Σάββατο 23 Φεβρουαρίου 2019
Diseño y evaluación de las propiedades antibacterianas de un prototipo de molde de audífono que incorpora cobre en su manufactura
Introduction: External otitis of infectious etiology among hearing aid users is a common motive of otolaryngology consultation. Antibacterial properties described copper, they have motivated the development of clinical applications of this metal. Aim: Evaluate the antibacterial capacity of copper-based ear molds manufactured with different materials such UV sensitive polymers, silicone and acrylic incorporating metallic copper, in an experimental system in vitro. Material and method: Ear molds with and without copper, were inoculated with different concentrations of microorganisms (S aureus and P aeruginosa) and determine the percentage of bacterial adherence to different contact times (4-8 and 12 hours). Results: There was significant reduction in bacterial adhesion to copper molds than those without copper, independent of the material, the type of microorganism and the bacterial inoculum. Discussion: The decrease in bacterial adherence on prototypes with copper, can be attributed to inhibitory activity on microorganisms depending on their concentration and contact time, exerting its effect by diffusion through the various materials. Conclusion: With these results, is necessary the development of clinical studies focused on checking whether the use of hearing aids with copper decreases external otitis of infectious origin.
https://ift.tt/2VdrhzX
Estudio epidemiológico descriptivo de pacientes hospitalizados en el Servicio de ORL del Hospital Clínico de la Universidad de Chile entre los años 2007 y 2014
Introduction: Diseases ofotolaryngology (ENT) origin have a high prevalence in primary health care, however, the epidemiological information on hospitalized patients is almost null. Aim: To obtain demographic and disease prevalence information in hospitalized patients of the ENT Department at the Hospital Clínico de la Universidad de Chile (HCUCh). Material and method: A descriptive and retrospective study, was carried out at the ENT department of the HCUCh, reviewing existing records of diagnostic related groups (GRD) for discharges between 2007 and 2014. Results: We review a total of 7353 discharges, with an average age of patients of 28.24 years. The most frequent cause of hospitalization was pharynx pathology. An 87.88% of discharges had surgery performed, where tonsillectomy with adenoidectomy reached 15,7% of the total. Conclusion: This study provides us with epidemiological information on patients hospitalized in an ENT department in a nationwide referral hospital.
https://ift.tt/2ErVGFl
Comparación de las amplitudes y latencias de la onda V del potencial evocado auditivo de tronco cerebral obtenidas a través de estímulos clic y CE-Chirp®
Introduction: The auditory brainstem response (ABR) has become a standard procedure in the audiological evaluation. For decades the most widely used stimulus was the click, but recently the use of chirp stimulus has been proposed for obtain more efficient results. Aim: To compare the amplitudes and latencies of wave V of ABR obtained through click and CE-Chirp® stimuli at different intensities. Material and method: A quantitative, not experimental, transversal and descriptive study was conducted with 17 subjects who were evaluated with ABR using click and CE-Chirp® stimuli. Results: Wave V larger amplitudes were verified for stimulus CE-Chirp®, in all the evaluated intensities (80, 60, 40, 30 and 20 dBnHL). Shorter latencies of wave V were obtained for CE-Chirp® stimuli only at 80 and 60 dBnHL, while it was found that the remaining intensities showed lower latencies with click stimuli. Conclusions: There are significant differences between latencies and amplitudes of the wave V obtained with CE-Chirp® and click stimuli. While the CE-Chirp® stimuli provides faster results for most accurate electrophysiological threshold, click stimuli would be appropriate to conduct site of the lesion testing.
https://ift.tt/2VgBtYx
Experiencia clínica en tiroidectomía total del Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello Hospital Guillermo Grant Benavente
Introduction: Thyroidectomy is one of the most common surgeries performed in head and neck. There are few reports of experience in thyroidectomy in otolaryngology services in Chile. Aim: To analyze the clinical experience with total thyroidectomy performed in the service of ENT and Head and Neck Surgery of our hospital. Material and method: Retrospective descriptive study. Review of medical records of patients undergoing total thyroidectomy (TT) between 2010 and 2014 in our service records. Results: A total of 271 thyroidectomy were performed. The most frequent indication was size (51%). The most frequent diagnoses were papillary carcinomas (46%) and follicular colloid hyperplasia (37%). We found 2.5% of transient recurrent laryngeal nerve injury and 2.9% had persistent lesions. Transient hypocalcemia occurred in 25% of patients. Discussion: Our series shows good agreement with literature, it has a low rate of complications, which are mainly seen in patients with neck dissection and/or observed 2 or less parathyroid during surgery. Conclusions: Total thyroidectomy is a safe surgical technique, and our experience shows consistent results to those reported in international literature.
https://ift.tt/2EriJ34
Prácticas audiológicas en Chile: encuesta online para tecnólogos médicos mención otorrinolaringología
Introduction: Internationally several institutions suggest minimum standards for the conduct of audiological procedures. This aims to ensure the quality of auditory assessments. This is of importance in Chile due to the implementation of hearing programs under the Explicit Health Guarantees (EHG). Aim: To document common audiological practices of Medical Technologist in order to development standardized protocols for audiological assessment. Material and method: An online-based questionnaire with 38 questions was provided through social networks and by email to members of the Chilean Society of Audiology and Otoneurology. Results: One hundred and twenty one completed surveys were analysed. About 70% of respondents work in the central region of Chile. Procedures such as pure audiometry, tympanometry and speech audiometry were frequently performed by respondents. Respondents followed international guidelines. Conclusion: There is a high adherence to international recommendations when conducting the most common procedures performed in audiology clinics in Chile by the Medical Technologists who responded to the survey.
https://ift.tt/2Eq0cny
Tumor neuroectodérmico primitivo de cavidad nasal
Primitive neuroectodermal tumors are rare malignancies arising from embryonic neural crest cells. They share characteristics with extraosseous Ewing sarcoma. They usually occur in children and young adults and the most common location is the thoracopulmonary region, abdomen and extremities. These tumors have significant aggressiveness, which determines their poor prognosis. The location in nasal fossa-paranasal cavities is anecdotal. Until now only one previous case has been reported in the located in the nasal fossa.
https://ift.tt/2VfT5Us
Glomangiopericitoma: Reporte de un caso
Glomangiopericytoma is an extremely rare sinonasal tumor, more common among elderly and women. Although its etiology and pathogeny are unknown, there are certain predisposing factors, such as arterial hypertension, pregnancy, trauma and corticosteroids. To diagnose this tumor, it is necessary imaging, histopathologic and inmunohistochemical studies. At the microscopic study, it is characterized by a prominent perivascular growth of oval-shaped or fusiform cells, arranged in short fascicles separated by capillary vessels of variable diameters, with staghorn-like ramifications, and lmmunohistochemistry positive mainly for actin, XIII-A factor and vimentin. Clinically, this tumor has a generally benign behavior, but with high recurrence percentage. We present the case of a 71 years old woman, with history of hypertension, who present in our center with a 5 years history of purulent rhinorrhea and right unilateral epistaxis, at the physical exam there is a polypoid mass in the right nasal fossa with rich vascularization, with no other findings. This tumor was resected entirely with endoscopic surgery. Histology and immunohistochemistry were compatible witch gomangiopericytoma. The patient evolve with remission of her symptoms and with no signs of recurrence at two-month follow-up.
https://ift.tt/2EqGCrB
Plasmocitoma extramedular del tabique nasal: Reporte de un caso y revisión bibliográfica
Plasmacytomas are malignant tumors characterized by abnormal proliferation of monoclonal plasma cells. They may originate in bone and soft tissue , called solitary bone plasmacytoma and extramedullary plasmacytomas (EMP) respectively. The latter represents less than 1% of all malignant disease of the head and neck, however, the report of these cases it is useful to cope with the shallow casuistics thereon. We report a case of EMP of the nasal septum in a man of 74 years with progressive nasal breathing difficulties and frequent epistaxis on the left side. A nasal speculoscopy was observed in tumor lift lobby smooth, gray, sessile surface. The biopsy showed it was a plasmacytoma. Subsequent studies reject the presence of multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely dissected, radiation therapy is indicated and the patient had no adherence. Upon the same place a similar injury returns. Conclusion: Septum extramedullary plasmacytoma is a rare entity of a long natural history and represents a diagnostic and therapeutic challenge. Depending on the resectability of the lesion, combination therapy with surgery and radiation therapy is the treatment of choice.
https://ift.tt/2Vg0gvI
Presencia de la celdilla supra-órbito-etmoidal: Revisión de la literatura a partir de un caso
The supraorbital ethmoid cell its an anatomical variation with different frecuency for diverse populations. It represents a challenge for the endoscopical functional :surgery of the frontal sinus. The supraorbital ethmoid cell presents an estable anatomical relationship with the anterior ethmoidal artery, serving as a dependable anatomical marker for the surgical approach. We stand out the importance to consider the presence of bony septations in the frontal sinus that might suggest the presence of the supraorbital ethmoid cell. We introduce a clinical case from a patient who had an expansive process from a mucocele in the supraorbital ethmoid cell.
https://ift.tt/2Etm9Cw
Rinosporidiosis nasal: Reporte de un nuevo caso y revisión de la literatura
Rhinosporidiosis is a rare granulomatous disease produced by the microorganism Rhinosporidium seeberi. Despite being considered an endemic infection in some areas of Asia, in our country it is an extremely rare disease. We present the case of a 10 year-old boy who consult for increased volumen in the left nostril of 1 month evolution, with progressive growth, self-limited epistaxis, and a physical examination with a polypoid lesion, in which there were no prior suspicion, histopathology determined the presence of rhinosporidiosis. Epidemiology of the disease, its dissemination mechanisms, treatment options and major complications are discussed.
https://ift.tt/2Vl5CpP
Tumor fibroso solitario de la glándula tiroides con extensión intratorácica
Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm initially described as spindle cells in the pleura but recognized location elsewhere. The TFS thyroid gland (TFST) even infrequent. A case of a 65 years old woman with progressive growth of a right cervical mass without associated symptoms described other than cosmesis is described . The patient had a thyroid mass in the right lobe with intrathoracic extension. A right Hemi thyroidectomy and thoracotomy for the extent of the mass was performed. Pathology reported a 15 cm tumor with spindle cell and growth pattern hemangiopericitic without pleomorphism, atypia, mitosis or necrosis. Immunohistochemistry was positive for CD34, Bcl-2, CD99 and vimentin, making the diagnosis of solitary fibrous tumor of thyroid gland. The patient's right Vagus nerve was injured intraoperatively and she is currently under voice therapy. Currently now, almost six months after her surgery she is free of disease.
https://ift.tt/2Etm81q
Traqueostoma persistente: Cierre con colgajo invertido. Reporte de tres casos clínicos y revisión de la literatura
Persistent tracheostoma is the most common late complication associated with the use of tracheostomy. We report three cases in which patients underwent a successful closure of persistent tracheostoma using primary closure in layers with inverted flap technique. The advantages of this method are that it represents a simple alternative and is able to be performed under local anesthesia on an outpatient basis, with excellent aesthetic results, significantly improving the quality of life of these patients.
https://ift.tt/2VfPqWQ
Anatomía, fisiología y rol clínico de la corteza vestibular
The vestibular system, thanks to its peripheral organs, allows us to properly process the angular head movements and linear acceleration in order to give us a proper orientation in space. The information from these sensory inputs is routed to the vestibular nuclei and thence ascending tracts of the brainstem, which communicate with the oculomotor nuclei of the thalamus and structures. Then the information goes to subcortical and cortical centers, which are eminently multisensory nature. The nature and function of these structures are controversial. In this review the main concepts and discoveries at the level of basic and clinical research generated cortical processing of vestibular stimulation are addressed.
https://ift.tt/2Erx3s9
Carcinoma basocelular metastásico
Basal cell carcinoma is the most frequent neoplasm worldwide. It's a slow growing and locally aggressive tumor, but it has a metastatic potential estimated between 0,0028 and 0,5%. The purpose of this study is to show the experience of a center in the management of this metastatic disease. Descriptive retrospective study of patients with metastatic basal cell carcinoma treated at the Instituto nacional del cancer from July2004 to July 2015. A revision of the literature was also made. 3 cases with this unusual disease during an 11 years period. The first one died at 42 months of follow up. There are 2 patients on follow up, 1 of them has lung metastatic disease after 29 months of follow up, and the last one is free of disease with 92 months of follow up. Metastatic basal cell carcinoma is an unusual entity, thus everyone that is involved in it's treatment, must be aware of this in order to do an early diagnosis. Surgery associated to radiotherapy are the mainstays of treatment. This disease should be managed on national referral centers.
https://ift.tt/2VfPmq4
Enmascaramiento clínico: Una revisión de la literatura
Adequate use of masking is key in the correct diagnosis of hearing loss. Various methods are suggested regarding the application of clinical masking, hence the need to review literature in order to reach a consensus. To critically review the specialized literature and international societies' recommendations regarding clinical masking. From August to November 2015, PUBMED, SciELO and Google Scholar articles on clinical masking methods used in tonal audiometries were consulted, as well as international organization guidelines, and literature in the area of Audiology. Hood's plateau method, later revised, received the most references. The modified versions consider the number of increments needed to determine the true threshold, and the occlusion effect. Optimized methods show the variations regarding interaural attenuation, need for masking, initial masking level, increments to reach "The Plateau", and the occlusion effect. Literature shows differences regarding when and how to use masking; however, common criteria can be established with reference to the levels of interaural attenuation, when to use masking, occlusion effect values and methodology. The plateau method proposed by Hood is still the most recommended. Yacullo's optimization is currently the one with the most references and recommendations in specialized literature.
https://ift.tt/2ErHzQa
Sonolocation during submandibular sialolithotomy
Objectives/Hypothesis
Ultrasound is a proven tool for diagnostic and therapeutic purposes for treatment of salivary gland pathology. It is also useful for localization of calculi during submandibular gland transoral sialolithotomy when calculi cannot easily be palpated. Our objective was to determine the efficacy of sialolith localization using ultrasound during submandibular gland sialolithotomy.
Study Design
Retrospective case series.
Methods
A study performed utilizing data compiled from 2009 through 2016 in a tertiary academic center. Treatment was completed in 164 patients with sialadenitis and sialolithiasis by submandibular gland transoral sialolithotomy in either the office (81%) or the operating room (19%). Ultrasound was used for localization of sialoliths during submandibular gland sialolithotomy. Main treatment outcomes studied were success of the procedure, complications, and follow‐up.
Results
Successful sialolithotomy was performed in (147 patients) 90% of cases. Complications were minimal and included stricture formation, which occurred in 3% (five patients) of cases, followed by ranula formation in 1.8% (three patients) of cases. There were no incidences of lingual nerve injury.
Conclusions
Ultrasound can be used effectively for precise sialolith localization intraoperatively.
Level of Evidence
4
Laryngoscope, 2019
https://ift.tt/2T06Hqp
Prognostic indicators of survival in sinonasal extranodal natural killer/T‐cell lymphoma
Objectives
Extranodal natural killer/T‐cell lymphoma (ENKTL) is a highly aggressive tumor of the sinonasal tract associated with poor overall survival (OS). This study expands upon epidemiologic, prognostic, and treatment factors for OS and disease‐specific survival (DSS), incorporating newly accessible chemotherapy data.
Methods
Retrospective population‐based cohort study performed on cases of sinonasal ENKTL identified through the Surveillance, Epidemiology, and End Results database. Univariate Kaplan‐Meier analysis and subsequent multivariate Cox‐regression analysis were performed to evaluate prognostic and treatment variables for OS and DSS.
Results
Four hundred and sixty cases of sinonasal ENKTL were identified. Five‐year OS and DSS were 46% and 56%, respectively. On multivariate analysis, higher Ann Arbor stage was associated with worse OS (P < 0.001) and DSS (P < 0.001), whereas administration of radiotherapy was associated with improved OS (P < 0.001) and DSS (P = 0.001). Additionally, a higher age at diagnosis was associated with reduced OS (P = 0.024). Chemotherapy was associated with improved OS (P < .01) and DSS (P = .04) for Ann Arbor stage I disease. Surgery was not associated with improved survival.
Conclusion
This represents the first study to investigate the use of chemotherapy for the treatment of sinonasal ENKTL using population‐based analysis. Radiation therapy and chemotherapy significantly improve survival in all Ann Arbor stage patients and early‐stage patients, respectively. Early‐stage disease is significantly associated with improved survival. With no established treatment regimen for sinonasal ENKTL, these findings suggest combination chemoradiation is an effective therapy for prolonged survival, especially in early stages of disease.
Level of Evidence
3.
Laryngoscope, 2019
https://ift.tt/2E7IkwB
Rapid Onset of Effect of Benralizumab on Morning Peak Expiratory Flow in Severe, Uncontrolled Asthma
Benralizumab (Fasenra™) is an interleukin (IL)-5 receptor alpha–directed cytolytic monoclonal antibody that induces direct, rapid, and nearly complete depletion of eosinophils in the circulation.1 Benralizumab is approved for use in Canada, Europe, Japan, and the United States.2–5 In the United States, it is indicated for the add-on maintenance treatment of patients with severe asthma aged 12 years and older with an eosinophilic phenotype.2 In the SIROCCO (NCT01928771) and CALIMA (NCT01914757) Phase III clinical trials, benralizumab treatment significantly reduced asthma exacerbations, increased lung function, and improved asthma symptoms in patients with severe, uncontrolled asthma and baseline blood eosinophil counts ≥300 cells/μL.
https://ift.tt/2Ergbln
Polish validation of the University of Washington “quality of life” questionnaire in patients with cancer of the larynx
The University of Washington Quality of Life questionnaire version 4 (UW-QoLv4), in English, is used worldwide to assess the quality of life in patients with head and neck cancer. The use of such a questionnaire in other languages requires translation and validation in that language, and our aim was to translate it into Polish (which we did) and validate it in a group of patients diagnosed with head and neck cancer who had been considered free of disease for at least six months during routine follow-up visits to the Lower Silesian Oncology Center, Wrocław.
https://ift.tt/2GHdkXM
Reticular and erosive oral lichen planus have a distinct metabolomic profile: A preliminary study using gas chromatography‐mass spectrometry
Abstract
Background
Oral Lichen Planus is a chronic inflammatory disorder that affects the oral mucosa, with the reticular and erosive forms representing the primary clinical variants of the disease. Previous studies have shown that metabolic alterations may well be involved in the pathogenesis of the disease; however, the molecular mechanisms related to the clinicopathological differences between erosive and reticular forms remain unknown.
Methods
A comparative metabolomic analysis was performed on formalin‐fixed and paraffin‐embedded tissue samples of erosive (n=6) and reticular (n=10) oral lichen planus using gas chromatography‐mass spectrometry.
Results
The metabolomic analysis showed a distinct profile between the two clinical variants. Five metabolites (cyclohexanamine, glycine, mannitol/sorbitol, methyl palmitate, and trehalose) were significantly diminished in erosive oral lichen planus as compared to the reticular form.
Conclusions
Reticular and erosive forms of oral lichen planus have a distinct metabolic profile. However, further studies using a large number of fresh tissue samples are necessary to confirm this data.
This article is protected by copyright. All rights reserved.
https://ift.tt/2VeHO6L
Speech intelligibility in patients with oral cancer: An objective baseline evaluation of pretreatment function and impairment
Abstract
Background
This study seeks to identify those factors that influence the pre‐therapeutic speech intelligibility in patients with oral squamous cell carcinoma (OSCC).
Method
A group of 172 patients (125 males, 47 females, mean age = 61 ± 11 a) with different OSCC stages ranging from T1 to T4 and N0 to N2 was examined for their speech intelligibility using a computerized measuring tool, and compared to a healthy reference group (30 males, 10 females, mean age = 59 ± 12 a).
Results
It was found that the pre‐therapeutic speech intelligibility in patients with OSCC is decreased when compared to a healthy collective. Two demographic factors that influence speech intelligibility could be identified: sex and age. It was determined that the only disease‐related factor that influences speech intelligibility before therapy is the location of the tumor.
Conclusion
The results of this study reveal that a preoperative speech intelligibility impairment in patients suffering from OSCC occurs independent of tumor stage, size of the tumor and infiltration status.
https://ift.tt/2NmWYUO
Monitoring of respiratory resistance in the diagnosis of mild‐intermittent asthma
Abstract
The evidence of significant variability in lung function is required to confirm the clinical diagnosis of asthma [1]. This is commonly obtained in laboratory settings by bronchoreversibility or bronchoprovocation testing. Because the hallmark of asthma is the variability of symptoms, a more clinically relevant method to confirm the diagnosis should be by revealing an increase of spontaneous variability in lung function [1].
This article is protected by copyright. All rights reserved.
https://ift.tt/2GYhhH8
The complex role of mast cells in fungal infections
Abstract
In addition to their critical role in allergic disorders, mast cells (MCs) are well recognized for their protective effector functions during bacteria and parasite infections. This review describes recent advancements of our understanding of the complex role of MCs in fungal infections. Specifically, we outline key features of the contribution of MCs to infections with six fungal pathogens, namelySporothrix, Paracoccidioides, Aspergillus, Malassezia,Candida andDermatophytes. Evidence from studies of these pathogens suggests that MCs can function as positive regulators that detect and contain fungi at the site of infection. However, it appears that the inflammation induced by MCs following fungal infections may not always and only be beneficial to the host. MC responses during fungal infections may primarily benefit the pathogen by facilitating its spreading and contributing to a greater severity of fungal infections.This review also highlights key drivers of MCs activation and effector mechanisms that have been identified for the multidimensional function of MCs in fungal diseases and in allergic diseases combined with fungal infection.
This article is protected by copyright. All rights reserved.
https://ift.tt/2E5gq4i
Differential expression of inflammatory cytokines and chemokines in lipopolysaccharide‐stimulated melanocytes from lightly and darkly pigmented skin
Abstract
Increasing evidence suggests that human epidermal melanocytes play an important role in the skin immune system, however, a role of their pigmentation in immune and inflammatory responses is poorly examined. In the study expression of Toll‐like receptor 4 (TLR4) and inflammatory cytokines and chemokines by cultured normal melanocytes derived from lightly and darkly pigmented skin was investigated after cell stimulation with lipopolysaccharide (LPS). The basal TLR4 mRNA level in heavily pigmented cells was higher as compared to their lightly pigmented counterparts. Melanocyte exposure to LPS upregulated the expression of TLR4 mRNA and enhanced the DNA‐binding activity of NF‐κB p50 and p65. We found substantial differences in the LPS‐stimulated expression of numerous genes encoding inflammatory cytokines and chemokines between the cells with various melanin contents. In lightly pigmented melanocytes the most significantly upregulated genes were nicotinamide phosphoribosyltransferase (NAMPT/visfatin), the chemokines CCL2 and CCL20, and IL6, while the genes for CXCL12, IL‐16 and the chemokine receptor CCR4 were the most significantly upregulated in heavily pigmented cells. Moreover, the lightly pigmented melanocytes secreted much more NAMPT, CCL2 and IL‐6. The results of our study suggest modulatory effect of melanogenesis on the immune properties of normal epidermal melanocytes.
This article is protected by copyright. All rights reserved.
https://ift.tt/2SUae9s
A multiscale hybrid mathematical model of epidermal‐dermal interactions during skin wound healing
Abstract
Following injury, skin activates a complex wound healing program. While cellular and signaling mechanisms of wound repair have been extensively studied, the principles of epidermal‐dermal interactions and their effects on wound healing outcomes are only partially understood. To gain new insight into the effects of epidermal‐dermal interactions, we developed a multiscale, hybrid mathematical model of skin wound healing. The model takes into consideration interactions between epidermis and dermis across the basement membrane via diffusible signals, defined as activator and inhibitor. Simulations revealed that epidermal‐dermal interactions are critical for proper extracellular matrix deposition in the dermis, suggesting these signals may influence how wound scars form. Our model makes several theoretical predictions. First, basal levels of epidermal activator and inhibitor help to maintain dermis in a steady‐state, whereas their absence results in a raised, scar‐like dermal phenotype. Second, wound‐triggered increase in activator and inhibitor production by basal epidermal cells, coupled with fast re‐epithelialization kinetics reduce dermal scar size. Third, high density fibrin clot leads to a raised, hypertrophic scar phenotype, whereas low density fibrin clot leads to a hypotrophic phenotype. Fourth, shallow wounds, compared to deep wounds, result in overall reduced scarring. Taken together, our model predicts the important role of signaling across dermal‐epidermal interface and the effect of fibrin clot density and wound geometry on scar formation. This hybrid modeling approach may be also applicable to other complex tissue systems, enabling the simulation of dynamic processes, otherwise computationally prohibitive with fully discrete models due to a large number of variables.
This article is protected by copyright. All rights reserved.
https://ift.tt/2E4XWAU
Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019
Abstract
Worldwide 2 to 3 million cases of keratinocyte carcinoma (KC) are diagnosed annually. Sun‐related knowledge is essential for adequate protection against solar ultraviolet radiation (UVR), the main risk factor for KC. The goal was (i) to provide an updated overview of primary prevention against KC including skin cancer‐related knowledge, attitudes and sun protection behaviour (SPB) of outdoor workers, the general population and medical professionals as well as (ii) to evaluate the effectiveness and acceptability of sun‐protection programmes. We conducted a systematic review of articles indexed for MEDLINE on PubMed using selected MeSH terms and keywords related to the studied topic as well as an extensive hand search of publications between January 1st, 2012 and December 31st, 2018. We identified 51 relevant cross‐sectional studies and 22 interventional studies. Sun‐related knowledge and attitude showed substantial differences with some alarming results, including people who had not even heard about skin cancer before. Reported SPB varied enormously between the included studies, with none of the studies providing an overall sufficient SPB in their examined sun protection measures. However, sun‐protection programmes using new technologies seem to have great potential to increase sun‐related knowledge and SPB. In countries worldwide, particularly in those where KC is not yet a public health issue, UVR protection should be promoted by health care institutions and authorities, politicians, cancer foundations and dermatologists to increase awareness as well as SPB and to decrease the worldwide burden of KC.
This article is protected by copyright. All rights reserved.
https://ift.tt/2BNiEVK
Skin cancer prevention: a review of current topical options complementary to sunscreens
Abstract
The incidence of non‐melanoma skin cancer (NMSC) is dramatically increasing worldwide, despite the increased use of improved sunscreens. In 2014, the Surgeon General estimated that 2.2 to 5.0 million people were treated annually for NMSC. As the number of newly diagnosed skin cancers continues to rise, there is a need for additional preventative measures beyond sunscreens. Several newer topical products that focus on boosting DNA repair, modulating DNA transcription, decreasing inflammation, and selectively targeting precancerous cells may play an important role in future skin cancer prevention.
This article is protected by copyright. All rights reserved.
https://ift.tt/2U5cV4C
Zinc and atopic dermatitis: a systematic review and meta‐analysis
Abstract
Zinc plays a central role in skin integrity via barrier and immune mechanisms and may also be relevant in the pathogenesis of atopic dermatitis (AD). However, little is known about the relationship between zinc and AD. We performed a systematic review to determine 1) the association between zinc levels or zinc deficiency and AD and 2) the efficacy of oral zinc supplementation in the treatment of AD. We searched PubMed, Scopus, Web of Science and article references for observational studies on zinc levels or zinc deficiency in participants with AD versus controls and for RCTs on zinc supplementation in AD. For observational studies, we calculated pooled standardised mean differences (SMDs) or odds ratios (ORs) along with 95% confidence intervals (CIs) using a random effects model. We included 14 observational studies and 2 RCTs. The pooled SMD demonstrated significantly lower serum (SMD 0.66, 95% CI 0.21‐1.10, p=0.004), hair (SMD 0.95, 95% CI 0.38‐1.52, p=0.001) and erythrocyte (SMD 0.95, 95% CI 0.38‐1.52, p=0.001) zinc levels in participants with AD compared to controls. Pooled unadjusted data from 3 studies showed a non‐significant increased odds of AD in those with zinc deficiency compared with those without zinc deficiency (OR=1.50, 95% CI 0.71‐3.16, p=0.28). One RCT of oral zinc supplementation among AD patients with zinc deficiency showed improvement in extent and severity of AD, while another RCT among all AD patients showed no significant improvement. All the studies were of low or moderate quality. We conclude that low serum, hair, and erythrocyte zinc levels are associated with AD. However, the poor quality of included studies make interpretation of these results problematic. High quality observational studies are needed to confirm the association between low zinc levels and AD, and RCTs are required to evaluate the merit of zinc supplementation for the treatment or prevention of AD.
This article is protected by copyright. All rights reserved.
https://ift.tt/2BLKuBy
Virulent Staphylococcus lugdunensis with limited genetic diversity in hidradenitis suppurativa lesions
Abstract
Hidradenitis suppurativa (HS) is an inflammatory skin disease characterized by recurring painful, deep‐seated inflammatory nodules, abscesses, sinus tracts, and scarring in the intertriginous areas. Bacteria may be involved in the pathogenesis of HS via follicular dysbiosis in the initial stages, and via biofilm in chronic sinus tracts. Staphylococcus lugdunensis, a coagulase‐negative staphylococcus (CNS), has been cultured from hidradenitis suppurativa nodules and abscesses. This points towards a role of S. lugdunensis in the aggravation and secondary colonization of HS lesions.
This article is protected by copyright. All rights reserved.
https://ift.tt/2U3OxAh
Ingenol mebutate‐mediated reduction of p53‐positive keratinocytes in skin cancerization field directly correlates with clinical response in patients with multiple actinic keratoses
Abstract
Background
UV radiation represents the main risk factor for Non Melanoma Skin Cancers (NMSC). Chronic UV exposure induces "p53 patches", i.e. clonal outgrowths of keratinocytes with high nuclear expression of mutated p53, which might progress to actinic keratosis (AK) and ultimately squamous cell carcinomas (SCC).
Aims
Analysis of Ingenol mebutate gel (150 and 500 mcg/g) effects in the reduction of "p53 patches" inside skin cancerization field (CF) in patients with multiple AKs of face/scalp or trunk/extremities, in order to investigate if the expected reduction of p53+ keratinocytes might have a direct role in the long‐term AK reduction in treated areas.
Results
We enrolled n=10 patients, treated with Ingenol mebutate and evaluated at 2 and 6 months after treatment. We observed clinical responses in the majority of patients (n=7), with AK reduction or complete clearance (n=6 and n=1, respectively). Notably, two patients did not respond to the treatment and in one patient, after initial partial response, new lesion were recorded. In untreated skin CF samples (n=3), we observed numerous p53+ keratinocytes, similar to those observed in invasive SCC samples (53.56±8.79 and 74.34±22.05, respectively; p=0.2). After treatment, we observed a variable p53+ keratinocytes reduction in CF samples at 2 months (24.67±31.19; p=0.19). Importantly, the amount of p53+ keratinocytes strongly and directly correlated with AK number (R2 =0.81).
Conclusion
Untreated skin CF expresses high level of p53+ keratinocytes as invasive SCC. Ingenol mebutate is able to reduce p53+ keratinocytes with variable efficacy, this reduction degree directly correlating with clinical efficacy.
This article is protected by copyright. All rights reserved.
https://ift.tt/2BR3v5y
Epidemiology and prognostic factors for mycosis fungoides and Sézary syndrome in a multi‐ethnic Asian cohort: A 12‐year review
Summary
Background
Limited information exists regarding survival of Asian patients with mycosis fungoides (MF) and Sézary syndrome (SS).
Objective
To evaluate the epidemiology, outcome and prognostic factors of these patients.
Methods
A retrospective review of MF/SS cases diagnosed from 2000 to 2011 at a tertiary referral dermatology centre in Singapore was performed.
Results
Of 246 patients, 63% were male and the median age at diagnosis was 49 years. 73.2% were Chinese, 12.6% Indian, 6.9% Malay and 7.3% Caucasian. 239 patients (97.2%) had MF and 7 had SS. Median follow‐up duration was 6.3 years and median duration of symptoms at diagnosis was 13 months. For patients with MF, the majority had early disease (92.8% stage IA‐IIA). 3.8% were stage IIB, 1.7% stage III and 1.7% stage IV. Complete response to treatment occurred in 78.2%, partial response in 9.6%, persistent but non‐progressive disease in 10.0% and disease progression in 4.1% of patients. Large cell transformation occurred in 4.1% of patients. Mean overall survival during this study was 12.7 years, with death occurring in 2.5% of patients (all ≥ stage IIB at diagnosis). For patients with SS, 71.4% presented with stage IVA disease, 28.6% stage IVB. Complete response to treatment occurred in 14.2%, persistent but non‐progressive disease in 28.6% and disease progression in 57.2% of patients. Mean overall survival was 3.3 years within this study, with death occurring in 42.9% of SS patients. Prognostic factors associated with favourable recurrence‐free survival were male gender (p = 0.008), early disease stage (T1) at diagnosis (p < 0.001) and absence of maintenance treatment after remission (p = 0.01).
Conclusion
Compared to Caucasian and East Asian cohorts, MF in Southeast Asians was diagnosed at a younger age and associated with lower mortality, largely due to greater prevalence of hypopigmented MF.
This article is protected by copyright. All rights reserved.
https://ift.tt/2U3Ccfp
Management of laryngeal papillomatosis using coblation: another option of surgical intervention
Abstract
Purpose
Recurrent respiratory papillomatosis is a disease caused by the human papilloma virus (HPV). HPV is frequently localised in the larynx. The disease tends to recur and frequent intervention is usually required. Management modules include surgical intervention using microdebriders or laser ablation as well as adjuvant treatments which aim mainly at maintaining an adequate airway and secondly to manage dysphonia caused by the growth on the vocal folds. In this pilot study, another surgical modality is trialled using plasma-mediated radio-frequency ablation (coblation).
Methods
Retrospective study examining management of 15 adult patients diagnosed with recurrent laryngeal papillomatosis and surgically treated using coblation. One patient required multiple procedures. Pre-operative assessment in voice clinic evaluating voice quality and its impact on patients' life-quality using voice parameters and self-assessment questionnaires. Follow-up post-operatively using the same parameters from 4 to 6 weeks after surgery until up to 2 years later to check recurrence rate. No other adjuvant treatment was used and all patients received post-operative voice therapy.
Results
78.6% of patients did not show evidence of recurrence during the study period. Improvement in voice handicap following first intervention is reported and recurrence rate in the rest of the sample reported.
Conclusions
The results of this small sample seem to support the previous small studies' findings that coblation is a good excisional technique to use for removal of laryngeal papillomatosis. Recurrence rates seem to be slightly lower than rates reported in the literature for the other surgical modalities.
Level of evidence
IV.
https://ift.tt/2GLJ2n5
A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty
Publication date: Available online 22 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): S. Shen, T. Jiang, S.G. Shen, X. Wang
Abstract
Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application.
https://ift.tt/2Vky9fb
Cockroach, Dust Mite, and Shrimp Sensitization Correlations in The National Health and Nutrition Examination Survey
Publication date: Available online 23 February 2019
Source: Annals of Allergy, Asthma & Immunology
Author(s): Emily C. McGowan, Roger Peng, Päivi M. Salo, Darryl C. Zeldin, Corinne A. Keet
https://ift.tt/2NpqOrY
Retrospective Review of Insurance Coverage for Patch Testing
Publication date: Available online 23 February 2019
Source: Annals of Allergy, Asthma & Immunology
Author(s): Azam A. Qureshi, Olabola Awosika, Kamaria Nelson, Spencer Brodsky, Haijun Wang, Alison Ehrlich
https://ift.tt/2GFRjJ2
Utilization of high-fidelity simulation for medical student and resident education of allergic-immunologic emergencies
Publication date: Available online 23 February 2019
Source: Annals of Allergy, Asthma & Immunology
Author(s): Stephanie L. Mawhirt, Luz Fonacier, Marcella Aquino
https://ift.tt/2NmvbDW
Perspective Pro Debate: To introduce solids early or not to introduce, this is the question.
Publication date: Available online 22 February 2019
Source: Annals of Allergy, Asthma & Immunology
Author(s): Helen R. Fisher, Gideon Lack, George Du Toit
https://ift.tt/2GGEnT4
Anatomical and frequencies-specific hearing results of retrograde mastoidectomy
Publication date: Available online 22 February 2019
Source: American Journal of Otolaryngology
Author(s): Emine Demir, Gorkem Atsal, Oben Yildirim, Filiz Gulustan, Abdullah Dalgic, Tolgahan Catli, Levent Olgun
https://ift.tt/2EqSqdj
Anesthesia and ventilation options for flex robotic assisted laryngopharyngeal surgery
Publication date: Available online 22 February 2019
Source: American Journal of Otolaryngology
Author(s): Yosef Krespi, Victor Kizhner, Robert Koorn, Anthony Giordano
Abstract
Background
Transoral treatment of benign and malignant lesions of laryngopharynx has limitations in exposure and access, partially due to the endotracheal tube (ETT). With a proper airway control to tailor ventilation and maximize exposure, transoral Flex robotic surgery (FLEX), using its 3D camera and instruments, can expand its ability. Choosing the right ETT, including a novel concept of using jet ventilation (JV) in FLEX, and placement technique can allow augmentation of the advantages that robotic surgery offers.
Methods
Chart review of FLEX assisted procedures was performed. Attention was given to demographics, all events of airway manipulation and ventilation type, procedures performed and outcomes including adverse effects.
Results
Fifty-two patients underwent eighty procedures. The airway was manipulated sixty-four times to include 8 JV. All possible FLEX instruments including CO2 laser were used. Three novel possible indications for trans-oral robotic surgery including the feasibility of JV in FLEX procedures were shown.
Conclusions
Lesions of the tongue base, hypopharynx, larynx and trachea have the possibility to be managed with adequate exposure with minimal obstruction from ETT. Robotic HD camera permits both the surgeon and anesthesiologist to observe surgery and safely monitor the airway. An algorithm was developed for selecting ideal ventilation method for different procedures. The FLEX and the utilization of JV allows flexibility of two instruments without obstruction.
https://ift.tt/2VeRIVT
Communication between the transverse cervical nerve (C2,3) and marginal mandibular branch of the facial nerve: a cadaveric and clinical study
Publication date: Available online 23 February 2019
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): P.A. Brennan, J. Mak, K. Massetti, D.A. Parry
Abstract
Several branches of the facial nerve are known to anastomose with branches of the cervical plexus, other cranial nerves, and the trigeminal nerve. Communication between the sensory transverse cervical nerve (C2, 3) and marginal mandibular nerve is, however, less well known, and in a previous study of 86 neck dissections we reported a 2.3% incidence of anastomoses between them. In this prospective study, we meticulously searched for more examples using both formalin-fixed cadavers and neck dissections. A total of 102 necks were included (both sides of 36 cadavers (n = 72 necks), and 30 patients who had neck dissection for the management of squamous cell carcinoma). We found communications between these nerves on one side of a cadaver and in one neck dissection. When combined with the numbers from our previous study, the overall incidence was 2.1% in 188 necks. The marginal mandibular nerve was inseparable from the anastomosis with the transverse cervical nerve, and the variant should not be forgotten if we are to reduce the chance of postoperative weakness of the lower lip, particularly when operative exposure is more limited (such as during removal of the submandibular gland).
https://ift.tt/2NmDkZ3
Supernumerary teeth in the bilateral buccal space: a rare case
Publication date: Available online 22 February 2019
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): Albert Ming Hsien Lee
Abstract
Supernumerary teeth are usually found in the alveolus, but may occasionally be sited in unusual places. We report a rare case of a patient who presented with two supernumerary teeth in the bilateral buccal space.
https://ift.tt/2GGC1Uw
Identification of NSDHL Mutations Associated with CHILD Syndrome in Oral Verruciform Xanthoma
Publication date: Available online 23 February 2019
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): George Getz, Kshitij Parag-Sharma, Jonathan Reside, Ricardo J. Padilla, Antonio L. Amelio
ABSTRACT
Objective
To perform a systematic analysis of the NAD(P)-dependent steroid dehydrogenase-like (NSDHL) gene in cases of oral verruciform xanthoma (VX) and test for the presence of mutations associated with Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects (CHILD) Syndrome patients.
Study Design
DNA was extracted from archived paraffin-embedded tissue of oral VX and control cases. Polymerase chain reaction (PCR) was then used to screen exons 4 and 6 of the NSDHL gene for the presence of four known germline mutations associated with CHILD Syndrome and one somatic mutation previously identified in VX lesions with no known CHILD Syndrome association.
Results
50% (8 out of 16) oral VX tissue samples had known missense mutations associated with CHILD syndrome. Furthermore, two of these aforementioned eight tissue samples also had an additional missense mutation previously identified in cutaneous VX lesions. No mutations of exons 4 and 6 were found in the five negative control tissue samples.
Conclusion
NSDHL gene mutations associated with CHILD Syndrome are common in sporadic oral VX cases suggesting that these mutations confer a greater risk for developing epithelial barrier defects that promote recurrent oral VX lesions and the potential for direct germline transmission of oral VX susceptibility.
https://ift.tt/2TafMvU
Acinetobacter baumannii orofacial cellulitis: report of two cases
Publication date: Available online 22 February 2019
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Thaís dos Santos Fontes Pereira, Denise Vieira Travassos, Raissa Cristina Costa Silva, Laiz Fernandes Mendes Nunes, Maria Edileusa Santos, Célia Regina Lanza, Gabriela Assunção Goebel, Fabiana Maria Kakehasi, Tarcília Aparecida Silva
Abstract
Acinetobacter baumannii infection of skin and soft tissues is uncommon and usually associated with trauma. The present report describes two cases of cellulitis in the orofacial region, caused by an A. baumannii infection in paediatric patients, and with fatal outcome. A twelve-year-old male patient, diagnosed with acute promyelocytic leukemia, presented an ulcerated lesion on the lip suggestive of local trauma. The condition evolved with cellulitis, epithelial necrosis and non-specific vesicles and blisters. The second case occurred in a 10-year-old male patient with a diagnosis of Burkitt's lymphoma. The patient evolved with mucositis WHO Grade IV and cellulitis. In both cases, hemoculture was positive for multidrug-resistant A. baumannii. In conclusion, A. baummanii should be considered a potential multidrug-resistant pathogen in the presence of skin and soft tissue cellulitis. Ulcerated oral lesions may place hospitalised paediatric patients at risk of A. baummanii infection.
https://ift.tt/2IwVhFC
Upregulation of eIF3a promotes cell survival in ameloblastoma
Publication date: Available online 22 February 2019
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Zhenjiang Ding, Jie Liu, Junting Wang, Biying Huang, Ming Zhong
Abstract
Objectives
This study aimed to detect the expression of eIF3a in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate the roles of eIF3a in AM-1 cell proliferation and apoptosis.
Study Design
We performed immunohistochemistry to determine the expression of eIF3a in AB tissues (n = 83) and NOM tissues (n = 20). RT-qPCR and western blotting analyses were conducted with AB tissues (n = 30) and NOM tissues (n = 6). The correlation between eIF3a expression and the clinical/pathological features of AB patients is also presented. The functional role of eIF3a in AM-1 cells was assessed with lentiviral vector-mediated shRNA.
Results
Our results indicated that eIF3a was significantly upregulated in AB. Additionally, eIF3a knockdown in AM-1 cells significantly inhibited cell proliferation and promoted apoptosis.
Conclusion
These data indicate that eIF3a facilitates the survival of AB cells and may serve as a promising therapeutic target for AB.
https://ift.tt/2TbNxNm
Diagnostic delay and sub-optimal management in persistent idiopathic facial pain and persistent dento-alveolar pain; a cross sectional study
Publication date: Available online 22 February 2019
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yazan Hassona, Ahmad El-Ma'aita, Jacqueline Amarin, Anas Al Taee
Abstract
Objectives
To explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP), and to investigate factors influencing its delayed diagnosis.
Study Design
In this cross-sectional study, 34 newly diagnosed PIFP patients were interviewed. Data about diagnostic delay, number and nature of previous consultations, and previous medical and surgical interventions were recorded. Pearson correlation and Student's t-test were used to examine differences among various variables in relation to diagnostic delay.
Results
The average time between the onset of symptoms to the correct diagnosis was 19.3 ±11.1 months. Diagnostic delay was significantly longer in patient with pain localized to intraoral sites (22.6 ± 7.4) compared to patients with extra-oral pain (16.1 ±9.3). The average number of health care professionals consulted before correct diagnosis was 3.7 ±2.3. General dental practitioners were the most commonly consulted professionals (n=27; 79.4%). On average, patients were offered 2.3± 0.24 misdiagnoses prior to correct diagnosis, and were prescribed 3.5 ± 2.4 classes of drugs. Twenty-five patients (73.5%) underwent unnecessary surgical/dental interventions.
Conclusion
Patients with PIFP are frequently misdiagnosed leading to prescription of ineffective medications and unnecessary investigations and surgical interventions. Educational efforts should emphasize on improving knowledge and awareness of this condition.
https://ift.tt/2IwV4lO
Normalization of breathing with adenotonsillectomy in Japanese pediatric OSA
Publication date: Available online 22 February 2019
Source: Auris Nasus Larynx
Author(s): Sachie Arima, Shigefumi Koike, Maki Fujinaga, Takenao Mihara, Shintaro Sato, Motohiko Suzuki, Shingo Murakami, Meiho Nakayama
Abstract
Objective
Since reports on surgical results for pediatric obstructive sleep apnea (OSA) in Japan are insufficient for debate, this study aimed to evaluate the feature of Japanese OSA children and surgical result and document whether is obesity and affecting factor similar to non-Asian countries.
Methods
This is a retrospective study. A total of 242 children with OSA at the Department of Otolaryngology and the Good Sleep Center, Nagoya City University Hospital and the Toyohashi Mates Sleep Disorders Center were included in the study. All children underwent pre- and postsurgical polysomnography. OSA was defined as an apnea hypopnea index (AHI) 5 or greater. Pre- and postsurgical respiratory parameters were compared using paired T test.
Results
Normalization of breathing after surgery for OSA children was 40% with AHI < 2 and 85% with AHI < 5. Japanese OSA children are not as obese as OSA children in many non-Asian countries. However, the normalization of breathing as a result of surgery in Japanese OSA children does not differ much from non-Asian countries.
Conclusion
Japanese pediatric OSA that is not normalized by surgery may be affected by factors other than obesity.
https://ift.tt/2Ve8xjR
Sublingual administration of liposomes enclosing alpha-galactosylceramide as an effective adjuvant of allergen immunotherapy in a murine model of allergic rhinitis
Publication date: Available online 22 February 2019
Source: Allergology International
Author(s): Satoshi Suzuki, Daiju Sakurai, Toshioki Sakurai, Syuji Yonekura, Tomohisa Iinuma, Yusuke Okuma, Fumie Ihara, Tomoyuki Arai, Toyoyuki Hanazawa, Emi Fukuda-Kawaguchi, Yasuyuki Ishii, Yoshitaka Okamoto
Abstract
Background
Sublingual immunotherapy (SLIT) is an established efficacious approach for the treatment of allergic rhinitis (AR). However, SLIT requires a long administration period to establish stable and adequate responses. This study investigated the efficacy of the sublingual administration of an allergen with liposomes enclosing α-GalCer (α-GC-liposome) as a potential adjuvant in mice with AR.
Methods
Mice with AR induced by OVA received the sublingual administration of OVA, α-GC-liposomes, or OVA plus α-GC-liposomes for 7 days. After nasal re-challenge with OVA, nasal symptoms were evaluated. The serum levels of OVA-specific Ig, the cytokine production of CD4+ T cells in the cultures of cervical lymph node (CLN) cells, and the gene expression of CLNs were analyzed.
Results
Although IL-4, IL-5 and IL-13 production from CD4+ T cells in CLN cells was significantly inhibited by the sublingual administration of OVA alone in mice with AR induced by OVA, their nasal symptoms were not significantly diminished. However, the combined sublingual administration of α-GC-liposomes and OVA completely suppressed nasal symptoms, downregulated Th2 and Th17 type cytokine production in CD4+ T cells as well as Th2 and Th17 gene expressions, and upregulated Th1 type cytokine production as well as Th1 gene expressions in CLN cells. Additionally, the serum levels of specific IgG2a were promoted, and specific IgE and IgG1 were inhibited.
Conclusions
Our findings suggest that the sublingual administration of an allergen with α-GC-liposomes as an adjuvant might increase the therapeutic efficacy and effectiveness of this treatment method.
https://ift.tt/2U0dlZP
Differentiation between control subjects and patients with chronic spontaneous urticaria based on the ability of anti-IgE autoantibodies (AAbs) to induce FcεRI crosslinking, as compared to anti-FcεRIα AAbs
Publication date: Available online 22 February 2019
Source: Allergology International
Author(s): Satoshi Izaki, Shota Toyoshima, Takahiro Endo, Kazuko Kanegae, Satoshi Nunomura, Jun-ichi Kashiwakura, Tomomi Sasaki-Sakamoto, Ryosuke Nakamura, Haruyo Akiyama, Chisei Ra, Koremasa Hayama, Tadashi Terui, Yoshimichi Okayama
Abstract
Background
The reported prevalences of IgG autoantibodies (AAbs) to FcεRIα and IgE in sera from patients with chronic spontaneous urticaria (CSU) have varied, and these AAbs are also often observed in healthy control subjects. Regarding the histamine release activity of purified IgG from patients with CSU, the number of examined patients has been small. Thus, we sought to determine the prevalence and FcεRI crosslinking ability of these AAbs in a large number of patients with CSU and non-atopic control (NC) subjects.
Methods
We compared the concentrations of anti-IgE and anti-FcεRIα AAbs and the abilities of these AAbs to cause FcεRI aggregation in patients with CSU (n = 134) and NC subjects (n = 55) using ELISA and an in vitro elicitation test, respectively.
Results
The concentration of anti-IgE AAbs was significantly different between the NC subjects and the CSU patients (P < 0.0001, cutoff value: 0.558 μg/mL), whereas the concentration of anti-FcεRIα AAbs was not. A significant difference in the duration of illness was noted between patients with lower and those with higher concentrations of anti-IgE AAbs relative to the cutoff value. The abilities of anti-IgE AAbs, but not anti-FcεRIα AAbs, to induce FcεRI crosslinking were significantly higher in CSU patients than in NC subjects (P = 0.0106).
Conclusions
In the Japanese population of CSU patients studied, the ability of the anti-IgE AAbs to induce FcεRI crosslinking differed significantly between NC subjects and CSU patients, suggesting the involvement of anti-IgE AAbs in the pathogenesis of CSU in the Japanese population.
https://ift.tt/2BKzvYX
Tonsillar Hyperplasia and Recurrent Acute Tonsillitis in children: immunohistochemical evaluation of the lymphatic tissue
Publication date: Available online 23 February 2019
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): João Henrique do Amaral e Silva, Élia Cláudia de Souza Almeida, Júlio Cláudio Sousa, Luciana Guedes Vilela Reis, Jacqueline Batista Sousa, Renata Margarida Etchebehere
https://ift.tt/2GUYgoZ
Bcl‐2 is a prognostic marker and its silencing inhibits recurrence in ameloblastomas
Abstract
Objectives
Ameloblastomas are the most common odontogenic epithelial tumors with high recurrence rate. The aim of this study is to identify apoptosis‐related genes with recurrence of ameloblastomas and to evaluate its feasibility as a prognostic marker and as a target molecule preventing from recurrence.
Materials and Methods
Public microarray data were analyzed. To evaluate their expression in ameloblastoma patients, immunohistochemical staining was performed in 89 human ameloblastoma tissues. Quantitative‐PCR was performed by use of ameloblastoma cell line, AM‐1. FACS analysis and western blotting were conducted following transfection with siRNA. Further, AM‐1 cells were implanted in the renal subcapsular layer of immunodeficient mice.
Results
Microarray data analysis revealed that Osteoprotegerin (OPG) and B‐cell lymphoma 2 (Bcl‐2) were the two most upregulated genes in ameloblastoma. Only Bcl‐2 expression was significantly (P = 0.020) associated with recurrence in conservative treatment group (n = 17) among 89 patients. Silencing of Bcl‐2 increased apoptosis in AM‐1 cells in vitro and inhibited tumor nodule formation of AM‐1 cells in vivo.
Conclusion
These results suggest that Bcl‐2 expression is a useful biomarker to predict recurrence of ameloblastomas, and as a therapeutic target molecule to prevent recurrence of ameloblastoma.
This article is protected by copyright. All rights reserved.
https://ift.tt/2GZOkKO
Subset of cd8+ and foxp3 + t cells in lichen planus associated with chronic hepatitis c infection
Abstract
Objective
To verify whether there are differences between populations of CD8+ and FoxP3+ T cells in lesions of oral lichen planus associated with hepatitis C virus chronic infection (OLP‐HCV) and lesions of idiopathic oral lichen planus (OLP‐I).
Materials & Methods
A case‐control study was performed using a convenience sample of 11 paraffin‐embedded tissue blocks of OLP‐HCV and 19 of OLP‐I. Histological sections stained with haematoxylin and eosin were used to classify the intensity of inflammatory infiltrate. Immunohistochemistry was used to identify CD8+ and FoxP3+ T cells. The count of positive cells was compared between the two groups and correlated to clinical and demographic data (P < 0.05).
Results
There were no statistically significant differences in the distribution of CD8+ and FoxP3+ T cells regarding the inflammatory infiltrate in lesions of OLP‐HCV and OLP‐I. Atrophic/erosive lesions showed a higher relationship between counts of CD8/FoxP3 T cells per mm2 (P = 0.018) and counts of CD8+ T cells per mm2 (p = 0.034) in OLP‐HCV group compared to OLP‐I group.
Conclusion
Overall, no difference was found between cell populations in the lesions of OLP‐HCV and OLP‐I. However, atrophic/erosive lesions of OLP‐HCV had a higher amount of CD8+ T cells and lower FoxP3 expression.
This article is protected by copyright. All rights reserved.
https://ift.tt/2tDQmbr
Pituitary macroadenoma presenting as severe hyponatremia: a case report
Hyponatremia is defined as a serum sodium level of less than 135 mEq/L in a patient. Although hyponatremia is not an uncommon laboratory finding, especially in the elderly, hunting for the etiology is a challe...
https://ift.tt/2T8Q1MC
Cortical auditory evoked potential in babies and children listeners
Publication date: Available online 22 February 2019
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Ana Carla Leite Romero, Ana Claudia Figueiredo Frizzo, Eduardo Federighi Baisi Chagas, Myriam de Lima Isaac
Abstract
Introduction
Cortical auditory evoked potentials have been increasingly used in research and audiological routines. However, there is a lack of studies with a large number of children who are stratified by age group. These would help clarify the variations in latency and amplitude of cortical auditory evoked potentials, and thus help establish reference values in children of different ages.
Objective
To identify the variation in latency and amplitude of the cortical auditory evoked potentials and to establish reference values for the pediatric population.
Methods
This was a cross-sectional study. Subjects were born at term and presented with no auditory complaints. A total of 105 children, of up to 6 years and eleven months old, who were divided into 7 age groups, named 1, 2, 3, 4, 5, 6 and 7, participated in the study. The tests were carried out using Biologic Navigator Pro. Initially, brainstem auditory evoked potential testing was performed in order to investigate the electrophysiological threshold of the subjects. Then, cortical auditory evoked potentials were elicited through oddball paradigm with tone burst differing in frequency, 750 Hz (frequent) and 1000 Hz (rare), and stimuli differing in speech: /ba/ (frequent) and /da/ (rare). In this study, descriptive and comparative analyzes of tonal and speech stimuli were performed for the age groups.
Results
Significant differences were observed when comparing cortical auditory evoked potentials with speech stimulus in the right ear for P2 amplitude, for P1 latency the left ear, for P2 amplitude of the left ear; and for P1 amplitude of the left ear when performed with tonal stimuli.
Conclusion
The obtained results can be considered as reference values of latency and amplitude of cortical auditory potentials in infants and children, and be used for monitoring their cortical auditory development.
Resumo
Introdução
Os potenciais evocados auditivos corticais têm sido cada vez mais utilizados em pesquisas e rotinas audiológicas. É importante que mais pesquisas sejam realizadas com maior número de crianças por faixa etária, a fim de contribuir para o conhecimento e descrever a variação das medidas de latência e amplitude, permitindo estabelecer valores de referência desse potencial para crianças de diferentes grupos etários.
Objetivo
Identificar a variação das medidas de latência e amplitude e estabelecer os valores de referência desse potencial para a população pediátrica.
Método
Este foi um estudo do tipo transversal. Os indivíduos nasceram a termo, com ausência de queixas auditivas. Participaram do estudo 105 crianças de até 6 anos e 11 meses de idade, divididas em 7 grupos de idade, denominados 1, 2, 3, 4, 5, 6 e 7. Os testes foram realizados utilizando-se o Biologic Navigator Pro. Inicialmente, foi realizado o potencial evocado auditivo de tronco encefálico para investigar o limiar eletrofisiológico dos indivíduos. Em seguida, o potencial evocado auditivo cortical foi realizado através do paradigma de oddball com tone burst diferindo em frequência, 750 Hz (frequente) e 1000 Hz (raro) e estímulo diferindo na fala: / ba/ (frequente) e /da/ (raro). Neste estudo, foram realizadas análises descritivas e comparativas dos estímulos tonais e de fala para os grupos etários.
Resultados
Diferenças significantes foram observadas na comparação do potencial evocado auditivo cortical com estímulo de fala da orelha direita para amplitude de P2, para latência de P1 da orelha esquerda, para amplitude de P2 da orelha esquerda; e para amplitude de P1 da orelha esquerda quando realizada com estímulo tonal.
Conclusõo
Os resultados obtidos podem ser utilizados como medidas de referência de latência e amplitude dos potenciais auditivos corticais em lactentes e crianças, bem como para monitorar o desenvolvimento auditivo cortical.
https://ift.tt/2Tf4gPO
Changes in substance P levels of inferior turbinate in patients with mucosal contact headache
Publication date: Available online 22 February 2019
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Hülya Eyigör, Mete Eyigor, Bekir Erol, Ömer Tarık Selcuk, Levent Renda, Mustafa Deniz Yılmaz, Üstün Osma, Cansu Demirkiran, Meral Gültekin, Nuray Erin
Abstract
Introduction
Mucosal contact headache is a referred pain that arises from contact between the nasal septum and the lateral nasal wall. Evidence supports the role of substance P in a contact headache such that release of substance P from sensory nerve endings causes inflammation and allergy.
Objective
This study aimed to determine possible differences in substance P levels in inferior turbinate hypertrophy creating a contact headache.
Methods
28 patients who had contact headaches (Study Group) and 16 volunteers with no complaints were included in the study. Substance P levels in the inferior turbinate tissue samples were quantified using a commercially available substance P EIA kit.
Results
In the study group average substance P levels were 2.65 ± 0.27 pg/mg tissue (range: 0.61–5.44) and in the control group it was 1.77 ± 0.27 pg/mg tissue (range: 0.11–4.35). The difference was statistically significant between the two groups (p = 0.0215). Average preoperative headache group visual analog scale scores was 5.93 ± 0.38 (2–9) and the turbinate volume was 6.56 ± 0.35 cm3 (3.50–10.30). The control group turbinate volume was 4.71 ± 0.39 cm3 (2.50–7.70). We found a correlation between the visual analog scale scores and substance P levels such that substance P levels were higher in visual analog scale scores above 5 (p = 0.001).
Conclusion
This study demonstrates the relationship between intranasal contact headaches and increased mucosal substance P levels. We also found that there is no correlation with substance P levels and volume of the inferior turbinate.
Resumo
Introdução
A cefaleia por ponto de contato da mucosa é uma dor direcionada que surge do contato entre o septo nasal e a parede nasal lateral. Evidências corroboram o papel da substância P na cefaleia de contato, de tal forma que a liberação da mesma a partir de terminações nervosas sensoriais possa causar inflamação e alergia.
Objetivo
O objetivo deste estudo foi determinar possíveis diferenças nos níveis da substância P na hipertrofia de conchas inferiores em relação à cefaleia de contato.
Método
28 pacientes que apresentaram cefaleia por ponto de contato (Grupo Estudo) e 16 voluntários sem queixas foram incluídos no estudo. Os níveis de substância P nas amostras de tecido da concha inferior foram quantificados utilizando-se um kit substância P EIA, comercialmente disponível.
Resultados
No grupo do estudo, os níveis médios de substância P foram 2,65 ± 0,27 pg/mg de tecido (variação: 0,61–5,44) e no grupo controle foram de 1,77 ± 0,27 pg/mg de tecido (variação: 0,11-4,35), e a diferença foi estatisticamente significante entre os dois grupos (p = 0,0215). O escore médio da escala visual analógica do grupo de cefaleia pré-operatória foi de 5,93 ± 0,38 (2–9) e o volume das conchas foi de 6,56 ± 0,35 cm3 (3,50–10,30). O volume da concha do grupo controle foi de 4,71 ± 0,39 cm3 (2,50 ± 7,70). Encontramos uma correlação entre o escore da escala visual analógica e os níveis de substância P, de modo que os níveis de substância P foram maiores nos escores da escala visual analógica acima de 5 (p = 0,001).
Conclusão
Este estudo demonstra a relação entre cefaleias por contato intranasais e níveis aumentados de substância P nas mucosas. Também observamos que não há correlação com os níveis de substância P e o volume da concha inferior.
https://ift.tt/2IxmCYi
Comparison of the Financial Burden of Survivors of Head and Neck Cancer With Other Cancer Survivors.
| Related Articles |
Comparison of the Financial Burden of Survivors of Head and Neck Cancer With Other Cancer Survivors.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 21;:
Authors: Massa ST, Osazuwa-Peters N, Adjei Boakye E, Walker RJ, Ward GM
Abstract
Importance: Head and neck cancer (HNC) is more common among socioeconomically disenfranchised individuals, making financial burden particularly relevant.
Objective: To assess the financial burdens of HNC compared with other cancers.
Design, Setting, and Participants: In this retrospective review of nationally representative, publicly available survey, data from the Medical Expenditure Panel Survey were extracted from January 1, 1998, to December 31, 2015. A total of 444 867 adults were surveyed, which extrapolates to a population of 221 503 108 based on the weighted survey design. Data analysis was performed from April 18, 2018, to August 20, 2018.
Exposures: Of 16 771 patients with cancer surveyed (weighted count of 10 083 586 patients), 489 reported HNC (weighted count of 261 631).
Main Outcomes and Measures: Patients with HNC were compared with patients with other cancers on demographics, income, employment, and health. Within the HNC group, risk factors for total medical expenses and relative out-of-pocket expenses were assessed with regression modeling. Complex sampling methods were accounted for with weighting using balanced repeated replication.
Results: A total of 16 771 patients (mean [SD] age, 62.3 [18.9] years; 9006 [53.7%] female) with cancer were studied. Compared with patients with other cancers, patients with HNC were more often members of a minority race/ethnicity, male, poor, publicly insured, and less educated, with lower general and mental health status. Median annual medical expenses ($8384 vs $5978; difference, $2406; 95% CI, $795-$4017) and relative out-of-pocket expenses (3.93% vs 3.07%; difference, 0.86%; 95% CI, 0.06%-1.66%) were higher for patients with HNC than for patients with other cancers. Among patients with HNC, median expenses were lower for Asian individuals compared with white individuals ($5359 vs $10 078; difference, $4719; 95% CI, $1481-$7956]), Westerners ($8094) and Midwesterners ($5656) compared with Northwesterners ($10 549), and those with better health status ($16 990 for those with poor health vs $6714 for those with excellent health). Higher relative out-of-pocket expenses were associated with unemployment (5.13% for employed patients vs 2.35% for unemployed patients; difference, 2.78%; 95% CI, 0.6%-4.95%), public insurance (5.35% for those with public insurance vs 2.87% for those with private insurance; difference, 2.48%; 95% CI, -0.6% to 5.55%), poverty (13.07% for poor patients vs 2.06% for high-income patients), and lower health status (10.2% for those with poor health vs 1.58% for those with excellent health).
Conclusions and Relevance: According to this study, HNC adds a substantial, additional burden to an already financially strained population in the form of higher total and relative expenses. The financial strain on individuals, assessed as relative out-of-pocket expenses, appears to be driven more by income than by health factors, and health insurance does not appear to be protective.
PMID: 30789634 [PubMed - as supplied by publisher]
https://ift.tt/2GZLaa6
Labels Reversed in Figure 1.
| Related Articles |
Labels Reversed in Figure 1.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 01;145(2):196
Authors:
PMID: 30789635 [PubMed - in process]
https://ift.tt/2tA5IOo
An Unusual Case of Lacrimal Duct Obstruction in a Teenager.
| Related Articles |
An Unusual Case of Lacrimal Duct Obstruction in a Teenager.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 21;:
Authors: Ray A, Frey HM, Carron JD
PMID: 30789663 [PubMed - as supplied by publisher]
https://ift.tt/2tIl8QR
Evaluation of a Preoperative Adverse Event Risk Index for Patients Undergoing Head and Neck Cancer Surgery.
| Related Articles |
Evaluation of a Preoperative Adverse Event Risk Index for Patients Undergoing Head and Neck Cancer Surgery.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 21;:
Authors: Mascarella MA, Richardson K, Mlynarek A, Forest VI, Hier M, Sadeghi N, Mayo N
Abstract
Importance: Patients 65 years or older are the most frequent users of operative resources and are also the most vulnerable to postoperative adverse events (AEs). Frailty indices are increasingly being used for preoperative risk stratification within head and neck cancer surgery, but most models lack a multifactorial basis and cannot be directly applied to clinical practice. A practical risk index is needed for clinicians to gauge risk factors preoperatively.
Objective: To develop a preoperative risk index of short-term major postoperative AEs for patients undergoing head and neck cancer surgery.
Design: Cohort analysis of patients from multiple medical centers undergoing inpatient ablative or reconstructive head and neck cancer surgery and registered in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) from 2006 to 2016.
Exposures: Inpatient ablative or reconstructive head and neck cancer surgery.
Main Outcomes and Measures: Sociodemographic, frailty-related, and surgical factors in the derivation cohort were evaluated using simple and multiple logistic regression. Risk factors were subsequently integrated into a preoperative head and neck surgery risk index (HNSRI) and compared with existing models using the validation cohort. A composite variable of major postoperative AEs was used, including death within 30 days of surgery.
Results: A total of 43 968 operations were found using the ACS NSQIP database. Of these, 12 569 cases were excluded as non-head and neck cancer or emergency surgery. Of the included 31 399 operations reviewed, the mean (SD) patient age was 56.9 (15.4) years, and 16 994 of the patients were women (54.1%). A total of 4556 (14.5%) patients had a major postoperative AE, and 209 (0.7%) died. Older age, male sex, smoking, anticoagulation, recent weight loss, functional dependence, free-tissue transfer, tracheotomy, duration of surgery, wound classification, anemia, leukocytosis, and hypoalbuminemia were independently associated with major AEs or death on multiple regression analysis (C statistic, 0.83). The area under the curve of the HNSRI to predict major AEs including death using the validation cohort (n = 15699) was 0.84 (95% CI, 0.83-0.85) with a sensitivity of 80.1% (95% CI, 79.4%-80.8%) and specificity, 72.3% (95% CI, 70.3%-74.2%). The HNSRI outperformed existing risk models for prediction of AEs: delta C index of the HNSRI to the modified frailty index 11, 0.23 (95% CI, 0.22-0.25); the American Society of Anesthesiologists classification, 0.14 (95% CI, 0.13-0.16); and the ACS risk calculator, 0.02 (95% CI, 0.01-0.03).
Conclusions and Relevance: The proposed HNSRI demonstrated a high sensitivity and specificity for major postoperative AEs and death in the studied population. This risk index can be used to counsel patients awaiting head and neck cancer surgery.
PMID: 30789650 [PubMed - as supplied by publisher]
https://ift.tt/2H3EGqm
Vertebral Bodies, Anterior Erosion, and Compression by Tracheostomy Canula.
| Related Articles |
Vertebral Bodies, Anterior Erosion, and Compression by Tracheostomy Canula.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 21;:
Authors: Costa G, Thiry T, Essid A, Mbieleu B, Haegy I, Perrier A, Bergounioux J
PMID: 30789646 [PubMed - as supplied by publisher]
https://ift.tt/2tIl5EF
Eosinophilic Esophagitis-A Primer for Otolaryngologists.
| Related Articles |
Eosinophilic Esophagitis-A Primer for Otolaryngologists.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 21;:
Authors: Kumar S, Choi S, Gupta SK
Abstract
Importance: Eosinophilic esophagitis (EoE) is a chronic, inflammatory condition of the esophagus. Prevalence of EoE is on the rise and, owing to its associated extragastrointestinal manifestations and comorbidities, otolaryngologists are increasingly encountering this condition in their practice.
Observations: Symptoms of EoE are vague and vary greatly based on patient's age. The gastrointestinal symptoms include dysphagia, food impaction, feeding difficulties, symptoms mimicking gastroesophageal reflux, abdominal pain, vomiting, and failure to thrive. Several otolaryngologic symptoms are associated with EoE including rhinosinusitis, chronic cough, recurrent croup, hoarseness, and other aerodigestive symptoms refractory to gastroesophageal reflux therapy. Eosinophilic esophagitis is also frequently associated with other atopic conditions, such as asthma, eczema, and food allergies. The diagnosis is made on endoscopy with biopsies that reveal eosinophil-predominant esophageal inflammation. There are 3 major treatment approaches to EoE, commonly referred to as the 3 Ds: diet, drugs, and dilation. Untreated inflammation of esophagus from EoE can result in irreversible structural damage to the esophagus, leading to fibrosis, strictures, and impaired esophageal function.
Conclusions and Relevance: Eosinophilic esophagitis is now a fairly prevalent condition with considerable morbidity. Otolaryngologists should be familiar with the various clinical presentations of this condition in different age groups. Early diagnosis and treatment of this condition is a key for avoiding or postponing its complications.
PMID: 30789641 [PubMed - as supplied by publisher]
https://ift.tt/2GURKP3
Εγγραφή σε:
Αναρτήσεις (Atom)