Impact of an Urban Environment on Trace Element Concentrations in Domestically Produced Lettuce ( Lactuca sativa L. )

Abstract

Urban horticulture is gaining more and more attention in the context of sustainable food supply. Yet, cities are exposed to (former) industrial activities and traffic, responsible for emission of contaminants. Trace elements were monitored in soils located in the urban environment of Ghent (Belgium) and 84 samples of Lactuca satica L. lettuce grown on it. The effects of cultivation in soil versus trays, neighbouring traffic and washing of the lettuce before consumption were studied. The 0–30 cm top layer of soils appeared heterogenic in composition and enriched in Co, Cd, Ni and Pb within 10 m from the nearest road. Yet, no similar elevated concentrations could be found in the crops, except for As. Besides uptake from the roots, the presence of trace elements in the plants is also caused by the atmospheric deposition of airborne particulate matter on the leaf surface. Correlation analysis and principal component analysis (PCA) revealed that this latter transport pathway might particularly be the case for Pt, Pd and Rh. Concentrations of Cd did not exceed the 0.2 mg kg⁻¹ (fresh weight) threshold for Cd in leafy vegetables set by the European Commission. Measurements to reduce the health risks include the washing of lettuce, which effectively reduced the number of samples trespassing the maximum Pb level of 0.3 mg kg⁻¹ (fresh weight). Also, cultivation in trays resulted in a lower As content in the plants. Taking into account a vigilance on crop selection, cultivation substrate and proper washing before consumption are considered essential steps for safe domestic horticulture in urban environments.

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Restless legs syndrome and sleep quality among adult sickle cell disease patients

Abstract

Objective

The purpose of this study is to determine and compare the prevalence of restless legs syndrome (RLS) between adult patients with sickle cell disease (SCD) and non-SCD anemia.

Methods

This cross-sectional study was conducted from December 2013 to July 2014. Patients with SCD and non-SCD anemia were recruited from a hematology clinic at a large university hospital. Patients with secondary RLS were excluded. Data were collected on demographic features, clinical evaluations, laboratory tests, sleep quality using the Pittsburgh Sleep Quality Index, RLS symptoms using the International Restless Legs Syndrome Study Group Criteria, severity of RLS using the International Restless Leg Syndrome Rating Scale, and daytime sleepiness using the Epworth Sleepiness Scale.

Results

The study sample consisted of 44 patients with SCD and 45 with non-SCD anemia. The two groups were comparable in age, gender, body mass index, smoking habit, and comorbidities. Poor sleep quality was found in 63% of the SCD group compared to 53% of the non-SCD group. The prevalence of RLS among SCD group and non-SCD group was 13.6% (6/44) and 8.8% (4/45), respectively. These differences, however, were not statistically significant, p > 0.05. Excessive daytime sleepiness was also similar in both groups, with the rate being 20.5 and 17.8% in the SCD and non-SCD groups, respectively.

Conclusion

Our study revealed that poor sleep quality and RLS were both common among adult patients with SCD; however, they did not differ significantly from patients with non-SCD anemia.

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Revisits after pediatric tracheotomy: Airway concerns result in returns

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Sophie Shay, Nina L. Shapiro, Neil Bhattacharyya
ObjectivesChildren undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy.MethodsCross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010–11 were linked and examined for cases of pediatric tracheotomy (patients < 18.0 years) and corresponding subsequent 30-day post-discharge revisits. Demographic and descriptive data were analyzed determining the revisit rate, revisit diagnoses, procedures, and discharge dispositions.Results2,248 pediatric tracheotomy cases were extracted (60.8% male, mean age 8.3 years). There were 373 inpatient or emergency department revisits (30-day revisit rate, 16.6%), of which 34.3% occurred within 48 h after discharge. Of these, 59.2% were inpatient readmissions. There were ≤10 deaths during these revisits (30-day revisit mortality rate, ≤2.7%). The most common primary revisit diagnoses were "fitting of prosthesis and adjustment of devices" (25.7%, likely representing adjustment/replacement of the tracheotomy tube), respiratory failure (11.0%), intracranial injury (5.4%), pneumonia (4.0%), "other upper respiratory disease" (3.8%), and "complications of surgical procedures or medical care" (3.8%). The most common revisit procedures were endotracheal intubation (11.4%), mechanical ventilation (8.8%), and replacement of tracheostomy tube (≤2.7%). Children discharged to a skilled care facility (47.1%) were more likely than those discharged to home (52.9%) to have a revisit (23.3% versus 12.0%, respectively; p < 0.001).ConclusionsChildren undergoing tracheotomy have a substantial 30-day revisit rate, most notably during the first 48 h after discharge, often involving tracheotomy tube or pulmonary complications. Improvements in discharge planning should target prevention of these complications.



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Branchial anomalies in children: A report of 105 surgical cases

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Wanpeng Li, Hongming Xu, Liming Zhao, Xiaoyan Li
BackgroundBranchial anomalies (BAs) account for 20% of all congenital masses in children. We sought to review the incidence of involvement of individual anomalies, diagnostic methods, surgical treatment, and complications of BAs in children. In addition, we also classified our study and analyzed a congenital lower neck cutaneous fistula near the sternoclavicular joint that was thought to be the skin-side remnant of the fourth BAs.MethodsWe conducted a retrospective analysis of 105 children who were referred to our hospital from June 2009 to December 2016 for the treatment of BAs.ResultsIn this series, there were 51 males and 54 females. The age at the time of operation varied from 19 days to 13 years, and the mean age was 4.5 years. A total of 33 (31.4%) cases presented with first BAs, 13 (12.4%) presented with second BAs, and 59 (56.2%) presented with third and fourth BAs, including 6 cases of congenital lower neck cutaneous fistula. Fistulectomy under general anesthesia was performed on all of them. For postoperative complications, 2 cases had temporary facial paralysis, 1 case had permanent facial paralysis, 4 cases had temporary recurrent laryngeal nerve injury. Recurrence occurred in 2 patients with first BAs after medium follow-up time of 3.6 years (6 months–8 years).ConclusionsBAs are common congenital head and neck lesions in children, and there are four distinct types (first, second, third and fourth anomalies). The incidence of third and fourth BAs in Asia maybe higher when compared with literature reports, second BAs seem rare in this population, but more research is needed to confirm this perspective. Diagnosis is not difficult with a proper knowledge of the anatomy of the BAs. The surgical procedures should be tailored depending on the various types, and complete excision of the fistula is the key to prevent recurrence.



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Adaptation and validation of Mandarin Chinese version of the pediatric Voice Handicap Index (pVHI)

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Dan Lu, Mengjie Huang, Zhen Li, Edwin M.-L. Yiu, Ivy K.-Y. Cheng, Hui Yang, Estella P.-M. Ma
ObjectiveThe aim of this study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Mandarin Chinese.
MethodsA cross-sectional study was performed from May 2016 to April 2017. A total of 367 parents participated in this study, and 338 parents completed the translated questionnaire without missing data, including 213 parents of children with voice disorders (patients group), and 125 parents of children without voice disorders (control group). The internal consistency, test-retest reliability, contents validity, construct validity, clinical validity, and cutoff point were calculated.ResultsThe most common voice disorder in the patients group was vocal fold nodules (77.9%), followed by chronic laryngitis (18.8%), and vocal fold polyps (3.3%). The prevalence for voice disorders was higher in boys (67.1%) than girls (32.9%). The most common vocal misuse and abuse habit was shouting loudly (n = 186, 87.3%), followed by speaking for a long time (n = 158, 74.2%), and crying loudly (n = 99, 46.5%). The internal consistency for the Mandarin Chinese version of pVHI was excellent in patients group (Cronbach α = 0.95). The inter-class correlation coefficient indicated strong test-retest reliability (ICC = 0.99). The principal-component analysis demonstrated three-factor eigenvalues greater than 1, and the cumulative proportion was 66.23%. The mean total scores and mean subscales scores were significantly higher in the patients group than the control group (p < 0.05). The physical domain had the highest mean score among the three subscales (functional, physical and emotional) in the patients group. The optimal cutoff point of the Mandarin Chinese version of pVHI was 9.5 points with a sensitivity of 80.3% and a specificity of 84.8%.ConclusionThe Mandarin Chinese version of pVHI was a reliable and valid tool to assess the parents' perception about their children's voice disorders. It is recommended that it can be used as a screening tool for discriminating between children with and without dysphonia.



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Coblation versus microdebrider in pediatric adenoidectomy

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Chris Mularczyk, David L. Walner, Katherine K. Hamming
ObjectiveTo compare and contrast coblation and microdebrider with touch-up electrocautery (ME) for adenoidectomy in children.MethodsPatients <18 years old undergoing adenoidectomy without tonsillectomy were selected for this prospective, single-blinded, randomized controlled trial. Participants were enrolled into one of two groups based on birth date: coblation or ME. The surgeons completed a standard survey about intraoperative factors for each method. Recovery nurses filled out a standardized survey postoperatively. A third standardized survey was completed via a phone interview with the parent or patient caregiver on postoperative day 3 to assess procedure outcomes. The survey results were then compared using ANOVA statistical analysis.Results50 patients were enrolled in the coblation group and 51 were enrolled in the ME group. There was no significant difference in mean age between the coblation (4.96 years) and ME groups (4.58 years) (p = 0.525). The mean time (in minutes) for coblation (5.50) was significantly lower than ME (9.47) when controlling for the confounder: surgical site exposure (p < 0.001). The surgical time was significantly influenced by the quality of exposure/visualization (p = 0.037). The coblator method had significantly less intraoperative blood loss compared to ME (p < 0.001). There was a statistically significant difference between coblation (1.53) and ME (2.05) for days of pain (p = 0.045) when controlling for the confounder adenoid size.ConclusionIn our study we found that coblation demonstrated significantly less intraoperative time and less blood loss, as well as a shorter duration of postoperative pain, when compared to ME for adenoidectomy.



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Congenital respiratory tract disorders in 22q11.2 deletion syndrome

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Emmy Verheij, Lucienne Speleman, Aebele B. Mink van der Molen, Henricus G.X.M. Thomeer
ObjectiveRespiratory tract disorders have been reported in patients with 22q11.2 deletion syndrome, however infrequently. This study describes the respiratory tract disorders encountered in a cohort of 278 patients with 22q11.2 deletion syndrome.MethodsWe conducted a retrospective, cross-sectional, study at a single tertiary referral center. We identified the patients with 22q11.2 deletion syndrome and with an upper and/or lower respiratory tract disorder at our otorhinolaryngologic department. The different disorders were described.ResultsOut of 278 patients referred to the otorhinolaryngologic department, we identified 14 patients with a laryngeal and/or tracheal disorder. Nine patients had more than one congenital disorder in this anatomical area. Disorders included a choanal stenosis (n = 1), laryngeal web (n = 5), laryngeal cleft (n = 2), subglottic stenosis (n = 3), pharyngo-, laryngo-, tracheo- and/or bronchomalacia (n = 11) and tracheal stenosis (n = 1).ConclusionDifferent types of respiratory tract disorders can be present in patients with 22q11.2 deletion syndrome. Clinicians should be aware of this clinical association for timely and accurate diagnosis and treatment. In addition, the diagnosis 22q11.2 deletion syndrome should be considered in patients presenting with a congenital respiratory tract disorder.



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Effect of preoperative visiting operation room on emergence agitation in preschool children under sevoflurane anesthesia

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Qiaosheng Zhong, Xianfeng Qu, Chuanhua Xu
BackgroundEmergence agitation (EA) is a common complication in children during recovery from sevoflurane anesthesia with an high incidence. The main objective of this study was to compare the effects of preoperative visiting operation room (PVOR) to administration of propofol at the end of anesthesia on EA in preschool children under sevoflurane anesthesia.MethodsSixty-nine preschool children aged from 3 to 6 years scheduled for tonsillectomy under sevoflurane anesthesia were randomly allocated to one of the three groups to receive either PVOR (Group PV), routine preoperative visit (Group RV) or routine preoperative visit plus propofol (Group RP), 23 patients were included in each group. General anesthesia was induced and maintained with sevoflurane. Parental separation status score, mask acceptance score, Aono's four point score and pediatric anesthesia emergence delirium (PAED) score and incidence of EA were recorded. PAED score >10 were regarded as EA. Recovery profile and adverse events were also recorded.ResultParental separation status score and mask acceptance score in group PV was significantly lower than that in group RV and group RP (P < 0.05); Aono's four point score, PAED score and incidence of EA in group PV and group RP was significantly lower than that in group RV (P < 0.05); Time to extubation and time to interaction in group PV and group RV was significantly shorter than that in group RP (P < 0.05); POV and rescue by fentanyl in group PV and group RP was significantly lower than that in group RV(P < 0.05).ConclusionPVOR can effectively reduce the incidence of EA as well as administration of propofol without additional medical expenses and other adverse effects.



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Evaluation and remediation of central auditory processing disorders in children with autism spectrum disorders

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Hesham Kozou, Hanan Galal Azouz, Rania M. Abdou, Alyaa Shaltout
ObjectivesThis study was carried out to assess various skills of central auditory processing (CAP) in children with autism spectrum disorders (ASD) and to evaluate the efficacy of auditory training in these children.MethodsThis study is a non-randomized clinical experiment. 30 high functioning ASD children aged from 7 to 12 years were included in the study. They underwent behavioral assessments of CAP skills with subsequent remediation by dichotic training therapy for the children who revealed dichotic deficits.ResultsScores of CAP skills in ASD children are wide-ranging from completely normal to substantially defective and generally lower than those of typically developing children. By auditory training, ASD children improved their dichotic deficits as well as other untrained areas of auditory and language processing skills.ConclusionsA group of ASD children showed different degrees of abnormalities in CAP that could be measured behaviorally and achieved benefits from auditory training in improving their dichotic listening, auditory and language processing skills.



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Closure of fistula of the hard palate with two layers of mucoperiosteum

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Mosaad Abdel-Aziz, Ahmed Kamel, Mohamed Fawaz, Ibrahim Rezk, Mohamed Kamel
ObjectiveOronasal fistula represents a functional problem, as it may result in nasal regurgitation of food and fluids and it also leads to hypernasal speech. Many methods have been proposed for its closure with a high recurrence rate. The aim of this study was to assess the efficacy of closure of hard palate fistula by two layers of mucoperiosteal flaps.MethodsEighteen patients with fistula of the hard palate were included. The fistula was repaired by two layers of mucoperiosteal flaps; the first layer was created from the mucoperiosteum surrounding the fistula as bilateral hinge flaps and the second layer was formed of a rotational flap based on the greater palatine artery. Pre- and postoperative clinical assessment was performed.ResultsThe etiology of fistulas was previous cleft palate repair in 13 patients, previous nasal septal surgery in 3 patients, and untreated sharp accidental trauma to the palate in 2 patients. All patients presented with nasal regurgitation and hypernasal speech. Complete closure of all fistulas was achieved at first attempt, with no recurrence through the follow up period.ConclusionsClosure of oronasal fistula by two layers of mucoperiosteal flaps is an effective method and it has neither complications nor recurrence.



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A novel splicing mutation in SMPX is linked to nonsyndromic progressive hearing loss

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Zhijie Niu, Denise Yan, Sara Bressler, Lingyun Mei, Yong Feng, Xuezhong Liu
ObjectiveX-linked nonsyndromic hearing impairment is the rarest form of genetic hearing loss and represents only a minor fraction of all cases. The aim of this study was to investigate the cause of X-linked nonsyndromic sensorineural hearing loss in a three-generation American family.MethodsWhole-exome sequencing and co-segregation analysis were used to identify disease-causing genes.ResultsIn this study, we described in detail the clinical characteristics of the family and identified a novel frameshift mutation creating a premature stop codon (c.133-1 G > A, p.(Gly45fs*36)) of SMPX. The loss-of-function mutation was co-segregated with the progressive hearing loss phenotype and was absent in 200 normal controls.ConclusionsWe report the first SMPX (DFNX4) mutation in a North American family. Our findings contribute to the existing genotypic and phenotypic spectrum of SMPX associated hearing loss. Furthermore, our data suggest that exome sequencing is promising in the genetic diagnosis of hearing loss.



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Incidence and factors associated with revision adenoidectomy: A retrospective study

Publication date: December 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 103
Author(s): James Johnston, Murali Mahadevan, Richard G. Douglas
IntroductionAdenoidectomy is one of the most commonly performed pediatric operations worldwide. There are a proportion of children who require revision adenoidectomy. Yet there is little in the literature about the incidence, associated factors and etiology of adenoidal regrowth. The aim of this retrospective cohort study was to determine incidence and factors associated with revision adenoidectomy.MethodsAn extraction of all hospital morbidity records belonging to patients under the age of 18 years who underwent one or more adenoidectomy procedures (with or without tonsillectomy) between January 1, 2000 and June 2016 at a tertiary care children's hospital was performed. Demographic, diagnostic, and procedural data were included in the analysis. Community prescribing information was examined for the number of courses of antibiotics prescribed to each patient prior to initial adenoidectomy.ResultsThere were 8260 patients under the age of 18 years who underwent primary adenoidectomy from 2000 to 2016 at a tertiary pediatric hospital. 2.5% (n = 212) of patients underwent revision adenoidectomy in our cohort during the same time period. A higher proportion of females underwent revision adenoidectomy when compared to male counterparts (p = 0.007). Patients who were prescribed more than five courses of antibiotics prior to initial adenoidectomy were more likely to undergo revision adenoidectomy (p = 0.003). Patients with a diagnosis of otitis media with effusion were more likely to undergo revision adenoidectomy (p=<0.001). A diagnosis of asthma (p=<0.001), gastroesophageal reflux disease (GERD) (p=<0.001), and allergic rhinitis (p=<0.001) was associated with revision adenoidectomy. An age of over 4 years at the time of initial adenoidectomy was associated with revision adenoidectomy (p=<0.001). Adenoids that obstructed over 75% of the nasal choanae were associated with revision adenoidectomy in this cohort (p=<0.001).ConclusionThis study has identified several factors associated with revision adenoidectomy.



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Microarray analysis of lncRNA and mRNA expression profiles in mice with allergic rhinitis

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Yue Ma, Le Shi, Chunquan Zheng
ObjectivesWe aimed to identify the effect of lncRNAs in CD4⁺ T cells on Allergic rhinitis (AR).MethodsThe present study conducted a microarray to identify the expression profiles of lncRNA and mRNA in CD4⁺ T cells in both AR murine models and normal controls. And qRT-PCR was used to confirm the results. GO and KEGG enrichment analysis were used to show all related pathways and a co-expression network was conducted to find lncRNAs which have high correlation with these pathways.ResultsThe results showed that the two groups contained a total of 158 deregulated lncRNAs, of which 110 were upregulated and 48 were downregulated. And positive regulation of calcium ion transport, B cell activation, chemokine-signaling pathways and calcium-signaling pathways may be involved in the development of T cells in AR pathology. Finally, we can find the differentially expressed mRNA in the pathways related to T cell differentiation correlated with many deregulated lncRNAs.ConclusionsThe present study was the first to show the differential expression profiles of lncRNAs in the CD4⁺ T cells of an AR murine model, which may provide significant insights into AR pathogenesis and offer new treatment targets to alleviate it.



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Effects of transient auditory deprivation during critical periods on the development of auditory temporal processing

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Bong Jik Kim, Jungyoon Kim, Il-Yong Park, Jae Yun Jung, Myung-Whan Suh, Seung-ha Oh
ObjectivesThe central auditory pathway matures through sensory experiences and it is known that sensory experiences during periods called critical periods exert an important influence on brain development. The present study aimed to investigate whether temporary auditory deprivation during critical periods (CPs) could have a detrimental effect on the development of auditory temporal processing.Materials and methodsTwelve neonatal rats were randomly assigned to control and study groups; Study group experienced temporary (18–20 days) auditory deprivation during CPs (Early deprivation study group). Outcome measures included changes in auditory brainstem response (ABR), gap prepulse inhibition of the acoustic startle reflex (GPIAS), and gap detection threshold (GDT). To further delineate the specific role of CPs in the outcome measures above, the same paradigm was applied in adult rats (Late deprivation group) and the findings were compared with those of the neonatal rats.ResultsSoon after the restoration of hearing, early deprivation study animals showed a significantly lower GPIAS at intermediate gap durations and a larger GDT than early deprivation controls, but these differences became insignificant after subsequent auditory inputs. Additionally, the ABR results showed significantly delayed latencies of waves IV, V, and interpeak latencies of wave I-III and wave I-V in study group. Late deprivation group didn't exhibit any deterioration in temporal processing following sensory deprivation.ConclusionTaken together, the present results suggest that transient auditory deprivation during CPs might cause reversible disruptions in the development of temporal processing.



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Low rate of positive bronchoscopy for suspected foreign body aspiration in infants

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Cameron C. Sheehan, Joseph Lopez, Charles A. Elmaraghy
ObjectivesTo describe our institution's low rate of positive bronchoscopy in infants suspected of inhaling a foreign body.Study DesignRetrospective chart review.MethodsA retrospective review was performed of patients at a tertiary children's hospital with suspected inhalation of a foreign body. Charts were reviewed for demographic information, radiologic findings, operative reports, and respiratory viral panels were reviewed.ResultsSixteen pediatric patients under 12 months of age were identified from 2008 to 2016 with a diagnosis of possible airway foreign body inhalation who underwent emergent bronchoscopy. Of these patients, only one was positive for a foreign body present in the airway. The remaining 15 children were found to have a negative direct laryngoscopy and bronchoscopy evaluation for a foreign body. Of these fifteen patients, 14 were found to have structural airway abnormalities and 7 tested positive for a respiratory viral infection.ConclusionsOur institution has a low rate of positive bronchoscopy for highly suspected foreign body inhalation in a group of patients less than 12 months of age. Patients presenting with respiratory distress, stridor, or other airway symptoms were often found to have an underlying airway abnormality or viral infection, which coupled with an unclear history, would increase the suspicion for an airway foreign body and subsequent decision to perform bronchoscopy. In stable patients, diagnostic evaluation for an underlying respiratory infection should be performed in these cases.Level of EvidenceCase Series.



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Cardiac complications in diphtheria and predictors of outcomes

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Sunil Samdani, Avani Jain, Vinod Meena, C.B. Meena
ObjectiveTo study the cardiac complications in diphtheria patients and to study the predictors of outcomes.Study DesignSingle centre prospective analysis of cardiac complications in diphtheria patients.ResultsIn this study, there were 60 patients diagnosed with diphtheria with ECG changes. The ECG changes seen were sinus tachycardia (68.3%), T wave inversion (20%), ST segment depression (13.3%), right bundle branch block (5%), multiple atrial ectopics (3.3%). The case fatality rate in our study was 25% (15 patients). High CPK-MB, myoglobulin and cardiac troponin levels were associated with cardiac mortality. In our study, cardiac troponin T had the highest sensitivity (80%) and CK-MB had the highest specificity (95.56%).ConclusionCardiac involvement is a common complication of infection with C. diphtheria and is associated with high mortality. As diphtheria can be prevented by adequate vaccination, efforts should be maximized for high vaccine coverage with booster doses.



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Management trends of infantile hemangioma: A national perspective

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Mana Espahbodi, Ke Yan, Robert H. Chun, Michael E. McCormick
IntroductionThe primary management of infantile hemangioma (IH) has changed since 2008, with the initiation of propranolol. The change that propranolol has affected on resource utilization is unknown.Materials and methodsThe Kids' Inpatient Database (KID) in 2003, 2006, 2009, and 2012 was queried for ICD-9 codes for IH in children under age three. The number of patients undergoing the following procedures of interest: tracheostomy, tracheoscopy and laryngoscopy with biopsy, and excision of skin lesion were evaluated. Data was analyzed for demographics and details on the admission. Trends were identified. Weighted statistical analyses were performed with SAS 9.4.ResultsThe number of qualified admissions significantly increased over the years (9271 in 2003–12029 in 2012, OR 1.042 per year increase, p < 0.001). The mean age at admission ranged from 26 to 28 days but did not vary over time (p = 0.54). The percentage undergoing tracheostomy significantly decreased from 1.05% in 2003 to 0.27% in 2012 (p = 0.0055), and the percentage undergoing tracheoscopy and laryngoscopy with biopsy significantly decreased from 7.29% in 2003 to 4.20% in 2012 (p = 0.011) among those with IH of unspecified or other sites. The percentage undergoing skin lesion excision also significantly decreased from 1.87% in 2003 to 1.03%, in 2012 (p = 0.0038) among those with IH of skin and subcutaneous tissue. These findings suggest a potential impact of propranolol. After adjusting for inflation, the total hospital charges increased from a mean of $17,838 in 2003 to an adjusted mean of $41,306 in 2012 (p < 0.0001).ConclusionsTotal admissions and hospital charges in children with IH has increased from 2003 to 2012. The percentage of patients undergoing tracheostomy, tracheoscopy and laryngoscopy with biopsy, and skin lesion excision significantly decreased in 2012 compared to 2003, suggesting a potential impact of propranolol. Further studies are needed to examine these changes more closely.



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A novel mutation of the EYA4 gene associated with post-lingual hearing loss in a proband is co-segregating with a novel PAX3 mutation in two congenitally deaf family members

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Federica Cesca, Elisa Bettella, Roberta Polli, Elona Cama, Pietro Scimemi, Rosamaria Santarelli, Alessandra Murgia
ObjectivesThis work was aimed at establishing the molecular etiology of hearing loss in a 9-year old girl with post-lingual non-syndromic mild sensorineural hearing loss with a complex family history of clinically heterogeneous deafness.MethodsThe proband's DNA was subjected to NGS analysis of a 59-targeted gene panel, with the use of the Ion Torrent PGM platform. Conventional Sanger sequencing was used for segregation analysis in all the affected relatives. The proband and all the other hearing impaired members of the family underwent a thorough clinical and audiological evaluation.ResultsA new likely pathogenic mutation in the EYA4 gene (c.1154C > T; p.Ser385Leu) was identified in the proband and in her 42-year-old father with post-lingual non-syndromic profound sensorineural hearing loss. The EYA4 mutation was also found in the proband's grandfather and uncle, both showing clinical features of Waardenburg syndrome type 1. A novel pathogenic splice-site mutation (c.321+1G > A) of the PAX3 gene was found to co-segregate with the EYA4 mutation in these two subjects.ConclusionThe identified novel EYA4 mutation can be considered responsible of the hearing loss observed in the proband and her father, while a dual molecular diagnosis was reached in the relatives co-segregating the EYA4 and the PAX3 mutations. In these two subjects the DFNA10 phenotype was masked by Waardenburg syndrome.The use of NGS targeted gene-panel, in combination with an extensive clinical and audiological examination led us to identify the genetic cause of the hearing loss in members of a family in which different forms of autosomal dominant deafness segregate. These results provide precise and especially important prognostic and follow-up information for the future audiologic management in the youngest affected member.



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Fertility management for malignant ovarian germ cell tumors patients

Publication date: December 2017
Source:Critical Reviews in Oncology/Hematology, Volume 120
Author(s): Chiara Di Tucci, Assunta Casorelli, Elisa Morrocchi, Innocenza Palaia, Ludovico Muzii, Pierluigi Benedetti Panici
Malignant Germ Cell Tumors have primarily affecting adolescents and young adults. In advanced disease, greater than 70% of patients can be cured with standard chemotherapy regimens and fertility-sparing surgery appears to be safe with excellent survival after long-term follow-up.Due to their rarity, follow up and fertility management is largely based on trials of epithelial ovarian cancer or on few small studies.We report a review of the literature studies about the assessment, the monitoring and the treatment of fertility for Malignant Germ Cell Tumors as pratical guidelines for management of fertility in these patients.



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The effects of enzalutamide and abiraterone on skeletal related events and bone radiological progression free survival in castration resistant prostate cancer patients: An indirect comparison of randomized controlled trials

Publication date: Available online 16 October 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Sergio Rizzo, Antonio Galvano, Francesco Pantano, Michele Iuliani, Bruno Vincenzi, Francesco Passiglia, Silvia Spoto, Giuseppe Tonini, Viviana Bazan, Antonio Russo, Daniele Santini
Two new drugs, the CYP17 inhibitor abiraterone acetate and the androgen receptor (AR) antagonist enzalutamide, have recently shown to prolong OS prior chemotherapy or in docetaxel treated mCRPC patients, using steroidal therapy or placebo as control group. Updated analyses underlined the role of these new agents on two prostate-specific endpoints as radiographic progression-free survival (rPFS) and time to first skeletal-related event (tSRE). On the basis of these reports, we made an indirect comparison between abiraterone and enzalutamide. We obtained a clinically but not significant difference favouring enzalutamide over abiraterone in terms of rPFS (HR 0.48, 95% CI 0.22–1.02). No significant difference was shown in term of tSRE (HR 0.99, 95% CI 0.83–1.17). In conclusion, abiraterone and enzalutamide have both demonstrated to significantly delay the bone progression resulting in similar improvements in bone-related endpoints in patients with mCRPC.



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