Αρχειοθήκη ιστολογίου

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

Κυριακή 6 Δεκεμβρίου 2020

Commensal Bacterium Rothia aeria Degrades and Detoxifies Gluten via a Highly Effective Subtilisin Enzyme.

p.aythelady61 shared this article with you from Inoreader
Related Articles

Commensal Bacterium Rothia aeria Degrades and Detoxifies Gluten via a Highly Effective Subtilisin Enzyme.

Nutrients. 2020 Dec 02;12(12):

Authors: Wei G, Darwish G, Oppenheim FG, Schuppan D, Helmerhorst EJ

Abstract
Celiac disease is characterized by a chronic immune-mediated inflammation of the small intestine, triggered by gluten contained in wheat, barley, and rye. Rothia aeria, a gram-positive natural colonizer of the oral cavity and the upper digestive tract is able to degrade and detoxify gluten in vitro. The objective of this study was to assess gluten-degrading activity of live and dead R. aeria bacteria in vitro, and to isolate the R. aeria gluten-degrading enzyme.
METHODS: After an overnight fast, Balb/c mouse were fed a 1 g pellet of standard chow containing 50% wheat (and 4% gliadin) with or without 1.6 × 107 live R. aeria bacteria. After 2 h, in vivo gluten degradation was assessed in gastric contents by SDS-PAGE and immunoblotting, and immunogenic epitope neutralization was assessed with the R5 gliadin ELISA assay. R. aeria enzyme isolation and identification was accomplished by separating proteins in the bacterial cell homogenate by C18 chromatography followed by gliadin zymography and mass spectrometric analysis of excised bands.
RESULTS: In mice fed with R. aeria, gliadins and immunogenic epitopes were reduced by 20% and 33%, respectively, as compared to gluten digested in control mice. Killing of R. aeria bacteria in ethanol did not abolish enzyme activity associated with the bacteria. The gluten degrading enzyme was identified as BAV86562.1, here identified as a member of the subtilisin family.
CONCLUSION: This study shows the potential of R. aeria to be used as a first probiotic for gluten digestion in vivo, either as live or dead bacteria, or, alternatively, for using the purified R. aeria enzyme, to benefit the gluten-intolerant patient population.

PMID: 33276655 [PubMed - as supplied by publisher]

View on the web

In Vivo Colonization with Candidate Oral Probiotics Attenuates Colonization and Virulence of Streptococcus mutans.

p.aythelady61 shared this article with you from Inoreader
Related Articles

In Vivo Colonization with Candidate Oral Probiotics Attenuates Colonization and Virulence of Streptococcus mutans.

Appl Environ Microbiol. 2020 Dec 04;:

Authors: Culp DJ, Hull W, Bremgartner MJ, Atherly TA, Christian KN, Killeen M, Dupuis MR, Schultz AC, Chakraborty B, Lee K, Wang DS, Afzal V, Chen T, Burne RA

Abstract
A collection of 113 Streptococcus strains from supragingival dental plaque of caries-free individuals were recently tested in vitro for direct antagonism of the dental caries pathogen Streptococcus mutans, and for their capacity for arginine catabolism via the arginine deiminase system (ADS). To advance their evaluation as potential probiotics, twelve strains of commensal oral streptococci with various antagonistic and ADS potentials were assessed in a mouse model for oral (i.e., oral mucosal pellicles and saliva) and dental colonization under four diets (healthy or high-sucrose, with or without prebiotic arginine). Colonization by autochthonous bacteria was also monitored. One strain failed to colonize, whereas oral colonization by the other eleven strains varied by 3 log units. Dental colonization was high for five strains regardless of diet, six strains increased colonization with at least one high-sucrose diet, and added dietary arginine decreased dental colonization of t wo strains. Streptococcus sp. A12 (high in vitro ADS activity and antagonism) and two engineered mutants lacking the ADS (ΔarcADS) or pyruvate oxidase-mediated H2O2 production (ΔspxB) were tested for competition against S. mutans UA159. A12 wild type and ΔarcADS colonized only transiently, whereas ΔspxB persisted, but without altering oral or dental colonization by S. mutans In testing four additional candidates, S. sanguinis BCC23 markedly attenuated S. mutans' oral and dental colonization, enhanced colonization of autochthonous bacteria, and decreased severity of smooth surface caries under highly cariogenic conditions. Results demonstrate the utility of the mouse model to evaluate potential probiotics, revealing little correlation between in vitro antagonism and competitiveness against S. mutans in vivo IMPORTANCE Our results demonstrate in vivo testing of potential oral probiotics can be accomplished and can yield information to facilitate the ultimate design and optimizatio n of novel anti-caries probiotics. We show human oral commensals associated with dental health are an important source of potential probiotics that may be used to colonize patients under dietary conditions of highly varying cariogenicity. Assessment of competitiveness against dental caries pathogen Streptococcus mutans and impact on caries identified strains or genetic elements for further study. Results also uncovered strains that enhanced oral and dental colonization by autochthonous bacteria when challenged with S. mutans, suggesting cooperative interactions for future elucidation. Distinguishing a rare strain that effectively compete with S. mutans under conditions that promote caries further validates our systematic approach to more critically evaluate probiotics for use in humans.

PMID: 33277269 [PubMed - as supplied by publisher]

View on the web

Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study.

p.aythelady61 shared this article with you from Inoreader
Via Larynx
Related Articles

Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study.

Auris Nasus Larynx. 2020 Dec 01;:

Authors: Kartal A, Konuksen O

Abstract
OBJECTIVE: This study aimed to investigate the temporal processing and binaural interaction functions of central auditory processing tests according to the anatomical localizations of young and elderly individuals. It also sought to evaluate the relationships between the same individuals' central auditory processing tests.
METHODS: This observational and cross-sectional study included individuals with normal hearing between 18 and 30 and 60-75 years of age, who were referred to as the young group and the elderly group, respectively. The evaluation of the central auditory processing tests was completed using the frequency pattern test, duration pattern test, masking level difference test, and random gap detection test. Furthermore, speech discrimination and speech in noise scores were analyzed for both groups.
RESULTS: Statistically significant differences were identified between the groups' scores for the speech in noise test, masking level difference test, random gap detection test, frequency pattern test, and duration pattern test (p < 0.05). A statistically significant relationship was observed between the age and the results of the central auditory processing tests (p < 0.05).
CONCLUSION: When compared to younger individuals, elderly individuals presented with declined temporal sequences, temporal resolutions, and binaural interaction skills.

PMID: 33277137 [PubMed - as supplied by publisher]

View on the web

Defining the dose-volume criteria for laryngeal sparing in locally advanced oropharyngeal cancer utilizing split-field IMRT, whole-field IMRT and VMAT.

p.aythelady61 shared this article with you from Inoreader
Via Larynx
Related Articles

Defining the dose-volume criteria for laryngeal sparing in locally advanced oropharyngeal cancer utilizing split-field IMRT, whole-field IMRT and VMAT.

J Appl Clin Med Phys. 2020 Dec 05;:

Authors: Wilke C, Takiar V, Wang H, Moreno AC, Tung SS, Quinlan-Davidson SR, Garden AS, Rosenthal DI, Fuller CD, Gunn GB, Reddy JP, Morrison WH, Wang C, Zhao G, Hutcheson KA, Phan J

Abstract
PURPOSE: To determine the optimal dose-volume constraint for laryngeal sparing using three commonly employed intensity modulated radiation therapy (IMRT) approaches in patients with oropharyngeal cancer treated to the bilateral neck.
MATERIALS AND METHODS: Thirty patients with stage II-IVA oropharynx cancers received definitive radiotherapy with split-field IMRT (SF-IMRT) to the bilateral neck between 2008 and 2013. Each case was re-planned using whole-field IMRT (WF-IMRT) and volumetric modulated arc therapy (VMAT) and plan quality metrics and dose to laryngeal structures was evaluated. Two larynx volumes were defined and compared on the current study: the Radiation Therapy Oncology Group (RTOG) larynx as defined per the RTOG 1016 protocol and the MDACC larynx defined as the components of the larynx bounded by the superior and inferior extent of the thyroid cartilage.
RESULTS: Target coverage, conformity, and heterogeneity indices were similar in all techniques. The RTOG larynx mean dose was lower with WF-IMRT than SF-IMRT (22.1 vs 25.8 Gy; P < 0.01). The MDACC larynx mean dose was 17.5 Gy ± 5.4 Gy with no differences between the 3 techniques. WF-IMRT and VMAT plans were associated with lower mean doses to the supraglottic larynx (42.1 vs 41.2 vs 54.8 Gy; P < 0.01) and esophagus (18.1 vs 18.2 vs 36 Gy; P < 0.01).
CONCLUSIONS: Modern whole field techniques can provide effective laryngeal sparing in patients receiving radiotherapy to the bilateral neck for advanced oropharyngeal cancers.
SUMMARY: We evaluated laryngeal dose in patients with locally advanced oropharyngeal cancer treated to the bilateral neck using split-field IMRT (SF-IMRT), whole-field IMRT (WF-IMRT) and volumetric arc therapy (VMAT). All three techniques provided good sparing of laryngeal structures and were able to achieve a mean larynx dose < 33 Gy. There were no significant differences in dose to target structures or non-laryngeal organs at risk among techniques.

PMID: 33277960 [PubMed - as supplied by publisher]

View on the web

The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population

xlomafota13 shared this article with you from Inoreader

?image=000511497-1.jpg

Background/Aims: The effortful swallow is a common treatment intervention requiring increased intensity to facilitate adaptations and modify swallow kinematics. The type of feedback and bolus volume provided may influence the intensity of the effortful swallow. To determine the increased effortful swallow intensity, a clinician can collect the peak amplitude of an effortful swallow and a typical swallow and compute a "swallow effort ratio" (SER). Dividing the effortful swall ow surface electromyography (sEMG) peak amplitude by the typical swallow sEMG peak amplitude derives the SER. A higher SER suggests increased intensity. An increase in the SER may have clinical relevance in swallowing therapy as a threshold of intensity is required to elicit neuroplastic change. The purpose of this investigation was to determine whether sEMG visual and clinician verbal feedback increases the SER. Additionally, the investigation examined whether the SER is influenced by different liquid bolus volumes. Methods: Eighty-two nondysphagic, healthy adults were assigned at random to 2 groups. One group received no feedback, and the other received verbal and visual feedback while performing typical and effortful swallows at 3 liquid volumes. Results: An analysis of covariance compared the typical and effortful peak swallow amplitudes among 3 volumes in the 2 feedback groups. There was a significant effect on the peak amplitude values by feedback g roup F(2, 79) = 22.82, p #x3c; 0.001. There were no differences in peak amplitude by volume regardless of feedback F(2, 78) = 0.413, p = 0.663. Conclusion: It appears that sEMG visual and clinician verbal feedback increases the SER, which may be a surrogate for intensity. An increased SER may have a positive effect on swallow intervention as intensity is known to influence outcomes of exercise and elicit neuroplastic change.
Folia Phoniatr Logop
View on the web

Factors Related to Extralaryngeal Spread in Juvenile Recurrent Respiratory Papillomatosis

xlomafota13 shared this article with you from Inoreader

Objectives/Hypothesis

To identify factors associated to increased risk of extra‐laryngeal spread in pediatric patients with recurrent respiratory papillomatosis (RRP).

Study Design

Retrospective chart review.

Methods

A retrospective study was conducted evaluating the clinical charts of patients younger than 16 years with histopathologically confirmed RRP treated between January 2014 and December 2018. Characteristics of patients with and without extra‐laryngeal disease dissemination were compared. Odds ratios were calculated and multivariate logistic regression analysis was performed.

Results

Data from 82 patients were analyzed. Mean age at symptom onset was 42 months. Fifteen (18.29%) patients had extra‐laryngeal spread (ELS) at time of diagnosis and in four, the disease continued to spread to other sites. Of 67 patients with disease restricted to the larynx, 17 (25.37%) developed ELS during the disease course. Human papilloma virus (HPV) typing was performed in 49 (59.8%) patients; in 28 (57.1%) HPV subtype 6 was identified and in 21 (42.9%) HPV subtype 11. ELS was found in 11 patients with serotype 11 (52.38%) and in seven patients with serotype 6 (25%) (P = .048). Statistically significant differences for ELS were also found for age at diagnosis younger than 5 years (P = .045), presence of tracheostomy (P = .031), and need for adjuvant therapy (P = .010).

Conclusions

Age at diagnosis of RRP younger than 5 years and presence of tracheostomy were factors related to ELS. A statistically significant association between infection with HPV subtype 11 and ELS were also observed. Adjuvant medication might be considered a protective factor against ELS. Laryngoscope, 2020

View on the web

Speech outcomes after palatal closure in 3-7-year-old children.

xlomafota13 shared this article with you from Inoreader
Related Articles

Speech outcomes after palatal closure in 3-7-year-old children.

Braz J Otorhinolaryngol. 2020 Sep 30;:

Authors: Rezaei P, Poorjavad M, Abdali H

Abstract
INTRODUCTION: One of the main goals of the team approach in management of oro-facial clefts is to help the children with cleft palate have adequate speech development.
OBJECTIVE: The present study aimed to investigate the prevalence of articulation and resonance disorders following palate closure in children who were visited for routine examination by the Isfahan Cleft Care Team between 2011 and 2015, and to study the impact of cleft type and age at the time of palatoplasty on speech outcomes.
METHODS: Clinical records of 180 preschool children with repaired cleft palate were reviewed. The percentage of children demonstrating hypernasality, nasal emission, nasal turbulence, and compensatory misarticulations was calculated. The relationship between cleft type and age at the time of palatal surgery, as independent variables, and speech outcomes were examined.
RESULTS: 67.7 and 64.5 percent of the children demonstrated respectively moderate/severe hypernasality and nasal emission, and 71.1 percent produced compensatory misarticulations. Age at the time of palatal repair was significantly associated with compensatory misarticulations and also with moderate/severe hypernasality. The prevalence of compensatory misarticulations, significant hypernasality, nasal emission and also nasal turbulence was not significantly different in various types of cleft.
CONCLUSIONS: We observed a high prevalence of different speech disorders in preschool children with repaired cleft palate compared to other studies. This can be partly due to late palatal repair in the studied population. Despite many advances in cleft palate management programs in Iran, there are still many children who do not access the interdisciplinary team cares in their early childhood. We should, therefore, try to increase accessibility of appropriate and timely management services to all Iranian children with cleft lip/palate.

PMID: 33268307 [PubMed - as supplied by publisher]

View on the web

Impact of opioid-free anesthesia on complications after deep inferior epigastric perforator flap surgery: A retrospective cohort study.

xlomafota13 shared this article with you from Inoreader
Related Articles

Impact of opioid-free anesthesia on complications after deep inferior epigastric perforator flap surgery: A retrospective cohort study.

J Plast Reconstr Aesthet Surg. 2020 Sep 30;:

Authors: Mulier H, De Frene B, Benmeridja L, Vanhoorebeeck F, Denis B, Casaer B, Rogge FJ, Leleu K, Mulier J

Abstract
This study measured the number of complications after deep inferior epigastric perforator (DIEP) flap reconstruction performed under opioid-free anesthesia (OFA) combined with goal-directed fluid therapy or opioid anesthesia with liberal fluid therapy (OA). This retrospective cohort study consisted of 204 patients who underwent DIEP flap reconstruction at AZSint Jan Brugge between April 2014 and March 2019. Primary outcomes were complications, according to the Clavien-Dindo classification and the length of hospital stay (LOS). The secondary outcomes were flap failure, postoperative nausea and vomiting (PONV), postoperative pain, postoperative opioid consumption, and postoperative skin flap temperature. OFA included a combination of dexmedetomidine, lidocaine, and ketamine without any opioid administered pre- or intraoperatively. OA included a combination of sufentanil and remifentanil. OFA patients received strict goal-directed fluid therapy, whereas OA patients received libe ral fluids to maintain perfusion pressure. All patients except 7 (TIVA with remifentanil) received inhalation anesthesia combined with an infusion of propofol. Of the 204 patients, 55 received OFA and 149 received OA. There were no differences in major complications, but fewer minor complications in the OFA group (17.9% vs. 51.4% and P < 0.001). Flap failure occurred in three patients of the OA group. Six patients developed flap thrombosis (five OA patients and one OFA patient). OFA was associated with fewer postoperative opioids, shorter LOS, less PONV, and less pain. In patients without previous nausea, the PONV incidence was higher in the OA group than in the OFA group (12.7% vs. 43.6% and P < 0.001). Patients with previous nausea more frequently required postoperative opioids and had a nausea rate of 60.87%.

PMID: 33268289 [PubMed - as supplied by publisher]

View on the web

Paracervical ganglion in the female pig during prenatal development: Morphology and immunohistochemical characteristics.

xlomafota13 shared this article with you from Inoreader
Related Articles

Paracervical ganglion in the female pig during prenatal development: Morphology and immunohistochemical characteristics.

Histol Histopathol. 2020 Dec 03;:18287

Authors: Franke-Radowiecka A

Abstract
The present study investigated the development of the paracervical ganglion in 5-, 7- and 10-week-old porcine foetuses using double labelling immunofluorescence method. In 5-week-old foetuses single PGP-positive perikarya were visible only along the mesonephric ducts. They contained DβH or VAChT, and nerve fibres usually were PGP/VAChT-positive. The perikarya were mainly oval. In 7-week-old foetuses, a compact group of PGP-positive neurons (3144±213) was visible on both sides and externally to the uterovaginal canal mesenchyme of paramesonephric ducts. Nerve cell bodies contained only DβH (36.40±1.63%) or VAChT (17.31±1.13%). In the 10-week-old foetuses, the compact group of PGP-positive neurons divided into several large and many small clusters of nerve cells and also became more expanded along the whole uterovaginal canal mesenchyme reaching the initial part of the uterine canal of the paramesonephric duct. The number of neurons located in these neuronal structures inc reased to 4121±259. Immunohistochemistry revealed that PGP-positive nerve cell bodies contained DβH (40.26±0,73%) and VAChT (30.73±1.34%) and were also immunoreactive for NPY (33.24±1,27%), SOM (23.6±0,44%) or VIP (22.9±1,13%). Other substances studied (GAL, NOS, CGRP, SP) were not determined at this stage of the development. In this study, for the first time, the morphology of PCG formation in the porcine foetus has been described in three stages of development. Dynamic changes in the number of neurons and their sizes were also noted, as well as the changes in immunochistochemical coding of maturing neurons.

PMID: 33269806 [PubMed - as supplied by publisher]

View on the web

Laparoscopy allows the harvest of the DIEP flap with shorter fascial incisions as compared to endoscopic harvest: A single surgeon retrospective cohort study.

xlomafota13 shared this article with you from Inoreader
Related Articles

Laparoscopy allows the harvest of the DIEP flap with shorter fascial incisions as compared to endoscopic harvest: A single surgeon retrospective cohort study.

J Plast Reconstr Aesthet Surg. 2020 Nov 09;:

Authors: Shakir S, Spencer AB, Piper M, Kozak GM, Soriano IS, Kanchwala SK

Abstract
BACKGROUND: We present a comparative series to utilize minimally invasive endoscopic, total extraperitoneal laparoscopic (TEP-lap), and transabdominal preperitoneal robotic perforator (TAP-RAP) harvest of the deep inferior epigastric (DIE) vessels for autologous breast reconstruction (ABR) to mitigate donor site morbidity. We hypothesized that TEP-lap and TAP-RAP harvests of abdominal-based free flaps are safe techniques associated with decreased fascial incision when compared with the endoscopic harvest.
METHODS: We designed a retrospective cohort series of subjects with newly diagnosed breast cancer who presented for ABR using endoscopic (control), laparoscopic, or robotic assistance between September 2017 and April 2019. The primary outcome variables were flap success (i.e., absence of perioperative flap loss), fascial incision length, and intraoperative complications. Secondary variables included operating time, costs, and postoperative complications within 90 days (arterial thrombosis, venous congestion, bulge/hernia, and operative revision). Exclusion criteria included < 90 days follow-up.
RESULTS: In total 94, 38, and 3 subjects underwent endoscopic, TEP-lap, and TAP-RAP flap harvests. Mean lengths of fascial incisions for the endoscopic and laparoscopic cohorts were 4.5 ± 0.5 cm and 2.0 ± 0.6 cm (p < 0.0001), while incision length depended on the concurrent procedure in the robotic cohort. No subjects required conversion to an open harvest. There were no bleeding complications, intra-abdominal injuries, flap losses, or abdominal bulges/hernias noted in the TEP-lap and TAP-RAP cohorts.
CONCLUSION: Minimally invasive DIEP flap harvest may decrease fascial injury when compared with conventional open harvest. There are significant trade-offs among harvest methods. TEP-lap harvest may better balance the trade-off related to abdominal wall morbidity.

PMID: 33268043 [PubMed - as supplied by publisher]

View on the web

Nerve wrapping for recurrent compression neuropathy: A systematic review.

xlomafota13 shared this article with you from Inoreader
Related Articles

Nerve wrapping for recurrent compression neuropathy: A systematic review.

J Plast Reconstr Aesthet Surg. 2020 Nov 08;:

Authors: Thakker A, Sharma SC, Hussain NM, Devani P, Lahiri A

Abstract
BACKGROUND: The recurrence of symptoms following primary nerve compression surgery can occur in up to 25% of cases. Nerve wrapping can be utilised for revision surgery. An ideal barrier should minimise the chance of fibrosis, scarring and allow for adequate nerve gliding. This review evaluates the use of autologous or commercially available allograft and xenograft options as barriers against nerve scarring following revision surgery.
METHODS: PubMed, Ovid Embase and Cochrane databases were searched using the All Fields Index. Nine hundred titles underwent title screening with 11 studies being included in the final analysis. The risk of bias was assessed using the Methodological Index for Non-Randomised Studies (MINORS) tool. PRISMA guidelines were followed at all stages and the review was registered with PROSPERO (CRD 42020182818).
RESULTS: The 11 studies comprised of all case series. In total, 114 patients were included, with ages ranging from 28 to 90. Previously, the number of revision surgeries ranged from 0 to 5. Autologous veins were used in 6 studies, collagen in 3 studies and human amniotic membrane in 2 studies. Improvements in subjective and objective outcomes were seen with all wrap types. Pain was the most common residual symptom (46% of patients). The most common complication was pain at the donor site following vein harvest (19% of patients).
CONCLUSION: This is the first systematic review to summarise the outcomes of nerve wraps for revision compression neuropathy. While improvements in outcomes were reported, further comparative studies are needed to determine the best nerve wrap.

PMID: 33268044 [PubMed - as supplied by publisher]

View on the web