Which spike train distance is most suitable for distinguishing rate and temporal coding?

Publication date: Available online 17 February 2018
Source:Journal of Neuroscience Methods
Author(s): Eero Satuvuori, Thomas Kreuz
BackgroundIt is commonly assumed in neuronal coding that repeated presentations of a stimulus to a coding neuron elicit similar responses. One common way to assess similarity are spike train distances. These can be divided into spike-resolved, such as the Victor-Purpura and the van Rossum distance, and time-resolved, e.g. the ISI-, the SPIKE- and the RI-SPIKE-distance.New MethodWe use independent steady-rate Poisson processes as surrogates for spike trains with fixed rate and no timing information to address two basic questions: How does the sensitivity of the different spike train distances to temporal coding depend on the rates of the two processes and how do the distances deal with very low rates?ResultsSpike-resolved distances always contain rate information even for parameters indicating time coding. This is an issue for reasonably high rates but beneficial for very low rates. In contrast, the operational range for detecting time coding of time-resolved distances is superior at normal rates, but these measures produce artefacts at very low rates. The RI-SPIKE-distance is the only measure that is sensitive to timing information only.Comparison with Existing MethodsWhile our results on rate-dependent expectation values for the spike-resolved distances agree with Chicharro et al. (2011), we here go one step further and specifically investigate applicability for very low rates.ConclusionsThe most appropriate measure depends on the rates of the data being analysed. Accordingly, we summarize our results in one table that allows an easy selection of the preferred measure for any kind of data.



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Homelessness and Emergency Medicine: Where Do We Go From Here?

Abstract

In many emergency departments (EDs) around the country, providers care for patients experiencing homelessness on every single shift. Despite its proven impact on health, housing status is not a routine part of the history taken by most emergency providers, and in many cases providers are unaware that they are caring for someone who has no stable home. Patients experiencing homelessness have unique needs spanning acute and chronic illness, injury, behavioral health diagnoses, and material deprivation.

This article is protected by copyright. All rights reserved.

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Incidence of haematological malignancies, Eastern Cape Province; South Africa, 2004–2013

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Diana Oelofse, Ilse Truter
BackgroundThe incidence of haematological malignancies in Africa's rapidly urbanising populations is insufficiently explored. Reliable population-based cancer statistics, however, continues to be a scarce resource in Africa and tends to be urban biased with limited rural coverage. In addition, many haematological malignancies are regarded as rare cancers, a sub-group that often affects the young disproportionately and require advanced diagnostic services and facilities able to deliver costly sophisticated treatments. This study provides a first attempt to estimate the incidence of haematological malignancies among the Eastern Cape Province population of South Africa.MethodMultiple public- and private sector data archives and resources were utilised to optimise the identification of incident cases, including clinical records; bone marrow; cytology; histology; flow cytometry and cytogenetic records. Crude incidence, age-and gender-standardised rates are presented and comparison made with existing national data and select data from other economically developed countries and global institutions.ResultsA total of 3603 incident cases were identified between 2004 and 2013. Mature lymphoid malignancies accounted for approximately 60% (n = 2153), myeloma/plasma cell neoplasms 13% (n = 465), acute leukaemia 17% (n = 596), chronic myeloid leukaemia 4% (n = 155) and other myeloproliferative neoplasms 6% (n = 234) when stratified according to conventional groups. Most subtypes increase with age, with male excess.ConclusionHaematological malignancies in the Eastern Cape Province show disparities in gender and pathology-specific incidence patterns. The present study suggest that haematological malignancies are not uncommon in this region and the incidence rate of at least one rare subtype, APL, is comparable with some European populations.



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Oculosympathetic paresis after selective neck dissection: A ‘distant’ complication

Publication date: Available online 17 February 2018
Source:Oral Oncology
Author(s): S. Mumtaz, J. Parrish, M. Singh




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Insulin-like growth factor 2: a poor prognostic biomarker linked to racial disparity in women with uterine carcinosarcoma

Abstract

The objective of this study was to investigate the relationship of insulin-like growth factor 2 (IGF2) expression and survival in women with uterine carcinosarcoma (UCS). Insulin-like growth factor 2 protein expression was determined by immunohistochemical staining of tumor tissues from 103 patients with UCS. The H-score (product of staining intensity and percentage positive cells) was quantified for the epithelial cytoplasmic (EC), epithelial nuclear (EN), and malignant stromal compartments. Multivariable Cox proportional hazard regression models were used to examine the relationship of IGF2 levels with progression-free survival (PFS) and overall survival (OS). Adjusting for stage, race, and adjuvant therapy, PFS and OS were reduced in patients with high IGF2 (H-score ≥ median) in the EC and EN compartments. Black race was independently associated with reduced PFS and OS in patients with early-stage disease, and IGF2 levels in the EC were higher in black than in white patients (P = 0.02, Wilcoxon test). In a race-stratified multivariable analysis, high IGF2 in the epithelial compartments more than doubled the risk of death in black women; HR = 2.43 (95% CI: 1.18–5.01, P = 0.02) for high IGF2 in the EC; and HR = 2.34 (95% CI: 1.25–4.39, P = 0.008) for high IGF2 in the EN. In conclusion, high tumor IGF2 expression is an independent risk factor for reduced PFS and OS in UCS. Black women have elevated tumor IGF2 compared with white women, and decreased survival associated with high IGF2. These findings identify IGF2 as a candidate biomarker for survival linked to racial disparity in women with UCS.

This study shows that IGF2 protein expression is an independent poor prognostic biomarker in uterine carcinosarcoma, a lethal uterine cancer that disproportionately impacts black women. These novel findings suggest that IGF2 is a biological mediator of an aggressive cancer phenotype and a potential therapeutic target in this disease. Moreover, we have uncovered an intriguing association of IGF2 with racial disparity in uterine carcinosarcoma survival.

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Lower third molar displaced to lateral pharyngeal space after mandibular angle fracture: a case report

Abstract

The removal of displaced dental elements from deep anatomical spaces is a condition that requires the knowledge of the region and skills to perform the procedure. The lateral pharyngeal space contains important structures such as the internal carotid artery and close proximity with the cranium basis. The aim of this paper is to report a clinical case of a lower third molar displaced to the lateral pharyngeal space after a mandibular angle fracture and its treatment by surgical intervention. The tooth was removed under general anesthesia by direct approach and the fracture was reduced and fixed with a plate and screws. This case report illustrates the importance of an immediate procedure to avoiding severe complications and further damage to important anatomical structures.

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Comparative Study of Different Classification Models in Renal-Cell Carcinoma

Abstract

The aim of this study was to compare the Memorial Sloan-Kettering Cancer Center (MSKCC) and the Cleveland Clinic Foundation (CCF) models of classification of aRCC patients. In addition, the model developed from the pivotal trial of temsirolimus and those proposed by Motzer et al. in 2004, Escudier et al., Heng et al., Choueiri et al. and Bamias et al. were examined. An observational, retrospective study of patients starting first-line systemic therapy was conducted between 2008 and 2011. The variables used to evaluate the classification models were median overall survival (mOS) and median progression-free survival (mPFS). The comparison of different classification models was performed by comparing the area under the ROC (Receiver Operating Characteristic) curve (AUC) for time-dependent variables proposed by Heagerty. Eighty-eight patients were included. When the different models were compared, it was found that although based on the mOS, the Escudier model had better short-term (1-year) prognostic value, followed by the Heng model; in the long term, the models that presented a higher prognosis capacity were the Hudes and CCF models, closely followed by the Heng model. In addition, the Heng model had a slightly higher predictive ability than the other models. Based on the results, and in line with the European society for medical oncology (ESMO) guidelines, it appears that the model of Heng could be the best model to classify patients with aRCC and combines good short- and long-term prognostics while possessing better predictive ability and a more equal distribution of patients.

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Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

Abstract

Objective

To determine the associations between individual metabolic syndrome (MetS) components and peripheral neuropathy in a large population-based cohort from Pinggu, China.

Methods

A cross-sectional, randomly selected, population-based survey of participants from Pinggu, China was performed. Metabolic phenotyping and neuropathy outcomes were performed by trained personnel. Glycemic status was defined according to the American Diabetes Association criteria, and the MetS using modified consensus criteria (body mass index instead of waist circumference). The primary peripheral neuropathy outcome was the Michigan Neuropathy Screening Instrument (MNSI) examination. Secondary outcomes were the MNSI questionnaire and monofilament testing. Multivariable models were used to assess for associations between individual MetS components and peripheral neuropathy. Tree-based methods were used to construct a classifier for peripheral neuropathy using demographics and MetS components.

Results

The mean (SD) age of the 4002 participants was 51.6 (11.8) and 51.0% were male; 37.2% of the population had normoglycemia, 44.0% prediabetes, and 18.9% diabetes. The prevalence of peripheral neuropathy increased with worsening glycemic status (3.25% in normoglycemia, 6.29% in prediabetes, and 15.12% in diabetes, P < 0.0001). Diabetes (odds ratio [OR] 2.60, 95% CI 1.77–3.80) and weight (OR 1.09, 95% CI 1.02–1.18) were significantly associated with peripheral neuropathy. Age, diabetes, and weight were the primary splitters in the classification tree for peripheral neuropathy.

Interpretation

Similar to previous studies, diabetes and obesity are the main metabolic drivers of peripheral neuropathy. The consistency of these results reinforces the urgent need for effective interventions that target these metabolic factors to prevent and/or treat peripheral neuropathy.

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Phenotypic heterogeneity in m.3243A>G mitochondrial disease: The role of nuclear factors

Abstract

Objective

The pathogenic mitochondrial DNA m.3243A>G mutation is associated with a wide range of clinical features, making disease prognosis extremely difficult to predict. We aimed to understand the cause of this heterogeneity.

Methods

We examined the phenotypic profile of 238 adult m.3243A>G carriers (patients and asymptomatic carriers) from the UK MRC Mitochondrial Disease Patient Cohort using the Newcastle Mitochondrial Disease Adult Scale. We modeled the role of risk factors for the development of specific phenotypes using proportional odds logistic regression. As mitochondria are under the dual control of their own and the nuclear genome, we examined the role of additive nuclear genetic factors in the development of these phenotypes within 46 pedigrees from the cohort.

Results

Seizures and stroke-like episodes affect 25% and 17% of patients, respectively; more common features include hearing impairment, gastrointestinal disturbance, psychiatric involvement, and ataxia. Age, age-adjusted blood heteroplasmy levels, and sex are poor predictors of phenotypic severity. Hearing impairment, diabetes, and encephalopathy show the strongest associations, but pseudo-R² values are low (0.14–0.17). We found a high heritability estimate for psychiatric involvement (h²=0.76, P = 0.0003) and moderate estimates for cognition (h²=0.46, P = 0.0021), ataxia (h² = 0.45, P = 0.0011), migraine (h² = 0.41, P = 0.0138), and hearing impairment (h² = 0.40, P = 0.0050).

Interpretation

Our results provide good evidence for the presence of nuclear genetic factors influencing clinical outcomes in m.3234A>G-related disease, paving the way for future work identifying these through large-scale genetic linkage and association studies, increasing our understanding of the pathogenicity of m.3243A>G and providing improved estimates of prognosis.

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Nucleocytoplasmic transport defect in a North American patient with ALS8

Abstract

Amyotrophic lateral sclerosis 8 (ALS8) is a rare progressive neurodegenerative disease resulting from mutation in the gene for vesicle-associated membrane protein-associated protein B. We evaluated a North American patient using exome sequencing, and identified a P56S mutation. The disease protein had similar subcellular localization and expression levels in the patient and control fibroblasts. Patient fibroblasts showed increased basal endoplasmic reticulum stress and dysfunction of nucleocytoplasmic transport as evidenced by impaired Ran trafficking. This finding extends the identification of ALS8 into North America, and indicates a cellular defect similar to other forms of hereditary motor neuron disease.

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Placebo-controlled crossover assessment of mecasermin for the treatment of Rett syndrome

Abstract

Objective

To measure the efficacy of mecasermin (recombinant human insulin-like growth factor 1, rhIGF-1), for treating symptoms of Rett syndrome (RTT) in a pediatric population using a double-blind crossover study design.

Methods

Thirty girls with classic RTT in postregression stage were randomly assigned to placebo or rhIGF-1 in treatment period 1 and crossed over to the opposite assignment for period 2 (both 20 weeks), separated by a 28-week washout period. The primary endpoints were as follows: Anxiety Depression and Mood Scale (ADAMS) Social Avoidance subscale, Rett Syndrome Behaviour Questionnaire (RSBQ) Fear/Anxiety subscale, Parent Target Symptom Visual Analog Scale (PTSVAS) top three concerns, Clinical Global Impression (CGI), Parent Global Impression (PGI), and the Kerr severity scale. Cardiorespiratory- and electroencephalography (EEG)-based biomarkers were also analyzed.

Results

There were no significant differences between randomization groups. The majority of AEs were mild to moderate, although 12 episodes of serious AEs occurred. The Kerr severity scale, ADAMS Depressed Mood subscale, Visual Analog Scale Hyperventilation, and delta average power change scores significantly increased, implying worsening of symptoms. Electroencephalography (EEG) parameters also deteriorated. A secondary analysis of subjects who were not involved in a placebo recall confirmed most of these findings. However, it also revealed improvements on a measure of stereotypic behavior and another of social communication.

Interpretation

As in the phase 1 trial, rhIGF-1 was safe; however, the drug did not reveal significant improvement, and some parameters worsened.

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Reflection impulsivity perceptual decision-making in patients with restless legs syndrome

Abstract

Objectives

The objective of this study was to investigate perceptual decision-making and reflection impulsivity in drug naïve patients with restless legs syndrome (RLS) and patients with dopaminergic therapy.

Methods

A total of 35 RLS patients (20 who were drug naïve regarding dopaminergic medication and 15 patients treated with dopaminergic therapy without augmentation or impulse control disorders) were included in this study. We used the Beads task and the Pixel task which assess reflection impulsivity and perceptual decision-making, respectively. Results were compared to 20 healthy controls.

Results

Both RLS patient groups gathered less evidence than healthy controls in the Beads task before making a decision (P < 0.001), but patients with dopaminergic treatment gathered less information than drug naïve patients (P = 0.026). Moreover, both patient groups made more choices against the evidence than healthy controls (both P < 0.01), but there was no difference between the two patient groups. In the Pixel task, we found an effect of task difficulty on reaction times with patients and controls responding faster with reduced task difficulty. There was neither an effect of group on reaction times nor an effect of group on error rates.

Conclusions

Reflection impulsivity is common in RLS patients, regardless whether they are drug naïve or treated with dopaminergic therapy. Thus, RLS patients tend to gather less information compared to healthy controls which could have a negative effect on decision-making in daily life and should be investigated further.

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Brain atrophy and disability worsening in primary progressive multiple sclerosis: insights from the INFORMS study

Abstract

Objective

To investigate the relationship between brain volume and disability worsening over ≥3 years in the natural history of primary progressive multiple sclerosis using data from the placebo group of the INFORMS trial (n = 487; clinicaltrials.gov NCT00731692).

Methods

Magnetic resonance imaging scans were collected annually. Brain volume loss was determined using SIENA. Patients were stratified by baseline normalized brain volume after adjusting for demographic and disease-burden covariates.

Results

Baseline normalized brain volume was predictive of disability worsening: Risk of 3-month confirmed disability progression was reduced by 36% for high versus low baseline normalized brain volume (Cox's model hazard ratio 0.64, P = 0.0339; log-rank test: P = 0.0297). Moreover, on-study brain volume loss was significantly associated with disability worsening (P = 0.012) and was evident in patients with or without new lesions or relapses. Brain volume loss depended significantly on baseline T2 lesion volume (P < 0.0001). Despite low inflammatory activity at baseline (13% of patients had gadolinium-enhancing lesions) and throughout the study (mean 0.5 new/enlarging T2 lesions and 172 mm³ T2 lesion volume increase per year), baseline T2 lesion volume was substantial (mean 10 cm³). Lower normalized brain volume at baseline correlated with higher baseline T2 volume and older age (both P < 0.0001).

Interpretation

Baseline brain volume and the rate of ongoing brain atrophy are significantly associated with disability worsening in primary progressive multiple sclerosis. Brain volume loss is significantly related to baseline T2 lesion volume, but partially independent of new lesion activity, which might explain the limited efficacy of anti-inflammatory treatment.

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Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy

Abstract

Objective

We aimed to evaluate the impact of underlying mechanism of basilar artery (BA) occlusion on the outcomes after endovascular therapy (EVT) for reperfusion and the outcome factors associated with each mechanism, and to identify radiologic parameters enabling to distinguish the underlying mechanism.

Methods

From a registry database, 194 consecutive patients with acute BA occlusion who underwent EVT were analyzed. Stroke mechanism, classified into in situ atherosclerotic thrombosis (ISAT) and embolism, clot sign location profiles in pre-angiography magnetic resonance image (MRI), parameters of angiography and EVT, and reperfusion were assessed. Poor outcome was defined as a modified Rankin-Scale score at 90 days of 3–6.

Results

The mean age was 68.8±11.8 years (range 21–92 years) and seventy-eight (40.2%) were female patients. 102 (52.6%) patients were classified into an embolism mechanism and 92 (47.4%) into an ISAT mechanism. Overall, ISAT mechanism compared with embolism was significantly associated with poor outcomes (P = 0.002), along with the NIHSS scores, reperfusion status, and collateral status. In the embolism group, reperfusion (P = 0.001), NIHSS scores (P < 0.001), and onset-to-treatment time (P = 0.030) were significant outcome factors. However, in the ISAT group, baseline collateral status (P = 0.001) and NIHSS scores (P < 0.001) were significant outcome factors. A clot sign at the distal BA segment on pre-angiography MRI was strongly associated with embolism mechanism (P < 0.001).

Interpretation

Stroke mechanism has a major influence on outcomes, and outcome predictors differ according to the underlying mechanism in acute BA occlusion with EVT. Clot sign profile on pre-angiography MRI might be useful to determine the underlying mechanism.

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De novo variants in CAMK2A and CAMK2B cause neurodevelopmental disorders

Abstract

Objective

α (CAMK2A) and β (CAMK2B) isoforms of Calcium/calmodulin-dependent protein kinase II (CaMKII) play a pivotal role in neuronal plasticity and in learning and memory processes in the brain. Here, we explore the possible involvement of α- and β-CaMKII variants in neurodevelopmental disorders.

Methods

Whole-exome sequencing was performed for 976 individuals with intellectual disability, developmental delay, and epilepsy. The effect of CAMK2A and CAMK2B variants on CaMKII structure and firing of neurons was evaluated by computational structural analysis, immunoblotting, and electrophysiological analysis.

Results

We identified a total of five de novo CAMK2A and CAMK2B variants in three and two individuals, respectively. Seizures were common to three individuals with CAMK2A variants. Using a minigene splicing assay, we demonstrated that a splice site variant caused skipping of exon 11 leading to an in-frame deletion of the regulatory segment of CaMKIIα. By structural analysis, four missense variants are predicted to impair the interaction between the kinase domain and the regulatory segment responsible for the autoinhibition of its kinase activity. The Thr286/Thr287 phosphorylation as a result of release from autoinhibition was increased in three mutants when the mutants were stably expressed in Neuro-2a neuroblastoma cells. Expression of a CaMKIIα mutant in primary hippocampal neurons significantly increased A-type K⁺ currents, which facilitated spike repolarization of single action potentials.

Interpretation

Our data highlight the importance of CaMKIIα and CaMKIIβ and their autoinhibitory regulation in human brain function, and suggest the enhancement of A-type K⁺ currents as a possible pathophysiological basis.

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Magnetic resonance spectroscopy reveals abnormalities of glucose metabolism in the Alzheimer's brain

Abstract

Objective

Brain glucose hypometabolism is a prominent feature of Alzheimer's disease (AD), and in this case–control study we used Magnetic Resonance Spectroscopy (MRS) to assess AD-related differences in the posterior cingulate/precuneal ratio of glucose, lactate, and other metabolites.

Methods

J-modulated Point-Resolved Spectroscopy (J-PRESS) and Prior-Knowledge Fitting (ProFit) software was used to measure glucose and other metabolites in the posterior cingulate/precuneus of 25 AD, 27 older controls, and 27 younger control participants. Clinical assessments for AD participants included cognitive performance measures, insulin resistance metrics and CSF biomarkers.

Results

AD participants showed substantially elevated glucose, lactate, and ascorbate levels compared to older (and younger) controls. In addition, the precuneal glucose elevation discriminated well between AD participants and older controls. Myo-inositol correlated with CSF p-Tau_181P, total Tau, and the Clinical Dementia Rating (CDR) sum-of-boxes score within the AD group.

Interpretation

Higher glucose to creatine ratios in the AD brain likely reflect lower glucose utilization. Our findings reveal pronounced metabolic abnormalities in the AD brain and strongly suggest that brain glucose merits further investigation as a candidate AD biomarker.

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Modulation of human corticospinal excitability by paired associative stimulation in patients with amyotrophic lateral sclerosis and effects of Riluzole

Publication date: Available online 7 February 2018
Source:Brain Stimulation
Author(s): M. Ceccanti, E. Onesti, A. Rubino, C. Cambieri, G. Tartaglia, A. Miscioscia, V. Frasca, M. Inghilleri
BackgroundAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that causes an impairment in both the upper and lower motor neurons. The recent description of numerous non-motor signs points to an involvement of the neocortex networks that is more complex than was previously believed. Paired associative stimulation (PAS), a combination of transcranial magnetic stimulation (TMS) and peripheral nerve stimulation, can enhance motor output in the contralateral hand through an NMDA-mediated sensorimotor mechanism.ObjectiveTo describe the effects of PAS on ALS patients before and after Riluzole intake compared with healthy subjects.MethodsPAS was used to detect differences between 24 newly-diagnosed ALS patients and 25 age-matched healthy controls. MEP amplitude from the abductor pollicis brevis was considered before PAS, immediately after (T0) and after 10 (T10), 20 (T20), 30 (T30) and 60 (T60) minutes. Statistical significance was calculated using RM-ANOVA.ResultsIn healthy controls, PAS significantly increased MEP amplitude at T10, T20 and T30 (p < 0.05). In ALS patients, a significant increase in MEP amplitude was also observed after 60 min (p < 0.05), thus demonstrating NMDA-mediated enhanced facilitatory plasticity. After two weeks of riluzole intake, no MEP amplitude increase was evident after PAS at any time point. In three monomelic-onset ALS patients, a long lasting sensorimotor facilitation was evident only in the hemisphere corresponding to the affected side and appeared in the opposite hemisphere when the patients manifested contralateral symptoms.ConclusionsPAS may be considered a useful tool when investigating NMDA-mediated neocortical networks in ALS patients and the modulation of such networks after anti-glutamatergic drug intake.



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Brain-state determines learning improvements after transcranial alternating-current stimulation to frontal cortex

Publication date: Available online 17 February 2018
Source:Brain Stimulation
Author(s): John Nguyen, Yuqi Deng, Robert M.G. Reinhart
BackgroundTheories of executive control propose that communication between medial frontal cortex (MFC) and lateral prefrontal cortex (lPFC) is critical for learning. 6-Hz phase synchronization may be the mechanism by which neural activity between MFC and lPFC is coordinated into a functional network. Recent evidence suggests that switching from eyes closed to open may induce a change in brain-state reflected by enhanced executive control and related functional connectivity.Objective/HypothesisTo examine whether causal manipulation of MFC and lPFC can improve learning according to the brain-state induced by switching from eyes closed to open.MethodsWithin-subjects, sham-controlled, double-blind study of 30 healthy subjects, each receiving 6-Hz in-phase high definition transcranial alternating-current stimulation (HD-tACS) applied to MFC and right lPFC prior to performing a time estimation task.ResultsHD-tACS with eyes open improved learning ability relative to sham, whereas HD-tACS with eyes closed had no significant effect on behavior.ConclusionResults suggest a phase-sensitive mechanism in frontal cortex mediates components of learning performance in a state-dependent manner.



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Combined effects of rTMS and botulinum toxin therapy in benign essential blepharospasm

Publication date: Available online 17 February 2018
Source:Brain Stimulation
Author(s): Aparna Wagle Shukla, Wei Hu, Joseph Legacy, Wissam Deeb, Mark Hallett




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Anodal Transcranial Direct Current Stimulation of the motor cortex reduces chronic pain in Alcock canal syndrome

Publication date: Available online 7 February 2018
Source:Brain Stimulation
Author(s): Raffaella Ricci, Ada Ghiggia, Ilenia La Rosa, Azzurra Milano, Walter Troni, Mark S. George, Jeffrey J. Borckardt, Lorys Castelli, Adriana Salatino




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ESMO 2017—my personal highlights

Summary

This article is not intended to be a comprehensive review of all highlights presented at the recent ESMO Annual Meeting, but rather a summary from a personal point of view in three very different fields of oncology. Breast cancer and lung cancer are traditionally in the focus of interest, and again, relevant new data were presented. The third part of this overview is focused on novel treatment strategies in malignant lymphoma, a field that is also quickly evolving and traditionally underrepresented at meetings dealing with solid cancers.

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Anti-angiogenic therapies in brain metastases

Summary

Brain metastases are a major challenge in modern oncology, as treatment options upon the diagnosis of symptomatic brain metastases are limited. Neo-angiogenesis was identified as a hallmark of brain metastasis development and inhibition using anti-angiogenic therapy might therefore be an experimental promising preventive as well as therapeutic approach. The current review will summarize the current available data on the efficacy of neo-angiogenic therapies in patients with brain metastases.

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Tracheocutaneous Sinus following Tracheocutaneous Fistula Repair: Management Strategies in a Pediatric Patient

Objective. To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutaneous fistula and to review management strategies. Background. A tracheocutaneous fistula is a common sequela of pediatric tracheostomy and can occur in as many as one in three pediatric patients. There is debate in the literature regarding optimal surgical management. Case Presentation. An 8-year-old girl presented to the emergency department with swelling and erythema over the anterior neck. Clinical exam and diagnostic imaging revealed an underlying tracheocutaneous sinus. Discussion. Complications following pediatric tracheostomy are common and range in complexity from stomal granulation to tracheocutaneous fistula. There is some debate regarding the optimal surgical management of children with tracheocutaneous fistula following tracheostomy. This report discusses the management of a pediatric child with an unusual tracheocutaneous sinus and reviews the various surgical techniques which have been described for definitive repair.

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CHANGES IN ANATOMIC POSITION OF ROOT CANAL ORIFICES IN PLURIRADICULAR TEETH FOLLOWING RE-LOCATION DURING ENDODONTIC TREATMENT

Publication date: Available online 16 February 2018
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Darian Rusu, Petra Surlin, Stratul Stefan-Ioan, Marius Boariu, Calniceanu Horia, Adrian Kasaj, Cosmin Sinescu, Didilescu Andreea
Direct access to the root canals in posterior teeth for endodontic treatment is most frequently facilitated by the straightening of the coronal parts of the root canals, having as a consequence the relocation of the canal orifices on the map of the floor of the pulp chamber (Christie & Thompson, 1994). This procedure intentionally moves the coronal aspect of a canal away from the center of the chamber, while simultaneously removing internal dentin from the pulp chamber walls. The aim of this study was to evaluate the displacement resulting from the relocation of root canal orifices during the initial phase of rotary root canal treatment in molars using the dental operating microscope (DOM) and digital image processing. Forty-three molars (17 maxillary and 26 mandibular) belonging to 43 patients (aged 18 to 62 years) with indications for root canal treatment were endodontically treated. The differences between the initial perimeter and the perimeter of the root canal orifices polygon after relocation varied between 2.7 and 3.4 microns (mean 3.0 microns), while the differences between the initial area and the area after relocation varied between 2,448,456.8 and 3,249,306.6 square microns (mean 2,848,881.7). The increase in access to the cavities and the alterations of the pulp chambers can be satisfactorily approximated by the variations of the perimeters and areas of the pulp floor polygons during root canal treatment. From a clinical perspective, these results indicate that there is a significant decrease in tooth substance in molars (except MB2).



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Porcine heart interatrial septum anatomy

Publication date: Available online 16 February 2018
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Mateusz K. Hołda, Mateusz Koziej, Katarzyna Piątek, Wiesława Klimek-Piotrowska
BackgroundThe left-sided atrial septal pouch (SP), a recently re-discovered anatomical structure within the human interatrial septum, has emerged as a possible source of thrombi formation and a trigger for atrial fibrillation, thereby potentially increasing the risk for ischemic stroke. In many studies, the swine interatrial septum has been used as model of the human heart. Also, possible new strategies and devices for management of the SPs may first be tested in this pig model. Therefore, in this study, we aimed to evaluate swine interatrial septum morphology and to compare it with the human analog, especially in the light of SP occurrence.MethodsA total of 75 swine (Sus scrofa f. domestica) hearts were examined. The interatrial septum morphology was assessed, and SPs were measured.ResultsThe most common variant of the interatrial septum was smooth septum (26.6%) followed by the patent foramen ovale channel and right SP (both 22.7%). No left or double SPs were observed. In 28.0% of all cases the fold of tissue (left septal ridge) was observed on the left side of the interatrial septum in the location where the left-sided SP should be expected. The mean length of the patent foramen ovale channel was 7.1±1.5mm. The mean right SP depth was 6.3±2.2mm, and its ostium width and height were 5.8±1.2 and 5.3±1.6mm, respectively.ConclusionsThere are significant differences between human and porcine interatrial septum morphology that should be taken into account during experimental studies. The absence of the left SP in swine results in the inability to use porcine heart as an experimental model for left-sided SP management.



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Expanding Quantification of Arsenic in Water to 0 μg L −1 with a Field Test Kit: Substituting 0.4% M/V Silver Nitrate as the Colorimetric Reagent; Employing Digital Image Analysis

Abstract

This study confronts the questionable reliability and accuracy of field test kits distributed globally to determine arsenic in drinking water. Because kits are the primary method of arsenic analysis in the areas most affected, an alternate, nontoxic formulation is needed to provide accurate results. Hypothesizing that introducing silver nitrate as the reagent in test kits could successfully substitute for restricted mercuric bromide, the study found that the reformulated kits provided reliable, precise, and accurate results over a broader range of contamination. Digital image analysis was used to examine the blue color value produced when arsine reacts with silver nitrate impregnated test strips. An optimal concentration of AgNO₃ exhibiting the greatest linearity was determined by graphical comparison and the color intensity of the strips observed to be inversely proportional to the concentration of As (III). Adapted field test kits were then constructed to examine water samples ranging in arsenic contamination from 0 to 50 μg L⁻¹. A series of reactions was completed to demonstrate reproducibility and test for the accuracy of the procedure. Statistical examination of colorimetrically quantified results confirmed the hypothesis that silver nitrate can reliably and precisely expand the kit's range of detection while maintaining its low cost, quick assessment, and uncomplicated technique. This new method, using 0.4% m/v AgNO₃ as a reagent for the Gutzeit reaction, was able to distinguish between concentrations of 0, 5, 10, 15, and 50 μg L⁻¹ at the 95% confidence level.

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Editorial Board

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Analytic validity of DecisionDx-Melanoma, a gene expression profile test for determining metastatic risk in melanoma patients

The DecisionDx-Melanoma test provides prognostic information for patients with cutaneous melanoma (CM). Using formalin-fixed paraffin-embedded primary tumor tissue, the RT-PCR-based test classifies patients in...

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PD-L1 diagnostic tests: a systematic literature review of scoring algorithms and test-validation metrics

The programmed death receptor 1 (PD-1) protein is a cell-surface receptor on certain lymphocytes that, with its ligand programmed death ligand 1 (PD-L1), helps to down-regulate immune responses. Many cancer ty...

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Differences in the expression profiles of claudin proteins in human nasopharyngeal carcinoma compared with non-neoplastic mucosa

Several studies have suggested that claudin proteins, which are the main components of tight junction structures, are related to the regulation of cell polarity and cell differentiation.

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Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by...

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Invasive Cutaneous Facial Mucormycosis in a Trauma Patient

Publication date: Available online 16 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jonathon S. Jundt, Mark E.K. Wong, Alexander M. Tatara, Nagi M. Demian
Mucormycosis, also known as zygomycosis, is an aggressive infection caused by a ubiquitous group of molds known as mucormycetes and is often associated with immune suppression or trauma among immunocompetent populations. We present the case of a 19-year-old woman who was involved in a motor vehicle accident in whom rapidly progressive invasive cutaneous facial mucormycosis subsequently developed. The diagnosis, treatment options, and incidence of this disease process are discussed in the context of trauma.



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Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis

Publication date: Available online 17 February 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): V.E. de Souza Batista, A.J. Vechiato-Filho, J.F. Santiago, M.V. Sonego, F.R. Verri, D.M. dos Santos, M.C. Goiato, E.P. Pellizzer
The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel–Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P=0.45) or prosthetic failure (P=0.65): RR 1.06 (95% CI 0.91–1.23) and RR 0.88 (95% CI 0.51–1.51), respectively; OR 2.56 (95% CI 0.27–24.39; P=0.41) and OR 0.44 (95% CI 0.15–1.26; P=0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.



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Professor Dr. Dr. Rudi Fries

September 2017 saw this Association lose some of its most influential Founder Members, including the indomitable Rudi Fries. He was deeply conscious of the major divisions in the speciality within Europe and particularly in those countries of Eastern Europe, isolated as they were by the "Iron Curtain". Perceiving a lack of flow of information in both directions, he made it his duty to discover just what was going on in the East by actively visiting all the centres he could to ascertain, personally, their state of education, training and clinical practice.

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Surgical treatment and outcome in patients over 80 years old with intracranial meningioma

Publication date: Available online 17 February 2018
Source:Clinical Neurology and Neurosurgery
Author(s): Mauro Dobran, Alessandra Marini, Davide Nasi, Valentina Liverotti, Roberta Benigni, Maurizio Iacoangeli, Massimo Scerrati
ObjectiveStudy of mortality rate and clinical outcomes in octogenarians patients operated for intracranial meningiomas.Patients and MethodsClinical, radiological and surgical data of 25 elderly patients aging over 80 years old operated at our Department from 2013 to 2016 for intracranial meningiomas have been recorded and analyzed. One-month mortality and clinical outcome at six-months after surgery were evaluated. Logistic regression was used for detecting the risk factors influencing mortality and neurological functions.ResultsThe median age at diagnosis was 81,85 years (range 80-87). Meningiomas were gross-total removed in 18 cases out of 25 (72%) and partially resected in 7 (28%).One-month post-operative mortality occurred in 2 pts out of 25 (8%). A close correlation was found between operative duration over 240 minutes and mortality (p = 0,0421). There was a significantly lower mortality in patients with ASA II rather than in patients with ASA III (p = 0,038).The median pre-operative KPS value was 74,3 (range 50-90) while at six-month follow-up was 82.The surgical time (p = 0,0006) and size of the lesion > 4 cm (p = 0,02) were a significant prognostic factors for clinical improvement at six-month follow-up.ConclusionsThe operative time and the ASA score are the most important prognostic factors for the mortality and neurological outcome of elderly patients over 80 years old operated for intracranial meningioma. Even if the number of patients is limited, our findings suggest that, after a careful preoperative stratification in elderly patients, it is possible to remove an intracranial meningioma with good results.



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Predictors of activity and participation across neurodegenerative conditions: a comparison of people with motor neurone disease, multiple sclerosis and Parkinson’s disease

Comparisons between neurological conditions have the potential to inform service providers by identifying particular areas of difficulty experienced by affected individuals. This study aimed to identify predic...

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Erratum

Publication date: Available online 17 February 2018
Source:Practical Radiation Oncology





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Editorial Board

Publication date: March 2018
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 29, Issue 1





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Diagnostic value of ultrasonography for the detection of disc displacements in the temporomandibular joint: a systematic review and meta-analysis

Abstract

Objectives

The aim was to assess the added diagnostic value of ultrasonography (US) for establishing the presence or absence of disc displacements (DDs) in temporomandibular joints (TMJs).

Materials and methods

Pubmed and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of US for the diagnosis of DD, using Magnetic resonance imaging (MRI) as the reference standard. Meta-analyses were performed with Metadisc 1.4 and RevMan 5.3.

Results

A total of 16 studies qualified for meta-analyses. For the diagnosis of DD at closed mouth position (DD-CM) and DD at maximum mouth-opening position (DD-MMO), the added values of a positive result with US for ruling in DD-CM and DD-MMO were 22 and 41%, while those of a negative result with US for ruling out DD-CM and DD-MMO were 30 and 20%. For the diagnosis of DD with reduction (DDWR) and DD without reduction (DDWoR), the added values of a positive result in US for ruling in DDWR and DDWoR were 35 and 41%, while those of a negative result in US for ruling out DDWR and DDWoR were 21 and 27%.

Conclusions

Using MRI as reference standard, the added values of both positive predictive values and negative predictive values of US for ruling in and ruling out DDs are sufficient in the decision-making in dental practice.

Clinical relevance

US can be a good imaging tool to supplement clinical examination findings in patients with suspected DDs. Combined static and dynamic examinations using high-resolution US should be preferred.

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Soft robotic devices for hand rehabilitation and assistance: a narrative review

The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To comb...

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An approach to successful slide tracheoplasty in the low birth weight neonate with single lung

Publication date: Available online 17 February 2018
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Matthew S. Yong, Joanne Harrison, Robert G. Berkowitz, Sarath Ranganathan, Igor E. Konstantinov
The advent of the slide tracheoplasty technique and a multi-disciplinary approach has improved outcomes of congenital tracheal stenosis. However, tracheal surgery in younger patients with pulmonary malformations, especially low birth-weight neonates, has been associated with increased mortality. Patients with very low birth-weight, pulmonary malformations and prematurity may be palliated prior to definitive tracheal surgery due to the poor prognosis. We report a successful and unique approach of delaying tracheal reconstruction to allow growth and development in the premature, very low birth-weight neonate (1046g) with left lung agenesis.



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A novel missense mutation in GIPC3 causes sensorineural hearing loss in an Iranian family revealed by targeted next-generation sequencing

Publication date: May 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 108
Author(s): Samira Asgharzade, Mohammad Amin Tabatabaiefar, Javad Mohammadi-asl, Morteza Hashemzadeh Chaleshtori
BackgroundRecent studies have confirmed the utility of targeted next-generation sequencing (NGS), providing a remarkable opportunity to find variants in known disease genes, especially in genetically heterogeneous disorders such as hearing loss (HL).MethodsAfter excluding mutations in the most common autosomal recessive non-syndromic HL (ARNSHL) genes via Sanger sequencing and genetic linkage analysis, we performed NGS in the proband an Iranian family with ARNSHL. The NimbleGen sequence capture array captures codingsequences (CDSs) and 100 bp of the flanking sequence of 129 common deafness genes (cat# Oto-DA3). NGSwas performed on the IlluminaHiSeq2000. BWA, SAMtools, Picard, GATK, Variant Tools, ANNOVAR, and IGV were applied for Bioinformatics analyses. Data filtering with allele frequencies (<5% in the 1000 Genomes Project and 5400 NHLBI exomes) and PolyPhen2/SIFTscores (>0.95) prioritized 1indel (insertions/deletions) and 3 missense variants in this family. Eventually, Sanger sequencing, segregation pattern, the frequency in 50 healthy matched normal controls, and evolutionary conservation of amino acid residues revealed the pathogenic variant.ResultsWe identified a novel missenseGIPC3 mutation, c.472G > A (p.Glu158 Lys). The pathogenicity of GIPC3c.472G > A was supported by its absence in the population databases and the healthy-matched controls.Sanger sequencing confirmed co-segregation of the mutation with HL.ConclusionsThis study is the first report of the contribution of theGIPC3 gene to HL in the Iranian population.Targeted NGS allows easier detection of mutations in relatively uncommon deafness genes in families with ARNSHL.



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Development and standardization of Arabic words in noise test in Egyptian children

Publication date: May 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 108
Author(s): Tayseer Taha Abdel Rahman
ObjectivesTo develop and establish norms of Arabic Words in Noise test in Egyptian children.MethodTotal number of participants was 152 with normal hearing and ranging in age from 5 to 12 years. They are subdivided into two main groups (standardization group) which comprised 120 children with normal scholastic achievement and (application group) which comprised 32 children with different types of central auditory processing disorders.Arabic version of both Speech perception in noise (SPIN) and Words in Noise (WIN) tests were presented in each ear at zero signal to-noise ratio (SNR) using ipsilateral Cafeteria noise fixed at 50 dB sensation level (dBSL).ResultsThe least performance in WIN test occurred between 5 and 7 years and highest scores from 9 to 12 years. However, no statistically significant difference was found among the three standardization age groups. Moreover, no statistically significant difference was found between the right and left ears scores or among the three lists. When the WIN test was compared to SPIN test in children with and without abnormal SPIN scores it showed highly consistent results except in children suffering from memory deficit reflecting that WIN test is more accurate than SPIN in this group of children.ConclusionsThe Arabic WIN test can be used in children as young as 5 years. Also, it can be a good cross check test with SPIN test or used to follow up children after rehabilitation program in hearing impaired children or follow up after central auditory remediation of children with selective auditory attention deficit.



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Clinical and sociodemographic characteristics associated with disease severity in juvenile recurrent respiratory papillomatosis: A study of 104 patients in a tertiary care pediatric hospital

Publication date: Available online 17 February 2018
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Lee Marvin Reyes, Juan León Aguilar, Perla Villamor, Carlos De La Torre, Alicia Álvarez, Edgar Mantilla, Hiram Álvarez-Neri
BackgroundJuvenile recurrent respiratory papillomatosis (JRRP) is generally aggressive and with a high recurrence rate. Currently, there is no definite curative treatment for JRRP. Therefore, a greater understanding of the aspects that influence the severity and prognosis of the disease is required.ObjectiveThe aim of this study was to establish the clinical and socioeconomic characteristics of pediatric patients with JRRP and its relationship with the severity of the disease in a tertiary care pediatric hospital.ResultsA strong relationship was observed between the severity of the disease and the age at the time of diagnosis, and having a tracheostomy. A moderate association was found between the severity of the disease and the age at the time of the study, the area of origin and the recurrence rate. None of the socioeconomic statuses had a correlation with the severity of the JRRP.ConclusionsJRRP is associated with multiple surgeries due to the recurrence and aggressiveness of the disease. The socioeconomic status does not seem to influence the severity of the disease, whereas younger patients and users of tracheostomy should receive a more strict follow-up given the increased risk of severe disease.



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Frequency-specific auditory brainstem response testing with age-appropriate sedation

Publication date: Available online 17 February 2018
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Yael Levit, Dror Mandel, Idit Matot
ObjectiveAuditory brainstem response (ABR) testing is the gold-standard procedure for hearing evaluation in pediatric patients who cannot complete a behavioral hearing test. The amount of audiological information obtained depends on the quality of the patient's sleep during the test. In this retrospective database review, we aimed to assess the amount and the characteristics of the audiological information obtained in ABR testing in pediatric patients with age-appropriate sedation.MethodsA retrospective chart review was conducted on 501 consecutive ABR sedation sessions performed between January 2014 and June 2016 at the Tel Aviv Medical Center. Oral triclofos was used for the sedation of younger patients (3–24 months) and intravenous propofol for older patients (>24 months). The dataset included 370 triclofos sessions (in 337 patients) and 131 propofol sessions (in 126 patients).ResultsNone of the children developed complications, and all were discharged on the same day of the evaluation. Among the hearing-impaired children, a mean of 10 (1.8 SD) ABR threshold measurements was obtained from propofol-sedated patients and 9.4 (2.8 SD) measurements from those sedated with triclofos (P = 0.039). The major characteristics of the hearing loss, including its degree, type, and configuration, were obtained from all propofol-sedated patients and from 95% of those sedated with triclofos.ConclusionsA comprehensive evaluation of hearing status can be obtained in ABR testing with age-appropriate sedation. An average number of ∼10 threshold measurements were obtained during ABR testing with age-appropriate sedation, thus allowing for the evaluation of the degree, type and configuration of the hearing loss.



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Caregivers' perception of speech and language status and related needs in children with cleft lip and palate

Publication date: Available online 17 February 2018
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): B. Subramaniyan, Roopa Nagarajan, R. Vaidyanathan, B. Rajashekhar, B.W.C. Sathiyasekaran
Background and PurposeComprehensive management for communication disorders in individuals with CLP was provided in a community based program in two rural districts in Tamilnadu, India. This program provides services at the community to empower the families about CLP and treatment options.ObjectiveTo document the caregiver perceptions' of communication status and needs in children with repaired CLP.MethodSix Focus Group Discussions were conducted in Thiruvannamalai and Cuddalore districts in Tamil Nadu, India. Participants were 55 Caregivers of children (5–12 years of age) with repaired CLP.ResultsMost participants were concerned about their child's communication and few expressed concerns about specific errors in speech observed in their children. The caregivers recognized the need for and were willing to avail speech correction services. The focus group discussions highlighted some factors that need to be considered while planning a service delivery program for speech correction. The caregivers' expressed inability to independently carryout home training programs attributing it the lack of cooperation from their children. However they were open to receiving services if it was logistically convenient.ConclusionThis study provided the caregiver perceptions' of needs relating to communication in children with CLP. These need to be incorporated in the existing program to develop a model for speech intervention that would be feasible, sustainable and have good compliance.



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Cortical plasticity with bimodal use in children with asymmetric hearing loss

Publication date: Available online 17 February 2018
Source:Hearing Research
Author(s): Melissa J. Polonenko, Blake C. Papsin, Karen A. Gordon
This longitudinal study aimed to identify auditory plasticity promoted by a cochlear implant in children with asymmetric hearing loss. Participants included 10 children who experienced (mean ± SD) 3.1 ± 3.6 years of asymmetric hearing (difference of 47.2 ± 47.6 dB) before receiving an implant at age 8.7 ± 5.1 years. Multi-channel electroencephalography was measured at initial implant use (5.8 ± 3.2 days) and after 10.2 ± 4.1 months in each child. Monaurally presented stimuli consisted of 36 ms trains of 9 acoustic clicks/biphasic electric pulses at a rate of 250 Hz, repeated at 1 Hz. The time-restricted artifact and coherent source suppression (TRACS) beamformer was used to locate sources underlying peak amplitudes of cortical responses. Results indicated consistent activity from the non-implanted ear but significant implant-driven changes to the auditory cortices. Initially, the newly implanted ear evoked activity which strongly lateralized to the ipsilateral auditory cortex and contributed to a significant aural preference for implant stimulation in children with limited acoustic experience pre-implantation. Cochlear implant use reversed these abnormalities, but the resolution was limited in children with longer periods of asymmetric hearing. These findings suggest that early implantation of children with asymmetric hearing rapidly restores hemispheric representations of bilateral auditory input in the auditory cortex. Most recorded changes were isolated to pathways stimulated by the cochlear implant, potentially reflecting an abnormal independence of the bilateral pathways with possible consequences for binaural integration in these bimodal listeners.



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EMCrit RACC Wee – State of the Crit

what's going on with the EMCrit Project

EMCrit Project by Scott Weingart.

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Age-Related Hearing Impairment Associated NAT2 , GRM7 , GRHL2 Susceptibility Gene Polymorphisms and Haplotypes in Roma and Hungarian Populations

Abstract

Age-related hearing impairment (ARHI) is the most frequent sensory disease in the elderly, which is caused by an interaction between genetic and environmental factors. Here we examined the ethnic differences, allele and genotype frequencies of the NAT2, GRM7, and GRHL2 genes pooled samples of healthy Hungarian and healthy and hearing impaired Roma people. Study populations of healthy Hungarian and Roma subjects were characterized for the rs1799930 NAT2, rs11928865 GRM7, rs10955255, rs13263539, and rs1981361 GRHL2 polymorphisms and deaf Roma subjects were characterized for the rs1799930 NAT2, rs13263539, and rs1981361 GRHL2 using a PCR-RFLP method. We found significant differences in minor allele frequencies for GRHL2 rs13263539 and rs1981361 polymorphism between healthy Roma and Hungarian samples (37.9% vs. 51.0% and 43.6% vs. 56.2%, respectively; p < 0.05). The differences of homozygous genotype of GRHL2 rs13263539 and rs1981361 variants, values were also significantly different (13.0% vs. 25.3% and 16.5 vs. 32.3%; p < 0.05). The NAT2 rs1799930 homozygous genotype was 14.0% in healthy Romas and 7.7% in Hungarians, while the minor A allele frequency was 38.0% and 26.7% in Roma and Hungarian population, respectively (p < 0.05). Furthermore, the frequency of GGT, GAC and GAT haplotypes was significantly higher in the Hungarian population than in healthy Roma (1.87 vs. 4.47%, 0.91 vs. 2.07% and 1.15 vs. 5.51%, respectively; p < 0.008). Present study revealed significant interethnic differences in allele polymorphisms of NAT2, GRM7 and GRHL2 exhibit quite marked ethnic differences in Roma populations that might have important implications for the preventive and therapeutic treatments in this population.

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Detection of acute and long-term effects of concussion: dual-task gait balance control vs. computerized neurocognitive test

Publication date: Available online 16 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): David R. Howell, Louis R. Osternig, Li-Shan Chou
ObjectiveOur aim was to examine the acute (within 72 hours of injury) and long-term (2 months post-injury) independent associations between objective dual-task gait balance and neurocognitive measurements among adolescents and young adults with a concussion and matched controls.DesignLongitudinal case-controlSettingMotion analysis laboratoryParticipantsParticipants who sustained a concussion underwent a dual-task gait analysis and computerized neurocognitive testing within 72 hours of injury and again 2 months later. Uninjured controls also completed the same test protocol in similar time increments.InterventionsNot applicableMain Outcome MeasuresWe compared dual-task gait balance control and computerized neurocognitive test performance between groups using independent samples t-tests. Multivariable binary logistic regression models were then constructed for each testing time to determine the association between group membership (concussion vs. control), dual-task gait balance control, and neurocognitive function.ResultsNinety-five participants completed the study, 51 who sustained a concussion (mean age= 17.5±3.3 years; 71% male) and 44 controls (mean age= 17.7±2.9 years; 72% male). Medial-lateral center-of-mass displacement during dual-task gait was independently associated group membership at the initial test (adjusted odds ratio [aOR]= 2.432, 95% CI= 1.269-4.661) and 2 month follow-up test (aOR= 1.817, 95% CI= 1.014-3.256) tests. Visual memory composite scores were significantly associated with group membership at the initial hour post-injury time point (aOR= 0.953, 95% CI= 0.833-0.998). However, the combination of computerized neurocognitive test variables did not predict dual-task gait balance control for concussion participants, and no single neurocognitive variable was associated with dual-task gait balance control at either testing time.ConclusionsDual-task assessments concurrently evaluating gait and cognitive performance may allow for the detection of persistent deficits beyond those detected by computerized neurocognitive deficits alone.



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Home-based neuromuscular electrical stimulation as an add-on to pulmonary rehabilitation does not provide further benefits in patients with chronic obstructive pulmonary disease: A multicenter randomized trial

Publication date: Available online 16 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tristan Bonnevie, Francis-Edouard Gravier, David Debeaumont, Catherine Viacroze, Jean-François Muir, Antoine Cuvelier, Marie Netchitaïlo, Anne Laure Roy, Jean Quieffin, Marie-Hélène Marques, Clément Médrinal, Johan Dupuis, Catherine Tardif
ObjectiveTo assess the additional effect of a home-based neuro muscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD).DesignSingle-blind, multicenter randomized trial.SettingThree PR centers.ParticipantsSubjects with severe to very severe COPD referred for PR (n=73; median FEV1, 1 (0.8-1.4) L). Twenty-two subjects discontinued the study but only one drop-out was related to the intervention (leg discomfort).InterventionSubjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, five time per week) or PR without NMES for 8 weeks.Main outcome measureThe six-minute walk test was used to assess functional capacity.ResultsEighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (p<0.01), VO2peak (p=0.02), Wmax (p<0.01), mMRC (p<0.01) and SGRQ total score (p=0.01). There was no significant difference in the magnitude of change for any outcome between groups.ConclusionsHome-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD, moreover, it may have been a burden for some patients.



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Experimental Design Optimization of Dairy Wastewater Ozonation Treatment

Abstract

In this work, an advanced oxidation process using ozonation combined with hydrogen peroxide (H₂O₂) and catalyzed by manganese (Mn²⁺) in alkaline conditions was investigated to degrade the organic matter present in a synthetic dairy wastewater (SDW) with a chemical oxygen demand (COD) of 2.3 g L⁻¹. The effect of independent factors such as pH (7–13), H₂O₂/O₃ ratio (0–1), and Mn²⁺ concentration (0–1.71 g L⁻¹) has been evaluated and the process optimized using a factorial design and a central composite design (CCD) in sequence. The experiment has been made in batch trials using 2 L of SDW in which ozone was bubbled during 2 h and samples collected for COD analyses, used as response variable. In the factorial experiment, the effect of H₂O₂ was not significant for all the ratios tested (p value > 0.10), and the effects of the pH and Mn²⁺ were positive and significant (p value ≤ 0.05). In the CCD, the linear (positive) and quadratic (negative) effects of pH and Mn²⁺ were significant (p values ≤ 0.05 and ≤ 0.10, respectively). According to the response optimizer, the optimal condition for the ozonation catalyzed by manganese at alkaline medium (COD removal of 69.4%) can be obtained in pH 10.2 and Mn²⁺ concentration of 1.71 g L⁻¹. Moreover, COD removals above 60% can be obtained for pH values of 9.5 to 11 and Mn²⁺ concentrations of 0.6 g L⁻¹.

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Evaluation of piezocision and laser-assisted flapless corticotomy in the acceleration of canine retraction: a randomized controlled trial

To evaluate the effectiveness of two minimally invasive surgical procedures in the acceleration of canine retraction: piezocision and laser-assisted flapless corticotomy (LAFC).

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Whole-exome sequencing for monozygotic twins discordant for hemifacial microsomia

Hemifacial microsomia (HFM) is the second most common congenital craniofacial malformation. Although many sporadic and familial cases have been studied to explore the etiology and pathogenesis of HFM, no common understanding has been reached. We aimed to further probe into the etiology of HFM through studying monozygotic twins. Here, we report two cases of pairs of monozygotic twins discordant for HFM, and performed whole-exome sequencing (WES) and bioinformatics analysis to help determine the underlying molecular mechanisms.

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Organisation of lymphocytic infiltrates inANCA-associated glomerulonephritis

Abstract

Aims

Renal involvement in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis contributes to significant morbidity and mortality in patients. In chronic inflammation, B cells are recruited to the inflamed tissue and organised lymphoid structures have been described in several autoimmune diseases. Aim of this study was to correlate the lymphoid organisation in renal biopsies with renal outcome in ANCA-associated glomerulonephritis (GN).

Methods and results

We investigated 112 renal biopsies from patients with newly diagnosed ANCA-associated necrotizing GN. We identified four different levels of the intrarenal organisation of lymphocytes: T cells without B cells, scattered B and T cells, clustered lymphocytic infiltrates, and nodular compartmentally arranged B and T cell aggregates. Almost half of patients showed clusters of B and T lymphocytes in their biopsies. In 15 of these biopsies, a higher degree of organisation with lymphocytic compartments was detected. Inflammatory cell organisation was associated with renal failure, but not with tubular atrophy and interstitial fibrosis. Patients with organised lymphocytic infiltrates in their biopsy had worse renal function during follow-up and were more likely to develop end stage renal disease.

Conclusions

In the present study, we show that the renal lymphocytic organisation is associated with renal outcome in ANCA-associated GN. The organisation of the lymphocytic infiltrate may be a morphologic correlate of a perpetual and exaggerated inflammation in renal ANCA disease. Classifying the lymphocytic infiltrate could help predict renal outcome, and might therefore be used for individualised adjustments in the intensity and duration of immunosuppressive therapy.

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Editorial Board

Publication date: February 2018
Source:Critical Reviews in Oncology/Hematology, Volume 122





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The anti-malarial mefloquine inhibits NF-κB signaling and induces apoptosis in colorectal cancer cells

Abstract

The NF-κB signaling pathway is activated in many colorectal cancer (CRC) cells and in the tumor microenvironment, which plays a critical role in cancer initiation, development, and response to therapies. We found in the present study that the widely used antimalarial drug mefloquine was a NF-κB inhibitor that blocked the activation of IκBα kinase, leading to the reduction of IκBα degradation, decrease of p65 phosphorylation, and suppressed expression of NF-κB target genes in colorectal cancer cells. We also found that mefloquine induced growth arrest and apoptosis of colorectal cancer cells harboring phosphorylated p65 in culture and mice. Furthermore, expression of constitutive active IKKβ kinase significantly attenuated the cytotoxic effect of the compound. These results demonstrated that mefloquine could exert anti-tumor action through inhibiting the NF-κB signaling pathway, and indicated that the antimalaria drug might be re-purposed for anti-CRC therapy in clinic as a single agent or in combination with other anti-cancer drugs.

This article is protected by copyright. All rights reserved.

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Downregulation of reticulocalbin-1 differentially facilitates apoptosis and necroptosis in human prostate cancer cells

Abstract

Reticulocalbin 1 (RCN1), an endoplasmic reticulum (ER)-resident Ca²⁺-binding protein, is dysregulated in cancers, but its pathophysiological roles are largely unclear. Here, we demonstrate that RCN1 is overexpressed in clinical prostate cancer (PCa) samples, associated with Cyclin B, not Cyclin D1 expression, compared to that of benign tissues in a Chinese Han population. Downregulation of endogenous RCN1 significantly suppresses PCa cell viability and arrests the cell cycles of DU145 and LNCaP cells at the S and G2/M phases, respectively. RCN1 depletion causes ER stress, which is evidenced by induction of GRP78, activation of PERK, and phosphorylation of eIF2α in PCa cells. Remarkably, RCN1 loss triggers DU145 cell apoptosis in a caspase-dependent manner but mainly causes necroptosis in LNCaP cells. An animal based analysis confirms that RCN1 depletion suppresses cell proliferation and promotes cell death. Further investigations reveal that RCN1 depletion leads to elevation of PTEN and inactivation of AKT in DU145 cells. Silencing of PTEN partially restores apoptotic cells upon RCN1 loss. In LNCaP cells, predominant activation of CaMKII is important for necroptosis in response to RCN1 depletion. Thus, RCN1 may promote cell survival and serve as a useful target for cancer therapy.

This article is protected by copyright. All rights reserved.

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Effectiveness and effect of non-vital bleaching on the quality of life of patients up to 6 months post-treatment: a randomized clinical trial

Abstract

Objectives

The aim of this study was to evaluate the esthetic perception of patients at 6 months after bleaching of non-vital teeth with 35% of hydrogen peroxide and 37% of carbamide peroxide using a walking bleach technique. We also assessed psychosocial impacts as well as the clinical effectiveness and stability of the color change.

Materials and methods

The teeth bleaching treatment was randomly assigned to two groups according to the bleaching agent used: G1 HP = 35% of hydrogen peroxide (n = 25) and G2 CP = 37% of carbamide peroxide (n = 25). The non-vital bleaching was performed in four sessions using the walking bleach technique. The color was objectively (ΔE) and subjectively (ΔSGU) evaluated. The esthetic perception and psychosocial factors were evaluated before treatment as well as one and 6 months post-treatment using Oral Health Impact Profile (OHIP) esthetics and Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ).

Results

The color change (ΔE) at 6 months (G1 = 14.53 ± 5.07 and G2 = 14.09 ± 6.61) for both color groups remained stable until the 6-month post-treatment (p > 0.05). There was a decrease in the values of OHIP esthetics and PIDAQ after treatment compared to the baseline (p < 0.05), and this effect was maintained 6 months post-treatment.

Conclusions

Both agents were highly effective and maintained the color stability at 6 months; this positively affected the esthetic perception and psychosocial impact of patients who also remained stable over time.

Clinical relevance

Non-vital bleaching produces a positive and stable impact on the esthetic perception and psychosocial factors at medium-term follow-ups.

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Prognostic importance of FGF2 And FGFR1 expression for patients affected by ameloblastoma

Abstract

Background

Fibroblast growth factor 2 (FGF2) and FGF receptor 1 (FGFR1) have been investigated in different human neoplasms and were shown to play important roles in the pathogenesis of these diseases; however, very few is known regarding their prognostic importance in the context of ameloblastoma. Therefore, the aim of this study is to investigate if the expression of FGF2 and FGFR1 is associated with ameloblastoma clinical behavior.

Methods

Fifty-eight cases of ameloblastoma arranged in tissue microarray were submitted to immunohistochemistry against FGF2 and FGFR1. Clinicopathological parameters regarding sex, age, tumor size, duration and location, treatment, recurrences, radiographic features, cortical disruptions, and follow-up data were obtained from patients' medical records and correlated with the molecules expression. Univariate and multivariate Cox regression analyses were used to investigate the prognostic potential of the biomarkers.

Results

Forty-four cases (75.9%) exhibited cytoplasmic positivity for FGF2 in central and peripheral epithelial cells, 46 out of 58 (79.3%) showed FGFR1 cytoplasmic positivity predominantly in the columnar peripheral cells, and 43 cases (74.1%) were positive for both. Expression of FGF2 and FGF2+FGFR1 was associated with tumor recurrences (p = 0.05). However, univariate and multivariate analyses did not demonstrate a significant influence of FGF2, FGFR1 or FGF2+FGFR1 in the 5-year disease-free survival (DFS) rate (p = 0.27, p = 0.33 and p = 0.25, respectively).

Conclusion

Cytoplasmic expression of FGF2 and FGF2+FGFR1 are associated with ameloblastoma recurrence, but FGF2 and FGFR1 are not determinants of a lower DFS.

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Whole-exome sequencing for monozygotic twins discordant for hemifacial microsomia

Publication date: Available online 16 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Xiaojun Chen, Feng Xu, Fatao Liu, Aung M. Zin, Wei Chen, Wenqing Han, Xianxian Yang, Yan Zhang, Gang Chai, Ruhong Zhang
Hemifacial microsomia (HFM) is the second most common congenital craniofacial malformation. Although many sporadic and familial cases have been studied to explore the etiology and pathogenesis of HFM, no common understanding has been reached. We aimed to further probe into the etiology of HFM through studying monozygotic twins. Here, we report two cases of pairs of monozygotic twins discordant for HFM, and performed whole-exome sequencing (WES) and bioinformatics analysis to help determine the underlying molecular mechanisms. We identified 93 and 83, and 101 and 104 genes containing rare germline mutations in the twins of the two pairs, respectively. No positive gene candidates were found among the samples, and none of the analyses results revealed a clear intersection with previously reported gene candidates. The pathogenesis of HFM twin pairs does not appear to be related to single nucleotide variants or small insertions/deletions. Thus, HFM may be caused by structure variations, epigenetic alterations, and/or instability of short repeat sequences, which requires further investigation in a larger cohort with sequencing technology for verification.



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Association between third molar and mandibular angle fracture: A systematic review and meta-analysis

Publication date: Available online 17 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Francesco Giovacchini, Daniele Paradiso, Caterina Bensi, Stefano Belli, Giuseppe Lomurno, Antonio Tullio
PurposeThe aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the mandibular fracture occurs.MethodsA systematic literary search was performed in Pubmed, Scopus, and the Cochrane Library for observational studies with at least 250 patients that included frequency of mandibular angle fracture, presence of third molar, and its position.ResultsA total of seven studies were included in the review, from an initial search of 622 titles. The relative risk of mandibular angle fracture with third molar was 1.90 (95% CI = 1.47–2.46). The relative risk of mandibular angle fracture related to third molar position (according to the Pell and Gregory classification) was 1.18 (95% CI = 0.62–2.25), 1.98 (95% CI = 0.95–4.10), 2.72 (95% CI = 1.78–4.16), 1.31 (95% CI = 0.80–2.14), 2.21 (95% CI = 1.69–2.87) and 2.99 (95% CI = 2.12–4.22) for Class A, Class B, Class C, Class I, Class II, and Class III, respectively.ConclusionsOur meta-analysis reported a two-fold increased risk of mandibular angle fracture with the presence of a third molar in patients who presented with mandibular fractures. Even the third molar position seemed to influence mandibular angle fracture, especially Class C, Class II, and Class III.



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Foreword

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1, Supplement
Author(s): B. Fraysse, V. Couloigner, D. Chevalier




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International consensus (ICON) on the ENT role in diagnosis of obstructive sleep apnea syndrome

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1, Supplement
Author(s): M.C. Ouayoun, F. Chabolle, A. De Vito, C. Heiser, V.K. Paramasivan, F.A.W. Rabelo, B. Rotenberg, M.V. Suurna
During the 2017 IFOS ENT World Congress, an international expert panel was asked to clarify the role of ENT in the diagnosis process of the obstructive sleep apnea syndrome (OSA) in adults around the world. OSA is a major public health issue throughout the world. OSA is a highly prevalent disease with heavy clinical, social and economical outcomes. This high prevalence raises serious difficulties of diagnosis accessibility if only somnologists are able to confirm OSA diagnosis. First of all, the panellists reviewed the impact of OSA. Secondly, they defined the ENT role stressing ENT legitimacy, professional expertise and academic and institutional tasks. They also defined when somnologists were necessary. For the international panel, the ENT is a major player in the OSA diagnosis process.



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Laparoscopic hemi-splenectomy

Abstract

Laparoscopic splenectomy is now established as a safe and feasible procedure. However, it remains associated with some short- and long-term postoperative complications, especially infectious complications. To our knowledge, this is the first report (with video) focusing on the safety and feasibility of laparoscopic hemi-splenectomy and its surgical outcomes for the treatment of splenic abscesses causing septic emboli. This technique combines the immunological benefits of partial splenectomy and the postoperative benefits of a minimally invasive approach. Further studies are needed to standardize this technique and to assess its immunological and surgical benefits.

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Whole-exome sequencing for monozygotic twins discordant for hemifacial microsomia

Publication date: Available online 16 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Xiaojun Chen, Feng Xu, Fatao Liu, Aung M. Zin, Wei Chen, Wenqing Han, Xianxian Yang, Yan Zhang, Gang Chai, Ruhong Zhang
Hemifacial microsomia (HFM) is the second most common congenital craniofacial malformation. Although many sporadic and familial cases have been studied to explore the etiology and pathogenesis of HFM, no common understanding has been reached. We aimed to further probe into the etiology of HFM through studying monozygotic twins. Here, we report two cases of pairs of monozygotic twins discordant for HFM, and performed whole-exome sequencing (WES) and bioinformatics analysis to help determine the underlying molecular mechanisms. We identified 93 and 83, and 101 and 104 genes containing rare germline mutations in the twins of the two pairs, respectively. No positive gene candidates were found among the samples, and none of the analyses results revealed a clear intersection with previously reported gene candidates. The pathogenesis of HFM twin pairs does not appear to be related to single nucleotide variants or small insertions/deletions. Thus, HFM may be caused by structure variations, epigenetic alterations, and/or instability of short repeat sequences, which requires further investigation in a larger cohort with sequencing technology for verification.



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Association between third molar and mandibular angle fracture: A systematic review and meta-analysis

Publication date: Available online 17 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Francesco Giovacchini, Daniele Paradiso, Caterina Bensi, Stefano Belli, Giuseppe Lomurno, Antonio Tullio
PurposeThe aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the mandibular fracture occurs.MethodsA systematic literary search was performed in Pubmed, Scopus, and the Cochrane Library for observational studies with at least 250 patients that included frequency of mandibular angle fracture, presence of third molar, and its position.ResultsA total of seven studies were included in the review, from an initial search of 622 titles. The relative risk of mandibular angle fracture with third molar was 1.90 (95% CI = 1.47–2.46). The relative risk of mandibular angle fracture related to third molar position (according to the Pell and Gregory classification) was 1.18 (95% CI = 0.62–2.25), 1.98 (95% CI = 0.95–4.10), 2.72 (95% CI = 1.78–4.16), 1.31 (95% CI = 0.80–2.14), 2.21 (95% CI = 1.69–2.87) and 2.99 (95% CI = 2.12–4.22) for Class A, Class B, Class C, Class I, Class II, and Class III, respectively.ConclusionsOur meta-analysis reported a two-fold increased risk of mandibular angle fracture with the presence of a third molar in patients who presented with mandibular fractures. Even the third molar position seemed to influence mandibular angle fracture, especially Class C, Class II, and Class III.



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Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) for Prevention of Breast Cancer-Related Lymphedema—a Preliminary Report

Abstract

Lymphatic microsurgical preventing healing approach (LYMPHA) for prevention of breast cancer-related lymphedema (BCRL)—a preliminary report BCRL—is a chronic debilitating condition which impairs quality of life of breast cancer survivors. The aim is to study the feasibility of preventing lymphedema by performing "Lymphatic Microsurgical Preventive Healing Approach (LYMPHA)." Patients undergoing breast cancer surgery with complete nodal dissection were taken up for the study. After the standard axillary nodal dissection, lymphatics were identified by the help of blue dye and were anastomosed with a tributary to the axillary vein. Post-operatively, patients were followed up clinically for development of lymphedema and lymphoscintigraphy was performed after treatment completion. A total of 35 patients were enrolled for the study. The average BMI was 29.5. LYMPHA was feasible in all cases. The number of lymphatics identified was 1 to 5 per axilla. Two patients developed transient lymphedema which resolved with conservative therapy and patients were able to discontinue the compression garment. Follow-up lymphoscintigraphy is performed in two patients, which showed normal lymphatic flow. LYMPHA is a feasible technique, not difficult to perform, takes a short time, is accomplished in same general anesthesia as for axillary dissection, and gives no extra scar. The early results are promising and long-term follow-up may make the procedure as a routine.

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Auditory effects of autologous fat graft for TORP stabilization in the middle ear: a cadaveric study

Total ossicular replacement prostheses (TORP) are often used to re-establish ossicular coupling of sound in an ear lacking a stapes supra-structure. The use of TORPs, however, is associated with a 2/3 five yea...

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Cancers, Vol. 10, Pages 54: Advanced EUS Guided Tissue Acquisition Methods for Pancreatic Cancer

Cancers, Vol. 10, Pages 54: Advanced EUS Guided Tissue Acquisition Methods for Pancreatic Cancer

Cancers doi: 10.3390/cancers10020054

Authors: Pujan Kandel Michael B. Wallace

Pancreas cancer is a lethal cancer as the majority patients are diagnosed at an advanced incurable stage. Despite improvements in diagnostic modalities and management strategies, including surgery and chemotherapies, the outcome of pancreas cancer remains poor. Endoscopic ultrasound (EUS) is an important imaging tool for pancreas cancer. For decades, resected pancreas cancer and other cancer specimens have been used to identify tissue biomarkers or genomics for precision therapy; however, only 20% of patients undergo surgery, and thus, this framework is not useful for unresectable pancreas cancer. With advancements in needle technologies, tumor specimens can be obtained at the time of tissue diagnosis. Tumor tissue can be used for development of personalized cancer treatment, such as performing whole exome sequencing and global genomic profiling of pancreas cancer, development of tissue biomarkers, and targeted mutational assays for precise chemotherapy treatment. In this review, we discuss the recent advances in tissue acquisition of pancreas cancer.

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Comparison of Post-therapy Dysphonic Voices and Normal Voices.

Related Articles

Comparison of Post-therapy Dysphonic Voices and Normal Voices.

J Voice. 2018 Feb 12;:

Authors: Schaeffer N, Fuse A

Abstract
PURPOSE: The purpose of the present investigation was to compare the voices of post-therapy dysphonic participants with participants who have normal voices to determine how close the corrected voices approached normal vocal levels. The present investigation is a follow-up to the authors' previous research in which dysphonic participants, with voices ranging from moderate-to-severe dysphonia, were evaluated pre- and post therapy using the Dysphonic Severity Percentage scale and the interval scale.
METHODS: In the present study, five raters, three speech-language pathologists experienced in assessing dysphonia, and two trained speech-language pathology college students evaluated 20 participants with normal voices under the same two conditions as those of the corrected participants-when reading a paragraph aloud and during spontaneous speech. While listening to the recordings of the normal voices, the raters tallied any dysphonic syllables produced by the participants to obtain a Dysphonic Severity Percentage for both paragraph reading and spontaneous speech. The raters also evaluated the normal voices on the interval scale. These data were compared with those of the post-therapy participants, who were evaluated under the same conditions and methods pre- and post therapy.
RESULTS AND CONCLUSION: The dysphonic participants' voices improved significantly post therapy in comparison with their pretherapy result; their improvement, however, was not commensurate with the voices of the normal participants, and the data showed a significant difference between the two groups. Both evaluation scales reflected a high agreement among raters.

PMID: 29449063 [PubMed - as supplied by publisher]

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Vocal Cord Paresis After Posterior Spinal Fusion to Treat Adolescent Idiopathic Scoliosis: A Case Report.

Related Articles

Vocal Cord Paresis After Posterior Spinal Fusion to Treat Adolescent Idiopathic Scoliosis: A Case Report.

JBJS Case Connect. 2016 Oct-Dec;6(4):e97

Authors: Rao RR, Ha J, Farley FA, Koopmann CF, Caird MS

Abstract
CASE: A 15-year-old girl with adolescent idiopathic scoliosis with a 50° curve underwent posterior spinal fusion from T3 to T11. After discharge from the hospital, the patient reported dysphonia and dysphagia. Flexible nasendoscopy confirmed left vocal cord paresis. Stretch injury to the recurrent laryngeal nerve from the left T5 pedicle screw or intubation may have caused the vocal cord paresis. The pedicle screw was removed during revision surgery. Postsurgically, the patient demonstrated immediate and ultimately full recovery and no longer had any symptoms.
CONCLUSION: To our knowledge, this is the first case report of vocal cord paresis most likely caused by pedicle screw position after posterior spinal fusion.

PMID: 29252751 [PubMed - indexed for MEDLINE]

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Unusual case of choking due to assassin bug ( Cydnocoris gilvus).

Related Articles

Unusual case of choking due to assassin bug ( Cydnocoris gilvus).

Med Sci Law. 2018 Jan;58(1):67-69

Authors: Sonar V, Patil S

Abstract
Choking is a form of asphyxia which is caused by an obstruction within the air passages. Here, we report a case of obstruction of the upper respiratory tract due to assassin bug ( Cydnocoris gilvus) where allegations of medical negligence were made by relatives of the deceased. Autopsy findings demonstrated that an insect was present inside the larynx, lodged at the epiglottis. Multiple haemorrhagic patches were present at the base of the tongue, larynx, epiglottis, vocal cords and tracheal bifurcation. As Reduviidae can be successfully used as a biological pest-control agents, they should be used with due precaution.

PMID: 29451084 [PubMed - in process]

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Nasal metastasis as the first manifestation of a metachronous bilateral renal cell carcinoma.

Related Articles

Nasal metastasis as the first manifestation of a metachronous bilateral renal cell carcinoma.

Pathologica. 2017 Dec;109(4):421-425

Authors: Serra A, Caltabiano R, Giorlandino A, Musumeci A, Conti A, Zanghì G, Maniaci A, Cocuzza S

Abstract
Renal cell carcinoma is one of the most common tumours to spread by extranodal metastases to the head and neck. Metastatic renal cell carcinoma to the head and neck area has been demonstrated mostly in the paranasal sinuses, parotid gland, the mandible, larynx and hypopharinx. Renal cell carcinoma should be excluded whenever a metastatic lesion is encountered in the head and neck area, even if the metastatic lesion is the first clinical presentation. The diagnosis of metastatic RCC should be suspected in any patient with even a remote history of renal cell carcinoma. We report a case of 79 year old woman with recurrent episodes of rhinorrhea, headache, hyposmia and monolateral right epistaxis, with a history of RCC. We describe RCC nasal metastases in a metachronous bilateral neoplasm, in which a second occult lesion debuted with a homolateral nasal metastases, ten years after left nephrectomy.

PMID: 29449739 [PubMed - in process]

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Bronchogenic Cyst in the Head and Neck Region.

Related Articles

Bronchogenic Cyst in the Head and Neck Region.

J Craniofac Surg. 2017 Jun;28(4):e303-e305

Authors: Lee DH, Yoon TM, Lee JK, Lim SC

Abstract
OBJECTIVE: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of patients with bronchogenic cysts in the head and neck region.
METHODS: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2006 to May 2016.
RESULTS: Eight patients with a final diagnosis of bronchogenic cyst in the head and neck region were identified based on their medical records. The most common location for the head and neck lymphatic malformations was the neck (4 patients), followed by the soft palate (1 patient), the posterior pharyngeal wall (1 patient), the floor of mouth (1 patient), and the arytenoid (1 patient). The size of the lymphatic malformations ranged from 1 to 6 cm. Bronchogenic cysts recurred in 2 patients. Both these patients were disease-free after the revision operation. No major complications resulting from the surgical intervention were observed.
CONCLUSION: Bronchogenic cysts are rare congenital malformations and they can occur at various sites in the head and neck region. Bronchogenic cyst should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts.

PMID: 28178103 [PubMed - indexed for MEDLINE]

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