OtoRhinoLaryngology News

Πέμπτη 19 Οκτωβρίου 2017

Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping.

Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping.

Acta Otolaryngol. 2017 Oct 16;:1-6

Authors: Saliba I, Alzahrani M, Weng X, Bestavros A

Abstract
OBJECTIVES: (1) To assess the ability of flow cytometric immunophenotyping to detect and quantitate eosinophils in patients with eosinophilic otitis media (EOM). (2) to evaluate the association of EOM to bronchial asthma.
METHODS: Twenty-one patients with chronic otorrhea or middle ear effusion (MEE) were included in this prospective cohort study. Group I composed of 10 patients (14 ears) and associated to bronchial asthma. Group II included 11 patients (11 ears) without bronchial asthma. Samples of MEE were sent for flow cytometric analysis at initial presentation. Patients with positive eosinophils on flow cytometric immunophenotyping were analyzed after one-month course of dexamethasone eardrops.
RESULTS: EOM was diagnosed in all patients of group I and in three patients of group II. The mean eosinophils percentage was 43.5% and 14.2% for group I and group II, respectively (p = .006). Those patients showed a significant response to dexamethasone eardrops, both on clinical examination and on flow cytometric analysis with a decrease in eosinophil levels post-treatment. However, this improvement was temporary and symptoms recurred after treatment cessation. Bronchial asthma was not associated to all patients with EOM.
CONCLUSION: Diagnosis of EOM remained mostly clinical; flow cytometry immunophenotyping of MEE may be helpful as an additional tool in diagnosis and monitoring the response to treatment, particularly in non-asthmatic patients.

PMID: 29037099 [PubMed - as supplied by publisher]

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

Does the Supine Position Affect the Nasal Profile in Rhinoplasty Patients? A Comparison of Nasal Anthropometric Measurements in Different Body Positions.

Does the Supine Position Affect the Nasal Profile in Rhinoplasty Patients? A Comparison of Nasal Anthropometric Measurements in Different Body Positions.

Aesthet Surg J. 2017 Sep 07;:

Authors: Kim SJ, Ryu IY, Kim SW, Lee KH

Abstract
Background: Rhinoplasty surgeons are aware that the nasal profile differs according to body position, namely, the erect position in the consultation room vs the supine position on the operating table. It is not clear whether this difference is caused by an optical illusion or skin laxity due to positional change.
Objectives: To evaluate anthropometric measurements of the nose with different body positions and determine whether the supine position affects the nasal profile.
Methods: In this retrospective study, 103 patients who underwent primary rhinoplasty were enrolled. Preoperatively, all patients underwent lateral cephalography in the erect position, and facial computed tomography (CT), in the supine position. We measured four nasal anthropometric parameters (the nasofrontal, nasolabial, and nasomental angles, and Simon's ratio) on lateral cephalograms and facial CT images, and compared these parameters between the two body positions.
Results: The nasofrontal angle was greater on facial CT than on cephalograms (P < 0.01). This difference was not related to age, sex, or body mass index (P > 0.05 each). We found no significant difference (P > 0.05) between the two positions in the nasolabial angle, nasomental angle, or Simon's ratio.
Conclusions: The supine position does affect the nasal profile, especially in the radix area. Surgeons need to consider this difference in patients undergoing rhinoplasty.
Level of Evidence 2:

PMID: 29040369 [PubMed - as supplied by publisher]

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

The Influence of Circadian Timing on Olfactory Sensitivity.

The Influence of Circadian Timing on Olfactory Sensitivity.

Chem Senses. 2017 Oct 17;:

Authors: Herz RS, Van Reen E, Barker D, Hilditch CJ, Bartz A, Carskadon MA

Abstract
Olfactory sensitivity has traditionally been viewed as a trait that varies according to individual differences but is not expected to change with one's momentary state. Recent research has begun to challenge this position and time of day has been shown to alter detection levels. Links between obesity and the timing of food intake further raise the issue of whether odor detection may vary as a function of circadian processes. To investigate this question, thirty-seven (21 male) adolescents (M age =13.7 years) took part in a 28-hr forced-desynchrony (FD) protocol with 17.5 hours awake and 10.5 hours of sleep, for seven FD cycles. Odor threshold was measured using Sniffin' Sticks six times for each FD cycle (total threshold tests = 42). Circadian phase was determined by intrinsic period derived from dim light melatonin onsets. Odor threshold showed a significant effect of circadian phase, with lowest threshold occurring on average slightly after the onset of melatonin production, or about 1.5 ○ (approximately 21:08 hours). Considerable individual variability was observed, however, peak olfactory acuity never occurred between 80.5 ○- 197.5 ○ (~02:22-10:10 hours). These data are the first to show that odor threshold is differentially and consistently influenced by circadian timing, and is not a stable trait. Potential biological relevance for connections between circadian phase and olfactory sensitivity are discussed.

PMID: 29045623 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2inD6oZ

Super- and subadditive neural processing of dynamic auditory-visual objects in the presence of congruent odors.

Super- and subadditive neural processing of dynamic auditory-visual objects in the presence of congruent odors.

Chem Senses. 2017 Oct 16;:

Authors: Ohla K, Höchenberger R, Freiherr J, Lundström JN

Abstract
Our sensory experiences comprise a variety of different inputs at any given time. Some of these experiences are unmistakable, others are ambiguous and profit from additional sensory information. Here, we explored whether the presence of a congruent odor influences the neural processing and sensory interaction of audio-visual objects using degraded videos (V) and sounds (A) of dynamic objects in unimodal and bimodal (AV) combinations without or with a congruent odor (VO, AO, AVO). Analyses of EEG data revealed super- and subadditive interaction effects. The topography and timing of these effects suggest evaluative rather than sensory processes as the underlying cause. Together, the results suggest that the mere presence of an odor affects the processing of A, V, and AV objects differently while multisensory interactions of AV and AVO objects have common neuronal mechanisms pointing to a robust, modality-independent network for the processing of redundant sensory information.

PMID: 29045615 [PubMed - as supplied by publisher]

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

Zebrafish aversive taste co-receptor is expressed in both chemo- and mechanosensory cells and plays a role in lateral line development.

Zebrafish aversive taste co-receptor is expressed in both chemo- and mechanosensory cells and plays a role in lateral line development.

Sci Rep. 2017 Oct 18;7(1):13475

Authors: Mojib N, Xu J, Bartolek Z, Imhoff B, McCarty NA, Shin CH, Kubanek J

Abstract
Fishes rely on both chemical and tactile senses to orient themselves to avoid predators, and to detect and taste food. This is likely achieved by highly coordinated reception of signals by mechano- and chemosensory receptors in fish. A small co-receptor from zebrafish, receptor activity modifying protein (RAMP)-like triterpene glycoside receptor (RL-TGR), was previously found to be involved in recognition of triterpene glycosides, a family of naturally occurring compounds that act as chemical defenses in various prey species. However, its localization, function, and how it impacts sensory organ development in vivo is not known. Here we show that RL-TGR is expressed in zebrafish in both i) apical microvilli of the chemosensory cells of taste buds including the epithelium of lips and olfactory epithelium, and ii) mechanosensory cells of neuromasts belonging to the lateral line system. Loss-of-function analyses of RL-TGR resulted in significantly decreased number of neuromasts in the posterior lateral line system and decreased body length, suggesting that RL-TGR is involved in deposition and migration of the neuromasts. Collectively, these results provide the first in vivo genetic evidence of sensory cell-specific expression of this unusual co-receptor and reveal its additional role in the lateral line development in zebrafish.

PMID: 29044184 [PubMed - in process]

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

From nose to memory: the involuntary nature of odor-evoked autobiographical memories in Alzheimer's disease.

From nose to memory: the involuntary nature of odor-evoked autobiographical memories in Alzheimer's disease.

Chem Senses. 2017 Oct 11;:

Authors: El Haj M, Gandolphe MC, Gallouj K, Kapogiannis D, Antoine P

Abstract
Research suggests that odors may serve as a potent cue for autobiographical retrieval. We tested this hypothesis in Alzheimer's disease (AD) and investigated whether odor-evoked autobiographical memory is an involuntary process that shares similarities with music-evoked autobiographical memory. Participants with mild AD and controls were asked to retrieve two personal memories after odor exposure, after music exposure, and in an odor-and-music-free condition. AD participants showed better specificity, emotional experience, mental time travel, and retrieval time after odor and music exposure than in the control condition. Similar beneficial effects of odor and music exposure were observed for autobiographical characteristics (i.e., specificity, emotional experience, and mental time travel), except for retrieval time which was more improved after odor than after music exposure. Interestingly, regression analyses suggested executive involvement in memories evoked in the control condition but not in those evoked after music or odor exposure. These findings suggest the involuntary nature of odor-evoked autobiographical memory in AD. They also suggest that olfactory cuing could serve as a useful and ecologically valid tool to stimulate autobiographical memory, at least in the mild stage of the disease.

PMID: 29040475 [PubMed - as supplied by publisher]

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

Impact of osteopathic therapy on proprioceptive balance and quality of life in patients with dizziness.

Impact of osteopathic therapy on proprioceptive balance and quality of life in patients with dizziness.

J Bodyw Mov Ther. 2017 Oct;21(4):866-872

Authors: Papa L, Amodio A, Biffi F, Mandara A

Abstract
The aim of the study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) in patients with Benign-Paroxysmal-Positional Vertigo (BPPV). Thirty-one patients with BPPV were randomly assigned into two groups: 19 patients received osteopathic treatments (TG) and 12 patients received sham therapy (SG), both in four weekly sessions. Before the first and the last treatment, those patients were evaluated using Dizziness Handicap Inventory (DHI) and stabilometric platform to assess lifestyle modification and balance functions. After the treatment session, TG compared to SG showed an improvement in DHI global (p = 0.02), functional (p = 0.03) and physical (p = 0.03) components, as well as a reduction of swinging area (p = 0.02). An association between swinging area and lifestyle measures (global [r = 0.53; p = 0.02]; functional [r = 0.50; p = 0.03]; physical [r = 0.60; p = 0.01]) changes were found in TG. These findings suggest that OMT could be a useful approach to reduce imbalance symptoms and to improve the quality of life in patients suffering from dizziness.

PMID: 29037641 [PubMed - in process]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gR22Sw

Quality of life in older individuals with joint contractures in geriatric care settings.

http:--production.springer.de-OnlineReso

Quality of life in older individuals with joint contractures in geriatric care settings.

Qual Life Res. 2016 Sep;25(9):2269-81

Authors: Heise M, Müller M, Fischer U, Grill E

Abstract
PURPOSE: The purpose of this study was to analyze the association between functioning and disability and quality of life (QoL) in older individuals with joint contractures in the geriatric care setting. More specifically, this study aimed to identify determinants of QoL out of a defined set of contracture-related categories of the International Classification of Functioning, Disability and Health (ICF).
METHODS: Participants for this multicenter cross-sectional survey were recruited from acute geriatric rehabilitation hospitals, nursing homes, and community nursing facilities in Germany between February and October 2013. QoL was assessed using the validated German version of the EQ-5D index score and the EQ-5D visual analog scale (VAS). Manual and automatic variable selection methods were used to identify the most relevant variables out of 125 contracture-related ICF categories.
RESULTS: A total of 241 eligible participants (34.9 % male, mean age 80.1 years) were included. The final models contained 14 ICF categories as predictors of the EQ-5D index score and 15 categories as predictors of the EQ-5D VAS. The statistically significant ICF categories from both models were 'muscle power functions (b730),' 'memory functions (b144),' 'taking care of plants (d6505),' 'recreation and leisure (d920),' 'religion and spirituality (d930),' 'drugs (e1101),' and 'products and technology for personal use in daily living (e115).'
CONCLUSIONS: We identified the most relevant ICF categories for older individuals with joint contractures and their health-related quality of life. These items describe potential determinants of QoL which may provide the basis for future health interventions aiming to improve QoL for the patients with joint contractures.

PMID: 26980418 [PubMed - indexed for MEDLINE]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gQsgo0

Antioxidants in the Treatment of Cancer.

Antioxidants in the Treatment of Cancer.

Nutr Cancer. 2017 Oct 18;:1-6

Authors: Athreya K, Xavier MF

Abstract
Several clinical trials have produced conflicting results regarding the benefit of antioxidants in cancer therapy thus questioning the incorporation of these substances in standard treatment regimens. Vitamins E and C, selenium, carotenoids, lycopene, soy products, and green tea extract are a few substances with antioxidant properties that have been studied in detail. This article reviews the results generated over the last 20 years through in vitro and in vivo studies in various types of cancers and stages of cancer treatment. Despite the commercial popularity and the multitude of studies examining antioxidant therapy, the true role of antioxidants is yet to be determined, requiring further investigation into its propagative, causal, or protective nature.

PMID: 29043851 [PubMed - as supplied by publisher]

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

The Protective and Immunomodulatory Effects of Fucoidan Against 7,12-Dimethyl benz[a]anthracene-Induced Experimental Mammary Carcinogenesis Through the PD1/PDL1 Signaling Pathway in Rats.

The Protective and Immunomodulatory Effects of Fucoidan Against 7,12-Dimethyl benz[a]anthracene-Induced Experimental Mammary Carcinogenesis Through the PD1/PDL1 Signaling Pathway in Rats.

Nutr Cancer. 2017 Oct 18;:1-11

Authors: Xue M, Liang H, Tang Q, Xue C, He X, Zhang L, Zhang Z, Liang Z, Bian K, Zhang L, Li Z

Abstract
Fucoidan is a sulfated polysaccharide that is extracted from brown algae seaweed. This study was designed to evaluate the protective and immunomodulatory effects of dietary fucoidan on 7,12-dimethyl benz[a]anthracene (DMBA)-induced experimental mammary carcinogenesis in rats. Sixty Sprague-Dawley rats were randomly assigned to four equal groups: the control group (control group), the cancer model group (model group), and the F1 and F2 groups, which were fed fucoidan at concentrations of 200 and 400 mg/kg·body weight, respectively. We found that fucoidan treatment decreased the tumor incidence and mean tumor weight and prolonged the tumor latency. Flow cytometric analyses revealed that the number of blood natural killer cells was higher after fucoidan treatment and that the proportions of CD4 and CD8 T cells were also increased. The serum levels of interleukin (IL)-6, IL-12p40, and interferon (IFN)-γ were higher in the rats treated with fucoidan compared to those of model rats. Moreover, the percentage of CD3+ Foxp3+ regulatory T cells in the blood and the levels of IL-10 and transforming growth factor β in the serum were lower in the rats treated with fucoidan. Furthermore, fucoidan treatment decreased the expression of Foxp3 and programmed cell death 1 ligand 1 (PDL1) in tumor tissues. The levels of p-phosphatidyl inositol kinase 3 and p-AKT in tumor tissues were also lower than those of model rats. These results suggest that a fucoidan-supplemented diet can inhibit DMBA-induced tumors in rats. This study provides experimental evidence toward elucidating the immune enhancement induced by fucoidan through the programmed cell death 1/PDL1 signaling pathway. The immunomodulatory effect is one of the possible mechanisms of the protective effect of fucoidan against mammary carcinogenesis.

PMID: 29043842 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2x7OOXA

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Int J Audiol. 2017 Oct 16;:1-9

Authors: Osisanya A, Adewunmi A

Abstract
OBJECTIVE: The need to develop a measure of managing children with a single profile of auditory processing disorders (APDs), and differentiate between true and artefactual improvements necessitated the study. The study also sought to determine the efficacy of interventions - both single and combined on APD, against no-treatment.
DESIGN: A randomised controlled trial of interventions (RCT) was adopted. Participants were randomly allocated to each of the intervention groups or the no intervention group. The 10 weeks intervention included 45 minutes three times a week therapeutic intervention on listening with noise and sound localisation ability in the home and school environments.
STUDY SAMPLE: 80 pupils (7-11 years) with a single profile of APD participated in the study.
RESULTS: Treatments were effective on the cocktail party and sound localisation. The best result was realised with the combined therapy (CT), and there was no significant difference in performance in the remaining treatment groups.
CONCLUSION: The intervention groups were beneficial to pupils with APD and should be adopted by clinicians.

PMID: 29037092 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gtu1ur

Effect of sound generator on tinnitus and hyperacusis.

Effect of sound generator on tinnitus and hyperacusis.

Acta Otolaryngol. 2017 Oct 18;:1-5

Authors: Park JM, Kim WJ, Ha JB, Han JJ, Park SY, Park SN

Abstract
OBJECTIVE: Sound generator (SG) plays a role as effective sound therapy of tinnitus retaining therapy (TRT) in patients with severe tinnitus (Category 1) or hyperacusis (Category 3). This study was performed to evaluate the therapeutic effect of SGs.
METHODS: A total of 120 tinnitus patients who visited our tinnitus clinic and were treated with SG along with TRT from January 2008 to December 2016 were included. The patients were divided into two groups by tinnitus category; 78 patients of category 1 and 42 patients of category 3. Their medical records including questionnaires regarding tinnitus severity were retrospectively reviewed to evaluate the therapeutic effect of SGs on tinnitus and hyperacusis.
RESULTS: Category 3 patients included more female patients, were younger than category 1 patients (p = .001), and were prescribed SG earlier due to their severe symptom of hyperacusis. (p = .004) All patients showed significant improvements on all categories of tinnitus visual analogue scale (VAS) scores and tinnitus handicap inventory (THI) scores after six months use of SG (p < .05). Loudness discomfort levels measured by pure tone audiometry were significantly improved in category 3 group after six months use of SGs.
CONCLUSION: SG with TRT seems to be an effective treatment modality for all tinnitus patients, especially those with comorbid hyperacusis.

PMID: 29043888 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2kZdrE9

Transcranial brain stimulation for the treatment of tinnitus: Positive lessons from a negative trial.

Transcranial brain stimulation for the treatment of tinnitus: Positive lessons from a negative trial.

Brain Stimul. 2017 Oct 05;:

Authors: Plewnia C

PMID: 29037789 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gnQoh6

Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy.

Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy.

Head Neck. 2017 Oct 16;:

Authors: Lansu J, Klop WM, Heemsbergen W, Navran A, Al-Mamgani A, Langendijk JA, Kaanders JH, Terhaard C, Karakullukcu B, Hamming-Vrieze O

Abstract
BACKGROUND: The purpose of this study was to analyze the effect of fractionation schedule on local control in postoperative radiotherapy (RT) for sinonasal malignant melanoma.
METHODS: Sixty-three patients who were treated with surgery and postoperative RT in 4 accredited head and neck cancer centers in the Netherlands between 1998 and 2013 were retrospectively studied. Outcomes with conventional fractionation (2-2.4 Gy per fraction; n = 27) were compared to hypofractionation (4-6 Gy per fraction; n = 36). The primary endpoint was local control and the secondary endpoint was toxicity.
RESULTS: Comparable local control rates were found after 2 and 5 years (63% vs 64% and 47% vs 53%; P = .73 for, respectively, conventional fractionation vs hypofractionation). Local recurrences were predominantly present ipsilateral (92%) and within the irradiated volume (88%). Late toxicity grade ≥ 3 was observed in 2 of 63 patients, 1 patient in both groups.
CONCLUSION: Radiotherapy fractionation schedule did not influence the local control rate or the incidence of late toxicity in patients treated with surgery and RT for sinonasal malignant melanoma in this retrospective analysis. Due to this retrospective nature and the limited number of patients, strong recommendations cannot be made. Expected toxicity, patient convenience, and workload may be taken into account for the choice of fractionation schedule until conclusive evidence becomes available.

PMID: 29044881 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gmaM24

Exercise therapy for trismus secondary to head and neck cancer: A systematic review.

Exercise therapy for trismus secondary to head and neck cancer: A systematic review.

Head Neck. 2017 Nov;39(11):2352-2362

Authors: Kamstra JI, van Leeuwen M, Roodenburg JLN, Dijkstra PU

Abstract
BACKGROUND: Effects of exercise therapy for trismus secondary to head and neck cancer have not been reviewed systematically since 2004.
METHODS: Four databases were searched. The quality of observational studies and randomized controlled trials was assessed.
RESULTS: Two hundred eleven articles were found, 20 studies were included. A large variation in research methodology, stretching techniques, duration of stretch, and repetition of exercises was found. The overall quality was moderate. Five of the 8 preventive studies found that exercises during (chemo)radiotherapy could not prevent a reduction in mouth opening. In 4 therapeutic case studies, mouth opening increased between 17 and 24 mm. In 8 other therapeutic studies, mouth opening increased between -1.9 and 13.6 mm. No exercise therapy was clearly superior to the others.
CONCLUSION: Changes in mouth opening ranged considerably and no stretching technique was superior to others regarding either prevention or treatment of trismus. Clinical guidelines cannot be given based on this systematic review. © 2016 Wiley Periodicals, Inc. Head Neck 39: 160-169, 2017.

PMID: 29044879 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ys0AzV

Efficacy and safety of vinorelbine plus cisplatin chemotherapy for patients with recurrent and/or metastatic salivary gland cancer of the head and neck.

Efficacy and safety of vinorelbine plus cisplatin chemotherapy for patients with recurrent and/or metastatic salivary gland cancer of the head and neck.

Head Neck. 2017 Oct 16;:

Authors: Hong MH, Kim CG, Koh YW, Choi EC, Kim J, Yoon SO, Kim HR, Cho BC

Abstract
BACKGROUND: The purpose of this study was to investigate the efficacy and safety of vinorelbine plus cisplatin chemotherapy in patients with recurrent and/or metastatic salivary gland cancer of the head and neck.
METHODS: In this single-arm phase II study, patients with recurrent and/or metastatic salivary gland cancer were treated with i.v. vinorelbine (25 mg/m(2) ) on days 1 and 8 plus cisplatin (80 mg/m(2) ) on day 1 every 3 weeks for 4 or 6 cycles. The primary endpoint was the objective response rate. Progression-free survival (PFS), overall survival (OS), and adverse events were also assessed.
RESULTS: Between September 2008 and November 2014, 40 patients with recurrent and/or metastatic salivary gland cancer received vinorelbine plus cisplatin chemotherapy. The objective response rate was 35.0%, including 1 complete response. Median PFS and OS rates were 6.3 months and 16.9 months, respectively. No treatment-related deaths occurred.
CONCLUSION: Administering vinorelbine plus cisplatin chemotherapy to patients with recurrent and/or metastatic salivary gland cancers is safe and effective.

PMID: 29044862 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gmW4bq

AHNS Series: Do you know your guidelines? Perioperative antithrombotic management in head and neck surgery.

AHNS Series: Do you know your guidelines? Perioperative antithrombotic management in head and neck surgery.

Head Neck. 2017 Oct 16;:

Authors: Meyer A, Gross N, Teng M

Abstract
Head and neck surgeons are commonly faced with surgical patients who have underlying medical problems requiring antithrombotic therapy. It is difficult to achieve a balance between minimizing the risk of thromboembolism and hemorrhage in the perioperative period. Data from randomized, controlled trials are limited, and procedure-specific bleed rates are also difficult to pinpoint. The decision is made more difficult when patients with moderate-to-high risk for thromboembolic events undergo procedures that are high risk for bleeding. This is true for many head and neck oncologic surgeries. Furthermore, although elective procedures may be delayed for optimization of antithrombotic medication, emergent procedures cannot. Head and neck surgery often represents the most challenging of all these circumstances, given the potential risk of airway compromise from bleeding after head and neck surgery.

PMID: 29044795 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ys7HIF

Management of the lateral neck compartment in patients with sporadic medullary thyroid cancer.

Management of the lateral neck compartment in patients with sporadic medullary thyroid cancer.

Head Neck. 2017 Oct 16;:

Authors: Pena I, Clayman GL, Grubbs EG, Bergeron JM, Waguespack SG, Cabanillas ME, Dadu R, Hu MI, Fellman BM, Li Y, Gross ND, Lai SY, Sturgis EM, Zafereo ME

Abstract
BACKGROUND: The purpose of this retrospective analysis was to evaluate the benefits of an elective lateral neck dissection (ELND) in patients with medullary thyroid cancer (MTC) without radiographically apparent lateral neck metastases.
METHODS: Patients with sporadic MTC without radiographic evidence of lateral neck metastasis who underwent definitive surgery were divided into 2 groups based on surgical approach: no ELND (the observation group) and ipsilateral or bilateral ELND (the ELND group). Primary outcomes were biochemical cure, locoregional recurrence, distant metastasis, and overall survival (OS).
RESULTS: Sixty-six patients met inclusion criteria: 44 patients (67%) in the observation group and 22 patients (33%) in the ELND group. Two of 44 patients (5%) in the observation group developed subsequent (ipsilateral) lateral neck disease. At last follow-up, locoregional disease control rates among the observation and ELND groups were 98% and 100% (P > .999), respectively, whereas biochemical cure rates were 82% and 85% (P > .999), respectively, and 5-year OSs were 84% and 100% (P = .156), respectively.
CONCLUSION: Patients with MTC without lateral neck metastasis have similar biochemical cure rates with observation or elective dissection of lateral neck compartments.

PMID: 29044788 [PubMed - as supplied by publisher]

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

A DNA vaccine delivered by dermal electroporation fully protects cynomolgus macaques against Lassa fever.

A DNA vaccine delivered by dermal electroporation fully protects cynomolgus macaques against Lassa fever.

Hum Vaccin Immunother. 2017 Oct 18;:0

Authors: Cashman KA, Wilkinson ER, Shaia CI, Facemire PR, Bell TM, Bearss JJ, Shamblin JD, Wollen SE, Broderick KE, Sardesai NY, Schmaljohn CS

Abstract
Lassa virus (LASV) is an ambisense RNA virus in the Arenaviridae family and is the etiological agent of Lassa fever, a severe hemorrhagic disease endemic to West and Central Africa (1,2) . There are no U.S. Food and Drug Administration (FDA)-licensed vaccines available to prevent Lassa fever (1,2) . in our previous studies, we developed a gene-optimized DNA vaccine that encodes the glycoprotein precursor gene of LASV (Josiah strain) and demonstrated that three vaccinations accompanied by dermal electroporation protected guinea pigs from LASV-associated illness and death. Here, we describe an initial efficacy experiment in cynomolgus macaque nonhuman primates (NHPs) in which we followed an identical 3-dose vaccine schedule that was successful in guinea pigs, and a follow-on experiment in which we employed an accelerated vaccination strategy consisting of two administrations, spaced four weeks apart. In both studies, all of the LASV DNA-vaccinated NHPs survived challenge and none of them had measureable, sustained viremia or displayed weight loss or other disease signs post-exposure. Three of 10 mock-vaccinates survived exposure to LASV, but all of them became acutely ill post-exposure and remained chronically ill to the study endpoint (45 days post-exposure). Two of the three survivors experienced sensorineural hearing loss (described elsewhere). These results clearly demonstrate that the LASV DNA vaccine combined with dermal electroporation is a highly effective candidate for eventual use in humans.

PMID: 29045192 [PubMed - as supplied by publisher]

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

Exome Sequencing Identifies a Novel Nonsense Mutation of MYO6 as the Cause of Deafness in a Brazilian Family.

Exome Sequencing Identifies a Novel Nonsense Mutation of MYO6 as the Cause of Deafness in a Brazilian Family.

Ann Hum Genet. 2017 Oct 17;:

Authors: Sampaio-Silva J, Batissoco AC, Jesus-Santos R, Abath-Neto O, Scarpelli LC, Nishimura PY, Galindo LT, Bento RF, Oiticica J, Lezirovitz K

Abstract
We investigated 313 unrelated subjects who presented with hearing loss to identify the novel genetic causes of this condition in Brazil. Causative GJB2/GJB6 mutations were found in 12.7% of the patients. Among the familial cases (100/313), four were selected for exome sequencing. In one case, two novel heterozygous variants were found and were predicted to be pathogenic based on bioinformatics tools, that is, p.Ser906* (MYO6) and p.Arg42Cys (GJB3). We confirmed that this nonsense MYO6 mutation segregated with deafness in this family. Only the proband and her unaffected mother exhibited the GJB3 mutation, which is in the same amino acid of a known Erythrokeratodermia variabilis mutation. None of the patients exhibited this skin disease, but the proband exhibited a more severe hearing loss. Hence, the GJB3 mutation was considered to be a variant of uncertain significance. In conclusion, we described a novel nonsense MYO6 mutation that was responsible for the hearing loss in a Brazilian family. This mutation resides in the neck domain of myosin-VI after the motor domain. Thus, our data give further support for genotype-phenotype correlations, which state that when the motor domain of the protein is functioning, the hearing loss is milder and has a later onset. The three remaining families without mutations in the known genes suggest that there are still deafness genes to be revealed.

PMID: 29044474 [PubMed - as supplied by publisher]

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

"Homozygous, and compound heterozygous mutation in 3 Turkish family with Jervell and Lange-Nielsen syndrome: case reports".

"Homozygous, and compound heterozygous mutation in 3 Turkish family with Jervell and Lange-Nielsen syndrome: case reports".

BMC Med Genet. 2017 Oct 16;18(1):114

Authors: Uysal F, Turkgenc B, Toksoy G, Bostan OM, Evke E, Uyguner O, Yakicier C, Kayserili H, Cil E, Temel SG

Abstract
BACKGROUND: Jervell and Lange-Nielsen syndrome (JLNS) isa recessive model of long QT syndrome which might also be related to possible hearing loss. Although the syndrome has been demonstrated to be originated from homozygous or compound heterozygous mutations in either the KCNQ1 or KCNE1 genes, additional mutations in other genetic loci should be considered, particularly in malignant course patients.
CASE PRESENTATIONS: Three patients were admitted into hospital due to recurrent seizures/syncope, intrauterine and postnatal bradycardia respectively; moreover all three patients had congenital sensorineural hearing-loss. Their electrocardiograms showed markedly prolonged QT interval. Implantable defibrillator was implanted and left cardiac sympathetic denervation was performed due to the progressive disease in case 1. She had countless ventricular fibrillation and appropriate shock while using an implantable defibrillator. The DNA sequencing analysis of the KCNQ1 gene disclosed a homozygous c.728G > A (p.Arg243His) missense mutation in case1. Further targeted next generation sequencing of cardiac panel comprising 68 gene revealed a heterozygous c.1346 T > G (p.Ile449Arg) variant in RYR2 gene and a heterozygous c.809G > A (p.Cys270Tyr) variant in NKX2-5 gene in the same patient. Additional gene alterations in RYR2 and NKX2-5 genes were thought to be responsible for progressive and malignant course of the disease. As a result of DNA sequencing analysis of KCNQ1 and KCNE1 genes, a compound heterozygosity for two mutations had been detected in KCNQ1 gene in case 2: a maternally derived c.477 + 1G > A splice site mutation and a paternally derived c.520C > T (p.Arg174Cys) missense mutation. Sanger sequencing of KCNQ1 and KCNE1 genes displayed a homozygous c.1097G > A (p.Arg366Gln) mutation in KCNQ1 gene in case 3. β-blocker therapy was initiated to all the index subjects.
CONCLUSIONS: Three families of JLNS who presented with long QT and deafness and who carry homozygous, or compound heterozygous mutation in KCNQ1 gene were presented in this report. It was emphasized that broad targeted cardiac panels may be useful to predict the outcome especially in patients with unexplained phenotype-genotype correlation. Clinical presentations and molecular findings will be discussed further to clarify the phenotype genotype associations.

PMID: 29037160 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2hPF6CJ

Molecular Analysis of Twelve Pakistani Families with Nonsyndromic or Syndromic Hearing Loss.

Molecular Analysis of Twelve Pakistani Families with Nonsyndromic or Syndromic Hearing Loss.

Genet Test Mol Biomarkers. 2017 May;21(5):316-321

Authors: Wang R, Han S, Khan A, Zhang X

Abstract
AIM: To investigate the causative genetic mutations in 12 Pakistani families with nonsyndromic or syndromic hearing loss.
METHODS: Mutations in the most common causative gene for hearing loss, GJB2, were evaluated by Sanger sequencing. Targeted next-generation sequencing or whole-exome sequencing was used to analyze the genomic DNA samples from 11 probands with hearing loss. Sanger sequencing was performed to verify all identified variants.
RESULTS: We found pathogenic, or likely to be pathogenic, mutations in all 12 families, including six known mutations in GJB2, SLC26A4, LHFPL5, and USH2A and eight novel mutations in ESPN, MYO7A, LRTOMT, PCDH15, USH2A, or EPS8L2. Notably, four compound heterozygous mutations in the MYO7A and USH2A genes were detected in two consanguineous families. In addition, the novel frameshift mutation in EPS8L2 was first documented in Pakistan.
CONCLUSIONS: Our study increases the spectrum of mutations associated with hearing loss in the Pakistani population. In addition, our study highlights the fact that compound heterozygous mutations, although rare, can occur in consanguineous families.

PMID: 28281779 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2hP5V9Y

Atypical speech lateralization in adults with developmental coordination disorder demonstrated using functional transcranial Doppler ultrasound.

http:--media.wiley.com-assets-7315-19-Wi

Atypical speech lateralization in adults with developmental coordination disorder demonstrated using functional transcranial Doppler ultrasound.

J Neuropsychol. 2017 Mar;11(1):1-13

Authors: Hodgson JC, Hudson JM

Abstract
Research using clinical populations to explore the relationship between hemispheric speech lateralization and handedness has focused on individuals with speech and language disorders, such as dyslexia or specific language impairment (SLI). Such work reveals atypical patterns of cerebral lateralization and handedness in these groups compared to controls. There are few studies that examine this relationship in people with motor coordination impairments but without speech or reading deficits, which is a surprising omission given the prevalence of theories suggesting a common neural network underlying both functions. We use an emerging imaging technique in cognitive neuroscience; functional transcranial Doppler (fTCD) ultrasound, to assess whether individuals with developmental coordination disorder (DCD) display reduced left-hemisphere lateralization for speech production compared to control participants. Twelve adult control participants and 12 adults with DCD, but no other developmental/cognitive impairments, performed a word-generation task whilst undergoing fTCD imaging to establish a hemispheric lateralization index for speech production. All participants also completed an electronic peg-moving task to determine hand skill. As predicted, the DCD group showed a significantly reduced left lateralization pattern for the speech production task compared to controls. Performance on the motor skill task showed a clear preference for the dominant hand across both groups; however, the DCD group mean movement times were significantly higher for the non-dominant hand. This is the first study of its kind to assess hand skill and speech lateralization in DCD. The results reveal a reduced leftwards asymmetry for speech and a slower motor performance. This fits alongside previous work showing atypical cerebral lateralization in DCD for other cognitive processes (e.g., executive function and short-term memory) and thus speaks to debates on theories of the links between motor control and language production.

PMID: 26917045 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gl9OTT

Sialic acid-binding immunoglobulin-like lectin1 as a Novel Predictive Biomarker for Relapse in Graves' Disease -A multicenter study.

Sialic acid-binding immunoglobulin-like lectin1 as a Novel Predictive Biomarker for Relapse in Graves' Disease -A multicenter study.

Thyroid. 2017 Oct 17;:

Authors: Hashimoto K, Nishihara E, Matsumoto M, Matsumoto S, Nakajima Y, Tsujimoto K, Yamakage H, Asahara-Satoh N, Noh JY, Ito K, Miyauchi A, Mori M, Yamada M, Ogawa Y

Abstract
BACKGROUND: There are currently no reliable biomarkers to predict relapse in Graves' disease (GD). In the present study, we investigated novel diagnostic biomarkers to predict the long-term remission of or relapse in GD.
METHODS: A DNA microarray analysis was performed to examine gene expression in the peripheral leukocytes of a frequently relapsing patient with GD and a patient in long-term remission after the discontinuation of anti-thyroid drugs (ATDs). Based on the DNA microarray analysis, we focused on Sialic acid-binding immunoglobulin-like lectin1 (Siglec1) as a candidate novel biomarker to predict GD relapse. Three hundred and fifty-eight patients with GD in the thyroid clinics of four different hospitals in Japan were included in a cross-sectional study to establish whether Siglec1 mRNA levels distinguish GD relapse experience from long-term remission. An additional 55 patients with GD were enrolled in a prospective study to clarify whether Siglec1 mRNA levels at ATD discontinuation predict GD relapse.
RESULTS: Siglec1 mRNA levels were significantly higher in patients with GD relapse experience than in those in long-term remission. Based on the receiver operating characteristic (ROC) analysis, we found that high Siglec1 mRNA levels (≧258.9 copies) significantly distinguished GD relapse experience from long-term remission (P < 0.0001; sensitivity 66.7%, specificity 70.1%). In the prospective study, when the optimal cut-off value from the ROC curve analysis was applied to Siglec1 mRNA positivity at ATD discontinuation, Siglec1-positive patients (≧ 258.9 copies) showed a significantly higher cumulative risk of relapse than Siglec1-negative patients (< 258.9 copies) (P = 0.022, the Log-rank test).
CONCLUSIONS: Siglec1 mRNA levels have potential as a novel predictive biomarker for GD relapse.

PMID: 29037117 [PubMed - as supplied by publisher]

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

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Int J Audiol. 2017 Oct 16;:1-9

Authors: Osisanya A, Adewunmi A

PMID: 29037092 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gtu1ur

Predictors of receptive and expressive vocabulary development in children with Down syndrome.

Predictors of receptive and expressive vocabulary development in children with Down syndrome.

Int J Speech Lang Pathol. 2017 Oct 18;:1-13

Authors: Deckers SRJM, Van Zaalen Y, Van Balkom H, Verhoeven L

Abstract
PURPOSE: There is a lack of longitudinal data on predictors of vocabulary development in children with Down syndrome (DS). In typically developing children, many internal and external predictors of vocabulary development have been determined before. The purpose of the present study was to investigate the role of these variables in the receptive and expressive vocabulary development of children with DS.
METHOD: The present study used a longitudinal design in young children with DS to study the vocabulary development over a period of 1.6 years and investigated the possible predictive role of child-related and environmental variables.
RESULT: Receptive vocabulary development was best predicted by the adaptive level of functioning and early receptive vocabulary skills. Expressive vocabulary development was best predicted by the adaptive level of functioning, receptive vocabulary, maternal educational level, level of communicative intent of the child, attention skills and phonological/phonemic awareness.
CONCLUSION: A wide range of internal and external predictors for vocabulary development of children with DS was found. Predictors resemble those predicting vocabulary development in peers with typical development between 1 and 6 years of age, as identified in other studies.

PMID: 29043855 [PubMed - as supplied by publisher]

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

Case 32-2017: A 64-Year-Old Man with Dyspnea, Wheezing, Headache, Cough, and Night Sweats

Presentation of Case. Dr. Amulya Nagarur: A 64-year-old man was evaluated in the emergency department of this hospital because of dyspnea, wheezing, headaches, cough, and night sweats. Approximately 6 years before this presentation, the patient had received a diagnosis of fibromyalgia, which had…

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

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Int J Audiol. 2017 Oct 16;:1-9

Authors: Osisanya A, Adewunmi A

PMID: 29037092 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gtu1ur

The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer.

The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer.

Acta Otolaryngol. 2017 Oct 18;:1-7

Authors: Yang Y, Fang J, Zhong Q, Xu W, Ma H, Feng L, Shi Q, Lian M, Wang R, Hou L

Abstract
BACKGROUND: Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer.
METHODS: A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination.
RESULTS: We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%).
CONCLUSION: NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity.

PMID: 29043905 [PubMed - as supplied by publisher]

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

Effects of anesthesia with nitrous oxide on tympanoplasty outcomes: a randomized controlled trial.

Effects of anesthesia with nitrous oxide on tympanoplasty outcomes: a randomized controlled trial.

Acta Otolaryngol. 2017 Oct 18;:1-4

Authors: Kouhi A, Hajimohammadi F, Dabiri S, Amali A, Enayati N, Manavi S, Saeedi N, Bidar Z

Abstract
OBJECTIVES: To investigate effects of nitrous oxide (N2O), as inhalational anesthetic agent, on tympanoplasty outcomes.
METHODS: In this randomized controlled trial, patients were randomized into two groups: 39 patients who received N2O as an inhalant anesthesia and 47 patients who did not receive. All were operated on with standard type of ear surgery. The protocol for the two groups was identical. Before surgery baseline audiometry was performed. Postoperative audiological controls were carried out at 3 months.
RESULTS: There was no statistically significant difference between two groups regarding graft outcomes. No significant differences were found between the two groups regarding air-bone gap or bone conduction hearing level.
CONCLUSIONS: Nitrous oxide usage does not seem to have significant impact on graft or hearing outcome of patients undergoing surgical repair of tympanic membrane.

PMID: 29043904 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2xS3qPi

Effect of sound generator on tinnitus and hyperacusis.

Effect of sound generator on tinnitus and hyperacusis.

Acta Otolaryngol. 2017 Oct 18;:1-5

Authors: Park JM, Kim WJ, Ha JB, Han JJ, Park SY, Park SN

PMID: 29043888 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2kZdrE9

Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping.

Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping.

Acta Otolaryngol. 2017 Oct 16;:1-6

Authors: Saliba I, Alzahrani M, Weng X, Bestavros A

PMID: 29037099 [PubMed - as supplied by publisher]

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

Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience.

Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience.

Oper Neurosurg (Hagerstown). 2017 Oct 10;:

Authors: Mascitelli JR, Schlachter L, Chartrain AG, Oemke H, Gilligan J, Costa AB, Shrivastava RK, Bederson JB

Abstract
BACKGROUND: The use of intraoperative navigation during microscope cases can be limited when attention needs to be divided between the operative field and the navigation screens. Heads-up display (HUD), also referred to as augmented reality, permits visualization of navigation information during surgery workflow.
OBJECTIVE: To detail our initial experience with HUD.
METHODS: We retrospectively reviewed patients who underwent HUD-assisted surgery from April 2016 through April 2017. All lesions were assessed for accuracy and those from the latter half of the study were assessed for utility.
RESULTS: Seventy-nine patients with 84 pathologies were included. Pathologies included aneurysms (14), arteriovenous malformations (6), cavernous malformations (5), intracranial stenosis (3), meningiomas (27), metastasis (4), craniopharygniomas (4), gliomas (4), schwannomas (3), epidermoid/dermoids (3), pituitary adenomas (2) hemangioblastoma (2), choroid plexus papilloma (1), lymphoma (1), osteoblastoma (1), clival chordoma (1), cerebrospinal fluid leak (1), abscess (1), and a cerebellopontine angle Teflon granuloma (1). Fifty-nine lesions were deep and 25 were superficial. Structures identified included the lesion (81), vessels (48), and nerves/brain tissue (31). Accuracy was deemed excellent (71.4%), good (20.2%), or poor (8.3%). Deep lesions were less likely to have excellent accuracy (P = .029). HUD was used during bed/head positioning (50.0%), skin incision (17.3%), craniotomy (23.1%), dural opening (26.9%), corticectomy (13.5%), arachnoid opening (36.5%), and intracranial drilling (13.5%). HUD was deactivated at some point during the surgery in 59.6% of cases. There were no complications related to HUD use.
CONCLUSION: HUD can be safely used for a wide variety of vascular and oncologic intracranial pathologies and can be utilized during multiple stages of surgery.

PMID: 29040677 [PubMed - as supplied by publisher]

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

Management of through-and-through penetrating skull injury: a railroad stake that transgressed the anterior skull base.

Management of through-and-through penetrating skull injury: a railroad stake that transgressed the anterior skull base.

World Neurosurg. 2017 Oct 13;:

Authors: Hoshide R, Steinberg J, Wali A, Ko A, Pannell JS, Chen CC

Abstract
Penetrating injuries involving foreign objects that transgress the entirety of the human skull presents challenges in the management of vascular injuries, infectious risk, cerebrospinal fluid leak, and cosmetic repair. Ultimately, effective management of these injuries requires a multi-disciplinary team and judicious surgical planning. Here we present the management of a patient who suffered a penetrating injury from a railroad stake, with entry and exit points involving left and right anterior aspect of the temporal fossa, respectively. Rationale for management decisions are reviewed in the context of the published literature.

PMID: 29038084 [PubMed - as supplied by publisher]

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

Supraorbital Approach for Resection of Clinoidal Meningioma.

Supraorbital Approach for Resection of Clinoidal Meningioma.

World Neurosurg. 2017 Oct 13;:

Authors: Dossani RH, Kalakoti P, Guthikonda B

Abstract
Meningiomas of the clinoid region pose formidable surgical challenge. Pterional craniotomy is the traditional approach, and often associated with high-risk post-surgical morbidities. In the current presentation, we describe an elderly male with a clinoidal meningioma that underwent a minimally invasive supra-orbital craniotomy for tumor resection. Patient presentation, neuroimaging, and surgical techniques (patient position, incision, anatomical consideration, and surgical steps) are described meticulously. Initial intraoperative steps include dissection via the corridor between the carotid artery and the tentorium, and exposing the tumor in the optico-carotid triangle, followed by tumor dissection using microsurgical techniques. Care must be taken to preserve the supraorbital nerve to prevent frontal numbness, and to avoid violation of the frontal sinus to prevent postoperative cerebrospinal fluid leak. Emphasis on using this minimally invasive procedure for clinoidal meningiomas over pterional approach for select cohort of patients is laid, considering the cosmetic merits and adequate extent of tumor resection.

PMID: 29038082 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2xR2nPx

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Evidence-based interventions of dichotic listening training, compensatory strategies and combined therapies in managing pupils with auditory processing disorders.

Int J Audiol. 2017 Oct 16;:1-9

Authors: Osisanya A, Adewunmi A

PMID: 29037092 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2gtu1ur

Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review.

Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review.

Eur Arch Otorhinolaryngol. 2017 Oct 17;:

Authors: Singh NK, Jha RH, Gargeshwari A, Kumar P

Abstract
Alteration in the process of bone remodelling is associated with falls and fractures due to increased bone fragility and altered calcium functioning. The auditory system consists of skeletal structures and is, therefore, prone to getting affected by altered bone remodelling. In addition, the vestibule consists of huge volumes of calcium (CaCO3) in the form of otoconia crystals and alteration in functioning calcium levels could, therefore, result in vestibular symptoms. Thus, the present study aimed at compiling information from various studies on assessment of auditory or vestibular systems in individuals with reduced bone mineral density (BMD). A total of 1977 articles were searched using various databases and 19 full-length articles which reported auditory and vestibular outcomes in persons with low BMD were reviewed. An intricate relationship between altered BMD and audio-vestibular function was evident from the studies; nonetheless, how one aspect of hearing or balance affects the other is not clear. Significant effect of reduced bone mineral density could probably be due to the metabolic changes at the level of cochlea, secondary to alterations in BMD. One could also conclude that sympathetic remodelling is associated with vestibular problems in individual; however, whether vestibular problems lead to altered BMD cannot be ascertained with confidence. The studies reviewed in the article provide an evidence of possible involvement of hearing and vestibular system abnormalities in individuals with reduced bone mineral density. Hence, the assessment protocol for these individuals must include hearing and balance evaluation as mandatory for planning appropriate management.

PMID: 29043479 [PubMed - as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2zjX7QM

Size Variation under Domestication: Conservatism in the inner ear shape of wolves, dogs and dingoes.

Size Variation under Domestication: Conservatism in the inner ear shape of wolves, dogs and dingoes.

Sci Rep. 2017 Oct 17;7(1):13330

Authors: Schweizer AV, Lebrun R, Wilson LAB, Costeur L, Schmelzle T, Sánchez-Villagra MR

Abstract
A broad sample of wolves, dingoes, and domesticated dogs of different kinds and time periods was used to identify changes in size and shape of the organs of balance and hearing related to domestication and to evaluate the potential utility of uncovered patterns as markers of domestication. Using geometric morphometrics coupled with non-invasive imaging and three-dimensional reconstructions, we exposed and compared complex structures that remain largely conserved. There is no statistically significant difference in the levels of shape variation between prehistoric and modern dogs. Shape variance is slightly higher for the different components of the inner ear in modern dogs than in wolves, but these differences are not significant. Wolves express a significantly greater level of variance in the angle between the lateral and the posterior canal than domestic dog breeds. Wolves have smaller levels of size variation than dogs. In terms of the shape of the semicircular canals, dingoes reflect the mean shape in the context of variation in the sample. This mirrors the condition of feral forms in other organs, in which there is an incomplete return to the characteristics of the ancestor. In general, morphological diversity or disparity in the inner ear is generated by scaling.

PMID: 29042574 [PubMed - in process]

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

Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review.

Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review.

Eur Arch Otorhinolaryngol. 2017 Oct 17;:

Authors: Singh NK, Jha RH, Gargeshwari A, Kumar P

PMID: 29043479 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2zjX7QM

Size Variation under Domestication: Conservatism in the inner ear shape of wolves, dogs and dingoes.

Size Variation under Domestication: Conservatism in the inner ear shape of wolves, dogs and dingoes.

Sci Rep. 2017 Oct 17;7(1):13330

Authors: Schweizer AV, Lebrun R, Wilson LAB, Costeur L, Schmelzle T, Sánchez-Villagra MR

PMID: 29042574 [PubMed - in process]

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

Can e-learning help you to connect compassionately? Commentary on a palliative care e-learning resource for India

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2zl3Utk

The predictive value of BRCA1/2 mRNA expression for response to neoadjuvant chemotherapy in BRCA negative breast cancers

Summary

It is well known that BRCA1 and BRCA2 play a central role in DNA repair, but the relationship between BRCA1 and BRCA2 mRNA expression and response to neoadjuvant chemotherapy in sporadic breast cancer patients has not been well established. Here, we investigate the association between BRCA1 or BRCA2 mRNA expression levels and pathological response in 674 BRCA1/2 mutation-negative breast cancer patients who received neoadjuvant chemotherapy. BRCA1and BRCA2 mRNA expression were assessed using quantitative real-time polymerase chain reaction in core biopsy breast cancer tissue obtained prior to the initiation of neoadjuvant chemotherapy. A total 129 patients (19.1%) achieved pCR (pathologic complete response) after neoadjuvant chemotherapy. Among patients treated with anthracycline-based chemotherapy (n=531), BRCA1 mRNA low expression patients had significantly higher pCR rate than intermediate or high BRCA1 mRNA expression groups (24.6% vs 16.8% or 14.0%, p=0.031) and retained borderline significance (OR=1.54, 95% CI=0.93–2.56, P=0.094) in multivariate analysis. Among the 129 patients who received taxane-based regimen, pCR rate showed no differences in BRCA1 low, intermediate, and high mRNA level subgroups (19.6%, 26.8% and 21.4%, respectively; p=0.71). BRCA2 mRNA level was not associated with pCR rate in the anthracyline-based treated subgroup (p=0.60) or the taxane-based regimen subgroup (p=0.82). Taken together, our findings suggested that BRCA1 mRNA expression could be used as a predictive marker in BRCA1/2 mutation-negative breast cancer patients who received neoadjuvant anthracycine-based treatment.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yTH0Nv

Case 32-2017: A 64-Year-Old Man with Dyspnea, Wheezing, Headache, Cough, and Night Sweats

Mutations in the genes for keratin-4 and -13 in Swedish patients with white sponge nevus

Abstract

Background

White sponge nevus is a rare autosomal dominant disorder that affects the non-keratinised stratified squamous epithelium. Mutations in the genes that encode mucosa-specific keratins 4 and 13 are strongly linked to the manifestation of white sponge nevus. This study involved mutational analysis of the genes encoding keratin-4 and keratin-13 in two Swedish families with white sponge nevus.

Methods

The diagnosis of white sponge nevus was based on disease history, clinical characteristics of the lesions and, in the majority of the cases, histopathological examination. Samples were collected from the affected buccal mucosa using buccal swabs. DNA was subsequently extracted and amplified using Touch-Down-PCR. The keratin-4 and -13 genes were sequenced and a genetic analysis was performed.

Results

A novel heterozygous missense mutation was identified in exon 1A of the keratin-4 gene in Family 2. In addition, previously reported heterozygous missense mutations were identified in the keratin-4 (E449K, A72V, Q156R, R208H) and keratin-13 (L115P) genes in both families.

Conclusion

We describe a novel heterozygous missense mutation in the keratin-4 gene of a Swedish family with white sponge nevus. Our results support the notion that mutations in keratin-4 and -13 are the underlying cause of white sponge nevus.

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

Patterns of Failure in Patients With Adult Medulloblastoma Presenting Without Extraneural Metastasis.

Objectives: The objective of this study is to evaluate long-term outcomes, specifically patterns of tumor recurrence, in patients with adult medulloblastoma treated with radiotherapy. Methods: We recorded outcomes of 28 (median age, 25 y) patients 18 years old or above with M0 to M3 medulloblastoma treated between 1971 and 2012. Among them, 61% had standard-risk disease. All received craniospinal irradiation with a posterior fossa boost. Median dose to the craniospinal axis was 36 Gy. Median total dose to the primary site was 55.9 Gy and 46% received chemotherapy. Results: Median follow-up among survivors was 14.2 years. At 5 and 10 years, local control was 80% and 73%, overall survival was 71% and 59%, cause-specific survival was 71% and 63%, and freedom from progression was 68% and 59%. Tumors recurred in 11 patients (39%); median time to recurrence was 2.4 years, and 82% of recurrences developed in patients with standard-risk disease. Of the recurrences, 55% involved the primary site; 36% were bone metastases without neural axis recurrence. There were no isolated recurrences in the spinal canal or ventricular system outside of the posterior fossa. Conclusion: The primary site is the main site of medulloblastoma recurrence, with isolated bone metastases more common in adults than children. Our results prompt us to consider 4 modifications to our treatment approach with adults who present with medulloblastoma: (1) initial staging to include PET or bone scan; (2) radiotherapy dose to the primary site of 59.4 Gy; (3) chemotherapy during and/or following radiotherapy in medically fit patients; (4) follow-up to include PET or bone scan twice a year for 3 years. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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

Dose Escalation Study of Concurrent Chemoradiotherapy With the Use of Involved-field Conformal Radiotherapy and Accelerated Hyperfractionation in Combination With Cisplatin and Vinorelbine Chemotherapy for Stage III Non-small Cell Lung Cancer: The Final Report.

Objectives: A phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small cell lung cancer was conducted. Materials and Methods: We used chemotherapy of a cisplatin doublet and 2 dose levels of radiation with accelerated hyperfractionation. The radiation dose levels were: a total dose of 60 Gy in 40 fractions at level 1, and 66 Gy in 44 fractions at level 2. Eligible patients with unresectable stage III non-small cell lung cancer received cisplatin and vinorelbine. Radiation therapy started on day 2 of chemotherapy and was delivered twice daily for 5 days a week. Results: Total 12 patients were enrolled, with 6 patients each at dose levels 1 and 2. Dose-limiting toxicity was noted in 2 patients at level 1; one patient had grade 3 febrile neutropenia and the other patient had grade 3 esophagitis. No dose-limiting toxicity was noted in the 6 patients at level 2. Grade 3 to 4 leukopenia, neutropenia, and anemia were noted in 11 (92%), 9 (75%), and 8 (67%) of the total 12 patients, respectively. Grade 3 anorexia and infection were noted in 2 patients (17%) at each level. Grade 3 nausea, fatigue, esophagitis, and febrile neutropenia were noted in 1 patient (8%) at each level. The response rate in the total 12 patients was 83.3%. The median progression-free survival time and the median overall survival time were 10.7 and 24.2 months, respectively. Conclusions: Sixty-six gray in 44 fractions is the recommended dose for the following phase II study. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2zxlCe1

Travel Distance as a Barrier to Receipt of Adjuvant Radiation Therapy After Radical Prostatectomy.

Objectives: Following radical prostatectomy (RP), adjuvant radiation therapy (RT) decreases biochemical recurrence and potentially improves metastasis-free and overall survival for patients with high-risk pathologic features. Since adjuvant RT typically occurs daily over several weeks, the logistical challenges of extensive traveling may be a significant barrier to its use. We examined the association between distance to treatment facility and use of adjuvant RT. Materials and Methods: We identified 97,568 patients in the National Cancer Database diagnosed from 2004 through 2011 with cT1-4N0-xM0-x prostate cancer and found to have high-risk pathologic features (pT3-4 stage and/or positive surgical margins) at RP. Multivariable logistic regression adjusting for sociodemographic and clinicopathologic factors was used to examine the association between travel distance and receipt of adjuvant RT, defined as radiotherapy initiated within 12 months after RP. Results: Overall, 10.6% (10,346) of the study cohort received adjuvant RT. On multivariable analysis, increasing travel distance was significantly associated with decreased use of adjuvant RT, with adjusted odds ratios of 1.0 (reference), 0.67, 0.46, 0.39, and 0.32 (all P100.0 miles away, respectively. Conclusions: Increasing travel distance was strongly associated with decreased use of adjuvant RT in this national cohort of postprostatectomy patients with high-risk pathologic features. These results strongly suggest that the logistical challenges of extensive travel are a significant barrier to the use of adjuvant RT. Efforts aimed at improving access to radiotherapy and reducing treatment time are urgently needed. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2zkj41Y

Diagnosis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: Epidemiology, Risk Factors, and Clinical Aspects: A Prospective Study.

Objectives: Axillary web syndrome (AWS) is a complication after breast cancer surgery associated with the axillary approach. We defined a diagnosis tool as well as evaluated cord frequency, characteristics, and risk factors. Methods: A prospective cohort study of 173 women followed-up at Breast Diseases Division of Universidade Federal de Sao Paulo between July 2014 and September 2015 was established as an evaluation protocol to diagnose AWS. Sociodemographic status, anthropometric values, range of motion, comorbidities, pain, cord frequency, and characteristics (localization, number, palpable, and/or visible) among other data were collected at different time points before and after surgery. Results: The majority of the cords appeared by the seventh day (66.1%), and the total incidence of the cords was 90.9% at the 180th day. The axilla was the place for 80% of the occurrence of AWS, and >70% of the cords were palpable. Flexion and abduction of the shoulder showed reduced range of motion. Pain was present in 39.7% of the patients. Lymphadenectomy as well as hypertension were associated with increased risk of cord development; diabetes was associated with a decreased risk. Conclusions: The evaluation protocol applied here showed a high incidence of AWS, with palpable cords more frequent than visible ones. The significance of hypertension and diabetes mellitus as risk factors for cord development in AWS should be evaluated in future studies. The evaluation protocol developed in this study seems to be of great importance for early detection of AWS and could also be valuable for future treatment planning. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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

Cytoskeleton and ECM tumor mutant peptides: Increased protease sensitivities and potential consequences for the HLA class I, mutant epitope reservoir

Abstract

Cytoskeleton and extracellular matrix-related proteins (CECMPs) represent the most common class of cancer mutants, owing to the large size of their coding regions and the randomness of mutagenesis. We used a bioinformatics approach to assess the impact of amino acid (AA) substitutions on the sensitivity of CECMPs to proteases relevant to melanoma; and on the binding affinities for HLA class I. CECMP peptides with AA substitutions overwhelmingly reflect increased sensitivity to proteases implicated in melanoma development (MME, CTSS, MMP2, CTSD, CTSL) in comparison to the wild type peptide sequences. Furthermore, peptides with AA substitutions representing increased peptide protease sensitivity also represented relatively high binding affinities for HLA class I allelic variants. These analyses raise the question of whether increased protease sensitivity, of mutant cancer peptides represents a significant increase in the availability of cancer mutant, HLA class I epitopes and a hitherto unappreciated aspect of cancer cell immunogenicity, particularly in the case of melanoma? This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2x7X9KK

In vivo tracking of the tropism of mesenchymal stem cells to malignant gliomas using reporter gene-based MR imaging

Abstract

Mesenchymal stem cells (MSCs) have emerged as a promising cellular vehicle for gene therapy of malignant gliomas due to their property of tumor tropism. However, MSCs may show bidirectional and divergent effects on tumor growth. Therefore, a robust surveillance system with a capacity for noninvasive monitoring of the homing, distribution and fate of stem cells in vivo is highly desired for developing stem cell-based gene therapies for tumors. In this study, we used ferritin gene-based magnetic resonance imaging (MRI) to track the tumor tropism of MSCs in a rat orthotopic xenograft model of malignant glioma. MSCs were transduced with lentiviral vectors expressing ferritin heavy chain (FTH) and enhanced green fluorescent protein (eGFP). Intra-arterial, intravenous and intertumoral injections of these FTH transgenic MSCs (FTH-MSCs) were performed in rats bearing intracranial orthotopic C6 gliomas. The FTH-MSCs were detected as hypointense signals on T2- and T2*-weighted images on a 3.0 T clinical MRI. After intra-arterial injection, 17% of FTH-MSCs migrated toward the tumor and gradually diffused throughout the orthotopic glioma. This dynamic process could be tracked in vivo by MRI up to 10 days of follow up, as confirmed by histology. Moreover, the tumor tropism of MSCs showed no appreciable impact on the progression of the tumor. These results suggest that FTH reporter gene-based MRI can be used to reliably track the tropism and fate of MSCs after their systemic transplantation in orthotopic gliomas. This real-time in vivo tracking system will facilitate the future development of stem cell-based therapies for malignant gliomas. This article is protected by copyright. All rights reserved.

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

Clinicopathologic Characteristics and Outcomes of Transformed Diffuse Large B-Cell Lymphoma in Hepatitis C Virus-Infected Patients

Abstract

Hepatitis C virus (HCV) causes a chronic but curable infection associated with the development of marginal zone lymphoma (MZL) and diffuse large B-cell lymphoma (DLBCL). Preliminary data have shown frequent transformation of indolent lymphoma to DLBCL in HCV-infected patients. To compare their clinicopathologic characteristics and oncologic outcomes, we reviewed the medical records and pathology reports of HCV-infected and uninfected patients with DLBCL that transformed from indolent lymphoma seen at The University of Texas MD Anderson Cancer Center (June 2004-May 2015). To identify predictors of DLBCL relapse, patients with relapse after first-line chemotherapy were compared with those without it using univariate and logistic regression analyses. Compared with the uninfected patients (n=63), HCV-infected patients (n=21) were younger (median age =54 years [interquartile range= 49-62 years] vs 62 years [53-66 years]; p= 0.01) and more often had advanced DLBCL (Ann Arbor stage 3-4; 95% vs 76%; p= 0.05). Immunophenotypically, more HCV-infected than uninfected patients had CD10-negative B cells (76% vs 43%; p= 0.008), CD5-positive B cells (39% vs 7%; p= 0.004), and activated B-cell phenotypes (57% v 31%; p= 0.07). Comparison of the patients who had relapse after first-line chemotherapy (n= 42) and those who did not (n= 40) revealed that having CD5-positive B cells was the only factor associated with DLBCL relapse in multivariate analysis (odds ratio= 10.7; p= 0.02). HCV-infected patients with transformed DLBCL have unique clinicopathologic characteristics that make their lymphoma difficult to treat, potentially leading to unfavorable outcome. The impact of HCV eradication should be explored in such patients. This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2x6MaBp

Extracellular 5'-nucleotidase (CD73) promotes human breast cancer cells growth through AKT/GSK-3β/β-catenin/cyclinD1 signaling pathway

Abstract

To identify the role and to explore the mechanism of extracellular 5'-nucleotidase (CD73) in human breast cancer growth, CD73 expression was measured firstly in breast cancer tissues and cell lines, and then interfered with or over-expressed by recombinant lentivirus in cell lines. Impacts of CD73 on breast cancer cell proliferation and cell cycle were investigated with colony formation assay, CCK-8 and flow cytometry. The relationship between CD73 and AKT/GSK-3β/β-catenin pathway was assessed with adenosine, adenosine 2A receptor antagonist (SCH-58261), adenosine 2A receptor agonist (NECA), CD73 enzyme inhibitor (APCP) and Akt inhibitor (MK-2206). Moreover, the effect of CD73 on breast cancer growth in vivo was examined with human breast cancer transplanting model of nude mice. The results showed that the expression of CD73 was high in breast cancer tissues and increased with advanced tumor grades and lympho-node status. CD73 expression was higher in more malignant cells, and CD73 overexpression promoted breast cancer cell proliferation in both in vivo and in vitro. It activated AKT/GSK-3β/β-catenin/cyclinD1 signaling pathway through CD73 enzyme activity and other mechanism. This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yxzh4G

γ-Secretase inhibitor reduces immunosuppressive cells and enhances tumour immunity in head and neck squamous cell carcinoma

Abstract

Immune evasion is a hallmark feature of cancer, and it plays an important role in tumour initiation and progression. In addition, tumour immune evasion severely hampers the desired antitumour effect in multiple cancers. In this study, we aimed to investigate the role of the Notch pathway in immune evasion in the head and neck squamous cell carcinoma (HNSCC) microenvironment. We first demonstrated that Notch1 signalling was activated in a Tgfbr1/Pten-knockout HNSCC mouse model. Notch signalling inhibition using a γ-secretase inhibitor (GSI-IX, DAPT) decreased tumour burden in the mouse model after prophylactic treatment. In addition, flow cytometry analysis indicated that Notch signalling inhibition reduced the sub-population of myeloid-derived suppressor cells (MDSCs), tumour-associated macrophages (TAMs), and regulatory T cells (Tregs), as well as immune checkpoint molecules (PD1, CTLA4, TIM3 and LAG3), in the circulation and in the tumour. Immunohistochemistry (IHC) of human HNSCC tissues demonstrated that elevation of the Notch1 downstream target HES1 was correlated with MDSC, TAM and Treg markers and with immune checkpoint molecules. These results suggest that modulating the Notch signalling pathway may decrease MDSCs, TAMs, Tregs and immune checkpoint molecules in HNSCC. This article is protected by copyright. All rights reserved.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2x7wkqa

Relevance of liver-limited disease in metastatic colorectal cancer: Subgroup findings of the FIRE-3/AIO KRK0306 trial

Abstract

In metastatic colorectal cancer (mCRC), liver-limited disease (LLD) is associated with a higher chance of metastectomy leading to long-term survival. However, limited data describes the prognostic and predictive relevance of initially unresectable LLD with regard to targeted first-line therapy.

The present analysis investigated the relevance of initially unresectable LLD in mCRC patients treated with targeted therapy against either the epidermal growth factor receptor (EGFR) or vascular epithelial growth factor (VEGF).

The analysis was performed based on FIRE-3, a randomized phase III trial comparing first-line chemotherapy with FOLFIRI plus either cetuximab (anti-EGFR) or bevacizumab (anti-VEGF) in RAS wild-type (WT) mCRC. Of 400 patients, 133 (33.3%) had LLD and 267 (66.8%) had non-LLD. Median overall survival (OS) was significantly longer in LLD compared to non-LLD patients (36.0 vs. 25.4 months; hazard ratio [HR]=0.66; 95% confidence interval [CI]: 0.51-0.87; P=0.002). In a multivariate analysis also including secondary hepatic resection as time-dependent variable, LLD status was independently prognostic for OS (HR=0.67; 95% CI: 0.50-0.91; P=0.01). As assessed by interaction tests, treatment benefit from FOLFIRI plus cetuximab compared to FOLFIRI plus bevacizumab was independent of LLD status with regard to objective response rate (ORR), early tumour shrinkage ≥20% (ETS), depth of response (DpR) and OS (all P>0.05).

In conclusion, LLD could be identified as a prognostic factor in RAS-WT mCRC, which was independent of hepatic resection in patients treated with targeted therapy. LLD had no predictive relevance since benefit from FOLFIRI plus cetuximab over bevacizumab was independent of LLD status. This article is protected by copyright. All rights reserved.

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

Effect of radiation on sucrose detection thresholds of mice.

Abstract

Radiotherapy is one of the most common treatments for head and neck cancers, with an almost obligate side effect of altered taste (Conger 1973). In mice, targeted irradiation of the head and neck causes transient repression of proliferation of basal epithelial cells responsible for taste cell replacement, leading to a temporary depletion of taste sensory cells within taste buds, including Type II taste cells involved in detection of sweet stimuli (Nguyen et al. 2012). These findings suggest that irradiation may elevate sucrose detection thresholds, peaking at 7 days post-irradiation when loss of Type II cells is greatest. To test this hypothesis, sucrose detection thresholds (concentration detected in 50% of presentations) were measured in mice for 15 days after treatment of: 1) irradiation while anesthetized, 2) anesthetic alone, or 3) saline. Mice were trained to distinguish water from several concentrations of sucrose. Mice were irradiated with one 8 Gy dose (RADSOURCE-2000 X-ray Irradiator) to the nose and mouth while under 2,2,2-tribromethanol anesthesia (Avertin). Unexpectedly, mice given anesthesia showed a small elevation in sucrose thresholds compared to saline-injected mice, but irradiated mice show significantly elevated sucrose thresholds compared to either control group, an effect that peaked at 6-8 days post-irradiation. The timing of loss and recovery of sucrose sensitivity generally coincides with the reported maximal reduction and recovery of Type II taste cells (Nguyen et al. 2012). Thus, even a single dose of irradiation can significantly alter detection of carbohydrates, an important consideration for patients undergoing radiotherapy.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xPC5IC

A nationwide survey of French dentists' knowledge and implementation of current guidelines for antibiotic prophylaxis of infective endocarditis in patients with predisposing cardiac conditions

Publication date: Available online 18 October 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Alexandra Cloitre, Xavier Duval, Bruno Hoen, François Alla, Philippe Lesclous
Objectives: To prevent infective endocarditis, antibiotic prophylaxis is recommended worldwide in patients with predisposing cardiac conditions, except in the United Kingdom. To conclude on the relevance of this strategy, how the current guidelines are applied is a crucial point to investigate. The first aim of this study was to assess dentists' implementation of the current guidelines. The secondary aims were to identify relevant areas to improve the training of dentists and to determine temporal trends in practitioners' attitudes by comparison with two previous surveys conducted in 1991 and 2001. Study design: An electronic national survey was sent to the 12,000-member practitioners of the French Union for Oral Health. Results: Even if 58.9% of the respondents stated that their knowledge of current guidelines was good, a scoring system evidenced that only 34.5% know these guidelines overall. Conclusions: This study evidenced relevant areas to improve the training of dentists such as knowledge of some cardiac conditions and the potential side effects of the antibiotics used, as well as a lack of knowledge of the pathogenesis of infective endocarditis. Consequently, dentists' knowledge should be improved before any conclusions can be drawn on the relevance of this antibiotic prophylaxis strategy and its influence on infective endocarditis incidence.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yAp5dT

Cervical mass in a 3-year-old child: raising awareness of an unusual diagnosis

Publication date: Available online 18 October 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Chunyue Ma, Shuiting Fu, Junjian Jiang, Yue He

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gwmyL3

Τετάρτη 18 Οκτωβρίου 2017

Reduction of Recurrence Risk of Pancreatitis in Cystic Fibrosis with Ivacaftor: Case Series.

The effect of ivacaftor in cystic fibrosis (CF) patients with recurrent pancreatitis is unknown. We conducted a multicenter retrospective study of CF patients taking ivacaftor who had a history of recurrent pancreatitis. During the first three months of therapy, only one of the six patients had an episode of pancreatitis, which was managed on an outpatient basis. Between three and twelve months on ivacaftor therapy, none of the patients had recurrence of pancreatitis or required hospitalization. The use of ivacaftor was associated with a reduced frequency and recurrence rate of pancreatitis in CF patients. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2xRB7jM

Choice of Endoscopic Procedure in Children With Clinically Suspected Gastrointestinal Graft-Versus-Host Disease.

Objectives: Gastrointestinal graft-versus-host disease (GI-GVHD) is a potentially life-threatening complication after hematopoietic stem cell transplantation. Symptoms indicating GI-GVHD motivates endoscopy with biopsy sampling and histopathological confirmation. However, optimal extent of endoscopy in children is presently unknown. Therefore, we aimed to evaluate if biopsies from the rectosigmoid area versus the rest of the colon/ileocolon with or without biopsies from simultaneous upper endoscopy, were equally reliable for detection of GI-GVHD and relevant differential diagnoses. Methods: Retrospective multicentre study based on histopathological re-evaluation of biopsies and hospital record data, collected from children with suspected GI-GVHD. Results: Forty-four children with 51 endoscopic occasions (81 procedures) were included. Thirty-nine of 51 (76.5%) were diagnosed as GI-GVHD, 14 (27.4%) received a differential diagnosis and 7 (13.7%) had normal histology findings. Co-morbidity, i.e. simultaneous detection of a differential diagnosis and GI-GVHD, was observed in 9 (23.1%) cases. CMV infection was the most frequent differential diagnosis, 6/7 were detected in biopsies from rectosigmoid- and esophagogastroduodenal areas. Sensitivity for detection of GI-GVHD in biopsies collected from rectosigmoid-ileocolonic-, rectosigmoid-, or esophagogastroduodenal areas were 97.4%, 84.6%, 83.3%, respectively, and 97.4% when the latter two were merged. The difference, non-detected GI-GVHD in the rectosigmoid area versus detected elsewhere in the GI tract, was statistically significant (p = 0.03). Conclusions: Biopsies collected from the rectosigmoid area solely, were not optimal for detection of paediatric GI-GVHD. However, when biopsy sampling from rectosigmoid- and upper GI tract areas were combined, the sensitivity for GI-GVHD was equally high as for ileocolonoscopy or full upper and lower endoscopy. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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

Αρχειοθήκη ιστολογίου

Πέμπτη 19 Οκτωβρίου 2017

Summary

Abstract

Background

Methods

Results

Conclusion

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Τετάρτη 18 Οκτωβρίου 2017