Dental erosion among 12-year-old schoolchildren: a population-based cross-sectional study in South Brazil.

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Dental erosion among 12-year-old schoolchildren: a population-based cross-sectional study in South Brazil.

Int Dent J. 2015 Dec;65(6):322-30

Authors: Alves LS, Brusius CD, Damé-Teixeira N, Maltz M, Susin C

Abstract
OBJECTIVE: To assess the epidemiology and risk indicators for dental erosion among 12-year-old schoolchildren in South Brazil.
METHODS: A population-based cross-sectional survey was conducted in Porto Alegre, Brazil, using a representative sample of 12-year-old schoolchildren (n = 1,528). Dental erosion was recorded according to the Basic Erosive Wear Examination (BEWE) index. Parents answered questions on socio-economic status, brushing frequency and general health. Schoolchildren answered questions on dietary habits. Anthropometric data were collected. Statistical analysis included logistic and Poisson regression models.
RESULTS: The prevalence of dental erosion was 15% [95% confidence interval (95% CI): 13.6-16.5], being mainly mild erosion. Boys [odds ratio (OR) = 1.57, 95% CI: 1.17-2.10], private school attendees (OR = 1.45, 95% CI: 1.01-2.06) and schoolchildren reporting the daily consumption of soft drinks (OR = 5.04, 95% CI: 1.17-21.71) were more likely to have at least one tooth with dental erosion. Gender [boys, rate ratio (RR) = 1.66, 95% CI: 1.28-2.17], type of school (private, RR = 1.89, 95% CI: 1.53-2.35), the consumption of soft drinks (sometimes: RR = 5.27, 95% CI: 1.46-19.05; daily: RR = 6.82, 95% CI: 1.39-33.50) and the daily consumption of lemon (RR = 1.49, 95% CI: 1.11-2.00) were significantly associated with the number of affected surfaces.
CONCLUSIONS: The present study found a moderate prevalence of dental erosion among young schoolchildren, with mild erosion being the most prevalent condition. Socio demographic variables and dietary habits were associated with dental erosion in this population.

PMID: 26462995 [PubMed - indexed for MEDLINE]

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Association of Tooth Loss With Development of Swallowing Problems in Community-Dwelling Independent Elderly Population: The Fujiwara-kyo Study.

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Association of Tooth Loss With Development of Swallowing Problems in Community-Dwelling Independent Elderly Population: The Fujiwara-kyo Study.

J Gerontol A Biol Sci Med Sci. 2015 Dec;70(12):1548-54

Authors: Okamoto N, Morikawa M, Yanagi M, Amano N, Tomioka K, Hazaki K, Harano A, Kurumatani N

Abstract
BACKGROUND: Tooth loss induces changes to the anatomy of the oral cavity. We hypothesized that tooth loss may disturb smooth swallowing in healthy elderly people. The purpose of this study was to investigate the effect of tooth loss on the development of swallowing problems in an independent elderly population.
METHODS: This was a 5-year prospective cohort study conducted in Nara, Japan. Included in this analysis were 1,988 community residents aged 65 years or older without swallowing problems at baseline. The participants were classified into quartile groups according to the number of remaining teeth at the baseline survey: 0-12, 13-22, 23-26, and 27-32 teeth. A decrease in the number of teeth during the survey was calculated by subtracting follow-up number from baseline number. Main outcome was the development of swallowing problems at follow-up.
RESULTS: During follow-up, 312 individuals developed swallowing problems. After adjustment for confounding factors by multiple logistic regression analysis, the odds ratios for developing swallowing problems in participants with 13-22 or 0-12 teeth were 2.42 (95% confidence interval [CI], 1.61-3.63) and 2.49 (95% CI, 1.68-3.69), respectively, compared to participants with 27-32 teeth, demonstrating a significant relationship. The odds ratio of per 1 tooth decrease over 5 years was 1.08 (95% CI, 1.02-1.13), showing a significant association.
CONCLUSIONS: Swallowing problems due to aging are more likely to develop in individuals with fewer teeth.

PMID: 26341784 [PubMed - indexed for MEDLINE]

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Increased Pharyngeal Reflux in Patients Treated for Laryngeal Cancer: A Pilot Study.

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Increased Pharyngeal Reflux in Patients Treated for Laryngeal Cancer: A Pilot Study.

Otolaryngol Head Neck Surg. 2015 Nov;153(5):791-4

Authors: LeBlanc B, Lewis E, Caldito G, Nathan CA

Abstract
OBJECTIVE: Laryngopharyngeal reflux may cause significant morbidity in the head and neck cancer population. The goal was to determine if pharyngeal reflux is increased as a result of treatment for laryngeal cancer.
STUDY DESIGN: A prospective clinical trial.
SETTING: Tertiary care center.
SUBJECTS: Head and neck cancer patients treated at LSU Health-Shreveport with a plan for total laryngectomy.
METHODS: Pharyngeal pH probes with resultant reflux scores were utilized in patients with laryngeal/pharyngeal cancer with a plan for total laryngectomy.
RESULTS: Twenty-four patients were enrolled, of whom 10 underwent postlaryngectomy pH probe monitoring. The mean upright Ryan score for patients with prior radiotherapy was 238.4 (n = 8), compared with 22.0 (n = 16) in those without prior radiotherapy (P = .02). The supine score was 12.7 in the radiotherapy group and 2.7 in those without radiotherapy (P = .12). For those who completed the postlaryngectomy pH study (n = 10), the mean preoperative upright Ryan score was 106.32 ± 279.1 versus a postoperative score of 209.0 ± 352.6 (P = .04). The mean supine preoperative Ryan score in this group was 3.9 ± 3.47, as opposed to 8.1 ± 9.6 postoperatively (P = .13) CONCLUSIONS: This study suggests that treatment of laryngeal cancer may increase the incidence of pharyngeal reflux. Consider screening for reflux in patients previously treated for laryngeal cancer.

PMID: 26307583 [PubMed - indexed for MEDLINE]

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Pierre Robin sequence: Management of respiratory and feeding complications during the first year of life in a tertiary referral centre.

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Pierre Robin sequence: Management of respiratory and feeding complications during the first year of life in a tertiary referral centre.

Int J Pediatr Otorhinolaryngol. 2015 Aug;79(8):1206-12

Authors: Rathé M, Rayyan M, Schoenaers J, Dormaar JT, Breuls M, Verdonck A, Devriendt K, Poorten VV, Hens G

Abstract
OBJECTIVES: To review early clinical manifestations of Pierre Robin sequence (PRS) and their management during the first year of life in the University Hospitals Leuven.
METHODS: Retrospective series of 48 patients with PRS born between 2001 and 2011 and treated at a tertiary referral hospital. Review of the current literature about management of respiratory and breathing difficulties in the early life of PRS patients.
RESULTS: Of our cleft palate patients 15.3% presented with PRS. A syndrome was diagnosed in 14.6%, associated anomalies without a syndromic diagnosis in 56.3% and isolated PRS in 29.2% of the cases. Mortality rate directly related to PRS was 2.1%. Respiratory difficulties were observed in 83.3% and feeding difficulties in 95.6% of the patients. Respiratory problems were addressed in a conservative way in 75%, in a non-surgical invasive way in 42.5% and in a surgical way in 12.5%. A statistically significant relationship between the association of a syndrome or other anomalies, and a higher need for resuscitation and invasive treatment were found (chi-square test, p-values=0.019 and 0.034). Feeding difficulties were managed conservatively in 91.3%, invasively in 80.4% and surgically in 15.2%.
CONCLUSIONS: PRS is frequently associated with other abnormalities or syndromes. Therefore routine screening for associated anomalies in neonates with PRS is recommendable. Respiratory and feeding complications are highly frequent and possibly severe, particularly in patients with associated anomalies or syndromes, and should be recognized and addressed appropriately in an early stage. There is a potential role for the nasopharyngeal airway in reducing the need for the more traditional surgical interventions for respiratory problems.

PMID: 26092549 [PubMed - indexed for MEDLINE]

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Prevalence of Chronic Metoclopramide Use and Associated Diagnoses in the US Pediatric Population.

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Prevalence of Chronic Metoclopramide Use and Associated Diagnoses in the US Pediatric Population.

Paediatr Drugs. 2015 Aug;17(4):331-7

Authors: Weinstein RB, Fife D, Sloan S, Voss EA, Treem W

Abstract
OBJECTIVE: Metoclopramide is the only medication widely used to promote gastrointestinal motility in the USA. Despite its appreciable risk of central nervous system complications, it continues to be prescribed to children for chronic use. We sought to estimate the prevalence of chronic metoclopramide use among US children and identify the diagnoses that may have prompted this use. The US metoclopramide label lists only two indications in adults: symptomatic gastroesophageal reflux (GERD) and diabetic gastroparesis. The latter is rare in children so, in examining the indications likely to have prompted chronic metoclopramide use, we focused on GERD.
METHODS: From two health services databases representing privately and publically insured children, respectively, we estimated the number of US children who used metoclopramide chronically and identified the diagnoses recorded at approximately the time when the chronic use began. We defined chronic use liberally as ≥ 35 days' supply, or conservatively as ≥ 130 days' supply in a 6-month period. For each chronic-use definition, insurance type, and age group, we estimated the proportion of children using metoclopramide chronically. We applied these proportions to US population estimates.
RESULTS: Under the liberal and conservative definitions, respectively, 89,020 and 28,222 US children used metoclopramide chronically.
CONCLUSION: In spite of its risk, substantial numbers of US children use metoclopramide chronically for symptoms suggestive of GERD.

PMID: 26014368 [PubMed - indexed for MEDLINE]

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Prevalence of chronic rhinosinusitis in a population of patients with gastroesophageal reflux disease.

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Prevalence of chronic rhinosinusitis in a population of patients with gastroesophageal reflux disease.

Am J Rhinol Allergy. 2015 May-Jun;29(3):e70-4

Authors: Bohnhorst I, Jawad S, Lange B, Kjeldsen J, Hansen JM, Kjeldsen AD

Abstract
BACKGROUND: An increased coexistence of gastroesophageal reflux disease (GERD) and chronic rhinosinusitis (CRS) has been reported in epidemiologic and register studies, and reflux has been shown more frequently in patients with CRS in studies using esophagus pH manometry compared to participants without CRS. A discussion is ongoing about whether there might be an association between these two diseases and, if so, whether the association is causal.
OBJECTIVE: The purpose of this study was to clinically investigate the prevalence and symptom severity scores of CRS among patients with GERD. The results were compared with those of a randomly assigned control group from the general Danish population.
METHOD: In this case-control study, 82 patients with GERD were examined for CRS using the European Position Paper on Rhinosinusitis and Nasal Polyps criteria, which combine patient history and anterior/posterior rhinoscopy results. Sinonasal-related quality of life was assessed by using the Sino-Nasal Outcome Test 22 (SNOT-22). These results were compared with those of a population-based control group examined for CRS in the same way.
RESULTS: The prevalence of CRS among patients with GERD was 20.7% (95% confidence interval [CI], 12.0%-29.5%), significantly higher than the CRS prevalence of 8.5% (95% CI, 6.8%-10.2%) in the background population. Patients with GERD and CRS had an average SNOT-22 score of 43.8, whereas patients with CRS from the background population scored, on average, 28.1. Having GERD increased the mean SNOT-22 score in patients with CRS by 15.7 (95% CI, 6.5-24.9).
CONCLUSION: The results of this study provide additional evidence of an association between GERD and CRS and indicate that GERD may play a role in the development of CRS. The results also show that sinonasal-related quality of life is decreased in patients with CRS who also suffer from GERD.

PMID: 25975241 [PubMed - indexed for MEDLINE]

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Partnership in optimizing management of reflux symptoms: a treatment algorithm for over-the-counter proton-pump inhibitors.

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Partnership in optimizing management of reflux symptoms: a treatment algorithm for over-the-counter proton-pump inhibitors.

Curr Med Res Opin. 2015;31(7):1309-18

Authors: Boardman HF, Delaney BC, Haag S

Abstract
BACKGROUND: Uncomplicated heartburn and acid regurgitation are increasingly treated and managed using over-the-counter medications. However, with over-the-counter availability of antacids, alginates, histamine 2 receptor antagonists (H2RAs), and proton-pump inhibitors (PPIs), consumers need guidance as to appropriate options and how to use them.
METHODS: Relevant guidelines, studies, and reviews were identified via literature searches of PubMed/Medline and Google Scholar, as well as cross-referencing from the identified papers.
RESULTS: Antacids, alginates, and H2RAs are best suited to management of occasional heartburn, taken either before provocative meals or other triggers or on demand when symptoms arise. Over-the-counter PPIs are appropriate options across the range of symptom severity/frequency typically encountered in the pharmacy, but may be particularly appropriate for treatment of those with frequent and/or very bothersome heartburn. A 2-4 week course of daily PPIs can lead to complete resolution of frequent heartburn. Counseling is important to ensure that patients understand that failure of symptoms to resolve or a rapid return of symptoms while taking a PPI is an indication to consult a doctor, whereas a return of symptoms after a period of months may be an indication for just another course of treatment. The need for effective communication and for ensuring use of the correct medication in the over-the-counter setting puts much of the responsibility for management of heartburn and acid regurgitation on the pharmacist. A proposed algorithm that details when and how to use available over-the-counter medications is presented. This algorithm also highlights alarm features and atypical symptoms indicative of other underlying conditions that should be referred directly to a physician.
CONCLUSION: Implementation of a simple algorithm will empower pharmacists and consumers alike and ensure consistent and appropriate care.

PMID: 25950642 [PubMed - indexed for MEDLINE]

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Gastro-oesophageal reflux disease increases the risk of intensive care unit admittance and mechanical ventilation use among patients with chronic obstructive pulmonary disease: a nationwide population-based cohort study.

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Gastro-oesophageal reflux disease increases the risk of intensive care unit admittance and mechanical ventilation use among patients with chronic obstructive pulmonary disease: a nationwide population-based cohort study.

Crit Care. 2015;19:110

Authors: Tsai CL, Lin YH, Wang MT, Chien LN, Jeng C, Chian CF, Perng WC, Chiang CH, Chiou HY

Abstract
INTRODUCTION: Gastro-oesophageal reflux disease (GORD) is common among chronic obstructive pulmonary disease (COPD) patients and may have a deleterious effect on COPD prognosis. However, few studies have investigated whether GORD increases the risk of severe outcomes such as intensive care unit (ICU) admittance or mechanical ventilator use among COPD patients.
METHODS: Propensity score matching by age, sex, comorbidities and COPD severity was used to match the 1,210 COPD patients with GORD sourced in this study to 2,420 COPD patients without GORD. The Kaplan-Meier method was used to explore the incidence of ICU admittance and machine ventilation with the log rank test being used to test for differences. Cox regression analysis was used to explore the risk of ICU admittance and mechanical ventilation use for patients with and without GORD.
RESULTS: During the 12-month follow-up, GORD patients and non-GORD patients had 5.22 and 3.01 ICU admittances per 1000 person-months, and 4.34 and 2.41 mechanical ventilation uses per 1000 person-month, respectively. The log rank test revealed a difference in the incidence of ICU admittance and machine ventilation between the two cohorts. GORD was found to be an independent predicator of ICU admittance (adjusted hazard ratio (HRadj) 1.75, 95% confidence interval (CI) 1.28-2.38) and mechanical ventilation (HRadj 1.92, 95% CI 1.35-2.72).
CONCLUSION: This is the first investigation to detect a significantly higher incidence rate and independently increased risk of admission to an ICU and mechanical ventilation use among COPD patients who subsequently developed GORD during the first year following their GORD diagnosis than COPD patients who did not develop GORD.

PMID: 25887791 [PubMed - indexed for MEDLINE]

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Primum non nocere and challenging conventional treatment.

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Primum non nocere and challenging conventional treatment.

Intensive Care Med. 2015 May;41(5):933-5

Authors: Deane AM, Guyatt GH

PMID: 25869403 [PubMed - indexed for MEDLINE]

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World gastroenterology organisation global guidelines: dysphagia--global guidelines and cascades update September 2014.

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World gastroenterology organisation global guidelines: dysphagia--global guidelines and cascades update September 2014.

J Clin Gastroenterol. 2015 May-Jun;49(5):370-8

Authors: Malagelada JR, Bazzoli F, Boeckxstaens G, De Looze D, Fried M, Kahrilas P, Lindberg G, Malfertheiner P, Salis G, Sharma P, Sifrim D, Vakil N, Le Mair A

PMID: 25853874 [PubMed - indexed for MEDLINE]

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From evoked potentials to cortical currents: Resolving V1 and V2 components using retinotopy constrained source estimation without fMRI.

From evoked potentials to cortical currents: Resolving V1 and V2 components using retinotopy constrained source estimation without fMRI.

Hum Brain Mapp. 2016 Feb 12;

Authors: Inverso SA, Goh XL, Henriksson L, Vanni S, James AC

Abstract
Despite evoked potentials' (EP) ubiquity in research and clinical medicine, insights are limited to gross brain dynamics as it remains challenging to map surface potentials to their sources in specific cortical regions. Multiple sources cancellation due to cortical folding and cross-talk obscures close sources, e.g. between visual areas V1 and V2. Recently retinotopic functional magnetic resonance imaging (fMRI) responses were used to constrain source locations to assist separating close sources and to determine cortical current generators. However, an fMRI is largely infeasible for routine EP investigation. We developed a novel method that replaces the fMRI derived retinotopic layout (RL) by an approach where the retinotopy and current estimates are generated from EEG or MEG signals and a standard clinical T1-weighted anatomical MRI. Using the EEG-RL, sources were localized to within 2 mm of the fMRI-RL constrained localized sources. The EEG-RL also produced V1 and V2 current waveforms that closely matched the fMRI-RL's (n = 2) r(1,198)  = 0.99, P < 0.0001. Applying the method to subjects without fMRI (n = 4) demonstrates it generates waveforms that agree closely with the literature. Our advance allows investigators with their current EEG or MEG systems to create a library of brain models tuned to individual subjects' cortical folding in retinotopic maps, and should be applicable to auditory and somatosensory maps. The novel method developed expands EP's ability to study specific brain areas, revitalizing this well-worn technique. Hum Brain Mapp, 2016. © 2016 Wiley Periodicals, Inc.

PMID: 26870938 [PubMed - as supplied by publisher]

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Interaction between visual and motor cortex: a transcranial magnetic stimulation study.

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Interaction between visual and motor cortex: a transcranial magnetic stimulation study.

J Physiol. 2015 May 15;593(10):2365-77

Authors: Strigaro G, Ruge D, Chen JC, Marshall L, Desikan M, Cantello R, Rothwell JC

Abstract
The major link between the visual and motor systems is via the dorsal stream pathways from visual to parietal and frontal areas of the cortex. Although the pathway appears to be indirect, there is evidence that visual input can reach the motor cortex at relatively short latency. To shed some light on its neural basis, we studied the visuomotor interaction using paired transcranial magnetic stimulation (TMS). Motor-evoked potentials (MEPs) were recorded from the right first dorsal interosseous in sixteen healthy volunteers. A conditioning stimulus (CS) was applied over the phosphene hotspot of the visual cortex, followed by a test stimulus over the left primary motor cortex (M1) with a random interstimulus interval (ISI) in range 12-40 ms. The effects of paired stimulation were retested during visual and auditory reaction-time tasks (RT). Finally, we measured the effects of a CS on short-interval intracortical inhibition (SICI). At rest, a CS over the occiput significantly (P < 0.001) suppressed test MEPs with an ISI in the range 18-40 ms. In the visual RT, inhibition with an ISI of 40 ms (but not 18 ms) was replaced by a time-specific facilitation (P < 0.001), whereas, in the auditory RT, the CS no longer had any effect on MEPs. Finally, an occipital CS facilitated SICI with an ISI of 40 ms (P < 0.01). We conclude that it is possible to study separate functional connections from visual to motor cortices using paired-TMS with an ISI in the range 18-40 ms. The connections are inhibitory at rest and possibly mediated by inhibitory interneurones in the motor cortex. The effect with an ISI of 40 ms reverses into facilitation during a visuomotor RT but not an audiomotor RT. This suggests that it plays a role in visuomotor integration.

PMID: 25762215 [PubMed - indexed for MEDLINE]

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Design and Analysis of a Neuromemristive Reservoir Computing Architecture for Biosignal Processing.

Design and Analysis of a Neuromemristive Reservoir Computing Architecture for Biosignal Processing.

Front Neurosci. 2015;9:502

Authors: Kudithipudi D, Saleh Q, Merkel C, Thesing J, Wysocki B

Abstract
Reservoir computing (RC) is gaining traction in several signal processing domains, owing to its non-linear stateful computation, spatiotemporal encoding, and reduced training complexity over recurrent neural networks (RNNs). Previous studies have shown the effectiveness of software-based RCs for a wide spectrum of applications. A parallel body of work indicates that realizing RNN architectures using custom integrated circuits and reconfigurable hardware platforms yields significant improvements in power and latency. In this research, we propose a neuromemristive RC architecture, with doubly twisted toroidal structure, that is validated for biosignal processing applications. We exploit the device mismatch to implement the random weight distributions within the reservoir and propose mixed-signal subthreshold circuits for energy efficiency. A comprehensive analysis is performed to compare the efficiency of the neuromemristive RC architecture in both digital(reconfigurable) and subthreshold mixed-signal realizations. Both Electroencephalogram (EEG) and Electromyogram (EMG) biosignal benchmarks are used for validating the RC designs. The proposed RC architecture demonstrated an accuracy of 90 and 84% for epileptic seizure detection and EMG prosthetic finger control, respectively.

PMID: 26869876 [PubMed]

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Spatial Noise in Coupling Strength and Natural Frequency within a Pacemaker Network; Consequences for Development of Intestinal Motor Patterns According to a Weakly Coupled Phase Oscillator Model.

Spatial Noise in Coupling Strength and Natural Frequency within a Pacemaker Network; Consequences for Development of Intestinal Motor Patterns According to a Weakly Coupled Phase Oscillator Model.

Front Neurosci. 2016;10:19

Authors: Parsons SP, Huizinga JD

Abstract
Pacemaker activities generated by networks of interstitial cells of Cajal (ICC), in conjunction with the enteric nervous system, orchestrate most motor patterns in the gastrointestinal tract. It was our objective to understand the role of network features of ICC associated with the myenteric plexus (ICC-MP) in the shaping of motor patterns of the small intestine. To that end, a model of weakly coupled oscillators (oscillators influence each other's phase but not amplitude) was created with most parameters derived from experimental data. The ICC network is a uniform two dimensional network coupled by gap junctions. All ICC generate pacemaker (slow wave) activity with a frequency gradient in mice from 50/min at the proximal end of the intestine to 40/min at the distal end. Key features of motor patterns, directly related to the underlying pacemaker activity, are frequency steps and dislocations. These were accurately mimicked by reduction of coupling strength at a point in the chain of oscillators. When coupling strength was expressed as a product of gap junction density and conductance, and gap junction density was varied randomly along the chain (i.e., spatial noise) with a long-tailed distribution, plateau steps occurred at pointsof low density. As gap junction conductance was decreased, the number of plateaus increased, mimicking the effect of the gap junction inhibitor carbenoxolone. When spatial noise was added to the natural interval gradient, as gap junction conductance decreased, the number of plateaus increased as before but in addition the phase waves frequently changed direction of apparent propagation, again mimicking the effect of carbenoxolone. In summary, key features of the motor patterns that are governed by pacemaker activity may be a direct consequence of biological noise, specifically spatial noise in gap junction coupling and pacemaker frequency.

PMID: 26869875 [PubMed]

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Memory Efficient PCA Methods for Large Group ICA.

Memory Efficient PCA Methods for Large Group ICA.

Front Neurosci. 2016;10:17

Authors: Rachakonda S, Silva RF, Liu J, Calhoun VD

Abstract
Principal component analysis (PCA) is widely used for data reduction in group independent component analysis (ICA) of fMRI data. Commonly, group-level PCA of temporally concatenated datasets is computed prior to ICA of the group principal components. This work focuses on reducing very high dimensional temporally concatenated datasets into its group PCA space. Existing randomized PCA methods can determine the PCA subspace with minimal memory requirements and, thus, are ideal for solving large PCA problems. Since the number of dataloads is not typically optimized, we extend one of these methods to compute PCA of very large datasets with a minimal number of dataloads. This method is coined multi power iteration (MPOWIT). The key idea behind MPOWIT is to estimate a subspace larger than the desired one, while checking for convergence of only the smaller subset of interest. The number of iterations is reduced considerably (as well as the number of dataloads), accelerating convergence without loss of accuracy. More importantly, in the proposed implementation of MPOWIT, the memory required for successful recovery of the group principal components becomes independent of the number of subjects analyzed. Highly efficient subsampled eigenvalue decomposition techniques are also introduced, furnishing excellent PCA subspace approximations that can be used for intelligent initialization of randomized methods such as MPOWIT. Together, these developments enable efficient estimation of accurate principal components, as we illustrate by solving a 1600-subject group-level PCA of fMRI with standard acquisition parameters, on a regular desktop computer with only 4 GB RAM, in just a few hours. MPOWIT is also highly scalable and could realistically solve group-level PCA of fMRI on thousands of subjects, or more, using standard hardware, limited only by time, not memory. Also, the MPOWIT algorithm is highly parallelizable, which would enable fast, distributed implementations ideal for big data analysis. Implications to other methods such as expectation maximization PCA (EM PCA) are also presented. Based on our results, general recommendations for efficient application of PCA methods are given according to problem size and available computational resources. MPOWIT and all other methods discussed here are implemented and readily available in the open source GIFT software.

PMID: 26869874 [PubMed]

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Structural Brain Network Characteristics Can Differentiate CIS from Early RRMS.

Structural Brain Network Characteristics Can Differentiate CIS from Early RRMS.

Front Neurosci. 2016;10:14

Authors: Muthuraman M, Fleischer V, Kolber P, Luessi F, Zipp F, Groppa S

Abstract
Focal demyelinated lesions, diffuse white matter (WM) damage, and gray matter (GM) atrophy influence directly the disease progression in patients with multiple sclerosis. The aim of this study was to identify specific characteristics of GM and WM structural networks in subjects with clinically isolated syndrome (CIS) in comparison to patients with early relapsing-remitting multiple sclerosis (RRMS). Twenty patients with CIS, 33 with RRMS, and 40 healthy subjects were investigated using 3 T-MRI. Diffusion tensor imaging was applied, together with probabilistic tractography and fractional anisotropy (FA) maps for WM and cortical thickness correlation analysis for GM, to determine the structural connectivity patterns. A network topology analysis with the aid of graph theoretical approaches was used to characterize the network at different community levels (modularity, clustering coefficient, global, and local efficiencies). Finally, we applied support vector machines (SVM) to automatically discriminate the two groups. In comparison to CIS subjects, patients with RRMS were found to have increased modular connectivity and higher local clustering, highlighting increased local processing in both GM and WM. Both groups presented increased modularity and clustering coefficients in comparison to healthy controls. SVM algorithms achieved 97% accuracy using the clustering coefficient as classifier derived from GM and 65% using WM from probabilistic tractography and 67% from modularity of FA maps to differentiate between CIS and RRMS patients. We demonstrate a clear increase of modular and local connectivity in patients with early RRMS in comparison to CIS and healthy subjects. Based only on a single anatomic scan and without a priori information, we developed an automated and investigator-independent paradigm that can accurately discriminate between patients with these clinically similar disease entities, and could thus complement the current dissemination-in-time criteria for clinical diagnosis.

PMID: 26869873 [PubMed]

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Chronic Intermittent Hypoxia Alters Local Respiratory Circuit Function at the Level of the preBötzinger Complex.

Chronic Intermittent Hypoxia Alters Local Respiratory Circuit Function at the Level of the preBötzinger Complex.

Front Neurosci. 2016;10:4

Authors: Garcia AJ, Zanella S, Dashevskiy T, Khan SA, Khuu MA, Prabhakar NR, Ramirez JM

Abstract
Chronic intermittent hypoxia (CIH) is a common state experienced in several breathing disorders, including obstructive sleep apnea (OSA) and apneas of prematurity. Unraveling how CIH affects the CNS, and in turn how the CNS contributes to apneas is perhaps the most challenging task. The preBötzinger complex (preBötC) is a pre-motor respiratory network critical for inspiratory rhythm generation. Here, we test the hypothesis that CIH increases irregular output from the isolated preBötC, which can be mitigated by antioxidant treatment. Electrophysiological recordings from brainstem slices revealed that CIH enhanced burst-to-burst irregularity in period and/or amplitude. Irregularities represented a change in individual fidelity among preBötC neurons, and changed transmission from preBötC to the hypoglossal motor nucleus (XIIn), which resulted in increased transmission failure to XIIn. CIH increased the degree of lipid peroxidation in the preBötC and treatment with the antioxidant, 5,10,15,20-Tetrakis (1-methylpyridinium-4-yl)-21H,23H-porphyrin manganese(III) pentachloride (MnTMPyP), reduced CIH-mediated irregularities on the network rhythm and improved transmission of preBötC to the XIIn. These findings suggest that CIH promotes a pro-oxidant state that destabilizes rhythmogenesis originating from the preBötC and changes the local rhythm generating circuit which in turn, can lead to intermittent transmission failure to the XIIn. We propose that these CIH-mediated effects represent a part of the central mechanism that may perpetuate apneas and respiratory instability, which are hallmark traits in several dysautonomic conditions.

PMID: 26869872 [PubMed]

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speech and language; +26 new citations

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

speech and language

These pubmed results were generated on 2016/02/13

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

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Fla. bill would increase benefits for fallen first responders' families

Associated Press

TALLAHASSEE, Fla. — The families of law enforcement officers and other first responders killed on duty would receive increased benefits under a bill unanimously passed by the Florida Senate.

The vote Wednesday would provide 100 percent pension benefits to surviving families. Right now, the benefit for surviving spouses of first responders killed on duty is 50 percent of the deceased's salary.

The bill (SB 7012) also protects families if the deceased opted for an investment retirement plan instead of paying into the state pension plan.

The bill was inspired by the death of Orange County Deputy Scott Pine, who was fatally shot by a burglary suspect in 2014, less than three years after joining the department. His death left his widow and three children ineligible for benefits under the state pension plan. The bill would give them full benefits.

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Electrical pharyngeal stimulation increases substance P level in saliva.

Electrical pharyngeal stimulation increases substance P level in saliva.

Neurogastroenterol Motil. 2016 Feb 12;

Authors: Suntrup-Krueger S, Bittner S, Recker S, Meuth SG, Warnecke T, Suttrup I, Marian T, Dziewas R

Abstract
BACKGROUND: Substance P (SP) is a neuropeptide known to enhance the swallow response. It likely acts as a neurotransmitter in the pharyngeal mucosa in response to local stimuli. It has been proposed that dysphagia after stroke may be related to reduced levels of SP, which therefore constitutes a therapeutic target. In the present pilot study, we evaluated whether electrical pharyngeal stimulation (EPS), a neuromodulation device to enhance cortical reorganization for the restoration of swallowing function after brain injury, is able to increase SP in saliva or serum.
METHODS: In a randomized crossover study design, 20 healthy volunteers were treated with 10 min of real (0.2-ms pulses, 5 Hz, 280 V, stimulation intensity (mA) individually adjusted to tolerance level) or sham EPS on two separate sessions. Stimulation was delivered via a pair of bipolar ring electrodes mounted on an intraluminal catheter positioned in the pharynx. Blood and saliva samples were taken prior to, during, and up to 1 h after EPS and analyzed for their SP concentration by ELISA.
KEY RESULTS: Following real EPS but not sham stimulation, SP levels in saliva increased immediately and significantly about 28% (p < 0.01) compared to baseline. Serum levels remained unchanged.
CONCLUSIONS & INFERENCES: Electrical pharyngeal stimulation is able to induce pharyngeal SP release in healthy subjects.

PMID: 26871730 [PubMed - as supplied by publisher]

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Cyclical hypofractionated radiotherapy technique for palliative treatment of locally advanced head and neck cancer: institutional experience and review of palliative regimens.

Cyclical hypofractionated radiotherapy technique for palliative treatment of locally advanced head and neck cancer: institutional experience and review of palliative regimens.

J Community Support Oncol. 2016 Jan;14(1):29-36

Authors: Finnegan TS, Bhatt NH, Shaughnessy JN, Perez C, Redman R, Silverman C, Bumpous J, Potts K, Dunlap NE

Abstract
BACKGROUND: Effective palliation in patients with locally advanced head and neck cancer is important. Cyclical hypofractionated radiotherapy (Quad Shot) is a short-course palliative regimen with good patient compliance, low rates of acute toxicity, and delayed late fibrosis.
OBJECTIVE: To review use of the Quad Shot technique at our institution in order to quantify the palliative response in locally advanced head and neck cancer.
METHODS: The medical records of 70 patients with head and neck squamous cell carcinoma who had been treated with the Quad Shot technique were analyzed retrospectively (36 had been treated with intensity-modulated radiation therapy and 34 with 3-D conformal radiotherapy). They had received cyclical hypofractionated radiotherapy administrated as 14.8 Gy in 4 fractions over 2 days, twice daily, repeated every 3 weeks for a total of 3 cycles. The total prescribed dose was 44.4 Gy. Primary endpoints were improvement in pain using a verbal numeric pain rating scale (range 1-10, 10 being severe pain) and dysphagia using the Food Intake Level Scale, and the secondary endpoints included overall survival (OS), local regional recurrence-free survival (LRRFS), progression-free survival (PFS) and time to progression.
RESULTS: Pain response occurred in 61% of the patients. The mean pain scores decreased significantly from pre to post treatment (5.81 to 2.55, 𝑃 = .009). The mean initial dysphagia score improved from 2.20 to 4.77 55 (𝑃 = .045). 26% of patients developed mucositis (≤ grade 2), with 9% developing grade 3-level mucositis. 12 patients had tumor recurrence. The estimated 1-year PFS was 20.7%. The median survival was 3.85 months with an estimated 1-year OS of 22.6%. Pain response (hazard ratio [HR], 2.69; 95% confidence index [CI], I.552-1.77) and completion of all 3 cycles (HR, 1.71; 95% CI, 1.003-2.907) were predictive for improved OS.
LIMITATIONS: This study is a retrospective analysis.
CONCLUSION: Quad Shot is an appropriate palliative regimen for locally advanced head and neck cancer.

PMID: 26870840 [PubMed - in process]

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Epiglottic diffuse B-cell malignant lymphoma: A case report.

Epiglottic diffuse B-cell malignant lymphoma: A case report.

Mol Clin Oncol. 2016 Jan;4(1):58-60

Authors: Chang HM, Li CC, Tsai SC, Tsao TY

Abstract
A 55-year-old male patient was admitted to our department with complaints of dysphagia and throat soreness for 2 months. A tumor of the left epiglottis, with an irregular surface, was identified by video laryngoscopy. The diagnosis of malignant lymphoma was confirmed by biopsy during laryngomicrosurgery. The atypical diffuse lymphocytic lymphoma was positive for CD20 and Bcl-2, and negative for CD3, CD10 and Bcl-1. The diagnosis was diffuse large B-cell malignant lymphoma. The patient was treated with eight cycles of rituximab with cyclophosphamide + doxorubicin + vincristine + prednisolone (R-CHOP regimen). This is a rare case of extranodal non-Hodgkin lymphoma occurring in the epiglottis.

PMID: 26870358 [PubMed - as supplied by publisher]

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Dysphagia and aspiration as the only manifestations of a stroke.

Dysphagia and aspiration as the only manifestations of a stroke.

BMJ Case Rep. 2016;2016

Authors: García Carretero R, Romero Brugera M, Rebollo-Aparicio N, Rodeles-Melero J

Abstract
A 56-year-old patient was admitted to our hospital, presenting with dysphagia as the only symptom. He was very concerned about this difficulty in swallowing. Diseases of the upper digestive tract were suspected, but further investigations revealed a neurological disorder. He had suffered a brain stem stroke and, as a consequence, developed an aspiration pneumonia. What seemed a digestive disorder was indeed a brain stem stroke, therefore we had to deal with the diverse impacts of this condition.

PMID: 26869627 [PubMed - in process]

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Preliminary Evaluation of Functional Swallow After Total Laryngectomy Using High-Resolution Manometry.

Preliminary Evaluation of Functional Swallow After Total Laryngectomy Using High-Resolution Manometry.

Ann Otol Rhinol Laryngol. 2016 Feb 11;

Authors: Lippert D, Hoffman MR, Britt CJ, Jones CA, Hernandez J, Ciucci MR, McCulloch TM

Abstract
INTRODUCTION: Understanding of swallowing pressures after total laryngectomy (TL) and what constitutes a "functional" swallow are limited. Mobile structures are altered or removed after TL, with consequent effects on pressure profiles. High-resolution manometry (HRM) can characterize these pressures.
METHODS: Six TL subjects without dysphagia and 6 controls underwent pharyngeal HRM. Timing and pressure variables for the velopharynx, mesopharynx, and upper esophageal sphincter (UES) were compared. Changes in variables due to bolus volume were evaluated in TL subjects.
RESULTS: The TL subjects had increased duration of velopharyngeal pressure (P = .012). Maximum mesopharyngeal pressure was lower versus controls (P = .003). Maximal and total pre-opening (P = .002, P = .002) and post-closure (P = .001, P = .002) UES pressures were lower. Maximum mesopharyngeal pressure (P = .032) decreased with increasing bolus volume.
CONCLUSIONS: Increased velopharyngeal pressure duration and total swallow duration reflect separation of the pharynx into distinct conduits for air and food, thus ensuring successful bolus passage without the need for respiration. Decreased UES pressure highlights the effects of disrupting the cricopharyngeal and rostral esophageal muscle fibers from their attachments to the larynx and performing a cricopharyngeal myotomy. Additional studies including subjects with dysphagia could further characterize the functional TL swallow and identify aspects susceptible to dysfunction.

PMID: 26868604 [PubMed - as supplied by publisher]

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Comparison of stand-alone anchored spacer versus plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis: a preliminary investigation.

Comparison of stand-alone anchored spacer versus plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis: a preliminary investigation.

World Neurosurg. 2016 Feb 9;

Authors: Shi S, Zheng S, Li XF, Yang LL, Liu ZD, Yuan W

Abstract
OBJECTIVE: The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proved to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study is to compare the clinical outcomes, radiologic results of SAAS and plate-cage construct (PCC) in the treatment of 2 noncontiguous levels of cervical spondylosis.
METHODS: A total of 65 patients with 2 noncontiguous levels of cervical spondylosis were included in the retrospective review of prospective collected data. The clinical and radiologic outcomes were assessed using Japanese Orthopaedic Association score, Neck Disability Index, cervical alignment (CA), and range of motion (ROM) and disc height (DH) of intermediate segment (IS), respectively. All the aforementioned parameters were compared before and after surgery in the respective group, which were also compared between the two groups. Besides, the complications were also recorded. Correlations between the surgical outcome and various factors were also analyzed.
RESULTS: No significant differences existed in clinical results between the two groups (p>0.05). Additionally, no statistical significance were observed in fusion rate, CA, ROM and DH of IS, dysphagia and hoarseness (p>0.05). Preoperative JOA score and high-intensity signal in T2WI were important predictors for surgical outcome.
CONCLUSIONS: Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS.

PMID: 26868426 [PubMed - as supplied by publisher]

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Botulinum Toxin Treatment of Cervical Dystonia.

Related Articles

Botulinum Toxin Treatment of Cervical Dystonia.

Semin Neurol. 2016 Feb;36(1):47-53

Authors: Bledsoe IO, Comella CL

Abstract
The use of botulinum toxin for the treatment of cervical dystonia (CD) was first reported in 1985. Since then, four commercially available formulations have been approved by the U.S. Food and Drug Administration for use in CD, including three botulinum toxin A formulations and one botulinum toxin B formulation. Recent clinical trials have generally demonstrated good efficacy and tolerability. Commonly reported side effects include dysphagia, muscle weakness, and dry mouth. Secondary nonresponse may develop, but the relationship of detected antibodies to clinical responsiveness remains unclear. Further research is needed into the treatment of complex subtypes of CD and the potential use of alternate botulinum toxin serotypes or subtypes with less immunogenic profiles.

PMID: 26866496 [PubMed - in process]

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Laparoscopic approach in the treatment of large epiphrenic esophageal diverticulum.

Related Articles

Laparoscopic approach in the treatment of large epiphrenic esophageal diverticulum.

Wideochir Inne Tech Maloinwazyjne. 2016 Jan;10(4):584-8

Authors: Beiša V, Kvietkauskas M, Beiša A, Strupas K

Abstract
Epiphrenic diverticulum of the lower third of the esophagus is a relatively rare disorder. We present the case of a large, 7.5 cm diameter esophageal epiphrenic diverticulum treated by the laparoscopic approach. Surgery was indicated by the severity of the patient's symptoms and size of the diverticulum. A laparoscopic transhiatal diverticulectomy with a myotomy and Dor fundoplication was carried out. The overall operative time was 180 min. The patient tolerated the surgery well and was discharged from hospital 4 days after the surgery. From the 10(th) postoperative day the patient resumed a regular diet. Four weeks after the operation the patient had no complaints, symptoms of dysphagia or vomiting. The laparoscopic approach in the treatment of a large, 7.5 cm epiphrenic diverticulum of the esophagus is feasible, safe and well tolerated by the patient.

PMID: 26865897 [PubMed]

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Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: A systematic review.

Related Articles

Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: A systematic review.

Laryngoscope. 2016 Feb 10;

Authors: Kao SS, Peters MD, Krishnan SG, Ooi EH

Abstract
OBJECTIVES/HYPOTHESIS: Dysphagia is still a treatment-related morbidity, despite advances in treatment modalities for oral and oropharyngeal squamous cell carcinoma. This systematic review aimed to analyze the effects of swallowing outcomes of patients with oral or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction, with or without adjuvant therapy, for patients undergoing treatment with curative intent.
STUDY DESIGN: A comprehensive search strategy was undertaken across MEDLINE, CINAHL, Embase, and Scopus. Gray literature was sought through Cochrane Central Register of Controlled Trials, MedNar, and ProQuest.
METHODS: Studies included patients with oral cavity or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction. Swallowing function was the primary outcome, evaluated at 6 months or later following surgery. Methodological quality and data extraction was conducted as per the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and standardized data extraction tool.
RESULTS: Fifteen articles comprising eight cohort studies and seven case series were included. Postoperative radiotherapy and oropharyngeal resections were demonstrated to be associated with increased dysphagia.
CONCLUSION: Advanced tumor-node-metastasis stage and use of adjuvant radiotherapy has been shown to have negative impacts on swallowing function. The majority of patients were able to have gastrostomy tubes removed at 6 months following curative therapy. Larger flap mass for the reconstruction of oral and oropharyngeal defects appeared to improve swallowing outcomes. A protocol for the identification of patients at high and low risk of developing dysphagia is proposed.
LEVEL OF EVIDENCE: N/A. Laryngoscope, 2016.

PMID: 26865034 [PubMed - as supplied by publisher]

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Association of oesophageal radiation dose volume metrics, neutropenia and acute radiation oesophagitis in patients receiving chemoradiotherapy for non-small cell lung cancer.

Related Articles

Association of oesophageal radiation dose volume metrics, neutropenia and acute radiation oesophagitis in patients receiving chemoradiotherapy for non-small cell lung cancer.

Radiat Oncol. 2016;11(1):20

Authors: Everitt S, Duffy M, Bressel M, McInnes B, Russell C, Sevitt T, Ball D

Abstract
INTRODUCTION: The relationship between oesophageal radiation dose volume metrics and dysphagia in patients having chemoradiation (CRT) for non-small cell lung cancer (NSCLC) is well established. There is also some evidence that neutropenia is a factor contributing to the severity of oesophagitis. We retrospectively analysed acute radiation oesophagitis (ARO) rates and severity in patients with NSCLC who received concurrent chemotherapy and high dose radiation therapy (CRT). We investigated if there was an association between grade of ARO, neutropenia and radiation dose volume metrics.
MATERIAL AND METHODS: Patients with NSCLC having concurrent CRT who had RT dose and toxicity data available were eligible. Exclusion criteria included previous thoracic RT, treatment interruptions and non-standard dose regimens. RT dosimetrics included maximum and mean oesophageal dose, oesophagus dose volume and length data.
RESULTS: Fifty four patients were eligible for analysis. 42 (78 %) patients received 60 Gy. Forty four (81 %) patients received carboplatin based chemotherapy. Forty eight (89 %) patients experienced ARO ≥ grade 1 (95 % CI: 78 % to 95 %). ARO grade was associated with mean dose (rs = 0.27, p = 0.049), V20 (rs = 0.31, p = 0.024) and whole oesophageal circumference receiving 20 Gy (rs = 0.32 p = 0.019). In patients who received these doses, V20 (n = 51, rs = 0.36, p = 0.011), V35 (n = 43, rs = 0.34, p = 0.027) and V60 (n = 25, rs = 0.59, P = 0.002) were associated with RO grade. Eleven of 25 (44 %) patients with ARO ≥ grade 2 also had ≥ grade 2 acute neutropenia compared with 5 of 29 (17 %) patients with RO grade 0 or 1 (p = 0.035).
CONCLUSION: In addition to oesophageal dose-volume metrics, neutropenia may also be a risk factor for higher grades of ARO.

PMID: 26864559 [PubMed - in process]

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[ACTIVITY OF LIPOPEROXIDATION AND STATE OF ANTIOXYDANT SYSTEM AT THE PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE ON BACKGROUND OF CHRONIC OBSTRUCTIVE LUNG DISEASE].

Related Articles

[ACTIVITY OF LIPOPEROXIDATION AND STATE OF ANTIOXYDANT SYSTEM AT THE PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE ON BACKGROUND OF CHRONIC OBSTRUCTIVE LUNG DISEASE].

Lik Sprava. 2015 Apr-Jun;(3-4):52-7

Authors: Ermolenko AV, Sotskaya YA

Abstract
At the patients with gastroesophageal reflux disease on background of chronic obstructive lung disease before treatment was detected the increase products of lipids peroxidation (LPO) such as malon dialdegide (MDA), dien's conjugates (DC) in the serum blood. The decline of enzymes activity of the antioxydant system (AOS)--catalase (CT) and superoxiddismutase (SOD) was marked. At treatment the generally accepted facilities was marked decline of MDA, DK and KT and SOD activity. But their level was differed from a norm. It testifies to the maintainance of disbalance of LPO-AOS and expedience of preparations with antioxydant activity application.

PMID: 26827439 [PubMed - indexed for MEDLINE]

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[Dysphonia as a symptom of a radiation of the neck].

Related Articles

[Dysphonia as a symptom of a radiation of the neck].

Laryngorhinootologie. 2014 Dec;93(12):859-60

Authors: Reiter R, Pickhard A, Hoffmann TK, Brosch S

PMID: 25098719 [PubMed - indexed for MEDLINE]

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3-D imaging mass spectrometry of protein distributions in mouse Neurofibromatosis 1 (NF1)-associated optic glioma

Publication date: Available online 13 February 2016
Source:Journal of Proteomics
Author(s): David M.G. Anderson, Raf Van de Plas, Kristie L. Rose, Salisha Hill, Kevin L. Schey, Anne C. Solga, David H. Gutmann, Richard M. Caprioli
Neurofibromatosis type 1 (NF1) is a common neurogenetic disorder, in which affected individuals develop tumors of the nervous system. Children with NF1 are particularly prone to brain tumors (gliomas) involving the optic pathway that can result in impaired vision. Since tumor formation and expansion requires a cooperative tumor microenvironment, it is important to identify the cellular and acellular components associated with glioma development and growth. In this study, we used 3-D matrix assisted laser desorption ionization imaging mass spectrometry (MALDI IMS) to measure the distributions of multiple molecular species throughout optic nerve tissue in mice with and without glioma, and to explore their spatial relationships within the 3-D volume of the optic nerve and chiasm. 3-D IMS studies often involve extensive workflows due to the high volume of sections required to generate high quality 3-D images. Herein, we present a workflow for 3-D data acquisition and volume reconstruction using mouse optic nerve tissue. The resulting 3-D IMS data yield both molecular similarities and differences between glioma-bearing and wild-type (WT) tissues, including protein distributions localizing to different anatomical subregions.Biological significanceThe current work addresses a number of challenges in 3-D MALDI IMS, driven by the small size of the mouse optic nerve and the need to maintain consistency across multiple 2-D IMS experiments. The 3-D IMS data yield both molecular similarities and differences between glioma-bearing and wild-type (WT) tissues, including protein distributions localizing to different anatomical subregions, which could then be targeted for identification and related back to the biology observed in gliomas of the optic nerve from this model.



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Integrative characterization of the venom of the coral snake Micrurus dumerilii (Elapidae) from Colombia: Proteome, toxicity, and cross-neutralization by antivenom

Publication date: Available online 12 February 2016
Source:Journal of Proteomics
Author(s): Paola Rey-Suárez, Vitelbina Núñez, Julián Fernández, Bruno Lomonte
In Colombia, nearly 2.8% of the 4200 snakebite accidents recorded annually are inflicted by coral snakes (genus Micrurus). Micrurus dumerilii has a broad distribution in this country, especially in densely populated areas. The proteomic profile of its venom was here studied by a bottom-up approach combining RP-HPLC, SDS-PAGE and MALDI-TOF/TOF. Venom proteins were assigned to eleven families, the most abundant being phospholipases A2 (PLA2; 52.0%) and three-finger toxins (3FTx; 28.1%). This compositional profile shows that M. dumerilii venom belongs to the 'PLA2-rich' phenotype, in the recently proposed dichotomy for Micrurus venoms. Enzymatic and toxic venom activities correlated with protein family abundances. Whole venom induced a conspicuous myotoxic, cytotoxic and anticoagulant effect, and was mildly edematogenic and proteolytic, whereas it lacked hemorrhagic activity. Some 3FTxs and PLA2s reproduced the lethal effect of venom. A coral snake antivenom to Micrurus nigrocinctus demonstrated significant cross-recognition of M. dumerilii venom proteins, and accordingly, ability to neutralize its lethal effect. The combined compositional, functional, and immunological data here reported for M. dumerilii venom may contribute to a better understanding of these envenomings, and support the possible use of anti-M. nigrocinctus coral snake antivenom in their treatment.Biological significanceCoral snakes represent a highly diversified group of elapids in the New World, with nearly 70 species within the genus Micrurus. Owing to their scarce yields, the biochemical composition and toxic activities of coral snake venoms have been less well characterized than those of viperid species. In this work, an integrative view of the venom of M.dumerilii, a medically relevant coral snake from Colombia, was obtained by a combined proteomic, functional, and immunological approach. The venom contains proteins from at least eleven families, with a predominance of phospholipases A2 (PLA2), followed by three-finger toxins (3FTx). According to its compositional profile, M. dumerilii venom can be grouped with those of several Micrurus species from North and Central America that present a PLA2-predominant phenotype, to date it is the most southerly coral snake species to do so. Other coral snake species that a 'PLA2-rich' venom, M. dumerilii venom contains both components that form MitTx, a pain-inducing heterodimeric complex recently characterized from the venom of Micrurus tener, also present in Micrurus mosquitensis and M. nigrocinctus venoms. In addition to a lethal three-finger toxin, PLA2s participate in the toxicity of M. dumerilii venom, some of them displaying ability to induce cytolysis, muscle necrosis, and lethality to mice. An antivenom to M. nigrocinctus demonstrated significant cross-recognition of M. dumerilii venom proteins, and accordingly, ability to neutralize its lethal effect, being of potential therapeutic usefulness in these envenomings.

Graphical abstract

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Future Oncology; +44 new citations

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

Future Oncology

These pubmed results were generated on 2016/02/13

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

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Field Evaluations of Tracking/Locating Technologies for Prevention of Missing Incidents.

Field Evaluations of Tracking/Locating Technologies for Prevention of Missing Incidents.

Am J Alzheimers Dis Other Demen. 2016 Feb 11;

Authors: Bulat T, Kerrigan MV, Rowe M, Kearns W, Craighead JD, Ramaiah P

Abstract
BACKGROUND: Persons with dementia are at risk of a missing incident, which is defined as an instance in which a demented person's whereabouts are unknown to the caregiver and the individual is not in an expected location. Since it is critical to determine the missing person's location as quickly as possible, we evaluated whether commercially available tracking technologies can assist in a rapid recovery.
METHODS: This study examined 7 commercially available tracking devices: 3 radio frequency (RF) based and 4 global positioning system (GPS) based, employing realistic tracking scenarios. Outcome measures were time to discovery and degree of deviation from a straight intercept course.
RESULTS/CONCLUSION: Across all scenarios tested, GPS devices were found to be approximately twice as efficient as the RF devices in locating a "missing person." While the RF devices showed reasonable performance at close proximity, the GPS devices were found to be more appropriate overall for tracking/locating missing persons over unknown and larger distances.

PMID: 26868299 [PubMed - as supplied by publisher]

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Adipose Tissue Hypoxia, Inflammation and Fibrosis in Obese Insulin Sensitive and Obese Insulin Resistant Subjects.

Adipose Tissue Hypoxia, Inflammation and Fibrosis in Obese Insulin Sensitive and Obese Insulin Resistant Subjects.

J Clin Endocrinol Metab. 2016 Feb 12;:jc20154125

Authors: Lawler HM, Underkofler CM, Kern PA, Erickson C, Bredbeck B, Rasouli N

Abstract
CONTEXT: A substantial number of obese individuals are relatively insulin sensitive and the etiology for this variation remains unknown.
OBJECTIVE: The primary objective was to detect factors in adipose tissue differentiating obese insulin sensitive (OBIS) from obese insulin resistant (OBIR) individuals and investigate whether adipose tissue hypoxia is a contributing factor in the pathogenesis of insulin resistance.
DESIGN AND SETTING: This was a cross sectional study in general community.
PARTICIPANTS: Subjects consisted of non-diabetic OBIS and OBIR subjects with similar BMI, age, and total body fat but different insulin sensitivity index as well as lean insulin sensitive subjects.
INTERVENTION(S): None Main Outcome Measure(s): We examined adipocytokines and the expression of candidate genes regulating hypoxia, inflammation, and lipogenesis in adipose tissue and adipose tissue oxygenation.
RESULTS: OBIS subjects had increased plasma adiponectin but similar plasma TNFα and leptin levels as compared to OBIR subjects. Genes regulating inflammation (CD68, MCP1, scavenger receptor A, and oxidized LDL receptor 1) were increased by 40-60% (p<0.05) in OBIR vs. OBIS cohorts. In addition, genes involved in extracellular matrix formation such as collagen VI and MMP7 were upregulated by 43% and 78% (p<0.05), respectively, in OBIR vs. OBIS. The expression of HIF1α and VEGF gene expression were increased by 37% and 52%, respectively, in OBIR vs. OBIS (p< 0.01). Despite the differential expression in hypoxia related genes, adipose tissue oxygenation measured by a Licox oxygen probe was not different between OBIS and OBIR subjects but it was higher in lean subjects as compared to obese subjects.
CONCLUSIONS: We confirmed that adipose tissue inflammation and fibrosis play an important role in the pathogenesis of insulin resistance independent of obesity in humans. Whether hypoxia is simply a consequence of adipose tissue expansion or is related to the pathogenesis of obesity induced insulin resistance is yet to be understood.

PMID: 26871994 [PubMed - as supplied by publisher]

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Clinical relationship between IgG4-positive Hashimoto's thyroiditis and papillary thyroid carcinoma.

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Clinical relationship between IgG4-positive Hashimoto's thyroiditis and papillary thyroid carcinoma.

J Clin Endocrinol Metab. 2016 Feb 11;:jc20153783

Authors: Yu Y, Zhang J, Lu G, Li T, Zhang Y, Yu N, Gao Y, Gao Y, Guo X

Abstract
CONTEXT: Hashimoto's thyroiditis (HT) can be divided into IgG4-positive and IgG4-negative HT. The potential association between IgG4-positive HT and papillary thyroid carcinoma (PTC) remains poorly understood.
OBJECTIVE: The aim was to investigate the relationship between IgG4-positive HT and PTC, and to compare the prognostic parameters of PTC patients with and without IgG4-positive HT.
DESIGN: A retrospective study.
PATIENTS AND SETTING: 66 HT patients (18 HT alone, 48 HT with PTC) with serum samples stored before operation were collected. Another 18 PTC alone patients were collected as controls.
MAIN OUTCOME MEASURES: Expression of IgG4, IgG and TGF-β1 in thyroid tissues, serum levels of IgG4, TgAb IgG, TgAb IgG4, TPOAb IgG, and TPOAb IgG4.
RESULTS: 17 (35.4%) HT with PTC patients were IgG4-positive HT, while only one patient (5.6%) was found to be IgG4-positive in HT alone group. In contrast, there were only few IgG4-positive plasma cells in PTC alone group. The association of IgG4-positive HT and PTC was statistically significant (P < 0.05). Moreover, serum levels of TgAb IgG4 and the ratios of TgAb IgG4/TgAb IgG were significantly higher in HT with PTC and PTC alone groups than in the HT alone group (P < 0.05). Furthermore, in the HT with PTC group, the average tumor diameter of 17 IgG4-positive HT with PTC patients was 1.7 ± 0.8 cm while of 31 IgG4-negative HT with PTC patients the diameter was 1.2 ± 0.6 cm (P = 0.01). A considerably higher percentage of lymph node metastasis (41.2% vs. 12.9%; P = 0.026) was found in PTC patients with IgG4-positive HT as compared to those with IgG4-negative HT.
CONCLUSION: PTC may be facilitated by pre-existing autoimmune inflammation of IgG4-positive HT. IgG4-positive HT with PTC cases may have worse clinical outcomes. The high levels of TgAb IgG4 might present a risk factor for PTC.

PMID: 26866571 [PubMed - as supplied by publisher]

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Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: A case-control study

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Paolo Scolozzi, Alexandre Perez, Raul Verdeja, Delphine S. Courvoisier, Tommaso Lombardi
ObjectiveTo evaluate the association between the development of a fungus ball (FB) of the maxillary sinus and sinus bone graft.Study DesignThe charts of all patients seen for surgical treatment of a maxillary sinus FB following sinus bone grafting between 2006 and 2014 were reviewed. The charts of 49 participants were selected from our internal registry for comparison as controls. The association between FB and age, gender, smoking habits, associated co-morbidities and bone grafting material was evaluated. A FB of the maxillary sinus was estimated using an odds ratio with a Yates' correction. P-values were computed using Fisher's exact test and the statistical significance was set at a p-value < 0.05.ResultsAll 13 cases (100%) with a FB of the maxillary sinus had received anorganic bovine bone as the bone substitute (p= 0.0001). There were significantly more women in the case group than in the control group (84.6% in the cases vs. 40.8% in the controls; p=0.01).ConclusionThis study demonstrated a significant association between a specific deproteinized bovine bone substitute use as sinus bone graft material and subsequent development of FB of the maxillary sinus.



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HLA genetic discrepancy between latent autoimmune diabetes in adults and type 1 diabetes: LADA China Study 6.

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HLA genetic discrepancy between latent autoimmune diabetes in adults and type 1 diabetes: LADA China Study 6.

J Clin Endocrinol Metab. 2016 Feb 11;:jc20153771

Authors: Luo S, Lin J, Xie Z, Xiang Y, Zheng P, Huang G, Li X, Liao Y, Hagopian WA, Wang CY, Zhou Z

Abstract
CONTEXT: The discrepancies in terms of HLA-DRB1-DQA1-DQB1 conferred risks between latent autoimmune diabetes in adults (LADA) and type 1 diabetes (T1D) patients remained almost completely unknown. The goal of current study is to determine and compare HLA conferred risks between LADA and T1D.
DESIGN: A case-control study was conducted in a representative Chinese dataset containing 520 T1D patients, 562 LADA patients, and 1065 controls. The frequencies and odds ratios for HLA susceptible haplotypes and genotypes, and for arginine at residue 52 (Arg52) in DQ alpha chain or aspartic acid at residue 57 (Asp57) in DQ beta chain, were analyzed.
RESULTS: DRB1*0405-DQA1*03-DQB1*0401 and DRB1*0901-DQA1*03- DQB1*0303 are the major LADA susceptible haplotypes, which also confer comparable risks for T1D (OR: 2.02 vs. 2.20; 1.61 vs. 2.30, respectively). The strongly-associated T1D haplotype DRB1*0301-DQA1*05-DQB1*0201 is also associated with LADA, but only confer half of the T1D risk (OR: 2.65 vs. 4.84). Interestingly, the most susceptible T1D haplotypes DRB1*0901-DQA1*05-DQB1*0201, DRB1*0301-DQA1*03-DQB1*0201 and DRB1*0301-DQA1*03-DQB1*0303 are not associated with LADA. Genotypes for DR3/DR3, DR3/DR9 and DR9/DR9 are highly associated with T1D susceptibility, while only DR9/DR9 confers risk for LADA. DR3/DR3 is the high-risk genotype in Chinese T1D patients, which manifests similar risk as the DR3/DR4 genotype in Caucasians but with a lower frequency. DR9/DR9 is the high risk LADA genotype in Chinese. Alleles with DQ alpha Arg52-positive, DQ beta Asp57-negative and their combination formed in cis or trans confer susceptibility to T1D but not to LADA.
CONCLUSION: Our results suggest that LADA risk conferred by HLA-DRB1-DQA1-DQB1 loci in Chinese differs significantly from that of T1D risk. This information would be useful for classifying Asian LADA patients, which should provides novel insight into the understanding of its pathoetiology as well.

PMID: 26866570 [PubMed - as supplied by publisher]

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Editorial: guidelines for oral and maxillofacial radiology.

Editorial: guidelines for oral and maxillofacial radiology.

Dentomaxillofac Radiol. 2016 Feb 12;:20160034

Authors: Schulze RK

PMID: 26869401 [PubMed - as supplied by publisher]

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A Clinical Comparison of Extraoral Panoramic and Intraoral Radiographic Modalities for Detecting Proximal Caries and Opening Posterior Interproximal Contacts.

A Clinical Comparison of Extraoral Panoramic and Intraoral Radiographic Modalities for Detecting Proximal Caries and Opening Posterior Interproximal Contacts.

Dentomaxillofac Radiol. 2016 Feb 12;:20150159

Authors: Terry GL, Noujeim M, Langlais RP, Moore WS, Prihoda TJ

Abstract
OBJECTIVES: The purpose of this study was to compare extraoral panoramic bitewings (BWs) to intraoral photostimulable phosphor (PSP) plate BWs for the detection of proximal surface caries and to establish if there was any difference between extraoral BWs, intraoral BWs and panoramic radiographs in opening posterior interproximal contacts.
METHODS: Extraoral panoramic and intraoral BW images were acquired on each of 20 patients, resulting in 489 total non-restored, readable surfaces that were evaluated by 4 observers. The ANOVA analysis to determine diagnostic variability between and within each subject was utilized. The surfaces included in the study extended from the distal of the canine(s) to the last posterior contact in the arch being assessed with non-readable proximal surfaces excluded surfaces where over half the enamel layer was overlapped or where those surfaces were not visible in one or both modalities.
RESULTS: The statistical analysis indicated the overall mean area under the ROC curves across all observers for the intraoral BWs and extraoral panoramic BWs were 0.832 and 0.827 respectively and the difference of 0.005 was not significant at p=0.7781. The percentage of non-readable proximal surfaces across the three modalities was 4.1% for intraoral bite-wings, 18.3% for extraoral panoramic bitewings and 51.5% for the standard panoramic images.
CONCLUSIONS: The investigators concluded there was no significant difference in posterior proximal surface caries detection between the modalities. Extraoral panoramic BWs were much better than panoramic radiographs in opening posterior interproximal contacts, 81.7% versus 48.5%, but below the 95.9% value for intraoral BWs.

PMID: 26869221 [PubMed - as supplied by publisher]

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Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jaana Helenius-Hietala, Fredrik Åberg, Jukka H. Meurman, Arno Nordin, Helena Isoniemi
ObjectiveUntreated dental infections pose a threat for immunocompromised liver transplant (LT) recipients. Therefore, pretransplant dental evaluations are recommended. However, risk of bleeding should be considered among patients with end-stage liver disease and prophylactic blood transfusions may be used to prevent bleeding. We retrospectively studied the incidence of and risk factors for oral surgery-related bleeding in candidates for LT and hypothesized that complications may occur despite pre- and peri-operative hemostatic actions.Study DesignOne hundred thirty four patients who had tooth extractions by oral and maxillofacial surgeons pre-LT were studied. The primary endpoint was bleeding between 24 h and 2 weeks post-extraction. Bleeding risk was analyzed by pre-operative platelet (PLT) count and INR. Invasiveness of procedures, severity of liver disease, PLT, INR, prophylactic transfusions of PLT, fresh frozen plasma, and tranexamic acid (TA) were included in uni- and multivariate logistic regression analysis to further assess risk.ResultsTwelve patients exhibited minor bleeding; four despite PLT>100×10⁹/L and INR<1.5. Increased bleeding associated with INR and prophylactic transfusions by univariate analysis; by multivariate analyses, prophylactic TA (OR=8.0, 95%CI 1.7-37.0) and PLT (OR=8.3, 95%CI 1.1-62.7) remained significant.ConclusionMost extractions were safe, but prophylactic transfusions did not ensure adequate hemostasis. Local hemostatic measures and close follow-up are warranted.



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The Use of Immunohistochemistry in Detection of Perineural Invasion in Mucoepidermoid Carcinoma

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Emily Lanzel, Robert A. Robinson, M.B. Zimmerman, Ali Pourian, John W. Hellstein
ObjectivesTo retrospectively study the prevalence of perineural invasion (PNI) in cases of mucoepidermoid carcinoma (MEC). The study evaluated if previously assessed PNI by original pathology reports would be increased by re-review of the originally hematoxylin-eosin-stained (H&E) slides as well as review of slides reacted immunohistochemically with S100 to enhance nerve visualization and whether is associated with clinical outcome.Study DesignThirty-one cases were reviewed for PNI with H&E stained slides as well as S-100 reacted slides. These results were compared to the original pathology report's PNI status when available (13/31). Subject demographics and clinical outcome were collected from electronic medical records.ResultsPNI was identified in 23% (3/13) of tumors in the original reports, 13% (4/31) of the authors' re-review of the slides, and 29% (9/31) of cases reacted with S100. PNI and larger-diameter nerve involvement were significantly associated with death at 5-year follow-up.ConclusionsImmunohistochemical enhancement improves the accuracy and speed of PNI determination. PNI is a significant factor in the survival outcome of cases of MEC.



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Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jinyang Wu, Jian Sun, Steve Guofang Shen, Bing Xu, Jun Li, Shilei Zhang
ObjectiveThis article presents our experiences of computer-assisted navigation in mandibular reconstruction and evaluates its effectiveness.MethodsEight patients who underwent navigation-guided mandibular reconstruction with a fibula free flap were reviewed. Under intraoperative navigation, the ideal positions of the mandibular angles and condyles were confirmed by the navigation probe. The surgical results were evaluated through postoperative panoramic radiographs, coronal CT scans and image fusion.ResultsNavigation-guided mandibular reconstructions were successfully completed based on preoperative planning and simulation. The surgical discrepancy in the mandibular angle between the actual surgical results and the preoperative designs was 1.92±0.97 mm. Panoramic radiographs and coronal CT scans illustrated that all the condyles fitted into their glenoid fossae. All patients were satisfied with their functional and esthetic outcomes.ConclusionComputer-assisted navigation is a viable technology for improving surgical outcomes in mandibular reconstruction, which can assist the surgeons by providing real-time 3-dimensional surgical references during the operation.



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Comparison of the performance of intraoral X-ray sensors using objective image quality assessment

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Kristina Hellén-Halme, Curt Johansson, Mats Nilsson
ObjectivesThe main aim of this study was to evaluate the performance of ten individual sensors of the same make using objective measures of key image quality parameters. A further aim was to compare eight different brands of sensors.Material and methodsTen new sensors of eight different models from six manufacturers, i.e. 80 sensors, were included in the study. All sensors were exposed in a standardized way using an X-ray tube voltage of 60 kVp and different exposure times. Sensor response, noise, low-contrast resolution, spatial resolution and uniformity were measured.ResultsIndividual differences between sensors of the same brand were surprisingly large in some cases. There were clear differences in the characteristics of the different brands of sensors. The largest variations were found for individual sensor response for some of the brands studied. Also, noise level and low contrast resolution showed large variations between brands.ConclusionsSensors, even of the same brand, vary significantly in their quality. It is thus valuable to establish action levels for the acceptance of newly delivered sensors and to use objective image quality control for commissioning purposes and periodic checks to ensure high performance of individual digital sensors.



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Possible alternative therapies for oral lichen planus cases refractory to steroid therapies

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Huamei Yang, Yuanqin Wu, Hui Ma, Lu Jiang, Xin Zeng, Hongxia Dan, Yu Zhou, Qianming Chen
Oral lichen planus (OLP) is a chronic inflammatory disorder with multifactorial etiopathogenesis. Immune dysregulation plays a critical role in the development and progression of this disease. Patients' life may be affected by pain caused by atrophic-erosive lesions. Treatment is usually symptomatic given the obscure etiology. Topical steroids remain the mainstay of management. However, their therapeutic benefits are not always evident. There are substantial data on the possible therapeutic strategies that are effective in OLP cases refractory to steroids. This review provides an overview of the current approaches for the management of steroid-refractory OLP. The miscellaneous treatment regimens include tacrolimus, pimecrolimus, thalidomide, low-level laser therapy, photodynamic therapy, and surgical excision. Some results obtained from these studies were promising. However, further studies, especially randomized controlled trials with strict inclusion and exclusion criteria and larger sample sizes, are required for the evaluation of long-term safety and efficacy of these therapies.



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Objective and subjective image evaluation of maxillary alveolar bone based on cone-beam CT exposure parameters

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Pollyana Marques de Moura, Rami Hallac, James Seaward, Alex Kane, Marcelo Aguiar, Ronir Raggio, Bianca Gutfilen
ObjectivesThe purpose of this study was to optimize the exposure parameters for cone-beam computed tomography (CBCT) for performing diagnostic imaging of maxillary alveolar bone.Study DesignCBCT (PROMAX 3D MAX) WAS PERFORMED ON A FROZEN HUMAN CADAVER HEAD. Image homogeneity and the degree of alveolar bone contrast were determined by objective assessment USING IMAGEJ SOFTWARE and subjective assessment by orthodontists and oral radiologists. Kruskal–Wallis tests and interrater agreement were used to compare results across groups.ResultsImage homogeneity and degree of alveolar bone contrast differed significantly among all exposure protocols (P < 0.001). Intraclass correlation values ranged from 0.681 to 0.779, with orthodontists having higher than for oral radiologists. Average of image quality scores between protocols were statistically significant (P < 0.001) and ranged from "fair" to "good".ConclusionsThere is great potential to reduce CBCT radiation doses for the maxillary alveolar bone while maintaining adequate image quality for diagnosis.

Teaser

Diagnostic imaging of orthodontic patients with craniofacial anomalies involves repetitive exposure of relatively young patients to radiation. There is a high potential to reduce CBCT radiation doses for maxillary alveolar bone while maintaining adequate image quality for diagnosis.


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Establishing a targeted plan for prophylactic dental extractions in patients with laryngeal cancer receiving adjuvant radiotherapy

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Courtney Hentz, Aidnag Z. Diaz, Richard W. Borrowdale, Bahman Emami, Michael Kase, Mehee Choi
Objective(s)The purpose of this study was to determine dose delivered to individual mandibular tooth-bearing regions during adjuvant intensity-modulated radiotherapy (IMRT) for laryngeal cancers.Study DesignTwenty patients with laryngeal cancer treated with IMRT were included. Individual mandibular tooth-borne areas were manually contoured. Average doses were calculated for individual teeth.ResultsDoses to individual teeth increased with more posterior location. Highest dose was observed for third molar (M3) (43.1Gy, p<0.001). Doses to molars and premolars correlated with T- and N-stage (p=0.007, p<0.001, respectively). For ipsilateral nodal disease, there was no difference between dose to ipsilateral vs. contralateral teeth. Only in N2c tumors, dose was above our threshold for extraction for M3 only (51.5Gy).Conclusion(s)T- and N- stage drive dose to individual mandibular tooth-borne areas. With the exception of the posterior molars, particularly in node-positive patients, radiation exposure falls below the threshold reported for pre-RT tooth extractions (50Gy). We conclude that a more conservative approach to prophylactic tooth extraction with a greater emphasis on dental management may be warranted for the prevention of osteoradionecrosis in laryngeal cancer patients receiving adjuvant RT.



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Mandibular Changes on Panoramic Imaging after Head and Neck Radiotherapy

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): King Chong Chan, Susanne E. Perschbacher, Ernest W.N. Lam, Andrew J. Hope, Andrea McNiven, Eshetu G. Atenafu, Linda Lee, Michael J. Pharoah
Changes to the radiographic appearance of the jaws after head and neck radiotherapy have not been thoroughly characterized. Objectives: This retrospective study examines changes to the appearance of the mandible on panoramic images following intensity modulated radiotherapy (IMRT), and relates these changes to medical comorbidities and radiation dose. Study Design: The medical and dental charts, and panoramic images of 126 subjects who received IMRT at Princess Margaret Hospital between January 1, 2005 and December 31, 2008 were analyzed independently by three observers. Results: Of the 126 subjects, 75 (60%) had post-IMRT changes on panoramic images; most, 66 (88%), consisted of widened periodontal ligament space (WPLS). The median time to WPLS was 29 months after IMRT. Female sex and radiation dose correlated with decreased time to WPLS. Conclusions: These results indicate that WPLS is a common radiographic sequela after head and neck radiotherapy, underscoring its clinical significance as a reliable marker of irradiated bone. Further, this type of WPLS needs to be differentiated from odontogenic inflammatory disease to avoid unnecessary treatment that may precipitate osteoradionecrosis.



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Novel Incision Design and Primary Flap Closure Reduces the Incidence of Alveolar Osteitis and Infection in Impacted Mandibular Third Molar Surgery

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jeffrey A. Elo, Ho-Hyun (Brian) Sun, Fanglong Dong, Rahul Tandon, Hardev M. Singh
PurposeTo measure the influence of flap design on alveolar osteitis (AO) and postoperative complications following mandibular third molar surgery.Patients and methodsThis study was designed as a randomized single-blind, split-mouth clinical trial. The predictor variable was flap type. Envelope flap (EF), modified triangular flap (MTF), and two related experimental flaps [second molar mesial papilla-sparing marginal incision with distobuccal release with double-pass single-layered primary closure (MPMI-2X) and single-pass single-layered primary closure (MPMI-1X)] were used. The primary outcome variable was AO. The secondary outcome variables were wound dehiscence and infection. Bivariate and logistic analyses were computed. P-value <0.05 was considered to be statistically significant.ResultsOne hundred ninety-six patients with symmetric bilateral partial bony or full bony impacted mandibular third molars participated. No sites (0/196) treated with MPMI-2X developed AO, and only two sites (2/196) treated with MPMI-2X developed post-operative infection. Both MPMI-1X and MPMI-2X were associated with decreased odds of complications compared to MTF and EF. MPMI-2X sites were significantly less likely than MTF sites to experience complications for both sides.ConclusionsMPMI-2X is a reliable technique to reduce complications such as AO, wound dehiscence, and infection in mandibular third molar surgery.



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