Post herpes zoster SUNCT like syndrome: Insights from two case reports

Background

SUNCT like syndrome secondary to post herpes zoster infection has not been reported in literature.

Case

We are reporting two cases of SUNCT like syndrome secondary to post herpes zoster infection of the V1 distribution of the trigeminal nerve. Treatment with pregabalin and lamotrigine achieved complete symptomatic relief in both patients.

Conclusion

SUNCT like syndrome can occur after herpetic infection of the trigeminal nerve. Unlike primary SUNCT syndrome, post-herpetic SUNCT like syndrome seems to respond well to pharmacological treatment and has a good prognosis.

from Cephalalgia via xlomafota13 on Inoreader http://ift.tt/2eOVDH8
via IFTTT

Impact of Time Interval between Radiation and Free Autologous Breast Reconstruction

J reconstr Microsurg
DOI: 10.1055/s-0036-1593806

Background To evaluate whether the timing of surgery after radiation in autologous breast reconstruction affects major complications. Methods We performed a retrospective review of 454 free flaps (331 patients) for breast reconstruction at a single institution from 2003 to 2014. Charts were reviewed for age, BMI, laterality, flap type (TRAM, msTRAM, DIEP), surgeon, donor vessels (IMA, TD), chemotherapy, smoking, diabetes, hypertension, DVT, venous anastomoses, vein size, and time from radiation (none, < 12 months, or ≥ 12 months). The primary outcome of major complications was defined as partial/total flap loss, thrombosis, ischemia, or hematoma requiring return to the operating room. To identify independent predictors of major complications, a multivariate logistic regression was constructed. Alpha = 0.05 indicated significance in all tests. Results Average age was 47.4 ± 8.4. Free flaps consisted of msTRAM (41.1%), TRAM (29.6%), or DIEP (29.3%). The donor vessel was IMA in 66.9% of flaps or TD in 33.0% of patients with 90.7% using only one vein and 9.3% with two veins. The average IMA/TDV size was 2.5 cm ± 0.5. Preoperative radiation occurred in 31.2% of flaps. There were 54 flaps with at least one major complication (11.7%). On multivariate regression, only flap type (OR =4.04, p < .01) and vein size (OR = 0.13, p = 0.02) independently predicted major complications. Conclusion There was no significant difference in major complications between flaps who had reconstruction within 12 months and greater than 12 months after radiation. Only having a more muscle sparing technique or smaller vein size were independent risk factors for major complications.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2egK7Uf

Laser-Assisted Indocyanine Green Angiography Aids in the Reconstruction of Gustilo Grade IIIB Open Lower-Limb Fractures

J reconstr Microsurg
DOI: 10.1055/s-0036-1593807

Background The treatment of trauma to the lower extremities often carries a high risk of complications. To the best of our knowledge, no study has been published regarding the treatment of open lower-limb fractures using laser-assisted indocyanine green angiography (LA-ICG). Here we retrospectively evaluated LA-ICG–based therapeutic interventions and reported the use of LA-ICG and its results in this application. Patients and Methods Between January 2011 and December 2015, a total of 23 cases with Gustilo grade IIIB open lower-limb fractures were investigated. LA-ICG was used to demonstrate the presence of necrotic tissue and determine the range of debridement. We compared 13 patients treated using LA-ICG from 2013 to 2015 with 10 patients treated without LA-ICG from 2010 to 2013. We reviewed tissue necrosis and other outcomes of these patients. Results The tissue necrosis rate in the LA-ICG–used group was significantly lower than that in the LA-ICG–free group. There were also significant differences in the average number of instances of tissue necrosis per patient, debridements, and deep-site infections. There was no flap loss. Conclusion By using LA-ICG, not only plastic surgeons but also clinicians in all associated departments including orthopedics can perform early reliable debridement and share in trauma treatment planning. We will continue to accumulate similar cases and hope to further improve LA-ICG techniques.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2egLGRZ

Extending the Limits of Microsurgical Reconstruction in Patients with Moderate to Very Severe Obesity: Single-Center 6-Year Experiences

J reconstr Microsurg
DOI: 10.1055/s-0036-1593769

Background Worldwide obesity has more than doubled since 1980. Given this epidemic change, surgical and medical care has become more complex as obesity is a known risk factor for complications. Consequently, one could expect a higher prevalence of medical and surgical complications in an obese patient collective in the setting of free tissue transfer. Goal of this study was to evaluate whether this assumption holds true. Material and Methods Between January 2009 and June 2015, 838 patients underwent free tissue transfers at a single institution. The cases were divided into three groups using the World Health Organization body mass index (BMI) criteria into a nonobese (n = 751), a moderately obese (n = 59), and a severely to very severely obese group (n = 28). The series was retrospectively analyzed and the groups were compared regarding the potential influence of BMI in respect to surgical complications and outcomes. Results Overall, there was no significant difference in morbidity between the groups of patients regarding the rate of surgical complications during our 3-month follow-up period. Conclusion This study analyzed a large series of microsurgical reconstructions, with a focus on the impact of patient obesity on outcomes. Our findings suggest that despite higher rates of patient comorbidities, successful free tissue transfer can be achieved in this population with acceptable risk for complications.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2egEZj5

Optimizing Outcomes following Total and Subtotal Tongue Reconstruction: A Systematic Review of the Contemporary Literature

J reconstr Microsurg
DOI: 10.1055/s-0036-1593772

Background More than 45,000 Americans are diagnosed with oropharyngeal cancer annually and multimodal treatment often requires wide excision, lymphadenectomy, chemotherapy, and radiation. Total and subtotal lingual resection severely impairs speech, swallow, and quality of life (QoL). This study investigates functional outcomes and QoL following subtotal and total tongue resection with free tissue transfer reconstruction. Materials and Methods A systematic review of the English language literature was performed using PubMed, Ovid, Embase, and Cochrane databases based on predetermined inclusion/exclusion criteria. Included studies were reviewed for surgical technique, adjuvant treatment, surgical and functional outcomes, and QoL. Results From an initial search yield of 1,467 articles, 22 studies were included for final analysis. Speech intelligibility was correlated with the volume and degree of protuberance of the neotongue. Adjuvant therapy (radiation) and large tumor size were associated with worse speech and swallow recovery. At 1 year follow-up, despite 14 to 20% rates of silent aspiration, 82 to 97% of patients resumed oral feeding. Neurotized flaps have been demonstrated to improve flap sensation but have not yet demonstrated any significant impact on speech or swallow recovery. Finally, many patients continue to experience pain after surgery, but patient motivation, family support with physician, and speech therapist follow-up are associated with improved QoL scores. Conclusion Tongue reconstruction is dictated by the amount of soft tissue resection. Taking into consideration the most common factors involved after tongue resection and reconstruction, further studies should focus on more objective measurements to offer solutions and maximize final outcomes.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2egMtCy

Racial Disparities in Sleep: The Role of Neighborhood Disadvantage

Disparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep.

http://ift.tt/2f3cWF5

Night-waking trajectories and associated factors in French preschoolers from the EDEN birth-cohort

Night waking in preschoolers has been associated with adverse health outcomes in cross-sectional studies, but has rarely been analyzed in a longitudinal setting. Therefore, little is known about the evolution of night waking in early childhood. The objectives of the present study were: to identify night-waking trajectories in preschoolers, and to examine the risk factors associated with those trajectories. Analyses were based on the French birth-cohort study EDEN, which recruited 2002 pregnant women between 2003 and 2006.

http://ift.tt/2eVKjqa

Six-month-old infant long sleepers prefer a human face

Sleep is known to influence socio-emotional regulation among children and preschoolers, whereas little is known about the association between sleep and social preference during infancy.

http://ift.tt/2f35cTw

What surgical treatment has the lowest recurrence rate following the management of keratocystic odontogenic tumor? A large systematic review and meta-analysis

Among the different surgical treatments for keratocystic odontogenic tumors (KOTs), there is no single method associated with a zero recurrence rate (RR). Thus, this study aimed to seek the best surgical treatment with the least RR using a weighted event rated meta-analysis.

http://ift.tt/2f6RZX7

Velopharyngeal insufficiency treated with levator muscle repositioning and unilateral myomucosal buccinator flap

Velopharyngeal insufficiency (VPI) is common (20−30%) after cleft palate closure. The myomucosal buccinator flap has become an important treatment option for velopharyngeal insufficiency; however, published studies all use bilateral buccinator flaps. This study assesses outcomes with a unilateral myomucosal buccinator flap that might result in less operating time and might prevent the need of a bite block and an extra procedure for division of the flap pedicle at a later stage.

http://ift.tt/2foO0ZL

Maxillofacial gunshot wounds and diagnostic tests for lead in the blood

We congratulate Edetanlen and Saheeb1 on their study of the potential association between people who have retained lead pellets after gunshot wounds to the craniomaxillofacial region, and the concentration of lead in the blood.1 The authors indicated the possible toxic effects in the soft tissues of the face,1 but we would like to add a note of caution.

http://ift.tt/2e6ZXxi

Effect of noise on tasks in operating theatres: a survey of the perceptions of healthcare staff

Noise in the operating theatre has an adverse impact on healthcare professionals, both physically and psychologically. It can be distracting, make communication difficult, and contribute to a perceived increase in stress. Staff in theatre must deliver high quality care, and overlook noise as a potentially damaging influence. The aim of this survey was to obtain further information about the perspective of healthcare professionals on how noise can affect their practice and whether it affects their work in theatre.

http://ift.tt/2fypqFh

Diagnostic value of cone beam computed tomography and panoramic radiography in predicting mandibular nerve exposure during third molar surgery

The aim of this study was to evaluate the diagnostic accuracies of cone beam computed tomography (CBCT) and panoramic techniques in predicting inferior alveolar nerve (IAN) exposure. The sample size was determined based on a pilot study. This prospective clinical series study included 59 third molar extraction sites with any of seven previously suggested panoramic signs of IAN exposure. The diagnosis of nerve exposure was done on panoramic and CBCT images. Molars were extracted and nerve exposure was evaluated clinically.

http://ift.tt/2f6IeIA

Expression and clinical significance of TrkB in sinonasal squamous cell carcinoma: a pilot study

Previous studies have confirmed that tropomyosin-related kinase B (TrkB) plays a critical role in the occurrence, development, and metastasis of many kinds of malignant tumour. More recently, TrkB was found to be overexpressed in head and neck squamous cell carcinoma (SCC) and to be involved in multistep tumour progression. In this study, the expression of TrkB was investigated in 27 cases of sinonasal SCC using an immunohistochemical method. The clinical significance and possible role of TrkB as a prognostic marker in these tumours was also explored.

http://ift.tt/2dWwsTE

Oral mucosal epithelial cells express the membrane anchored mucin MUC1

Publication date: January 2017
Source:Archives of Oral Biology, Volume 73
Author(s): Helena Ukkonen, Paula Pirhonen, Maria Herrala, Jopi J.W. Mikkonen, Surya P. Singh, Raija Sormunen, Arja M. Kullaa
ObjectiveThe presence of a stable salivary pellicle (SP) is essential to provide a wet surface for the oral mucosal epithelia. The oral mucosa is covered by the SP which is suggested to be a mixed film of both salivary and epithelial components. Our aim was to analyse the presence of membrane-anchored mucin MUC1 in the oral mucosal epithelia.DesingThe presence of MUC1 was studied by immunohistochemical and immunoelectron microscopical methods in 19 buccal mucosal specimens. The localization and intensity of the epithelial expression were analyzed.ResultsStrong staining of MUC1 was found in the epithelial cells of intermediate and superficial layers. Some basal cells were shown faint expression. In the intermediate and superficial layers, the MUC1 expression was seen mainly on the upper cell surface. Furthermore, the expression of MUC1 was noted in the cytoplasm near the nucleus and in the rough granules. By electron microscopy, extracellular domain of membrane-anchored molecules extruded about 15–30nm above the cell surface in the apical cells of the oral epithelium. Immunoelectron microscopic examination shows that MUC1 is mainly localized in the plasma membrane of epithelial cells and also in small vesicles (75–100nm) just below the plasma membrane.ConclusionThe membrane-anchored MUC1 is expressed in the superficial layer of the oral mucosal epithelium, especially on the upper surface of epithelial cells. MUCI may be the anchoring protein of the salivary pellicle stabilization.



http://ift.tt/2eVoEyr

Immunoglobulin Glycosylation Effects in Allergy and Immunity

Abstract

Purpose of Review

The aim of this review will be to familiarize the reader with the general area of antibody (Ab) glycosylation and to summarize the known functional roles of glycosylation and how glycan structure can contribute to various disease states with emphasis on allergic disease.

Recent Findings

Both immunoglobulin (Ig) isotype and conserved Fc glycosylation sites often dictate the downstream activity of an Ab where complexity and degree of glycosylation contribute to its ability to bind Fc receptors (FcRs) and activate complement. Most information on the effects of glycosylation center on IgG in cancer therapy and autoimmunity. In cancer therapy, glycosylation modifications that enhance affinity for activating FcRs are utilized to facilitate immune-mediated tumor cell killing. In autoimmunity, disease severity has been linked to alterations in the presence, location, and composition of Fc glycans. Significantly less is understood about the role of glycosylation in the setting of allergy and asthma. However, recent data demonstrate that glycosylation of IgE at the asparagine-394 site of Cε3 is necessary for IgE interaction with the high affinity IgE receptor but, surprisingly, glycosylation has no effect on IgE interaction with its low-affinity lectin receptor, CD23.

Summary

Variations in the specific glycoform may modulate the interaction of an Ig with its receptors. Significantly more is known about the functional effects of glycosylation of IgG than for other Ig isotypes. Thus, the role of glycosylation is much better understood in the areas of autoimmunity and cancer therapy, where IgG is the dominant isotype, than in the field of allergy, where IgE predominates. Further work is needed to fully understand the role of glycan variation in IgE and other Ig isotypes with regard to the inhibition or mediation of allergic disease.

http://ift.tt/2eTePRL

Interleukin-5 Antagonists Usher in a New Generation of Asthma Therapy

Abstract

Asthma is the most common chronic respiratory disease in the USA. A subset of patients with asthma have refractory symptoms, persistent eosinophilic inflammation, and recurrent exacerbations despite maximal medical therapy. The monoclonal antibodies targeting the IL-5 pathway are a new class of medications designed to target severe eosinophilic asthma. There are two medications clinically available: mepolizumab and reslizumab, both of which target IL-5. A third medication, benralizumab, is currently under development and targets the IL-5 receptor. Clinical data suggest these medications can reduce asthma exacerbations and improve lung function in patients with peripheral eosinophilia and poorly controlled asthma despite maximal medical therapy. The anti-IL-5 medications are among the first targeted molecular therapies for asthma and will usher in an exciting new era in the treatment of severe asthma.

http://ift.tt/2eZPMPR

The Reemergence of the Asthma-COPD Overlap Syndrome: Characterizing a Syndrome in the Precision Medicine Era

Abstract

Purpose of Review

The asthma-COPD overlap syndrome (ACOS) has reemerged in the medical literature. This review addresses our current understanding of ACOS as a clinical and biological entity and how new and existing therapies may be targeted to this group.

Recent Findings

Many studies suggest that ACOS is common and associated with more morbidity than asthma and COPD in general. However, there is no consensus on an ACOS definition, likely due to the heterogeneity of the disease. Variable definitions have led to variable results in ACOS studies. Given this clinical variability, biomarkers (e.g., eosinophils and type 2 inflammatory markers) are increasingly being used to identify an ACOS molecular phenotype which appears to be more responsive to inhaled corticosteroids.

Summary

Although ACOS has become a popular diagnosis, it is unclear whether identifying ACOS as a separate disease entity is clinically useful. Future studies should focus on identifying key clinical features and biomarkers that characterize vulnerable and treatment-responsive patients.

http://ift.tt/2eTc42V

Erratum to “The effect of human papillomavirus on DNA repair in head and neck squamous cell carcinoma” [Oral Oncol. 61 (2016) 27–30]

The publisher regrets that Vicky Yamamoto's forename appeared incorrectly in the original article. It appears correctly above.

http://ift.tt/2faUN4r

Erratum to “Neoadjuvant radiotherapy plus radical surgery for locally advanced stage III/IV oral cancer: Analysis of prognostic factors affecting overall survival” [Oral Oncol. 60 (2016) 1–7]

The publisher regrets that the author's forename and surnames were displayed in an incorrect order in the original article. They appear correctly above.

http://ift.tt/2egjAX8

Night-waking trajectories and associated factors in French preschoolers from the EDEN birth-cohort

Publication date: Available online 31 October 2016
Source:Sleep Medicine
Author(s): Eve Reynaud, Anne Forhan, Barbara Heude, Blandine de Lauzon-Guillain, Marie-Aline Charles, Sabine Plancoulaine
Night waking in preschoolers has been associated with adverse health outcomes in cross-sectional studies, but has rarely been analyzed in a longitudinal setting. Therefore, little is known about the evolution of night waking in early childhood. The objectives of the present study were: to identify night-waking trajectories in preschoolers, and to examine the risk factors associated with those trajectories. Analyses were based on the French birth-cohort study EDEN, which recruited 2002 pregnant women between 2003 and 2006. Data on a child's night waking at the ages of 2, 3 and 5–6 years, and potential confounders, were collected through parental self-reported questionnaires. Night-waking trajectories were computerized using group-based trajectory modeling on 1346 children. Two distinct developmental patterns were identified: the "2–5 rare night-waking" (77% of the children) and the "2–5 common night-waking" pattern. Logistic regressions were performed to identify the factors associated with the trajectories. Risk factors for belonging to the "2–5 common night-waking" trajectory were: exposure to passive smoking at home, daycare in a collective setting, watching television for extended periods, bottle feeding at night, high emotionality, and low shyness. This approach allowed identification of the risk factors associated with night waking during a critical age window, and laid the groundwork for identifying children at higher risk of deleterious sleep patterns. Those risk factors were mainly living habits, which pointed towards the fact that prevention and intervention programs could be highly beneficial in this population.

Graphical abstract

from #SleepMedicine via xlomafota13 on Inoreader http://ift.tt/2fyaNlo
via IFTTT

Night-waking trajectories and associated factors in French preschoolers from the EDEN birth-cohort

Publication date: Available online 31 October 2016
Source:Sleep Medicine
Author(s): Eve Reynaud, Anne Forhan, Barbara Heude, Blandine de Lauzon-Guillain, Marie-Aline Charles, Sabine Plancoulaine
Night waking in preschoolers has been associated with adverse health outcomes in cross-sectional studies, but has rarely been analyzed in a longitudinal setting. Therefore, little is known about the evolution of night waking in early childhood. The objectives of the present study were: to identify night-waking trajectories in preschoolers, and to examine the risk factors associated with those trajectories. Analyses were based on the French birth-cohort study EDEN, which recruited 2002 pregnant women between 2003 and 2006. Data on a child's night waking at the ages of 2, 3 and 5–6 years, and potential confounders, were collected through parental self-reported questionnaires. Night-waking trajectories were computerized using group-based trajectory modeling on 1346 children. Two distinct developmental patterns were identified: the "2–5 rare night-waking" (77% of the children) and the "2–5 common night-waking" pattern. Logistic regressions were performed to identify the factors associated with the trajectories. Risk factors for belonging to the "2–5 common night-waking" trajectory were: exposure to passive smoking at home, daycare in a collective setting, watching television for extended periods, bottle feeding at night, high emotionality, and low shyness. This approach allowed identification of the risk factors associated with night waking during a critical age window, and laid the groundwork for identifying children at higher risk of deleterious sleep patterns. Those risk factors were mainly living habits, which pointed towards the fact that prevention and intervention programs could be highly beneficial in this population.

Graphical abstract

http://ift.tt/2fyaNlo

Erratum to “The effect of human papillomavirus on DNA repair in head and neck squamous cell carcinoma” [Oral Oncol. 61 (2016) 27–30]

The publisher regrets that Vicky Yamamoto's forename appeared incorrectly in the original article. It appears correctly above.

from #ORL via xlomafota13 on Inoreader http://ift.tt/2faUN4r
via IFTTT

Erratum to “Neoadjuvant radiotherapy plus radical surgery for locally advanced stage III/IV oral cancer: Analysis of prognostic factors affecting overall survival” [Oral Oncol. 60 (2016) 1–7]

The publisher regrets that the author's forename and surnames were displayed in an incorrect order in the original article. They appear correctly above.

from #ORL via xlomafota13 on Inoreader http://ift.tt/2egjAX8
via IFTTT

Meta-analysis of 701 published cases of sinonasal neuroendocrine carcinoma: The importance of differentiation grade in determining treatment strategy

Sinonasal tumors with neuroendocrine differentiation are a rare group of neoplasms that account for only 5% of all sinonasal malignancies [1]. A broad distinction is made between tumors of neuroectodermal origin - esthesioneuroblastoma - and those of epithelial origin - sinonasal neuroendocrine carcinoma (SNC). The latter can be subdivided based on differentiation grade into well, moderately and poorly differentiated SNC. Poorly differentiated SNC are further subdivided into a small and large cell variants.

from #ORL via xlomafota13 on Inoreader http://ift.tt/2faWAGS
via IFTTT

Sound perception and the importance of context

We all subconsciously and easily assign meanings to sounds. Recent research shows that this effortless ability of the human mind is deceptively complex.

from #Audiology via xlomafota13 on Inoreader http://ift.tt/2erSwlx
via IFTTT

How to Overcome the Struggles of Pediatric Hearing Loss

Having unilateral hearing loss is like having an invisible disability. Although the person can still hear, communicate and respond in many situations, they are often missing out on much of what is said, especially in dynamic listening situations. People with unilateral hearing loss may have to work extra hard to figure out what they have missed in conversation. There may be a delay in their response time, as they are continually trying to make sense of what was just said. This can be exhausting, as their brain is compensating to fill in the blanks of conversations.

from #Audiology via xlomafota13 on Inoreader http://ift.tt/2fa0Kyp
via IFTTT

How to Overcome the Struggles of Pediatric Hearing Loss

Having unilateral hearing loss is like having an invisible disability. Although the person can still hear, communicate and respond in many situations, they are often missing out on much of what is said, especially in dynamic listening situations. People with unilateral hearing loss may have to work extra hard to figure out what they have missed in conversation. There may be a delay in their response time, as they are continually trying to make sense of what was just said. This can be exhausting, as their brain is compensating to fill in the blanks of conversations.

http://ift.tt/2fa0Kyp

Putting T cells to work – outsourcing neoantigen detection in head and neck cancer?

The recent genomic characterization of head and neck squamous cell carcinomas by The Cancer Genome Atlas demonstrated the high frequency of mutations affecting these cancers (Cancer Genome Atlas Network, 2015). This high rate of genomic alterations allows head and neck cancers to be highly immunogenic, thus promoting responses to immune therapies (Allen et al, 2015; Ferris, 2015). For instance, inhibitors of immune checkpoints like the anti-PD-1 monoclonal antibodies nivolumab and pembrolizumab have demonstrated promising results in head and neck cancer (Ferris et al, 2016; Chow et al, 2016), both recently receiving FDA approval in the setting of recurrent or metastatic disease.

This article is protected by copyright. All rights reserved.

http://ift.tt/2erCoAv

A Robust Skin Particulate Sebum, Oil, and Pollution for Assessing Cleansing Efficacy

Abstract

With increasing concerns over the rise of atmospheric particulate pollution globally and its impact on systemic health and skin aging, we have developed a pollution model to mimic particulate matter trapped in sebum and oils creating a robust (difficult to remove) surrogate for dirty, polluted skin.

Objective

To evaluate the cleansing efficacy/protective effect of a sonic brush vs. manual cleansing against particulate pollution (trapped in grease/oil typical of human sebum).

Methods

The pollution model (Sebollution; Sebum Pollution Model; SPM) consists of atmospheric particulate matter/pollution combined with grease/oils typical of human sebum. Twenty subjects between the ages of 18 to 65 were enrolled in a single-center, cleansing study comparisons between the sonic cleansing brush (normal speed) compared to manual cleansing.

Equal amount of SPM were applied to the center of each cheek (left and right). Method of cleansing (sonic vs. manual) was randomized to the side of the face (left or right) for each subject. Each side was cleansed for five seconds using the sonic with sensitive brush head or manually, using equal amounts of water and a gel cleanser.

Photographs (VISIA CR, Canfield Imaging, NJ, USA) were taken at baseline, before application of the SPM and following cleansing. Image analysis (Image J, NIH, Bethesda, MD, USA) was used to quantify color intensity (amount of particulate pollutants on the skin) using a scale of 0 to 255 (0=all black pixels; 255=all white pixels). Differences between the baseline and post-cleansing values (pixels) are reported as the amount of SPM remaining following each method of cleansing.

Results

Using a robust cleansing protocol to assess removal of pollutants (SPM; atmospheric particulate matter trapped in grease/oil), the sonic brush removed significantly more SPM than manual cleansing (p<0.001). While extreme in color, this pollution method easily allows assessment of efficacy through image analysis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2f1b5An

Re: The effects of Air Pollution on asthma Hospital admissions in Adelaide, South Australia, 2003-2013: time series and case-crossover analysis

Abstract

We read with great interest the recent study by Chen K and colleagues [1] which showed an increase risk of asthma hospital admissions in all age groups with total pollen. However, there are numerous issues that have been overlooked in the analysis of the pollen variable. If these issues were considered, the authors may have observed stronger species-specific effects thereby contributing to the evidence base on which pollen species is the major trigger of asthma exacerbations requiring hospitalization.

This article is protected by copyright. All rights reserved.

http://ift.tt/2eU2EUu

Can routine office-based audiometry predict cochlear implant evaluation results?

Objectives/Hypothesis

Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates.

Study Design

Retrospective, observational, diagnostic study.

Methods

The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test).

Results

The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation.

Conclusions

Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation.

Level of Evidence

4 Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f0OLXS
via IFTTT

Phase I/II Study OF Metformin in Combination With Cisplatin and Radiation in Head and Neck Squamous Cell Carcinoma

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:   Drug: Metformin
Sponsor:   Baylor College of Medicine
Not yet recruiting - verified October 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f5caoE
via IFTTT

A Study of Laparoscopic Right Hemicolectomy Using the Caudal-to-cranial Approach

Conditions:   Ascending Colon Cancer;   Ileocaecal Valve Carcinoma;   Cancer Flexure Hepatic;   Adenocarcinoma of Hepatic Flexure (Diagnosis)
Interventions:   Procedure: the caudal-to-cranial approach;   Procedure: the medial-to-lateral approach
Sponsor:   Guangdong Provincial Hospital of Traditional Chinese Medicine
Recruiting - verified October 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f0PnwD
via IFTTT

The Efficacy of Vocal Function Exercises for Laryngeal Cancers

Condition:   Vocal Folds
Interventions:   Procedure: Vocal Function Exercises;   Procedure: Vocal Hygiene
Sponsor:   Vrushali Angadi
Recruiting - verified October 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2eTSdjV
via IFTTT

Acute pancreatitis due to a papillary obstruction by a vegetable foreign body

Abstract

We report a rare cause of acute pancreatitis due to an obstruction of the pancreatic duct by a vegetable foreign body that was trapped in the papilla of Vater.

A 68-year-old female was referred to the emergency room due to acute epigastric pain. She had no prior medical history. A physical examination showed tenderness in the upper abdominal region. Laboratory analyses showed an elevated C-reactive protein level (300 mg/L, [0.0 – 5.0]) and an elevated lipase level (1176 IU/L, [13 – 60]) without liver function distortion. Computed tomography scan (CT) showed an acute pancreatitis with a mild dilatation of both the pancreatic duct and the common bile duct with an abnormal appearance of the papilla of Vater (Fig. 1). An upper gastrointestinal endoscopy was performed. This showed the esophagus, stomach and duodenal bulb to be normal, but revealed a filamentous vegetable projection to be protruding from a normal papilla of Vater into the second portion of the duodenum. This 7 cm long foreign body was removed by a biopsy forceps (Fig. 2 a,b,c). Afterwards, the patient recovered fast and she could be discharged from the hospital after five days. Exhaustive screening for other causes of acute pancreatitis was satisfying. There was no recurrence of pancreatitis afterwards.

This article is protected by copyright. All rights reserved.

from #Esophageal Cancer via a.lsfakia on Inoreader http://ift.tt/2f9rQpy
via IFTTT

Test

Test thyroid system post

The post Test appeared first on American Thyroid Association.

from #ORL via xlomafota13 on Inoreader http://ift.tt/1PAQjVG
via IFTTT

Amyloid beta modulators and neuroprotection in Alzheimer's disease: a critical appraisal.

Amyloid beta modulators and neuroprotection in Alzheimer's disease: a critical appraisal.

Drug Discov Today. 2016 Oct 26;:

Authors: Kuruva CS, Reddy PH

Abstract
Multiple cellular changes have been identified as being involved in Alzheimer's disease (AD) pathogenesis, including mitochondrial damage, synaptic loss, amyloid beta (Aβ) production and/or accumulation, inflammatory responses, and phosphorylated tau formation and/or accumulation. Studies have established that Aβ-induced synaptic dysfunction is dependent on abnormal amyloid precursor protein (APP) processing caused by β- and γ-secretases, resulting in the generation of Aβ. The Aβ formed as a result of abnormal APP processing induces phosphorylated tau and activates glycogen synthase kinase-3β (GSK3β) and cyclin-dependent kinase-5 (CDK5). Here, we review the latest research on the development of Aβ modulators for neuroprotection in AD. We also review the use of molecular inhibitors as therapeutic targets in AD.

PMID: 27794478 [PubMed - as supplied by publisher]

from Speech via a.lsfakia on Inoreader http://ift.tt/2fw2W7B
via IFTTT

Temporal fine structure mediated recognition of speech in the presence of multitalker babble.

Temporal fine structure mediated recognition of speech in the presence of multitalker babble.

J Acoust Soc Am. 2016 Oct;140(4):EL296

Authors: Nambi PM, Mahajan Y, Francis N, Bhat JS

Abstract
This experiment investigated the mechanisms of temporal fine structure (TFS) mediated speech recognition in multi-talker babble. The signal-to-noise ratio 50 (SNR-50) for naive-listeners was measured when the TFS was retained in its original form (ORIG-TFS), the TFS was time reversed (REV-TFS), and the TFS was replaced by noise (NO-TFS). The original envelope was unchanged. In the REV-TFS condition, periodicity cues for stream segregation were preserved, but envelope recovery was compromised. Both the mechanisms were compromised in the NO-TFS condition. The SNR-50 was lowest for ORIG-TFS followed by REV-TFS, which was lower than NO-TFS. Results suggest both stream segregation and envelope recovery aided TFS mediated speech recognition.

PMID: 27794309 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2e4wELQ
via IFTTT

Lexically guided perceptual tuning of internal phonetic category structure.

Lexically guided perceptual tuning of internal phonetic category structure.

J Acoust Soc Am. 2016 Oct;140(4):EL307

Authors: Drouin JR, Theodore RM, Myers EB

Abstract
Listeners use lexical information to retune the mapping between the acoustic signal and speech sound representations, resulting in changes to phonetic category boundaries. Other research shows that phonetic categories have a rich internal structure; within-category variation is represented in a graded fashion. The current work examined whether lexically informed perceptual learning promotes a comprehensive reorganization of internal category structure. The results showed a reorganization of internal structure for one but not both of the examined categories, which may reflect an attenuation of learning for distributions with extensive category overlap. This finding points towards potential input-driven constraints on lexically guided phonetic retuning.

PMID: 27794292 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2fw0QVv
via IFTTT

Consonantal timing and release burst acoustics distinguish multiple coronal stop place distinctions in Wubuy (Australia).

Consonantal timing and release burst acoustics distinguish multiple coronal stop place distinctions in Wubuy (Australia).

J Acoust Soc Am. 2016 Oct;140(4):2794

Authors: Bundgaard-Nielsen RL, Kroos C, Baker BJ, Best CT, Harvey M

Abstract
Substantial research has established that place of articulation of stop consonants (labial, alveolar, velar) are reliably differentiated using a number of acoustic measures such as closure duration, voice onset time (VOT), and spectral measures such as centre of gravity and the relative energy distribution in the mid-to-high spectral range of the burst. It is unclear, however, whether such measurable acoustic differences are present in multiple place of articulation contrasts among coronal stops. This article presents evidence from the highly endangered indigenous Australian language Wubuy, which maintains a 4-way coronal stop place contrast series in all word positions. The authors examine the temporal and burst characteristics of / t̪ t ʈ/ in three prosodic positions (utterance-initial, word-initial but phrase medial, and word-medial). The results indicate that VOT, closure duration, and the spectral quality of the burst may indeed differentiate multiple coronal place contrasts, in most positions, although measures that distinguish the apical contrast in absolute initial position remain elusive. The authors also examine measures (spectrum kurtosis, spectral tilt) previously used in other studies of multiple coronals in Australian languages. These results suggest that the authors' measures perform at least as well as those previously applied to multiple coronals in other Australian languages.

PMID: 27794291 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2e4zD77
via IFTTT

Effectiveness of the Language Intervention Programme for Preschool Children.

Related Articles

Effectiveness of the Language Intervention Programme for Preschool Children.

Folia Phoniatr Logop. 2016;68(2):80-85

Authors: Lousada M, Ramalho M, Marques C

Abstract
OBJECTIVE: This paper investigates the effectiveness of the Language Intervention Programme for the treatment of 14 preschool-aged children with primary language impairment.
PATIENTS AND METHODS: We used a waiting list control design, in which half the sample (7 children) received immediate intervention with the Language Intervention Programme, whereas the remaining children received treatment after a 4-week delay. The intervention consisted of 8 individual biweekly sessions. Outcome measures of language ability (receptive semantic and morphosyntactic, expressive semantic and morphosyntactic, and metalinguistic) were taken before and after intervention.
RESULTS: After 4 weeks of intervention, the experimental group showed significant improvements in language (receptive, expressive and metalinguistic skills), but no differences were found for those in the waiting control group. After 4 weeks of intervention for the control group, significant progress in language was also observed.
CONCLUSION: The Language Intervention Programme was found to be effective in treating language skills of children with language impairment, providing clinical evidence for speech and language therapists to employ this programme for the treatment of preschool children with language disorders.

PMID: 27684522 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2fw4mz3
via IFTTT

Preschoolers' Performance on the Brazilian Adaptation of the Preschool Language Assessment Instrument - Second Edition.

Related Articles

Preschoolers' Performance on the Brazilian Adaptation of the Preschool Language Assessment Instrument - Second Edition.

Folia Phoniatr Logop. 2016;68(2):73-79

Authors: Lindau TA, Rossi NF, Giacheti CM

Abstract
PURPOSE: The objective was to test whether the Brazilian version of the Preschool Language Assessment Instrument - Second Edition (PLAI-2) has the potential to assess and identify differences in typical language development of Portuguese-speaking preschoolers.
METHODS: The study included 354 children of both genders with typical language development who were between the ages of 3 years and 5 years 11 months. The version of the PLAI-2 previously translated into Brazilian Portuguese was used to assess the communication skills of these preschool-age children.
RESULTS: Statistically significant differences were found between the age groups, and the raw score tended to increase as a function of age. With nonstandardized assessments, the performances of the younger groups revealed behavioral profiles (e.g., nonresponsive, impulsive behavior) that directly influenced the evaluation.
CONCLUSIONS: The findings of this study show that the PLAI-2 is effective in identifying differences in language development among Brazilian children of preschool age. Future research should include studies validating and standardizing these findings.

PMID: 27583970 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2e4Bjxu
via IFTTT

Does the degree of linguistic experience (native versus nonnative) modulate the degree to which listeners can benefit from a delay between the onset of the maskers and the onset of the target speech?

Related Articles

Does the degree of linguistic experience (native versus nonnative) modulate the degree to which listeners can benefit from a delay between the onset of the maskers and the onset of the target speech?

Hear Res. 2016 Nov;341:9-18

Authors: Ben-David BM, Avivi-Reich M, Schneider BA

Abstract
Background noise has a greater adverse effect on word recognition when people are listening in their second language (L2) as opposed to their first language (L1). The present study investigates the extent to which linguistic experience affects the ability of L2 listeners to benefit from a delay between the onset of a masker and the onset of a word. In a previous study (Ben-David, Tse & Schneider, 2012), word recognition thresholds for young L1s were found to improve with the increase in the delay between the onset of a masker (either a stationary noise or a babble of voices) and the onset of a word. The investigators interpreted this result as reflecting the ability of L1 listeners to rapidly segregate the target words from a masker. Given stream segregation depends, in part, on top-down knowledge-driven processes, we might expect stream segregation to be more "sluggish" for L2 listeners than for L1 listeners, especially when the masker consists of a babble of L2 voices. In the present study, we compared the ability of native English speakers to those who had either recent or long-term immersion in English as L2, to benefit from a delay between masker onset and word onset for English words. Results show that thresholds were higher for the two L2s groups than for the L1s. However, the rate at which word recognition improved with word-onset delay was unaffected by linguistic status, both when words were presented in noise, and in babble. Hence, for young listeners, stream segregation appears to be independent of linguistic status, suggesting that bottom-up sensory mechanisms play a large role in stream segregation in this paradigm. The implications of a failure of older L1 listeners (in Ben-David et al.) to benefit from a word-onset delay when the masker is a babble of voices are discussed.

PMID: 27496539 [PubMed - in process]

from Speech via a.lsfakia on Inoreader http://ift.tt/2fw49fw
via IFTTT

Immunoglobulin Glycosylation Effects in Allergy and Immunity

Abstract

Purpose of Review

The aim of this review will be to familiarize the reader with the general area of antibody (Ab) glycosylation and to summarize the known functional roles of glycosylation and how glycan structure can contribute to various disease states with emphasis on allergic disease.

Recent Findings

Both immunoglobulin (Ig) isotype and conserved Fc glycosylation sites often dictate the downstream activity of an Ab where complexity and degree of glycosylation contribute to its ability to bind Fc receptors (FcRs) and activate complement. Most information on the effects of glycosylation center on IgG in cancer therapy and autoimmunity. In cancer therapy, glycosylation modifications that enhance affinity for activating FcRs are utilized to facilitate immune-mediated tumor cell killing. In autoimmunity, disease severity has been linked to alterations in the presence, location, and composition of Fc glycans. Significantly less is understood about the role of glycosylation in the setting of allergy and asthma. However, recent data demonstrate that glycosylation of IgE at the asparagine-394 site of Cε3 is necessary for IgE interaction with the high affinity IgE receptor but, surprisingly, glycosylation has no effect on IgE interaction with its low-affinity lectin receptor, CD23.

Summary

Variations in the specific glycoform may modulate the interaction of an Ig with its receptors. Significantly more is known about the functional effects of glycosylation of IgG than for other Ig isotypes. Thus, the role of glycosylation is much better understood in the areas of autoimmunity and cancer therapy, where IgG is the dominant isotype, than in the field of allergy, where IgE predominates. Further work is needed to fully understand the role of glycan variation in IgE and other Ig isotypes with regard to the inhibition or mediation of allergic disease.

http://ift.tt/2eTePRL

Interleukin-5 Antagonists Usher in a New Generation of Asthma Therapy

Abstract

Asthma is the most common chronic respiratory disease in the USA. A subset of patients with asthma have refractory symptoms, persistent eosinophilic inflammation, and recurrent exacerbations despite maximal medical therapy. The monoclonal antibodies targeting the IL-5 pathway are a new class of medications designed to target severe eosinophilic asthma. There are two medications clinically available: mepolizumab and reslizumab, both of which target IL-5. A third medication, benralizumab, is currently under development and targets the IL-5 receptor. Clinical data suggest these medications can reduce asthma exacerbations and improve lung function in patients with peripheral eosinophilia and poorly controlled asthma despite maximal medical therapy. The anti-IL-5 medications are among the first targeted molecular therapies for asthma and will usher in an exciting new era in the treatment of severe asthma.

http://ift.tt/2eZPMPR

The Reemergence of the Asthma-COPD Overlap Syndrome: Characterizing a Syndrome in the Precision Medicine Era

Abstract

Purpose of Review

The asthma-COPD overlap syndrome (ACOS) has reemerged in the medical literature. This review addresses our current understanding of ACOS as a clinical and biological entity and how new and existing therapies may be targeted to this group.

Recent Findings

Many studies suggest that ACOS is common and associated with more morbidity than asthma and COPD in general. However, there is no consensus on an ACOS definition, likely due to the heterogeneity of the disease. Variable definitions have led to variable results in ACOS studies. Given this clinical variability, biomarkers (e.g., eosinophils and type 2 inflammatory markers) are increasingly being used to identify an ACOS molecular phenotype which appears to be more responsive to inhaled corticosteroids.

Summary

Although ACOS has become a popular diagnosis, it is unclear whether identifying ACOS as a separate disease entity is clinically useful. Future studies should focus on identifying key clinical features and biomarkers that characterize vulnerable and treatment-responsive patients.

http://ift.tt/2eTc42V

Biocompatibility of “On-command” dissolvable tympanostomy tube in the rat model

Objectives/Hypothesis

A prototype tympanostomy tube, composed of polybutyl/methyl methacrylate-co-dimethyl amino ethyl methacrylate (PBM), was tested to 1) evaluate the effect of PBM tubes on rat dermis as a corollary for biocompatibility and (2) to observe the efficacy of dissolution with isopropyl alcohol (iPrOH) and ethanol (EtOH).

Study Design

Original animal experiment and bench testing.

Methods

A two-part study was conducted to assess biocompatible substance with inducible dissolvability as a critical characteristic for a newly engineered tympanostomy tube. First, tympanostomy tubes were inserted subcutaneously in 10 rats, which served as an animal model for biosafety, and compared to traditional tubes with respect to histologic reaction. Tissue surrounding the PBM prototype tubes was submitted for histopathology and demonstrated no tissue reactivity or signs of major inflammation. In the second part, we evaluated the dissolvability of the tube with either isopropyl alcohol, ethanol, ofloxacin, ciprodex, water, and soapy water. PBM tubes were exposed to decreasing concentrations of iPrOH and EtOH with interval qualitative assessment of dissolution.

Results

Histologic examination did not reveal pathology with PBM tubes. Concentrations of at least 50% iPrOH and EtOH dissolve PBM tubes within 48 hours, whereas concentrations of at least 75% iPrOH and EtOH were required for dissolution when exposure was limited to four 20-minute intervals.

Conclusions

PBM is biocompatible in the rat model. Additionally, PBM demonstrates rapid dissolution upon alcohol-based stimuli, validating the proof-of-concept of dissolvable on-command or biocommandible ear tubes. Further testing of PBM is needed with a less ototoxic dissolver and in a better simulated middle ear environment before testing can be performed in humans.

Level of Evidence

NA Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2eLq4y2
via IFTTT

Rapid maxillary expansion for pediatric obstructive sleep apnea: A systematic review and meta-analysis

Objectives/Hypothesis

To perform a systematic review with meta-analysis for sleep study outcomes in children who have undergone rapid maxillary expansion (RME) as treatment for obstructive sleep apnea (OSA).

Data Sources

PubMed/MEDLINE and eight additional databases.

Review Methods

Three authors independently and systematically reviewed the international literature through February 21, 2016.

Results

Seventeen studies reported outcomes for 314 children (7.6 ± 2.0 years old) with high-arched and/or narrow hard palates (transverse maxillary deficiency) and OSA. Data were analyzed based on follow-up duration: ≤3 years (314 patients) and >3 years (52 patients). For ≤3-year follow-up, the pre- and post-RME apnea–hypopnea index (AHI) decreased from a mean ± standard deviation (M ± SD) of 8.9 ± 7.0/hr to 2.7 ± 3.3/hr (70% reduction). The cure rate (AHI <1/hr) for 90 patients for whom it could be calculated was 25.6%. Random effects modeling for AHI standardized mean difference (SMD) is −1.54 (large effect). Lowest oxygen saturation (LSAT) improved from 87.0 ± 9.1% to 96.0 ± 2.7%. Random effects modeling for LSAT SMD is 1.74 (large effect). AHI improved more in children with previous adenotonsillectomy or small tonsils (73–95% reduction) than in children with large tonsils (61% reduction). For >3-year follow-up (range = 6.5–12 years), the AHI was reduced from an M ± SD of 7.1 ± 5.7/hr to 1.5 ± 1.8/hr (79% reduction).

Conclusions

Improvement in AHI and lowest oxygen saturation has consistently been seen in children undergoing RME, especially in the short term (<3-year follow-up). Randomized trials and more studies reporting long-term data (≥3-year follow-up) would help determine the effect of growth and spontaneous resolution of OSA. Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f3zVxs
via IFTTT

Management of acute complicated mastoiditis at an urban, tertiary care pediatric hospital

Objectives/Hypothesis

To describe the presentation and management of acute complicated mastoiditis in children.

Study Design

Retrospective case series.

Methods

An analysis of pediatric patients with acute complicated mastoiditis treated at an urban, tertiary care children's hospital from 2007 to 2014 was performed.

Results

Forty-eight patients presented with a total of 67 complications of acute mastoiditis. Mean age at presentation was 4.8 years (range = 0.1–15.3 years). The most common complications were subperiosteal abscess (n = 22, 45.8%), epidural abscess (n = 16, 33.3%), and sigmoid sinus thrombosis (n = 14, 29.2%). The most common pathogens isolated included Streptococcus pneumoniae (n = 14, 29.2%) and group A streptococcus (n = 10, 20.8%). Multidrug resistance was not associated with complication type. Surgical management included myringotomy ± tympanostomy tube placement in 46 (95.8%) patients (the only surgery in 10), drainage of subperiosteal abscess without mastoidectomy in 18 (37.5%) patients, and mastoidectomy in 21 (43.8%) total patients. Patients presenting with intracranial complications were the most likely to undergo a mastoidectomy. Anticoagulation was used in the management of nine of 14 (64.3%) patients presenting with sigmoid sinus thrombosis. Neurosurgical interventions (n = 7, 14.6% patients) were primarily performed to manage increased intracranial pressure.

Conclusions

Subperiosteal abscess was the most common complication of acute mastoiditis, and when occurring as the sole complication was successfully managed with antibiotics and surgical intervention that did not include mastoidectomy. Epidural abscess and sigmoid sinus thrombosis were more prevalent than reported in prior series and were managed more aggressively. These patients were more likely to need neurosurgical interventions.

Level of Evidence

4. Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2eLp1Oj
via IFTTT

Does drug-induced sleep endoscopy predict surgical success in transoral robotic multilevel surgery in obstructive sleep apnea?

Objectives/Hypothesis

The aim of this study was to determine if drug-induced sleep endoscopy (DISE) was predictive of success for patients undergoing transoral robotic surgery (TORS) and multilevel procedures for sleep apnea.

Study Design

Retrospective case series of patients who underwent TORS surgery for sleep apnea

Methods

Before and after polysomnograms were analyzed to assess improvement, success, and cure. Improvement was defined as any decrease in apnea-hypopnea index (AHI), success as an AHI <20 with a decrease >50%, and cure as an AHI <5. DISE videos were scored using the NOHL (nose, oropharynx, hypopharynx, larynx) and VOTE (velum, oropharynx, tongue, epiglottis) classification systems.

Results

One hundred one patients were available for analysis. Eighty-seven percent of patients had an improvement in their AHI. Fifty-one percent met criteria for success, whereas 17% were cured. The degree of collapse at individual NOHL and VOTE subsites as well as total additive scores did not predict improvement, success, or cure. Patients with no oropharyngeal lateral collapse in the VOTE classification system were more likely to improve following surgery (P = .001); however, this effect did not hold for success or cure. Multivariate analysis of DISE variables was not predictive of success.

Conclusions

In obstructive sleep apnea patients, there is a 51% success rate and a 17% cure rate. DISE, as scored by the NOHL and VOTE system, did not readily identify patients who would benefit most from surgery. Patients with lateral oropharyngeal collapse may be poorer candidates. Prospective, larger studies are required to further evaluate the use of DISE in predicting success following TORS.

Level of Evidence

4 Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f3DML1
via IFTTT

Optimal anesthetic regimen for ambulatory laser microlaryngeal surgery

Objectives/Hypothesis

Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade. This study aimed to compare the surgical conditions and anesthesia time between two combinations of neuromuscular blocker and reversal agent, rocuronium-sugammadex (R-S) and succinylcholine-cisatracurium-pyridostigmine (S-C-P), and propose an optimal anesthetic regimen for improving the surgical conditions in LMS patients.

Study Design

Prospective, randomized, double-blinded clinical study.

Methods

Patients in the R-S group received 1 mg/kg rocuronium bromide, whereas those in the S-C-P group received 1 mg/kg succinylcholine. After endotracheal intubation, 0.08 mg/kg cisatracurium was injected in S-C-P patients. After the procedure, R-S patients received 2 mg/kg sugammedex, whereas S-C-P patients received 0.2 mg/kg pyridostigmine plus 10 μg/kg atropine.

Results

In the R-S group, surgical condition scores were significantly higher and anesthesia time was significantly shorter. The use of additive neuromuscular blocking agents was significantly higher in the S-C-P group.

Conclusions

Muscle relaxation with rocuronium and reversal with sugammadex resulted in better surgical conditions and a shorter anesthesia time in patients undergoing LMS when compared to the S-C-P regimen.

Level of Evidence

1b Laryngoscope, 2016

from #ORL via xlomafota13 on Inoreader http://ift.tt/2eLoYC9
via IFTTT

Is bevacizumab effective for reducing epistaxis in hereditary hemorrhagic telangiectasia?

from #ORL via xlomafota13 on Inoreader http://ift.tt/2f3GrnV
via IFTTT

In reference to “Review of videolaryngoscopy pharyngeal wall injuries”

from #ORL via xlomafota13 on Inoreader http://ift.tt/2eLrcSf
via IFTTT

Oral Swirl (OS) samples – A robust source of microRNA protected by extracellular vesicles

Abstract

MicroRNAs are small non-coding RNAs which are dysregulated in disease states, such as oral cancer. Extracellular vesicles, a potential source of microRNA, are found in saliva.

Objective

To demonstrate that a quantifiable amount of microRNA can be isolated from oral swirl samples. Additionally, we hypothesized that extracellular vesicles may protect contained microRNA from degradation in these samples.

Method

A polyethylene glycol based precipitation was used for extracellular vesicle enrichment of oral swirl samples. Comparison was made between samples treated with and without RNase. Further, samples from 3 subjects were submitted to a range of conditions over 7 days and assessed for presence of microRNA by reverse transcription quantitative PCR. Extracellular vesicles from samples were identified under transmission electron microscopy.

Results

An adequate quantity of microRNA for qPCR analysis was extractable from samples despite exposure to conditions under which degradation of RNA would be expected.

Conclusion

A technique was developed to isolate an adequate quantity of microRNA for analysis from oral swirl samples. Extracellular vesicle associated microRNA may be protected from degradation. This technique moves towards chairside application of translational microRNA research in the field of oral cancer prognostics.

This article is protected by copyright. All rights reserved.

http://ift.tt/2flHIKA

Immune Responses in Rhinovirus-Induced Asthma Exacerbations

Abstract

Acute asthma exacerbations are responsible for urgent care visits and hospitalizations; they interfere with school and work productivity, thereby driving much of the morbidity and mortality associated with asthma. Approximately 80 to 85 % of asthma exacerbations in children, adolescents, and less frequently adults are associated with viral upper respiratory tract viral infections, and rhinovirus (RV) accounts for ∼60–70 % of these virus-associated exacerbations. Evidence suggests that it is not the virus itself but the nature of the immune response to RV that drives this untoward response. In particular, evidence supports the concept that RV acts to exacerbate an ongoing allergic inflammatory response to environmental allergens present at the time of the infection. The interaction of the ongoing IgE- and T cell-mediated response to allergen superimposed on the innate and adaptive immune responses to the virus and how this leads to triggering of an asthma exacerbation is discussed.

http://ift.tt/2e9Q8Sv

Occupational Respiratory Allergic Diseases in Healthcare Workers

Abstract

Healthcare workers (HCWs) are exposed to a range of high and low molecular weight agents that are allergic sensitizers or irritants including cleaners and disinfectants, natural rubber latex, and various medications. Studies have shown that exposed HCWs are at risk for work-related rhinitis and asthma (WRA). Work-related rhinitis may precede development of WRA and should be considered as an early marker of WRA. Avoidance of causative exposures through control strategies such as elimination, substitution, engineering controls, and process modification is the preferred primary prevention strategy for preventing development of work-related allergic diseases. There is limited evidence for the effectiveness of respirators in preventing occupational asthma. If sensitizer-induced WRA is diagnosed, it is important to avoid further exposure to the causative agent, preferably by more rigorous application of exposure control strategies to the workplace. This review focuses on allergic occupational respiratory diseases in HCWs.

http://ift.tt/2f4lt70

La Revue devient Journal of Stomatology Oral and Maxillofacial Surgery

Publication date: November 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale, Volume 117, Issue 5
Author(s): P. Léger




http://ift.tt/2eReDCm

Editorial board

Publication date: November 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale, Volume 117, Issue 5





http://ift.tt/2eWsIRX

Agenda

Publication date: November 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale, Volume 117, Issue 5





http://ift.tt/2eRe8s9

Erratum à « Articulation temporomandibulaire (ATM) : hypercondylie et condylectomie » [Rev. Stomatol. Chir. Maxillofac. Chir. Orale 117 (2016) 259–65]

Publication date: Available online 21 October 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Author(s): J. Ferri, G. Raoul, J. Potier, R. Nicot




http://ift.tt/2eWoNEG

RNA polymerase II senses obstruction in the DNA minor groove via a conserved sensor motif.

Related Articles

RNA polymerase II senses obstruction in the DNA minor groove via a conserved sensor motif.

Proc Natl Acad Sci U S A. 2016 Oct 17;:

Authors: Xu L, Wang W, Gotte D, Yang F, Hare AA, Welch TR, Li BC, Shin JH, Chong J, Strathern JN, Dervan PB, Wang D

Abstract
RNA polymerase II (pol II) encounters numerous barriers during transcription elongation, including DNA strand breaks, DNA lesions, and nucleosomes. Pyrrole-imidazole (Py-Im) polyamides bind to the minor groove of DNA with programmable sequence specificity and high affinity. Previous studies suggest that Py-Im polyamides can prevent transcription factor binding, as well as interfere with pol II transcription elongation. However, the mechanism of pol II inhibition by Py-Im polyamides is unclear. Here we investigate the mechanism of how these minor-groove binders affect pol II transcription elongation. In the presence of site-specifically bound Py-Im polyamides, we find that the pol II elongation complex becomes arrested immediately upstream of the targeted DNA sequence, and is not rescued by transcription factor IIS, which is in contrast to pol II blockage by a nucleosome barrier. Further analysis reveals that two conserved pol II residues in the Switch 1 region contribute to pol II stalling. Our study suggests this motif in pol II can sense the structural changes of the DNA minor groove and can be considered a "minor groove sensor." Prolonged interference of transcription elongation by sequence-specific minor groove binders may present opportunities to target transcription addiction for cancer therapy.

PMID: 27791148 [PubMed - as supplied by publisher]

http://ift.tt/2eIIDmk

Behavioral response of the malaria mosquito, Anopheles gambiae, to human sweat inoculated with axilla bacteria and to volatiles composing human axillary odor.

Related Articles

Behavioral response of the malaria mosquito, Anopheles gambiae, to human sweat inoculated with axilla bacteria and to volatiles composing human axillary odor.

Chem Senses. 2016 Oct 27;:

Authors: Frei J, Kröber T, Troccaz M, Starkenmann C, Guerin PM

Abstract
The responses of Anopheles gambiae Giles sensu stricto (Diptera: Culicidae) to odors from male and female axillary sweat incubated with human axilla bacteria were recorded in a dual-choice olfactometer. Staphylococcus epidermidis was selected for its low odor-producing pattern, Corynebacterium jeikeium for its strong Nα-acylglutamine aminoacylase activity liberating carboxylic acids including (R)/(S)-3-hydroxy-3-methylhexanoic acid (HMHA) and Staphylococcus haemolyticus for its capacity to liberate sulfur-containing compounds including (R/S)-3-methyl-3-sulfanylhexan-1-ol (MSH). Anopheles gambiae behavioral responses were evaluated under (i) its responsiveness to take off and undertake sustained upwind flight and (ii) its discriminating capacity between the two olfactometer arms bearing a test odor in either one or both arms. Experiments were conducted in the presence of carbon dioxide pulses as a behavioral sensitizer. Anopheles gambiae clearly discriminated for the olfactometer arm conveying odor generated by incubating any of the three bacteria species with either male or female sweat. Whereas An. gambiae did not discriminate between male and female sterile sweat samples in the olfactometer, the mosquito consistently showed a preference for male sweat over female sweat incubated with the same bacterium, independent of the species used as inoculum. Sweat incubated with C. jeikeium rendered mosquitoes particularly responsive and this substrate elicited the strongest preference for male over female sweat. Tested on their own, neither HMHA nor MSH elicited a clear discriminating response but did affect mosquito responsiveness. These findings serve as a basis for further research on the odor-mediated anthropophilic host-seeking behavior of An. gambiae.

PMID: 27789516 [PubMed - as supplied by publisher]

http://ift.tt/2fsOUni

RNA polymerase II senses obstruction in the DNA minor groove via a conserved sensor motif.

Related Articles

RNA polymerase II senses obstruction in the DNA minor groove via a conserved sensor motif.

Proc Natl Acad Sci U S A. 2016 Oct 17;:

Authors: Xu L, Wang W, Gotte D, Yang F, Hare AA, Welch TR, Li BC, Shin JH, Chong J, Strathern JN, Dervan PB, Wang D

Abstract
RNA polymerase II (pol II) encounters numerous barriers during transcription elongation, including DNA strand breaks, DNA lesions, and nucleosomes. Pyrrole-imidazole (Py-Im) polyamides bind to the minor groove of DNA with programmable sequence specificity and high affinity. Previous studies suggest that Py-Im polyamides can prevent transcription factor binding, as well as interfere with pol II transcription elongation. However, the mechanism of pol II inhibition by Py-Im polyamides is unclear. Here we investigate the mechanism of how these minor-groove binders affect pol II transcription elongation. In the presence of site-specifically bound Py-Im polyamides, we find that the pol II elongation complex becomes arrested immediately upstream of the targeted DNA sequence, and is not rescued by transcription factor IIS, which is in contrast to pol II blockage by a nucleosome barrier. Further analysis reveals that two conserved pol II residues in the Switch 1 region contribute to pol II stalling. Our study suggests this motif in pol II can sense the structural changes of the DNA minor groove and can be considered a "minor groove sensor." Prolonged interference of transcription elongation by sequence-specific minor groove binders may present opportunities to target transcription addiction for cancer therapy.

PMID: 27791148 [PubMed - as supplied by publisher]

from #ΓεύσηΌσφρηση via a.lsfakia on Inoreader http://ift.tt/2eIIDmk
via IFTTT

Behavioral response of the malaria mosquito, Anopheles gambiae, to human sweat inoculated with axilla bacteria and to volatiles composing human axillary odor.

Related Articles

Behavioral response of the malaria mosquito, Anopheles gambiae, to human sweat inoculated with axilla bacteria and to volatiles composing human axillary odor.

Chem Senses. 2016 Oct 27;:

Authors: Frei J, Kröber T, Troccaz M, Starkenmann C, Guerin PM

Abstract
The responses of Anopheles gambiae Giles sensu stricto (Diptera: Culicidae) to odors from male and female axillary sweat incubated with human axilla bacteria were recorded in a dual-choice olfactometer. Staphylococcus epidermidis was selected for its low odor-producing pattern, Corynebacterium jeikeium for its strong Nα-acylglutamine aminoacylase activity liberating carboxylic acids including (R)/(S)-3-hydroxy-3-methylhexanoic acid (HMHA) and Staphylococcus haemolyticus for its capacity to liberate sulfur-containing compounds including (R/S)-3-methyl-3-sulfanylhexan-1-ol (MSH). Anopheles gambiae behavioral responses were evaluated under (i) its responsiveness to take off and undertake sustained upwind flight and (ii) its discriminating capacity between the two olfactometer arms bearing a test odor in either one or both arms. Experiments were conducted in the presence of carbon dioxide pulses as a behavioral sensitizer. Anopheles gambiae clearly discriminated for the olfactometer arm conveying odor generated by incubating any of the three bacteria species with either male or female sweat. Whereas An. gambiae did not discriminate between male and female sterile sweat samples in the olfactometer, the mosquito consistently showed a preference for male sweat over female sweat incubated with the same bacterium, independent of the species used as inoculum. Sweat incubated with C. jeikeium rendered mosquitoes particularly responsive and this substrate elicited the strongest preference for male over female sweat. Tested on their own, neither HMHA nor MSH elicited a clear discriminating response but did affect mosquito responsiveness. These findings serve as a basis for further research on the odor-mediated anthropophilic host-seeking behavior of An. gambiae.

PMID: 27789516 [PubMed - as supplied by publisher]

from #ΓεύσηΌσφρηση via a.lsfakia on Inoreader http://ift.tt/2fsOUni
via IFTTT

speech and language; +22 new citations

22 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

speech and language

These pubmed results were generated on 2016/10/30

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

from Speech via a.lsfakia on Inoreader http://ift.tt/2f0xdJ2
via IFTTT

Neem leaf glycoprotein regulates function of tumor associated M2 macrophages in hypoxic tumor core: Critical role of IL-10/STAT3 signaling

Publication date: December 2016
Source:Molecular Immunology, Volume 80
Author(s): Kuntal Kanti Goswami, Madhurima Sarkar, Sarbari Ghosh, Akata Saha, Tithi Ghosh, Ipsita Guha, Subhasis Barik, Saptak Banerjee, Soumyabrata Roy, Anamika Bose, Parthasarathi Dasgupta, Rathindranath Baral
Heterogeneous tumor microenvironment (TME), broadly divided into tumor core and peripheral sub-microenvironments, differentially polarize normal macrophages into a different form known as tumor associated M2 macrophages (M2TAMs) to promote tumor growth. In view of the extensive immune-editing role of NLGP, here, we have observed that NLGP is effective to convert M2TAMs (CD11b⁺F4/80^high) to M1 (CD11b⁺F4/80^low) more prominently in tumor core, along with downregulation of other M2 associated markers, like, ManR, Ym1, Fizz1. High IL-10:IL-12 ratio at tumor core was downregulated in NLGP treated melanoma bearing mice. Decrease in IL-10 by NLGP is again associated with the decrease in hypoxia, as indicated by prominent downregulation of HIF1α and VEGF, particularly at tumor core. Macrophages exposed to hypoxic tumor core lysates in vitro exhibited high IL-10, HIF1α and VEGF expression that was significantly downregulated by NLGP. Further evidences suggest M2TAM to M1 conversion by NLGP is associated with STAT3-regulated IL-10 dependent pathway without affecting the IL-4 dependent one. Such TAM modulatory functions of NLGP might help in the restriction of melanoma growth by increasing the proportion of M1 TAMs in tumor core that helps in prevention of tumor relapse and dissemination of the tumor mass.



http://ift.tt/2eYe2Qk

Prolonged survival effects induced by immature dendritic cells and regulatory T cells in a rat liver transplantation model

Publication date: November 2016
Source:Molecular Immunology, Volume 79
Author(s): Wubing He, Lihong Chen, Lin Zheng, Liuping Luo, Lingyun Gao
BackgroundDendritic cells (DCs) and regulatory T (Treg) cells are crucial for inducing immune tolerance. However, the suppressive function of infused Treg cells and immature DCs (imDCs) following solid organ transplantation remains unclear.MethodsImDCs derived from DA-donor rats and Treg cells isolated from spleens of Lewis rats were prepared. A heterotopic liver transplantation model was established to examine the immune tolerance effects of infusion of Treg-imDCs, imDCs and Treg cells individually. Th1/Th2 cytokines and TRAL were detected by ELISA. The overall rejection grade was assessed and the rejection activity index (RAI) was calculated. TUNEL-positive lymphocytes were detected in the portal area in liver sections.ResultsThe infusion of Treg-imDCs was more effective than imDCs or Treg cells individually. Moreover, the expression of IL-10 and TGF-β1 was significantly up-regulated, and IL-12 expression was significantly down-regulated, especially in the Treg-imDCs group. The percentage of TUNEL-positive cells was significantly higher in the Treg cells and imDCs groups. The RAI values in Treg-imDCs group on days 3 and 7 were lower than control, imDCs and Treg cells groups individually (p<0.05). Both TBIL and ALT levels in the Treg-imDCs and imDCs groups were significantly lower than those of the control and Treg cells groups, and serum TRAL levels increased significantly 10days after transplantation in the imDC and Treg-imDC groups compared with the control and Treg cells groups (P<0.001).ConclusionThese data demonstrated that infusion of Treg cells and/or imDCs induces alloantigen tolerance and prolongs liver allograft survival. The infusion of Treg-imDCs was more effective than imDCs or Treg cells individually. ImDCs synergize with Treg cells in inducing and maintaining the feedback loop between imDCs and Treg cells in vivo.



http://ift.tt/2eGqfe1

Comparative assessment of lipid based nano-carrier systems for dendritic cell based targeting of tumor re-initiating cells in gynecological cancers

Publication date: November 2016
Source:Molecular Immunology, Volume 79
Author(s): Arpit Bhargava, Dinesh K. Mishra, Subodh K. Jain, Rupesh K. Srivastava, Nirmal K. Lohiya, Pradyumna K. Mishra
We aimed to identify an optimum nano-carrier system to deliver tumor antigen to dendritic cells (DCs) for efficient targeting of tumor reinitiating cells (TRICs) in gynecological malignancies. Different lipid based nano-carrier systems i.e. liposomes, ethosomes and solid lipid nanoparticles (SLNPs) were examined for their ability to activate DCs in allogeneic settings. Out of these three, the most optimized formulation was subjected for cationic and mannosylated surface modification and pulsed with DCs for specific targeting of tumor cells. In both allogeneic and autologous trials, SLNPs showed a strong ability to activate DCs and orchestrate specific immune responses for targeting TRICs in gynecological malignancies. Our findings suggest that the mannosylated form of SLNPs is a suitable molecular vector for DC based therapeutics. DCs pulsed with mannosylated SLNPs may be utilized as adjuvant therapy for specific removal of TRICs to benefit patients from tumor recurrence.



http://ift.tt/2eYfvWP

A novel p38 MAPK indentified from Crassostrea hongkongensis and its involvement in host response to immune challenges

Publication date: November 2016
Source:Molecular Immunology, Volume 79
Author(s): Fufa Qu, Zhiming Xiang, Yang Zhang, Jun Li, Shu Xiao, Yuehuan Zhang, Fan Mao, Haitao Ma, Ziniu Yu
p38 mitogen-activated protein kinases (MAPKs) are conserved serine/threonine-specific kinases that are activated by various extracellular stimuli and play crucial regulatory roles in immunity, development and homeostasis. However, the function of p38s in mollusks, the second most diverse group of animals, is still poorly understood. In this study, a novel molluscan p38 (designated Chp38) was cloned and characterized from the Hong Kong oyster Crassostrea hongkongensis. Its full-length cDNA encoded a putative protein of 353 amino acids with a calculated molecular weight of approximately 40.3kDa. Similar to other reported p38 family proteins, the deduced Chp38 sequence contained a conserved dual phosphorylation TGY motif and a substrate binding site of ATRW. Phylogenetic analysis revealed that Chp38 was closest to its homolog from the Pacific oyster and belonged to the mollusk cluster. Quantitative real-time PCR analysis showed that Chp38 was constitutively expressed in all examined oyster tissues and developmental stages and that its expression in hemocytes was significantly up-regulated after pathogen (Vibrio alginolyticus and Staphylococcus haemolyticus) and PAMP (lipopolysaccharide and peptidoglycan) infections. Moreover, overexpression analysis revealed that Chp38 was localized in both the cytoplasm and nucleus of HEK293T cells and that it could significantly enhance AP-1 reporter gene activation in a dose-dependent manner. Altogether, these results provide the first experimental evidence of a functional p38 in oysters and suggest its involvement in the innate immunity of C. hongkongensis.



http://ift.tt/2eGsvlw

Intercellular communication for innate immunity

Publication date: Available online 18 October 2016
Source:Molecular Immunology
Author(s): Tan A. Nguyen, Ken C. Pang, Seth L. Masters
An effective innate immune response relies on the detection of pathogen associated molecular patterns (PAMPs) by various host pattern recognition receptors (PRRs) that result in the production of pro-inflammatory cytokines and chemokines. Viruses and bacteria have co-evolved with the immune system and developed multiple strategies to usurp or circumvent host machinery and blunt the innate immune response in infected cells. Recently, it has become apparent that infected or dying cells can transmit PAMPs and host PRR signalling proteins to uninfected bystander cells to thereby bypass pathogen evasion strategies, and potentiate innate immune signalling. This bystander activation of innate immunity represents an alternative method by which the host can control infections via cell-to-cell communication. In this review, we discuss what is currently known about the intercellular transfer of pathogen- or host-derived RNA, DNA and proteins from infected cells to neighbouring cells and how this impacts on host innate immunity.



http://ift.tt/2eYakGf

Is there any place for spontaneous healing in deep palmar burn of the child?

Publication date: Available online 21 October 2016
Source:Annales de Chirurgie Plastique Esthétique
Author(s): J. Chateau, M. Guillot, L. Zevounou, F. Braye, J.-L. Foyatier, J.-P. Comparin, D. Voulliaume
Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol.



http://ift.tt/2eZT9Ud

Évaluation de la prise en charge des sarcomes des tissus mous en Franche-Comté depuis l’instauration d’une réunion de concertation pluridisciplinaire au CHRU. À propos de 47 cas

Publication date: Available online 22 October 2016
Source:Annales de Chirurgie Plastique Esthétique
Author(s): J. Haddad, E. Kalbacher, M. Piccard, S. Aubry, L. Chaigneau, J. Pauchot
Buts de l'étudeUne réunion de concertation pluridisciplinaire (RCP) dédiée à la prise en charge des sarcomes a été instaurée en Franche-Comté en 2010. Les buts de l'étude sont : (a) évaluer la prise en charge des sarcomes par confrontation à la revue de la littérature ; (b) évaluer l'influence de la RCP sur la prise en charge des sarcomes par les hôpitaux au niveau régional.Matériel et méthodeIl s'agit d'une étude rétrospective unicentrique de 2010 à 2015 chez des patients présentant un sarcome des tissus mous périphériques et établie à partir d'une base de données NetSarc (Réseau national des sarcomes) et du dossier communicant de cancérologie. Une base de données CleanWeb^® spécialement dédiée est créée.RésultatsQuarante-sept patients sont inclus : dix sarcomes au niveau du membre supérieur, quarante-sept patients ont été inclus, 26 au niveau des membres inférieurs, 11 au niveau du tronc. Quarante patients ont été opérés : dix hors CHRU, 28 en CHRU et deux en centre coordinateur. Quatre-vingt-dix pour cent des patients pris en charge au CHRU étaient conformes aux recommandations. Aucun patient opéré en dehors du CHRU ne bénéficiait d'une prise en charge conforme aux recommandations. On constate une augmentation du nombre de dossiers adressés par les hôpitaux hors CHRU discuté en RCP avant tout traitement.ConclusionLa création d'une RCP dédiée au sarcome améliore la prise en charge de ces tumeurs et diminue les prises en charge inadaptées en sensibilisant les médecins au niveau régional.Goals of studyA multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level.Materials and MethodsThis is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created.ResultsForty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment.ConclusionThe creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians.



http://ift.tt/2fh6pYr

Re: Lead diagnostic testing and maxillofacial gunshot wounds

Publication date: Available online 27 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): B.E. Edetanlen, B.D. Saheeb




http://ift.tt/2eXTfMC

Thyrolingual trunk: aberrant branches of the external carotid artery

Publication date: Available online 27 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): S. Al-Ali, R. Elledge, T. Esmil, G. Walton




http://ift.tt/2eGbJD1

Measurements of chlorhexidine, p-chloroaniline, and p-chloronitrobenzene in saliva after mouth wash before and after operation with 0.2% chlorhexidine digluconate in maxillofacial surgery: a randomised controlled trial

Publication date: Available online 24 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): H. Below, O. Assadian, R. Baguhl, U. Hildebrandt, B. Jäger, K. Meissner, D.J. Leaper, A. Kramer
Chlorhexidine gluconate is used to prevent the accumulation of dental plaque and gingivitis, infection of the surgical site, and ventilator-associated pneumonia in maxillofacial surgery, but it is not clear whether the metabolites of chlorhexidine are detectable in the patient's saliva at clinically relevant concentrations. Forty-three patients who had orofacial operations were randomised to use a 0.2% chlorhexidine gluconate (n=23), or an octenidine-based, chlorhexidine-free (n=20), mouthwash once preoperatively and three times daily for five postoperative days. After the first, 8.7 (23.3) mg/L chlorhexidine (0.7%-2.5% of the total amount used) was measured in saliva. The concentration increased to 15.2 (6.2) mg/L after the second rinse (first postoperative day), and peaked at 29.4 (11.2) mg/L on the fourth postoperative day. It remained detectable for up to 12hours after the last one, but was not detectable in serum or urine at any time. The potentially carcinogenic metabolite p-chloroaniline was detectable in saliva at higher concentrations in the chlorhexidine group (0.55mg/L) than the octenidine group (0.21mg/L), and p-chloronitrobenzene was detected in both groups in only minimal concentrations (0.001-0.21mg/L). Chlorhexidine gluconate mouthwashes do increase the concentration of p-chloroaniline, but a single use seems to be safe. Whether prolonged exposure over many years may have carcinogenic potential is still not clear. Based on the hitherto unknown kinetics of p-chloroaniline in saliva, the recent recommendation of the Federal Drug Administration (FDA) in the USA to limit the use of a chlorhexidine gluconate mouthwash to a maximum of six months seems to be justified.



http://ift.tt/2eXPPd0

Use of a bolster to secure a skin regeneration system on the tongue

Publication date: Available online 22 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J.N. Farrier, A.N. Beech




http://ift.tt/2eG9fEG

Experimental model of osteonecrosis of the jaw in rats treated with zoledronic acid

Publication date: Available online 22 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): M.E. Kolpakova, A.A. Zubarevа, T.D. Artamonova, E.K. Lisovskaya, S.G. Chefu, O.D. Yagmurov, A.I. Yaremenko, T.D. Vlasov
We have examined the development of medication-related osteonecrosis of the jaws (MRONJ) in rats with no previous accumulation of zoledronic acid in the mandible. Ten male Wistar rats (weight 350–400g) were anaesthetised with chloral hydrate 450mg/kg intraperitoneally and the first and second mandibular molars on the left side were extracted. The five experimental rats were given six injections of zoledronic acid 0.18mg/kg over the next four weeks (total dose 1.08mg/kg). Two injections were given at once as an intravenous bolus injection (0.36mg/kg). Then rats were given 4 injections (0.18mg/kg) with 1 week interval over the next four weeks, after which they observed for a further four weeks. The five control rats were injected with saline. At the end of the eighth week, the animals were killed by asphyxiation in a carbon dioxide chamber, and their bone structure was visualised using cone-beam computed tomography (CT) and Galaxis software. We then studied the mandibles histopathologically to investigate the incidence of necrosis and infiltration of inflammatory cells. The cone-beam CT images in the experimental group showed deficiencies in the bone structure in the extracted molar area of the lower alveolar ridge. The histological findings in the mandibles of the group given zoledronic acid showed necrosis and infiltration of inflammatory cells, which were not present in the control group. We conclude that the immediate effect of zoledronic acid on the bone tissue during regeneration is an important factor in the development of MRONJ, in addition to the previously reported effects of the duration of treatment with zoledronic acid.



http://ift.tt/2eXRqPF

Quality of information about maxillofacial trauma on the Internet

Publication date: Available online 28 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): D.M. McGoldrick, P. Kielty, C. Cotter
Patients increasingly search the Internet for information about health and potential treatments, but the content and accuracy of some websites are questionable. To evaluate the quality of information on maxillofacial trauma, we searched for the terms "jaw fracture" and "cheekbone fracture" on Google, Yahoo, and Bing. We assessed the first 10 results of each search and excluded duplicates or those that were unrelated. We then used the DISCERN tool and the JAMA (Journal of the American Medical Association) benchmarks to assess those that remained. Of the original 60 found, 38 were excluded (29 duplicates, 9 unrelated). The mean (range) DISCERN score for each search was 38.5 (27–57) for jaw fracture and 41.9 (26–61) for cheekbone fracture. No website achieved an excellent score (more than 63), and over three-quarters were categorised as poor (27–38) or fair (39–50). None met all the JAMA benchmarks, but most adhered to at least two. The standard of online information on maxillofacial trauma varies, but is generally of poor quality. Patients should therefore be advised to be cautious of online sources and should be directed towards higher-quality websites.



http://ift.tt/2eG7irG

Re: Novel approach in the treatment of a persistent oroantral fistula using an acellular dermal graft: technical note

Publication date: Available online 22 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): A.N. Beech, J.N. Farrier




http://ift.tt/2eXPg2O

In vitro evaluation of the resistance of three types of fixation to treat fractures of the mandibular angle

Publication date: Available online 21 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): D. Maritza Contreras Gonzalez, G. Spagnol, C. Edvard Sverzut, A. Elias Trivellato
The purpose of this study was to compare the mechanical resistance of three different plates used to treat fractures of the mandibular angle: a regular 4-hole plate, a longer 4-hole plate (both positioned using the Champy technique), and a 3-dimensional plate positioned over the oblique line. Three equal groups of replicas of human dentate mandibles made out of polyurethane resin were used (n=21 in each group). The force was applied perpendicular to the occlusal plane at a rate of 2mm/minute at three different points: the first molar on the sectioned side; the first molar on the contralateral side; and between the central incisors. This was followed by a resistance-to-load test. The two varying factors (type of plate and site-of-load application) were tested by analysis of variance, and probabilities of less than 0.05 were accepted as significant. There were no significant differences between the subgroups, or between the mean values of the different types of plates (p=0.925). The three types of plates showed similar mechanical behaviour, which showed that the 3-dimensional plates positioned over the oblique line can produce mechanical scores similar to those of conventional plates.



http://ift.tt/2f2ol4b

Intraoral ultrasonography with wrapped acoustic coupling medium

Publication date: Available online 21 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): K. Sugiura, T. Iwai, S. Oguri, I. Tohnai




http://ift.tt/2e7THJc

Management of oromandibular dystonia with botulinum A toxin: a series of cases

Publication date: Available online 21 October 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): T.A. Teemul, R. Patel, A. Kanatas, L.M. Carter
Oromandibular dystonia is a disorder of movement that is often misdiagnosed. We present our experience of six patients treated with botulinum A toxin, for whom we recorded the symptoms, the group of muscles targeted, and the quantity of botulinum toxin used. We used the Glasgow Benefit Inventory (GBI) questionnaire to record and analyse outcomes after treatment. Five of the six patients had a good outcome as recorded by the GBI, the mean (SD) score of which was +40 (28), which reflected that the patients were well satisfied. The overall improvement in the categories of general health, social health, and physical health were 82%, 37%, and 31%, respectively. Botulinum type A toxin is an effective treatment of oromandibular dystonia. It is important for clinicians to recognise the condition, as treatment is well-tolerated and can improve quality of life.



http://ift.tt/2f2rj8L