Teaching & Learning Tips 10: Interspecialty teaching through inpatient dermatology consults

International Journal of Dermatology, Volume 57, Issue 8, Page 985-988, August 2018.


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PERSONAL OVERVIEW OF OTOLOGY IN SUB-SAHARAN AFRICA

Publication date: Available online 10 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): C.A.J. Prescott

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Congenital dilatation of the submandibular duct

Publication date: Available online 10 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Maria Luiza Prosdócimo, Ana Paula Barreto Nogueira, Maria Aparecida de Albuquerque Cavalcante, Michelle Agostini, Mário José Romañach, Bruno Augusto Benevenuto de Andrade

Abstract

Congenital dilatation of the submandibular duct also known as imperforate submandibular duct is a rare condition of unknown etiology, clinically characterized as a well-defined, fluctuant swelling in the floor of the mouth, and microscopically defined as a cystic cavity covered with pseudostratified columnar epithelium consistent with a dilated salivary duct. A 1-month-old female presented with a translucent, smooth cystic swelling in the floor of the mouth causing breastfeeding difficulty. The lesion was surgically excised and microscopically, a cystic cavity lined with pseudostratified columnar epithelium was observed. The final diagnosis was congenital dilatation of the submandibular duct. Dentists and otolaryngologists should consider congenital dilatation of the submandibular duct when evaluating fluctuant swelling in the floor of the month of infants.

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Hearing loss in type 1 diabetes: Are we facing another microvascular disease? A meta-analysis

Publication date: Available online 10 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Mario A. Mujica-Mota, Neel Patel, Issam Saliba

Abstract

Objective

Evidence shows type 1 diabetes(T1D) leads to vascular damage and neuropathy. The purpose of this study was to perform a systematic review and a meta-analysis to assess the evidence of the effects of T1D on hearing function.

Methods

Three electronic databases were used. The articles were independently reviewed by two authors using predefined inclusion criteria to identify eligible studies. They were then classified as high or low methodological quality. Meta-analysis was performed on pooled data of hearing loss(HL) prevalence, pure tone audiometry(PTA), otoacoustic emissions(OAE) and auditory brainstem response(ABR).

Results

Twenty-one articles fulfilled the inclusion criteria. In all studies, HL was defined as pure tone greater than 20 dB in at least one frequency. The prevalence of HL ranged between 5.17% and 48% for diabetics, which was higher than in controls which ranged between 0% à 40% (OR=7.7, 95% CI 3.32–17.98, p<0.05 and I²=40%). The tendency of mean thresholds of PTA was higher in diabetics than in controls, with results being statistically significant at 250, 500 and 1000 Hz. OAE were significantly lower in diabetic patients. ABR latencies were longer in T1D group compared to controls and were statistical significant.

Conclusions

Patients with T1D have a significantly greater prevalence of HL compared to the control group. These damages could be compared to other microvascular diseases. Further studies are needed to assess whether hearing testing should be considered as a part of the screening process in T1D patients and therefore, secondary preventive treatment may be warranted as well.

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Peptide Tk-PQ induces immunosuppression in skin allogeneic transplantation via increasing Foxp3+ Treg and impeding nuclear translocation of NF-κB

Publication date: Available online 10 July 2018

Source: Molecular Immunology

Author(s): Yue Wang, Qing Li, Lin Zhou, Xuping Ding, Liming Lu

Abstract

Solid organ transplantation is used as the last resort for patients with end-stage disease, but allograft rejection is an unsolved problem. Here, we showed that Tk-PQ, a peptide derived from trichosanthin, had an immune-suppressive effect without obvious cytotoxicity in vitro and in a mouse skin allo-transplantation model. In vitro, treatment of Tk-PQ administrated type 2 T helper cell (Th2)/regulatory T-cell (Treg) cytokines, and increased the ratio of CD4⁺CD25⁺Foxp3⁺ Treg by repressing the PI3K/mTOR pathway. In addition, Tk-PQ decreased NF-κB activation to downregulate pro-inflammatory cytokines. Tk-PQ treatment in the mouse skin transplantation model also caused the similar molecular and cellular phenotypes. Furthermore, Tk-PQ enhanced the suppressive function of Treg by increasing Foxp3 expression, and substantially improved allograft survival. These finding demonstrate that Tk-PQ has the potential to be used in clinical allogeneic transplantation.

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Secukinumab decreases the serum KL‐6 level in psoriasis patients with elevated serum KL‐6 level

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


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Prospects for Monoclonal Antibody Therapy in Pediatric Asthma

Abstract

Purpose of Review

The profile of biologic therapies for asthma is growing rapidly. We discuss how to match the proper pediatric patient with the most effective therapy.

Recent Findings

Currently available biologic therapies are most effective in patients with T2 high asthma. Newer drugs are currently being studied which target TSLP and interleukin 33. These newer drugs may provide options for asthmatics who do not respond to the current anti-IgE, anti-IL5, and anti-IL4/13 therapies.

Summary

Asthma is a heterogeneous disease which can be driven by different inflammatory mediators in different patients. To select the most effective biologic therapy for a pediatric patient, the asthma phenotype must first be determined. The steep cost of biologics limits their use, which makes proper pairing of patient to therapy even more crucial. Presently, several therapies exist for T2 high asthma, but it is hoped in the future that development of drugs effective for T2 low asthmatics will be available as well.

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