Inflammatory eruptions associated with immune checkpoint inhibitor therapy: A single-institutional, retrospective analysis with stratification of reactions by toxicity and implications for management

There is increasing recognition of distinct inflammatory eruptions associated with checkpoint inhibitors. A better understanding of their severity, therapeutic response and impact on cancer treatment is needed.

https://ift.tt/2Qnp3ME

Are electronic cigarettes a healthier alternative to conventional tobacco smoking?

Abstract

Electronic cigarettes (EC) with and without nicotine are used by more and more consumers within the last decade. The long-term risks of vapor inhalation are unknown. This study should describe the state of the art of knowledge with respect to the following four items: (1) ingredients of the vapor and their potential risks, the influence of EC on smoking of combustible tobacco to (2) adults and (3) the youth, and (4) the side effects of passive vaping. The vapor of EC contains, in comparison to tobacco smoke, less harmful substances, qualitatively and quantitatively. But, due to failing standardization of EC, this comparison is difficult. Adults are often using both, EC and combustible cigarettes dually. In addition, EC were used for supporting smoke-quitting. Unfortunately, consuming EC with and without nicotine due later to a higher risk of conventional tobacco smoking for the user. In general, the effects of passive vaporing are unknown. Although the vapor of EC is less harmful than tobacco smoke, EC are not hazard-free lifestyle products. Technical standardization should be desirable. Adult smoker's benefit using EC is given by completely change to EC only. The rates of success using EC for smoke quitting are not well evaluated. Children and their parents should be informed on the risks of EC use as a precursor of combustible smoking mandatorily. Internet selling EC to any non-adult should be forbidden by law. EC ought not to be allowed to weaken non-smoker's rights, and third persons should be protected by the potential hazards of EC vaporing.

https://ift.tt/2JDhaQg

The irradiated human mandible: A quantitative study on bone vascularity

Publication date: December 2018

Source: Oral Oncology, Volume 87

Author(s): H. Dekker, N. Bravenboer, D. van Dijk, E. Bloemena, D.H.F. Rietveld, Chr.M. ten Bruggenkate, E.A.J.M. Schulten

Abstract

Objectives

Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.

Materials and methods

Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm²).

Results

Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels.

Conclusions

Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.

https://ift.tt/2CWJdJn

The diverse cutoff of PD-L1 positivity and negativity in studies regarding head and neck squamous cell carcinoma

Publication date: Available online 3 November 2018

Source: Oral Oncology

Author(s): Wei Liu, Shengkai Chen, Wenbin Yang

https://ift.tt/2P5XFpQ

Delineation of organs at risk in the head and neck region

Publication date: Available online 2 November 2018

Source: Oral Oncology

Author(s): Francesca De Felice, Vincenzo Tombolini

https://ift.tt/2CZlJ6j

Routine admission to step-down unit as an alternative to intensive care unit after pediatric supraglottoplasty

Publication date: Available online 3 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Diane W. Chen, Yi-Chun Carol Liu

Abstract

Objective

To evaluate the feasibility and the outcomes for step-down (SD) unit admission as an alternative to intensive care unit (ICU) admission after supraglottoplasty in the pediatric patient. Methods: A review of 98 patients who underwent supraglottoplasty from 2012 to 2017 at a tertiary referral pediatric hospital was performed. An SD unit had 1-to-3 nurse-to-patient ratio with noninvasive positive pressure ventilation capability. Data variables included demographics, comorbidities, preoperative and postoperative respiratory requirements, and length of stay. Results: Routine admission to SD occurred for 85% patients while 15% patients were selectively admitted to ICU due to intubation requirement or perioperative respiratory distress. In SD, noninvasive respiratory support was required for 28 (34%) patients. Three (4%) required re-intubation and ICU transfer without delay in care. Patients at high risk for requiring respiratory support after surgery have a neurologic condition (OR 7.0, 95% 2.4-20.2, p<0.01) or intrinsic pulmonary disease (OR 4.5, 95% CI 1.5-13.3, p<0.01). Median length of stay was shorter for patients in step-down (1 day, IQR 1-2). Conclusion: Patients can be managed safely in a SD unit after supraglottoplasty supporting de-escalation of care. Patients with neurologic and pulmonary comorbidities may have higher respiratory needs postoperatively. Prospective studies are warranted to further optimize resource allocation.

https://ift.tt/2znr5oB

Prevalence and etiology of sensorineural hearing loss in children with Down syndrome: A cross-sectional study

Publication date: Available online 3 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): L. De Schrijver, V. Topsakal, M. Wojciechowski, P. Van de Heyning, A. Boudewyns

Abstract

Background

The prevalence and causes of sensorineural hearing loss (SNHL) in children with Down syndrome (DS) are poorly delineated.

Objective

To describe the prevalence, severity, laterality and underlying etiology of SNHL in a cohort of children with DS.

Methods

A cross-sectional study was performed among all children with DS followed at the multidisciplinary Downteam of the Antwerp University Hospital. Patients' characteristics, risk factors for hearing loss, audiometric data and results of an etiological work-up were collected.

Results

Among 291 patients in follow-up, 138 patients (47.4%) presented with hearing loss. In the majority this was caused by middle ear effusion and only 13 patients (4.5%) had sensorineural hearing loss, 7 boys and 6 girls with a mean age of 14.4 ± 7.4 years. Hearing loss was bilateral in 8 cases. Hearing loss severity was graded as mild in 38.5%, moderate in 30.8% and profound in 30.8% of the patients. An etiological work-up was completed in 9 children. Four patients presented with single sided deafness due to cochlear nerve deficiency. One patient had a genetic cause and in 2 patients the hearing loss was attributed to excessive noise exposure. The etiology of hearing loss was unknown in 6 patients.

Conclusion

Sensorineural hearing loss is uncommon in children with DS with a prevalence of 4.5%. Etiological work-up may allow identifying a specific underlying cause. Cochlear nerve deficiency was found in 4 children with DS and single sided deafness.

https://ift.tt/2SHtzHh

Extrusion of Straight Cochlear Implant Electrodes May be Diminished by Proximal Fixation

Publication date: Available online 3 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Faisal Zawawi, Sharon L. Cushing, Adrian L. James, Karen A. Gordon, Blake C. Papsin

Abstract

Objectives

To determine if proximal fixation of the cochlear implant helps reduce the rate of straight electrode array extrusion/migration.

Methods

Records of 278 children implanted with a straight electrode at a tertiary pediatric hospital from 1990-2017 were reviewed. Demographics, operative reports, electrode type, radiological studies and audiological assessments including impedance and stimulation parameters were collected. Significant abnormalities were defined by >75% change in impedance relative to 1 month post-implant values. The main outcome is the incidence of electrode extrusion based on significant changes in impedance and comparative radiological imaging looking for electrode extrusion.

Results

During this period, straight electrodes were chosen infrequently (298/1781 devices implanted (16.73%) in 278 children). They were used prior to the introduction of pre-curved electrodes (153/298) and subsequently for hearing preservation (33/298) and in anomalous cochleae (48/298). Most recently they were used in a comparative study of children receiving one perimodiolar and one straight array (64/298). All electrodes were proximally fixated with a suture around the incus buttress (Ned's knot).

None of the 298 electrodes required repositioning. Comparative radiographs after long duration implant use were available in 72 of 298 devices (24.2%) revealing no changes in electrode position. Significant impedance changes (>75%), indicative of open circuits, were noted in 6/298 devices (2%); ≤2 electrodes at various array positions were affected in each child. In one case, repositioning of the receiver/stimulator may have damaged the electrodes as they exited the device body but no changes in electrode position were evident on the post-repositioning radiograph.

Conclusions

Extrusion of straight electrodes is a recognized complication of cochlear implant surgery but was not observed in our cohort with proximal electrode fixation.

https://ift.tt/2zoRanm

Hidden hearing loss in children and adolescents with sickle cell anemia

Publication date: Available online 2 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Mara Renata Rissatto - Lago, Luciene da Cruz Fernandes, Isa Menezes Lyra, Regina Terse – Ramos, Rozana Teixeira, Cristina Salles, Ana Marice Teixeira Ladeia

Abstract

Objective

To evaluate the auditory system for hidden hearing loss (HHL) and its association with clinical variables and endothelial dysfunction (ED) in children and adolescents with sickle cell anemia (SCA).

Methods

Participants included 37 patients with stable SCA and 44 healthy controls (HC group) (aged 6–18 years) with hearing thresholds ≤ 20 decibels (dB) were evaluated for pure tone audiometry, tympanometry, acoustic reflex, otoacoustic emission, and auditory evoked potentials. Laboratory analysis of the lipid profile, and C-reactive protein levels and endothelial function using ultrasonographic imaging of the brachial artery to assess flow-mediated dilation were performed.

Results

The SCA group presented with a higher rate of increased contralateral acoustic reflex thresholds, compared to those in the HC group at all frequencies and in both ears (p<0.05). There were significant differences in the brainstem auditory evoked potentials between the SCA and HC groups. In the SCA group, the waves III and V latencies were increased (p=0.006 and 0.004 respectively), and the I-III and I-V interpeak intervals were longer (p=0.015 and 0.018 respectively) than those in the HC group. There was no association between the audiological measures and clinical and metabolic variables and sickle cell anemia complications including endothelial function and therapy.

Conclusion

In conclusion, our findings suggest that damage in the auditory system in SCA patients can be present involving retrocochlear structures, causing functional deficits without deterioration of auditory sensitivity.

https://ift.tt/2SILuNR

Assessment of oropharyngeal swallowing dysfunction in myasthenia gravis patients presenting with difficulty in swallowing

Publication date: Available online 2 November 2018

Source: Auris Nasus Larynx

Author(s): Yoshihiko Kumai, Takumi Miyamoto, Keigo Matsubara, Yasuhiro Samejima, Satoshi Yamashita, Yukio Ando, Yorihisa Orita

Abstract

Objective

To examine the correlation between the results of a clinical neurological evaluation and swallowing dysfunction in myasthenia gravis (MG) patients who presented with difficulty in swallowing and underwent videofluorographic (VF) and fiber-optic endoscopic (FE) evaluation.

Methods

The swallowing studies of 13MG patients with difficulty in swallowing seen at the Department of Neurology from June 2016 to April 2018 were reviewed. The assessment parameters on VF and FE examination were as follows: swallowing initiation, bolus stasis at the pyriform sinus (PS) and vallecula (VC), and the degree of aspiration. They were assessed using a 4 or 5-point scale. Associations between these parameters and the clinical neurological evaluation, which included the Myasthenia Gravis Foundation of America (MGFA) clinical classification, the MG Activities of Daily Living score, and a quantitative MG score, were statistically determined.

Results

No patients demonstrated aspiration. However, in patients MGFA IIb/IIIb disease, the Hydo's FEES scale and pharyngeal residue examined using VF were significantly (p < 0.05) more severe than in patients classified with MGFA IIa/IIIa disease. None of the parameters evaluated with VF and FE correlated significantly with the clinical neurological evaluation except for the grip assessment.

Conclusion

While not presenting with aspiration but with swallowing difficulty alone, patients classified with MGFA IIb/IIIb disease, regardless of clinical neurological evaluation, require care addressing the reduced pharyngeal clearance. Controlling the severity of the pharyngeal residue may be the key to preventing silent aspiration, especially in patients with MGFA IIb/IIIb disease.

https://ift.tt/2RrUbuc

Familial congenital choanal atresia with GATA3 associated hypoparathyroidism-deafness-renal dysplasia syndrome unidentified on auditory brainstem response

Publication date: Available online 2 November 2018

Source: Auris Nasus Larynx

Author(s): Makoto Kita, Yasuhiro Kuwata, Takeshi Usui

Abstract

Hypoparathyroidism-deafness-renal dysplasia (HDR) syndrome is a rare autosomal dominant disorder primarily caused by GATA3 haploinsufficiency and is challenging to diagnose in early childhood. We report a Japanese family with HDR syndrome and congenital choanal atresia. The 6-year-old female proband was diagnosed with epilepsy at the age of three. Under carbamazepine monotherapy, the patient presented hypoparathyroidism accompanied by severe hypocalcemia. Subsequently, renal ultrasound analysis revealed bilateral multicystic dysplastic kidneys. Because she had difficulty hearing, we sequenced GATA3 and determined that she had a c.708_709insC (p.Ser237Glnfs*66) allelic variant in exon 3. As a result, we found a family of this disease. Each family member, including her grandfather, mother, and two siblings, had HDR syndrome of varying clinical penetrance. We found a craniofacial anomaly, congenital choanal atresia, which was inherited as an autosomal dominant trait. Hypocalcemia coupled with vitamin D deficiency, triggered by carbamazepine treatment, ultimately revealed the proband's childhood- onset HDR syndrome. Pure-tone audiometry revealed different severities of deafness as well as the progression of sensory hearing loss. However, auditory brainstem response for hearing screening is probably insufficient for ascertaining HDR syndrome in the early stages of life. We presented new clinical clues to diagnose the HDR syndrome.

https://ift.tt/2PGlOCE

Postoperative hemorrhage following tonsillectomy in adults: Analysis of population-based inpatient cohort in Taiwan

Publication date: Available online 2 November 2018

Source: Auris Nasus Larynx

Author(s): Wan-Yi Hsueh, Wei-Chung Hsu, Jenq-Yuh Ko, Te-Huei Yeh, Chia-Hsuan Lee, Kun-Tai Kang

Abstract

Objective

Because of the lack of population-based analyses, this study elucidated the epidemiology and 30-day postoperative complications of inpatient adult tonsillectomies in Taiwan.

Methods

Using the Taiwan National Health Insurance Research Database, we identified all inpatient adult tonsillectomies (age > 20 years) in Taiwan during 1997–2012 through International Codes of Diseases, 9th Revision. Trend of the inpatient tonsillectomy in adult during the study period was explored. Major complications of readmission, reoperation, and mortality within 30 days after tonsillectomies were identified. Factors associated with major complications were analyzed using multivariate logistic model.

Results

In total, 27,365 adults received inpatient tonsillectomies (mean age, 38.4 ± 13.0 years; 57.2% male). The overall incidence was 10.2 per 100,000 population per year among adults. Incidence rates increased from 1997 (8.2/100,000 adults) to 2012 (11.2/100,000 adults) (P trend < 0.001). The rate of readmission for any reason, readmission for bleeding, reoperation for bleeding, and mortality were 4.9%, 2.2%, 1%, and 0.1%, respectively. Young age increased the risk of bleeding-related readmission and reoperation, whereas old age increased the risk of readmission for any reason and mortality. Male gender increased the risk of all major complications. Hypertension was associated with an increased risk of bleeding-related readmission (odds ratio [OR] = 2.21; 95% confidence interval [CI] 1.68–2.92) and reoperation (OR = 2.17; 95% CI 1.44–3.27). Existing catastrophic illness increased the risk of readmission (OR = 4.28; 95% CI 3.60–5.08) for any reason and mortality (OR = 3.24; 95% CI 1.37–7.65). Nonsteroidal anti-inflammatory drugs and steroids were associated with an increased risk of readmission or reoperation for bleeding.

Conclusion

Incidence rates of inpatient adult tonsillectomy increased during 1997–2012 in Taiwan. Age, gender, comorbidity, and drug administration characteristics were associated with major complications of adult tonsillectomies in this cohort.

https://ift.tt/2RAy315

Characterization of the biomechanical properties of canine trachea using a customized 3D-printed apparatus

Publication date: Available online 2 November 2018

Source: Auris Nasus Larynx

Author(s): Jennifer Sang-jee Lee, Jonghyun Park, Dong-A Shin, Yoon-jong Ryu, Hee Chan Kim, Jung Chan Lee, Seong Keun Kwon

Abstract

Objectives

The canine trachea is considered to be an excellent preclinical model for tracheal research due to its similar mechanical and dimensional characteristics to the human trachea. However, normative biomechanical properties have yet to be defined and it is one of the main reasons tracheal reconstruction has not succeeded in animal models at large scale. Variation and inaccurate measurement due to a lack of proper apparatus for mechanical tests further prevent determination of normative mechanical data of the trachea. The goal of this study was to overcome these shortcomings by designing the measuring apparatus using 3D-printing technology. Using this apparatus, we determined the normative biomechanical properties of the canine trachea.

Methods

Whole tracheas were obtained from thirteen mongrel dogs. Biomechanical measurements were performed to determine the radial compressive strength and tensile strength of the intact trachea, and the elastic modulus of the tracheal cartilage.

Results

Structural parameter data indicated the canine trachea to have inner-diameters similar to those of the human trachea and other widely used animal models. The compressive strength was 4.24 N while the tensile strength was 29.96 N. The elastic modulus of the cartilage portion of the trachea was 1.58 N without showing a significant difference in value based on the location of the trachea.

Conclusions

This study delineates a comprehensive and foundational characterization of the biomechanical properties of both the intact and cartilage portion of the canine trachea. The parameters were in agreement with those of the human trachea, confirming the canine trachea to be an excellent preclinical model for tracheal research.

https://ift.tt/2PAoMZA

BJORL: moving forward, always

Wilma Terezinha Anselmo‐Lima, Shirley Shizue Nagata Pignatari
Braz J Otorhinolaryngol.2018;84:673-4

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20th National Voice Campaign

Gustavo Polacow Korn, Marcos André de Sarvat
Braz J Otorhinolaryngol.2018;84:675-6

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https://ift.tt/2qpEXuv

Anatomical terminology of the internal nose and paranasal sinuses: cross‐cultural adaptation to Portuguese

Thiago Freire Pinto Bezerra, Aldo Stamm, Wilma Teresinha Anselmo‐Lima, Marco Aurélio Fornazieri, Nelson D'Ávila Melo, Leonardo Balsalobre, Geraldo Pereira Jotz, Henrique Zaquia Leão, André Alencar Araripe Nunes, Alexandre Felippu, Antonio Carlos Cedin, Carlos D. Pinheiro‐Neto, Diego Lima Oliveira, Eulalia Sakano, Eduardo Macoto Kosugi, Elizabeth Araújo, Fabiana Cardoso Pereira Valera, Fábio de Rezende Pinna, Fabrizio Ricci Romano, Francine Grecco de Melo Pádua, Henrique Faria Ramos, João Telles Jr., Leonardo Conrado Barbosa de Sá, Leopoldo Marques D'Assunção Filho, Luiz Ubirajara Sennes, Luis Carlos Gregório, Marcelo H. Sampaio, Marco César Jorge dos Santos, Marco Franca, Marcos Mocellin, Marcus Miranda Lessa, Melissa Ameloti G. Avelino, Miguel Tepedino, Nilvano Alves de Andrade, Otavio B. Piltcher, Renato Roithmann, Renata Mendonça Pilan, Roberto Campos Meireles, Roberto Eustáquio Guimarães, Rodrigo de Paula Santos, Rogério Pezato, Shirley Pignatari, Tatiana Telles Abdo, Victor Nakajima, Washington Almeida, Richard L. Voegels
Braz J Otorhinolaryngol.2018;84:677-86

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Incidence of bifid uvula and its relationship to submucous cleft palate and a family history of oral cleft in the Brazilian population

Sizina Aguiar G. Sales, Maria Luiza Santos, Renato Assis Machado, Verônica Oliveira Dias, Jairo Evangelista Nascimento, Mario Sérgio Oliveira Swerts, Hercílio Martelli Júnior, Daniella Reis Barbosa Martelli
Braz J Otorhinolaryngol.2018;84:687-90

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Clinicopathologic factors associated with recurrence in parotid carcinoma

Dong Hoon Lee, Tae Mi Yoon, Joon Kyoo Lee, Sang Chul Lim
Braz J Otorhinolaryngol.2018;84:691-6

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Buccinator myomucosal flap for the treatment of velopharyngeal insufficiency in patients with cleft palate and/or lip

Rafael Denadai, Anelise Sabbag, Cassio Eduardo Raposo Amaral, João Carlos Pereira Filho, Mirian Hideko Nagae, Cesar Augusto Raposo Amaral
Braz J Otorhinolaryngol.2018;84:697-707

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Validation of a Portuguese version of the health‐related quality of life measure for active chronic otitis media (COMQ‐12)

Anna Carolina Oliveira Fonseca, Pedro Ramos, Fernando A. Balsalobre, Edson L. Freitas, John S. Phillips, Matthew W. Yung, Ricardo F. Bento
Braz J Otorhinolaryngol.2018;84:708-12

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Computed tomography evaluation of the morphometry and variations of the infraorbital canal relating to endoscopic surgery

Gülay Açar, Kemal Emre Özen, İbrahim Güler, Mustafa Büyükmumcu
Braz J Otorhinolaryngol.2018;84:713-21

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Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation

Ana Carolina Martins de Oliveira, Amélia Augusta de Lima Friche, Marina Silva Salomão, Graziela Chamarelli Bougo, Laélia Cristina Caseiro Vicente
Braz J Otorhinolaryngol.2018;84:722-8

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Hashimoto's thyroiditis – an independent risk factor for papillary carcinoma

Barbora Uhliarova, Andrej Hajtman
Braz J Otorhinolaryngol.2018;84:729-35

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Revision rhinoplasty: physician–patient aesthetic and functional evaluation

Heloisa Nardi Koerner Vian, Cezar Augusto Sarraff Berger, Danielle Candia Barra, Ana Paula Perin
Braz J Otorhinolaryngol.2018;84:736-43

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Behavioural and objective vestibular assessment in persons with osteoporosis and osteopenia: a preliminary investigation

Aditi Gargeshwari, Raghav Hira Jha, Niraj Kumar Singh, Prawin Kumar
Braz J Otorhinolaryngol.2018;84:744-53

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Effects of diabetes mellitus and systemic arterial hypertension on elderly patients’ hearing

Laurie Penha Rolim, Alessandra Giannella Samelli, Renata Rodrigues Moreira, Carla Gentile Matas, Itamar de Souza Santos, Isabela Martins Bensenor, Paulo Andrade Lotufo
Braz J Otorhinolaryngol.2018;84:754-63

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Neutrophil‐lymphocyte ratios in the prognostication of primary non‐metastatic nasopharyngeal carcinoma

Kong Yew Liew, Abu Bakar Zulkiflee
Braz J Otorhinolaryngol.2018;84:764-71

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Side effects of intraoral devices for OSAS treatment

Andressa Otranto de Britto Teixeira, Ana Luiza Ladeia Andrade, Rhita Cristina da Cunha Almeida, Marco Antonio de Oliveira Almeida
Braz J Otorhinolaryngol.2018;84:772-80

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Treatment of post‐intubation laryngeal granulomas: systematic review and proportional meta‐analysis

Caroline Fernandes Rimoli, Regina Helena Garcia Martins, Daniele Cristina Catâneo, Rui Imamura, Antonio José Maria Catâneo
Braz J Otorhinolaryngol.2018;84:781-9

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Solitary plasmacytoma of the jaws: therapeutical considerations and prognosis based on a case reports systematic survey

Eduardo Madruga Lombardo, Fábio Luiz Dal Moro Maito, Cláiton Heitz
Braz J Otorhinolaryngol.2018;84:790-8

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Diagnosis and comprehensive therapy for cutaneous neuroendocrine carcinoma of the external auditory canal: a case report and literature review

Qian Xiu, Xue‐Ju Wang, Dong‐Dong Zhu, Cui‐Da Meng
Braz J Otorhinolaryngol.2018;84:799-801

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Transient ischemic attack: an unusual presentation of a carotid body tumor

Mojtaba Maleki, Mahdi Safdarian, Ali Daneshvar
Braz J Otorhinolaryngol.2018;84:802-4

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The effect of adenotonsillar hypertrophy and other obstructive diseases on sleep disorders in children

Fatma Caylakli
Braz J Otorhinolaryngol.2018;84:805

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Insulin-like growth factor-1 engaged in the mandibular condylar cartilage degeneration induced by experimental unilateral anterior crossbite

Publication date: Available online 3 November 2018

Source: Archives of Oral Biology

Author(s): Dongmei Wang, Hongxu Yang, Mian Zhang, Hongyun Zhang, Lei Lu, Jing Zhang, Xianghong Wan, Meiqing Wang

ABSTRACT

Objective

To investigate the changes in insulin-like growth factor-1 (IGF-1) expression levels in the degenerative mandibular condylar cartilage.

Design

Thirty-six rats were divided into the unilateral anterior crossbite and control groups. The expression levels of IGF-1; IGF-1 receptor (IGF-1R); IGF-binding protein-3 and -5 (IGFBP-3 and -5); proliferating cell nuclear antigen (PCNA); aggrecan; type-I, -II, -VI, and -X collagen; tissue inhibitor of metalloproteinases-1 and -3 (TIMP-1 and -3); metalloproteinases of matrix metalloproteinases-3 and-13 (MMP-3 and -13); a disintegrin and metalloproteinase thrombospondin-4 and -5 (ADAMTS-4 and -5); alkaline phosphatase (ALP); β-glucuronidase; and N-acetyl-β-glucosaminidase in the mandibular condylar cartilage were assessed.

Results

The protein expression levels of IGF-1and IGF-1R were increased from week 4 in the unilateral anterior crossbite group. The mRNA expression level of IGFBP-3 and -5 was upregulated from week 4 and week 2, respectively; that of IGFBP-3 was downregulated at week 8; and that of PCNA, type-II collagen, type-X collagen, aggrecan, TIMP-1, and TIMP-3 was downregulated, whereas that of MMP-3, MMP-13, ADAMTS-4, ADAMTS-5, β-glucuronidase, and N-acetyl-β-glucosaminidase were upregulated from week 2. The positive area size of type-I collagen was increased and that of type VI collagen was decreased from week 2. The positive area size of type X collagen was increased at week 2 but decreased at week 8. The percentage of ALP-positive cells was increased from week 4.

Conclusions

Unilateral anterior crossbite stimulated the multifarious expression of IGF-1 and IGFBP, which may be linked to chondrocyte proliferation and differentiation in the mandibular condylar cartilage that showed progressive degeneration.

https://ift.tt/2zr3OC7

IL-1ß rs1143634 and rs16944 polymorphisms in patients with periodontal disease

Publication date: Available online 3 November 2018

Source: Archives of Oral Biology

Author(s): Małgorzata Mazurek-Mochol, Elżbieta Dembowska, Damian Malinowski, Krzysztof Safranow, Andrzej Pawlik

Abstract

Background

Periodontal disease (PD) is a chronic inflammatory condition caused by pathogenic microflora in a biofilm, often leading to tooth loss. The inflammatory response of periodontal tissues to infection is influenced by both environmental and genetic factors. The interleukin (IL)-1 family of proinflammatory cytokines plays a role in the tissue destruction associated with PD due to their proinflammatory and bone-resorptive properties. In addition, recent studies have indicated that polymorphisms in the genes encoding IL-1 might be associated with greater PD severity. In this study, we examined the association between IL-1ß rs1143634 and rs16944 polymorphisms and PD in non-smoking and smoking patients.

Materials and methods

This study included 200 patients with PD (130 non-smokers and 70 smokers) and 156 control subjects (124 non-smokers and 32 smokers). Periodontal evaluation included approximal plaque index, modified sulcus bleeding index, probing pocket depth and clinical attachment loss.

Genotyping was utilized for all samples by using allelic discrimination assays with TaqMan® probes on a 7500Fast Real-Time PCR Detection System.

Results

There were no statistically significant differences in the distribution of rs1143634 and rs16944 genotypes and alleles between patients with PD and control subjects, between smoking patients with PD and smoking controls, or between non-smoking patients with PD and non-smoking controls.

Conclusions

The results of this study suggest there is no association between IL-1ß rs1143634 and rs16944 polymorphisms and PD.

https://ift.tt/2SIuves

Deregulated phospholipase D2/mammalian target of rapamycin/hypoxia-inducible factor 1 alpha in peripheral T lymphocytes of oral lichen planus correlated with disease severity

Publication date: Available online 3 November 2018

Source: Archives of Oral Biology

Author(s): Fang Wang, Jing Zhang, Gang Zhou

Abstract

Objective

Oral lichen planus (OLP) is a common T lymphocyte-mediated autoimmune disease of unknown etiology. The mammalian target of rapamycin (mTOR) can regulate proliferation, apoptosis, and autophagy of T lymphocytes, therefore impacting the T lymphocyte-mediated immunity. The present study was aimed to investigate the possible association between Akt/mTOR/4E-BP1 (eIF4E-binding protein 1) signaling, phospholipase D (PLD) and hypoxia-inducible factor 1 alpha (Hif-1α) in peripheral T lymphocytes of OLP and the correlation of their expression with the disease severity.

Design

RAE (reticular, atrophic and erosive lesion) scores were used to assess the disease severity of OLP. Akt, mTOR, 4E-BP1, PLD1, PLD2 and Hif-1α expression in peripheral T lymphocytes were measured by using quantitative real-time polymerase chain reaction. Associations of Akt/mTOR/4E-BP1 expression with PLD1, PLD2 and Hif-1α expression were also assessed, respectively. Moreover, correlations of their expression with RAE scores were analyzed.

Results

Expressions of mTOR, 4E-BP1, PLD2 and Hif-1α mRNA were significantly reduced in peripheral T lymphocytes of OLP patients, especially in erosive form. mTOR expression was positively correlated with PLD2 and Hif-1α expression in OLP. Moreover, mTOR, PLD2 and Hif-1α expression were negatively correlated with RAE scores, respectively.

Conclusions

Deregulated PLD2/mTOR/Hif-1α may contribute to the development of OLP and reflect the severity of the disease.

https://ift.tt/2zu9vPE

Blockade of peripheral endothelin receptors abolishes heat hyperalgesia and spontaneous nociceptive behavior in a rat model of facial cancer

Publication date: Available online 2 November 2018

Source: Archives of Oral Biology

Author(s): Caroline Machado Kopruszinski, Renata Cristiane dos Reis, Giles Alexander Rae, Juliana Geremias Chichorro

Abstract

Objective

To improve understanding of the pathophysiology of cancer-induced facial nociception, by evaluating the contribution of peripheral endothelin receptors in tumor-induced facial heat hyperalgesia, increased spontaneous grooming, as well as ongoing nociception in a rat model of facial cancer.

Design

The study was conducted using 396 rats. Facial cancer was induced by inoculating a suspension of Walker-256 cells into the rats' right vibrissal pad. Facial heat hyperalgesia and spontaneous grooming were assessed on day 6, while the conditioned place preference (CPP) test was performed on days 3 to 6 after tumor cells inoculation. Rats received local injections of the non-peptidic dual ET_A/ET_B endothelin receptors antagonist, bosentan (10 and 30 µg/50 µL), single or combined injections of peptidic ET_A and ET_B endothelin receptors antagonists (BQ-123 and BQ-788, at 20 ug/50 µL, each), or of lidocaine (1 mg/50 µl) and morphine (30 µg/50 µL).

Results

Bosentan, lidocaine and morphine local treatment all attenuated tumor-induced heat hyperalgesia (p < 0.05) and spontaneous facial grooming (p < 0.05). However, BQ-123 and BQ-788 did not modify tumor-induced heat hyperalgesia or the spontaneous facial grooming (p > 0.05). Whether this difference in effectiveness is due to receptor affinity or to pharmacokinetic factors still needs to be explored. Local injection of bosentan, lidocaine or morphine failed to control ongoing nociception, as evidenced by the absence of CPP in tumor-bearing rats (p > 0.05).

Conclusion

Endothelins, acting through peripheral ET_A and ET_B receptors, may play a significant role on the development of heat hyperalgesia and increased spontaneous grooming associated to facial cancer in rats.

https://ift.tt/2SBA0vv

Liver-type of tissue non-specific alkaline phosphatase is induced during mouse bone and tooth cell differentiation

Publication date: Available online 2 November 2018

Source: Archives of Oral Biology

Author(s): Tomomi T. Baba, Tatsuo Terashima, Shinichiro Oida

Abstract

Background and objective

Tissue non-specific alkaline phosphatase (TNSALP) contains two types—bone- and liver-type—which are produced from the same gene due to differences in splicing. These two differ in their promoter, but the amino acid sequences of the mature proteins are identical. In this study, we examined the relationship between the two types of TNSALP expression and osteoblast differentiation.

Design

Gene expression of the two types of TNSALP was observed by reverse transcription-polymerase chain reaction. MC3T3-NM4 was sub-cloned from an established mouse osteoblastic cell line in which osteoblast characters do not appear without dexamethasone. The C2C12 mouse myoblastic cell line, which can be induced to osteoblasts with bone morphogenic protein2, and organ-cultured tooth germs were also used in this work.

Results

The gene expression of liver-type TNSALP was observed in only MC3T3-NM4 activated by dexamethasone. For C2C12, the gene expression of bone-type TNSALP was observed even in non-induced conditions where myotubes were formed, whereas the liver-type TNSALP mRNA was only expressed when C2C12 differentiated into osteoblasts by bone morphogenic protein 2. Furthermore, in the organ-cultured tooth germs, the liver-type TNSALP mRNA was expressed according to differentiation of tooth germs.

Conclusion

These results suggest that the liver-type TNSALP mRNA is induced according to differentiation of bone and tooth.

https://ift.tt/2zpAbRD

TiF4 and NaF varnishes induce low levels of apoptosis in murine and human fibroblasts through mitochondrial Bcl-2 family and death receptor signalling

Publication date: Available online 2 November 2018

Source: Archives of Oral Biology

Author(s): Priscila Maria Aranda Salomão, Flávia Amadeu de Oliveira, Daiana Moreli Soares dos Santos, João Paulo Domezi, Thiago José Dionísio, Rodrigo Cardoso de Oliveira, Ana Carolina Magalhães

Abstract

Objectives

This study evaluated the level and mechanism of apoptosis in human gingival fibroblasts (HGF) and murine fibroblasts (NIH/3T3) treated with a titanium tetrafluoride (TiF₄) varnish compared those treated with a sodium fluoride (NaF) varnish.

Methods

Cells were treated with a TiF₄, NaF (both 2.45%F) or placebo varnish for 6 h and were then examined using the TUNEL method. The activities of caspase-3, -8 and -9 were assessed. cDNA for Bax, Bad, Bcl-2 and Fas-L was amplified by quantitative PCR. Bax, Bcl-2 and Fas-L were further detected by western blot analysis.

Results

Both fluorides similarly increased the percentage of apoptosis, while they failed to activate caspases. The Bax/Bcl-2 gene expression ratio was not altered by either fluoride treatment regardless of the type of cell. NaF varnish increased the amplification of the Fas-L gene in NIH/3T3 and HGF cells, while treatment with the TiF₄ varnish resulted in a lower Bad/Bcl-2 expression ratio compared to that of the control for NIH/3T3 cells, but not for HGF cells. No effect of the fluorides was detected in the protein analysis.

Conclusions

NaF and TiF₄, at the studied conditions, similarly induce a low level of apoptosis, with consequent modest activation of the Bcl-2 and Fas-L-dependent signalling pathways. Generally, HGF cells are more susceptible to the fluoride effect than NIH/3T3 cells.

https://ift.tt/2SNm9lU

Activity of Quercetin and Kaemferol against Streptococcus mutans Biofilm

Publication date: Available online 2 November 2018

Source: Archives of Oral Biology

Author(s): Yan Zeng, Anna Nikikova, Hossam Abdelsalam, Jiyao Li, Jin Xiao

Abstract

Objective

Nidus Vespae (NV) is the honeycomb of Polistes Olivaceous, P. Japonicus Saussure, and Parapolybiavaria Fabricius. Previously, we have shown the extract and chemical fractions from NV demonstrated remarkable capacities of inhibiting the acid production of oral bacteria at sub-minimum inhibitory concentration (MIC) concentrations. In searching the most potent anti-caries compounds in NV, we further separated the NV Chl/MeOH fraction and obtained two purified compounds: quercetin and kaemferol. The objective of this study was to assess the effectiveness of quercetin and kaemferol against S. mutans biofilm formation.

Methods

The MIC, minimum biofilm inhibition concentration (MBIC₅₀) and minimum biofilm reduction concentration (MBRC₅₀) against Streptococcus mutans were examined for NV-derived of quercetin and kaemferol. The effectiveness of inhibiting S. mutans biofilm formation was further examined using in vitro biofilm model.

Results

Both quercetin and kaemferol compounds demonstrated anti-biofilm activities when compared to the negative control. They are capable of reducing biofilm dry-weight, total protein, viable cells measured by colony forming unit (CFU), insoluble and soluble glucans formation. The in situ culture pH was less acidic when the biofilms were treated by quercetin and kaemferol. The quercetin and kaemferol demonstrated comparable capability of S. mutans killing in biofilms, compared to chlorhexidine.

Conclusions

The results of this study showed inhibitory activity of quercetin and kaemferol against S. mutans biofilms, suggesting that quercetin and kaemferol might be considered as alternative anti-caries agents in searching novel anti-caries therapeutics.

https://ift.tt/2zpA4pb

Hyperoxia reduces salivary secretion by inducing oxidative stress in mice

Publication date: Available online 2 November 2018

Source: Archives of Oral Biology

Author(s): Ayako Tajiri, Hitoshi Higuchi, Takuya Miyawaki

Abstract

Objective

The aim of this study was to determine the effects of prolonged hyperoxia on salivary glands and salivary secretion in mice.

Design

Male C57BL/6 J mice were kept in a 75% oxygen chamber (hyperoxia group) or a 21% oxygen chamber for 5 days. We measured the secretion volume, protein concentration, and amylase activity of saliva after the injection of pilocarpine. In addition, we evaluated the histological changes induced in the submandibular glands using hematoxylin and eosin and Alcian blue staining and assessed apoptotic changes using the TdT-mediated dUTP nick end labeling (TUNEL) assay. We also compared the submandibular gland expression levels of heme oxygenase-1 (HO-1), superoxide dismutase (SOD)-1, and SOD-2 using the real-time polymerase chain reaction.

Results

In the hyperoxia group, salivary secretion was significantly inhibited at 5 and 10 minutes after the injection of pilocarpine, and the total salivary secretion volume was significantly decreased. The salivary protein concentration and amylase activity were also significantly higher in the hyperoxia group. In the histological examinations, enlargement of the mucous acini and the accumulation of mucins were observed in the submandibular region in the hyperoxia group, and the number of TUNEL-positive cells was also significantly increased in the hyperoxia group. Moreover, the expression levels of HO-1, SOD-1, and SOD-2 were significantly higher in the hyperoxia group.

Conclusion

Our results suggest that hyperoxia reduces salivary secretion, and oxidative stress reactions might be involved in this.

https://ift.tt/2SIomPh

Scoping Review on Use of Drugs Targeting Interleukin 1 Pathway in DIRA and DITRA

Abstract

Introduction

Deficiencies in interleukin (IL)-1 receptor (IL-R) antagonist (DIRA) and IL-36R antagonist (DITRA) are rare genetic autoinflammatory diseases related to alterations in antagonists of the IL-1 pathway. IL-1 antagonists may represent therapeutic alternatives. Here, we aim to provide a scoping review of knowledge on use of IL-1-targeting drugs in DIRA and DITRA.

Methods

An a priori protocol was published, and the study was conducted using the methodology described in the Joanna Briggs Institute Reviewer's Manual and the recently published PRISMA Extension for Scoping Review statement. A three-step search using MEDLINE and EMBASE databases until March 2018 with additional hand searching was performed. Data charting was performed. The search, article selection, and data extraction were carried out by two researchers independently.

Results

Twenty-four studies on use of anti-IL-1 drugs were included [15 studies including patients with diagnosis of DIRA (n = 19) and 9 studies including patients with diagnosis of DITRA (n = 9)]. Most studies followed a multicenter observational design. Among all patients who received treatment with anti-IL-1 drugs, nine and four mutations in IL1RN and IL36RN were found, respectively. Patients with DIRA were treated with anakinra (n = 17), canakinumab (n = 2), or rinolacept (n = 6). All patients with DITRA were treated with anakinra, and only one case was also treated with canakinumab. Time-to-response frequencies were evaluated as immediate, short, and medium–long term for DIRA (17/17, 15/17, and 9/10, respectively) and DITRA (7/9, 3/9, and 2/9, respectively). Most DITRA patients in whom anti-IL-1 treatment failed experienced good response to anti-tumor necrosis factor alpha or anti-IL-12/23 drugs. The safety profiles of treatments were similar in both diseases.

Conclusions

Evidence on use of anti-IL-1 drugs in DIRA and DITRA is scarce and based on observational studies. Larger studies with better methodological quality are needed to increase confidence in use of these drugs in patients with DIRA and DITRA.

https://ift.tt/2SG20Om

Unassisted percutaneous tracheostomy: A new flow chart decision making based on simple physical conditions

Publication date: Available online 2 November 2018

Source: American Journal of Otolaryngology

Author(s): Nicolás Avalos, Rodrigo Cataldo, Luis Contreras

Abstract

Introduction

Percutaneous dilatation tracheostomy (PDT) has several advantages over traditional surgical tracheostomy. However, it is still performed using bronchoscopy guidance.

Objective

To suggest the safety of unassisted PDT, without bronchoscopy guidance, based on bed–side screening flow chart evaluation.

Material and methods

180 consecutive UCI patients referred to tracheostomy were submitted to Avalo's Screening Chart (ASC), in order to decide surgical technique.

Results

161 patients were referred to unassisted PDT (un PDT) and 19 to surgical tracheostomy (ST) due to nonfulfillment of ASC steps. 10 patients submitted to unassisted PDT presented early complications, 8 presented mild bleeding and 2 false tracts. None of 6 months follow up patients presented long term complications.

Conclusion

The authors suggest unPDT is a safety surgical method in UCI patients who were submitted and approved to an easy anatomical and clinical screening chart (ASC).

https://ift.tt/2P40LKV

School-based Interventions – Where Do We Go From Here?

Publication date: Available online 3 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jean-Marie Bruzzese, Meyer Kattan

https://ift.tt/2P5uzGV

IgE to galactose-α-1,3-galactose and the α-Gal syndrome: Insights from Basophil Activation Testing

Publication date: Available online 3 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jeffrey M. Wilson, Thomas A.E. Platts-Mills

https://ift.tt/2D14wJX

2B4 dysfunction in XLP1 NK cells: More than inability to control EBV infection

Publication date: Available online 2 November 2018

Source: Clinical Immunology

Author(s): Daniela Pende, Raffaella Meazza, Stefania Marcenaro, Maurizio Aricò, Cristina Bottino

Abstract

X-linked lymphoproliferative disease 1 (XLP1) is a monogenic disorder caused by mutations in SH2D1A, resulting in the absence/dysfunction of the signaling lymphocyte activation molecule (SLAM)-associated protein (SAP). Consequently, SLAM receptors as 2B4 (CD244) and NTB-A (SLAMF6), upon ligand engagement, exert inhibitory instead of activating function. This causes an immune dysfunction that is worsened by the selective inability of NK and T cells to kill EBV-infected B cells with dramatic clinical sequelae (e.g. fulminant mononucleosis, hyperinflammation, lymphoma). Here we outline recent findings on the interplay between inhibitory 2B4 and the various activating receptors in NK cells. 2B4 engagement selectively blocks ITAM-dependent activating receptors as NCR and CD16, while it does not affect NKG2D and DNAM-1. Furthermore, inhibitory 2B4 participates to NK cell education, as highlighted by the existence in XLP1 patients of a large subset of fully functional NK cells that lack self-HLA specific inhibitory receptors and exert autoreactivity against mature dendritic cells.

https://ift.tt/2JEJT7G

A Markov Multi-State model of lupus nephritis urine biomarker panel dynamics in children: Predicting changes in disease activity

Publication date: Available online 2 November 2018

Source: Clinical Immunology

Author(s): E.M.D. Smith, A. Eleuteri, B. Goilav, L. Lewandowski, A. Phuti, T. Rubinstein, D. Wahezi, C.A. Jones, S.D. Marks, R. Corkhill, C. Pilkington, K. Tullus, C. Putterman, C. Scott, A.C. Fisher, M.W. Beresford

Abstract

Background

A urine 'biomarker panel' comprising alpha-1-acid-glycoprotein, ceruloplasmin, transferrin and lipocalin-like-prostaglandin-D synthase performs to an 'excellent' level for lupus nephritis identification in children cross-sectionally. The aim of this study was to assess if this biomarker panel predicts lupus nephritis flare/remission longitudinally.

Methods

The novel urinary biomarker panel was quantified by enzyme linked immunoabsorbant assay in participants of the United Kingdom Juvenile Systemic Lupus Erythematosus (UK JSLE) Cohort Study, the Einstein Lupus Cohort, and the South African Paediatric Lupus Cohort. Monocyte chemoattractant protein-1 and vascular cell adhesion molecule-1 were also quantified in view of evidence from other longitudinal studies. Serial urine samples were collected during routine care with detailed clinical and demographic data. A Markov Multi-State model of state transitions was fitted, with predictive clinical/biomarker factors assessed by a corrected Akaike Information Criterion (AICc) score (the better the model, the lower the AICc score).

Results

The study included 184 longitudinal observations from 80 patients. The homogeneous multi-state Markov model of lupus nephritis activity AICc score was 147.85. Alpha-1-acid-glycoprotein and ceruloplasmin were identified to be the best predictive factors, reducing the AICc score to 139.81 and 141.40 respectively. Ceruloplasmin was associated with the active-to-inactive transition (hazard ratio 0.60 (95% confidence interval [0.39, 0.93])), and alpha-1-acid-glycoprotein with the inactive-to-active transition (hazard ratio 1.49 (95% confidence interval [1.10, 2.02])). Inputting individual alpha-1-acid-glycoprotein/ceruloplasmin values provides 3, 6 and 12 months probabilities of state transition.

Conclusions

Alpha-1-acid-glycoprotein was predictive of active lupus nephritis flare, whereas ceruloplasmin was predictive of remission. The Markov state-space model warrants testing in a prospective clinical trial of lupus nephritis biomarker led monitoring.

https://ift.tt/2Diq3yH

Delayed presentation of pulmonary artery perforation by an Amulet left atrial appendage closure device

Left atrial appendage occlusion (LAAO) devices offer stroke prevention in atrial fibrillation for patients intolerant of anticoagulation. Device placement leading to bleeding and cardiac tamponade have been reported periprocedurally but delayed presentations have not been reported in the literature. We present the case of an Amulet LAAO device causing erosion and bleeding from the main pulmonary artery that presented with cardiac tamponade 6 months after device placement. The pulmonary artery defect was repaired primarily and buttressed with a pericardial patch with good result.

https://ift.tt/2AJGD8c

Squamous cell carcinoma of male urethra presenting as urethrocutaneous fistula

Description 

A 65-year-old man was referred with non-healing wound in the perineum and passage of urine from wound for last 3 months. He initially presented with voiding lower urinary tract symptoms (LUTS) and perineoscrotal swelling to a local practitioner 3 months ago. The discharge card given to the patient mentioned that he underwent incision and drainage of the swelling under anaesthesia with suprapubic catheter placement. He also revealed history of two sessions of endoscopic dilatation performed 1 year ago. On local examination, there was normal external urethral meatus, presence of partially healed wound in the hemiscrotum with a hard indurated round partially healed wound at penoscrotal junction (figure 1). The inguinal lymph nodes were palpable and enlarged. History including local trauma, sexually transmitted diseases were unremarkable. His routine blood/urine examination was unremarkable. Further evaluation with retrograde urethrogram/micturating cystourethrogram showed evidence of urethrocutaneous fistula in the region of penobulbar urethra (figure 2). After proper...

https://ift.tt/2F1MBFu

Leptomeningeal metastases of a well-differentiated neuroendocrine tumour: a rare entity

A 73-year-old man, without any medical history, had presented with dark urine and pale stool without pain. Diagnostic imaging revealed a tumour in the pancreas with liver metastases. Histopathological examination showed a well-differentiated pancreatic neuroendocrine tumour. After a stable 2.5 years on everolimus, progression of the liver metastases was seen and a switch was made to chemotherapy. Three months later, he developed progressive spinal neurological symptoms. MRI of the spine and brain revealed leptomeningeal contrast-enhancing lesions. Cytopathological examination of the cerebrospinal fluid showed malignant epithelial cells compatible with well-differentiated neuroendocrine tumour. Epithelial cell-adhesion molecule-based flow cytometry of the cerebrospinal fluid confirmed the presence of epithelial tumour cells. Based on these results, the diagnosis of leptomeningeal metastases of an originally well-differentiated neuroendocrine tumour of the pancreas was made.

https://ift.tt/2AJV1Nu

Laparoscopic IPOM repair of an acquired abdominal intercostal hernia

Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk. Recently, laparoscopic and robot-assisted repairs have been proposed. We discuss a 49-year-old man presented through outpatient setting with a 5-year history of ongoing left subcostal discomfort and a reducible lump. His history included a workplace accident 5 years ago. Contrast-enhanced abdominal CT confirmed AAIH with omentum herniation into the sac. A successful laparoscopic repair with intraperitoneal onlay mesh technique using composite mesh was performed.

https://ift.tt/2F2wjMG

Neurocysticercosis: do not miss the eye

Description 

A 6-year-old girl presented with new-onset left focal seizures, and was started on valproate. There was no history of fever, headache, visual deficit and neurological examination was completely normal. Neuroimaging revealed ring enhancing lesion in the right parietal lobe. Ocular examination revealed visual acuity of 6/6 in both eyes, with no evidence of uveitis or other abnormality of the anterior segment. Fundus examination revealed hypopigmented area in left retina midway between fovea and optic disc. Optical coherence tomography (OCT) using Spectralis HRA-OCT revealed presence of scolex beneath the retinal pigment epithelium (figure 1A). A Child was started on oral prednisolone and albendazole, and a 28-day course was completed. Repeat OCT revealed resolution of the scolex (figure 1B) and neuroimaging showed disappearance of the ring-enhancing lesion.

Figure 1

(A) Optical coherence tomography showing scolex beneath the retinal pigment epithelium (B) Optical coherence tomography showing resolution of scolex...

https://ift.tt/2AJGxxm

Adenobronchial fistula secondary to tuberculosis in an immunocompetent adult patient

Description 

A 72-year-old patient, retired miner, with no history of interest, which comes for an irritative cough with dark expectoration of 9 months of evolution. On physical examination, the patient was haemodynamically stable, afebrile and without notable alterations. No alterations were observed in the blood analysis and chest X-ray. A sputum microbiological study was performed observing resistant alcohol-acid bacilli, with positive Xpert Mycobacterium tuberculosis (MTB)/Rifampicin (RIF) study and culture of mycobacteria with MTB isolate sensitive to all first-line drugs. A chest CT scan showed calcified mediastinal and bilateral hilar adenopathies, a bilateral micronodular interstitial pattern suggestive of pneumoconiosis and an increase in pseudonodular density with a bronchogram on right interior lobe (RIL) suggestive of an infectious process. An air cavity of subcarinal localisation with fistulisation to both main bronchi is observed in relation to adenopathy with necrosis (figure 1A). A bronchoscopy was performed in which a fistulous orifice with thick...

https://ift.tt/2F1iGgI

Interest of video-otoscopy for the general practitioner

Publication date: Available online 2 November 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): L. Damery, E. Lescanne, K. Reffet, C. Aussedat, D. Bakhos

Abstract

Introduction

General practitioners (GPs) play an essential role in the management of ear disease, but their diagnosis of pathologic eardrums is inadequate. The aim of this study was to compare the quality of otoscopic diagnosis by GPs using a conventional otoscope versus a video-otoscope.

Subjects and method Eleven GPs included 124 patients with ear complaints (193 otoscopies). Examination successively used conventional otoscopy and video-otoscopy. After each type of examination, a 10-criterion assessment questionnaire was filled out and a diagnosis was proposed. Two blinded ENT specialists reviewed the video-otoscopy images and filled out the same grid questionnaire to make their diagnosis. GPs also completed a Likert-scale satisfaction questionnaire on video-otoscopy.

Results

There were no significant differences in overall examination results between the three groups (GP conventional otoscopy, GP video-otoscopy and ENT specialist). However, focusing exclusively on pathologic eardrums, there was a significant difference in results between ENT specialists and GPs using a conventional otoscope (P = 0.0032); this was not the case when GPs used video-otoscopy (P = 0.0754). All GPs expressed enthusiastic interest in video-otoscopy, even when not convinced to make the purchase.

Conclusion

Video-otoscopy showed superiority over conventional otoscopy in assessing pathological eardrums.

https://ift.tt/2JBEn5o

Endoscopic evaluation of middle ear anatomic variations in autopsy series: analyses of 204 ears

Publication date: Available online 3 November 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Bayram Şahin, Kadir Serkan Orhan, Hızır Asliyüksek, Erdoğan Kara, Yalçın Büyük, Yahya Güldiken, Bayram Şahin

Abstract

Introduction

Microsurgery of the ear requires complete evaluation of middle ear surgical anatomy, especially the posterior tympanic cavity anatomy. Preoperative assessment of the middle ear cavity is limited by the permeability of eardrum and temporal bone density. Therefore, middle ear exploration is an extremely useful method to identify structural abnormalities and anatomical variations.

Objective

The aim of this study is to determine anatomic variations of the middle ear in an autopsy series.

Methods

All evaluations were performed in the Forensic Medicine Institute Morgue Department. The cases over 18 years of age, with no temporal bone trauma and history of otologic surgery included in this study.

Results

One hundred and two cadavers were included in the study. The mean age was 49.08 ± 17.76 years. Anterior wall prominence of the external auditory canal was present in 27 of all corpses (26.4%). The tympanic membrane was normal in 192 ears (94%) while several eardrum pathologies were detected in 12 ears (6%). Agenesis of the pyramidal eminence and stapedial tendon was found in 3 ears. While the ponticulus was bony ridge-shaped in 156 of 204 ears (76.4%), it was bridge-shaped in 25 ears (12.3%). The ponticulus was absent in 23 ears (11.3%). While complete subiculum was present in 136 of all ears (66.7%), incomplete subiculum was present in 21 ears (10.3%). Subiculum was absent in 47 ears (23%). Facial dehiscence was found in 32 ears and the round window niche was covered by a pseudomembrane in 85 ears (41.6%). A fixed footplate was present in 7.4% of all ears, and no persistent stapedial artery was seen in any cases.

Conclusion

The pseudomembrane frequency covering the round window niche was found different from reports in the literature. In addition, the frequency of the external auditory canal wall prominence has been reported for the first time.

Resumo

Introdução

A otomicrocirurgia requer avaliação completa da anatomia cirúrgica orelha média, especialmente da anatomia da cavidade timpânica posterior. A avaliação pré-operatória da cavidade timpânica é limitada pela permeabilidade do tímpano e densidade do osso temporal. Portanto, a exploração da orelha média é um método extremamente útil para identificar anormalidades estruturais e variações anatômicas.

Objetivo

O objetivo deste estudo é determinar as variações anatômicas da orelha média em uma série de autópsias.

Método

Todas as avaliações foram realizadas no necrotério do instituto médico-legal. Os casos com mais de 18 anos, sem trauma do osso temporal e história de cirurgia otológica foram incluídos neste estudo.

Resultados

Cento e dois cadáveres foram incluídos no estudo. A média de idade foi de 49,08 ± 17,76 anos. A proeminência da parede anterior do conduto auditivo externo estava presente em 27 de todos os cadáveres (26,4%). A membrana timpânica era normal em 192 orelhas (94%), enquanto várias alterações do tímpano foram detectadas em 12 orelhas (6%). Agenesia da eminência piramidal e do tendão do estapédio foi encontrada em 3 orelhas. Enquanto o pontículo tinha formato de crista óssea em 156 das 204 orelhas (76,4%), tinha o formato de ponte em 25 orelhas (12,3%). O pontículo estava ausente em 23 orelhas (11,3%). Enquanto o subículo completo estava presente em 136 de todas as orelhas (66,7%), encontrava-se incompleto em 21 orelhas (10,3%). O subículo estava ausente em 47 orelhas (23%). Deiscência facial foi encontrada em 32 orelhas e o nicho da janela redonda estava coberto por uma pseudomembrana em 85 orelhas (41,6%). A platina fixa foi observada em 7,4% de todas as orelhas, e a artéria estapediana persistente não foi vista em nenhum dos casos.

Conclusão

A frequência da pseudomembrana que cobre o nicho da janela redonda foi diferente daquela encontrada na literatura. Além disso, a frequência da proeminência da parede do canal auditivo externo foi relatada pela primeira vez.

https://ift.tt/2ztPclo

Death related to Cedecea lapagei in a soft tissue bullae infection: a case report

Cedecea lapagei bacterium was discovered in 1977 but was not known to be pathogenic to humans until 2006. In the medical literature there are very few clinical case reports of Cedecea lapagei; none have reported ...

https://ift.tt/2DmMhPO

Modeling creative abduction Bayesian style

Abstract

Schurz (Synthese 164:201–234, 2008) proposed a justification of creative abduction on the basis of the Reichenbachian principle of the common cause. In this paper we take up the idea of combining creative abduction with causal principles and model instances of successful creative abduction within a Bayes net framework. We identify necessary conditions for such inferences and investigate their unificatory power. We also sketch several interesting applications of modeling creative abduction Bayesian style. In particular, we discuss use-novel predictions, confirmation, and the problem of underdetermination in the context of abductive inferences.

https://ift.tt/2QgIbM9

Will precision medicine be available for all patients in the near future?

Purpose of review Evidence-based medicine and guidelines directing the diagnosis and treatment of patients are changing. General recommendations are moving towards an individual focus, where technology evolution allows identification of specific patterns and where 'one size fits all' no longer has a place. Recent findings Emerging innovations on health technology include useful tools for individualizing patients' specific conditions and follow-up. There are several preventive initiatives that aim to reduce allergic disease development, but they have no generalizable and definitive results as yet. Both omics and molecular diagnosis have provided the basis for differentiating clusters of patients, both allowing prediction of severity and also indicating appropriate management. Here we discuss examples contributing to some specific conditions we are now facing. Summary Precision medicine encompasses a personalized care of the patient, the prediction of a successful treatment, the potential prevention of a disease and its progression when present and the important active participation of the patient in the planning and guidance of the approach and management. Technology and medical innovations like omics and molecular diagnosis help for discriminating specific phenotypes/endotypes and the correct individualized interventions. The great challenge for implementing precision medicine will be the possibility of providing those advances to everyone at affordable costs. Conclusion Technology and innovations in medicine are aimed to help all patients globally, providing evidence for particular conditions that need to be personally considered, involving the patient's decision while treating, predicting and preventing disease. Our aim should be to have precision medicine available everywhere at any time. Correspondence to René Maximiliano Gómez, Sarmiento 771, Salta 4400, Argentina. Tel: +54 9 387 464 5561; fax: +54 387 432 0886; e-mails: maxigom@gmail.com, mgomez@fundacionayre.org.ar Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2JB43z9

TRS score: A proposed mnemonic for airway assessment and management in patients with head and neck cancers

Head &Neck, EarlyView.


https://ift.tt/2CYfNdL

Melanotic neuroectodermal tumor of infancy of the jaw bones: Update on the factors influencing survival and recurrence

Head &Neck, EarlyView.


https://ift.tt/2Pad6xj

Surgical resection of carotid body tumors with versus without preoperative embolization: A retrospective case‐control study

Head &Neck, EarlyView.


https://ift.tt/2D2fTBp

Efficacy and safety of lower extremity nerve blocks for postoperative analgesia at free fibular flap donor sites

Head &Neck, EarlyView.


https://ift.tt/2Pad2xz

Oral and pharyngeal cancer risk associated with occupational carcinogenic substances: A systematic review

Head &Neck, EarlyView.


https://ift.tt/2CX7Gye

Compounded topical preparations in plaque psoriasis: still a place for it in 2018?

Dermatologic Therapy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2qqohTv

A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo

Holm, LL; Vukmanovic-Stejic, M; Blauenfeldt, T; Benfield, T; Andersen, P; Akbar, AN; Ruhwald, M; (2018) A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo. JOVE-Journal of Visualized Experiments (138) , Article e57554. 10.3791/57554 . Green open access

https://ift.tt/2Ryh9jz

Concept design of the LiteBIRD satellite for CMB B-mode polarization

Sekimoto, Y; Ade, P; Arnold, K; Aumont, J; Austermann, J; Baccigalupi, C; Banday, A; ... Linder, E; + view all Sekimoto, Y; Ade, P; Arnold, K; Aumont, J; Austermann, J; Baccigalupi, C; Banday, A; Banerji, R; Basak, S; Beckman, S; Bersanelli, M; Borrill, J; Boulanger, F; Brown, ML; Bucher, M; Calabrese, E; Casas, FJ; Challinor, A; Chinone, Y; Columbro, F; Cukierman, A; Curtis, D; De Bernardis, P; De Petris, M; Dobbs, M; Dotani, T; Duband, L; Duval, JM; Ducout, A; Ebisawa, K; Elleot, T; Eriksen, H; Errard, J; Flauger, R; Franceschet, C; Fuskeland, U; Ganga, K; Gao, RJ; Ghigna, T; Grain, J; Gruppuso, A; Halverson, N; Hargrave, P; Hasebe, T; Hasegawa, M; Hattori, M; Hazumi, M; Henrot-Versille, S; Hill, C; Hirota, Y; Hivon, E; Hoang, TD; Hubmayr, J; Ichiki, K; Imada, H; Ishino, H; Jaehnig, G; Kanai, H; Kashima, S; Kataoka, Y; Katayama, N; Kawasaki, T; Keskitalo, R; Kibayashi, A; Kikuchi, T; Kimura, K; Kisner, T; Kobayashi, Y; Kogiso, N; Kohri, K; Komatsu, E; Komatsu, K; Konishi, K; Krachmalnicoff, N; Kuo, LC; Kurinsky, N; Kushino, A; Lamagna, L; Lee, TA; Linder, E; - view fewer (2018) Concept design of the LiteBIRD satellite for CMB B-mode polarization. In: Lystrup, M and MacEwen, HA and Fazio, Natalie, G and Batalha, N and Siegler, N and Tong, EC, (eds.) Space Telescopes and Instrumentation 2018: Optical, Infrared, and Millimeter Wave. (pp. 106981Y). Society of Photo-Optical Instrumentation Engineers (SPIE) Green open access

https://ift.tt/2PBs8eD

A CST simulation and performance analysis for a passive façade integratable metamaterials structure

Meng, T; Savini, G; Leung, C; Zhao, G; Deng, F; (2017) A CST simulation and performance analysis for a passive façade integratable metamaterials structure. In: 2017 10th UK-Europe-China Workshop on Millimetre Waves and Terahertz Technologies (UCMMT). IEEE Green open access

https://ift.tt/2RryI4A

Out of the loop - a superconducting tunnel junction that behaves like a SQUID

Romans, E; (2018) Out of the loop - a superconducting tunnel junction that behaves like a SQUID. Superconductor Science and Technology , 31 (6) , Article 060501. 10.1088/1361-6668/aac0e6 .

https://ift.tt/2PBqslf

Low percolation threshold in highly conducting graphene nanoplatelets/glass composite coatings

Nistal, A; Garcia, E; Perez-Coll, D; Prieto, C; Belmonte, M; Osendi, M; Miranzo, P; (2018) Low percolation threshold in highly conducting graphene nanoplatelets/glass composite coatings. Carbon , 139 pp. 556-563. 10.1016/j.carbon.2018.07.030 .

https://ift.tt/2RwJYg7

4‐cyano‐2‐methoxybenzenesulfonyl chloride

Bayle, ED; Igoe, N; Fish, PV; (2018) 4‐cyano‐2‐methoxybenzenesulfonyl chloride. Organic Syntheses , 94 10.1002/0471264229.os094.15 .

https://ift.tt/2PF7eLy

The Influence of West Slope Technique on Isseian Pottery Production

Mise, M; (2018) The Influence of West Slope Technique on Isseian Pottery Production. In: 9th Scientific Meeting on Hellenistic Pottery: Proceedings Volume II. (pp. pp. 635-647). Aristotle University of Thessaloniki [and] Greece. Ministry of Culture and Sports (In press).

https://ift.tt/2Rx2Qvs

Antimalarial Lead-Optimization Studies on a 2,6-Imidazopyridine Series within a Constrained Chemical Space To Circumvent Atypical Dose-Response Curves against Multidrug Resistant Parasite Strains

Le Manach, C; Paquet, T; Wicht, K; Nchinda, AT; Brunschwig, C; Njoroge, M; Gibhard, L; ... Chibale, K; + view all Le Manach, C; Paquet, T; Wicht, K; Nchinda, AT; Brunschwig, C; Njoroge, M; Gibhard, L; Taylor, D; Lawrence, N; Wittlin, S; Eyermann, CJ; Basarab, GS; Duffy, J; Fish, PV; Street, LJ; Chibale, K; - view fewer (2018) Antimalarial Lead-Optimization Studies on a 2,6-Imidazopyridine Series within a Constrained Chemical Space To Circumvent Atypical Dose-Response Curves against Multidrug Resistant Parasite Strains. Journal of Medicinal Chemistry , 61 (20) pp. 9371-9385. 10.1021/acs.jmedchem.8b01333 .

https://ift.tt/2Py40K3

Trichain cationic lipids: the potential of their lipoplexes for gene delivery

Kudsiova, L; Mohammadi, A; Mustapa, MFM; Campbell, F; Welser, K; Vlaho, D; Story, H; ... Lawrence, MJ; + view all Kudsiova, L; Mohammadi, A; Mustapa, MFM; Campbell, F; Welser, K; Vlaho, D; Story, H; Barlow, DJ; Tabor, AB; Hailes, HC; Lawrence, MJ; - view fewer (2018) Trichain cationic lipids: the potential of their lipoplexes for gene delivery. Biomaterials Science 10.1039/c8bm00965a . (In press).

https://ift.tt/2Rv5l1q

Exploring the affective dimension of teachers' work in alternative school settings

te Riele, K; Mills, M; McGregor, G; Baroutsis, A; (2017) Exploring the affective dimension of teachers' work in alternative school settings. Teaching Education , 28 (1) pp. 56-71. 10.1080/10476210.2016.1238064 . Green open access

https://ift.tt/2PGH3UQ

Des névroses à une nouvelle cure des âmes: C. G. Jung et la refonte du patient thérapeutique

Shamdasani, S; (2017) Des névroses à une nouvelle cure des âmes: C. G. Jung et la refonte du patient thérapeutique. Cahiers Jungiens de Psychanalyse , 146 pp. 7-29. 10.3917/cjung.146.0007 .

https://ift.tt/2RvpHrj

GIS-based analysis of the relationship between outdoor and indoor air temperature in the Taiwan metropolitan area

Hsu, S; Hamilton, I; Mavrogianni, A; O'Sullivan, A; (2017) GIS-based analysis of the relationship between outdoor and indoor air temperature in the Taiwan metropolitan area. Presented at: Healthy Buildings 2017 Asia (HB2017-Asia), Tainan, Taiwan. Green open access

https://ift.tt/2PCCvit

Sustained and Widespread Gene Delivery to the Corneal Epithelium via in Situ Transduction of Limbal Epithelial Stem Cells, Using Lentiviral and Adeno-associated Viral Vectors

Basche, M; Kampik, D; Kawasaki, S; Branch, MJ; Robinson, M; Larkin, DF; Smith, AJ; Basche, M; Kampik, D; Kawasaki, S; Branch, MJ; Robinson, M; Larkin, DF; Smith, AJ; Ali, RR; - view fewer (2018) Sustained and Widespread Gene Delivery to the Corneal Epithelium via in Situ Transduction of Limbal Epithelial Stem Cells, Using Lentiviral and Adeno-associated Viral Vectors. Human Gene Therapy , 29 (10) pp. 1140-1152. 10.1089/hum.2018.115 .

https://ift.tt/2RAmSW9

Thalamic nuclei segmentation using tractography, population-specific priors and local fibre orientation

Semedo, C; Cardoso, MJ; Vos, SB; Sudre, CH; Bocchetta, M; Ribbens, A; Smeets, D; ... Ourselin, S; + view all Semedo, C; Cardoso, MJ; Vos, SB; Sudre, CH; Bocchetta, M; Ribbens, A; Smeets, D; Rohrer, JD; Ourselin, S; - view fewer (2018) Thalamic nuclei segmentation using tractography, population-specific priors and local fibre orientation. In: Frangi, A and Schnabel, J and Davatzikos, C and Alberola-López, C and Fichtinger, G, (eds.) Medical Image Computing and Computer Assisted Intervention – MICCAI 2018. Lecture Notes in Computer Science. (pp. pp. 383-391). Springer: Cham.

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Decreased attention to object size information in scale errors performers

Grzyb, BJ; Cangelosi, A; Cattani, A; Floccia, C; (2017) Decreased attention to object size information in scale errors performers. Infant Behavior & Development , 47 pp. 72-82. 10.1016/j.infbeh.2017.03.001 . Green open access

https://ift.tt/2RuokJq

Cohort Profile: The Study of Cognition, Adolescents and Mobile Phones (SCAMP)

Toledano, MB; Mutz, J; Röösli, M; Thomas, MSC; Dumontheil, I; Elliott, P; (2018) Cohort Profile: The Study of Cognition, Adolescents and Mobile Phones (SCAMP). International Journal of Epidemiology 10.1093/ije/dyy192 . (In press). Green open access

https://ift.tt/2PE5qmf

Mapping climate disadvantage for care provision in London, UK: a sociospatial heat vulnerability assessment

Oikonomou, E; Raslan, R; Dennett, A; Taylor, J; Symonds, P; Mavrogianni, A; (2018) Mapping climate disadvantage for care provision in London, UK: a sociospatial heat vulnerability assessment. Presented at: Public Health Science 2018, Belfast, UK.

https://ift.tt/2RxPhfo

Locally optimal symplectic control of multimode Gaussian states

Shackerley-Bennett, U; Carlini, A; Giovannetti, V; Serafini, A; (2017) Locally optimal symplectic control of multimode Gaussian states. Quantum Science and Technology , 2 (4) , Article 044014. 10.1088/2058-9565/aa8883 . Green open access

https://ift.tt/2PK93at

The reachable set of single-mode quadratic Hamiltonians

Shackerley-Bennett, U; Pitchford, A; Genoni, MG; Serafini, A; Burgarth, DK; (2017) The reachable set of single-mode quadratic Hamiltonians. Journal of Physics A: Mathematical and Theoretical , 50 , Article 155203. 10.1088/1751-8121/aa6243 . Green open access

https://ift.tt/2RwncoH

Mapping climate disadvantage for London's care provision

Mavrogianni, A; Oikonomou, E; Raslan, R; Dennett, A; (2018) Mapping climate disadvantage for London's care provision. Presented at: Healthy City Design 2018: Equity and resilience: Creating healthy cities for all, London, UK. Green open access

https://ift.tt/2PFbVoK

Chinese case of Nakajo–Nishimura syndrome with a novel mutation of the PSMB8 gene

The Journal of Dermatology, EarlyView.


https://ift.tt/2qsyYFe

Gender and age significantly determine patient needs and treatment goals in psoriasis ‐ a lesson for practice

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2yK4jrq

Multiple neonatal Staphylococcal cold abscesses in large skin folds: a benign neonatal skin infection

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OlYMfJ

Time Trends in Incidence and Mortality of Cutaneous Melanoma in Germany

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2yONg7x

人皮肤表皮中黑色素分布依据

British Journal of Dermatology, Volume 179, Issue 5, Page e223-e223, November 2018.


https://ift.tt/2QeOakr

大疱性类天疱疮中嗜酸性粒细胞增多症

British Journal of Dermatology, Volume 179, Issue 5, Page e222-e222, November 2018.


https://ift.tt/2qqtHhi

Short contact with nickel causes allergic contact dermatitis

British Journal of Dermatology, Volume 179, Issue 5, Page e211-e211, November 2018.


https://ift.tt/2Qo0iQ4

HLA‐Cw6 等位基因和苏金单抗的疗效

British Journal of Dermatology, Volume 179, Issue 5, Page e221-e221, November 2018.


https://ift.tt/2qyB9at

Cost of narrowband ultraviolet B for psoriasis

British Journal of Dermatology, Volume 179, Issue 5, Page e199-e199, November 2018.


https://ift.tt/2Qo0izy

MiTES 中等位基因 PRDM12 突变

British Journal of Dermatology, Volume 179, Issue 5, Page e220-e220, November 2018.


https://ift.tt/2qrpJ87

Image Gallery: Severe combined immunodeficiency presenting with disseminated bacille Calmette–Guérin

British Journal of Dermatology, Volume 179, Issue 5, Page e194-e194, November 2018.


https://ift.tt/2QheavN

红斑狼疮患者中的抑郁风险增高

British Journal of Dermatology, Volume 179, Issue 5, Page e219-e219, November 2018.


https://ift.tt/2qoUN8y

酒色巨唇中 GNAQ 突变

British Journal of Dermatology, Volume 179, Issue 5, Page e216-e216, November 2018.


https://ift.tt/2QgK3Eu

Eosinophilia in BP

British Journal of Dermatology, Volume 179, Issue 5, Page e208-e208, November 2018.


https://ift.tt/2qsdqbU

Basis of melanin distribution in the human skin epidermis

British Journal of Dermatology, Volume 179, Issue 5, Page e209-e209, November 2018.


https://ift.tt/2QcSmRP

敏感皮肤患者中定量感觉检测

British Journal of Dermatology, Volume 179, Issue 5, Page e224-e224, November 2018.


https://ift.tt/2qr4tPP

Image Gallery: Transient localized livedo racemosa following liver embolization procedure for metastatic neuroendocrine tumour

British Journal of Dermatology, Volume 179, Issue 5, Page e195-e195, November 2018.


https://ift.tt/2QhZw7m

Editor's Choice

British Journal of Dermatology, Volume 179, Issue 5, Page ix-ix, November 2018.


https://ift.tt/2qqtIBS

窄波 UVB 用于银屑病治疗的费用

British Journal of Dermatology, Volume 179, Issue 5, Page e213-e213, November 2018.


https://ift.tt/2Qhec6T

HLA‐Cw6 allele and efficacy of secukinumab

British Journal of Dermatology, Volume 179, Issue 5, Page e207-e207, November 2018.


https://ift.tt/2qrpGZZ

Biallelic PRDM12 mutations in MiTES

British Journal of Dermatology, Volume 179, Issue 5, Page e206-e206, November 2018.


https://ift.tt/2QgK5fA

Phototherapy for psoriasis – outdated or underused?

British Journal of Dermatology, Volume 179, Issue 5, Page 1019-1020, November 2018.


https://ift.tt/2qqmIVD

Increased risk of depression in patients with lupus erythematosus

British Journal of Dermatology, Volume 179, Issue 5, Page e205-e205, November 2018.


https://ift.tt/2QgYKYn

健康成人中的 TEWL 参考值

British Journal of Dermatology, Volume 179, Issue 5, Page e218-e218, November 2018.


https://ift.tt/2qpQoCj

Will precision medicine be available for all patients in the near future?

Purpose of review Evidence-based medicine and guidelines directing the diagnosis and treatment of patients are changing. General recommendations are moving towards an individual focus, where technology evolution allows identification of specific patterns and where 'one size fits all' no longer has a place. Recent findings Emerging innovations on health technology include useful tools for individualizing patients' specific conditions and follow-up. There are several preventive initiatives that aim to reduce allergic disease development, but they have no generalizable and definitive results as yet. Both omics and molecular diagnosis have provided the basis for differentiating clusters of patients, both allowing prediction of severity and also indicating appropriate management. Here we discuss examples contributing to some specific conditions we are now facing. Summary Precision medicine encompasses a personalized care of the patient, the prediction of a successful treatment, the potential prevention of a disease and its progression when present and the important active participation of the patient in the planning and guidance of the approach and management. Technology and medical innovations like omics and molecular diagnosis help for discriminating specific phenotypes/endotypes and the correct individualized interventions. The great challenge for implementing precision medicine will be the possibility of providing those advances to everyone at affordable costs. Conclusion Technology and innovations in medicine are aimed to help all patients globally, providing evidence for particular conditions that need to be personally considered, involving the patient's decision while treating, predicting and preventing disease. Our aim should be to have precision medicine available everywhere at any time. Correspondence to René Maximiliano Gómez, Sarmiento 771, Salta 4400, Argentina. Tel: +54 9 387 464 5561; fax: +54 387 432 0886; e-mails: maxigom@gmail.com, mgomez@fundacionayre.org.ar Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2JB43z9