Purpose of review: To perform analysis of evidence in current literature on the topic of genetics and chronic rhinosinusitis (CRS), with a particular focus on recent findings in the cystic fibrosis transmembrane regulator (CFTR), genes associated with primary ciliary dyskinesia, and taste receptor T2R38. Other genes that have been found to have association with CRS are also presented and discussed. Recent findings: Recent studies in CFTR and CRS research have investigated possible CFTR-potentiators for treatment of refractory CRS. The T2R38 gene has been shown to be applicable in the clinical setting with a testable phenotype and may have a role in the prognosis and influencing management strategies of CRS patients. Many genes of the immune system have been studied, with genome-wide association studies and candidate-gene approaches identifying new associations that will need replication and further elucidation. Summary: CRS is a multifactorial disease, with strong evidence of a genetic component in its pathophysiology for some cases. Currently, there are over 70 genes that have been genetically associated with CRS in the past 15 years. Future investigations into genetic causes and predispositions of CRS may allow for improved prognostication and development of disease-prevention strategies as well as novel therapeutic targets. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2ft4oEx
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Σάββατο 12 Νοεμβρίου 2016
Sinonasal methicillin-resistant Staphylococcus aureus: updates on treatment.
Purpose of review: Over the past two decades, the management of methicillin-resistant Staphylococcus aureus (MRSA) in chronic rhinosinusitis has posed significant challenges. This document reviews current management techniques and novel treatment modalities for sinonasal MRSA infections. Recent findings: Topical antibiotic therapy, that is, drops (ofloxacin) and ointments (mupirocin) as off-label use for the management of MRSA chronic sinusitis, has shown beneficial results. Other more recently trialed nonantibiotic modalities such as antimicrobial photodynamic therapy and colloidal silver irrigation are also showing promise. Summary: Sinonasal MRSA is considered to be associated with recalcitrant chronic sinusitis. Advancements in systemic and local antibiotics in its management have been slow and unsatisfactory. Attention is shifting to the use of nonantibiotic antibacterial treatments. Knowledge of these options is critical to improve the overall management of these chronic patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2ft3PL5
http://ift.tt/2ft3PL5
Comprehensive management of hereditary hemorrhagic telangiectasia.
Purpose of review: Hereditary hemorrhagic telangiectasia (HHT), or Osler Weber-Rendu disease, is a rare inherited disorder of fibrovascular tissue affecting various organs. Epistaxis is the most common symptom of HHT but as the disease affects multiple organs, a multisystem and multidisciplinary approach to management is required. The purpose of this article is to provide an overview of the multidisciplinary approach to HHT for the otolaryngologist and to discuss the current pharmacologic and procedural treatment options available for HHT-related epistaxis. Recent findings: Multidisciplinary expert guidelines have better defined what screening tests are advised for the multisystem evaluation of the HHT patient. New pharmacologic therapies including bevacizumab (Avastin) used submucosally or topically have shown promise as in-office treatment modalities. Sclerotherapy of telangiectasia, including in-office applications, has recently proven safe and effective. Summary: HHT remains a difficult disease to treat. Being aware of the common organ systems involved by the disease will help the practicing otolaryngologist to ensure the patient receives appropriate multidisciplinary care. For HHT-related epistaxis, new medical and surgical options allow for a wider range of treatments than were previously available. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2fKgzQs
http://ift.tt/2fKgzQs
The evidence for olfactory training in treating patients with olfactory loss.
Purpose of review: The purpose of this review is to go over the only therapy for olfactory loss supported by level 1a evidence that is currently available, which is olfactory training. This therapy is widely underutilized and has the potential to help many patients with olfactory dysfunction who are otherwise offered no management options. Recent findings: We will review the rationale, clinical studies, and quality of the evidence regarding olfactory training, specifically the olfactory system's inherent ability to regenerate, the plasticity of the system, and the multiple protocols and modifications of protocols present in the literature. Summary: Olfactory training is an effective therapy for some patients suffering from olfactory loss, and, while we do not yet know the optimal duration or number of odorants or exact patient population it may be most beneficial for, as an extremely easy, self-driven therapy with no significant side-effects, it should be consistently offered to this patient population. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2ft3qse
http://ift.tt/2ft3qse
Systematic review and individual patient data analysis of pediatric head and neck squamous cell carcinoma: An analysis of 217 cases
Publication date: Available online 12 November 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): V. Bhanu Prasad, Supriya Mallick, Ashish Dutt Upadhyay, G.K. Rath
IntroductionPediatric head and neck Squamous cell carcinoma (PHNSCC) is a rare disease. The optimum treatment and outcome remains poorly understood because of rarity.MethodsWe conducted an individual patient data analysis of PHNSCC. Two authors independently searched PubMed, google search, and Cochrane library for eligible studies using following search words: Pediatric Head and neck squamous cell carcinoma, Head and neck squamous cell carcinoma under age of 20, Head and neck squamous cell carcinoma in young, PHNSCC till June 1, 2016 published in English language.ResultsTotal of 217 patients of PHNSCC were found in the literature. Median age among the cohort was 15 years (Range: 0–20 years) with a clear male preponderance. Oral cavity tumors were commonest 75 (70%) followed by laryngeal neoplasms 16(15%). Median disease free survival was 9 months (Range: 0–216 months). Median overall survival was 48 months (Range: 1–216 months). In univariate analysis treatment modality had significant impact on disease free survival (DFS). Whereas, patients treated with Surgery, Laryngeal primary had significantly better OS. Patients with associated fanconis anemia had significantly worse overall survival (OS).ConclusionPHNSCC is a rare disease with poorer outcome. Associated DNA defects leads to poorer OS. Patients treated with surgery alone or surgery followed by adjuvant radiation had better DFS and OS. Molecular profiling and personalized therapy may improve survival with limited toxicity.
http://ift.tt/2fMIPC6
A pearl in the ear: Intracranial complications of pediatric cholesteatomas
Publication date: Available online 12 November 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Krystyne Basa, Jessica R. Levi, Erin Field, Robert C. O'Reilly
A nine-year-old male had a cholesteatoma of the mastoid and middle ear found incidentally after myringotomy tube placement. Associated asymptomatic sigmoid plate dehiscence with sinus invasion or thrombosis and ossicular chain destruction complicated his case. He had canal wall down tympanomastoidectomy and was followed for 4.5 years. Disease recurrence necessitated revision. Our case highlights an unusual clinical presentation, possible complications, and the aggressive quality of a benign lesion common in the pediatric population. To our knowledge, this is the first report of an asymptomatic lateral sinus obstruction secondary to an invasive cholesteatoma in this population.
http://ift.tt/2fuGqJ0
A review of acute postoperative sialadenitis in children
Publication date: Available online 12 November 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Michael T. Yim, Yi-Chun C. Liu, Julina Ongkasuwan
ObjectiveAcute postoperative sialadenitis is a previously described rare entity that has occurred following general anesthesia and has also been associated with prolonged neurosurgical procedures. We aim to better characterize this entity while performing a literature review regarding potential etiologies, diagnosis, airway management and treatment options.MethodsA retrospective chart review was performed at a pediatric tertiary care center from 2000 to 2014. Charts were selected for the study utilizing an ICD-9 diagnosis of sialadenitis occurring within two weeks of a surgical procedure. Data including age, gender, medical history, preoperative diagnosis, operation length, time to symptom onset, and subsequent management were collected. An additional literature review was performed focusing on reports of post-operative acute sialadenitis involving airway compromise.Result244 charts were reviewed and 4 patients met inclusion criteria. The average time to symptom onset was 4.3 days (range 1 h–12 days) following conclusion of the surgical procedure. Symptoms ranged from mild inflammation of the parotid gland to rapid swelling of the neck necessitating intubation. All patients were treated with standard sialadenitis treatment including hydration, antibiotics, and airway management as needed.ConclusionTo our knowledge this is the first case series reviewing this entity specifically within the pediatric population. There appears to be two distinct categories of postoperative sialadenitis; one of which presents very acutely and results in massive neck swelling and airway compromise. It is important for practicing Otolaryngologists to be aware of this potentially life-threatening complication in the immediate postoperative period.
http://ift.tt/2fMGbMB
Tooth loss early in life suppresses neurogenesis and synaptophysin expression in the hippocampus and impairs learning in mice
Publication date: February 2017
Source:Archives of Oral Biology, Volume 74
Author(s): Kin-ya Kubo, Chika Murabayashi, Mika Kotachi, Ayumi Suzuki, Daisuke Mori, Yuichi Sato, Minoru Onozuka, Kagaku Azuma, Mitsuo Iinuma
ObjectiveTooth loss induced neurological alterations through activation of a stress hormone, corticosterone. Age-related hippocampal morphological and functional changes were accelerated by early tooth loss in senescence-accelerated mouse prone 8 (SAMP8). In order to explore the mechanism underlying the impaired hippocampal function resulting from early masticatory dysfunction due to tooth loss, we investigated the effects of early tooth loss on plasma corticosterone levels, learning ability, neurogenesis, and synaptophysin expression in the hippocampus later in life of SAMP8 mice.DesignWe examined the effects of tooth loss soon after tooth eruption (1 month of age) on plasma corticosterone levels, learning ability in the Morris water maze, newborn cell proliferation, survival and differentiation in the hippocampal dentate gyrus, and synaptophysin expression in the hippocampus of aged (8 months of age) SAMP8 mice.ResultsAged mice with early tooth loss exhibited increased plasma corticosterone levels, hippocampus-dependent learning deficits in the Morris water maze, decreased cell proliferation, and cell survival in the dentate gyrus, and suppressed synaptophysin expression in the hippocampus. Newborn cell differentiation in the hippocampal dentate gyrus, however, was not affected by early tooth loss.ConclusionThese findings suggest that learning deficits in aged SAMP8 mice with tooth loss soon after tooth eruption are associated with suppressed neurogenesis and decreased synaptophysin expression resulting from increased plasma corticosterone levels, and that long-term tooth loss leads to impaired cognitive function in older age.
http://ift.tt/2eswKlO
Mitotic rate correlates with sentinel lymph node status and outcome in cutaneous melanoma greater than 1 millimeter in thickness: A multi-institutional study of 1524 cases
The 7th edition of the TNM American Joint Committee on Cancer classification incorporates mitotic rate (MR) only for primary cutaneous melanoma (PCM) with Breslow thickness (BT) ≤1 mm.
http://ift.tt/2f40scJ
Uncovering potential key genes associated with the pathogenesis of asthma: A microarray analysis of asthma-relevant tissues
Source:Allergologia et Immunopathologia
Author(s): Y. Guan, X. Jin, X. Liu, Y. Huang, M. Wang, X. Li
BackgroundThe present study aimed to discover more potential genes associated with the pathogenesis of asthma.MethodsThe microarray data of GSE67940 was downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified in bronchial alveolar lavage cells from patients with mild-moderate asthma (notSA) and severe asthma (SA) compared with normal controls (NC), respectively. Functional and pathway enrichment analysis, protein–protein interaction (PPI) network analysis were performed upon the identified up- and down-regulated DEGs. Besides, the gene association network based on the common up-regulated and down-regulated genes was generated and transcriptional regulatory pairs of overlapping DEGs in the PPI network were identified.ResultsA total of 104 DEGs (30 up- and 74 down-regulated genes) were identified in notSA vs. NC. Additionally, 2796 DEGs were screened out in SA vs. NC group, including 320 up-regulated DEGs, and 135 down-regulated DEGs. Specially, 41 overlapping DEGs were screened out in notSA vs. NC and SA vs. NC, including 16 common up-regulated genes and 25 common down-regulated genes. No pathways were enriched by the DEGs in notSA vs. NC. DEGs in SA vs. NC were associated with cytokine–cytokine receptor interaction. VEGFA was a hub protein in both the PPI networks of DEGs in notSA vs. NC and SA vs. NC. Gene association network showed that signalling pathways and cytokine–cytokine receptor interaction were involved in. The overlapping VEGFA, and IFRD1, and ZNF331 were regulated by more TFs.ConclusionGenes such as VEGFA, and IFRD1, and ZNF331 may be associated with pathogenesis of asthma.
http://ift.tt/2es5pQA
Efficacy and toxicity of rechallenge with combination immune checkpoint blockade in metastatic melanoma: a case series
Abstract
Background
The efficacy and potential toxicity of rechallenge with combination ipilimumab and nivolumab has not been described. Retreatment of patients with immune checkpoint inhibitors in the setting of prior significant toxicity lacks evidence-based guidance.
Methods
We present the first three, consecutive patients who received re-treatment with combination ipilimumab and nivolumab for metastatic melanoma managed at our institution.
Results
Rechallenge with combination ipilimumab and nivolumab in the setting of prior grade 3 toxicity with initial combination therapy is feasible, and responses are seen. We highlight the fact that grade 3 toxicity is likely to recur, but if so, can be manageable.
Conclusions
Retreatment with ipi + nivo may be considered an option in carefully selected, well-informed patients. More research is required to delineate the benefits and risks with this approach.
http://ift.tt/2fmdtSc
Allergies – A T cells perspective in the era beyond the TH1/TH2 paradigm
Publication date: Available online 12 November 2016
Source:Clinical Immunology
Author(s): Moritz Berker, Larissa Johanna Frank, Anja Lidwina Geßner, Niklas Grassl, Anne Verena Holtermann, Stefanie Höppner, Christian Kraef, Martin Dominik Leclaire, Pia Maier, David Alexander Christian Messerer, Lino Möhrmann, Jan Philipp Nieke, Diana Schoch, Dominik Soll, Christina Marianne Paulina Woopen
Allergic diseases have emerged as a major health care burden, especially in the western hemisphere. They are defined by overshooting reactions of an aberrant immune system to harmless exogenous stimuli. The TH1/TH2 paradigm assumes that a dominance of TH2 cell activation and an inadequate TH1 cell response are responsible for the development of allergies. However, the characterization of additional T helper cell subpopulations such as TH9, TH17, TH22, THGM-CSF and their interplay with regulatory T cells suggest further layers of complexity. This review summarizes state-of-the-art knowledge on T cell diversity and their induction, while revisiting the TH1/TH2 paradigm. With respect to these numerous contributors, it offers a new perspective on the pathogenesis of asthma, allergic rhinitis (AR) and atopic dermatitis (AD) incorporating recent discoveries in the field of T cell plasticity.
http://ift.tt/2g0jtC1
An infant case of severe hypereosinophilia and systemic symptoms with multiple drug hypersensitivity and reactivation of cytomegalovirus and BK virus
Publication date: Available online 12 November 2016
Source:Allergology International
Author(s): Ayumi Kobayashi, Reiko Takasawa, Kei Takasawa, Masato Nishioka, Masahide Kaneko, Hiroshi Ono, Takanobu Maekawa, Tomohiro Morio, Masayuki Shimohira
http://ift.tt/2fKQQ6T
Atypical presentation of livedo racemosa in a factor V Leiden heterozygous positive patient with Pseudomonas aeruginosa urosepsis
Abstract
Impairment of the protein C pathway, detectable by reduced plasma levels of activated protein C (APC), are risk factors for venous thrombosis. Activated protein C maintains clotting homeostasis by regulation of pro-coagulant factors Va and VIIIa. Both infection and the factor V Leiden mutation reduce the formation of APC from protein C in the blood. With low levels of APC, excess factors Va and VIIIa exist, increasing the risk of thrombus formation. Livedo racemosa is characterised by a striking, violaceous branch-like pattering of the skin. It is similar to livedo reticularis, but with a different morphology and histopathology. In this case report we present the first case of livedo racemosa, in an 89-year-old factor V Leiden-positive patient with a Pseudomonas aeruginosa urinary tract infection. The cutaneous biopsies demonstrated vasculopathy with intraluminal thrombi in subcutaneous vessels with no evidence of inflammatory vasculitis.
http://ift.tt/2eRXQ4b
Omenn Syndrome Presenting with Striking Erythroderma and Extreme Lymphocytosis in a Newborn
Abstract
Omenn syndrome is an autosomal recessive form of "leaky" severe combined immune deficiency resulting in distinct phenotypic features. The patient described herein had an atypical presentation of Omenn syndrome, with conspicuous erythroderma and extreme lymphocytosis at birth, in contrast to the typical evolution of rash seen during the first few weeks of life. In addition, the skin findings were secondary to infiltration of CD8+ (cytotoxic) T-cells in contrast to the CD4+ (helper) T-cells typically seen, which broadens the Omenn syndrome phenotype.
http://ift.tt/2eRIhJL
Serum cathelicidin, nasopharyngeal microbiota, and disease severity among infants hospitalized with bronchiolitis
Source:Journal of Allergy and Clinical Immunology
Author(s): Kohei Hasegawa, Jonathan M. Mansbach, Nadim J. Ajami, Joseph F. Petrosino, Robert J. Freishtat, Stephen J. Teach, Pedro A. Piedra, Carlos A. Camargo
Teaser
Among infants hospitalized with bronchiolitis, and who had low serum LL-37 levels, the Haemophilus-dominant nasopharyngeal microbiota profile was associated with higher disease severity. By contrast, in those with high LL-37 levels, we observed no association.http://ift.tt/2eN3bqf
Haploinsufficiency of TNFAIP3 (A20) by germline mutation is involved in autoimmune lymphoproliferative syndrome
Source:Journal of Allergy and Clinical Immunology
Author(s): Masatoshi Takagi, Shohei Ogata, Hiroo Ueno, Kenichi Yoshida, Tzuwen Yeh, Akihiro Hoshino, Jinhua Piao, Motoy Yamashita, Mai Nanya, Tsubasa Okano, Michiko Kajiwara, Hirokazu Kanegane, Hideki Muramatsu, Yusuke Okuno, Yuichi Shiraishi, Kenichi Chiba, Hiroko Tanaka, Yuki Bando, Motohiro Kato, Yasuhide Hayashi, Satoru Miyano, Kohsuke Imai, Seishi Ogawa, Seiji Kojima, Tomohiro Morio
BackgroundAutoimmune diseases in children are rare and can be difficult to diagnose. Autoimmune lymphoproliferative syndrome (ALPS) is a well-characterized pediatric autoimmune disease caused by mutations in genes associated with the FAS-dependent apoptosis pathway. In addition, various genetic alterations are associated with the ALPS-like phenotype.ObjectiveThe aim of the present study was to elucidate the genetic etiology of the ALPS-like phenotype.MethodsCandidate genes associated with the ALPS-like phenotype were screened by whole exome sequencing. The functional impact of the identified mutations was examined by analyzing the activity of related signaling pathways.ResultsA de novo heterozygous frameshift mutation of tumor necrosis factor alpha-induced protein 3 (TNFAIP3, A20), a negative regulator of the NF-κB pathway, was identified in one of patients who exhibiting ALPS-like phenotype. Increased activity of the NF-κB pathway was associated with haploinsufficiency of TNFAIP3 (A20).ConclusionHaploinsufficiency of TNFAIP3 (A20) by a germline heterozygous mutation leads to the ALPS phenotype.
Teaser
Haploinsufficiency of TNFAIP3 (A20) by frameshift germline mutation causes autoimmune lymphoproliferative syndrome.http://ift.tt/2g4Q3C4
Early-life Farm Exposures and Adult Asthma and Atopy in the Agricultural Lung Health Study
Source:Journal of Allergy and Clinical Immunology
Author(s): John S. House, Annah B. Wyss, Jane A. Hoppin, Marie Richards, Stuart Long, David M. Umbach, Paul Henneberger, Laura E. Beane Freeman, Dale P. Sandler, Elizabeth Long O'Connell, Christie Barker Cummings, Stephanie J. London
BackgroundPrevious studies, mostly from Europe, suggest that early-life farming exposures protect against childhood asthma and allergy; few data exist on asthma and allergy in adults.ObjectiveTo examine associations between early-life farming exposures and current asthma and atopy in an older adult US farming population.MethodsWe analyzed data from 1,746 farmers and 1,555 spouses (mean age=63) from a case-control study nested within the Agricultural Health Study. Current asthma and early-life farming exposures were assessed via questionnaires. We defined atopy based on specific IgE>0.70 IU/ml to at least one of ten allergens measured in blood. We used logistic regression, adjusted for age, sex, race, state (Iowa or North Carolina), and smoking (pack-years), to estimate associations between early-life exposures and asthma (1,198 cases and 2,031 non-cases) or atopy (578 cases and 2,526 non-cases).ResultsExposure to the farming environment in utero and in early childhood had little or no association with asthma but was associated with reduced odds of atopy. The strongest association was seen for having a mother who performed farm activities while pregnant (Odds Ratio=0.60, 95% Confidence Interval=0.48-0.74) and remained significant in models with correlated early-life exposures including early childhood farm animal contact and raw milk consumption.ConclusionsIn a large US farming population, early-life farm exposures, particularly maternal farming activities while pregnant, were strongly associated with reduced risk of atopy in adults. These results extend previous work done primarily on childhood outcomes and suggest that protective associations of early-life farming exposures on atopy endure across the life-course.
Teaser
Early-life farming exposures were associated with reduced odds of atopy, but not asthma, in an older adult US farming population, suggesting that the protective association of early-life farming exposures on atopy endures across the life-course.http://ift.tt/2g4O6p4
Two diseases one remedy? Systemic amyloidosis secondary to hidradenitis suppurativa: Treatment with infliximab
Abstract
Hidradenitis suppurativa, known as acne inversa, is a relapsing and chronic inflammatory skin disease affecting the skin folds. During the chronic course of the disease many local complications like fistulae to other tissues or systemic complications including anemia, secondary amyloidosis, lymphedema, nephrotic syndrome, artropathy may take place. Amyloid A amyloidosis is a rare complication of hidradenitis suppurativa, which has been described in a limited number of case reports. Herein, we present such a patient that had developed AA amyloidosis during the course of hidradenitis suppurativa. Both AA amyloidosis and hidradenitis suppurativa have responded to infliximab therapy which was shown by clinical recovery and by the improvement in renal functions.
http://ift.tt/2f2g3tD
Dermoscopic monitoring of efficacy of ingenol mebutate in the treatment of pigmented and non-pigmented basal cell carcinomas
Abstract
Basal cell carcinoma is the most common non-melanoma skin cancer, and its incidence continues to raise. Although surgery can be considered the mainstay of therapy, new current pharmacological options are available and focus on tumor eradication, maximizing cosmetic results, and functional capacity. Several studies have recently reported on safety and efficacy of topical ingenol mebutate gel, a derivative of the plant Euphorbia Peplus, used to treat actinic keratosis and superficial basal cell carcinoma. In our knowledge, we report for the first time the dermoscopic evaluation of outcome and monitoring of superficial pigmented and non-pigmented basal cell carcinomas in four patients treated by this novel non-ablative agent. Ingenol mebutate gel therapy has showed to be effective and without important side-effects for pigmented and non-pigmented superficial basal cell carcinomas. We emphasize the usefulness of dermoscopy in supporting the clinical diagnosis and excluding the presence of tumor residue or recurrence. In a future scenario, we hope it will be soon possible to follow-up the lesions, after treatment, avoiding post-control biopsy punch.
http://ift.tt/2fZAbkL
The efficacy of intradermal injection of type A botulinum toxin for facial rejuvenation
Abstracts
The aim of this study is to evaluate the efficacy for effectiveness of type A botulinum toxin intradermal injection for facial rejuvenation. Forty female subjects were randomly divided into two groups: BoNTA group and control group. In BoNTA group, each subject's facial skin was treated with intradermal injection of BoNTA, and subjects of the control group were treated with intradermal saline solution injection. Subjects receiving one session of treatment and evaluations were conducted at baseline, four weeks, and twelve weeks after treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), erythema, and melanin index. BoNTA group showed higher physician's global assessment score, subject satisfaction score, roughness, skin hydration, skin elasticity, and lower TEWL compared to that of control group at 12 weeks post-treatment. No significant difference was found among erythema and melanin index at baseline, four, and twelve weeks after treatment among the two major groups. In conclusion, intradermal BoNTA injection can be considered as an effective method for facial rejuvenation.
http://ift.tt/2eqUarL
Survival rates of biological therapies for psoriasis treatment in real-world clinical practice: A Canadian multicentre retrospective study
Abstract
Background/Objectives
Data on biologic drug survival in real-world psoriasis treatment are limited. There is a need to evaluate long-term trends of biologic use outside the realm of clinical trials.
Methods
A multicentre chart review was conducted with patients' data from September 2005 to September 2014. Kaplan–Meier plot analysis was used to determine 5-year drug survival rates. A log–rank test was used to compare the rates of drug survival between the studied biologics.
Results
For the 398 patients and 545 treatment series analysed, 1, 2, 3, 4 and 5-year survival rates were 0.826, 0.687, 0.563, 0.475 and 0.420 with etanercept; 0.804, 0.648, 0.553, 0.508 and 0.508 with adalimumab; 0.838, 0.664, 0.554, 0.485 and 0.382 with infliximab; and 0.914, 0.856, 0.800, 0.755 and 0.755 with ustekinumab, respectively. A statistically significant difference was seen between ustekinumab and the other three biologics.
Conclusion
A progressive decrease in treatment adherence was seen with all four biologics, as expected, but the survival rate of ustekinumab was highest.
http://ift.tt/2eRA60e
Newborn Hearing Screening in Prematurity: Fate of Screening Failures and Auditory Maturation
Abstract
Objectives
The purpose of this study was to identify delayed auditory maturation and the fate of premature infants who failed the newborn hearing screening (NHS) in neonatal intensive care unit.
Materials and methods
A total of 1,375 neonates underwent NHS using the transient evoked otoacoustic emission (TEOAE) in a tertiary hospital between 2007 and 2010 according to the Joint Committee on Infant Hearing Guidelines. In addition, a structured telephone survey was given to caregivers of infants who were lost to follow-up NHS. Auditory steady state response (ASSR) threshold and the threshold change of diagnostic test failures were analyzed.
Result
Among the 1,375 NICU babies, 344 (25.0%) babies, 111 (9.7%) babies and 64 (4.6%) babies failed to pass the first TEOAE, second TEOAE and diagnostic ASSR, respectively. However, at the age about five, 12 (0.9%) infants showed permanent hearing loss (PHL). The ASSR threshold improved from 69.0 ± 19.7 dB to 52.9 ± 21.6 dB in < 4 months (p<0.001). Premature infants < 29 weeks of gestational age at birth showed higher referral (p = 0.003) rate at the first OAE test compared to the others, and the difference continued until the last follow up. The odds ratio for the initial ASSR threshold > 67.5 dB for PHL was 9.00 (95% confidence interval, 1.7–46.7).
Conclusion
Most first TEOAE screening failures (91.3%) showed normal hearing and speech development. Hearing levels in premature infants can improve over time, particularly in neonates with initial ASSR threshold < 67.5 dB.
This article is protected by copyright. All rights reserved.
http://ift.tt/2g4JUFT
Natural killer cells in asthma.
Purpose of review: This review article discusses current knowledge on natural killer (NK) cells in asthma. Recent findings: It is now well accepted that NK cell activities go beyond cancer immune surveillance and antiviral defense. Recent reports indicate that NK cells are activated in response to allergens in vivo. NK cells promote allergic sensitization, type-2 immune response, development of eosinophilic inflammation, and airway hyperresponsiveness. NK cells are activated by respiratory syncytial virus and other respiratory viruses. When infection occurs in the setting of active allergic inflammation, NK cells augment its magnitude and contribute to asthma exacerbations. Proasthma activities of NK cells can be programmed during embryogenesis through maternal exposure to environmental pollutants. Prenatally programmed NK cells produce type-2 and type-3 cytokines and mediate asthma predisposition. NK cells can also act as asthma antagonists. NK cells contribute to the resolution of inflammation through suppression of antigen-specific CD4+ T cells and type-3 immunity. When viral infection occurs in naive mice prior to allergic sensitization, NK cells antagonize type-2 immunity and prevent development of asthma. Summary: NK cells are nonredundant participants of allergic inflammation. The environmental context determines whether NK cells act as protagonists or antagonists. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2fLRbrk
http://ift.tt/2fLRbrk
Asthma-chronic obstructive pulmonary disease overlap syndrome: a controversial concept.
Purpose of review: To illustrate the scant evidence and the shortcomings of the concept of 'asthma-COPD overlap syndrome' (ACOS) in terms of clinical utility. Recent findings: Asthma and chronic obstructive pulmonary disease (COPD) are considered as two distinct and heterogeneous diseases. For many years, physicians have been aware that asthma and COPD can coexist in some patients. Recently, the term ACOS has been applied when a person has clinical features of both asthma and COPD. However, the lack of an accurate diagnosis has led to inconsistent data regarding reported prevalence, prognosis and therapeutics. Even today, it has not been possible to establish a phenotypic characterization of ACOS, although it is part of the overall complexity and heterogeneity of COPDs. No high quality data exist on which to base treatment recommendations for ACOS. Consequently, in clinical practice, treatment is extrapolated from the available evidence on asthma and COPD. Summary: The current concept of ACOS seems clinically irrelevant because it has no influence on the prognosis and treatment of these patients. The authors concluded that the term ACOS should be avoided in the case of patients with features of both asthma and COPD. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2fln7nT
http://ift.tt/2fln7nT
A survey of the dose of inhalational agents used to maintain anaesthesia in infants.
http://ift.tt/2fGebI6
Numerical modelling and fragility assessment of typical freestanding building contents
Petrone, C; Di Sarno, L; Magliulo, G; Cosenza, E; (2016) Numerical modelling and fragility assessment of typical freestanding building contents. Bulletin of Earthquake Engineering pp. 1-25. 10.1007/s10518-016-0034-1 . (In press). Green open access
http://ift.tt/2eMTKHd
Amphibian Symbiotic Bacteria Do Not Show a Universal Ability To Inhibit Growth of the Global Panzootic Lineage of Batrachochytrium dendrobatidis
Antwis, RE; Preziosi, RF; Harrison, XA; Garner, TWJ; (2015) Amphibian Symbiotic Bacteria Do Not Show a Universal Ability To Inhibit Growth of the Global Panzootic Lineage of Batrachochytrium dendrobatidis. Applied and Environmental Microbiology , 81 (11) pp. 3706-3711. 10.1128/AEM.00010-15 . Green open access
http://ift.tt/2g4BOgz
Population genetic structure and direct observations reveal sex-reversed patterns of dispersal in a cooperative bird
Harrison, XA; York, JE; Young, AJ; (2014) Population genetic structure and direct observations reveal sex-reversed patterns of dispersal in a cooperative bird. Molecular Ecology , 23 (23) pp. 5740-5755. 10.1111/mec.12978 . Green open access
http://ift.tt/2eMUSL6
A comparison of observation-level random effect and Beta-Binomial models for modelling over dispersion in Binomial data in ecology and evolution
Harrison, X; (2015) A comparison of observation-level random effect and Beta-Binomial models for modelling over dispersion in Binomial data in ecology and evolution. PeerJ , 3 , Article e1114. 10.7717/peerj.1114 . Green open access
http://ift.tt/2g4Dlmx
ImageSpirit: Verbal Guided Image Parsing
Cheng, M-M; Zheng, S; Lin, W-Y; Vineet, V; Sturgess, P; Crook, N; Mitra, NJ; Cheng, M-M; Zheng, S; Lin, W-Y; Vineet, V; Sturgess, P; Crook, N; Mitra, NJ; Torr, PHS; - view fewer (2014) ImageSpirit: Verbal Guided Image Parsing. ACM Transactions on Graphics , 34 (1) , Article 3. 10.1145/2682628 . Green open access
http://ift.tt/2eMPPdL
Glaucoma drainage device surgery outcomes for pediatric uveitic glaucoma
Khaw, PT; Clarke, J; Gkaragkani, E; Papadopoulos, M; Pavesio, C; brookes, J; (2016) Glaucoma drainage device surgery outcomes for pediatric uveitic glaucoma. Investigative Ophthalmology & Visual Science , 57 (12) , Article 6493. Green open access
http://ift.tt/2g4HE1i
Random-access scanning microscopy for 3D imaging in awake behaving animals
Nadella, KM; Roš, H; Baragli, C; Griffiths, VA; Konstantinou, G; Koimtzis, T; Evans, GJ; Nadella, KM; Roš, H; Baragli, C; Griffiths, VA; Konstantinou, G; Koimtzis, T; Evans, GJ; Kirkby, PA; Silver, RA; - view fewer (2016) Random-access scanning microscopy for 3D imaging in awake behaving animals. Nature Methods 10.1038/nmeth.4033 . (In press).
http://ift.tt/2eMRvnk
Ischaemic conditioning and targeting reperfusion injury: a 30 year voyage of discovery
Hausenloy, DJ; Barrabes, JA; Bøtker, HE; Davidson, SM; Di Lisa, F; Downey, J; Engstrom, T; Hausenloy, DJ; Barrabes, JA; Bøtker, HE; Davidson, SM; Di Lisa, F; Downey, J; Engstrom, T; Ferdinandy, P; Carbrera-Fuentes, HA; Heusch, G; Ibanez, B; Iliodromitis, EK; Inserte, J; Jennings, R; Kalia, N; Kharbanda, R; Lecour, S; Marber, M; Miura, T; Ovize, M; Perez-Pinzon, MA; Piper, HM; Przyklenk, K; Schmidt, MR; Redington, A; Ruiz-Meana, M; Vilahur, G; Vinten-Johansen, J; Yellon, DM; Garcia-Dorado, D; - view fewer (2016) Ischaemic conditioning and targeting reperfusion injury: a 30 year voyage of discovery. Basic Research in Cardiology , 111 (6) , Article 70. 10.1007/s00395-016-0588-8 . Green open access
http://ift.tt/2g4CPoK
Logistic regression models may predict Gleason grade of prostate cancer in the peripheral zone but not the transition zone
Johnston, E; Cheung, K; Dikaios, N; Sidhu, HS; Appayya, M; Simmons, L; Freeman, A; Johnston, E; Cheung, K; Dikaios, N; Sidhu, HS; Appayya, M; Simmons, L; Freeman, A; Ahmed, H; Atkinson, D; Punwani, S; - view fewer (2016) Logistic regression models may predict Gleason grade of prostate cancer in the peripheral zone but not the transition zone. In: Proceedings of the ISMRM 24th Annual Meeting & Exhibition. (pp. p. 2752). International Society for Magnetic Resonance in Medicine (ISMRM): Singapore.
http://ift.tt/2eMOy6h
Exosomes and Cardiovascular Protection
Davidson, SM; Takov, K; Yellon, DM; (2016) Exosomes and Cardiovascular Protection. Cardiovascular Drugs and Therapy 10.1007/s10557-016-6698-6 . (In press). Green open access
http://ift.tt/2g4CfqW
The natural history of enthesitis-related arthritis on biologic therapy
Bray, T; Vendhan, K; Atkinson, D; Fischer, C; Sen, D; Ioannou, Y; Hall-Craggs, M; (2016) The natural history of enthesitis-related arthritis on biologic therapy. In: Proceedings of the 10th International Congress on Spondyloarthritides. International Congress on Spondyloarthritides: Ghent, Belgium.
http://ift.tt/2eMSWlT
Distinct Salmonella Enteritidis lineages associated with enterocolitis in high-income settings and invasive disease in low-income settings
Feasey, NA; Hadfield, J; Keddy, KH; Dallman, TJ; Jacobs, J; Deng, X; Wigley, P; Feasey, NA; Hadfield, J; Keddy, KH; Dallman, TJ; Jacobs, J; Deng, X; Wigley, P; Barquist, LB; Langridge, GC; Feltwell, T; Harris, SR; Mather, AE; Fookes, M; Aslett, M; Msefula, C; Kariuki, S; Maclennan, CA; Onsare, RS; Weill, F-X; Le Hello, S; Smith, AM; McClelland, M; Desai, P; Parry, CM; Cheesbrough, J; French, N; Campos, J; Chabalgoity, JA; Betancor, L; Hopkins, KL; Nair, S; Humphrey, TJ; Lunguya, O; Cogan, TA; Tapia, MD; Sow, SO; Tennant, SM; Bornstein, K; Levine, MM; Lacharme-Lora, L; Everett, DB; Kingsley, RA; Parkhill, J; Heyderman, RS; Dougan, G; Gordon, MA; Thomson, NR; - view fewer (2016) Distinct Salmonella Enteritidis lineages associated with enterocolitis in high-income settings and invasive disease in low-income settings. Nature Genetics , 48 (10) pp. 1211-1217. 10.1038/ng.3644 .
http://ift.tt/2g4EqLr
Anti-angiogenic therapy in treating outer barrier dysfunction in diabetic retinopathy
Ved, NK; (2016) Anti-angiogenic therapy in treating outer barrier dysfunction in diabetic retinopathy. Doctoral thesis, UCL (University College London).
http://ift.tt/2eMSXGt
Quantitative Apparent Diffusion Coefficient measurements are a more repeatable measure of sacroiliitis than visual scoring
Bray, T; Vendhan, K; Atkinson, D; Punwani, S; Fischer, C; Sen, D; Ioannou, Y; Bray, T; Vendhan, K; Atkinson, D; Punwani, S; Fischer, C; Sen, D; Ioannou, Y; Hall-Craggs, MA; - view fewer (2016) Quantitative Apparent Diffusion Coefficient measurements are a more repeatable measure of sacroiliitis than visual scoring. In: Proceedings of the 10th International Congress on Spondyloarthritides. International Congress on Spondyloarthritides: Ghent, Belgium.
http://ift.tt/2g4HyHc
Quantification of inflammation using Diffusion-weighted Imaging: Biological validation in enthesitis-related arthritis
Bray, T; Vendhan, K; Atkinson, D; Punwani, S; Fischer, C; Sen, D; Ioannou, Y; Bray, T; Vendhan, K; Atkinson, D; Punwani, S; Fischer, C; Sen, D; Ioannou, Y; Hall-Craggs, MA; - view fewer (2016) Quantification of inflammation using Diffusion-weighted Imaging: Biological validation in enthesitis-related arthritis. In: Proceedings of the 10th International Congress on Spondyloarthritides. International Congress on Spondyloarthritides: Ghent, Belgium.
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Observations on the variability of corticospinal tract excitability during the reaction time period for simple human finger movements
Van Den Bos, M; (2016) Observations on the variability of corticospinal tract excitability during the reaction time period for simple human finger movements. Doctoral thesis, UCL (University College London).
http://ift.tt/2g4HQxp
Infrared vibrational spectroscopy: a rapid and novel diagnostic and monitoring tool for cystinuria
Oliver, KV; Vilasi, A; Maréchal, A; Moochhala, SH; Unwin, RJ; Rich, PR; (2016) Infrared vibrational spectroscopy: a rapid and novel diagnostic and monitoring tool for cystinuria. Scientific Reports , 6 , Article 34737. 10.1038/srep34737 . Green open access
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Non-Monotonic Relation between Noise Exposure Severity and Neuronal Hyperactivity in the Auditory Midbrain
Hesse, LL; Bakay, W; Ong, H-C; Anderson, L; Ashmore, J; McAlpine, D; Linden, J; Hesse, LL; Bakay, W; Ong, H-C; Anderson, L; Ashmore, J; McAlpine, D; Linden, J; Schaette, R; - view fewer (2016) Non-Monotonic Relation between Noise Exposure Severity and Neuronal Hyperactivity in the Auditory Midbrain. Frontiers in Neurology , 7 , Article 133. 10.3389/fneur.2016.00133 . Green open access
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Association between dental attendance patterns and oral health in a national sample of British adults
Tania, ; (2016) Association between dental attendance patterns and oral health in a national sample of British adults. Doctoral thesis, UCL (University College London).
http://ift.tt/2eMLNBV
Evaluation of the Use of Sub-Pixel Offset Tracking Techniques to Monitor Landslides in Densely Vegetated Steeply Sloped Areas
Sun, L; Muller, J-P; (2016) Evaluation of the Use of Sub-Pixel Offset Tracking Techniques to Monitor Landslides in Densely Vegetated Steeply Sloped Areas. Remote Sensing , 8 (8) , Article 659. 10.3390/rs8080659 . Green open access
http://ift.tt/2g4FkY7
Rosacea treatment update: Recommendations from the global ROSacea COnsensus (ROSCO) panel
Summary
Background
Rosacea is currently treated according to subtypes. As this does not adequately address the patient spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus (ROSCO) panel was established to address this issue.
Objectives
To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea.
Methods
17 dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management by a modified Delphi approach by voting on statements: strongly disagree, disagree, agree or strongly agree (consensus ≥75% agree/strongly agree). All voting was electronic and blinded.
Results
The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skin care measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea.
Conclusions
Rosacea diagnosis and treatment should be based on clinical presentation. Consensus is shown for treatment strategies to support this approach.
This article is protected by copyright. All rights reserved.
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