Αρχειοθήκη ιστολογίου

Πέμπτη 5 Οκτωβρίου 2017

Emerging techniques in assessment and treatment of muscle tension dysphonia.

Purpose of review: The purpose of this review is to summarize current evidence regarding treatment for muscle tension dysphonia (MTD) and to present recent advances in evaluation and management. Recent findings: It is generally accepted that voice therapy for MTD is effective, but current systematic reviews report limited evaluation specific to MTD patients with moderate evidence, at best, available to support voice therapy techniques. Individual studies are difficult to compare because of heterogeneity. Considerable work is underway to identify most important metrics to include in assessment, and to advance and define direct voice therapy approaches. Summary: Further standardization of assessment and treatment protocols for MTD will improve future research. Novel therapeutic techniques are under investigation. In small studies, these have found value in improving voice outcomes and measures compared with pretreatment values but have not met success greater than existing therapeutic methods. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Vocal tremor: where are we at?.

Purpose of review: Vocal tremor in movement disorders is often overlooked, although it has a significant impact on quality of life. Careful observation of tremor phenomenology allows for accurate diagnosis and tailored treatment. Recent findings: The central pathways associated with various vocal tremor-associated diseases have been further elucidated. Summary: Patients are likely to benefit from a combination of medical and interventional treatments delivered within a multidisciplinary setting Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Seasonal Rhythms: The Role of Thyrotropin and Thyroid Hormones

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Thyroid , Vol. 0, No. 0.


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Thyroid Storm: A Japanese Perspective

Thyroid , Vol. 0, No. 0.


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Projecting Survival in Papillary Thyroid Cancer: A Comparison of the Seventh and Eighth Editions of the American Joint Commission on Cancer/Union for International Cancer Control Staging Systems in Two Contemporary National Patient Cohorts

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Thyroid , Vol. 0, No. 0.


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Correction to: Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network



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Plastic Surgery Videos Need Strict Ethics Standards, Doctors Argue

Some plastic surgeons have gained large social media followings by sharing theatrical videos of surgery with entertainment, rather than education, in mind. Now experts are proposing ethics guidelines to ensure that the content of plastic surgery videos on social media isn't harmful to patients.
Reuters Health Information

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Anxiety and Fear of Recurrence Despite a Good Prognosis: An Interview Study with Differentiated Thyroid Cancer Patients

Thyroid , Vol. 0, No. 0.


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Adult reference intervals for IgG subclasses with Siemens immunonephelometric assays in Chinese population

To determine the adult reference intervals for the Siemens IgG subclass reagents.

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Erratum to: How to choose the best journal for your case report



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Mechanical and hypoxia stress can cause chondrocytes apoptosis through over-activation of endoplasmic reticulum stress

Publication date: December 2017
Source:Archives of Oral Biology, Volume 84
Author(s): Ziwei Huang, Min Zhou, Qian Wang, Mengjiao Zhu, Sheng Chen, Huang Li
ObjectiveTo examine the role of mechanical force and hypoxia on chondrocytes apoptosis and osteoarthritis (OA)-liked pathological change on mandibular cartilage through over-activation of endoplasmic reticulum stress (ERS).MethodsWe used two in vitro models to examine the effect of mechanical force and hypoxia on chondrocytes apoptosis separately. The mandibular condylar chondrocytes were obtained from three-week-old male Sprague–Dawley rats. Flexcell 5000T apparatus was used to produce mechanical forces (12%, 0.5Hz, 24h vs 20%, 0.5Hz, 24h) on chondrocytes. For hypoxia experiment, the concentration of O2 was down regulated to 5% or 1%. Cell apoptosis rates were quantified by annexin V and propidium iodide (PI) double staining and FACS analysis. Quantitative real-time PCR and western blot were performed to evaluate the activation of ERS and cellular hypoxia. Then we used a mechanical stress loading rat model to verify the involvement of ERS in OA-liked mandibular cartilage pathological change. Histological changes in mandibular condylar cartilage were assessed via hematoxylin & eosin (HE) staining. Immunohistochemistry of GRP78, GRP94, HIF-1α, and HIF-2α were performed to evaluate activation of the ERS and existence of hypoxia. Apoptotic cells were detected by the TUNEL method.ResultsTunicamycin, 20% mechanical forces and hypoxia (1% O2) all significantly increased chondrocytes apoptosis rates and expression of ERS markers (GRP78, GRP94 and Caspase 12). However, 12% mechanical forces can only increase the apoptotic sensitivity of chondrocytes. Mechanical stress resulted in OA-liked pathological change on rat mandibular condylar cartilage which included thinning cartilage and bone erosion. The number of apoptotic cells increased. ERS and hypoxia markers expressions were also enhanced. Salubrinal, an ERS inhibitor, can reverse these effects in vitro and in vivo through the down-regulation of ERS markers and hypoxia markers.ConclusionWe confirmed that mechanical stress and local hypoxia both contributed to the chondrocytes apoptosis. Mechanical stress can cause OA-like pathological change in rat mandibular condylar cartilage via ERS activation and hypoxia existed in the meantime. Both mechanical forces and hypoxia can induce ERS and cause chondrocytes apoptosis only if the stimulate was in higher level. Salubrinal can protect chondrocytes from apoptosis, and relieve OA-liked pathological change on mandibular condylar cartilage under mechanical stress stimulation.



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Correction to: Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network



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Medication-Related Osteonecrosis of the Posterior Maxilla: Surgical Treatment Using a Combined Transnasal Endoscopic and Intraoral Approach, our experience with seven consecutive patients

Abstract

Upper jaw MRONJ if not correctly treated can lead to serious complication.

Upper jaw MRONJ is frequently associated with maxillary sinusitis, the disease can spread to other paranasal sinuses.

Combined approach is the most reliable procedure to treat odontogenic sinusitis; although MRONJ associated sinusitis is considered odontogenic there is no report in literature describing combined approach to treat MRONJ-induced sinusitis.

Buccal fat pad represents the best reconstructive option to close the bony defect.

BFPF does not allow rehabilitation through dental implant since it is adipose tissue and not bone tissue. However, guidelines do not recommend implant-supported prosthetic rehabilitation in patients with history of MRONJ so conventional dental rehabilitation should be carried out.

This article is protected by copyright. All rights reserved.



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Ipilimumab and early signs of pulmonary toxicity in patients with metastastic melanoma: a prospective observational study

Abstract

Ipilimumab, an immune checkpoint inhibitor, is approved for treatment metastastic melanoma and is a promising agent against other malignancies. There is some preliminary evidence from case reports that ipilimumab treatment may be associated with pulmonary side effects. However, data from prospective studies on ipilimumab-related pulmonary toxicity are still scarce. Serial spirometries and measurements of CO-diffusion capacity (DLCO) in patients with metastatic melanoma before and during treatment with ipilimumab were performed. A reduction from baseline of forced vital capacity (FVC) of ≥ 10%, or ≥ 15% of DLCO was defined as clinically meaningful and indicative for pulmonary toxicity. Of 71 patients included in this study, a clinically meaningful lung function decline was registered in 6/65 (9%), 5/44 (11%), and 9/38 (24%) patients after 3, 6, and 9 weeks of treatment initiation, respectively. Even after adjusting for age, concomitant melanoma treatment, progressive pulmonary metastases, and baseline pulmonary function values, mean ± SD DLCO decreased significantly during follow-up (−4.3% ± 13.6% from baseline, p = 0.033). Only 7% of patients reported respiratory symptoms. Clinically manifest ipilimumab-related pneumonitis was diagnosed only in one patient (1.4%). DLCO decline maybe an early indicator of subclinical pulmonary drug toxicity. Therefore, routine pulmonary function testing including DLCO measurement during treatment might help for risk stratification to screen for ipilimumab-related pneumonitis.



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Importance of lymph node ratio for locoregional recurrence of squamous cell carcinoma of the buccal mucosa

Abstract

Background

There is no published study on the influence of lymph node ratio on locoregional recurrence of squamous cell carcinoma (SCC) of the buccal mucosa. Therefore, we focused in our study on this specific anatomic subsite.

Methods

We conducted a retrospective chart review of 95 patients from 2003-2013 with treatment-naive SCC of the buccal mucosa. Exclusion criteria were neoadjuvant chemoradiotherapy, perioperative death, N3 disease, unresectable disease, synchronous malignancy, and follow-up <3 months. Statistical analysis was performed using univariate and multivariate analysis.

Results

Significant correlations were found between locoregional recurrence and pathologic N classification (P < .001), grading (P = .001), and lymph node ratio (P < .001). Multivariate analysis indicated lymph node ratio as an independent risk factor for locoregional recurrence (P = .002). A cutoff value under 7% led to a 10.383-fold higher risk of incurring a locoregional recurrence.

Conclusion

Lymph node ratio is a useful parameter to stratify the risk of locoregional recurrence in patients with SCC of the buccal mucosa.



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Head and Neck Cancer, Multimodality Management, 2nd ed, Editor: Jacques Bernier Jeffrey C. Liu Springer, Switzerland, 2016, USD $329, 878 pages



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Topical propranolol improves epistaxis in patients with hereditary hemorrhagic telangiectasia - a preliminary report

Severe epistaxis is often difficult to control in patients with hereditary hemorrhagic telangiectasia (HHT). Propranolol has been shown to have antiangiogenic properties in vitro and in vivo and is commonly us...

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The Use of Chewing Gum for Xerostomia and Hyposalivation After Radiotherapy for Oral and Oropharyngeal Tumors

Conditions:   Head and Neck Cancer;   Radiation Therapy Complication;   Xerostomia;   Hyposalivation
Intervention:   Dietary Supplement: Chewing gum
Sponsors:   Odense University Hospital;   Danish Cancer Society;   OPEN - Odense Patient data Explorative Network
Recruiting

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Are optic nerve heads of patients with helicobacter pylori infection more susceptible to glaucomatous damage?

Abstract

Background

To compare retinal nerve fiber layer thicknesses (RNFLT) of patients with or without Helicobacter pylori infection and to reveal the possible RNFLT changes after H. pylori eradication.

Materials and methods

Sixty-five eyes of 65 patients that tested positive for H. pylori (Group 1) and 48 eyes of 48 patients that tested negative for H. pylori (Group 2) were included. RNFLT analyses were performed with spectral-domain (SD) optical coherence tomography (OCT) in a total of five regions: the superior, inferior, nasal, and temporal quadrants and the average. Then, a comparison was made between groups. After H. pylori eradication in 38 patients, RNFLTs were compared with both pre-eradication values and Group 2.

Results

The groups were similar in terms of age and gender. Temporal quadrant RNFLT was thinner in Group 1 than in Group 2 (P=.02). After H. pylori eradication, RNFLTs did not differ from pre-eradication values in Group 1 (P>.05 for all), whereas temporal quadrant RNFLT after H. pylori eradication was thinner compared to Group 2 (P=.03).

Conclusions

H. pylori may cause the localized defects on RNFL that are the early signs of glaucoma.



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A Real-time Prediction Model for Post-irradiation Malignant Cervical Lymph Nodes

Abstract

Objective

To establish a real-time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation.

Methods

One-hundred-forty-four irradiation-treated patients underwent ultrasonography and ultrasound-guided fine needle aspirations (USgFNAs), and the resultant data were used to construct a real-time and computerized predictive scoring model. This scoring system was further compared with our previously proposed prediction model.

Results

A predictive scoring model, 1.35 x (L axis) + 2.03 x (S axis) + 2.27 x (Margin) + 1.48 x (Echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ≥ 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, positive predictive value (PPV) of 82.3%, negative predictive value (NPV) of 83.1%, and overall accuracy of 82.6%. When this new model and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) were 0.89 and 0.81, respectively (p < 0.05).

Conclusions

A real-time sonographic predictive scoring model was constructed to provide prompt and reliable guidance for USgFNA biopsies to manage cervical LNs after neck irradiation.

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Incurable, progressive Merkel cell carcinoma: a single institution study of 54 cases

Abstract

The median overall survival, disease-free survival and survival from disease progression of patients with progressive disease was 15, 8 months and 5 months, respectively.

22 (96%) out of 23 individuals suffering from disease progression died of the disease. The overall mortality rate was 70%.

Patients with progressive MCC spend significantly more tumour related days in the hospital compared to patients without a progressive disease.

The rate of immunosuppression was significantly higher in the MCC progressive group and those patients received more often radio- and/or chemotherapy.

Despite an aggressive therapy approach and long hospitalization, survival among patients suffering from progressive MCC was very poor. Randomized clinical trials are required to assess whether aggressive systemic and local therapy is justified in Merkel cell carcinoma patients with progressive disease.

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Novel middle ear applications for a synthetic cerebrospinal fluid (CSF) sealant

Abstract

TissuePatchDural is an easy to store and apply synthetic CSF sealant.

Its breakdown products are naturally occurring and non-toxic.

Its use appears safe in the middle ear.

It is shown to successfully close mastoid CSF leaks.

Its use as an adjunct in sealing middle ear fistulae is also demonstrated.

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Nodal factors predictive of recurrence and survival in patients with oral cavity squamous cell carcinoma

Abstract

Objectives

Lymph node (LN) metastasis of oral cavity squamous cell carcinoma (OSCC) is associated with survival outcomes. However, the relationship between different metastatic nodal factors and treatment outcomes require further elucidation. This study examined nodal factors predictive of recurrence and survival in patients with OSCC.

Methods

This prospective observational study included 157 patients with OSCC who underwent surgery between 2010 and 2015. Clinicopathological and follow-up information were recorded. Univariate and multivariate Cox proportional hazard models were performed to identify factors associated with recurrence-free survival, disease-specific survival and overall survival.

Results

Sixty-five of 157 patients (41.4%) had neck metastasis. During a median follow-up of 46 months, any recurrences and all deaths occurred in 43 (27.4%) and 43 (27.4%) of cases, respectively. All nodal factors (LN classification, size, number and ratio) and extra-nodal extension were significantly associated with all survival outcomes (P <0.001). Multivariate analyses indicated that a tumour size >2 cm and LN ratio were independentlyassociated with all survival (P <0.05). Patients with LN ratio >0.05 had six-fold higher recurrence and mortality rates than other patients (P <0.001).

Conclusion

LN ratio is an independent and predictive determinant of post-treatment recurrence and survival.

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Prospective multi-centre study on barbed reposition pharyngoplasty standing alone or as a part of multilevel surgery for sleep apnea

Abstract

Objectives

The aim of this study was to demonstrate in a prospective multi-centre study that Barbed Reposition Pharyngoplasty (BRP) procedure is safe and effective in management of obstructive sleep apnea/hypopnea syndrome (OSAHS) patients.

Design

prospective study.

Setting

multicenter study.

Participants

patients suffering from obstructive sleep apnea.

Main outcomes measures

values of post-operative apnea-hypopnea index(AHI), oxygen desaturation index (ODI), epworth sleepiness scale (ESS).

Results

111 BRP procedures standing alone or as a part of multilevel surgery for OSAHS, performed between January and September 2016, were analyzed in 15 different centers. The average hospitalization period was 2.5 ± 0.5 days. The mean patient age was 46.3 ± 10.5 years. The average BMI at the time of the procedure was 27.9 ± 3.2 and the majority of the patients were men (83%). The mean pre-operative and post-operative apnea/hypopnea index was 33.4 ± 19.5 and 13.5 ± 10.3, respectively (p < 0.001). The mean pre-operative and post-operative epworth sleepiness scale score was 10.2 ± 4.5 and 6.1 ± 3.6, respectively (p < 0.001). The mean pre- and post-operative oxygen desaturation index was 29.6 ± 20.7 and 12.7 ± 10.8, respectively (p < 0.001).

Conclusions

Patients undergoing BRP standing alone or as part of a multilevel approach for the treatment of OSAHS have a reasonable expectation for success with minimal morbidity.

This article is protected by copyright. All rights reserved.



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Risk of Infection in Patients with Atopic Dermatitis Treated with Dupilumab: A Meta-Analysis of Randomized Controlled Trials

Atopic dermatitis (AD) is characterized by skin barrier defects, Th2 activation, and increased risk for cutaneous and extracutaneous infections. In clinical trials, dupilumab appeared to decrease rates of skin infections in AD.

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Treatment for facial alopecia areata: A systematic review with evidence-based analysis



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Randomized, placebo-controlled, double-blind study of oral tranexamic acid in the treatment of moderate to severe melasma

Melasma is a common pigmentary disorder that is often difficult to treat. Tranexamic acid (TA) has emerged as a promising treatment for melasma; however, few controlled studies exist.

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Detection And Characterization Of Igg, Ige And Iga Autoantibodies In Patients With Bullous Pemphigoid Associated With Dipeptidyl Peptidase-Iv Inhibitors



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Nail Braces for Severe Paronychia Induced by Epidermal Growth Factor Receptor Inhibitors: An alternative to nail extraction



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Reduction of bone mineral density in native Chinese female idiopathic benign paroxysmal positional vertigo patients

This study aimed to investigate the clinical association between idiopathic benign paroxysmal positional vertigo (BPPV) and reduction of bone mineral density (BMD).

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Sudden Deafness during Antepartum versus Postpartum Periods

Objective: This study reviewed our experience in treating sudden deafness in antepartum (pregnant) and postpartum women during the past 2 decades. Methods: From 1997 to 2016, we have recorded sudden deafness in 16 antepartum (mean age, 32 years) and 3 postpartum (mean age, 31 years) women. Sudden deafness occurred during the 1st, 2nd, and 3rd trimesters in 5, 4, and 7 antepartum women, respectively. In contrast, the mean interval between giving birth and symptom onset in the 3 postpartum women was 18 days. Each patient underwent an inner ear test battery. Results: In 8 antepartum women treated by dextran infusion, the outcome as regards hearing was improved in 7 patients (88%) and unchanged in 1 patient. In contrast, the other 8 antepartum women selected no treatment, and only 1 patient (12%) achieved hearing improvement, exhibiting a significantly better outcome when receiving dextran treatment. For the postpartum women, 2 patients had hearing improvement when treated by antioxidants, while 1 patient retained unchanged hearing without treatment. Conclusion: Medication is needed in sudden deafness in antepartum or postpartum women rather than waiting for a natural course. No adverse effects have been identified in any of the mothers or offspring 1 year after delivery.
ORL 2017;79:274-281

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Choking dermatitis: A neologism alerting the nature of factitious dermatitis acquired from self-asphyxial behaviors



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Drastic effect on giant lung metastatic melanoma by sequential administration of nivolumab with ipilimumab/radiation combination therapy



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Metabolic parameters in psoriatic patients treated with interleukin-12/23 blockade (ustekinumab)

Abstract

The associations between psoriasis, metabolic syndrome and cardiovascular events are increasingly recognized. Studies have shown decreased cardiovascular events with the treatment of methotrexate and anti-tumor necrosis factor, however, effects of interleukin (IL)-12/23 blockade remain debatable. Our study investigated the effect of IL-12/23 blockade on the metabolic parameters in patients with psoriasis. We performed a retrospective cohort study to assess 93 consecutive patients with moderate to severe plaque type psoriasis who received IL-12/23 blockade (ustekinumab) for 24 weeks between January 2012 and May 2016. Metabolic parameters and disease activity (Psoriasis Area and Severity Index [PASI] score) at baseline and 24 weeks of treatment were collected. At week 24, the disease activity improved significantly (P < 0.0001), with a significant reduction of erythrocyte sedimentation rate. Conversely, body mass index was significantly elevated in PASI-75 responders at week 24 of treatment and was independent of disease severity. Fasting sugar and triglyceride levels were also elevated at week 24 in both PASI-75 responders and PASI-75 non-responders. Cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) remained unchanged. These metabolic parameters were not correlated with the improvement in disease severity after ustekinumab treatment. Nonetheless, the atherogenic index, LDL/HDL ratio and cholesterol/HDL ratio remained unchanged. Male sex and cigarette smoking are predictors of elevated plasma triglyceride levels. Our results suggest that despite tremendous improvement in disease activity after ustekinumab treatment, obesity, fasting sugar and hypertriglyceridemia still present in these patients. Regular screening of lipid profile, obesity control and smoking cessation are advised during the treatment of ustekinumab especially in male psoriatic patients with predisposing cardiovascular risks.



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Dysregulation of Innate Lymphoid Cells in Common Variable Immunodeficiency

Abstract

Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immune deficiency. With widespread use of immunoglobulin replacement therapy, non-infectious complications, such as autoimmunity, chronic intestinal inflammation, and lung disease, have replaced infections as the major cause of morbidity and mortality in this immune deficiency. The pathogenic mechanisms that underlie the development of these complications in CVID are not known; however, there have been numerous associated laboratory findings. Among the most intriguing of these associations is elevation of interferon signature genes in CVID patients with inflammatory/autoimmune complications, as a similar gene expression profile is found in systemic lupus erythematosus and other chronic inflammatory diseases. Linked with this heightened interferon signature in CVID is an expansion of circulating IFN-γ-producing innate lymphoid cells. Innate lymphoid cells are key regulators of both protective and pathogenic immune responses that have been extensively studied in recent years. Further exploration of innate lymphoid cell biology in CVID may uncover key mechanisms underlying the development of inflammatory complications in these patients and may inspire much needed novel therapeutic approaches.



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Influenza Vaccination in Patients with Common Variable Immunodeficiency (CVID)

Abstract

Purpose of Review

Vaccination against influenza in patients with primary antibody deficiency is recommended. Common variable immunodeficiency (CVID) is the most frequent and clinically relevant antibody deficiency disease and is by definition characterized by an impaired vaccination response. The purpose of this review is to present the current knowledge of humoral and cellular vaccine response to influenza in CVID patients.

Recent Findings

Studies conducted in CVID patients demonstrated an impaired humoral response upon influenza vaccination. Data on cellular immune response are in part conflicting, with two out of three studies showing responses similar to healthy controls.

Summary

Available data suggest a benefit from influenza vaccination in CVID patients. Therefore, annual influenza vaccination in patients and their close household contacts is recommended.



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Somatic Hypermutation Defects in Common Variable Immune Deficiency

Abstract

Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by impaired antibody production and recurrent infections. In the last 20 years, several groups have reported that B cells from CVID patients have an impaired somatic hypermutation (SHM). The reported frequency of this defect among CVID patient cohorts is highly variable and so is the methodology used to evaluate this process. Interestingly, the low level of SHM on B cells from CVID patients has been correlated with the presence of infectious and non-infectious complications. In this review, an overview of the studies regarding SHM in CVID patients is presented. We highlight the importance of SHM studies in CVID patients as a clinical tool due to the reported association with clinical complications by several groups. We also considered SHM measurement useful to guide future investigations in order to identify genetic defects involved in the development of the disease.



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Electronic Cigarettes: Their Constituents and Potential Links to Asthma

Abstract

Purpose of Review

Vaping is gaining popularity in the USA, particularly among teens and young adults. While e-cigs are commonly represented as safer alternatives to tobacco cigarettes, little is known regarding the health effects of their short- or long-term use, especially in individuals with pre-existing respiratory diseases such as asthma. Flavored e-cig liquids (e-liquids) and e-cig aerosols contain airway irritants and toxicants that have been implicated in the pathogenesis and worsening of lung diseases. In this review, we will summarize existing data on potential health effects of components present in e-cig aerosols, such as propylene glycol, vegetable glycerin, nicotine, and flavorings, and discuss their relevance in the context of asthma.

Recent Findings

Recent survey data indicate that adolescents with asthma had a higher prevalence of current e-cig use (12.4%) compared to their non-asthmatics peers (10.2%) and conveyed positive beliefs about tobacco products, especially e-cigs. Similarly, a study conducted among high school students from Ontario, Canada, indicated a greater likelihood of e-cig use in asthmatics as compared to their non-asthmatic peers. Availability of different flavorings is often cited as the main reason among youth/adolescents for trying e-cigs or switching from cigarettes to e-cigs. Occupational inhalation of some common food-safe flavoring agents is reported to cause occupational asthma and worsen asthmatic symptoms. Moreover, workplace inhalation exposures to the flavoring agent diacetyl have caused irreversible obstructive airway disease in healthy workers. Additionally, recent studies report that thermal decomposition of propylene glycol (PG) and vegetable glycerin (VG), the base constituents of e-liquids, produces reactive carbonyls, including acrolein, formaldehyde, and acetaldehyde, which have known respiratory toxicities. Furthermore, recent nicotine studies in rodents reveal that prenatal nicotine exposures lead to epigenetic reprogramming in the offspring, abnormal lung development, and multigenerational transmission of asthmatic-like symptoms.

Summary

Comparisons of the toxicity and health effects of e-cigs and conventional cigarettes often focus on toxicants known to be present in cigarette smoke (CS) (i.e., formaldehyde, nitrosamines, etc.), as well as smoking-associated clinical endpoints, such as cancer, bronchitis, and chronic obstructive pulmonary disease (COPD). However, this approach disregards potential toxicity of components unique to flavored e-cigs, such as PG, VG, and the many different flavoring chemicals, which likely induce respiratory effects not usually observed in cigarette smokers.



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Are food allergic consumers ready for informative precautionary allergen labelling?

Precautionary allergen labelling (PAL) has resulted in consumer confusion. Previous research has shown that interpretive labels (using graphics, symbols, or colours) are better understood than the traditional ...

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Pseudoangiomatous stromal hyperplasia – a benign and rare tumor of the breast in an adolescent: a case report

Pseudoangiomatous stromal hyperplasia is an uncommon mesenchymal breast neoplasm.

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An Element of Unsteadiness

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Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 61-year-old woman presented with…

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