasciitis in an immunocompromised patient: a case report

Aeromonas hydrophila is a water-dwelling, gram-negative rod-shaped bacterium, associated with diarrheal illness and, less commonly, necrotizing skin and soft tissue infections, especially among immunocompromised ...

https://ift.tt/2zilGip

MicroRNAs regulating mucin type O‐glycan biosynthesis and transforming growth factor β signaling pathways in nasal mucosa of patients with chronic rhinosinusitis with nasal polyps in Northern China

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2PwD0ul

Guidelines of care for the management of primary cutaneous melanoma

The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer–related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy).

https://ift.tt/2CW4jYt

The increase of interfollicular epidermal stem cells and regulation of aryl hydrocarbon receptor and its repressors in the skin through hydroporation with anti‐aging cocktail

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2EWt0GA

Appearance of aging signs in differently pigmented facial skin by a novel imaging system

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AFvN2P

Effect of chewing rate on meal intake

European Journal of Oral Sciences, EarlyView.


https://ift.tt/2Rs26rt

IL‐17‐positive mast cell infiltration in the lesional skin of lichen planopilaris: possible role of mast cells in inducing inflammation and dermal fibrosis in cicatricial alopecia

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2P3Tt9K

Fevipiprant, a DP2 Receptor Antagonist, Inhibits Eosinophil Migration Towards Mast Cells

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


https://ift.tt/2EU9lqJ

In Response

No abstract available

https://ift.tt/2P1aYrj

National Partnership for Maternal Safety Recommended Maternal Early Warning Criteria Are Associated With Maternal Morbidity

BACKGROUND: Many cases of maternal mortality and morbidity are preventable. A delayed response to clinical warning signs contributes to preventability. Therefore, the National Partnership for Maternal Safety devised maternal early warning criteria (MEWC), composed of abnormal vital signs that trigger bedside evaluation by a provider with the capacity to escalate care. The relationship of the MEWC to maternal morbidity has not been studied. We evaluated the correlation between the MEWC and maternal morbidity. METHODS: We retrospectively reviewed the first 400 deliveries at the University of Chicago in 2016. We analyzed the electronic medical record to determine whether vital signs triggered the MEWC during the admission to labor and delivery and whether patients experienced morbidity during their delivery hospitalization. The association between MEWC and morbidity was tested using χ2 analysis. We calculated the sensitivity, specificity, and positive and negative predictive values of the MEWC. RESULTS: Two hundred eighty-one (70%) of 400 patients triggered the MEWC at least once, and 198 (50%) of 400 patients had multiple or recurrent triggers. Ninety-nine (25%) of 400 patients experienced morbidity. The most common causes of morbidity were hemorrhage, suspected infection, and preeclampsia with severe features. The relative risk of maternal morbidity with at least a single trigger was 13.55 (95% confidence interval [CI], 4.38–41.91) and with recurrent or multiple triggers was 5.29 (95% CI, 3.22–8.71). The sensitivity of the MEWC in predicting morbidity was 0.97 (95% CI, 0.92–0.99) and the specificity was 0.39 (95% CI, 0.33–0.44) when patients with at least a single trigger were included. When including only patients with multiple or recurrent triggers, the sensitivity was 0.84 (95% CI, 0.75–0.90) and the specificity was 0.62 (95% CI, 0.56–0.67). The positive predictive value of the MEWC in our population was 0.34 (95% CI, 0.29–0.40), and the negative predictive value was 0.97 (95% CI, 0.93–0.99). When considering only patients with multiple or recurrent triggers, the positive predictive value was 0.42 (95% CI, 0.38–0.46) and the negative predictive value was 0.92 (95% CI, 0.88–0.95). CONCLUSIONS: The MEWC are associated with maternal morbidity. As a screening tool, they appropriately prioritize sensitivity and have an excellent negative predictive value. The criteria demonstrate low specificity, which is slightly improved by considering only patients with recurrent or multiple triggers. Additional efforts to improve the specificity of MEWC, with a focus on identifying sustained or recurrent patterns of abnormal vital signs, may be necessary before their widespread implementation. Accepted for publication September 26, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Barbara M. Scavone, MD, Departments of Anesthesia and Critical Care and Obstetrics and Gynecology, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637. Address e-mail to bscavone@dacc.uchicago.edu. © 2018 International Anesthesia Research Society

https://ift.tt/2CTGS1H

Psychometrics: Trust, but Verify

There is a continued mandate for practicing evidence-based medicine and the prerequisite rigorous analysis of the comparative effectiveness of alternative treatments. There is also an increasing emphasis on delivering value-based health care. Both these high priorities and their related endeavors require correct information about the outcomes of care. Accurately measuring and confirming health care outcomes are thus likely now of even greater importance. The present basic statistical tutorial focuses on the germane topic of psychometrics. In its narrower sense, psychometrics is the science of evaluating the attributes of such psychological tests. However, in its broader sense, psychometrics is concerned with the objective measurement of the skills, knowledge, and abilities, as well as the subjective measurement of the interests, values, and attitudes of individuals—both patients and their clinicians. While psychometrics is principally the domain and content expertise of psychiatry, psychology, and social work, it is also very pertinent to patient care, education, and research in anesthesiology, perioperative medicine, critical care, and pain medicine. A key step in selecting an existing or creating a new health-related assessment tool, scale, or survey is confirming or establishing the usefulness of the existing or new measure; this process conventionally involves assessing its reliability and its validity. Assessing reliability involves demonstrating that the measurement instrument generates consistent and hence reproducible results—in other words, whether the instrument produces the same results each time it is used in the same setting, with the same type of subjects. This includes interrater reliability, intrarater reliability, test–retest reliability, and internal reliability. Assessing validity is answering whether the instrument is actually measuring what it is intended to measure. This includes content validity, criterion validity, and construct validity. In evaluating a reported set of research data and its analyses, in a similar manner, it is important to assess the overall internal validity of the attendant study design and the external validity (generalizability) of its findings. Accepted for publication September 10, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Thomas R. Vetter, MD, MPH, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Health Discovery Bldg, Room 6.812, 1701 Trinity St, Austin, TX 78712. Address e-mail to thomas.vetter@austin.utexas.edu. © 2018 International Anesthesia Research Society

https://ift.tt/2P6PwBy

Development and Pilot Testing of a Context-Relevant Safe Anesthesia Checklist for Cesarean Delivery in East Africa

BACKGROUND: Maternal mortality rate in developing countries is 20 times higher than in developed countries. Detailed reports surrounding maternal deaths have noted an association between substandard management during emergency events and death. In parallel with these findings, there is increasing evidence for cognitive aids as a means to prevent errors during perioperative crises. However, previously published findings are not directly applicable to cesarean delivery in low-income settings. Our hypothesis was that the use of obstetric anesthesia checklists in the management of high-fidelity simulated obstetrical emergency scenarios would improve adherence to best practice guidelines in low- and middle-income countries. METHODS: Accordingly, with input from East African health care professionals, we created a context-relevant obstetric anesthesia checklist for cesarean delivery. Second, clinical observations were performed to assess in a real-world setting. Third, a pilot testing of the cognitive aid was undertaken. RESULTS: Clinical observation data highlighted significant deficiencies in the management of obstetric emergencies. The use of the cesarean delivery checklist during simulations of peripartum hemorrhage and preeclampsia showed significant improvement in the percentage of completed actions (pretraining 23% ± 6% for preeclampsia and 22% ± 13% for peripartum hemorrhage, posttraining 75% ± 9% for preeclampsia, and 69% ± 9% for peripartum hemorrhage [P

https://ift.tt/2CSNKfY

Monitoring Mechanical Ventilation Using Ventilator Waveforms

No abstract available

https://ift.tt/2P15KMh

Limitation of the Internationalized Normalized Ratio in Guiding Perioperative Plasma Transfusion

No abstract available

https://ift.tt/2CU5hEg

Preoperative Echocardiography for Patients With Hip Fractures Undergoing Surgery: A Retrospective Cohort Study Using a Nationwide Database

BACKGROUND: The effect of preoperative transthoracic echocardiography on the clinical outcomes of patients with hip fractures undergoing surgical treatment remains controversial. We hypothesized that preoperative echocardiography is associated with reduced postoperative morbidity and improved patient survival after surgical repair of hip fractures. METHODS: Drawing from a nationwide administrative database, patients undergoing hip fracture surgeries between April 1, 2008 and December 31, 2016 were included. We examined the association of preoperative echocardiography with the incidence of in-hospital mortality using propensity score matching. Secondary outcomes included postoperative complications, the incidence of postoperative intensive care unit admissions, and length of hospital stay. For sensitivity analyses, we restricted the overall cohort to include only hip fracture surgeries performed within 2 days from admission. RESULTS: Overall, 34,679 (52.1%) of 66,620 surgical patients underwent preoperative echocardiography screening. The screened patients (mean [SD] age, 84.3 years [7.7 years]; 79.0% female) were propensity score matched to 31,941 nonscreened patients (mean [SD] age, 82.1 years [8.7 years]; 78.2% female). The overall in-hospital mortality, before propensity matching, was 1.8% (1227 patients). Propensity score matching created a matched cohort of 25,205 pairs of patients. There were no in-hospital mortality differences between the 2 groups (screened versus nonscreened: 417 [1.65%] vs 439 [1.74%]; odds ratio, 0.95; 95% confidence interval, 0.83–1.09; P = .45). Preoperative echocardiography was not associated with reduced postoperative complications and intensive care unit admissions. In sensitivity analysis, we identified 25,637 patients from the overall cohort (38.5%) with hip fracture surgeries performed within 2 days of admission. There were no in-hospital mortality differences between the 2 groups (screened versus nonscreened: 1.67% vs 1.80%; odds ratio, 0.93; 95% confidence interval, 0.72–1.18; P = .53). Findings were also consistent with other sensitivity analyses and subgroup analyses. CONCLUSIONS: This large, retrospective, nationwide cohort study demonstrated that preoperative echocardiography was not associated with reduced in-hospital mortality or postoperative complications. Accepted for publication September 25, 2018. Funding: Institutional/departmental. Conflicts of Interest: See Disclosures at the end of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). The authors have no conflicts of interest directly relevant to the content of this article within 36 months before submission. Reprints will not be available from the authors. Address correspondence to Koji Kawakami, MD, PhD, Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto 6068501, Japan. Address e-mail to kawakami.koji.4e@kyoto-u.ac.jp. © 2018 International Anesthesia Research Society

https://ift.tt/2OZYkJg

Is Activity Tracker–Measured Ambulation an Accurate and Reliable Determinant of Postoperative Quality of Recovery? A Prospective Cohort Validation Study

BACKGROUND: Quality of recovery (QOR) instruments measure patients' ability to return to baseline health status after surgery. Whether, and the extent to which, postoperative ambulation contributes to QOR is unclear, in part due to the lack of valid tools to measure ambulation in clinical settings. This cohort study of the cesarean delivery surgical model examines the accuracy and reliability of activity trackers in quantifying early postoperative ambulation and investigates the correlation between ambulation and QOR. METHODS: A prospective cohort of 200 parturients undergoing cesarean delivery between July 2015 and June 2017 was fitted with wrist-worn activity trackers immediately postpartum. The trackers were collected 24 hours later, along with QOR assessments (QoR-15 scale). The relationship between QOR and various covariates, including ambulation, was explored using multivariable linear regression and Spearman correlation (ρ). Forty-eight parturients fitted with 2 trackers also completed a walk exercise accompanied by a step-counting assessor, to evaluate accuracy, inter-, and intradevice reliability using interclass correlation (ICC). RESULTS: Compared to step counting, activity trackers had high accuracy (ICC = 0.93) and excellent inter- and intradevice reliability (ICC = 0.98 and 0.96, respectively). Correlation analysis suggested that early ambulation is moderately correlated with postcesarean QoR-15 scores, with a ρ (95% confidence interval) equivalent to 0.56 (0.328–0.728). Regression analysis suggested that ambulation is a determinant of postcesarean QoR-15 scores, with an effect estimate (95% confidence interval) equivalent to 0.002 (0.001–0.003). Ambulation was also associated with all QoR-15 domains, except psychological support. The patient's acceptable symptom state (subjective threshold for good ambulation) in the first 24 hours was 287 steps. CONCLUSIONS: This study demonstrated the accuracy and reliability of activity trackers in measuring ambulation in clinical settings and suggested that postoperative ambulation is a determinant of postoperative QOR. A hypothetical implication of our findings is that interventions that improve ambulation may also help to enhance QOR, but further research is needed to establish a causal relationship. Accepted for publication October 5, 2018. Funding: This work was supported by departmental funding. J.G.L., D.N.W., and F.W.A. were supported by the Merit Award Program, Department of Anesthesia, University of Toronto. F.W.A. also receives research time support from the Department of Anesthesiology and Pain Medicine, and the Ottawa Hospital Research Institute, University of Ottawa. D.N.W. is also supported by a New Investigator Award from the Canadian Institutes of Health Research. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Faraj W. Abdallah, MD, Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada. Address e-mail to FAbdallah@toh.ca. © 2018 International Anesthesia Research Society

https://ift.tt/2P5ZTVZ

Challenging the Traditional Definition of a Difficult Intubation: What Is Difficult?

No abstract available

https://ift.tt/2CSaGvM

Fundamentals of Pain Medicine, 1st ed

No abstract available

https://ift.tt/2OZEr50

Do We Need Specific Certification to Use Anesthesia Information Management Systems?

No abstract available

https://ift.tt/2CSaHjk

Liver Anesthesiology and Critical Care Medicine, 2nd ed

No abstract available

https://ift.tt/2P4S2rS

In Response

No abstract available

https://ift.tt/2CUs6Yt

Four cases of paradoxical cephalocervical pyogenic granuloma during treatment with paclitaxel and ramucirumab

The Journal of Dermatology, EarlyView.


https://ift.tt/2RvBrKD

High‐grade trichoblastic carcinoma arising through malignant transformation of trichoblastoma: Immunohistochemical analysis and the expression of p53 and phosphorylated AKT

The Journal of Dermatology, EarlyView.


https://ift.tt/2PtAVzt

Autophagy in malnutrition‐associated dermatoses

The Journal of Dermatology, EarlyView.


https://ift.tt/2RsYbur

Sézary syndrome without erythroderma: A case report and review of published work

The Journal of Dermatology, EarlyView.


https://ift.tt/2Pu9aqr

Association between rosacea severity and relative muscle mass: A cross‐sectional study

The Journal of Dermatology, EarlyView.


https://ift.tt/2RvBhTx

Two cases of chronic oral ulcers effectively treated with systemic corticosteroid therapy: Circumorificial plasmacytosis and traumatic ulcerative granuloma with stromal eosinophilia

The Journal of Dermatology, EarlyView.


https://ift.tt/2PBaKXA

Effectiveness of weekly paclitaxel for edema and pain in classic Kaposi sarcoma with widespread eruption in the lower legs

The Journal of Dermatology, EarlyView.


https://ift.tt/2RsIbsp