Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τρίτη 6 Ιουνίου 2017
Ventilation through an extraglottic tracheal tube: a technique for deep extubation and airway control
| Ventilation through an extraglottic tracheal tube: a technique for deep extubation and airway control |
Wed, 07 Jun 2017 05:57:03 +0000 |
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Emergency front-of-neck access: scalpel or cannula
| ,The parable of Buridan's ass |
| Wed, 07 Jun 2017 05:46:05 +0000 |
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
The combination of DEX and OND should be recommended in children with a high risk of POV.......Dexamethasone (DEX), ondansetron (OND) and droperidol (DRO) FOR Children undergoing elective surgery under general anaesthesia and considered at high risk for postoperative vomiting (POV)
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Tissue Sample Collection From Patients With Head and Neck Cancer and From Healthy Participants
Condition: Head and Neck Cancer
Interventions: Other: biologic sample preservation procedure; Other: medical chart review
Sponsors: Vanderbilt University Medical Center; National Cancer Institute (NCI)
Recruiting - verified June 2017
http://ift.tt/2rKjTyz
Interventions: Other: biologic sample preservation procedure; Other: medical chart review
Sponsors: Vanderbilt University Medical Center; National Cancer Institute (NCI)
Recruiting - verified June 2017
http://ift.tt/2rKjTyz
Various combinations of velopharyngeal and hypopharyngeal surgical procedures for treatment of obstructive sleep apnea: Single-stage, multilevel surgery
The aim of this study was to investigate the safety and outcomes of velopharyngeal surgeries combined with hypopharyngeal surgeries as single-stage interventions for treatment of obstructive sleep apnea (OSA).
http://ift.tt/2rJQyEt
Non-invasive papillary urothelial carcinoma of the vagina: molecular analysis of a rare case identifies clonal relationship to non-invasive urothelial carcinoma of the bladder
Abstract
We present a rare case of non-invasive papillary urothelial carcinoma of the vagina as the initial presentation of a multicentric urothelial carcinoma also involving bladder and renal pelvis and report for the first time in the literature the molecular alterations observed in the vaginal urothelial lesion and the synchronous lesions of the urinary tract. In this case, the non-invasive papillary urothelial carcinoma in the vagina displayed the same genetic alterations in the FGFR3 and PIK3CA genes as those seen in the non-invasive papillary urothelial carcinoma of the bladder contrasting with the wild phenotype observed in the invasive urothelial carcinoma of the renal pelvis. This observation could reinforce the theory of "seeding" of carcinoma cells as a valid and most likely explanation of this multifocality. In addition, we emphasize in this report the importance of recognizing this rare lesion in the female genital tract and its differential diagnosis.
http://ift.tt/2s2azZQ
Abordaje endoscópico endonasal puro de estesioneuroblastoma
Presentamos el caso de una mujer de 56 años con diagnóstico de estesioneuroblastoma Kadish C/Hyams II tratado con resección quirúrgica mediante un abordaje endoscópico endonasal puro y radioterapia adyuvante. Describimos el caso y discutimos sus aspectos relevantes.
We report the case of a 56-year-old woman with diagnosis of esthesioneuroblastoma Kadish C/Hyams II treated with a purely endonasal endoscopic resection and adjuvant radiotherapy. We described the case and discuss its relevant aspects.
http://ift.tt/2rSMK62
Tiroplastía de medialización con Gore-Tex®: Experiencia de 8 años en Hospital Clínico de la Universidad de Chile
Introducción: La parálisis de cuerda vocal causa disfonía y puede ser complicación posterior a ciertas cirugías. Existen diversos tratamientos, uno de ellos es la tiroplastía de medialización, procedimiento realizado con anestesia local, permitiendo un fino ajuste de la voz. Objetivo: Analizar la experiencia en tiroplastía de medialización con Gore-tex® en el Hospital Clínico de la Universidad de Chile entre los años 2008-2016. Material y método: Estudio descriptivo, retrospectivo, con revisión de fichas clínicas de los pacientes que fueron sometidos a tiroplastía de medialización. Para el análisis de los datos se utilizará la prueba Wilcoxon. Resultados: Se analizaron datos de 21 pacientes, correspondientes a 24 tiroplastías de medialización. La edad promedio fue 54,2 años, 13 parálisis fueron secundarias a cirugía y 8 idiopáticas. En 17 pacientes se obtuvo la encuesta VHI-10 en el pre y posoperatorio, con valores promedio de 33,2y 17,4 (p =0,0003). Cinco pacientes requirieron de algún procedimiento complementario, entre 4 y 22 meses poscirugía: inyección de grasa, de Radiesse y refuerzo con otra prótesis de Gore-teX®. Conclusión: La tiroplastía de medialización es excelente para tratar la parálisis de cuerda vocal unilateral no recuperada en forma espontánea, siendo la encuesta VHI-10 una buena herramienta para evaluar la calidad de la voz.
Introduction: Vocal cord paralysis can cause hoarseness and coud be a complications to following certain surgeries. In its treatment, there are several alternatives, one of them is the medialization thyroplasty. This procedure, is performed under local anesthesia, allowing the fine-tune of the voice. Aim: To analyze the experience in Medialization Thyroplasty with Gore-tex in the Clinical Hospital of the University of Chile between 2008 and 2016. Material and method: Retrospective and descriptive, with the review of patient's clinical records who were treated with medialization thyroplasty. The data analysis is done using Wilcoxon test. Results: Data from 21 patients, corresponding to 24 medialization thyroplasty. The average age was 54.2 years old, 13 paralysis were secondary to surgeries and 8 were Idiopathic. In 17 patients it was posible to get the VHI-10 survey in the pre and postoperative, with an average value of 33.2 and 17.4 (p =0.0003). Five patients required some additional procedure, between 4 and 22 months post surgery: injection of fat, Radiesse and installation of a new Gore-tex prosthesis Conclusions: Medialization thyroplasty is an excellent method to treat paralysis of unilateral vocal cord in cases when is not recovered spontaneously, being the VHI-10 survey a good tool for assessing voice quality.
http://ift.tt/2rT31HQ
Cirugía endoscópica nasosinusal y de base de cráneo asistida por navegación
Introducción: La cirugía guiada por imágenes corresponde a una herramienta quirúrgica que comienza a desarrollarse a mediados del siglo XX. En 1990 comienza a utilizarse en otorrinolaringología, siendo sus principales indicaciones la cirugía endoscópica de cavidades paranasales y la cirugía de base de cráneo anterior. Objetivo: Analizar y presentar el resultado del uso de cirugía guiada por imágenes en pacientes intervenidos en el Hospital Clínico de la Universidad de Chile (HCUCH). Material y método: Se realizó un estudio retrospectivo incluyendo todos los casos de cirugía endoscópica nasosinusal y base de cráneo asistida por imágenes en HCUCH. La selección para usar la navegación se hizo en base a las recomendaciones de la Academia Americana de Otorrinolaringología. Resultados: De un total de 12 pacientes intervenidos con el uso de navegación, se obtuvo 100% de éxito quirúrgico con disminución de los síntomas y sin complicaciones intraoperatorias. Conclusión: La cirugía asistida por navegación en cavidades paranasales y base de cráneo, es una herramienta de suma utilidad en casos seleccionados que potencia las habilidades quirúrgicas del cirujano sin reemplazar sus conocimientos anatómicos. Otorga seguridad y precisión en cirugías que comprometen estructuras nobles como base de cráneo y órbita entre otros.
Introduction: Image Guided Surgery is a surgical tool that develop in the mid-twentieth century. In 1990 it began to be used in otolaryngology, being its main indications endoscopic surgery of paranasal sinuses and anterior skull base. Aim: To analyze and present the result of image-guided surgery in patients undergoing surgery at the Hospital of the University of Chile. Material and method: A retrospective study included all cases of endoscopic sinus surgery and skull base imaging assisted at the Clinical Hospital of the University of Chile from August 2015 to August 2016. The choice to use the navigation was made in based on the recommendations of the American Academy of Otolaryngology, and analyzed case by case. Results: A total of 12 patients were operated using Navigation, achieving 100 % of surgical success with decreased symptoms and without intraoperative complications. Conclusion: Image Guided Surgery in paranasal sinuses and skull base is a tool very useful in selected cases where enhances the surgeon skills without replacing their anatomical knowledge. Provides security and accuracy in surgeries involving noble structures such as the skull base, orbit among others. their anatomical knowledge. Provides security and accuracy in surgeries involving noble structures such as the skull base, orbit among others.
http://ift.tt/2sQDhcE
Cirugía hipofisiaria endoscópica transesfenoidal, con realización de colgajo nasoseptal: Evaluación del impacto de la técnica en la olfación. Serie de casos
Introducción: La cirugía endoscópica transesfenoidal en la exéresis de patología hipofisaria ha sido ratificada dentro de la mejores opciones para conseguir abordajes exitosos. Para cerrar la brecha ósea, se puede utilizar el colgajo nasoseptal, el cual lograría un cierre adecuado y seguro, evitando complicaciones como persistencia de fístulas de líquido cefalorraquídeo. Dentro de los probables efectos secundarios de este colgajo se señala la presencia de anosmia o hiposmia. Objetivo: Nuestro objetivo es mostrar los resultados obtenidos empleando la técnica del colgajo nasoseptal y la evaluación del olfato posoperatorio. Material y método: Incluimos 14 pacientes con diagnóstico de adenoma hipofisiario intervenidos en nuestro servicio entre diciembre 2014 a diciembre 2015. Se evaluaron diversos parámetros entre otros, olfatometría pre y posoperatorias. A todos se les realizó la técnica endoscópica transesfenoidal. Efectuando la disección del colgajo con la técnica tipo Hadad. La exéresis tumoral fue realizada por neurocirujano, se cubrió la osteotomía con este colgajo. Resultados: De los 14 pacientes, 13 llegaron al estado olfativo preoperatorio. 1 paciente se mantuvo hipósmico mantenidamente. En nuestro estudio, no hemos encontrado deterioro significativo en la calidad del sentido del olfato. Así como tampoco observamos otras complicaciones. Conclusiones: Esta experiencia aún inicial, estimamos que podría ya esbozar una tendencia de mantención de la función olfativa en este tipo de cirugía.
Introduction: Transsphenoidal endoscopic surgery resection of pituitary pathology has been ratified within the best options for successful approaches. To close the gap bone, you can use the nasoseptal flap, which achieved an adequate and secure closure, preventing complications such as persistent cerebrospinal fluid leaks. Among possible side effects of this flap anosmia-hyposmia noted. Aim: Our goal is to show the results obtained using the technique of nasoseptal flap and postoperative evaluation of smell. Material and method: We included 14 patients with a diagnosis of pituitary adenoma surgery in our department between December 2014 to December 2015. Various parameters were evaluated pre and post operative, specially olfactory function. All underwent transsphenoidal endoscopic technique. Performing dissection flap with the technical type Hadad. The tumor resection was performed by neurosurgeon, osteotomy covered with this flap. Results: Of the 14 patients, 13 reached the olfactory preoperative state. 1 patient remained with hyposmia. In our study, we found no significant deterioration in the quality of the sense of smell. Not other complications were found. Conclusions: This is an initial experience, and we estimate that could outline a trend of maintaining olfactory function in this surgery approach.
http://ift.tt/2rT6oP6
Cáncer de laringe: Serie de casos en 6 años en el Complejo Asistencial Doctor Sótero del Río
Introducción: El cáncer de laringe es la segunda causa de muerte en otorrinolaringología. Su tratamiento en estadios avanzados es agresivo y controversial. Objetivo: Reportar los datos de pacientes atendidos en el Complejo Asistencial Doctor Sótero del Río entre los años 2005-2011. Material y método: Análisis retrospectivo descriptivo. Resultados: Total de 38 pacientes, 30 (79%) hombres, mediana de edad 66 años. Los principales motivos de consulta fueron dificultad respiratoria en 18 pacientes (47%) y disfonía en 14 (37%). Se realizó estudio y etapificación con nasofibroscopía y tomografía computarizada. El 71% se presentó en estadio avanzado, de ellos, el 30% recibió quimiorradioterapia exclusiva. La sobrevida global a 2 y 5 años fue de 56% y 42% respectivamente en estadio avanzado y de 100% y 71% respectivamente en estadio precoz. Discusión: El cáncer de laringe es una enfermedad con sobrevida baja a pesar de tratamientos agresivos. Se han planteado alternativas al tratamiento estándar como terapia conservadora con quimiorradioterapia exclusiva o microcirugía láser transoral. Conclusiones: La epidemiología del cáncer laríngeo se ha mantenido relativamente estable y la clasificación TNM sigue siendo fundamental para el tratamiento, especialmente en contexto de nuevas alternativas de manejo de cáncer avanzado. Se espera evaluar estas terapias.
Introduction: Laryngeal cancer is the second cause of death in otolaryngology. Its treatment in advanced stage is aggressive and controversial. Aim: To report data from patients treated in Complejo Asistencial Doctor Sótero del Río in the period between 2005-2011. Material and method: Descriptive retrospective analysis. Results: 38 patients in total, 30 (79%) men, median age 66 years. The main symptoms were breathing difficulty in 18 patients (47%) and dysphonia in 14 (37%). Every patient completed study and disease staging with nasofibroscopy and computed tomography. 71% presented in advanced stage, among them, 30% received exclusive chemoradiotherapy. Overall survival for 2 and 5-year in advanced stage was 56% and 42% respectively; and 100% and 71% in early stage. Discussion: Advanced laryngeal cancer has low survival rate in spite of aggressive treatments. Alternatives to standard care have been proposed, such as conservative therapy with exclusive chemoradiotherapy or transoral laser microsurgery. Conclusions: Laryngeal cancer's epidemiology remains relatively unchanged and TNM classification still remains fundamental for treatment, specially in the context of new therapeutic alternatives for advanced cancer. Evaluation of these therapies is expected.
http://ift.tt/2sQZtmO
Injerto costal para reconstrucción nasal: Experiencia de 6 años en el Hospital San Juan de Dios
Introducción: El injerto de preferencia para cirugía nasal es el cartílago septal. El Injerto de cartílago costal otorga gran material para trabajo ya que posee características similares al cartílago septal. Este injerto se utiliza generalmente para cirugías de dorso nasal, nariz en silla de montar, laterorrinias, disfunciones de la válvula nasal interna y/o externa, poca proyección nasal y rinoplastías de revisión. Objetivo: Conocer las características, resultados y complicaciones de las rinoplastías con injerto de cartílago costal realizadas en el Hospital San Juan de Dios (HSJD) entre los años 2010 y 2016. Material y método: Estudio retrospectivo con revisión de fichas clínicas de pacientes sometidos a cirugías de reconstrucción nasal con injerto de cartílago costal en el HSJD entre enero 2010 y agosto 2016. Resultado: Entre los años 2010 y 2016 se realizaron 20 rinoplastías con uso de cartílago costal: 14 eran hombres (70%) y 6 eran mujeres (30%). En 14 pacientes se usó el cartílago costal en la primera cirugía. No se presentaron complicaciones a corto, mediano y largo plazo. Conclusión: El injerto de cartílago costal es una herramienta útil a la hora de enfrentarse a cirugías complicadas. La técnica quirúrgica no es dificultosa y tiene una baja tasa de complicaciones.
Introduction: The ideal graft for nasal surgery is septal cartilage. The costal cartilage has similar characferistics to the septal cartilage. This particular graft is generally used for nasal dorsum, saddle nose, nasal deviations, dysfunctions of the internal or external nasal valve, poor nasal projection and revision rhinoplasty. Aim: Determine the characteristics, outcomes and complications of rhinoplasty with costal cartilage graft made in the San Juan de Dios Hospital (HSJD) between 2010 and 2016. Material and method: Retrospective study with reviewing medical records of all patients underwent nasal surgery reconstruction with costal cartilage graft in the HSJD between January 2010 and August 2016. Results: Between 2010 and 2016 a total of 20 rhinoplasties were performed with use of costal cartilage. Of these 14 were men (70%) and 6 were women (30%). In 14 patients we used the costal cartilage in the first surgery. No complications in short, medium and long term were presented. Conclusion: The rib cartilage graft is a useful tool when dealing with complicated surgeries. The surgical technique is not difficult and has a low complication rate.
http://ift.tt/2rT5n9G
Tumor condroide del cartílago tiroides: Reporte de un caso clínico y revisión de la literatura
Los tumores condroides de la laringe son poco frecuentes, y generalmente se ubican en el cartílago cricoides. El tratamiento de elección es quirúrgico, con buen pronóstico general. Se presenta el caso de un hombre de 60 años con historia de disfonía. El estudio nasofaringolaringofibroscópico revela una masa laríngea supraglótica. Las imágenes son compatibles con una lesión del cartílago tiroides. La biopsia obtenida por microlaringoscopía directa informa tumor compatible con condroma. Se realiza una resección completa de la masa por abordaje externo, la biopsia corrobora el diagnóstico de tumor condroide de bajo grado. Se describe esta patología mediante revisión bibliográfica.
Chondroid tumors of the larynx are uncommon, and usually located in the cricoid cartilage. Surgery is the treatment of choice, with good prognosis in general. We report the case of a 60-year-old man consulting for dysphonia. The nasopharyngolaryngoscopy showed a supraglottic laryngeal mass. The images were compatible with a thyroid cartilage lesion. The biopsy sample obtained by direct microlaryngoscopy was consistent with a condroma. A complete excision of the lesion was performed by external approach and the biopsy confirmed the diagnosis of a low grade chondroid tumor. We present a review of chondroid tumors of the larynx based on available literature.
http://ift.tt/2sQFXqs
Estesioneuroblastoma o neuroblastoma olfatorio
Estesioneuroblastoma o también llamado neuroblastoma olfatorio es un tumor maligno infrecuente derivado del neuroepitelio olfatorio. La historia clínica de un paciente con un neuroblastoma olfatorio es muy inespecífica. Durante la última década, los métodos endoscópicos se han aplicado gradualmente para el tratamiento de tumores de la base del cráneo. El tratamiento puramente endoscópico endonasal del estesioneuroblastoma ha mostrado excelentes resultados de supervivencia con disminución de las complicaciones. Presentamos un paciente afectado por un neuroblastoma olfatorio tratado solo con cirugía endoscópica endonasal.
Esthesioneuroblastoma or olfactory neuroblastoma is an uncommon malignant tumor arising from the olfactory neuroepithelium. The clinical symptoms of a patient with olfactory neuroblastoma are very inespecific. During the past decade, endoscopic approaches have been gradually applied in treating skull base tumors. The purely endoscopic endonasal surgery for esthesioneuroblastoma showed successful survival results with remarkably decreased complications. We reported a patient who suffered olfactory neuroblastoma treated with only endoscopic endonasal surgery.
http://ift.tt/2sQwkIr
Malformación arteriovenosa en cavidad oral: A propósito de un caso y revisión de la literatura
Las malformaciones arteriovenosas (malformaciones A-V) de alto flujo en la cavidad oral no son una patología frecuente, existen pocos datos publicados sobre su tratamiento y sigue siendo muy controvertido debido a la alta tasa de complicaciones vitales que conlleva y la alta tasa de recurrencia. El único tratamiento curativo es la resección radical, con las consecuencias no sólo vitales, sino también desfigurativas que supone. Presentamos un caso de malformación A-V congénita en región submandibular, suelo de boca derecho y lengua, que tras varios episodios de dolor y aumento de tamaño, sin realizar ninguna medida agresiva, en el último control se observa trombosis espontánea de la misma. En este caso, la evolución con un tratamiento expectante sin cirugía, ha sido la trombosis con mejoría clínica, sin presentar nuevo episodio de aumento de tamaño, ni sangrado doce meses después, a pesar de seguir con una lesión de gran tamaño en el suelo de la boca.
he high-flow arteriovenous malformations (A-V malformations) in oral cavity are not a common disease, there are few published data on treatment and it remains highly controversial because of the high rate of vital complications and the high rate of recurrence. The only curative treatment is radical resection, with not only vital consequences but also the disfigurement involved. We present a case of congenital A-V malformation in right submandibular region, floor of the mouth and tongue. After several episodes of pain and enlargement, in the last control without any aggressive action, the lesion presented spontaneous thrombosis. In this case, despite following with a large lesion on the floor mouth, the evolution with an expectant non-surgical treatment has been the thrombosis with clinical improvement, without presenting new episode of enlargement, nor bleeding twelve months later.
http://ift.tt/2rSVOaV
Hallazgo de arteria lusoria en el estudio de otitis media a repetición: A propósito de una observación pediátrica y revista breve de la literatura
Arteria Lusoria (AL) o arteria subclavia aberrante derecha es una malformación vascular rara. Es la más común de las malformaciones del arco aórtico. Fue descrita por primera vez por Hunalud en 1735. La etiología no está clarificada hasta hoy en día. AL puede formar parte de un cuadro sindrómico (síndrome de Down, síndrome de Edwards) o de una malformación cardiaca compleja. Es casi siempre asintomática, pero algunas veces puede revelarse por signos respiratorios o disfagia. Se elige habitualmente el tratamiento conservador. Les presentamos el caso de un niño de 2 años que presentó una AL revelada atipicamente por otitis media a repetición.
Arteria Lusoria (AL) or aberrant right subclavian artery is a rare congenital aortic arch malformation. Hunauld described it for the first time in 1735.The cause is until now no totally clarified. Usually it is associated with chromosomal disorders such as Down's syndrome, Edwards's syndrome or appears in childhood with complexes cardiovascular abnormalities. Patients are frequently asymptomatic, but it may be revealed by respiratories symptoms or by a dysphagia. The treatment is generally conservative. We expose a case report about a child of 2 years old with AL diagnosed after several episodes of purulent otitis.
http://ift.tt/2sQPnCl
Dolor cervical atípico: Síndrome de Eagle
Presentamos el caso de un varón de 45 años con dolor cervical derecho muy localizado, característico y persistente. El estudio radiológico nos permitió diagnosticar claramente un síndrome de Eagle. Por lo anterior el paciente fue sometido a cirugía de extirpación de apófisis estiloides derecha. El paciente evolucionó sin mayores complicaciones ni incidencias, y obteniendo la resolución del cuadro.
Here we introduce a 45-year-old man suffering from an intense, unique and permanent pain, located in his right neck. Radiology showed us signs leading to the diagnosis of Eagle Syndrome. Surgery of right Styloid apophysis removal, with no complications, letting the patient free of symptoms.
http://ift.tt/2rSL646
Manejo del cáncer de cabeza y cuello: ¿Radioterapia a quién, cuándo y por qué?
Revisión del enfrentamiento del paciente con cáncer escamoso de la vía aerodigestiva superior, orientada a la radioterapia. Las principales alternativas de tratamiento para los pacientes con cáncer escamoso de cabeza y cuello son la cirugía y la radioterapia (RT). La planificación del tratamiento debe considerar el tumor primario y la diseminación linfática cervical. La enfermedad subclínica es significativa en este grupo de pacientes. Cuando ésta es mayor a 20%, la disección cervical electiva ha mostrado mejorar la sobrevida libre de enfermedad y la sobrevida global. La RT por Intensidad Modulada (IMRT) permite mayor protección de los tejidos vecinos. El fenómeno de repoblación acelerada implica que dosis insuficientes o períodos largos de interrupción traducen persistencia o recidiva tumoral. Por esta razón, la adyuvancia con RT debe iniciarse precozmente. Para esto, es fundamental una evaluación dental oportuna. Los efectos adversos de la RT se dividen en agudos y tardíos, pudiendo estos últimos presentarse meses o años posterior a la terapia. Los pacientes con indicación de RT deben ser derivados tempranamente y con previa evaluación dental. La IMRT es una excelente herramienta terapéutica cuando es correctamente indicada y aplicada. Los principales beneficios en relación a la cirugía son menor morbilidad y mejor costo-efectividad por lo que suele ser la terapia de elección en enfermedad localizada y una alternativa a la disección cervical electiva.
Radiation therapy for squamous cell carcinoma of the upper aerodigestive tract: review of management. Head and neck cancer treatment includes several treatment options. Surgery and radiotherapy are the most important local treatments. When planning the local treatment, the choices for the primary tumor, and the lymphatic spread to the neck must be considered. Subclinical metastatic disease to the neck is present in about 20% of patients, and can be controlled equally with surgery or radiation therapy. In a randomized trial, elective neck dissection has been shown to improve disease-free, and overall survival when compared with observation and salvage. Intensity-modulated radiotherapy (IMRT) allows a better sparing of normal tissues in the neck, and less morbidity from the treatment. Accelerated repopulation is a main determinant of poor local control in patients treated with radiotherapy who undergo treatment interruptions or a delay in its start. Thus, adjuvant radiotherapy must begin as early as possible, within six weeks of resection. Irradiated patients are at significant risk of dental complications, even when IMRT is used. That makes mandatory a dental evaluation and treatment prior to radiotherapy. Adverse radiation effects can occur during treatment (early reactions), or months to years after completion (late reactions). Patients with indication of radiotherapy must be referred early, preferably after dental evaluation. IMRT is an excellent tool when correctly indicated and uses. Main benefits of elective neck irradiation are less morbidity and higher cosst-effectiveness, making it a very useful treatment alternative to elective neck dissection in patients with localized disease.
http://ift.tt/2sR8VXc
Prevención, diagnóstico y manejo de lesiones laringotraqueales agudas y subagudas posintubación en pacientes pediátricos
Las lesiones laringotraqueales asociadas a intubación se deben principalmente a una técnica defectuosa y a daño por presión del tubo endotraqueal sobre la mucosa; además influyen características propias del paciente y de los cuidados de enfermería. Hasta el 40% de los pacientes pediátricos intubados pueden presentar alteraciones laríngeas inmediatas y hasta 30% tienen estridor o disnea posextubación. Si estos síntomas persisten por más de 3 días tendrían indicación de laringotraqueoscopía. Las lesiones más habituales son edema, úlceras y tejido de granulación. El edema puede producir obstrucción respiratoria aguda que puede manejarse con reintubación con tubos más pequeños y aplicación tópica de crema de corticoides con antibióticos. Las úlceras y granulaciones pueden evolucionar hacia secuelas cicatriciales que comprometen la fisiología laringotraqueal; las granulaciones exofíticas deben retirarse endoscópicamente. Aunque la incidencia de estenosis subglótica posintubación ha disminuido en las últimas décadas, situándose entre 2,7%y 4,2%, algunos estudios sugieren un subdiagnóstico debido a lesiones poco sintomáticas al alta. En el período cicatricial activo, estas estenosis pueden dilatarse para evitar llegar a una cirugía abierta. El manejo otorrinolaringológico de estos pacientes en etapas tempranas es fundamental para evitar secuelas cicatriciales irreversibles que requieren de cirugías complejas, con riesgo vital por obstrucción de la vía aérea.
Intubation-associated laryngotracheal injuries are mainly caused by a defective technique and endotracheal tube pressure-induced mucosal damage; patient factors and nursing care are also important. Up to 40% of intubated pediatric patients may show immediate laryngeal alterations and up to 30% have post-extubation stridor or dyspnea. If these symptoms last for over 3 days, laryngotracheoscopy is indicated. Edema, ulcers and granulation tissue are the most usual lesions. Edema can lead to acute airway obstruction, and is managed by reintubation with a smaller tube and topical application of a corticosteroid and antibiotic cream. Ulcers and granulations can lead to scarring that compromise laryngotracheal physiology; exophytic granulations must be removed endoscopically. Although the incidence of post-intubation subglottic stenosis has diminished over the last decades to about2,7% to 4,2%, some studies suggest that there is a subdiagnosis because of oligosymptomatic lesions at the time of discharge. On the active scarring period, dilatation of the stenosis can be used to avoid open surgery. Early otorhinolaryngologic management of these patients is fundamental for avoiding irreversible cicatricial sequels that require complex surgeries, with life risk due to airway obstruction.
http://ift.tt/2rT30Ui
Repercusiones de la roncopatía y respiración bucal en el crecimiento facial
Los trastornos respiratorios obstructivos del sueño corresponden a un amplio espectro de patologías que incluyen a los roncadores primarios, el síndrome de resistencia de vía aérea superior y al síndrome de apnea obstructiva del sueño (SAOS). Dentro de sus manifestaciones clínicas se encuentra la roncopatía y la respiración bucal, las cuales generan alteraciones en el crecimiento craneofacial del niño pudiendo ser la causa de un SAOS residual. El objetivo de esta revisión es analizar las alteraciones del crecimiento craneofacial en niños generadas por la roncopatía y respiración bucal.
Obstructive sleep breathing disorders correspond to a broad spectrum of diseases that include primary snorers, upper airway resistance syndrome and obstructive sleep apnea syndrome (OSAS). Its clinical manifestations include snoring and mouth breathing, which generates alterations in the craniofacial growth of the child that may be the cause of a residual OSAS. The objective of this review is to analyze the alterations of craniofacial growth generated by snoring and mouth breathing in children.
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Importancia de la epidemiología en cáncer laríngeo: Incidencia y mortalidad por carcinoma escamoso de laringe
Actualmente se realiza un diagnóstico anual de 650.000 nuevos casos de carcinoma escamoso de cabeza y cuello en el mundo, siendo el carcinoma escamoso de laringe una patología neoplásica que compete al otorrinolaringólogo. La incidencia mundial del cáncer escamoso de laringe se estima en 3,9 por cada 100.000 habitantes con una mortalidad general de 2,0 por cada 100.000 habitantes. En Chile el registro de cáncer se realiza en base a los cinco registros poblacionales de cáncer que existen. No se tienen datos exactos respecto a incidencia y mortalidad por carcinoma escamoso de laringe, siendo la estimación de la incidencia de 1,2 casos por cada 100.000 habitantes y la estimación de mortalidad ajustada por edad de 0,7 casos por cada 100.000 habitantes. Se han descrito diversos factores de riesgo ambientales y estilos de vida para este cáncer, por lo tanto, las estrategias de prevención primaria en salud son claves a la hora de generar un impacto en la incidencia del carcinoma escamoso de laringe.
The annual diagnosis of head and neck squamous cell carcinoma is 650,000 new cases. The laryngeal carcinoma is a malignant disease that should include an otolaryngologist in its evaluation. The global incidence of laryngeal carcinoma is estimated at 3.9 per 100,000 inhabitants with an overall mortality rate of 2.0 per 100,000 inhabitants. In Chile the cancer registry is based on the five population cancer registries that exist. There is no accurate data on incidence and mortality from laryngeal carcinoma, being an estimated incidence of 1.2 cases per 100,000 inhabitants and an age-adjusted mortality of 0.7 cases per 100.00 inhabitants. There have been described various environmental risk factors and lifestyles for this cancer, therefore, primary prevention strategies are key to generate an impact on the incidence of larynx carcinoma.
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Various combinations of velopharyngeal and hypopharyngeal surgical procedures for treatment of obstructive sleep apnea: Single-stage, multilevel surgery
Source:American Journal of Otolaryngology
Author(s): Murat Binar, Omer Karakoc, Timur Akcam, Burak Asik, Mustafa Gerek
ObjectiveThe aim of this study was to investigate the safety and outcomes of velopharyngeal surgeries combined with hypopharyngeal surgeries as single-stage interventions for treatment of obstructive sleep apnea (OSA).MethodsRetrospective analysis of operated patients. The velopharyngeal surgical interventions were uvulopalatal flap, anterior palatoplasty, expansion sphincter pharyngoplasty, transpalatal advancement pharyngoplasty, Cahali lateral pharyngoplasty, Z-palatoplasty, and modified uvulopalatopharyngoplasty. The hypopharyngeal surgical interventions were tongue base suspension, mucosal sparing partial glossectomy, genioglossus advancement, mandibulohyoid suspension, thyrohyoid suspension, and epiglottoplasty.ResultsForty-one patients were enrolled after inclusion and exclusion criteria. The evaluation of symptoms and polysomnographic findings were performed preoperatively and at a minimum of 3months postoperatively. The mean age was 42.17±9.50years and the mean follow-up time was 6.8±6.0months. After single-stage multilevel surgery, the mean apnea hypopnea index (AHI) improved from 29.13±15.87events/h to 14.28±16.14events/h (p<0.001). According to the classical definition of success criteria (>50% reduction in AHI and postoperative AHI<20events/h), the surgical success rate was 56%, with cure of OSA (AHI<5events/h) in 41% of study population. The combined surgeries also improved Epworth scores, snoring scores, and respiratory parameters significantly (in all p<0.05). The major complications were bleeding requiring re-admission in surgery room and severe tongue base edema which regressed by steroid administration. The minor complications were pain, difficulty in swallowing, velopharyngeal insufficiency, regurgitation, minor bleeding, and occlusion disorder. The mean postoperative period to beginning of normal feeding was 1.81±1.01days. The percentage of pain, the number of patients with major bleeding, and the need for patient-controlled analgesia were higher in patients undergoing tissue resection/ablative hypopharyngeal procedures. The mean postoperative period to beginning of normal feeding was shorter in patients undergoing suture/repositioning hypopharyngeal procedures.ConclusionAccording to outcomes of this study, OSA patients with multilevel obstructions can benefit from combined surgeries for velopharyngeal and hypopharyngeal regions at the same operation stage, without experiencing persistent complaints. It is promising that, despite multiple levels of obstruction was operated at single-stage, airway safety was preserved in all patients.
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Letter to the Editor regarding “Biodegradable airway stents in infants - Potential life-threatening pitfalls”
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): David Vondrys, Juan Anton-Pacheco Sanchez
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Assessment of the feeding Swallowing Impact Survey as a quality of life measure in children with laryngeal cleft before and after repair
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): M. Shannon Fracchia, Gillian Diercks, Alisa Yamasaki, Cheryl Hersh, Stephen Hardy, Marina Hartnick, Christopher Hartnick
ObjectiveTo cross-validate the Feeding Swallowing Impact Survey (FSIS), a quality of life instrument, specifically to a subpopulation of children who aspirate due to laryngeal cleft.IntroductionThe FSIS is a recently validated instrument used to describe caregiver quality of life (QOL) in children with aspiration due to various causes. To cross-validate the FSIS specifically to the subpopulation of children who aspirate due to laryngeal cleft, we tested the hypotheses that caregivers would report significant different scores form baseline if their children improved at the one year mark postintervention due to either successful conservative or surgical measures (discriminant validity) and would not report significant differences in their FSIS reporting if there was no change in their child's aspiration at the one year mark post intervention (convergent validity).MethodsThe FSIS was administered to the caregivers of 35 children (19 male, 16 female; age range: 5–79 months) who aspirate secondary to known laryngeal cleft (diagnosed by suspension laryngoscopy and inspection). All children had a baseline VFSS demonstrating aspiration and documenting what feeding plan to follow and caregivers completed the FSIS at this point as well. All children regardless of whether they were treated by conservative or surgical intervention underwent a follow-up VFSS at the one year post-intervention mark and the caregivers completed a FSIS at this time point as well.ResultsAmong two distinct sub-populations of children who underwent either successful conservative or surgical treatment for their laryngeal cleft and demonstrated improvement at the one year mark (as defined by a VFSS documented decreased need for thickener by at least one consistency or more) and where we hypothesized that FSIS scores would not be significantly different, the caregivers reported no significant differences in FSIS scores cleft repair (mean FSIS scores 2.45 (SD 0.88)/2.1 (SD 0.94); p = 0.28). Moreover, as another test to convergent validity, for children who underwent either unsuccessful conservative treatment (and subsequently went on to need surgery) or who were not successfully surgically treated for their laryngeal cleft and demonstrated no significant improvement at the one year mark (as defined by a VFSS documented decreased need for thickener by at least one consistency or more), the caregivers reported no significant differences in FSIS scores cleft repair (mean FSIS scores 2.8(SD 0.79)/2.5(SD 0.88); p = 0.69). For divergent validity, two distinct sub-populations of children who underwent either successful or not successful surgical treatment for their laryngeal cleft (demonstrated by either improvement or lack of improvement at the one year mark VFSS as defined by a decreased need for thickener by at least one consistency or more) revealed significant differences in caregiver FSIS scores cleft repair (mean FSIS scores 1.38 (SD 0.32); 32.8 (SD 0.79); p=<0.0002).DiscussionThis results of this study provide convergent and divergent validity supporting the cross-validation of the FSIS instrument to be utilized as a validated QOL instrument to evaluate children with aspiration specifically due laryngeal cleft as another tool with which to evaluate the outcomes of medical or surgical interventions for this disorder.
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Editorial Board
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
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Safety of endoscopic sinus surgery in children with cystic fibrosis
Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Dmitry Tumin, Don Hayes, Stephen E. Kirkby, Joseph D. Tobias, Christopher McKee
IntroductionData on the safety of endoscopic sinus surgery (ESS) are limited in children with cystic fibrosis (CF). We used a multi-institutional surgical registry to examine ESS outcomes in children with CF.MethodsThe 2014–2015 American College of Surgeons' National Surgical Quality Improvement Program-Pediatric database was queried for patients age <18 years undergoing elective ESS. Prolonged hospital stay (>1 day), 30-day readmission, and 30-day unplanned reoperation were compared according to presence of CF diagnosis.ResultsThe data included 213 children with CF (age 10 ± 5 years, 105/108 male/female) and 821 children without CF (age 10 ± 5 years, 504/317 male/female). CF patients were more likely than non-CF patients to require prolonged hospital stay (30% vs. 9%, p < 0.001), yet had similar rates of readmission (6% vs. 4%; p = 0.189) and reoperation (0 vs. 1%; p = 0.133). All readmissions but one among CF patients were unrelated to ESS. In the non-CF cohort, reasons for ESS-related readmissions included recurrence of sinusitis, postoperative pain, and bleeding.ConclusionsWe demonstrate the safety of ESS in the largest cohort of children with CF reviewed to date. Multi-institutional review of ESS safety may contribute to monitoring expansion of this intervention in children with CF.
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Response to the letter to the Editor “Biodegradable airway stents in infants - Potential life-threating pitfalls”
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Balazs Sztano, Laszlo Rovo
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Medication Use During Pregnancy and Lactation: Introducing the Pregnancy and Lactation Labeling Rule
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2r3jVzB
Respiratory Hospitalizations and Rehospitalizations in Infants Born Late Preterm
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2ryRfSF
Tracheomalacia and Protracted Bacterial Bronchitis Resulting from Straight Back Syndrome: A Case Report and Commentary
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2r3sHgR
Pneumonia Continues to Pose a Significant Healthcare Burden in Children
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2ryHu75
Cross-Reactivity Between Molds and Mushrooms
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2r3lw8r
Prevalence, Risk Factors, and Outcomes of Bronchiolitis Obliterans After Allogeneic Hematopoietic Stem Cell Transplantation
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
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The Interplay Between Fat Mass and Fat Distribution as Determinants of the Metabolic Syndrome Is Sex-Dependent
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
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Opioid-induced hyperalgesia in clinical anesthesia practice: what has remained from theoretical concepts and experimental studies?.
Purpose of review: This article reviews the phenomenon of opioid-induced hyperalgesia (OIH) and its implications for clinical anesthesia. The goal of this review is to give an update on perioperative prevention and treatment strategies, based on findings in preclinical and clinical research. Recent findings: Several systems have been suggested to be involved in the pathophysiology of OIH with a focus on the glutaminergic system. Very recently preclinical data revealed that peripheral [mu]-opioid receptors (MORs) are key players in the development of OIH and acute opioid tolerance (AOT). Peripheral MOR antagonists could, thus, become a new prevention/treatment option of OIH in the perioperative setting. Although the impact of OIH on postoperative pain seems to be moderate, recent evidence suggests that increased hyperalgesia following opioid treatment correlates with the risk of developing persistent pain after surgery. In clinical practice, distinction among OIH, AOT and acute opioid withdrawal remains difficult, especially because a specific quantitative sensory test to diagnose OIH has not been validated yet. Summary: Since the immediate postoperative period is not ideal to initiate long-term treatment for OIH, the best strategy is to prevent its occurrence. A multimodal approach, including choice of opioid, dose limitations and addition of nonopioid analgesics, is recommended. Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Gender Differences in the Relationship Between Self-Esteem and Aggression in Young People Leaving Care
Violence and Gender Jun 2017, Vol. 4, No. 2: 49-54.
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Fine Epitope Mapping of Monoclonal Antibodies to the DNA Repair Protein, RadA
Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.
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Specific Monoclonal Antibodies Recognizing the Endogenous Chicken High Mobility Group Box 1 Protein
Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.
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Myeloma-Derived Light Chain Paired with a Diagnostic Monoclonal Antibody Hinders Immunoassay Performance
Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.
http://ift.tt/2sdBEJo
Investigation of Methylenetetrahydrofolate Reductase C677T Polymorphism and Human Papilloma Virus Genotypes in Iranian Breast Cancer
Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.
http://ift.tt/2qUtHot
Chinese Data of Efficacy of Low- and High-Dose Iodine-131 for the Ablation of Thyroid Remnant
http://ift.tt/2qYm98t
Changes in the DNA Methylation and Hydroxymethylation Status of the Intercellular Adhesion Molecule 1 Gene Promoter in Thyrocytes from Autoimmune Thyroiditis Patients
http://ift.tt/2rIYZzT
Aspirin challenge and desensitization: how, when and why.
Purpose of review: To investigate the current approach to aspirin challenge (drug provocation) and/or desensitization in patients with histories of hypersensitivity reactions to it, particularly in those with cardiovascular diseases. Recent findings: The literature indicates that patients with coronary artery disease (CAD), including those with an acute coronary syndrome, may safely undergo low-dose aspirin challenge and/or desensitization. Recently, flowcharts regarding challenge/desensitization procedures with aspirin in patients with CAD and histories of aspirin hypersensitivity reactions have become available. Aspirin desensitization and continuous aspirin therapy constitute an effective option in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD) who have suboptimally controlled asthma or rhinosinusitis, or require multiple revision polypectomies. Summary: The use of aspirin has proven to reduce morbidity and mortality associated with CAD. There is a general consensus on aspirin's effectiveness in secondary prevention of CAD. Therefore, aspirin desensitization is necessary in patients with CAD and histories of hypersensitivity reactions to it. The effectiveness of aspirin desensitization and continuous therapy in patients with NERD has been shown in numerous studies. However, shared selection criteria of candidates for aspirin challenge/desensitization procedures, and simple and homogeneous protocols are necessary. Moreover, preventive safety measures are still needed in order to reduce the potential risks of these procedures. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Aspirin challenge and desensitization: how, when and why.
Purpose of review: To investigate the current approach to aspirin challenge (drug provocation) and/or desensitization in patients with histories of hypersensitivity reactions to it, particularly in those with cardiovascular diseases. Recent findings: The literature indicates that patients with coronary artery disease (CAD), including those with an acute coronary syndrome, may safely undergo low-dose aspirin challenge and/or desensitization. Recently, flowcharts regarding challenge/desensitization procedures with aspirin in patients with CAD and histories of aspirin hypersensitivity reactions have become available. Aspirin desensitization and continuous aspirin therapy constitute an effective option in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD) who have suboptimally controlled asthma or rhinosinusitis, or require multiple revision polypectomies. Summary: The use of aspirin has proven to reduce morbidity and mortality associated with CAD. There is a general consensus on aspirin's effectiveness in secondary prevention of CAD. Therefore, aspirin desensitization is necessary in patients with CAD and histories of hypersensitivity reactions to it. The effectiveness of aspirin desensitization and continuous therapy in patients with NERD has been shown in numerous studies. However, shared selection criteria of candidates for aspirin challenge/desensitization procedures, and simple and homogeneous protocols are necessary. Moreover, preventive safety measures are still needed in order to reduce the potential risks of these procedures. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2rybRui
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Medication Use During Pregnancy and Lactation: Introducing the Pregnancy and Lactation Labeling Rule
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2rJbHic
Respiratory Hospitalizations and Rehospitalizations in Infants Born Late Preterm
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2qZ2LrF
Tracheomalacia and Protracted Bacterial Bronchitis Resulting from Straight Back Syndrome: A Case Report and Commentary
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2rIE7c0
Pneumonia Continues to Pose a Significant Healthcare Burden in Children
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2qYBVQl
Cross-Reactivity Between Molds and Mushrooms
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2rIP7pT
Prevalence, Risk Factors, and Outcomes of Bronchiolitis Obliterans After Allogeneic Hematopoietic Stem Cell Transplantation
Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.
http://ift.tt/2qYBUvL
SOD2 Facilitates the Antiviral Innate Immune Response by Scavenging Reactive Oxygen Species
Viral Immunology , Vol. 0, No. 0.
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Elevated Plasma Growth Arrest-Specific 6 Protein Levels Are Associated with the Severity of Disease During Hantaan Virus Infection in Humans
Viral Immunology Jun 2017, Vol. 30, No. 5: 330-335.
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Frontal Fibrosing Alopecia Severity Index (FFASI): A Call for a More Inclusive and Globally Relevant Severity Index for Frontal Fibrosing Alopecia
Abstract
We read with interest the article by Holmes et al,1 published in the February 2016 edition of the British Journal of Dermatology, and associated comments by Saceda-Corralo et al.2
We would like to congratulate all the above authors for addressing this important topic. Nevertheless, we would like to raise a few additional points about the proposed severity index for Frontal Fibrosing Alopecia (FFA), which may assist in making it more culturally inclusive and globally relevant, especially for patients of African and/or South Asian descent.
This article is protected by copyright. All rights reserved.
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Excessive Iodine Intake and Thyrotropin Reference Interval: Data from the Korean National Health and Nutrition Examination Survey
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Growth Kinetics of Macronodular Lung Metastases and Survival in Differentiated Thyroid Carcinoma
Thyroid , Vol. 0, No. 0.
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Effect of Thyroid-Related Symptoms on Long-Term Quality of Life in Patients with Differentiated Thyroid Carcinoma: A Population-Based Study in Sweden
Thyroid , Vol. 0, No. 0.
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Increased Cardiovascular Mortality and Morbidity in Patients Treated for Toxic Nodular Goiter Compared to Graves' Disease and Nontoxic Goiter
http://ift.tt/2sP8EnK
Low Rate of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Asian Practice
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Salvage Lenvatinib Therapy in Metastatic Anaplastic Thyroid Cancer
Thyroid , Vol. 0, No. 0.
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Prognostic and biological significance of the proangiogenic factor EGFL7 in acute myeloid leukemia [Medical Sciences]
Epithelial growth factor-like 7 (EGFL7) is a protein that is secreted by endothelial cells and plays an important role in angiogenesis. Although EGFL7 is aberrantly overexpressed in solid tumors, its role in leukemia has not been evaluated. Here, we report that levels of both EGFL7 mRNA and EGFL7 protein are...
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The FERM protein EPB41L5 regulates actomyosin contractility and focal adhesion formation to maintain the kidney filtration barrier [Medical Sciences]
Podocytes form the outer part of the glomerular filter, where they have to withstand enormous transcapillary filtration forces driving glomerular filtration. Detachment of podocytes from the glomerular basement membrane precedes most glomerular diseases. However, little is known about the regulation of podocyte adhesion in vivo. Thus, we systematically screened for...
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Selective regulation of Notch ligands during angiogenesis is mediated by vimentin [Cell Biology]
Notch signaling is a key regulator of angiogenesis, in which sprouting is regulated by an equilibrium between inhibitory Dll4-Notch signaling and promoting Jagged-Notch signaling. Whereas Fringe proteins modify Notch receptors and strengthen their activation by Dll4 ligands, other mechanisms balancing Jagged and Dll4 signaling are yet to be described. The...
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Major contribution of the 3/6/7 class of TRPC channels to myocardial ischemia/reperfusion and cellular hypoxia/reoxygenation injuries [Cell Biology]
The injury phase after myocardial infarcts occurs during reperfusion and is a consequence of calcium release from internal stores combined with calcium entry, leading to cell death by apoptopic and necrotic processes. The mechanism(s) by which calcium enters cells has(ve) not been identified. Here, we identify canonical transient receptor potential...
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Effect of Thyroid-Related Symptoms on Long-Term Quality of Life in Patients with Differentiated Thyroid Carcinoma: A Population-Based Study in Sweden
Thyroid , Vol. 0, No. 0.
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Increased Cardiovascular Mortality and Morbidity in Patients Treated for Toxic Nodular Goiter Compared to Graves' Disease and Nontoxic Goiter
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Low Rate of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Asian Practice
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Salvage Lenvatinib Therapy in Metastatic Anaplastic Thyroid Cancer
Thyroid , Vol. 0, No. 0.
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Excessive Iodine Intake and Thyrotropin Reference Interval: Data from the Korean National Health and Nutrition Examination Survey
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Growth Kinetics of Macronodular Lung Metastases and Survival in Differentiated Thyroid Carcinoma
Thyroid , Vol. 0, No. 0.
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Changes in Hepatic TRβ Protein Expression, Lipogenic Gene Expression, and Long-Chain Acylcarnitine Levels During Chronic Hyperthyroidism and Triiodothyronine Withdrawal in a Mouse Model
Thyroid , Vol. 0, No. 0.
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Copper-mediated C-H cyanation of (hetero)arenes with ethyl (ethoxymethylene)cyanoacetate as a cyanating agent
Chem. Commun., 2017, Accepted Manuscript
DOI: 10.1039/C7CC03384B, Communication
DOI: 10.1039/C7CC03384B, Communication
Chaorong Qi, Xiaohan HU, Huanfeng Jiang
A copper-mediated direct C-H cyanation of (hetero)arenes with ethyl (ethoxymethylene)cyanoacetate as a safe cyanating agent has been successfully developed by using molecular oxygen as the oxidant. The reaction tolerates a...
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A copper-mediated direct C-H cyanation of (hetero)arenes with ethyl (ethoxymethylene)cyanoacetate as a safe cyanating agent has been successfully developed by using molecular oxygen as the oxidant. The reaction tolerates a...
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Single Site Silica Supported Tetramethyl Niobium by the SOMC Strategy: Synthesis, Characterization and Structure-Activity Relationship in Ethylene Oligomerization Reaction
Chem. Commun., 2017, Accepted Manuscript
DOI: 10.1039/C7CC02585H, Communication
DOI: 10.1039/C7CC02585H, Communication
Ali Hamieh, Raju Dey, Bijan Nekoueishahraki, manoja samantaray, Yin Chen, edy Abou-Hamad, Jean-Marie Basset
Silica supported Tetramethyl niobium complex [([identical with]SiO)NbMe4] 2 has been isolated by surface alkylation of [([identical with]SiO-)NbCl3Me] 1 with dimethyl zinc in pentane. 1 can be easily synthesized by grafting of NbCl3Me2...
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Silica supported Tetramethyl niobium complex [([identical with]SiO)NbMe4] 2 has been isolated by surface alkylation of [([identical with]SiO-)NbCl3Me] 1 with dimethyl zinc in pentane. 1 can be easily synthesized by grafting of NbCl3Me2...
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Tracking Thermal-Induced Amorphization of a Zeolitic Imidazolate Framework via Synchrotron In Situ Far-Infrared Spectroscopy
Chem. Commun., 2017, Accepted Manuscript
DOI: 10.1039/C7CC01985H, Communication
DOI: 10.1039/C7CC01985H, Communication
Matthew R Ryder, Thomas Douglas Bennett, Chris Kelley, Mark Frogley, Gianfelice Cinque, Jin-Chong Tan
We present the first use of in situ far-infrared spectroscopy to analyze the thermal amorphization of a zeolitic imidazolate framework material. We explain the nature of vibrational motion changes during...
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We present the first use of in situ far-infrared spectroscopy to analyze the thermal amorphization of a zeolitic imidazolate framework material. We explain the nature of vibrational motion changes during...
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A Supramolecular Assembly based on an Engineered Hemoprotein Exhibiting a Thermal Stimulus-Driven Conversion to a New Distinct Supramolecular Structure
Chem. Commun., 2017, Accepted Manuscript
DOI: 10.1039/C7CC02678A, Communication
DOI: 10.1039/C7CC02678A, Communication
Koji Oohora, Yoshitaka Onuma, Yuta Tanaka, Akira Onoda, Takashi Hayashi
An engineered version of apocytochrome b562 with an external heme moiety covalently attached to the protein surface via an azobenzene or stilbene moiety as a linker forms two different self-assembled...
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An engineered version of apocytochrome b562 with an external heme moiety covalently attached to the protein surface via an azobenzene or stilbene moiety as a linker forms two different self-assembled...
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Reply to Padmanabhan and Dixit: Hepatitis C virus entry inhibitors for optimally boosting direct-acting antiviral-based treatments [Biological Sciences]
We thank Padmanabhan and Dixit for their comments (1) on our paper (2). They pointed out that entry inhibitors might form potent partners for optimal drug combinations. They analyzed previously published data on 10 hepatitis C virus (HCV) entry inhibitors that are under clinical or preclinical development and found some...
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Inhibitors of hepatitis C virus entry may be potent ingredients of optimal drug combinations [Biological Sciences]
With the large number of drugs now approved for the treatment of chronic hepatitis C virus (HCV) infection and an even larger number under development, rational identification of effective drug combinations becomes necessary for better disease management and the judicious design of clinical trials. In PNAS, Koizumi et al. (1)...
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Learned response sequences in cerebellar Purkinje cells [Neuroscience]
Associative learning in the cerebellum has previously focused on single movements. In eyeblink conditioning, for instance, a subject learns to blink at the right time in response to a conditional stimulus (CS), such as a tone that is repeatedly followed by an unconditional corneal stimulus (US). During conditioning, the CS...
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Wild tobacco genomes reveal the evolution of nicotine biosynthesis [Plant Biology]
Nicotine, the signature alkaloid of Nicotiana species responsible for the addictive properties of human tobacco smoking, functions as a defensive neurotoxin against attacking herbivores. However, the evolution of the genetic features that contributed to the assembly of the nicotine biosynthetic pathway remains unknown. We sequenced and assembled genomes of two...
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Emergence of categorical face perception after extended early-onset blindness [Psychological and Cognitive Sciences]
It is unknown whether the ability to visually distinguish between faces and nonfaces is subject to a critical period during development. Would a congenitally blind child who gains sight several years after birth be able to acquire this skill? This question has remained unanswered because of the rarity of cases...
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Selective lowering of synapsins induced by oligomeric {alpha}-synuclein exacerbates memory deficits [Neuroscience]
Mounting evidence indicates that soluble oligomeric forms of amyloid proteins linked to neurodegenerative disorders, such as amyloid-β (Aβ), tau, or α-synuclein (αSyn) might be the major deleterious species for neuronal function in these diseases. Here, we found an abnormal accumulation of oligomeric αSyn species in AD brains by custom ELISA,...
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cGAS is essential for cellular senescence [Immunology and Inflammation]
Cellular senescence is a natural barrier to tumorigenesis and it contributes to the antitumor effects of several therapies, including radiation and chemotherapeutic drugs. Senescence also plays an important role in aging, fibrosis, and tissue repair. The DNA damage response is a key event leading to senescence, which is characterized by...
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Spatiotemporal dynamics of word retrieval in speech production revealed by cortical high-frequency band activity [Psychological and Cognitive Sciences]
Word retrieval is core to language production and relies on complementary processes: the rapid activation of lexical and conceptual representations and word selection, which chooses the correct word among semantically related competitors. Lexical and conceptual activation is measured by semantic priming. In contrast, word selection is indexed by semantic interference...
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HDAC1 links early life stress to schizophrenia-like phenotypes [Neuroscience]
Schizophrenia is a devastating disease that arises on the background of genetic predisposition and environmental risk factors, such as early life stress (ELS). In this study, we show that ELS-induced schizophrenia-like phenotypes in mice correlate with a widespread increase of histone-deacetylase 1 (Hdac1) expression that is linked to altered DNA...
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Impact of the round window membrane accessibility on hearing preservation in adult cochlear implantation
Abstract
This study was conducted to evaluate the effect of the round window membrane accessibility on the residual hearing after cochlear implantation surgery in adults. Moreover, the effects of the other demographics and intra-operative factors on the residual hearing loss have been evaluated. The hearing preservation cochlear implantation surgery was performed on 64 adults with residual hearing thresholds ≤80 dB at 250 and 500 Hz, who had referred to our tertiary academic center. All the patients underwent a standardized surgical approach with the same straight electrode inserted through the round window membrane. The hearing thresholds at 250, 500, and 1000 Hz were compared in pre-operative and 1 month postoperative pure-tone audiograms. The average hearing threshold shifts at these frequencies was used to evaluate the hearing preservation. The effects of the round window accessibility and other factors (including gender, age, side of the surgery, necessity of anterior–inferior drilling of the round window margin and average insertion speed) on hearing threshold shifts were analyzed. The mean low-frequency hearing threshold shift was found to be 17.5 dB for all the patients. The hearing preservation goal (threshold shifts ≤30 dB) was achieved in 58 patients. Among the evaluated parameters, only accessibility of the round window membrane could change the hearing threshold shifts significantly (p = 0.026), and was a predictor for the hearing loss (B coefficient = 7.5, p = 0.006). Incomplete accessibility of the round window membrane may be a predictor for increased hearing threshold shifts in short-term evaluations after cochlear implantation.
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Safety Assessment of Oil from Pequi (Caryocar brasiliense Camb.): Evaluation of the Potential Genotoxic and Clastogenic Effects
Journal of Medicinal Food , Vol. 0, No. 0.
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Genotoxicity and Antigenotoxicity Assessments of the Flavonoid Vitexin by the Drosophila melanogaster Somatic Mutation and Recombination Test
Journal of Medicinal Food , Vol. 0, No. 0.
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Comparison of Three Adiposity Indexes and Cutoff Values to Predict Metabolic Syndrome Among University Students
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
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Squamous cell carcinoma associated with inverted papilloma : Inverted papilloma is a benign, locally aggressive neoplasm that arises in the nasal cavity and is associated with squamous cell carcinoma in approximately 5% of patients.
http://ent-crete.blogspot.com/2017/06/inverted-papilloma-is-benign-locally.html
Squamous cell carcinoma associated with inverted papilloma of the maxillary sinus: our experience with 21 patients
MS Yu, WS Lim, BJ Lee, YS Chung - Clinical Otolaryngology, 2017 - Wiley Online Library
Methods We retrospectively analysed the records of 117 patients with SCC of the maxillary
sinus who had been treated at Asan Medical Center between 1990 and 2014. SCC of the
maxillary sinus was histologically confirmed in all patients. Of these 117 patients, 31 were
excluded because of unidentified primary tumour sites or inadequate follow-up data.
According to the final pathological diagnosis, patients with IP-associated SCC were ...
sinus who had been treated at Asan Medical Center between 1990 and 2014. SCC of the
maxillary sinus was histologically confirmed in all patients. Of these 117 patients, 31 were
excluded because of unidentified primary tumour sites or inadequate follow-up data.
According to the final pathological diagnosis, patients with IP-associated SCC were ...
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Synoptic sampling and principal components analysis to identify sources of water and metals to an acid mine drainage stream
Abstract
Combining the synoptic mass balance approach with principal components analysis (PCA) can be an effective method for discretising the chemistry of inflows and source areas in watersheds where contamination is diffuse in nature and/or complicated by groundwater interactions. This paper presents a field-scale study in which synoptic sampling and PCA are employed in a mineralized watershed (Lion Creek, Colorado, USA) under low flow conditions to (i) quantify the impacts of mining activity on stream water quality; (ii) quantify the spatial pattern of constituent loading; and (iii) identify inflow sources most responsible for observed changes in stream chemistry and constituent loading. Several of the constituents investigated (Al, Cd, Cu, Fe, Mn, Zn) fail to meet chronic aquatic life standards along most of the study reach. The spatial pattern of constituent loading suggests four primary sources of contamination under low flow conditions. Three of these sources are associated with acidic (pH <3.1) seeps that enter along the left bank of Lion Creek. Investigation of inflow water (trace metal and major ion) chemistry using PCA suggests a hydraulic connection between many of the left bank inflows and mine water in the Minnesota Mine shaft located to the north-east of the river channel. In addition, water chemistry data during a rainfall-runoff event suggests the spatial pattern of constituent loading may be modified during rainfall due to dissolution of efflorescent salts or erosion of streamside tailings. These data point to the complexity of contaminant mobilisation processes and constituent loading in mining-affected watersheds but the combined synoptic sampling and PCA approach enables a conceptual model of contaminant dynamics to be developed to inform remediation.
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Connectivity predicts deep brain stimulation outcome in Parkinson's disease
Abstract
Objective: The benefit of deep brain stimulation (DBS) for Parkinson's disease (PD) may depend on connectivity between the stimulation site and other brain regions, but which regions and whether connectivity can predict outcome in patients remains unknown. Here, we identify the structural and functional connectivity profile of effective DBS to the subthalamic nucleus (STN) and test its ability to predict outcome in an independent cohort.
Methods: A training dataset of 51 PD patients with STN DBS was combined with publicly available human connectome data (diffusion tractography and resting state functional connectivity) to identify connections reliably associated with clinical improvement (motor score of Unified Parkinson's Disease Rating Scale). This connectivity profile was then used to predict outcome in an independent cohort of 44 patients from a different center.
Results: In the training dataset, connectivity between the DBS electrode and a distributed network of brain regions correlated with clinical response including structural connectivity to supplementary motor area and functional anticorrelation to primary motor cortex (p < 0.001). This same connectivity profile predicted response in an independent patient cohort (p < 0.01). Structural and functional connectivity were independent predictors of clinical improvement (p < 0.001) and estimated response in individual patients with an average error of 15% UPDRS improvement. Results were similar using connectome data from normal subjects or a connectome age, sex, and disease-matched to our DBS patients.
Interpretation: Effective STN-DBS for PD is associated with a specific connectivity profile that can predict clinical outcome across independent cohorts. This prediction does not require specialized imaging in PD patients themselves. This article is protected by copyright. All rights reserved.
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Epileptic networks in action: Synchrony between distant hemodynamic responses
ABSTRACT
Objective: Structural and functional imaging studies in focal epilepsy often reveal distributed regions of abnormality. These are interpreted as representing the existence of epileptic networks but the presence of actual neuronal interactions between these regions has not been demonstrated. We sought to determine if the distributed hemodynamic responses often seen in fMRI studies of scalp interictal epileptic discharges (IEDs) actually correspond to synchronized neuronal activities when examining the intracerebral EEG (iEEG) at distant nodes of the network.
Methods: We studied 28 patients who underwent first EEG-fMRI and then iEEG, and had significant hemodynamic responses in the gray matter. We co-registered the hemodynamic responses to the iEEG electrode contacts positions and analyzed synchrony, measured by correlation, between IEDs recorded by iEEG in regions with and without hemodynamic responses.
Results: The synchrony of intracerebral IED activity between pairs of regions showing a hemodynamic response was higher compared to that between pairs of regions without (p<0.0001) and between pairs of regions, one with and one without hemodynamic response (p<0.0001). These differences were found during the interictal periods with IEDs but were absent during the interictal periods without IEDs. Higher synchrony was also observed between regions involved at seizure-onset (p<0.0001).
Interpretation: EEG-fMRI studies are unique in their ability to reveal hemodynamic concomitants of IEDs anywhere in the brain. This study proves that iEEG activity is synchronized between these regions of hemodynamic response, thus demonstrating the existence of an actual neuronally-based interictal epileptic network. This also validates the EEG-fMRI approach to reveal this network non-invasively. This article is protected by copyright. All rights reserved.
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