Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Τετάρτη 31 Μαΐου 2017
The extended medial plantar artery (EMPA) free flap for plantar foot defects
Abstract
The medial plantar artery (MPA) flap was first introduced by Mir y Mir in 1954 and used to reconstruct a heel defect. The sole of the foot is designed to bear body weight and absorb the shocks of a bipedal gait. The properties of the plantar skin and deeper tissues are therefore highly specialised, and if normal function is to be restored, it is essential to replace "like with like" which is a fundamental principle of reconstructive surgery.
The aim of this article is to introduce the concept of an extended medial plantar artery (EMPA) free flap for plantar foot defects. The advantage of the extended version of the MPA flap in the presented cases is the harvest of a larger bulk of tissue and thus the possibility of covering larger defects in the weight-bearing area of the foot.
Level of Evidence: Level V, therapeutic study.
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Masseteric to buccal branch nerve transfer.
Purpose of review: To review recent literature pertaining to the use of masseteric-facial nerve neurorrhaphy (MFNN) for facial reanimation in patients with facial paralysis. Recent findings: First, MFNN effectively restores some midface tone and function, including the ability to smile. Second, use of the masseteric nerve minimizes synkinesis, dysarthria, and dysphagia that frequently occur after hypoglossal-facial nerve neurorrhaphy. Third, concurrent cable grafting to the zygomatic branch from an intact proximal facial nerve remnant - when available - can restore dynamic eye closure. Summary: Masseteric nerve transfer is an alternative to hypoglossal nerve transfer that improves midface appearance and function for properly selected patients with facial paralysis. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Randomised non-inferiority trial: 1600 mg versus 400 mg tablets of mesalazine for the treatment of mild-to-moderate ulcerative colitis
Summary
Background
High concentration mesalazine formulations are more convenient than conventional low concentration formulations for the treatment of ulcerative colitis (UC).
Aim
To compare the efficacy and safety of 1600 mg and 400 mg tablet mesalazine formulations.
Methods
Patients with mild-to-moderate active UC (Mayo Clinic Score >5; N=817) were randomised to 3.2 g of oral mesalazine, administered as two 1600 mg tablets once, or four 400 mg tablets twice daily. We hypothesised that treatment with the 1600 mg tablet was non-inferior (within a 10% margin) to the 400 mg tablet for induction of clinical and endoscopic remission at week 8. Open-label treatment with the 1600 mg tablet continued for 26-30 weeks based on induction response. Predictors of treatment response were also explored.
Results
At week 8, remission occurred in 22.4% and 24.6% of patients receiving the 1600 mg and 400 mg tablets, respectively (absolute difference −2.2%, 95% CI: −8.1% to 3.8%, non-inferiority P=.005). Endoscopic and histopathologic disease activity, leucocyte concentration and age were significantly associated with clinical remission (P=.022, .042, .014 and .023, respectively). At week 38, 43.9% (296/675) of patients who continued treatment with the 1600 mg formulation were in remission, including 70.3% (142/202) of patients who received a reduced dose of mesalazine (1.6 g/d). The overall incidence of serious adverse events was low.
Conclusions
Induction therapy with 3.2 mg mesalazine using two 1600 mg tablets once-daily was statistically and clinically non-inferior to a twice-daily regimen using four 400 mg tablets (NCT01903252).
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Denaturing gradient gel electrophoresis profiles of bacteria from the saliva of twenty four different individuals form clusters that showed no relationship to the yeasts present
Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Manjula M Weerasekera, Chris H Sissons, Lisa Wong, Sally A Anderson, Ann R Holmes, Richard D Cannon
ObjectivesThe aim was to investigate the relationship between groups of bacteria identified by cluster analysis of the DGGE fingerprints and the amounts and diversity of yeast present.MethodsBacterial and yeast populations in saliva samples from 24 adults were analysed using denaturing gradient gel electrophoresis (DGGE) of the bacteria present and by yeast culture.ResultsEubacterial DGGE banding patterns showed considerable variation between individuals. Seventy one different amplicon bands were detected, the band number per saliva sample ranged from 21 to 39 (mean±SD=29.3±4.9). Cluster and principal component analysis of the bacterial DGGE patterns yielded three major clusters containing 20 of the samples. Seventeen of the 24 (71%) saliva samples were yeast positive with concentrations up to 103cfu/mL. Candida albicans was the predominant species in saliva samples although six other yeast species, including Candida dubliniensis, Candida tropicalis, Candida krusei, Candida guilliermondii, Candida rugosa and Saccharomyces cerevisiae, were identified. The presence, concentration, and species of yeast in samples showed no clear relationship to the bacterial clusters.ConclusionDespite indications of in vitro bacteria-yeast interactions, there was a lack of association between the presence, identity and diversity of yeasts and the bacterial DGGE fingerprint clusters in saliva. This suggests significant ecological individual-specificity of these associations in highly complex in vivo oral biofilm systems under normal oral conditions.
Graphical abstract
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Agomelatine, a MT1/MT2 melatonergic receptor agonist with serotonin 5-HT2C receptor antagonistic properties, suppresses Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages
Source:Archives of Oral Biology, Volume 82
Author(s): Jin-Yi Hyeon, Eun-Young Choi, So-Hui Choe, Hae Ryoun Park, Jeom-Il Choi, In Soon Choi, Sung-Jo Kim
ObjectiveThis study was performed in an attempt to examine the influence of agomelatine in mitigating the generation of proinflammatory mediators in RAW264.7 murine macrophages exposed to lipopolysaccharide (LPS) obtained from Prevotella intermedia, a gram-negative anaerobic bacterium that is related with various types of periodontal diseases, and the molecular mechanisms behind its effects.DesignLPS from P. intermedia strain ATCC 25611 was prepared employing the conventional phenol-water procedure. Conditioned culture media were analyzed for the levels of nitric oxide (NO), interleukin-1β (IL-1β) and IL-6. Real-time PCR analysis was carried out to determine the mRNA levels of inducible NO synthase (iNOS), IL-1β, IL-6 and SOCS1. Protein expression levels were evaluated by immunoblot test. NF-κB-dependent SEAP reporter assay was performed using a reporter cell line. DNA-binding activities of NF-κB subunits were analyzed utilizing the ELISA-based kits.ResultsAgomelatine was found to down-regulate significantly the generation of iNOS-derived NO, IL-1β and IL-6 as well as the expression of their mRNAs in cells activated with P. intermedia LPS. Agomelatine decreased NF-κB-dependent SEAP release caused by P. intermedia LPS. Agomelatine did not inhibit NF-κB transcription induced by LPS at the level of IκB-α degradation. Instead, LPS-induced nuclear translocation and DNA binding of NF-κB p50 subunit was blocked by agomelatine. P. intermedia LPS-elicited activation of STAT1 and STAT3 was reduced notably by co-treatment with agomelatine. Agomelatine showed a tendency to enhance mRNA level of SOCS1 in LPS-activated cells as well.ConclusionsAgomelatine merits further evaluation to reveal its usefulness on the host modulation of periodontal disease.
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Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 80
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Denaturing gradient gel electrophoresis profiles of bacteria from the saliva of twenty four different individuals form clusters that showed no relationship to the yeasts present
Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Manjula M Weerasekera, Chris H Sissons, Lisa Wong, Sally A Anderson, Ann R Holmes, Richard D Cannon
ObjectivesThe aim was to investigate the relationship between groups of bacteria identified by cluster analysis of the DGGE fingerprints and the amounts and diversity of yeast present.MethodsBacterial and yeast populations in saliva samples from 24 adults were analysed using denaturing gradient gel electrophoresis (DGGE) of the bacteria present and by yeast culture.ResultsEubacterial DGGE banding patterns showed considerable variation between individuals. Seventy one different amplicon bands were detected, the band number per saliva sample ranged from 21 to 39 (mean±SD=29.3±4.9). Cluster and principal component analysis of the bacterial DGGE patterns yielded three major clusters containing 20 of the samples. Seventeen of the 24 (71%) saliva samples were yeast positive with concentrations up to 103cfu/mL. Candida albicans was the predominant species in saliva samples although six other yeast species, including Candida dubliniensis, Candida tropicalis, Candida krusei, Candida guilliermondii, Candida rugosa and Saccharomyces cerevisiae, were identified. The presence, concentration, and species of yeast in samples showed no clear relationship to the bacterial clusters.ConclusionDespite indications of in vitro bacteria-yeast interactions, there was a lack of association between the presence, identity and diversity of yeasts and the bacterial DGGE fingerprint clusters in saliva. This suggests significant ecological individual-specificity of these associations in highly complex in vivo oral biofilm systems under normal oral conditions.
Graphical abstract
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Agomelatine, a MT1/MT2 melatonergic receptor agonist with serotonin 5-HT2C receptor antagonistic properties, suppresses Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages
Source:Archives of Oral Biology, Volume 82
Author(s): Jin-Yi Hyeon, Eun-Young Choi, So-Hui Choe, Hae Ryoun Park, Jeom-Il Choi, In Soon Choi, Sung-Jo Kim
ObjectiveThis study was performed in an attempt to examine the influence of agomelatine in mitigating the generation of proinflammatory mediators in RAW264.7 murine macrophages exposed to lipopolysaccharide (LPS) obtained from Prevotella intermedia, a gram-negative anaerobic bacterium that is related with various types of periodontal diseases, and the molecular mechanisms behind its effects.DesignLPS from P. intermedia strain ATCC 25611 was prepared employing the conventional phenol-water procedure. Conditioned culture media were analyzed for the levels of nitric oxide (NO), interleukin-1β (IL-1β) and IL-6. Real-time PCR analysis was carried out to determine the mRNA levels of inducible NO synthase (iNOS), IL-1β, IL-6 and SOCS1. Protein expression levels were evaluated by immunoblot test. NF-κB-dependent SEAP reporter assay was performed using a reporter cell line. DNA-binding activities of NF-κB subunits were analyzed utilizing the ELISA-based kits.ResultsAgomelatine was found to down-regulate significantly the generation of iNOS-derived NO, IL-1β and IL-6 as well as the expression of their mRNAs in cells activated with P. intermedia LPS. Agomelatine decreased NF-κB-dependent SEAP release caused by P. intermedia LPS. Agomelatine did not inhibit NF-κB transcription induced by LPS at the level of IκB-α degradation. Instead, LPS-induced nuclear translocation and DNA binding of NF-κB p50 subunit was blocked by agomelatine. P. intermedia LPS-elicited activation of STAT1 and STAT3 was reduced notably by co-treatment with agomelatine. Agomelatine showed a tendency to enhance mRNA level of SOCS1 in LPS-activated cells as well.ConclusionsAgomelatine merits further evaluation to reveal its usefulness on the host modulation of periodontal disease.
http://ift.tt/2qIql7h
Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 80
http://ift.tt/2rdwkEu
Denaturing gradient gel electrophoresis profiles of bacteria from the saliva of twenty four different individuals form clusters that showed no relationship to the yeasts present
Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Manjula M Weerasekera, Chris H Sissons, Lisa Wong, Sally A Anderson, Ann R Holmes, Richard D Cannon
ObjectivesThe aim was to investigate the relationship between groups of bacteria identified by cluster analysis of the DGGE fingerprints and the amounts and diversity of yeast present.MethodsBacterial and yeast populations in saliva samples from 24 adults were analysed using denaturing gradient gel electrophoresis (DGGE) of the bacteria present and by yeast culture.ResultsEubacterial DGGE banding patterns showed considerable variation between individuals. Seventy one different amplicon bands were detected, the band number per saliva sample ranged from 21 to 39 (mean±SD=29.3±4.9). Cluster and principal component analysis of the bacterial DGGE patterns yielded three major clusters containing 20 of the samples. Seventeen of the 24 (71%) saliva samples were yeast positive with concentrations up to 103cfu/mL. Candida albicans was the predominant species in saliva samples although six other yeast species, including Candida dubliniensis, Candida tropicalis, Candida krusei, Candida guilliermondii, Candida rugosa and Saccharomyces cerevisiae, were identified. The presence, concentration, and species of yeast in samples showed no clear relationship to the bacterial clusters.ConclusionDespite indications of in vitro bacteria-yeast interactions, there was a lack of association between the presence, identity and diversity of yeasts and the bacterial DGGE fingerprint clusters in saliva. This suggests significant ecological individual-specificity of these associations in highly complex in vivo oral biofilm systems under normal oral conditions.
Graphical abstract
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Agomelatine, a MT1/MT2 melatonergic receptor agonist with serotonin 5-HT2C receptor antagonistic properties, suppresses Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages
Source:Archives of Oral Biology, Volume 82
Author(s): Jin-Yi Hyeon, Eun-Young Choi, So-Hui Choe, Hae Ryoun Park, Jeom-Il Choi, In Soon Choi, Sung-Jo Kim
ObjectiveThis study was performed in an attempt to examine the influence of agomelatine in mitigating the generation of proinflammatory mediators in RAW264.7 murine macrophages exposed to lipopolysaccharide (LPS) obtained from Prevotella intermedia, a gram-negative anaerobic bacterium that is related with various types of periodontal diseases, and the molecular mechanisms behind its effects.DesignLPS from P. intermedia strain ATCC 25611 was prepared employing the conventional phenol-water procedure. Conditioned culture media were analyzed for the levels of nitric oxide (NO), interleukin-1β (IL-1β) and IL-6. Real-time PCR analysis was carried out to determine the mRNA levels of inducible NO synthase (iNOS), IL-1β, IL-6 and SOCS1. Protein expression levels were evaluated by immunoblot test. NF-κB-dependent SEAP reporter assay was performed using a reporter cell line. DNA-binding activities of NF-κB subunits were analyzed utilizing the ELISA-based kits.ResultsAgomelatine was found to down-regulate significantly the generation of iNOS-derived NO, IL-1β and IL-6 as well as the expression of their mRNAs in cells activated with P. intermedia LPS. Agomelatine decreased NF-κB-dependent SEAP release caused by P. intermedia LPS. Agomelatine did not inhibit NF-κB transcription induced by LPS at the level of IκB-α degradation. Instead, LPS-induced nuclear translocation and DNA binding of NF-κB p50 subunit was blocked by agomelatine. P. intermedia LPS-elicited activation of STAT1 and STAT3 was reduced notably by co-treatment with agomelatine. Agomelatine showed a tendency to enhance mRNA level of SOCS1 in LPS-activated cells as well.ConclusionsAgomelatine merits further evaluation to reveal its usefulness on the host modulation of periodontal disease.
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Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 80
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Protective Strategies Against Dysphonia in Teachers: Preliminary Results Comparing Voice Amplification and 0.9% NaCl Nebulization
This study aimed to compare the effects of two protective strategies, voice amplification (VA) and 0.9% NaCl nebulization (NEB), on teachers' voice in the work setting.
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Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers
The present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers.
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A magnetic resonance imaging study of gastric motor function in patients with dyspepsia associated with Ehlers-Danlos Syndrome-Hypermobility Type: A feasibility study
Abstract
Background
The clinical use of Magnetic Resonance Imaging (MRI) for investigating gastric motor function in dyspepsia is limited, largely due to protocol complexity, cost and limited availability. In this study, we explore the feasibility of a sub 60-minute protocol using a water challenge to assess gastric emptying, motility and accommodation in a cohort of Ehlers-Danlos Syndrome-Hypermobility type (EDS-HT) patients presenting with dyspepsia.
Methods
Nine EDS-HT patients (mean age 33, range: 26-50 all female) with a history of dyspepsia were recruited together with nine-matched controls. Subjects fasted for 6 hours prior to MRI. A baseline anatomical and motility scan was performed after which the subjects ingested 300 mL water. The anatomical and motility scans were then repeated every 10 minutes to a total of 60 minutes. Gastric emptying time, motility, and accommodation were calculated based on the observations of two observers for each EDS-HT subject and compared to their matched control using paired statistics.
Key Results
Median motility increase following the water challenge was lower in EDS-HT subjects (11%, range: 0%-22%) compared to controls (22%, range: 13%-56%), P=.03. Median gastric emptying time was non-significantly decreased in EDS-HT subjects (12.5 minutes, range: 6-27) compared to controls (20 minutes, range: 7-30), P=.15. Accommodation was non-significantly reduced in EDS-HT subjects (56% increase, range: 32%-78%) compared to healthy controls (67% increase, range: 52%-78%), P=.19.
Conclusions & Inferences
This study demonstrates the feasibility of a water challenge MRI protocol to evaluate gastric physiology in the clinical setting. Motility differences between EDS-HT and controls are worthy of further investigation.
Aberrant gastric motility, accommodation, transit time likely play a role in dyspepsia. MRI has the ability to quantitatively evaluate these processes but remains underused due the length of existing protocols and uncertainly regarding its role in the clinical care pathway. In this study, we propose a 60 minutes protocol using a water stimulus which reveals differences between Ehlers Danlos patients with dyspepsia and healthy matched controls.
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Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection
Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection.
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Predicting fractures using trabecular patterns on panoramic radiographs
Abstract
Objectives
The observer score of the trabecular pattern on panoramic radiographs is known to be a strong predictor of bone fractures. The aim of this study was to enhance the predictive power of panoramic radiographs by means of texture analysis methods.
Material and methods
The study followed 304 postmenopausal women during 26 years. At the beginning of the study, panoramic radiographs were obtained. One observer assessed the trabecular pattern in the premolar region as dense, sparse, or alternating dense and sparse. In addition, on each radiograph, a region of interest was selected in the molar/premolar region and analyzed with texture analysis procedures. During 26 years of follow-up, 115 women suffered a fracture of the hip, spine, leg, or arm. Logistic regression was applied to test the predictive power of various variables with respect to fractures.
Results
Of all variables, the observer score of the trabecular pattern correlated strongest with the occurrence of fractures. By itself, the score yielded an ROC curve with an area of 0.80 under the curve. Combining the observer score with the texture analysis features increased the area under the ROC curve to 0.85.
Conclusions
The trabecular pattern on panoramic radiographs provides a strong predictor of fractures, at least for postmenopausal women. The assessment by an observer combined with texture analysis procedures yields a predictive power that parallels best known predictions in literature.
Clinical relevance
This study illustrates that panoramic radiographs are state of the art predictors of postcranial fractures.
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Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection
Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection.
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Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection
Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection.
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Patterns of regional recurrence in papillary thyroid cancer patients with lateral neck metastases undergoing neck dissection
Practice variability exists for the extent of neck dissection undertaken for papillary thyroid carcinoma (PTC) metastatic to the lateral neck nodes, with disagreement over routine level V dissection.
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Eosinophilic esophagitis induced by aeroallergen sublingual immunotherapy in an enteral feeding tube–dependent pediatric patient
Eosinophilic esophagitis (EoE) is an increasingly recognized eosinophilic gastrointestinal disorder that affects children and adults, with a prevalence of 5 per 10,000 inhabitants in Europe and the United States.1 Food antigens trigger more than 90% of cases; however, data suggest that aeroallergens may also play a pathogenic role.2,3 In addition, sublingual immunotherapy (SLIT) is being increasingly used for the treatment of allergic rhinitis and allergic asthma. In this report, we describe a 9-year-old enteral feeding tube–dependent boy who developed increased esophageal eosinophilia, suggesting EoE after initiating aeroallergen SLIT.
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Prospective evaluation of electronic medical record penicillin allergy documentation at a tertiary community teaching hospital
The global threat of increasing antibiotic resistance has driven regulatory organizations to advocate for the judicious and prudent use of antibiotics through robust antibiotic stewardship programs. Recently published antibiotic stewardship guidelines detail recommended strategies to optimize antibiotic use in a variety of health care settings.1 One such strategy includes a thorough penicillin allergy history assessment and, if indicated, subsequent penicillin skin testing in patients with a reported penicillin allergy.
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VideoEndocrinology™ High-Impact Videos
VideoEndocrinology™
Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association
FREE ACCESS through June 14, 2017.
Transoral Endoscopic Parathyroid Cyst Removal
Jonathon O. Russell, Mai G. Al Khadem, Ralph P. Tufano
Needle-Assisted Endoscopic Lateral Neck Dissection Through Bilateral Areola Approach for Papillary Thyroid Carcinoma Patients
Wen-Xin Zhao, Bo Wang, Shou-Yi Yan, Li-Yong Zhang, Jia Wen
The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.
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VideoEndocrinology™ High-Impact Videos
VideoEndocrinology™
Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association
FREE ACCESS through June 14, 2017.
Transoral Endoscopic Parathyroid Cyst Removal
Jonathon O. Russell, Mai G. Al Khadem, Ralph P. Tufano
Needle-Assisted Endoscopic Lateral Neck Dissection Through Bilateral Areola Approach for Papillary Thyroid Carcinoma Patients
Wen-Xin Zhao, Bo Wang, Shou-Yi Yan, Li-Yong Zhang, Jia Wen
The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.
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Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: A meta-analysis
Although some authors have recently investigated the co-occurrence of posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA), the topic remains insufficiently studied. The aim of this meta-analysis was to detect the pooled prevalence of OSA in PTSD and its impact on adherence to continuous positive airway pressure (CPAP) therapy.
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Cannabis for restless legs syndrome: A report of six patients
Restless legs syndrome (RLS) is a chronic and sometimes severe sensorimotor disorder of still unclear pathophysiology [1]. Usually symptoms respond well to dopamine agonists (DA), opiates, or anticonvulsants, used either alone or in combination. However, a subset of patients remains refractory to medical therapy, and serious side effects such as augmentation and impulse control disorder have been observed with DA. We present six patients' spontaneous reports of a remarkable and total remission of RLS symptoms after cannabis use.
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GHB Levels in Breast Milk of Women with Narcolepsy with Cataplexy Treated with Sodium Oxybate
To determine GHB levels in breastmilk of women taking sodium oxybate (Xyrem) for treatment of narcolepsy and cataplexy.
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Do gender and racial/ethnic disparities in sleep duration emerge in early adulthood? Evidence from a longitudinal study of U.S. adults
Gender and racial/ethnic disparities in sleep duration are well documented among the U.S. adult population, but we know little about how these disparities are shaped during the early course of adult life, a period marked by substantial changes in social roles that can influence time for sleep.
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Electrophysiological and microstructural features of sleep in children at high risk for depression: A preliminary study
This preliminary study investigated electrophysiological and microstructural features of sleep in children and adolescents 4–18 years of age who were born to depressed mothers.
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Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: A meta-analysis
Although some authors have recently investigated the co-occurrence of posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA), the topic remains insufficiently studied. The aim of this meta-analysis was to detect the pooled prevalence of OSA in PTSD and its impact on adherence to continuous positive airway pressure (CPAP) therapy.
http://ift.tt/2sp0Skm
Cannabis for restless legs syndrome: A report of six patients
Restless legs syndrome (RLS) is a chronic and sometimes severe sensorimotor disorder of still unclear pathophysiology [1]. Usually symptoms respond well to dopamine agonists (DA), opiates, or anticonvulsants, used either alone or in combination. However, a subset of patients remains refractory to medical therapy, and serious side effects such as augmentation and impulse control disorder have been observed with DA. We present six patients' spontaneous reports of a remarkable and total remission of RLS symptoms after cannabis use.
http://ift.tt/2rqBPjB
GHB Levels in Breast Milk of Women with Narcolepsy with Cataplexy Treated with Sodium Oxybate
To determine GHB levels in breastmilk of women taking sodium oxybate (Xyrem) for treatment of narcolepsy and cataplexy.
http://ift.tt/2sp0TVs
Do gender and racial/ethnic disparities in sleep duration emerge in early adulthood? Evidence from a longitudinal study of U.S. adults
Gender and racial/ethnic disparities in sleep duration are well documented among the U.S. adult population, but we know little about how these disparities are shaped during the early course of adult life, a period marked by substantial changes in social roles that can influence time for sleep.
http://ift.tt/2rqWaFE
Electrophysiological and microstructural features of sleep in children at high risk for depression: A preliminary study
This preliminary study investigated electrophysiological and microstructural features of sleep in children and adolescents 4–18 years of age who were born to depressed mothers.
http://ift.tt/2soWTEC
Vascular targeted photodynamic therapy with TOOKAD® Soluble (WST11) in localized prostate cancer: efficiency of automatic pre-treatment planning
Abstract
Vascular targeted photodynamic therapy (VTP) with WST11 is a novel non-thermal focal treatment for localized prostate cancer that has shown favorable and early efficacy results in previously published studies. In this work, we investigate the efficiency of automatic dosimetric treatment planning. An action model established in a previous study was used in an image-guided optimization scheme to define the personalized optimal light dose for each patient. The calculated light dose is expressed as the number of optical cylindrical fibers to be used, their positions according to an external insertion grid, and the lengths of their diffuser parts. Evaluation of the method was carried out on data collected from 17 patients enrolled in two multi-centric clinical trials. The protocol consisted of comparing the method-simulated necrosis to the result observed on day 7 MR enhanced images. The method performances showed that the final result can be estimated with an accuracy of 10%, corresponding to a margin of 3 mm. In addition, this process was compatible with clinical conditions in terms of calculation times. The overall process took less than 10 min. Different aspects of the VTP procedure were already defined and optimized. Personalized treatment planning definition remained as an issue needing further investigation. The method proposed herein completes the standardization of VTP and opens new pathways for the clinical development of the technique.
http://ift.tt/2rcEeOw
Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers
Source:Journal of Voice
Author(s): María Priscilla Portillo, Sandra Rojas, Marco Guzman, Camilo Quezada
PurposeThe present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers.MethodsThirty subjects were asked to perform a 15-minute session of vocal warm-up. They were randomly assigned to one of two types of vocal warm-up: physiological (based on semi-occluded exercises) or traditional (singing warm-up based on open vowel [a:]). Aerodynamic, electroglottographic, acoustic, and self-perceived voice quality assessments were carried out before (pre) and after (post) warm-up.ResultsNo significant differences were found when comparing both types of vocal warm-up methods, either in subjective or in objective measures. Furthermore, the main positive effect observed in both groups when comparing pre and post conditions was a better self-reported quality of voice. Additionally, significant differences were observed for sound pressure level (decrease), glottal airflow (increase), and aerodynamic efficiency (decrease) in the traditional warm-up group.ConclusionBoth traditional and physiological warm-ups produce favorable voice sensations. Moreover, there are no evident differences in aerodynamic and electroglottographic variables when comparing both types of vocal warm-ups. Some changes after traditional warm-up (decreased intensity, increased airflow, and decreased aerodynamic efficiency) could imply an early stage of vocal fatigue.
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Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers
Publication date: Available online 31 May 2017
Source:Journal of Voice
Author(s): María Priscilla Portillo, Sandra Rojas, Marco Guzman, Camilo Quezada
PurposeThe present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers.MethodsThirty subjects were asked to perform a 15-minute session of vocal warm-up. They were randomly assigned to one of two types of vocal warm-up: physiological (based on semi-occluded exercises) or traditional (singing warm-up based on open vowel [a:]). Aerodynamic, electroglottographic, acoustic, and self-perceived voice quality assessments were carried out before (pre) and after (post) warm-up.ResultsNo significant differences were found when comparing both types of vocal warm-up methods, either in subjective or in objective measures. Furthermore, the main positive effect observed in both groups when comparing pre and post conditions was a better self-reported quality of voice. Additionally, significant differences were observed for sound pressure level (decrease), glottal airflow (increase), and aerodynamic efficiency (decrease) in the traditional warm-up group.ConclusionBoth traditional and physiological warm-ups produce favorable voice sensations. Moreover, there are no evident differences in aerodynamic and electroglottographic variables when comparing both types of vocal warm-ups. Some changes after traditional warm-up (decreased intensity, increased airflow, and decreased aerodynamic efficiency) could imply an early stage of vocal fatigue.
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Effects of upper-airway stimulation on sleep architecture in patients with obstructive sleep apnea
Abstract
Purpose
Selective upper-airway stimulation (UAS) is a novel therapy for patients with obstructive sleep apnea (OSA). The aim of this study was to compare changes in sleep architecture during the diagnostic polysomnography and the post-implantation polysomnography in UAS in patients with OSA.
Methods
Twenty-six patients who received a UAS device (Inspire Medical Systems) were included. Treatment outcome was evaluated 2 and 3 months after surgery. Data collection included demographics, body mass index (BMI), apnea hypopnea index (AHI), oxygen saturation and desaturation index (ODI), Epworth sleepiness score (ESS), arousal parameter, and sleep patterns.
Results
The mean age was 60.2 years, 25 patients were male, 1 patient was female. Mean BMI was 29.0 kg/m2. The mean pre-implantation AHI of 33.9/h could be reduced to 9.1/h at 2 months post-implantation (p < 0.001). The amount of time spent in N1-sleep could be reduced from 23.2% at baseline to 16.0% at month 3 post-implantation. The amount of time spent in N2- and N3-sleep did not change during the observation period. A significant increase of the amount of REM sleep at month 2 (15.7%) compared to baseline (9.5%; p = 0.010) could be observed. A reduction of the number of arousals and the arousal index could be observed.
Conclusion
In conclusion, significant changes in sleep architecture of patients with OSA and sufficient treatment with UAS could be observed. A reduction of the amount of time spent in N1-sleep could be caused by treatment with UAS and the rebound of REM sleep, observed for the first time in a study on UAS, is also a potential marker of the efficacy of UAS on sleep architecture.
Trial registration
NCT02293746.
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Effects of upper-airway stimulation on sleep architecture in patients with obstructive sleep apnea
Abstract
Purpose
Selective upper-airway stimulation (UAS) is a novel therapy for patients with obstructive sleep apnea (OSA). The aim of this study was to compare changes in sleep architecture during the diagnostic polysomnography and the post-implantation polysomnography in UAS in patients with OSA.
Methods
Twenty-six patients who received a UAS device (Inspire Medical Systems) were included. Treatment outcome was evaluated 2 and 3 months after surgery. Data collection included demographics, body mass index (BMI), apnea hypopnea index (AHI), oxygen saturation and desaturation index (ODI), Epworth sleepiness score (ESS), arousal parameter, and sleep patterns.
Results
The mean age was 60.2 years, 25 patients were male, 1 patient was female. Mean BMI was 29.0 kg/m2. The mean pre-implantation AHI of 33.9/h could be reduced to 9.1/h at 2 months post-implantation (p < 0.001). The amount of time spent in N1-sleep could be reduced from 23.2% at baseline to 16.0% at month 3 post-implantation. The amount of time spent in N2- and N3-sleep did not change during the observation period. A significant increase of the amount of REM sleep at month 2 (15.7%) compared to baseline (9.5%; p = 0.010) could be observed. A reduction of the number of arousals and the arousal index could be observed.
Conclusion
In conclusion, significant changes in sleep architecture of patients with OSA and sufficient treatment with UAS could be observed. A reduction of the amount of time spent in N1-sleep could be caused by treatment with UAS and the rebound of REM sleep, observed for the first time in a study on UAS, is also a potential marker of the efficacy of UAS on sleep architecture.
Trial registration
NCT02293746.
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Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers
Publication date: Available online 31 May 2017
Source:Journal of Voice
Author(s): María Priscilla Portillo, Sandra Rojas, Marco Guzman, Camilo Quezada
PurposeThe present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers.MethodsThirty subjects were asked to perform a 15-minute session of vocal warm-up. They were randomly assigned to one of two types of vocal warm-up: physiological (based on semi-occluded exercises) or traditional (singing warm-up based on open vowel [a:]). Aerodynamic, electroglottographic, acoustic, and self-perceived voice quality assessments were carried out before (pre) and after (post) warm-up.ResultsNo significant differences were found when comparing both types of vocal warm-up methods, either in subjective or in objective measures. Furthermore, the main positive effect observed in both groups when comparing pre and post conditions was a better self-reported quality of voice. Additionally, significant differences were observed for sound pressure level (decrease), glottal airflow (increase), and aerodynamic efficiency (decrease) in the traditional warm-up group.ConclusionBoth traditional and physiological warm-ups produce favorable voice sensations. Moreover, there are no evident differences in aerodynamic and electroglottographic variables when comparing both types of vocal warm-ups. Some changes after traditional warm-up (decreased intensity, increased airflow, and decreased aerodynamic efficiency) could imply an early stage of vocal fatigue.
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Uncovering the pathogenesis of microtia using bioinformatics approach
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Liu Lei, Liu Zhenzhong, Lin Lin, Pan Bo
ObjectiveBioinformatics is widely used in the field of cancer research, but in the research of pathogenesis of congenital malformations the situation is different. The aim of this study was to explore the underlying mechanism using bioinformatics approach.MethodsThe data were available from Mouse Genome Informatics and Pubmed. Protein–protein interaction (PPI) network of pathogenic genes was conducted using STRING. Gene ontology and pathway enrichment analyses were also performed to pathogenic genes.ResultsTotal 63 genes were identified as pathogenic genes in the study. The PPI networks for pathogenic genes were constructed, which contained 62 nodes and 228 edges with PAX6, FGFR1 and CTNNB1 as the hub genes. All the genes were linked to 921 pathways in biological processes, 31 pathways in cell component, 41 pathways in molecular function, and 76 pathways in the KEGG. These genes were discovered significantly enriched in embryonic organ development, ear morphogenesis, ear development, and regulation of RNA synthesis and processing.Conclusionsbioinformatics methods were utilized to analysis pathogenic genes involved in microtia development, including pathogenic genes identifying, PPI network construction and functional analysis. And we also predicted that several potential mechanisms might contribute to occurrence of microtia by disturbing GO terms and pathways. This approach could be useful for the study of the etiology and pathogenesis of microtia.
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Uncovering the pathogenesis of microtia using bioinformatics approach
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Liu Lei, Liu Zhenzhong, Lin Lin, Pan Bo
ObjectiveBioinformatics is widely used in the field of cancer research, but in the research of pathogenesis of congenital malformations the situation is different. The aim of this study was to explore the underlying mechanism using bioinformatics approach.MethodsThe data were available from Mouse Genome Informatics and Pubmed. Protein–protein interaction (PPI) network of pathogenic genes was conducted using STRING. Gene ontology and pathway enrichment analyses were also performed to pathogenic genes.ResultsTotal 63 genes were identified as pathogenic genes in the study. The PPI networks for pathogenic genes were constructed, which contained 62 nodes and 228 edges with PAX6, FGFR1 and CTNNB1 as the hub genes. All the genes were linked to 921 pathways in biological processes, 31 pathways in cell component, 41 pathways in molecular function, and 76 pathways in the KEGG. These genes were discovered significantly enriched in embryonic organ development, ear morphogenesis, ear development, and regulation of RNA synthesis and processing.Conclusionsbioinformatics methods were utilized to analysis pathogenic genes involved in microtia development, including pathogenic genes identifying, PPI network construction and functional analysis. And we also predicted that several potential mechanisms might contribute to occurrence of microtia by disturbing GO terms and pathways. This approach could be useful for the study of the etiology and pathogenesis of microtia.
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Tau pathology and cognitive reserve in Alzheimer's disease
Publication date: September 2017
Source:Neurobiology of Aging, Volume 57
Author(s): Merle Christine Hoenig, Gérard Nisal Bischof, Jochen Hammes, Jennifer Faber, Klaus Fliessbach, Thilo van Eimeren, Alexander Drzezga
Cognitive reserve (CR) is defined as the ability to maintain functionality despite accumulating pathology. Education has been used as a proxy for CR. For example, by using positron emission tomography imaging, higher educated Alzheimer's disease (AD) patients presented increased amyloid β pathology than lower educated patients despite equal symptomatology. Whether similar associations exist for in vivo tau pathology remains elusive. We utilized [18F]AV-1451 positron emission tomography imaging to examine whether high-educated AD patients (n = 12) present more severe tau pathology compared with low-educated patients (n = 12) despite equal clinical severity in regions of interest corresponding to the pathologic disease stages defined by Braak & Braak. We report tau pathology in advanced Braak stages associated with parietal and frontal regions in high-educated AD patients, whereas in low-educated AD patients tau accumulation is still confined to lower Braak stages associated with temporal and cingulate regions. Highly educated AD patients seem to be able to tolerate more tau tangle pathology than lower educated patients with comparable cognitive impairment supporting the cognitive reserve hypothesis.
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Uncovering the pathogenesis of microtia using bioinformatics approach
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Liu Lei, Liu Zhenzhong, Lin Lin, Pan Bo
ObjectiveBioinformatics is widely used in the field of cancer research, but in the research of pathogenesis of congenital malformations the situation is different. The aim of this study was to explore the underlying mechanism using bioinformatics approach.MethodsThe data were available from Mouse Genome Informatics and Pubmed. Protein–protein interaction (PPI) network of pathogenic genes was conducted using STRING. Gene ontology and pathway enrichment analyses were also performed to pathogenic genes.ResultsTotal 63 genes were identified as pathogenic genes in the study. The PPI networks for pathogenic genes were constructed, which contained 62 nodes and 228 edges with PAX6, FGFR1 and CTNNB1 as the hub genes. All the genes were linked to 921 pathways in biological processes, 31 pathways in cell component, 41 pathways in molecular function, and 76 pathways in the KEGG. These genes were discovered significantly enriched in embryonic organ development, ear morphogenesis, ear development, and regulation of RNA synthesis and processing.Conclusionsbioinformatics methods were utilized to analysis pathogenic genes involved in microtia development, including pathogenic genes identifying, PPI network construction and functional analysis. And we also predicted that several potential mechanisms might contribute to occurrence of microtia by disturbing GO terms and pathways. This approach could be useful for the study of the etiology and pathogenesis of microtia.
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Copyright
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
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Contributors
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
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Contents
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
http://ift.tt/2qHhYst
Forthcoming Issues
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
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Volume 1: Rescue, Resuscitation, and Resurfacing
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Charles Scott Hultman, Michael W. Neumeister
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Burn Care: Rescue, Resuscitation, and Resurfacing
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Charles Scott Hultman, Michael W. Neumeister
http://ift.tt/2rcuROK
Index
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
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Burn Injuries
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Ernest J. Grant
Teaser
Each year in the United States and Canada, thousands of individuals seek medical care for a burn injury. Some individuals are burned significantly enough they require treatment at specialized burn care facilities. Most of these injuries are preventable. This article presents an historical perspective related to burn prevention and elements of successful burn prevention programs and explores ways in which the plastic surgeon can promote burn prevention through education, advocacy, and the legislative process. Prevention efforts undertaken by the surgeon can increase awareness, ensure a safe environment, and reduce burn injuries.http://ift.tt/2rcE7T5
Negligent and Inflicted Burns in Children
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Zachary J. Collier, Michelle C. Roughton, Lawrence J. Gottlieb
Teaser
One in 4 American children have been abused and up to 5 children die per day from abuse. Children are vulnerable and error or lag in diagnosis may lead to further injury or death. In contrast, misdiagnosis of abuse is also unacceptable. Burns are a leading cause of abuse-related fatality and determination of cause can be difficult. It is critical that clinicians distinguish between burns of abuse (inflicted) and neglect and those received accidentally (noninflicted). Discordant narratives, use of alcohol and illicit substances, characteristics of the burn wound, and concomitant injury are all red flags for inflicted and negligent burns.http://ift.tt/2qHhWAR
Global Burn Care
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Anna Schoenbrunner, Wone Banda, Amanda A. Gosman
Teaser
Burns are an often-overlooked health indicator in global health literature, but account for a significant global health burden in lower middle income countries. This article provides an overview of burn injury from the global health perspective. It focuses on education and research, emphasizing the appropriate role of volunteerism.http://ift.tt/2rcJiSN
Management of Pulmonary Failure after Burn Injury
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Apoorve Nayyar, Anthony G. Charles, Charles Scott Hultman
Teaser
This article highlights the challenges in managing pulmonary failure after burn injury. The authors review several different ventilator techniques, provide weaning parameters, and discuss complications.http://ift.tt/2qHnDi0
Clinician’s Guide to Nutritional Therapy Following Major Burn Injury
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Christina Rollins, Franziska Huettner, Michael W. Neumeister
Teaser
This article provides a clinician's guide to nutritional support of the burn patient. The authors review the assessment and management of the needs of the thermally injured patient and provide recommendations on replacement and supplementation with calories, protein, carbohydrates, lipids, fluids, and minerals. Furthermore, the authors compare and contrast enteral versus parenteral delivery of nutrition.http://ift.tt/2rcKrKg
Venous Thromboembolism in Patients with Thermal Injury
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Christopher J. Pannucci, Andrea T. Obi, Benjamin H. Timmins, Amalia L. Cochran
Teaser
Venous thromboembolism (VTE) can be a life-threatening or limb-threatening complication of thermal injury. The severity of burn injury can be used to predict VTE risk among patients with thermal injury, and a weighted risk-stratification tool has been developed. This article reviews the incidence, diagnosis, and management of thromboembolic events in patients with burns. The article particularly focuses on identifying those patients who are at highest risk for VTE and provides recommendations on mechanical and chemical prophylaxis.http://ift.tt/2qHDiy2
Burn Center Care of Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Robert Cartotto
Teaser
Stevens-Johnson syndrome and toxic epidermal necrolysis are rare, life-threatening, cutaneous drug reactions. Medications are the most common cause, although an infection may be responsible. A link between genetics and certain medications has been established. Clinical diagnosis should be confirmed with biopsy. When the area of epidermal detachment approaches 30%, burn center care is advisable. An ophthalmologist should be consulted to optimize ocular care. Pharmacologic interruption has been sought but there is little consensus on the most appropriate agent and no high-quality studies have been conducted to demonstrate if any of these agents lead to improved survival.http://ift.tt/2rcqZNA
Pediatric Burn Care
Publication date: July 2017
Source:Clinics in Plastic Surgery, Volume 44, Issue 3
Author(s): Amita R. Shah, Lillian F. Liao
Teaser
Severe pediatric burns require a multidisciplinary team approach at a specialized pediatric burn center. Special attention must be paid to estimations of total body surface area, fluid resuscitation and metabolic demands, and adequate analgesia and sedation. Long-term effects involve scar management and psychosocial support to the child and their family. Compassionate comprehensive burn care is accomplished by a multidisciplinary team offering healing in the acute setting and preparing the child and family for long-term treatment and care.http://ift.tt/2qHDihw
Comparison of HER2 amplification status among breast cancer subgroups offers new insights in pathways of breast cancer progression
Abstract
Although the prognostic and predictive significance of human epidermal growth factor receptor 2 (HER2) in invasive breast cancer is well established, its role in ductal carcinoma in situ (DCIS) remains unclear. Reports on combined evaluation of both HER2 protein expression and HER2 amplification status in pure DCIS and DCIS adjacent to invasive ductal carcinoma (i.e., admixed DCIS) are scarce. In this study, immunohistochemistry and fluorescence in situ hybridization (FISH) were used to assess HER2 status in 72 cases of pure DCIS, 73 cases of DCIS admixed with invasive ductal carcinoma (IDC), and 60 cases of pure IDC. HER2 copy number-based amplification was present in 49% of pure DCIS, 16% of admixed DCIS, 18% of admixed IDC, and 8% of pure IDC. Amplified pure DCIS with clusters of HER2 signals showed a significantly lower HER2 copy number than amplified admixed DCIS with clusters. Whereas pure DCIS and admixed DCIS presented significant differences, the in situ and invasive component of admixed tumors showed striking similarities regarding mean HER2 and chromosome 17 centromere (CEP17) copy number, grade, and estrogen and progesterone receptor expression. The discrepant prevalence of HER2 amplification among breast cancer subgroups indirectly suggests that HER2 may not play a crucial role in the transition of in situ to invasive breast cancer. The similarities in HER2 amplification status between the in situ and invasive component of admixed tumors hint at a common biological pathway for both components. Our data support the theory that pure DCIS, pure IDC, and admixed lesions have a common progenitor, but can progress as separate lineages.
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Apatinib Treatment for Advanced Esophagus Cancer
Condition: Advanced Esophagus Cancer
Intervention: Drug: Apatinib
Sponsors: Henan Cancer Hospital; Jiangsu HengRui Medicine Co., Ltd.
Recruiting - verified May 2017
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Intervention: Drug: Apatinib
Sponsors: Henan Cancer Hospital; Jiangsu HengRui Medicine Co., Ltd.
Recruiting - verified May 2017
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Genomic Profiling of Nodular Thyroid Disease and Thyroid Cancer
Conditions: Thyroid Nodule; Thyroid Cancer; Thyroid Diseases; Thymic Carcinoma
Intervention:
Sponsor: Aventura Hospital and Medical Center
Recruiting - verified May 2017
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Intervention:
Sponsor: Aventura Hospital and Medical Center
Recruiting - verified May 2017
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Gastric Pull up Versus Free Flap Reconstruction for Laryngo-pharyngeal Defects
Conditions: Head and Neck Neoplasms; Pharyngectomy; Reconstructive Surgical Procedures
Interventions: Procedure: Gastric Pull Up; Procedure: Free Flap Surgery
Sponsor: University of British Columbia
Recruiting - verified May 2017
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Interventions: Procedure: Gastric Pull Up; Procedure: Free Flap Surgery
Sponsor: University of British Columbia
Recruiting - verified May 2017
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Apatinib Treatment for Advanced Esophagus Cancer
Condition: Advanced Esophagus Cancer
Intervention: Drug: Apatinib
Sponsors: Henan Cancer Hospital; Jiangsu HengRui Medicine Co., Ltd.
Recruiting - verified May 2017
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Intervention: Drug: Apatinib
Sponsors: Henan Cancer Hospital; Jiangsu HengRui Medicine Co., Ltd.
Recruiting - verified May 2017
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Genomic Profiling of Nodular Thyroid Disease and Thyroid Cancer
Conditions: Thyroid Nodule; Thyroid Cancer; Thyroid Diseases; Thymic Carcinoma
Intervention:
Sponsor: Aventura Hospital and Medical Center
Recruiting - verified May 2017
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Intervention:
Sponsor: Aventura Hospital and Medical Center
Recruiting - verified May 2017
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Gastric Pull up Versus Free Flap Reconstruction for Laryngo-pharyngeal Defects
Conditions: Head and Neck Neoplasms; Pharyngectomy; Reconstructive Surgical Procedures
Interventions: Procedure: Gastric Pull Up; Procedure: Free Flap Surgery
Sponsor: University of British Columbia
Recruiting - verified May 2017
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Interventions: Procedure: Gastric Pull Up; Procedure: Free Flap Surgery
Sponsor: University of British Columbia
Recruiting - verified May 2017
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Rotational and Collic Vestibular-Evoked Myogenic Potential Testing in Normal Developing Children and Children With Combined Attention Deficit/Hyperactivity Disorder.
Objectives: Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. Design: We enrolled 30 typically developing children (15 boys and 15 girls; mean age, 9 years 6 months; range, 7 to 12 years) and 33 children (19 boys and 14 girls; mean age, 9 years 0 months; range, 7 to 12 years) with cADHD diagnosed by our research psychiatrist. Typically developing controls were used to obtain normative data on vestibular testing and to examine the impact of age on the vestibular response parameters, and these results were compared with those of the cADHD group. All children underwent the sinusoidal harmonic acceleration subtype of the rotary chair test (0.01, 0.02, 0.08, 0.16, and 0.32 Hz) and the cervical vestibular-evoked myogenic potential (cVEMP) test. Results: At all five frequencies in the sinusoidal harmonic acceleration test, there was no significant correlation between age and any of the following rotary chair response parameters in typically developing children: vestibulo-ocular reflex (VOR) gain, phase, asymmetry, and fixation index. Furthermore, there was no significant correlation between age and any of the following cVEMP parameters for the right and left ears of control group: p1 and n1 latency, amplitude, threshold, and amplitude ratio. Significantly higher VOR gains were observed for children with cADHD at frequencies of 0.01 (p = 0.001), 0.08 (p
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Age-Related Differences in the Processing of Temporal Envelope and Spectral Cues in a Speech Segment.
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Age-Related Differences in the Processing of Temporal Envelope and Spectral Cues in a Speech Segment.
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Rotational and Collic Vestibular-Evoked Myogenic Potential Testing in Normal Developing Children and Children With Combined Attention Deficit/Hyperactivity Disorder.
Objectives: Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. Design: We enrolled 30 typically developing children (15 boys and 15 girls; mean age, 9 years 6 months; range, 7 to 12 years) and 33 children (19 boys and 14 girls; mean age, 9 years 0 months; range, 7 to 12 years) with cADHD diagnosed by our research psychiatrist. Typically developing controls were used to obtain normative data on vestibular testing and to examine the impact of age on the vestibular response parameters, and these results were compared with those of the cADHD group. All children underwent the sinusoidal harmonic acceleration subtype of the rotary chair test (0.01, 0.02, 0.08, 0.16, and 0.32 Hz) and the cervical vestibular-evoked myogenic potential (cVEMP) test. Results: At all five frequencies in the sinusoidal harmonic acceleration test, there was no significant correlation between age and any of the following rotary chair response parameters in typically developing children: vestibulo-ocular reflex (VOR) gain, phase, asymmetry, and fixation index. Furthermore, there was no significant correlation between age and any of the following cVEMP parameters for the right and left ears of control group: p1 and n1 latency, amplitude, threshold, and amplitude ratio. Significantly higher VOR gains were observed for children with cADHD at frequencies of 0.01 (p = 0.001), 0.08 (p
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Masseteric to buccal branch nerve transfer.
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Masseteric to buccal branch nerve transfer.
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Masseteric to buccal branch nerve transfer.
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Accommodating Active Lifestyles: Patient-Centered Hearing Care for Sports and Fitness
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Insider Tips on Marketing Your Hearing Aid Practice to Physicians
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Ankle-foot orthosis bending axis influences running mechanics
Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Elizabeth Russell Esposito, Ellyn C. Ranz, Kelly A. Schmidtbauer, Richard R. Neptune, Jason M. Wilken
Passive-dynamic ankle-foot orthoses (AFOs) are commonly prescribed to improve locomotion for people with lower limb musculoskeletal weakness. The clinical prescription and design process are typically qualitative and based on observational assessment and experience. Prior work examining the effect of AFO design characteristics generally excludes higher impact activities such as running, providing clinicians and researchers limited information to guide the development of objective prescription guidelines. The proximal location of the bending axis may directly influence energy storage and return and resulting running mechanics. The purpose of this study was to determine if the location of an AFO's bending axis influences running mechanics. Marker and force data were recorded as 12 participants with lower extremity weakness ran overground while wearing a passive-dynamic AFO with posterior struts manufactured with central (middle) and off-centered (high and low) bending axes. Lower extremity joint angles, moments, powers, and ground reaction forces were calculated and compared between limbs and across bending axis conditions. Bending axis produced relatively small but significant changes. Ankle range of motion increased as the bending axis shifted distally (p<0.003). Peak ankle power absorption was greater in the low axis than high (p=0.013), and peak power generation was greater in the low condition than middle or high conditions (p<0.009). Half of the participants preferred the middle bending axis, four preferred low and two preferred high. Overall, if greater ankle range of motion is tolerated, a low bending axis provides power and propulsive benefits during running, although individual preference and physical ability should also be considered.
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Dynamic and static knee alignment at baseline predict structural abnormalities on MRI associated with medial compartment knee osteoarthritis after 2 years
Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Armaghan Mahmoudian, Jaap H. van Dieёn, Sjoerd M. Bruijn, Isabel A.C. Baert, Gert S. Faber, Frank P. Luyten, Sabine M.P. Verschueren
BackgroundDynamic and static varus alignment, both, have been reported as risk factors associated with structural progression of knee osteoarthritis. However the association of none of the static and dynamic alignment with structural, clinical, and functional progression associated with knee osteoarthritis has not been assessed yet in a longitudinal study.MethodsForty-seven women with early and established medial knee osteoarthritis were evaluated. Static and dynamic alignment as well as MRI detected structural features, clinical, and functional characteristics of patients were assessed at baseline and at 2 years follow-up. Associations between baseline static and dynamic alignment with structural, functional, and clinical characteristics at the time of entry, as well as the changes over 2 years were evaluated.FindingsBoth static and dynamic varus alignment at baseline were significantly associated with osteoarthritis related tibio-femoral joint structural abnormalities detected on MRI, at the time of entry. Only the magnitude of varus thrust at baseline was predictive of the changes in the presence of meniscal maceration over two years. None of the static or dynamic measures of knee joint alignment were associated with clinical characteristics associated with medial knee osteoarthritis.InterpretationThe key finding of this study is that both frontal plane dynamic and static alignment, are associated with structural abnormalities in patients with medial knee osteoarthritis.
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Foot muscle morphology is related to center of pressure sway and control mechanisms during single-leg standing
Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Xianyi Zhang, Kurt Heinrich Schütte, Benedicte Vanwanseele
Maintaining balance is vitally important in everyday life. Investigating the effects of individual foot muscle morphology on balance may provide insights into neuromuscular balance control mechanisms. This study aimed to examine the correlation between the morphology of foot muscles and balance performance during single-leg standing. Twenty-eight recreational runners were recruited in this study. An ultrasound device was used to measure the thickness and cross-sectional area of three intrinsic foot muscles (abductor hallucis, flexor digitorum brevis and quadratus plantae) and peroneus muscles. Participants were required to perform 30s of single-leg standing for three trials on a force plate, which was used to record the center of pressure (COP). The standard deviation of the amplitude and ellipse area of the COP were calculated. In addition, stabilogram diffusion analysis (SDA) was performed on COP data. Pearson correlation coefficients were computed to examine the correlation between foot muscle morphology and traditional COP parameters as well as with SDA parameters. Our results showed that larger abductor hallucis correlated to smaller COP sway, while larger peroneus muscles correlated to larger COP sway during single-leg standing. Larger abductor hallucis also benefited open-loop dynamic stability, as well as supported a more efficient transfer from open-loop to closed loop control mechanisms. These results suggest that the morphology of foot muscles plays an important role in balance performance, and that strengthening the intrinsic foot muscles may be an effective way to improve balance.
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Ankle-foot orthosis bending axis influences running mechanics
Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Elizabeth Russell Esposito, Ellyn C. Ranz, Kelly A. Schmidtbauer, Richard R. Neptune, Jason M. Wilken
Passive-dynamic ankle-foot orthoses (AFOs) are commonly prescribed to improve locomotion for people with lower limb musculoskeletal weakness. The clinical prescription and design process are typically qualitative and based on observational assessment and experience. Prior work examining the effect of AFO design characteristics generally excludes higher impact activities such as running, providing clinicians and researchers limited information to guide the development of objective prescription guidelines. The proximal location of the bending axis may directly influence energy storage and return and resulting running mechanics. The purpose of this study was to determine if the location of an AFO's bending axis influences running mechanics. Marker and force data were recorded as 12 participants with lower extremity weakness ran overground while wearing a passive-dynamic AFO with posterior struts manufactured with central (middle) and off-centered (high and low) bending axes. Lower extremity joint angles, moments, powers, and ground reaction forces were calculated and compared between limbs and across bending axis conditions. Bending axis produced relatively small but significant changes. Ankle range of motion increased as the bending axis shifted distally (p<0.003). Peak ankle power absorption was greater in the low axis than high (p=0.013), and peak power generation was greater in the low condition than middle or high conditions (p<0.009). Half of the participants preferred the middle bending axis, four preferred low and two preferred high. Overall, if greater ankle range of motion is tolerated, a low bending axis provides power and propulsive benefits during running, although individual preference and physical ability should also be considered.
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Dynamic and static knee alignment at baseline predict structural abnormalities on MRI associated with medial compartment knee osteoarthritis after 2 years
Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Armaghan Mahmoudian, Jaap H. van Dieёn, Sjoerd M. Bruijn, Isabel A.C. Baert, Gert S. Faber, Frank P. Luyten, Sabine M.P. Verschueren
BackgroundDynamic and static varus alignment, both, have been reported as risk factors associated with structural progression of knee osteoarthritis. However the association of none of the static and dynamic alignment with structural, clinical, and functional progression associated with knee osteoarthritis has not been assessed yet in a longitudinal study.MethodsForty-seven women with early and established medial knee osteoarthritis were evaluated. Static and dynamic alignment as well as MRI detected structural features, clinical, and functional characteristics of patients were assessed at baseline and at 2 years follow-up. Associations between baseline static and dynamic alignment with structural, functional, and clinical characteristics at the time of entry, as well as the changes over 2 years were evaluated.FindingsBoth static and dynamic varus alignment at baseline were significantly associated with osteoarthritis related tibio-femoral joint structural abnormalities detected on MRI, at the time of entry. Only the magnitude of varus thrust at baseline was predictive of the changes in the presence of meniscal maceration over two years. None of the static or dynamic measures of knee joint alignment were associated with clinical characteristics associated with medial knee osteoarthritis.InterpretationThe key finding of this study is that both frontal plane dynamic and static alignment, are associated with structural abnormalities in patients with medial knee osteoarthritis.
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Foot muscle morphology is related to center of pressure sway and control mechanisms during single-leg standing
Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Xianyi Zhang, Kurt Heinrich Schütte, Benedicte Vanwanseele
Maintaining balance is vitally important in everyday life. Investigating the effects of individual foot muscle morphology on balance may provide insights into neuromuscular balance control mechanisms. This study aimed to examine the correlation between the morphology of foot muscles and balance performance during single-leg standing. Twenty-eight recreational runners were recruited in this study. An ultrasound device was used to measure the thickness and cross-sectional area of three intrinsic foot muscles (abductor hallucis, flexor digitorum brevis and quadratus plantae) and peroneus muscles. Participants were required to perform 30s of single-leg standing for three trials on a force plate, which was used to record the center of pressure (COP). The standard deviation of the amplitude and ellipse area of the COP were calculated. In addition, stabilogram diffusion analysis (SDA) was performed on COP data. Pearson correlation coefficients were computed to examine the correlation between foot muscle morphology and traditional COP parameters as well as with SDA parameters. Our results showed that larger abductor hallucis correlated to smaller COP sway, while larger peroneus muscles correlated to larger COP sway during single-leg standing. Larger abductor hallucis also benefited open-loop dynamic stability, as well as supported a more efficient transfer from open-loop to closed loop control mechanisms. These results suggest that the morphology of foot muscles plays an important role in balance performance, and that strengthening the intrinsic foot muscles may be an effective way to improve balance.
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Childhood idiopathic spinal cord infarction: Description of 7 cases and review of the literature
Source:Brain and Development
Author(s): Claire Bar, Emmanuel Cheuret, Pierre Bessou, Jean-Michel Pedespan
ObjectivesTo describe the clinical course, neuroimaging findings and functional outcome of idiopathic spinal cord infarction (SCI) in adolescents.MethodsRetrospective and descriptive analyses of seven patients with idiopathic SCI and 50 additional cases from the literature were included. Data collected concerned clinical presentation, MRI findings, initial diagnosis, treatments and functional outcome at the last medical visit.ResultsMean age at presentation was 13.2years (range 13–15). All patients presented a sudden and painful acute myelopathy with <24h time to maximal symptoms manifestation. A suspected trigger related to a minor effort was reported in 3/7 cases. Six patients presented with paraplegia, one with paraparesis. All had bladder dysfunction needing catheterization. Three patients had an initial misdiagnosis. Initial MRI was considered as normal in 2 cases. In the 5 other cases, T2-weighted-MR images showed hyperintensity within the thoracolumbar spinal cord, affecting mostly the anterior spinal artery territory. Evidence for associated spinal growth dystrophy were present in 6/7 cases. Mean follow-up time was 27.4months (range 3–46): 2 patients recovered autonomous ambulation, 4 patients regained walking ability with aids and one child (the shortest follow-up) remained wheelchair-dependent. A neurogenic bladder was still reported in 6/7 children at the last visit. Complementary analyses with literature cases were consistent with the findings obtained in our cohort.ConclusionIdiopathic SCI typically occurs in adolescence with a rapid onset and painful acute myelopathy. The MRI shows a T2-hyperintense signal within the spinal cord and provides evidence for an ischemic mechanism. Etiology remains unclear in most cases even though some specific risk factors for this age must play an important role in the pathogenesis, such as mechanical constraints on the immature spine.
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Three years’ experience with the first pediatric hospice in Asia
Source:Brain and Development
Author(s): Kohei Ando, Makoto Nabetani, Nobuyuki Yotani, Tatsushi Rin, Hiroyuki Sano
ObjectivePediatric hospice has been the adoption of several service provision models in highly developed countries such as UK, Germany, Australia or Canada for a few decades, yet it has seldom been the case in the Asian Continent. This study aimed to evaluate the newest challenge for the children with Life-threatening illness (LTI) and described the characteristic of pediatric palliative care at the first pediatric hospice in Japan.MethodsA retrospective review of all patients at our pediatric hospice in these three years was conducted. Of the 294 cases reviewed, 269 cases were eligible for analysis.ResultsWe reviewed 269 patients admitted during the first three years. Most patients required intensive medical intervention. Patients were hospitalized in our pediatric hospice not only for end-of-life care (EOL), but also for respite care. Only 7% of the patients were with cancer. To support children and family to make the most of their time together, we provided a range of medical and recreational care. It is expected that the pediatric hospice will extend and establish cooperation with other hospitals or community services.ConclusionThree years' experience of pediatric palliative care at the first pediatric hospice in the Asian Continent is encouraging. Further experience and improved communication with other pediatric service providers as well as their education in palliative care will enhance the recognition of the capacity of our hospice and support the needs of more children. Furthermore, we would like to introduce the idea of pediatric hospice and spread it throughout the Asian Continent in the future.
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Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation.
Objective: We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Forty-six patients with acute unilateral vestibular neuritis were included. Interventions: Diagnostic, therapeutic, and rehabilitative. Main Outcome Measures: All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed. Results: After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p
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Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation.
Objective: We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Forty-six patients with acute unilateral vestibular neuritis were included. Interventions: Diagnostic, therapeutic, and rehabilitative. Main Outcome Measures: All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed. Results: After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p
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Fibrin sealant (Tisseel™) for mesh fixation in repair of the deep circumflex iliac artery (DCIA) free flap donor site
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R. Cobb, K. Muscat, L. Cascarini, A. Fry
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Forearm skin aging: characterization by instrumental measurements
Abstract
Background
The intrinsic aging and photoaged skin presents biomechanical and morphological differences, which are reflected in the appearance of roughness, superficial and deep wrinkles, atrophy, reduced elasticity, hypo and hyperpigmentation and actinic keratosis
Objective
To evaluate and compare the characteristics of the flexor (with a predominance of intrinsic aging) and extensor (chronically exposed to sunlight and other environmental factors, with a predominance of photoaging) skin surfaces of the forearms
Methods
Interventional, prospective, diagnostic study, including 23 females, aged over 60 years. The extensor and flexor faces of forearms were compared in relation to clinical parameters and non-invasive instrumental measurements, such as skin surface, elasticity, hydration as well as dermal thickness and echogenicity
Results
Regarding the water content of the stratum corneum, the flexor face presented an average value higher than the extensor face. The average of measures obtained through images of high frequency ultrasound demonstrated greater echogenicity of flexor face compared to the extensor face. The measurements of the skin surface showed significant differences between the faces. The roughness and scaliness were lower in the flexor face. Regarding the wrinkles depth, there was no significant difference between the faces. The average of the measurements was slightly higher in the flexor face, which demonstrated that wrinkles are present in the intrinsic aging and photoaging. The presence of elastosis and the reduction of elasticity in the clinical aspect of the photoaged face of forearms were according to results of the non-invasive measurements
Conclusion
Meaningful differences in the biophysical characteristics of the extensor and flexor faces of the forearms were detected. Because the non-invasive instrumental measurements correlated with clinical findings, they may represent useful tools to assess efficacy and safety of skin aging treatments in clinical research.
This article is protected by copyright. All rights reserved.
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Shrimp TAB1 interacts with TAK1 and p38 and activates the host innate immune response to bacterial infection
Source:Molecular Immunology, Volume 88
Author(s): Sheng Wang, Mengqiao Li, Bin Yin, Haoyang Li, Bang Xiao, Kai Lǚ, Zhijian Huang, Sedong Li, Jianguo He, Chaozheng Li
Mammalian TAB1 has been previously identified as transforming growth factor-β (TGF-β)-activated kinase 1 (TAK1) binding protein, which functions as the activator of TAK1 and p38. This report, for the first time, identified and characterized the homolog of TAB1 in shrimp, to be specific, the homolog gene from Litopenaeus vannamei, containing a 1560-bp open reading frame (ORF) that encoded a putative protein of 519 amino acids with the conserved PP2Cc (Serine/threonine phosphatases, family 2C, catalytic) domain in N-terminal and a TAK1 binding motif in C-terminus, has been cloned and named LvTAB1. LvTAB1 was most abundant in gills and its expression could respond significantly to a series of stimuli, including LPS, Vibrio parahemolyticus and Staphylococcus aureus. Moreover, Co-immunoprecipitation (Co-IP) experiments showed that LvTAB1 could combine with LvTAK1 as well as Lvp38, two members of IMD-NF-κB/MAPK pathway, which meant LvTAB1 could have a role in regulating the activities of these kinases. Over-expression of LvTAB1 in drosophila S2 cells could improve the transcriptional levels of antimicrobial peptide genes (AMPs) such as Diptericin (Dpt), the hallmark of drosophila NF-κB activated genes, indicating its activation effect on NF-κB pathway. Furthermore, suppression of LvTAB1 expression in vivo by RNA-interference increased the sensibility of shrimps to V. parahaemolyticus infection, implying its protective role against bacterial infection. In conclusion, these results provide some insight into the function of LvTAB1 during bacterial infection.
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