No abstract available
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Κυριακή 7 Οκτωβρίου 2018
Perfusion of Porcine Kidneys with Macromolecular Heparin Reduces Early Ischemia Reperfusion Injury
Background Previously we have been able to demonstrate the possibility of coating the inner surface of the renal arteries in porcine kidneys with a heparin conjugate during hypothermic machine perfusion (HMP). The purpose of this study was to assess the efficacy of this treatment in reducing early ischemia-reperfusion injury. Method Brain death was induced in male landrace pigs by stepwise volume expansion of an epidural balloon catheter until negative cerebral perfusion pressure was obtained. Both kidneys (matched pairs; n=6+6) were preserved for 20 hours by HMP during which 50 mg heparin conjugate was added to 1 of the HMP systems (treated group). A customized ex vivo normothermic oxygenated perfusion (NP) system with added exogenous creatinine was used to evaluate early kidney function. Blood, urine and histological samples were collected during the subsequent 3 hours of NP. Results Kidney weight was lower at the end of NP (p=0.017) in the treated group compared to control kidneys. The rate of decline in creatinine level was faster (p=0.024), total urinary volume was higher (p=0.031) and the level of urine neutrophil gelatinase-associated lipocalin (NGAL) was lower (p=0.031) in the treated group. Histologically, less tubular changes were seen (p=0.046). During NP intrarenal resistance remained lower (p
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The first case of thrombocytopenia, anasarca, fever, renal impairment or reticulin fibrosis, and organomegaly (TAFRO) syndrome with unilateral adrenal necrosis: a case report
TAFRO syndrome, which was first reported in 2010 in Japan, is a relatively rare disease characterized by thrombocytopenia, anasarca, fever, renal impairment, reticulin fibrosis, and organomegaly. Although this...
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Rhinosectan® spray (containing xyloglucan) on the ciliary function of the nasal respiratory epithelium; results of an in vitro study
To assess the effects of Rhinosectan® spray, a medical device containing xyloglucan, on nasal ciliary function (in MucilAir™Nasal cells).
https://ift.tt/2y6mebI
Tinnitus and Cognition: Linked?
Abstract
Tinnitus is conscious auditory perception without corresponding external stimuli resulting from neuronal activity along auditory pathway either in peripheral or central auditory system. The exact origin, pathophysiologic pathway and its treatment is still under exploration. The main risk factor is hearing loss, but can occur in patients with normal hearing. Auditory brainstem response test helps to objectify this subjective complaint and aid in locating its origin. P300 is late latency auditory evoked potential, objective marker of cognitive potential. The purpose of our study was to ascertain any significant difference in P300 latency and amplitude values in cases of sensorineural hearing loss with tinnitus when compared to controls (normal hearing subjects) and also to find any correlation between severity of tinnitus and cognition. This was a case control study conducted at the department of ENT at Safdarjung Hospital, New Delhi between September 2016 to March 2018. The study comprised of one hundred and six patients, out of which fifty five patients were having sensorineural hearing loss with tinnitus and fifty one patients were normal hearing subjects. General medical and audiological history and examination was done. Significant increase in P300 latency and decrease in P300 amplitude was found in sensorineural hearing loss with tinnitus cases on comparing with controls. The similar pattern of P300 values was observed on increasing severity of tinnitus and degree of hearing loss. Hence, results revealed the role of cognition and involvement of central auditory pathway in tinnitus generation.
https://ift.tt/2zXGQ76
A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre
Abstract
To identify patients of vocal cord paresis and palsy and to establish an etiological diagnosis based on a study performed in a tertiary centre. Study was done prospectively in the Department of ENT in KIMS Hospital, Bangalore, for 1 year, from June 2016 to June 2017. 100 patients with vocal cord paresis and palsy were identified and examined by using various tests and investigations to establish the etiology. Most of the patients presented with complaints of change in voice (92%). Some of the other common presenting complaints included noisy breathing and difficulty in swallowing, difficulty in voice production and vocal fatigue and cough. Unilateral paralysis (82%) was found to be more common than bilateral paralysis (18%), of which left (52%) was more commonly affected than right (48%) vocal cord. The most common age group affected was 51–60 years (24%) followed by 61–70 years (19%). Males (60%) were affected more than females (40%) in a ratio of 3:2 and among the affected males 73% were known smokers. The most common cause of vocal cord paresis and palsy was found to be idiopathic (38%), followed by primary laryngeal growths (27%). Other causes included carcinomas of lung, thyroid and oesophagus, traumatic, inflammatory, systemic diseases like Rheumatoid arthritis, Hypertension leading to stroke. Identifying the exact etiopathogenesis of vocal cord paresis and palsy in patients has been difficult and is very important in order to establish a proper diagnostic and treatment protocol for these patients.
https://ift.tt/2C1rikc
Tinnitus and Cognition: Linked?
Abstract
Tinnitus is conscious auditory perception without corresponding external stimuli resulting from neuronal activity along auditory pathway either in peripheral or central auditory system. The exact origin, pathophysiologic pathway and its treatment is still under exploration. The main risk factor is hearing loss, but can occur in patients with normal hearing. Auditory brainstem response test helps to objectify this subjective complaint and aid in locating its origin. P300 is late latency auditory evoked potential, objective marker of cognitive potential. The purpose of our study was to ascertain any significant difference in P300 latency and amplitude values in cases of sensorineural hearing loss with tinnitus when compared to controls (normal hearing subjects) and also to find any correlation between severity of tinnitus and cognition. This was a case control study conducted at the department of ENT at Safdarjung Hospital, New Delhi between September 2016 to March 2018. The study comprised of one hundred and six patients, out of which fifty five patients were having sensorineural hearing loss with tinnitus and fifty one patients were normal hearing subjects. General medical and audiological history and examination was done. Significant increase in P300 latency and decrease in P300 amplitude was found in sensorineural hearing loss with tinnitus cases on comparing with controls. The similar pattern of P300 values was observed on increasing severity of tinnitus and degree of hearing loss. Hence, results revealed the role of cognition and involvement of central auditory pathway in tinnitus generation.
https://ift.tt/2zXGQ76
A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre
Abstract
To identify patients of vocal cord paresis and palsy and to establish an etiological diagnosis based on a study performed in a tertiary centre. Study was done prospectively in the Department of ENT in KIMS Hospital, Bangalore, for 1 year, from June 2016 to June 2017. 100 patients with vocal cord paresis and palsy were identified and examined by using various tests and investigations to establish the etiology. Most of the patients presented with complaints of change in voice (92%). Some of the other common presenting complaints included noisy breathing and difficulty in swallowing, difficulty in voice production and vocal fatigue and cough. Unilateral paralysis (82%) was found to be more common than bilateral paralysis (18%), of which left (52%) was more commonly affected than right (48%) vocal cord. The most common age group affected was 51–60 years (24%) followed by 61–70 years (19%). Males (60%) were affected more than females (40%) in a ratio of 3:2 and among the affected males 73% were known smokers. The most common cause of vocal cord paresis and palsy was found to be idiopathic (38%), followed by primary laryngeal growths (27%). Other causes included carcinomas of lung, thyroid and oesophagus, traumatic, inflammatory, systemic diseases like Rheumatoid arthritis, Hypertension leading to stroke. Identifying the exact etiopathogenesis of vocal cord paresis and palsy in patients has been difficult and is very important in order to establish a proper diagnostic and treatment protocol for these patients.
https://ift.tt/2C1rikc
Clinical Thyroidology®High-Impact Articles
Mary Ann Liebert, Inc., publishers and the American Thyroid Association salute Jerry Hershman, MD for his superb leadership and years as Editor-in-Chief of Clinical Thyroidology. We are pleased to welcome our new incoming editor in 2019, Angela Leung, MD, and wish her well in this important new role.
We invite you to read these top-read papers with free access through October 19, 2018.
Read Now:
The Increased Incidence of Thyroid Cancer Is Worldwide
Jerome M. Hershman
No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung
Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits
Does Normal TSH Mean Euthyroidism in L-T4 Treatment?
Jacques Orgiazzi
Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann and Katrin Brauckhoff
Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration
Stephanie A. Fish
The post Clinical Thyroidology<sup>®</sup>High-Impact Articles appeared first on American Thyroid Association.
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VideoEndocrinology™ High-Impact Videos
VideoEndocrinology™
The Official Journal of: American Thyroid Association
FREE ACCESS through October 20, 2018.
Watch now:
Thyroid Fine-Needle Aspiration and Smearing Techniques
Mitsuyoshi Hirokawa, Ayana Suzuki, Akira Miyauchi
Thyroid Fine Needle Aspiration Smear Preparation
Juan Munoz Pena, Jeffrey Arnold
Transoral Endoscopic Thyroidectomy Vestibular Approach
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom
An Elusive Parathyroid: Interesting Case Presentation
Anton F. Engelsman, Robert F. Parkyn, Andrew Carter, James Christie, Leigh W. Delbridge
Delphian Lymph Node Dissection: Surgical Dissection Technique as Illustrated by the Johns Hopkins Head and Neck Endocrine Surgery Division
Vaninder K. Dhillon, Jonathon O. Russell, Ralph P. Tufano
The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.
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Topical application of phenytoin or nifedipine-loaded PLGA microspheres promotes periodontal regeneration in vivo
Publication date: Available online 6 October 2018
Source: Archives of Oral Biology
Author(s): Xiao-Heng Zhao, Franklin R. Tay, Yan-Jun Fang, Liu-Yan Meng, Zhuan Bian
Abstract
Objectives
Gingival recession and alveolar bone loss are common manifestations of periodontitis. Periodontal regeneration is the ideal strategy for rehabilitating periodontal tissue defects and preventing tooth loss. The present study examined whether localized, topical application of gingival overgrowth-inducing drugs, phenytoin, nifedipine or cyclosporine, induces periodontal regeneration.
Methods
Polylactic-co-glycolic acid (PLGA) was used as the carrier for preparation of phenytoin, nifedipine or cyclosporine-loaded PLGA microspheres, using an oil-in-water emulsification technique. The drug-loaded microspheres were delivered to periodontal defects created on alveolar ridges mesial to the first maxillary molars of Sprague-Dawley rats. After eight weeks, the operation area in each rat, including the maxillary molars and periodontal tissues, was harvested and evaluated by micro-computed tomography, histochemical and immunohistochemical analyses.
Results
Physical parameters representative of periodontal regeneration, including the length of new alveolar bone (p < 0.01) and the area of new alveolar bone (p < 0.01) were significantly improved in the phenytoin group. Compared to other groups, the phenytoin group demonstrated increased expression of COL-1, VEGF-A, osteoblast and osteoclast markers (BMP-2, TGF-β1, OCN and TRAP staining), as well as decreased expression of MMP-8.
Conclusions
Results of the present study provided new evidence that localized, controlled release of phenytoin confers therapeutic benefits toward gingival recession and alveolar bone loss. Phenytoin appears to be a promising drug that promotes periodontal regeneration.
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Non-nucleoside reverse transcriptase inhibitors (NNRTIs)-induced Stevens-Johnson syndrome and gynecomastia in an HIV-infected child: A case report
Publication date: Available online 6 October 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): B. Saka, A.S. Akakpo, A. Bassowa, A.N. Dapam, G. Mahamadou, J.N. Teclessou, A. Mouhari-Toure, A.Y. Laouali, E. Mensah, K. Kombaté, P. Pitché
Summary
Background
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are antiretroviral drugs often used in the first-line treatment regimen of HIV1 infection worldwide. We report a case of successive gynecomastia and Stevens-Johnson syndrome (SJS) respectively induced by efavirenz and nevirapine in a single patient.
Case report
A 16-year-old boy, HIV1-infected since birth, was started on antiretroviral treatment (ART) in August 2015 and was taking a regimen comprising abacavir, lamivudine and efavirenz. In April 2016, when his weight reached 35 kg, abacavir was replaced with tenofovir. Bilateral breast enlargement, previously hidden by the patient, was diagnosed two years after the start of ART. History-taking, physical examination and laboratory tests ruled out known causes of gynecomastia, and efavirenz was thus considered the most likely cause. This drug was then withdrawn and replaced with nevirapine in July 2017. Thirty-three days after the patient started nevirapine treatment, a skin rash appeared. Physical examination revealed erythematous macules and flaccid bullae with estimated skin detachment of 10%. There were also conjunctival, buccal and genital lesions. A diagnosis was made of SJS induced by nevirapine. Three months after withdrawal of efavirenz, breast size decreased by 3 cm on the left breast and 2 cm on the right breast; two months after the SJS, cutaneous sequelae alone persisted, such as diffuse hyperchromic macules.
Discussion
Recognition of gynecomastia as a side-effect of efavirenz is important to allow the condition to be treated while it is still potentially reversible. Moreover, when efavirenz is replaced, a protease inhibitor should be preferred to nevirapine.
Résumé
Introduction
Les inhibiteurs non nucléosidiques de la transcriptase inverse (INNTI) sont des antirétroviraux souvent utilisés en première ligne du traitement de l'infection par le VIH1. Nous rapportons un cas de gynécomastie bilatérale sévère et de syndrome de Stevens-Johnson (SSJ) respectivement induits par l'efavirenz et la névirapine chez un même patient.
Observation
Un garçon de 16 ans, infecté par le VIH1 depuis la naissance, était mis en août 2015 sous abacavir, lamivudine et efavirenz. En avril 2016, son poids atteignant 35 kg, l'abacavir était remplacé par le tenofovir. Une augmentation bilatérale de volume mammaire, dissimulée par le patient, était diagnostiquée deux ans après le début du traitement. L'histoire de la maladie, l'examen physique et les examens de laboratoire écartant les principales causes connues de gynécomastie, la responsabilité de l'efavirenz était alors considérée comme la plus vraisemblable. Ce médicament était donc retiré et remplacé par la névirapine en juillet 2017. Trente-trois jours après le début du traitement par la névirapine, une éruption cutanée apparaissait. À l'examen physique, on notait des macules érythémateuses et des bulles flasques avec un décollement cutané estimé à 10 % de la surface corporelle. Il existait également des lésions conjonctivales, buccales et génitales. Le diagnostic de SSJ induit par la névirapine était retenu. Trois mois après le retrait de l'efavirenz, la taille des seins diminuait de 3 cm à gauche et 2 cm à droite ; deux mois après le SSJ, il persistait uniquement des séquelles cutanées à type de macules hyperchromiques diffuses.
Discussion
La recherche d'une gynécomastie comme effet indésirable de l'efavirenz est importante afin d'intervenir au moment où elle peut encore être réversible. Par ailleurs, en cas de substitution de l'efavirenz, un inhibiteur de protéase devrait être préféré à la névirapine.
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To transfuse or not to transfuse? Jehovah’s Witnesses and postoperative hemorrhage in pediatric otolaryngology
Publication date: Available online 6 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Andrew J. Redmann, Melissa Schopper, Armand H. Matheny Antommaria, Judith Ragsdale, Alessandro de Alarcón, Michael J. Rutter, Catherine K. Hart, Charles M. Myer
Abstract
Objectives
Discuss the ethical issues in the management of postoperative hemorrhage in pediatric patients whose parents are Jehovah's Witnesses (JW) and 2) Describe a framework for shared decision making in this population.
Methods
A recall review of pediatric otolaryngology patients with parents of the JW faith and postoperative hemorrhage was performed over a year long period at a single institution. The literature on transfusions for JW minors was reviewed.
Results
Two patients were identified. The first patient had a severe post-tonsillectomy hemorrhage requiring multiple emergency operative interventions. The child developed a hemoglobin of 5.2 g/dl and received an emergent transfusion against parents' wishes. The child subsequently did not require further intervention. The second patient hemorrhaged after a supraglottoplasty and was administered erythropoietin and iron infusion but did not require transfusion (hemoglobin nadir 7.9 g/dl). In both cases hematology was consulted, and extensive discussion with the families and the JW Hospital Liaison Committee occurred.
Conclusions
The risks of hemorrhage should be discussed with JW parents of patients undergoing even routine otolaryngologic surgery. In these cases, early shared decision making with family, the JW Hospital Liaison committee, and hematology was pursued regarding mutually acceptable interventions. Aggressive non-transfusion based resuscitation was carried out to minimize the likelihood of transfusion. In the first case, danger to the patient's life eventually necessitated transfusion in accordance with the patient's best interest and previous case law. A defined framework involving all stake-holders, including Pastoral Care, in the event of postoperative hemorrhage is critical.
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Using single cell analysis for translational studies in immune mediated diseases: Opportunities and challenges
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Siddhartha Sharma, Louis Gioia, Brian Abe, Marie Holt, Anne Costanzo, Lisa Kain, Andrew Su, Luc Teyton
Abstract
The difficulty of studying small tissue samples and rare cell populations have been some of the main limitations in performing efficient translational studies of immune mediated diseases. Many of these conditions are grouped under the name of a single disease whilst there are strong suggestions that disease heterogeneity leads to variable disease progression as well as therapeutic responses. The recent development of single cell techniques, such as single cell RNA sequencing, gene expression profiling, or multiparametric cytometry, is likely to be a turning point. Single cell approaches provide researchers the opportunity to finally dissect disease pathology at a level that will allow mechanistic classifications and precision therapeutic strategies. In this review, we will give an overview of the current and developing repertoire of single cell techniques, the benefits and limitations of each, and provide an example of how single cell techniques can be utilized to understand complex immune mediated diseases and their translation from mouse to human.
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Patient preferences regarding the communication of biopsy results in the general otolaryngology clinic
Publication date: Available online 7 October 2018
Source: American Journal of Otolaryngology
Author(s): Anirudh Saraswathula, Jennifer Y. Lee, Uchechukwu C. Megwalu
Abstract
Objectives
To determine the preferred methods of communicating biopsy results for patients in our comprehensive otolaryngology clinic, and to examine factors associated with preferring remote vs. in-person communication of results.
Study design
Cross-sectional study.
Setting
Academic comprehensive otolaryngology clinic.
Subjects and methods
A survey instrument was administered to 107 consecutive adult otolaryngology patients undergoing head and neck fine needle aspiration biopsy from March 1, 2017 to April 30, 2018 assessing their health literacy using the Brief Health Literacy Score and their preferred method of notification of biopsy results (in-person vs. remote).
Results
69% of patients preferred remote notification of their biopsy results (either by telephone or via an online portal). 54% of patients prioritized clear explanation of the results as the most important factor when communicating a malignant result. Adequate health literacy was associated with lower odds of preferring in-person notification (adjusted odds ratio 0.11, 95% CI 0.03 to 0.39). Patients who prioritized clear explanation of the results were more likely to prefer in-person notification (adjusted OR 4.13, 95% CI 1.31 to 14.88).
Conclusions
A significant proportion of patients in our comprehensive otolaryngology clinic undergoing fine needle aspiration biopsy preferred remote communication of their biopsy results. Patients most valued clear explanations from the provider and prompt receipt of the result when communicating malignant results. This highlights the need for individualized results communication plans, for patients undergoing biopsy.
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Instruments evaluating the clinical findings of laryngopharyngeal reflux: A systematic review
The Laryngoscope, EarlyView.
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Table of contents
The Laryngoscope, Volume 128, Issue 9, Page iii-vi, September 2018.
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Clearance of facial tattoo with triple‐wavelength picosecond laser and fractionated carbon dioxide laser
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
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Legends of Allergy: Carla Bruijnzeel‐Koomen
Allergy, Volume 0, Issue ja, -Not available-.
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γδ T cells amplify Blomia tropicalis‐induced allergic airway disease
Allergy, Volume 0, Issue ja, -Not available-.
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Aged human skin accumulates mast cells with altered functionality which localise to macrophage and VIP+ nerve fibres
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
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Effects of psychosocial interventions on patient‐reported outcomes in patients with psoriasis: A systematic review and meta‐analysis
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
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