A Case of Prethoracic Pain Radiating Upward and Initiating Nervus Intermedius Neuralgia and Migraine Headache: Could Epicrania Fugax Pain Start in the Upper Body?

Related Articles

A Case of Prethoracic Pain Radiating Upward and Initiating Nervus Intermedius Neuralgia and Migraine Headache: Could Epicrania Fugax Pain Start in the Upper Body?

J Oral Facial Pain Headache. 2017 Sep 20;:

Authors: Wang Y, Kan PL, Tao YF, Li XY, Yang XJ, Liang GL

Abstract
Epicrania fugax (EF) was recently classified as a primary headache in the Appendix of the International Classification of Headache Disorders, third edition (ICHD-III). It is characterized by a paroxysmal pain rapidly radiating forward or backward along a linear or zigzag trajectory on the surface of the head. This article reports a 76-year-old woman who newly developed a paroxysmal EF-type pain distributed not only in the territories of the trigeminal and occipital nerves, but also in the territories of the cervical and thoracic nerves. This EF-type pain started in a point on the prethoracic area, radiated along the ipsilateral neck, face, auditory canal, and head surface in a linear trajectory, and finally initiated attacks of nervus intermedius neuralgia (NIN) and migraine without aura (MWA). Treatment with a low dose of carbamazepine was associated with decreased intensity of EF-type pain and fewer NIN and MWA attacks, while a higher dose of carbamazepine was associated with complete termination of EF-type pain and NIN and MWA attacks. This case report expands the clinical spectrum of EF and may also be helpful in understanding its pathophysiology.

PMID: 28931106 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2fm01A0

Neurofibromatosis Type 1 Accompanied by Craniofacial Pain: Literature Review and Descriptive Case.

Related Articles

Neurofibromatosis Type 1 Accompanied by Craniofacial Pain: Literature Review and Descriptive Case.

J Oral Facial Pain Headache. 2017 Sep 20;:

Authors: Son C, Park JW

Abstract
Neurofibromatosis type 1 (NF-1) is a genetic disease with characteristic neurofibromas and bony dysplasia that manifest throughout the body, including the craniofacial region. NF-1 patients are known to frequently report chronic pain in areas below the head; however, the matter of pain in the craniofacial region in this patient group has not been handled intensively so far, and studies have mainly focused on headaches. This article comprehensively reviews the related literature and reports a case of an NF-1 patient whose chief complaint was headache and pain in the temporomandibular joint area. Craniofacial pain is probably not an exceptional problem in NF-1, but the current inadequacy of related data is worrisome, considering the impact of pain on NF-1 prognosis and patient quality of life. The presence of craniofacial pain in NF-1 patients should be actively sought out in the diagnostic process and appropriate guidelines for its diagnosis and treatment should be established.

PMID: 28931105 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2fmosxv

Lichen Planus triggered by infliximab biosimilar CT-P13 and recurred during secukinumab treatment

Abstract

we read with interest the manuscript published by Gonzales et al,¹ highlighting lichenoid reactions as an emerging side effect of biologics, with special regard to infliximab-biosimilar. We recently observed a 50-year-old male patient with a long-standing history of moderate-to-severe psoriasis, who developed oral lichen planus (LP) triggered by infliximab biosimilar CT-P13. Interestingly the same patient experienced cutaneous and oral LP when treated with IL-17A blocker, secukinumab. The patient suffered for hypertension, in treatment with valsartan, and anxiety. He previously failed to respond to phototherapy, methotrexate, etanercept and adalimumab.

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jOKeLz

Irradiance, as well as body site and timing of readings, is important in determining ultraviolet A minimal erythemal dose

Abstract

Irradiance, as well as body site and timing of readings, is important in determining ultraviolet A minimal erythemal dose. (Response to Gambichler et al. July BJD)

Gambichler et al. demonstrated that, in their population, using a 25 mWcm⁻² ultraviolet A-1 (UVA-1) source the median 24-hour delayed minimal erythema dose (MED) on the inner forearm was > 130 Jcm⁻².¹ This differs from the 20 Jcm⁻² to 28 Jcm⁻² median MED reported from our centre.²

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xXrY8U

Risk of malignancies associated with ustekinumab

Abstract

A recently published report by Florek et al.¹ associates malignancies with ustekinumab (STELARA^®) treatment. Janssen emphasizes patient safety and welcomes rigorous safety analyses from other parties. However, it is unclear how this report adds to the understanding of ustekinumab's safety profile.

This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jOKaLP

Chronic Poststernotomy Pain: Incidence, Risk Factors, Treatment, Prevention, and the Anesthesiologist's Role.

Chronic pain following median sternotomy is common after cardiac surgery. If left untreated, chronic sternal pain can reduce quality of life, affecting sleep, mood, activity level, and overall satisfaction. This has a significant societal effect given the large number of cardiac surgeries annually. Although a number of pathophysiologic processes and risk factors are assumed to contribute, the exact cause and major risk factors remain unknown. Moreover, the treatment of chronic poststernotomy pain is often inadequate, relying on opioids and other medications that provide minimal benefit to the patient and have significant adverse effects. Indeed, little is known regarding the prevention of chronic pain development following sternotomy. This review aims to present the current, limited data regarding the incidence, risk factors, treatment, and prevention of chronic poststernotomy pain and to identify areas of future research to improve management of this common complaint following cardiac surgery. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xVYkkD

The Spread of Ultrasound-Guided Injectate From the Adductor Canal to the Genicular Branch of the Posterior Obturator Nerve and the Popliteal Plexus: A Cadaveric Study.

Background and Objectives: The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Reduced hip adductor motor function could be avoided by a posterior obturator nerve block inside the popliteal fossa. The aim of this study was to evaluate the spread of dye after a distal adductor canal (AC) injection to the popliteal fossa and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve by dissection. We also assessed the spread of dye into the popliteal fossa after a distal femoral triangle injection. Methods: Ten milliliters of dye was injected into the distal part of the AC in 10 cadaver sides and into the distal part of the femoral triangle in 3 sides. Dissection was used to assess the spread of the injectate and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve, as well as the saphenous and medial vastus nerves. Results: The popliteal plexus and the genicular branch of the posterior obturator nerve were dyed in all 10 dissections after AC injections. No dye spread into the popliteal fossa after femoral triangle injections. Conclusions: Injection of 10 mL of dye into the distal part of the AC spreads into the popliteal fossa and colors the popliteal plexus and the genicular branch of the posterior obturator nerve. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yuWmof

Double-Layer Surface Modification of Polyamide Denture Base Material by Functionalized Sol-Gel Based Silica for Adhesion Improvement

Abstract

Purpose

Limited surface treatments have been proposed to improve the bond strength between autopolymerizing resin and polyamide denture base materials. Still, the bond strength of autopolymerizing resins to nylon polymer is not strong enough to repair the fractured denture effectively. This study aimed to introduce a novel method to improve the adhesion of autopolymerizing resin to polyamide polymer by a double layer deposition of sol-gel silica and N-2-(aminoethyl)-3-aminopropyltrimethoxysilane (AE-APTMS).

Materials and Methods

The silica sol was synthesized by acid-catalyzed hydrolysis of tetraethylorthosilicate (TEOS) as silica precursors. Polyamide specimens were dipped in TEOS-derived sol (TS group, n = 28), and exposed to ultraviolet (UV) light under O₂ flow for 30 minutes. UV-treated specimens were immersed in AE-APTMS solution and left for 24 hours at room temperature. The other specimens were either immersed in AE-APTMS solution (AP group, n = 28) or left untreated (NT group, n = 28). Surface characterization was investigated by fourier transform infrared spectroscopy (FTIR) and atomic force microscopy (AFM). Two autopolymerizing resins (subgroups G and T, n = 14) were bonded to the specimens, thermocycled, and then tested for shear bond strength with a universal testing machine. Data were analyzed with one-way ANOVA followed by Tukey's HSD (α = 0.05).

Results

FTIR spectra of treated surfaces confirmed the chemical modification and appearance of functional groups on the polymer. One-way ANOVA revealed significant differences in shear bond strength among the study groups. Tukey's HSD showed that TS_T and TS_G groups had significantly higher shear bond strength than control groups (p = 0.001 and p < 0.001, respectively). Moreover, bond strength values of AP_T were statistically significant compared to controls (p = 0.017).

Conclusion

Amino functionalized TEOS-derived silica coating is a simple and cost-effective method for improving the bond strength between the autopolymerizing resin and polyamide denture base. Clinical implications: Amino-functionalized silica coating could represent a more applicable and convenient option for improving the repair strength of autopolymerizing resin to polyamide polymer.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wL9i7q

Osteonecrosis of the jaw and survival of patients with cancer: a nationwide cohort study in Denmark

Abstract

Osteonecrosis of the jaw (ONJ) is an adverse effect of bone-targeted therapies, which are used to prevent symptomatic skeletal events following bone malignancy. We examined the association between ONJ and survival among cancer patients treated with bone-targeted agents. Using nationwide registries and databases in Denmark, we identified 184 cancer patients with incident ONJ between 2010 and 2015, and a comparison cohort of 1067 cancer patients without ONJ and with a history of hospital-administered treatment with bisphosphonates or denosumab initiating from cancer diagnosis. At the date of confirmed ONJ diagnosis, the comparison cohort was matched to the ONJ patients on age, cancer site, year of cancer diagnosis, and stage at diagnosis. The patients were followed up for survival until emigration or 15 June 2016. We computed overall survival and estimated mortality rate ratios adjusted for sex, and for the presence of distant metastases and other comorbidity at start of follow-up. A match was found for 149 of the 184 ONJ patients. The 1- and 3-year survival among all 184 cancer patients with ONJ was 70% (95% confidence interval [CI]: 63%–76%) and 42% (95% CI: 34%–51%), respectively. Among the matched patients, ONJ was associated with an adjusted mortality rate ratio of 1.31 (95% CI: 1.01–1.71). ONJ was associated with reduced survival among cancer patients treated with bone-targeted agents. ONJ may be a marker of advanced disease or of survival-related lifestyle characteristics.

In this nationwide cohort study, the authors examined the association between osteonecrosis of the jaw (ONJ) and survival among cancer patients treated with bone-targeted agents. ONJ was associated with reduced survival. The reason for the association is likely ONJ being a marker of advanced disease or of survival-related lifestyle characteristics.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xshmO6

Oral food challenge outcomes in a pediatric tertiary care center

Oral food challenges are the clinical standard for diagnosis of food allergy. Little data exist on predictors of oral challenge failure and reaction severity.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yhlYnT

Squamous-Cell Carcinoma of the Mouth

Figure 1.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fcZXPz

Sleep-Related Hypermotor Syndrome: An arousal parasomnia or nocturnal frontal lobe epilepsy?

Publication date: Available online 21 September 2017
Source:Sleep Medicine
Author(s): Sudhansu Chokroverty




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fn8wLc

Long sleep duration is associated with lower cognitive function among middle-aged adults—the Doetinchem Cohort Study

Publication date: Available online 21 September 2017
Source:Sleep Medicine
Author(s): Sandra H. van Oostrom, Astrid C.J. Nooyens, Martin P.J. van Boxtel, W.M. Monique Verschuren
ObjectiveIn older adults, both short and long sleep duration are associated with lower cognitive function, suggesting an inverted U-shaped association between sleep duration and cognitive outcomes. This study examined whether sleep duration is associated with changes in cognitive function in a middle-aged population.MethodsIn the Doetinchem Cohort Study, the cognitive function of 2970 men and women aged 41–75 years at baseline (1995–2007) was examined 2–3 times, with 5-year time intervals. Global cognitive function and the domains memory, information processing speed, and cognitive flexibility were assessed. In multivariable linear regression models, change in self-reported sleep duration was studied in association with the level and change in cognitive function. In a subsample of the population (n = 2587), the association of sleep duration and sleep quality with cognitive function was studied.ResultsSleep duration of 9 hours and more was statistically significantly associated with lower global cognitive function (p < 0.01), memory (p = 0.02), and flexibility (p = 0.03), compared to a sleep duration of 7 or 8 hours. Among adults feeling frequently not well rested, both short and long sleep duration were associated with a lower speed of cognitive function. An inverted U-shaped association between sleep duration and cognitive function was observed for speed, flexibility, and global cognitive function. Sleep duration was not associated with change in cognitive function.ConclusionMiddle-aged adults with long sleep duration had a lower cognitive function.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xzH041

Impaired objective and subjective sleep in children and adolescents with inflammatory bowel disease compared to healthy controls

Publication date: Available online 21 September 2017
Source:Sleep Medicine
Author(s): Laura Mählmann, Markus Gerber, Raoul I. Furlano, Corinne Legeret, Nadeem Kalak, Edith Holsboer-Trachsler, Serge Brand
ObjectivePoor sleep and higher inflammation markers are associated, and impaired sleep quality is common among patients with inflammatory bowel disease (IBD). However, information on sleep among children and adolescents with IBD is currently lacking. The aims of the present study were to compare subjective and objective sleep of children and adolescents with IBD with healthy controls and to shed more light on the relationship between sleep and inflammation. We expected that poor sleep, as assessed via sleep electroencephalography recordings, would be observed among participants with IBD, but particularly among participants in an active state of disease. Furthermore, we expected that poor sleep and higher inflammatory markers would be associated.MethodsA total of 47 children and adolescents participated in the study; 23 were diagnosed with IBD (mean age: 13.88 years, 44% female). The IBD group was divided into a medically well adjusted "remission-group" (IBD-RE; n = 14) and a group with an "active state of disease" (IBD-AD; n = 8). Healthy controls (HC; n = 24) were age and gender matched. Participants completed self-rating questionnaires for subjective sleep disturbances. Anthropometric data, acute and chronic inflammatory markers (C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) and objective sleep were considered.ResultsCompared to HC and IBD-RE, IBD-AD patients showed impaired objective sleep patterns (eg, more awakenings, longer sleep latency, and reduced stage 3 sleep). Linear relationships described the correlation between higher ESR and more stage 4 (minutes, percentage) sleep. Nonlinear relationships described the relation between ESR and subjective sleep quality (inverse U-shaped) and between CRP and sleep latency (U-shaped).ConclusionIn children and adolescents with an active IBD, objective sleep was impaired and overall sleep quality and inflammation indices were associated in a complex manner. It seems advisable to include assessment of subjective sleep quality in the care of paediatric IBD patients as an additional indicator for objective sleep disturbances and inflammation.Trial registration numberNCT02264275.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2flWXnt

Subjective Evaluation of Dreams in pregnant women in the different trimesters and in non-pregnant women

Publication date: Available online 21 September 2017
Source:Sleep Medicine
Author(s): Stella Maris Valiensi, Gustavo Izbizky




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xykWGN

Comparison of volumetric-modulated arc therapy using simultaneous integrated boosts (SIB-VMAT) of 45 Gy/55 Gy in 25 fractions with conventional radiotherapy in preoperative chemoradiation for rectal cancers: a propensity score case-matched analysis

The aim of this retrospective study was to compare volumetric-modulated arc therapy using simultaneous integrated boosts (SIB-VMAT) of 45 Gy/55 Gy in 25 fractions with three-dimensional conformal radiotherapy ...

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xV0yR3

Computed tomography in children with community-acquired pneumonia

Abstract

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yuoaZN

Perianal pseudoverrucous papules and nodules in Hirschsprung's disease: Rapid resolution with oral loperamide

Abstract

We report the case of a 2-year-old boy with Hirschsprung's disease who developed perianal pseudoverrucous papules and nodules subsequent to persistent diarrhea and stool leakage after Giardia infection. Bleeding from the papules resulted in iron deficiency anaemia requiring blood transfusion and iron infusion. Topical therapies used over 6 months were of limited benefit and colostomy was considered, but the condition completely resolved after commencement of oral loperamide. This demonstrates that perianal pseudoverrucous papules and nodules can be severe but are entirely reversible upon removal of the source of skin irritation.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wKVbiu

Eruptive milia during isotretinoin therapy

Abstract

Isotretinoin (13-cis-retinoic acid) is a synthetic vitamin A derivative that is effective in the treatment of recalcitrant, nodulocystic acne. To our knowledge, there are no reports in the medical literature of milia as a side effect of isotretinoin. We report a case of eruptive facial milia in the setting of isotretinoin treatment for acne.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xrF39h

Treatment of oesophageal cancer – Stressing the patient perspective

Publication date: October 2017
Source:European Journal of Cancer, Volume 84
Author(s): Florian Lordick




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ytpNa9

First-line treatment in metastatic colorectal cancer: Important or crucial?

Publication date: October 2017
Source:European Journal of Cancer, Volume 84
Author(s): David Malka, Federico Rotolo, Valérie Boige




from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wDAWb9

Sleep apneas trigger epilepsy

Dr. Brunetti: study concept and design, drafting the manuscript, accepts responsibility for conduct of research, and analysis or interpretation of data. Dr. Ferilli and Dr. Vollono: accepts responsibility for conduct of research, and analysis or interpretation of data. Dr. Della Marca: interpretation of data, accepts responsibility for conduct of research, study supervision, revising the manuscript, and final approval.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xkPBFf

Long sleep duration is associated with lower cognitive function among middle-aged adults—the Doetinchem Cohort Study

In older adults, both short and long sleep duration are associated with lower cognitive function, suggesting an inverted U-shaped association between sleep duration and cognitive outcomes. This study examined whether sleep duration is associated with changes in cognitive function in a middle-aged population.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xjqogT

ASXL3 is a Novel Pluripotency Factor in Human Respiratory Epithelial Cells and a Potential Therapeutic Target in Small Cell Lung Cancer

In this study, we generated induced pluripotent stem cells (iPSC) from normal human small airway epithelial cells (SAEC) to investigate epigenetic mechanisms of stemness and pluripotency in lung cancers. We documented key hallmarks of reprogramming in lung iPSC (Lu-iPSC) that coincided with modulation of more than 15,000 genes relative to parental SAEC. Of particular novelty, we identified the PRC2-associated protein, ASXL3 which was markedly upregulated in Lu-iPSC and small cell lung cancer (SCLC) lines and clinical specimens. ASXL3 overexpression correlated with increased genomic copy number in SCLC lines. ASXL3 silencing inhibited proliferation, clonogenicity and teratoma formation by Lu-iPSC, and diminished clonogenicity and malignant growth of SCLC cells in-vivo. Collectively, our studies validate the utility of the Lu-iPSC model for elucidating epigenetic mechanisms contributing to pulmonary carcinogenesis, and highlight ASXL3 as a novel candidate target for SCLC therapy.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xrNZvb

miR-130a deregulates PTEN and stimulates tumor growth

H-RasV12 oncogene has been shown to promote autophagic cell death. Here we provide evidence of a contextual role for H-RasV12 in cell death that is varied by its effects on miR-130a. In E1A-immortalized murine embryo fibroblasts, acute expression of H-RasV12 promoted apoptosis but not autophagic cell death. miRNA screens in this system showed that miR-130a was strongly downregulated by H-RasV12 in this model system. Enforced expression of miR-130a increased cell proliferation in part via repression of PTEN. Consistent with this effect, miR-130a overexpression in human breast cancer cells promoted Akt phosphorylation, cell survival and tumor growth. In clinical specimens of multiple human cancers, expression of miR-130 family members correlated inversely with PTEN expression. Overall, our results defined miR-130a as an oncogenic microRNA that targets PTEN to drive malignant cell survival and tumor growth.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wLlsxa

Diabetes treatments and risks of adverse breast cancer outcomes among early stage breast cancer patients: A SEER-Medicare analysis

The widely prescribed diabetes medicine metformin has been reported to lower the risk of incident breast cancer, but it is unclear if it affects malignant progression after diagnosis. In this study, we conducted a retrospective cohort study using the linked Surveillance, Epidemiology and End-Results (SEER)-Medicare database. Women were included in the study if they were aged 66-80 years, newly diagnosed with stage I or II breast cancer, and enrolled in Medicare Parts A, B, and D during 2007-2011. Information on dispensed diabetes-related medications was obtained from Medicare Part D claims data. Our primary outcomes were second breast cancer events (SBCE), breast cancer recurrence, and breast cancer death. Time-varying Cox proportional hazard models were used to estimate hazard ratios and their 95% confidence intervals (CI). Among 14,766 women included in the study, 791 experienced SBCE, 627 had a recurrence, and 237 died from breast cancer. Use of metformin (n=2,558) was associated with 28% (95% CI: 0.57-0.92), 31% (95% CI: 0.53-0.90), and 49% (95% CI: 0.33-0.78) lower risks of a SBCE, breast cancer recurrence, and breast cancer death. Use of sulfonylureas or insulin was associated with 1.49 (95% CI: 1.00-2.23) and 2.58-fold (95%CI: 1.72-3.90) higher risks of breast cancer death. Further research may be warranted to determine if metformin is a preferred treatment for diabetes among breast cancer survivors and whether it benefits breast cancer patients without diabetes.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xs3wLI

Bases anatomiques du tégument facial appliquées à la chirurgie du rajeunissement facial

Publication date: Available online 21 September 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): R. Sinna, C. Herlin, S. Garson, S. Dast, E. Delay
La compréhension de l'anatomie du visage reste un prérequis avant de passer à l'étude des différentes techniques de rajeunissement. Certes, il existe encore de nombreuses controverses et de variations anatomiques. Cependant, certains travaux récents nous ont permis de comprendre que la structure des tissus mous de la face n'était pas uniquement une succession de couches superposées, mais une structure tridimensionnelle avec une architecture lamellaire interconnectée par un système fibreux perpendiculaire à ces couches. Ainsi, il existe une alternance d'espace, de graisse et de « retaining ligaments » que l'on peut relativement bien systématiser. Cette systématisation peut aider le chirurgien dans son geste chirurgical afin de reconnaître les zones sans danger et d'avoir des repères anatomiques des zones à risque, en particulier les zones de transition des branches du nerf facial, qui sont le plus souvent proches des « retaining ligaments ». Cet article tente de résumer ces bases anatomiques.The understanding of the face anatomy is mandatory before to be able to appreciate the different surgical techniques of face lifting. Despite numerous controversies and anatomical variations, we can find in the literature several keystone works that allows us to understand that the soft tissues of the face are not only a superposition of layers but also a tridimensionnal structure with a fibrous system that links the different layers. This structures creates a mix loose spaces, fat and retaining ligament that can be describe in a quite systematic manner. This systematisation can help the surgeon during the surgical procedure to search and find the area where there is no danger and alert him around the retaining for example, which is where we can often find a vessel or a branch of the facial nerve that we want to avoid. This article summarizes these anatomical knowledge.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wCCQZz

Longitudinal and cross-sectional assessment of quality of life in surgically treated 225 advanced (T4)Buccal mucosa cancers

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Manish Mair, Sudhir Nair, Santosh Nikam, Deepa Nair, Jai Prakash Agrawal, Pankaj Chaturvedi
BackgroundQuality of life(QOL) has become an important aspect of today's health care management.Longitudinal assessment of QOL in patients with advanced buccal mucosa cancers(T4) is done in this study.Comparison of QOL between patients who received adjuvant chemo-radiation(CTRT) or radiation(RT) alone is done and whether baseline QOL can predict disease recurrence is also assessed.Materials and MethodsThiswas a prospective study of 225 T4 buccal mucosa cancer patients.Health-related (QOL) was assessed at baseline and at 3,6,9 and 12 months after completion of treatment by means of the EORTC Core QOL Questionnaire and theEORTC HN35 questionnaire.ResultsThere was a persistent improvement in Global QOL and pain. Emotional functioning improved at 12 months.Most of the Head and Neck specific symptoms deteriorated at 3 months with subsequent improvement at 12 months except for Swallowing,Senses,Speech,Socialeating,Socialcontact, and Sexuality.Patients who received adjuvant CTRT had poorer QOL.Poorer Baseline Global QOL(p-0.049),dyspnea(p-0.04),appetite loss(p-0.015) and weight loss(p-0.08) may predict recurrence.ConclusionWhile there is an improvement in global QOL,pain and painkillers,most of the Head and Neck specific symptoms worsened in the immediate post operative period.Adjuvant CTRT has persistent effect on specific domains as compared to adjuvant RT alone.Poor baseline QOL score is associated with higher risk of recurrences.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jPqd7G

A description of the sequence of longterm behaviour of autogenous boneblock in maxillary sinus augmentation in sheep: additional morphological and histomorphometric evidence

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): S. Pohl, R. Haas, S. Tangl, C. Schuh, G. Mailath-Pokorny, V. Pohl
ObjectiveBehaviour of autogenous bone block in sinus lift and surgical consequencesStudy Design: Twelve sinus lifts with autogenous hip bone blocks and simultaneous insertion of two implants in 6 adult female sheep. Polychrome sequential labelling and histologic and histomorphometric evaluation after 6, 16 and 26 weeks.ResultsAugmentation material in the apical third was almost fully resorbed after 26 weeks (p=0.00388).Percentage of bone tissue increased 0.5-1.0 mm from the implant in crestal region (15.3 ± 7.5% to 16.2 ± 10.1%), while it vanished in the apical region from 16 to 26 weeks (4.2 ± 10.4% to 0 %). (p=0,363)ConclusionsAutogenous bone block leaves an apical thin but functionally crucial layer covering implants in a form follows function way.Denial of animal originated biomaterials and prion diseases remain a rarely discussed issue.The use of an implant length adapted autogenous transplant with osseoinductive advantages should be taken into consideration.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xs0Iy3

Methotrexate associated osteonecrosis of the jaw: a report of two cases

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Marianne Henien, Barbara Carey, Esther Hullah, Chris Sproat, Vinod Patel
There has been a rise in medication related osteonecrosis of the jaws (MRONJ) predominantly related to anti-resorptive and anti-angiogenic medications. More evidence is revealing that MRONJ is not limited to these drug groups. With the introduction of newer and varied medications used in the treatment of cancer and autoimmune diseases, reports of possible related osteonecrosis of the jaw (ONJ) are also on the rise. We present two cases of ONJ in patients with long-standing arthritis treated with methotrexate in the absence of a lymproliferative disorder and anti-resorptive or anti-angiogenic medications.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jNOniT

Bite force and EMG evaluation after cranioplasty in patients with craniosynostosis

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Markus Martini, Valentin Wiedemeyer, Nils Heim, Martina Messing-Jünger, Sabine Linsen
ObjectiveThis long-term follow-up investigation aimed to assess masticatory muscle function in 15 craniosynostosis patients with detachment of the temporal muscle during fronto-orbital Advancement 6 years after cranioplasty compared to a non-operative stomatognathic healthy collective at the same age (n = 25).Study designThe follow-up assessment for the operative children occurred on average 5.2±1.7 years post-operation at the age of 7±1.6 years. The maximum bite force was assessed in addition to the bilateral function of both temporal and masseter muscles, which were analyzed using superficial electromyography.ResultsThe maximum bite force was 257±89 N respectively 255±88 N (right/left) in the group of operative children and 212±61 N respectively 203±57 N (right/left) in the control group, without clinical relevant difference between groups. The surface EMG signal of the temporal muscle correlated positively with the bite force and showed a slightly lower average resting tone activity in the control group, while the muscle fatigue was slightly faster in the operative children for both muscles without statistically significant difference between the two groups.ConclusionThere was no measurable dysfunction in the temporal muscle after the operative correction of craniosynostosis in comparison to a healthy norm population of children.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xs1BH0

Evaluation of an experimental oblique plate for osteosynthesis of mandibular condyle fractures

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Florian Wagner, Martin Strasz, Hannes Traxler, Kurt Schicho, Rudolf Seemann
ObjectiveThe aim of this study was to test the bone thickness and potential screw length for osteosynthesis of condylar base fractures (according to the Loukota classification) with an experimental titanium plate, placed in an ideal position against two types of conventional plates.Study DesignAfter exclusion of completely edentulous mandibles 28 dentate macerated mandibles available at the time of the study were included. Linear regression models (LM) 1 & 2 compared the sums of the two cranial bone thicknesses and the three caudal thicknesses between the three different plate designs and linear models 3 & 4 tested the bone thickness in the two most cranial screw axes.ResultsLinear models 1&2 revealed significantly higher potential screw lengths for the experimental oblique plate. Equally, linear models 3&4 showed significantly higher bone thickness for the novel oblique plate.ConclusionThe novel proposed oblique plate allows for favorable plate positioning in a biomechanically ideal location with sufficient amounts of local bone for stable plate fixation. When plates with 15° angulated screw holes are used, stable bicortical plate fixation can be achieved.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jPoLCl

Potentially inappropriate medications in geriatric population: a clinical update for oral medicine and orofacial pain practitioners

Publication date: Available online 21 September 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Arwa Farag, Bhavik Desai
The American Geriatric Society has periodically published guidelines, known as the Beers Criteria, for identifying potentially inappropriate medications (PIMs) for the geriatric population. In addition, the Screening Tool of Older Person's Potentially Inappropriate Medications is another list that was developed on the basis of hospital admissions resulting from adverse drug events in geriatric adults. This review paper provides a summary of these PIMs that are commonly prescribed to the geriatric population by dental practitioners, with a focus on medications prescribed by oral medicine and orofacial pain specialists. Five classes of medications have been identified and discussed in this review, namely, tricyclic antidepressants, benzodiazepines, muscle relaxants, anticonvulsants, and nonsteroidal anti-inflammatory drugs. Alternative medications in lieu of PIMs for geriatric adults have also been provided, along with the required dosage modifications.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xrQdLa

Denosumab as a treatment alternative for central giant cell granuloma: a long-term retrospective cohort study

Publication date: Available online 21 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Marius Bredell, Tamara Rordorf, Sabine Kroiss, Martin Rücker, Daniel Fritz Zweifel, Claudio Rostetter
PurposeGiant cell granuloma of the jaw is a rare disease with a high morbidity. Various treatment options have been discussed in the past. Since 2010, a pharmaceutical therapy with denosumab seems to be successful for giant cell tumors of the femur. The investigators hypothesized the equally successful use of denosumab for giant cell granulomas of the jaws.MethodIn the current retrospective cohort study five patients with large giant cell granulomas of the jaws were treated with denosumab on a follow-up of 25 to 49 months. Frequent clinical and a radiological follow up was performed and systematically analysed.ResultsAll patients showed curative treatment response and complete metabolic resolution of the giant cell granulomas under treatment with denosumab.ConclusionA brief review of the relevant literature and a detailed evaluation of the current cases lead us the conclusion that denosumab therapy should be considered as a therapeutic option in large CGCG's of the jaws. The results of this study suggest a successful treatment option. Treatment length of not shorter than 12 months is recommended and monitoring of treatment response can be well managed by PET CT or MRI.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xVG6iX

How rare is an oral presentation of myeloid sarcoma in the infant?

Publication date: Available online 21 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Austin Gaal, Karen M. Chisholm, Mark Egbert
Myeloid sarcoma, or chloroma, is a malignancy consisting of immature, extramedullary leukemic cells of the granulocytic lineage that was first described by Burns in 1811.¹ In 1853, King coined the term "chloroma," as the lesion commonly, but not always, develops a characteristic green color when exposed to air.² Dock was the first to associate this tumor with acute leukemia.³ The tumor is composed of granulocytic immature cells, resembling sarcoma, and it infiltrates into adjacent tissue and effaces the architecture. As such, myeloid sarcoma is a more appropriate term than chloroma.^3,4,5 myeloid sarcoma may present in virtually any organ.⁶ Approximately 50% of cases present in the skin and subcutaneous tissue.⁷ Less commonly, these lesions present in bone, with the incidence in the skeleton estimated at 10%.⁷ Initial presentation of myeloid sarcoma in the oral cavity is exceedingly rare although there have been a number case reports (Table 1)^8-70. The more recent reports and case reviews of Pau et al (2010)⁵², Zhou et al (2013)⁵⁸, and Kumar et al (2017)⁷⁰ estimate that 88 prior cases of oral MS have been reported. To our knowledge, this is the 89th case reported and the youngest patient to date (Table 1).



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xVG0b5

Risk factors for complications of intraoral removal of submandibular sialoliths

Publication date: Available online 21 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sung Hwa Dong, Seok Hyun Kim, Jeon Gang Doo, Ah Ra Jung, Young Chan Lee, Young-Gyu Eun
PurposeIntraoral removal of submandibular sialoliths is a surgical technique for the treatment of sialolithiasis and is reported to have excellent outcomes. In this study, we sought to determine the risk factors leading to complications of this procedure.Patients and MethodsThe medical records of 200 patients who had undergone intraoral removal of sialoliths between January 2006 and June 2015 were retrospectively reviewed. We used a telephone survey to check the postoperative symptoms. Dry mouth, wound infection, lingual nerve dysfunction, and recurrence were considered to be complications. Computed tomography (CT) scans of the neck were reviewed for location, shape, number, and size of the stone.ResultsThe number of patients who complained of a complication was 44. The incidence of complications was significantly higher in patients in whom the stone was located in the proximal region of the salivary duct (proximal group) than in those with middle or distally located stones (middle/distal group) (p < 0.05). The average stone size was larger in the proximal group; the operation time and length of admission were also longer in the proximal group, with a statistically significant difference (p < 0.05). Complaints of lingual nerve dysfunction were significantly higher in the proximal group than in the middle/distal group (p < 0.05).ConclusionPatients with proximally located stones had more complications, especially lingual nerve dysfunction, than those with middle/distally located stones. The former group also required a longer operation time and hospital stay.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yuRQGz

Patient-reported quality of life outcomes following treatment for oral cancer

Patient-reported quality of life (QoL) outcomes have the potential to assist clinicians in providing individually tailored treatment decisions. QoL assessments were collected prospectively for 168 consecutive patients treated for oral cancer between 1 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire. Patients were followed up for 18 months post-treatment. Sub-group analyses were performed using paired t-tests and analysis of variance (ANOVA) to compare the effects of adjunctive chemoradiotherapy, type of bone resection, and methods of soft and hard tissue flap reconstruction.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ygRnXo

A case of adult congenital laryngeal cleft asymptomatic until hypopharynx cancer treatment

Laryngeal cleft is an anomaly of failed posterior closure of the larynx. Most cases are diagnosed and need treatment early in life due to respiratory and swallowing problems. We report an unusual case of a 66-year-old man with an asymptomatic laryngeal cleft until treatment for hypopharyngeal cancer. During concurrent chemoradiotherapy (CCRT), despite reduced tumor volume, he presented severe dysphagia and dyspnea, followed by severe pneumonia twice. Because CCRT had to be discontinued, a pharyngolaryngectomy was performed for the cancer treatment.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xlD5Wi

Our experience with 500 patients with benign paroxysmal positional vertigo: Reexploring aetiology and reevaluating MRI investigation

To explore the aetiology of and to evaluate the importance of MRI investigation on the posterior semicircular canal benign paroxysmal positional vertigo in an Irish population.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ygQJJs

Management of tinnitus in children: Review of literature and effect of counseling

Tinnitus in children has not been studied sufficiently to date. And, there is no consensus regarding the management of tinnitus in children. Tinnitus counseling can be considered as the most basic tool among therapeutic options of tinnitus in children. In this article, the importance of management in children with tinnitus is highlighted through the review of the literature. Also, we present survey results regarding usefulness and necessity of tinnitus counseling provided from parents of children with tinnitus.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xmemko

Chronic noise exposure in the spontaneously hypertensive rat

Anne T.M Konkle, Stephen E Keith, James P McNamee, David Michaud

Noise and Health 2017 19(90):213-221

Introduction: Epidemiological studies have suggested an association between the relative risk for developing cardiovascular disease (CVD) and long-term exposure to elevated levels of transportation noise. The contention is that this association is largely owing to an increase in stress-related biomarkers that are thought to be associated with CVD. Animal models have demonstrated that acute noise exposure is capable of triggering a stress response; however, similar studies using chronic noise models are less common. Materials and Methods: The current study assessed the effects of intermittent daily exposure to broadband 80 kHz bandwidth noise of 87.3 dBA for a period of 21 consecutive days in spontaneously hypertensive rats. Results: Twenty-one days of exposure to noise significantly reduced body weight relative to the sham and unhandled control groups; however, noise had no statistically significant impact on plasma adrenocorticotropic hormone (or adrenal gland weights). Noise was associated with a significant, albeit modest, increase in both corticosterone and aldosterone concentrations following the 21 days of exposure. Interleukin 1 and interleukin 6 levels were unchanged in the noise group, whereas both tumour necrosis factor alpha and C-reactive protein were significantly reduced in noise exposed rats. Tail blood sampling for corticosterone throughout the exposure period showed no appreciable difference between the noise and sham exposed animals, largely due to the sizeable variation for each group as well as the observed fluctuations over time. Discussion: The current pilot study provides only modest support that chronic noise may promote stress-related biological and/or developmental effects. More research is required to verify the current findings and resolve some of the unexpected observations.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2w9Sc3O

Sex bias in basic and preclinical noise-induced hearing loss research

Amanda Marie Lauer, Katrina Marie Schrode

Noise and Health 2017 19(90):207-212

Introduction: Sex differences in brain biochemistry, physiology, structure, and function have been gaining increasing attention in the scientific community. Males and females can have different responses to medications, diseases, and environmental variables. A small number of the approximately 7500 studies of noise-induced hearing loss (NIHL) have identified sex differences, but the mechanisms and characterization of these differences have not been thoroughly studied. The National Institutes of Health (NIH) issued a mandate in 2015 to include sex as a biological variable in all NIH-funded research beginning in January 2016. Materials and Methods: In the present study, the representation of sex as a biological variable in preclinical and basic studies of NIHL was quantified for a 5-year period from January 2011 to December 2015 prior to the implementation of the NIH mandate. Results: The analysis of 210 basic and preclinical studies showed that when sex is specified, experiments are predominantly performed on male animals. Discussion: This bias is present in studies completed in the United States and foreign institutions, and the proportion of studies using only male participants has actually increased over the 5-year period examined. Conclusion: These results underscore the need to invest resources in studying NIHL in both sexes to better understand how sex shapes the outcomes and to optimize treatment and prevention strategies.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2feOQpi

Impact of usage of personal music systems on oto-acoustic emissions among medical students

Prasanth G Narahari, Jayashree Bhat, Arivudai Nambi, Anshul Arora

Noise and Health 2017 19(90):222-226

Background: Intact hearing is essential for medical students and physicians for communicating with patients and appreciating internal sounds with a stethoscope. With the increased use of (PMSs), they are exposed to high sound levels and are at a risk of developing hearing loss. The effect of long term personal music system (PMS) usage on auditory sensitivity has been well established. Our study has reported the immediate and short term effect of PMS usage on hearing especially among medical professionals. Objective: To assess the effect of short term PMS usage on distortion product otoacoustic emissions (DPOAE) among medical professionals. Materials and Method: 34 medical students within the age range of 17–22 years who were regular users of PMS participated in the study. All participants had hearing thresholds <15 dBHL at audiometric octave frequencies. Baseline DPOAEs were measured in all participants after 18 h of non-usage of PMS. One week later DPOAEs were again measured after two hours of continuous listening to PMS. DPOAEs were measured within the frequency range of 2 to 12 kHz with a resolution of 12 points per octave. Output sound pressure level of the PMS of each participant was measured in HA-1 coupler and it was converted to free field SPL using the transformations of RECD and REUG. Results: Paired sample t test was used to investigate the main effect of short term music listening on DPOAE amplitudes. Analysis revealed no significant main effect of music listening on DPOAE amplitudes at the octave frequencies between 2 to 4 KHz (t67 = −1.02, P = 0.31) and 4 to 8 KHz (t67 = 0.24, P = 0.81). However, there was a small but statistically significant reduction in DPOAE amplitude (t67 = 2.10, P = 0.04) in the frequency range of 9 to 12 kHz following short term usage of PMS. The mean output sound pressure level of the PMS was 98.29. Conclusion: Short term exposure to music affects the DPOAE amplitude at high frequencies and this serves as an early indicator for noise induced hearing loss (NIHL). Analysis of output sound pressure level suggests that the PMSs of the participants have the capability to induce hearing loss if the individual listened to it at the maximum volume setting. Hence, the medical professionals need to be cautious while using PMS.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2w9m0gH

Improvements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions

Journal of Adolescent and Young Adult Oncology , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2w9XCeW

Geographic Access to Cancer Care and Mortality Among Adolescents

Journal of Adolescent and Young Adult Oncology , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fd3BIU

Predicting the Future: A Case Study in Prognostication

Purpose

Clinicians are regularly asked to make long-term prognoses. The aim of the current report was to present one systematic approach to doing so. A case example from a malpractice case involving a child fitted with a cochlear implant was presented. Implantation occurred at age 17 months (activation 1 month later), but due to a procedural error, the implant was not functional for 19 months. The problem was ultimately rectified, but the legal case hinged largely on whether the child would be able to make up for the lost time.

Method

A review of the literature on long-term outcomes in children with cochlear implants was conducted. Using 4 studies measuring outcomes 7–10 years later, outcomes were compared between children implanted at age 17–18 months and those implanted at age 36–37 months.

Results

Analysis suggested no potential impact on nonverbal cognitive skills. However, analysis in the areas of speech perception, word comprehension, speech intelligibility, and reading suggested that after 7–10 years, this child would potentially continue to be approximately 1–2 years behind where she might otherwise have been.

Conclusions

This case illustrated the possibility of deriving a long-term prognosis using a systematic examination of the existing outcomes literature. Such an approach is consistent with our mandate to engage in evidence-based practice.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://article/doi/10.1044/2017_AJSLP-17-0022/2655029/Predicting-the-Future-A-Case-Study-in

Parental Understanding of Educational Materials on Laryngotracheal Reconstruction

This study assesses the understandability and actionability of parental educational materials for laryngotracheal reconstruction in children.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tQDYq6

Control of Pain After Tonsillectomy in Children

This review examines the treatment of postoperative pain in children after tonsillectomy.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ttUcpD

An Objective Drug-Induced Sedation Endoscopy Data Capture and Analysis System

To the Editor We read with great interest the article published by Gobbi et al. We would like to acknowledge 3 key points presented in the article. First, the authors presented a novel objective technique—a drug-induced sleep endoscopy technique implemented with simultaneous polygraphic monitoring of cardiorespiratory parameters (DISE-PG)—for capturing and visualizing anatomical and physiological data simultaneously in real time. Second, DISE-PG was shown to be better than standalone DISE in terms of feasibility, safety, and detecting obstructive breathing patterns. Third, DISE-PG provides accurate comprehension of upper airway obstructive dynamics and a nonobstructive breathing pattern. Our letter focuses on 4 questions.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2s098qq

Partial Resection in Microsurgical Management of Vestibular Schwannomas

This Viewpoint discusses selective use of partial tumor resection, in particular near total resection, over gross total resection when there is concern for imminent facial nerve compromise in the management of vestibular schwannomas.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2rYT6xl

Otolaryngology Research Challenges in Patient Care and Outcomes

Eight years ago, Chalmers and Glasziou estimated that nearly 85% of the public and private monies spent on biomedical research were wasted because of inadequately produced and reported research, thereby slowing improvement in patient care. There have been significant efforts made to remedy these issues, yet they persist because the underlying problems have not been corrected.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uOCU3f

September 2017 Issue Highlights

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jPZjg0

Expression of Concern

This Expression of Concern alerts readers to potential questions about research results published in a report of a trial in this journal in 2015 and announces the beginning of deeper investigation into the quality of this research.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vspnzw

Nocturnal Dyspnea as a Result of a Hypopharyngeal Mass

A man had worsening nocturnal dyspnea, dysphagia, and dysphonia; distal chip laryngeal endoscopy revealed a large, well-mucosalized mass of the left pyriform sinus, and CT with contrast showed a nonenhancing, well-circumscribed mass. What is your diagnosis?

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vhklVF

Somatization and the Review of Systems

This cohort study examines the association between patient responses on a form used for review of systems and somatization.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2rkOLVk

The Reduction in the Age-Adjusted Prevalence of Hearing Impairment in the United States An Unexpected Dividend of Phasing Out Leaded Gasoline?

In their article, "Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years," Hoffman and colleagues concluded that there was a 25% reduction in high-frequency hearing impairment and a 30% reduction in speech frequency hearing impairment in respondents' worse ear between the 1999 to 2004 cycle of the National Health and Nutrition Examination Survey (NHANES) and the 2011 to 2012 NHANES cycle. I hypothesize that this beneficial trend may be partially owing to the phasing out of leaded gasoline which resulted in an 87% decline in the geometric mean blood lead levels (BLL) in American adults from 13.1 μg/dL in the late 1970s to 1.64 μg/dL by the year 2000.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sfiMY7

Comprehensive Hearing Aid Intervention at a Free Subspecialty Clinic

This observational cohort study describes the structure, feasibility, and outcomes of a free subspecialty clinic providing hearing aids to develop a paradigm for other programs interested in implementing similar projects.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2sDMx7y

Typographical Data Error in Abstract

In the Original Investigation titled "Objective and Subjective Measures of Simultaneous vs Sequential Bilateral Cochlear Implants in Adults: A Randomized Clinical Trial," published online June 22, 2017, a typographical data error occurred in the Results section of the abstract. For the difference of 0.9 dB, the upper limit of the 95% CI should have been reported as 4.4 dB, not −4.4 dB (ie, difference, 0.9 dB [95% CI, –3.1 to 4.4 dB], not [95% CI, –3.1 to –4.4 dB]). This article was corrected online.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2iu7Ww9

Simultaneous vs Sequential Bilateral Cochlear Implants in Adults

This randomized clinical trial investigates the hearing capabilities and the self-reported benefits of simultaneous bilateral cochlear implants compared with sequential bilateral cochlear implants.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2suFtcy

Variations in the Prevalence of Hearing Loss in Children

Epidemiologic estimates of the prevalence of childhood hearing loss (HL) are important to public health and policy for a host of reasons. On the public health front, estimating the disease and disability burden of HL influences priorities in health care and research, determines whether prevention strategies are effective, and tracks longitudinal progression vs new onset of HL in the population. On a policy level, knowing the prevalence of HL in children helps policymakers allocate resources needed in the schools to rehabilitate and accommodate children and adolescents with HL, as mandated by the Individuals with Disability Education Act part C, and contributes to understanding the overall societal cost as children with HL grow into adulthood. However, epidemiological studies have reported large differences in the prevalence of childhood HL over time, from approximately 1 in 1000 to 19.5%.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vMFCay

Evaluating Surgeon-Specific Performance for Endoscopic Sinus Surgery

This study evaluates differences in surgeon-specific performance for endoscopic sinus surgery using a risk-adjusted 5-year revision endoscopic sinus surgery rate as a quality metric.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2suLtC5

Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy

This review provides an overview of the key challenges for research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2tQLlOd

Audiometric Measurement for Vocal-Fold Function Assessment

This study examines whether bedside measurement of infant cry volume using a smartphone application can be a screening tool for vocal-fold movement in flexible nasolaryngoscopy.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2u2OnNa

Exercise-Induced Vertigo in Vestibular Schwannoma

This case report describes a man in his 60s with a right intracanalicular vestibular schwannoma who presented with persistent motion-induced vertigo.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uBG3WU

Analyses of Sustained Vowels in Down Syndrome (DS): A Case Study Using Spectrograms and Perturbation Data to Investigate Voice Quality in Four Adults With DS

Automatic acoustic measures of voice quality in people with Down syndrome (DS) do not reliably reflect perceived voice qualities. This study used acoustic data and visual spectral data to investigate the relationship between perceived voice qualities and acoustic measures.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wKChYS

Persistent impairment on spirometry in chronic eosinophilic pneumonia: a longitudinal observation study (Shizuoka-CEP study)

Chronic eosinophilic pneumonia (CEP) is characterized by the accumulation of eosinophils in the lung with unknown etiology. Although systemic corticosteroid administration leads to dramatic improvement, nearly half the patients with CEP experience relapse and some develop persistent impairment of pulmonary function. However, predictive factors for this persistent impairment have not been determined.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2w9ypBl

Smartphone Photos in OR Not So Smart, Says Privacy Expert

Several physicians at a Pennsylvania hospital were disciplined after taking photos of a patient with a gruesome genital injury.
Medscape Medical News

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ygtShb

Dose-Response Effects of T Gel in Medically Castrated Men

A new study examines the treatment effects of variable doses of transdermal testosterone gel among medically castrated men.
Clinical Endocrinology

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wCgVlr

Otologic disorders in Turner syndrome

Publication date: Available online 21 September 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Bois, M. Nassar, D. Zenaty, J. Léger, T. Van Den Abbeele, N. Teissier
IntroductionPatients with Turner syndrome (TS) have craniofacial malformations, such as Eustachian tube hypoplasia and dysfunction and velar dysfunction, which foster acute otitis media. The aim of this study was to inventory pediatric otologic disorders in patients with TS at their first ENT consultation in our center.Patients and methodsWe reviewed the ENT consultation data of pediatric TS patients followed in our center between 2005 and 2015: otoscopy, hearing threshold, and history of acute otitis media or ENT surgery. Data were compared according to karyotype: X monosomy (45,X), mosaic (45,X/46,XX), isochromosome (46,Xi [Xq]), X ring chromosome X (XrX), with Y material, and "other".ResultsNinety patients, with mean age 11.9years (±4.8years) at first ENT consultation, were included: 29% showed tympanic abnormality on otoscopy, 21% had hearing loss, 24% had history of recurrent acute otitis media; 18% had undergone adenoidectomy, 24% T-tube insertion, and 5.6% tympanoplasty. No particular karyotype was associated with higher risk of hearing loss or acute otitis media.ConclusionPatients with TS showed high prevalence of pediatric otologic disorders; they therefore require close and prolonged ENT follow-up.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2feqHiw

US Food and Drug Administration Approval of Soft-Tissue Fillers

This systematic review examines the quality of evidence leading to US Food and Drug Administration approval of soft-tissue fillers.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uiXN9B

September-October Issue Highlights

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2w9UoIl

Capsular Contracture in Silicone Implant Rhinoplasty

This case series study examines the immunohistochemical features of capsular contracture in patients who have undergone silicone implant rhinoplasty.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vh1YQw

Perceived Benefits of Facial Rejuvenation Beyond Restoring Youth

This survey study examines whether face-lift and upper facial rejuvenation surgery improve observer ratings of age, attractiveness, success, and health.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2qjALdr

Association of Mental Health Status With Perception of Nasal Function

This cross-sectional study assesses the association of poor mental health with perception of nasal function.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vFVaMJ

A New Nasal Septum Splint

This Surgical Pearl describes a new type of splint designed to sit extremely caudally along the septum, to be left in place for 2 to 3 weeks postoperatively, and to replace other methods of posterior septal angle fixation to the nasal spine.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2qBx3jd

Neurovascular Characteristics of Facial Skin After Rhytidectomy

This study describes the change in epidermal nerve fibers, neurotransmitters, vasculature, and mast cells in facial skin following primary and revision face-lifts.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2olBaMl

Duration of Facial Paralysis in Studies of Emotion and Well-Being—Reply

In Reply We appreciate Chaiet and Carpenter's thoughtful contribution regarding our recently published article "Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients."

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2s5kfSc

Anatomy and Surgical Approaches to the Rabbit Nasal Septum

This ex vivo study examines the anatomy and approaches to rabbit septal surgery.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2qEmJnR

Two-Dimensional Threshold for Perception of Artificial-Appearing Lips

This survey study characterizes the quantitative measurements for the perceptual threshold of artificial- and unnatural-appearing lips.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2nheX5t

Don’t Miss the Fourth Dimension of the Nasal Airway

Nasal obstruction as a symptom is supposedly simple to grasp, with the nasal airway being easy to inspect and objective measures for both its resistance and diameter at hand. Because the nasal cavity is also amenable to enlargement through straightforward surgical procedures, a permanently blocked nose ought to be easy to fix. Yet, how often are physicians intrigued by patient dissatisfaction after surgery with what must be considered a success after nasal endoscopy? Little is known about the incidence of postoperative dissatisfaction after septoplasty, with no failures to be seen or measured. One reason for an incongruent appraisal of the outcome of surgery may be that reducing the cause of nasal obstruction or the sensation of nasal fullness to a septal deviation or mucosal edema and to swelling may be simplistic in light of the advances in our understanding of nasal pathologic conditions and mucosal neural regulation. Few studies have shown highly correlated associations of the sensation of nasal fullness with any of the objective parameters measured in routine clinical practice. The cause may be that the sensation of fullness is the computational end product of a complex neurologic integrative process. This process encompasses interoceptive sensation on the basis of the currently assessed severity relative to other competing sensory and emotional stimuli. Recollections of the difficulties experienced in breathing through the nose in the recent and more distant past also play a role. The sensation of fullness or blockage attributed to the nasal mucosa is a highly integrated interpretation of afferent information from multiple subsets of nociceptive and other neurons, with the perception of cooling during inspiration likely playing a central role.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uMSZub

Association of Diet With Skin Histological Features in UV-B–Exposed Mice

This animal model study examines the influence of a calorie-restricted diet and an obesity diet in mice exposed to long-term UV-B irradiation to assess if there is an association between diet and histopathological response to UV-B irradiation.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2pdG0vG

Association of Velopharyngeal Insufficiency With Quality of Life

This study uses the Velopharyngeal Insufficiency Effects on Life Outcomes instrument to assess the association of improved speech with quality of life in patients who underwent secondary speech surgery.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uN4ORh

Negative and Positive Online Patient Reviews of Physicians

This study explores reasons for both excellent and poor patient reviews on websites rating physicians.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2k5xEWG

Patterns of Change in Facial Skeletal Aging

This case series study of 14 adults documents patterns of change in the facial skeleton and develops a methodology for measuring these changes.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2vT3FXY

Impact of Blood Pressure, Lesion Level, and Physical Activity on Aortic Augmentation Index in Persons with Spinal Cord Injury

Journal of Neurotrauma , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xrjNjW

A Brain Electrical Activity (EEG)-Based Biomarker of Functional Impairment in Traumatic Brain Injury: A Multi-Site Validation Trial

Journal of Neurotrauma , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xm3m6K

With or without you: predictive coding and Bayesian inference in the brain

Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Laurence Aitchison, Máté Lengyel
Two theoretical ideas have emerged recently with the ambition to provide a unifying functional explanation of neural population coding and dynamics: predictive coding and Bayesian inference. Here, we describe the two theories and their combination into a single framework: Bayesian predictive coding. We clarify how the two theories can be distinguished, despite sharing core computational concepts and addressing an overlapping set of empirical phenomena. We argue that predictive coding is an algorithmic/representational motif that can serve several different computational goals of which Bayesian inference is but one. Conversely, while Bayesian inference can utilize predictive coding, it can also be realized by a variety of other representations. We critically evaluate the experimental evidence supporting Bayesian predictive coding and discuss how to test it more directly.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xr3gMR

The diverse actions of astrocytes during synaptic development

Publication date: December 2017
Source:Current Opinion in Neurobiology, Volume 47
Author(s): Alexandra P Bosworth, Nicola J Allen
In the developing brain, cortical circuits are established through a complex process of synaptogenesis, maturation, and synaptic pruning. Astrocytes carry out diverse functions during each of these stages to facilitate the formation of complex networks. Recent work has begun to demonstrate that these heterogeneous roles during excitatory synaptic development are determined by the astrocyte population, brain region, and neuron type. This review will focus on current findings which highlight cell type specific mechanisms of excitatory synaptogenesis, as well as multiple mechanisms engaged by astrocytes to facilitate synaptic maturation and pruning.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wKtWEx

Cortical inhibitory interneurons control sensory processing

Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Katherine C Wood, Jennifer M Blackwell, Maria Neimark Geffen
Inhibitory and excitatory neurons form intricate interconnected circuits in the mammalian sensory cortex. Whereas the function of excitatory neurons is largely to integrate and transmit information within and between brain areas, inhibitory neurons are thought to shape the way excitatory neurons integrate information, and they exhibit context-specific and behavior-specific responses. Over the last few years, work across sensory modalities has begun unraveling the function of distinct types of cortical inhibitory neurons in sensory processing, identifying their contribution to controlling stimulus selectivity of excitatory neurons and modulating information processing based on the behavioral state of the subject. Here, we review results from recent studies and discuss the implications for the contribution of inhibition to cortical circuit activity and information processing.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xrfipw

Ordinary Interactions Challenge Proposals That Maternal Verbal Responses Shape Infant Vocal Development

Purpose

This study tested proposals that maternal verbal responses shape infant vocal development, proposals based in part on evidence that infants modified their vocalizations to match mothers' experimentally manipulated vowel or consonant–vowel responses to most (i.e., 70%–80%) infant vocalizations. We tested the proposal in ordinary rather than experimentally manipulated interactions.

Method

Response-based proposals were tested in a cross-sectional study of 35 infants, ages 4 to 14 months, engaged in everyday interactions in their homes with their mothers using a standard set of toys and picture books.

Results

Mothers responded to 30% of infant vocalizations with vocal behaviors of their own, far fewer than experimentally manipulated response rates. Moreover, mothers produced comparatively few vowel and consonant–vowel models and responded to infants' vowel and consonant–vowel vocalizations in similar numbers. Infants showed little evidence of systematically modifying their vocal forms to match maternal responses in these interactions. Instead, consonant–vowel vocalizations increased significantly with infant age.

Conclusions

Results obtained in ordinary interactions, rather than response manipulation, did not provide substantial support for response-based mechanisms of infant vocal development. Consistent with other research, however, consonant–vowel productions increased with infant age.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://article/doi/10.1044/2017_JSLHR-S-16-0005/2655031/Ordinary-Interactions-Challenge-Proposals-That

Architecture of the Suprahyoid Muscles: A Volumetric Musculoaponeurotic Analysis

Purpose

Suprahyoid muscles play a critical role in swallowing. The arrangement of the fiber bundles and aponeuroses has not been investigated volumetrically, even though muscle architecture is an important determinant of function. Thus, the purpose was to digitize, model in three dimensions, and quantify the architectural parameters of the suprahyoid muscles to determine and compare their relative functional capabilities.

Method

Fiber bundles and aponeuroses from 11 formalin-embalmed specimens were serially dissected and digitized in situ. Data were reconstructed in three dimensions using Autodesk Maya. Architectural parameters were quantified, and data were compared using independent samples t-tests and analyses of variance.

Results

Based on architecture and attachment sites, suprahyoid muscles were divided into 3 groups: anteromedial, superolateral, and superoposterior. Architectural parameters differed significantly (p < .05) across muscles and across the 3 groups, suggesting differential roles in hyoid movement during swallowing. When activated simultaneously, anteromedial and superoposterior muscle groups could work together to elevate the hyoid.

Conclusions

The results suggest that the suprahyoid muscles can have individualized roles in hyoid excursion during swallowing. Muscle balance may be important for identifying and treating hyolaryngeal dysfunction in patients with dysphagia.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://article/doi/10.1044/2017_JSLHR-S-16-0277/2655032/Architecture-of-the-Suprahyoid-Muscles-A

JMV2894, a novel growth hormone secretagogue, accelerates body mass recovery in an experimental model of cachexia

Abstract

Oncologic patients subjected to chemotherapy frequently present aphagia, malnutrition, and cachexia. The purpose of this study was to investigate whether selected growth hormone secretagogues including hexarelin, JMV2894 and JMV2951 could antagonize body weight loss and wasting induced by cisplatin administration in rats. The three growth hormone secretagogues behaved as full agonists of the growth hormone secretagogues receptor both in terms of ability to stimulate calcium mobilization in Chinese hamster ovary cells and stimulation of growth hormone release in neonatal rats. Adult rats were (i) treated with vehicle throughout (controls), or (ii) treated with cisplatin (days 1–3) and a growth hormone secretagogues or vehicle, (days 1–12). Body weight and food consumption were measured daily. Although all growth hormone secretagogues caused initial transient acute increases in food intake, the total amount of food eaten by controls and growth hormone secretagogues treated groups over the 12 experimental days was not significantly different. All groups pre-treated with cisplatin lost up to 5–10 % body weight in the first 4 days; they subsequently gained weight at a rate comparable with controls. Interestingly, rats which received JMV2894 demonstrated a faster gain in body weight than any other growth hormone secretagogues treated group and at the end of the protocol reached a weight similar to that of controls. JMV2894 did not stimulate perirenal and epididymal fat accumulation but reduced MuRF mRNA levels in skeletal muscles. In conclusion, our findings demonstrate that JMV2894 antagonizes cisplatin induced weight loss in rats and may prove useful in antagonizing cachexia associated with cancer and chemotherapy in humans.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2flr6Ub

Is the hypothalamic–pituitary–adrenal axis disrupted in type 2 diabetes mellitus and is this relevant for bone health?

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xyQxby

Significance of glucocorticoid receptor expression in patients with non-small cell lung cancer treated with pemetrexed-based chemotherapy

Abstract

Background

Pemetrexed is the preferred chemotherapy agent in the management of non-squamous non-small cell lung cancer (non-sq-NSCLC), but lacks biomarkers predicting its efficacy. Dexamethasone, one of the premedications of pemetrexed, may downregulate p53 through the glucocorticoid receptor (GR). The purpose of our study was to explore the effect of GR in peripheral blood mononuclear cells (PBMC) and its role in predicting pemetrexed efficacy.

Methods

In all, 122 patients with stage IV non-sq-NSCLC who received first-line pemetrexed-containing chemotherapy were retrospectively reviewed. The expression of GR in PBMC was measured before treatment with pemetrexed using real-time PCR was used to detect the levels of GRα and GRβ.

Results

The response rate for all patients was 38.5%, with a median progression-free survival (PFS) of 5.9 months and overall survival (OS) of 14.3 months. In univariate analyses, patients with a low GRα/GRβ ratio in PBMC had higher RR, better PFS, and better OS than those with a high GRα/GRβ ratio (RR: 48.2 vs. 30.3%, p = 0.043; mPFS: 6.9 vs. 4.0 months, p < 0.001; mOS: 18.7 vs. 12.2 months, p = 0.005). The baseline GRα/GRβ ratio was an independent factor for RR (odds ratio [OR] = 0.451, 95% CI 0.208–0.978; p = 0.044), PFS (HR = 1.584, 95% CI 1.094–2.295; p = 0.015), and OS (HR = 1.761, 95% CI 1.195–2.595; p = 0.004).

Conclusions

Baseline GRα/GRβ ratio in PBMC may play a role in predicting the efficacy of first-line pemetrexed-containing chemotherapy in stage IV non-sq NSCLC patients.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2hn7yLV

Synthetic lethality in malignant pleural mesothelioma with PARP1 inhibition

Abstract

Malignant pleural mesotheliomas (MPM) are most often surgically unresectable, and they respond poorly to current chemotherapy and radiation therapy. Between 23 and 64% of malignant pleural mesothelioma have somatic inactivating mutations in the BAP1 gene. BAP1 is a homologous recombination (HR) DNA repair component found in the BRCA1/BARD1 complex. Similar to BRCA1/2 deficient cancers, mutation in the BAP1 gene leads to a deficient HR pathway and increases the reliance on other DNA repair pathways. We hypothesized that BAP1-mutant MPM would require PARP1 for survival, similar to the BRCA1/2 mutant breast and ovarian cancers. Therefore, we used the clinical PARP1 inhibitors niraparib and olaparib to assess whether they could induce synthetic lethality in MPM. Surprisingly, we found that all MPM cell lines examined, regardless of BAP1 status, were addicted to PARP1-mediated DNA repair for survival. We found that niraparib and olaparib exposure markedly decreased clonal survival in multiple MPM cell lines, with and without BAP1 mutations. This clonal cell death may be due to the extensive replication fork collapse and genomic instability that PARP1 inhibition induces in MPM cells. The requirement of MPM cells for PARP1 suggests that they may generally arise from defects in HR DNA repair. More importantly, these data demonstrate that the PARP1 inhibitors could be effective in the treatment of MPM, for which little effective therapy exists.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2hjoB58

Superactive human leptin antagonist (SHLA), triple Lan1 and quadruple Lan2 leptin mutein as a promising treatment for human folliculoma

Abstract

Purpose

There are no data showing a direct correlation between obesity and increased blood leptin levels with folliculoma. Moreover, folliculoma is not the best studied among other ovarian cancer types. We investigated whether oestradiol can modulate ObR expression in some oestrogen-responsive tissues and that leptin exerts its activity not only via the leptin receptor but also through cross talk with other signalling systems. We hypothesise that blocking ObR expression could be a novel treatment for gonadal ovarian cancer.

Methods

We evaluated the effect of SHLA, Lan1 and Lan2 blockers on cell proliferation (BrdU incorporation assay), ObR and ERα/β gene expression (qPCR), oestradiol secretion (ELISA) and cell cycle protein expression (Western blot) in the non-cancerous cell line HGrC1 and two granulosa cancer cell lines: the juvenile form (COV434) and the adult form (KGN).

Results

ObR gene expression in cancer cell lines was 50% higher than in the non-cancer cells. Lan-1 and Lan-2 decreased ObR expression in COV434, while it had no effect in KGN cells. Higher ERβ expression in non-cancer and higher ERα expression in both cancer cell lines was noted. SHLA and Lan-1 changed the ratio towards greater expression of ERβ, characteristic of non-cancer granulosa cells. All ObR antagonists in HCrC1 and KGN but only Lan-2 in COV434 reversed leptin-stimulated proliferation. In both non-cancer and cancer granulosa cells, leptin acts as a cyclinD/cdk4, cyclin A/cdk2 and E2F inhibitor.

Conclusion

These results indicate that SHLA and Lan2 are promising leptin receptor inhibitors that can eliminate the negative effects of leptin. These compounds should be considered in further ex vivo studies on the cancer microenvironment.

Graphical abstract

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2hmkIc2

Consumption of alcohol and cardiovascular disease mortality: a 16 year follow-up of 115,592 Norwegian men and women aged 40–44 years

Abstract

We tested whether teetotalism explains the upturn in cardiovascular risk for non-drinkers and whether wine is a more favorable alcohol type. We studied 115,592 men and women aged 40–44 years who participated in the age 40 program in Norway in 1994–1999 and were followed for an average of 16 years with 550 cardiovascular deaths. Self-reported number of glasses of beer, wine and spirits during 14 days was transformed to alcohol units/day. One unit is approximately 8 grams of pure alcohol. The mean and median number of alcohol units/day were 0.70 and 0.46. Teetotallers had higher risk of dying from cardiovascular disease than alcohol consumers, multivariate adjusted hazard ratio (95% CI) 1.97 (1.52–2.56). The use of alcohol-related deaths as endpoint substantiated a selection of previous alcohol users to the teetotal group. Without teetotallers there was no association between alcohol consumption and cardiovascular disease mortality. However, the multivariate adjusted hazard ratio per one unit/day of wine was 0.76 (0.58–0.99). The corresponding figures for beer and spirits were 1.04 (0.94–1.15) and 0.98 (0.75–1.29). The upturn in risk for non-drinkers could be explained by a higher risk for teetotallers who likely included previous alcohol users or teetotalers who started to drink during follow-up. Wine gave the most favorable risk estimates.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yt6U7e

Advantages of the glove port docking technique in robotic single-site cholecystectomy: comparison with the conventional silicone port

Abstract

Although the da Vinci Single-Site^® silicone port allows exact alignment and effective triangulation of instruments, it also has drawbacks. We introduce an alternative docking technique using the Glove port^®. From April 2014 to December 2016, respective 50 patients of the conventional silicone port and the glove port group were compared. The mean docking time was 16.6 ± 6.6 min in the silicone port group and 10.6 ± 3.6 min in the glove port group. Re-docking during the operation was needed in three patients in the silicone port group and readjustment of cannulae without re-docking could be simply performed in five patients in the glove port group. Skin injury was observed in 17 patients in the silicone port group and 0 patients in the glove port group without significant complications. Some limitations of the conventional silicone port were improved by the glove port.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xr8cl3

JMV2894, a novel growth hormone secretagogue, accelerates body mass recovery in an experimental model of cachexia

Abstract

Oncologic patients subjected to chemotherapy frequently present aphagia, malnutrition, and cachexia. The purpose of this study was to investigate whether selected growth hormone secretagogues including hexarelin, JMV2894 and JMV2951 could antagonize body weight loss and wasting induced by cisplatin administration in rats. The three growth hormone secretagogues behaved as full agonists of the growth hormone secretagogues receptor both in terms of ability to stimulate calcium mobilization in Chinese hamster ovary cells and stimulation of growth hormone release in neonatal rats. Adult rats were (i) treated with vehicle throughout (controls), or (ii) treated with cisplatin (days 1–3) and a growth hormone secretagogues or vehicle, (days 1–12). Body weight and food consumption were measured daily. Although all growth hormone secretagogues caused initial transient acute increases in food intake, the total amount of food eaten by controls and growth hormone secretagogues treated groups over the 12 experimental days was not significantly different. All groups pre-treated with cisplatin lost up to 5–10 % body weight in the first 4 days; they subsequently gained weight at a rate comparable with controls. Interestingly, rats which received JMV2894 demonstrated a faster gain in body weight than any other growth hormone secretagogues treated group and at the end of the protocol reached a weight similar to that of controls. JMV2894 did not stimulate perirenal and epididymal fat accumulation but reduced MuRF mRNA levels in skeletal muscles. In conclusion, our findings demonstrate that JMV2894 antagonizes cisplatin induced weight loss in rats and may prove useful in antagonizing cachexia associated with cancer and chemotherapy in humans.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2flr6Ub

Is the hypothalamic–pituitary–adrenal axis disrupted in type 2 diabetes mellitus and is this relevant for bone health?

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xyQxby

Integrated network analysis to explore the key genes regulated by parathyroid hormone receptor 1 in osteosarcoma

Abstract

Background

As an invasive malignant tumor, osteosarcoma (OS) has high mortality. Parathyroid hormone receptor 1 (PTHR1) contributes to maintaining proliferation and undifferentiated state of OS. This study is designed to reveal the action mechanisms of PTHR1 in OS.

Methods

Microarray dataset GSE46861, which included six PTHR1 knockdown OS samples and six control OS samples, was obtained from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) were identified and then performed with enrichment analysis separately using the limma package and DAVID online tool. Then, protein-protein interaction (PPI) network and module analyses were conducted using Cytoscape software. Using the WebGestalt tool, microRNAs (miRNAs) were predicted for the DEGs involved in the PPI network. Following this, transcription factors (TFs) were predicted and an integrated network was constructed by Cytoscape software.

Results

There were 871 DEGs in the PTHR1 knockdown OS samples compared with the control OS samples. Besides, upregulated ZFPM2 was involved in the miRNA-DEG regulatory network. Moreover, TF LEF1 was predicted for the miRNA-DEG regulatory network of the downregulated genes. In addition, LEF1, NR4A2, HAS2, and RHOC had higher degrees in the integrated network.

Conclusions

ZFPM2, LEF1, NR4A2, HAS2, and RHOC might be potential targets of PTHR1 in OS.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xUmjRj

Do Tattoos Raise the Risk for Cancer?

Components of the ink in tattoos migrate from the skin to the lymph nodes, leading to chronic enlargement, but the health risk has yet to be determined.
Medscape Medical News

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xTAPIH

How Residents Cope: Binging, Drinking, Sports, and Friends

Overeating. Drinking. Antidepressants. These are a few of the coping mechanisms residents rely on to get through their stressful residencies. Are there any positive coping strategies?
Medscape Business of Medicine

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xqXc6S

Extracellular Matrix and Compression for Venous Ulcers

Is the use of a hyaluronic acid extracellular matrix plus compression an effective treatment option for venous leg ulcers?
Wounds

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jNOs6f

In Breast Cancer, a Victory for Common Sense

An ambitious randomized clinical trial neither accrued its planned number of patients nor met its expected events but has changed cancer care anyway.
Medscape Medical News

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2jHBrep

'Big Alcohol' Deliberately Downplays Cancer Risk

Global alcohol producers are downplaying the cancer risks associated with drinking in order to protect profits, just like tobacco firms did, say public health experts.
Medscape Medical News

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xb5cqU

Pediatric Radiology Continuing Medical Education Activity

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fDx1k4

Hermes

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fDwEGc

Imaging community-acquired pneumonia in children

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xiiNiF

Community-acquired pneumonia in children — a changing spectrum of disease

Abstract

Pneumonia remains the leading cause of death in children outside the neonatal period, despite advances in prevention and management. Over the last 20 years, there has been a substantial decrease in the incidence of childhood pneumonia and pneumonia-associated mortality. New conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae have contributed to decreases in radiologic, clinical and complicated pneumonia cases and have reduced hospitalization and mortality. The importance of co-infections with multiple pathogens and the predominance of viral-associated disease are emerging. Better access to effective preventative and management strategies is needed in low- and middle-income countries, while new strategies are needed to address the residual burden of disease once these have been implemented.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fkjW2e

Awards from the Society for Pediatric Radiology annual meeting and categorical course, Vancouver, BC, Canada, May 16 to May 20, 2017

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xyKhk4

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project

Abstract

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2flj91h

Response of Winter Manure Application on Surface Runoff Water Quantity and Quality from Small Watersheds in South Dakota

Abstract

Manure application on frozen soil, which is a common practice in the upper Midwest of USA, results in degraded soil and water quality. During snowmelt or precipitation events, water runoff carries nutrients into nearby streams and impairs the water quality. There is a need, therefore, to identify improved management of manure application in the soils. This study was conducted to assess water quality impacts associated following manure application during winter months when soil is completely covered with snow. The study site included three watersheds, named south (SW), east (CW), and north (NW) managed with a corn (Zea mays L.)-soybean (Glycine max L.) rotation located in South Dakota. The SW and NW were used as treatment, and CW as the control watershed. The treatments included manure application on the upper half of the SW and lower half of the NW, and CW received no manure application. This study showed that manure improved soil properties including infiltration rate and organic matter. Nitrogen and phosphorus losses in the surface runoff were higher from NW compared to that of SW. The CW had similar nutrient losses compared to the NW with slight differences. It can be concluded that maintaining a setback distance can help in improving the environmental quality as well as managing the agricultural wastes during the winter months.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xU1SUj

Is There Even Such a Thing as “Idiopathic Normal Pressure Hydrocephalus”?

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2ytnvIb

Consumption of alcohol and cardiovascular disease mortality: a 16 year follow-up of 115,592 Norwegian men and women aged 40–44 years

Abstract

We tested whether teetotalism explains the upturn in cardiovascular risk for non-drinkers and whether wine is a more favorable alcohol type. We studied 115,592 men and women aged 40–44 years who participated in the age 40 program in Norway in 1994–1999 and were followed for an average of 16 years with 550 cardiovascular deaths. Self-reported number of glasses of beer, wine and spirits during 14 days was transformed to alcohol units/day. One unit is approximately 8 grams of pure alcohol. The mean and median number of alcohol units/day were 0.70 and 0.46. Teetotallers had higher risk of dying from cardiovascular disease than alcohol consumers, multivariate adjusted hazard ratio (95% CI) 1.97 (1.52–2.56). The use of alcohol-related deaths as endpoint substantiated a selection of previous alcohol users to the teetotal group. Without teetotallers there was no association between alcohol consumption and cardiovascular disease mortality. However, the multivariate adjusted hazard ratio per one unit/day of wine was 0.76 (0.58–0.99). The corresponding figures for beer and spirits were 1.04 (0.94–1.15) and 0.98 (0.75–1.29). The upturn in risk for non-drinkers could be explained by a higher risk for teetotallers who likely included previous alcohol users or teetotalers who started to drink during follow-up. Wine gave the most favorable risk estimates.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yt6U7e

Effect of proanthocyanidin on ultrastructure and mineralization of dentine collagen

Publication date: December 2017
Source:Archives of Oral Biology, Volume 84
Author(s): D.J. Epasinghe, M.F. Burrow, C.K.Y. Yiu
ObjectiveProanthocyanidin (PA) is a natural collagen cross-linker that has been used in dentine matrix biomodification for reparative and preventive therapies. This study evaluated the ultrastructure of collagen after its interaction with PA. Furthermore, the mineralization of PA-biomodified collagen matrix was observed.MethodsTen freshly extracted sound human molars were sectioned into 0.5mm×1.7mm×7mm beams for ultrastructural evaluation of PA and dentine matrix under Field Emission Scanning Electron Microscopy (FESEM) and Transmission Electron Microscopy (TEM). Specimens for TEM were completely demineralized and divided into three groups according to PA treatments: deionized water, 2% PA and 6.5% PA. The specimens were fixed, dehydrated, sectioned and examined using TEM. Specimens for FESEM were lightly conditioned with EDTA and similarly divided into the three groups for observation using FESEM. Type I collagen from calf skin was used to analyse the mineral interaction after treatment with 6.5% PA. Formvar- and carbon-coated 400-mesh Ni grids (EMS, Hatfiels, PA, USA) were placed over a 2mg/mL collagen solution prepared from calf skin-derived Type I collagen to achieve self-assembly of collagen fibrils. Grids were treated with 6.5% PA and divided into two groups. One group was floated over a remineralization solution containing 20mM HEPES, 2.25mM CaCl2-2H2O, 1.35mM KH2PO4, 3.08mM NaN3 and 130mM KCl and the other group was over a CPP-ACP solution (Tooth mousse 1:100 dilution with deionized water). The floating samples were kept in a 37°C and 100% humidity chamber. Grids were taken out at selected time durations (24h, 48h and 72h for mineralization solution/24h for CPP-ACP) and observed under TEM without staining. Selected area electron diffractions (SAEDs) were performed at 110kV.ResultsFollowing treatment of demineralized dentine collagen matrix with PA, the size and number of interfibrillar spaces were reduced. The collagen fibrils aggregated together with a reduction in porosity. A characteristic banding pattern of collagen fibrils was observed under TEM. Treatment of PA-biomodified collagen fibrils with remineralization solution increased mineral aggregation along its long axis, when compared to the control group. Furthermore, treatment of PA-biomodified collagen fibrils with CPP-ACP solution enhanced mineral uptake and deposition as well as initiated apatite formation within 24h.ConclusionProanthocyanidin alters the ultrastructure of demineralized dentine collagen matrix. The PA-biomodified collagen matrix promotes remineralization.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xq4LuC