Αρχειοθήκη ιστολογίου

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

Τετάρτη 6 Ιουνίου 2018

Residual T cell activation and skewed CD8+ T cell memory differentiation despite antiretroviral therapy-induced HIV suppression

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Publication date: Available online 5 June 2018
Source:Clinical Immunology
Author(s): Ramla F. Tanko, Andreia P. Soares, Lindi Masson, Nigel J. Garrett, Natasha Samsunder, Quarraisha Abdool Karim, Salim S. Abdool Karim, Catherine Riou, Wendy A. Burgers
HIV infection results in excessive T cell activation and dysfunction which may persist even during effective antiretroviral therapy (ART). The dynamics of immune 'deactivation' and extent to which T cell memory subsets normalize after ART are unclear. We longitudinally assessed the influence of 1 year of ART on the phenotype of T cells in HIV-infected African women, relative to matched HIV-uninfected women, using activation (CD38, HLA-DR) and differentiation markers (CD27, CD45RO). ART induced a substantial reduction in T cell activation, but remained higher than HIV-uninfected controls. ART largely normalized the distribution of CD4+ T cell memory subsets, while the distribution of CD8+ T cell memory subsets remained significantly skewed compared to HIV-uninfected individuals. Thus, there was a considerable but only partial reversal of T cell defects upon ART. Understanding T cell impairment may provide important insights into mechanisms of HIV pathogenesis in the era of ART.



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Τρίτη 5 Ιουνίου 2018

Perioperative management of patients with cancer pain treated with opioids: a retrospective study

Abstract

Purpose

We retrospectively studied perioperative management of patients receiving opioid treatment for cancer pain to facilitate establishing a standard policy for our institute.

Methods

Subjects were patients who had been administered strong opioids for cancer pain and had undergone surgery with general anesthesia. We divided the patients into groups C and D. Group C was comprised of patients who had been administered their baseline opioids continuously during the perioperative period, and group D of those who had discontinued baseline opioid use during this period.

Results

We identified 70 evaluable patients, 36 in group C and 34 in group D. The intraoperative anesthesia courses were similar, being uneventful, in all cases. With respect to postoperative adverse effects within 24 h after awakening from anesthesia, severe adverse effects (additional administration of more than four analgesics and intense agitation) were significantly more frequent in group D than in group C (12 vs 1, respectively. p = 0.004). Univariate analysis revealed that baseline opioid discontinuation was the only factor associated with severe adverse effects [odds ratio 12.6, 95% confidence interval (1.49–105.8), p = 0.01].

Conclusion

Discontinuation of baseline opioid increased adverse effects in the early postoperative period, which were attributed to exacerbation of early postoperative pain.



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Olfactory bulbus volume and olfactory sulcus depth in migraine patients: an MRI evaluation

Abstract

Objectives

To compare the measurements of olfactory bulb volume and olfactory sulcus depth in patients with migraine and a control group.

Methods

The study included the cranial MRI (1.5 T) images of 200 adults diagnosed with migraine and a control group of 100 subjects without migraine. The control group mainly consisted of the patients with non-migraneous headache. The measurements were obtained from coronal T2-weighted images for standard olfactory bulb (OB) volume and olfactory sulcus (OS) depth.

Results

The OB volume and OS depth values were lower in the migraine group than in the control group. In the migraine group, left OB volume of the males was significantly lower than those of the females. In both the migraine and control groups separately, the left-side OB volume values and the right side OS depth values were significantly greater than those of the contralateral side. There were positive correlations between right and left OB volume, and right and left OS depth values. No change was seen in OB volume and OS depth values according to gender. In older patients, a decrease was determined in the right and left OB volume, and the left-side OS depth values. There was a negative correlation between osmophobia and OB volume values. In migraine patients with osmophobia, the OB volume values were significantly decreased.

Conclusion

OB volume values were lower in migraine patients. When osmophobia was present, the OB volume was lower than that of the non-osmophobia migraine patients. Olfactory function monitoring with olfactory tests and olfactory volume monitoring on MRI can be recommended for all migraine patients to diagnose olfactory dysfunction earlier, especially those with osmophobia. Because their OB volume values were detected as lower than those of the migraine patients without osmophobia, it may be thought that blood flow changes and osmophobia may affect the olfactory bulb volume shrinkage in migraine patients.



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Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate: a systematic review

Publication date: Available online 5 June 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): L.A.M. Thierens, N.M.C. De Roo, G.A.M. De Pauw, N. Brusselaers
The use non-ionizing three-dimensional (3D) imaging in cleft lip and palate is an emerging field, but properly designed methods for the assessment of these images are not well established. Therefore, the aim of this study was to review the current literature on the modalities of assessment of non-ionizing 3D images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate, and to assess the method error of these modalities. A systematic literature search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, and Embase. Cross-sectional studies with prospective or retrospective data collection, using non-ionizing 3D imaging, with a subjective or objective outcome assessment and including at least 10 cleft lip and/or palate patients were considered eligible. Overall, 1767 unique studies were identified and 33 met the inclusion criteria. The images were objectively assessed using elementary measurements and comprehensive statistical methods for superimposition, shape description, and structuring. Subjective assessment was performed using a Likert-type scale or visual analogue scale. It can be concluded that non-ionizing 3D images are widely used in cleft research, but 3D analysis of the images is often methodologically suboptimal. Researchers must fully utilize the content of 3D images to quantify morphology, symmetry, and appearance.



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Miriam’s Journey to Sound

"It was one of the best days of my life," says Miriam Green in an emotionally charged voice. "I wish...

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Save the Date: Dr. Steven Zeitels to Speak at ORL Frontiers Next Month

Steven Marc Zeitels, MD, is the invited speaker for ORL Frontiers 2018, which will be held Saturday, June 23, at...

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Amber Luong, MD, PhD Recognized as Trailblazer

Amber Luong, MD, PhD, associate professor of otorhinolaryngology, has been recognized with the 2017 Helen F. Krause, MD Memorial Trailblazer...

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