Psychoneuroimmunoendocrinology: clinical implications

Psychoneuroimmunoendocrinology, which was first described in 1936, is the study of the interactions between the psyche, neural and endocrine functions and immune responses. The aim of psychoneuroimmunoendocrin...

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The transotic approach for vestibular schwannoma: indications and results

Abstract

To analyze retrospectively the indications and the results obtained with the transotic approach in a series of patients with vestibular schwannoma. The study included 36 patients from 2007 to 2013 with a vestibular schwannoma that was removed with a transotic approach. All patients underwent preoperative pure tone audiometry, evaluation of facial function and CT and MR imaging. All patients having (1) a hearing loss of more than 50 dB, (2) an average tumor size of 2.7 cm (range 0.5–5.0 cm) and (3) signs of a contracted mastoid (high jugular bulb, anteriorly located sigmoid sinus, low middle cranial fossa, or reduced pneumatization) were selected. The tumor was totally removed in 34 and near-totally removed in 2 patients. The facial nerve was preserved in all patients. The postoperative facial function after 6 weeks was House–Brackmann grade I in 7, grade II in 27, and grade III in 2 patients. All patients presented postoperatively with unilateral total deafness. Seven patients experienced transitory postoperative imbalance. There were two patients who required revision surgery, one with intracranial hemorrhage and another with a CSF leak. There were no deaths and no severe complications such as hemiplegia or intracranial infections. The transotic approach has proven to be of value for the removal of vestibular schwannomas up to 5.0 cm in the presence of temporal bone contraction. Hearing was not preserved; however, other clinical outcomes were very favorable, including high rates of total tumor removal and facial nerve preservation, and low rates of complications.

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The effect of triclosan on posttranslational modification of proteins through citrullination and carbamylation

Abstract

Objectives

The aim of this study was evaluate the effect of triclosan on citrullination and carbamylation, two important protein posttranslational modifications associated with inflammatory conditions such as periodontitis and rheumatoid arthritis.

Materials and methods

A range of triclosan concentrations were incubated in the presence of appropriate substrates used for the generation of either citrullinated or carbamylated proteins. The effect of triclosan on protein citrullination and carbamylation in macrophages was also assessed.

Results

Citrullination and carbamylation were both significantly decreased by triclosan at concentrations six times lower than the 0.3% triclosan approved by the FDA to use in mouthwash and toothpaste. When macrophages were exposed to triclosan, carbamylation was significantly deceased (p = 0.01), and while citrullination also decreased, this reduction was not statistically significant (p = 0.06).

Conclusion

Triclosan reduced the generation of protein citrullination and carbamylation in vitro.

Clinical relevance

Triclosan may be useful as an adjunct therapy in the management of inflammatory periodontal diseases and help to reduce posttranslational protein modification citrullination and carbamylation) in these tissues.

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Low Grade Carcinoma Ex-Pleomorphic Adenoma: Diagnosis and Diagnostic Challenges Caused by Fine Needle Aspiration: Report of Three Cases and Review of Literature

Abstract

Low grade carcinoma ex pleomorphic adenoma (LG CXPA) is a rare low grade malignant neoplasm arising from preexisting pleomorphic adenoma (PA). LG CXPA demonstrates no overt cytological atypia, and can be difficult to distinguish from cellular PA. Invasive growth is one of the hallmarks of LG CXPA, e.g., tumor extends beyond the capsule and into adjacent non-neoplastic tissue. However, it is known that capsular and vascular invasion, as well as the presence of stroma-rich PA in soft tissue without a capsule (pseudopodia) can be seen in PA. These histological findings have no prognostic significance and are not diagnostic of malignancy. In addition, recurrent PA typically presents as numerous nodules extending into soft tissue and skeletal muscle, which again are not considered malignant features. Thus, "infiltrative growth" of LG CXPA is difficult to define and diagnosis is challenging to many practicing pathologists. In this study, we report three cases of LG CXPA. We review the diagnostic criteria for LG CXPA, and discuss the diagnostic challenges caused by fine needle aspiration (FNA) changes. FNA is widely used as a cost-effective, quick and accurate method for diagnosing salivary gland lesions. Histological changes post-FNA are usually focal and mild, and are not causes of diagnostic difficulties. According to our knowledge, this is the first report of LG CXPA complicated with FNA changes.

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Mechanisms Underlying Improvement in Obstructive Sleep Apnea Syndrome by Uvulopalatopharyngoplasty

In a previous case report, we determined for the first time that uvulopalatopharyngoplasty (UPPP) does not change the volume of the upper airway but causes morphological changes in the entire upper airway. The objective of this study is to elucidate the mechanisms underlying the improvement in obstructive sleep apnea syndrome (OSAS) by UPPP. We present an additional case involving a patient with OSAS treated using UPPP. Morphological and numerical parameter changes after surgery were compared with the corresponding preoperative values. Anatomically accurate upper airway computational models were reconstructed from computed tomographic imaging data. In addition, computed fluid dynamics analysis was performed to reveal inhalation flow characteristics before and after UPPP and clearly assess the effect of UPPP on airflow patterns in the patient's upper airway. An important benefit of UPPP is the morphological changes in the entire upper airway, in addition to widening the restricted area. These morphological changes induce laminarization of the pharyngeal jet. To obtain sufficient efficacy of UPPP in OSAS, the morphological changes in the upper airway and the airflow pattern after the surgery must be controlled.

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Manual Therapy and Use of the Dynasplint for Trismus in Patients With Head and Neck Cancer

Conditions:   Neoplasms, Head and Neck;   Trismus
Intervention:   Behavioral: Physical therapy and dynasplint
Sponsors:   University of Alberta;   Cross Cancer Institute
Not yet recruiting - verified May 2017

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Study Assessing the Position of Cricothyroid Membrane in Relation to Movement of Neck From Neutral to Extended Position

Condition:   Difficult Intubation
Intervention:   Procedure: ultrasound
Sponsor:   Northampton General Hospital NHS Trust
Not yet recruiting - verified June 2017

http://ift.tt/2qXqloK