Fernanda Zucki, Thais C. Morata, Josilene L. Duarte, Maria Cecília F. Ferreira, Manoel H. Salgado, Kátia F. Alvarenga
Braz J Otorhinolaryngol.2018;84:150-8
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Παρασκευή 23 Μαρτίου 2018
The maturation state of the auditory nerve and brainstem in rats exposed to lead acetate and supplemented with ferrous sulfate
Inferior turbinectomy: what is the best technique?
Renato Roithmann
Braz J Otorhinolaryngol.2018;84:133-4
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Functional results in airflow improvement using a “flip‐flap” alar technique: our experience
Arianna Di Stadio, Carlo Macro
Braz J Otorhinolaryngol.2018;84:166-72
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Role of preoperative air‐bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus
Hong Chan Kim, Chul Ho Jang, Young Yoon Kim, Jong Yuap Seong, Sung Hoon Kang, Yong Beom Cho
Braz J Otorhinolaryngol.2018;84:173-7
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Sleep disorders in children with moderate to severe persistent allergic rhinitis
Jessica Loekmanwidjaja, Ana Cláudia F. Carneiro, Maria Lúcia T. Nishinaka, Daniela A. Munhoes, Gabriela Benezoli, Gustavo F. Wandalsen, Dirceu Solé
Braz J Otorhinolaryngol.2018;84:178-84
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The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study
Hanifi Kurtaran, K. Serife Ugur, Ceyda Sel Yilmaz, Mesut Kaya, Alper Yuksel, Nebil Ark, Mehmet Gunduz
Braz J Otorhinolaryngol.2018;84:185-90
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Influence of dietary and physical activity restriction on pediatric adenotonsillectomy postoperative care in Brazil: a randomized clinical trial
Denise Manica, Leo Sekine, Larissa S. Abreu, Michelle Manzini, Luísi Rabaioli, Marcel M. Valério, Manoela P. Oliveira, João A. Bergamaschi, Luciano A. Fernandes, Gabriel Kuhl, Cláudia Schweiger
Braz J Otorhinolaryngol.2018;84:191-5
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Rapid maxillary expansion in mouth breathers: a short‐term skeletal and soft‐tissue effect on the nose
Fauze Ramez Badreddine, Reginaldo R. Fujita, Fabio Eduardo Maiello Monteiro Alves, Mario Cappellette Jr
Braz J Otorhinolaryngol.2018;84:196-205
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Anti‐inflammatory effects of hyperbaric oxygen on irradiated laryngeal tissues
Mitat Arıcıgil, Mehmet Akif Dündar, Abitter Yücel, Hamdi Arbağ, Abdullah Arslan, Meryem Aktan, Sıdıka Fındık, İbrahim Kılınç
Braz J Otorhinolaryngol.2018;84:206-11
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Digital design of functional surgery for odontogenic cyst intruding into maxillary sinus
Ying Kai Hu, Chi Yang, Guang Zhou Xu, Qian Yang Xie
Braz J Otorhinolaryngol.2018;84:212-9
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A novel method to evaluate salivary flow rates of head and neck cancer patients after radiotherapy: a pilot study
Luiz Felipe Palma, Fernanda Aurora Stabile Gonnelli, Marcelo Marcucci, Adelmo José Giordani, Rodrigo Souza Dias, Roberto Araújo Segreto, Helena Regina Comodo Segreto
Braz J Otorhinolaryngol.2018;84:227-31
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Giant fronto‐ethmoidal osteoma – selection of an optimal surgical procedure
Maria Humeniuk‐Arasiewicz, Grażyna Stryjewska‐Makuch, Małgorzata A. Janik, Bogdan Kolebacz
Braz J Otorhinolaryngol.2018;84:232-9
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Biofeedback in dysphonia – progress and challenges
Geová Oliveira de Amorim, Patrícia Maria Mendes Balata, Laís Guimarães Vieira, Thaís Moura, Hilton Justino da Silva
Braz J Otorhinolaryngol.2018;84:240-8
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Acquired stenosis of external auditory canal secondary to paraneoplastic manifestation of renal cancer
Loraine Entringer Falqueto, Marcos Lyra Kaddoum, Marcio Maia Lamy de Miranda, Henrique Faria Ramos
Braz J Otorhinolaryngol.2018;84:249-51
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Chorda tympani schwannoma: one new case revealed during malignant otitis externa and review of the literature
Marion Montava, Sophie Giusiano, Marianne Jolibert, Jean‐Pierre Lavieille
Braz J Otorhinolaryngol.2018;84:252-6
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Prevention of neck infection by endoscopic suture closure of pyriform sinus fistulae: a report of two cases
Hiroumi Matsuzaki, Kiyoshi Makiyama, Hirotaka Suzuki, Takeshi Ohshima
Braz J Otorhinolaryngol.2018;84:257-9
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Endoscopic surgery of the frontoethmoidal osteomas
Tomasz Gotlib
Braz J Otorhinolaryngol.2018;84:260-1
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HIV and the Macrophage: From Cell Reservoirs to Drug Delivery to Viral Eradication
Abstract
Macrophages serve as host cells, inflammatory disease drivers and drug runners for human immunodeficiency virus infection and treatments. Low-level viral persistence continues in these cells in the absence of macrophage death. However, the cellular microenvironment changes as a consequence of viral infection with aberrant production of pro-inflammatory factors and promotion of oxidative stress. These herald viral spread from macrophages to neighboring CD4+ T cells and end organ damage. Virus replicates in tissue reservoir sites that include the nervous, pulmonary, cardiovascular, gut, and renal organs. However, each of these events are held in check by antiretroviral therapy. A hidden and often overlooked resource of the macrophage rests in its high cytoplasmic nuclear ratios that allow the cell to sense its environment and rid it of the cellular waste products and microbial pathogens it encounters. These phagocytic and intracellular killing sensing mechanisms can also be used in service as macrophages serve as cellular carriage depots for antiretroviral nanoparticles and are able to deliver medicines to infectious disease sites with improved therapeutic outcomes. These undiscovered cellular functions can lead to reductions in persistent infection and may potentially facilitate the eradication of residual virus to eliminate disease.
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Frailty and Comorbidities Among Survivors of Adolescent and Young Adult Cancer: A Cross-Sectional Examination of a Hospital-Based Survivorship Cohort
Journal of Adolescent and Young Adult Oncology, Ahead of Print.
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The impact of [ 68 Ga]PSMA I&T PET/CT on radiotherapy planning in patients with prostate cancer
Abstract
Purpose
To determine the impact of Gallium-68-labled prostate-specific membrane antigen positron-emission tomography/computed tomography ([68Ga]PSMA PET/CT) on radiotherapy planning for primary disease, biochemical cancer relapse, and advanced disease of prostate cancer.
Methods
A total of 106 patients with prostate cancer scheduled for radiation therapy underwent 120 [68Ga]PSMA PET/CT scans prior to radiotherapy treatment. In 20 cases, patients underwent [68Ga]PSMA PET/CT for primary therapy (PT), 75 cases were referred for biochemical relapse after surgery (RL), and 25 cases were intended for palliative treatment of localized metastases (MD). We retrospectively compared the impact of [68Ga]PSMA PET/CT on lesion detection and treatment decision to CT alone.
Results
[68Ga]PSMA PET/CT revealed a total of 271 positive lesions, whereas CT detected 86 lesions (32%). Overall, the radiotherapy regime was changed in 55 of 120 cases (46%) based on the higher detection rate of [68Ga]PSMA PET/CT: in 15% of cases with PT, in 43% of cases with RL, and in 44% of cases with MD.
Conclusion
[68Ga]PSMA PET/CT is superior to CT alone for lesion detection in prostate cancer, thereby significantly impacting on radiotherapy planning for primary disease, biochemical cancer relapse, and advanced disease of prostate cancer.
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Survivorship Care Planning for Young Adults After Cancer Treatment: Understanding Care Patterns and Patient-Reported Outcomes
Journal of Adolescent and Young Adult Oncology, Ahead of Print.
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Highly Sensitive Thyroglobulin Assays Are Reliable Indicators of Persistent Disease in Thyroid Cancer Patients with Thyroglobulin Antibody
Clinical Thyroidology, Volume 30, Issue 3, Page 122-125, March 2018.
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Low Urinary Iodine Concentrations Predict Decreased Fertility
Clinical Thyroidology, Volume 30, Issue 3, Page 135-137, March 2018.
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Thyroid Status Has Measurable Effects on Gene Expression in Whole Blood
Clinical Thyroidology, Volume 30, Issue 3, Page 129-131, March 2018.
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Most “Recurrences” of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Clinical Thyroidology, Volume 30, Issue 3, Page 108-111, March 2018.
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No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Clinical Thyroidology, Volume 30, Issue 3, Page 100-103, March 2018.
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Thyroseq v3 Molecular Test for Indeterminate Thyroid Nodules Has Improved Sensitivity and Specificity
Clinical Thyroidology, Volume 30, Issue 3, Page 112-114, March 2018.
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The Baseline Survey of the 294,905 Fukushima Children and Adolescents Reveals a Panorama of Thyroid Ultrasound Features
Clinical Thyroidology, Volume 30, Issue 3, Page 115-118, March 2018.
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Patients with Advanced Lung Cancer in Whom Thyroid Dysfunction Develops During Programmed Death-1 Protein Blockade May Have a Good Prognosis
Clinical Thyroidology, Volume 30, Issue 3, Page 132-134, March 2018.
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Preoperative Ultrasonography Guides the Extent of Thyroidectomy for Papillary Thyroid Cancer
Clinical Thyroidology, Volume 30, Issue 3, Page 119-121, March 2018.
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Reduced Functional Connectivity in Adults with Persistent Post-Concussion Symptoms: A Functional Near-Infrared Spectroscopy Study
Journal of Neurotrauma, Ahead of Print.
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Impact of Admission Imaging Findings on Neurological Outcomes in Acute Cervical Traumatic Spinal Cord Injury
Journal of Neurotrauma, Ahead of Print.
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Neuroimmunology of Traumatic Brain Injury: A Longitudinal Study of Interdependency of Inflammatory Markers and Heart Rate Variability in Severe Traumatic Brain Injury
Journal of Neurotrauma, Ahead of Print.
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Divergent Classification Methods of Post-Concussion Syndrome after Mild Traumatic Brain Injury: Prevalence Rates, Risk Factors, and Functional Outcome
Journal of Neurotrauma, Ahead of Print.
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Making Football Safer: Assessing the Current National Football League Policy on the Type of Helmets Allowed on the Playing Field
Journal of Neurotrauma, Ahead of Print.
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Regorafenib in the treatment of metastatic colorectal cancer
Future Oncology, Ahead of Print.
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Pathological assessment of gastrointestinal biopsies from patients with idelalisib-associated diarrhea and colitis
Future Oncology, Ahead of Print.
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S100A11 promotes TGF-β1-induced epithelial-mesenchymal transition through SMAD2/3 signaling pathway in intrahepatic cholangiocarcinoma
Future Oncology, Ahead of Print.
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Standardizing procedures improves and homogenizes short-term outcomes after minimally invasive esophagectomy
Abstract
Purpose
Esophageal cancer is one of the deadliest cancers worldwide. Esophagectomy with lymphadenectomy is regarded as the only curative option for resectable esophageal cancer, but it is associated with high morbidity and mortality. Multidisciplinary team (MDT) management was recently associated with improved outcomes after surgery for esophageal cancer. The aim of this study was to investigate the effect of standardizing procedures for minimally invasive esophagectomy (MIE) in the MDT setting.
Methods
This was a case-matched control study of 154 patients with esophageal cancer who underwent thoracoscopic esophagectomy in the prone position (TEP) between 2012 and 2016. Surgery was performed by two attending surgeons (surgeons A and B) who began working together in the same MDT in 2015. At that time, the following surgical procedures were standardized between surgeons A and B: mediastinal lymphadenectomy, abdominal procedures, and estimation of the blood supply of the gastric conduit. Short-term outcomes were compared between the following paired groups using propensity scores: surgeon A's pre- and post-standardization groups, surgeon B's pre- and post-standardization groups, and surgeon A's post-standardization group and surgeon B's post-standardization group.
Results
Concerning surgeon A, the estimated total blood loss in the post-standardization group (142 ± 87 mL) was significantly lower than that in the pre-standardization group (376 ± 215 mL, P = 0.006). The rate of left recurrent laryngeal nerve palsy in the post-standardization group (13%) was significantly lower than that in the pre-standardization group (47%, P = 0.046). Concerning surgeon B, the rate of anastomotic leakage in the post-standardization group (0%) was significantly lower than that in the pre-standardization group (11%, P = 0.039). Comparing the post-standardization groups of surgeons A and B, there were no significant differences in operative outcomes or morbidity.
Conclusions
Standardizing procedures for MIE improved and homogenized surgical short-term outcomes.
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A case of mature cystic teratoma with intestinal structures harboring intestinal-type low-grade mucinous neoplasm
Abstract
The formation of gastrointestinal-type epithelium is found in 7–13% of mature cystic teratomas, which are the most common germ cell tumors of the ovary. Few cases harboring organized gastrointestinal tract formation have been reported, and a mucinous neoplasm arising in them is further rare. Here, we report a case of an ovarian mature cystic teratoma with intestinal structures harboring intestinal-type mucinous neoplasm, mimicking low-grade appendiceal mucinous cystadenoma. A 66-year-old female, with remarkably increased serum carcinoembryonic antigen (CEA) level, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the ovarian tumor. The immunoprofile of the tumor showed CK7−/CK20+. We review the past literatures, and then consider that the existence of mucinous neoplasm should be kept in mind if we find elevated level of serum CEA and the organized gastrointestinal development in an ovary. The immunoprofile of CK7/CK20 is useful to determine the origin of mucinous tumors associated with mature cystic teratomas.
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Regorafenib in the treatment of metastatic colorectal cancer
Future Oncology, Ahead of Print.
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Pathological assessment of gastrointestinal biopsies from patients with idelalisib-associated diarrhea and colitis
Future Oncology, Ahead of Print.
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S100A11 promotes TGF-β1-induced epithelial-mesenchymal transition through SMAD2/3 signaling pathway in intrahepatic cholangiocarcinoma
Future Oncology, Ahead of Print.
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Noradrenergic Modulation on Dopaminergic Neurons
Abstract
It is now well accepted that there is a close relationship between noradrenergic and dopaminergic neurons in the brain, especially referring to the modulation of the locus coeruleus–norepinephrine (LC-NE) system on dopamine transmission. The disturbance of this modulation may contribute to neurodegeneration of dopaminergic neurons in Parkinson's disease. In this article, we briefly review evidence related to such modulation. Firstly, we illustrated the noradrenergic innervation and functional implication for the LC-NE system and nigra–striatum dopaminergic system. Furthermore, we depicted neuroprotective effects of the LC-NE on dopaminergic neurons in vivo and in vitro. Moreover, we present data implicating the potential mechanisms underlying the modulation of the LC-NE system on dopaminergic neurons, in particular the effects of NE as a neurotrophic factor and through its ability to stimulate the expression of other neurotrophic factors, such as the brain-derived neurotrophic factor. Finally, we discussed other mechanisms intrinsic to NE's effects. A better understanding of the noradrenergic modulation on dopaminergic neurons may be rewarding by significant advances in etiologic study and promising treatment of Parkinson's disease.
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To Evaluate the Role of H. pylori in Patients with Chronic Recurrent Tonsillitis
Abstract
The usual indication for surgical resection of tonsils is chronic recurrent tonsillitis. Literature also does not indicate the reason behind the fact that only part of the population suffers from recurrent chronic tonsillitis in spite being exposed to similar conditions. This was a prospective study, in which 50 tonsil biopsy samples obtained from chronic tonsillitis patients. Specimens were analysed with rapid urease broth test, HelicotecUT PLUS assay and Toluidine blue staining for presence of Helicobacter pylori. The age ranged from 4 to 34 years. The median age for patients with chronic recurrent tonsillitis was 9.5, 23 (46%) patients were male while 27 (54%) were female, presence of H. pylori by rapid urease broth test, HelicotecUT PLUS assay and Histopathology was 4%. Our analysis revealed that H. pylori did not significantly colonize the tonsils and does not play a role in the pathogenesis or development of chronic tonsillitis. The heterogeneity in study population and methodology may have contributed to the non significant results.
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Reduction of Marek's Disease Virus Infection by Toll-Like Receptor Ligands in Chicken Embryo Fibroblast Cells
Viral Immunology, Ahead of Print.
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Reduced Functional Connectivity in Adults with Persistent Post-Concussion Symptoms: A Functional Near-Infrared Spectroscopy Study
Journal of Neurotrauma, Ahead of Print.
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Abnormal Turning and Its Association with Self-Reported Symptoms in Chronic Mild Traumatic Brain Injury
Journal of Neurotrauma, Ahead of Print.
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Impact of Admission Imaging Findings on Neurological Outcomes in Acute Cervical Traumatic Spinal Cord Injury
Journal of Neurotrauma, Ahead of Print.
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Neuroimmunology of Traumatic Brain Injury: A Longitudinal Study of Interdependency of Inflammatory Markers and Heart Rate Variability in Severe Traumatic Brain Injury
Journal of Neurotrauma, Ahead of Print.
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Divergent Classification Methods of Post-Concussion Syndrome after Mild Traumatic Brain Injury: Prevalence Rates, Risk Factors, and Functional Outcome
Journal of Neurotrauma, Ahead of Print.
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Multi-locus transcranial magnetic stimulation—theory and implementation
Publication date: Available online 23 March 2018
Source:Brain Stimulation
Author(s): Lari M. Koponen, Jaakko O. Nieminen, Risto J. Ilmoniemi
BackgroundTranscranial magnetic stimulation (TMS) is a non-invasive brain stimulation method: a magnetic field pulse from a TMS coil can excite neurons in a desired location of the cortex. Conventional TMS coils cause focal stimulation underneath the coil centre; to change the location of the stimulated spot, the coil must be moved over the new target. This physical movement is inherently slow, which limits, for example, feedback-controlled stimulation.ObjectiveTo overcome the limitations of physical TMS coil movement by introducing electronic targeting.MethodsWe propose electronic stimulation targeting using a set of large overlapping coils and introduce a matrix-factorisation-based method to design such sets of coils. We built one such device and demonstrated the electronic stimulation targeting in vivo.ResultsThe demonstrated two-coil transducer allows translating the stimulated spot along a 30-mm line segment in the cortex; with five coils, a target can be selected from within a region of the cortex and stimulated in any direction. Thus, far fewer coils are required by our approach than by previously suggested ones, none of which have resulted in practical devices.ConclusionAlready with two coils, we can adjust the location of the induced electric field maximum along one dimension, which is sufficient to study, for example, the primary motor cortex.
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To Evaluate the Role of H. pylori in Patients with Chronic Recurrent Tonsillitis
Abstract
The usual indication for surgical resection of tonsils is chronic recurrent tonsillitis. Literature also does not indicate the reason behind the fact that only part of the population suffers from recurrent chronic tonsillitis in spite being exposed to similar conditions. This was a prospective study, in which 50 tonsil biopsy samples obtained from chronic tonsillitis patients. Specimens were analysed with rapid urease broth test, HelicotecUT PLUS assay and Toluidine blue staining for presence of Helicobacter pylori. The age ranged from 4 to 34 years. The median age for patients with chronic recurrent tonsillitis was 9.5, 23 (46%) patients were male while 27 (54%) were female, presence of H. pylori by rapid urease broth test, HelicotecUT PLUS assay and Histopathology was 4%. Our analysis revealed that H. pylori did not significantly colonize the tonsils and does not play a role in the pathogenesis or development of chronic tonsillitis. The heterogeneity in study population and methodology may have contributed to the non significant results.
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Coincidence of Concha Bullosa with Nasal Septal Deviation; Radiological Study
Abstract
Introduction Concha bullosa (CB) is the most common sinonasal anatomical variation reported in literature, it occurs most often in the middle turbinate. Causes of development are not clearly identified but coincident prevalence with deviated nasal septum (DS) is common. Objective To study the relationship between DS and development of CB. Methods A prospective study including 40 patients with DS, CT scans were thoroughly analyzed to detect the presence of CB, its type, and laterality. Effect of degree of septal deviation from the midline and level of deviation in the axial plane were also addressed. Results The study included 40 patients with DS; 15 of them had associated CB; the lamellar type of CB was the most prevalent followed by the true type. Conclusion Incidence of CB was higher in patients with increased angle of septal deviation and with lower level of deviation in the axial plane.
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Depleted polymorphonuclear leukocytes in human metastatic liver reflect an altered immune microenvironment associated with recurrent metastasis
Abstract
Background
Hepatic immunity, normally protective against neoplasia, is subverted in colorectal liver metastasis (CRLM). Here, we compare the inflammatory microenvironment of CRLM-bearing liver tissue to donor liver.
Methods
Twenty-five patients undergoing resection for CRLM were recruited, 13 of whom developed intrahepatic recurrence within 18 months. Biopsies were obtained from tumour and normal liver tissue adjacent to and distal from, the tumour. Donor liver biopsies were obtained during transplantation. Biopsies were cultured and conditioned media (CM) screened for 102 inflammatory mediators. Twelve of these were validated by Luminex assay. Transwell assays measured cancer cell chemotaxis. Polymorphonuclear leukocytes (PMN) and lymphocytes were quantified in H&E sections.
Results
Fewer periportal tissue-resident PMN were present in metastatic liver compared to donor liver. Patients with the fewest PMN in liver tissue distal to their tumour had a shorter time to intrahepatic recurrence (P < 0.001). IL-6, CXCL1, CXCL5, G-CSF, GM-CSF, VEGF, LIF, and CCL3 were higher in liver-bearing CRLM compared to donor tissue. Consequently, cancer cells migrated equally towards CM of all regions of metastatic liver but not towards donor liver CM.
Conclusions
The local inflammatory environment may affect both immune cell infiltration and cancer cell migration contributing to recurrence following resection for CRLM.
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Diacylglycerol kinase α inactivation is an integral component of the costimulatory pathway that amplifies TCR signals
Abstract
The arsenal of cancer therapies has evolved to target T lymphocytes and restore their capacity to destroy tumor cells. T cells rely on diacylglycerol (DAG) to carry out their functions. DAG availability and signaling are regulated by the enzymes diacylglycerol kinase (DGK) α and ζ, whose excess function drives T cells into hyporesponsive states. Targeting DGKα is a promising strategy for coping with cancer; its blockade could reinstate T-cell attack on tumors while limiting tumor growth, due to positive DGKα functions in several oncogenic pathways. Here, we made a side-by-side comparison of the effects of commercial pharmacological DGK inhibitors on T-cell responses with those promoted by DGKα and DGKζ genetic deletion or silencing. We show the specificity for DGKα of DGK inhibitors I and II and the structurally similar compound ritanserin. Inhibitor treatment promoted Ras/ERK (extracellular signal-regulated kinase) signaling and AP-1 (Activator protein-1) transcription, facilitated DGKα membrane localization, reduced the requirement for costimulation, and cooperated with enhanced activation following DGKζ silencing/deletion. DGKiII and ritanserin had similar effects on TCR proximal signaling, but ritanserin counteracted long-term T-cell activation, an effect that was potentiated in DGKα−/− cells. In contrast with enhanced activation triggered by pharmacological inhibition, DGKα silencing/genetic deletion led to impaired Lck (lymphocyte-specific protein tyrosine kinase) activation and limited costimulation responses. Our results demonstrate that pharmacological inhibition of DGKα downstream of the TCR provides a gain-of-function effect that amplifies the DAG-dependent signaling cascade, an ability that could be exploited therapeutically to reinvigorate T cells to attack tumors.
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A large-scale, exome-wide association study of Han Chinese women identifies three novel loci predisposing to breast cancer
Genome-wide association studies have identified more than 90 susceptibility loci for breast cancer. However, the missing heritability is evident, and the contributions of coding variants to breast cancer susceptibility have not yet been systematically evaluated. Here we present a large-scale whole-exome association study for breast cancer consisting of 24,162 individuals (10,055 cases and 14,107 controls). In addition to replicating known susceptibility loci (e.g. ESR1, FGFR2 and TOX3), we identify two novel missense variants in C21orf58 (rs13047478, Pmeta = 4.52 × 10-8) and ZNF526 (rs3810151, Pmeta = 7.60 × 10-9) and one new non-coding variant at 7q21.11 (P < 5 × 10-8). C21orf58 and ZNF526 possessed functional roles in the control of breast cancer cell growth, and the two coding variants were found to be the eQTL for several nearby genes. rs13047478 was significantly (P < 5.00 x 10-8) associated with the expression of genes MCM3AP and YBEY in breast mammary tissues. rs3810151 was found to be significantly associated with the expression of genes PAFAH1B3 (P = 8.39 x 10-8) and CNFN (P = 3.77 x 10-4) in human blood samples. C21orf58 and ZNF526, together with these eQTL genes, were differentially expressed in breast tumors versus normal breast. Our study reveals additional loci and novel genes for genetic predisposition to breast cancer and highlights a polygenic basis of disease development.
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IL-22RA1/ STAT3 signaling promotes stemness and tumorigenicity in pancreatic cancer
Chronic inflammation is a feature of pancreatic cancer, but little is known about how immune cell or immune cell-related signal affects pancreatic cancer stemness and development. Our previous work showed that IL-22/IL-22RA1 plays a vital role in acute and chronic pancreatitis progression by mediating crosstalk between immune cells and acinar cells or stellate cells, respectively. Here we find IL-22RA1 is highly but heterogeneously expressed in pancreatic cancer cells, with high expression associated with poor prognosis of pancreatic cancer patients. The IL-22RA1hi population from pancreatic tumor harbored higher stemness potential and tumorigenicity. Notably, IL-22 promoted pancreatic cancer stemness via IL-22RA1/STAT3, which identified a functional signaling to regulate cancer stemness by microenvironmental factor. Moreover, STAT3 was indispensable for the maintenance of IL-22RA1hi cells. Overall, these findings provide a therapeutic strategy for PDAC patients with high expression of IL-22RA1.
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Therapeutic targeting of sunitinib-induced AR phosphorylation in renal cell carcinoma
Androgen receptor (AR) plays a crucial role in the development and progression of prostate cancer. AR expression has also been reported in other solid tumors, including renal cell carcinoma (RCC), but its biological role here remains unclear. Through integrative analysis of a reverse phase protein array (RPPA), we discovered increased expression of AR in an RCC patient-derived xenograft model of acquired resistance to the receptor tyrosine kinase inhibitor (RTKi) sunitinib. AR expression was increased in RCC cell lines with either acquired or intrinsic sunitinib resistance in vitro. An AR signaling gene array profiler indicated elevated levels of AR target genes in sunitinib-resistant cells. Sunitinib-induced AR transcriptional activity was associated with increased phosphorylation of serine 81 (pS81) on AR. Additionally, AR overexpression resulted in acquired sunitinib resistance, and the AR antagonist enzalutamide-induced AR degradation and attenuated AR downstream activity in sunitinib-resistant cells, also indicated by decreased secretion of human kallikrein 2 (KLK2). Enzalutamide-induced AR degradation was rescued by either proteasome inhibition or by knockdown of the AR ubiquitin ligase speckle-type POZ protein (SPOP). In vivo treatment with enzalutamide and sunitinib demonstrated that this combination efficiently induced tumor regression in an RCC model following acquired sunitinib resistance. Overall, our results suggest the potential role of AR as a target for therapeutic interventions, in combination with RTKi, to overcome drug resistance in RCC.
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Vitamin D and primary hypothyroidism: Is there an association?
Thyroid Research and Practice 2018 15(1):34-37
Background: Association studies between the vitamin D deficiency (VDD) and hypothyroidism have given mixed results. Because of this controvery and relatively common prevalence of these two conditions, we conducted a case-control study investigating the prevalence of VDD in patients with hypothyroidism (both TPO-Ab positive and negative) and compared it with euthyroid controls. Methodology: This is a single centre cross sectional study. Adults (aged 18 years or more) of both the sexes diagnosed with primary hypothyroidism (TSH >5.1 mIU/L) were included (n = 115) along with age and sex matched euthyroid (TSH <5 mIU/ml) controls (n = 120) chosen from the outpatients' department. Biochemical parameters like Thyroid stimulating hormone (TSH), free T4 (fT4), 25 hydroxy vitamin D (Vit D) and thyroid peroxidase antibody (TPO-Ab) were tested in both the groups. Results: Patients in the hypothyroid group [38 (males) and 77 (females)] had a mean (SD) age 46 (15) years, while the euthyroid control group [24 (males) and 96 (females) had a mean (SD) age of 45 (17) years. In the hypothyroid group, 96% (110/115) had VDD as compared to 90% (108/120) in the control group with a significantly lower mean Vit D level was observed in the hypothyroid group as compared to the euthyroid group (12+8.6 vs 17.49+11.89 ng/ml; P < 0.001). While 27 cases with hypothyroidism had severe VDD (Vit D levels <4.2 ng/ml) only 10 among the control group had severe VDD (OR 2.04, CI: 1.03-4.05, P < 0.05)). The mean level of Vit D in the TPO-Ab positive hypothyroid group was 10.4+7.2 ng/ml in comparison to the TPO-Ab negative group 15.3+10.3 (P = 0.004) (OR 3.39, CI:1.18-9.80; P < 0.05) 3.62). Conclusion: The vitamin D levels in patients with hypothyroidism were significantly lower compared to euthyroid controls.TPO-Ab positive patients had lower levels of vitamin D in comparison with negative
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Clinicopathological features of differentiated thyroid carcinoma referred to radioiodine therapy at Tripoli Medical Center
Thyroid Research and Practice 2018 15(1):3-9
Objectives: The objective of this study is to study the demographic, clinicopathological features, and geographical distribution of differentiated thyroid cancer (DTC) among Libyan patients referred from all parts of the country to the nuclear medicine department, for radioactive iodine (RAI) therapy. Materials and Methods: Retrospective review of medical records of 265 patients with differentiated thyroid carcinoma (DTC) referred to RAI therapy in the Nuclear Medicine Branch-Tripoli Medical Center, in the period from May 2005 to October 2010. The data analyzed included sex, age at the time of diagnosis, the city of residence, pathological diagnosis, the extent of disease, and types of treatment. Results: There were 225 (84.9%) females and 40 (15.1%) males giving a sex ratio of 5.6:1. The mean age of males at diagnosis was 51.2 ± 14.8 (range 24–78) years and the mean age of the females was 44.6 ± 15.6 (range 10–95) years. Two hundred and twenty-three (84.2%) had papillary thyroid cancer (PTC), 31 (11.7%) had follicular thyroid cancer, 3 (1.1%) had Hurthle cell thyroid cancer, and 2 (0.8%) had follicular-insular thyroid cancer. About 43 (16.2%) had a history of multinodular goiter, and 3 (1.1%) Hashimoto's thyroiditis. From data collected, cervical lymph node metastases were found in 45 (17.0%), and distal metastases in 27 (10.2%). Conclusions: PTC was the most common type of DTC. DTC was more common among females. The current study showed that the disease tends to occur at an older age, and with less cervical lymph node metastases than previously reported.
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Depression, anxiety, and somatization in patients with clinical and subclinical hypothyroidism: An exploratory study
Thyroid Research and Practice 2018 15(1):10-14
Background: Hypothyroidism and subclinical hypothyroidism (SCHT) are common disorders seen in clinical practice. A large proportion of patients with these disorders show psychiatric comorbidity. The current study was carried out to assess the prevalence and proportion of depression, anxiety, and somatization symptoms and compare the same between these two groups of patients. Methodology: Patients attending a medical outpatient department were screened for thyroid dysfunction using laboratory parameters, and patients detected with clinical and SCHT were included in the study. The sample consisted of 34 patients with CHT and 36 patients with SCHT. The patients were administered the Hamilton Rating Scale for Depression, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Questionnaire, and PHQ-15 for somatization. The data were analyzed statistically using computerized software. Results: The study groups were well matched on sociodemographic profile and basic data. On assessing the severity of depression and anxiety, more cases of mild depression were reported in the subclinical hypothyroid group compared to moderate and severe depression being higher in the clinical hypothyroid group (P = 0.0001). Anxiety was well matched in both groups while somatization was higher in the subclinical hypothyroid group (P = 0.0001). Scores on depression scales were higher in the clinical group (P = 0.0001) and anxiety and somatization scores were higher in the subclinical group (P = 0.0001). Conclusions: Depression is usually seen in CHT while anxiety and somatization may be greater in SCHT. Further studies in larger populations are needed to validate the findings.
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The Bethesda system for reporting thyroid cytopathology: A relook
Thyroid Research and Practice 2018 15(1):1-2
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A cross-sectional survey to assess knowledge, attitude, and practices in patients with hypothyroidism in India
Thyroid Research and Practice 2018 15(1):15-22
Objective: The objective of this study is to assess the knowledge, attitude, and practices (KAP) in patients with hypothyroidism in India. Methods: This was a questionnaire-based, cross-sectional KAP study conducted in patients with hypothyroidism across 16 centers in India. The questionnaire was validated initially by a panel of experts, followed by 120 patients with primary hypothyroidism. Results: Out of 500 patients enrolled, about three-fourths (72.4%) were women. Most patients had low levels of knowledge (66.6%), were quite concerned (46.6%), and practiced a moderate level of precaution (77.8%). Around 18.4%, 26.2%, 27.8%, and 37.6% of patients had incorrect/no knowledge that weight gain, fatigue, muscle aches/pain, and dry skin were effects of hypothyroidism, respectively. Patients had poor knowledge regarding various risks associated with hypothyroidism such as abnormal menstruation (41.6%), depression (47%), hypercholesterolemia (65.6%), and medications causing hypothyroidism (74.2%). Most patients (91.4%) affirmed the need to consult a physician for or seek medical advice before treatment initiation. However, a small percentage did not agree on testing pregnant women (20.2%) and family members (26.2%) for hypothyroidism. Most patients (93.2% and 92.6%) practiced compliance to frequency and timings for medications; however, one-thirds reported missing doses. There was lack of knowledge-seeking behavior both from online sources (57.4%) and treating doctors (24.2%). Significant associations were found between education and the levels of knowledge, concern, and precautions taken. Conclusion: This study identified significant gaps in the knowledge about the risks associated with hypothyroidism, importance of laboratory investigation, and dietary precautions.
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Clinicopathological study of medullary carcinoma of thyroid: A single institute experience
Thyroid Research and Practice 2018 15(1):38-41
Context: Medullary thyroid carcinoma is one of the rare thyroid malignancies representing only about 5%–10%of total thyroid cancers. Aims: To study the age, sex distribution, and various histopathological features of medullary carcinoma of thyroid in our institute over a period of 5 years. Settings and Design: This is a retrospective descriptional study of the cases diagnosed as medullary carcinoma over a period of 5 years in our institute (i.e., from April 01, 2010, to March 31, 2015). Subjects and Methods: The study material obtained from departmental records, gross specimens, paraffin blocks or slides and case files from medical record sections. Histopathologically, tumor was identified according to the classical features as described in the World Health Organization of classification of tumors of endocrine organs. Results: We found 20 cases of medullary carcinoma which accounted for 12% of thyroid malignancies. There was female dominance, and the age group of patients ranged from 20 years to 66 years. Microscopically, tumor cell arrangement was classic in all the cases with some showing pseudopapillary and spindle cell areas. Apoptosis of the tumor cells were seen notably in three cases. Three cases had necrotic areas. One case of micro medullary carcinoma was found incidentally. We had one interesting case where the clinical and cytological features were more in favor of papillary carcinoma. Conclusions: Medullary carcinoma of the thyroid is rare. Identifying the histopathological features and its variations may show light into understanding of the tumor biology with its implications on patient management and prognosis.
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Vitamin D levels in children with Hashimoto's thyroiditis: Before and after L-thyroxine therapy
Thyroid Research and Practice 2018 15(1):23-28
Background: Vitamin D deficiency has been associated with Hashimoto's thyroiditis (HT). Hypothyroidism per se can cause poor absorption and metabolism of Vitamin D leading to Vitamin D deficiency. It is unknown that Vitamin D deficiency in HT is a cause or effect of HT. Objectives: To study Vitamin D level in children with newly diagnosed HT and to follow the changes in Vitamin D level after L-thyroxine therapy. Material and Methods: A prospective observational study was conducted on 35 children recently diagnosed with HT who had not received Vitamin D supplementation in the past 6 months. Serum 25 hydroxy Vitamin D levels along with serum calcium profile were estimated before starting L-thyroxine and on follow-up after 3 months. Results: The mean Vitamin D level at diagnosis of HT was significantly low as compared to controls (33.34 ± 16.93 nmol/L vs. 65.13 ± 30.57 nmol/L; P < 0.0001). Out of 22 Vitamin D-deficient patients who were treated, seven (31.8%) remained deficient at follow-up. Thirteen patients (sufficient/insufficient Vitamin D levels) who were not supplemented with Vitamin D had fall in Vitamin D levels in follow-up. Conclusions: Children with HT have low Vitamin D levels at diagnosis, and L-thyroxine therapy can further compromise Vitamin D status. Children with recent diagnosis of HT should be screened and treated or supplemented with Vitamin D.
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Case report: An unusual variation in the course of recurrent laryngeal nerve in relation to the thyroid gland
Thyroid Research and Practice 2018 15(1):46-48
A complete understanding of the anatomic variations of the thyroid gland is necessary for a safe thyroid surgery. Injury to recurrent laryngeal nerve during thyroid surgery remains a significant source of morbidity. We present an uncommon variation in the position of right recurrent laryngeal nerve with the Tubercle of Zuckerkandl in a 40-year-old female who underwent thyroidectomy for a benign multinodular goiter. Identification and meticulous dissection of the Tubercle of Zuckerkandl and recognition of its association with the recurrent laryngeal nerve are essential to maintain the integrity of the nerve and prevent complications during thyroid surgery.
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Spectrum of clinical symptomatology and its resolution following levothyroxine supplementation in primary and subclinical hypothyroidism: An Indian perspective
Thyroid Research and Practice 2018 15(1):29-33
Background: Data are scant on the spectrum of features associated with subclinical hypothyroidism (ScH) and overt primary hypothyroidism (OPH). This study aimed was to determine the burden as well as predictors of the lack of resolution of symptoms of hypothyroidism in patients of ScH and OPH following levothyroxine supplementation. Methods: A total of 505 patients were screened, of which 411 consecutive patients with ScH and 94 with OPH were evaluated. Data from 347 patients with ScH and 76 patients with overt OPH, who completed the study, were analyzed. Thyroid symptomatology was evaluated using standardized questionnaire. Results: The median age of participants was 35 (28–41) years; 95.04% being females. Common symptoms in OPH were shortness of breath (72.36%), depression (57.89%), irritability (57.89%), periorbital edema (53.94%), "feeling tired" (51.31%), and swelling of limbs (48.68%). Common symptoms in ScH were "feeling tired" (62.82%), "unhappy with routine" (44.95%), depression (40.92%), irritability (38.90%), and "weight gain with a poor appetite" (36.31%). Goiter was documented in 31.58% OPH and 3.17% in ScH (P < 0.001). Hair loss was observed 31.57% OPH and 29.68% ScH. Median (interquartile range) dose of levothyroxine supplemented was 37.5 (12.5–50) and 100 (75–112.5) mcg, respectively. Resolution of hypothyroidism symptoms was lesser in ScH. Persisting features included goiter, irregular menstruation, "weight gain with poor appetite," irritability, depression, "feeling tired," body aches, and depression. Binary logistic regression revealed thyroid stimulating hormone (TSH) to be an independent predictor of symptoms resolution. Every unit increase in TSH was associated with 0.7% greater resolution. Conclusion: Symptoms associated with hypothyroidism are diverse and nonspecific. Resolution of symptoms following levothyroxine supplementation and achieving biochemical euthyroidism is more likely in OPH that ScH.
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Steroid-responsive encephalopathy in autoimmune thyroiditis: A diagnostic enigma?
Thyroid Research and Practice 2018 15(1):52-55
Hashimoto's encephalopathy or steroid-responsive encephalopathy associated with autoimmune thyroiditis is a neuroendocrine disorder of unknown cause associated with thyroid autoimmunity. We report case of a 61-year-old male, previously healthy, who developed a subacute onset of declining higher mental functions. Serologic studies demonstrated the high levels of antithyroid antibodies. Electroencephalographic, cerebrospinal fluid, and magnetic resonance image findings were normal, consistent with Hashimoto's encephalopathy. It is a diagnosis of exclusion once the detailed neurology evaluations were done. This unusual disorder is often underrecognized because of the multiple and protracted neurocognitive manifestations; therefore, it is important to be aware of this clinical manifestations to make a correct diagnosis and favorable outcome.
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Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication
Abstract
Objective
The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement.
Materials and methods
Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE2, MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p < 0.05). T test was used to compare data on periodontal characteristics.
Results
ICM did not reduce the number of microorganisms in PP and RC, except for Fusobacterium nucleatum in RC. There was a significant reduction in LPS, MMPs, IL-1 β, and TNF-α levels in PP after ICM. In RC, LPS, MMP13, PGE2, and IL-1β levels remained unaltered (p > 0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05).
Conclusions
The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets.
Clinical significance
Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.
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Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication
Abstract
Objective
The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement.
Materials and methods
Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE2, MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p < 0.05). T test was used to compare data on periodontal characteristics.
Results
ICM did not reduce the number of microorganisms in PP and RC, except for Fusobacterium nucleatum in RC. There was a significant reduction in LPS, MMPs, IL-1 β, and TNF-α levels in PP after ICM. In RC, LPS, MMP13, PGE2, and IL-1β levels remained unaltered (p > 0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05).
Conclusions
The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets.
Clinical significance
Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.
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Editorial Board
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
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Percutaneous treatment of orofacial vascular malformations
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
Author(s): A. Sindel, A. Sayan, Ö. Özgür, T. Sindel, V. Ilankovan
The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous injection of bleomycin as the primary treatment for low-flow vascular malformations. A total of 34 patients (mean (range) age 24 (8–51) years) with orofacial vascular lesions were treated in the Department of Interventional Radiology and Maxillofacial Surgery. There were 20 low-flow venous malformations, 11 lymphatic malformations, and three of mixed type. All patients were treated by fluoroscopy-guided percutaneous injection of a mixture of bleomycin (mean (range) 15 (5–15)mg) and a radio-opaque agent (Ultravist® (iopromide), Bayer)/session. The number of sessions ranged from one to six. The clinical response was complete in 21 patients, obvious in nine, and of clinical benefit in four. Patients were reviewed within the first week, third week, and at three-month periods until 24 months. There were no serious complications such as pulmonary fibrosis. Fluoroscopy-guided intralesional injection of bleomycin should be considered as the first-line treatment for lymphatic malformations because it is effective and reliable with few complications.
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Patient Concerns Inventory (at diagnosis) and intention to treat
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
Author(s): B. Rushworth, S. Milne, A. Kanatas
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Early removal of sequestrum in patients affected by medication-related osteonecrosis of the jaw
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
Author(s): M. Kharazmi, P. Hallberg
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Corrigendum to “Medial approach for minimally-invasive harvesting of a deep circumflex iliac artery flap for reconstruction of the jaw using virtual surgical planning and CAD/CAM technology” [Br J Oral Maxillofac Surg 2017;55(November (9)):946–51]
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
Author(s): A. Modabber, N. Ayoub, A. Bock, S.C. Möhlhenrich, B. Lethaus, A. Ghassemi, D.A. Mitchell, F. Hölzle
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Training Groups
Source:British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 3
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Survivorship care plans: are randomized controlled trials assessing outcomes that are relevant to stakeholders?
Abstract
Purpose
The purpose of this study was to compare outcomes assessed in extant randomized controlled trials (RCTs) to outcomes that stakeholders expect from survivorship care plans (SCPs). To facilitate the transition from active treatment to follow-up care for the 15.5 million US cancer survivors, many organizations require SCP use. However, results of several RCTs of SCPs' effectiveness have been null, possibly because they have evaluated outcomes on which SCPs should be expected to have limited influence. Stakeholders (e.g., survivors, oncologists) may expect outcomes that differ from RCTs' outcomes.
Methods
We identified RCTs' outcomes using a PubMed literature review. We identified outcomes that stakeholders expect from SCPs using semistructured interviews with stakeholders in three healthcare systems in the USA and Canada. Finally, we mapped RCTs' outcomes onto stakeholder-identified outcomes.
Results
RCT outcomes did not fully address outcomes that stakeholders expected from SCPs, and RCTs assessed outcomes that stakeholders did not expect from SCPs. RCTs often assessed outcomes only from survivors' perspectives.
Conclusions
RCTs of SCPs' effectiveness have not assessed outcomes that stakeholders expect. To better understand SCPs' effectiveness, future RCTs should assess outcomes of SCP use that are relevant from the perspective of multiple stakeholders.
Implications for Cancer Survivors
SCPs' effectiveness may be optimized when used with an eye toward outcomes that stakeholders expect from SCPs. For survivors, this means using SCPs as a map to guide them with respect to what kind of follow-up care they should seek, when they should seek it, and from whom they should seek it.
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The Relationship Between Speech, Language, and Phonological Awareness in Preschool-Age Children With Developmental Disabilities
Purpose
A number of intrinsic factors, including expressive speech skills, have been suggested to place children with developmental disabilities at risk for limited development of reading skills. This study examines the relationship between these factors, speech ability, and children's phonological awareness skills. Method
A nonexperimental study design was used to examine the relationship between intrinsic skills of speech, language, print, and letter–sound knowledge to phonological awareness in 42 children with developmental disabilities between the ages of 48 and 69 months. Hierarchical multiple regression was done to determine if speech ability accounted for a unique amount of variance in phonological awareness skill beyond what would be expected by developmental skills inclusive of receptive language and print and letter–sound knowledge. Results
A range of skill in all areas of direct assessment was found. Children with limited speech were found to have emerging skills in print knowledge, letter–sound knowledge, and phonological awareness. Speech ability did not predict a significant amount of variance in phonological awareness beyond what would be expected by developmental skills of receptive language and print and letter–sound knowledge. Conclusion
Children with limited speech ability were found to have receptive language and letter–sound knowledge that supported the development of phonological awareness skills. This study provides implications for practitioners and researchers concerning the factors related to early reading development in children with limited speech ability and developmental disabilities.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2G6EV0P
Fidget Spinner Ingestion
No abstract availablefrom #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2uf1crF
Diagnostic Tests in Pediatric Constipation
Constipation is one of the most common gastrointestinal symptoms in children. With a median reported prevalence of 12%, it accounts for about 25% of all pediatric gastroenterology consultations. The majority of children experiences functional constipation and do not usually require any diagnostic testing. For those children not responding to conventional medical treatment or in the presence of a more significant clinical picture, however, an accurate instrumental assessment is usually recommended to evaluate either the underlying pathophysiologic mechanisms or a possible organic etiology. The present review analyzes the possible diagnostic investigations for severely constipated children, focusing on their actual indications and their utility in clinical practice. During the last decade, there has been a remarkable increase in our knowledge of normal and abnormal colonic and anorectal motility in children, and a number of different techniques to measure transit and motility have been developed and are discussed in this narrative review.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2FYRvD7
Donor Human Milk and Fortifier Use in United States Level 2, 3, and 4 Neonatal Care Hospitals
Objective: In 2011, the United States Surgeon General issued a call to action to "identify and address obstacles to greater availability of safe banked donor milk for fragile infants." The purpose of the present study is to analyze patterns in donor human milk (DHM) and fortifier use in level 2, 3, and 4 neonatal facilities in 2015 and to identify factors associated with nonuse. Methods: Data from the 2015 Maternity Practices in Infant Nutrition and Care survey, conducted by the Center for Disease Control and Prevention, were analyzed for questions about feeding practices within neonatal hospitals. Results: The percentage of neonatal facilities that reported using DHM in 2015 was 38.3%, up 74% from 2011. The majority of level 3 and level 4 facilities reported using DHM (65.7% and 73.3%, respectively) and fortifiers (96.1% and 91.9%, respectively). Within DHM-using facilities, a wide range of DHM feeding patterns was reported. The prevalence of DHM use was higher in facilities that had the highest rates of mother's own milk feedings (P from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2DQx7y6
Non-invasive Markers of Portal Hypertension: Appraisal of Adult Experience and Potential Utilisation in Children
Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT. We evaluated the research performed on adult population, as well as the limited work done on children, to identify promising areas for future research. A literature search was conducted on "PubMed." Several search terms were used including "portal hypertension," "paediatric portal hypertension," "non-invasive markers of portal hypertension," "spleen stiffness," "liver stiffness," "elastography," and "endothelial damage." The articles included were selected based on their relevance to the purpose of our review. The research suggests a combination of several biomarkers, in addition to an imaging technique such as transient elastography or magnetic resonance elastography, would allow for the best prediction of significant varices. The most promising indicators would be those that are applicable in both intra- and extra-hepatic causes of PHT. Further research on these predictors in children with PHT is required to determine their potential role as selection criteria for PHT and stratification of surveillance GI endoscopies.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2FYAN6N
Celiac Disease Diagnosis Without Biopsy: Is a 10× ULN Antitransglutaminase Result Suitable for a Chemiluminescence Method?
Objectives: 2012 European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines allow to establish a celiac disease diagnosis without duodenal biopsy in symptomatic pediatric patients with antitissue transglutaminase (anti-tTG) titers >10 times the upper limit of normal. For some years now, new chemiluminescence immunoassays have been made available: it is important to establish the clinical performance of anti-tTG and to determine the cut-off best suited to predict Marsh ≥2 to avoid gastrointestinal endoscopy not only in children, but also in the adult population. Methods: A total of 2565 patients performed duodenal biopsy from July 2012 to September 2016; we selected all the patients who had undergone QUANTA Flash anti-tTG immunoglobulin A (IgA) within −3 months of duodenal biopsy and before the start of gluten-free diet. A total of 827 patients fulfilled the criteria for selection. Results: Using a cut-off of 20 chemiluminescent unit (CU; area under the curve: 0.995), sensitivity, specificity, positive, and negative predictive value were 98.2%, 98.4%, 97.9%, and 98.6%, respectively. For the correlation with Marsh ≥2, in the pediatric population, positive predictive values (PPV) were 92.1%, 99%, and 100% at 200 CU (10×), 560 CU (28×), and 1000 CU (50×), respectively. In the adult population PPV was 94.2%, 98.2%, and 100% at 200 CU (10×), 350 CU (15×), and 400 CU (20×). Conclusions: Sensitivity, specificity, positive, and negative predictive value of QUANTA Flash h-tTG IgA were excellent. The cut-off providing an optimized PPV for histological lesions compatible for celiac disease (Marsh ≥2) for the QUANTA Flash h-tTG IgA is 350 CU (15×) in adult and 560 CU (28×) in children.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2DQhTJz
Nutrition in Pediatric Inflammatory Bowel Disease: A Position Paper on Behalf of the Porto Inflammatory Bowel Disease Group of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition
Background and Aims: A growing body of evidence supports the need for detailed attention to nutrition and diet in children with inflammatory bowel disease (IBD). We aimed to define the steps in instituting dietary or nutritional management in light of the current evidence and to offer a useful and practical guide to physicians and dieticians involved in the care of pediatric IBD patients. Methods: A group of 20 experts in pediatric IBD participated in an iterative consensus process including 2 face-to-face meetings, following an open call to Nutrition Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition Porto, IBD Interest, and Nutrition Committee. A list of 41 predefined questions was addressed by working subgroups based on a systematic review of the literature. Results: A total of 53 formal recommendations and 47 practice points were endorsed with a consensus rate of at least 80% on the following topics: nutritional assessment; macronutrients needs; trace elements, minerals, and vitamins; nutrition as a primary therapy of pediatric IBD; probiotics and prebiotics; specific dietary restrictions; and dietary compounds and the risk of IBD. Conclusions: This position paper represents a useful guide to help the clinicians in the management of nutrition issues in children with IBD.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2DQx6dw
Well Preserved Renal Function in Children With Untreated Chronic Liver Disease
Objectives: On the basis of studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease (CLD). Therefore, we investigated renal function in children with CLD. Methods: In a retrospective study of 277 children with CLD, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol. The data were analyzed with regard to different subgroups of liver disease and to the grade of damage. Results: Hyperfiltration (>+2 SD of controls) was found in the subgroups of progressive familial intrahepatic cholestasis (44%), glycogenosis (75%), and acute fulminant liver failure (60%). Patients with biliary atresia, most other patients with metabolic disease and intrahepatic cholestasis, and those with vascular anomalies and cryptogenic cirrhosis had normal renal function. Decreased renal function was found in patients with Alagille's syndrome (64% from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2FYRjUp
Errata
Magnetic Resonance Imaging Findings in Neonatal Hemochromatosis
Background: There are limited data on utility of magnetic resonance imaging (MRI) in the assessment of suspected neonatal hemochromatosis (NH). Objectives: The aim of the study was to present our experience with utilization of multi-echo sequence MRI technique in the evaluation of NH and to compare MRI findings in infants with and without NH. Methods: MRI performed for suspected NH were retrospectively reviewed to note the presence and severity of iron deposition (ID) in liver, spleen, pancreas, and kidneys on multi-echo sequences. Findings were compared in infants with and without NH. Results: Of 20 infants (9 boys and 11 girls; median age of 12.5 days) included in the study, 7 of 20 had NH and 13 of 20 were assigned to the non-NH group. Higher degree of pancreatic ID was seen in the NH group (P = 0.001) with 4 of 7 evaluable pancreas showing moderate-to-severe degree and 1 of 7 showing mild degree of ID whereas none of the 13 infants in non-NH group showed moderate or severe degree of pancreatic ID. Even though the severity of hepatic ID was higher in NH group (P = 0.033), variable severity of hepatic ID was seen in both groups with most infants in both groups showing moderate-to-severe degree of ID. The severity of splenic ID was not particularly associated with any group (P = 0.774) but there was no moderate or severe degree of ID in NH. Renal ID was seen in two infants in non-NH group. Conclusions: A moderate-to-severe degree of pancreatic ID seen on MRI tends to be associated with NH and should be sought to establish a timely diagnosis of NH. Presence and severity of hepatic ID cannot be used for differentiation of NH from other causes of neonatal liver failure.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2FYRH5o
The Effect of Gluten-free Diet on Clinical Symptoms and the Intestinal Mucosa of Patients With Potential Celiac Disease
In this prospective study, we evaluated the effect of gluten-free diet (GFD) in a cohort of 65 children with potential celiac disease. Patients received GFD for signs/symptoms (N = 47) or parents' choice (N = 18). Most frequent signs/symptoms were low body mass index (36%), recurrent abdominal pain (34%), and diarrhea (19%). Of the 35/47 patients followed-up on GFD, only 54% (19/35) showed a complete clinical response. In 9 of 65 patients an intestinal biopsy was also performed after at least 1 year of GFD. No significant differences were observed in terms of Marsh grade (P = 0.33), lamina propria CD25+ cells (P = 0.80), CD3+ (P = 0.9), and γδ+ (P = 0.59) intraepithelial lymphocytes density and intestinal anti-TG2 deposits (P = 0.60). In conclusion, caution is necessary before attributing all symptoms to gluten in this condition.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2uhC9Ex
Hepatic Parenchymal Injury in Crigler-Najjar Type I
Background: Crigler-Najjar syndrome type I (CNI) arises from biallelic variants of UGT1A1 that abrogate uridine diphosphate glucuronosyltransferase (UGT1A1) activity resulting in unconjugated hyperbilirubinemia. Historically, liver parenchyma in CNI was considered structurally and histologically normal. Recent review of CNI liver explants revealed fibrosis. Our aim was to investigate the association between hepatic histology and disease phenotype in CNI. Methods: We extracted data from the medical record at the time of liver transplant from 22 patients with CNI at the Children's Hospital of Pittsburgh, and reviewed explant histology. Continuous data were normally distributed, are presented as mean (±1 SD), and analyzed using two-tailed Student t-test. Categorical data were analyzed using the Chi-square test. Results: Both alanine transaminase (ALT; mean 87.4 IU/L) and aspartate transaminase (AST; mean 54.6 IU/L) were elevated. Nine (41%) of 22 explants had significant fibrosis. Pericentral (n = 5), periportal (n = 2), and mixed (n = 2) patterns of fibrosis occurred. A significant difference in mean age of subjects with fibrotic versus non-fibrotic livers (16.1 years vs 10.5 years; P = 0.02) was seen. There were no indices of synthetic liver dysfunction or portal hypertension. Neither a history of gallstone disease nor excess weight appeared to contribute to the development of fibrosis. Conclusions: For the first time, we report a 41% prevalence of clinically silent, yet histologically significant fibrosis among subjects with Crigler-Najjar type 1. Risk for fibrosis appears to accrue with time, indicating that earlier intervention may be prudent whenever considering alternative treatments such as hepatocyte transplant, auxiliary liver transplant, or viral gene therapy.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2G2mize
Serum 25 Hydroxy Vitamin D Levels in Very Low Birth Weight Infants Receiving Oral Vitamin D Supplementation
Background and Objective: Vitamin D supplementation in preterm infants has been recommended by American Academy of Pediatrics (AAP); however, its efficacy and safety has not been well studied. To study 25-hydroxy vitamin D (25OHD) levels as a marker of vitamin D status of very low birth weight infants while on vitamin D supplementation during neonatal intensive care unit hospitalization. Methods: Retrospective study of preterm infants with birth weight 100 ng/mL. Results: A total of 301 infants were enrolled, 186 very low birth weight (VLBW; 1000–1499 g) infants and 115 extremely low birth weight (ELBW;from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2ufVCWa
Button Battery Powered Fidget Spinners: A Potentially Deadly New Ingestion Hazard for Children
Toys entering the marketplace may have unrecognized hazard risks until data on injury become known. The fidget spinner is a new popular toy mass marketed to children and is primarily sold without warning labels. The US Consumer Product Safety Commission has recently issued a formal statement on potential safety concerns related to ingestion of the toy parts and other hazards. Button batteries within this toy pose the greatest danger to children as ingestion can lead to lethal injury. We report 2 cases of children who swallowed a button battery from a fidget spinner, causing severe esophageal injury. Various aspects of this type of ingestion important for clinicians to be aware of are reviewed.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2G1z0hq
Endoscopic Transesophageal Drainage of Mediastinal Pseudocyst in a Child
Shifting Practice in the Diagnosis of Paediatric Coeliac Disease in English District General Hospitals
Nutritional State and Feeding Behaviors of Children With Eosinophilic Esophagitis and Gastroesophageal Reflux Disease
Objective: As both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are associated with malnutrition and feeding dysfunction, this study compares growth, nutrition, and feeding behaviors in children with GERD and EoE. Methods: Subjects ages 1 to 7 years with GERD or EoE were enrolled in a prospective study. Assessments included length/height, weight, 3-day food diary, serum biomarkers of nutrition, and the Behavioral Pediatric Feeding Assessment Scale. Results: Mean weight-for-length z scores in GERD and EoE children were −0.93 and −1.14 (p = NS) and mean body mass index z scores were 0.29 and −0.13 (P = NS). Vitamin D intake was below the daily recommended intake in GERD subjects. EoE subjects' intake was below daily recommended intake of Vitamin D and calcium. GERD and EoE groups both had normal intake of calories, carbohydrates, proteins, fats, and iron, and normal serum ferritin (25 vs 34 ng/mL), prealbumin (21 vs 20 mg/dL), parathyroid hormone (42 vs 37 pg/mL), and Vitamin D (both 30 ng/mL). Behavioral Pediatric Feeding Assessment Scale problem and frequency scores were similar in GERD and EoE subjects but were higher than those of a historical cohort of healthy controls (Hedges' g of 0.95 and 1.1, respectively). EoE subjects on food allergen restriction diets had significantly less feeding dysfunction than those on regular diets. Conclusions: As a selected group of children with uncomplicated GERD or EoE were without nutritional deficiencies but had maladaptive feeding, providing anticipatory guidance to minimize mealtime challenges, monitoring for improvement, or referring to a feeding therapist, may be beneficial. A trial of food allergen restriction may provide additional benefit for those with EoE.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2G0eWfx
Commentary: Button Batteries in Fidget Spinners Is It Time to Push the “Panic Button”?
Herpes Simplex Virus Esophagitis in Immunocompetent Children: A Harbinger of Eosinophilic Esophagitis?
Herpes simplex virus (HSV) is a common cause of infectious esophagitis. The aim of this retrospective study is to identify comorbid and predisposing conditions and sequelae of HSV esophagitis in immunocompetent children. We reviewed 16 cases of HSV esophagitis diagnosed from January 1982 to March 2016. Five patients were immunosuppressed, 11 were immunocompetent and included in the study. Three (27%) had no other significant medical history. Five patients (45%) had repeat biopsies following their HSV infection, which showed eosinophilic infiltrate consistent with current diagnostic criteria of eosinophilic esophagitis (EoE), one of whom had known EoE. Environmental allergies and/or asthma were present in 4 of 5 of these patients. Among the immunocompetent patients, EoE was a comorbidity in almost half, although biopsies at the time of HSV esophagitis did not show diagnostic features of EoE. Clinical follow-up is therefore warranted for immunocompetent children presenting with HSV esophagitis, particularly those with atopic conditions.from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2G08eGm
Highly Sensitive Thyroglobulin Assays Are Reliable Indicators of Persistent Disease in Thyroid Cancer Patients with Thyroglobulin Antibody
Clinical Thyroidology, Volume 30, Issue 3, Page 122-125, March 2018.
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Low Urinary Iodine Concentrations Predict Decreased Fertility
Clinical Thyroidology, Volume 30, Issue 3, Page 135-137, March 2018.
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Methimazole Has a Dose-Dependent Association With Congenital Malformations, but Switching to PTU in the First Trimester Seems Too Late
Clinical Thyroidology, Volume 30, Issue 3, Page 104-107, March 2018.
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Thyroid Status Has Measurable Effects on Gene Expression in Whole Blood
Clinical Thyroidology, Volume 30, Issue 3, Page 129-131, March 2018.
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Most “Recurrences” of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Clinical Thyroidology, Volume 30, Issue 3, Page 108-111, March 2018.
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No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Clinical Thyroidology, Volume 30, Issue 3, Page 100-103, March 2018.
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Thyroseq v3 Molecular Test for Indeterminate Thyroid Nodules Has Improved Sensitivity and Specificity
Clinical Thyroidology, Volume 30, Issue 3, Page 112-114, March 2018.
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Tumor Size and Nodal Stage Predict Recurrence and Timing of Ultrasonography in Papillary Thyroid Carcinoma Patients
Clinical Thyroidology, Volume 30, Issue 3, Page 126-128, March 2018.
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The Baseline Survey of the 294,905 Fukushima Children and Adolescents Reveals a Panorama of Thyroid Ultrasound Features
Clinical Thyroidology, Volume 30, Issue 3, Page 115-118, March 2018.
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Patients with Advanced Lung Cancer in Whom Thyroid Dysfunction Develops During Programmed Death-1 Protein Blockade May Have a Good Prognosis
Clinical Thyroidology, Volume 30, Issue 3, Page 132-134, March 2018.
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Preoperative Ultrasonography Guides the Extent of Thyroidectomy for Papillary Thyroid Cancer
Clinical Thyroidology, Volume 30, Issue 3, Page 119-121, March 2018.
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TSH Has Effects on Peripheral Thyroid Hormone Metabolism That Are Mild but Run Counter to Its Direct Effects on Thyroid Hormone Secretion
Clinical Thyroidology, Volume 30, Issue 3, Page 138-141, March 2018.
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Blindness after facial trauma: epidemiology, incidence and risk factors. a 27-year cohort study of 5708 patients.
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Panagiotis Stathopoulos, Dimosthenis Igoumenakis, Michalis Mezitis, George Rallis
ObjectivesThis is a 27-year study of a cohort of 5708 patients who sustained maxillofacial fractures. Our purpose is to present the aetiology, mechanism of trauma, site and concomitant injuries that led to visual loss. We hypothesize that fractures caused by high energy impact of the midface may be associated with blindness. A discussion of the treatment approaches is also included.Study Design5708 patients sustained a maxillofacial fracture during the years from 1985 to 2012 and were included in this study. Patients' records were reviewed for gender, age, fracture site, aetiology of trauma, concomitant injuries, method of treatment, length of hospital stay and cause of blindness. The relation of the above variables to blindness was investigated.ResultsThe incidence of loss of vision was 0.34%. A very strong association between firearm injuries and blindness is demonstrated. (p<0.001) These patients spent much longer time in hospital (p<0.01) and suffered serious concomitant injuries involving the brain.ConclusionRetrobullbar haemorrhage should be treated with lateral canthotomy whereas in traumatic optic neuropathy, observation seems to be the safest thing to do. In patients with penetrating injuries of the globe the immediate involvement of an Ophthalmic Surgeon is of paramount importance.
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Demographics and referral patterns of a university-based oral maxillofacial radiology clinic over a 20 year period
Publication date: Available online 23 March 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Chen Nadler, Linda Lee
Objectives– The aim of this study was to review the referral patterns, distribution of interpretations, and type of diagnostic imaging used in a university based oral maxillofacial radiology clinic for patients referred for consultation from both dental and non-dental clinicians.Study Design– The database of the Special Procedures clinic in the Oral Radiology department of the University of Toronto, Faculty of Dentistry, containing over 5,000 entries, from 1993 to 2013, was queried. Using descriptive categorical analysis, the results were analyzed to describe patient demographics, the speciality of the referring clinicians, the imaging modalities used and the interpretation provided.Results– Most referrals were from oral and maxillofacial surgeons and general dentists. Approximately 25% of referrals were interpreted as variations of normal anatomic structures. The most common reasons for referral were intraosseous lesions (42%), temporomandibular joints (39%), and sialography. Ten per cent of all referrals were for recall examinations. The distribution of image modalities has changed through the years covered by this study.Conclusion– This study reflects a lower proportion of referrals reported as normal structures and their variations, than reported in a previous comparable study.
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Endoscopic Skull Base Reconstruction: An Evolution of Materials and Methods.
  | Related Articles |
Endoscopic Skull Base Reconstruction: An Evolution of Materials and Methods.
Otolaryngol Clin North Am. 2017 Jun;50(3):643-653
Authors: Sigler AC, D'Anza B, Lobo BC, Woodard TD, Recinos PF, Sindwani R
Abstract
Endoscopic skull base surgery has developed rapidly over the last decade, in large part because of the expanding armamentarium of endoscopic repair techniques. This article reviews the available technologies and techniques, including vascularized and nonvascularized flaps, synthetic grafts, sealants and glues, and multilayer reconstruction. Understanding which of these repair methods is appropriate and under what circumstances is paramount to achieving success in this challenging but rewarding field. A graduated approach to skull base reconstruction is presented to provide a systematic framework to guide selection of repair technique to ensure a successful outcome while minimizing morbidity for the patient.
PMID: 28372814 [PubMed - indexed for MEDLINE]
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Neurogastroenterology &Motility, Ahead of Print.
Neurogastroenterology &Motility, Ahead of Print.
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Clinical trials for inner ear drugs: Design and execution challenges
Source:Hearing Research
Author(s): David H. Jung, Steven D. Rauch
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Functional outcomes assessment following free muscle transfer for dynamic reconstruction of facial paralysis: a literature review
Publication date: Available online 22 March 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Anson Dong, Kevin J. Zuo, Georgina Papadopoulos-Nydam, Jaret Olson, Gordon Wilkes, Jana Rieger
Facial reanimation provides patients affected by chronic facial paralysis a chance to regain basic human functions such as emotional expression, verbal communication, and oral competence for eating and swallowing, but there is still no consensus as to the best way to measure surgical outcomes. We performed a literature review to investigate the different functional outcomes that surgeons use to evaluate facial function after reanimation surgery, focusing on outcomes other than facial expressions such as speech, oral competence, and patient quality of life/satisfaction. A total of 37 articles were reviewed, with the majority reporting outcomes through subjective facial expression ratings and only 15 dealing with other functional outcomes. In particular, outcomes related to oral competence and speech were reported inconsistently. Facial reanimation patients would benefit from a unified movement to create and validate through consensus, an outcomes reporting system incorporating not only facial expression, but also oral competence, speech, and patient-reported quality of life, to enable global patient assessment.
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Clinical trials for inner ear drugs: Design and execution challenges
Publication date: Available online 22 March 2018
Source:Hearing Research
Author(s): David H. Jung, Steven D. Rauch
from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2I1zVuZ
Efficacy of bedside respiratory muscle training in patients with stroke: A randomized controlled trial
Objectives Inspiratory and the expiratory muscles are important for effective respiratory function. This study aimed to investigate the efficacy of bedside respiratory muscle training on pulmonary function and stroke-related disabilities in stroke rehabilitation. Design Patients with stroke (N=40) in a rehabilitation unit were randomly assigned to either the intervention group (N1=20) or control group (N2=20). Both groups participated in a conventional stroke rehabilitation program. During the study period, the intervention group received bedside respiratory muscle training twice a day for three weeks. The respiratory muscle training consisted of (1) a breath stacking exercise, (2) inspiratory muscle training, and (3) expiratory muscle training. The primary outcomes were measures of pulmonary function: forced vital capacity, forced expiratory volume in one second, and peak flow. Secondary outcomes were stroke-related disabilities assessed using the National Institutes of Health Stroke Scale, Modified Barthel Index, Berg Balance Scale, Fugl-Meyer Assessment, the Korean Mini-Mental State Examination, and pneumonia incidence. Results Pulmonary function was significantly improved in the intervention group after 3 weeks of respiratory muscle training (p
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ULTRASONOGRAPHIC IMAGING OF THE MEDIAN NERVE WITH A STRUTHERS LIGAMENT
Assessment of genotoxicity and genomic instability in rat primary astrocytes exposed to 872 MHz radiofrequency radiation and chemicals
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The use of the term ‘radiosensitivity’ through history of radiation: from clarity to confusion
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Estimation of lifetime attributable risks (LARs) of cancer associated with abdominopelvic radiotherapy treatment planning computed tomography (CT) simulations
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from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2HW3k9R
Functional outcomes assessment following free muscle transfer for dynamic reconstruction of facial paralysis: a literature review
Publication date: Available online 22 March 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Anson Dong, Kevin J. Zuo, Georgina Papadopoulos-Nydam, Jaret Olson, Gordon Wilkes, Jana Rieger
Facial reanimation provides patients affected by chronic facial paralysis a chance to regain basic human functions such as emotional expression, verbal communication, and oral competence for eating and swallowing, but there is still no consensus as to the best way to measure surgical outcomes. We performed a literature review to investigate the different functional outcomes that surgeons use to evaluate facial function after reanimation surgery, focusing on outcomes other than facial expressions such as speech, oral competence, and patient quality of life/satisfaction. A total of 37 articles were reviewed, with the majority reporting outcomes through subjective facial expression ratings and only 15 dealing with other functional outcomes. In particular, outcomes related to oral competence and speech were reported inconsistently. Facial reanimation patients would benefit from a unified movement to create and validate through consensus, an outcomes reporting system incorporating not only facial expression, but also oral competence, speech, and patient-reported quality of life, to enable global patient assessment.
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Correction to: From IB2 to IIIB locally advanced cervical cancers: report of a ten-year experience
Abstract
In the original publication [1] one author name was spelled incorrect.
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Radioiodine Refractory Differentiated Thyroid Cancer
Publication date: Available online 22 March 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Yuchen Jin, Douglas Van Nostrand, Lingxiao Cheng, Min Liu, Libo Chen
Differentiated thyroid cancer (DTC) is usually curable with surgery, radioactive iodine (RAI), and thyroid-stimulating hormone (TSH) suppression. However, local recurrence and/or distant metastases occur in approximately 15% of cases during follow-up, and nearly two-thirds of these patients will become RAI-refractory (RR-DTC) with a poor prognosis. This review focuses on the most challenging and rapidly evolving aspects of RR-DTC, and we discuss the considerable improvement in more accurately defining RR-DTC, more effective therapeutic strategies, and describe the diagnosis, pathogenesis, and future prospects of RR-DTC. Along with the detection of serum thyroglobulin and anatomic imaging modalities, such as ultrasound and computer tomography, radionuclide molecular imaging plays a vital role in the evaluation of RR-DTC. In addition, continual progress has been made in the management of RR-DTC, including watchful waiting under appropriate TSH suppression, local treatment approaches, and systemic therapies (molecular targeted therapy, redifferentiation therapy, gene therapy, and cancer immunotherapy). These all hold promise to change the natural history of RR-DTC.
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