UTHealth/Memorial Hermann Conduct First Sinus Surgery in U.S. Using Augmented Reality Technology

Sinus surgeons with The University of Texas Health Science Center at Houston (UTHealth) and Memorial Hermann-Texas Medical Center were the...

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Treating Esophageal Diverticula: Life-changing Surgeries for Two Patients

In most cases, Zenker's diverticula are spontaneous and occur in people over the age of 60. More complicated cases of...

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Dr. William Yao Serves as Guest Editor of Otolaryngology Journal

William C. Yao, MD, was guest editor of  "Surgical Techniques of Emergencies in Otolaryngology,"  in recent issue of Operative Techniques...

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Idiopathic cervical tracheal stenosis in an 11-year-old male

Publication date: October 2018

Source: International Journal of Pediatric Otorhinolaryngology, Volume 113

Author(s): Matthew R. Hoffman, Katrina M. Thompson, Jessica Van Beek-King

Abstract

Idiopathic laryngotracheal stenosis is a fibroinflammatory stenosis in persons without alternative explanation such as trauma, intubation, or autoimmune disease. Patients are usually females of child-bearing age. We report on an 11-year-old male who developed progressive dyspnea and stridor. Bronchoscopy revealed 90% stenosis of the cervical trachea. He underwent serial balloon dilation with steroid injection; stenosis decreased to 20%. He had no history of intubation or trauma. Histologic and laboratory workup for autoimmune disease was negative. This report highlights occurrence of a well-known disease in an uncommon population, and alerts providers to consider this when seeing new pediatric patients with symptoms of progressive airway restriction.

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Genome-wide analyses and functional profiling of human NK cell lines

Publication date: Available online 24 July 2018

Source: Molecular Immunology

Author(s): Justin T. Gunesch, Laura S. Angelo, Sanjana Mahapatra, Raquel P. Deering, Johanna E. Kowalko, Patrick Sleiman, John W. Tobias, Linda Monaco-Shawver, Jordan S. Orange, Emily M. Mace

Abstract

Natural killer (NK) cell lines, including YTS, NK92, NK3.3, and NKL, represent excellent models for the study of human natural killer cells. While phenotypic and functional differences between these cell lines have been reported, a multi-parametric study, encompassing genomic, phenotypic, and functional assays, has not been performed. Here, using a combination of techniques including microarray and copy number analyses, flow cytometry, and functional assays, we provide in-depth genetic, functional, and phenotypic comparison of YTS, NK92, NK3.3, and NKL cell lines. Specifically, we found that while the cell lines shared similarities in enrichment of growth and survival pathways, they had differential expression of 557 genes, including genes related to NK cell development, survival, and function. In addition, we provide genetic and phenotypic analyses that demonstrate distinct developmental origins of NK92, YTS, and NKL cell lines. Specifically, NK92 has a phenotype associated with the CD56^bright NK cell subset, while both YTS and NKL appear more CD56^dim-like. Finally, by classifying cell lines based on their lytic potential, we identified genes differentially expressed between NK cell lines with high and low lytic function. Taken together, these data provide the first comprehensive genetic, phenotypic, and functional analyses of these commonly used NK cell lines and provides deeper understanding into their origins and function. This will ultimately improve their use as models for human NK cell biology.

https://ift.tt/2OfYYOM

Response to YAJOT_2018_288 “Letter to the Editor: T2-weighted MRI screening algorithm for patients with asymmetric sensorineural hearing loss”

Publication date: Available online 24 July 2018

Source: American Journal of Otolaryngology

Author(s): Matthew L. Carlson, Alex D. Sweeney, John I. Lane

https://ift.tt/2LjQb0q

Correction to: Correction to: The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients with Cervical Cancer

Regrettably, the author metadata used for the previous correction (doi: https://ift.tt/2LyZA3v) contained an error in the tagging of W. Glenn McCluggage's name; this has been corrected. No further adjustments have been made to the Correction, or the original Guideline paper (doi: https://ift.tt/2LM3IKq).

https://ift.tt/2uMU0kg

The Nasal Width and Boxiness Index: Introduction and Pilot Study on Reliability and Validity of Sonographic Morphometry

Facial plast Surg 2018; 34: 373-380
DOI: 10.1055/s-0038-1667025

Both intended and unintended surgical modifications of nasal width and shape of the nasal tip continue to be of interest to the rhinoplasty surgeon. As validated instruments for quantifying width and boxiness are lacking, the objective of this study was to introduce a width index and a boxiness index for the nasal dorsum and the nasal tip. A width index and a boxiness index were defined within the methodological limits of noncontact sonography. The reliability of both indices was studied by comparing the measurements of two examiners on the noses of five volunteers. The validity of the indices was studied by correlating the sonographic width and boxiness with the 5-point Likert scale ratings of photographs of 5 noses by 21 lay persons. Nasal width was defined as the diameter at a distance of 5 mm from the skin surface on a sonographic cross-section perpendicular to the skin surface. Boxiness was defined as the quotient of width at a depth of 1 and 5 mm. Bland–Altmann analysis revealed negligible bias between both examiners and 95% of limits of agreement of 13, 7, and 13% for width at 1 mm, width at 5 mm, and boxiness, respectively. Corresponding Pearson's correlation coefficients were r = 0.93, r = 0.93, and r = 0.71. The correlation between the cumulative lay persons' scores and sonographic width and boxiness were r = 0.97, r = 0.66, and r = 0.81 for nasal tip width, dorsal width, and boxiness, respectively. Both the width at a depth of 5 mm as measured with sonography and the boxiness index that is defined as width at a depth of 1 mm divided by the width at a depth of 5 mm may prove to be acceptable surrogate parameters for width and boxiness of the nose in comparative morphometric studies.
[...]

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Rhinoplasty—Do Patients and Surgeons See the Same? A Double-Blind Study with 100 Randomized Patients

Facial plast Surg 2018; 34: 356-362
DOI: 10.1055/s-0038-1660823

One of the key points of a successful rhinoplasty is communication between the patient and surgeon. The surgeon needs to get a clear understanding of the patient's motivation for surgery and expectations of the procedure. This information is mandatory in formulating an optimal surgical plan and managing realistic expectations of the procedures. Ideally, surgeons and patients see, discuss, and quantify the same nasal defects. In reality, the subjective nature of perceiving aesthetics can cause variability of inter-rating nasal appearance. Therefore, one might question how well surgeons understand their patients. Do they see what patients see? The aim of this study is to assess the level of agreement on the evaluation of nasal appearance between patients, surgeons, and nonphysicians observers, and try to find predictive factors that cause high interobserver variability. This prospective, observational, and cross-sectional study was performed on a total of 100 randomized patients undergoing rhinoplasty. All patients were photographed before surgery and asked to rate the appearance of their nose on a 10 cm visual analogue scale (VAS) with 0 indicating very ugly and 10 indicating very nice. Subsequently, the photographs of each patient were, independently, rated by two panels: one constituted by two rhinoplasty surgeons and the other by four nonmedical raters. Both panels included European raters from the north (The Netherlands) and south (Portugal). Data regarding age, gender, skin type, and major nasal deformity were also collected. The authors found that there is no statistical agreement between the aesthetical evaluation of the nose between patients and surgeons or patients and nonmedical raters. Based exclusively on the VAS for subjective evaluation of nasal appearance, the authors' findings show that surgeons and patients do not "see the same" and generally, the score attributed by the surgeon is more favorable (almost 1 point higher) than the auto-assessment's score. This is important to realize when communicating about nasal appearance before rhinoplasty.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Teaching Facial Plastic Surgery

Facial plast Surg 2018; 34: 341-342
DOI: 10.1055/s-0038-1667136

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Introducing Hair Transplantation into a Facial Plastic Surgery Practice

Facial plast Surg 2018; 34: 384-388
DOI: 10.1055/s-0038-1666785

Hair restoration can be an integral addition to the facial plastic surgery practice. As surgeons dedicated to reconstructive and aesthetic surgery of the head and neck, hair restoration is a natural complement to a facial plastic surgeon's practice. This article presents the keys to adding and starting hair restoration to one's facial plastic surgery practice.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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A Plea for Ethics: Suggestions for Implementation in the Medical Curriculum

Facial plast Surg 2018; 34: 343-349
DOI: 10.1055/s-0038-1667026

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Refinements in Saddle Nose Reconstruction

Facial plast Surg 2018; 34: 363-372
DOI: 10.1055/s-0038-1660824

Saddle nose correction remains a challenging procedure for rhinoplasty surgeons due to both aesthetic and functional issues. The most common causes of saddle nose are nasal trauma and prior septal surgery, and a defective relationship between the caudal septum and the anterior septal spine is the principal postoperative pathology. The authors propose their own classification system for saddle nose with one new category and several approaches to deal with this condition in accordance with the level of severity. They strongly advocate major septal reconstruction for most cases of saddle nose, either by placing extended spreader grafts, caudal extension grafts, or a new extracorporeally made L strut. For extreme cases, integrated dorsal implant with columellar strut can successfully bypass the saddled nasal dorsum without dissecting the septal mucoperichondrial pocket and achieve adequate dorsal height. Further dorsal augmentation can be achieved by applying side/gap grafts or dorsal onlay grafts in different forms. In cases with retracted columella, a premaxillary plumping graft is another useful technique. Finally, in autoimmune-related saddling patients, the evidence indicates that their aesthetic problems can be managed safely with surgery as long as the disease is well under control.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Development and Validation of a Brief Four-Component Questionnaire to Identify Patient's Motivation to Undergo Functional Rhinoplasty

Facial plast Surg 2018; 34: 350-355
DOI: 10.1055/s-0038-1660835

Outcome of functional rhinoplasty depends on different domains such as functional and aesthetic improvement. The aim of this study was to develop a brief and comprehensible questionnaire to identify patient motivation to undergo rhinoplasty and to measure the outcome of an intervention within a short time during outpatient consultation. Patients undergoing rhinoplasty were asked to complete the Rhinoplasty Outcome Evaluation (ROE) questionnaire, the Nasal Obstruction Symptom Evaluation (NOSE) scale, and the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty (OAR) preoperatively, as well as one, three, and twelve months postoperatively. Patient satisfaction after surgery was assessed at postoperative consultations using a five-point Likert scale. Principle component analysis was performed to reveal the main domains, which were detected by the different questionnaires. Items with the strongest loading on a factor were identified by correlation matrix. Influence of the nasal appearance on the quality of life, troubles with nasal breathing, subjective perception of nasal appearance, and the wish for modification or alteration were found to be the four important domains of the questionnaires. The questions with the strongest loading on these domains were compiled and the four-component questionnaire (4CQ) was developed. The 4CQ is a very effective instrument to obtain a comprehensive impression of the varied determinants representing the major motifs to undergo functional rhinoplasty within a short time. The preoperative assessment of the 4CQ allows an estimation concerning the expected outcome.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Facial Asymmetry Index: Validation and Applications in Various Smile Restoration Techniques

Facial plast Surg 2018; 34: 381-383
DOI: 10.1055/s-0038-1660836

Consistent and objective evaluation of the paralyzed face is imperative for documenting preoperative findings and assessing postoperative outcomes of reanimation techniques. Static and dynamic facial asymmetry are the key features of the paralyzed face. To date, there is no consensus among surgeons on how best to document facial asymmetry. The authors propose a Facial Asymmetry Index (FAI) as an objective measure of facial asymmetry and validate its use and reliability across numerous reanimation techniques. Frontal photographs of patients with unilateral facial nerve paralysis were analyzed. The length from the medial canthus to the ipsilateral oral commissure was compared between affected and nonaffected sides. The FAI is the difference between the two values, with a higher value reflecting poorer facial symmetry. Validation and reliability testing was then performed. There was a consistent decrease in the FAI with procedural intervention (FAI pre = 10.1, FAI post = 3.17; p < 0.0001). Furthermore, there was excellent inter- and intrarater reliability among independent judges. The FAI is a powerful and accessible tool to quantify operative outcomes for many lower facial nerve reanimation techniques.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Tip-on-Tip Scapular (TOTS) Flap for Reconstruction of Combined Palatectomy and Rhinectomy Defects

Facial plast Surg 2018; 34: 389-393
DOI: 10.1055/s-0038-1666784

Combination anterior palatectomy and rhinectomy defects result in complete loss of midface and nasal support and present a significant reconstructive challenge. A novel use of the scapular tip free flap—the tip-on-tip scapula flap—was developed to provide both palatal repair and restoration of intrinsic nasal support. The scapular tip bone is split into a large proximal segment for the anterior palate and a smaller distal bone segment for nasal framework reconstruction. Two patients undergoing reconstruction of both total palatectomy and partial rhinectomy defects at a single academic tertiary care center were reviewed. In both cases, the larger proximal segment of the scapular tip flap, used for the palatal defect, was based on the angular artery. The distal bone segment, used for nasal framework repair, was vascularized in one of two ways. In the osteomyogenous serratus-scapular tip variant, the serratus arterial branch provided periosteal blood supply to the bone through a cuff of attached serratus muscle. In the split-scapular tip variant, the periosteum of the scapular tip was kept in continuity with the distal bone segment and fed through the periosteal vascular arcade from the angular branch. In both patients, the distal bone segment demonstrated robust intraoperative vascularity and both flaps healed without complication. Both patients were able to resume oral diets and had good nasal breathing.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Erratum: Failure of Synthetic Implants: Strategies and Management

Facial plast Surg 2018; 34: 429-430
DOI: 10.1055/s-0038-1667174

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Recent Molecular Profiling Studies in Papillary and Follicular Thyroid Carcinoma Provide Clinical and Basic Insights

Clinical Thyroidology, Volume 30, Issue 7, Page 319-323, July 2018.


https://ift.tt/2v33bwB

A High Proportion of Serum rT3 Tests Are Ordered by a Relatively Small Number of Providers in a U.S.-Wide Sample

Clinical Thyroidology, Volume 30, Issue 7, Page 337-339, July 2018.


https://ift.tt/2LlQqIs

New Genomic Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules Shows Improved Results

Clinical Thyroidology, Volume 30, Issue 7, Page 328-331, July 2018.


https://ift.tt/2LnJtqp

Higher Preconception Maternal Iodine Intakes Are Associated with Higher Child IQ

Clinical Thyroidology, Volume 30, Issue 7, Page 302-304, July 2018.


https://ift.tt/2v33asx

Some Advanced Thyroid Cancer Patients Have a Prolonged Response to Lenvatinib

Clinical Thyroidology, Volume 30, Issue 7, Page 305-308, July 2018.


https://ift.tt/2v337Nn

Editorial: Will the EUGOGO Predictive Score for Graves’ Orbitopathy Be Useful for Management?

Clinical Thyroidology, Volume 30, Issue 7, Page 300-301, July 2018.


https://ift.tt/2LnJkTT

Analysis of Clinical Factors 1 Year After Surgery for Thyroid Cancer Enables Prediction of Treatment-free Survival

Clinical Thyroidology, Volume 30, Issue 7, Page 309-311, July 2018.


https://ift.tt/2v33305

Residual Lymph Node Metastases after Initial Surgery—What Are the Implications for the Approach to Initial Surgery and Postoperative Therapy?

Clinical Thyroidology, Volume 30, Issue 7, Page 324-327, July 2018.


https://ift.tt/2LhEur7

Thyroglobulin Levels Do Not Predict Recurrence After Lobectomy for Low-Risk Papillary Thyroid Cancer

Clinical Thyroidology, Volume 30, Issue 7, Page 312-314, July 2018.


https://ift.tt/2v1wQGo

Automated Analysis of Gray-Scale Ultrasound Images of Thyroid Nodules (“Radiomics”) May Outperform Image Interpretation by Less Experienced Thyroid Radiologists

Clinical Thyroidology, Volume 30, Issue 7, Page 332-336, July 2018.


https://ift.tt/2LnJ6Mx

What Factors Contribute to the Development of Central Hypothyroidism When Adult Patients with GH Deficiency Are Treated with rhGH?

Clinical Thyroidology, Volume 30, Issue 7, Page 315-318, July 2018.


https://ift.tt/2v0N2I0

Letter to the Editor: Molecular Analysis Should Be Incorporated Into the Definition of NIFTP

Clinical Thyroidology, Volume 30, Issue 7, Page 340-341, July 2018.


https://ift.tt/2LnJ0Vb

Effect of Runx2 silencing on autophagy and RANKL expression in osteoblasts

Publication date: Available online 24 July 2018

Source: Archives of Oral Biology

Author(s): Han Qin, Jun Cai

Abstract

Objective

This study aimed to investigate the effect of Runx2 silencing on autophagy and RANKL expression in mouse osteoblasts, and provide an experimental basis to assess obstacles in dental eruption.

Methods

In accordance with previously reported methods, LVpFU-GW-016PSC60109-1 virus was used to transfect mouse osteoblasts (MOI = 40). Target gene expression was assessed via cytometer, and the effect of silencing Runx2 was assessed via a two-step quantitative real-time polymerase chain reaction (qRT-PCR)-based method. Western blotting was performed to assess LC3, Beclin-1 and RANKL expression.

Results

As confirmed via qRT-PCR analysis, Runx2 was efficiently silenced in the experimental group (>90% efficiency). Western blotting revealed that LC3 and RANKL proteins were significantly down -regulated in the experimental group (group KD), their expression levels being particularly lower than those in the control group (group NC). However, Beclin-1 protein expression was not significantly different from that of the control.

Conclusion

Upon Runx2 silencing, autophagy-related proteins and RANKL were repressed in osteoblasts, thereby potentially causing the tooth eruption disorder.

https://ift.tt/2LkKUWu

Asthma Clinical Practice Guidelines: time for an update

Publication date: Available online 24 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Zuhair K. Ballas

https://ift.tt/2Og8RMy

Allergic Contact Dermatitis To Personal Care Products And Topical Medications In Adults With Atopic Dermatitis

Atopic dermatitis (AD) is associated with skin-barrier disruption, immune dysregulation, and application of emollients and topical medications, which may predispose towards developing allergic contact dermatitis (ACD).

https://ift.tt/2A8rvCM

Pore Architecture Effects on Chondrogenic Potential of Patient-Specific 3-Dimensionally Printed Porous Tissue Bioscaffolds for Auricular Tissue Engineering

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): David A. Zopf, Colleen L. Flanagan, Anna G. Mitsak, Julia R. Brennan, Scott J. Hollister

Abstract

Objective

This study aims to determine the effect of auricular scaffold microarchitecture on chondrogenic potential in an in vivo animal model.

Methods

DICOM computed tomography (CT) images of a human auricle were segmented to create an external anatomic envelope. Image-based design was used to generate 1) orthogonally interconnected spherical pores and 2) randomly interspersed pores, and each were repeated in three dimensions to fill the external auricular envelope. These auricular scaffolds were then 3D printed by laser sintering poly-L-caprolactone, seeded with primary porcine auricular chondrocytes in a hyaluronic acid/collagen hydrogel and cultured in a pro-chondrogenic medium. The auricular scaffolds were then implanted subcutaneously in rats and explanted after 4 weeks for analysis with Safranin O and Hematoxylin and Eosin staining.

Results

Auricular constructs with two micropore architectures were rapidly manufactured with high fidelity anatomic appearance. Subcutaneous implantation of the scaffolds resulted in excellent external appearance of both anterior and posterior auricular surfaces. Analysis on explantation showed that the defined, spherical micropore architecture yielded histologic evidence of more robust chondrogenic tissue formation as demonstrated by Safranin O and Hematoxylin and Eosin staining.

Conclusions

Image-based computer-aided design and 3D printing offers an exciting new avenue for the tissue-engineered auricle. In early pilot work, creation of spherical micropores within the scaffold architecture appears to impart greater chondrogenicity of the bioscaffold. This advantage could be related to differences in permeability allowing greater cell migration and nutrient flow, differences in surface area allowing different cell aggregation, or a combination of both factors. The ability to design an anatomically correct scaffold that maintains its structural integrity while also promoting auricular cartilage growth represents an important step towards clinical applicability of this new technology.

https://ift.tt/2A70i3l

Nodular fasciitis of the tongue: A case report in an infant

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Raymond P. Shupak, Bruce B. Horswell, Marcus D. Shaffer, Milton J. Plata

Abstract

Nodular fasciitis is a benign lesion uncommonly found in the head and neck region. Although described previously in adults, there have been no reports of nodular fasciitis in a child's tongue. A 4 month old male infant was referred for evaluation of a rapidly growing tongue lesion. He underwent excisional biopsy of the lesion. Initial pathology suggested a spindle cell tumor. Subsequent outside facility molecular testing was obtained and Nodular Fasciitis was confirmed. Nodular fasciitis is a rare benign tumor that can be often mistaken for malignancy. Special histochemical and molecular testing is required to obtain final diagnosis.

https://ift.tt/2mHprIE

Spoken word recognition in noise in Mandarin-speaking pediatric cochlear implant users

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Cuncun Ren, Jing Yang, Dingjun Zha, Ying Lin, Haihong Liu, Ying Kong, Sha Liu, Li Xu

Abstract

Objective

The purpose of the present study was to compare spoken word recognition performance in the presence of speech spectrum-shaped noise and four-talker babbles in Mandarin-speaking children with cochlear implants (CIs).

Methods

Participants included 33 children with unilateral CIs (with a mean age of 10.4 ± 2.9 years old and a mean length of CI use of 7.5 ± 3.0 years). The Standard Chinese version of Lexical Neighborhood Test was implemented in quiet, speech-spectrum-shaped noise (SSN), and four-talker babble (FTB). The signal-to-noise ratios (SNRs) were set at +5 and +10 dB for both types of maskers. Participants responded by verbally repeating each word they heard and the response was scored as the percentage accuracy of recognition performance. A Generalized Linear Model (GLM) fitting, correlational tests, and a two-way repeated-measures ANOVA were conducted on the percent-correct data.

Results

Word recognition in quiet was on average 74.5% correct but dropped to 57.3% and 48.8% correct for SSN and FTB at 10 dB SNR, respectively, and 44.4% and 32.6% correct for SSN and FTB at 5 dB SNR, respectively. In both quiet and noise conditions, the participants showed lower recognition accuracy for the hard words than for the easy words. Disyllabic words were recognized with higher accuracy rates than were the monosyllabic words. The GLM analysis revealed that all four tested factors (masker type, SNR, lexical neighborhood feature, and lexical type) showed significant impacts on word recognition in children with CIs. Word recognition scores in the two types of maskers were significantly correlated for the disyllabic words at both SNRs and monosyllabic words at 10 dB SNR.

Conclusions

The present study demonstrated that the lexical features such as the lexical neighborhood characteristics and lexical type had significant effects on speech recognition performance in both quiet and noise conditions in pediatric CI users. Children with years of experience of CI use still encountered remarkable difficulties in everyday listening environment although their speech recognition in quiet reached relatively desired level. Fluctuating noise, such as speech babbles, caused greater challenge than steady-state noise for speech recognition in children with CIs.

https://ift.tt/2A73nkd

PREDICTORS OF NATURE OF INGESTED FOREIGN BODIES IN CHILDREN & ASSESSMENT OF OPERATIVE OUTCOMES

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Rubeena Arora, Sunil Kumar, Gautam Bir Singh

Abstract

OBJECTIVE

To examine sensitivity/specificity of history & radiology to identify ingested foreign body (FB) and develop a protocol for management of ingested FBs in paediatric patients; to assess outcomes of removal of lithium button battery foreign body (LBBFB).

METHODS

Retrospective review. Children presenting to ENT emergency with suspected FB ingestion underwent rigid esophagoscopy and FB removal. Average age, number of attempts, duration of ingestion, success rate, and complications were analysed.

RESULTS

Cases of coin/LBBFB ingestion: 916/70. Mean age: 5.8/2.03 years (p<0.001). Average duration of ingestion: 37/9.5 h (p<0.001). Patients below 3: 31.3/62.8% (p<0.001). Suggestive history/radiological signs: 100%/100%, 75.7%/98.6% (p<0.0001). Site of impaction cricopharynx: 60.3%/74.3% (p=0.02). LBBFB group: Successful removal in 1^st attempt: 66 (94.3%). Cases requiring multiple attempts due to impaction: 4 (5.7%). Parenteral steroids were administered before successful reattempt. No relation was found between duration of ingestion/impaction. Five (7.1%) cases developed complications. Average follow-up duration: 13.59 months.

CONCLUSIONS

Children <3 years with vague history of FB ingestion and suggestive chest x-ray should be sent urgently for FB removal. Parenteral pre-and postoperative short course steroid use may be considered to improve outcomes.

https://ift.tt/2OcRR9C

Evaluating the Efficacy and Tolerability of Application of Metaderm Product for the Treatment of Psoriasis

Condition:   Psoriasis
Intervention:   Drug: Metaderm
Sponsor:   University of Alabama at Birmingham
Not yet recruiting

https://ift.tt/2uXDUna

Efficacy of Osteopathic Manual Therapy Combined With Myofunctional Exercise for Temporomandibular Chronic Disorders

Condition:   Temporomandibular Joint Dysfunction Syndrome
Interventions:   Procedure: Osteopathic Treatment;   Procedure: Myofunctional Motor control exercises
Sponsor:   Maxilofacial Institute Bara Gaseni
Not yet recruiting

https://ift.tt/2LnjUpi

Study Investigating a Single Oral Dose of Fenebrutinib in Healthy Volunteers

Condition:   Healthy Participants
Intervention:   Drug: Fenebrutinib
Sponsor:   Hoffmann-La Roche
Recruiting

https://ift.tt/2uXDNYM

Reply to Doi et al.: Functional architecture matters in the formation of perception [Biological Sciences]

We agree that elimination of false matches is a multistep process and show that V2 is an important step in the process. Below, we further show that by integrating disparity domain neuron responses (Fig. 1A, large red circle) with similar preferred disparity but across different preferences of other visual features...

https://ift.tt/2Ll4zp1

Spatial pooling inherent to intrinsic signal optical imaging might cause V2 to resemble a solution to the stereo correspondence problem [Biological Sciences]

Using intrinsic signal optical imaging, Chen et al. (1) show that disparity information in visual area V2 is decodable from correlated random dot stereograms (cRDSs), but not from anticorrelated RDSs (aRDSs). The authors conclude that "V2 is the initial locus of false matching elimination," indicating that the correspondence problem is...

https://ift.tt/2v0Rs1m

Genetic selection of athletic success in sport-hunting dogs [Population Biology]

Modern dogs are distinguished among domesticated species by the vast breadth of phenotypic variation produced by strong and consistent human-driven selective pressure. The resulting breeds reflect the development of closed populations with well-defined physical and behavioral attributes. The sport-hunting dog group has long been employed in assistance to hunters, reflecting...

https://ift.tt/2v1BXq6

Positional specificity of different transcription factor classes within enhancers [Systems Biology]

Gene expression is controlled by sequence-specific transcription factors (TFs), which bind to regulatory sequences in DNA. TF binding occurs in nucleosome-depleted regions of DNA (NDRs), which generally encompass regions with lengths similar to those protected by nucleosomes. However, less is known about where within these regions specific TFs tend to...

https://ift.tt/2LipKrT

Correction to Supporting Information for Hayashi et.al., Distinct requirements for energy metabolism in mouse primordial germ cells and their reprogramming to embryonic germ cells [SI Correction]

DEVELOPMENTAL BIOLOGY Correction to Supporting Information for "Distinct requirements for energy metabolism in mouse primordial germ cells and their reprogramming to embryonic germ cells," by Yohei Hayashi, Kei Otsuka, Masayuki Ebina, Kaori Igarashi, Asuka Takehara, Mitsuyo Matsumoto, Akio Kanai, Kazuhiko Igarashi, Tomoyoshi Soga, and Yasuhisa Matsui, which was first published...

https://ift.tt/2LmNMSz

Correction for Fregel et al., Ancient genomes from North Africa evidence prehistoric migrations to the Maghreb from both the Levant and Europe [Corrections]

GENETICS Correction for "Ancient genomes from North Africa evidence prehistoric migrations to the Maghreb from both the Levant and Europe," by Rosa Fregel, Fernando L. Méndez, Youssef Bokbot, Dimas Martín-Socas, María D. Camalich-Massieu, Jonathan Santana, Jacob Morales, María C. Ávila-Arcos, Peter A. Underhill, Beth Shapiro, Genevieve Wojcik, Morten Rasmussen, André...

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Gradual progression from sensory to task-related processing in cerebral cortex [Neuroscience]

Somewhere along the cortical hierarchy, behaviorally relevant information is distilled from raw sensory inputs. We examined how this transformation progresses along multiple levels of the hierarchy by comparing neural representations in visual, temporal, parietal, and frontal cortices in monkeys categorizing across three visual domains (shape, motion direction, and color). Representations...

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Scleral hypoxia is a target for myopia control [Cell Biology]

Worldwide, myopia is the leading cause of visual impairment. It results from inappropriate extension of the ocular axis and concomitant declines in scleral strength and thickness caused by extracellular matrix (ECM) remodeling. However, the identities of the initiators and signaling pathways that induce scleral ECM remodeling in myopia are unknown....

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Integration of cell cycle signals by multi-PAS domain kinases [Microbiology]

Spatial control of intracellular signaling relies on signaling proteins sensing their subcellular environment. In many cases, a large number of upstream signals are funneled to a master regulator of cellular behavior, but it remains unclear how individual proteins can rapidly integrate a complex array of signals within the appropriate spatial...

https://ift.tt/2A4vgcD

Observation of highly stable and symmetric lanthanide octa-boron inverse sandwich complexes [Chemistry]

While boron forms a wide range of metal borides with important industrial applications, there has been relatively little attention devoted to lanthanide boride clusters. Here we report a joint photoelectron spectroscopy and quantum chemical study on two octa-boron di-lanthanide clusters, Ln2B8− (Ln = La, Pr). We found that these clusters...

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Different roles of myocardial ROCK1 and ROCK2 in cardiac dysfunction and postcapillary pulmonary hypertension in mice [Medical Sciences]

Although postcapillary pulmonary hypertension (PH) is an important prognostic factor for patients with heart failure (HF), its pathogenesis remains to be fully elucidated. To elucidate the different roles of Rho-kinase isoforms, ROCK1 and ROCK2, in cardiomyocytes in response to chronic pressure overload, we performed transverse aortic constriction (TAC) in cardiac-specific...

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1.1-billion-year-old porphyrins establish a marine ecosystem dominated by bacterial primary producers [Earth, Atmospheric, and Planetary Sciences]

The average cell size of marine phytoplankton is critical for the flow of energy and nutrients from the base of the food web to higher trophic levels. Thus, the evolutionary succession of primary producers through Earth's history is important for our understanding of the radiation of modern protists ∼800 million...

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Separation of circadian- and behavior-driven metabolite rhythms in humans provides a window on peripheral oscillators and metabolism [Physiology]

Misalignment between internal circadian rhythmicity and externally imposed behavioral schedules, such as occurs in shift workers, has been implicated in elevated risk of metabolic disorders. To determine underlying mechanisms, it is essential to assess whether and how peripheral clocks are disturbed during shift work and to what extent this is...

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Confinement transition of Z2 gauge theories coupled to massless fermions: Emergent quantum chromodynamics and SO(5) symmetry [Physics]

We study a model of fermions on the square lattice at half-filling coupled to an Ising gauge theory that was recently shown in Monte Carlo simulations to exhibit Z2 topological order and massless Dirac fermion excitations. On tuning parameters, a confining phase with broken symmetry (an antiferromagnet in one choice...

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GC content elevates mutation and recombination rates in the yeast Saccharomyces cerevisiae [Genetics]

The chromosomes of many eukaryotes have regions of high GC content interspersed with regions of low GC content. In the yeast Saccharomyces cerevisiae, high-GC regions are often associated with high levels of meiotic recombination. In this study, we constructed URA3 genes that differ substantially in their base composition [URA3-AT (31%...

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Diffusion in networks and the virtue of burstiness [Social Sciences]

Whether an idea, information, or infection diffuses throughout a society depends not only on the structure of the network of interactions, but also on the timing of those interactions. People are not always available to interact with others, and people differ in the timing of when they are active. Some...

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Recognition of conserved antigens by Th17 cells provides broad protection against pulmonary Haemophilus influenzae infection [Microbiology]

Nontypeable Haemophilus influenzae (NTHi) is a major cause of community acquired pneumonia and exacerbation of chronic obstructive pulmonary disease. A current effort in NTHi vaccine development has focused on generating humoral responses and has been greatly impeded by antigenic variation among the numerous circulating NTHi strains. In this study, we...

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Systems genetic analysis of inversion polymorphisms in the malaria mosquito Anopheles gambiae [Applied Biological Sciences]

Inversion polymorphisms in the African malaria vector Anopheles gambiae segregate along climatic gradients of aridity. Despite indirect evidence of their adaptive significance, little is known of the phenotypic targets of selection or the underlying genetic mechanisms. Here we adopt a systems genetics approach to explore the interaction of two inversions...

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Role of sodium channel subtype in action potential generation by neocortical pyramidal neurons [Neuroscience]

Neocortical pyramidal neurons express several distinct subtypes of voltage-gated Na+ channels. In mature cells, Nav1.6 is the dominant channel subtype in the axon initial segment (AIS) as well as in the nodes of Ranvier. Action potentials (APs) are initiated in the AIS, and it has been proposed that the high...

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Unrestrained markerless trait stacking in Nannochloropsis gaditana through combined genome editing and marker recycling technologies [Applied Biological Sciences]

Robust molecular tool kits in model and industrial microalgae are key to efficient targeted manipulation of endogenous and foreign genes in the nuclear genome for basic research and, as importantly, for the development of algal strains to produce renewable products such as biofuels. While Cas9-mediated gene knockout has been demonstrated...

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Conformation of the N-Terminal Ectodomain Elicits Different Effects on DUOX Function: A Potential Impact on Congenital Hypothyroidism Caused by a H2O2 Production Defect

Thyroid, Ahead of Print.


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Changes in Serum Thyroglobulin Levels After Lobectomy in Patients with Low-Risk Papillary Thyroid Cancer

Thyroid, Ahead of Print.


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Congenital Cholesteatoma: The Silent Pathology

Background: Congenital cholesteatomas (CC) arise from epithelial remnants around the petrous bone. They enlarge gradually causing progressive destruction and functional damage to the ear and surrounding structures. Because of their insidious course, most patients are misdiagnosed and present late with complications. Methods: This is a retrospective study of 41 cases diagnosed as CC and followed up for 2 years. All patients underwent full audiological evaluation and a radiological study (CT, MRI). Results: The male:female ratio was 2.3: 1, and the mean age was 30.89 years. The mean delay before presentation was 13 months. The commonest presentations in order of frequency were: discharge (60.9%), hearing loss (51.2%), facial paralysis (31.7%) and intracranial complications (31.7%). Forty patients were treated surgically by a variety of approaches depending on the extensions and functional status. The facial nerve was decompressed in 9 cases and cable grafted in 4. Two cases underwent VII-XII anastomosis later on. Conclusion: CC present with a myriad of clinical manifestations and should be suspected in all patients with unexplained otological signs and symptoms. They must be completely excised and the functional status of the ear rehabilitated either immediately or later. Follow-up must be indefinite as they have a high recurrence rate.
ORL 2018;80:108–116

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In This Issue

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Reprogramming of Th1 cells into regulatory T cells through rewiring of the metabolic status

Abstract

T helper type 1 (T_h1) cells form one of the most stable CD4 T-cell subsets, and direct conversion of fully differentiated T_h1 to regulatory T (T_reg) cells has been poorly investigated. Here, we established a culture method for inducing Foxp3 from T_h1 cells of mice and humans. This is achieved simply by resting T_h1 cells without T-cell receptor ligation before stimulation in the presence of transforming growth factor-beta (TGF-β). We named the resulting T_h1-derived Foxp3⁺ cells T_h1_reg cells. Mouse T_h1_reg cells showed an inducible T_reg-like phenotype and suppressive ability both in vitro and in vivo. T_h1_reg cells could also be induced from in vivo-developed mouse T_h1 cells. Unexpectedly, the resting process enabled Foxp3 expression not through epigenetic changes at the locus, but through metabolic change resulting from reduced mammalian target of rapamycin complex 1 (mTORC1) activity. mTORC1 suppressed TGF-β-induced phosphorylation of Smad2/3 in T_h1 cells, which was restored in rested cells. Our study warrants future research aiming at development of immunotherapy with T_h1_reg cells.

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STAT4 is required for the generation of Th1 and Th2, but not Th17 immune responses during monophosphoryl lipid A adjuvant activity

International Immunology, Volume 28, Issue 11, 1 November 2016, Pages 565–570, https://doi.org/10.1093/intimm/dxw038

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Molekulare Netzwerke von Hypoxie und neuronaler Apoptose in der Cochlea

Zusammenfassung

Hintergrund

In organotypischen Kulturen zeigt die Region des Modiolus (MOD) von neugeborenen Ratten eine 4‑fach höhere Rate des Zelltods als die Region des Corti-Organs (OC). Die unterschiedliche Vulnerabilität geht mit einer differenziellen Expression zahlreicher Gene einher.

Methodik

Organotypische Kulturen von OC und MOD von 3–5 Tage alten Ratten wurden einer norm- bzw. hypoxischen (pO₂: 10–20 mmHg; 5 h) Atmosphäre ausgesetzt. 24 h nach Anlegen der Kultur wurde die Zelltodrate bestimmt und die Expression mittels c‑DNA-Microarray untersucht. Mithilfe der DAVID-Datenbank wurden aus einer Liste von 60 Genen mit veränderter Expression biologische Prozesse entsprechend der Gene-Ontology-Datenbank (GO) zugeordnet. Molekulare Netzwerke wurden mithilfe der Datenbanken STRING und ConsensusPathDB erstellt.

Ergebnisse

Das Netzwerk der GO-Annotationen „Hypoxie", „Entzündung" und „mechanischer Stimulus" deutet auf das Vorliegen von 2 Gen-Clustern, einem Cluster mit proinflammatorischen Genen (Ccl3, Cxcl2, Cxcr4, Ccl20) und einem Cluster mit hypoxieassoziierten Genen (c-Jun, Hif1a und Vegfa). Das Netzwerk der GO-Annotationen „positive und negative neuronale Apoptose" lässt vermuten, dass die unterschiedliche Expression der Gene c-Jun, Ngfr und Casp3 von entscheidender Bedeutung für die Regulation des programmierten Zelltods von neuronalen Zellen des OC und MOD ist.

Schlussfolgerung

Während c‑JUN als ein wichtiger Modulator des Gleichgewichts zwischen Zelltod und Überleben wirkt, scheinen die Assoziationen von NGFR und CASP3 bedeutsam für die Einleitung des Zelltods zu sein. Die Auswertung und Anwendung von Erkenntnissen aus biostatistischen Datenbanken sind ein wichtiges Mittel für das Verständnis der Funktion von einzelnen Genen und Gen-Clustern in medizinisch relevanten biologischen Prozessen.

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Purees vs Baby-Led Weaning?

Traditionally, American parents have introduced thin purees or baby cereals as infants' first foods. However, you may have noticed that Baby-Led Weaning (BLW) has been trending on social media lately. The idea is that babies are given small bits of different types of solid foods and will self-feed. Some parents argue that babies will grow up to be more adventurous eaters if they explore different tastes and textures on their own. On the other hand, conventional wisdom argues that it is harder to choke on a thin puree, so they may be safer to introduce earlier.

When to Start Introducing Solid Foods to Your Baby

There is no research to say what foods to introduce first. For most babies, starting with purees or doing BLW is probably fine! Either way, you want to wait to start "solids" (that is, anything besides breast milk or formula) until your baby is ready. That means he or she has good head control, can sit in a high chair, opens his or her mouth when food approaches or seems interested in food, and is at least double his or her birth weight. The American Academy of Pediatrics generally recommends waiting until a baby is six months old, but for some babies, an earlier or later start may be appropriate. Your pediatrician can help you decide.

Safety Tips for Baby-Led Weaning

• Foods should be soft enough for a baby to mash them with his or her gums, or they should dissolve quickly in the mouth (like some crackers). Remove peels and skins.
• No hot dogs, popcorn, seeds, nuts, hard candy or other hard foods
• No grapes, grape or cherry tomatoes, small berries (blueberries, cranberries) or other small, round foods
• No sticky foods, like peanut butter*
• Limit foods with added salt or sugar
• No honey before age one (for babies eating purees or doing BLW)

Remember, it's OK to take a combination approach: purees and BLW foods! Even after starting solids, babies will still get most of his or her nutrition from breast milk or formula until age one.

*Early introduction of peanut products and eggs may reduce the risk of food allergies. Talk to your doctor about when and how to try these.

The post Purees vs Baby-Led Weaning? appeared first on ChildrensMD.

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Small intestine polypoid arteriovenous malformation: a stepwise approach to diagnosis in a paediatric case

We report a case of acute gastrointestinal haemorrhage due to a small intestine polypoid arteriovenous malformation (AVM) in a patient with a remote history of obscure gastrointestinal bleeding (OGIB) 8 years earlier. The diagnosis of a small intestine AVM was made using video capsule endoscopy (VCE) and confirmed using single-balloon push enteroscopy. The lesion was marked with submucosal tattoo to aid in subsequent surgical resection of the lesion with primary duodenoduodenostomy. Since our patient's initial bleeding episode, a variety of advanced tools have become widely available to aid in the localisation of OGIB. This case illustrates the use of a stepwise approach using new medical technology to identify and manage OGIB in children. VCE and push enteroscopy proved to be important diagnostic modalities in this paediatric case.

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Acute peritonsillar swelling: a unique presentation for Kawasaki disease in adolescence

We report the case of a 14-year-old man with unilateral peritonsillar swelling, airway compromise and fever. On physical examination, the patient was pyrexic with trismus, dysphonia, uvula deviation, exudative unilateral peritonsillar swelling and unilateral cervical lymphadenopathy. Attempts at aspirating the prominent peritonsillar region were unsuccessful. CT head and neck identified a large inflammatory mass arising from the left palatine tonsil. The patient was treated for presumptive peritonsillar abscess. After failing to respond to intravenous antimicrobials, he progressively developed the classical sequale of Kawasaki's Disease. Echocardiogram identified coronary arteritis. Intravenous immunoglobulin and high-dose aspirin were initiated and his clinical picture improved. Kawasaki's disease mimicking an acute infective process can pose a diagnostic dilemma. It is an uncommon differential in the adolescent population. Prompt recognition and initiation of appropriate therapy are imperative to minimise morbidity.

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Multiple cranial nerve injuries and neck abscesses caused by a transorally penetrating organic stick

Foreign bodies cause a remarkable number of otolaryngological emergency visits and occasionally result in life-threatening conditions and later-emerging complications. Patient recovery depends on the detection and proper extraction of all foreign materials. Despite various obtainable diagnostic tools, adequate anamnesis forms the basis of clinical reasoning and should direct later examinations and radiological imaging. This case report describes a challenging patient with a unique trauma mechanism: many pieces of a fragmented organic foreign body emerged within 1 year of the initial injury, leading to repeated operations, a long period in an intensive care unit and a long-term swallowing and speech dysfunction.

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Sporadic Burkitts lymphoma masquerading as an intussuscepted Meckels diverticulum in a 9-year-old child

We report the case of a 9-year-old boy who presented with abdominal pain and was found to have an intussusception with a sporadic Burkitt's lymphoma (BL) lead point. Our case was unusual in that the patient did not present with the typical clinical features of BL, nor was he in a high-risk demographic for this uncommon disease.

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Acinic cell carcinoma of the parotid gland in pregnancy: an approach to cancer in pregnancy

A 27-year-old woman presented with an enlarging painless right preauricular mass at 28 weeks' pregnant. The mass had been stable for more than 10 years, but showed rapid growth during pregnancy. Imaging and biopsy were consistent with parotid gland malignancy, with surgical resection undertaken at 33+4 weeks' gestation. Histopathology confirmed acinic cell carcinoma. Labour was induced without complication at 36+6 weeks' gestation and adjuvant radiotherapy commenced 2 weeks postpartum. At 9 months follow-up, both mother and baby were well, with no signs of disease recurrence. Rapid progression in pregnancy, of a previously stable salivary gland mass, is a common feature among reported cases and was also observed in the current case. This suggests an aetiological link between pregnancy and salivary gland tumour progression. We demonstrate successful management of a parotid gland malignancy in pregnancy and review guiding principles for cancer management in pregnancy.

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Double-positive with positive anti-glomerular basement membrane antibody and ANCA-positive disease in a patient with dermatomyositis

Approximately one in four patients (23.3%) with inflammatory myositis including dermatomyositis can require evaluation for acute kidney injury. The main cause of kidney injury is acute tubular necrosis from medications or myoglobinuria, though clinicians should be aware of a wide variety of possible aetiologies. We present the case of a 44-year-old woman with stable anti-Jo1 dermatomyositis, who presented with acute kidney injury. During her hospital course, she was diagnosed with double-positive disease characterised by circulating anti-glomerular basement membrane antibody and myeloperoxidase antineutrophil cytoplasmic antibody and renal biopsy revealing crescentic glomerulonephritis with linear staining of capillary wall for IgG.

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Transabdominal ultrasound-guided Gartners abscess drainage, a rare cause of acute urinary retention in second trimester of pregnancy

Acute retention of urine in pregnancy is an emergency, since it can lead to loss of pregnancy besides other dire complications. Gartner's abscess is an extremely rare cause for this condition. We present a case of a 23-year-old primigravida woman who presented to us at 24 weeks of pregnancy with acute retention of urine. After clinical and radiological evaluation, a large Gartner's abscess was found to be the cause. Per vaginal drainage of the abscess was not attempted because insertion of transvaginal probe was extremely painful for the patient, and the abscess was located high up in the anterior fornix. Transabdominal approach under sonographic guidance was used for the drainage of the abscess. Careful aspiration of the abscess, avoiding injury to the placenta, fetus and maternal bladder, revealed 60 cc of frank pus. The patient was given injection hydroxyprogesterone caproate and antibiotics in the preprocedure period. Antibiotics were continued in the postprocedure period, and she was discharged at 26 weeks of pregnancy in satisfactory condition.

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Allopurinol-induced DRESS syndrome presented as a cholecystitis-like acute abdomen and aggravated by antibiotics

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening adverse drug reaction characterised by generalised skin rash, fever, lymph node enlargement and haematological abnormalities, in addition to multiorgan involvement. However, diagnosis can be challenging, with rare cases presenting as an acute abdomen.

Its aetiopathogenesis is not fully understood but inefficient drug detoxification, deregulated immune responses, reactivation of host viruses and genetic predisposition appear to be important. Furthermore, it has been recently recognised that antibiotics may act as promoters of DRESS syndrome caused by another drug. We report the case of a 48-year-old man, receiving allopurinol, who developed DRESS syndrome, initially presenting with a cholecystitis-like acute abdomen that was triggered by antibiotics. This report also emphasises the utility of performing patch skin tests to establish drug imputability.

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Unsuspected Von Hippel-Lindau syndrome in acute-onset resistant hypertension

The discovery of adrenal lesions during routine testing for hypertension requires focused consideration for adrenal overproduction of cortisol, aldosterone or metanephrines. An otherwise healthy 25-year-old woman presented with headaches, diaphoresis and hot flushes with grossly elevated urine catecholamines, normetanephrines and norepinephrine levels, yet normal metanephrines, epinephrine/epinephrine, cortisol and aldosterone levels. Subsequent functional uptake studies and scans identified bilateral adrenal adenomas consistent with phaeochromocytomas. There was no family history of phaeochromocytomas or familial syndromes; however, a targeted genetic analysis for causes of familial phaeochromocytomas identified a heterozygous germline mutation in the VHL gene consistent with Von Hippel-Lindau syndrome. In this case, the identification of the VHL mutation led to careful screening and detection of clinically occult central nervous system hemangioblastomas and pancreatic neuroendocrine tumours. Verified genetic mutations facilitated best practices for long-term surveillance protocols, preconception counselling and screening of blood relatives. The patient responded well to surgical treatment and has ongoing multidisciplinary long-term surveillance.

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Corneal perforation in undiagnosed Sjögrens syndrome following topical NSAID and steroid drops post routine cataract extraction

A 74-year-old man presented with a progressive decrease in visual acuity and foreign body sensation in his right eye 8 days post uncomplicated phacoemulsification cataract surgery and intraocular lens insertion. The patient had been placed on a perioperative cataract regimen which consisted of G. Maxitrol (dexamethasone, polymyxin B sulfate, neomycin sulfate) four times a day and G. Yellox twice daily (bromfenac, a non-steroidal anti-inflammatory) for 2 weeks. On examination, he had a corneal ulcer and stromal thinning in his right eye which progressed to a full thickness perforation 12 hours later. The patient required a full thickness tectonic corneal transplant. Direct questioning revealed that this patient had both dry mouth and eyes. Serology revealed that the patient was positive for rheumatoid factor and for anti-Ro and anti-La antibodies. A parotid gland biopsy revealed significant lymphocytic infiltrate consistent with Sjögren's syndrome.

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Multiple distal coronary artery thrombosis in acute myocardial infarction: a rare presentation

Description 

A 47-year-old man was referred to us with severe retrosternal chest pain and diaphoresis 6 hours back. Except for smoking, he had no other risk factors for coronary artery disease. The patient was haemodynamically stable and physical examination was unremarkable. The ECG done at the referral hospital revealed changes suggestive of inferolateral wall ST elevation myocardial infarction (STEMI) (figure 1), and left circumflex coronary artery was the most likely culprit vessel. Echocardiogram revealed hypokinesia of the inferolateral wall with mild mitral regurgitation. The patient was immediately shifted to the catheterisation lab and coronary angiogram was done. However, to our surprise, both the terminal branches of the major obtuse marginal artery and the distal segment of the left anterior descending coronary artery were occluded by thrombi in their distal segments (figure 2, videos 1 and 2). Because of the distal location of the thrombi, we...

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3D printing for corrective osteotomy of malunited distal radius fractures: a low-cost workflow

After a severe trauma, a 16-year-old female patient sustained multiple injuries, including a distal radius fracture of the left arm. This distal radius fracture eventually developed into a malunion. In this case, we demonstrate our preoperative low-cost workup for three-dimensional (3D) planned and assisted corrective osteotomy of a malunited distal radius fracture using an in-hospital 3D printer.

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Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

Ruderfer, DM; Ripke, S; McQuillin, A; Boocock, J; Stahl, EA; Pavlides, JMW; Mullins, N; ... Craig, DW; + view all Ruderfer, DM; Ripke, S; McQuillin, A; Boocock, J; Stahl, EA; Pavlides, JMW; Mullins, N; Charney, AW; Ori, APS; Loohuis, LMO; Domenici, E; Di Florio, A; Papiol, S; Kalman, JL; Trubetskoy, V; Adolfsson, R; Agartz, I; Agerbo, E; Akil, H; Albani, D; Albus, M; Alda, M; Alexander, M; Alliey-Rodriguez, N; Als, TD; Amin, F; Anjorin, A; Arranz, MJ; Awasthi, S; Bacanu, SA; Badner, JA; Baekvad-Hansen, M; Bakker, S; Band, G; Barchas, JD; Barroso, I; Bass, N; Bauer, M; Baune, BT; Begemann, M; Bellenguez, C; Belliveau, RA; Bellivier, F; Bender, S; Bene, J; Bergen, SE; Berrettini, WH; Bevilacqua, E; Biernacka, JM; Bigdeli, TB; Black, DW; Blackburn, H; Blackwell, JM; Blackwood, DHR; Pedersen, CB; Boehnke, M; Boks, M; Borglum, AD; Bramon, E; Breen, G; Brown, MA; Bruggeman, R; Buccola, NG; Buckner, RL; Budde, M; Bulik-Sullivan, B; Bumpstead, SJ; Bunney, W; Burmeister, M; Buxbaum, JD; Bybjerg-Grauholm, J; Byerley, W; Cahn, W; Cai, G; Cairns, MJ; Campion, D; Cantor, RM; Carr, VJ; Carrera, N; Casas, JP; Casas, M; Catts, SV; Cervantes, P; Chambert, KD; Chan, RCK; Chen, EYH; Chen, RYL; Cheng, W; Cheung, EFC; Chong, SA; Clarke, TK; Cloninger, CR; Cohen, D; Cohen, N; Coleman, JRI; Collier, DA; Cormican, P; Coryell, W; Craddock, N; Craig, DW; - view fewer (2018) Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes. Cell , 173 (7) 1705-1715.e16. 10.1016/j.cell.2018.05.046 .

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ANÁLISIS ESPACIAL DEL SOBREPESO Y LA OBESIDAD INFANTIL EN EL PERÚ, 2014/Spatial analysis of childhood obesity and overweight in Peru, 2014

Hernández-Vásquez, A; Bendezú-Quispe, G; Díaz-Seijas, D; Santero, M; Minckas, N; Azañedo, D; Antiporta, DA; (2016) ANÁLISIS ESPACIAL DEL SOBREPESO Y LA OBESIDAD INFANTIL EN EL PERÚ, 2014/Spatial analysis of childhood obesity and overweight in Peru, 2014. Revista Peruana de Medicina Experimental y Salud Pública , 33 (3) pp. 489-497. 10.17843/rpmesp.2016.333.2298 . Green open access

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Characterisation of tissue-type metabolic content in secondary progressive multiple sclerosis: a magnetic resonance spectroscopic imaging study

Marshall, I; Thrippleton, MJ; Bastin, ME; Mollison, D; Dickie, DA; Chappell, FM; Semple, SIK; ... Chandran, S; + view all Marshall, I; Thrippleton, MJ; Bastin, ME; Mollison, D; Dickie, DA; Chappell, FM; Semple, SIK; Cooper, A; Pavitt, S; Giovannoni, G; Wheeler-Kingshott, CAMG; Solanky, BS; Weir, CJ; Stallard, N; Hawkins, C; Sharrack, B; Chataway, J; Connick, P; Chandran, S; - view fewer (2018) Characterisation of tissue-type metabolic content in secondary progressive multiple sclerosis: a magnetic resonance spectroscopic imaging study. Journal of Neurology , 265 (8) pp. 1795-1802. 10.1007/s00415-018-8903-y . Green open access

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In Memoriam: Sidney George Shaw, DPhil (1948-2017)

Barton, M; Little, HJ; Vaughan-Jones, RD; Daniels, S; Dashwood, MR; Tsui, JC; (2018) In Memoriam: Sidney George Shaw, DPhil (1948-2017). Physiological Research , 67 S27-S35. Green open access

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Validation of the quality of relationships inventory in a peruvian sample of adolescents and associations to peer attachment

Yearwood, K; Vliegen, N; Luyten, P; Chau, C; Corveleyn, J; (2018) Validation of the quality of relationships inventory in a peruvian sample of adolescents and associations to peer attachment. Psykhe , 27 (1) , Article 1122. 10.7764/psykhe.27.1.1122 . Green open access

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Parkinsonism in patients with chronic hepatitis C treated with interferon-alpha 2b: a report of two cases

Kajihara, M; Montagnese, S; Khanna, P; Amodio, P; Schapira, AHV; Dusheiko, GM; Morgan, MY; (2010) Parkinsonism in patients with chronic hepatitis C treated with interferon-alpha 2b: a report of two cases. European Journal of Gastroenterology & Hepatology , 22 (5) pp. 628-631. 10.1097/MEG.0b013e32833383e3 . Green open access

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Valuation of knowledge and ignorance in mesolimbic reward circuitry

Charpentier, CJ; Bromberg-Martin, ES; Sharot, T; (2018) Valuation of knowledge and ignorance in mesolimbic reward circuitry. Proceedings of the National Academy of Sciences of the United States of America 10.1073/pnas.1800547115 . (In press). Green open access

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Web-based indicated prevention of common mental disorders in university students in four European countries - Study protocol for a randomised controlled trial

Musiat, P; Potterton, R; Gordon, G; Spencer, L; Zeiler, M; Waldherr, K; Kuso, S; ... Schmidt, U; + view all Musiat, P; Potterton, R; Gordon, G; Spencer, L; Zeiler, M; Waldherr, K; Kuso, S; Nitsch, M; Adamcik, T; Wagner, G; Karwautz, A; Ebert, DD; Dodd, A; Dooley, B; Harrison, A; Whitt, E; Haselgrove, M; Sharpe, H; Smith, J; Tressler, R; Troop, N; Vinyard, C; Görlich, D; Beecham, J; Bonin, E; Jacobi, C; Schmidt, U; - view fewer (2018) Web-based indicated prevention of common mental disorders in university students in four European countries - Study protocol for a randomised controlled trial. Internet Interventions 10.1016/j.invent.2018.02.004 . (In press). Green open access

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Divergent Elementoboration: 1,3-Haloboration versus 1,1-Carboboration of Propargyl Esters

Wilkins, LC; Soltani, Y; Lawson, JR; Slater, B; Melen, RL; (2018) Divergent Elementoboration: 1,3-Haloboration versus 1,1-Carboboration of Propargyl Esters. Chemistry - A European Journal , 24 (29) pp. 7364-7368. 10.1002/chem.201801493 . Green open access

https://ift.tt/2LMq1zI

What to expect from electronic patient record system implementation: Lessons learned from published evidence

Priestman, W; Sridharan, S; Vigne, H; Collins, R; Seamer, L; Sebire, NJ; (2018) What to expect from electronic patient record system implementation: Lessons learned from published evidence. Journal of Innovation in Health Informatics , 25 (2) pp. 92-104. 10.14236/jhi.v25i2.1007 . Green open access

https://ift.tt/2uRJPeD

Realistic forest stand reconstruction from terrestrial LiDAR for radiative transfer modelling

Calders, K; Origo, N; Burt, A; Disney, M; Nightingale, J; Raumonen, P; Åkerblom, M; ... Lewis, P; + view all Calders, K; Origo, N; Burt, A; Disney, M; Nightingale, J; Raumonen, P; Åkerblom, M; Malhi, Y; Lewis, P; - view fewer (2018) Realistic forest stand reconstruction from terrestrial LiDAR for radiative transfer modelling. Remote Sensing , 10 (6) , Article 933. 10.3390/rs10060933 . Green open access

https://ift.tt/2LMpFsS

The developmental course of inattention symptoms predicts academic achievement due to shared genetic aetiology: a longitudinal twin study

Liu, C-Y; Li, Y; Viding, E; Asherson, P; Pingault, J-B; (2018) The developmental course of inattention symptoms predicts academic achievement due to shared genetic aetiology: a longitudinal twin study. European Child & Adolescent Psychiatry 10.1007/s00787-018-1200-6 . (In press).

https://ift.tt/2uMGkpx

Integration of supercapacitors into printed circuit boards

Abouelamaiem, DI; Rasha, L; He, G; Neville, TP; Millichamp, J; Mason, TJ; Jorge, AB; ... Brett, DJL; + view all Abouelamaiem, DI; Rasha, L; He, G; Neville, TP; Millichamp, J; Mason, TJ; Jorge, AB; Parkin, IP; Titirici, MM; Wang, R; Ji, S; Shearing, PR; Brett, DJL; - view fewer (2018) Integration of supercapacitors into printed circuit boards. Journal of Energy Storage , 19 pp. 28-34. 10.1016/j.est.2018.06.016 . Green open access

https://ift.tt/2NIJ8Lh

Reflective Analytics for Interactive e-books

Mavrikis, M; Karkalas, S; (2017) Reflective Analytics for Interactive e-books. IxD&A , 33 pp. 33-53. Green open access

https://ift.tt/2uJrXSK

Impaired Recognition of Basic Emotions from Facial Expressions in Young People with Autism Spectrum Disorder: Assessing the Importance of Expression Intensity

Griffiths, S; Jarrold, C; Penton-Voak, IS; Woods, AT; Skinner, AL; Munafò, MR; (2017) Impaired Recognition of Basic Emotions from Facial Expressions in Young People with Autism Spectrum Disorder: Assessing the Importance of Expression Intensity. Journal of Autism and Developmental Disorders 10.1007/s10803-017-3091-7 . (In press). Green open access

https://ift.tt/2NFW8Bq

Nonlinear optics in plasmonic nanostructures

Panoiu, NC; Sha, WEI; Lei, DY; Li, G-C; (2018) Nonlinear optics in plasmonic nanostructures. Journal of Optics , 20 (8) , Article 083001. 10.1088/2040-8986/aac8ed . Green open access

https://ift.tt/2LBnc7w

Structured approaches to participatory design for children: can targeting the needs of children with autism provide benefits for a broader child population?

Benton, L; Johnson, H; (2014) Structured approaches to participatory design for children: can targeting the needs of children with autism provide benefits for a broader child population? Instructional Science , 42 (1) pp. 47-65. 10.1007/s11251-013-9297-y . Green open access

https://ift.tt/2NFVOCI

Homogenization and nonlinearity enhancement of 2D graphene-based metasurfaces

You, JW; Panoiu, NC; (2018) Homogenization and nonlinearity enhancement of 2D graphene-based metasurfaces. In: Proceedings Conference on Lasers and Electro-Optics 2018 (CLEO: QELS Fundamental Science). OSA

https://ift.tt/2LypRiw

A generative model of whole-brain effective connectivity

Frässle, S; Lomakina, EI; Kasper, L; Manjaly, ZM; Leff, A; Pruessmann, KP; Buhmann, JM; Frässle, S; Lomakina, EI; Kasper, L; Manjaly, ZM; Leff, A; Pruessmann, KP; Buhmann, JM; Stephan, KE; - view fewer (2018) A generative model of whole-brain effective connectivity. Neuroimage , 179 pp. 505-529. 10.1016/j.neuroimage.2018.05.058 . Green open access

https://ift.tt/2NGkStr

Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys.

Singh, G; Selai, C; Islam, S; Chaudhary, P; Sander, JW; (2018) Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys. Epilepsy Behav , 85 pp. 164-172. 10.1016/j.yebeh.2018.06.005 .

https://ift.tt/2uMGihp

Is orbital floor a reliable and useful surgical landmark in endoscopic endonasal surgery?: a systematic review

Abstract

Background

The orbital floor is considered as an important intraoperative reference point in endoscopic sinonasal surgery. The aim of this review is to evaluate its reliability and usefulness as a surgical landmark in endoscopic endonasal surgery.

Methods

A literature search was performed on electronic databases, namely PUBMED. The following keywords were used either individually or in combination: orbital floor; maxillary sinus roof; endoscopic skull base surgery; endoscopic sinus surgery. Studies that used orbital floor as a landmark for endoscopic endonasal surgery were included in the analysis. In addition, relevant articles were identified from the references of articles that had been retrieved. The search was conducted over a period of 6 months between 1st June 2017 and 16th December 2017.

Results

One thousand seven hundred forty-three articles were retrieved from the electronic databases. Only 5 articles that met the review criteria were selected. Five studies of the orbital floor (or the maxillary sinus roof) were reviewed, one was a cadaveric study while another 4 were computed tomographic study of the paranasal sinuses. All studies were of level III evidence and consists of a total number of 948 nostrils. All studies showed the orbital floor was below the anterior skull base irrespective of the populations. The orbital floor serves as a guide for safe entry into posterior ethmoids and sphenoid sinus.

Conclusions

The orbital floor is a reliable and useful surgical landmark in endoscopic endonasal surgery. In revision cases or advanced disease, the normal landmarks can be distorted or absent and the orbital floor serves as a reference point for surgeons to avoid any unintentional injury to the skull base, the internal carotid artery and other critical structures.

https://ift.tt/2uO2WWC

Acute kidney injury in parturients with severe preeclampsia

https://ift.tt/2NGUeAz

Reply to: Acute kidney injury in parturients with severe preeclampsia

https://ift.tt/2uJ2sBo

From ‘Frowns and Groans’ to ‘Astonishment and Delight’: Indicators of a (Developing) Mathematics Teachers Identity

Crisan, C; Rodd, M; (2018) From 'Frowns and Groans' to 'Astonishment and Delight': Indicators of a (Developing) Mathematics Teachers Identity. In: Proccedings of the 42nd Annual Meeting of the International Group for the Psychology of Mathematics Education. (pp. pp. 315-322). GPME - The International Group for the Psychology of Mathematics Education: Umea, Sweden. (In press).

https://ift.tt/2mG2Egk

Interactive computer-based interventions for sexual health promotion

Bailey, JV; Murray, E; Rait, G; Mercer, CH; Morris, RW; Peacock, R; Cassell, J; Bailey, JV; Murray, E; Rait, G; Mercer, CH; Morris, RW; Peacock, R; Cassell, J; Nazareth, I; - view fewer (2010) Interactive computer-based interventions for sexual health promotion. Cochrane Database of Systematic Reviews (9) , Article CD006483. 10.1002/14651858.CD006483.pub2 . Green open access

https://ift.tt/2JUhfO6

Weighted Fractal Networks

Carletti, T; Righi, S; (2010) Weighted Fractal Networks. Physica A - Statistical Mechanics and Its Applications , 389 (10) pp. 2134-2142. 10.1016/j.physa.2010.01.019 . Green open access

https://ift.tt/2Lwe1VV

Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin

Ethylene glycol poisoning is a medical emergency. The metabolites glycolate and glyoxylate give metabolic acidosis. Because of similar structure, these metabolites are misinterpreted as lactate by many point-of-care blood gas analyzers. The falsely high lactate values can lead to misdiagnosis, inappropriate laparotomies, and delayed antidotal therapy. As laboratory analyzers measure plasma lactate only, the difference or the "lactate gap" aids in early diagnosis. We present a patient with severe metabolic acidosis and elevated lactate levels on the point-of-care analyzer. A lactate gap supported the diagnosis of ethylene glycol poisoning. Hemodialysis and fomepizole treatment could be started immediately.

https://ift.tt/2NFbxSx

Brachial Plexus Chemical Neurolysis with Ethanol for Cancer Pain

Chemical neurolytic nerve blocks have been successfully used to treat a variety of cancer-related pain. However, the literature has been sparse regarding neurolysis of the brachial plexus for cancer pain. We present a unique case report of a successful chemical neurolysis of the brachial plexus with dehydrated ethanol for a patient suffering from metastatic mammary carcinoma with tumor invasion of the right brachial plexus.

https://ift.tt/2OcjRuf

Production of Infant Scale Evaluation (PRISE) in Persian normal hearing children: A validation study

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Mohammad Majid Oryadi-Zanjani

Abstract

Introduction

Production of Infant Scale Evaluation (PRISE) is a popular parent-report scale used to assess the pre-first word vocalization of children. There is not any tool to assess pre-verbal vocalizations in Persian speaking children. Therefore, considering the two important roles of pre-verbal vocalizations both in the early diagnosis of hearing impairment and in measuring the effectiveness of CIs and habilitation programs, we aimed to adapt and validate the PRISE questionnaire on Persian normal hearing children aged 3-18 months and estimate the PRISE's normative distribution for them.

Methods

The research was administered as a cross-sectional study. Back translation method was used to develop the Persian version of the PRISE (PRISE-P). Six hundred and forty 3-18 month old Persian speaking children were recruited through consecutive sampling method. All of the children had passed the universal newborn hearing screening. According to the standard developmental test, all of the children had normal development. The internal consistency of the scale was measured through the Cronbach's alpha. The convergent validity was analyzed through comparing the PRISE scores with the Persian version of the Auditory Behavior in Everyday Life (ABEL-P).

Results

The Cronbach's alpha value of the PRISE was 0.88. The PRISE corrected item-total correlations were significantly high ranging from 0.86 to 0.89. A significant correlation was found between the PRISE-P and the ABEL-P total scores (r = 0.628). There was a high positive correlation between the PRISE total scores and the children's age (r = 0.791).

Conclusion

The PRISE-P is a valid and reliable tool to assess the pre-verbal vocalizations development in Persian speaking children aged 3 months and more.

https://ift.tt/2mG01Ls

Treatment outcome of childhood nasopharyngeal carcinoma: a single institution experience

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Marina Nikitovic, Marija Popovic-Vukovic, Dragana Stanic, Jelena Bokun, Lejla Paripovic, Vesna Ilic, Ivana Miskovic, Milan Saric

Abstract

Objectives

Nasopharyngeal carcinoma is a rare malignancy in children. The aim of this study was to provide analysis of children with nasopharyngeal carcinoma treated in a single institution.

Methods and materials

Between 1999 and 2016, fourteen pediatric patients with a diagnosis of undifferentiated nasopharyngeal carcinoma were treated in our institution, and the patients' clinical characteristics, treatment modality, outcome, and toxicity were analyzed.

Results

The median age at diagnosis was 15,5 years. The gender ratio was 1:1. The majority of patients had regionally and/or locally advanced tumors and one had bone metastases at the time of diagnosis. All patients received chemotherapy before radiotherapy, with partial response in thirteen patients and complete response in one. Radiation dose to the primary tumor and involved cervical lymph nodes was 55-60 Gy, uninvolved cervical and supraclavicular regions received prophylactic radiation with dose of 45-50 Gy. Ten patients received adjuvant chemotherapy. Three-year time to progression (TTP) and three-year overall survival (OS) rates were 75% and 73% respectively. Five-year TTP was 65% and OS 63% respectively, and after ten years TTP and OS remained the same. At the end of follow-up period, ten patients were alive, and four died. All of the patients that had distant metastases died. Most common late complications were skin fibrosis and xerostomia.

Conclusions

Multimodal therapy of children with nasopharyngeal carcinoma is associated with long-term survival. It is expected that further advances in the management of these patients, with improved radiotherapy and chemotherapy, will reduce acute and late toxicity and improve quality of life of treated children.

https://ift.tt/2A2hjMd

Cochlear implantation in children with meningitis related deafness: The influence of electrode impedance and implant charge on auditory performance – a case control study

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Victor Helmstaedter, Andreas Buechner, Stefan Stolle, Friedrich Goetz, Thomas Lenarz, Martin Durisin

Abstract

Objectives

Bacterial meningitis can cause a labyrinthitis. Consequences often are intracochlear soft tissue neoformation (cochlear obliteration) or intracochlear osteoneogenesis (cochlear ossification) and deafness. Cochlear implantation becomes challenging and hearing rehabilitation is complicated. This retrospective case-control-study aimed to find correlations between morphologic, electric and functional parameters.

Methods

The study group included children, who lost hearing due to a bacterial meningitis (n = 35 cases). Using preoperative computed tomography and intraoperative findings we grouped into 'unaltered cochleae', 'obliterated cochleae' and 'ossified cochleae'. Control group children suffered from deafness (n=16) of other etiology and presented with radiologically unchanged cochleae. Postoperative routine controls documented impedances, stimulation charge and hearing tests a various time points, which all were analysed.

Results

Control group patients showed a mean impedance of 6.3 kΩ and the mean charge applied was 19 nC. The study group averaged at 7.9 kΩ and 24.6 nC respectively. Patients with ossified cochleae had increased values of 8.6 kΩ and 29.7 nC. The control group reached a monosyllabic word understanding of 74% and the study group of 58%. Patients with ossified cochleae reached 36%.

Conclusions

Impedances and stimulation charge influence each other. Increased charge is necessary for higher cochlear implant output. Despite higher charges, patients with obliterated and patients with ossified cochleae significantly perform worse in hearing rehabilitation. Reduced audiological outcome in study group patients without morphologic cochlear changes furthermore hints at additional factors besides cochlear tissue neogenesis like postinflammational changes at the neural pathway.

https://ift.tt/2OdP8Nx

Early experience and health related quality of life outcomes following auditory brainstem implantation in children

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Leena Asfour, David Friedmann, William H. Shapiro, J. Thomas Roland, Susan Waltzman

Abstract

Objective

To assess auditory brainstem implantation (ABI) outcomes in children with a prospective study.

Methods

Twelve patients with cochlear nerve deficiency received an auditory brainstem implant. Patients were evaluated with age appropriate speech perception and production assessments, and health related quality of life (HRQoL) surveys for parents of subjects and for subjects if age appropriate.

Results

Twelve patients received an ABI without major complications. Eleven out of twelve received some auditory benefit from their ABI. Parental HRQoL ratings were positive for all domains with the exception of communication. Self reported overall HRQoL metrics from two subjects were also positive.

Conclusions

ABI is a good option for patients who are not eligible for or fail CI. Our findings show that despite varying degrees of postoperative performance, HRQoL ratings were positive. The presence of additional disabilities and health problems resulted in less positive HRQoL outcomes. Our results emphasize the need to assess outcomes in these patients beyond speech perception and communication.

https://ift.tt/2A1TYds

Ausreichende Schmerztherapie in der Sterbephase

Zusammenfassung

Die Therapie in der Sterbephase umfasst immer die Beachtung der physischen, psychischen, sozialen und spirituellen Bedürfnisse. Schmerzen können Ausdruck von Leiden auf allen 4 Ebenen sein. Die Therapie muss daher grundsätzlich neben medikamentösen Methoden auch angstlindernde Gespräche, Integration der Angehörigen in die Begleitung und seelsorgerliche Unterstützung beinhalten. Der Zustand des Patienten muss regelmäßig, in der Terminalphase bedarfsorientiert stündlich oder öfter evaluiert werden. Notfallsituationen können meist antizipiert werden. Adäquate Bedarfsanordnungen ermöglichen den Pflegenden eine rasche und suffiziente Symptomlinderung. Angehörige müssen in die Begleitung mit einbezogen werden. Regelmäßige Gesprächsangebote verhindern Ängste, Missverständnisse und erschwerte Trauer. Das Team kann durch regelmäßige Supervisionen unterstützt werden.

https://ift.tt/2uKINAY

Diagnosis of DOCK8 deficiency using Flow cytometry Biomarkers: an Egyptian Center experience

Publication date: Available online 24 July 2018

Source: Clinical Immunology

Author(s): Safa S. Meshaal, Rabab E. El Hawary, Alia Eldash, Bodo Grimbacher, Nadezhda Camacho-Ordonez, Dalia S. Abd Elaziz, Nermeen M. Galal, Jeannette A. Boutros, Shereen M. Shawky, Aisha M. Elmarsafy

Abstract

In the past few years, several genes were shown to be implicated in various forms of the Hyper Immunoglobulin E syndrome. The present study is the first to describe a cohort of DOCK8 deficiency patients from Egypt. The study included 15 patients with features of combined immunodeficiency (CID) suggestive of DOCK8 deficiency. Flow cytometry was used for evaluation of DOCK8 expression and studying different immunological characteristics of those patients including evaluation of Th17, Tregs, T and B lymphocytes differentiation and the effect of the DOCK8 deficiency on the activation of the STAT3. Diagnosis was confirmed by mutational analysis.

Profound defects in Th17 cells and Tregs were observed in all patients with impaired STAT3 phosphorylation, indicating that DOCK8 plays a pivotal role in the STAT3 signaling pathway. These findings together with decrease in memory B cells and defective DOCK8 expression by flow cytometry can confirm the diagnosis.

https://ift.tt/2LjgQum

High frequencies of asymptomatic Epstein-Barr virus viremia in affected and unaffected individuals with CTLA4 mutations

Publication date: Available online 24 July 2018

Source: Clinical Immunology

Author(s): Akihiro Hoshino, Kay Tanita, Kenji Kanda, Ken-Ichi Imadome, Yoshiaki Shikama, Takahiro Yasumi, Kohsuke Imai, Masatoshi Takagi, Tomohiro Morio, Hirokazu Kanegane

Abstract

Patients with CTLA4 mutations present with autoimmune diseases, lymphoproliferation, and hypogammaglobulinemia, and a subset of patients developed Epstein-Barr virus (EBV)-associated malignancies, suggesting an impaired immune function against EBV. Here we investigated EBV infection in individuals with CTLA4 mutations. We measured EBV viral DNA in healthy individuals, individuals with autoimmune diseases, and individuals with CTLA4 mutations. In addition, we evaluated the numbers and function of EBV-specific T cells, invariant NKT cells, and NK cells. More than half of individuals with CTLA4 mutations including asymptomatic ones had detectable EBV DNA, which is a significantly higher frequency with higher viral loads compared with healthy and disease controls. However, individuals with CTLA4 mutations had almost normal immunity against EBV. Individuals with CTLA4 mutations have an increased susceptibility to Epstein-Barr virus infections. Asymptomatic viremia occurs at high frequencies, which can be persistent and can occur in unaffected individuals.

https://ift.tt/2uZ2uUQ

Incidental small cell carcinoma of the gallbladder—an unexpected finding at elective cholecystectomy

Abstract

A 69-year-old woman was admitted electively for a laparoscopic cholecystectomy. Pre-operatively she had an ultrasound abdomen which demonstrated a large gallbladder (GB) stone. Intraoperatively, a nodule was noted on the liver supero-lateral to GB. The procedure was subsequently converted to open and the lesion was resected en-bloc with GB. The histology result showed small cell carcinoma (SCC) of the gallbladder with invasion into the liver parenchyma. A staging computerized tomographic of the thorax, abdomen and pelvis was performed. This demonstrated enlarged adenopathy locally and systemically with metastasis to medial segment of the left hepatic lobe and right lung. Following multi-disciplinary team meeting she was referred to Oncology for chemotherapy. The patient has survived for 7 months after the initial diagnosis of SCC.

https://ift.tt/2JP6QDi

Management of T-cell large granular lymphocyte leukemia and concurrent retroperitoneal liposarcoma

Abstract

T-cell large granular leukemia (T-LGL) is a rare lymphoproliferative disorder characterized by the clonal expansion of cytotoxic T lymphocytes. We present a unique case of T-LGL and concurrent retroperitoneal sarcoma occurring in a patient with long-standing rheumatoid arthritis. Pathology revealed a high-grade dedifferentiated liposarcoma. The diagnosis of T-LGL with a synchronous retroperitoneal sarcoma is a case that highlights the surgical management of these two rare conditions.

https://ift.tt/2uKGeip

Gastritis might be considered as a technical factor affecting laparoscopic sleeve gastrectomy

Abstract

There is a paucity of data regarding gastritis as a technical factor affecting the surgical technique. Antritis and gastritis usually cause stomach wall thickness which can interrupt stapler function or even can cause serosal tear during the dissection. We report a video presentation of laparoscopic sleeve gastrectomy in a morbidly obese patient with antritis. Choosing black cartridge for patients with Helicobacter pylori gastritis might be the optimal technique for division of the antrum in laparoscopic sleeve gastrectomy. Further studies are required to clarify this parameter.

https://ift.tt/2JUMj0s

Where do women and men in Britain obtain contraception? Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

French, RS; Geary, R; Jones, K; Glasier, A; Mercer, CH; Datta, J; Macdowall, W; ... Wellings, K; + view all French, RS; Geary, R; Jones, K; Glasier, A; Mercer, CH; Datta, J; Macdowall, W; Palmer, M; Johnson, AM; Wellings, K; - view fewer (2018) Where do women and men in Britain obtain contraception? Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). BMJ Sexual and Reproductive Health 10.1136/bmjsrh-2017-101728 . Green open access

https://ift.tt/2A3KtKK

Greetings from the conference chairs

McLoone, S; Li, K; Naeem, W; Spurgeon, S; (2016) Greetings from the conference chairs. In: McLoone, Seán, (ed.) Proceedings of 2016 UKACC International Conference on Control (UKACC Control 2016). IEEE: Belfast, UK. Green open access

https://ift.tt/2OdVkF8

High power sodium-ion batteries and hybrid electrochemical capacitors using Mo or Nb-doped nano-titania anodes

Bauer, D; Roberts, AJ; Patnaik, SG; Brett, DJL; Shearing, PR; Kendrick, E; Matsumi, N; Bauer, D; Roberts, AJ; Patnaik, SG; Brett, DJL; Shearing, PR; Kendrick, E; Matsumi, N; Darr, JA; - view fewer (2018) High power sodium-ion batteries and hybrid electrochemical capacitors using Mo or Nb-doped nano-titania anodes. Journal of the Electrochemical Society , 165 (9) A1662-A1670. 10.1149/2.0341809jes . Green open access

https://ift.tt/2A1zQbi

Biological Therapies of the Inner Ear: What Otologists Need to Consider

Schilder, AGM; Blackshaw, H; Lenarz, T; Warnecke, A; Lustig, LR; Staecker, H; (2018) Biological Therapies of the Inner Ear: What Otologists Need to Consider. [Editorial comment]. Otology & Neurotology , 39 (2) pp. 135-137. 10.1097/MAO.0000000000001689 .

https://ift.tt/2Ob8JO9

Species Tree Inference with BPP Using Genomic Sequences and the Multispecies Coalescent

Yang, Z; Flouris, T; Jiao, X; Rannala, B; (2018) Species Tree Inference with BPP Using Genomic Sequences and the Multispecies Coalescent. Molecular Biology and Evolution (In press).

https://ift.tt/2A1zu4s

Molecular landscape of esophageal cancer: implications for early detection and personalized therapy

Talukdar, FR; di Pietro, M; Secrier, M; Moehler, M; Goepfert, K; Lima, SSC; Pinto, LFR; ... Herceg, Z; + view all Talukdar, FR; di Pietro, M; Secrier, M; Moehler, M; Goepfert, K; Lima, SSC; Pinto, LFR; Hendricks, D; Parker, MI; Herceg, Z; - view fewer (2018) Molecular landscape of esophageal cancer: implications for early detection and personalized therapy. Annals of the New York Academy of Sciences 10.1111/nyas.13876 . (In press).

https://ift.tt/2ObnfFC

Treating linear molecule HCCH in calculations of rotation-vibration spectra

Chubb, KL; Yachmenev, A; Tennyson, J; Yurchenko, SN; (2018) Treating linear molecule HCCH in calculations of rotation-vibration spectra. Journal of Chemical Physics , 149 , Article 014101. 10.1063/1.5031844 . Green open access

https://ift.tt/2A1yM7i

Monolithic quantum-dot distributed feedback laser array on silicon

Wang, Y; Chen, S; Yu, Y; Zhou, L; Liu, L; Yang, C; Liao, M; ... Yu, S; + view all Wang, Y; Chen, S; Yu, Y; Zhou, L; Liu, L; Yang, C; Liao, M; Tang, M; Liu, Z; Wu, J; Li, W; Ross, I; Seeds, AJ; Liu, H; Yu, S; - view fewer (2018) Monolithic quantum-dot distributed feedback laser array on silicon. Optica , 5 (5) pp. 528-533. 10.1364/OPTICA.5.000528 . Green open access

https://ift.tt/2OdnWyo

Mutation burden and other molecular markers of prognosis in colorectal cancer treated with curative intent: results from the QUASAR 2 clinical trial and an Australian community-based series

Domingo, E; Camps, C; Kaisaki, PJ; Parsons, MJ; Mouradov, D; Pentony, MM; Makino, S; ... Tomlinson, I; + view all Domingo, E; Camps, C; Kaisaki, PJ; Parsons, MJ; Mouradov, D; Pentony, MM; Makino, S; Palmieri, M; Ward, RL; Hawkins, NJ; Gibbs, P; Askautrud, H; Oukrif, D; Wang, H; Wood, J; Tomlinson, E; Bark, Y; Kaur, K; Johnstone, EC; Palles, C; Church, DN; Novelli, M; Danielsen, HE; Sherlock, J; Kerr, D; Kerr, R; Sieber, O; Taylor, JC; Tomlinson, I; - view fewer (2018) Mutation burden and other molecular markers of prognosis in colorectal cancer treated with curative intent: results from the QUASAR 2 clinical trial and an Australian community-based series. The Lancet Gastroenterology and Hepatology 10.1016/S2468-1253(18)30117-1 . (In press). Green open access

https://ift.tt/2A1zb9O

Observation of Laser Power Amplification in a Self-Injecting Laser Wakefield Accelerator

Streeter, MJ; Kneip, S; Bloom, MS; Bendoyro, RA; Chekhlov, O; Dangor, AE; Doepp, A; ... Najmudin, Z; + view all Streeter, MJ; Kneip, S; Bloom, MS; Bendoyro, RA; Chekhlov, O; Dangor, AE; Doepp, A; Hooker, CJ; Holloway, J; Jiang, J; Lopes, NC; Nakamura, H; Norreys, PA; Palmer, CAJ; Rajeev, PP; Schreiber, J; Symes, DR; Wing, M; Mangles, SPD; Najmudin, Z; - view fewer (2018) Observation of Laser Power Amplification in a Self-Injecting Laser Wakefield Accelerator. Physical Review Letters , 120 , Article 254801. 10.1103/PhysRevLett.120.254801 . Green open access

https://ift.tt/2ObmNao

A correction for sample overlap in genome-wide association studies in a polygenic pleiotropy-informed framework

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Monocular enucleation alters retinal waves in the surviving eye

Failor, SW; Ng, A; Cheng, H-J; (2018) Monocular enucleation alters retinal waves in the surviving eye. Neural Development , 13 (1) , Article 4. 10.1186/s13064-018-0101-1 . Green open access

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Randomized trials and propensity score analyses in transcatheter aortic valve replacement: how should we interpret the results?

Freemantle, N; Pagano, D; (2018) Randomized trials and propensity score analyses in transcatheter aortic valve replacement: how should we interpret the results? European Journal of Cardio-Thoracic Surgery , 53 (6) pp. 1108-1111. 10.1093/ejcts/ezy120 .

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p57KIP2 immunostaining for diagnosis of hydatidiform mole.

Kaur, B; Sebire, NJ; (2018) p57KIP2 immunostaining for diagnosis of hydatidiform mole. BJOG 10.1111/1471-0528.15330 .

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Seven Lives from Mass Observation

Sutcliffe-Braithwaite, F; (2018) Seven Lives from Mass Observation. [Review]. English Historical Review , 133 (562) pp. 771-773. 10.1093/ehr/cey122 .

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Partial CSI Acquisition for Size-Constrained Massive MIMO Systems with User Mobility

Qian, J; Masouros, C; Garcia-Rodriguez, A; (2018) Partial CSI Acquisition for Size-Constrained Massive MIMO Systems with User Mobility. IEEE Transactions on Vehicular Technology 10.1109/TVT.2018.2849263 . (In press). Green open access

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Photocatalytic and electrically conductive transparent Cl-doped ZnO thin films: Via aerosol-assisted chemical vapour deposition

Jiamprasertboon, A; Powell, MJ; Dixon, SC; Quesada-Cabrera, R; Alotaibi, AM; Lu, Y; Zhuang, A; ... Carmalt, CJ; + view all Jiamprasertboon, A; Powell, MJ; Dixon, SC; Quesada-Cabrera, R; Alotaibi, AM; Lu, Y; Zhuang, A; Sathasivam, S; Siritanon, T; Parkin, IP; Carmalt, CJ; - view fewer (2018) Photocatalytic and electrically conductive transparent Cl-doped ZnO thin films: Via aerosol-assisted chemical vapour deposition. Journal of Materials Chemistry A , 6 (26) pp. 12682-12692. 10.1039/c8ta01420e . Green open access

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On the pooling and subgrouping of data from percutaneous coronary intervention versus coronary artery bypass grafting trials: a call to circumspection

Freemantle, N; Ruel, M; Gaudino, MFL; Pagano, D; (2018) On the pooling and subgrouping of data from percutaneous coronary intervention versus coronary artery bypass grafting trials: a call to circumspection. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY , 53 (5) pp. 915-918. 10.1093/ejcts/ezy140 .

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An Optimized Collagen-Fibrin Blend Engineered Neural Tissue Promotes Peripheral Nerve Repair

Schuh, CMAP; Day, AGE; Redl, H; Phillips, J; (2018) An Optimized Collagen-Fibrin Blend Engineered Neural Tissue Promotes Peripheral Nerve Repair. Tissue Engineering Part A 10.1089/ten.tea.2017.0457 . (In press). Green open access

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Impact of Macroporosity on Catalytic Upgrading of Fast Pyrolysis Bio-Oil by Esterification over Silica Sulfonic Acids

Manayil, JC; Osatiashtiani, A; Mendoza, A; Parlett, CMA; Isaacs, MA; Durndell, LJ; Michailof, C; ... Wilson, K; + view all Manayil, JC; Osatiashtiani, A; Mendoza, A; Parlett, CMA; Isaacs, MA; Durndell, LJ; Michailof, C; Heracleous, E; Lappas, A; Lee, AF; Wilson, K; - view fewer (2017) Impact of Macroporosity on Catalytic Upgrading of Fast Pyrolysis Bio-Oil by Esterification over Silica Sulfonic Acids. ChemSusChem , 10 (17) pp. 3506-3511. 10.1002/cssc.201700959 . Green open access

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