A hydrazone based probe for the selective fluorescent detection of Al(III) and Al(III)-probe complex mediated secondary PPi sensing: computational studies, interpretation of molecular logic circuit and memory device and intracellular application

Photochem. Photobiol. Sci., 2017, Accepted Manuscript
DOI: 10.1039/C7PP00286F, Paper

Ali Mahammad, Mohammad Hasan, Abu Saleh Musha Islam, Chandraday Prodhan, Keya Chaudhuri
A hydrazone based conjugate Nap-hyz-pyz (H3L3) with potential N2O2 donor atoms was found to act as a dual channel (colori- and fluorimetric) sensor towards Al3+ and PPi in H2O-MeOH (6:4,...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Evidence of the efficacy and safety of house dust mite subcutaneous immunotherapy in elderly allergic rhinitis patients: a randomized, double-blind placebo-controlled trial

Allergen specific immunotherapy (AIT) in elderly patients is controversial, and there is still little evidence supporting the safety and efficacy of this treatment in this population. The study objective was t...

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Report on the 2nd European Tissue Repair Society summer school, Brussels, Sept 11–12th, 2017

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Liver Function Tests “Gone Viral”: Acute Hepatitis of Uncertain Cause

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Efficacy of Rebamipide in Organic and Functional Dyspepsia: A Systematic Review and Meta-Analysis

Abstract

Objective

The role of gastritis in dyspepsia remains controversial. We aimed to examine the efficacy of rebamipide, a gastric mucosal protective agent, in both organic and functional dyspepsia.

Design

A systematic review and meta-analysis was performed. The following databases were searched using the keywords ("rebamipide" OR "gastroprotective agent*" OR "mucosta") AND ("dyspepsia" OR "indigestion" OR "gastrointestinal symptoms"): PubMed, Wed of Science, Embase, CINAHL, Cochrane Clinical Trials Register. The primary outcome was dyspepsia or upper GI symptom score improvement. Pooled analysis of the main outcome data were presented as risk ratio (RR) for dichotomous data and standardized mean difference (SMD) for continuous data.

Results

From an initial 248 records, 17 randomised controlled trial (RCT) publications involving 2170 subjects (1224 rebamipide, 946 placebo/control) were included in the final analysis. Twelve RCTs were conducted in subjects with organic dyspepsia (peptic ulcer disease, reflux esophagitis or NSAID-induced gastropathy) and five RCTs were conducted in patients with functional dyspepsia (FD). Overall, dyspepsia symptom improvement was significantly better with rebamipide compared to placebo/control drug (RR 0.77, 95% CI = 0.64–0.93; SMD −0.46, 95% CI = −0.83 to −0.09). Significant symptom improvement was observed both in pooled RR and SMD in subjects with organic dyspepsia (RR 0.72, 95% CI = 0.61–0.86; SMD −0.23, 95% CI = −0.4 to −0.07), while symptom improvement in FD was observed in pooled SMD but not RR (SMD −0.62, 95% CI = −1.16 to −0.08; RR 1.01, 95% CI = 0.71–1.45).

Conclusion

Rebamipide is effective in organic dyspepsia and may improve symptoms in functional dyspepsia.

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Impact of Bacterial Translocation on Hepatopulmonary Syndrome: A Prospective Observational Study

Abstract

Background/Aims

Hepatopulmonary syndrome (HPS) is characterized by a defect in oxygenation induced by pulmonary vascular dilatation in cirrhosis. While severe HPS is responsible for a high rate of mortality, the prevalence and pathophysiology of HPS are not fully elucidated. We evaluated the prevalence and pathophysiology of HPS in patients with cirrhosis.

Methods

A total of 142 patients with cirrhosis who underwent saline-agitated contrast echocardiography were enrolled in this prospective observational study. HPS was defined by positive findings on contrast echocardiography, cirrhosis, and the presence of an oxygenation defect (alveolar–arterial oxygen gradient > 15 mmHg). HPS grades from 0 to 3 were assigned based on the density and spatial distribution of microbubbles in the left ventricle. The primary endpoint was the prevalence of HPS. The secondary endpoints included clinical characteristics and levels of lipopolysaccharide (LPS), LPS-binding protein (LBP), nitric oxide, and endothelin-1 in HPS.

Results

Fifty-nine patients (41.5%) were diagnosed with HPS (grade 1: 24, grade 2: 23, and grade 3: 12 patients). The mean levels of LPS (0.36 ± 0.02, 1.02 ± 0.18, 2.86 ± 0.77, and 6.56 ± 1.46 EU/mL, p < 0.001) and LBP (7026 ± 3336, 11,445 ± 1247, 11,947 ± 1164, and 13,791 ± 2032 ng/mL, p = 0.045) were found to be increased according to HPS grade (negative, grade 1–3). Endothelin-1 levels were significantly elevated according to HPS grade (1.83 ± 0.17, 2.62 ± 0.22, 3.69 ± 0.28, and 4.29 ± 0.34 pg/mL, p < 0.001), demonstrating a significant difference between each grade (p < 0.05).

Conclusions

HPS is a common complication with a prevalence of 41.5% in patients with cirrhosis. Bacterial translocation and portal pulmonary vascular dilatation are key mechanism involved in the progression of HPS.

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Congratulations Shannon O’Donnell, Diane Guerrero, Irina Potapova, and Shannon Doolittle, Student Success Fee Funding Recipients!

SLHS wants to congratulate the following recipients of the 2017-2018 Student Success Fee Academic Related Program.  This program provides students an opportunity to become engaged and involved in their education outside their academic courses.  Successful student proposals focus on academic enhancement, high impact practices, colloquia etc.

Undergraduate:

Shannon O'Donnell (Faculty Sponsor: Peter Torre):  Excellence in SLHS Student Research

The goal for this proposed project is directly in line with the San Diego State University mission to have students, at all levels, be involved in research. This proposal is requesting travel support for students to independently present at a national conference.

MA Program:

Diane Guerrero (Faculty Sponsor: Sonja Pruitt-Lord):  Speech Language Pathology CSHA Convention

Funds are requested to support 20 undergraduate, graduate and doctoral students in attending the 2018 CSHA Convention being held in Sacramento, CA, March 22-25, 2018. Funds will be used to pay for student registration, airfare, and hotel costs.

SDSU/UCSD Joint Doctoral Program in Language and Communicative Disorders:

Irina Potapova (Faculty Sponsor: Sonja Pruitt-Lord):  Fourth Annual Speech, Language and Hearing Awareness and Information Day (SAID)

Professional development events for students in Speech, Language and Hearing Sciences and peers in related fields (e.g., Education, Public Health, Physical Therapy). The project includes a professional mentoring event and our fourth annual Speech, Language and Hearing Awareness and Information Day.

SDSU/UCSD Joint Doctoral Program in Audiology:

Shannon Doolittle (Faculty Sponsor: Laura Dreisbach-Hawe):  Speech, Language, and Hearing Sciences Guest Speaker Event

Since 2003, the Student Academy of Audiology has invited internationally-recognized speakers to present their leading research to students of all levels, faculty, and professional members of the community through the generous support of IRA funds provided by the College of Health and Human Sciences.

 

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Congratulations Shannon O’Donnell, Diane Guerrero, Irina Potapova, and Shannon Doolittle, Student Success Fee Funding Recipients!

SLHS wants to congratulate the following recipients of the 2017-2018 Student Success Fee Academic Related Program.  This program provides students an opportunity to become engaged and involved in their education outside their academic courses.  Successful student proposals focus on academic enhancement, high impact practices, colloquia etc.

Undergraduate:

Shannon O'Donnell (Faculty Sponsor: Peter Torre):  Excellence in SLHS Student Research

The goal for this proposed project is directly in line with the San Diego State University mission to have students, at all levels, be involved in research. This proposal is requesting travel support for students to independently present at a national conference.

MA Program:

Diane Guerrero (Faculty Sponsor: Sonja Pruitt-Lord):  Speech Language Pathology CSHA Convention

Funds are requested to support 20 undergraduate, graduate and doctoral students in attending the 2018 CSHA Convention being held in Sacramento, CA, March 22-25, 2018. Funds will be used to pay for student registration, airfare, and hotel costs.

SDSU/UCSD Joint Doctoral Program in Language and Communicative Disorders:

Irina Potapova (Faculty Sponsor: Sonja Pruitt-Lord):  Fourth Annual Speech, Language and Hearing Awareness and Information Day (SAID)

Professional development events for students in Speech, Language and Hearing Sciences and peers in related fields (e.g., Education, Public Health, Physical Therapy). The project includes a professional mentoring event and our fourth annual Speech, Language and Hearing Awareness and Information Day.

SDSU/UCSD Joint Doctoral Program in Audiology:

Shannon Doolittle (Faculty Sponsor: Laura Dreisbach-Hawe):  Speech, Language, and Hearing Sciences Guest Speaker Event

Since 2003, the Student Academy of Audiology has invited internationally-recognized speakers to present their leading research to students of all levels, faculty, and professional members of the community through the generous support of IRA funds provided by the College of Health and Human Sciences.

 

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Challenge and Yield of Enrolling Racially and Ethnically Diverse Patient Populations in Low Event Rate Clinical Trials [Original Contributions]

Background and Purpose—We report patient enrollment and retention by race and ethnicity in the CREST (Carotid Revascularization Endarterectomy versus Stent Trial) and assess potential effect modification by race/ethnicity. In addition, we discuss the challenge of detecting differences in study outcomes when subgroups are small and the event rate is low.Methods—We compared 2502 patients by race, ethnicity, baseline characteristics, and primary outcome (any periprocedural stroke, death, or myocardial infarction and subsequent ipsilateral stroke up to 10 years).Results—Two hundred forty (9.7%) patients were minority by race (6.1%) or ethnicity (3.6%); 109 patients (4.4%) were black, 32 (1.3%) Asian, 2332 (93.4%) white, 11 (0.4%) other, and 18 (0.7%) unknown. Ninety (3.6%) were Hispanic, 2377 (95%) non-Hispanic, and 35 (1.4%) unknown. The rate of the primary end point for all patients was 10.9%±0.9% at 10 years and did not differ by race or ethnicity (Pinter>0.24).Conclusions—The proportion of minorities recruited to CREST was below their representation in the general population, and retention of minority patients was lower than for whites. Primary outcomes did not differ by race or ethnicity. However, in CREST (like other studies), the lack of evidence of a racial/ethnic difference in the treatment effect should be interpreted with caution because of low statistical power to detect such a difference.Clinical Trial Registration—URL: http://ift.tt/PmpYKN. Unique identifier: NCT00004732.

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DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) Mismatch in Thrombectomy Candidates [Brief Reports]

Background and Purpose—We aimed to study the intrarater and interrater agreement of clinicians attributing DWI-ASPECTS (Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging–Fluid Attenuated Inversion Recovery) mismatch in patients with acute ischemic stroke referred for mechanical thrombectomy.Methods—Eighteen raters independently scored anonymized magnetic resonance imaging scans of 30 participants from a multicentre thrombectomy trial, in 2 different reading sessions. Agreement was measured using Fleiss κ and Cohen κ statistics.Results—Interrater agreement for DWI-ASPECTS was slight (κ=0.17 [0.14–0.21]). Four raters (22.2%) had a substantial (or higher) intrarater agreement. Dichotomization of the DWI-ASPECTS (0–5 versus 6–10 or 0–6 versus 7–10) increased the interrater agreement to a substantial level (κ=0.62 [0.48–0.75] and 0.68 [0.55–0.79], respectively) and more raters reached a substantial (or higher) intrarater agreement (17/18 raters [94.4%]). Interrater agreement for DWI-FLAIR mismatch was moderate (κ=0.43 [0.33–0.57]); 11 raters (61.1%) reached a substantial (or higher) intrarater agreement.Conclusions—Agreement between clinicians assessing DWI-ASPECTS and DWI-FLAIR mismatch may not be sufficient to make repeatable clinical decisions in mechanical thrombectomy. The dichotomization of the DWI-ASPECTS (0–5 versus 0–6 or 0–6 versus 7–10) improved interrater and intrarater agreement, however, its relevance for patients selection for mechanical thrombectomy needs to be validated in a randomized trial.

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Statin Treatment in Patients With Intracerebral Hemorrhage [Comments and Opinions]

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Long-Term Effect of Pravastatin on Carotid Intima-Media Complex Thickness [Original Contributions]

Background and Purpose—The effect of statins on progression of carotid intima–media complex thickness (IMT) has been shown exclusively in nonstroke Western patients. This study aimed to determine the effect of low-dose pravastatin on carotid IMT in Japanese patients with noncardioembolic ischemic stroke.Methods—This is a substudy of the J-STARS trial (Japan Statin Treatment Against Recurrent Stroke), a multicenter, randomized, open-label, parallel-group trial to examine whether pravastatin reduces stroke recurrence. Patients were randomized to receive pravastatin (10 mg daily, usual dose in Japan; pravastatin group) or not to receive any statins (control group). The primary outcome was IMT change of the common carotid artery for a 5-year observation period. IMT change was compared using mixed-effects models for repeated measures.Results—Of 864 patients registered in this substudy, 71 without baseline ultrasonography were excluded, and 388 were randomly assigned to the pravastatin group and 405 to the control group. Baseline characteristics were not significantly different, except National Institute of Health Stroke Scale scores (median, 0 [interquartile range, 0–2] versus 1 [interquartile range, 0–2]; P=0.019) between the 2 groups. Baseline IMT (mean±SD) was 0.887±0.155 mm in the pravastatin group and 0.887±0.152 mm in the control group (P=0.99). The annual change in the IMT at 5-year visit was significantly reduced in the pravastatin group as compared with that in the control group (0.021±0.116 versus 0.040±0.118 mm; P=0.010).Conclusions—The usual Japanese dose of pravastatin significantly reduced the progression of carotid IMT at 5 years in patients with noncardioembolic stroke.Clinical Trial Registration—URL: http://ift.tt/PmpYKN. Unique identifier: NCT00361530.

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Clinical Thyroidology High-Impact Articles

FREE ACCESS through December 14, 2017.
Read Now:

Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration
Stephanie A. Fish 

Are Wider TSH Cutoffs for Reflex Testing of Free T4 Feasible, Safe and Cost-Effective?
Jacques Orgiazzi 

Punctate Echogenic Foci on Thyroid Ultrasound Do Not Necessarily Represent Calcifications on Histopathology
Martin Biermann 

Significant Variations of Thyroid Testing in the U.S. Argue for Improved Standardization of Practice Patterns
Angela M. Leung 

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

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Clinical Thyroidology High-Impact Articles

FREE ACCESS through December 14, 2017.
Read Now:

Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration
Stephanie A. Fish 

Are Wider TSH Cutoffs for Reflex Testing of Free T4 Feasible, Safe and Cost-Effective?
Jacques Orgiazzi 

Punctate Echogenic Foci on Thyroid Ultrasound Do Not Necessarily Represent Calcifications on Histopathology
Martin Biermann 

Significant Variations of Thyroid Testing in the U.S. Argue for Improved Standardization of Practice Patterns
Angela M. Leung 

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

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In reference to “Central nervous system anomalies in craniofacial microsomia: a systematic review”

We read with interest the in-depth review by Renkema and colleagues on central nervous system (CNS) involvement in patients affected by craniofacial microsomia1. In this article, the authors clearly showed that CNS abnormalities are commonly detected (2–69%), thus confirming that malformations in craniofacial microsomia go far beyond isolated skeletal abnormalities. The authors also underlined the need to investigate further the true prevalence rate of CNS involvement through the performance of dedicated studies, and attributed the wide range of CNS abnormality detection rates to selection bias, as patients with neurological symptoms are more likely to undergo neuroimaging studies.

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Anaesthetic efficacy of 4% articaine compared with 2% mepivacaine: a randomized, double-blind, crossover clinical trial

The aim of this study was to evaluate the clinical efficacy of 4% articaine (Ar4) compared to 2% mepivacaine (Me2), both in combination with 1:100,000 epinephrine, in a unique soft tissue model. This was a randomized, double-blind, crossover clinical trial. The anaesthetic was applied to the lower lip using a computerized local delivery system. The following were evaluated: blood flow, thermal sensation, pressure and proprioception, extent of anaesthesia, gradual elimination, and the final duration of the effect of the anaesthesia.

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Earwax MD Now Available in Canada

Eosera (https://earcaremd.com/) has made Earwax MD available in Canada through Amazon.ca, the first foreign market the company has brought its product to. On Amazon.ca, the product is available in a kit that includes a 15 mL bottle and rinsing bulb. Amazon Prime members can get Earwax MD with free shipping on Amazon.ca. The topical cerumen-dissolving drop has been stocked in CVS stores across the United States since August, and has been part of the U.S. Amazon Exclusives program since April 2017.

Elyse Dickerson, co-founder and CEO of Eosera, said they founded Eosera to develop solutions for unmet healthcare needs that would have a global impact, and since launching Earwax MD on Amazon.com in April, they have received considerable interest from Canadian consumers, audiologists, ENTs and other health care professionals. "We are thrilled to enter Canada on Amazon.ca, so that from the start, we are available to all Canadians," Dickerson said. "We are working towards a larger distribution channel in Canada, and anticipate availability in retail stores and additional distributors in the future."

Published: 11/30/2017 3:52:00 PM

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Earwax MD Now Available in Canada

Eosera (https://earcaremd.com/) has made Earwax MD available in Canada through Amazon.ca, the first foreign market the company has brought its product to. On Amazon.ca, the product is available in a kit that includes a 15 mL bottle and rinsing bulb. Amazon Prime members can get Earwax MD with free shipping on Amazon.ca. The topical cerumen-dissolving drop has been stocked in CVS stores across the United States since August, and has been part of the U.S. Amazon Exclusives program since April 2017.

Elyse Dickerson, co-founder and CEO of Eosera, said they founded Eosera to develop solutions for unmet healthcare needs that would have a global impact, and since launching Earwax MD on Amazon.com in April, they have received considerable interest from Canadian consumers, audiologists, ENTs and other health care professionals. "We are thrilled to enter Canada on Amazon.ca, so that from the start, we are available to all Canadians," Dickerson said. "We are working towards a larger distribution channel in Canada, and anticipate availability in retail stores and additional distributors in the future."

Published: 11/30/2017 3:52:00 PM

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Cytomixis in plants: facts and doubts

Abstract

The migration of nuclei between plant cells (cytomixis) is a mysterious cellular phenomenon frequently observable in the male meiosis of higher plants. Cytomixis attracts attention because of unknown cellular mechanisms underlying migration of nuclei and its potential evolutionary significance, since the genetic material is transferred between the cells that form pollen. Although cytomixis was discovered over a century ago, the advance in our understanding of this process has been rather insignificant because of methodological difficulties. The data that allowed for a new insight into this phenomenon were obtained by examining the migrating nuclei with electron and confocal laser microscopy, immunostaining, and fluorescence in situ hybridization. As has been shown, the chromatin migrating between cells is surrounded by an undamaged nuclear membrane. Such chromatin does not undergo heterochromatization and contains normal euchromatin markers. The condensation degree of the migrating chromatin corresponds to the current meiotic stage, and normal structures of synaptonemal complex are present in the migrating part of the nucleus. The cells involved in cytomixis lack any detectable morphological and molecular markers of programmed cell death. It has been shown that individual chromosomes and genomes (in the case of allopolyploids) have no predisposition to the migration between cells, i.e., parts of the nucleus are involved in cytomixis in a random manner. However, the fate of migrating chromatin after it has entered the recipient cell is still vague. A huge amount of indirect data suggests that migrating chromatin is incorporated into the nucleus of the recipient cell; nonetheless, the corresponding direct evidences are still absent. No specific markers of cytomictic chromatin have been yet discovered. Thus, the causes and consequences of cytomixis are still disputable. This review briefs the recent data on the relevant issues, describes the classical and modern methodological approaches to analysis of the intercellular migration of nuclei, and discusses the problems in cytomixis research and its prospects.

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Development of a fluorescence-image scoring system for assessing noncavitated occlusal caries

Publication date: March 2018
Source:Photodiagnosis and Photodynamic Therapy, Volume 21
Author(s): Eun-Ha Jung, Eun-Song Lee, Hoi-In Jung, Si-Mook Kang, Elbert de Josselin de Jong, Baek-Il Kim
BackgroundThis study aimed (1) to develop a scoring system based on a quantitative light-induced fluorescence (QLF) score for the occlusal caries (QS-Occlusal) that standardizes the fluorescence properties of noncavitated lesions from QLF images, (2) to confirm the validity and reliability of QS-Occlusal, and (3) to determine whether it is possible to replace existing clinical examinations by image evaluations based on the developed QS-Occlusal for assessing occlusal caries lesions.MethodsThis clinical study investigated 791 teeth of 94 subjects. The teeth were assessed by visual and tactile examinations using ICDAS criteria and quantitative light-induced fluorescence-digital (QLF-D) image examinations. QS-Occlusal was divided into four stages (from 0 to 3) based on the progression level of the lesion and the fluorescence loss and red fluorescence on captured QLF-D images. Two trained examiners who were not involved in the visual examination evaluated occlusal fluorescence images using QS-Occlusal. The maximum loss of fluorescence (|ΔFmax|) and the maximum change in the ratio of red and green fluorescence (ΔRmax) were quantitatively analyzed by the QA2 software to detect differences between the QS-Occlusal groups. The modalities were compared in terms of sensitivity, specificity, and area under the receiver operating characteristics (AUROC) curve for three different thresholds of the ICDAS codes: 0 vs 1–4 (D1), 0–2 vs 3/4 (D2), and 0–3 vs 4 (D3).Results|ΔFmax| increased significantly by about 4.7-fold (from 15.94 to 75.63) when QS-Occlusal increased from 0 to 3. ΔRmax was about 6.2-fold higher for QS-Occlusal=1 (49.74) than for QS-Occlusal=0 (8.04), and 21.6-fold higher for QS-Occlusal=3 (P<0.05). The new QS-Occlusal showed an excellent AUROC (ranging from 0.807 to 0.976) in detecting occlusal caries when optimum cutoff values were applied. The intra- and interexaminer agreements indicated excellent reliability, with ICC values of 0.94 and 0.86, respectively.ConclusionsThe QS-Occlusal proposed in this study can be used in the clinical detection of noncavitated lesions with an excellent diagnostic ability. This makes it possible to replace clinical examinations and intuitively evaluate the lesion severity and status relatively easily and objectively by applying this scoring system to fluorescence images.



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Intense phototoxic reactions to photodynamic therapy in immunosuppressed renal transplant patients

Publication date: March 2018
Source:Photodiagnosis and Photodynamic Therapy, Volume 21
Author(s): V.K. Ortner, M. Haedersdal, H.C. Wulf, K. Togsverd-Bo




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Voice Profile Recovery and Quality of Life Changes After Microdirect Laryngoscopy in Three Categories of Glottis Lesions: Benign, Precancerous, and Malignant

The aim of the study was comparison of voice and life quality after microdirect laryngoscopy in three patient histopathological categories: benign, precancerous, and malignant glottic lesions. A totalnof 137 patients treated with microdirect laryngoscopy were included in the study. Each patient was evaluated with a multidimensional protocol before and 3, 6, and 12 months after treatment. Final 1-year evaluations were achieved in 74.5% (102). The assessment included laryngovideostroboscopy (LVS), perceptual (GRBAS) grading, aerodynamic measures including maximum phonation time and phonation quotient and acoustic measurements (Kay Elemetrics Multi-Speech program), Voice Handicap Index (VHI), Voice-Related Quality of Life questionnaire; and World Health Organization Quality of Life Scale-Brief Version (WHOQoL-BREF).

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Fasciculation: Does distance really matter?

The needle electromyography (EMG) discloses fasciculation potentials (FPs) so frequently in amyotrophic lateral sclerosis (ALS) that neurophysiologists are reluctant to accept this diagnosis unless FPs are shown (de Carvalho et al., 2008). Their presence has also been associated with hyperexcitability in ALS (de Carvalho et al., 2017), recently confirmed by the finding that the most excitable lower motor neuron is the one more susceptible to fasciculate (de Carvalho and Swash, 2017). Moreover, the presence of FPs is a very early finding in muscles of ALS patients (Lambert, 1969) and antedates morphological changes of the motor units (MUs) or signs of end-plate dysfunction (de Carvalho and Swash, 2013).

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Retrograde parotidectomy and facial nerve outcomes: A case series of 44 patients (Letter to Editor)

I read with interest about the nicely written article entitled "Retrograde Parotidectomy and Facial Nerve Outcomes: A case Series of 44 Patients" by Kligerman et al. [1]. I would like to congratulate the authors on their good results of retrograde parotidectomy. They demonstrated that the complications after retrograde parotidectomy, especially of facial nerve injury, are not inferior to the counterpart of antegrade parotidectomy. In addition, the former approach could achieve a low wound complication rate of 6.8% and facilitate outpatient surgery.

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Commentary to letter to the editor to manuscript “Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life”

We indeed appreciate the comments of Dr. Singh Bakshi and would like to take the opportunity to remark on them.

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Commentary to letter to the editor to manuscript “Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life”

We indeed appreciate the comments of Dr. Singh Bakshi and would like to take the opportunity to remark on them.

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Retrograde parotidectomy and facial nerve outcomes: A case series of 44 patients (Letter to Editor)

I read with interest about the nicely written article entitled "Retrograde Parotidectomy and Facial Nerve Outcomes: A case Series of 44 Patients" by Kligerman et al. [1]. I would like to congratulate the authors on their good results of retrograde parotidectomy. They demonstrated that the complications after retrograde parotidectomy, especially of facial nerve injury, are not inferior to the counterpart of antegrade parotidectomy. In addition, the former approach could achieve a low wound complication rate of 6.8% and facilitate outpatient surgery.

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Commentary to letter to the editor to manuscript “Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life”

We indeed appreciate the comments of Dr. Singh Bakshi and would like to take the opportunity to remark on them.

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Retrograde parotidectomy and facial nerve outcomes: A case series of 44 patients (Letter to Editor)

I read with interest about the nicely written article entitled "Retrograde Parotidectomy and Facial Nerve Outcomes: A case Series of 44 Patients" by Kligerman et al. [1]. I would like to congratulate the authors on their good results of retrograde parotidectomy. They demonstrated that the complications after retrograde parotidectomy, especially of facial nerve injury, are not inferior to the counterpart of antegrade parotidectomy. In addition, the former approach could achieve a low wound complication rate of 6.8% and facilitate outpatient surgery.

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Commentary to letter to the editor to manuscript “Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life”

We indeed appreciate the comments of Dr. Singh Bakshi and would like to take the opportunity to remark on them.

from ORL via alkiviadis.1961 on Inoreader http://ift.tt/2zRdDfL

Retrograde parotidectomy and facial nerve outcomes: A case series of 44 patients (Letter to Editor)

I read with interest about the nicely written article entitled "Retrograde Parotidectomy and Facial Nerve Outcomes: A case Series of 44 Patients" by Kligerman et al. [1]. I would like to congratulate the authors on their good results of retrograde parotidectomy. They demonstrated that the complications after retrograde parotidectomy, especially of facial nerve injury, are not inferior to the counterpart of antegrade parotidectomy. In addition, the former approach could achieve a low wound complication rate of 6.8% and facilitate outpatient surgery.

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2017 Highlights

Patient Success Stories Otorhinolaryngology And Neurosurgery Team Up To Maximize The Outcome For A Patient With Pituitary Tumor Virtual Presurgical... Read the full article...

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2017 Highlights

Patient Success Stories Otorhinolaryngology And Neurosurgery Team Up To Maximize The Outcome For A Patient With Pituitary Tumor Virtual Presurgical... Read the full article...

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The Clinicopathological Study of Benign Lesions of Vocal Cords

In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after p honosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatme nt, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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Peak Nasal Inspiratory Flow as an Objective Measure

This study assesses the utility of peak nasal inspiratory flow as an objective diagnostic and outcome measure for functional septorhinoplasty in combination with the Nasal Obstruction Symptom Evaluation scale.

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Length of Stay for Free Tissue Transfer to Head and Neck Defects

This database review evaluates patient and surgical factors associated with length of stay and reoperation following surgical procedures for malignant neoplasm of the head and neck involving microvascular free tissue transfer reconstruction.

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Association of Lymph Node Density With Survival in Papillary Thyroid Cancer

This cohort study assesses the association of lymph node density—the ratio of the number of positive lymph nodes to the total number of nodes excised—with survival in patients with papillary thyroid cancer.

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Asymptomatic Septal Mass

A woman in her 40s presented with a 2-month history of an enlarging asymptomatic anterior septal mass; she denied a history of localized trauma, and examination revealed an 8-mm pink-red, soft fleshy growth posterior to the membranous septum near the nostril apex. What is your diagnosis?

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Association of Hearing Loss and Otologic Outcomes With Fibrous Dysplasia

This study characterizes audiologic and otologic manifestations in a cohort of individuals with fibrous dysplasia and/or McCune-Albright syndrome and investigated potential mechanisms of hearing loss.

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Association of Lymph Node Density With Survival in Papillary Thyroid Cancer

This cohort study assesses the association of lymph node density—the ratio of the number of positive lymph nodes to the total number of nodes excised—with survival in patients with papillary thyroid cancer.

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Asymptomatic Septal Mass

A woman in her 40s presented with a 2-month history of an enlarging asymptomatic anterior septal mass; she denied a history of localized trauma, and examination revealed an 8-mm pink-red, soft fleshy growth posterior to the membranous septum near the nostril apex. What is your diagnosis?

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Association of Hearing Loss and Otologic Outcomes With Fibrous Dysplasia

This study characterizes audiologic and otologic manifestations in a cohort of individuals with fibrous dysplasia and/or McCune-Albright syndrome and investigated potential mechanisms of hearing loss.

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Association of Lymph Node Density With Survival in Papillary Thyroid Cancer

This cohort study assesses the association of lymph node density—the ratio of the number of positive lymph nodes to the total number of nodes excised—with survival in patients with papillary thyroid cancer.

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Asymptomatic Septal Mass

A woman in her 40s presented with a 2-month history of an enlarging asymptomatic anterior septal mass; she denied a history of localized trauma, and examination revealed an 8-mm pink-red, soft fleshy growth posterior to the membranous septum near the nostril apex. What is your diagnosis?

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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The Clinicopathological Study of Benign Lesions of Vocal Cords

Abstract

Benign vocal lesions are non-malignant growths of abnormal tissue on the vocal cords. The common benign lesions of vocal cord are singer's nodule, polyps, papilloma, polypoidal degeneration and cysts. The aim of this study was to analyze the demographics such as age, sex, occupation, symptomatology, site of involvement. An objective evaluation of voice handicap was done pre and postoperatively using VHI-10 scale to see improvement in patient's symptoms. In this prospective study, a total of 50 cases were selected with benign lesions in regional hospital of India. The pre and post operative assessment for voice handicap was assessed by VHI-10. Chi square test (SPSS 20.0 version) used to analyze result; value of p < 0.05 was taken significant. In this study of 50 patients, the benign lesions were most common in 20–29 age group. Male (70%) outnumbered females (30%). Most common was Vocal polyp (56%), followed by nodule (32%), cyst (10%) and papilloma (2%) respectively. All patients showed improvement after phonosurgery and postoperative speech therapy, being assessed by VHI-10 scale. The benign lesions of vocal cords produces symptoms which can vary from hoarseness to stridor, affect social functioning, work performance. Speech therapy following microlaryngeal surgery forms an essential part of treatment, to avoid recurrence. VHI-10 scale as found to be a useful and convenient tool in measuring patient voice handicap and to see improvement after surgery.

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Cancer of the Head of the Pancreas: Early Surgery or Preoperative Biliary Drainage?

Conditions:   Pancreatic Cancer;   Biliary Stasis
Intervention:   Device: Tannenbaum Fr 10 stent or WallFlex stent
Sponsor:   Helsinki University Central Hospital
Recruiting

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Pembrolizumab Plus Epacadostat, Pembrolizumab Monotherapy, and the EXTREME Regimen in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma (KEYNOTE-669/ECHO-304)

Conditions:   Recurrent Head and Neck Squamous Cell Carcinoma;   Metastatic Head and Neck Squamous Cell Carcinoma
Interventions:   Drug: Pembrolizumab;   Drug: Epacadostat;   Drug: Cetuximab;   Drug: Cisplatin;   Drug: Carboplatin;   Drug: 5-Fluorouracil
Sponsors:   Incyte Corporation;   Merck Sharp & Dohme Corp.
Not yet recruiting

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Radiotherapy vs Neck Dissection for Clinical T1/2N0 Supraglottic Cancer

Condition:   Supraglottic Cancer
Interventions:   Radiation: Radiatherapy;   Procedure: Selective neck dissection
Sponsors:   Tianjin Medical University Cancer Institute and Hospital;   Tianjin Medical University General Hospital;   Tianjin Medical University Second Hospital
Not yet recruiting

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Cancer of the Head of the Pancreas: Early Surgery or Preoperative Biliary Drainage?

Conditions:   Pancreatic Cancer;   Biliary Stasis
Intervention:   Device: Tannenbaum Fr 10 stent or WallFlex stent
Sponsor:   Helsinki University Central Hospital
Recruiting

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Pembrolizumab Plus Epacadostat, Pembrolizumab Monotherapy, and the EXTREME Regimen in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma (KEYNOTE-669/ECHO-304)

Conditions:   Recurrent Head and Neck Squamous Cell Carcinoma;   Metastatic Head and Neck Squamous Cell Carcinoma
Interventions:   Drug: Pembrolizumab;   Drug: Epacadostat;   Drug: Cetuximab;   Drug: Cisplatin;   Drug: Carboplatin;   Drug: 5-Fluorouracil
Sponsors:   Incyte Corporation;   Merck Sharp & Dohme Corp.
Not yet recruiting

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Radiotherapy vs Neck Dissection for Clinical T1/2N0 Supraglottic Cancer

Condition:   Supraglottic Cancer
Interventions:   Radiation: Radiatherapy;   Procedure: Selective neck dissection
Sponsors:   Tianjin Medical University Cancer Institute and Hospital;   Tianjin Medical University General Hospital;   Tianjin Medical University Second Hospital
Not yet recruiting

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Scientific abstracts from the 2017 ACOMS and CAOMS Joint Scientific Conference and Exhibition

Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): ACOMS




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Table of Contents

Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6





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Letter to the editor: Comments in relation to the CPC case entitled: “Submucosal nodule in buccal mucosa” Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:660-665.1

Publication date: Available online 16 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ciro Dantas Soares, Román Carlos




http://ift.tt/2ipMKbd

Prevalence of temporomandibular disorders discovered incidentally during routine dental examination using the research diagnostic criteria for temporomandibular disorders

Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Wael M. Talaat, Omar I. Adel, Saad Al Bayatti
ObjectivesTo assess the prevalence of temporomandibular disorders (TMD) discovered incidentally during routine dental examination, identify disease patterns, and evaluate patients' attitude toward accepting treatment.Study designA total of 3009 subjects were examined at the University Dental Hospital Sharjah. Research Diagnostic Criteria for TMD (RDC/TMD) Axes I and II were used for assessment. Subjects with acute/serious dysfunction symptoms underwent cone-beam computed tomography (CBCT) examination. MRI was used to confirm the diagnosis of disc displacement.ResultsNon-self-reported TMD prevalence was 10.8% (n=325). Among TMD patients, the disorders were diagnosed more in women (65.85%) (p<0.05), and between the ages of 25 and 45 (65.54%) (p<0.05). Axis I assessment revealed disc displacement with reduction (group IIa) was the most common (40.92%). Axis II chronic pain grade (CPG) showed 32.62% of TMD patients experienced chronic pain, whereas 66.77% had mild disability. Interest to pursue treatment was indicated by 92.31% of patients. CBCT and MRI assessment changed the primary diagnosis in 26.08% and 18.47% of cases, respectively.ConclusionsTMD screening during routine dental examination led to the diagnosis of non-self-reported TMD, most commonly related to disc displacement with reduction. Radiographic assessment was important to confirm TMD diagnosis. Patients diagnosed with TMD during dental screening expressed interest in pursuing treatment.



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Khat and synthetic cathinones: emerging drugs of abuse with dental implications

Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Worku Abebe
The rising global availability of the stimulant and euphoric substances, khat and synthetic cathinones, has become a cause for concern in many countries, including the US. Both substances are illegal in US, although this has not deterred the use. Besides central nervous system effects, these drugs also cause sympathomimetic and oro-dental adverse effects, similar to those of amphetamine. While synthetic cathinones are more stronger than khat in most cases, the latter additionally contains tannins, which have astringent effects on tissues components, including in the oral cavity. Recognizing the use prevalence and reported oro-dental adverse effects of khat and synthetic cathinones, dental practitioners should be more familiar with these substances in order to optimally treat and educate their patients abusing them. This paper reviews the pharmacology and adverse effects of khat and synthetic cathinones, along with the extent of their use in US, with particular emphasis on dental implications.



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Reply to the letter to the editor

Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jesca Silva, Priscila Andrade, Bruno Sotto-Maior, Neuza Assis, Karina Lopes Devito




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Acknowledgement of reviewers 2017

Publication date: Available online 20 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology





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Inflammatory reaction of the anterior dorsal tongue presumably to sodium lauryl sulfate within toothpastes: a triple case report.

Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ronald S. Brown, Langston Smith, Alison L. Glascoe
BackgroundSodium lauryl sulfate (SLS) is a popular surface active agent ingredient within toothpastes, known for its foaming action. Surface active agents increase the effectiveness of toothpastes with respect to dental plaque removal. SLS is a known irritant and also has allergenic potential. The authors report three patients with oral pain secondary to inflammation of the dorsal anterior tongue. These patients were all using toothpastes with SLS as an ingredient.ResultsThe dorsal tongue lesions and oral pain resolved upon switching to toothpastes without SLS as an ingredient.ConclusionsClinicians should be aware of the potential of SLS within toothpastes to cause oral mucosal inflammatory reactions of the anterior dorsal tongue. To our knowledge, these are the first case reports of oral mucosal inflammatory reactions of the anterior dorsal tongue associated with SLS containing toothpastes.



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DNA methylation polymerase chain reaction (PCR) array of apoptosis-related genes in pleomorphic adenomas of the salivary glands

Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6
Author(s): Núbia Braga Pereira, Ana Carolina de Melo do Carmo, Kelma Campos, Sara Ferreira dos Santos Costa, Marina Gonçalves Diniz, Ricardo Santiago Gomez, Carolina Cavalieri Gomes
ObjectiveThe aim of this study was to evaluate the DNA methylation profile in 22 apoptosis-related genes in pleomorphic adenomas (PAs) of the salivary glands, in comparison with normal salivary glands (NSGs), and to address the differences in methylation patterns between smaller and larger tumors. Additionally, we investigated if the hypermethylation of differentially methylated genes between NSGs and PAs impacted the messenger RNA (mRNA) transcription.DesignTwenty-three fresh PA samples and 12 NSG samples were included. The PA samples were divided into 2 groups: PAs with clinical size larger than 2 cm (n = 12) and PAs with clinical size 2 cm or smaller (n = 11). DNA methylation at the promoter region of a panel of 22 genes involved in apoptosis was profiled by using a human apoptosis DNA methylation polymerase chain reaction array, and the transcriptional levels of genes showing differential methylation profiles between PAs and NSGs were assessed.ResultsTNFRSF25 and BCL2 L11 were highly methylated in PAs, in comparison with NSGs, irrespective of tumor size. However, no difference could be observed in the mRNA transcription between PAs and NSGs.ConclusionsHypermethylation of the proapoptotic genes BCL2 L11 and TNFRSF25 is observed in PA. However, this phenomenon did not impact mRNA transcription.



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Multifocal occurrence of intraoral isolated MS in a patient without leukemic presentation: a case report and literature review

Publication date: Available online 22 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yanxin Shen, Lei Zhao, Yafei Wu, Ping Huang
Myeloid sarcoma (MS), also referred to as chloroma or granulocytic sarcoma, is a rare extramedullary malignant tumor composed of immature myeloid cells. MS usually occurs with acute myelocytic leukemia (AML), myeloproliferative neoplasm, or myelodysplastic syndrome, or as a recurrence of AML; however, MS may occasionally present isolated, without current or previous peripheral blood or bone marrow involvement. The oral and maxillofacial MS, especially isolated, is extremely rare, and the clinical manifestations are diverse and usually non-specific. Here we report a rare case of isolated nonleukemic MS involving the gingivae, mucosa of the left maxillary edentulate region and the adjacent hard palate. The pertinent literature was also reviewed to provide additional clarification on the clinicopathologic characteristics, differential diagnosis, treatment regimens and prognosis of oral and maxillofacial isolated MS.



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Evaluation of clinical and radiographic indices as predictors of osteoporotic fractures: a 10-year longitudinal study

Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Grethe Jonasson, Valter Sundh, Magnus Hakeberg, Margareta Ahlqwist, Lauren Lissner, Dominique Hange
ObjectivesTo evaluate two radiographic and three clinical indices as predictors of future osteoporotic fractures.Study designIn a prospective, longitudinal study with a 10-year fracture follow-up, the two radiographic indices, mandibular cortical erosion (normal, mild/moderate erosion, and severe erosion of the inferior cortex) and cortex thickness, were assessed using panoramic radiographs of 411 women, aged 62-78 years. The clinical indices were the fracture assessment tool, FRAX^(R), the osteoporosis index of risk, OSIRIS, and the osteoporosis self-assessment tool, OST.ResultsThe relative risks (RR) for future fracture were significant for FRAX^(R)>15%, 4.1 (95% CI: 2.4-7.2), and for severely eroded cortices, 1.7 (95% CI: 1.1-2.8). Cortical thickness <3mm, OSIRIS, and OST were not significant fracture predictors (RR 1.1, 1.4, and 1.5 respectively). For the five tested fracture predictors, Fisher's exact test gave the following p-values for differences between fractured and non-fractured groups: FRAX^{( R)} <0.001, cortical erosion 0.023, OST 0.078, OSIRIS 0.206, and cortical thickness 0.678. The area under the curve (AUC) was 0.69 for FRAX^(R)>15%, 0.58 for cortical erosion, and 0.52 for cortical thickness. Adding OSIRIS and OST did not change AUC significantly.ConclusionFRAX^(R) and severely eroded cortices predicted fracture but cortical thickness, OSIRIS, and OST did not.



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It is not about lip retraction

Publication date: Available online 21 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Sze Lok Lau




http://ift.tt/2Asxgds

Accuracy of biomarkers obtained from cone beam computed tomography in assessing the internal trabecular structure of the mandibular condyle

Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6
Author(s): Fouad H. Ebrahim, Antonio C.O. Ruellas, Beatriz Paniagua, Erika Benavides, Karl Jepsen, Larry Wolford, Joao Roberto Goncalves, Lucia H.S. Cevidanes
ObjectiveThe aim of this study was to validate the ability of cone beam computed tomography (CBCT) to measure condylar internal trabecular bone structure and bone texture parameters accurately.Study DesignSixteen resected condyles of individuals undergoing temporomandibular joint replacement were collected and used as samples. These condyles were then radiographically imaged by using clinically oriented dental CBCT and research oriented micro–computed tomography (micro-CT). The CBCT scans were then compared with the gold standard micro-CT scans in terms of 21 bone imaging parameters. Descriptive histologic investigation of the specimens was also performed.ResultsSignificant correlations were found for several imaging parameters between the CBCT and micro-CT images, including trabecular thickness (r = 0.92), trabecular separation (r = 0.78), bone volume (r = 0.90), bone surface area (r = 0.79), and degree of anisotropy measurements (r = 0.77).ConclusionsMeasurements of trabecular thickness, trabecular separation, bone volume, bone surface area, and degree of anisotropy obtained from high-resolution dental CBCT images may be suitable bone imaging biomarkers that can be utilized clinically and in future research.



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Reply to the Letter to the Editor: Comments in relation to the CPC case entitled:

Publication date: Available online 20 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Natália Batista Daroit, Bruna Jalfim Maraschin, Vinícius Coelho Carrard, Pantelis Varvaki Rados, Fernanda Visioli




http://ift.tt/2iqNZXC

A symptomatic swelling of the upper lip

Publication date: Available online 17 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ana Carolina Uchoa Vasconcelos, Adriano Mota Loyola, Ana Paula Neutzling Gomes, Vera Cavalcanti de Araújo, Sandra Beatriz Chaves Tarquínio, Felipe Martins Silveira, Maria Cássia Ferreira de Aguiar




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Announcement

Publication date: December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 6





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Anticoagulants are dental friendly

Publication date: Available online 16 November 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Michael J. Wahl, Craig S. Miller, Nelson L. Rhodus, Peer Kämmerer, Atanaska Dinkova, Rajesh V. Lalla, Branislav V. Bajkin




http://ift.tt/2ArnF6M

Physiological responses and toxin production of Microcystis aeruginosa in short-term exposure to solar UV radiation

Photochem. Photobiol. Sci., 2018, Advance Article
DOI: 10.1039/C7PP00265C, Paper

Marcelo Hernando, Melina Celeste Crettaz Minaglia, Gabriela Malanga, Christian Houghton, Dario Andrinolo, Daniela Sedan, Lorena Rosso, Leda Giannuzzi
We found a UVBR threshold and different responses were activated depending on the exposure to UVAR or UVBR and their doses. =: no changes; -: decrease; +: increase. The number of signals represents the intensity of the effect.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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Vaskuläre Anomalien. Teil I: Gefäßtumoren

Zusammenfassung

Vaskuläre Anomalien stellen strukturelle Störungen und angeborene Fehler der vaskulären Morphogenese dar, die das gesamte arterielle und venöse Gefäßsystem betreffen können. Sie sind in zwei Hauptkategorien unterteilt: Tumoren, die eine endotheliale Hyperplasie aufweisen, und Malformationen, die einen normalen endothelialen Umsatz haben. Je nach Art und Komplexität reicht das Spektrum von einem einfachen „Muttermal" bis zu lebensbedrohlichen Entitäten. Die relativ geringe Inzidenz (4–10 %) vaskulärer Anomalien unter der Allgemeinbevölkerung in Verbindung mit der Tatsache, dass ihr Management oft in den Zuständigkeitsbereich mehrerer medizinischer und chirurgischer Spezialitäten fällt, hat zu einer unzureichenden Expertise in der Beurteilung und Therapie dieser Bedingungen geführt. Identifikation, einheitliche Nomenklatur und multidisziplinärer Ansatz sind für das ordnungsgemäße Management von größter Bedeutung.

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Optimizing venous outflow in reconstruction of Gustilo IIIB lower extremity traumas with soft tissue free flap coverage: Are two veins better than one?

Purpose

The dependent nature of the lower extremity predisposes to venous congestion, especially following significant trauma. The benefit of a second venous anastomosis, however, remains unclear in lower extremity trauma free flap reconstruction. This study investigated the effect of an additional venous anastomosis on flap outcomes in lower extremity trauma reconstruction.

Methods

Retrospective review between 1979 and 2016 identified 361 soft tissue flaps performed for Gustilo IIIB/C coverage meeting inclusion criteria. Muscle flaps were performed in 287 cases (79.9%) and fasciocutaneous flaps in 72 cases (20.1%). Single-vein anastomosis was performed in 76% of cases and dual-vein anastmoses in 24% of cases. Patient demographics, flap characteristics, and outcomes were examined.

Results

Fasciocutaneous flaps were more likely to have two veins performed (P < .001). Complications occurred in 143 flaps (39.8%): 45 take-backs (12.4%), 37 partial losses (10.3%), 31 complete losses (8.6%). Compared to single-vein flaps, two veins reduced major complications (P = .005), partial flap failures (P = .008), and any flap failure (P = .018). Multivariable regression analysis demonstrated two veins to be protective against complications (RR = 2.58, P = .009). Subset regression analysis by flap type demonstrated an even more significant reduction in complications among muscle flaps (RR = 3.92, P = .005). Additionally, a >1 mm vein size mismatch was predictive of total flap failure (RR = 3.02, P = .038).

Conclusion

Lower extremity trauma free flaps with two venous anastomoses demonstrated a fourfold reduction in complication rates compared to single-vein flaps. Additionally, venous size mismatch >1 mm was an independent predictor of total flap failure, suggesting beneficial effects of both two-vein outflow and matched vessel diameter.

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The Role of Ultrasound in Diagnosis of Temporomandibular Joint Disc Displacement: A Case–Control Study

Abstract

Purpose

Ultrasound is extensively being used for imaging of temporomandibular joint as it is non-invasive and relatively inexpensive. The purpose of this study was to evaluate the use of ultrasound in identifying TMJ with internal derangement and to access its usefulness as a diagnostic tool in patients with TMJ clicking.

Methods

A case–control study was done: 25 patients with a complaint of clicking sound while opening the jaw were randomly selected as the study group and 25 patients who were asymptomatic on TMJ examination were selected as the control group. Both the groups were subjected to bilateral ultrasound scanning of the TMJ. The lateral part of capsule to condyle distance (LCCD) and the anterior part of capsule to condyle distance (ACCD) were measured.

Results

The mean LCCD of all the 50 joints in the control group was 1.3630 mm, and the mean ACCD of the 50 joints was 1.4850 mm. These values were compared with each of the 50 symptomatic joints scanned in the study group. It was noted that 56% of the subjects showed deviation towards right side and 44% showed deviation towards right side. Clicking was heard in all the subjects while opening the mouth on auscultation. The frequency and percentage distribution of negative and non-negative deviations of LCCD from that of control group were noted. In total, 40% showed negative deviation and 60% showed non-negative deviation. In total, 24% of the subjects showed negative deviation and 76% showed non-negative 190 deviation of ACCD when compared with the control group. T test shows that with respect to LCCD measurement there is no significant difference between symptomatic and asymptomatic subjects, whereas ACCD measurements are significantly different between the symptomatic and asymptomatic subjects.

Conclusions

Hence, it can be concluded that auscultation is mandatory in the examination of temporomandibular joint for clicking sound. Ultrasonography, which has shown high specificity, can supplement clinical evaluation in patients with TMJ disorders and can be used as a potential diagnostic tool for identifying internal derangement of the temporomandibular joint with reduction.

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Double tinnitus in a single ear

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Audiology answers for otolaryngologists

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Lack of additional effects of long-term, low-dose clarithromycin combined treatment compared with topical steroids alone for chronic rhinosinusitis in China: a randomized, controlled trial

Background

In China, clarithromycin is considered an effective treatment option for chronic rhinosinusitis (CRS) due to its unique immunopathologic characteristics. Our study's aim was to determine whether a topical steroid and clarithromycin combination is better than a single topical steroid for Chinese patients with CRS.

Methods

Patients with CRS with/without nasal polyps were included in this study and randomly assigned to a clarithromycin plus budesonide aqua nasal spray group (CLM + BUD, clarithromycin 0.25 g/d and budesonide 256 μg/d) or a budesonide-alone group (BUD, budesonide 256 μg/d). The treatment period was 3 months. The primary outcome was visual analog scale (VAS) score for 5 major symptoms and a general nasal symptom. Other assessments included the 22-item Sino-Nasal Outcome Test (SNOT-22), computed tomography scan (Lund-Mackay score), and rigid nasal endoscopy (Lund-Kennedy score). Nasal secretion evaluation was the secondary outcome.

Results

Seventy-four patients were included and randomly assigned to the CLM + BUD group (n = 38) or the BUD group (n = 36). VAS scores for nasal obstruction, rhinorrhea, smell reduction, headache, nasal pain, and general nasal symptom were markedly improved in both treatment arms, but the differences between groups were not significant. Furthermore, SNOT-22, Lund-Mackay, and Lund-Kennedy scores improved significantly after treatment in both groups, and were slightly better in the CLM + BUD group. For the responders in the CLM + BUD group, interleukin (IL)-6 and IL-8 were markedly reduced.

Conclusion

The combination of CLM + BUD for the treatment of first-time-diagnosed CRS in this Chinese population cohort did not show a better effect compared with a single BUD regimen, but it may have a better effect in some patients with increased IL-6 or IL-8.

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Double tinnitus in a single ear

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Audiology answers for otolaryngologists

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ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA.

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Lack of additional effects of long-term, low-dose clarithromycin combined treatment compared with topical steroids alone for chronic rhinosinusitis in China: a randomized, controlled trial

Background

In China, clarithromycin is considered an effective treatment option for chronic rhinosinusitis (CRS) due to its unique immunopathologic characteristics. Our study's aim was to determine whether a topical steroid and clarithromycin combination is better than a single topical steroid for Chinese patients with CRS.

Methods

Patients with CRS with/without nasal polyps were included in this study and randomly assigned to a clarithromycin plus budesonide aqua nasal spray group (CLM + BUD, clarithromycin 0.25 g/d and budesonide 256 μg/d) or a budesonide-alone group (BUD, budesonide 256 μg/d). The treatment period was 3 months. The primary outcome was visual analog scale (VAS) score for 5 major symptoms and a general nasal symptom. Other assessments included the 22-item Sino-Nasal Outcome Test (SNOT-22), computed tomography scan (Lund-Mackay score), and rigid nasal endoscopy (Lund-Kennedy score). Nasal secretion evaluation was the secondary outcome.

Results

Seventy-four patients were included and randomly assigned to the CLM + BUD group (n = 38) or the BUD group (n = 36). VAS scores for nasal obstruction, rhinorrhea, smell reduction, headache, nasal pain, and general nasal symptom were markedly improved in both treatment arms, but the differences between groups were not significant. Furthermore, SNOT-22, Lund-Mackay, and Lund-Kennedy scores improved significantly after treatment in both groups, and were slightly better in the CLM + BUD group. For the responders in the CLM + BUD group, interleukin (IL)-6 and IL-8 were markedly reduced.

Conclusion

The combination of CLM + BUD for the treatment of first-time-diagnosed CRS in this Chinese population cohort did not show a better effect compared with a single BUD regimen, but it may have a better effect in some patients with increased IL-6 or IL-8.

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ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA.

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ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA.

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¿Por qué se caracteriza la tiroiditis crónica?

La tiroiditis crónica, también conocida como enfermedad de Hashimoto, es el resultado de una reacción del sistema inmunológico (las defensas del organismo) contra la glándula tiroides, que se encuentra en la base del cuello, por delante de la tráquea. A consecuencia de esa reacción, la glándula puede dejar de producir la cantidad de hormonas necesarias para el correcto funcionamiento de muchos órganos del cuerpo. Esta situación se conoce como hipotiroidismo.

La tiroiditis crónica puede presentarse en cualquier momento de la vida, pero es más frecuente en mujeres de mediana edad.

Como tiene un comienzo lento, pueden pasar meses o incluso años hasta que una persona descubre que la padece y logra devolver a la normalidad sus niveles de hormonas mediante un tratamiento.

La enfermedad de Hashimoto o tiroiditis crónica es más frecuente en personas que tienen una historia familiar de enfermedad tiroidea.

En casos muy raros, está relacionada con otros problemas hormonales provocados por el sistema inmunológico.

Entre otros, la tiroiditis crónica puede provocar los siguientes síntomas:

• Estreñimiento
• Dificultad para concentrarse
• Sequedad de la piel
• Aumento del tamaño de la glándula (bocio)
• Fatiga
• Pérdida de cabello
• Uñas quebradizas
• Debilidad muscular
• Alteraciones del ciclo menstrual
• Intolerancia al frío
• Aumento de peso que no se explica por otras causas
• Depresión

Por norma general, no hacen falta pruebas de imagen ni biopsia para diagnosticar la tiroiditis crónica.

Pruebas (de laboratorio) para detectar la tiroiditis crónica:

• Prueba de T4 libre
• TSH sérico
• T3
• Autoanticuerpos tiroideos 

Además, en pacientes con enfermedad de Hashimoto pueden verse resultados alterados en los siguientes análisis de sangre:

• Recuento sanguíneo completo
• Prolactina
• Sodio
• Colesterol total

Tratamiento

Si su médico detecta que su tiroides está hipoactiva, es posible que le prescriba terapia de reemplazo para corregir los niveles de hormonas en su organismo.

Pronóstico

No es infrecuente que la tiroiditis crónica se mantenga estable y controlada durante años. Cuando evoluciona hacia deficiencia hormonal (hipotiroidismo), se trata de forma sencilla y eficaz administrando las hormonas que faltan.

Prevención

No hay una estrategia que sirva para prevenir la tiroiditis crónica. No obstante, conocer los factores de riesgo puede ayudar a conseguir que la enfermedad se diagnostique y se trate pronto, consiguiendo mejores resultados y alivio rápido de los síntomas.

Cuándo acudir al médico

Es buena idea consultar a su médico ante los siguientes signos:

• Cansancio sin razón aparente
• Piel seca
• Rostro hinchado y pálido
• Estreñimiento
• Ante niveles altos de colesterol

Además, el médico le pedirá que acuda a la consulta de forma periódica para realizar controles de la función de la glándula tiroidea en las siguientes circunstancias:

• Si recibe terapia hormonal para el hipotiroidismo provocado por tiroiditis crónica, su equipo médico programa consultas de seguimiento para garantizar que recibe la dosis correcta de medicamento. Con el paso del tiempo, la cantidad necesaria para reemplazar las hormonas que faltan puede cambiar.
• Tras una cirugía de tiroides
• Después del tratamiento con yodo radioactivo o medicamentos antitiroideos
• Si se le ha administrado radioterapia en la cabeza, el cuello o en la parte superior del pecho

Causas

La tiroiditis crónica es una alteración autoinmune: el sistema inmunológico crea anticuerpos que dañan la glándula tiroides. No está establecido qué provoca ese ataque, aunque hay expertos que creen que agentes infecciosos como virus o bacterias podrían ser desencadenantes. También se ha planteado que puede haber una explicación genética.

Por otro lado, se ha sugerido que una combinación de factores (hereditarios, el sexo y la edad de la persona) pueden hacer que se desarrolle la enfermedad.

Factores de riesgo

• Las mujeres son más propensas que los varones a padecer tiroiditis crónica.
• La tiroiditis crónica es más frecuente en personas de mediana edad.
• Factor hereditario. El riesgo de sufrir la enfermedad es mayor si algún miembro de la familia padece enfermedades de la tiroides u otras enfermedades autoinmunitarias.
• Otras enfermedades autoinmunes. Padecer otra enfermedad autoinmune (como artritis reumatoide, diabetes tipo 1 o lupus) aumenta el riesgo de desarrollar tiroiditis crónica.
• Exposición a la radiación. Las personas expuestas a niveles excesivos de radiación son más propensas a sufrir la enfermedad de Hashimoto.

Complicaciones

Si no se trata, una glándula tiroides hipoactiva (hipotiroidismo) causada por tiroiditis crónica puede provocar enfermedad cardiaca, problemas de salud mental, defectos congénitos en bebés de mujeres embarazadas con hipotiroidismo no tratado y –en raras ocasiones- mixedema, una condición muy seria que exige atención médica inmediata.

La entrada ¿Por qué se caracteriza la tiroiditis crónica? se publicó primero en Cuida tu tiroides.

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El hipertiroidismo autoinmune: qué es y cuantos tipos existen

El hipertiroidismo autoinmune o enfermedad de Graves es la causa más frecuente de hipertiroidismo. Se produce cuando el sistema inmunológico produce anticuerpos que hacen que la glándula aumente de tamaño y produzca hormonas en exceso.

El término hipertiroidismo hace referencia a cualquier condición en la que se presente un exceso de hormonas en la glándula tiroides. Viene a ser lo mismo que decir que la glándula está 'hiperactiva'. Otro término que se emplea en esta situación es 'tirotoxicosis', que se refiere más bien a que los niveles de hormonas en el riego sanguíneo están por encima de lo normal, independientemente de cuál sea la causa.

Aunque las palabras 'hipertiroidismo' y 'tirotoxicosis' se usan con frecuencia como sinónimos, en realidad son dos conceptos diferentes. La tirotoxicosis es una consecuencia del hipertiroidismo.

El diagnóstico y el tratamiento tempranos del hipertiroidismo autoinmune son esenciales, ya que la enfermedad no tratada puede dañar las funciones del corazón, la estructura de los huesos y los ojos.

El hipertiroidismo suele tener un comienzo lento, aunque en algunos pacientes jóvenes se han observado presentaciones súbitas.

Al principio, es normal que los síntomas se interpreten como signos de estrés. En el hipertiroidismo autoinmune, que es la forma más frecuente de hipertiroidismo, es posible que los ojos se agranden debido a una elevación de los párpados superiores

Síntomas

Las hormonas tiroideas desempeñan funciones importantes en muchas partes del cuerpo. Si hay cantidades excesivas, los procesos tienden a acelerarse.

Algunos de los síntomas más frecuentes son:

• Nerviosismo
• Irritabilidad
• Aumento de la sudoración
• Intolerancia al calor
• Aumento de la frecuencia cardiaca
• Temblores en las manos
• Ansiedad
• Dificultad para conciliar el sueño
• Adelgazamiento de la piel
• Debilidad del cabello
• Debilidad muscular (sobre todo en los brazos y las piernas)
• Pérdida de peso
• Alteraciones del ciclo menstrual
• Fatiga
• Cambios de humor
• Bocio

Oftalmopatía

Se calcula que cerca del 30 por ciento de las personas con hipertiroidismo autoinmune muestra algunos signos y síntomas propios de una condición conocida como 'oftalmopatía de Graves'. En esta enfermedad, la inflamación y otras acciones del sistema inmunológico afectan a los músculos y otros tejidos próximos a los ojos. Entre sus consecuencias están:

• Exoftalmos (ojos protuberantes)
• Sensación de tener arena en los ojos
• Presión o dolor en los ojos
• Párpados abultados o retraídos
• Inflamación y enrojecimiento
• Sensibilidad a la luz
• Visión doble
• Pérdida de visión

Diagnóstico

Si su médico sospecha que usted padece hipertiroidismo, el diagnóstico es razonablemente sencillo. En un reconocimiento físico suelen detectarse un aumento en el tamaño de la tiroides y pulso acelerado.

El médico también atenderá a la presencia de humedad en la piel, así como a posibles temblores en los dedos de las manos. También cabe la posibilidad de que sus reflejos sean excesivamente rápidos, y de que se aprecien algunas alteraciones en los ojos.

El diagnóstico de hipertiroidismo autoinmune se confirma con pruebas de laboratorio que miden los niveles de:

• Hormonas tiroideas
  • Tiroxina (T4)
  • Triyodotironina (T3)
  • Hormona estimulante de la tiroides (TSH)

Los niveles elevados de T4 en la sangre y un nivel bajo de TSH son típicos del hipertiroidismo. Si los análisis de sangre muestran que ese es el caso, es probable que el médico quiera obtener pruebas de imagen. En un escáner puede determinarse si toda la glándula es hiperactiva o por el contrario existen nódulos o inflamación de la tiroides.

En el mismo procedimiento puede realizarse una prueba de captación de yodo.

Tratamiento

No existe un único tratamiento para el hipertiroidismo autoinmune. El plan terapéutico se adapta a la edad, la gravedad, la presencia de otras condiciones y las preferencias personales del paciente.

• Medicamentos antitiroideos que bloquean la capacidad de la tiroides para producir hormonas
• Yodo radiactivo que actúa sobre las células que producen las hormonas
• Cirugía
• Betabloqueantes que impiden que las hormonas actúen en el organismo

Algunos expertos han advertido que es frecuente que haya pacientes con hipertiroidismo autoimmune subclínico. Son personas en las cuales las concentraciones de TSH están fuera de los valores considerados normales, pero con niveles de T3 y T4 normales. Su recomendación es prestar especial atención a las alteraciones de la función tiroidea en grupos de riesgo, incluidos familiares de pacientes, para diagnosticar y tratar lo antes posible la enfermedad y reducir las posibles complicaciones.

La entrada El hipertiroidismo autoinmune: qué es y cuantos tipos existen se publicó primero en Cuida tu tiroides.

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Semi-automatic tracking, smoothing and segmentation of hyoid bone motion from videofluoroscopic swallowing study.

Semi-automatic tracking, smoothing and segmentation of hyoid bone motion from videofluoroscopic swallowing study.

PLoS One. 2017;12(11):e0188684

Authors: Kim WS, Zeng P, Shi JQ, Lee Y, Paik NJ

Abstract
Motion analysis of the hyoid bone via videofluoroscopic study has been used in clinical research, but the classical manual tracking method is generally labor intensive and time consuming. Although some automatic tracking methods have been developed, masked points could not be tracked and smoothing and segmentation, which are necessary for functional motion analysis prior to registration, were not provided by the previous software. We developed software to track the hyoid bone motion semi-automatically. It works even in the situation where the hyoid bone is masked by the mandible and has been validated in dysphagia patients with stroke. In addition, we added the function of semi-automatic smoothing and segmentation. A total of 30 patients' data were used to develop the software, and data collected from 17 patients were used for validation, of which the trajectories of 8 patients were partly masked. Pearson correlation coefficients between the manual and automatic tracking are high and statistically significant (0.942 to 0.991, P-value<0.0001). Relative errors between automatic tracking and manual tracking in terms of the x-axis, y-axis and 2D range of hyoid bone excursion range from 3.3% to 9.2%. We also developed an automatic method to segment each hyoid bone trajectory into four phases (elevation phase, anterior movement phase, descending phase and returning phase). The semi-automatic hyoid bone tracking from VFSS data by our software is valid compared to the conventional manual tracking method. In addition, the ability of automatic indication to switch the automatic mode to manual mode in extreme cases and calibration without attaching the radiopaque object is convenient and useful for users. Semi-automatic smoothing and segmentation provide further information for functional motion analysis which is beneficial to further statistical analysis such as functional classification and prognostication for dysphagia. Therefore, this software could provide the researchers in the field of dysphagia with a convenient, useful, and all-in-one platform for analyzing the hyoid bone motion. Further development of our method to track the other swallowing related structures or objects such as epiglottis and bolus and to carry out the 2D curve registration may be needed for a more comprehensive functional data analysis for dysphagia with big data.

PMID: 29182687 [PubMed - in process]

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Prevalence and association of oral candidiasis with dysphagia in individuals with acquired brain injury.

Prevalence and association of oral candidiasis with dysphagia in individuals with acquired brain injury.

Brain Inj. 2017 Nov 28;:1-5

Authors: Odgaard L, Kothari M

Abstract
OBJECTIVE: To describe the prevalence of oral candidiasis (OC) in individuals with acquired brain injury (ABI) and to evaluate the association of OC with improvement in dysphagia.
DESIGN: Longitudinal observational study.
METHODS: Individuals with ABI admitted to rehabilitation were recruited over a one-year period (n = 206 (59% with dysphagia)). OC-data were collected by clinical examinations and verified by cultivation/microscopy in every 3 weeks during first 10 weeks of admission. Dysphagia improvement was defined by: 1) first positive change in food consistency, 2) initiation of at least soft food consistency. Individuals with/without OC were compared using multivariable Cox proportional hazards regression.
RESULTS: The overall OC prevalence in all individuals, in individuals with dysphagia and in individuals not treated with antifungal agents were 32.5%, 43.4% and 29.7%, respectively. The OC prevalence was 24.8% at one week after admission and reduced to 10.1% ten weeks after admission. Adjusted hazard ratios for improvement in dysphagia were 0.64-0.77 in OC compared to without OC, though not statistically significant.
CONCLUSION: Prevalence of OC was high at admission but reduced during rehabilitation. Though non-significant, the negative trend between OC and improvement in dysphagia suggest that OC may delay rehabilitation of dysphagia.

PMID: 29182379 [PubMed - as supplied by publisher]

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Aural stimulation with capsaicin ointment improved swallowing function in elderly patients with dysphagia: a randomized, placebo-controlled, double-blind, comparative study.

Related Articles

Aural stimulation with capsaicin ointment improved swallowing function in elderly patients with dysphagia: a randomized, placebo-controlled, double-blind, comparative study.

Clin Interv Aging. 2017;12:1921-1928

Authors: Kondo E, Jinnouchi O, Nakano S, Ohnishi H, Kawata I, Okamoto H, Takeda N

Abstract
Objective: The aim of this study was to assess whether aural stimulation with ointment containing capsaicin improves swallowing function in elderly patients with dysphagia.
Study design: A randomized, placebo-controlled, double-blind, comparative study.
Settings: Secondary hospital.
Patients and methods: Twenty elderly dysphagic patients with a history of cerebrovascular disorder or Parkinson's disease were randomly divided into two groups: 10 receiving aural stimulation with 0.025% capsaicin ointment and 10 stimulated with placebo. The ointments were applied to the external auditory canal with a cotton swab. Then, swallowing of a bolus of blue-dyed water was recorded using transnasal videoendoscopy, and the swallowing function was evaluated according to both endoscopic swallowing scoring and Sensory-Motor-Reflex-Clearance (SMRC) scale.
Results: The sum of endoscopic swallowing scores was significantly decreased 30 and 60 min after a single administration in patients treated with capsaicin, but not with placebo. Reflex score, but not Sensory, Motion and Clearance scores, of the SMRC scale was significantly increased 5, 30 and 60 min after single administration in patients treated with capsaicin, but not with placebo. No patient showed signs of adverse effects.
Conclusion: As capsaicin is an agonist of the transient receptor potential vanilloid 1 (TRPV1), these findings suggest that improvement of the swallowing function, especially glottal closure and cough reflexes, in elderly dysphagic patients was due to TRPV1-mediated aural stimulation of vagal Arnold's nerve with capsaicin, but not with a nonspecific mechanical stimulation with a cotton swab.

PMID: 29180855 [PubMed - in process]

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PURLs: The benefits--and limits--of PPIs with warfarin regimens.

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PURLs: The benefits--and limits--of PPIs with warfarin regimens.

J Fam Pract. 2017 Nov;66(11):694-696

Authors: Ludden-Schlatter A, Stevermer JJ

Abstract
Patients on warfarin plus antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story.

PMID: 29099511 [PubMed - indexed for MEDLINE]

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Determinants of the Association between Non-Cardiac Chest Pain and Reflux.

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Determinants of the Association between Non-Cardiac Chest Pain and Reflux.

Am J Gastroenterol. 2017 Nov;112(11):1671-1677

Authors: Herregods TVK, Bredenoord AJ, Oors JM, Bogte A, Smout AJPM

Abstract
OBJECTIVES: Gastroesophageal reflux is considered to be the most common gastrointestinal cause of non-cardiac chest pain (NCCP). It remains unclear why some reflux episodes in the same patient cause chest pain while others do not. To understand more about the mechanisms by which reflux elicits chest pain, we aimed to identify factors which are important in triggering chest pain.
METHODS: In this multicenter study, 120 patients with NCCP were analyzed using 24-h pH-impedance monitoring. In the patients with a positive association between reflux and chest pain, the characteristics of the reflux episodes which were followed by a chest pain episode were compared with chest pain-free reflux episodes.
RESULTS: Using 24-h pH-impedance monitoring, 40% of the NCCP patients were identified as having reflux as a possible cause of their chest pain. Reflux episodes that were associated with chest pain had a higher proximal extent (P=0.007), a higher volume clearance time (P=0.030), a higher 15-minute acid burden (P=0.041), were more often acidic (P=0.011), had a lower nadir pH (P=0.044), and had a longer acid duration time (P=0.027) than reflux episodes which were not followed by chest pain. Patients who experienced typical reflux symptoms were more likely to have reflux as the cause of their chest pain (52 vs. 31.4%, P=0.023).
CONCLUSIONS: The presence of a larger volume of acid refluxate for a longer period of time appears to be an important determinant of perceiving a reflux episode as chest pain. 24-h pH-impedance monitoring is an important tool in identifying gastroesophageal reflux as a potential cause of symptoms in patients with NCCP.

PMID: 29016562 [PubMed - indexed for MEDLINE]

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