Relationship between chronic rhinosinusitis exacerbation frequency and asthma control

Objectives/Hypothesis

To determine the association between the frequency of acute chronic rhinosinusitis (CRS) exacerbations (AECRS) and the degree of asthma control in asthmatic CRS patients.

Study Design

Cross-sectional study.

Methods

We prospectively recruited 108 asthmatic CRS patients as participants. Asthma control was assessed using the Asthma Control Test (ACT). The frequency of AECRS was assessed using three previously described indirect metrics for AECRS: the frequency of patient-reported sinus infections, CRS-related antibiotics use, and CRS-related oral corticosteroids use in the last 3 months. CRS symptom severity was measured using the 22-item Sinonasal Outcome Test (SNOT-22). Associations between ACT score and metrics for AECRS were performed using linear regression while controlling for clinical and demographic characteristics, including SNOT-22 score.

Results

ACT score was significantly and negatively associated with the frequency of patient-reported sinus infections (adjusted linear regression coefficient [β] = −1.2, 95% confidence interval [CI]: −2.3 to −0.1, P = .033), CRS-related antibiotics courses (adjusted β = −1.4, 95% CI: −2.3 to −0.5, P = .004), and CRS-related oral corticosteroid courses (adjusted β = −1.5, 95% CI: −2.5 to −0.5, P = .004) in the last 3 months, independent of characteristics including SNOT-22 score. Poor asthma control could be detected using one or more sinus infections (70.6% sensitivity, 47.3% specificity), CRS-related antibiotics (50.0% sensitivity, 73.0% specificity), or CRS-related oral corticosteroids (58.8% sensitivity, 71.6% specificity) in the last 3 months.

Conclusions

AECRS are negatively associated with the level of asthma control in asthmatic CRS patients, independent of CRS symptom severity. These results highlight AECRS as a distinct clinical manifestation of CRS that should be routinely assessed in CRS patients.

Level of Evidence

2c. Laryngoscope, 2017

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Sphingobacterium spiritivorum bacteremia due to cellulitis in an elderly man with chronic obstructive pulmonary disease and congestive heart failure: a case report

Sphingobacterium spiritivorum is a glucose non-fermenting Gram-negative rod, formerly classified as one of the Flavobacterium species. It is characterized by a large number of cellular...

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Bacterial cellulose skin masks—Properties and sensory tests

Summary

Background

Bacterial cellulose (BC) is a versatile material produced by microorganisms in the form of a membranous hydrogel, totally biocompatible, and endowed with high mechanical strength. Its high water-holding capacity based on its highly porous nanofibrillar structure allows BC to incorporate and to release substances very fast, thus being suitable for the preparation of skincare masks.

Aims

The preparation and characterization of cosmetic masks based on BC membranes and active cosmetics.

Methods

The masks were prepared by the simple incorporation of the cosmetic actives into BC membranes, used as a swelling matrix. The masks were characterized by Fourier transform infrared (FTIR), scanning electron microscopy (SEM), sensory tests, and skin moisture tests on volunteers.

Results

The results of sensory tests revealed the good performance of BC, being considered effective by the panel of volunteers, specially for adhesion to the skin (7.7 at the score scale), and improvement of the skin moisture (the hydration effect increased 76% in 75% of the volunteers that used vegetable extract mask formulation [VEM]), or a decrease in skin hydration (80% of the volunteers showed 32.6% decrease on skin hydration using propolis extract formulation [PEM] treatment), indicating the BC nanofiber membranes can be used to skincare applications.

Conclusion

The results demonstrate the BC can be used as an alternative support for cosmetic actives for skin treatment.

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Recovery of 3-Iodothyronamine and Derivatives in Biological Matrixes: Problems and Pitfalls

Thyroid Oct 2017, Vol. 27, No. 10: 1323-1331.


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Do Lower-Risk Thyroid Cancer Patients Who Live in Regions with More Aggressive Treatments Have Better Outcomes?

Thyroid Oct 2017, Vol. 27, No. 10: 1246-1257.


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Future Meetings

Thyroid Oct 2017, Vol. 27, No. 10: 1339-1339.


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87th Annual Meeting of the American Thyroid Association October 18–22, 2017, Victoria, British Columbia, Canada

Thyroid Oct 2017, Vol. 27, No. 10: 1213-1214.


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Thyroid Hormone Receptor Alpha is Essential to Maintain the Satellite Cell Niche During Skeletal Muscle Injury and Sarcopenia of Aging

Thyroid Oct 2017, Vol. 27, No. 10: 1316-1322.


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Referral Trends for Surgical Management of Graves' Disease

Thyroid Oct 2017, Vol. 27, No. 10: 1337-1338.


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International Journal of Otolaryngology and Head & Neck Surgery Vol.6,No.5 (September 2017)

Orbital Injury in Endoscopic Sinus Surgery for Sinonasal Inflammatory Disorders: Juntendo's Ten-Year Experience
Orbital Injury, Orbital Complications, Endoscopic Sinus Surgery, Orbital Fat
Paper Information Full Paper: PDF (Size:336KB)
DOI: 10.4236/ijohns.2017.65009

Catheter in Antrochoanal Polyp: Functions Intact
Antrochoanal Polyp, Catheter
Paper Information Full Paper: PDF (Size:835KB)
DOI: 10.4236/ijohns.2017.65008

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Save the Date! Lone Star Rhinology and Rhinoplasty Course Scheduled for November

The Department of Otorhinolaryngology-Head & Neck Surgery at UTHealth's McGovern Medical School is proud to sponsor 2017 Lone Star Rhinology... Read the full article...

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Dr. Amber Luong Receives 2017 Helen F. Krause, MD Memorial Trailblazer Award

Amber Luong, MD, PhD, associate professor of otorhinolaryngology, has been recognized with the 2017 Helen F. Krause, MD Memorial Trailblazer... Read the full article...

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ORL Frontiers 2017 Recap

More than 70 physicians and other healthcare professionals attended ORL Frontiers 2017, held last June at the Brown Foundation Institute... Read the full article...

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Factors influencing age of onset of wheezing among children with recurrent wheezing and the association of Vitamin D status with atopic manifestations

Bijay Kumar Meher, Deepti Damayanty Pradhan, S Pradeep, Leena Das, Siba Shankar Beriha, Sumanta Panigrahi

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):76-82

Background: Onset of wheezing before 3 years of age is concerning due to its potential for the development of asthma. Different risk factors, atopic manifestations, and Vitamin D deficiency are attributed to it. Aims: The aim of this study is to assess the factors influencing the age of wheezing onset among children with early-onset recurrent wheezing and the association of Vitamin D status with different atopic manifestations. Subjects And Methods: This cross-sectional observational study included 141 children aged from 1 month to 14 years with recurrent wheezing. Onset of wheezing after 36 months was excluded from the study. Different risk factors and atopic manifestations were recorded, and Vitamin D levels were measured. Descriptive analysis, independent t-test, analysis of variance, and regression analysis were done using SPSS version 24.0. Results: Of 141 children, 65 (46.0%) had onset of wheezing at <1 year of age. Children with onset of wheezing <1 year had early age of presentation (29.38 ± 29.35 vs. 46.25 ± 27.77 months) were predominately male (52.1% vs. 47.9%) and had a low birth weight (2688.46 ± 608.84 vs. 2904.61 ± 510.96 g) and high Vitamin D level (22.01 ± 12.63 vs. 16.65 ± 9.05 ng/mL; P < 0.05). In the regression analysis, birth weight, family with >1 sibling, and atopic dermatitis had regression coefficients of 0.393 (P < 0.01), 4.525 (P < 0.01), and −2.970, respectively (P > 0.05). Conclusions: Children with onset of wheezing before 1 year were predominantly male and had a lower birth weight. Vitamin D deficiency does not hasten the onset of wheezing; however, a low birth weight and associated atopic dermatitis hasten the onset of wheezing, and being part of a family with >1 sibling delays onset.

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Swine flu: Brief overview

Saurabh Srivastava, SN Gaur

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):37-37



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Diagnostic and treatment challenges in management of allergic fungal rhinosinusitis

Abhishek Bahadur Singh, Rashmi Upadhyay, Nitesh Tayal

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):38-44

Among infections pertaining to head and neck rhinosinusitis holds a significant position both with regard to the prevalence and morbidity. Allergic fungal rhinosinusitis (AFRS) was initially considered a counterpart of allergic bronchopulmonary aspergillosis when first diagnosed by Sa firstein in 1976 due to its clinical presentations and seemingly similar pathogenesis. Initially only Aspergillus was known as the causative, but now various other fungal species are known to cause chronic rhinosinusitis; hence, the terminology allergic fungal sinusitis was preferred. Exposure to fungi results in similar as asthma in atopic individuals, but then, some nonatopic individuals may also present with similar symptoms. It has also been studied that the presence of serum immunoglobulin E does not ensure the presence of allergy. Till date, there are several controversies regarding pathogenesis, whether humoral or immune mediated, population at risk, variations in presentations, diagnostic parameters, and treatment protocols. In this review, we try to revisit and learn from past documented experiences to further our attempt toward better understanding of the disease process, its diagnosis, and management.

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In silico identification and characterization of putative kuruma prawn (Marsupenaeus japonicus) allergens

Kar Ee Hoh, Venkataramanan Swaminathan

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):87-93

Background: Prawn is one of the major sources of shellfish allergens, which will induce mild to severe allergic reactions. Aim: The objective of this study was to predict putative allergens and its characteristics present in Marsupenaeus japonicus through an in silico approach. Materials And Methods: In this present study, in silico tools, RaptorX, Bepipred Linear Epitope and Parker Hydrophilicity Prediction method, and MHC2Pred were used to predict the putative and cross-reactive allergens, tertiary and secondary structures, B-cell linear epitopes, and T-cell epitopes, respectively. Results: As a result, eight putative and cross-reactive allergens including tropomyosin fast isoform, arginine kinase, sarcoplasmic calcium binding protein, myosin light chain, chymotrypsin like proteinase, superoxide dismutase, cathepsin B, and trypsin were predicted by analyzing the protein sequences of M. japonicus. Furthermore, five amino acids (Ala, Ser, Asn, Gly, and Lys) play a vital role in immunoglobulin E binding allergenic epitope. At least one of them was found in the predicted B-cell epitope for each of the predicted putative allergens. Moreover, the predicted T-cell epitopes were highly associated with human leukocyte antigen (HLA) DRB1*0101 and HLA-DRB1*0901 alleles while mediating T-cell immune responses. Conclusion: These results can be utilized to contribute in peptide immunotherapy and reduce the allergic diseases related to shellfish.

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Prevalence of aeroallergens in patients of bronchial asthma and/or allergic rhinitis in India based on skin prick test reactivity

Raj Kumar, Manoj Kumar, Indu Bisht, Kamal Singh

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):45-55

Background: Exposures to various aeroallergens play a crucial role in the pathogenesis of bronchial asthma (BA) and allergic rhinitis (AR). On the basis of climate change, the prevalence of aeroallergens may vary in different regions. AIMS: The aim of the study was to determine the prevalence of the sensitivity to aeroallergens among patients with BA and/or AR based on skin prick test (SPT) reactivity in India. Settings And Design: This study was conducted at National Centre of Respiratory Allergy, Asthma and Immunology and Department of Respiratory Allergy and Applied Immunology, (Department of Respiratory Medicine), Vallabhbhai Patel Chest Institute, University of Delhi, Delhi-110007 (India). Subjects And Methods: A total of 4835 patients were screened from the Outpatient Department of institute during the period of August 2008 to July 2016. Out of 4835 patients, 4263 patients were performed SPT consisting of 2361 (55.38%) males and 1902 (44.62%) females, with a mean age of 30.06 years were included in the study. Diagnosis of BA and AR was made according to the GINA and ARIA guidelines, respectively. SPT was done with 58 different types of aeroallergens, which included grass pollens, weed pollens, tree pollens, dust, fungi, insects, kapok cotton, wool, and silk antigens. Statistical Analysis Used: Data analysis was done using Excel 2007. Results: Significant skin positive reaction (2 + and above) against aeroallergens were found in 1993 (46.77%) participants including 422 (9.9%) BA patients, 570 (13.37%) AR patients, and 1001 (23.48%) of both BA/AR. The younger adults aged 20–29 years were the foremost commonly affected group with 626 (14.68%) significant skin-positive patients. Among individual allergens, most common aeroallergen was mosquito (30.89%) and least common was Ehretia (0.37%). Conclusions: In different states of India, the mosquito was found the most common sensitizing allergen in BA and/or AR patients. Sensitization was the most common in the younger age group (20–29 years) patients.

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Epidemiology of bronchial asthma among children in Jazan Region, Saudi Arabia

Alhussen F Khawaji, Abdulhameed Basudan, Abdulrahman Moafa, Mohammed Faqihi, Mohammed Alhazmi, Taher A Mahnashi, Yaseen Haddadi, Abuobaida K Yassin

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):69-75

Context: Asthma is a global problem, its prevalence varies among different countries and cities and age groups. In children, asthma is one of the most common chronic diseases and one of the leading causes of morbidity and mortality. Aims: This study was conducted to estimate the prevalence of asthma among children in Jazan Region (JR), Saudi Arabia. Settings And Design: This is study conducted in Jazan region, saudi arabia among school age children. It is a cross-sectional study used a modified international study os asthma and allergy in children questionnaire. Subjects And Methods: The target study population were school age, witth sample size of 1200 distributed to all geographical areas. Statistical Analysis Used: The data had been entered and analyzed using Statistical Package for Social Sciences software version 22.0. Descriptive statistics (e.g., number, percentage) and analytic statistics using Chi-square tests (χ2) to test for the association and/or the difference between two categorical variables will be applied. A P < 0.05 was considered statistically significant. Results: The total study population was 1400, most of them were Saudi (1273, 90.9%). Male students were 840 (60.0%), and female students were 560 (40.0%). According to the residency, 811 (57.9%) students were lived in rural, 64.7% of them were male, and 589 (42.1%) of participants lived in urban area. Most of the students lived in plain area (840, 60.0%), and only 16.4% of them lived in mountain area in which 63.5% of them were male. Elementary school students account 54.1% of total students; about 63% of them were male. The prevalence of life-long wheezes was 17.7%. The prevalence of exercise-induced wheeze and wheeze during the last 12 months was 206 (14.7%) and 159 (11.4%), respectively. Students with the past medical history of bronchial asthma were 212 (15.1%), with no clear statistical significant difference in frequency between male and female (P = 0.161). Asthma was confirmed by doctor in 10% of participants. Conclusions: The prevalence of asthma among children in JR is slightly higher than those reported from local and regional reports.

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Study of prevalence of bronchial asthma in school children of 6–12 years of age in rural schools of Tumakuru district

Priyadarshini Bai Govinda Naik, Puttaswamy Ravikumar

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):56-60

Context: Pediatric asthma is a serious global health problem. The recent rise in the prevalence of asthma was associated with environmental pollution, urbanization, and the change in demography. Aims: The present study was undertaken to determine the prevalence of asthma in school children of rural parts of Tumakuru district and to study its association with different epidemiological factors. Settings And Design: This study is a questionnaire-based study (International Study of Asthma and Allergies in Childhood-Questionnaire) carried out in four randomly selected rural schools of Tumakuru district. Subjects And Methods: The questionnaire was distributed to all the children (n = 1750) and asked to fill the questionnaire with the help of their parents. These questionnaires were given standard scores to diagnose asthma. Other epidemiological factors were also recorded in the questionnaire and studied. Statistical Analysis Used: The statistical analysis was done using MSTAT software. Chi-square test was used to get the P value. P < 0.05 was considered statistically significant. Results: The prevalence of asthma in our study was 3.12% (n = 51). Boys had a slightly higher prevalence 3.36% (n = 32) than girls 2.8% (n = 19). We found 58.8% (n = 30) of these asthmatics had allergic rhinitis and 19.6% (n = 10) had a history of atopy. Overall prevalence of allergic rhinitis was 8.3% (n = 137) and atopy was 1.13% (n = 23). Conclusions: The study showed 3.12% of children are affected with asthma, and its prevalence is significantly associated with epidemiological factors such as family history of allergy, high socioeconomic status, and use of fire wood for cooking.

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Pediatric peak expiratory flow rate nomograms for Ernakulam district

Jomon Mathew John

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):83-86

Objective: To obtain the normal reference values of peak expiratory flow rates (PEFRs) among healthy school-going children between 8 and 12 years and thereby construct a nomogram. Materials And Methods: A cross-sectional study was conducted among healthy children attending schools in Ernakulam district over a period of 1 year. PEFR values were recorded using a Mini-Wright peak flow meter, and the best of three readings was documented. Results: Nine hundred and fifty-four students were studied. PEFR increases as the age increases. A similar trend was observed across various heights. Nomograms based on age and height were constructed separately for boys and girls. Conclusion: Established baseline values of PEFR in this study can be useful in diagnosing and following asthmatic children in Ernakulam district.

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Improvement in pulmonary functions and clinical parameters due to addition of breathing exercises in asthma patients receiving optimal treatment

Dipti Agarwal, Prem Parkash Gupta, Sushma Sood

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):61-68

Background: Breathing exercises have been described to be useful in asthma management. Objective: The aim of this study is to detect the efficacy of breathing exercises (Pranayamas) in asthma patients using spirometric indices, clinical symptoms parameters, and requirement of rescue medications. Methods: A total of 60 stable asthma patients (34 females) diagnosed and received optimal asthma treatment for 3 months or more according to the GINA guidelines were enrolled. All patients continued their respective medications and in addition performed seven breathing exercises (Surya Bhedana Pranayama, Nadi Shuddi Pranayama, Bhramari Pranayama, Surya Nadi Pranayama, Kapal Bhati, Bhastrika, and Om Chanting) under supervision at Yoga center at our Institute for 3 months after inclusion to study. Spirometry, nocturnal symptoms, and the requirement of rescue medicines were assessed before and after breathing exercise intervention. Visual analog scale (VAS) was used to assess the dyspnea and wheezing in the study participants. Results: The mean age of asthma patients was 25.45 ± 5.41 years. After breathing exercise intervention, mean forced expired volume in one second increased from 2.492 ± 0.358 L to 2.745 ± 0.343 L and mean peak expiratory flow rate increased from 283.82 ± 51.12 L/min to 336.23 ± 51.47 L/min; the increases were statistically significant. The mean nocturnal symptoms score decreased significantly from 1.416 ± 1.619 to 0.067 ± 0.362. The requirement of rescue medications decreased significantly from 6.23 ± 2.95 to 0.90 ± 1.25 puffs/week. VAS scores for breathlessness and wheezing were significantly decreased. Conclusions: Breathing exercises provided significant improvements in spirometric parameters and significant reduction in breathlessness, wheezing, and nocturnal symptoms as well as requirements of rescue medicines in asthma patients who were receiving optimal asthma treatment.

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Endobronchial aspergilloma mimicking bronchogenic carcinoma removed through flexible fiber-optic bronchoscopy

P Hari Lakshmanan, Muhammed Jasim Abdul Jalal, Dhanya Jacob, Ami Maria Emmanuel

Indian Journal of Allergy, Asthma and Immunology 2017 31(2):94-96

Endobronchial aspergilloma is a rare, noninvasive aspergillosis. It may be associated with a parenchymal lesion and/or cavity. We describe a case of endobronchial aspergillosis mimicking bronchogenic carcinoma subsequently removed completely through fiber-optic bronchoscope itself. This case report, while highlighting the existence of this unique clinical entity, also throws light on potential treatment option which can be curative.

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Results of the 2016 International Skin Imaging Collaboration International Symposium on Biomedical Imaging challenge: Comparison of the accuracy of computer algorithms to dermatologists for the diagnosis of melanoma from dermoscopic images

Computer vision may aid in melanoma detection.

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Brimonidine for treatment of telangiectasia of dermatomyositis

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Second primary cancer after major salivary gland carcinoma

Abstract

Background

We investigated the risk of second primary cancers after major salivary gland carcinoma in Finland, with a population of 5.5 million.

Methods

Nationwide cancer registry data were used to identify patients with major salivary gland carcinoma diagnosed between 1953 and 2014. Standardized incidence ratios (SIRs) were estimated to compare their second primary cancer risk with the respective site-specific cancer risk in the general population.

Results

There were 1727 patients with major salivary gland carcinomas and 222 second primary cancers had been diagnosed in these patients (SIR 1.43). The risk was increased for cancers of the thyroid (SIR 5.12), breast (SIR 1.63), respiratory organs (SIR 1.63), male genital organs (SIR 1.48), melanoma of the skin (SIR 3.35), and nonmelanoma skin cancer (SIR 2.50). The risk was high during the first 5 years and after 20 years of diagnosis.

Conclusion

Second primary cancers can occur among patients with major salivary gland carcinoma even after a long time period. This needs to be recognized in the follow-up of these patients.

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Giardia duodenalis et son implication dans diverses dermatoses

Publication date: Available online 29 September 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): P. Humbert, A. Guichard, I. Bennani, S. Chiheb
ObjectifAu cours de ces trente dernières années, la communauté scientifique s'est de plus en plus intéressée à la flore intestinale, microbiote ou pathogène et son impact sur les autres organes. La possibilité qu'un agent microbien intestinal soit un facteur étiologique de symptômes cutanés n'est plus à démontrer. Un parasite, en particulier, a fait l'objet de nombreuses investigations : Giardia duodenalis. L'objectif de ce travail était de dresser une revue complète des publications démontrant l'implication de G. duodenalis dans diverses dermatoses.MéthodeUne revue de la littérature a été réalisée via différentes bases de données (Medline, Pubmed et Google Scholar) pour la période de 1975 à 2015. Parmi la trentaine de cas décrits depuis 1976, nous en rapportons ici une vingtaine qui nous semblent les plus objectifs et cliniquement pertinents.Résultats et discussionBien qu'il s'agisse le plus souvent de cas isolés, cette revue démontre que la giardiose intestinale peut être associée à des dermatoses variées par l'intermédiaire de mécanismes inflammatoires, allergiques ou d'hyperperméabilité intestinale, voire en être elle-même le facteur étiologique. Les lésions cutanéomuqueuses sont variées : urticaire, angio-œdème, érythème noueux, syndrome de Wells… Le rôle et l'origine de l'infestation étant souvent inconnus, il est alors difficile de déterminer l'intervalle de temps entre l'infestation parasitaire et l'apparition des lésions cutanées. C'est pourquoi il faut discuter un examen parasitologique des selles à la recherche de ce parasite devant une urticaire ou un angio-œdème chronique ou récidivant, une dermatite atopique sévère, voire même proposer un traitement d'épreuve, tant celui-ci est aisé, et les examens de selles peu sensibles.BackgoundOver the last thirty years, the scientific community has become increasingly interested in the intestinal flora, whether commensal or pathogenic, and its impact on other organs. In dermatology, the correlation between intestinal microbial agents and cutaneous lesions is well established. Giardia duodenalis, an intestinal parasite, has been particularly widely studied. The aim of this work is to provide a review of studies demonstrating the involvement of G. duodenalis in various forms of dermatosis.Patients and methodsThe data were obtained by an English-language literature search of Medline, PubMed and Google Scholar for the period 1975–2015. Among the thirty case reports since 1976, we selected the twenty most objective and clinically relevant.Results and discussionThis review demonstrates that intestinal giardiasis may be an etiological factor, either alone or in combination with other agents, of various dermatoses through inflammatory and allergic mechanisms or intestinal hyperpermeability. The mucocutaneous lesions are varied: urticaria, angioedema, atopic dermatitis, erythema nodosum, Wells syndrome, among others. The role and origin of the infection are often unknown, and it is thus difficult to determine the interval between parasite infestation and the onset of skin lesions. Consequently, a fecal examination to identify G. duodenalis should be considered in chronic urticaria or angioedema, and where atopic dermatitis occurs in adulthood without any specific etiology. Therapeutic test should be done in every suspicion.



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Diagnostic accuracy of PCR-based detection tests for Helicobacter Pylori in stool samples: A systematic review and meta-analysis

Abstract

Background

Although different methods have been established to detect Helicobacter pylori (H. pylori) infection, identifying infected patients is an ongoing challenge. The aim of this meta-analysis was to provide pooled diagnostic accuracy measures for stool PCR test in the diagnosis of H. pylori infection.

Methods

In this study, a systematic review and meta-analysis were carried out on various sources, including MEDLINE, Web of Sciences, and the Cochrane Library from April 1, 1999, to May 1, 2016. This meta-analysis adheres to the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses report (PRISMA Statement). The clinical value of DNA stool PCR test was based on the pooled false positive, false negative, true positive, and true negative of different genes.

Results

Twenty-six of 328 studies identified met the eligibility criteria. Stool PCR test had a performance of 71% (95% CI: 68-73) sensitivity, 96% (95% CI: 94-97) specificity, and 65.6 (95% CI: 30.2-142.5) diagnostic odds ratio (DOR) in diagnosis of H. pylori. The DOR of genes which showed the highest performance of stool PCR tests was as follows: 23S rRNA 152.5 (95% CI: 55.5-418.9), 16S rRNA 67.9 (95%CI: 6.4-714.3), and glmM 68.1 (95%CI: 20.1-231.7).

Conclusions

The sensitivity and specificity of stool PCR test are relatively in the same spectrum of other diagnostic methods for the detection of H. pylori infection. In descending order of significance, the most diagnostic candidate genes using PCR detection were 23S rRNA, 16S rRNA, and glmM. PCR for 23S rRNA gene which has the highest performance could be applicable to detect H. pylori infection.

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Dermoscopic features of a case of external dental fistula

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Apoptosis induced by caffeic acid phenethyl ester in human oral cancer cell lines: Involvement of Puma and Bax activation

Publication date: December 2017
Source:Archives of Oral Biology, Volume 84
Author(s): Hyun-Ju Yu, Ji-Ae Shin, In-Hyoung Yang, Dong-Hoon Won, Chi Hyun Ahn, Hye-Jeong Kwon, Jeong-Sang Lee, Nam-Pyo Cho, Eun-Cheol Kim, Hye-Jung Yoon, Jae Il Lee, Seong-Doo Hong, Sung-Dae Cho
ObjectiveCaffeic acid phenethyl ester (CAPE), a natural honeybee product exhibits a spectrum of biological activities including antimicrobial, anti-inflammatory, antioxidant and antitumor actions. The purpose of this research was to investigate the anticancer potential of CAPE and its molecular mechanism in human oral cancer cell lines (YD15, HSC-4 and HN22 cells).DesignTo determine the apoptotic activity of CAPE and identify its molecular targets, trypan blue exclusion assay, soft agar assay, Western blot analysis, DAPI staining, and live/dead assay were performed.ResultsCAPE significantly suppressed transformation of neoplastic cells induced by epidermal growth factor (EGF) and 12-O-tetradecanoylphorbol 13-acetate (TPA) without inhibiting growth. CAPE treatment inhibited cell growth, increased the cleavages of caspase-3 and poly (ADP-ribose) polymerase (PARP), and augmented the number of fragmented nuclei in human oral cancer cell lines. CAPE activated Bax protein causing it to undergo a conformational change, translocate to the mitochondrial outer membrane, and oligomere. CAPE also significantly increased Puma expression and interestingly Puma and Bax were co-localized.ConclusionOverall, these results suggest that CAPE is a potent apoptosis-inducing agent in human oral cancer cell lines. Its action is accompanied by up-regulation of Bax and Puma proteins.



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Electroneurography in the acute stage of facial palsy as a predictive factor for the development of facial synkinesis sequela

Publication date: Available online 29 September 2017
Source:Auris Nasus Larynx
Author(s): Takahiro Azuma, Katsuhiko Nakamura, Mika Takahashi, Hitomi Miyoshi, Naoki Toda, Hidetaka Iwasaki, Noriaki Takeda
ObjectiveWe investigated whether the value of ENoG is a predictive factor for the development of facial synkinesis in patients with facial palsy.MethodsThe degree of oral-ocular synkinesis was evaluated quantitatively by an asymmetry of the interpalpebral space width during the mouth movement (% eye opening). Twenty healthy volunteers without a history of facial palsy (12 men and 8 women; 25–65 years old; mean age: 42.3±9.7years) were included in the study to examine the normal range of % eye opening. Fifty-one patients with facial palsy including 38 with Bell palsy and 15 with herpes zoster oticus (28 men and 25 women; 11–86 years old; mean age: 54±19years) were enrolled to examine the relationship between the ENoG value 10–14days after the onset of facial palsy, and the % eye opening 12 months later. Receiver operating characteristic (ROC) curve for the ENoG value was then used to decide the optimum cut-off value as a predictor of the development of oral-ocular synkinesis.ResultsWe defined a % eye opening inferior to 85% as an index of the development of oral-ocular synkinesis. There was a significant correlation between the values of ENoG 10–14days after the onset of facial palsy and those of % eye opening 12 months later (ρ=0.81, p<0.001). The area under the ROC curve for the ENoG value was the predictor for the development of oral-ocular synkinesis at 0.913 (95%CI: 0.831–0.996, p<0.001). The optimum cut-off value of ENoG 10–14days after the onset of facial palsy was 46.5% to predict the development of oral-ocular synkinesis 12 months after the onset of facial palsy (sensitivity 97.1% and specificity 77.5%).ConclusionThe value of ENoG 10–14days after the onset of facial palsy is a predictive factor for the development of facial synkinesis 12 months later. Since facial palsy patients with a ENoG value inferior to 46.5% have a high risk of developing synkinesis, they should receive the facial biofeedback rehabilitation with a mirror as a preventive therapy.



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Comparison of snoring sounds between natural and drug-induced sleep recorded using a smartphone

Publication date: Available online 28 September 2017
Source:Auris Nasus Larynx
Author(s): Soo Kweon Koo, Soon Bok Kwon, Ji Seung Moon, Sang Hoon Lee, Ho Byung Lee, Sang Jun Lee
ObjectivesSnoring is an important clinical feature of obstructive sleep apnea (OSA), and recent studies suggest that the acoustic quality of snoring sounds is markedly different in drug-induced sleep compared with natural sleep. However, considering differences in sound recording methods and analysis parameters, further studies are required. This study explored whether acoustic analysis of drug-induced sleep is useful as a screening test that reflects the characteristics of natural sleep in snoring patients.Subjects and materialsThe snoring sounds of 30 male subjects (mean age=41.8years) were recorded using a smartphone during natural and induced sleep, with the site of vibration noted during drug-induced sleep endoscopy (DISE); then, we compared the sound intensity (dB), formant frequencies, and spectrograms of snoring sounds.ResultsRegarding the intensity of snoring sounds, there were minor differences within the retrolingual level obstruction group, but there was no significant difference between natural and induced sleep at either obstruction site. There was no significant difference in the F1 and F2 formant frequencies of snoring sounds between natural sleep and induced sleep at either obstruction site. Compared with natural sleep, induced sleep was slightly more irregular, with a stronger intensity on the spectrogram, but the spectrograms showed the same pattern at both obstruction sites.ConclusionAlthough further studies are required, the spectrograms and formant frequencies of the snoring sounds of induced sleep did not differ significantly from those of natural sleep, and may be used as a screening test that reflects the characteristics of natural sleep according to the obstruction site.



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Fluorescence Imaging in Sentinel Lymph Node Biopsy for Head and Neck Cancer

Conditions:   Head and Neck Cancer;   Cancer of the Head and Neck
Intervention:   Drug: IC-GREEN
Sponsor:   Washington University School of Medicine
Recruiting

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Alterations of CCR5 and CCR7 expression on donor peripheral blood T cell subsets after mobilization with rhG-CSF correlate with acute graft-versus-host disease

Publication date: Available online 28 September 2017
Source:Clinical Immunology
Author(s): Meng Wang, Jian Hu, Zhi-Xiang Qiu, Wei Liu, Mang-Ju Wang, Yuan Li, Yu-Hua Sun, Sai-Nan Zhu, Han-Yun Ren, Yu-Jun Dong
To investigate the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on chemokine receptors and explore the potential mechanism of rhG-CSF inducing immune tolerance, ninety-seven donor and recipient pairs undergoing family-donor allogeneic hematopoietic stem cell transplantation were studied. The results indicated that different donors showed great disparities in expression changes after mobilization. Multivariate analysis revealed that both HLA mismatching and CCR7 downregulation on donors' CD4+ T cells after mobilization were independent risk factors for acute graft-versus-host disease (GVHD). In contrast, CCR5 downregulation on CD4+ T cells was associated with reduced incidence of acute GVHD. In conclusion, rhG-CSF mobilization could lead to differential regulation of chemokine receptors expression on T cell subsets in different donors. Downregulation of CCR5 and upregulation of CCR7 expression on donor CD4+ T cells might protect recipients from acute GVHD. This finding may provide a promising new strategy for the prevention and treatment of acute GVHD.



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The inhibition of 5-lipoxygenase (5-LO) products leukotriene B4 (LTB4) and cysteinyl leukotrienes (cysLTs) modulates the inflammatory response and improves cutaneous wound healing

Publication date: Available online 28 September 2017
Source:Clinical Immunology
Author(s): Francielle Rodrigues Guimarães, Helioswilton Sales-Campos, Viviani Nardini, Thiago Alvares da Costa, Monique Thaís Costa Fonseca, Virmondes Rodrigues Júnior, Carlos Artério Sorgi, João Santana da Silva, Javier Emílio Lazo Chica, Lúcia Helena Faccioli, Cristina Ribeiro de Barros Cardoso
To analyze the participation of the enzyme 5-lipoxygenase (5-LO) in skin repair, WT wounds were compared to those in 5-LO deficient mice (5-LO^−/−), which presented faster closure and reduced inflammatory infiltrate in the skin, together with increased CD4 regulatory T cells markers in the draining lymph nodes. The 5-LO^−/− wounds also had diminished TNF-α, CCL11, CCL7, CCL2, CXCL9, CCR1 and CXCR2 mRNA expression in the lesions, besides differential extracellular matrix remodeling. Furthermore, when cysteinyl leukotriene (cysLT) and leukotriene (LTB4) receptors were antagonized in WT mice, there was a remarkable reduction in TNF-α expression and faster skin healing, similarly to the findings in 5-LO^−/− animals. Finally, our results suggested that 5-LO products, in special cysLT and LTB4, underline skin inflammation that follows skin injury and their neutralization may be an important strategy to improve cutaneous healing.



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Benign Rolandic epilepsy presenting like paradoxical vocal fold motion

Publication date: November 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 102
Author(s): Jennifer H. Gross, Mary Bertrand, Keiko Hirose
Paradoxical vocal fold motion (PVFM) is characterized by vocal fold adduction during respiration. Benign Rolandic epilepsy (BRE) is the most common childhood epilepsy and can cause oropharyngolaryngeal or facial manifestations. A 9-year-old male presented with intermittent apnea lasting 30–60 seconds and presumed PVFM. The patient's physical and fiberoptic exam were normal. He was admitted and found to have episodes of oxygen desaturation, neck twitching, and tongue burning. An EEG revealed focal epilepsy. After starting anti-epileptic medications, he had resolution of symptoms. Our patient was eventually diagnosed with BRE, a focal onset epilepsy that can mimic primary otolaryngologic disease.



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Robotic epiglottopexy for severe epiglottic prolapse limiting decannulation

Publication date: November 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 102
Author(s): C. Alessandra Colaianni, Sarah N. Bowe, Heather A. Osborn, Derrick T. Lin, Jeremy D. Richmon, Christopher J. Hartnick
Surgical management of supraglottic collapse at the level of the epiglottis limiting decannulation has historically consisted of placement of epiglottopexy sutures which are technically challenging and often unsuccessful. Herein we describe the use of robotic technology to assist with epiglottopexy for a case of a 9 year old child with severe epiglottic petiole prolapse limiting capping and decannulation. Postoperatively the patient is tolerating capping during waking hours.



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Value of confocal laser endomicroscopy in the diagnosis of vocal cord lesions

OBJECTIVE: The aim of this study was to assess the reliability and limitations of confocal laser endomicroscopy (CLE) for diagnosing lesions of the vocal cords and differentiating malignant from non-malignant lesions.

PATIENTS AND METHODS: During microlaryngoscopy, the vocal cords were scanned by probe-based CLE (pCLE: a GastroFlex probe with the Cellvizio® laser system, Mauna Technologies, Paris, France). The video recordings were analyzed and compared with the histological results. Thirty-one representative images were extracted and presented to four medical professionals (blinded examiners) for assessment.

RESULTS: The accuracy for the category malignant/nonmalignant ranged between 58.1% and 87.1%. Overall interrater reliability was 0.29. Sensitivity ranged between 45.5 and 100%, specificity between 60.0 and 100%, PPV between 38.5% and 100% and NPV between 66.7 and 100%.

CONCLUSIONS: CLE is a promising method for the non-invasive diagnosis of vocal cord lesions in vivo, but factors such as small penetration depth, not available contrast media for the nuclei and subjective analyses of the images limit, at the moment, its diagnostic value.

L'articolo Value of confocal laser endomicroscopy in the diagnosis of vocal cord lesions sembra essere il primo su European Review.

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Periprosthetic total knee fracture after remote reconstruction of the anterior cruciate ligament: a case report

Distal femoral fracture is a rare, but significant, postoperative complication of anterior cruciate ligament reconstruction. However, there has not been a reported case of periprosthetic total knee arthroplast...

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Embolization of a cavernous carotid fistula through the vein of Labbe: a new alternative transvenous access route

Endovascular treatment of carotid cavernous fistulas (CCFs) via a transvenous approach is standard, but in rare cases this approach is challenging due to absence or thrombosis of the commonly used venous routes. A 61-year-old woman presented with a symptomatic CCF with all but one of the venous access routes to the CCF thrombosed, leaving an engorged superficial middle cerebral vein (SMCV) as the only venous outflow from the cavernous sinus. Access to the CCF was made possible after careful navigation of the sigmoid sinus, the vein of Labbé and the SMCV, bypassing the need for surgical access to the SMCV or for a direct transorbital puncture. The CCF was completely occluded by coiling and Onyx embolization. The patient made an uneventful recovery, with resolution of her symptoms. To the best of our knowledge, this access route has not been previously reported in the treatment of CCFs.

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