Head &Neck, EarlyView.
https://ift.tt/2GgW0nV
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 14 Μαΐου 2018
Neutrophil‐to‐lymphocyte ratio as a prognostic indicator in head and neck cancer: A systematic review and meta‐analysis
Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases
Head &Neck, EarlyView.
https://ift.tt/2rHAlRk
Volvulus with bowel necrosis after laparoscopic appendectomy. Migration of Clip?
Abstract
About 2.8% of patients develop small bowel obstruction, mostly following an open approach appendectomy. Case Report: we present an 18-year-old girl with acute abdomen 10 days following laparoscopic appendectomy. An emergency laparotomy was performed which revealed bowel necrosis and an impacted slipped clip on the mesenterial side of the bowel with signs of bowel strangulation and necrosis. Bowel resection was carried out with primary enteroenteric anastomosis. We suspect the sharp ends of the open clip allowed it to become lodged in the bowel segment resulting in bowel obstruction and subsequent necrosis. It is possible that the clip migrated or was a failed deployment. To our knowledge, this is the first report of mechanical bowel obstruction after laparoscopic appendectomy caused by aberrant surgical clip.https://ift.tt/2KqUL8h
Otolaryngology and the Global Burden of Disease
The Global Burden of Disease (GBD) project provides longitudinal analysis of the global burden of otolaryngologic diseases by measuring the all-cause mortality, years of life lost, the years of life lived with disability, and disability-adjusted life years. Hearing loss burden is assessed overall and as sequelae of other diseases, such as otitis media or meningitis. Using these measures, we can appreciate the high prevalence and disability related to hearing loss globally. Other otolaryngologic diseases that contribute to the GBD include otitis media, cleft lip and palate, head and neck cancer, facial trauma, and oral disorders.
https://ift.tt/2wGDDcD
The Small World of Global Otolaryngology
The world is indeed becoming smaller, and the medical field has been transformed by this rapid globalization. As global communication and travel have increased, the Otolaryngology-Head and Neck Surgery community has also become increasingly connected and interwoven across the world, from highly sophisticated tertiary care centers to rural communities in developing countries. As medical professionals, it has always been a part of our fiber to impart information and skills that improve the lives of patients; now, more than ever, it is incumbent upon physicians to share expertise on a global scale.
https://ift.tt/2KkEBx5
Regional Overview of Specific Populations, Workforce Considerations, Training, and Diseases in Latin America
Latin America has significant disparities that make the region vulnerable in the delivery of health care. There is a need to plan comprehensive health care strategies that result in a more robust trained health care workforce, while improving the quality and efficiencies of tertiary public hospitals. This article introduces a survey conducted among otorhinolaryngology leaders in the region that identified the need to strengthen postgraduate programs. Although all countries in Latin America have at least one residency program, more otorhinolaryngology-trained specialists are necessary to address the workforce shortages that are present in about 50% of Latin American countries.
https://ift.tt/2Kpz9c6
Low or Undetectable Basal Thyroglobulin Levels Obviate the Need for Neck Ultrasound in Differentiated Thyroid Cancer Patients After Total Thyroidectomy and 131I Ablation
Thyroid, Ahead of Print.
https://ift.tt/2rJjlcO
An anti-NMDA receptor encephalitis mimicking an HIV encephalitis
Source:Clinical Immunology
Author(s): Fatiha Haneche, Sophie Demeret, Dimitri Psimaras, Christine Katlama, Valérie Pourcher
The incidence of HIV associated neurocognitive disorders (HAND) were reduced with the use of antiretroviral therapy. In case of neuropsychiatric symptoms, after elimination of all infections, auto-immune encephalitis could be evocated as a differential diagnosis. We describe a case of anti-N-Methyl-d-Aspartate receptor encephalitis in an HIV-1 infected woman.
https://ift.tt/2IiD2iI
Networked Individuals, Gendered Violence: A Literature Review of Cyberviolence
Violence and Gender, Ahead of Print.
https://ift.tt/2L0RYnl
Oesophageal causes of dysphagia localised only to the pharynx: Implications for the suspected head and neck cancer pathway
Clinical Otolaryngology, EarlyView.
https://ift.tt/2ILPbzU
Total glossolaryngectomy cohort study (N = 25): Survival, function and quality of life
Clinical Otolaryngology, EarlyView.
https://ift.tt/2jX7d4b
COPPER ACYL SALICYLATE HAS POTENTIAL AS AN ANTI-CRYPTOCOCCUS ANTI-FUNGAL AGENT [PublishAheadOfPrint]
The in vitro anti-fungal activity of aspirin against cryptococcal cells has been reported. However, its undesired effects may limit its clinical application. Conceivably, a derivative of aspirin could overcome this challenge. Toward this end, this paper considered the usage of an aspirinate-metal complex viz. copper acyl salicylate (CAS) as an anti-Cryptococcus anti-fungal agent. Additionally, the paper examined the influence of this compound on macrophage function. The in vitro susceptibility results revealed that cryptococcal cells were vulnerable (in a dose-dependent manner) to CAS, which may have effected growth inhibition by damaging cryptococcal cell membranes. Interestingly, when used in combined therapy with fluconazole or amphotericin B, synergism was observed. Furthermore, CAS did not negatively affect the growth as well as the metabolic activity of macrophages rather it sensitised these immune cells to produce INF-y and IL-6, which, in turn, may have aided in the phagocytosis of cryptococcal cells. When compared to our aspirin data, CAS was noted to be more effective in killing cryptococcal cells (based on susceptibility results) and less toxic towards macrophages (based on growth inhibition results). Taken together, it is reasonable to conclude that CAS may be a better anti-Cryptococcus drug that could deliver better therapeutic outcomes when compared to aspirin.
https://ift.tt/2IjteJa
Developmental sensitivity in Schistosoma mansoni to puromycin to establish drug selection of transgenic schistosomes [PublishAheadOfPrint]
Schistosomiasis is considered the most important disease caused by helminth parasites, in terms of morbidity and mortality. Tools to facilitate gain- and loss- of-function approaches can be expected to precipitate the discovery of novel interventions, and drug selection of transgenic schistosomes would facilitate the establishment of stable lines of engineered parasites. Sensitivity of developmental stages of schistosomes to the aminonucleoside antibiotic puromycin was investigated. For the schistosomulum and sporocyst stages, viability was quantified by fluorescence microscopy following dual staining with fluorescein diacetate and propidium iodine. By six days in culture, the 50% lethal concentration (LC50) for schistosomula was 19 μg/ml whereas the sporocysts were 45-fold more resilient. Puromycin potently inhibited the development of in vitro laid eggs (LC50 68 ng/ml) but was less effective against liver eggs (LC50 387 μg/ml). Toxicity for adult stages was evaluated using the xCELLigence-based, real-time motility assay (xWORM), which revealed LC50 values after 48 h of 4.9 and 17.3 μg/ml for male and female schistosomes, respectively. Also, schistosomula transduced with pseudotyped retrovirus encoding the puromycin resistance marker were partially rescued when cultured in the presence of the antibiotic. Together, these findings will facilitate selection on puromycin of transgenic schistosomes and the enrichment of cultures of transgenic eggs and sporocysts to facilitate the establishment of schistosome transgenic lines. Streamlining schistosome transgenesis with drug selection will open up new avenues to understand parasite biology and hopefully lead to new interventions for this neglected tropical disease.
https://ift.tt/2rIGA6C
Evolution of antibiotic resistance in biofilm and planktonic P. aeruginosa populations exposed to sub-inhibitory levels of ciprofloxacin [PublishAheadOfPrint]
The opportunistic Gram-negative pathogen Pseudomonas aeruginosa, known for its intrinsic and acquired antibiotic resistance, has a notorious ability to form biofilms, which often facilitate chronic infections. The evolutionary paths to antibiotic resistance have mainly been investigated in planktonic cultures and are less studied in biofilms. We experimentally evolved P. aeruginosa PAO1 colony-biofilms and stationary-phase planktonic cultures for seven passages in the presence of sub-inhibitory levels (0.1 mg/L) of ciprofloxacin (CIP) and performed a genotypic (whole bacterial population sequencing) and phenotypic assessment of the populations. We observed a higher proportion of CIP resistance in the CIP-evolved biofilm populations compared to planktonic populations exposed to the same drug concentrations. However, the minimal inhibitory concentrations (MICs) of ciprofloxacin were lower in CIP-resistant isolates selected from biofilm population compared to the MICs of CIP-resistant isolates from the planktonic cultures. We found common evolutionary trajectories between the different lineages, with mutations in known CIP resistance determinants as well as growth condition-dependent adaptations. A general trend towards a reduction in type IV-pili dependent motility (twitching) in CIP-evolved populations, and towards loss of virulence associated traits in the populations evolved in the absence of antibiotic, was observed. In conclusion, our data indicate that biofilms facilitate the development of low-level mutational resistance, probably due to the lower effective drug exposure compared to planktonic cultures. These results provide a framework for the selection process of resistant variants and the evolutionary mechanisms in the two different growth conditions.
https://ift.tt/2L1OSj4
Bacterial Silver Resistance Gained by Cooperative Interspecies Redox Behavior [PublishAheadOfPrint]
Silver has emerged as an important therapeutic option for wound infections in recent years due to its broad spectrum antimicrobial activity. The silver cation (Ag+), but not the bulk metal (Ag0), is highly toxic for most microorganisms although resistance due to genetic modification or horizontal gene transfer does occur. Pseudomonas aeruginosa, however, achieves silver resistance by producing the redox active metabolite pyocyanin that reduces Ag+ to non-toxic Ag0. Pyocyanin also possess broad spectrum antimicrobial activity. Many microbial species reduce pyocyanin, which reduces molecular oxygen to antimicrobial hydrogen peroxide. In this study it was hypothesized that both Ag+ and oxygen would act as competing terminal electron acceptors for pyocyanin thus acting as a universal microbial protectant from Ag+ while avoiding hydrogen peroxide formation. Escherichia coli and Staphylococcus aureus efficiently reduced pyocyanin and generated hydrogen peroxide while Ag+ markedly reduced the amount of hydrogen peroxide produced. Although unable to reduce directly Ag+ to Ag0 on their own, E. coli and S. aureus did so when pyocyanin was present resulting in increased survival when exposed to Ag+. Co-incubation experiments with either E. coli or S. aureus with P. aeruginosa demonstrated increased survival for those species to Ag+ but only if pyocyanin was present. These data demonstrate that microorganisms that display no intrinsic silver resistance may survive and proliferate under potentially toxic conditions provided their environment contains a suitable redox-active metabolite-producing bacterium. Chronic wounds are often polymicrobial in nature with pyocyanin producing P. aeruginosa frequently present therefore redox-based silver resistance may compromise treatment efforts.
https://ift.tt/2rIOsFk
Personalizing Polymyxin B Dosing Using an Adaptive Feedback Control Algorithm [PublishAheadOfPrint]
Polymyxin B is used as an antibiotic of last resort for patients with multidrug-resistant Gram-negative bacterial infections; however, it carries a significant risk of nephrotoxicity. Herein we present a polymyxin B therapeutic window based on target area under the concentration-time curve (AUC) values and an adaptive feedback control algorithm (algorithm) which allows for the personalization of polymyxin B dosing. The upper bound of this therapeutic window was determined through a pharmacometric meta-analysis of polymyxin B nephrotoxicity data, and the lower bound was derived from murine thigh-infection pharmacokinetic/pharmacodynamic studies. A previously developed polymyxin B population pharmacokinetic model was used as the backbone for the algorithm. Monte Carlo simulations (MCS) were performed to evaluate the performance of the algorithm using different sparse PK sampling strategies. The results of the nephrotoxicity meta-analysis showed that nephrotoxicity rate was significantly correlated with polymyxin B exposure. Based on this analysis and previously reported murine pharmacokinetic/pharmacodynamic studies, the target AUC0-24h window was determined to be 50-100 mg⋅h/L. MCS showed that with standard polymyxin B dosing without adaptive feedback control, only 71% of simulated subjects achieved AUC values within this window. Using a single pharmacokinetic sample collected at 24 hours and the algorithm, personalized dosing regimens could be computed, which resulted in over 95% of simulated subjects achieving AUC0-24h values within the target window. Target attainment further increased when more samples were used. Our algorithm increases the probability of target attainment using as few as one pharmacokinetic sample and enables precise, personalized dosing in a vulnerable patient population.
https://ift.tt/2L1wkz7
Co-location of the polymyxin resistance gene mcr-1 and variant of mcr-3 on a plasmid in Escherichia coli from chicken farm [PublishAheadOfPrint]
A colistin-resistant Escherichia coli from commercial poultry farm in China carried two colistin-resistance genes mcr-1 and variant of mcr-3 in an IncP plasmid. The variant of mcr-3 gene, named mcr-3.11, encoded two amino acid substitutions compared with the mcr-3. A novel genetic structure, ISKpn40-mcr-3-dgkA- ISKpn40, might be the key element mediating translocation of mcr-3 through the formation of circular form. The mcr-1 and mcr-3 genes co-located on a plasmid might pose huge threat to public health.
https://ift.tt/2KYf65I
Identification and characterization of conjugative plasmids that encode ciprofloxacin resistance in Salmonella [PublishAheadOfPrint]
This study aimed to characterize novel conjugative plasmids that encode transferrable ciprofloxacin resistance in Salmonella. In this study, 157 non-duplicated Salmonella isolates were recovered from food products, 55 out of which were found to be resistant to ciprofloxacin. Interestingly, 37 out of the 55 (67%) CipRSalmonella isolates did not harbor any mutations in the Quinolone resistance determine regions (QRDR). Interestingly, six Salmonella isolates were shown to carry two novel types of conjugative plasmids that could transfer ciprofloxacin resistance phenotype to E. coli J53 (AziR). The first type belonged to the ~110kb IncFIB type conjugative plasmid carrying qnrB-bearing and aac(6')-Ib-cr-bearing mobile elements. Transfer of the plasmid between E. coli or Salmonella could confer CIP MIC to 1 to 2μg/ml. The second type of conjugative plasmid belonged to ~240kb IncH1/IncF plasmids carrying a single PMQR gene, qnrS. Importantly, this type of conjugative ciprofloxacin resistance plasmids could be detected in clinical isolates of Salmonella. Dissemination of these conjugative plasmids that confer ciprofloxaicn resistance poses serious public health impact and Salmonella infection control.
https://ift.tt/2rEczoy
in vitro Activity of Imipenem-Relebactam and Ceftolozane-Tazobactam Against Resistant Gram-Negative Bacilli [PublishAheadOfPrint]
Understanding which antimicrobial agents are likely to be active against Gram-negative bacilli can guide selection of antimicrobials for empiric therapy as mechanistic-based (i.e., molecular) rapid diagnostics are adopted. Here, we determined the MICs of the novel β-lactam/β-lactamase inhibitor combination, imipenem-relebactam, along with ceftolozane-tazobactam, imipenem, ertapenem, meropenem, ceftriaxone, and cefepime, against 283 multidrug resistant isolates of Gram-negative bacilli. For isolates harboring blaKPC (n=111), the addition of relebactam to imipenem lowered the MIC50/MIC90 from 16/>128 μg/ml for imipenem alone to 0.25/1 μg/ml. For isolates harboring blaCTX-M (n=48), the MIC50/MIC90 of ceftolozane-tazobactam was 0.5/16 μg/ml (83% susceptible). For isolates harboring blaCMY-2 (n=17), the MIC50/MIC90 of ceftolozane-tazobactam was 4/8 μg/ml (47% susceptible). Imipenem-relebactam was active against most KPC-producing (but not NDM- or IMP-producing) Enterobacteriaceae, and is an encouraging addition to the present antibiotic repertoire.
https://ift.tt/2L3eRX9
OXA-72-mediated carbapenem resistance in sequence type 1 multidrug (colistin)-resistant Acinetobacter baumannii associated with urinary tract infection in a dog from Serbia [PublishAheadOfPrint]
Multidrug resistant Acinetobacter (A.) baumannii is primarily important as a causative agent of difficult to treat nosocomial infections in humans (1)....
https://ift.tt/2KZyC21
Rifabutin acts in synergy and is bactericidal with frontline Mycobacterium abscessus antibiotics clarithromycin and tigecycline, suggesting a potent treatment combination [PublishAheadOfPrint]
Mycobacterium abscessus (MAB) is a rapidly emerging mycobacterial pathogen causing dangerous pulmonary infections. Because these bacteria are intrinsically multidrug resistant, treatment options are limited and have questionable efficacy. The current treatment regimen relies on a combination of antibiotics including clarithromycin paired with amikacin and either imipenem or cefoxitin. Tigecycline may be added when triple therapy is ineffective. We initially screened a library containing the majority of clinically available antibiotics for anti-MAB activity. The screen identified rifabutin, which was then investigated for its interactions with MAB antibiotics used in drug regimens. Combination of rifabutin with either clarithromycin or tigecycline generated synergistic anti-MAB activity, dropping the rifabutin minimum inhibitory concentration below concentrations found in the lung. Importantly, these combinations generated bactericidal activity. The triple combination of clarithromycin, tigecycline, and rifabutin was also synergistic, and clinically relevant concentrations had a sterilizing effect on MAB cultures. We suggest that combinations including rifabutin should be further investigated for treatment of MAB pulmonary infections.
https://ift.tt/2L3bqzQ
Efficacy of Daptomycin Monotherapy and In Combination with {beta}-lactams for Daptomycin-Susceptible Enterococcus faecium Harboring LiaSR Substitutions: Influence of The Inoculum Effect [PublishAheadOfPrint]
Enterococcus faecium that harbor LiaFSR substitutions but are phenotypically susceptible to daptomycin (DAP) by current breakpoints are problematic since predisposition to resistance may lead to therapeutic failure. Using a simulated endocardial vegetation (SEV) PK/PD model, we investigated DAP regimens (6, 8 and 10 mg/kg/day) as monotherapy and in combination with ampicillin (AMP), ceftaroline (CPT) or ertapenem (ERT) against E. faecium HOU503, a DAP-susceptible strain that harbors common LiaS and LiaR substitutions found in clinical isolates (T120S and W73C, respectively). Of interest, the efficacy of DAP monotherapy, at any dose regimen, was dependent on the size of the inoculum. At an inoculum of ~109 CFU/g, DAP doses of 6-8 mg/kg/d were not effective and led to significant regrowth with emergence of resistant derivatives. In contrast, at an inoculum of ~107, marked reductions in bacterial counts were observed with DAP 6 mg/kg/d with no resistance. The inoculum effect was confirmed in a rat model using humanized DAP exposures. Combinations of DAP with AMP, CPT or ERT demonstrated enhanced eradication and reduced potential for resistance allowing for de-escalation of the DAP dose. Persistence of the LiaRS substitutions were identified in DAP-resistant isolates recovered from the SEV model and in DAP-resistant derivatives of an initially DAP-susceptible clinical isolate of E. faecium (HOU668) harboring LiaSR substitutions and recovered from a patient with a recurrent bloodstream infection. Our results provide novel data for the use of DAP monotherapy and combinations for recalcitrant E. faecium infections and paves the way for testing these approaches in humans.
https://ift.tt/2rHbTyT
In Vitro Activity of Imipenem-Relebactam against Clinical Isolates of Gram-Negative Bacilli Isolated in Hospital Laboratories in the United States - SMART 2016 [PublishAheadOfPrint]
Relebactam is a non-β-lactam, bicyclic diazabicyclooctane β-lactamase inhibitor of class A and class C β-lactamases, including Klebsiella pneumoniae carbapenemases (KPCs). It is in phase 3 clinical development in combination with imipenem/cilastatin. The in vitro activities of imipenem-relebactam, imipenem, and comparators were determined using the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method for isolates of Enterobacteriaceae (n=3,419) and Pseudomonas aeruginosa (n=896) collected in 2016 by 21 U.S. hospital laboratories participating in the SMART (Study for Monitoring Antimicrobial Resistance Trends) global surveillance program. Relebactam was tested at a fixed concentration of 4 μg/ml. Imipenem-relebactam MICs were interpreted using CLSI breakpoints for imipenem. Rates of susceptibility to imipenem-relebactam and imipenem for non-Proteeae Enterobacteriaceae (n=3,143) and P. aeruginosa were 99.1% (3,115/3,143) and 95.9% (3,013/3,143), and 94.4% (846/896) and 74.7% (669/896), respectively. Relebactam restored imipenem susceptibility to 78.5% (102/130) of imipenem non-susceptible non-Proteeae Enterobacteriaceae and to 78.0% (177/227) of imipenem-non-susceptible P. aeruginosa. Susceptibility to imipenem-relebactam was 98.2% (444/452) and 82.2% (217/264) for multidrug-resistant (MDR) non-Proteeae Enterobacteriaceae and MDR P. aeruginosa, respectively. Given the ability of relebactam to restore susceptibility to imipenem in non-susceptible isolates of both non-Proteeae Enterobacteriaceae and P. aeruginosa and to demonstrate potent activity against current MDR isolates of both non-Proteeae Enterobacteriaceae and P. aeruginosa, further development of imipenem-relebactam appears warranted.
https://ift.tt/2KZPbdS
Pharmacokinetics and safety profile of artesunate-amodiaquine co-administered with antiretroviral therapy in malaria uninfected HIV-positive Malawian adults. [PublishAheadOfPrint]
There are limited data on the pharmacokinetic and safety profiles of artesunate-amodiaquine in human immnunodeficiency virus infected (HIV+) individuals receiving antiretroviral therapy. In a two-step intensive sampling pharmacokinetic trial, we compared area under the concentration-time curve from 0 to 28 days (AUC0-28 days) of an active metabolite of amodiaquine, desethylamodiaquine, and treatment-emergent adverse events between antiretroviral therapy-naive HIV+ adults and those taking nevirapine and ritonavir-boosted lopinavir-based antiretroviral therapy. In step 1, malaria uninfected adults (n=6/arm) received half the standard adult treatment regimen of artesunate-amodiaquine. In step 2, another cohort (n=25/arm) received the full regimen. In step 1, there were no safety signals and significant differences in desethylamodiaquine AUC0-28 days among participants in the ritonavir-boosted lopinavir, nevirapine and antiretroviral therapy-naive arms. In step 2, compared with the antiretroviral therapy-naive arm, participants in the ritonavir-boosted lopinavir arm had 51% lower desethylamodiaquine AUC0-28 days, (geometric mean [95% CI]; 23,822 [17,458-32506] vs 48,617 [40,787-57,950] ng.hr/mL, p < 0.001). No significant differences in AUC0-28 days were observed between nevirapine and antiretroviral therapy-naïve arms. Treatment-emergent transaminitis was higher in the nevirapine (20% [5/25]) than the antiretroviral therapy naïve (0.0% [0/25]) arm (risk difference 20% [95% CI:4.3-35.7] p=0.018). Ritonavir-boosted lopinavir antiretroviral regimen was associated with reduced desethylamodiaquine exposure which may compromise artesunate-amodiaquine's efficacy. Co-administration of nevirapine and artesunate-amodiaquine may be associated with hepatoxicity.
https://ift.tt/2rKeGY5
Identification and Characterization of Salmonella enterica Serotype Newport Isolates with Decreased Susceptibility to Ciprofloxacin in the United States [PublishAheadOfPrint]
Nontyphoidal Salmonella (NTS) causes an estimated 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths each year in the United States. Decreased susceptibility to ciprofloxacin (DSC) has historically been associated with chromosomal mutations (QRDR), but plasmid-mediated quinolone resistance (PMQR) genes are increasing. To investigate DSC among serotype Newport, we examined 40 isolates with DSC from 1996-2016. Thirty isolates (71%) contained the PMQR gene, qnrB, and eight isolates (19%) contained a QRDR....
https://ift.tt/2IhROKC
Experimental Amphotericin B-Deoxycholate formulations for pulmonary aspergillosis: efficacy, biodistribution and nephrotoxicity. [PublishAheadOfPrint]
An experimental micellar formulation of amphotericin B (AMB) with sodium deoxycholate (DCH), AMB:DCH 1:1.5, was obtained and characterized to determine its aggregation state and particle size. Biodistribution, nephrotoxicity and efficacy against pulmonary aspergillosis in a murine model were studied and compared to the liposomal commercial amphotericin B after intravenous administration. The administration of 5 mg/kg AMB:DCH 1:1.5 presented 2.8-fold higher lung concentrations (18.125 ± 3.985 μg/g, after 6 daily doses) and lower kidney exposure (0.391 ± 0.167 μg/g) compared to liposomal commercial amphotericin B (6.567 ± 1.536 and 5.374 ± 1.157 μg/g, in lungs and kidneys, respectively). The different biodistribution of AMB:DCH micelle systems compared to liposomal commercial amphotericin B was attributed to their different morphology and particle size. The efficacy study has shown that both drugs administered at 5 mg/kg produced similar survival percentages and reduction of fungal burden. A slightly lower nephrotoxicity, associated to amphotericin B, was observed with AMB:DCH 1:1.5 than the one induced by the liposomal commercial formulation. However, AMB:DCH 1:1.5 reached higher AMB concentrations in lungs that could represents a therapeutic advantage over liposomal commercial amphotericin B-based treatment of pulmonary aspergillosis. These results are encouraging to explore the AMB:DCH 1:1.5 usefulness against this disease.
https://ift.tt/2rIXkdV
Nitric Oxide-Releasing Macromolecule Exhibits Broad-spectrum Anti-Fungal Activity and Utility as a Topical Treatment for Superficial Fungal Infections [PublishAheadOfPrint]
Cutaneous and superficial fungal infections affecting the skin, nails, and hair of humans are caused primarily by dermatophytes of the genera Trichophyton, and Epidermophyton, or by yeasts of the genera Candida and Malassezia. Onychomycosis is a common fungal infection of the nail frequently coexisting with tinea pedis, the most prevalent mycotic skin infection. Efficacy rates for current topical onychomycosis therapies are hampered by low drug penetration across the nail plate that is theoretically obviated with nitric oxide (NO)-based topical therapies.
The Nitricil technology platform is comprised of polysiloxane-based macromolecules that stably release therapeutic levels of NO. In the reported studies NVN1000, the lead candidate of the platform, was assessed for its spectrum of in vitro activity against a broad range of filamentous fungi and yeast species commonly associated with cutaneous fungal infections. Time-kill assays demonstrated that NVN1000 exhibited fungicidal activity in as early as 4 hours. Additionally, the penetration of several unique NVN1000 NO-releasing drug product formulations (gel, cream, lacquer) was evaluated following a single topical application in an in vitro infected human nail assay with all formulations showing similar inhibition of fungal growth. Repeated topical application in this model demonstrated that a lower strength dose of NO could achieve the same efficacy as a higher strength dose after 7 days. Together these in vitro results demonstrate that NO-releasing treatments rapidly penetrate the nail plate and eradicate the fungal infection, representing promising novel topical therapies for the treatment of onychomycosis and other cutaneous fungal infections.
https://ift.tt/2IfTK6l
Mycobacterium simiae: clinical, radiological and microbiological characteristics in 97 patients [PublishAheadOfPrint]
Mycobacterium simiae is a rare species of slow-growing nontuberculous mycobacteria (NTM).
From 2002 to 2017, we conducted a retrospective study that included all patients with NTM-positive respiratory samples detected in two university hospitals of the French overseas department of Reunion Island. We recorded the prevalence of M. simiae in this cohort, as well as the clinical, radiological, and microbiological features of patients with at least one sample positive for M. simiae.
In our cohort, 97 patients (15.1%) were positive for M. simiae. Twenty-one patients (21.6%) met the American Thoracic Society (ATS) criteria for infection. M. simiae infection was associated with bronchiectasis, micronodular lesions and weight loss. Antibiotic susceptibility testing was performed in 60 patients and the isolates were found to have low susceptibility to antibiotics, except for amikacin, fluoroquinolones, and clarithromycin. Treatment failed in 4 of the 8 patients treated for M. simiae infection.
Here, we describe a specific cluster corresponding to a large cohort of patients with M. simiae, a rare nontuberculous mycobacteria associated with low pathogenicity and a poor susceptibility to antibiotics.
https://ift.tt/2rIYnLa
Identifying and siding the stylohyoid bone for North American artiodactyls
International Journal of Osteoarchaeology, EarlyView.
https://ift.tt/2GfyZSc
First evidence of elongated styloid process in two female archaeological individuals from Córdoba hills, Argentina (late Holocene)
International Journal of Osteoarchaeology, EarlyView.
https://ift.tt/2L2bSyo
VideoEndocrinology™ High-Impact Videos
VideoEndocrinology™
The Official Journal of: American Thyroid Association
FREE ACCESS through May 28, 2018.
Watch now:
Postoperative Continuous Pressure Monitoring in Thyroid Surgery: Pathophysiology of Post-Thyroidectomy Hemorrhage
Ulrich Wirth, Thomas von Ahnen, Stefan Schopf, Hans Martin Schardey
Transaxillary Robotic Parathyroidectomy: Huge Parathyroid Adenoma
Patrick Aidan, Maroun Bechara
Thyroid Fine-Needle Aspiration and Smearing Techniques
Mitsuyoshi Hirokawa, Ayana Suzuki, Akira Miyauchi
The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.
https://ift.tt/2wF0C7L
The role of sentinel lymph node biopsy as a staging procedure in patients with melanoma – A critical appraisal
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2rIlpCs
Contact dermatitis to Dermabond Advance®
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2wM3OhQ
A ticking time bomb: A case of Lyme disease
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2rH3Qme
A rare case of chronic expanding haematoma in the occipital region mimicking a malignant soft tissue tumour
Australasian Journal of Dermatology, EarlyView.
https://ift.tt/2IgqE6V
Successful treatment of a skin tears with a single‐use negative pressure wound therapy device
Dermatologic Therapy, EarlyView.
https://ift.tt/2wHRIqh
Integrated behavioral health care for management of stress in allergic diseases
Publication date: Available online 8 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Alyssa Oland, Genery D. Booster, Bruce G. Bender
ObjectiveThe present article will review current findings regarding the management of stress in allergic disease.Data SourcesThe present review article uses articles and books published between 1995 and 2017. Approximately 85% of sources used were published in the last 10 years and 60% were published in the last 5 years. The majority of sources are peer-reviewed articles.Study SelectionsArticles that focused on allergic diseases such as allergic rhinitis, food allergies, urticaria, and allergic asthma were included in the present review. Articles in which it was not clear that the underlying disorder was allergic in nature (for example, non-specified asthma) were not included in the present review. Preference was given to articles published within the past five years.ResultsPatients with allergic diseases, particularly those with chronic and/or co-occurring allergic diseases, often experience stress and, in turn, this experience of stress can exacerbate disease presentation. High rates of treatment non-adherence in patients with allergic disease can also increase disease burden and stress. Research to date supports the benefit of behavioral health interventions for patients with allergic disease. Interventions with multidisciplinary teams, that include behavioral health, as well as interventions at the school, workplace, and community level are recommended.ConclusionMedical providers working with patients with allergic disease need to address patient's experience of stress and non-adherence to treatment recommendations. This could be done through routine screening and referrals to behavioral health or, ideally, through incorporation of a behavioral health provider within a multidisciplinary patient team.
https://ift.tt/2wEXJUt
Epinephrine, auto-injectors and anaphylaxis: challenges of dose, depth and device
Publication date: Available online 7 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Julie Brown
Objectives1. To review epinephrine dosing, site and route of administration, focusing on special populations (patients weighing less that 15 kg, and obese patients). 2. To discuss storage and delivery of epinephrine in pre-hospital and hospital settings.Data SourcesReview of published literature.Study SelectionRelevancy.ResultsThe recommended 0.01 mg/kg (max 0.3-0.5 mg) epinephrine dose in anaphylaxis is based on limited pharmacokinetic data in healthy volunteers. There are no pharmacokinetic or pharmacodynamics studies involving patients in anaphylaxis. When epinephrine auto-injectors (EAIs) are used in infants, the dose increasingly exceeds the recommended dose as weight decreases, although the clinical significance is unclear. Limited data indicate that the intramuscular route and lateral thigh site are superior. Ultrasound studies suggest that 0.15 EAI needles may be too long for many patients under 15 kg and 0.3 mg EAI needles may be too short for obese patients over 30 kg. A newly available 0.1 mg EAI has a lower dose and shorter needle better suited to patients 7.5-15 kg. In some medical settings, vials and syringes may provide a safe, efficient alternative with substantial cost savings over EAIs.ConclusionEAIs should be available in the community with doses and needle depths that meet the needs of all patients. More research on epinephrine pharmacodynamics are needed in children and adults in anaphylaxis, in order to better delineate what optimal doses should be. Optimizing epinephrine dose and delivery has the potential to improve anaphylaxis outcomes and prevent adverse events.
https://ift.tt/2IIOHec
Angioedema: systemic activation process during prodromes
Source:Annals of Allergy, Asthma & Immunology
Author(s): Samuel Luyasu, Delphine Charignon, Denise Ponard, Christian Drouet, Arije Ghannam
https://ift.tt/2KoIPUq
The impact of patient autonomy on older adults with asthma
Publication date: Available online 3 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Keerthi R. Karamched, Wei Hao, Peter X. Song, Laurie Carpenter, Joel Steinberg, Alan P. Baptist
BackgroundUnderstanding patient preferences and desire for involvement in making medical decisions is important when managing chronic conditions. Previous studies have utilized the Autonomy Preference Index (API) in younger asthmatic patients to evaluate these preferences.ObjectiveTo identify factors associated with autonomy, and to determine if autonomy is related to asthma outcomes among older adults.Methods189 older adults (>55 yr) with persistent asthma were included. Preferences for autonomy were assessed using the API, with a higher score indicating higher desire for autonomy. Scores were separated into two domains of 'information seeking' and 'decision making' preferences. The separated scores were correlated with asthma outcomes and demographic variables. To control for confounding factors, a linear regression analysis was performed.ResultsHigher 'decision making' preference scores correlated with female gender (p=0.007), higher education level (p=0.01), and lower depression scores (p=0.04). Regarding outcomes, 'decision making' scores positively correlated with asthma quality of life questionnaire (AQLQ) scores (p=0.01). On linear regression analysis, the AQLQ score remained significantly associated with 'decision making' preference scores (p=0.03). There was no association with asthma control test scores, spirometry values, and healthcare utilization. 'Information seeking' preference scores correlated with education level (p=0.03), but there was no correlation with asthma outcomes.ConclusionOlder asthmatic adults with a greater desire for involvement in decision making have a higher asthma related quality of life. Future studies with the intention to increase patient autonomy may help establish a causal relationship.
https://ift.tt/2IIPkV6
Suspected severe acute food protein-induced enterocolitis syndrome caused by cow's milk through breast milk
Source:Annals of Allergy, Asthma & Immunology
Author(s): Ines Vergara Perez, Leticia Vila Sexto
https://ift.tt/2jWxM9V
Aldolase: a new crustacea allergen
Source:Annals of Allergy, Asthma & Immunology
Author(s): P.M. Gamboa, B. Bartolomé, E. García Lirio, J. Cuesta-Herranz, C. Pastor-Vargas
https://ift.tt/2IIOBmQ
Information for Readers
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
https://ift.tt/2KoyfwM
Table of Contents
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
https://ift.tt/2jWxIab
Pain inhibits itch, but not in atopic dermatitis?
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
Author(s): Hjalte H. Andersen, Gil Yosipovitch, Lars Arendt-Nielsen
https://ift.tt/2KmyN6a
Information for Authors
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
https://ift.tt/2IIPbRy
Immunology, Volume 1: Immunotoxicology, Immunopathology, and Immunotherapy. Edited by M.A. Hayat. San Diego, CA: Elsevier Science, Academic Press. Soft copy, 255 pages, $213.00. ISBN: 978-0-12-809819-6.
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
Author(s): Jonathan A. Bernstein
https://ift.tt/2wEfAuX
Editorial Board
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
https://ift.tt/2jUXM5n
From the pages of allergywatch June 2018
Publication date: Available online 26 April 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): David Michael Lang, Stanley M. Fineman, David A. Khan, Stephen A. Tilles
https://ift.tt/2wEfxzh
Looking into the seeds of time
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
Author(s): Matthew Greenhawt, Jonathan O'B. Hourihane
https://ift.tt/2jV5xIw
Food allergy to previously tolerated foods: course and patient characteristics
Publication date: Available online 21 April 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Liat Nachshon, Michael R. Goldberg, Arnon Elizur, Michael Y. Appel, Michael B. Levy, Yitzhak Katz
https://ift.tt/2wHRHCv
School exposure and asthma
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
Author(s): Brittany Esty, Wanda Phipatanakul
ObjectiveTo provide a comprehensive overview of common school exposures and the association between school exposures and pediatric asthma morbidity.Data SourcesA comprehensive literature review was performed using PubMed.Study SelectionsFull-length, peer-reviewed studies published in English were considered for review. In vivo, in vitro, and animal studies were excluded. Studies of school exposure to cockroach, mouse, dust mite, dog, cat, molds, pollution, and endotoxin associated with asthma and asthma morbidity were considered.ResultsThe current literature establishes an association between school exposure and pediatric asthma morbidity. There is a need for ongoing research to evaluate the effects of school-based environmental interventions on asthma morbidity.ConclusionIt is evident that the indoor school environment is a significant reservoir of allergens, molds, pollutants, and endotoxin and that there is an association between school exposure and pediatric asthma morbidity. School-based interventions have the potential for substantial individual, community, and public health benefit. It is important that researchers continue to study the health effects associated with school exposures and assess cost-effectiveness of multifaceted school-based interventions.
https://ift.tt/2wD6nmk
Authors' response
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 5
Author(s): Jonathan I. Silverberg, Kevin R. Patel, Vivek Singam
https://ift.tt/2Ijrpw5
Promoting new concepts of skincare via skinomics and systems biology—From traditional skincare and efficacy‐based skincare to precision skincare
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2IIJ5QX
Antioxidant properties evaluation of topical astaxanthin formulations as anti‐aging products
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2IiDgGh
Automated scoring of vitiligo using superpixel‐generated computerized digital image analysis of clinical photographs: a novel and consistent way to score vitiligo
British Journal of Dermatology, EarlyView.
https://ift.tt/2IE9hwc
Does the gastrointestinal microbiome contribute to the ‘obesity paradox’ in melanoma survival?
British Journal of Dermatology, EarlyView.
https://ift.tt/2jZ8sQy
The prevalence of honorary authorship in the dermatological literature
British Journal of Dermatology, EarlyView.
https://ift.tt/2KqxAdZ
Profound consequences of hidradenitis suppurativa: a review
British Journal of Dermatology, EarlyView.
https://ift.tt/2KqxqTV
Baseline neutrophil‐to‐lymphocyte ratio in patients with advanced melanoma treated with immune checkpoint inhibitors
British Journal of Dermatology, EarlyView.
https://ift.tt/2jYaG2K
Drug survival of secukinumab for moderate‐to‐severe plaque psoriasis: reply from authors
British Journal of Dermatology, EarlyView.
https://ift.tt/2Kqxinp
Asthma‐COPD Overlap Syndrome among subjects with newly diagnosed adult‐onset asthma
Allergy, EarlyView.
https://ift.tt/2L0zzqP
Early‐life secondhand smoke exposure and food hypersensitivity through adolescence
Allergy, EarlyView.
https://ift.tt/2GgkXzU
Issue Information ‐ Cover and Editorial Board
Allergy, Volume 73, Issue 5, Page 967-967, May 2018.
https://ift.tt/2Gh9rEi
A retrospective study of dermatitis herpetiformis from an immunobullous disease clinic in north India
International Journal of Dermatology, EarlyView.
https://ift.tt/2wLGMYO
Suppurative cribriform ulcers in one leg
International Journal of Dermatology, EarlyView.
https://ift.tt/2jZ70xA
Teaching & Learning Tips 8: Preparing to teach in ambulatory settings
International Journal of Dermatology, Volume 57, Issue 6, Page 715-718, June 2018.
https://ift.tt/2KpuzL7
Issue Information
Pediatric Dermatology, Volume 35, Issue 3, Page 291-295, May/June 2018.
https://ift.tt/2Ges1gc
Superficial acral fibromyxoma with bony change: Successful treatment with en bloc nail excision using a full‐thickness skin graft
International Journal of Dermatology, EarlyView.
https://ift.tt/2Kqvvib
Issue Information
International Journal of Dermatology, Volume 57, Issue 6, Page i-iii,625-626, June 2018.
https://ift.tt/2jUzmsH
Periumbilical purpura: dermatoscopic findings in disseminated strongyloidiasis
International Journal of Dermatology, EarlyView.
https://ift.tt/2jXdKMA
Eruptive pseudoangiomatosis in two children with acute lymphoblastic leukemia
International Journal of Dermatology, EarlyView.
https://ift.tt/2wLGC3E
Socioeconomic status and survival for patients with melanoma in the United States: an NCDB analysis
International Journal of Dermatology, EarlyView.
https://ift.tt/2IGavqB
Frontal fibrosing alopecia: is the melanocyte of the upper hair follicle the antigenic target?
International Journal of Dermatology, EarlyView.
https://ift.tt/2KpY67E
Ewing′s sarcoma metastatic to skin: a case report and review of the literature
International Journal of Dermatology, EarlyView.
https://ift.tt/2jUblSK
A child with peculiar pigmentation after a bout of fever
Pediatric Dermatology, Volume 35, Issue 3, Page 408-409, May/June 2018.
https://ift.tt/2KXL6XE
Firm, protuberant plaque on a 7‐year‐old's arm
Pediatric Dermatology, Volume 35, Issue 3, Page 403-405, May/June 2018.
https://ift.tt/2Gg5qA5
Extensive hypopigmented cribriform lesions with fine scaling in a child
Pediatric Dermatology, Volume 35, Issue 3, Page 410-412, May/June 2018.
https://ift.tt/2rGIiGl
Twelve‐year‐old boy with multiple waffle‐like purpuric patches
Pediatric Dermatology, Volume 35, Issue 3, Page 406-407, May/June 2018.
https://ift.tt/2Gf7doU
Multiple anogenital hemorrhagic blisters in a 2‐year‐old girl
Pediatric Dermatology, Volume 35, Issue 3, Page 413-414, May/June 2018.
https://ift.tt/2Kntp2V
Patient Perspectives: Risks of indoor tanning
Pediatric Dermatology, Volume 35, Issue 3, Page 401-402, May/June 2018.
https://ift.tt/2k0FTCt
Stapes surgery preserving the superstructure of stapes (Takagi’s stapedotomy) in otosclerosis: A retrospective study of 24 consecutive cases
The aim of this study was to evaluate the hearing outcomes and complications of stapedotomy in which the stapes superstructure was preserved (Takagi's stapedotomy). In this surgical approach, the lenticular process of the incus rather is removed, than the superstructure of the stapes.
https://ift.tt/2rItLJK
Retiform hemangioendothelioma presenting as a pedunculated nodule on the site of an inguinal pyoderma chronica
The Journal of Dermatology, EarlyView.
https://ift.tt/2jXz6sQ
Comparison of ultrasonographic findings of schwannomas and angioleiomyomas
The Journal of Dermatology, EarlyView.
https://ift.tt/2wBmwsy
Long‐term safety and efficacy of continuous acitretin monotherapy for three children with different severe hyperkeratotic disorders in China
The Journal of Dermatology, EarlyView.
https://ift.tt/2jU2EYm
Dystrophic calcinosis cutis of the auricles after injury in Down's syndrome
The Journal of Dermatology, EarlyView.
https://ift.tt/2wIzLrw
Tuberculous granuloma developed 9 years after bacillus Calmette–Guérin vaccination in a patient with immunodeficiency
The Journal of Dermatology, EarlyView.
https://ift.tt/2IHFmmL
Customized reconstruction with modified keystone flaps
The Journal of Dermatology, EarlyView.
https://ift.tt/2wBmrFg
Successful treatment of plaque‐type psoriasis by granulocyte and monocyte adsorption apheresis in a patient with psoriatic arthritis
The Journal of Dermatology, EarlyView.
https://ift.tt/2jU2BMa
Novel mutations in Chinese Han patients with tuberous sclerosis complex: Case series and review of the published work
The Journal of Dermatology, EarlyView.
https://ift.tt/2wIzFQG
Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy
The Journal of Dermatology, EarlyView.
https://ift.tt/2k01zyd
Hailey–Hailey disease patient with a novel missense mutation in ATP2C1 successfully treated with minocycline hydrochloride
The Journal of Dermatology, EarlyView.
https://ift.tt/2wG9s5o
Assessment of two screening tools to identify psoriatic arthritis in patients with psoriasis
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2rH7Rr2
The impact of psoriasis on professional life: PsoPRO, a French national survey
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2GezWKR
Detection of titanium nanoparticles in the hair shafts of a patient with frontal fibrosing alopecia
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2L0xNpF
Acne and nutrition: hypotheses, myths and facts
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2Gg3is5
Dermoscopic features of melanocytic skin lesions in Greek children and adolescents and their association with environmental factors and skin types
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2L0qUV6
A case of neutrophilic dermatoses including pyoderma gangrenosum as a continuous disease spectrum to SAPHO syndrome
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GdLbTv
Searching for a mathematical model for blood perfusion of random pattern skin flaps: a clinical pilot study using in vivo laser speckle contrast imaging
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2GgfSY9
Impact of the mechanical hyperkeratotic lesions and its association with quality of life: An observational case–control study
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2rJiQjF
Response to ‘Psoriasis patients’ preference for an aerosol foam topical formulation’ by Vender R et al.
Journal of the European Academy of Dermatology and Venereology, EarlyView.
https://ift.tt/2Gf460c
Localized genital bullous pemphigoid
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2KZkLZn
Unilateral periorbital swelling: a diagnostic dilemma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GdLei9
Oral Fumaderm® to treat cutaneous sarcoidosis
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2L1VMEH
Rapid growth rate is associated with poor prognosis in cutaneous squamous cell carcinoma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2rJibyH
Cutaneous manifestations of JAK2+ myeloproliferative neoplasms
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GeoEpy
Sustained response of graft‐versus‐host disease‐associated angiomatosis treated with propranolol
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2rH1Sm7
A polymorphous rash of an uncommon blistering disease
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GdL6iF
Association between serum interleukin‐17A and clinical response to tofacitinib and etanercept in moderate to severe psoriasis
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2L0n3aH
A solitary and tender acral papule in a young patient
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GdKZUh
CD8+ T cell‐mediated interface dermatitis during combination chemotherapy with mogamulizumab in a patient with adult T‐cell leukaemia/lymphoma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2KZkGF3
Tattoo‐related squamous proliferations: a spectrum of reactive hyperplasia
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2GeoAWQ
A rare missense mutation in GJB3 (Cx31G45E) is associated with a unique cellular phenotype resulting in necrotic cell death
Experimental Dermatology, EarlyView.
https://ift.tt/2IFQqRe
Reduction in ultraviolet B light–induced erythema by oxymetazoline and brimonidine is mediated by different α‐adrenoceptors
Experimental Dermatology, EarlyView.
https://ift.tt/2InsuP8
Issue Information
Experimental Dermatology, Volume 27, Issue S1, Page 1-4, May 2018.
https://ift.tt/2IFQfp2
Author Index
Experimental Dermatology, Volume 27, Issue S1, Page 33-35, May 2018.
https://ift.tt/2InsoXM
Abstracts
Experimental Dermatology, Volume 27, Issue S1, Page 5-32, May 2018.
https://ift.tt/2IG4mKV
Lipidomics for translational skin research: A primer for the uninitiated
Experimental Dermatology, EarlyView.
https://ift.tt/2ImYovj
Survival without adjuvant chemotherapy for selected patients with stage II and III nasopharyngeal carcinoma after concurrent chemoradiotherapy alone
Head &Neck, EarlyView.
https://ift.tt/2KXZrn4
Narrow band imaging for risk stratification of glottic cancer within leukoplakia
Head &Neck, EarlyView.
https://ift.tt/2GiHw7e
Age‐adjusted comorbidity and survival in locally advanced laryngeal cancer
Head &Neck, EarlyView.
https://ift.tt/2rFM4Qy
Free jejunal flap transfer with multiple vascular pedicles for safe and reliable pharyngoesophageal reconstruction
Head &Neck, EarlyView.
https://ift.tt/2GgdS27
Topical superoxide dismutase in posttreatment fibrosis in patients with head and neck cancer
Head &Neck, EarlyView.
https://ift.tt/2GiHlsA
Successful treatment of severe facial lymphedema by lymphovenous anastomosis
Head &Neck, EarlyView.
https://ift.tt/2rGONcj
Esthesioneuroblastoma with distant metastases: Systematic review & meta‐analysis
Head &Neck, EarlyView.
https://ift.tt/2Gg1aAB
Age‐related differences in health‐related quality of life among thyroid cancer survivors compared with a normative sample: Results from the PROFILES Registry
Head &Neck, EarlyView.
https://ift.tt/2rFM4jw
Ewing sarcoma of the head and neck: The Mayo Clinic experience
Head &Neck, EarlyView.
https://ift.tt/2GdzjB6
Oral cancer involving masticator space (T4b): Review of literature and future directions
Head &Neck, EarlyView.
https://ift.tt/2GeIXUa
Early outcomes in transoral vestibular thyroidectomy: Robotic versus endoscopic techniques
Head &Neck, EarlyView.
https://ift.tt/2rGZKL9
Primary intestinal‐type adenocarcinoma of the oral tongue: Case report and review of histologic origin and oncologic management
Head &Neck, EarlyView.
https://ift.tt/2Gg19g1
Value of CT added to ultrasonography for the diagnosis of lymph node metastasis in patients with thyroid cancer
Head &Neck, EarlyView.
https://ift.tt/2rGZFXR
Effect of cell‐phone radiofrequency on angiogenesis and cell invasion in human head and neck cancer cells
Head &Neck, EarlyView.
https://ift.tt/2GeIMIu
Adjuvant therapy in major salivary gland cancers: Analysis of 8580 patients in the National Cancer Database
Head &Neck, EarlyView.
https://ift.tt/2rGXJOO
Marsupialization of mandibular cystic ameloblastoma: Retrospective study of 7 years
Head &Neck, EarlyView.
https://ift.tt/2GeIDVs
Prognostic stratification of patients with nasopharyngeal carcinoma based on tumor immune microenvironment
Head &Neck, EarlyView.
https://ift.tt/2Km6lRR
Nasal fibroscopy as a routine screening procedure of sinonasal adenocarcinoma of woodworkers: French longitudinal case study
Head &Neck, EarlyView.
https://ift.tt/2IfFs5M
Cerebral amyloid angiopathy mimicking central nervous system metastases: a case report
This case describes an unusual presentation of an intracranial hemorrhage first thought to be metastatic disease on computed tomography and magnetic resonance imaging. The healthcare team completed an exhausti...
https://ift.tt/2Gh2d38
Orbital T-cell lymphoma in youngest recorded patient – early diagnosis, management, and successful outcome: a case report and review of the literature
Primary orbital peripheral T-cell lymphoma, not otherwise specified is an exceedingly rare disorder with a very poor outcome, and to the best of our knowledge only a few cases have been reported in the English...
https://ift.tt/2rJftt1
A blind area of origins of epistaxis: technical or cognitive?
Abstract
Purpose
To investigate common origins and features of anterior epistaxis.
Methods
Patients (168) with anterior nose bleed were studied from May to October 2013. Endoscopic examination with angled endoscope and then subsequent management (radiofrequency, selective packing,) was performed.
Results
Under thorough nasal endoscopy, anterior nasal bleeding origin was ranked in turn as follows: the anterior nasal septum (NS 83.3%), the small area of anterior lateral wall of nasal cavity corresponding to the nasal back (NB 7.1%), the anterior end of the inferior turbinate (IT 5.4%), and the nasal part of the nasal cavity roof (NR 4.2%). Arterial lesion and hypertension led to large instant quantity of bleeding; hypertension and negligible bleeding origin prolonged bleeding duration. Bleeding was successfully controlled with nasal endoscopy and radiofrequency or selective packing.
Conclusions
The arterial bleeding small area of anterior lateral wall of nasal cavity corresponding to the nasal back and the nasal part of the nasal cavity roof accounted for more than 10% of anterior epistaxis and a thorough endoscopic examination should include these area with angled endoscope. Then radiofrequency and selective packing will sharply reduce the bleeding duration.
https://ift.tt/2Kjw3qo
Septal branches of the anterior ethmoidal artery: anatomical considerations and clinical implications in the management of refractory epistaxis
Abstract
Purpose
Epistaxis is a commonly presenting complaint. In severe cases, nosebleeds may occur despite antero-posterior nasal packing and often in the absence of identifiable sources of bleeding. In such cases, epistaxis may occur from septal branches of the anterior ethmoidal artery (sbAEA). The purposes of this study are to highlight the clinical role of the sbAEA in different fields of endoscopic endonasal surgery and to evaluate the efficacy and safety of their selective endoscopic endonasal ligation in the management of refractory epistaxis.
Methods
A retrospective review was performed of all patients presenting with epistaxis who underwent endoscopic endonasal coagulation of sbAEA in three Italian tertiary-care referral centers between October 2010 and October 2017.
Results
A total of 30 patients met the inclusion criteria. Sixteen patients had never experienced nosebleeds before, while 14 patients recalled previous epistaxes. Seventeen patients were treated under local anesthetic, while 13 required general anesthesia. No intra- or post-operative complications were observed and none of the patients received nasal packing after the procedure. In all cases the coagulation was effective in controlling the bleeding, with only two relapses in the series (2/30, 6.7%).
Conclusions
The sbAEA are of great interest in endoscopic endonasal surgery, both as surgical landmarks and as feeding vessels for a variety of pedicled nasal flaps. What is more, they can be crucial for the management of refractory epistaxis. Their selective endoscopic coagulation represents an effective and safe procedure in cases of difficult-to-control epistaxis from the upper nasal fossa, with several advantages over nasal packing.
https://ift.tt/2KoQfXV
Synchronized roles of pannexin and connexin in nasal mucosal epithelia
Abstract
Background
Nasal mucosal epithelial cells express connexins, the prototypical gap junction proteins, and pannexins, a new family of channel proteins homologous to the invertebrate gap junction proteins. The physiological and pathophysiological roles of these transmembrane proteins in nasal mucosa are largely still unknown.
Purpose
Pannexins participate in ATP release into the extracellular space in various tissues, and ATP plays important roles in mucociliary clearance, especially by regulating ciliary beat activity. Therefore, we focused on the functional relationship between connexins, pannexin-1, ATP release, and mucociliary clearance in nasal epithelia.
Results and Conclusions
Connexins participate in the generation of intercellular calcium waves, in which calcium-mediated signaling responses spread to contiguous cells through the gap junction formed by connexins to transmit calcium signaling throughout the airway epithelium. Pannexins in the nasal mucosa may contribute to not only ciliary beat modulation via ATP release, but also regulation of mucus blanket components via H2O efflux. The synchronized roles of pannexin and connexin may provide a new insight into effective mucociliary clearance systems in nasal mucosa.
https://ift.tt/2KoOz0C
The predictive value of polysomnography combined with quality of life for treatment decision of children with habitual snoring related to adenotonsillar hypertrophy
Abstract
Purpose
Both surgical treatment and non-surgical treatment are suggested by clinicians for children with habitual snoring related to adenotonsillar hypertrophy; However, how should the decision be made remains unclear. The objective of this study was to investigate potential predictors for the treatment decision, i.e., surgical treatment vs wait and see in children with habitual snoring related to adenoidal and/or tonsillar hypertrophy.
Methods
Children with complaints of snoring and/or apnea associated with adenotonsillar hypertrophy who received polysomnography (PSG) monitoring at our Hospital were recruited. After at least 6 months, the subjects were followed up and grouped according to whether or not they had received adenoidectomy and/or tonsillectomy (AT) execution. The heights, weights, as well as the quality of life (assessed using the obstructive sleep apnea-18 (OSA-18) quality of life questionnaire) and baseline PSG of the subjects were recorded and compared. Two logistic regressions were performed to reveal the factors influencing decision-making on conducting AT.
Results
A total of 509 children were finally included (345 males and 164 females). Among these children, 287 eventually received AT. Significant differences in age, scores for item 1 and 5 of the OSA-18, apnea–hypopnea index, obstructive apnea index, obstructive apnea–hypopnea index (OAHI), and Lowest arterial oxygen saturation (P < 0.05) were observed between groups. By multivariate logistic regression, the factors that influenced the surgical decision were identified as follows: age < 7 years (P = 0.008: odds ratio [OR] = 1.667, 95% confidence interval [CI] 1.140–2.438), score for item 5 of OSA-18 > 4 points (P = 0.042: OR = 1.489, 95% CI 1.014–2.212) and OAHI > 1/h (P = 0.044: OR = 1.579, 95% CI 1.013–2.463).
Conclusion
School-age children aged < 7 years, with OAHI > 1/h and mouth breathing scored > 4 points were more likely to receive AT during the disease process and thus require increased attention.
https://ift.tt/2rHaFUV
Procedure-specific assessment tool for flexible pharyngo-laryngoscopy: gathering validity evidence and setting pass–fail standards
Abstract
Objective
The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner. The flexible pharyngo-laryngoscopy (FPL) is central to the otorhinolaryngologist. We aim to evaluate the flexible pharyngo-laryngoscopy assessment tool (FLEXPAT) created in a previous study and to establish a pass–fail level for proficiency.
Methods
Eighteen physicians with different levels of experience (novices, intermediates, and experienced) were recruited to the study. Each performed an FPL on two patients. These procedures were video recorded, blinded, and assessed by two specialists. The score was expressed as the percentage of a possible max score. Cronbach's α was used to analyze internal consistency of the data, and a generalizability analysis was performed. The scores of the three different groups were explored, and a pass–fail level was determined using the contrasting groups' standard setting method.
Results
Internal consistency was strong with a Cronbach's α of 0.86. We found a generalizability coefficient of 0.72 sufficient for moderate stakes assessment. We found a significant difference between the novice and experienced groups (p < 0.001) and strong correlation between experience and score (Pearson's r = 0.75). The pass/fail level was established at 72% of the maximum score. Applying this pass–fail level in the test population resulted in half of the intermediary group receiving a failing score.
Discussion
We gathered validity evidence for the FLEXPAT according to the contemporary framework as described by Messick. Our results support a claim of validity and are comparable to other studies exploring clinical assessment tools. The high rate of physicians underperforming in the intermediary group demonstrates the need for continued educational intervention.
Conclusion
Based on our work, we recommend the use of the FLEXPAT in clinical assessment of FPL and the application of a pass–fail level of 72% for proficiency.
https://ift.tt/2rIEO6n
Influence of MP 29-02 on ciliary beat frequency in human epithelial cells in vitro
Abstract
Purpose
MP 29-02, which contains fluticasone propionate and azelastine hydrochloride, is used as a topical nasal application for the treatment of seasonal and perennial allergic rhinitis. Although a multitude of data is available on the clinical symptom reduction and treatment safety of MP 29-02, the effect of MP 29-02 on ciliary beat frequency (CBF) has not been evaluated thus far.
Methods
MP 29-02-containing solution was applied at concentrations of 2.5, 5, 10, and 20% to 14 healthy subjects, and nasal ciliated epithelial cells were then visualized using a phase-contrast microscope. CBF was measured after the application of MP 29-02. For a comparison, fluticasone propionate was used. CBF measurements were then performed for 15 min at 22 °C. Ringer's solution was applied as a negative control.
Results
MP 29-02 significantly reduced CBF at all the tested concentrations compared with that of the control group within the observation time. At a 2.5% concentration, MP 29-02 significantly reduced CBF from 6.81 Hz (SD ± 1.35 Hz) at baseline to 4.88 Hz (SD ± 1.52 Hz, p < 0.001) after 15 min. In contrast, for fluticasone propionate, a significant reduction was observed only with the 20% concentration after 5, 10, and 15 min.
Conclusions
MP 29-09 significantly reduced CB, with an almost linear relationship between the MP 29-09 concentration and reduction in CBF. For fluticasone propionate, a significant reduction of CBF was observed only at the highest analyzed concentration. The findings have implications for the long-term use of the MP 29-02. Yet, further clinical studies are needed to confirm these results in vivo, especially in patients with seasonal or perennial allergic rhinits.
https://ift.tt/2wEqtNg
Single nucleotide polymorphisms of IL-13 and CD14 genes in allergic rhinitis: a meta-analysis
Abstract
Purpose
The aim of this study was to conduct a meta-analysis for single nucleotide polymorphisms (SNPs) in interleukin-13 (IL-13) and cluster of differentiation 14 (CD14) genes and the risk for allergic rhinitis (AR).
Methods
We screened studies identified through seven databases including Pubmed, Medline, Web of Science, Embase, China Biology Medicine disc, Wanfang, and China Academic Journal Network Publishing Database. The odds ratios (ORs) and 95% confidence intervals (CIs) were determined to assess the association under allelic, dominant and recessive models.
Results
Twelve studies with a total of 8547 participants (3223 cases and 5324 controls) investigated IL-13 SNP rs20541, five studies combining 4580 participants (1411 cases and 3169 controls) examined IL-13 SNP rs1800925, and nine studies with 2301 participants (1174 cases and 1127 controls) assessed CD14 SNP rs2569190. We found that the A allele of IL-13 SNP rs20541 was associated with an increased risk of AR (OR 1.19, 95% CI 1.11–1.28, P < 0.001). Stratifying studies by ethnic group produced significant results in Asians (OR 1.21, 95% CI 1.11–1.32, P < 0.001), but not in Caucasians (OR 1.14, 95% CI 1.00–1.30, P = 0.051). No association of IL-13 SNP rs1800925 and CD14 SNP rs2569190 with AR risk was found in either Asians or Caucasians (P > 0.05).
Conclusion
Our findings suggest that IL-13 SNP rs20541 is significantly associated with AR risk in Asians but not in Caucasians. However, the accumulating evidence does not support an association of IL-13 SNP rs1800925 and CD14 SNP rs2569190 with AR risk.
https://ift.tt/2rFsXWu
Extramucosal pyriplasty without stenting for management of pyriform aperture stenosis
Abstract
Purpose
The current management options of congenital pyriform aperture stenosis (CNPAS) are either conservative measures awaiting further growth of the bony nasal framework or surgical intervention that focuses on bone removal from the margin of the pyriform aperture (PA) without exposure of the nasolacrimal duct (NLD) followed by stenting. Recently, CT measurements of the nasal cavity in CNPAS have shed light that the site of maximal bony obstruction corresponds to the bony buttress encasing the NLD rather than the margin of the PA as initially thought. Herein, we present an extramucosal pyriplasty technique that can be used without stenting to enlarge the PA and achieve immediate and sustained relief of nasal obstruction.
Methods
Retrospective chart review of 4 patients with radiologically confirmed CNPAS who had undergone extramucosal pyriplasty without stenting during the period from 2012 to 2016.
Results
Three patients were full term without any clinically detectable congenital anomaly. The fourth patient was preterm infant who needed ICU management. On computerized tomography scan, the PA width ranged from 5.8 to 7.1 mm with a mean of 6.4 mm while site of maximal stenosis ranged from 5.4 to 6.8 with a mean of 6 mm. Extramucosal pyriplasty relieved nasal obstruction and restored normal oral feeding in all patients. Postoperative follow-up endoscopy revealed an adequately patent airway with no scarring, granulation or restenosis.
Conclusions
Extramucosal pyriplasty with decompression of the NLD without stenting is a treatment modality for CNPAS that provides prompt sustainable relief of nasal obstruction and avoids the drawbacks of stenting and shortcomings of the current conservative methods.
https://ift.tt/2wENy2n
Antero- vs. retrograde nerve dissection in parotidectomy: a systematic review and meta-analysis
Abstract
Introduction
The retrograde approach (RP) to nerve identification is a method seldom used in parotid surgery. A systematic review comparing this method to the standard anterograde approach (AP) with respect to facial nerve palsy (FNP) does not currently exist.
Methods
In a meta-analysis according to the PRISMA statement, eight publications, including one randomized controlled trial, were selected. The primary aim was to compare the temporary and permanent FNP resulting from the two dissection methods. Facial nerve function was graded according to the House–Brackmann Scale. The secondary goal was a comparison of the cut–suture times (CST), the volume of healthy tissue (VHT) dissected, the rates of postoperative hematoma (PH), and postoperative infection (PI).
Results
Temporary FNP was noted in 18.2% in the RP group as well as in 34.4% in the AP group. Permanent FNP occurred in 0.9% RPs and 2.4% APs. According to the mixed-effect logistic regression model, there was no significant difference between the two groups in the pooled odds ratio (OR) for either temporary [OR 2.64, 95% confidence interval (CI) 0.97–7.21] or permanent FNP (OR 4.31, 95% CI 0.44–42.28). The CST was significantly shorter in the RP group (p = 0.005), with a significantly smaller VHT dissected (p < 0.0001). There were no differences regarding PH and PI.
Conclusion
The RP is a safe procedure with no significant difference in FNP rates when compared to the AP and, considering the shorter CST and the lesser VHT resected in the RP, it is superior to the AP. Surgeons engaged in parotidectomy should be familiar with both methods of dissection.
https://ift.tt/2rHy8oY
The multiplanar analysis of the retromandibular vein in surgical planning for parotid gland tumors
Abstract
Objective
To analyze the effectiveness of the multiplanar analysis of the retromandibular vein in establishing the position of the parotid gland tumor and its relationship with the facial nerve, together with the most common radiological criteria (facial nerve line, Utrecht line, retromandibular vein and parapharyngeal space variations) using the magnetic resonance imaging.
Study design
Retrospective study
Setting
Tertiary Academic Hospital
Subjects and methods
128 preoperative magnetic resonances were analyzed to study preoperative tumor location (medial or lateral to the expected course of the facial nerve) based on comparison between the radiological criteria and the surgical findings.
Results
FN line had the lowest accuracy at 77%, whereas the retromandibular vein achieved 85% accuracy and the UT line achieved accuracy of 93%. The retromandibular vein could not be identified in 11 cases (9%). The multiplanar evaluation of the retromandibular vein allowed us to identify it on almost all MR images (99% of cases) and reach 87% of accuracy. The parapharyngeal space evaluation achieved 92% of accuracy. In the subgroup of 66 cases where the neoplasms were strictly related to the main trunk, where the surgery entailed manipulation if situated laterally to the tumor, the multiplanar evaluation of the retromandibular vein reached 98% of accuracy and UT line achieved 94%.
Conclusions
The multiplanar modality, combined with the evaluation of the parapharyngeal space, is effective in helping the surgeon to achieve accurate planning: it enables the tumor to be located and the facial nerve course predicted with a good precision.
https://ift.tt/2rGohQe
Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register: a case study
Abstract
Purpose
Tonsillectomy (TE) is one of the most frequently performed ENT surgical procedures. Post-tonsillectomy haemorrhage (PTH) is a potentially life-threatening complication of TE. The National Tonsil Surgery Register in Sweden (NTSRS) has revealed wide variations in PTH rates among Swedish ENT centres. In 2013, the steering committee of the NTSRS, therefore, initiated a quality improvement project (QIP) to decrease the PTH incidence. The aim of the present study was to describe and evaluate the multicentre QIP initiated to decrease PTH rates.
Methods
Six ENT centres, all with PTH rates above the Swedish average, participated in the 7-month quality improvement project. Each centre developed improvement plans describing the intended changes in clinical practice. The project's primary outcome variable was the PTH rate. Process indicators, such as surgical technique, were also documented. Data from the QIP centres were compared with a control group of 15 surgical centres in Sweden with similarly high PTH rates. Data from both groups for the 12 months prior to the start of the QIP were compared with data for the 12 months after the QIP.
Results
The QIP centres reduced the PTH rate from 12.7 to 7.1% from pre-QIP to follow-up; in the control group, the PTH rate remained unchanged. The QIP centres also exhibited positive changes in related key process indicators, i.e., increasing the use of cold techniques for dissection and haemostasis.
Conclusions
The rates of PTH can be reduced with a QIP. A national quality register can be used not only to identify areas for improvement but also to evaluate the impact of subsequent improvement efforts and thereby guide professional development and enhance patient outcomes.
https://ift.tt/2wIC4Li
Effects of gadolinium-based contrast agents on submandibular gland tissue in rats
Abstract
Aim
The aim of this prospective animal study is to investigate the influence of multiple administrations of macrocyclic ionic (gadoteric acid) and linear nonionic (gadodiamide) gadolinium-based contrast agents (GBCA) on submandibular gland tissue (SGT) of the rats.
Material and method
Twenty-four Sprague Dawley female rats were included the study. Group 1 was determined as a control group (n = 6). Group 2 was determined as saline group (n = 6). Group 3 was determined as Omniscan group (n = 6) and received only intraperitoneal (IP) 0.1 mmol (0.2 mL/kg)/kg gadodiamide for 8 days. Group 4 was determined as Dotarem group (n = 6) and received only IP 0.1 mmol (0.2 mL/kg)/mg/kg gadoteric acid daily for 8 days. On the 9th day of the administration, the rats were sedated with ketamine and xylazine through IP injection. The right SGT was removed after sedation. Histopathological and immunohistochemical changes in SGT were evaluated.
Results
The SGT of the Omniscan and Dotarem groups decreased SGT acini surface area, and serous acinar cells number were observed. On the other hand, no pathology was observed. Mucous acinar cells' caspase-3 positivity for the same markers in Omniscan and Dotarem sections was similar to the control group. However, Omniscan and Dotarem groups serous acinar cells were caspase-3 (+) staining. The intensity of serous acinar cells' caspase-3 (+) for the same markers in Dotarem sections was similar to the Omniscan group. The results also revealed in the analysis of the mean area of the acinus area of the SGT; there were significantly decreased Dotarem group rats when compared to control rats (p < 0.05).
Conclusion
We consider that numerical increased apoptosis results arise from repeated doses of GBCAs. Being aware of this effect of the contrast agent may have significance for the chronic sialo-adenitis patients group when used for recurrent contrasted MRI for diagnosis of diseases like MS which requires in follow-up. We should be aware about the frequently contrasted MRI in routine investigations.
https://ift.tt/2rGojaO
Low inter-examiner agreement of the Friedman staging system indicating limited value in patient selection
Abstract
Purpose
The Friedman staging system is a clinical method for selecting patients with obstructive sleep apnoea who are likely to benefit from uvulopalatopharyngoplasty. The objective of this study was to evaluate the system by determining its inter-examiner agreement.
Methods
Twelve patients with obstructive sleep apnoea were examined by 14 doctors. The Friedman stage was derived from tonsil size and tongue position, and a Cohen's kappa analysis was performed to assess inter-examiner agreement.
Results
One hundred and sixty-eight ratings were performed. The median kappa for tongue position was 0.32 (first and third quartiles: 0.21 and 0.44) and was 0.62 (0.50 and 0.63) for tonsil size. The median kappa for the Friedman stage was 0.38 (0.24 and 0.55), which corresponds to only a slight or fair agreement.
Conclusion
The Friedman staging system demonstrated a low inter-examiner agreement, indicating that the system is an uncertain method for selecting patients for uvulopalatopharyngoplasty.
Level of evidence
2B.
https://ift.tt/2KoPazo
Cripto-1 is overexpressed in carcinoma ex pleomorphic adenoma of salivary gland
Abstract
Introduction
Cripto-1 is a member of the epidermal growth factor—Cripto-1/FRL-1/Cryptic family. Besides being critical for early embryonic development, Cripto-1 is also associated with the development and behavior of several cancers. Objective: We analyzed the immunoexpression of Cripto-1 in normal salivary glands (NSGs), pleomorphic adenomas (PAs), and carcinoma ex pleomorphic adenomas (CaExPAs) of salivary glands.
Methods
A total of 12 NSGs, 16 PAs and 12 CaExPAs underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were evaluated semiquantitatively (scores 0–3). For statistical analysis, Mann–Whitney and Kruskal–Wallis tests were performed and a significance level of p ≤ 0.05 was established.
Results
Most CaExPAs (n = 10) were strong positive (score 3) for Cripto-1, and only three cases of PAs and two specimens of NSGs exhibited some expression (score 1), being statistically significant these findings (p < 0.001). No difference between the expression of this protein in tumors of major and minor salivary glands was observed. Overexpression was found mainly in cases of CaExPAs with invasive growth (n = 8) when compared to those without capsular invasion (intracapsular pattern) (p = 0.036). Patients with or without lymph node metastasis showed no difference (p = 0.294).
Conclusion
The results revealed a significantly higher expression of Cripto-1 in CaExPA compared to PA and NSG, suggesting this protein is possibly deregulated in PA malignant transformation. Furthermore, the increased expression of this protein is associated with a more aggressive behavior (invasive growth) in salivary gland tumors.
https://ift.tt/2rGye0l
Chronic inflammatory demyelinating polyneuropathy: evaluation of the vestibular system with cervical and ocular vestibular evoked myogenic potentials
Abstract
Purpose
To investigate the possibility of vestibular damage in a group of patients suffering from chronic inflammatory demyelinating polyneuropathy (CIDP) using a diagnostic protocol including the caloric test, C-VEMPs and O-VEMPs.
Methods
Twenty patients suffering from CIDP (mean age 58.5 years, range 33–80 years; 4 women and 16 men) were investigated. To assess any eventual audio-vestibular involvement, all patients of the study underwent pure tone audiometry, Fitzgerald–Hallpike caloric vestibular test, C-VEMPs and O-VEMPs.
Results
In 11 patients with CIDP values of both O-VEMPs and C-VEMPs were either absent or abnormal. An absent trace at O-VEMPs testing occurred in 36% of these pathological patients, whereas an increase of n10 latency and amplitude was present in the other 64% .
Conclusions
A specific diagnostic protocol including the caloric test, C-VEMPS, O-VEMPS, could be useful when employed for identifying vestibular damage in CIDP patients.
https://ift.tt/2rFpI1q
Hopkins-led High Value Practice Academic Alliance and AHA’s Health Research & Educational Trust to Collaborate on High Value Health Care
https://ift.tt/2rGDz7O
Fetal Type Rhabdomyoma of the Soft Palate in an Adult Patient: Report of One Case and Review of the Literature
Abstract
Rhabdomyoma is a rare benign tumor with skeletal muscle differentiation. Rhabdomyoma is further classified into cardiac, adult, fetal, and genital subtypes. Out of these, fetal type rhabdomyoma (FTR) is the rarest. Only a small number of cases have been recorded in the literature. FTR typically affects male infants and young children and occurs predominantly in the head and neck region. FTR is exceedingly rare in the adult, with less than 30 cases reported. The classic FTR is composed of primitive undifferentiated spindle cells with scant eosinophilic cytoplasm embedded in a myxoid stroma. Immunohistochemically, the tumor cells are positive for desmin, muscle specific actin, and myogenin. Awareness and proper recognition of this rare entity is of considerable importance to avoid misdiagnosis of embryonal rhabdomyosarcoma. In this study, we report one case of FTR in an adult patient and reviewed the literature about the clinical and pathologic presentation of FTR in the adult.
https://ift.tt/2wEYpJy
Fetal Type Rhabdomyoma of the Soft Palate in an Adult Patient: Report of One Case and Review of the Literature
Abstract
Rhabdomyoma is a rare benign tumor with skeletal muscle differentiation. Rhabdomyoma is further classified into cardiac, adult, fetal, and genital subtypes. Out of these, fetal type rhabdomyoma (FTR) is the rarest. Only a small number of cases have been recorded in the literature. FTR typically affects male infants and young children and occurs predominantly in the head and neck region. FTR is exceedingly rare in the adult, with less than 30 cases reported. The classic FTR is composed of primitive undifferentiated spindle cells with scant eosinophilic cytoplasm embedded in a myxoid stroma. Immunohistochemically, the tumor cells are positive for desmin, muscle specific actin, and myogenin. Awareness and proper recognition of this rare entity is of considerable importance to avoid misdiagnosis of embryonal rhabdomyosarcoma. In this study, we report one case of FTR in an adult patient and reviewed the literature about the clinical and pathologic presentation of FTR in the adult.
https://ift.tt/2wEYpJy
Fetal Type Rhabdomyoma of the Soft Palate in an Adult Patient: Report of One Case and Review of the Literature
Abstract
Rhabdomyoma is a rare benign tumor with skeletal muscle differentiation. Rhabdomyoma is further classified into cardiac, adult, fetal, and genital subtypes. Out of these, fetal type rhabdomyoma (FTR) is the rarest. Only a small number of cases have been recorded in the literature. FTR typically affects male infants and young children and occurs predominantly in the head and neck region. FTR is exceedingly rare in the adult, with less than 30 cases reported. The classic FTR is composed of primitive undifferentiated spindle cells with scant eosinophilic cytoplasm embedded in a myxoid stroma. Immunohistochemically, the tumor cells are positive for desmin, muscle specific actin, and myogenin. Awareness and proper recognition of this rare entity is of considerable importance to avoid misdiagnosis of embryonal rhabdomyosarcoma. In this study, we report one case of FTR in an adult patient and reviewed the literature about the clinical and pathologic presentation of FTR in the adult.
https://ift.tt/2wEYpJy
Tip Sheet: Johns Hopkins Researchers Present Study Findings at Society for Academic Emergency Medicine Meeting 2018
https://ift.tt/2Igqj43
A Randomized Study of Palliative Radiation Therapy vs. no Palliative Radiation Therapy for Patients With High Risk Bone Metastases That Are Not Causing Significant Pain
Condition: Metastatic Solid Tumors of Metastatic Disease
Interventions: Radiation: Radiation Therapy; Drug: Systemic Therapy
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2wEGBOB
Interventions: Radiation: Radiation Therapy; Drug: Systemic Therapy
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2wEGBOB
Testing Lenvatinib and Cetuximab in Patients With Advanced Head and Neck Squamous Cell Carcinoma and Cutaneous Squamous Cell Carcinoma
Conditions: Head and Neck Squamous Cell Carcinoma; Cutaneous Squamous Cell Carcinoma; Head and Neck Cancer; Head and Neck Carcinoma
Interventions: Drug: Lenvatinib Pill; Drug: Cetuximab
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2IBBtQ7
Interventions: Drug: Lenvatinib Pill; Drug: Cetuximab
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2IBBtQ7
The Markov blankets of life: autonomy, active inference and the free energy principle
Kirchhoff, M; Parr, T; Palacios, E; Friston, KJ; Kiverstein, J; (2018) The Markov blankets of life: autonomy, active inference and the free energy principle. Journal of the Royal Society Interface , 15 (138) , Article 20170792. 10.1098/rsif.2017.0792 . Green open access
https://ift.tt/2L1XwxN
The role of circulating tumour cells and nucleic acids in blood for the detection of bladder cancer: A systematic review
Khetrapal, P; Lee, MWL; Tan, WS; Dong, L; de Winter, P; Feber, A; Kelly, JD; (2018) The role of circulating tumour cells and nucleic acids in blood for the detection of bladder cancer: A systematic review. Cancer Treatment Reviews , 66 pp. 56-63. 10.1016/j.ctrv.2018.03.007 .
https://ift.tt/2GfgJbG
Polymer brush lubrication of the silicon nitride-steel contact: a colloidal force microscopy study
Watson, S; Dennington, S; Wang, L; Nie, M; Hinder, S; Stokes, K; (2017) Polymer brush lubrication of the silicon nitride-steel contact: a colloidal force microscopy study. RSC Advances , 7 (68) pp. 42667-42676. 10.1039/c7ra08897c . Green open access
https://ift.tt/2jWw5t3
Would changing the selection process for GP trainees stem the workforce crisis? A cohort study using multiple-imputation and simulation
Taylor, C; McManus, IC; Davison, I; (2018) Would changing the selection process for GP trainees stem the workforce crisis? A cohort study using multiple-imputation and simulation. BMC Medical Education , 18 (1) , Article 81. 10.1186/s12909-018-1160-z . Green open access
https://ift.tt/2Gdnk6J
Profiling Distributed Virtual Environments by Tracing Causality
Friston, SJ; Elias, G; Swapp, D; Marshall, A; Steed, A; (2018) Profiling Distributed Virtual Environments by Tracing Causality. In: (Proceedings) IEEE VR 2018, 25th IEEE Conference on Virtual Reality and 3D User Interfaces, 18-22 March 2018, Reutlingen, Germany. IEEE (In press). Green open access
https://ift.tt/2KX9EjE
Development of Evidence Based Surveillance Intervals following Radiofrequency Ablation of Barrett's Esophagus
Cotton, CC; Haidry, R; Thrift, AP; Lovat, L; Shaheen, NJ; (2018) Development of Evidence Based Surveillance Intervals following Radiofrequency Ablation of Barrett's Esophagus. Gastroenterology 10.1053/j.gastro.2018.04.011 . (In press).
https://ift.tt/2GeYYcB
DAGAN: Deep De-Aliasing Generative Adversarial Networks for Fast Compressed Sensing MRI Reconstruction
Yang, G; Yu, S; Dong, H; Slabaugh, G; Dragotti, PL; Ye, X; Liu, F; ... Firmin, D; + view all Yang, G; Yu, S; Dong, H; Slabaugh, G; Dragotti, PL; Ye, X; Liu, F; Arridge, S; Keegan, J; Guo, Y; Firmin, D; - view fewer (2017) DAGAN: Deep De-Aliasing Generative Adversarial Networks for Fast Compressed Sensing MRI Reconstruction. IEEE Transactions on Medical Imaging 10.1109/TMI.2017.2785879 . (In press). Green open access
https://ift.tt/2KZxCLd
Public Health England prematurely endorses e-cigarettes
Greenberg, A; Jose, RJ; (2018) Public Health England prematurely endorses e-cigarettes. [Letter]. BMJ , 360 , Article k1262. 10.1136/bmj.k1262 . Green open access
https://ift.tt/2GeIbX5
Influence of substrate initial temperature on adhesion strength of ice on aluminum alloy
Chen, T; Cong, Q; Sun, C; Jin, J; Choy, K-L; (2018) Influence of substrate initial temperature on adhesion strength of ice on aluminum alloy. Cold Regions Science and Technology , 148 pp. 142-147. 10.1016/j.coldregions.2018.01.017 .
https://ift.tt/2KZxvPN
A Mathematical Model of Melt Lake Development on an Ice Shelf
Buzzard, SC; Feltham, DL; Flocco, D; (2018) A Mathematical Model of Melt Lake Development on an Ice Shelf. Journal of Advances in Modeling Earth Systems , 10 (2) pp. 262-283. 10.1002/2017MS001155 . Green open access
https://ift.tt/2GeYAuF
A MEMS thermal shear stress sensor produced by a combination of substrate-free structures with anodic bonding technology
Ou, Y; Qu, F; Wang, G; Nie, M; Li, Z; Ou, W; Xie, C; (2016) A MEMS thermal shear stress sensor produced by a combination of substrate-free structures with anodic bonding technology. Applied Physics Letters , 109 (2) 10.1063/1.4958842 . Green open access
https://ift.tt/2L14x24
Dissociating frontoparietal brain networks with neuroadaptive Bayesian optimization
Lorenz, R; Violante, IR; Monti, RP; Montana, G; Hampshire, A; Leech, R; (2018) Dissociating frontoparietal brain networks with neuroadaptive Bayesian optimization. Nature Communications , 9 (1) , Article 1227. 10.1038/s41467-018-03657-3 . Green open access
https://ift.tt/2GeYnHT
Utilizing swelling force to decrease the ice adhesion strength
Chen, T; Cong, Q; Li, Y; Jin, J; Choy, K-L; (2018) Utilizing swelling force to decrease the ice adhesion strength. Cold Regions Science and Technology , 146 pp. 122-126. 10.1016/j.coldregions.2017.11.018 .
https://ift.tt/2KUN1MR
The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study
Wayal, S; Reid, D; Blomquist, PB; Weatherburn, P; Mercer, CH; Hughes, G; (2018) The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study. JMIR Public Health Surveillance , 4 (2) , Article e52. 10.2196/publichealth.9010 . Green open access
https://ift.tt/2Ge5LDj
Shining a light on an unusual case of chronic kidney disease - Adenine phosphoribosyltransferase deficiency with crystalline nephropathy
Oomatia, A; Dupont, P; Bass, P; Moochhala, S; (2018) Shining a light on an unusual case of chronic kidney disease - Adenine phosphoribosyltransferase deficiency with crystalline nephropathy. [Editorial comment]. Kidney International , 93 (4) pp. 1023-1024. 10.1016/j.kint.2017.08.028 .
https://ift.tt/2jZ8acd
Governance of mutual housing in London
Fitzpatrick, Daniel Madav; (2018) Governance of mutual housing in London. Doctoral thesis (Ph.D), UCL (University College London). Green open access
https://ift.tt/2Gdngnv
Heuristic and optimal policy computations in the human brain during sequential decision-making
Korn, CW; Bach, DR; (2018) Heuristic and optimal policy computations in the human brain during sequential decision-making. Nature Communications , 9 , Article 325. 10.1038/s41467-017-02750-3 . Green open access
https://ift.tt/2jTfLt4
Role of Bioreactor Technology in Tissue Engineering for Clinical Use and Therapeutic Target Design
Selden, C; Fuller, B; (2018) Role of Bioreactor Technology in Tissue Engineering for Clinical Use and Therapeutic Target Design. Bioengineering , 5 (2) , Article 32. 10.3390/bioengineering5020032 . Green open access
https://ift.tt/2GfgEVq
Hematopoietic stem cell transplantation for CTLA4 deficiency
Slatter, MA; Engelhardt, KR; Burroughs, LM; Arkwright, PD; Nademi, Z; Skoda-Smith, S; Hagin, D; ... Torgerson, TR; + view all Slatter, MA; Engelhardt, KR; Burroughs, LM; Arkwright, PD; Nademi, Z; Skoda-Smith, S; Hagin, D; Kennedy, A; Barge, D; Flood, T; Abinun, M; Wynn, RF; Gennery, AR; Cant, AJ; Sansom, D; Hambleton, S; Torgerson, TR; - view fewer (2016) Hematopoietic stem cell transplantation for CTLA4 deficiency. Journal of Allergy and Clinical Immunology , 138 (2) 615-619.e1. 10.1016/j.jaci.2016.01.045 . Green open access
https://ift.tt/2jWP6LM
Immune privilege: failure of immunotherapy in controlling metastatic cutaneous melanoma to the eye
Sia, DIT; Thaung, C; O'Hanlon-Brown, C; Cohen, VML; Sagoo, MS; (2018) Immune privilege: failure of immunotherapy in controlling metastatic cutaneous melanoma to the eye. Melanoma Research 10.1097/CMR.0000000000000443 . (In press).
https://ift.tt/2GdDEnY
Targeted Cancer Therapies
A fact sheet that describes targeted cancer therapies, which are drugs that interfere with specific molecules involved in cancer cell growth and survival.
https://ift.tt/2djUp3B
Johns Hopkins Rehabilitation Network Opens New Therapy Clinic At acac Fitness & Wellness Center
The Johns Hopkins Rehabilitation Network is opening a new therapy clinic inside the acac Fitness & Wellness center in Timonium, Maryland. This model of business is becoming an increasingly popular way for health clubs and health systems to approach delivery of care, providing access to club members as well as patients in a community setting.
https://ift.tt/2Gd9nWf
New ‘Scoring’ System Improves Survival Forecasting Before and After Surgery for Advanced Colorectal Cancer
Georgios Margonis, M.D., Ph.D., a surgical oncology fellow at the Johns Hopkins University School of Medicine, and Matthew Weiss, M.D., surgical director of the Johns Hopkins Liver and Pancreas Cancer Multidisciplinary Clinics, report advances in efforts to improve the treatment and prognosis of colorectal cancers that have spread to the liver.
https://ift.tt/2rHj2zc
Retrograde jejunojejunal intussusception in a pregnant female after laparoscopic Roux-en-Y gastric bypass
Abstract
Adult intussusception is a rare complication after laparoscopic Roux-En-Y gastric bypass (LRYGB) surgery. Incidence of intussusception is on the rise as the demand of bariatric surgeries is increased to treat morbid obesity. Among the bariatric surgeries, LRYGB gastric bypass results in significantly higher weight loss with thinning of the mesentery resulting in increased risk for intussusception. Majority of intussusception cases after gastric bypass have been reported in non-pregnant patients. We report a case of retrograde jejunojejunal intussusception in 6 weeks pregnant female following laparoscopic gastric bypass, which was diagnosed with abdominal magnetic resonance imaging and managed successfully with resection and revision of the anastomosis.https://ift.tt/2rHbOv6
Haemangiopericytoma of the greater omentum: a rare tumour requiring long-term follow-up
Abstract
Haemangiopericytomas (HPC) are highly vascularized tumours located in any part of the body where capillaries can be found. Since 2002, they have been re-classified under the umbrella 'extrapleural Solitary Fibrous Tumour (SFT)' and the term HPC is nowadays used to describe a growth pattern rather than a clinical entity. Their biological behaviour varies and they require a long-term follow-up since they may recur or metastasise several years after successful treatment. We present the case of a gentleman with HPC of the greater omentum initially appeared in 1998. HPC rarely develops in the greater omentum and only 20 cases have been described in the literature till today. Despite complete excision the mass re-appeared in 2011 and 2017, 13 and 19 years after initial treatment. Surgical management included en bloc excision of three lesions along with greater omentum. No further treatment was required.https://ift.tt/2IdPBzI
Abdominal hernia and the unexpected final diagnosis
Abstract
Mucinous neoplasm of the appendix are rare entities, among these, mucinous cystadenomas contribute to 31–34%. Cystadenomas often produce extensive dilatation of the appendix with epithelial atypia. Spontaneous perforation often occurs in 20%, leading to mucin distribution throughout the peritoneal cavity. Half of the patients are completely asymptomatic and are detected as an incidental diagnosis, others symptoms include a palpable mass, hernias, weight loss, peritonism or even intestinal obstruction. We present a case of a 71-year-old female, she presented with a palpable mass in the upper abdomen. A ventral hernia was the most likely diagnosis and hernioplasty was planned. At surgery, a mucinous mass was discovered and mucous material was found free en the peritoneal cavity. Also, a perforated appendix and a mass in the cecum was found. Patient underwent full recovery. Pathology reported pseudomyxoma peritonei as the final diagnosis.https://ift.tt/2rIxuH1
Primary jejunal Burkitt lymphoma in a child: ultrasonic detection
Abstract
Gastrointestinal Burkitt lymphoma (BL) is a highly aggressive malignancy in childhood, and early treatment is critical for its favorable prognosis. Ultrasonography is a widely accepted initial imaging workup; therefore, recognition of the sonographic features of BL should contribute to its early diagnosis and initiation of treatment. We present a 4-year-old boy with primary jejunal BL with intussusception mimicking presentation, in which initial abdominal US allowed sustainable detection and characterization of the intestinal lesion. Jejunotomy was performed and histopathological analysis revealed a 'starry sky' pattern and c-myc split signals characteristic of BL. The patient remains disease-free following chemotherapy.https://ift.tt/2IeX5md
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