Purpose of review Surgical mission trips in head and neck surgery are common. There are an increasing number of surgical groups performing complex reconstructions in low and middle-income countries (LMIC). Consideration of reconstructive options that are location and patient specific are critical for optimum patient care and local physician education. Recent findings The pectoralis muscle regional flap is a versatile and reliable option and has been shown to reconstruct defects in nearly every head and neck subsite. Additional regional flap options described are the supraclavicular island flap and submental island flap. There are 15 published case series describing experience with performing microvascular reconstructions in LMIC. The average success rate was 87.1%. Both loupe and microscope magnification are used. Summary Complex reconstructions are successfully being performed in LMIC. Although microvascular reconstruction is being utilized by some groups, local and patient-specific factors should be carefully considered, as many regional and local flap options available provide the same reconstruction benefit while minimizing operating room time, resources, and postoperative care needs. Correspondence to Chad Zender, MD, University Hospitals Ear, Nose and Throat Institute, 11100 Euclid Ave, Cleveland, OH 44106, USA. Tel: +1 216 844 5307; fax: +1 216 201 5157; e-mail: chad.zender@uhhospitals.org Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2ON4FTK
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Κυριακή 19 Αυγούστου 2018
‘Physics is a kind of metaphysics’: Émile Meyerson and Einstein’s late rationalistic realism
Abstract
Gerald Holton has famously described Einstein's career as a philosophical "pilgrimage". Starting on "the historic ground" of Machian positivism and phenomenalism, following the completion of general relativity in late 1915, Einstein's philosophy endured (a) a speculative turn: physical theorizing appears as ultimately a "pure mathematical construction" guided by faith in the simplicity of nature and (b) a realistic turn: science is "nothing more than a refinement "of the everyday belief in the existence of mind-independent physical reality. Nevertheless, Einstein's mathematical constructivism that supports his unified field theory program appears to be, at first sight, hardly compatible with the common sense realism with which he countered quantum theory. Thus, literature on Einstein's philosophy of science has often struggled in finding the thread between ostensibly conflicting philosophical pronouncements. This paper supports the claim that Einstein's dialog with Émile Meyerson from the mid 1920s till the early 1930s might be a neglected source to solve this riddle. According to Einstein, Meyerson shared (a) his belief in the independent existence of an external world and (b) his conviction that the latter can be grasped only by speculative means. Einstein could present his search for a unified field theory as a metaphysical-realistic program opposed to the positivistic-operationalist spirit of quantum mechanics.
https://ift.tt/2MyqIQN
Hearing Performance in the Follicular-Luteal Phase of the Menstrual Cycle
Introduction. Estrogen has a protective role on auditory function. It may have an excitatory action on auditory nerve fibers and can have a neuroprotective effect. Progesterone has a mainly inhibitory action on the central nervous system, which may balance the mainly excitatory action of estrogen. Objective. To determine changes in hearing performance with pure tone audiometry (PTA), tympanometry, distortion product otoacoustic emissions (DPOAEs), and auditory brainstem responses (ABR) as hormonal changes occur from follicular to luteal phase. Materials and Methods. Twenty healthy female volunteers (age 19 ± 30 years) with normal menstrual cycle and without any hearing problems are included in this case-control study. Hearing evaluation was performed on the 13th day of the menstrual cycle (follicular phase) and then on the 22nd day (luteal phase). Results. All of the participants had normal results in follicular phase. In luteal phase, four cases showed abnormalities as follows: reduced hearing thresholds 250 Hz (mean= 15 dBHL), increased amplitudes of DPOAE (mean= 3 dBspl), decreased middle ear pressure (mean= -110 dapa), and delayed ABR interpeak latencies (mean of IPLs I-III= 0.4 and mean of IPLs III-V= 0.6 ms). Conclusions. In some women, changing of ovarian hormones may induce fluctuating hearing and increased progesterone in luteal phase can lead to abnormal outcomes in auditory function. However, elevated estrogen modifies its consequences in follicular phase.
https://ift.tt/2OSaNu7
American Thyroid Association Announces 2018 Research Grant Recipients
- Research Grant to Study Common Resistance to Papillary Thyroid Cancer Treatment Is Awarded to Ann-Kathrin Eisfeld, MD
- Research Grant to Identify the Source and Mechanism of Thyroid and Kidney Comorbidity Is Awarded to Nicholas Tardi, PhD
- Research Grant to Study the Action of T-Regulatory Cells in Thyroid-Antibody-Positive Pregnant Women Awarded to Stephanie Behringer-Massera, MD
- Research Grant Focused on Identifying T3-Forming Sites in Thyroglobulin Is Awarded to Cintia Eliana Citterio, PhD
- Research Grant to Determine How Specific Drugs Work or Fail in Anaplastic Thyroid Cancer Is Awarded to Miles Miller, PhD
- Research Grant for Study of Resistance to Precision Medication for Medullary Thyroid Cancer Is Awarded to Brendan Frett, PhD
- Research Grant to Determine the Genes Responsible for Survival and Growth of Medullary Thyroid Cancer Is Awarded to Wayne Miles, PhD
The post American Thyroid Association Announces 2018 Research Grant Recipients appeared first on American Thyroid Association.
https://ift.tt/2Mxbxr1
Association between Diabetes and Asthma: Evidence from a Nationwide Korean Study
Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness and airway inflammation, resulting in bronchoconstriction, airway remodeling, and airway obstruction.1,2 It is a serious health issue world-wide, affecting more than 300 million individuals. The global prevalence of clinical asthma has increased during recent decades.3 Although the absolute prevalence of asthma in Korea is reported to be lower than that of other countries,4,5 the prevalence of asthma has been steadily increasing from 4.94% to 5.7% between 2006 and 2010.
https://ift.tt/2N3YRVH
Parent-Physician Perceptions of Shared Decision-Making and Care Coordination for Children with Asthma
In conducting initiatives to improve care quality for children with asthma, a useful approach begins with identifying alignments and discordances in perceptions of parents and providers. Studies applying this approach have generally focused on parent-provider perceptions of children's asthma control and medication use.1-3 A need exists for assessing the 2 groups' perceptions of collaborative patient-centered practices.4-8 In the context of a quality improvement (QI) program in 2 health systems, we compared parents' and interdisciplinary physicians' perceptions and self-reported practices regarding pediatric asthma education, shared decision-making, and care coordination.
https://ift.tt/2MnZcGg
Is small airways dysfunction related to asthma control and type 2 inflammation?
Small airways dysfunction (SAD) in persistent adult asthmatics who have a preserved forced expiratory volume in 1 second (FEV1) is related to worse asthma control.1 Impulse oscillometry (IOS) is an effort-independent test used to phenotype SAD which involves normal quiet tidal breathing.2 Peripheral airways resistance can be derived from the difference between resistance at 5 Hz and 20 Hz (R5-R20) while the area under the reactance curve (AX) reflects the peripheral lung compliance.3 In patients with moderate to severe persistent asthma, R5-R20 and AX but not spirometry were closely related to asthma control assessed by asthma control questionnaire (ACQ).
https://ift.tt/2BmSdYU
Exploration of genetic factors determining cleft side in a pair of monozygotic twins with mirror-image cleft lip and palate using whole-genome sequencing and comparison of craniofacial morphology
Publication date: Available online 19 August 2018
Source: Archives of Oral Biology
Author(s): Masahiro Takahashi, Kazuyoshi Hosomichi, Tetsutaro Yamaguchi, Ryo Nagahama, Hiroshi Yoshida, Mary L. Marazita, Seth M. Weinberg, Koutaro Maki, Atsushi Tajima
Abstract
Objective
The aim of the present study is to explore genetic factors determining difference of cleft side using whole-genome sequencing and evaluation of craniofacial morphology using cephalometric analysis between Japanese monozygotic (MZ) twins with mirror-image cleft lip and palate (CLP).
Design
We selected a Japanese MZ twin pair (MZ-A and MZ-B) affected with unilateral CLP who are discordant for cleft side (left/right) and conducted whole-genome sequencing to identify genetic factors determining cleft side. Moreover, we compared their craniofacial morphologies using cephalograms.
Results
Whole-genome sequencing results suggested that no discordant DNA variants were found between MZ-A and MZ-B. The comparison of craniofacial morphology between the MZ twins revealed that MZ-B had maxillary deficiency and slightly more mandibular protrusion than MZ-A.
Conclusions
It is indicated that environmental factors might be a critical factor that influences the determination of difference of cleft side in orofacial clefts. In addition, we found some differences in craniofacial morphology between MZ-A and MZ-B. Our findings suggest that various environmental factors, such as epigenetics, might be a critical factor that influences the determination of difference of cleft side in CLP rather than inherited genetic factors.
https://ift.tt/2PnK89l
PULP PATHOSIS ASSOCIATED WITH ANCIENT MAYA DENTAL INLAYS
Publication date: Available online 19 August 2018
Source: Archives of Oral Biology
Author(s): M. Ramírez-Salomón, E. Vega-Lizama, P. Quintana-Owen, A. Cucina, V. Tiesler
Abstract
Objective
The ancient Maya used to practice dental inlays as part of the cultural traditions. Most of those inlays remain in place after more than one thousand years. The purpose of this paper is to investigate the incidence of pulp pathosis associated with ancient Maya dental inlays to assess the impact that such common practice had on the population's oral health.
Design
We scored 193 anterior inlaid teeth from 107 pre-Hispanic Maya dentitions studied at three archaeological storage facilities (Universidad Autonoma de Yucatan, Harvard University, Atlas of Guatemala Project). Two hundred eleven untreated frontal teeth of pre-Hispanic Mayan collections were used as controls. We performed macroscopic, radiographic and microscopic analyses to assess the frequency of caries, pulp calcifications, internal root resorption (IRR), and periapical lesions (PALs).
Results
In the inlaid teeth, the frequencies of pulp calcifications, IRR, caries and PALs were 59.8%, 2.2%, 18.5% and 19.2%, respectively. Compared with untreated teeth, inlaid specimens exhibited greater susceptibility to caries, pulp calcifications, IRR and PALs than untreated teeth (pulp calcifications: 44.5%, IRR: 0%, caries: 1.4%, and PAL: 1.9%). Age-at-death did not have any significant influence on susceptibility to pulp calcifications, IRR, caries or PALs.
Conclusions
We noted relatively low pulp irritation and a low frequency of carious infections, IRR and PALs in Mayan inlaid teeth. However, these levels exceeded the frequencies of untreated teeth from the same area and time period. We follow that the cements used by the pre-Hispanic Maya to fix the inlays into their sockets provided excellent sealing characteristics on average.
https://ift.tt/2MXZYpH
Is small airways dysfunction related to asthma control and type 2 inflammation?
Publication date: Available online 19 August 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Chris RuiWen Kuo, Sunny Jabbal, Brian Lipworth
https://ift.tt/2vXKHib
Association between Diabetes and Asthma: Evidence from a Nationwide Korean Study
Publication date: Available online 19 August 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Ji Yeon Baek, Seung Eun Lee, Kyungdo Han, Eun Hee Koh
https://ift.tt/2L304KY
Parent-Physician Perceptions of Shared Decision-Making and Care Coordination for Children with Asthma
Publication date: Available online 19 August 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Giselle Mosnaim, Andrew H. Liu, Laura C. Simone, Madeleine Shalowitz, Ewa H. Schafer, Sindhura Bandi, Christopher D. Codispoti, James J.L. Mateka, Laurence Greene, Tamar Sapir
https://ift.tt/2MlGVt3
Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body
Summary. Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. Objective. We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. Case report. A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. Conclusion. Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.
https://ift.tt/2L6gwdj
Pneumomediastinum, Pneumopericardium, and Epidural Pneumatosis following Adenotonsillectomy: A Very Rare Complication
Adenotonsillectomy is a common surgical otolaryngology procedure that is associated with several complications, including hemorrhage, odynophagia, damage to teeth, taste disorders, atlantoaxial subluxation, lingual edema, infection, and injury of the carotid artery. Pneumomediastinum, pneumopericardium, and epidural pneumatosis are an extremely unusual condition in children with adenotonsillectomy. Treatment should be conservative in the majority of cases and based on benign self-limiting course of these diseases; early recognition can prevent further complications. The combination of pneumomediastinum with epidural pneumatosis, pneumopericardium, retropharyngeal-prevertebral pneumatosis, axillar-perihumeral pneumatosis, and subcutaneous emphysema is also a very rare condition. We present a unique case with the radiological findings of air in all of these areas in a 6-year-old male child with adenotonsillectomy. The case was unusual in that the patient developed this complication 3 hours later after adenotonsillectomy with severe vomitting. The possible mechanism, the algorithm of treatment, and precautions in such cases will be discussed.
https://ift.tt/2LaOHk2
A Study and Development of Workplace Facilities and Working Environment to Increase the Work Efficiency of Persons with Disabilities: A Case Study of Major Retail and Wholesale Companies in Bangkok
This research aims to improve the work effectiveness of people with physical disabilities in department stores, retail and wholesale companies in Bangkok. It focuses on the environment and facilities needed by people with three types of disabilities, visual impairment, hearing impairment, and wheelchair users. A mixed research method was used (questionnaires, interviews, and observations). The results were applied to a design process based on the needs of people with physical disabilities and addressed solving their work problems, increasing their work effectiveness, and bringing the results of the design to a group discussion. The group was made up of 15 experts who were supervisors, representatives of the people with each type of physical disability, instructors, and personnel from the university knowledgeable about universal design for people with disabilities. Architects and designers helped to brainstorm ideas and develop designs that led to production and product testing. Testing was conducted to compare pretest and posttest results using designed products to evaluate the work effectiveness of the people with physical disabilities using statistical analysis (paired t-tests). The results using developed products showed a higher average posttest score than pretest. This indicated a statistically higher work effectiveness (α =0.05) and supports the research hypothesis.
https://ift.tt/2MGldj6
Epithelial‐mesenchymal transition and microRNAs: Challenges and future perspectives in oral cancer
Head &Neck, EarlyView.
https://ift.tt/2BrQNMY
Noninvasive, tube‐based, continuous vagal nerve monitoring using the laryngeal adductor reflex: Feasibility study of 134 nerves at risk
Head &Neck, EarlyView.
https://ift.tt/2MDacyI
Local production of prolactin in lesions may play a pathogenic role in psoriatic patients and imiquimod‐induced psoriasis‐like mouse model
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2nNVVRL
Role of IL‐17A receptor blocking in melanocytes survival: A strategic intervention against vitiligo
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2wdRiEz
Autoantibody to transcriptional intermediary factor‐1β as myositis‐specific antibody: clinical correlation with CADM or DM with mild myopathy
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2MA6YfC
Impact of Hidradenitis Suppurativa on Work Loss, Indirect Costs and Income
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2N1iTA6
Skin resident memory T cell population is not effectively constructed in systemic sclerosis
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2MugIIj
Long‐term 52‐week trends in apremilast safety outcomes for treatment of psoriasis in clinical practice: a multicentre, retrospective case series
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2BxkIDE
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