Transoral robotic medial hypopharyngectomy: Surgical technique.

Transoral robotic medial hypopharyngectomy: Surgical technique.

Head Neck. 2015 Dec 29;

Authors: Sims JR, Robinson NL, Moore EJ, Janus JR

Abstract
BACKGROUND: Transoral robotic surgery (TORS) has been shown to be both feasible and oncologically sound for use in early T classification hypopharyngeal cancers. The purpose of this study was to present our surgical technique for performing a transoral robotic hypopharyngectomy.
METHODS: A 48-year-old man with a T2, N2a, M0 squamous cell carcinoma of the hypopharynx underwent a transoral robotic hypopharyngectomy and a left select neck dissection of levels II to IV.
RESULTS: The hypopharyngeal tumor was removed en bloc after circumferential cuts were made until the tumor was finally amputated from the apex of the piriform sinus. Negative margins were achieved. A left select neck dissection was performed. The patient was tolerating an oral diet and his tracheostomy tube was decannulated before discharge.
CONCLUSION: TORS offers improved manual dexterity and tumor manipulation over conventional transoral approaches to hypopharyngeal cancers. It is both a feasible and effective method for certain early-stage hypopharyngeal cancers. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26714289 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OZaIgG
via IFTTT

The relationship between communicative participation and postlaryngectomy speech outcomes.

The relationship between communicative participation and postlaryngectomy speech outcomes.

Head Neck. 2015 Dec 29;

Authors: Eadie TL, Otero D, Cox S, Johnson J, Baylor CR, Yorkston KM, Doyle PC

Abstract
BACKGROUND: The purpose of this study was to examine relationships between communicative participation and postlaryngectomy speech outcomes, including listener-rated speech intelligibility and acceptability, and patient-rated speech acceptability and voice handicap.
METHODS: Thirty-six laryngectomized individuals completed the Communicative Participation Item Bank (CPIB) short form and the Voice Handicap Index-10 (VHI-10). They provided recordings from the Sentence Intelligibility Test (SIT) and a reading passage, and rated their own speech acceptability. Forty-eight inexperienced listeners transcribed the SIT sentences to derive intelligibility scores. Eighteen additional listeners judged the speech acceptability using the rating scales.
RESULTS: Listeners judged tracheoesophageal speakers as significantly more intelligible and acceptable than electrolaryngeal speakers (p < .05). Speech acceptability was significantly more acceptable to speakers than listeners (p < .05). Weak, nonsignificant relationships were found between communicative participation and listener-rated outcomes. Stronger, significant relationships were found between communicative participation and self-rated speech acceptability and voice handicap (p < .05).
CONCLUSION: Patient-reported communication outcomes are complementary to listener-rated outcomes. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26714043 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OZaG8x
via IFTTT

Evaluation of Polo-like kinase 1 as a potential therapeutic target in Merkel cell carcinoma.

Evaluation of Polo-like kinase 1 as a potential therapeutic target in Merkel cell carcinoma.

Head Neck. 2015 Dec 29;

Authors: Kadletz L, Bigenzahn J, Thurnher D, Stanisz I, Erovic BM, Schneider S, Schmid R, Seemann R, Birner P, Heiduschka G

Abstract
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and aggressive malignancy of the skin. Treatment options for MCC include surgery, radiotherapy, and chemotherapy. The purpose of this study was to assess the expression of Polo-like kinase 1 (PLK1) in MCC and the role of the inhibitor, BI2536, as a potential therapeutic option in MCC.
METHODS: PLK1 expression was assessed in tissue samples from 28 patients with MCC and 5 healthy skin samples via immunohistochemistry and furthermore in the 2 MCC cell lines, MCC13 and MCC26, via immunoblotting. The impact of increasing doses of BI2536 alone and in combination with cisplatin or irradiation on cell viability was measured using the CCK-8 assay. Colony forming assays were performed to evaluate long-term effects of combination treatments. Additionally, the induction of apoptotic cell death was measured via flow cytometry.
RESULTS: PLK1 is moderately to strongly expressed in 75% of the patients with MCC. The PLK1 inhibitor, BI2536, demonstrated marked inhibition of cell proliferation with IC50 in the low nM range (from 10.07-12.39 nM). Furthermore, BI2536 induces apoptosis in MCC cell lines and acts synergistically in combination with irradiation and cisplatin.
CONCLUSION: Because of the marked upregulation of PLK1 in MCC tumor samples and potent inhibition of cell proliferation using a specific clinically available inhibitor, targeting of PLK1 qualifies as a potential novel therapeutic strategy in MCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26713885 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OZaG8m
via IFTTT

Effect of β-catenin silencing in overcoming radioresistance of head and neck cancer cells by antagonizing the effects of AMPK on Ku70/Ku80.

Effect of β-catenin silencing in overcoming radioresistance of head and neck cancer cells by antagonizing the effects of AMPK on Ku70/Ku80.

Head Neck. 2015 Dec 29;

Authors: Chang HW, Nam HY, Kim HJ, Moon SY, Kim MR, Lee M, Kim GC, Kim SW, Kim SY

Abstract
BACKGROUND: We attempted to elucidate the mechanism of cell death after radiation by studying how β-catenin silencing controls the radiation sensitivity of radioresistant head and neck cancer cells.
METHODS: The most radioresistant cancer cell line (AMC-HN-9) was selected for study. Targeted silencing of β-catenin was used on siRNAs. Sensitivity to radiation was examined using clonogenic and methylthiazol tetrazolium (MTT) assays.
RESULTS: A combination of irradiation plus β-catenin silencing led to a significant reduction in the inherent radioresistance of AMC-HN-9 cells. Although expression of Ku70/80 was upregulated in AMC-HN-9 cells after irradiation, Ku70/80 was dramatically decreased in a combination of irradiation and β-catenin silencing. Interestingly, irradiation-induced Ku70/80 was completely prevented by β-catenin silencing-induced LKB1/AMP-activated protein kinase (LKB1/AMPK) signal.
CONCLUSION: The LKB1/AMPK pathway might relay the signal between the Wnt/β-catenin pathway and the Ku70/Ku80 DNA repair machinery, and play a decisive role in fine-tuning the responses of cancer cells to irradiation. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26713771 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OkrJFB
via IFTTT

Cervical lymph node metastases from remote primary tumor sites.

Cervical lymph node metastases from remote primary tumor sites.

Head Neck. 2015 Dec 29;

Authors: López F, Rodrigo JP, Silver CE, Haigentz M, Bishop JA, Strojan P, Hartl DM, Bradley PJ, Mendenhall WM, Suárez C, Takes RP, Hamoir M, Robbins KT, Shaha AR, Werner JA, Rinaldo A, Ferlito A

Abstract
Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26713674 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OZaHZU
via IFTTT

Regional variation in head and neck cancer mortality: Role of patient and hospital characteristics.

Regional variation in head and neck cancer mortality: Role of patient and hospital characteristics.

Head Neck. 2015 Dec 29;

Authors: Divi V, Ma Y, Rhoads KF

Abstract
BACKGROUND: The purpose of this study was to determine whether outcomes in head and neck cancer would vary based on geographic location of patients.
METHODS: A dataset from the California Cancer Registry was linked to publicly available discharge abstracts. Patients were separated into geographic areas based on health service areas (HSAs). Multilevel logistic regression models were constructed to include geographic, patient, and hospital-level characteristics.
RESULTS: There was significant variation in 5-year survival hazard ratios (HRs) among the majority of the 14 HSAs in the unadjusted model. After adjusting for patient and hospital characteristics, the differences between regions were not significant except for Orange County (HR = 0.75). Commission on Cancer certification (HR = 0.82; p < .01) and hospital volume (HR = 0.975; p < .01) were each independently associated with differences in survival.
CONCLUSION: Geographic variation in 5-year survival outcomes is seen in head and neck cancer. Patient characteristics and treating hospitals explain much of this variation. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26713544 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OZaHZS
via IFTTT

Anesthetic considerations and airway management in professional singers: an "orphan disease"?

Related Articles

Anesthetic considerations and airway management in professional singers: an "orphan disease"?

Can J Anaesth. 2015 Aug;62(8):928-9

Authors: Errando CL

PMID: 25894907 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgV9f
via IFTTT

Gorham-Stout Disease of the Skull Base With Hearing Loss: Dramatic Recovery and Antiangiogenic Therapy.

Gorham-Stout Disease of the Skull Base With Hearing Loss: Dramatic Recovery and Antiangiogenic Therapy.

Pediatr Blood Cancer. 2015 Dec 29;

Authors: Nozawa A, Ozeki M, Kuze B, Asano T, Matsuoka K, Fukao T

Abstract
Gorham-Stout disease (GSD) is a rare disorder of unknown etiology. We present a 6-year-old male with GSD involving the skull base who presented with recurrent cerebrospinal fluid (CSF) rhinorrhea, severe hearing loss, and facial palsy secondary to cerebellar herniation into the internal auditory canal. After 2 months of treatment with pegylated interferon (IFN) α-2b (50 μg/week), his hearing recovered dramatically. Two years later, new bone formation appeared radiologically and IFN was switched to sirolimus. One year after the switch, CSF rhinorrhea disappeared. Antiangiogenic therapy might inhibit proliferation of vascular endothelial cells in osteolytic lesions and lead to new bone formation.

PMID: 26713883 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgXOt
via IFTTT

The Value of Oro-Pharyngo-Esophageal Scintigraphy in the Management of Patients with Aspiration into the Tracheo-bronchial Tree and Consequent Dysphagia.

The Value of Oro-Pharyngo-Esophageal Scintigraphy in the Management of Patients with Aspiration into the Tracheo-bronchial Tree and Consequent Dysphagia.

N Am J Med Sci. 2015 Nov;7(11):533-6

Authors: Grosso M, Duce V, Fattori B, Bruschini L, Meniconi M, Raschillà R, Cocco F, Locantore L, Guidoccio F, Orsini F, Massri K, Volterrani D, Rubello D

Abstract
CONTEXT: Tracheo-bronchial aspiration is the most invalidating condition which can happen to patients affected by dysphagia, especially when caused by central neurologic disorders; the associated pneumonia episodes represent the most frequent cause of death in these patients. Oro-pharyngo-esophageal scintigraphy (OPES) allows both functional imaging and semiquantitative evaluation of the subsequent phases of swallowing.
CASE REPORT: We evaluated by means of OPES a woman who had previously undergone high-dose external beam radiation therapy for a nasopharyngeal carcinoma, which determined tissue fibrosis and progressive dysphagia.
CONCLUSION: In this patient with dysphagia, OPES was a simple, inexpensive, noninvasive, and reliable technique that allowed to show the presence of bolus aspiration and quantified tracheobronchial aspirate.

PMID: 26713303 [PubMed]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgUSF
via IFTTT

Videoendoscopic evaluation of food bolus preparation: A comparison between normal adult dentates and older adult dentates.

Videoendoscopic evaluation of food bolus preparation: A comparison between normal adult dentates and older adult dentates.

Geriatr Gerontol Int. 2015 Dec 29;

Authors: Matsuno K, Nohara K, Fukatsu H, Tanaka N, Fujii N, Sasao Y, Sakai T

Abstract
AIM: Food bolus preparation plays an important role in swallowing food. The ability to carry out oral functions varies with age, and the same might be true of the ability to prepare food boluses. Previously developed methods for assessing food bolus preparation were not able to evaluate swallowed boluses; that is, the boluses were spat out before they were swallowed. The aim of the present study was to evaluate food bolus preparation in older adults using videoendoscopy, and to compare the food bolus preparation abilities of older adults and younger healthy adults.
METHODS: The participants were 30 older adults and 30 younger healthy adults. None of the participants showed any symptoms of dysphagia or eating difficulties. In each examination, an endoscope was inserted into the nasal passage, and the participant was instructed to eat cooked rice. The grinding, mixing and aggregation of each bolus was graded from 0 to 2, with higher numbers indicating more marked grinding, mixing and aggregation. We simultaneously investigated the number of chewing cycles.
RESULTS: The older adults showed higher grinding scores and lower mixing scores than the younger healthy adults. However, neither of these differences was significant. In contrast, the older adults showed significantly lower aggregation scores and carried out a significantly greater number of chewing cycles than the younger healthy adults.
CONCLUSIONS: Using videoendoscopy, we found that older adults showed lower aggregation scores and carried out a greater number of chewing cycles than younger healthy adults. These results suggest that older adults are less able to prepare food boluses than younger healthy adults. Geriatr Gerontol Int 2015; ●●: ●●-●●.

PMID: 26711790 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgXxV
via IFTTT

A Rare Cause of Dysphagia--Kommerell's Diverticulum.

Related Articles

A Rare Cause of Dysphagia--Kommerell's Diverticulum.

J Assoc Physicians India. 2015 Jan;63(1):59-62

Authors: Parikh P, Nasa M, Patil S, Patel J, Bhate P, Sawant P

Abstract
A right-sided aortic arch with an aneurysm of the aberrant subclavian artery is a rare disease. We report a case of Kommerell's diverticulum of an aberrant left subclavian artery in a patient with a right-sided aortic arch with associated ventricular septal defect. Fewer than 50 cases have been reported in literature so far. Our patient presented with short duration of dysphagia without any syncope or left subclavian steal syndrome. The major morbidity was caused by Barrett's oesophagus with reflux and a mixed paraoesophageal and hiatal hernia. There was associated psoriasis. An attempt at repair was not undertaken because of the high operative risk and a small aneurysm. Left thoracotomy for direct repair of Kommerell's diverticulum is a simple and safe method.

PMID: 26591131 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1N9asug
via IFTTT

Guidelines on gastroesophageal reflux disease.

Related Articles

Guidelines on gastroesophageal reflux disease.

J Pak Med Assoc. 2015 May;65(5):532-41

Authors: Niaz SK, Quraishy MS, Taj MA, Abid S, Alam A, Nawaz AA, Ali Shah SH, Khan IM, Memon AR, Zuberi BF, Tayyab GN, Malik K, Mirza S, Abbas Z, Pakistan Society of Gastroenterology (GERD Consensus Group)

Abstract
Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered during clinical practice in Pakistan and is associated with significant impairment of health-related quality of life. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Pakistani accepted directive by the standards of evidence-based medicine is still lacking. Our aim was to create an understanding of the natural history and presentations of reflux disease; evaluating possible treatment options available for the patients with complex and uncomplicated reflux ailments with the development of current and up to date evidence based endorsement, relevant to the needs of Pakistani health care providers in order to treat oesophageal manifestations of GERD. In order to make such guidelines, a comprehensive literature search was conducted with pertinent evidence reviewed, and quality of relevant data assessed. The resultant conclusions were based on the best available evidence and expert opinion of the authors of technical review panel.

PMID: 26028389 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxmCnJ
via IFTTT

Synchronous airway lesions in children: an analysis of characteristics and comorbidities.

Related Articles

Synchronous airway lesions in children: an analysis of characteristics and comorbidities.

Int J Pediatr Otorhinolaryngol. 2014 Oct;78(10):1586-91

Authors: Ho-Wo-Cheong D, Mijovic T, Manoukian JJ, Bergeron M, Nguyen LH

Abstract
OBJECTIVES: To analyze the characteristics and the associated medical co-morbidities in children with synchronous airway lesions (SALs) found during rigid bronchoscopy.
METHODS: Retrospective case series and chart review of patients who were found to have more than one airway lesion after undergoing airway evaluation via rigid endoscopy at a tertiary care pediatric hospital between 2001 and 2011. Patient demographics, presence of associated non-airway pathologies, and the number and types of airway lesions were collected. For analysis, airway lesions were classified based on the anatomical subsites involved (supraglottic, glottic, subglottic, tracheal and bronchial).
RESULTS: Out of 592 rigid bronchoscopies performed, there were 73 cases with SALs (12.3%). Of these, only 20% of patients were term infants without associated congenital anomalies. Over 70% of patients with SALs have combinations of lesions involving the trachea, subglottis and supraglottis. Neurological anomalies and GERD were both independently associated with a three-time increase in the odds of having synchronous involvement of these three anatomical subsites (OR 3.15, 95% CI 1.06-9.41; OR 3.0, 95% CI 1.05-8.50, respectively). Glottic lesions were present in 28.7% of patients. Prematurity and cardiac anomalies were both associated with tendency of doubling the odds of glottic lesions (OR 2.34, 95% CI 0.84-6.52; OR 2.0, 95% CI 0.76-5.60, respectively). Overall, almost 10% of newly diagnosed lesions in context of SALs required an additional intervention.
CONCLUSIONS: The majority of patients with SALs are either born prematurely or have associated congenital anomalies. In SAL patients with associated neurological anomalies or GERD, the lesions are more likely to be localized to the supraglottis, subglottis and trachea whereas prematurity and cardiac anomalies could both be increasing the odds of a glottic lesion. High suspicious index should be kept in mind when rigid bronchoscopy is performed to not miss an associated lesion.

PMID: 25074344 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxmCnD
via IFTTT

Robot-assisted oesophageal and gastric surgery for benign disease: antireflux operations and Heller's myotomy.

Related Articles

Robot-assisted oesophageal and gastric surgery for benign disease: antireflux operations and Heller's myotomy.

ANZ J Surg. 2015 Mar;85(3):113-20

Authors: Falkenback D, Lehane CW, Lord RV

Abstract
BACKGROUND: Robot-assisted general surgery operations are being performed more frequently. This review investigates whether robotic assistance results in significant advantages or disadvantages for the operative treatment of gastro-oesophageal reflux disease and achalasia.
METHODS: The electronic databases (Medline, Embase, PubMed) were searched for original English language publications for antireflux surgery and Heller's myotomy between January 1990 and December 2013.
RESULTS: Thirty-three publications included antireflux operations and 20 included Heller's myotomy. The publications indicate that the safety and effectiveness of robotic surgery is similar to that of conventional minimally invasive surgery for both operations. The six randomized trials of robot-assisted versus laparoscopic antireflux surgery showed no significant advantages but significantly higher costs for the robotic method. Gastric perforation during non-redo robotic fundoplication occurred in four trials.
CONCLUSIONS: No consistent advantage for robot-assisted antireflux surgery has been demonstrated, and there is an increased cost with current robotic technology. A reported advantage for robotic in reducing the perforation rate during Heller's myotomy for achalasia remains unproven. Gastric perforation during robotic fundoplication may be due to the lack of haptic feedback combined with the superhuman strength of the robot.

PMID: 25039924 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgTya
via IFTTT

Incidence of severe dysphagia after brain surgery in pediatric traumatic brain injury: a nationwide population-based retrospective study.

Related Articles

Incidence of severe dysphagia after brain surgery in pediatric traumatic brain injury: a nationwide population-based retrospective study.

J Head Trauma Rehabil. 2014 Nov-Dec;29(6):E31-6

Authors: Huang CT, Lin WC, Ho CH, Tung LC, Chu CC, Chou W, Wang CH

Abstract
OBJECTIVES: To investigate the incidence of dysphagia and medical resource utilization in a nationwide population of pediatric patients with traumatic brain injury (TBI).
SETTING: Subjects' data were obtained from the Taiwan National Health Insurance Research Database.
PARTICIPANTS: Between 2000 and 2008, 6290 children less than 18 years old who had received surgery post-TBI were included in the study.
DESIGN: Retrospective study.
MAIN OUTCOME MEASURE: Biographic data and medical utilization results.
RESULTS: Of all the children postsurgery after TBI, 12.3% were categorized as having severe dysphagia. The occurrence of severe dysphagia was not related to sex but was statistically and significantly related to a younger mean age. The relationship between age and dysphagia also showed an interestingly biphasic distribution, mostly in the subgroups of 1 to 3 and 16 to 18 years of age. The medical resource utilization was higher in severely dysphagia patients, but only 8.4% received intervention by a speech language pathologist.
CONCLUSIONS: Severe dysphagia among postsurgical pediatric patients after TBI is relatively common, and those with severe dysphagia have a greater need for medical services. However, the ratio of such patients who receive swallowing treatment is still low in Taiwan. Clinicians are prompted to pay more attention to the impairment in functional oral intake of children postsurgery after TBI.

PMID: 24590154 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxkM60
via IFTTT

Upper Airway Hematoma Secondary to Warfarin Therapy: A Systematic Review of Reported Cases.

Upper Airway Hematoma Secondary to Warfarin Therapy: A Systematic Review of Reported Cases.

N Am J Med Sci. 2015 Nov;7(11):494-502

Authors: Karmacharya P, Pathak R, Ghimire S, Shrestha P, Ghimire S, Poudel DR, Khanal R, Shah S, Aryal MR, Alweis RL

Abstract
Upper airway hematoma (UAH) is a rare but life-threatening complication of oral anticoagulants requiring early recognition. However, no consensus exists regarding the best approach to treatment. We therefore, sought to systematically review the published literature on UAH to elaborate its demographic and clinical characteristics, treatment, complications, and outcomes. A systematic electronic search of PubMed and EMBASE for case reports, case series, and related articles of UAH related to warfarin published from inception (November 1950) to March 2015 was carried out. Categorical variables were expressed as percentage and continuous variables as mean ± standard deviation (SD). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. All cases were reported to have UAH as a complication of anticoagulation therapy with warfarin. Demographic and clinical characteristics, treatment, complications and outcomes of UAH were studied. Thirty-eight cases of UAH were identified from 34 reports in the literature. No gender preponderance (male = 52.78%) was seen and the average age of presentation was 60.11 ± 12.50 years. Dysphagia, sore throat, and neck swelling were the most common symptoms and the mean international normalized ratio (INR)at presentation was 8.07 ± 4.04. Most cases had sublingual hematoma (66.57%) followed by retropharyngeal hematoma (27.03%). Of the cases, 48.65% were managed conservatively while the rest underwent either cricothyrotomy or intubation with the time to resolution being 7.69 ± 5.44 days. UAH is a rare butpotentially serious complication of warfarin therapy. It is more common in the elderly population with supratherapeutic INR; inciting events were present in many cases. Overall, it has a good prognosis with significant morbidity present only if concomitant respiratory compromise is present. Reversal of anticoagulation with low threshold for artificial airway placement in the event of airway compromise leads to a favorable outcome in most cases.

PMID: 26713297 [PubMed]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1TpgThB
via IFTTT

Up-regulation of P2X7 receptor–mediated inhibition of GABA uptake by nerve terminals of the human epileptic neocortex

Summary

Objective

Thirty percent of patients with epilepsy are refractory to medication. The majority of these patients have mesial temporal lobe epilepsy (MTLE). This prompts for new pharmacologic targets, like ATP-mediated signaling pathways, since the extracellular levels of the nucleotide dramatically increase during in vitro epileptic seizures. In this study, we investigated whether sodium-dependent high-affinity γ-aminobutyric acid (GABA) and glutamate uptake by isolated nerve terminals of the human neocortex could be modulated by ATP acting via slow-desensitizing P2X7 receptor (P2X7R).

Methods

Modulation of [³H]GABA and [¹⁴C]glutamate uptake by ATP, through activation of P2X7R, was investigated in isolated nerve terminals of the neocortex of cadaveric controls and patients with drug-resistant epilepsy (non-MTLE or MTLE) submitted to surgery. Tissue density and distribution of P2X7R in the human neocortex was assessed by Western blot analysis and immunofluorescence confocal microscopy.

Results

The P2X7R agonist, 2′(3′)-O-(4-benzoylbenzoyl)ATP (BzATP, 3–100 μm) decreased [³H]GABA and [¹⁴C]glutamate uptake by nerve terminals of the neocortex of controls and patients with epilepsy. The inhibitory effect of BzATP (100 μm) was prevented by the selective P2X7R antagonist, A-438079 (3 μm). Down-modulation of [¹⁴C]glutamate uptake by BzATP (100 μm) was roughly similar in controls and patients with epilepsy, but the P2X7R agonist inhibited more effectively [³H]GABA uptake in the epileptic tissue. Neocortical nerve terminals of patients with epilepsy express higher amounts of the P2X7R protein than control samples.

Significance

High-frequency cortical activity during epileptic seizures releases huge amounts of ATP, which by acting on low-affinity slowly desensitizing ionotropic P2X7R, leads to down-modulation of neuronal GABA and glutamate uptake. Increased P2X7R expression in neocortical nerve terminals of patients with epilepsy may, under high-frequency firing, endure GABA signaling and increase GABAergic rundown, thereby unbalancing glutamatergic neuroexcitation. This study highlights the relevance of the ATP-sensitive P2X7R as an important negative modulator of GABA and glutamate transport and prompts for novel antiepileptic therapeutic targets.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Px5NGp
via IFTTT

New insights on hormones and factors that modulate Sertoli cell metabolism.

New insights on hormones and factors that modulate Sertoli cell metabolism.

Histol Histopathol. 2015 Dec 29;:11717

Authors: Rato L, Meneses MJ, Silva BM, Sousa M, Alves MG, Oliveira PF

Abstract
Sertoli cells (SCs) play a key role in spermatogenesis by providing the physical support for developing germ cells and ensuring them the appropriate nutrients, energy sources, hormones, and growth factors. The control of SCs metabolism has been in the spotlight for reproductive biologists, since it may be crucial to determine germ cells' fate. Indeed, the maintenance of spermatogenesis is highly dependent on the metabolic cooperation established between SCs and germ cells, though this event has been overlooked. It depends on the orchestration of various metabolic pathways and an intricate network of signals. Several factors and/or hormones modulate the metabolic activity of SCs, which are major targets for the hormonal signalling that regulates spermatogenesis. Any alteration in the regulation of these cells' metabolic behaviour may compromise the normal development of spermatogenesis and consequently, male fertility. In this context, SC metabolism arises as a key regulation point for spermatogenesis. Herein, we present an up-to-date overview on the impact of hormones and factors that modulate SC metabolism, with special focus on glycolytic metabolism, highlighting their relevance in determining male reproductive potential.

PMID: 26711246 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1MGAqEM
via IFTTT

Painful small fiber neuropathy with gastroparesis: A new phenotype with a novel mutation in the SCN10A gene.

Painful small fiber neuropathy with gastroparesis: A new phenotype with a novel mutation in the SCN10A gene.

J Clin Neurosci. 2015 Dec 17;

Authors: Dabby R, Sadeh M, Broitman Y, Yosovich K, Dickman R, Leshinsky-Silver E

Abstract
Gain-of-function mutations in the SCN10A gene (encoding the Nav1.8 voltage gated sodium channel) have been reported in a small number of patients. All presented with predominantly painful sensory neuropathy, congruent with the expression of Nav1.8 in nociceptive sensory neurons of the dorsal root ganglion. Only a few had mild autonomic symptoms, including dry eyes and mouth, orthostatic dizziness, palpitations, diarrhea and constipation. The underlying mechanism of the autonomic symptoms in these patients is unclear. We describe a 37-year-old woman with severe progressive gastroparesis and diffuse painful small fiber sensory neuropathy that started at age 32. Due to the severe dysphagia she could not ingest solid food, and lost eight kilograms. The gastroparesis was documented by esophageal manometry and gastric scintigraphy. The neuropathic pain started distally and then intensified and spread to most body areas. The patient harbored a novel heterozygous mutation: c.G4915A:p.D1639N in the SCN10A gene. To the best of our knowledge, this is the first description of such a phenotype due to a Nav1.8 mutation. Thus, our study expands the clinical spectrum of Nav1.8 associated disorders, and suggests that mutations in this sodium channel should be considered in patients with gastrointestinal motility dysfunction and painful neuropathy.

PMID: 26711856 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mid6Zj
via IFTTT

Evidence of β-cell Dedifferentiation in Human Type 2 Diabetes.

Evidence of β-cell Dedifferentiation in Human Type 2 Diabetes.

J Clin Endocrinol Metab. 2015 Dec 29;:jc20152860

Authors: Cinti F, Bouchi R, Kim-Muller JY, Ohmura Y, Rodrigo Sandoval P, Masini M, Marselli L, Suleiman M, Ratner LE, Marchetti P, Accili D

Abstract
CONTEXT: Diabetes is associated with a deficit of insulin-producing β cells. Animal studies show that β cells become dedifferentiated in diabetes, reverting to a progenitor-like stage, and partly converting to other endocrine cell types.
OBJECTIVE: To determine whether similar processes occur in human type 2 diabetes, we surveyed pancreatic islets from 15 diabetic and 15 non-diabetic organ donors.
DESIGN: We scored dedifferentiation using markers of endocrine lineage, β cell-specific transcription factors, and a newly identified endocrine progenitor cell marker, aldehyde dehydrogenase 1A3 (ALDH1A3).
RESULTS: By these criteria, dedifferentiated cells accounted for 31.9% of β cells in type 2 diabetics vs. 8.7% in controls, and for 16.8% vs. 6.5% of all endocrine cells (p<0.001). The number of ALDH1A3-positive/hormone-negative cells was threefold higher in diabetics compared to controls. Moreover, β cell-specific transcription factors were ectopically found in glucagon- and somatostatin-producing cells of diabetic subjects.
CONCLUSIONS: The data support the view that pancreatic β cells become dedifferentiated and convert to α- and δ-"like" cells in human type 2 diabetes. The findings should prompt a reassessment of goals in the prevention and treatment of β cell dysfunction.

PMID: 26713822 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBbRlX
via IFTTT

Cognitive effects of intentional weight loss in elderly obese individuals with mild cognitive impairment.

Cognitive effects of intentional weight loss in elderly obese individuals with mild cognitive impairment.

J Clin Endocrinol Metab. 2015 Dec 29;:jc20152315

Authors: Horie NC, Serrao VT, Simon SS, Polo Gascon MR, Xavier Dos Santos A, Zambone MA, Bigio de Freitas MM, Cunha-Neto E, Marques EL, Halpern A, Edna de Melo M, Mancini MC, Cercato C

Abstract
CONTEXT: Obesity in midlife is a risk factor for dementia, but it is unknown if caloric restriction-induced weight loss could prevent cognitive decline and therefore dementia in elderly patients with cognitive impairment.
OBJECTIVE: To evaluate the cognitive effect of intentional weight loss in obese elderly patients with mild cognitive impairment (MCI), considering the influence of age, apolipoprotein E genotype (APOE), physical activity, biochemical markers and diet.
DESIGN: Single-center, prospective controlled trial.
SETTING: Academic medical center Participants: Eighty obese patients with MCI, aged 60 or older (68.1±4.9 years, body mass index (BMI) 35.5±4.4kg/m(2), 83.7% women, 26.3% APOE4 carriers).
INTERVENTION: Random allocation to conventional medical care alone (n=40) or together with nutritional counselling (n=40) in group meetings aiming to promote weight loss through caloric restriction for 12 months.
OUTCOME: Measurements: Clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, APOE genotype, physical performance, dietary recalls.
RESULTS: Seventy-five patients completed the follow-up. BMI, on average, decreased 1.7 ±1.8kg/m(2) (p=0.021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function and global cognition, after adjustment for education, gender, physical activity and baseline tests: this association was strongest in younger seniors (for memory and fluency) and in APOE4 carriers (for executive function). Changes in HOMA-IR, C-reactive protein, leptin and intake of energy, carbohydrates and fats were associated with improvement in cognitive tests.
CONCLUSIONS: Intentional weight loss through diet was associated with cognitive improvement in patients with MCI.

PMID: 26713821 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1NVwge4
via IFTTT

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Head Neck. 2015 Dec 29;

Authors: Wang CC, Liu SA, Wu SH, Lin WJ, Jiang RS, Wang L

Abstract
BACKGROUND: Transoral robotic surgery (TORS) for early glottic cancer has been reported, but the issue of anterior commissure involvement has seldom been addressed. Therefore, the purpose of this study was to preliminarily report the treatment results of TORS in this disease entity.
METHODS: Eight patients with T1 and T2 glottic carcinoma with anterior commissure involvement were selected to receive TORS. The clinical parameters, including rates of adjuvant radiotherapy (RT), survivals, as well as organ and function preservation, were retrospectively analyzed.
RESULTS: TORS was successfully performed in all patients without temporary tracheostomy. There were no major complications and no patient received adjuvant RT to the larynx after surgery. With a mean follow-up of 40 months, all patients survived with their larynx preserved and no local recurrence, tracheostomy, or tube feeding dependence.
CONCLUSION: TORS is a feasible approach for selected patients with early T classification glottic carcinoma with anterior commissure involvement. The preliminary oncologic and functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26714200 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OkrHxA
via IFTTT

Adaptation and validation of stroke-aphasia quality of life (SAQOL-39) scale to Malayalam.

Adaptation and validation of stroke-aphasia quality of life (SAQOL-39) scale to Malayalam.

Ann Indian Acad Neurol. 2015 Oct-Dec;18(4):441-4

Authors: Raju R, Krishnan G

Abstract
BACKGROUND: Aphasia, an acquired inability to understand and/or speak language, is a common repercussion of stroke that denigrates the quality of life (QOL) in the affected persons. Several languages in India experience the dearth of instruments to measure the QOL of persons with aphasia. Malayalam, the language spoken by more than 33 million people in Kerala, the southern state of India, is not an exception to this.
OBJECTIVE: This study aimed to adapt and validate the widely-used stroke-aphasia quality of life (SAQOL-39) scale to Malayalam.
MATERIALS AND METHODS: We required seven Malayalam-speaking Speech Language Pathologists (SLPs), hailing from different regions of Kerala, to examine the socio-cultural suitability of the original items in SAQOL-39 and indicate modifications, wherever necessary. Subsequently, the linguistic adaptation was performed through a forward-backward translation scheme. The socio-culturally and linguistically adapted Malayalam version was then administered on a group of 48 Malayalam-speaking persons with aphasia to examine the test-retest reliability, acceptability, as well as the internal consistency of the instrument.
RESULTS: The Malayalam SAQOL-39 scale showed high test-retest reliability (intraclass correlation coefficient, ICC = 0.91) as well as acceptability with minimal missing data (0.52%). Further, it yielded high internal consistency (Chronbach's ∝ = 0.98) as well as item-to-total and inter-domain correlations.
CONCLUSIONS: The Malayalam version of SAQOL-39 is the first socio-culturally and linguistically adapted tool to measure the QOL of persons with stroke-aphasia speaking this language. It may serve as a potential tool to measure the QOL of this population in both clinical practice and future research endeavors.

PMID: 26713018 [PubMed]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBiBjS
via IFTTT

Clinicoanatomical correlation in stroke related aphasia.

Clinicoanatomical correlation in stroke related aphasia.

Ann Indian Acad Neurol. 2015 Oct-Dec;18(4):424-9

Authors: Bohra V, Khwaja GA, Jain S, Duggal A, Ghuge VV, Srivastava A

Abstract
CONTEXT: With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles.
AIMS: To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke.
SETTINGS AND DESIGN: Observational study, based in a tertiary care center.
MATERIALS AND METHODS: Stroke patient's ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB). Statistical analysis was done with χ(2) test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05.
RESULTS: Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%), Broca's (28.3%), transcortical motor (13.33%), transcortical sensory (10%), Wernicke's (8.33%), anomic (5%), and conduction (1.67%) aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only.
CONCLUSIONS: No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke.

PMID: 26713015 [PubMed]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxkNXT
via IFTTT

Classifier Subset Selection for the Stacked Generalization Method Applied to Emotion Recognition in Speech.

Classifier Subset Selection for the Stacked Generalization Method Applied to Emotion Recognition in Speech.

Sensors (Basel). 2015;16(1)

Authors: Álvarez A, Sierra B, Arruti A, López-Gil JM, Garay-Vitoria N

Abstract
In this paper, a new supervised classification paradigm, called classifier subset selection for stacked generalization (CSS stacking), is presented to deal with speech emotion recognition. The new approach consists of an improvement of a bi-level multi-classifier system known as stacking generalization by means of an integration of an estimation of distribution algorithm (EDA) in the first layer to select the optimal subset from the standard base classifiers. The good performance of the proposed new paradigm was demonstrated over different configurations and datasets. First, several CSS stacking classifiers were constructed on the RekEmozio dataset, using some specific standard base classifiers and a total of 123 spectral, quality and prosodic features computed using in-house feature extraction algorithms. These initial CSS stacking classifiers were compared to other multi-classifier systems and the employed standard classifiers built on the same set of speech features. Then, new CSS stacking classifiers were built on RekEmozio using a different set of both acoustic parameters (extended version of the Geneva Minimalistic Acoustic Parameter Set (eGeMAPS)) and standard classifiers and employing the best meta-classifier of the initial experiments. The performance of these two CSS stacking classifiers was evaluated and compared. Finally, the new paradigm was tested on the well-known Berlin Emotional Speech database. We compared the performance of single, standard stacking and CSS stacking systems using the same parametrization of the second phase. All of the classifications were performed at the categorical level, including the six primary emotions plus the neutral one.

PMID: 26712757 [PubMed - in process]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxkNXR
via IFTTT

The Intensive Dysphagia Rehabilitation approach applied to patients with neurogenic dysphagia: a case series design study.

The Intensive Dysphagia Rehabilitation approach applied to patients with neurogenic dysphagia: a case series design study.

Arch Phys Med Rehabil. 2015 Dec 19;

Authors: Malandraki GA, Rajappa A, Kantarcigil C, Wagner E, Ivey C, Youse K

Abstract
OBJECTIVE: To examine the effects of the Intensive Dysphagia Rehabilitation (IDR) approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia.
DESIGN: Intervention study; before-after trial with 4-week follow-up through an online survey.
SETTING: Outpatient university clinics.
PARTICIPANTS: A consecutive sample of 10 subjects recruited from outpatient university clinics. All were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subject withdrew from the study.
INTERVENTIONS: Participants completed the 4-week Intensive Dysphagia Rehabilitation, including: two oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice/week, and home practice for ∼45 minutes/day.
MAIN OUTCOME MEASURE(S): Outcome measures assessed pre- and post-IDR were: (1) airway safety using an 8-point Penetration Aspiration scale; (2) lingual isometric pressures; (3) self-reported swallowing-related quality of life (QOL), and (4) level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey).
RESULTS: IDR was effective in improving maximum and mean Penetration Aspiration scale scores (p<0.05, η(2)=0.8146; p<0.05, η(2)=0.799708); and level of oral intake (p<0.005, Cohen's d=-1.387). Of 5 patients who were feeding tube dependent initially, two progressed to total, and two to partial oral nutrition. One remained tube dependent. QOL was significantly improved at the 4-week follow-up (95% CI [6.38, 14.5], p<0.00), but not at the post-IDR assessment. No adverse effects were observed/reported.
CONCLUSION(S): We conclude that IDR was safe and improved physiological and some functional swallowing outcomes in our sample, however further investigation is needed before it can be widely applied.

PMID: 26711168 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBiAfO
via IFTTT

Exploring Attitudes of Indian Classical Singers Toward Seeking Vocal Health Care.

Exploring Attitudes of Indian Classical Singers Toward Seeking Vocal Health Care.

J Voice. 2015 Dec 17;

Authors: Gunjawate DR, Aithal VU, Guddattu V, Kishore A, Bellur R

Abstract
OBJECTIVE: The attitude of Indian classical singers toward seeking vocal health care is a dimension yet to be explored. The current study was aimed to determine the attitudes of these singers toward seeking vocal health care and further understand the influence of age and gender.
STUDY DESIGN: Cross-sectional.
METHOD: A 10-item self-report questionnaire adapted from a study on contemporary commercial music singers was used. An additional question was added to ask if the singer was aware about the profession and role of speech-language pathologists (SLPs). The questionnaire was administered on 55 randomly selected self-identified trained Indian classical singers who rated the items using a five-point Likert scale. Demographic variables were summarized using descriptive statistics and t test was used to compare the mean scores between genders and age groups.
RESULTS: Of the singers, 78.2% were likely to see a doctor for heath-related problems, whereas 81.8% were unlikely to seek medical care for voice-related problems; the difference was statistically significant (P < 0.001). Responses for the questions assessing the attitudes toward findings from medical examination by a specialist revealed a statistically significant difference (P = 0.02) between the genders. Age did not have a significant influence on the responses. Only 23.6% of the respondents were aware about the profession and the role of SLPs.
CONCLUSION: The findings are in tune with western literature reporting hesitation of singers toward seeking vocal health care and draws attention of SLPs to promote their role in vocal health awareness and management.

PMID: 26710726 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxkNHn
via IFTTT

Hearing performance and voice acoustics of cochlear implanted children.

Hearing performance and voice acoustics of cochlear implanted children.

Braz J Otorhinolaryngol. 2015 Dec 2;

Authors: Coelho AC, Brasolotto AG, Bevilacqua MC, Moret AL, Bahmad Júnior F

Abstract
INTRODUCTION: The voice of hearing-impaired individuals has been described extensively, and exhibits abnormalities in quality, articulation and resonance. Having an understanding of the aspects that may have an impact on voice characteristics of cochlear implant users is important for users and for professionals in this field.
OBJECTIVE: To verify the existence of correlation between age, time of device use, voice detection threshold, hearing category score and language category score with acoustic data of voices of cochlear implanted children.
METHODS: Retrospective study. Fifty-one children ranging in age from 3 years to 5 years and 11 months who unilaterally used cochlear implants participated. Acoustic analysis of the sustained vowel /a/, sequential speech and spontaneous speech was performed. The results were correlated with demographic data and hearing test results.
RESULTS: Children with worse voice detection threshold showed higher frequency in the sustained vowel (p≤0.001) and in the spontaneous speech (p≤0.005).
CONCLUSION: There was a correlation between the voice detection threshold and the frequency values of the sustained vowel and spontaneous speech of the studied population.

PMID: 26710684 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBiAfD
via IFTTT

THINGS THAT CAN BE CHANGED IN EARLY INTERVENTION IN CHILDHOOD.

Related Articles

THINGS THAT CAN BE CHANGED IN EARLY INTERVENTION IN CHILDHOOD.

Med Pregl. 2015 Jul-Aug;68(7-8):267-72

Authors: Golubović Š, Marković J, Perović L

Abstract
INTRODUCTION: Early intervention implies a model of support focused on a child, family and a broader community from early childhood. The aim of this study was to analyze the elements of the successful early intervention in childhood, as well as to assess the role of a special educator and rehabilitator and level of their involvement in implementing the program on the territory of Novi Sad.
MATERIAL AND METHODS: The study sample included 100 parents of children with disabilities (aged 3-7), who completed the questionnaire designed for the purposes of this research, based on a similar questionnaire design.
RESULTS: Speech delay is one of the most common reasons (over 50%) why parents seek professional help. By the end of the first year of life of their child, 43% of parents responded that they had noticed the first problems, that is, a problem was identified in 25% of children of this age group, and the same number was included in the treatment. About 55% of children were involved in organized treatment from 3 years of age onwards. Special educators and rehabilitators are usually involved in treatment when the team consists of three or more professionals.
CONCLUSIONS: It is necessary to improve early intervention services, to educate staff, and provide conditions which would make it possible to overcome the existing disadvantages in treating children from an early age. In addition, the involvement of special education and rehabilitation professionals in treatment teams since children's early age is vital.

PMID: 26591640 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBizZ9
via IFTTT

The use of functional near-infrared spectroscopy for measuring cortical reorganisation in cochlear implant users: a possible predictor of variable speech outcomes?

Related Articles

The use of functional near-infrared spectroscopy for measuring cortical reorganisation in cochlear implant users: a possible predictor of variable speech outcomes?

Cochlear Implants Int. 2015 Jan;16 Suppl 1:S30-2

Authors: Lawler CA, Wiggins IM, Dewey RS, Hartley DE

PMID: 25614264 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxkNHd
via IFTTT

Acoustic markers to differentiate gender in prepubescent children's speaking and singing voice.

Related Articles

Acoustic markers to differentiate gender in prepubescent children's speaking and singing voice.

Int J Pediatr Otorhinolaryngol. 2014 Oct;78(10):1592-8

Authors: Guzman M, Muñoz D, Vivero M, Marín N, Ramírez M, Rivera MT, Vidal C, Gerhard J, González C

Abstract
OBJECTIVES: Investigation sought to determine whether there is any acoustic variable to objectively differentiate gender in children with normal voices.
METHODS: A total of 30 children, 15 boys and 15 girls, with perceptually normal voices were examined. They were between 7 and 10 years old (mean: 8.1, SD: 0.7 years). Subjects were required to perform the following phonatory tasks: (1) to phonate sustained vowels [a:], [i:], [u:], (2) to read a phonetically balanced text, and (3) to sing a song. Acoustic analysis included long-term average spectrum (LTAS), fundamental frequency (F0), speaking fundamental frequency (SFF), equivalent continuous sound level (Leq), linear predictive code (LPC) to obtain formant frequencies, perturbation measures, harmonic to noise ratio (HNR), and Cepstral peak prominence (CPP). Auditory perceptual analysis was performed by four blinded judges to determine gender.
RESULTS: No significant gender-related differences were found for most acoustic variables. Perceptual assessment showed good intra and inter rater reliability for gender. Cepstrum for [a:], alpha ratio in text, shimmer for [i:], F3 in [a:], and F3 in [i:], were the parameters that composed the multivariate logistic regression model to best differentiate male and female children's voices.
CONCLUSION: Since perceptual assessment reliably detected gender, it is likely that other acoustic markers (not evaluated in the present study) are able to make clearer gender differences. For example, gender-specific patterns of intonation may be a more accurate feature for differentiating gender in children's voices.

PMID: 25085074 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBixRa
via IFTTT

Histone Deacetylase Inhibition via RGFP966 Releases the Brakes on Sensory Cortical Plasticity and the Specificity of Memory Formation.

Related Articles

Histone Deacetylase Inhibition via RGFP966 Releases the Brakes on Sensory Cortical Plasticity and the Specificity of Memory Formation.

J Neurosci. 2015 Sep 23;35(38):13124-32

Authors: Bieszczad KM, Bechay K, Rusche JR, Jacques V, Kudugunti S, Miao W, Weinberger NM, McGaugh JL, Wood MA

Abstract
Research over the past decade indicates a novel role for epigenetic mechanisms in memory formation. Of particular interest is chromatin modification by histone deacetylases (HDACs), which, in general, negatively regulate transcription. HDAC deletion or inhibition facilitates transcription during memory consolidation and enhances long-lasting forms of synaptic plasticity and long-term memory. A key open question remains: How does blocking HDAC activity lead to memory enhancements? To address this question, we tested whether a normal function of HDACs is to gate information processing during memory formation. We used a class I HDAC inhibitor, RGFP966 (C21H19FN4O), to test the role of HDAC inhibition for information processing in an auditory memory model of learning-induced cortical plasticity. HDAC inhibition may act beyond memory enhancement per se to instead regulate information in ways that lead to encoding more vivid sensory details into memory. Indeed, we found that RGFP966 controls memory induction for acoustic details of sound-to-reward learning. Rats treated with RGFP966 while learning to associate sound with reward had stronger memory and additional information encoded into memory for highly specific features of sounds associated with reward. Moreover, behavioral effects occurred with unusually specific plasticity in primary auditory cortex (A1). Class I HDAC inhibition appears to engage A1 plasticity that enables additional acoustic features to become encoded in memory. Thus, epigenetic mechanisms act to regulate sensory cortical plasticity, which offers an information processing mechanism for gating what and how much is encoded to produce exceptionally persistent and vivid memories. Significance statement: Here we provide evidence of an epigenetic mechanism for information processing. The study reveals that a class I HDAC inhibitor (Malvaez et al., 2013; Rumbaugh et al., 2015; RGFP966, chemical formula C21H19FN4O) alters the formation of auditory memory by enabling more acoustic information to become encoded into memory. Moreover, RGFP966 appears to affect cortical plasticity: the primary auditory cortex reorganized in a manner that was unusually "tuned-in" to the specific sound cues and acoustic features that were related to reward and subsequently remembered. We propose that HDACs control "informational capture" at a systems level for what and how much information is encoded by gating sensory cortical plasticity that underlies the sensory richness of newly formed memories.

PMID: 26400942 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KyRgYJ
via IFTTT

Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor.

Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor.

Braz J Otorhinolaryngol. 2015 Dec 3;

Authors: de Moraes BT, de Biase NG

Abstract
INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms.
OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes.
METHODS: Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor. Patients were diagnosed with essential or dystonic tremor according to the phenomenological characterization of each group. Once they were classified, the tasks associated with the presence of tremor in each syndrome were identified.
RESULTS: The tasks that significantly contributed to the differential diagnosis between essential and dystonic tremor were /s/ production, continuous whistling and reduction of tremor in falsetto. These tasks were phenomenologically different with respect to the presence of tremor in the two syndromes.
CONCLUSION: The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto.

PMID: 26712633 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mQJTol
via IFTTT

Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes.

Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes.

J Craniomaxillofac Surg. 2015 Nov 17;

Authors: Doerga PN, Spruijt B, Mathijssen IM, Wolvius EB, Joosten KF, van der Schroeff MP

Abstract
INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent in children with Apert and Crouzon syndromes. Although often related to midface hypoplasia, it is a multi-level problem for which routine midface advancement might be a suboptimal treatment choice. We therefore wished to: 1.) use upper airway endoscopy to examine the level of obstruction in children with OSA; 2.) determine the relationship between endoscopic assessment and OSA severity; and 3.) evaluate the effect of surgery on endoscopic assessment and OSA severity.
METHODS: Prospective observational cohort study of patients considered for midface advancement, underwent upper airway endoscopy. Endoscopy findings were scored according to the system of Bachar, based on level (nose, uvulopalatine plane, tongue base, hypopharynx and larynx); and severity (no, partial or complete obstruction). Polysomnography was used to diagnose OSA.
RESULTS: We included 22 children (Apert N = 10, Crouzon N = 12), 17 had OSA, 14 of whom had multilevel obstruction and 3 single-level obstruction. The endoscopy findings were correlated with OSA severity: R = 0.56, P = 0.01. Midface advancement (N = 8) reduced Bachar's severity index in 7 of 8 patients, and OSA in all patients.
CONCLUSIONS: OSA in children with Apert or Crouzon syndrome is often a multi-level problem. Upper airway endoscopy is essential to optimizing OSA treatment.

PMID: 26712482 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OktzX0
via IFTTT

[BIOFILM FORMATION BY STREPTOCOCCUS PNEUMONIAE].

Related Articles

[BIOFILM FORMATION BY STREPTOCOCCUS PNEUMONIAE].

Mol Gen Mikrobiol Virusol. 2015;33(3):16-22

Authors: Mayanskiy AN, Chebotar IV, Lazareva AV, Mayanskiy NA

Abstract
The biofilm process in Streptococcus pneumoniae (pneumococcus) is described. Virtually all wild-type pneumococci are capable of the biofilm formation. The pneumococcal capsule may reduce the biofilm production, and the propensity to form biofilms has a reverse correlation with the amount of the capsule material. Invasive pneumococcal isolates and noninvasive strains that persist in the nasopharynx have different biofilm potential. A number of issues related to effector and regulatory factors in the pneumococcal biofilms are discussed in this review. In the summary, a biofilm may be essential only for the persistent pneumococcal infection.

PMID: 26665737 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mQJQca
via IFTTT

Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness.

Related Articles

Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness.

B-ENT. 2015;11(2):151-5

Authors: Honings J, van Rossum MM, van den Hoogen FJ

Abstract
BACKGROUND: Lipoid proteinosis is an autosomal recessive disorder characterized by hyalin deposits in the skin and mucosa of the upper aerodigestive tract; currently, no treatment exists. Nearly all patients experience hoarseness and speech difficulties, due to hyalin deposition in the vocal folds and diminished mobility in infiltrated lips, tongue, and palate.
METHODS: We describe a patient with extensive hyalin plaques on the vocal folds, which resulted in near-aphonic hoarseness. Hyalin deposits in the vocal folds and skin were treated with laser resection.
RESULTS: Both the vocal folds and skin improved in appearance, with smoother surface epithelium. However, the patient's speech remained impaired, due to extensive hyalin plaques in the mouth, tongue, and lips. The voice improved only temporarily.
CONCLUSIONS: Laser resection of hyalin plaques in the vocal folds and skin is a feasible treatment for lipoid proteinosis. However, speech may remain severely limited, due to impaired tongue and lip movement.

PMID: 26563017 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Mdkr4g
via IFTTT

Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution.

Related Articles

Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution.

Can J Anaesth. 2015 May;62(5):495-503

Authors: Lamb A, Zhang J, Hung O, Flemming B, Mullen T, Bissell MB, Arseneau I

Abstract
PURPOSE: We sought to determine the rate of successful identification of the cricothyroid membrane by anesthesia residents and staff at a Canadian institution.
METHODS: In this prospective study, healthy adult volunteer subjects were positioned supine with their necks placed in neutral position. There were 12 subjects, half of whom were non-obese (body mass index < 30.0 kg·m(2)) and half of whom were obese. There were equal numbers of male and female subjects in each of the obese and non-obese groups. Anesthesia staff and resident participants were allowed to palpate multiple subjects but with only one attempt per subject. For each subject, ultrasonography was used to identify the superior and inferior borders of the cricothyroid membrane, which were then marked with "invisible" ink that could be made visible with ultraviolet light. The midline was also marked with invisible ink. Identification of the cricothyroid membrane was considered correct if the mark was between the superior and inferior borders and within 0.5 cm of the midline.
RESULTS: Altogether, 61 participants palpated 12 subjects, resulting in 186 identifications. The success rates for the subgroups were as follows: non-obese men 72% (95% confidence interval [CI] 59 to 85%); obese men 39% (95% CI 26 to 54%); non-obese women 24% (95% CI 12 to 36%); obese women 35% (95% CI 21 to 49%).
CONCLUSION: Success rates for correct identification of the cricothyroid membrane were poor in this Canadian institution.

PMID: 25637060 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mQJQsq
via IFTTT

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial.

Related Articles

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial.

Can J Anaesth. 2015 May;62(5):485-94

Authors: You-Ten KE, Bould MD, Friedman Z, Riem N, Sydor D, Boet S

Abstract
PURPOSE: Non-adherence to airway guidelines in a 'cannot intubate-cannot oxygenate' (CICO) crisis situation is associated with adverse patient outcomes. This study investigated the effects of hands-on training in cricothyrotomy on adherence to the American Society of Anesthesiologists difficult airway algorithm (ASA-DAA) during a simulated CICO scenario.
METHODS: A total of 21 postgraduate second-year anesthesia residents completed a pre-test teaching session during which they reviewed the ASA-DAA, became familiarized with the Melker cricothyrotomy kit, and watched a video on cricothyrotomy. Participants were randomized to either the intervention 'Trained' group (n = 10) (taught and practiced cricothyrotomy) or the control 'Non-Trained' group (n = 11) (no extra training). After two to three weeks, performances of the groups were assessed in a simulated CICO scenario. The primary outcome measure was major deviation from the ASA-DAA. Secondary outcome measures were (1) performance of the four categories of non-technical behaviours using the validated Anaesthetists' Non-Technical Skills scale (ANTS) and (2) time to perform specific tasks.
RESULTS: Significantly more non-trained than trained participants (6/11 vs 0/10, P = 0.012) committed at least one major ASA-DAA deviation, including failure to insert an oral airway, failure to call for help, bypassing the laryngeal mask airway, and attempting fibreoptic intubation. ANTS scores for all four categories of behaviours, however, were similar between the groups. Trained participants called for help faster [26 (2) vs 63 (48) sec, P = 0.012] but delayed opening of the cricothyrotomy kit [130 (50) vs 74 (36) sec, P = 0.014].
CONCLUSION: Hands-on training in cricothyrotomy resulted in fewer major ASA-DAA deviations in a simulated CICO scenario. Training in cricothyrotomy may play an important role in complying with the ASA-DAA in a CICO situation but does not appear to affect non-technical behaviours such as decision-making.

PMID: 25547068 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QXNNs8
via IFTTT

Hyperthermia for non-muscle invasive bladder cancer.

Hyperthermia for non-muscle invasive bladder cancer.

Expert Rev Anticancer Ther. 2015 Dec 29;

Authors: Soria F, Allasia M, Oderda M, Gontero P

Abstract
Recurrent non muscle invasive bladder cancer (NMIBC) represents a therapeutic challenge, especially in the case of Bacillus Calmette Guerin (BCG)-failures. Chemohyperthermia (CHT) has been tested as adjuvant therapy in selected categories of patients with promising results. The aim of this systematic review is to explore the current role of CHT and its future perspectives. The review process was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. After the selection process, 30 articles were used in this review. Treatment with CHT is safe and quite well tolerated. CHT seems to be effective in low and intermediate risk bladder cancer. Moreover CHT could be offered to selected categories of high risk patients and BCG failures NMIBC. Further trials are needed in order to better identify the categories of patients which could benefit from this therapy and to standardise the right schedule of treatment.

PMID: 26713510 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1ZBhEYE
via IFTTT

Digital implant impressions by cone-beam computerized tomography: a pilot study

Abstract

Objectives

To evaluate the adjustment of structures designed from a digital impression of implants obtained by cone-beam computerized tomography (CBCT).

Materials and methods

Thirty implants were placed in five edentulous mandibles of fresh cadaver heads, six per mandible. Special scan bodies were screwed in the implants and a CBCT was taken. DICOM images were converted to STL and digitally processed to obtain a digital model of the implants. A Cr-Co structure was designed and milled for each mandible, and the adjustment was assessed as in a real clinical situation: passivity while screwing, radiographic fitting, optical fitting, and probing.

Results

Good adjustment was found in three of the structures, and only slight discrepancies were found in the other two.

Conclusion

Cone-beam computerized tomography might be a valid impression-taking method in full-mouth rehabilitations with implants. Further evaluations are needed with more implant and CBCT systems. The radiation dose might be considered when deciding to use this impression system. The types of patients appropriate for this treatment option should also be determined to fulfill the principles of the ALARA law.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1OxjKXL
via IFTTT

The impact of the cochlear-carotid interval on tinnitus perception.

The impact of the cochlear-carotid interval on tinnitus perception.

Surg Radiol Anat. 2015 Dec 29;

Authors: Gunbey HP, Gunbey E, Sayit AT, Aslan K, Unal A, Incesu L

Abstract
PURPOSE: We hypothesized that the cochlear-carotid interval (CCI), which is defined as the smallest distance along the petrous segment of the internal carotid artery and basal turn of cochlea, may be associated with direct stimulation of hair cells, thereby affecting tinnitus perception. The aim of this study was to investigate the relationships between the CCI, tinnitus perception, and accompanying hearing loss in patients with tinnitus.
METHODS: The CCI on both sides was measured independently by two observers from the temporal 3D b-FFE MR images of 25 patients with tinnitus and 20 age/gender matched control subjects. The relationships between CCI, tinnitus visual analog scale (VAS), and tinnitus handicap inventory (THI) were investigated.
RESULTS: CCI ranged 0.2-5.6 mm (1.9 ± 1.5) on the right and 0.1-5.4 mm (2.2 ± 1.6) on the left side in the patient group and 0.5-5.4 (1.9 ± 1.4) mm on the right and 0.3-6.7 (2.3 ± 1.7) on the left side in the control group. The differences between the two groups were not statistically significant (p > 0.05). CCI showed a strong negative correlation with THI and VAS scores on both sides. Correlation of audiologic findings with CCI revealed a significant negative correlation with pure tone average of the ipsilateral ear most affectedly at high frequencies.
CONCLUSION: The strong negative correlation of CCI with tinnitus-related distress and accompanying sensorineural hearing loss predominantly at high frequencies suggests that further studies on patients with tinnitus that focus on this small area may help to improve the knowledge of tinnitus pathophysiology.

PMID: 26711900 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mQJNgo
via IFTTT

Primary Peritoneal Papillary Serous Cystadenocarcinoma - A Rare Malignancy.

Primary Peritoneal Papillary Serous Cystadenocarcinoma - A Rare Malignancy.

Chirurgia (Bucur). 2015 Nov-Dec;110(6):570-572

Authors: Sahu SK, Agrawal S, Shirazi N, Kapruwan H, Dasgupta P, Ghildiyal D, Singh SN, -

Abstract
Primary peritoneal papillary serous carcinoma is a rare primary malignancy diffusively involving the peritoneum of abdomen and pelvis. Epithelial ovarian cancers and primary peritoneal cancers arise from the common germinal epithelium which develops from the coelomic epithelium. Due to a common embryonic origin of the ovary and the peritoneum, carcinoma of the ovary and primary peritoneal carcinoma have much histological similarity. However the incidence of Primary peritoneal serous carcinoma is considerably lower than that of epithelial ovarian cancer and is mostly seen in elderly women. Early stages of this disease may be asymptomatic; symptoms of the advance stages of the disease include abdominal distention, abdominal lump, non-specific abdominal pain, vomiting and dyspnoea all as a result of massive ascites. Patients diagnosed with primary peritoneal papillary serous carcinoma are treated using the same staging, surgical and chemotherapeutic approach as epithelial ovarian cancer because of the similarities in biological behavior.

PMID: 26713835 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Uggmib
via IFTTT

Axillary lymph node metastases in adenoid cystic carcinoma of the breast. A rare finding.

Axillary lymph node metastases in adenoid cystic carcinoma of the breast. A rare finding.

G Chir. 2015 Sep-Oct;36(5):209-13

Authors: Spiliopoulos D, Mitsopoulos G, Kaptanis S, Halkias C

Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare malignant salivary-type neoplasm that has a good prognosis and represents less than 1% of all breast cancers. It is a triple negative carcinoma that presents as a painful mass. The mean age at the time of diagnosis is 50-60 years old. The solid variant of this type of tumour with basaloid features and presence of nodal metastases is very rare and considered to have a more aggressive clinical course. We present a case with presence of axillary lymph node metastases that was successfully treated with no evidence of recurrence one year after the diagnosis and review the literature.

PMID: 26712257 [PubMed - in process]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QXVIWF
via IFTTT

Vulvar Syringoma in a Postmenopausal Woman: A Case Report.

Related Articles

Vulvar Syringoma in a Postmenopausal Woman: A Case Report.

J Reprod Med. 2015 Sep-Oct;60(9-10):452-4

Authors: Ozdemir O, Sari ME, Sen E, Ozcanli G, Atalay C

Abstract
BACKGROUND: First described in 1872, syringomas are common intraepidermal sweat gland tumors most often found in women during adolescence. Frequent involvement areas are the lower eyelids and malar areas; vulvar involvement is relatively rare. These lesions often appear as small, separate, yellowish papules of about 1-3 mm in size and are generally associated with increased vulvar discomfort and itching.They typically occur in multiples and are bilateral and symmetrical.
CASE: A 52-year-old, postmenopausal woman presented with vulvar pruritis and was diagnosed with syringomas after vulvar biopsy in our polyclinics.
CONCLUSION: Vulvar syringoma should be included in the differential diagnosisf or itchy and papular lesions of vulvae in a postmenopausal woman.

PMID: 26592076 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1UggjTG
via IFTTT

Isolated Endobronchial Capillary Haemangioma: A Rare Cause of Haemoptysis in Adult.

Related Articles

Isolated Endobronchial Capillary Haemangioma: A Rare Cause of Haemoptysis in Adult.

Indian J Chest Dis Allied Sci. 2015 Apr-Jun;57(2):109-11

Authors: Kundu S, Dhua A, Hariprasath K, Ghosh S, Bandyopadhyay A

Abstract
Endobronchial capillary haemangioma is a very rare benign tumour in adults. The clinical presentation and management of adult capillary haemangiomas involving the tracheo-bronchial tree is not yet established. We present a case of an isolated capillary haemangioma of the left main bronchus detected during the evaluation of an adult male presented with haemoptysis. The lesion was managed successfully bronchoscopically.

PMID: 26591971 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QXVGOm
via IFTTT

Tuberous Sclerosis and Polycystic Kidney Disease: A Rare Association.

Related Articles

Tuberous Sclerosis and Polycystic Kidney Disease: A Rare Association.

J Assoc Physicians India. 2015 Apr;63(4):64-6

Authors: Das S, Bala BL, Ray AN, Sherpa PL, Kumar RR

Abstract
Tuberous sclerosis complex (TSC) and autosomal dominant polycystic kidney disease (ADPKD) are two different genetic diseases. Although these two diseases are associated very rarely, the association is well recognized. This occurs due to a large deletion involving both PKD-1 and TSC-2 genes on chromosome 16. This is also known as TSC-2/PKD-1 contiguous gene syndrome. We report a 26-year-old female patient with TSC who presented with severe metabolic acidosis due to renal failure. She had palpable enlarged kidneys bilaterally. CT scan of abdomen revealed bilateral enlarged lobulated kidneys studded with multiple cysts which was consistent with the diagnosis of ADPKD.

PMID: 26591174 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QXVGxR
via IFTTT

Inflammatory pseudotumour of the maxillary sinus mimicking malignancy.

Related Articles

Inflammatory pseudotumour of the maxillary sinus mimicking malignancy.

B-ENT. 2015;11(2):147-50

Authors: Giotakis EI, Kotrotsos IN

Abstract
Inflammatory pseudotumours of the paranasal sinuses are rare entities and can be easily confused with aggressive malignant tumours. In this report we describe the characteristic behavior of inflammatory pseudotumours in the maxillary sinus. We present a case of a 47-year-old Caucasian woman, who presented in our ENT department because of progressive nasal obstruction, epistaxis, and epiphora. The clinical as well as the radiological findings suggested a maxillary sinus neoplasm, most probably of malignant nature. The histopathological examination showed an inflammatory pseudotumour of the maxillary sinus with polypoid structure and no signs of malignancy.

PMID: 26563016 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1YawRiF
via IFTTT

Schwannoma of the nasal septum presenting as a multicentric neuronal tumour.

Related Articles

Schwannoma of the nasal septum presenting as a multicentric neuronal tumour.

B-ENT. 2015;11(2):141-5

Authors: Yokoi H, Tsutsumi S, Kohno N

Abstract
PROBLEM: Schwannomas (neurilemmomas) are benign primary tumours that arise from Schwann cells. Schwannomas arising from the nasal septum are exceptionally rare. Here, we report a unique case of schwannoma of the nasal septum presenting as a multicentric neuronal tumour.
RESULTS: A 40-year old male sustained intermittent left tinnitus. Magnetic resonance imaging revealed masses near the nasal septum and upper cervical cord in addition to a tumour in the left cerebellopontine (CP) angle. The tumour in the nasal septum was completely resected by endoscopic endonasal surgery and diagnosed as a typical schwannoma. The CP angle tumour was treated with stereotactic radiosurgery, while the asymptomatic cord lesion showed no significant growth and remains under observation.
CONCLUSION: Endoscopic endonasal surgery is useful for the resection of schwannomas of the nasal septum. Schwannomas of the nasal septum may present as multiple neuronal tumours.

PMID: 26563015 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1MdkoFC
via IFTTT

Clear Cell Sarcoma Of Metatarsus.

Related Articles

Clear Cell Sarcoma Of Metatarsus.

Folia Med (Plovdiv). 2014 Oct-Dec;56(4):271-4

Authors: Licata L, Fenga D, Speciale G, Rosa MA

Abstract
We report a case of clear cell sarcoma in the third metatarsus of the right foot. This type of tumor is very rare and scantily reported in literature. A 42-year-old Caucasian male presented with a nodular ulcerated mass on the dorsal side of the left foot. X-rays demonstrated a nodular solid lesion which dislodged the third metatarsus. A biopsy revealed a neoplastic proliferation with a sarcoma clear cell profile; because of the aggressive nature of this type of neoplasm, we performed a trans-tibial amputation according to Bugess to achieve a better functionality for the patient. The present study underlines clinical, morphological, as well as imaging and therapeutic aspects of a rare neoplasm such as clear cell sarcoma. The location site is also quite unusual - the metatarsus of the foot. The histological and immunohistochemical data were suggestive of the diagnosis of clear cell sarcoma of metatarsus. After MRI and a bone scan, the surgical treatment suggested the extension over the forefoot and the ankle and therefore a trans-tibial amputation was made.

PMID: 26444357 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1UggjD4
via IFTTT

Folliculotropic Mycosis Fungoides as a Posttransplant Lymphoproliferative Disorder.

Related Articles

Folliculotropic Mycosis Fungoides as a Posttransplant Lymphoproliferative Disorder.

Pediatrics. 2015 Sep;136(3):e701-5

Authors: Spence-Shishido A, Streicher JL, George RP, Parker SR, Lawley LP

Abstract
Posttransplant lymphoproliferative disorder (PTLD) is a known complication of solid organ transplantation. The majority are B cell in origin and related to Epstein-Barr virus infection. T-cell PTLD is much less common; most are Epstein-Barr virus negative and have a worse prognosis. Primary cutaneous T-cell lymphoma (CTCL) as a presentation of PTLD is rare. CTCL has a less favorable prognosis in transplant patients compared with that in immune-competent patients. Herein, we report a case of a 13-year-old boy who developed folliculotropic mycosis fungoides, a rare subtype of CTCL, subsequent to renal transplantation. To our knowledge, this is the first report of this type of PTLD in a pediatric patient.

PMID: 26283779 [PubMed - indexed for MEDLINE]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1UggiPA
via IFTTT